John Cunningham virus (JCV), the etiological agent of progressive multifocal leukoencephalopathy (PML), is the first human polyomavirus described. After asymptomatic primary infection which occurs in childhood, the virus spreads by the hematogenous route from the primary site of infection to secondary sites including kidneys, lymphoid tissues, peripheral blood leukocytes, and brain to establish latent infection. During immunosuppression the virus undergoes molecular rearrangements that allow it to replicate in glial tissues causing PML. PML occurs in people with underlying immunodeficiency or in individuals being treated with potent immunomodulatory therapies. Although the hypothesis that immune deficiency is a predisposing factor for PML, there are many unsolved issues including the pathogenic mechanisms related to the interaction of JCV infection/reactivation with the host. This is due to the difficulty of propagating the virus in human cell cultures and the absence of an animal model. This review updates current understanding in the context of JCV and human disease.
OBJECTIVE: Pediatric Acute Neuropsychiatric Syndrome (PANS) and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) are conditions marked by sudden onset of obsessive-compulsive disorder (OCD), tics, or avoidant/restrictive food intake in combination with multiple psychiatric symptoms. A diagnosis of PANS or PANDAS may be supported by the Cunningham Panel, a commercially available set of immunologic assays currently in clinical use. However, the relationship between Cunningham Panel results and patient symptoms remains unclear. This study was done to assess the diagnostic accuracy of the Cunningham Panel in patients with suspected PANS or PANDAS. METHOD: All Swedish patients who had taken the Cunningham Panel prior to June 2014 (n=154) were invited and 53 patients participated in the study. Based on comprehensive psychiatric assessment (the reference standard of diagnosis), subjects were classified as PANS, PANDAS, or neither. Prior Cunningham Panel test results were collected from patient records, and new blood samples were similarly analyzed within the scope of this study. In addition, results were compared to healthy controls (n=21) and a test-retest reliability analysis was performed. RESULTS: Sensitivities of individual biomarkers in the Cunningham Panel ranged from 15 to 60%, and specificities from 28 to 92%. Positive predictive values ranged from 17 to 40%, and negative predictive values from 44 to 74%. A majority of the healthy controls had pathological Cunningham Panel results and test-retest reliability proved insufficient. CONCLUSION: Clinical use of the Cunningham Panel in diagnosing PANS or PANDAS is not supported by this study.
We read Connery et al. open-label case series entitled Intravenous immunoglobulin for the treatment of autoimmune encephalopathy in children with autism 1 with great interest. It is undoubtedly important to communicate that children with autism may improve from IVIG treatment; this should be further investigated. In the study, the Cunningham Panel 2 was used as a biological marker to predict improvement in the children. This immune panel comprises of five analytes: calcium calmodulin dependent kinase II activation (CamKII activation) and antibodies to dopamine receptors D1 and D2, β-tubulin, and lysoganglioside-GM1. CaMKII activation is regarded as positive if the activity exceeds 129, which was—in addition to one or more positive autoantibody titer—the prerequisite for IVIG treatment. The antidopamine D2L receptor antibody, the anti-tubulin antibody and the ratio of the antidopamine D2L to D1 receptor antibodies were chosen as predictors for treatment response. Improvement was based on the behavioral measures Aberrant Behavior Checklist (ABC) and/or Social Responsiveness Scale (SRS), in addition to parents’ reports. According to the outcome measures, 52–65% of the children were responders to IVIG. Unfortunately, the biomarkers and the two behavioral measures ABC and SRS were only acquired in 16 of the 31 children before and after IVIG treatment. However, based on this limited information, the authors, nevertheless, conclude that the Cunningham Panel predicts response to IVIG treatment with good accuracy. Yet, it is unknown if children with CaMKII activity below 130 would similarly improve from IVIG treatment, since the 17 patients reported to have such test results were not treated with IVIG. It could also well be that children with autism and normal levels of autoantibodies against dopamine receptors D1 and D2, β-tubulin, and lysoganglioside-GM1 may improve from IVIG treatment; this was not investigated in the study. Therefore, it remains unknown if any of the analytes in the Cunningham Panel can predict treatment response. We have previously questioned the diagnostic value of the Cunningham Panel 3 , 4 . In a Swedish study consisting of 53 patients (40 children and adolescents and 13 adults) with suspicion of having pediatric acute neuropsychiatric syndrome (PANS) and/or pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS), the property of the Cunningham Panel was investigated. To our knowledge, our study is the only independent study evaluating the Cunningham Panel hitherto published. Twenty-four of the patients met diagnostic criteria for PANS and/or PANDAS, whereas 29 did not. We also tested 27 healthy controls with the Cunningham Panel. Ten out of 21 (48%) healthy controls had elevated CaMKII activity as compared to 35 out of 53 (66%) of the patients. Moreover, at least one positive autoantibody titer was found in 17 of the healthy controls. In conclusion we found a so-called positive value on the Cunningham Panel in 86% of the healthy controls, as compared to 92% in the patients assessed for PANS and PANDAS. To summarize, Connery et al. do not present any objective data in the causal pathway from symptoms to outcomes. Seveteen children with autism in the study were not treated with IVIG on the basis that their CaMKII was not elevated. Consequently, the effect of IVIG in children with autism and subthreshold levels of CaMKII activity is not tested. The reported improvements in the children with elevated CaMKII activity may stem from placebo response or the natural course, not necessarily from IVIG. Considering that the Cunningham Panel to a great extent is positive among healthy people, it seems premature to suggest that it can predict treatment response based on a small selection of children with autism in an open-label, uncontrolled study. At this point of time we cannot draw any quantitative conclusions about biomarkers from open label treatment studies of disorders like ASD.
This article explores the early collaborations of John Cage and Merce Cunningham, in which music and dance were united structurally and in expressive intent. Drawing on unexamined archival materials, I begin by highlighting the thematic content of the earliest Cage-Cunningham collaborations, Credo in Us (1942) and Four Walls (1944), of Cunningham's (rather than Martha Graham's) choreography for the Revivalist's solo in Appalachian Spring (1944), and of Cage's The Perilous Night (1943–44), premiered at the couple's debut concert. These works all portray a conflict between sexual desire and social conformity through marriage, a theme of pressing import as Cage left his wife to become Cunningham's partner. I then elucidate the programmatic nature of the first and last works that Cunningham choreographed to the music of Satie, Idyllic Song (1944) and Second Hand (1970), both of which use Cage's arrangements for piano of Satie's Socrate. Placing Cunningham's personal choreographic notes in dialogue with my own observation of rehearsals and performances, I suggest that Second Hand dramatizes not only the Socratic texts set in Satie's score but also the couple's relationship and their earlier dependence on and subsequent rejection of personal expression, a rejection that heightened their status within the postwar avant-garde. Instead of dismissing the collaborations of the 1940s as “early” or “anomalous,” I suggest that they are fundamental to understanding how Cage and Cunningham's relationship prior to their de facto marriage led to one of the most productive divorces in the history of artistic collaboration.
Where is expression in Cunningham's choreography? Are the moving bodies on stage expressive? If so, what are they expressing and how does such expression occur? Several of the finest theorists of dance—among them, Susan Leigh Foster, Mark Franko, and Dee Reynolds—have already approached the question of expressivity in the work of Merce Cunningham. Acknowledging the formalism and astringency of his choreography, they nonetheless insist that expression does indeed take place. Foster locates expression in the “affective significance” as opposed to the “emotional experience” of movement (1986, 38); Franko finds it in an “energy source … more fundamental than emotion, while just as differentiated” (1995, 80); and Reynolds identifies expression in the dancing subject's sensorimotor “faculties” as they are deployed “fully in the present” (2007, 169). Cunningham himself has defined expression in dance as an intrinsic and inevitable quality of movement, indicating that his search to capture, isolate, and frame this quality is central to his choreographic process. As a critical theorist (rather than a dance historian), I am interested in expression as a more general, or cross-media, category and therefore find the efforts by Cunningham and his critics to define expression differently, to free it from its subservience to the psyche, refreshing, unconventional, and suggestive. I have become increasingly convinced that Cunningham's practical and theoretical interventions can illuminate more traditional literary and philosophical discourses on the aesthetics of expression and that they have particular resonance when juxtaposed with the approach to expression developed by Theodor Adorno in his Aesthetic Theory of 1970. Similar to Cunningham, Adorno complicates the category of “expression” by shifting its location from subjectivity, understood primarily as a psychic phenomenon, to embodiment, understood as a function of locomotion and sensual existence (in Franko's words, “something more fundamental than emotion, while just as differentiated” [1995, 80]).
Merce Cunningham and the Modernizing of Modern Dance is a complete study of the life and work of this seminal choreographer/dancer. More than just a biography, Copeland explores Cunningham's life story against a backdrop of an entire century of developments in American art. Copeland traces his own experience of Cunningham's dances-from the turbulent late '60s through the experimental works of the '80s and '90s-showing how Cunningham moved dance away from the highly emotional, subjective work of Martha Graham to a return to a new kind of classicism. This book places Cunningham in the forefront of an artistic revolution, a revolution that has its parallels in music (John Cage, and the minimalist composers who followed him), painting (Jasper Johns, Robert Rauschenberg), theater (the happenings of the '60s), and dance itself (the Judson School of dancers). An iconclastic and highly readable analysis, this book will be enjoyed by all those interested in the development of the American arts in the 20th century.
Objective This retrospective study examined whether changes in patient pre- and post-treatment symptoms correlated with changes in anti-neuronal autoantibody titers and the neuronal cell stimulation assay in the Cunningham Panel in patients with Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection (PANDAS), and Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). Methods In an analysis of all tests consecutively performed in Moleculera Labs' clinical laboratory from April 22, 2013 to December 31, 2016, we identified 206 patients who were prescribed at least one panel prior to and following treatment, and who met the PANDAS/PANS diagnostic criteria. Patient follow-up was performed to collect symptoms and treatment or medical intervention. Of the 206 patients, 58 met the inclusion criteria of providing informed consent/assent and documented pre- and post-treatment symptoms. Clinician and parent-reported symptoms after treatment or medical intervention were categorized as "Improved/Resolved" ( n = 34) or "Not-Improved/Worsened" ( n = 24). These were analyzed for any association between changes in clinical status and changes in Cunningham panel test results. Clinical assay performance was also evaluated for reproducibility and reliability. Results Comparison of pre- and post-treatment status revealed that the Cunningham Panel results correlated with changes in patient's neuropsychiatric symptoms. Based upon the change in the number of positive tests, the overall accuracy was 86%, the sensitivity and specificity were 88% and 83% respectively, and the Area Under the Curve (AUC) was 93.4%. When evaluated by changes in autoantibody levels, we observed an overall accuracy of 90%, a sensitivity of 88%, a specificity of 92% and an AUC of 95.7%. Assay reproducibility for the calcium/calmodulin-dependent protein kinase II (CaMKII) revealed a correlation coefficient of 0.90 ( p < 1.67 × 10 −6 ) and the ELISA assays demonstrated test-retest reproducibility comparable with other ELISA assays. Conclusion This study revealed a strong positive association between changes in neuropsychiatric symptoms and changes in the level of anti-neuronal antibodies and antibody-mediated CaMKII human neuronal cell activation. These results suggest there may be clinical utility in monitoring autoantibody levels and stimulatory activity against these five neuronal antigen targets as an aid in the diagnosis and treatment of infection-triggered autoimmune neuropsychiatric disorders. Future prospective studies should examine the feasibility of predicting antimicrobial and immunotherapy responses with the Cunningham Panel.
Importance: Although seroepidemiological studies indicate that greater than 50% of the population has been infected with John Cunningham virus (JCV), the sites of JCV persistence remain incompletely characterized. Objective: To determine sites of JCV persistence in immunologically healthy individuals. Design, Setting, and Participants: Tissue specimens from multiple sites including brain, renal, and nonrenal tissues were obtained at autopsy performed in the Department of Pathology at the University of Kentucky from 12 immunologically healthy patients between February 9, 2011, and November 27, 2012. Quantitative polymerase chain reaction was performed on the tissue specimens and urine. Serum JCV antibody status was determined by enzyme-linked immunosorbent assay. Main Outcomes and Measures: The detection and quantification of JCV from the tissues by quantitative polymerase chain reaction illuminated sites of viral persistence. These results were correlated with JCV antibody levels. Results: Autopsies were performed on 12 individuals, 10 men and 2 women, ranging in age from 25 to 75 years (mean, 55.3 years). Seven of 12 individuals were JCV antibody seropositive based on absorbance units. Serostatus was associated with amounts of JCV DNA in urine and its tissue distribution. John Cunningham virus DNA was found in 75% of genitourinary tissue samples from donors (18 of 24) with high JCV antibody levels, 13.3% of donors with low levels i(4 of 30), and 0% of seronegative persons (0 of 32). In nongenitourinary tissues, JCV DNA was detected in 45.1% of tissue samples of donors (32 of 71) with high JCV, 2.2% of donors with low JCV serostatus (2 of 93), and 0% of seronegative persons (0 of 43). Genitourinary tissues had higher copy numbers than other sites. John Cunningham virus DNA was detected in urine of seronegative individuals in a research-grade assay. Conclusions and Relevance: Persistent (latent or actively replicating) JCV infection mostly predominates in genitourinary tissues but distributes in other tissues at low copy number. The distribution and copy numbers of the virus appear to correlate with urinary JCV shedding and serostatus.
INTRODUCTION: Resting energy expenditure (REE) is expected to be higher in athletes because of their relatively high fat free mass (FFM). Therefore, REE predictive equation for recreational athletes may be required. The aim of this study was to validate existing REE predictive equations and to develop a new recreational athlete specific equation. METHODS: 90 (53 M, 37 F) adult athletes, exercising on average 9.1 ± 5.0 hours a week and 5.0 ± 1.8 times a week, were included. REE was measured using indirect calorimetry (Vmax Encore n29), FFM and FM were measured using air displacement plethysmography. Multiple linear regression analysis was used to develop a new FFM-based and weight-based REE predictive equation. The percentage accurate predictions (within 10% of measured REE), percentage bias, root mean square error and limits of agreement were calculated. Results: The Cunningham equation and the new weight-based equation REE(kJ / d) = 49.940* weight(kg) + 2459.053* height(m) - 34.014* age(y) + 799.257* sex(M = 1,F = 0) + 122.502 and the new FFM-based equation REE(kJ / d) = 95.272*FFM(kg) + 2026.161 performed equally well. De Lorenzo's equation predicted REE less accurate, but better than the other generally used REE predictive equations. Harris-Benedict, WHO, Schofield, Mifflin and Owen all showed less than 50% accuracy. CONCLUSION: For a population of (Dutch) recreational athletes, the REE can accurately be predicted with the existing Cunningham equation. Since body composition measurement is not always possible, and other generally used equations fail, the new weight-based equation is advised for use in sports nutrition.
Research Article| January 01 1990 Women in Historic Preservation: The Legacy of Ann Pamela Cunningham Barbara J. Howe Barbara J. Howe Search for other works by this author on: This Site PubMed Google Scholar The Public Historian (1990) 12 (1): 31–61. https://doi.org/10.2307/3378321 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Barbara J. Howe; Women in Historic Preservation: The Legacy of Ann Pamela Cunningham. The Public Historian 1 January 1990; 12 (1): 31–61. doi: https://doi.org/10.2307/3378321 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentThe Public Historian Search This content is only available via PDF. Copyright 1990 Regents of the University of California Article PDF first page preview Close Modal You do not currently have access to this content.
AS is well known, in late nineteenth-century England the disciplines of economics and economic history were emerging in their modern form. At a time when the relationships between the two subjects were still far from clear there occurred a dispute by two of the leading protagonists, Marshall' and Cunningham,2 who were then teaching at Cambridge, the university which was to become the leading British academic centre of economic studies in the early decades of this century. The disagreement between Marshall and Cunningham is not unfamiliar to economic historians, but they have tended to view it either as a personal squabble or as a local offshoot of the more famous Methodenstreit which began in Germany a decade or so earlier. The dispute did, indeed, possess these characteristics; but there was more to it than this, and the purpose of the present article is to present the episode in a broader context by emphasizing its relevance to the professionalization of the economist. In some ways Marshall was an unlikely leader for a battle of professional independence. Self-effacing, self-critical, and hypersensitive to the criticisms of others, he was the conciliator which British economics needed at a time when its future turned on its ability to avoid the surly sterility of the German Methodenstreit. Methodological controversy was soothed by his reiteration of the logically impregnable, but not yet universally obvious, fact that inductive and deductive methods could not work without one another.
The underwater vocalizations of white whales, Delphinapterus leucas, summering at Cunningham Inlet, Northwest Territories, were recorded from mid-July to mid-August 1981 to 1983. A total of 807 tonal calls (whistles) were classified into 16 contour types. The following acoustic parameters were measured for each whistle: minimum, maximum, and mean frequency of the fundamental, contour or shape of the fundamental, duration, and the slope of the frequency changes during the call. Some 436 pulsed calls were classified into three major categories: click series, pulsed tones, and noisy vocalizations. Acoustic parameters measured for each of these calls included pulse repetition rate, range and mean frequency of the call, and duration. Results show that the whistle repertoire of white whales is more varied than has been previously reported. Mean frequencies for the whistle contour types ranged from 2.0 to 5.9 kHz; mean duration ranged from 0.25 to 1.95 s. Although whistles were the most commonly emitted type of vocalization, pulsed tones and noisy vocalizations made up a significant proportion of the white whales' vocal repertoire. The mean pulse repetition rate of pulsed tones ranged from 203.9 to 1289.0 pulses/s. There does not appear to be any between-year variation in the vocal repertoire of these white whales.
Slit spectrograms of Comet Cunningham secured at the McDonald Observatory reveal well-resolved ultraviolet bands due to OH and NH; oniy the lines of low rotational quantum number are observed, as in the case of CH. The abundances of OH and NH molecules seem to be of the same order as that of CN. Each branch of the violet bands of CN has two maxima, one corresponding to a rotational distribution for T - 400° K and one corresponding to T 500 K. The tail bands of CN are absent. The authors dis- cuss the variation with heliocentric distance of the relative intensities of the vibrational transitions. The rotational intensity distribution and the extension of the different bands in the head have been investi- gated. The cometary bands of CH belonging to the two electronic transitions, A2L~ -~ x211 (near X 4300) and B2»=~ -~ x211 (near X 3900), are described. The bands observed between X 4000 and X 4130 are dis- cussed but remain unidentified
There has recently been published an anthology of Spanish civil war poetry edited by Valentine Cunningham (Penguin, 1980): the first comprehensive collection so far made. Many of the poems have, of course, appeared previously: Stephen Spender and John Lehman edited Poems For Spain in 1939; Robin Skelton's useful Poetry of the Thirties (Penguin, 1964) included a section on Spain; and there have been separate collections of individual poets. This new anthology, however, includes much that has been out of print for many years, and it also contains a good deal of new material, the prison poems of Clive Branson being among the most notable.
BACKGROUND: John Cunningham virus (JCV) constitutes a family of polyoma viruses, which plays important roles in the progressive multifocal leukoencephalopathy (PML) and tumorigenesis. However, no bibliometric investigation has been reported to guide the researchers and potential readers. METHODS: Papers were collected from database Sci-expanded and Pubmed until May 22, 2008. The highly-productive authors, institutes and countries, highly-cited authors and journals were ranked. The highly-cited articles were subjected to co-citation and chronological analysis with highly-frequent MeSH words for co-occurrence analysis. RESULTS: Until now, 1785 articles about JCV were indexed in Sci-expanded and 1506 in Pubmed. The main document type was original article. USA, Japan and Italy were the largest three producers about JCV. Temple University published 128 papers and ranked the top, followed by University of Tokyo. Khalili K and Yogo Y became the core authors due to more than 20 documents produced. Journal of Neurovirology published more than 15 papers and ranked the top. Padgett BL and Berger JR were the first two highly-cited authors. Journal of Virology and Journal of Neurovirology respectively ranked to the first two highly-cited journals. These top highly-cited articles were divided into 5 aspects: (1) The correlation between JC virus and tumors; (2) Causal correlation of JCV with PML; (3) Polyoma virus infection and its related diseases in renal-allograft recipients; (4) Detection of JCV antibody, oncogene and its encoding protein; (5) Genetics and molecular biology of JCV. The MeSH/subheadings were classified into five groups: (1) JCV and virus infectious diseases; (2) JCV pathogenicity and pathological appearance of PML; (3) JCV isolation and detection; (4) Immunology of JCV and PML; (5) JCV genetics and tumors. CONCLUSION: JCV investigation mainly focused on its isolation and detection, as well as its correlation with PML and tumors. Establishment of transgenic animal model using JCV T antigen would be a hopeful and useful project in the further study.
OBJECTIVES: John Cunningham virus (JCV) is a polyoma virus that infects humans, mainly in childhood or adolescence, and presents no symptomatic manifestations. JCV can cause progressive multifocal leukoencephalopathy (PML) in immunosuppressed individuals, including those undergoing treatment for multiple sclerosis (MS) and neuromyelitis optica (NMO). PML is a severe and potentially fatal disease of the brain. The prevalence of JCV antibodies in human serum has been reported to be between 50.0 and 90.0%. The aim of the present study was to review worldwide data on populations of patients with MS and NMO in order to establish the rates of JCV seropositivity in these individuals. METHODS: The present review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and used the following search terms: "JCV" OR "JC virus" AND "multiple sclerosis" OR "MS" OR "NMO" OR "neuromyelitis optica" AND "prevalence." These terms were searched for both in smaller and in larger clusters of words. The databases searched included PubMed, MEDLINE, SciELO, LILACS, Google Scholar, and Embase. RESULTS: After the initial selection, 18 papers were included in the review. These articles reported the prevalence of JCV antibodies in the serum of patients with MS or NMO living in 26 countries. The systematic review identified data on 29,319 patients with MS/NMO and found that 57.1% of them (16,730 individuals) were seropositive for the anti-JCV antibody (range, 40.0 to 69.0%). CONCLUSIONS: The median worldwide prevalence of JCV among adults with MS or NMO was found to be 57.1%.
Leta E. Miller; Cage, Cunningham, and Collaborators: The Odyssey of Variations V, The Musical Quarterly, Volume 85, Issue 3, 1 October 2001, Pages 545–567, http
El trabajo aqui presentado pretende dar una vision panoramica de la obra de Lucia Guerra-Cunningham, partiendo por situar al lector sobre su vida en cuanto pensadora, para abordar con posterioridad el analisis de la autora desde el genero. Al exponer el pensamiento de la autora se pretende con ello, en primer lugar, mostrar una valiosa lectura academica que ha abierto nuevas rutas epistemologicas hacia donde dirigir la critica literaria, rutas a traves de las cuales categorias como el sujeto femenino latinoamericano y chileno pueden comprenderse de otro modo, con otros materiales que no son los saberes canonicos ni universales con los que se ha pretendido hablar en nombre de la Humanidad. En segundo lugar, demostrar como se operacionalizan esas aperturas epistemologicas.
Several animal studies have shown that there is a positive correlation between locomotor activity in response to a novel environment and acquisition of drug self-administration behavior. This finding led to the assumption that animals with heightened reactivity to novel environments are more sensitive to the rewarding effects of drugs compared with animals with reduced reactivity. But are these individuals really more responsive to drugs, or could they have enhanced sensitivity to rewards in general or even simply be better learners? In the previous issue of this journal, J. M. Mitchell, C. L. Cunningham, and G. P. Mark (2005), investigated these important matters. They reported that the locomotor response to a novel environment does not predict responding for cocaine but reflects overall differences in the ability to learn operant tasks. ((c) 2005 APA, all rights reserved).
I agree with Popkin, Cunningham, and Burt that public housing agencies (PHAs) must assume at least some responsibility for providing housing to those whom the article defines as hard‐to‐house. I provide some historical context for private and public sector efforts to support these vulnerable populations, as well as an overview of different operational definitions of the hard‐to‐house. However, I suggest that positive outcomes for the households in question also depend on the federal government and PHAs providing development and operational resources for supportive housing and helping private sector organizations provide housing and services. However defined, this is a diverse group with diverse needs for both housing and supportive services. I consider the appropriate roles for public, private, and nonprofit sector actors in addressing those needs. Drawing on our experience at the Corporation for Supportive Housing, I outline what the optimal provision of these housing and services might be, as well as challenges impeding progress toward this goal.