634 research outputs found
America's Underinsured: A State-by-State Look at Health Insurance Affordability Prior to the New Coverage Expansions
The Affordable Care Act insurance reforms seek to expand coverage and to improve the affordability of care and premiums. Before the implementation of the major reforms, data from U.S. census surveys indicated nearly 32 million insured people under age 65 were in households spending a high share of their income on medical care. Adding these "underinsured" people to the estimated 47.3 million uninsured, the state share of the population at risk for not being able to afford care ranged from 14 percent in Massachusetts to 36 percent to 38 percent in Idaho, Florida, Nevada, New Mexico, and Texas. Nationally, more than half of people with low incomes and 20 percent of those with middle incomes were either underinsured or uninsured in 2012. The report provides state baselines to assess changes in coverage and affordability and compare states as insurance expansions and market reforms are implemented.
The Arclight vs. traditional ophthalmoscope:a cross-over trial
BACKGROUND/OBJECTIVES: To compare skill acquisition of the new, cost-effective Arclight ophthalmoscope, with the traditional ophthalmoscope (TO), in medical students with no prior experience of ophthalmoscopy. SUBJECTS/METHODS: University of Dundee medical students took part in a cross-over trial. Students were divided into two groups and were alternately taught each device using a video tutorial. In period one, Group A was taught the TO first; Group B was taught the Arclight. They were then assessed using simulated objective, structured, clinical, examinations, examining four model heads with lettered fundal photographs of varying sizes of font. Groups crossed over following a 2-week washout period and were taught the second device and reassessed. A questionnaire was distributed to ascertain students’ opinions and preferences. RESULTS: Forty medical students participated. Overall, 92.5% of students performed better with the Arclight, irrespective of cross-over trial period. The mean difference in score in period one of the cross-over trial was 16.77 (95% CI: 11.63–21.93), with students performing better with the Arclight (p < 0.0001). The mean difference in score in period two was 8.02 (95% CI: 4.52–11.52), with students performing better with the Arclight (p < 0.0001). In addition, performance with the TO improved by 52.9% following initial exposure to the Arclight. The Arclight was the preferred device by 82.5% of students, and 82.5% of students would choose this device for future practice. CONCLUSION: Students performed better with and preferred the Arclight ophthalmoscope. The Arclight could be considered as a suitable alternative to the TO used for training medical students
Combined CO & Dust Scaling Relations of Depletion Time and Molecular Gas Fractions with Cosmic Time, Specific Star Formation Rate and Stellar Mass
We combine molecular gas masses inferred from CO emission in 500 star forming
galaxies (SFGs) between z=0 and 3, from the IRAM-COLDGASS, PHIBSS1/2 and other
surveys, with gas masses derived from Herschel far-IR dust measurements in 512
galaxy stacks over the same stellar mass/redshift range. We constrain the
scaling relations of molecular gas depletion time scale (tdepl) and gas to
stellar mass ratio (Mmolgas/M*) of SFGs near the star formation main-sequence
with redshift, specific star formation rate (sSFR) and stellar mass (M*). The
CO- and dust-based scaling relations agree remarkably well. This suggests that
the CO-H2 mass conversion factor varies little within 0.6dex of the main
sequence (sSFR(ms,z,M*)), and less than 0.3dex throughout this redshift range.
This study builds on and strengthens the results of earlier work. We find that
tdepl scales as (1+z)^-0.3 *(sSFR/sSFR(ms,z,M*))^-0.5, with little dependence
on M*. The resulting steep redshift dependence of Mmolgas/M* ~(1+z)^3 mirrors
that of the sSFR and probably reflects the gas supply rate. The decreasing gas
fractions at high M* are driven by the flattening of the SFR-M* relation.
Throughout the redshift range probed a larger sSFR at constant M* is due to a
combination of an increasing gas fraction and a decreasing depletion time
scale. As a result galaxy integrated samples of the Mmolgas-SFR rate relation
exhibit a super-linear slope, which increases with the range of sSFR. With
these new relations it is now possible to determine Mmolgas with an accuracy of
0.1dex in relative terms, and 0.2dex including systematic uncertainties.Comment: ApJ accepte
Novel mutations in TARDBP (TDP-43) in patients with familial amyotrophic lateral sclerosis.
The TAR DNA-binding protein 43 (TDP-43) has been identified as the major disease protein in amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration with ubiquitin inclusions (FTLD-U), defining a novel class of neurodegenerative conditions: the TDP-43 proteinopathies. The first pathogenic mutations in the gene encoding TDP-43 (TARDBP) were recently reported in familial and sporadic ALS patients, supporting a direct role for TDP-43 in neurodegeneration. In this study, we report the identification and functional analyses of two novel and one known mutation in TARDBP that we identified as a result of extensive mutation analyses in a cohort of 296 patients with variable neurodegenerative diseases associated with TDP-43 histopathology. Three different heterozygous missense mutations in exon 6 of TARDBP (p.M337V, p.N345K, and p.I383V) were identified in the analysis of 92 familial ALS patients (3.3%), while no mutations were detected in 24 patients with sporadic ALS or 180 patients with other TDP-43-positive neurodegenerative diseases. The presence of p.M337V, p.N345K, and p.I383V was excluded in 825 controls and 652 additional sporadic ALS patients. All three mutations affect highly conserved amino acid residues in the C-terminal part of TDP-43 known to be involved in protein-protein interactions. Biochemical analysis of TDP-43 in ALS patient cell lines revealed a substantial increase in caspase cleaved fragments, including the approximately 25 kDa fragment, compared to control cell lines. Our findings support TARDBP mutations as a cause of ALS. Based on the specific C-terminal location of the mutations and the accumulation of a smaller C-terminal fragment, we speculate that TARDBP mutations may cause a toxic gain of function through novel protein interactions or intracellular accumulation of TDP-43 fragments leading to apoptosis
The Eyes Have It: Sex and Sexual Orientation Differences in Pupil Dilation Patterns
Recent research suggests profound sex and sexual orientation differences in sexual response. These results, however, are based on measures of genital arousal, which have potential limitations such as volunteer bias and differential measures for the sexes. The present study introduces a measure less affected by these limitations. We assessed the pupil dilation of 325 men and women of various sexual orientations to male and female erotic stimuli. Results supported hypotheses. In general, self-reported sexual orientation corresponded with pupil dilation to men and women. Among men, substantial dilation to both sexes was most common in bisexual-identified men. In contrast, among women, substantial dilation to both sexes was most common in heterosexual-identified women. Possible reasons for these differences are discussed. Because the measure of pupil dilation is less invasive than previous measures of sexual response, it allows for studying diverse age and cultural populations, usually not included in sexuality research
Reduction of intratumoral brain perfusion by noninvasive transcranial electrical stimulation
Malignant brain neoplasms have a poor prognosis despite aggressive treatments. Animal models and evidence from human bodily tumors reveal that sustained reduction in tumor perfusion via electrical stimulation promotes tumor necrosis, therefore possibly representing a therapeutic option for patients with brain tumors. Here, we demonstrate that transcranial electrical stimulation (tES) allows to safely and noninvasively reduce intratumoral perfusion in humans. Selected patients with glioblastoma or metastasis underwent tES, while perfusion was assessed using magnetic resonance imaging. Multichannel tES was applied according to personalized biophysical modeling, to maximize the induced electrical field over the solid tumor mass. All patients completed the study and tolerated the procedure without adverse effects, with tES selectively reducing the perfusion of the solid tumor. Results potentially open the door to noninvasive therapeutic interventions in brain tumors based on stand-alone tES or its combination with other available therapies
TIA1 Mutations in Amyotrophic Lateral Sclerosis and Frontotemporal Dementia Promote Phase Separation and Alter Stress Granule Dynamics.
Amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) are age-related neurodegenerative disorders with shared genetic etiologies and overlapping clinical and pathological features. Here we studied a novel ALS/FTD family and identified the P362L mutation in the low-complexity domain (LCD) of T cell-restricted intracellular antigen-1 (TIA1). Subsequent genetic association analyses showed an increased burden of TIA1 LCD mutations in ALS patients compared to controls (p = 8.7 × 1
Evolutionary and socio-cultural influences on feelings and attitudes towards nature: a cross-cultural study
Mounting environmental issues have prompted reconsideration of the human–nature relationship. Accordingly, attitudes to nature, as an important dimension of human–nature interactions, have become a research focus. How feelings and attitudes towards nature are influenced by evolutionary and social-cultural constructions, and whether there is variation between different cultural groups, demands more attention. Using a survey of visitors to two very different National Parks, the New Forest National Park, England and Jiuzhaigou Scenic Area, China, this paper shows that of nationality and living environment, differences between the two nationalities were significant in respect of both attitudes and feelings. Specifically, it demonstrates that the biophilia thesis, which purports that people have an innate and a genetically inherited need for affiliation with nature, is influenced by their socio-cultural environment, in particular their national culture, but also by their current living place. The study contributes to our understanding of sustainable tourism in natural areas
First direct detection of an exoplanet by optical interferometry; Astrometry and K-band spectroscopy of HR8799 e
To date, infrared interferometry at best achieved contrast ratios of a few
times on bright targets. GRAVITY, with its dual-field mode, is now
capable of high contrast observations, enabling the direct observation of
exoplanets. We demonstrate the technique on HR8799, a young planetary system
composed of four known giant exoplanets. We used the GRAVITY fringe tracker to
lock the fringes on the central star, and integrated off-axis on the HR8799e
planet situated at 390 mas from the star. Data reduction included
post-processing to remove the flux leaking from the central star and to extract
the coherent flux of the planet. The inferred K band spectrum of the planet has
a spectral resolution of 500. We also derive the astrometric position of the
planet relative to the star with a precision on the order of 100as. The
GRAVITY astrometric measurement disfavors perfectly coplanar stable orbital
solutions. A small adjustment of a few degrees to the orbital inclination of HR
8799 e can resolve the tension, implying that the orbits are close to, but not
strictly coplanar. The spectrum, with a signal-to-noise ratio of
per spectral channel, is compatible with a late-type L brown dwarf. Using
Exo-REM synthetic spectra, we derive a temperature of \,K and a
surface gravity of cm/s. This corresponds to a radius
of and a mass of , which is an independent confirmation of mass estimates from evolutionary
models. Our results demonstrate the power of interferometry for the direct
detection and spectroscopic study of exoplanets at close angular separations
from their stars.Comment: published in A&
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