Shaping Research That Informs Inclusive Policy

Ironman grad student combines machine learning, statistics and engineering to increase representation for underserved populations

Octavio Mesner is fascinated by ripple effects — or, as epidemiologists call them, casual pathways.

For instance, he never imagined being diagnosed with a language processing disorder as a child would lead to his focus on math, which led him to a master's degree in biostatistics, which ultimately led him to pursue a combined Ph.D. at Carnegie Mellon University in engineering and public policy and in statistics and data science.

But he now sees the ways in which his early emphasis on STEM contributed to his methodical research habits. He knows that the increased effort he had to put toward learning to read helped him build the resilience necessary to embark upon graduate statistics classes without having studied this subject before.

"It's amazing to me how you can use data and statistics to inform policy," he said. "I want to see, quantitatively, what outcomes we can expect with each policy alternative."

Policy is not Mesner's first vocation. Initially, he wanted to join the priesthood. Such a journey seemed at odds with his identity as a gay Latino, but Mesner said, "I wanted my life's work to contribute to social good." At the time, the Capuchin Franciscan Seminary seemed like the road to societal influence.

Mesner was a bit of an outlier among the friars. In a space where most students focused on philosophy, Mesner majored in math. Amid a religious community that limited the relationships available to him as a gay man, Mesner said he broadened his intellectual habits and redefined his spiritual beliefs. "I just learned a ton there," he said. "The experience got me asking questions about myself, about church teachings, and opened my mind in a huge way."

Following a break from Catholicism, Mesner felt a bit unmoored. Still aiming to devote his work to the greater good, he decided to pursue a master's degree in biostatistics and, in his spare time, decided to train for triathlons. Joining the DC Triathlon Club in Washington, D.C., introduced him both to intentional, dedicated training methods and a group of multi-faceted athletes who relentlessly pursued improvement.

"They were amazing people to be around," said Mesner, who is modest about his own achievements— he completed his third Ironman competition during his Ph.D. coursework. These grueling races include a multi-mile swim, a bike race of over 100 miles, and end with a full marathon.

Training for such an event involves as much mental clarity as it does physical endurance. Lucky for Mesner, his time in seminary taught him meditation and stillness — habits that contributed to his ability to log dozens of miles each week on top of graduate studies.

Once he completed his master's, Mesner was recruited by his department chair to work for a collaborative nonprofit funded by both the Department of Defense and the National Institutes of Health. The infectious disease clinical research program taught Mesner how poignantly numbers could tell a story.

"In one study, we examined military personnel living with HIV who were subsequently infected with syphilis," Mesner explained. The medical community was unsure how to treat an immunocompromised person with antibiotics for a syphilis infection — what dosage was appropriate? Which specific type of antibiotic would be most impactful? "From the thousands of cases of syphilis in the US Military HIV Natural History Study, we saw no statistical significance in using a greater dosage of penicillin to treat a patient for syphilis who was also living with HIV," Mesner said.

He clarified that Centers for Disease Control guidelines already indicated this treatment protocol, but there were differing opinions among the medical community on this guideline.  In fact, some doctors wrote a response questioning our findings.  "Fortunately, we were very meticulous," Mesner said. "Biostatistical models help doctors make sense of large datasets. I think that's how science should always be done. I'm a firm believer in not bringing in your opinion about causal mechanisms to data analysis."

Studying military personnel affected by sexually transmitted disease was a paradigm-shifting opportunity for Mesner. Because the United States Military has universal healthcare for its service members, researchers like Mesner have an unparalleled data set available to them. "I don't know if I will ever have another data set that rich," Mesner explained.

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