Mortality Differences Between Traditional Medicare and Medicare Advantage: A Risk-Adjusted Assessment Using Claims Data.

Medicare Advantage (MA) has grown rapidly since the Affordable Care Act; nearly one-third of Medicare beneficiaries now choose MA. An assessment of the comparative value of the 2 options is confounded by an apparent selection bias favoring MA, as reflected in mortality differences. Previous assessments have been hampered by lack of access to claims diagnosis data for the MA population. An indirect comparison of mortality as an outcome variable was conducted by modeling mortality on a traditional fee-for-service (FFS) Medicare data set, applying the model to an MA data set, and then evaluating the ratio of actual-to-predicted mortality in the MA data set. The mortality model adjusted for clinical conditions and demographic factors. Model development considered the effect of potentially greater coding intensity in the MA population. Further analysis calculated ratios for subpopulations. Predicted, risk-adjusted mortality was lower in the MA population than in FFS Medicare. However, the ratio of actual-to-predicted mortality (0.80) suggested that the individuals in the MA data set were less likely to die than would be predicted had those individuals been enrolled in FFS Medicare. Differences between actual and predicted mortality were particularly pronounced in low income (dual eligibility), nonwhite race, high morbidity, and Health Maintenance Organization (HMO) subgroups. After controlling for baseline clinical risk as represented by claims diagnosis data, mortality differences favoring MA over FFS Medicare persisted, particularly in vulnerable subgroups and HMO plans. These findings suggest that differences in morbidity do not fully explain differences in mortality between the 2 programs

Do terrorist attacks affect ethnic discrimination in the labour market? Evidence from two randomized field experiments

Terrorist attacks are known to influence public opinion. But do they also change behaviour? We address this question by comparing the results of two identical randomized field experiments on ethnic discrimination in hiring that we conducted in Oslo. The first experiment was conducted before the 2011 terrorist attacks in Norway; the second experiment was conducted after the attacks. In both experiments, applicants with a typical Pakistani name were significantly less likely to get a job interview compared to those with a typical Norwegian name. But the ethnic gap in call‐back rates were very similar in the two experiments. Thus, Pakistanis in Norway still experienced the same level of discrimination, despite claims that Norwegians have become more positive about migrants after the far‐right, anti‐migrant terrorist attacks of 2011

First Principles Calculations of the pK_a Values and Tautomers of Isoguanine and Xanthine

The accurate replication of DNA requires the formation of complementary hydrogen bonds between a template base and the base moiety of an incoming deoxynucleotide-5‘-triphosphate. Recent structural studies suggest that some DNA polymerases contribute additional constraints by interrogating the minor groove face of the incoming and template bases. Therefore, the hydrogen bond-donating or -accepting properties of the base pairing as well as minor groove faces of the bases could be important determinants of correct base selection. In this paper, we investigate two purines that could arise by endogenous damage of the normal DNA bases:  isoguanine (which can be generated by the oxidation of adenine) and xanthine (which can be generated by the deamination of guanine). In both cases, the potential exists for the placement of a proton in the N3 position, converting the N3 position from a hydrogen bond acceptor to a donor. In this paper, we use first principles quantum mechanical methods (density functional theory using the B3LYP functional and the 6-31G++G**basis set) to predict the ionization and tautomeric equilibria of both isoguanine and xanthine in the gas phase and aqueous solution. For isoguanine, we find that the N1H and N3H neutral tautomeric forms are about equally populated in aqueous solution, while the enol tauotomers are predominant in the gas phase. In contrast, we find that xanthine displays essentially no tautomeric shifts in aqueous solution but is nearly equally populated by both an anionic and a neutral form at physiological pH. To obtain these results, we carried out an extensive examination of the tautomeric and ionic configurations for both xanthine and isoguanine in solution and in the gas phase. The potential hydrogen-bonding characteristics of these damaged purines may be used to test predictions of the important components of base selection by different DNA polymerases during DNA replication

Kinematic modelling of disk galaxies I. A new method to fit tilted rings to data cubes

This is the first of a series of papers in which the kinematics of disk galaxies over a range of scales is scrutinised employing spectroscopy. A fundamental aspect of these studies is presented here: the new publicly available software tool TiRiFiC (http://www.astro.uni-bonn.de/~gjozsa/tirific.html) enables a direct fit of a ``tilted-ring model'' to spectroscopic data cubes. The algorithm generates model data cubes from the tilted-ring parametrisation of a rotating disk, which are automatically adjusted to reach an optimum fit via a chi-squared minimisation method to an observed data cube. The structure of the new software, the shortcomings of the previously available programs to produce a tilted-ring model, and the performance of TiRiFiC are discussed. Our method is less affected by the well-known problem of beam smearing that occurs when fitting to the velocity field. Since with our method we fit many data points in a data cube simultaneously, TiRiFiC is sensitive to very faint structures and can hence be used to derive tilted-ring models significantly extending in radius beyond those derived from a velocity field. The software is able to parametrise HI disks of galaxies that are intersected by the line-of-sight twice or more, i.e. if the disks are heavily warped, and/or with a significant shift of the projected centre of rotation, and/or if seen edge-on. Furthermore, our method delivers the surface-brightness profile of the examined galaxy in addition to the orientational parameters and the rotation curve. In order to derive kinematic and morphological models of disk galaxies, especially reliable rotation curves, a direct-fit method as implemented in our code should be the tool of choice.Comment: 37 pages, 24 figures. Accepted for publication in Astronomy and Astrophysic

HI in the Outskirts of Nearby Galaxies

The HI in disk galaxies frequently extends beyond the optical image, and can trace the dark matter there. I briefly highlight the history of high spatial resolution HI imaging, the contribution it made to the dark matter problem, and the current tension between several dynamical methods to break the disk-halo degeneracy. I then turn to the flaring problem, which could in principle probe the shape of the dark halo. Instead, however, a lot of attention is now devoted to understanding the role of gas accretion via galactic fountains. The current $\rm \Lambda$ cold dark matter theory has problems on galactic scales, such as the core-cusp problem, which can be addressed with HI observations of dwarf galaxies. For a similar range in rotation velocities, galaxies of type Sd have thin disks, while those of type Im are much thicker. After a few comments on modified Newtonian dynamics and on irregular galaxies, I close with statistics on the HI extent of galaxies.Comment: 38 pages, 17 figures, invited review, book chapter in "Outskirts of Galaxies", Eds. J. H. Knapen, J. C. Lee and A. Gil de Paz, Astrophysics and Space Science Library, Springer, in pres

Mechanisms of base selection by human single-stranded selective monofunctional uracil-DNA glycosylase

hSMUG1 (human single-stranded selective monofunctional uracil-DNA glyscosylase) is one of three glycosylases encoded within a small region of human chromosome 12. Those three glycosylases, UNG (uracil-DNA glycosylase), TDG (thymine-DNA glyscosylase), and hSMUG1, have in common the capacity to remove uracil from DNA. However, these glycosylases also repair other lesions and have distinct substrate preferences, indicating that they have potentially redundant but not overlapping physiological roles. The mechanisms by which these glycosylases locate and selectively remove target lesions are not well understood. In addition to uracil, hSMUG1 has been shown to remove some oxidized pyrimidines, suggesting a role in the repair of DNA oxidation damage. In this paper, we describe experiments in which a series of oligonucleotides containing purine and pyrimidine analogs have been used to probe mechanisms by which hSMUG1 distinguishes potential substrates. Our results indicate that the preference of hSMUG1 for mispaired uracil over uracil paired with adenine is best explained by the reduced stability of a duplex containing a mispair, consistent with previous reports with Escherichia coli mispaired uracil-DNA glycosylase. We have also extended the substrate range of hSMUG1 to include 5-carboxyuracil, the last in the series of damage products from thymine methyl group oxidation. The properties used by hSMUG1 to select damaged pyrimidines include the size and free energy of solvation of the 5-substituent but not electronic inductive properties. The observed distinct mechanisms of base selection demonstrated for members of the uracil glycosylase family help explain how considerable diversity in chemical lesion repair can be achieved

Evidence for universal structure in galactic halos

The late infall of dark matter onto a galaxy produces structure (such as caustics) in the distribution of dark matter in the halo. We argue that such structure is likely to occur generically on length scales proportional to $l \sim t_0 v_{rot}$, where $t_0$ is the age of the universe and $v_{rot}$ is the rotation velocity of the galaxy. A set of 32 extended galactic rotation curves is analyzed. For each curve, the radial coordinate is rescaled according to $r\to \tilde r \equiv r (v_0 / v_{rot})$, where we choose $v_0 = 220 km/s$. A linear fit to each rescaled rotation curve is subtracted, and the residuals are binned and averaged. The sample shows significant features near $\tilde r = 40 kpc$ and $\tilde r = 20 kpc$. This is consistent with the predictions of the self-similar caustic ring model of galactic halos.Comment: 4 pages, LaTeX, 1 epsf figur

Paramagnetic liposomes as thermosensitive probes for MRI-guided thermal treatment: In vitro feasibility studies

In this work the potential of thermosensitive paramagnetic liposomes for in vitro temperature monitoring during radiofrequency heating has been assessed. Two thermosensitive liposome formulations with different phase-transition properties were investigated. Temperature-dependent spin-lattice (T 1) relaxivity measurements were performed at 0.24 T. Magnetic resonance imaging was performed at 2 T in liposome-containing phantom models and T 1 relaxation rates (R 1) were quantified as a function of temperature. Independent temperature measurements were performed using both thermocouple and magnetic-resonance-based methods (proton resonance frequency and diffusion-based thermometry). The relaxometric measurements showed that the T 1 relaxivity increased from low values (about 0.3 s -1mM -1 at 35 °C) to about 4 s -1mM -1 when the temperature approached and exceeded the phase-transition temperature (T c) of the liposome preparations. These data correlated well to the imaging data where an increased signal intensity was observed on T 1-weighted images at temperatures above T c. The derived R 1 maps reflected the measured liposomal temperature sensitivity and temperature quantification was possible on the basis of the measured linear temperature versus R 1 correlation in the transition range of the liposomes. The studies have therefore shown that thermosensitive paramagnetic liposomes exhibit the required temperature sensitivity to allow for an accurate mapping of the temperature changes in an in vitro imaging model. © 2008 Springer-Verlag

CO(1-0), CO(2-1) and Neutral Gas in NGC 6946: Molecular Gas in a Late-Type, Gas Rich, Spiral Galaxy

We present "On The Fly" maps of the CO(1-0) and CO(2-1) emission covering a 10' X 10' region of the NGC 6946. Using our CO maps and archival VLA HI observations we create a total gas surface density map, Sigma_gas, for NGC 6946. The predominantly molecular inner gas disk transitions smoothly into an atomic outer gas disk, with equivalent atomic and molecular gas surface densities at R = 3.5' (6 kpc). We estimate that the total H2 mass is 3 X 10^9 Mo, roughly 1/3 of the interstellar hydrogen gas mass, and about 2% of the dynamical mass of the galaxy at our assumed distance of 6 Mpc. The value of the CO(2-1)/CO(1-0) line ratio ranges from 0.35 to 2; 50% of the map is covered by very high ratio, >1, gas. The very high ratios are predominantly from interarm regions and appear to indicate the presence of wide-spread optically thin gas. Star formation tracers are better correlated with the total neutral gas disk than with the molecular gas by itself implying SFR is proportional to Sigma_gas. Using the 100 FIR and 21 cm continuum from NGC 6946 as star formation tracers, we arrive at a gas consumption timescale of 2.8 Gyr, which is relatively uniform across the disk. The high star formation rate at the nucleus appears to be due to a large accumulation of molecular gas rather than a large increase in the star formation efficiency. The mid-plane gas pressure in the outer (R > 10 kpc) HI arms of NGC 6946 is close to the value at the radial limit (10 kpc) of our observed CO disk. If the mid-plane gas pressure is a factor for the formation of molecular clouds, these outer HI gas arms should contain molecular gas which we do not see because they are beyond our detection limit

DSN Beowulf Cluster-Based VLBI Correlator

The NASA Deep Space Network (DSN) requires a broadband VLBI (very long baseline interferometry) correlator to process data routinely taken as part of the VLBI source Catalogue Maintenance and Enhancement task (CAT M&E) and the Time and Earth Motion Precision Observations task (TEMPO). The data provided by these measurements are a crucial ingredient in the formation of precision deep-space navigation models. In addition, a VLBI correlator is needed to provide support for other VLBI related activities for both internal and external customers. The JPL VLBI Correlator (JVC) was designed, developed, and delivered to the DSN as a successor to the legacy Block II Correlator. The JVC is a full-capability VLBI correlator that uses software processes running on multiple computers to cross-correlate two-antenna broadband noise data. Components of this new system (see Figure 1) consist of Linux PCs integrated into a Beowulf Cluster, an existing Mark5 data storage system, a RAID array, an existing software correlator package (SoftC) originally developed for Delta DOR Navigation processing, and various custom- developed software processes and scripts. Parallel processing on the JVC is achieved by assigning slave nodes of the Beowulf cluster to process separate scans in parallel until all scans have been processed. Due to the single stream sequential playback of the Mark5 data, some ramp-up time is required before all nodes can have access to required scan data. Core functions of each processing step are accomplished using optimized C programs. The coordination and execution of these programs across the cluster is accomplished using Pearl scripts, PostgreSQL commands, and a handful of miscellaneous system utilities. Mark5 data modules are loaded on Mark5 Data systems playback units, one per station. Data processing is started when the operator scans the Mark5 systems and runs a script that reads various configuration files and then creates an experiment-dependent status database used to delegate parallel tasks between nodes and storage areas (see Figure 2). This script forks into three processes: extract, translate, and correlate. Each of these processes iterates on available scan data and updates the status database as the work for each scan is completed. The extract process coordinates and monitors the transfer of data from each of the Mark5s to the Beowulf RAID storage systems. The translate process monitors and executes the data conversion processes on available scan files, and writes the translated files to the slave nodes. The correlate process monitors the execution of SoftC correlation processes on the slave nodes for scans that have completed translation. A comparison of the JVC and the legacy Block II correlator outputs reveals they are well within a formal error, and that the data are comparable with respect to their use in flight navigation. The processing speed of the JVC is improved over the Block II correlator by a factor of 4, largely due to the elimination of the reel-to-reel tape drives used in the Block II correlator