America's unprecedented levels of inequality have far-reaching negative consequences for society as a whole. Although differential access to resources contributes to inequality, the current review illuminates how ongoing participation in different social class contexts also gives rise to culture-specific selves and patterns of thinking, feeling, and acting. We integrate a growing body of interdisciplinary research to reveal how social class culture cycles operate over the course of the lifespan and through critical gateway contexts, including homes, schools, and workplaces. We first document how each of these contexts socializes social class cultural differences. Then, we demonstrate how these gateway institutions, which could provide access to upward social mobility, are structured according to middle-class ways of being a self and thus can fuel and perpetuate inequality. We conclude with a discussion of intervention opportunities that can reduce inequality by taking into account the contextual responsiveness of the self.

No abstract

Advanced cholangiocarcinoma continues to harbor a difficult prognosis and therapeutic options have been limited. During the course of a clinical trial of whole genomic sequencing seeking druggable targets, we examined six patients with advanced cholangiocarcinoma. Integrated genome-wide and whole transcriptome sequence analyses were performed on tumors from six patients with advanced, sporadic intrahepatic cholangiocarcinoma (SIC) to identify potential therapeutically actionable events. Among the somatic events captured in our analysis, we uncovered two novel therapeutically relevant genomic contexts that when acted upon, resulted in preliminary evidence of anti-tumor activity. Genome-wide structural analysis of sequence data revealed recurrent translocation events involving the FGFR2 locus in three of six assessed patients. These observations and supporting evidence triggered the use of FGFR inhibitors in these patients. In one example, preliminary anti-tumor activity of pazopanib (in vitro FGFR2 IC50≈350 nM) was noted in a patient with an FGFR2-TACC3 fusion. After progression on pazopanib, the same patient also had stable disease on ponatinib, a pan-FGFR inhibitor (in vitro, FGFR2 IC50≈8 nM). In an independent non-FGFR2 translocation patient, exome and transcriptome analysis revealed an allele specific somatic nonsense mutation (E384X) in ERRFI1, a direct negative regulator of EGFR activation. Rapid and robust disease regression was noted in this ERRFI1 inactivated tumor when treated with erlotinib, an EGFR kinase inhibitor. FGFR2 fusions and ERRFI mutations may represent novel targets in sporadic intrahepatic cholangiocarcinoma and trials should be characterized in larger cohorts of patients with these aberrations.

The renin-angiotensin-aldosterone system (RAAS) is a major regulator of blood pressure. The octapeptide angiotensin II (AII) is proteolytically processed from the decapeptide AI by angiotensin-converting enzyme (ACE), and then acts via angiotensin type 1 and type 2 receptors (AT1R and AT2R). Inhibitors of ACE and antagonists of the AT1R are used in the treatment of hypertension, myocardial infarction, and stroke. We now show that the RAAS also plays a major role in autoimmunity, exemplified by multiple sclerosis (MS) and its animal model, experimental autoimmune encephalomyelitis (EAE). Using proteomics, we observed that RAAS is up-regulated in brain lesions of MS. AT1R was induced in myelin-specific CD4 ؉ T cells and monocytes during autoimmune neuroinflammation. Blocking AII production with ACE inhibitors or inhibiting AII signaling with AT1R blockers suppressed autoreactive TH1 and TH17 cells and promoted antigenspecific CD4؉FoxP3؉ regulatory T cells (Treg cells) with inhibition of the canonical NF-B1 transcription factor complex and activation of the alternative NF-B2 pathway. Treatment with ACE inhibitors induces abundant CD4؉FoxP3؉ T cells with sufficient potency to reverse paralytic EAE. Modulation of the RAAS with inexpensive, safe pharmaceuticals used by millions worldwide is an attractive therapeutic strategy for application to human autoimmune diseases. multiple sclerosis ͉ lisinopril ͉ FoxP3 ͉ AT1R

United States higher education prioritizes independence as the cultural ideal. As a result, firstgeneration students (neither parent has a four-year degree) often confront an initial cultural mismatch early on in college settings: they endorse relatively interdependent cultural norms that diverge from the independent cultural ideal. This initial cultural mismatch can lead first-generation students to perform less well academically compared with continuing-generation students (one or more parents have a four-year degree) early in college. Yet, what happens as first-generation students experience the university culture throughout their time in college? Using cross-sectional and longitudinal approaches, we find that initial cultural mismatch is associated with psychological and academic costs that persist until graduation. First, at college entry, we find social class differences in cultural norms: first-generation students endorse more interdependent cultural norms than their continuing-generation peers. Second, endorsing interdependence at college entry predicts reduced subjective sense of fit in college four years later. Third, lower subjective sense of fit predicts lower grade point average and subjective social status upon graduation. Together, these results suggest that initial cultural mismatch contributes to worse experiences and academic outcomes among first-generation students, and that these disparities persist even until graduation. Further, we find that social class differences in cultural norms remain stable throughout college: first-generation students continue to endorse more interdependence than do continuing-generation students. We suggest providing access is not sufficient to reduce social class inequity; colleges need to create more inclusive environments to ensure that students from diverse backgrounds can reap similar rewards.