The Affordable Care Act, Medicare Costs, and Retirement Security

Rising Medicare costs have been a major contributor to projected long-run budget deficits, and rising outof-pocket costs have become an increasing challenge to individuals' retirement security. The 2010 Patient Protection and Affordable Care Act (ACA) made substantial changes to Medicare, designed both to improve the program's finances and to reduce the outof-pocket costs faced by retirees. However, the Office of the Actuary (OACT) at the Centers for Medicare & Medicaid Services (CMS) warns that the assumed impact of the ACA may be overly optimistic and that realized savings may be far more muted. As a result, since 2010, OACT each year has released a set of alternative projections to illustrate Medicare expenditures if current-law payment reductions are not sustained.This brief compares the baseline projections in the annual Medicare Trustees Report with OACT's alternative projections

Planar unclustered scale-free graphs as models for technological and biological networks

Many real life networks present an average path length logarithmic with the number of nodes and a degree distribution which follows a power law. Often these networks have also a modular and self-similar structure and, in some cases - usually associated with topological restrictions- their clustering is low and they are almost planar. In this paper we introduce a family of graphs which share all these properties and are defined by two parameters. As their construction is deterministic, we obtain exact analytic expressions for relevant properties of the graphs including the degree distribution, degree correlation, diameter, and average distance, as a function of the two defining parameters. Thus, the graphs are useful to model some complex networks, in particular several families of technological and biological networks, and in the design of new practical communication algorithms in relation to their dynamical processes. They can also help understanding the underlying mechanisms that have produced their particular structure.Comment: Accepted for publication in Physica

A high-throughput screen identifies that CDK7 activates glucose consumption in lung cancer cells.

Elevated glucose consumption is fundamental to cancer, but selectively targeting this pathway is challenging. We develop a high-throughput assay for measuring glucose consumption and use it to screen non-small-cell lung cancer cell lines against bioactive small molecules. We identify Milciclib that blocks glucose consumption in H460 and H1975, but not in HCC827 or A549 cells, by decreasing SLC2A1 (GLUT1) mRNA and protein levels and by inhibiting glucose transport. Milciclib blocks glucose consumption by targeting cyclin-dependent kinase 7 (CDK7) similar to other CDK7 inhibitors including THZ1 and LDC4297. Enhanced PIK3CA signaling leads to CDK7 phosphorylation, which promotes RNA Polymerase II phosphorylation and transcription. Milciclib, THZ1, and LDC4297 lead to a reduction in RNA Polymerase II phosphorylation on the SLC2A1 promoter. These data indicate that our high-throughput assay can identify compounds that regulate glucose consumption and that CDK7 is a key regulator of glucose consumption in cells with an activated PI3K pathway

The Value of Transportation for Improving the Quality of Life of the Rural Elderly

When an elderly individual living in a rural community is no longer able to drive, issues that come with living in an isolated area (i.e. limited access to health and personal services, distance between home and town centers) are exaggerated and the individual may experience a decrease in their quality of life. Public transportation that supports elderly individuals may be an important issue for rural communities to consider in creating an aging-friendly community and maintaining quality of life for residents who are no longer able to drive. The purpose of this research is to obtain an understanding of opinions about public transportation for the elderly held by rural county residents and their WTP for transportation options through an additional vehicle registration fee. To achieve this objective, a survey with choice experiments was distributed to residents in Atascosa and Polk County, Texas in September 2011. Researchers employed a conditional logit model to analyze the choice survey data and examine county residents’ WTP for various transportation options. The results of this study provide public transportation managers insights into the attributes taxpayers expect in transportation routes and programs.Elderly Transportation, Rural Transportation, Rural Elderly, Rural Quality of Life, Community/Rural/Urban Development,

What Are the Implications of Rising Debt for Older Americans?

The share of older Americans with debt has been on the rise over the last several decades. Having debt, however, does not always signal financial fragility because debt can be used for various purposes. For example, households that take out a low-interest mortgage to buy a home, which typically appreciates in value, are likely making a savvy choice. In contrast, households that carry unpaid credit card balances could see their debt snowball, leading to financial distress. Identifying these distinctions in household debt situations is crucial to understanding the implications of the rise in debt holding among seniors.  This brief, based on a new paper, addresses three key questions: 1) As more older households carry debt in retirement, what share are at "high-risk" and "low-risk" of financial hardship? 2) Is the growth in debt holding driven by the high- or low-risk households? and 3) What are the different types of high-risk households?The answers will help policymakers determine which types of borrowers are most vulnerable and develop tailored solutions for assisting them.   The discussion proceeds as follows. The first section provides background on trends in debt holding among older Americans. The second section sorts households into high-risk and low-risk based on their debt and asset profiles, and it shows that high-risk borrowers are driving the growth in debt. The third section identifies four groups of high-risk borrowers with very different characteristics. Given the diverse situations of high-risk borrowers, the fourth section suggests some potential ways to address each group's specific needs. The final section concludes that the debt burdens of high-risk borrowers are cause for concern, but a one-size-fits-all solution does not exist, so targeted interventions would be most effective.  Click "Download" to access this resource

Lagrangian submanifolds in complex space forms satisfying an improved equality involving δ(2,2)

It was proved in [8, 9] that every Lagrangian submanifold M of a complex space form M˜ 5 (4c) of constant holomorphic sectional curvature 4c satisfies the following optimal inequality: δ(2, 2) ≤ 25 4 H 2 + 8c, (A) where H 2 is the squared mean curvature and δ(2, 2) is a δ-invariant on M introduced by the first author. This optimal inequality improves a special case of an earlier inequality obtained in [B.-Y. Chen, Japan. J. Math. 26 (2000), 105-127]. The main purpose of this paper is to classify Lagrangian submanifolds of M˜ 5 (4c) satisfying the equality case of the improved inequality (A).Fundación Cámara (Universidad de Sevilla)National Natural Science Foundation of Chin

Planar unclustered graphs to model technological and biological networks

Many real life networks present an average path length logarithmic with the number of nodes and a degree distribution which follows a power law. Often these networks have also a modular and self-similar structure and, in some cases - usually associated with topological restrictions- their clustering is low and they are almost planar. In this paper we introduce a family of graphs which share all these properties and are defined by two parameters. As their construction is deterministic, we obtain exact analytic expressions for relevant properties of the graphs including the degree distribution, degree correlation, diameter, and average distance, as a function of the two defining parameters. Thus, the graphs are useful to model some complex networks, in particular technological and biological networks

A Comparison of Self-Acceptance of Disability between Thai Buddhists and American Christians

Having a disability can significantly change a person’s life in many aspects. Research has shown that people with disabilities collectively have diminished access and fewer opportunities to pursue education, find gainful employment, and engage in intimate relationships. Self-acceptance of disability is, therefore, critical to help build resilience, confidence, and psychological well-being in this population. The purpose of the study was to compare the self-acceptance of disability in international settings, specifically in the context of religions. The sample of the study included 98 Thai Buddhists and 95 American Christians with neuromuscular disorders. Constructs used for the study included demographic characteristics, Hope Scale (Snyder et al., 1991), Future Time Orientation Scale (Gjesme, 1979), Spiritual Well-Being Scale (Paloutzian & Ellison, 1991), and Acceptance of Disability Scale-Revised (Groomes & Linkowski, 2007). The self-acceptance of disability multiple regression model to predict Thai Buddhists shows their spiritual well-being, age, number of years since diagnosis, and sex are significant contributing variables. Significant predictors in the regression model to explain the variance of self-acceptance of disability among American Christians include hope, spiritual well-being, and number of years since diagnosis. Discussion, limitations of the study, and implications are also discussed

Dexamethasone Attenuates Hyperexcitability Provoked by Experimental Febrile Status Epilepticus.

The role of neuroinflammation in the mechanisms of epilepsy development is important because inflammatory mediators provide tractable targets for intervention. Inflammation is intrinsically involved in the generation of childhood febrile seizures (FSs), and prolonged FS [febrile status epilepticus (FSE)] precedes a large proportion of adult cases of temporal lobe epilepsy (TLE). As TLE is often refractory to therapy and is associated with serious cognitive and emotional problems, we investigated whether its development can be prevented using anti-inflammatory strategies. Using an immature rat model of FSE [experimental FSE (eFSE)], we administered dexamethasone (DEX), a broad anti-inflammatory agent, over 3 d following eFSE. We assessed eFSE-provoked hippocampal network hyperexcitability by quantifying the presence, frequency, and duration of hippocampal spike series, as these precede and herald the development of TLE-like epilepsy. We tested whether eFSE provoked hippocampal microgliosis, astrocytosis, and proinflammatory cytokine production in male and female rats and investigated blood-brain barrier (BBB) breaches as a potential contributor. We then evaluated whether DEX attenuated these eFSE sequelae. Spike series were not observed in control rats given vehicle or DEX, but occurred in 41.6% of eFSE-vehicle rats, associated with BBB leakage and elevated hippocampal cytokines. eFSE did not induce astrocytosis or microgliosis but provoked BBB disruption in 60% of animals. DEX significantly reduced spike series prevalence (to 7.6%) and frequency, and abrogated eFSE-induced cytokine production and BBB leakage (to 20%). These findings suggest that a short, postinsult intervention with a clinically available anti-inflammatory agent potently attenuates epilepsy-predicting hippocampal hyperexcitability, potentially by minimizing BBB disruption and related neuroinflammation