Medi-Cal Versus Employer-Based Coverage: Comparing Access to Care

This report takes a close look at access to care under Medi-Cal for nonelderly adults and children on the eve of Affordable Care Act (ACA) implementation. Using data from the 2012 and 2013 California Health Interview Surveys (CHIS), the research examines a total of 49 measures (45 on realized and potential access and 4 on health status and health behaviors) for nonelderly adults and 31 measures (28 on realized and potential access and 3 on health status and behaviors) for children.For adults, access under Medi-Cal is compared to access under employer-sponsored insurance (ESI) overall; among Medi-Cal enrollees, access is compared across subgroups defined by region, race/ethnicity, language, and other dimensions. For children, access under Medi-Cal and Healthy Families together (referred hereafter simply as "Medi-Cal") is compared against access under ESI. To account for differences in health status and socioeconomic status between those with Medi-Cal and those with ESI, for each measure, three sets of analyses are presented: unadjusted percentages, predicted percentages adjusted for health care need, and predicted percentages adjusted for both health care need and socioeconomic status. The same approach is used in the analysis of regional and subgroup differences within the Medi-Cal population

Atomic Force Microscopy Imaging of Living Cells

Over the last two decades, Atomic Force Microscopy (AFM) has emerged as the tool of choice to image living organisms in a near-physiological environment. Whereas fluorescence microscopy techniques allow labeling and tracking of components inside cells and the observation of dynamic processes, AFM is mainly a surface technique that can be operated on a wide range of substrates including biological samples. AFM enables extraction of topographical, mechanical and chemical information from these sample

The Politics of Fiscal Federalism: Building a Stronger Decentralization Theorem

We explore how party structures can condition the benefits of decentralization in modern democracies. In particular, we study the interaction of two political institutions: democratic (de)centralization (whether a country has fiscally autonomous and elected local governments) and party (non)integration (whether power over local party leaders flows upwards through party institutions, which we model using control over candidate selection). We incorporate these institutions into our strong decentralization theorem, which expands on Oates (1972) to examine when the decentralized provision of public services will dominate centralized provision even in the presence of inter-jurisdictional spillovers. Our findings suggest that, when externalities are present, democratic decentralization will be beneficial only when parties are integrated. In countries with non-integrated parties, we find that the participation rules of primaries have implications for the expected gains from democratic decentralization. Under blanket primaries, Oates’ conventional decentralization theorem holds but our strong decentralization theorem does not. By contrast, when primaries are closed, not even Oates’ conventional decentralization theorem holds

ONCOS-102 plus pemetrexed and platinum chemotherapy in malignant pleural mesothelioma: a randomized phase 2 study investigating clinical outcomes and the tumor microenvironment

T-lymphocytes; Oncolytic viruses; Tumor microenvironmentLinfocitos T; Virus oncolíticos; Microambiente tumoralLimfòcits T; Virus oncolítics; Microambient tumoralBackground ONCOS-102, an oncolytic adenovirus expressing granulocyte-macrophage colony-stimulating factor, can alter the tumor microenvironment to an immunostimulatory state. Combining ONCOS-102 with standard-of-care chemotherapy for malignant pleural mesothelioma (MPM) may improve treatment outcomes. Methods In this open-label, randomized study, patients with unresectable MPM received intratumoral ONCOS-102 (3×1011 virus particles on days 1, 4, 8, 36, 78, and 120) and pemetrexed plus cisplatin/carboplatin (from day 22), or pemetrexed plus cisplatin/carboplatin alone. The primary endpoint was safety. Overall survival (OS), progression-free survival, objective response rate, and tumor immunologic activation (baseline and day 36 biopsies) were also assessed. Results In total, 31 patients (safety lead-in: n=6, randomized: n=25) were enrolled. Anemia (15.0% and 27.3%) and neutropenia (40.0% and 45.5%) were the most frequent grade ≥3 adverse events (AEs) in the ONCOS-102 (n=20) and chemotherapy-alone (n=11) cohorts. No patients discontinued ONCOS-102 due to AEs. No statistically significant difference in efficacy endpoints was observed. There was a numerical improvement in OS (30-month OS rate 34.1% vs 0; median OS 20.3 vs 13.5 months) with ONCOS-102 versus chemotherapy alone in chemotherapy-naïve patients (n=17). By day 36, ONCOS-102 was associated with increased T-cell infiltration and immune-related gene expression that was not observed in the control cohort. Substantial immune activation in the tumor microenvironment was associated with survival at month 18 in the ONCOS-102 cohort. Conclusions ONCOS-102 plus pemetrexed and cisplatin/carboplatin was well tolerated by patients with MPM. In injected tumors, ONCOS-102 promoted a proinflammatory environment, including T-cell infiltration, which showed association with survival at month 18.This work was supported by Circio, the study sponsor (no grant number)

Spiritual Practices and Dispositional Optimism in an Underprivileged Population

Optimism seems to foster the ability to manage adverse situations better - a finding especially relevant for disadvantaged populations. Employing a unique sample from a small underprivileged village, we study the association between spiritual practices and dispositional optimism. The village belongs to a developing country that is, by far, the most secular country in Latin America: this makes particularly interesting exploring the role of spiritual practices in this context. We find that spiritual practices are positively associated with higher optimism, measured by the Life Orientation Test-Revised (LOT-R): those who practice spirituality, score, on average, 14.4 percentage points higher on the LOT-R than those who do not. And this association seems to be especially robust in the case of the poor and less educated: those with spiritual practices score 20 percentage points higher on the LOT-R. Thus, the role that spiritual practices may play in dispositional optimism in disadvantaged populations deserves more attentio

Spiritual Practices and Dispositional Optimism in an Underprivileged Population

Optimism seems to foster the ability to manage adverse situations better - a finding especially relevant for disadvantaged populations. Employing a unique sample from a small underprivileged village, we study the association between spiritual practices and dispositional optimism. The village belongs to a developing country that is, by far, the most secular country in Latin America: this makes particularly interesting exploring the role of spiritual practices in this context. We find that spiritual practices are positively associated with higher optimism, measured by the Life Orientation Test-Revised (LOT-R): those who practice spirituality, score, on average, 14.4 percentage points higher on the LOT-R than those who do not. And this association seems to be especially robust in the case of the poor and less educated: those with spiritual practices score 20 percentage points higher on the LOT-R. Thus, the role that spiritual practices may play in dispositional optimism in disadvantaged populations deserves more attentio

Recognition in Terra Incognita

It is desirable for detection and classification algorithms to generalize to unfamiliar environments, but suitable benchmarks for quantitatively studying this phenomenon are not yet available. We present a dataset designed to measure recognition generalization to novel environments. The images in our dataset are harvested from twenty camera traps deployed to monitor animal populations. Camera traps are fixed at one location, hence the background changes little across images; capture is triggered automatically, hence there is no human bias. The challenge is learning recognition in a handful of locations, and generalizing animal detection and classification to new locations where no training data is available. In our experiments state-of-the-art algorithms show excellent performance when tested at the same location where they were trained. However, we find that generalization to new locations is poor, especially for classification systems. (The dataset is available at https://beerys.github.io/CaltechCameraTraps/

Recognition in Terra Incognita

It is desirable for detection and classification algorithms to generalize to unfamiliar environments, but suitable benchmarks for quantitatively studying this phenomenon are not yet available. We present a dataset designed to measure recognition generalization to novel environments. The images in our dataset are harvested from twenty camera traps deployed to monitor animal populations. Camera traps are fixed at one location, hence the background changes little across images; capture is triggered automatically, hence there is no human bias. The challenge is learning recognition in a handful of locations, and generalizing animal detection and classification to new locations where no training data is available. In our experiments state-of-the-art algorithms show excellent performance when tested at the same location where they were trained. However, we find that generalization to new locations is poor, especially for classification systems. (The dataset is available at https://beerys.github.io/CaltechCameraTraps/