Search

Drugs that inhibit HIV transcription and/or reactivation of latent HIV have been proposed as a strategy to reduce HIV-associated immune activation or to achieve a functional cure, yet comparative studies are lacking. We evaluated 26 drugs, including drugs previously reported to inhibit HIV transcription (inhibitors of Tat-dependent HIV transcription, Rev, HSF-1/PTEF-b, HSP90, Jak/Stat, or SIRT1/Tat deacetylation) and other agents that were not tested before (inhibitors of PKC, NF-κB, SP-1, or histone acetyltransferase; NR2F1 agonists), elongation (inhibitors of CDK9/ PTEF-b), completion (inhibitors of PolyA-polymerase), or splicing (inhibitors of human splice factors). To investigate if those drugs would vary in their ability to affect different blocks to HIV transcription, we measured levels of initiated, elongated, midtranscribed, completed, and multiply spliced HIV RNA in PBMCs from antiretroviral therapy-suppressed individuals following ex vivo treatment with each drug and subsequent T cell activation. We identified new drugs that prevent HIV reactivation, including CDK and splicing inhibitors. While some drugs inhibited 1 or 2 steps, other drugs (CDK inhibitors, splicing inhibitors, tanespimycin, and triptolide) inhibited multiple stages of HIV transcription and blocked the production of supernatant viral RNA. These drugs and targets deserve further study in strategies aimed at reducing HIV-associated immune activation or achieving a functional cure.

ObjectivesSome drugs that augment cell-intrinsic defenses or modulate cell death/survival pathways have been reported to selectively kill cells infected with HIV or Simian Immunodeficiency Virus (SIV), but comparative studies are lacking. We hypothesized that these drugs may differ in their ability to kill cells infected with intact and defective proviruses.DesignTo investigate this hypothesis, drugs were tested ex vivo on peripheral blood mononuclear cells (PBMC) from nine antiretroviral therapy (ART)-suppressed individuals.MethodsWe tested drugs currently in clinical use or human trials, including auranofin (p53 modulator), interferon alpha2A, interferon gamma, acitretin (RIG-I inducer), GS-9620/vesatolimod (TLR7 agonist), nivolumab (PD-1 blocker), obatoclax (Bcl-2 inhibitor), birinapant [inhibitor of apoptosis proteins (IAP) inhibitor], bortezomib (proteasome inhibitor), and INK128/sapanisertib [mammalian target of rapamycin mTOR] [c]1/2 inhibitor). After 6 days of treatment, we measured cell counts/viabilities and quantified levels of total, intact, and defective HIV DNA by droplet digital PCR (Intact Proviral DNA Assay).ResultsObatoclax reduced intact HIV DNA [median = 27-30% of dimethyl sulfoxide control (DMSO)] but not defective or total HIV DNA. Other drugs showed no statistically significant effects.ConclusionObatoclax and other Bcl-2 inhibitors deserve further study in combination therapies aimed at reducing the intact HIV reservoir in order to achieve a functional cure and/or reduce HIV-associated immune activation.

Abstract Wine industry faces significant sustainability challenges in the wake of climate change. Life cycle assessments for carbon footprint in wineries suggest that the conventional farming exhibits higher values of 0.06–3.0 kg CO2-eq bottle–1 of 750 mL wine as compared to mixed and organic farming. Life cycle assessment findings highlight that most studies often overlooked the resources in farming practices, biogenic emissions, and wastewaters in the overall reduction of winery carbon footprint. We demonstrate that the adoption of eco-innovations such as constructed wetlands and Phycosol utilize the overlooked resource loop and significantly reduce the winery carbon footprint. Empirical data analysis suggests that the use of these eco-innovative models results in 25‒30% reduction of CO2 emissions bottle–1 of 750 mL wine besides embracing Sustainable Development Goal 9, and effectively synergizing with Sustainable Development Goals 6 and 12, thus emphasizing their critical role in ensuring the sustainability of wine production.

Abstract Background Among the crises engulfing the world is the symbiotic rise of ultra-processed foods (UPFs) and plastics. Together, this co-dependent duo generates substantial profits for agri-food and petrochemical industries at high costs for people and planet. Cheap, lightweight and highly functional, plastics have ideal properties that enable business models to create demand for low-cost, mass-produced and hyper-palatable UPFs among populations worldwide, hungry, or not. Evidence linking UPF consumption to deterioration in diet quality and higher risk of chronic diseases is well-established and growing rapidly. At the same time, the issue of plastic food contact chemicals (FCCs) is receiving increasing attention among the human health community, as is the generation and dispersion of micro- and nanoplastics. Main body In this commentary, we explore how the lifecycles and shared economic benefits of UPFs and plastics interact to co-produce a range of direct and indirect harms. We caution that the chemical dimension of these harms is underappreciated, with thousands of plastic FCCs known to migrate into foodstuffs. Some of these are hazardous and have been detected in humans and the broader environment, while many are yet to be adequately tested. We question whether policies on both UPF and plastic chemicals are fit for purpose when production and consumption of these products is adding to the chronic chemical exposures that plausibly contribute to the increasing global burden of non-communicable diseases. Conclusions In the context of ongoing negotiations for a legally binding global treaty to end plastics pollution, and rapidly growing concern about the burgeoning share of UPFs in diets worldwide, we ask: What steps are needed to call time on this toxic relationship?

Objective: Lipids play key role in coronary atherosclerosis. The role of non-high-density lipoprotein cholesterol (non-HDL-C) in atherosclerotic plaques using intravascular imaging remains unclear. This study aimed to assess its relationship with coronary plaque features using intravascular ultrasound (IVUS) in acute coronary syndrome (ACS). Methods: A total of 601 patients divided into two groups: normal non-HDL-C≤130 mg/dl (n = 410) and high non-HDL cholesterol >130 mg/dl (n = 191). IVUS performed before coronary intervention. Results: Mean age 53.18 ± 12.29 years. No significant differences in hypertension, diabetes, and smoking between groups. Plaque burden was significantly higher among normal versus high non-HDL-C groups (79.59 ± 9.98 % vs. 81.61 ± 5.39 %; p = 0.001). At minimal luminal site, fibrofatty percentage was higher in normal non-HDL-C group (p = 0.027), while necrotic core greater in high non-HDL-C group (p = 0.033). Segmental analysis, necrotic core was significantly higher in percentage (p = 0.006) and volumes (p = 0.011) in normal versus high non-HDL-C groups. Total cholesterol (r = 0.099, p = 0.015), LDL-C (r = 0.081, p = 0.046), triglycerides (r = 0.083, p = 0.041),and non-HDL-C (r = 0.099, p = 0.015) positively correlated with plaque burden. Total cholesterol (r = 0.115, p = 0.005), LDL-C (r = 0.107, p = 0.009), and non-HDL-C (r = 0.105, p = 0.010) positively correlated with necrotic core volume. Linear regression analysis showed age and non-HDL-C as predictors of higher plaque burden. Multiple linear regression analysis; age, body mass index, and non-HDL-C were predictors of larger necrotic core volume. Conclusion: Non-HDL-C levels were positively associated with plaque burden, measure of extent of atherosclerosis. It is closely associated with and is a predictor of necrotic core volume; a marker of plaque vulnerability. This IVUS study demonstrates potential role of non-HDL-C in causation of plaque in ACS.

Molecular docking simulations were conducted to analyze the interactions between eight lead molecules with AR and PSA proteins. The lead molecules included Enzalutamide, Abiraterone, Docetaxel, Apalutamide, Cabazitaxel, Bicalutamide, Curcumin, Galeterone, Resveratrol, and Darolutamide. For the Androgen Receptor (AR), Enzalutamide displayed the most favorable docking energy of -10.96Kcal/mol, followed by Galeterone (-10.52Kcal/mol) and Darolutamide (-9.97Kcal/mol). The binding affinities of these compounds to AR suggest potential inhibitors. On the other hand, resveratrol exhibited the strongest interaction with the AR protein (-8.02Kcal.mol) among the natural compounds studied (Resveratrol and Curcumin). In the case of Prostate Specific Antigen (PSA), Abiraterone showed a docking energy of -9.14 kcal/mol, indicating a potential interaction with PSA. The docking results suggest that Enzalutamide, Galeterone, and Darolutamide, hold promise as potential inhibitors for the Androgen Receptor in prostate cancer treatment. Abiraterone, Enzalutamide, Apalutamide ligands shown a significant interaction on Prostate Specific Antigen, hinting at its potential as a dual-target agent.

Background and Aim: Osteoporosis significantly compromises the quality of life of postmenopausal women. There are DALY (Disability-Adjusted Life Years) losses for postmenopausal women who suffer from osteoporosis. Therefore, this study was taken up with the objective to determine prevalence of osteopenia and osteoporosis among postmenopausal women and to study the association of their anthropometric parameters and lifestyle factors with their bone mineral density (BMD). To study the determinants of BMD among postmenopausal women with special reference to anthropometric and lifestyle factors in an urban slum. Materials and Methods: A community-based, cross-sectional study was conducted in an urban slum of Mumbai. The study was conducted among 148 postmenopausal women. BMD of the study group was measured using portable, noninvasive Calcaneum Ultrasound Bone Densitometer, and T-score reading was noted. Lifestyle factors and dietary habits were assessed through a prestructured, validated questionnaire. Body mass index (BMI) was calculated with a standard procedure. No trial was conducted in the study. Statistical Package for Social Sciences (version 20) was used for statistical analysis. Results: The prevalence of osteopenia among study participants was found to be 43.9% and that of osteoporosis was 12.8%. Their BMI was in the range of 16.44–39.18 kg/m2. Walking, stretching exercises, and yoga were the form of exercise being practiced by 29.1% of postmenopausal women. Conclusions: BMD was significantly associated with age, socioeconomic status, BMI, exercise, walking, and consumption of fruits. Negative correlation was found between duration since menopause and BMD T-score reading, which implied that duration since menopause had an inverse relationship with BMD.

We studied five patients who presented with complaints of swelling of the sternoclavicular joint (SCJ), with pain and restriction of shoulder movements in some. There was no clinical or imaging evidence of pulmonary involvement in any of these patients. The diagnosis of SCJ tuberculosis (TB) was ascertained by histopathological evidence (n = 2), by Xpert MTB/RIF (n = 1) and based on clinical presentation and response to anti-TB treatment (n = 2). On follow-up, all patients had responded well to anti-TB treatment. TB should be considered in the differential diagnosis in patients presenting with subacute/chronic SCJ arthritis, with or without pulmonary involvement, especially in high TB burden countries.

Introduction: Campylobacter infections cause diarrhoeal diseases as frequently as Salmonella and Shigella infections. The prevalence of Campylobacter infection among children with acute diarrhoea in developing countries ranges from 5-35%. Diagnosing Campylobacter infections is challenging as the organism is difficult to isolate, grow, and identify. Currently, no best-practice clinical or public health laboratory guidelines exist for laboratory diagnosis of Campylobacter infections. Aim: To explore the clinical and bacterial aspects of childhood diarrhoea, emphasising the prevalence and molecular detection of Campylobacter. Materials and Methods: A hospital-based cross-sectional descriptive study was conducted with 55 stool samples of children under five with diarrhoea or dysentery at the Department of Microbiology, JSS Medical College, Mysuru, Karnataka, India, from October 2016 to September 2017. All stool samples were inoculated onto Campylobacter selective and non selective media with filtration and incubated in microaerophilic conditions. The culture isolates were identified by standard phenotypic tests. Molecular characterisation of Campylobacter was performed targeting the Campylobacter adhesion to fibronectin F (cadF) gene. The presence of a phylogenetically conserved 16S ribosomal Ribonucleic Acid (16SrRNA) domain was studied, followed by specific detection of pathogenic Campylobacter species. The Statistical Package for Social Sciences (SPSS) version 22.0 was used for statistical analysis. Descriptive statistics like percentage, mean, and Standard Deviation (SD) were applied. Results: Campylobacter was isolated by culture in one out of 55 stool samples. The isolate was confirmed to be Campylobacter jejuni by phenotypic tests. Campylobacter genus-level Polymerase Chain Reaction (PCR) was positive for 6 samples (10.9%). Six positive samples were subjected to species-level PCR; all were positive for C. jejuni. Out of 55 stool samples, two diarrheagenic Escherichia coli, two Shigella sonnei, one Shigella dysenteriae, and one Salmonella enterica serovar Typhi were also identified. Conclusion: Culture is insufficiently sensitive for diagnosing Campylobacter infection compared with nucleic acid-based diagnostics. Nucleic acid-based diagnostics offer increased sensitivity, can determine both the presence and burden of infection, and can distinguish between Campylobacter infections at the species level. Therefore, PCR is recommended, if feasible, as the preferred diagnostic modality for detecting Campylobacter infection.

In April, the Biden Administration announced a proposed rule that would allow an estimated 40,000 uninsured DACA recipients in California access to subsidized health coverage through Covered California. This fills an important gap in health coverage options, but it renders access to Covered California contingent on DACA status—which itself is at risk of being overturned by the courts.

PURPOSE: Mutant isocitrate dehydrogenase 1 (mIDH1) alters the epigenetic regulation of chromatin, leading to a hypermethylation phenotype in adult glioma. This work focuses on identifying gene targets epigenetically dysregulated by mIDH1 to confer therapeutic resistance to ionizing radiation (IR). EXPERIMENTAL DESIGN: We evaluated changes in the transcriptome and epigenome in a radioresistant mIDH1 patient-derived glioma cell culture (GCC) following treatment with an mIDH1-specific inhibitor, AGI-5198. We identified Zinc Finger MYND-Type Containing 8 (ZMYND8) as a potential target of mIDH1 reprogramming. We suppressed ZMYND8 expression by shRNA knockdown and genetic knockout (KO) in mIDH1 glioma cells and then assessed cellular viability to IR. We assessed the sensitivity of mIDH1 GCCS to pharmacologic inhibition of ZMYND8-interacting partners: HDAC, BRD4, and PARP. RESULTS: Inhibition of mIDH1 leads to an upregulation of gene networks involved in replication stress. We found that the expression of ZMYND8, a regulator of DNA damage response, was decreased in three patient-derived mIDH1 GCCs after treatment with AGI-5198. Knockdown of ZMYND8 expression sensitized mIDH1 GCCs to radiotherapy marked by decreased cellular viability. Following IR, mIDH1 glioma cells with ZMYND8 KO exhibit significant phosphorylation of ATM and sustained γH2AX activation. ZMYND8 KO mIDH1 GCCs were further responsive to IR when treated with either BRD4 or HDAC inhibitors. PARP inhibition further enhanced the efficacy of radiotherapy in ZMYND8 KO mIDH1 glioma cells. CONCLUSIONS: These findings indicate the impact of ZMYND8 in the maintenance of genomic integrity and repair of IR-induced DNA damage in mIDH1 glioma. See related commentary by Sachdev et al., p. 1648.

California continues to make remarkable progress in expanding access to health coverage, including by expanding Medi-Cal eligibility for low-income undocumented residents. Yet, we project there will be 520,000 uninsured undocumented residents who earn too much for Medi-Cal and do not have employer coverage. This group remains categorically excluded from enrolling in Covered California and cannot receive federal subsidies to make coverage more affordable.

Research on gold catalysis has flourished over the last 20 years, and gold catalysts are now acknowledged as the “best choice” for a range of organic transformations. Gold complexes have emerged as promising candidates for this use in recent years because of their high reactivity, which enables them to induce a broad range of transformations under mild conditions. Extensive demonstrations have showcased the extraordinary efficiency of synthesizing complex organic compounds from the basic starting components. In addition to its traditional applications in catalysis, gold catalysis has expanded to include the total synthesis of natural compounds, which is a complex and demanding undertaking. The class of molecules known as carbo- and heterocycles, which is arguably the most important, has a significant impact on the synthesis of agrochemicals and pharmaceuticals among the numerous additional products made possible by the novel procedures pioneered. The main topic of this review is how to use Au salts in homogeneous catalysis to create cyclization processes for small heterocyclic and carbocyclic systems. This study gives an overview of most of the books and articles written after 2013 that discuss making three- and four-membered carbo- and heterocyclic rings with gold as a catalyst. We have made every effort to include all outstanding reports on this subject; nonetheless, we apologize for any omissions.

Posttreatment controllers (PTCs) are rare HIV-infected individuals who can limit viral rebound after antiretroviral therapy interruption (ATI), but the mechanisms of this remain unclear. To investigate these mechanisms, we quantified various HIV RNA transcripts (via reverse transcription droplet digital PCR [RT-ddPCR]) and cellular transcriptomes (via RNA-seq) in blood cells from PTCs and noncontrollers (NCs) before and two time points after ATI. HIV transcription initiation did not significantly increase after ATI in PTCs or in NCs, whereas completed HIV transcripts increased at early ATI in both groups and multiply-spliced HIV transcripts increased only in NCs. Compared to NCs, PTCs showed lower levels of HIV DNA, more cell-associated HIV transcripts per total RNA at all times, no increase in multiply-spliced HIV RNA at early or late ATI, and a reduction in the ratio of completed/elongated HIV RNA after early ATI. NCs expressed higher levels of the IL-7 pathway before ATI and expressed higher levels of multiple cytokine, inflammation, HIV transcription, and cell death pathways after ATI. Compared to the baseline, the NCs upregulated interferon and cytokine (especially TNF) pathways during early and late ATI, whereas PTCs upregulated interferon and p53 pathways only at early ATI and downregulated gene translation during early and late ATI. In NCs, viral rebound after ATI is associated with increases in HIV transcriptional completion and splicing, rather than initiation. Differences in HIV and cellular transcription may contribute to posttreatment control, including an early limitation of spliced HIV RNA, a delayed reduction in completed HIV transcripts, and the differential expression of the IL-7, p53, and TNF pathways. IMPORTANCE The findings presented here provide new insights into how HIV and cellular gene expression change after stopping ART in both noncontrollers and posttreatment controllers. Posttreatment control is associated with an early ability to limit increases in multiply-spliced HIV RNA, a delayed (and presumably immune-mediated) ability to reverse an initial rise in processive/completed HIV transcripts, and multiple differences in cellular gene expression pathways. These differences may represent correlates or mechanisms of posttreatment control and may provide insight into the development and/or monitoring of therapeutic strategies that are aimed at a functional HIV cure.

Most of the HIV DNA in infected individuals is noninfectious because of deleterious mutations. However, it is unclear how much of the transcribed HIV RNA is potentially infectious or defective. To address this question, we developed and validated a novel intact viral RNA assay (IVRA) that uses droplet digital reverse transcriptase PCR (dd-RT-PCR) for the commonly mutated packaging signal (Psi) and Rev response element (RRE) regions (from the intact proviral DNA assay [IPDA]) to quantify likely intact (Psi+ RRE+), 3' defective (Psi+ RRE-), and 5' defective (Psi- RRE+) HIV RNA. We then applied the IPDA and IVRA to quantify intact and defective HIV DNA and RNA from peripheral CD4+ T cells from 9 antiretroviral therapy (ART)-suppressed individuals. Levels of 3' defective HIV DNA were not significantly different from those of 5' defective HIV DNA, and both were higher than intact HIV DNA. In contrast, 3' defective HIV RNA (median 86 copies/106 cells; 94% of HIV RNA) was much more abundant than 5' defective (2.1 copies/106 cells; 5.6%) or intact (0.6 copies/106 cells;

A dipole magnet generating 20 T and beyond will require high-temperature superconductors such as Bi2Sr2CaCu2O 8 − x and REBa2Cu3O 7 − x (RE = rare earth, rebco). Symmetric tape round (star®) wires based on rebco tapes are emerging as a potential conductor for such a magnet, demonstrating a whole-conductor current density of 580 A mm−2 at 20 T, 4.2 K, and at a bend radius of 15 mm. There are, however, few magnet developments using star® wires. Here we report a subscale canted cos θ dipole magnet as an initial experiment for two purposes: to evaluate the conductor performance in a magnet configuration and to start developing the magnet technology, leveraging the small bend radius afforded by star® wires. The magnet was wound with two star® wires, electrically in parallel and without transposition. We tested the magnet at 77 and 4.2 K. The magnet reached a peak current of 8.9 kA, 78% of the short-sample prediction at 4.2 K, and a whole-conductor current density of 1500 A mm−2. The experiment demonstrated a minimum viable concept for dipole magnet applications using star® wires. The results also allowed us to identify further development needs for star® conductors and associated magnet technology to enable high-field rebco magnets.

IntroductionAlthough Coronavirus disease 2019 (COVID-19) vaccination is critical to control its spread, vaccine hesitancy varies significantly among the United States population; moreover, some vaccine recipients experienced various adverse effects. We aim to assess the impact of COVID-19 vaccine hesitancy in a university-affiliated community, the factors affecting participants’ decisions, and their adverse effects.MethodsA pre-vaccination online Institutional Review Board IRB-approved survey was emailed in Nov/Dec 2020, 2 months before the implementation of state-policy protocols for COVID-19 vaccination. A post-vaccination survey was emailed in May/June 2021, two months after protocol execution. A third follow-up survey was sent in Nov/Dec 2021, and a fourth was sent in June/July 2022. The study population included three groups of adult participants: university students, faculty, and staff-(MS), university health system patients-(MP), and Cancer Center patients-(MCP). The study was designed as a longitudinal cohort study. Statistical analyses were performed using SPSS.ResultsWith a combined response rate of 26% (40,578/157,292) among the four surveys, 15,361 participants completed the first survey (MS = 4,983, MP = 9,551, and MCP = 827). 2/3 of participants (63.5%) were willing to get vaccinated, with a significant difference in acceptance among groups, MS:56.6%, MP:66.2%, and MCP:71.6% (p

Background With the increase in popularity of cannabis and its use and the lack of large‐scale data on cannabis use and venous thromboembolism and pulmonary embolism (PE), we used a nationally representative cohort of young adults (aged 18–44 years) to compare the odds of admissions and in‐hospital mortality of PE with and without cannabis use disorder (CUD). Methods and Results Identified patients with PE using the National Inpatient Sample (2018) were compared for baseline, comorbidities, and outcomes. Multivariable regression analysis, adjusted for covariates, was used to compare the odds of PE in young patients with CUD (CUD+) versus those without (CUD−) and those with prior venous thromboembolism. Propensity score–matched analysis (1:6) was also performed to assess in‐hospital outcomes. A total of 61 965 (0.7%) of 8 438 858 young adult admissions in 2018 were PE related, of which 1705 (0.6%) had CUD+. On both unadjusted (odds ratio, 0.80 [95% CI, 0.71–0.90]; P

Large Language Models (LLMs) combined with visual foundation models have demonstrated significant advancements, achieving intelligence levels comparable to human capabilities. This study analyzes the latest Multimodal LLMs (MLLMs), including Multimodal-GPT, GPT-4 Vision, Gemini, and LLaVa, with a focus on hydrological applications such as flood management, water level monitoring, agricultural water discharge, and water pollution management. We evaluated these MLLMs on hydrology-specific tasks, testing their response generation and real-time suitability in complex real-world scenarios. Prompts were designed to enhance the models’ visual inference capabilities and contextual comprehension from images. Our findings reveal that GPT-4 Vision demonstrated exceptional proficiency in interpreting visual data, providing accurate assessments of flood severity and water quality. Additionally, MLLMs showed potential in various hydrological applications, including drought prediction, streamflow forecasting, groundwater management, and wetland conservation. These models can optimize water resource management by predicting rainfall, evaporation rates, and soil moisture levels, thereby promoting sustainable agricultural practices. This research provides valuable insights into the potential applications of advanced AI models in addressing complex hydrological challenges and improving real-time decision-making in water resource management

The layer-by-layer deposition of molten polymer filament in fused deposition modeling (FDM) has evolved as a disruptive technology for building complex parts. This technology has drawbacks such as the anisotropic property of the printed parts resulting in lower strength for parts printed in the vertical Z direction compared with the other two planes. In this manuscript, we attempt to address these challenges as well as the lack of standardization in sample preparation and mechanical testing of the printed parts. The paper focuses on process parameters and design optimization of the ZX build orientation. Type I tensile bars in ZX orientation were printed as per the ASTM D638 standard using two (2B) and four (4B) tensile bar designs. The proposed design reduces material loss and post-processing to extract the test coupons. Printing a type I tensile bar in the ZX orientation is more challenging than type IV and type V due to the increased length of the specimen and changes in additional heat buildup during layer-by-layer deposition. Three different polymer composite systems were studied: fast-crystallizing nanofiller-based high-temperature nylon (HTN), slow-crystallizing nanofiller-based polycyclohexylene diethylene terephthalate glycol-modified (PCTG), and amorphous carbon fiber-filled polyetherimide (PEI-CF). For all the polymer composite systems, the 2B showed the highest strength properties due to the shorter layer time aiding the diffusion in the interlayers. Further, rheological studies and SEM imaging were carried out to understand the influence of the two designs on fracture mechanics and interlayer bonding, providing valuable insights for the field of additive manufacturing and material science.

Proposed federal regulations would fix the family glitch by extending subsidies to spouses and children offered unaffordable family coverage through an employer. The employee would still be excluded from subsidies if their cost for single coverage through their employer was affordable. We use the California Simulations of Insurance Markets (CalSIM) model to project for 2023 how many people would fall into the family glitch in California, how many would be newly eligible for a positive dollar subsidy, and how many would enroll in Covered California with subsidies under the family glitch fix.

Women's nutritional status remains poor in South Asia, impacting maternal and infant health outcomes. Women's household status is also low, as evidenced by eating behaviours. We started with triadic qualitative interviews with newly married women, husbands and mothers-in-law to explore the link between women's status and eating patterns, followed by longitudinal data from a cohort of 200 newly married women in rural Nepal to measure associations over time. Quantitative data were collected every 6 months for 18 months (four rounds of data) between 2018 and 2020. Interviews suggested that household relationships, women's status, and how much and what types of food she was given were intricately linked. Using mixed effects logistic regression models, we explore the association between markers of changing women's status (becoming pregnant, giving birth and working outside the home) on two outcomes (eating last always/usually and achieving minimum dietary diversity). We also explore for interaction between women's status and household food insecurity. Pregnancy increases women's dietary diversity, but this is not sustained post-partum. Women who work outside the home are less likely to eat last in the household. Food insecurity is associated with both the order of household eating and dietary diversity. Interactions between food insecurity and giving birth suggested that women who give birth in food insecure households are more likely to eat last in the household. Changes in women's household status are associated with some improvements in dietary diversity and order of household eating, but the associations are not long-lasting and depend on food security status.