Climate Risk, Insurance Retreat, and State Response

Climate change is fundamentally destabilizing the private insurance industry, with many high-profile insurance companies exiting states in the face of catastrophic, climate-induced risk. This rapid “insurance retreat” represents a major market signal in response to climate-exacerbated risks. Private businesses are making actuarial decisions, assessing that some locations are just too vulnerable to insure. At the same time, this insurance retreat also poses a policy challenge for states as they react to the mounting insurance gaps left by exiting private insurers. This Article analyzes insurance retreat, its attendant policy challenges, and the lessons that can be drawn from state responses. It first describes the causes and effects of private insurance retreat. Then, the Article examines different potential policy responses to insurance retreat, including interventions modeled after the federal National Federal Insurance Program (NFIP) as well as state insurance programs in California, Florida, and Louisiana. Finally, the Article offers a comparative analysis of these different policy response options. It observes that existing policies differ substantially along two important dimensions: 1) extent of government intervention, and 2) prioritization of physical risk concerns versus financial transition concerns. It also explores how the different state programs show surprisingly diverse policy approaches and how—contrary to assumptions—many do not actually subsidize insurance affordability. Through these observations, the Article uncovers unexpected examples of state insurance policies complementing, rather than contravening, pricing signals sent by private insurance retreat

Climate Risk, Insurance Retreat, and State Response

Climate change is fundamentally destabilizing the private insurance industry, with many high-profile insurance companies exiting states in the face of catastrophic, climateinduced risk. This rapid “insurance retreat” represents a major market signal in response to climate-exacerbated risks. Private businesses are making actuarial decisions, assessing that some locations are just too vulnerable to insure. At the same time, this insurance retreat also poses a policy challenge for states as they react to the mounting insurance gaps left by exiting private insurers. This Article analyzes insurance retreat, its attendant policy challenges, and the lessons that can be drawn from state responses. It first describes the causes and effects of private insurance retreat. Then, the Article examines different potential policy responses to insurance retreat, including interventions modeled after the federal National Federal Insurance Program (NFIP) as well as state insurance programs in California, Florida, and Louisiana. Finally, the Article offers a comparative analysis of these different policy response options. It observes that existing policies differ substantially along two important dimensions: 1) extent of government intervention, and 2) prioritization of physical risk concerns versus financial transition concerns. It also explores how the different state programs show surprisingly diverse policy approaches and how—contrary to assumptions—many do not actually subsidize insurance affordability. Through these observations, the Article uncovers unexpected examples of state insurance policies complementing, rather than contravening, pricing signals sent by private insurance retreat

Magnetic ordering above room temperature in the sigma-phase of Fe66V34

Magnetic properties of four sigma-phase Fe_(100-x)V_x samples with 34.4<x<55.1 were investigated by Mossbauer spectroscopy and magnetic measurements in the temperature interval 5-300 K. Four magnetic quantities viz. hyperfine field, Curie temperature, magnetic moment and susceptibility were determined. The sample containing 34.4 at% V was revealed to exhibit the largest values found up to now for the sigma-phase for average hyperfine field, B = 12.1 T, average magnetic moment per Fe atom, m = 0.89 mB, and Curie temperature, TC = 315.5 K. The quantities were shown to be strongly correlated with each other. In particular, TC is linearly correlated with m with a slope of 406.5 K/mB, as well as B is so correlated with m yielding 14.3 T/mB for the hyperfine coupling constant.Comment: 15 pages, 11 figures, 1 tabl

Site Occupancy and Lattice Parameters in Sigma-Phase Co-Cr alloys

Neutron diffraction technique was used to study distribution of Co and Cr atoms over different lattice sites as well as lattice paramaters in sigma-phase Co100-xCrx compounds with x = 57.0, 62.7 and 65.8. From the diffractograms recorded in the temperature range of 4.2 - 300 K it was found that all five sites A, B, C, D and E are populated by both kinds of atoms. Sites A and D are predominantly occupied by Co atoms while sites B, C and E by Cr atoms. The unit cell parameters a and c, hence the unit cell volume, increase with x, the increase being characteristic of the lattice paramater and temperature. Both a and c show a non-linear increase with temperature.Comment: 5 figure

Relation of Temporal Asymmetry During Walking to Two-Year Knee Pain Outcomes in Those With Mild-to-Moderate Unilateral Knee Pain: An Exploratory Analysis From the Multicenter Osteoarthritis Study.

OBJECTIVE: We aimed to explore the cross-sectional relation of unilateral knee pain severity and temporal asymmetry during walking and to determine relations of temporal asymmetry during walking to 2-year changes in ipsilateral and contralateral knee pain in those with mild-to-moderate unilateral knee pain. METHODS: The Multicenter Osteoarthritis Study is a prospective cohort study of adults with or at risk for knee osteoarthritis. The current study included participants with unilateral knee pain. Gait was assessed during self-selected and fast walking at baseline. Knee pain was assessed at baseline and 2 years. We calculated limb symmetry indices (LSIs; nonpainful limb/painful limb × 100) for stance, single-limb support time, and double-limb support time, then examined their relations to unilateral knee pain severity, incident contralateral knee pain, and persistent ipsilateral knee pain. RESULTS: Unilateral knee pain severity was not associated with temporal asymmetry during self-selected or fast walking. At 2 years, 17.1% of participants had incident contralateral knee pain and 51.4% had persistent ipsilateral knee pain. For self-selected walking, greater LSIs (i.e., longer time on the nonpainful limb) for stance and single-limb support time were associated with decreased odds of incident contralateral knee pain. Measures of temporal asymmetry were not associated with persistent ipsilateral knee pain, except for single-limb support time during fast walking. CONCLUSION: For those with unilateral knee pain, temporal asymmetry during walking is not associated with pain severity. However, select measures of stance and single-limb support time during self-selected and fast walking relate to longitudinal knee pain outcomes

3414 Association of blood pressure and biochemical knee cartilage composition assessed by T2 relaxation time measurements: Data from the Osteoarthritis Initiative

OBJECTIVES/SPECIFIC AIMS: The goal of this study was to investigate the associations of systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse pressure (PP) with knee articular cartilage composition using magnetic resonance imaging (MRI)-based T2 relaxation time measurements in study participants from the Osteoarthritis Initiative (OAI). METHODS/STUDY POPULATION: In this longitudinal study, 1,139 participants from the OAI, a multi-center, observational study of the evolution of knee OA, were selected using the following inclusion criteria: right knee Kellgren Lawrence (KL) score (radiographic classification of OA severity) 0-2 indicating no to mild radiographic OA at baseline, no history of rheumatoid arthritis at baseline, available blood pressure measurements at baseline, available T2 measurements in at least three knee compartments at baseline and 48-month follow-up. Linear regression models were performed using standardized values for SBP, DBP and PP as primary predictors and change in cartilage T2 over 48 months, a measure of cartilage matrix quality and degeneration, as the primary outcome. PP was defined as SBP minus DBP. Change in superficial layer and deep layer cartilage T2, which reflect differences in the laminar organization of knee cartilage T2, were also included as outcomes. Statistical models were adjusted for common risk factors for knee OA (baseline age, sex, BMI, KL score) as well as number of currently used anti-hypertensive medications (AHM) reported at baseline. We included AHMs whose primary indication was the treatment of hypertension including beta blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARB), thiazides, chlorthalidone, dihydropyridine calcium channel blockers (CCB) and aliskiren. All predictors, outcomes and covariates (except sex) were analyzed as continuous variables. We included interaction terms in the models to evaluate whether the covariates (age, sex, BMI, KL score, number of AHMs) modified the association of SBP, DBP and PP with cartilage T2. RESULTS/ANTICIPATED RESULTS: The average age of all study participants was 58.8 years (SD ± 8.6) with a higher proportion of men (59.4%), average body mass index (BMI) was 28.3 (SD ± 4.5), average SBP was 122.4 (SD ± 15.4) mmHg, average DBP was 75.5 (SD ± 9.6) mmHg and 469 (38.1%) study participants were taking at least one AHM. Higher baseline DBP was significantly associated with a faster increase in global T2 (0.22 [0.10,0.35], P &lt; 0.001), global deep layer T2 (0.20 [0.03,0.36], P &lt; 0.022) and global superficial layer T2 (0.39 [0.20,0.58], P &lt; 0.001). These associations were significant in both unadjusted and the models adjusted for age, sex, BMI and KL score. No significant associations were found between SBP or PP and cartilage T2 and no significant interactions were found between SBP, DBP, PP and the covariates. DISCUSSION/SIGNIFICANCE OF IMPACT: Higher baseline DBP was associated with a faster increase in knee cartilage T2, suggesting accelerated cartilage degeneration. This association was stronger for the superficial layer of knee cartilage T2 compared to the deep layer. Although further basic mechanistic studies are needed to elucidate the underlying pathophysiology of this relationship, these results suggest lowering DBP may influence knee OA

Association of blood pressure with knee cartilage composition and structural knee abnormalities: data from the osteoarthritis initiative.

ObjectiveTo investigate the associations of systolic blood pressure (SBP) and diastolic blood pressure (DBP) with changes in knee cartilage composition and joint structure over 48&nbsp;months, using magnetic resonance imaging (MRI) data from the Osteoarthritis Initiative (OAI).Materials and methodsA total of 1126 participants with right knee Kellgren-Lawrence (KL) score 0-2 at baseline, no history of rheumatoid arthritis, blood pressure measurements at baseline, and cartilage T2 measurements at baseline and 48&nbsp;months were selected from the OAI. Cartilage composition was assessed using MRI T2 measurements, including laminar and gray-level co-occurrence matrix texture analyses. Structural knee abnormalities were graded using the whole-organ magnetic resonance imaging score (WORMS). We performed linear regression, adjusting for age, sex, body mass index, physical activity, smoking status, alcohol use, KL score, number of anti-hypertensive medications, and number of nonsteroidal anti-inflammatory drugs.ResultsHigher baseline DBP was associated with greater increases in global T2 (coefficient 0.22 (95% CI 0.09, 0.34), P = 0.004), global superficial layer T2 (coefficient 0.39 (95% CI 0.20, 0.58), P = 0.001), global contrast (coefficient 15.67 (95% CI 8.81, 22.53), P &lt; 0.001), global entropy (coefficient 0.02 (95% CI 0.01, 0.03) P = 0.011), and global variance (coefficient 9.14 (95% CI 5.18, 13.09), P &lt; 0.001). Compared with DBP, the associations of SBP with change in cartilage T2 parameters and WORMS subscores showed estimates of smaller magnitude.ConclusionHigher baseline DBP was associated with higher and more heterogenous cartilage T2 values over 48&nbsp;months, indicating increased cartilage matrix degenerative changes

Epidemiologic studies for osteoarthritis: new versus conventional study design approaches

Current insights into osteoarthritis epidemiology Osteoarthritis (OA) is the most common form of arthritis. Symptomatic knee OA occurs in approximately 13% of persons who are aged 60 and older Epidemiology is the study of the occurrence of disease in populations and its association with characteristics of people and their environments. Epidemiologic studies have provided much information about the occurrence of OA. Disease in the knee is common, especially among the aged; hip OA is less prevalent in most populations than disease in the knee; and for disease in the hand, radiographic OA is nearly universal in older people, whereas symptoms are less frequent. Studies have also shown that, for most joints, women who are olde

The Association of Obesity with Walking Independent of Knee Pain: The Multicenter Osteoarthritis Study

Practice guidelines recommend addressing obesity for people with knee OA, however, the association of obesity with walking independent of pain is not known. We investigated this association within the Multicenter Osteoarthritis Study, a cohort of older adults who have or are at high risk of knee OA. Subjects wore a StepWatch to record steps taken over 7 days. We measured knee pain from a visual analogue scale and obesity by BMI. We examined the association of obesity with walking using linear regression adjusting for pain and covariates. Of 1788 subjects, the mean steps/day taken was 8872.9 ± 3543.4. Subjects with a BMI ≥35 took 3355 fewer steps per day independent of knee pain compared with those with a BMI ≤25 (95% CI −3899, −2811). BMI accounted for 9.7% of the variability of walking while knee pain accounted for 2.9%. BMI was associated with walking independent of knee pain

Associations between alcohol, smoking, and cartilage composition and knee joint morphology: Data from the Osteoarthritis Initiative

Summary: Objective: To determine the cross-sectional associations of alcohol consumption and smoking history with magnetic resonance imaging (MRI) measures of cartilage composition (T2) and joint structure using data from the Osteoarthritis Initiative (OAI). Design: Subjects with radiographic Kellgren Lawrence right knee grades 0–2 were selected from the OAI database, and those with previously analyzed MRI cartilage T2 and semi-quantitative joint morphology gradings (WORMS) were included (n ​= ​2061). Alcohol consumption was categorized as: no drinks to 7 drinks/week. Smoking history was categorized as none, current, or former. Linear regression was used to assess the relationships of alcohol consumption and smoking history with both WORMS scores and cartilage T2. Results: Subjects who consumed >7 drinks/week had significantly higher cartilage T2 than subjects who consumed 7 drinks/week was associated with elevated cartilage T2. Compared to non-smokers, current smokers had a more degenerated cartilage matrix as evidenced by greater cartilage T2