How Women's Legal Protection from Physical Harm Affects Fertility: Evidence from Nigeria

Using data from the Demographic and Health Surveys (DHS), this paper estimates the effect on fertility of a legal reform in Nigeria in 2000 that made women more vulnerable to physical violence out-side of the household. I find that yearly probability of giving birth of women most exposed to the reform increased by at least 0.03, which amounts roughly to one extra child per woman. Using stated preferences about the number of children and information on demo-graphic outcomes, I propose and examine empirically the hypothesis that the reform increased for women the value of being married, and hence decreased their intra-household bargaining power, which led fertility decisions to shift in the direction of husbands ’ preferences.

Identification of genetic variants associated with Huntington's disease progression: a genome-wide association study

Background Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify genetic markers associated with this progression measure. Methods We generated a progression score on the basis of principal component analysis of prospectively acquired longitudinal changes in motor, cognitive, and imaging measures in the 218 indivduals in the TRACK-HD cohort of Huntington's disease gene mutation carriers (data collected 2008–11). We generated a parallel progression score using data from 1773 previously genotyped participants from the European Huntington's Disease Network REGISTRY study of Huntington's disease mutation carriers (data collected 2003–13). We did a genome-wide association analyses in terms of progression for 216 TRACK-HD participants and 1773 REGISTRY participants, then a meta-analysis of these results was undertaken. Findings Longitudinal motor, cognitive, and imaging scores were correlated with each other in TRACK-HD participants, justifying use of a single, cross-domain measure of disease progression in both studies. The TRACK-HD and REGISTRY progression measures were correlated with each other (r=0·674), and with age at onset (TRACK-HD, r=0·315; REGISTRY, r=0·234). The meta-analysis of progression in TRACK-HD and REGISTRY gave a genome-wide significant signal (p=1·12 × 10−10) on chromosome 5 spanning three genes: MSH3, DHFR, and MTRNR2L2. The genes in this locus were associated with progression in TRACK-HD (MSH3 p=2·94 × 10−8 DHFR p=8·37 × 10−7 MTRNR2L2 p=2·15 × 10−9) and to a lesser extent in REGISTRY (MSH3 p=9·36 × 10−4 DHFR p=8·45 × 10−4 MTRNR2L2 p=1·20 × 10−3). The lead single nucleotide polymorphism (SNP) in TRACK-HD (rs557874766) was genome-wide significant in the meta-analysis (p=1·58 × 10−8), and encodes an aminoacid change (Pro67Ala) in MSH3. In TRACK-HD, each copy of the minor allele at this SNP was associated with a 0·4 units per year (95% CI 0·16–0·66) reduction in the rate of change of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score, and a reduction of 0·12 units per year (95% CI 0·06–0·18) in the rate of change of UHDRS Total Functional Capacity score. These associations remained significant after adjusting for age of onset. Interpretation The multidomain progression measure in TRACK-HD was associated with a functional variant that was genome-wide significant in our meta-analysis. The association in only 216 participants implies that the progression measure is a sensitive reflection of disease burden, that the effect size at this locus is large, or both. Knockout of Msh3 reduces somatic expansion in Huntington's disease mouse models, suggesting this mechanism as an area for future therapeutic investigation

The Birth of the Congressional Clinic ∗

This paper studies the impact of mortality in the districts/states represented in key congressional groups (i.e. committees, subcommittees, and parties) on the National Institutes of Health (NIH) allocation of medical research funds across diseases, for the period 1985-2002. Exploiting the recomposition of any group after congressional elections, I find that congressmen who sit in the House Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies appear successful in steering more funds towards research on diseases that affect their constituents disproportionately. This effect is larger for clinical than for basic research. No other relevant congressional group, except, to a lesser extent, the House majority, seems to impact that allocation. No group significantly impacts the allocation of funds across states

Voter Turnout and Fiscal Policy

In this paper, we examine whether shocks in voting costs can impact elected representatives' quality, defined as the capacity to fund projects at the lowest cost. Using data on French municipalities and local variations in seasonal infections incidence as a shock on voting cost, we estimate that higher incidence lowers voter turnout, increases subsidies obtained by a municipality, decreases harmful financial decisions, and increases the municipality's investment in infrastructure. We present a model where these predictions would hold, in particular for municipalities with a high base level of turnout

Respiratory Syncytial Virus Infection: Its Propensity for Bacterial Coinfection and Related Mortality in Elderly Adults

Respiratory syncytial virus (RSV) is an increasingly recognized cause of acute respiratory infection (ARI) in adults. We compared the crude in-hospital mortality of patients with RSV infection alone with that of patients with RSV-bacterial coinfection. Overall, 12 144 hospitalized patients with ARI were screened for RSV detection by polymerase chain reaction between February 2014 and April 2019. In total, 701 (5.8%) had a positive RSV result, including 85 (12.1%) with bacterial coinfection. RSV-bacterial coinfection was associated with an increase in crude in-hospital mortality in patients >65 years old (hazard ratio, 2.94; 95% CI, 1.30-6.60; P = .010). Optimized prevention and management strategies to reduce this burden are needed