Revisiting the effects of state earned income tax credits on infant health: a quasi-experimental study using contiguous border counties approach.

BACKGROUND: To examine the effects of refundable state earned income tax credits (EITC) on infant health. METHODS: We use the restricted-access U.S. birth certificate data with county codes from 1989 to 2018. Birth outcomes include birth weight, low birth weight, gestational weeks, preterm birth, and the fetal growth rate. The analytical sample includes single mothers with high school education or less. Two specifications of two-way fixed effects models are employed. The first specification accounts for shared time trends across all states/counties. The second specification estimates effects based on EITC changes within contiguous counties across state borders which accounts for contemporaneous events specific to each contiguous county pair. Models are estimated pooling and stratifying by parity subgroups. RESULTS: Under the first specification, refundable state EITC is associated with improved birth outcomes. Pooling all parity, a 10%-point increase in refundable EITC is associated with an 8-gram increase in birth weight (95% CI: 2.9,14.6). The effect increases by parity. In contrast, the estimates from the second model are much smaller and statistically non-significant, both pooling and stratifying by parity. CONCLUSIONS: Comparing contiguous counties across state borders, there is no evidence that refundable state EITC affects birth outcomes. However, the estimates still do not rule out moderate to large benefits for third or higher born infants.

Increasing the HIV testing among MSM through HIV test result exchange mechanism: study protocol for a cluster randomized controlled trial.

BACKGROUND: HIV testing is an essential gateway to HIV prevention and treatment thus controlling the HIV epidemic. More innovative interventions are needed to increase HIV testing among men who have sex with men (MSM) since their testing rate is still low. We proposed an online HIV test results exchange mechanism whereby the one without a certified online HIV report will be asked to test HIV for exchanging HIV report with others. The exchange mechanism is developed as an extension to the existing online HIV testing service system. Through the extended system, MSM can obtain certified online HIV reports and exchange their reports with friends via WeChat. This study aims to assess effectiveness of the exchange mechanism to increase the HIV testing rate among MSM. METHODS: This study will use a cluster randomized controlled trial (RCT) design. Participants are recruited based on the unit of individual social network, the sender and the receivers of the HIV report. An individual social network is composed of one sender (ego) and one or more receivers (alters). In this study, MSM in an HIV testing clinic are recruited as potential egos and forwarded online reports to their WeChat friends voluntarily. Friends are invited to participate by report links and become alters. Ego and alters serve as a cluster and are randomized to the group using the certified online HIV report with exchange mechanism (intervention group) or without exchange mechanism (control group). Alters are the intervention targeting participants. The primary outcome is HIV testing rate. Other outcomes are sexual transmitted infections, sexual behaviors, HIV testing norms, stigma, risk perception and HIV report delivery. The outcomes will be assessed at baseline and follow-up questionnaires. Analysis will be according to intention to treat approach and using mixed-effect models with networks and individuals as random effects. DISCUSSION: This is the first study to evaluate the effectiveness of an HIV test result exchange mechanism to increase the HIV testing among MSM. This assessment of the intervention will also provide scientific evidence on other potential effects. Findings from this study will yield insights for sustainability driven by communities' intrinsic motivation. Trail registration: ClinicalTrials.gov NCT03984136. Registered 12 June 2019.

Food Insecurity, Memory, and Dementia Among US Adults Aged 50 Years and Older.

Importance: Despite existing federal programs to increase access to food, food insecurity is common among US older adults. Food insecurity may affect Alzheimer disease and Alzheimer disease-related dementias via multiple mechanisms, yet there is almost no quantitative research evaluating this association. Objective: To examine whether food insecurity in older adults is associated with later-life cognitive outcomes. Design, Setting, and Participants: This cohort study of US residents aged 50 years and older from the US Health and Retirement Study was restricted to respondents with food insecurity data in 2013 and cognitive outcome data between calendar years 2014 and 2018. Analyses were conducted from June 1 to September 22, 2023. Exposure: Food insecurity status in 2013 was assessed using the validated US Department of Agriculture 6-item Household Food Security Module. Respondents were classified as being food secure, low food secure, and very low food secure. Main Outcomes and Measures: Outcomes were dementia probability and memory score (standardized to 1998 units), estimated biennially between 2014 and 2018 using a previously validated algorithm. Generalized estimation equations were fit for dementia risk and linear mixed-effects models for memory score, taking selective attrition into account through inverse probability of censoring weights. Results: The sample consisted of 7012 participants (18 356 person-waves); mean (SD) age was 67.7 (10.0) years, 4131 (58.9%) were women, 1136 (16.2%) were non-Hispanic Black, 4849 (69.2%) were non-Hispanic White, and mean (SD) duration of schooling was 13.0 (3.0) years. Compared with food-secure older adults, experiencing low food security was associated with higher odds of dementia (odds ratio, 1.38; 95% CI, 1.15-1.67) as was experiencing very low food security (odds ratio, 1.37; 95% CI, 1.11-1.59). Low and very low food security was also associated with lower memory levels and faster age-related memory decline. Conclusions and Relevance: In this cohort study of older US residents, food insecurity was associated with increased dementia risk, poorer memory function, and faster memory decline. Future studies are needed to examine whether addressing food insecurity may benefit brain health.

The Effects of Refundable and Nonrefundable State Earned Income Tax Credit Programs on Health of Mothers of Two or More Children.

BACKGROUND: More than one-half of U.S. states have enacted Earned Income Tax Credit (EITC) programs. Yet little is known about the effects of state EITC programs on the health of recipients. This study examines the effects of refundable and nonrefundable state EITC programs on the health of single low-educated women of childbearing age with two or more children, the group receiving the highest credits on average. METHODS: The data come from the Behavioral Risk Factors Surveillance Survey from 1993 through 2018. Outcomes include self-rated general health, days not in good physical health, and days not in good mental health, both in the past 30 days. The research design accounts for time-invariant differences between states, national trends shared across states, and other state policies. RESULTS: Depending on the outcome measure, the analytical sample ranges between 103,362 and 107,782 mothers. Refundable state EITC programs are associated with improvements in all three health outcomes. A 10 percentage-point increase in refundable state EITC is associated with better self-rated health by 0.02 points (95% confidence interval [CI], 0.006-0.04) on a 1- to 5-point scale, or 0.7% improvement above the sample mean; 0.2 fewer days not in good physical health (95% CI, -0.21 to -0.12) in the past 30 days, or 4.4% lower than the sample mean; and 0.2 fewer days not in good mental health (95% CI, -0.29 to -0.1), or 3.4% lower than the sample mean. Estimates for nonrefundable EITC programs are smaller and not statistically significant. As expected, there are small and statistically insignificant refundable EITC effects for single low-educated childless women who receive low state EITC benefits on average. CONCLUSIONS: These findings suggest that an increase in refundable state EITC improves the health of single women of childbearing age with low incomes and two or more children; this factor may also lead to better preconception health. There is no evidence for effects from nonrefundable state EITC.

Biosynthesis of levan by levansucrase from Bacillus methylotrophicus SK 21.002.

A new strain SK 21.002 which could produce intracellular levansucrase was isolated from beet sugar growing soil. It was identified as Bacillus methylotrophicus based on the sequence analysis of the 16S rRNA and the morphological characteristic. The structure of levan biosynthesized from the levansucrase was determined to be connected through ß-(2→6) linkages with fructofuranosyl residues. The molecular weight of the product was between 4 and 5 kDa. The optimal conditions to produce levan using the levansucrase were studied. The presence of Mg(2+) could increase the yield of levan. The yield of levan reached about 100g/L with the enzyme under the optimum conditions.