45 research outputs found
Household income relationship with health services utilization and healthcare expenditures in people aged 75 years or older in Japan: A population-based study using medical and long-term care insurance claims data
Background: This study aimed to determine whether there are disparities in healthcare services utilization according to household income among people aged 75 years or older in Japan.Methods: We used data on medical and long-term care (LTC) insurance claims and on LTC insurance premiums and needs levels for people aged 75 years or older in a suburban city. Data on people receiving public welfare were not available. Participants were categorized according to household income level using LTC insurance premiums data. The associations of low income with physician visit frequency, length of hospital stay (LOS), and medical and LTC expenditures were evaluated and adjusted for 5-year age groups and LTC needs level.Results: The study analyzed 12,852 men and 18,020 women, among which 13.3% and 41.5%, respectively, were categorized as low income. Participants with low income for both genders were more likely to be functionally dependent. In the adjusted analyses, lower income was associated with fewer physician visits (incidence rate ratio [IRR] 0.90; 95% confidence interval [CI], 0.87–0.92 for men and IRR 0.97; 95% CI, 0.95–0.99 for women), longer LOS (IRR 1.98; 95% CI, 1.54–2.56 and IRR 1.42; 95% CI, 1.20–1.67, respectively), and higher total expenditures (exp(β) 1.09; 95% CI, 1.01–1.18 and exp(β) 1.09; 95% CI, 1.05–1.14, respectively).Conclusions: This study suggests that older people with lower income had fewer consultations with physicians but an increased use of inpatient services. The income categorization used in this study may be an appropriate proxy of socioeconomic status
Using spin to understand the formation of LIGO's black holes
With the detection of four candidate binary black hole (BBH) mergers by the
Advanced LIGO detectors thus far, it is becoming possible to constrain the
properties of the BBH merger population in order to better understand the
formation of these systems. Black hole (BH) spin orientations are one of the
cleanest discriminators of formation history, with BHs in dynamically formed
binaries in dense stellar environments expected to have spins distributed
isotropically, in contrast to isolated populations where stellar evolution is
expected to induce BH spins preferentially aligned with the orbital angular
momentum. In this work we propose a simple, model-agnostic approach to
characterizing the spin properties of LIGO's BBH population. Using measurements
of the effective spin of the binaries, which is LIGO's best constrained spin
parameter, we introduce a simple parameter to quantify the fraction of the
population that is isotropically distributed, regardless of the spin magnitude
distribution of the population. Once the orientation characteristics of the
population have been determined, we show how measurements of effective spin can
be used to directly constrain the underlying BH spin magnitude distribution.
Although we find that the majority of the current effective spin measurements
are too small to be informative, with LIGO's four BBH candidates we find a
slight preference for an underlying population with aligned spins over one with
isotropic spins (with an odds ratio of 1.1). We argue that it will be possible
to distinguish symmetric and anti-symmetric populations at high confidence with
tens of additional detections, although mixed populations may take
significantly more detections to disentangle. We also derive preliminary spin
magnitude distributions for LIGO's black holes, under the assumption of aligned
or isotropic populations
Integrative Annotation of 21,037 Human Genes Validated by Full-Length cDNA Clones
The human genome sequence defines our inherent biological potential; the realization of the biology encoded therein requires knowledge of the function of each gene. Currently, our knowledge in this area is still limited. Several lines of investigation have been used to elucidate the structure and function of the genes in the human genome. Even so, gene prediction remains a difficult task, as the varieties of transcripts of a gene may vary to a great extent. We thus performed an exhaustive integrative characterization of 41,118 full-length cDNAs that capture the gene transcripts as complete functional cassettes, providing an unequivocal report of structural and functional diversity at the gene level. Our international collaboration has validated 21,037 human gene candidates by analysis of high-quality full-length cDNA clones through curation using unified criteria. This led to the identification of 5,155 new gene candidates. It also manifested the most reliable way to control the quality of the cDNA clones. We have developed a human gene database, called the H-Invitational Database (H-InvDB; http://www.h-invitational.jp/). It provides the following: integrative annotation of human genes, description of gene structures, details of novel alternative splicing isoforms, non-protein-coding RNAs, functional domains, subcellular localizations, metabolic pathways, predictions of protein three-dimensional structure, mapping of known single nucleotide polymorphisms (SNPs), identification of polymorphic microsatellite repeats within human genes, and comparative results with mouse full-length cDNAs. The H-InvDB analysis has shown that up to 4% of the human genome sequence (National Center for Biotechnology Information build 34 assembly) may contain misassembled or missing regions. We found that 6.5% of the human gene candidates (1,377 loci) did not have a good protein-coding open reading frame, of which 296 loci are strong candidates for non-protein-coding RNA genes. In addition, among 72,027 uniquely mapped SNPs and insertions/deletions localized within human genes, 13,215 nonsynonymous SNPs, 315 nonsense SNPs, and 452 indels occurred in coding regions. Together with 25 polymorphic microsatellite repeats present in coding regions, they may alter protein structure, causing phenotypic effects or resulting in disease. The H-InvDB platform represents a substantial contribution to resources needed for the exploration of human biology and pathology