The Precarious State of Family Balance Sheets

This report seeks to develop a clear picture of the current state of household financial security. It begins by exploring three components of family balance sheets -- income, expenditures, and wealth -- and how they have changed over the past several decades, and concludes with an examination of how these pieces interrelate and why understanding family finances requires that they be examined holistically. The data tell a powerful story about the state of household economic security and opportunity: Despite the national recovery, most families feel vulnerable and stressed, and could not withstand a serious financial emergency. This reality must begin to change if the American Dream is to remain alive and well for future generations

Neighborhood Poverty and Household Financial Security

In a previous study, The Pew Charitable Trusts examined the effects of neighborhood context on American families' economic mobility. That analysis found that neighborhood poverty is associated with downward mobility, reinforcing other research that has shown a link between high-poverty neighborhoods and unemployment, poorer performing schools, and increased violence, all of which pose risks to residents' economic security.This chartbook draws on data from the Survey of American Family Finances, commissioned by Pew in November 2014, to illustrate the health of family balance sheets in high- and low-poverty communities across the United States and to examine how neighborhood context influences people's attitudes toward the economy

The Complex Story of American Debt

This report explores a key element of wealth: household debt. Debt is sometimes acquired for mobility-enhancing purposes, such as to pay for college or purchase a home. But debt can also serve as a stopgap for families to cover regular expenses or deal with financial emergencies, especially if their savings are not sufficient. The type and amount of debt that households carry contribute to their wealth and their overall financial health

Long COVID After Bamlanivimab Treatment

BackgroundProspective evaluations of long COVID in outpatients with coronavirus disease 2019 (COVID-19) are lacking. We aimed to determine the frequency and predictors of long COVID after treatment with the monoclonal antibody bamlanivimab in ACTIV-2/A5401.MethodsData were analyzed from participants who received bamlanivimab 700 mg in ACTIV-2 from October 2020 to February 2021. Long COVID was defined as the presence of self-assessed COVID symptoms at week 24. Self-assessed return to pre-COVID health was also examined. Associations were assessed by regression models.ResultsAmong 506 participants, median age was 51 years. Half were female, 5% Black/African American, and 36% Hispanic/Latino. At 24 weeks, 18% reported long COVID and 15% had not returned to pre-COVID health. Smoking (adjusted risk ratio [aRR], 2.41 [95% confidence interval {CI}, 1.34- 4.32]), female sex (aRR, 1.91 [95% CI, 1.28-2.85]), non-Hispanic ethnicity (aRR, 1.92 [95% CI, 1.19-3.13]), and presence of symptoms 22-28 days posttreatment (aRR, 2.70 [95% CI, 1.63-4.46]) were associated with long COVID, but nasal severe acute respiratory syndrome coronavirus 2 RNA was not.ConclusionsLong COVID occurred despite early, effective monoclonal antibody therapy and was associated with smoking, female sex, and non-Hispanic ethnicity, but not viral burden. The strong association between symptoms 22-28 days after treatment and long COVID suggests that processes of long COVID start early and may need early intervention.Clinical trials registrationNCT04518410

Association Between Anterior Nasal and Plasma SARS-CoV-2 RNA Levels and Hospitalization or Death in Nonhospitalized Adults With Mild-to-Moderate COVID-19

BackgroundThere is little information regarding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA as a predictor for clinical outcomes in outpatients with mild-to-moderate coronavirus disease 2019 (COVID-19).MethodsAnterior nasal (AN) and plasma SARS-CoV-2 RNA data from 2115 nonhospitalized adults who received monoclonal antibodies (mAbs) or placebo in the ACTIV-2/A5401 trial were analyzed for associations with hospitalization or death.ResultsOne hundred two participants were hospitalized or died through 28 days of follow-up. Higher day 0 (pretreatment) AN RNA was associated with increasing risk of hospitalization/death (risk ratio [RR], 1.24 per log10 copies/mL [95% confidence interval {CI}, 1.04-1.49]) among placebo recipients, ranging from 3% to 16% for <2 to ≥6 log10 copies/mL. Although only 1% had quantifiable levels, there was a similar trend across day 0 plasma RNA categories. Higher day 3 AN RNA was associated with subsequent hospitalization/death among placebo recipients (RR, 1.42 per log10 copies/mL [95% CI, 1.00-2.03]), but not mAb recipients (RR, 1.02 per log10 copies/mL [95% CI, 0.68-1.56]). The proportion of treatment effect (reduction in hospitalizations/deaths after day 3 for mAb vs placebo) explained by day 3 AN RNA was 8%.ConclusionsSARS-CoV-2 RNA levels are predictive of hospitalization/death in the natural history setting, but AN RNA levels may not be a reliable surrogate marker of mAb treatment effect in COVID-19 trials. Clinical Trials Registration. NCT04518410

Shipping blood to a central laboratory in multicenter clinical trials: effect of ambient temperature on specimen temperature, and effects of temperature on mononuclear cell yield, viability and immunologic function

<p>Abstract</p> <p>Background</p> <p>Clinical trials of immunologic therapies provide opportunities to study the cellular and molecular effects of those therapies and may permit identification of biomarkers of response. When the trials are performed at multiple centers, transport and storage of clinical specimens become important variables that may affect lymphocyte viability and function in blood and tissue specimens. The effect of temperature during storage and shipment of peripheral blood on subsequent processing, recovery, and function of lymphocytes is understudied and represents the focus of this study.</p> <p>Methods</p> <p>Peripheral blood samples (n = 285) from patients enrolled in 2 clinical trials of a melanoma vaccine were shipped from clinical centers 250 or 1100 miles to a central laboratory at the sponsoring institution. The yield of peripheral blood mononuclear cells (PBMC) collected before and after cryostorage was correlated with temperatures encountered during shipment. Also, to simulate shipping of whole blood, heparinized blood from healthy donors was collected and stored at 15°C, 22°C, 30°C, or 40°C, for varied intervals before isolation of PBMC. Specimen integrity was assessed by measures of yield, recovery, viability, and function of isolated lymphocytes. Several packaging systems were also evaluated during simulated shipping for the ability to maintain the internal temperature in adverse temperatures over time.</p> <p>Results</p> <p>Blood specimen containers experienced temperatures during shipment ranging from -1 to 35°C. Exposure to temperatures above room temperature (22°C) resulted in greater yields of PBMC. Reduced cell recovery following cryo-preservation as well as decreased viability and immune function were observed in specimens exposed to 15°C or 40°C for greater than 8 hours when compared to storage at 22°C. There was a trend toward improved preservation of blood specimen integrity stored at 30°C prior to processing for all time points tested. Internal temperatures of blood shipping containers were maintained longer in an acceptable range when warm packs were included.</p> <p>Conclusions</p> <p>Blood packages shipped overnight by commercial carrier may encounter extreme seasonal temperatures. Therefore, considerations in the design of shipping containers should include protecting against extreme ambient temperature deviations and maintaining specimen temperature above 22°C or preferably near 30°C.</p

Pursuing the American Dream: Economic Mobility Across Generations

Pursuing the American Dream uses the most current data to measure mobility by family income, wealth, and personal earnings to reveal how closely tied a person’s place on the economic ladder is to that of his or her parents’. While a majority of Americans exceed their parents’ family income and wealth, the extent of their absolute mobility gains are not always enough to move them to a different rung of the economic ladder. Measuring both absolute and relative mobility, some of the highlights of the research include: Eighty-four percent of Americans have higher family incomes than their parents did. However, those born at the top and bottom of the income ladder are likely to stay there as adults. Over 40 percent of Americans raised in the bottom quintile of the family income ladder remain stuck there adults, and 70 percent remain below the middle. African Americans are still less likely to exceed their parents’ income than are whites and they are more likely to be stuck at the bottom of the economic ladder across a generation. A four-year college degree promotes upward mobility from the bottom and prevents downward mobility from the middle and the top.https://www.pewtrusts.org/en/research-and-analysis/reports/2012/07/10/pursuing-the-american-dream-economic-mobility-across-generation

Pursuing the American Dream: Economic Mobility Across Generations

Pursuing the American Dream uses the most current data to measure mobility by family income, wealth, and personal earnings to reveal how closely tied a person’s place on the economic ladder is to that of his or her parents’. While a majority of Americans exceed their parents’ family income and wealth, the extent of their absolute mobility gains are not always enough to move them to a different rung of the economic ladder. Measuring both absolute and relative mobility, some of the highlights of the research include: Eighty-four percent of Americans have higher family incomes than their parents did. However, those born at the top and bottom of the income ladder are likely to stay there as adults. Over 40 percent of Americans raised in the bottom quintile of the family income ladder remain stuck there adults, and 70 percent remain below the middle. African Americans are still less likely to exceed their parents’ income than are whites and they are more likely to be stuck at the bottom of the economic ladder across a generation. A four-year college degree promotes upward mobility from the bottom and prevents downward mobility from the middle and the top