Independence at Risk: Older Californians With Disabilities Struggle to Remain at Home as Public Supports Shrink

Presents findings about aging Californians with disabilities who depend on paid public programs and unpaid help to live at home. Makes policy recommendations, including consolidating long-term care programs and enhancing support for caregivers

An online experiment to assess bias in professional medical coding.

BackgroundMultiple studies have documented bias in medical decision making, but no studies have examined whether this bias extends to medical coding practices. Medical coding is foundational to the US health care enterprise. We evaluate whether bias based on patient characteristics influences specific coding practices of professional medical coders.MethodsThis is an online experimental study of members of a national professional medical coding organization. Participants were randomly assigned a set of six clinical scenarios reflecting common medical conditions and asked to report encounter level of service codes for these clinical scenarios. Clinical scenarios differed by patient demographics (race, age, gender, ability) or social context (food insecurity, housing security) but were otherwise identical. We estimated Ordinary Least Squares regression models to evaluate differences in outcome average visit level of service by patient demographic characteristics described in the clinical scenarios; we adjusted for coders' age, gender, race, and years of coding experience.ResultsThe final analytic sample included 586 respondents who coded at least one clinical scenario. Higher mean level of service was assigned to clinical scenarios describing seniors compared to middle-aged patients in two otherwise identical scenarios, one a patient with type II diabetes mellitus (Coef: 0.28, SE: 0.15) and the other with rheumatoid arthritis (Coef: 0.30, SE: 0.13). Charts describing women were assigned lower level of service than men in patients with asthma exacerbation (Coef: -0.25, SE: 0.13) and rheumatoid arthritis (Coef: -0.20, SE: 0.12). There were no other significant differences in mean complexity score by patient demographics or social needs.ConclusionWe found limited evidence of bias in professional medical coding practice by patient age and gender, though findings were inconsistent across medical conditions. Low levels of observed bias may reflect medical coding workflow and training practices. Future research is needed to better understand bias in coding and to identify effective and generalizable bias prevention practices

Deportation Worry, Cardiovascular Disease Risk Factor Trajectories, and Incident Hypertension: A Community-Based Cohort Study.

Background Worry about deportation has been associated with cardiovascular disease risk factors in cross-sectional research. No research has evaluated this association longitudinally or examined the association between deportation worry and incident cardiovascular disease outcomes. Methods and Results We used data from an ongoing community-based cohort of 572 women primarily of Mexican origin. We estimated associations between self-reported deportation worry and: (1) trajectories of blood pressure, body mass index, and waist circumference with linear mixed models, and (2) incident hypertension with Cox proportional hazards models. Nearly half (48%) of women reported "a lot," 24% reported "moderate," and 28% reported "not too much" deportation worry. Higher worry at baseline was associated with nonlinear systolic blood pressure and mean arterial pressure trajectories. For example, compared with not too much worry, a lot of worry was associated with a faster initial increase (β, interaction with linear year term: 4.10; 95% CI, 1.17-7.03) followed by a faster decrease in systolic blood pressure (β, interaction with quadratic year term: -0.80; 95% CI, -1.55 to -0.06). There was weak evidence of an association between deportation worry and diastolic blood pressure and no association with body mass index, waist circumference, or pulse pressure trajectories. Among 408 women without baseline hypertension, reporting a lot (hazard ratio, 2.17; 95% CI, 1.15-4.10) and moderate deportation worry (hazard ratio, 2.48; 95% CI, 1.17-4.30) were each associated with greater risk of incident hypertension compared with reporting not too much worry. Conclusions Deportation worry may contribute to widening disparities in some cardiovascular disease risk factors and outcomes over time

Does schooling attained by adult children affect parents' psychosocial well-being in later life? Using Mexico's 1993 compulsory schooling law as a quasi-experiment

Higher adult child educational attainment may benefit older parents' psychosocial well-being in later life. This may be particularly important in low- and middle-income countries, where recent generations have experienced comparatively large increases in educational attainment. We used data from the 2012 Mexican Health and Aging Study, a nationally representative study of adults aged ≥50 years and leveraged the exogenous variation in adult child education induced by Mexico's compulsory schooling law passed in 1993. We employed two-stage least squares (2SLS) regression to estimate the effects of increased schooling among adult children on parents' (respondents') depressive symptoms and life satisfaction scores, controlling for demographic and socioeconomic characteristics. We considered heterogeneity by parent and child gender and other sociodemographic characteristics. Our study included 7186 participants with an average age of 60.1 years; 54.9% were female. In the 2SLS analyses, increased schooling among oldest adult children was associated with fewer depressive symptoms (β = −0.25; 95% CI: −0.51, 0.00) but no difference in life satisfaction (β = 0.01; 95% CI: −0.22, 0.25). Stratified models indicated differences in the magnitude of association with depressive symptoms for mothers (β = −0.27, 95% CI: −0.56, 0.01) and fathers (β = −0.18, 95% CI: −0.63, 0.26) and when considering increased schooling of oldest sons (β = −0.37; 95% CI: −0.73, −0.02) and daughters (β = −0.05, 95% CI: −0.23, 0.13). No parent and child gender differences were found for life satisfaction. Power was limited to detect heterogeneity across other sociodemographic characteristics in the second stage although first-stage estimates were larger for urban (vs. rural) dwelling and more (vs. less) highly educated respondents. Results were similar when considering the highest educated child as well as increased schooling across all children. Our findings suggest that longer schooling among current generations of adult children, particularly sons, may benefit their older parents' psychosocial well-being

Holding On: Older Californians With Disabilities Rely on Public Services to Remain Independent

Presents findings from a study of low-income older Californians with disabilities receiving Medicare, Medi-Cal, and In-Home Supportive Services; their unmet physical, mental health, and social needs; and limited care options. Outlines policy implications

Global Analysis of Predicted G Protein-Coupled Receptor Genes in the Filamentous Fungus, Neurospora crassa.

G protein-coupled receptors (GPCRs) regulate facets of growth, development, and environmental sensing in eukaryotes, including filamentous fungi. The largest predicted GPCR class in these organisms is the Pth11-related, with members similar to a protein required for disease in the plant pathogen Magnaporthe oryzae. However, the Pth11-related class has not been functionally studied in any filamentous fungal species. Here, we analyze phenotypes in available mutants for 36 GPCR genes, including 20 Pth11-related, in the model filamentous fungus Neurospora crassa. We also investigate patterns of gene expression for all 43 predicted GPCR genes in available datasets. A total of 17 mutants (47%) possessed at least one growth or developmental phenotype. We identified 18 mutants (56%) with chemical sensitivity or nutritional phenotypes (11 uniquely), bringing the total number of mutants with at least one defect to 28 (78%), including 15 mutants (75%) in the Pth11-related class. Gene expression trends for GPCR genes correlated with the phenotypes observed for many mutants and also suggested overlapping functions for several groups of co-transcribed genes. Several members of the Pth11-related class have phenotypes and/or are differentially expressed on cellulose, suggesting a possible role for this gene family in plant cell wall sensing or utilization

The Carnegie Supernova Project. I. Third Photometry Data Release of Low-redshift Type Ia Supernovae and Other White Dwarf Explosions

We present final natural-system optical (ugriBV) and near-infrared (YJH) photometry of 134 supernovae (SNe) with probable white dwarf progenitors that were observed in 2004-2009 as part of the first stage of the Carnegie Supernova Project (CSP-I). The sample consists of 123 Type Ia SNe, 5 Type Iax SNe, 2 super-Chandrasekhar SN candidates, 2 Type Ia SNe interacting with circumstellar matter, and 2 SN 2006bt-like events. The redshifts of the objects range from to 0.0835; the median redshift is 0.0241. For 120 (90%) of these SNe, near-infrared photometry was obtained. Average optical extinction coefficients and color terms are derived and demonstrated to be stable during the five CSP-I observing campaigns. Measurements of the CSP-I near-infrared bandpasses are also described, and near-infrared color terms are estimated through synthetic photometry of stellar atmosphere models. Optical and near-infrared magnitudes of local sequences of tertiary standard stars for each supernova are given, and a new calibration of Y-band magnitudes of the Persson et al. standards in the CSP-I natural system is presented.Fil: Krisciunas, Kevin. Texas A&M University; Estados UnidosFil: Contreras, Carlos. University Aarhus; Dinamarca. Las Campanas Observatory; ChileFil: Burns, Christopher R.. Las Campanas Observatory; ChileFil: Phillips, M. M.. Las Campanas Observatory; ChileFil: Stritzinger, Maximilian D.. Las Campanas Observatory; Chile. University Aarhus; DinamarcaFil: Morrell, Nidia Irene. Las Campanas Observatory; ChileFil: Hamuy, Mario. Universidad de Chile; ChileFil: Anais, Jorge. Las Campanas Observatory; ChileFil: Boldt, Luis. Las Campanas Observatory; ChileFil: Busta, Luis. Las Campanas Observatory; ChileFil: Campillay, Abdo. Las Campanas Observatory; ChileFil: Castellón, Sergio. Las Campanas Observatory; ChileFil: Folatelli, Gaston. Las Campanas Observatory; Chile. Universidad Nacional de La Plata. Facultad de Ciencias Astronómicas y Geofísicas; ArgentinaFil: Freedman, Wendy L.. University of Chicago; Estados UnidosFil: González, Consuelo. Las Campanas Observatory; ChileFil: Hsiao, Eric Y.. Florida State University; Estados Unidos. University Aarhus; Dinamarca. Las Campanas Observatory; ChileFil: Krzeminski, Wojtek. Las Campanas Observatory; ChileFil: Persson, Sven Eric. Carnegie Observatories;Fil: Roth, Miguel. Gmto Corporation; Chile. Las Campanas Observatory; ChileFil: Salgado, Francisco. Leiden Observatory Research Institute; . Las Campanas Observatory; ChileFil: Serón, Jacqueline. Las Campanas Observatory; Chile. Cerro Tololo Inter American Observatory; ChileFil: Suntzeff, Nicholas B.. Texas A&M University; Estados UnidosFil: Torres, Simón. Soar Telescope; Chile. Las Campanas Observatory; ChileFil: Filippenko, Alexei V.. University of California at Berkeley; Estados UnidosFil: Li, Weidong. University of California at Berkeley; Estados UnidosFil: Madore, Barry F.. Jet Propulsion Laboratory, California Institute Of Technology; . Las Campanas Observatory; ChileFil: DePoy, D.L.. Texas A&M University; Estados UnidosFil: Marshall, Jennifer L.. Texas A&M University; Estados UnidosFil: Rheault, Jean Philippe. Texas A&M University; Estados UnidosFil: Villanueva, Steven. Texas A&M University; Estados Unidos. Ohio State University; Estados Unido

Carnegie Supernova Project-II: Extending the Near-Infrared Hubble Diagram for Type Ia Supernovae to z∼0.1z\sim0.1

The Carnegie Supernova Project-II (CSP-II) was an NSF-funded, four-year program to obtain optical and near-infrared observations of a "Cosmology" sample of $\sim100$ Type Ia supernovae located in the smooth Hubble flow ($0.03 \lesssim z \lesssim 0.10$). Light curves were also obtained of a "Physics" sample composed of 90 nearby Type Ia supernovae at $z \leq 0.04$ selected for near-infrared spectroscopic time-series observations. The primary emphasis of the CSP-II is to use the combination of optical and near-infrared photometry to achieve a distance precision of better than 5%. In this paper, details of the supernova sample, the observational strategy, and the characteristics of the photometric data are provided. In a companion paper, the near-infrared spectroscopy component of the project is presented.Comment: 43 pages, 10 figures, accepted for publication in PAS

A long-term record of early to mid-Paleozoic marine redox change

The extent to which Paleozoic oceans differed from Neoproterozoic oceans and the causal relationship between biological evolution and changing environmental conditions are heavily debated. Here, we report a nearly continuous record of seafloor redox change from the deep-water upper Cambrian to Middle Devonian Road River Group of Yukon, Canada. Bottom waters were largely anoxic in the Richardson trough during the entirety of Road River Group deposition, while independent evidence from iron speciation and Mo/U ratios show that the biogeochemical nature of anoxia changed through time. Both in Yukon and globally, Ordovician through Early Devonian anoxic waters were broadly ferruginous (nonsulfidic), with a transition toward more euxinic (sulfidic) conditions in the mid–Early Devonian (Pragian), coincident with the early diversification of vascular plants and disappearance of graptolites. This ~80-million-year interval of the Paleozoic characterized by widespread ferruginous bottom waters represents a persistence of Neoproterozoic-like marine redox conditions well into the Phanerozoic

Genetic association study of QT interval highlights role for calcium signaling pathways in myocardial repolarization.

The QT interval, an electrocardiographic measure reflecting myocardial repolarization, is a heritable trait. QT prolongation is a risk factor for ventricular arrhythmias and sudden cardiac death (SCD) and could indicate the presence of the potentially lethal mendelian long-QT syndrome (LQTS). Using a genome-wide association and replication study in up to 100,000 individuals, we identified 35 common variant loci associated with QT interval that collectively explain ∼8-10% of QT-interval variation and highlight the importance of calcium regulation in myocardial repolarization. Rare variant analysis of 6 new QT interval-associated loci in 298 unrelated probands with LQTS identified coding variants not found in controls but of uncertain causality and therefore requiring validation. Several newly identified loci encode proteins that physically interact with other recognized repolarization proteins. Our integration of common variant association, expression and orthogonal protein-protein interaction screens provides new insights into cardiac electrophysiology and identifies new candidate genes for ventricular arrhythmias, LQTS and SCD