Incidence and risk factors for graft failure in the modern era of cord blood transplantation.

BACKGROUND AND OBJECTIVES: Graft failure (GF) after cord blood transplant (CBT) has decreased with improved supportive care and cord selection strategies. We aimed to evaluate cord blood selection and factors associated with retransplantation on the incidence of GF, determine risk factors for GF including host antibodies to Kell antigen and evaluate survival after GF. MATERIALS AND METHODS: We retrospectively reviewed 84 patients who underwent CBT at the University of Oklahoma between 2000 and 2016 and compared outcomes in patients with/without engraftment by Day 28. The nonengraftment cohort was further divided into patients who underwent retransplantation. Kaplan-Meier curves with log-rank tests were calculated to assess the association between mortality and engraftment. RESULTS: Engraftment following CBT was high at 81%, with 52% engrafting by Day 28 and an additional 29% engrafting by a median of 36 days. Retransplantation led to 88% engraftment at a median of 53 days. Overall, 75% of the 40 patients who did not engraft by Day 28 died. Female sex and total nucleated cell count < 3.5/kg were significantly associated with lack of engraftment and higher mortality. Antibodies to Kell fetal antigen were not identified. Retransplantation by Day 28 for primary GF conferred a survival advantage. CONCLUSION: This study demonstrates that failure to engraft by 28 days was associated with increased mortality, and risk was mitigated with early retransplantation. Female sex and low total cell dose were associated with increased mortality. Early identification of GF coupled with early retransplantation can reduce mortality in CBT.

Means-Tested Safety Net Programs and Hispanic Families: Evidence from Medicaid, SNAP, and WIC.

Hispanic families have historically used means-tested assistance less than high-poverty peers, and one explanation for this may be that anti-immigrant politics and policies are a barrier to program participation. We document the participation of Hispanic children in three antipoverty programs by age and parental citizenship and the correlation of participation with state immigrant-based restrictions. Hispanic citizen children with citizen parents participate in Supplemental Nutrition Assistance Program (SNAP) and Medicaid more than Hispanic citizen children with noncitizen parents. Foreign-born Hispanic mothers use Medicaid less than their socioeconomic status would suggest. However, little evidence exists that child participation in Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) varies by mother's nativity: foreign-born mothers of Hispanic infants participate in WIC at higher rates than U.S.-born Hispanic mothers. State policies that restrict immigrant program use correlate to lower SNAP and Medicaid uptake among citizen children of foreign-born Hispanic mothers. WIC participation may be greater because it is delivered through nonprofit clinics, and WIC eligibility for immigrants is largely unrestricted.

Children and the Elderly: Wealth Inequality Among America's Dependents.

Life cycle theory predicts that elderly households have higher levels of wealth than households with children, but these wealth gaps are likely dynamic, responding to changes in labor market conditions, patterns of debt accumulation, and the overall economic context. Using Survey of Consumer Finances data from 1989 through 2013, we compare wealth levels between and within the two groups that make up America's dependents: the elderly and child households (households with a resident child aged 18 or younger). Over the observed period, the absolute wealth gap between elderly and child households in the United States increased substantially, and diverging trends in wealth accumulation exacerbated preexisting between-group disparities. Widening gaps were particularly pronounced among the least-wealthy elderly and child households. Differential demographic change in marital status and racial composition by subgroup do not explain the widening gap. We also find increasing wealth inequality within child households and the rise of a "parental 1 %." During a time of overall economic growth, the elderly have been able to maintain or increase their wealth, whereas many of the least-wealthy child households saw precipitous declines. Our findings suggest that many child households may lack sufficient assets to promote the successful flourishing of the next generation.

"His" and "Hers": Meeting the Economic Bar to Marriage.

Scholars have suggested that low-income parents avoid marriage because they have not met the so-called economic bar to marriage. The economic bar is multidimensional, referring to a bundle of financial achievements that determine whether couples feel ready to wed. Using the Building Strong Families data set of low-income parents (n = 4,444), we operationalized this qualitative concept into a seven-item index and examined whether couples who met the economic bar by achieving the majority of the items were more likely to marry than couples who did not. Meeting the bar was associated with a two-thirds increase in marriage likelihood. The bar was not positively associated with cohabitation, suggesting that it applies specifically to marriage. When we examined different definitions of the bar based on whether the mother, father, or both parents contributed items, all variants were associated with marriage, even if the bar was based on the mother's economic accomplishments alone. When mothers contributed to the economic bar, they reported significantly higher relationship quality. Our results reinforce the importance of the multidimensional economic bar for marriage entry, highlighting the role of maternal economic contributions in low-income relationships.

Role of Calcium in the Coagulation of NOM with Ferric Chloride.

Natural organic matter (NOM) is capable of interfering with Fe hydrolysis and influencing the size, morphology, and identity of Fe precipitates. Conversely, Ca2+ raises surface potential and increases the size and aggregation of Fe precipitates, leading to more effective coagulation and widening the pH range of water treatment. Experiments and modeling were conducted to investigate the significance of the Fe/NOM ratio and the presence of Ca2+ in coagulation. At the high Fe/NOM ratio, sufficient or excess Fe was available for NOM removal, and coagulation proceeded according to expectations based upon the literature. At the low Fe/NOM ratio, however, NOM inhibited Fe hydrolysis, reduced zeta potential, and suppressed the formation of filterable Fe flocs, thereby interfering with NOM removal. In these dose-limited systems without Ca2+, complexation of Fe species by NOM appears to be the mechanism by which coagulation is disrupted. Equilibrating NOM with 1 mM Ca2+ in dose-limited systems prior to dosing with FeCl3 increased Fe hydrolysis and zeta potential, decreased the fraction of colloidal Fe, and improved NOM removal. In systems with Ca2+, data and modeling indicate that Ca2+ complexation by NOM neutralizes some of the negative organic charge and minimizes Fe complexation, making Fe species available for hydrolysis and effective coagulation. This finding represents an important advance in understanding not only how Ca2+ may improve coagulation outcomes, but also in predicting the conditions under which Ca2+ may prove beneficial.

Midpregnancy Marriage and Divorce: Why the Death of Shotgun Marriage Has Been Greatly Exaggerated.

Conventional wisdom holds that births following the colloquially termed "shotgun marriage"-that is, births to parents who married between conception and the birth-are nearing obsolescence. To investigate trends in shotgun marriage, we matched North Carolina administrative data on nearly 800,000 first births among white and black mothers to marriage and divorce records. We found that among married births, midpregnancy-married births (our preferred term for shotgun-married births) have been relatively stable at about 10 % over the past quarter-century while increasing substantially for vulnerable population subgroups. In 2012, among black and white less-educated and younger women, midpregnancy-married births accounted for approximately 20 % to 25 % of married first births. The increasing representation of midpregnancy-married births among married births raises concerns about well-being among at-risk families because midpregnancy marriages may be quite fragile. Our analysis revealed, however, that midpregnancy marriages were more likely to dissolve only among more advantaged groups. Of those groups considered to be most at risk of divorce-namely, black women with lower levels of education and who were younger-midpregnancy marriages had the same or lower likelihood of divorce as preconception marriages. Our results suggest an overlooked resiliency in a type of marriage that has only increased in salience.

Ion-regulated allosteric binding of fullerenes (C60 and C70) by tetrathiafulvalene-calix[4]pyrroles.

The effect of ionic species on the binding of fullerenes (C60 and C70) by tetrathiafulvalene-calix[4]pyrrole (TTF-C4P) receptors and the nature of the resulting supramolecular complexes (TTF-C4P + fullerene + halide anion + tetraalkylammonium cation) was studied in the solid state through single crystal X-ray diffraction methods and in dichloromethane solution by means of continuous variation plots and UV-vis spectroscopic titrations. These analyses revealed a 1:1 stoichiometry between the anion-bound TTF-C4Ps and the complexed fullerenes. The latter guests are bound within the bowl-like cup of the C4P in a ball-and-socket binding mode. The interactions between the TTF-C4P receptors and the fullerene guests are highly influenced by both the nature of halide anions and their counter tetraalkylammonium cations. Three halides (F(-), Cl(-), and Br(-)) were studied. All three potentiate the binding of the two test fullerenes by inducing a conformational change from the 1,3-alternate to the cone conformer of the TTF-C4Ps, thus acting as positive heterotropic allosteric effectors. For a particular halide anion, the choice of tetraalkylammonium salts serves to modulate the strength of the TTF-C4P-fullerene host-guest binding interactions and, in conjunction with variations in the halide anion, can be exploited to alter the inherent selectivity of the host for a given fullerene. Differences in binding are reflected in the excited state optical properties. Overall, the present four-component system provides an illustration of how host-guest binding events involving appropriately designed artificial receptors can be fine-tuned via the addition of simple ionic species as allosteric modulators.

Effects of statewide job losses on adolescent suicide-related behaviors.

OBJECTIVES: We investigated the impact of statewide job loss on adolescent suicide-related behaviors. METHODS: We used 1997 to 2009 data from the Youth Risk Behavior Survey and the Bureau of Labor Statistics to estimate the effects of statewide job loss on adolescents' suicidal ideation, suicide attempts, and suicide plans. Probit regression models controlled for demographic characteristics, state of residence, and year; samples were divided according to gender and race/ethnicity. RESULTS: Statewide job losses during the year preceding the survey increased girls' probability of suicidal ideation and suicide plans and non-Hispanic Black adolescents' probability of suicidal ideation, suicide plans, and suicide attempts. Job losses among 1% of a state's working-age population increased the probability of girls and Blacks reporting suicide-related behaviors by 2 to 3 percentage points. Job losses did not affect the suicide-related behaviors of boys, non-Hispanic Whites, or Hispanics. The results were robust to the inclusion of other state economic characteristics. CONCLUSIONS: As are adults, adolescents are affected by economic downturns. Our findings show that statewide job loss increases adolescent girls' and non-Hispanic Blacks' suicide-related behaviors.

Beyond Parental Wealth: Grandparental Wealth and the Transition to Adulthood.

This study considers the multigenerational consequences of wealth transmission for the transition to young adulthood. Using a wider set of outcomes than has previously been considered, and by analyzing parental and grandparental wealth simultaneously, this work underscores the salience of multiple generations of wealth as a predictor for young adult well-being. Data comes from the US Panel Study of Income Dynamics on a sample of youth followed from mid-adolescence until the age of 20. Results from linear regression models indicate that parental wealth was associated with increases in the probability of college attendance and steady employment and inversely associated with the likelihood of nonmarital birth and idleness. Grandparental wealth predicted non-educational outcomes at least as well as parental wealth did and explained more variance in young adults' outcomes when parental wealth was lower. The association between parental wealth and non-educational outcomes suggest that wealth may inform young adults' broader life course by predicting outcomes other than college attendance. Grandparental wealth may serve a compensatory function for children with low parental wealth. Results suggest that persistently low wealth across multiple generations may impede the successful transition to young adulthood.

The Natural Products Discovery Center: Release of the First 8490 Sequenced Strains for Exploring Actinobacteria Biosynthetic Diversity.

Actinobacteria, the bacterial phylum most renowned for natural product discovery, has been established as a valuable source for drug discovery and biotechnology but is underrepresented within accessible genome and strain collections. Herein, we introduce the Natural Products Discovery Center (NPDC), featuring 122,449 strains assembled over eight decades, the genomes of the first 8490 NPDC strains (7142 Actinobacteria), and the online NPDC Portal making both strains and genomes publicly available. A comparative survey of RefSeq and NPDC Actinobacteria highlights the taxonomic and biosynthetic diversity within the NPDC collection, including three new genera, hundreds of new species, and ~7000 new gene cluster families. Selected examples demonstrate how the NPDC Portal's strain metadata, genomes, and biosynthetic gene clusters can be leveraged using genome mining approaches. Our findings underscore the ongoing significance of Actinobacteria in natural product discovery, and the NPDC serves as an unparalleled resource for both Actinobacteria strains and genomes.

Porphyrins fused with strongly electron-donating 1,3-dithiol-2-ylidene moieties: redox control by metal cation complexation and anion binding.

A new class of redox-active free base and metalloporphyrins fused with the 1,3-dithiol-2-ylidene subunits present in tetrathiafulvalene, termed MTTFP (M = H2, Cu, Ni, Zn), have been prepared and characterized. The strong electron-donating properties of MTTFP were probed by electrochemical measurement and demonstrated that oxidation potentials can be tuned by metalation of the free base form, H2TTFP. X-ray crystal structures of H2TTFP, ZnTTFP, and CuTTFP revealed that a severe saddle-shape distortion was observed with the dithiole rings bent out of the plane toward one another in the neutral form. In contrast, the structure of the two-electron oxidized species (CuTFFP(2+)) is planar, corresponding to a change from a nonaromatic to aromatic structure upon oxidation. A relatively large two-photon absorption (TPA) cross-section value of H2TTFP(2+) (1200 GM) was obtained for the free base compound, a value that is much higher than those typically seen for porphyrins (<100 GM). Augmented TPA values for the metal complexes were also seen. The strong electron-donating ability of ZnTTFP was further enhanced by binding of Cl(-) and Br(-) as revealed by thermal electron-transfer between ZnTTFP and Li(+)-encapsulated C60 (Li(+)@C60) in benzonitrile, which was "switched on" by the addition of either Cl(-) or Br(-) (as the tetrabutylammonium salts). The X-ray crystal structure of Cl(-)-bound ZnTTFP was determined and provided support for the strong binding between the Cl(-) anion and the Zn(2+) cation present in ZnTTFP.

The Perceived Stress Scale for Kids (PeSSKi): Initial development of a brief measure for children aged 7-11 years.

Perceived stress, a known risk factor for poor health, has been extensively assessed in adult populations. Yet an equivalent assessment tool for measurement of global perceived stress in children is lacking. This study aimed to develop and provide initial validation of a scale to measure perceived stress in children aged 7-11 years. Using a two-phase design, we conducted semi-structured interviews with thirteen child-parent dyads for development of items. In a sample of 123 children (age range 7-11 years, Mage = 9 years 7 months, 54.5% male) we administered the resulting Perceived Stress Scale for Kids (PeSSKi). Exploratory factor analysis of the 10-item PeSSKi yielded support for both a one-factor and a two-factor solution (negative, positive item wording). The PeSSKi was associated positively with the Penn-State Worry Questionnaire for Children (r = 0.748, p < 0.001) and negatively with the Students' Life Satisfaction Scale (r = 0.381, p < 0.001) indicating strong convergent/divergent validity respectively. Girls showed higher scores on the PeSSKi than boys with no effects observed by age. Initial psychometrics suggest the PeSSKi provides a robust scale for assessment of perceived stress in children. Further validation is needed across different child populations, over time and with physical measures of stress and health outcomes.

A systematic review of the frequency of features of the seven-point checklist in proven cutaneous melanoma: The importance of change.

Background: Pigmented skin lesions in human adults can present with several different visible features that may indicate signs of malignancy, particularly melanoma. Patient and clinician awareness of these features can aid the early recognition and melanoma diagnosis improving patient outcomes. The seven-point checklist (7PCL) is a clinical prediction rule advocated by the National Institute for Health Care Excellence to aid the assessment of pigmented skin lesions in primary care to indicate referral for specialist opinion. Objectives: Assess the current evidence to establish which features of the 7PC present more frequently, so public education and clinician assessment can be focused to maximise early diagnosis and minimise referrals of benign lesions. Methods: A systematic review of published evidence identified studies that assessed the seven features of the 7PCL in histologically proven melanomas. Two independent reviewers screened eligible studies and independently extracted data and assessed quality. Results: 112 studies were screened, 20 were assessed in full, seven met the inclusion criteria. 1184 histologically diagnosed melanomas were assessed using the 7PCL. Four studies involved patients assessing 335 melanomas, and three involved clinicians who assessed 849 melanomas. The most common feature identified was a change in size of the lesion, and the least common was inflammation. Conclusions: The most frequently occurring features of melanoma involve shape, size and colour, however focussing on changes in features, rather than irregularity, is more likely to identify early melanoma and increase the accuracy of referrals.

Net worth poverty and adult health.

This study broadens the traditional focus on income as the primary measure of economic deprivation by providing the first analysis of wealth deprivation, or net worth poverty (NWP), and adult health. Net worth poverty-having wealth (assets minus debts) less than one-fourth of the federal poverty line-likely exacerbates the negative effects of income poverty (IP). In 2019, one-third of US households were net worth poor, with substantially higher rates among Black (60%) relative to White (25%) households. We estimate longitudinal growth curve (i.e., linear mixed effects) models to test how NWP, IP, and the interaction of the two predict a diverse set of health measures. We also consider whether NWP resulting from either low assets or high debts is more predictive of health outcomes and test for heterogeneous associations by race. Data come from Panel Study of Income Dynamics on 8,962 individuals ages 25 to 64, observed between 2011 and 2019 (n = 26,776). Adjusting for income poverty, net worth poverty, relative to no poverty, was associated with a one-quarter to one-third increase in the likelihood of reporting poor self-rated health, psychological distress, and work limitations. Simultaneously experiencing both NWP and IP was associated with the largest deficits. Both asset-driven (low asset) and debt-driven (high debt) NWP reduced health, but asset-driven NWP had stronger associations (e.g., a 5-percentage point increase of being in poor health, twice that of debt-driven). White, relative to Black, adults exhibited statistically larger associations for psychological distress (4.3 vs 1.1 percentage points) and work limitations (3.7 vs. 1.5 percentage points). White and Black adults who were jointly net worth and income poor exhibited the most disadvantage. Findings underscore how wealth is a critical component of financial deprivation and that wealth deprivation, particularly the lack of assets, merits attention in socioeconomic studies of health inequalities.

The Buffering Effect of State Eviction and Foreclosure Policies for Mental Health during the COVID-19 Pandemic in the United States.

The COVID-19 pandemic spurred an economic downturn that may have eroded population mental health, especially for renters and homeowners who experienced financial hardship and were at risk of housing loss. Using household-level data from the Census Bureau's Household Pulse Survey (n = 805,223; August 2020-August 2021) and state-level data on eviction/foreclosure bans, we estimated linear probability models with two-way fixed effects to (1) examine links between COVID-related financial hardship and anxiety/depression and (2) assess whether state eviction/foreclosure bans buffered the detrimental mental health impacts of financial hardship. Findings show that individuals who reported difficulty paying for household expenses and keeping up with rent or mortgage had increased anxiety and depression risks but that state eviction/foreclosure bans weakened these associations. Our findings underscore the importance of state policies in protecting mental health and suggest that heterogeneity in state responses may have contributed to mental health inequities during the pandemic.

Biogeochemical and historical drivers of microbial community composition and structure in sediments from Mercer Subglacial Lake, West Antarctica.

Ice streams that flow into Ross Ice Shelf are underlain by water-saturated sediments, a dynamic hydrological system, and subglacial lakes that intermittently discharge water downstream across grounding zones of West Antarctic Ice Sheet (WAIS). A 2.06 m composite sediment profile was recently recovered from Mercer Subglacial Lake, a 15 m deep water cavity beneath a 1087 m thick portion of the Mercer Ice Stream. We examined microbial abundances, used 16S rRNA gene amplicon sequencing to assess community structures, and characterized extracellular polymeric substances (EPS) associated with distinct lithologic units in the sediments. Bacterial and archaeal communities in the surficial sediments are more abundant and diverse, with significantly different compositions from those found deeper in the sediment column. The most abundant taxa are related to chemolithoautotrophs capable of oxidizing reduced nitrogen, sulfur, and iron compounds with oxygen, nitrate, or iron. Concentrations of dissolved methane and total organic carbon together with water content in the sediments are the strongest predictors of taxon and community composition. δ¹³C values for EPS (-25 to -30‰) are consistent with the primary source of carbon for biosynthesis originating from legacy marine organic matter. Comparison of communities to those in lake sediments under an adjacent ice stream (Whillans Subglacial Lake) and near its grounding zone provide seminal evidence for a subglacial metacommunity that is biogeochemically and evolutionarily linked through ice sheet dynamics and the transport of microbes, water, and sediments beneath WAIS.

Brief overview: cemiplimab for the treatment of advanced basal cell carcinoma: PD-1 strikes again.

Basal cell carcinoma (BCC) is the most common malignancy worldwide. Fortunately, most tumors are localized and easily amenable to surgical resection or locally destructive treatments. However, a subset of BCCs can become locally advanced or metastatic. The development of small-molecule inhibitors of smoothened, a protein in the hedgehog pathway, which is almost universally activated in BCCs, was a breakthrough in the treatment of patients with advanced BCC. However, these agents are associated with primary and secondary resistance and have a toxicity profile that makes long-term use difficult. The recent approval of cemiplimab for patients with advanced BCC who are resistant to or are intolerant of hedgehog inhibitor therapy fills a significant unmet need as these patients now have a viable, second-line systemic therapeutic option. This article summarizes the rationale and data leading to the approval for cemiplimab in advanced BCC.

Marriage, Kids, and the Picket Fence? Household Type and Wealth among U.S. Households, 1989 to 2019.

Evidence on how parenthood impacts household wealth in the United States has been inconclusive, partially because previous studies have decontextualized parenthood from gender, marital, and relationship status. Yet, insights from economic sociology suggest that wealth-related behaviors are shaped by the intersection of identities, not by a binary classification of parental status. We examine net worth by the intersection of gender, parental, and relationship status during a period of increasing wealth inequality and family diversification. Using data from the Survey of Consumer Finances from 1989 through 2019, we show that aggregate comparisons between parents and non-parents mask substantial wealth variation across nine household types. Despite changing social selection into marriage and parenthood, married parents consistently held a wealth advantage over demographically similar adults in other household types. Married parents' wealth advantage descriptively arises from homeownership, perhaps because the combined spousal and parental identities are normatively and culturally associated with homeownership.

Net Worth Poverty and Child Development.

The authors investigate whether net worth poverty (NWP) reduces children's well-being. NWP-having wealth (assets minus debts) less than one fourth of the federal poverty line-is both theoretically and empirically distinct from income poverty (IP) and is the modal form of poverty among children. Data come from the Panel Study of Income Dynamics and its Child Development Supplement on children ages 3 to 17 years observed between 2002 and 2019. The authors use linear mixed-effects models to investigate the associations among NWP, IP, and four cognitive and behavioral outcomes. NWP reduces children's cognitive scores and was associated with increases in both problem behavior scores. Negative associations for NWP are similar in magnitude to those found for IP. Much of the NWP effect operates through asset deprivation rather than high debt. The results illustrate the potential risks many children, previously overlooked in studies of IP, face because of wealth deprivation.