Health care costs, utilization and patterns of care following Lyme disease

BACKGROUND:Lyme disease is the most frequently reported vector borne infection in the United States. The Centers for Disease Control have estimated that approximately 10% to 20% of individuals may experience Post-Treatment Lyme Disease Syndrome - a set of symptoms including fatigue, musculoskeletal pain, and neurocognitive complaints that persist after initial antibiotic treatment of Lyme disease. Little is known about the impact of Lyme disease or post-treatment Lyme disease symptoms (PTLDS) on health care costs and utilization in the United States. OBJECTIVES:1) to examine the impact of Lyme disease on health care costs and utilization, 2) to understand the relationship between Lyme disease and the probability of developing PTLDS, 3) to understand how PTLDS may impact health care costs and utilization. METHODS:This study utilizes retrospective data on medical claims and member enrollment for persons aged 0-64 years who were enrolled in commercial health insurance plans in the United States between 2006-2010. 52,795 individuals treated for Lyme disease were compared to 263,975 matched controls with no evidence of Lyme disease exposure. RESULTS:Lyme disease is associated with $2,968 higher total health care costs (95$3,798 higher total health care costs (95% CI: 3,542-4,055, p<.001) and 66% more outpatient visits (95% CI: 64%-69%, p<.001) over a 12-month period, relative to those with no PTLDS-related diagnoses. CONCLUSIONS:Lyme disease is associated with increased costs above what would be expected for an easy to treat infection. The presence of PTLDS-related diagnoses after treatment is associated with significant health care costs and utilization

A community-maintained standard library of population genetic models

The explosion in population genomic data demands ever more complex modes of analysis, and increasingly, these analyses depend on sophisticated simulations. Recent advances in population genetic simulation have made it possible to simulate large and complex models, but specifying such models for a particular simulation engine remains a difficult and error-prone task. Computational genetics researchers currently re-implement simulation models independently, leading to inconsistency and duplication of effort. This situation presents a major barrier to empirical researchers seeking to use simulations for power analyses of upcoming studies or sanity checks on existing genomic data. Population genetics, as a field, also lacks standard benchmarks by which new tools for inference might be measured. Here, we describe a new resource, stdpopsim, that attempts to rectify this situation. Stdpopsim is a community-driven open source project, which provides easy access to a growing catalog of published simulation models from a range of organisms and supports multiple simulation engine backends. This resource is available as a well-documented python library with a simple command-line interface. We share some examples demonstrating how stdpopsim can be used to systematically compare demographic inference methods, and we encourage a broader community of developers to contribute to this growing resource.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

CFH, C3 and ARMS2 Are Significant Risk Loci for Susceptibility but Not for Disease Progression of Geographic Atrophy Due to AMD

Age-related macular degeneration (AMD) is a prevalent cause of blindness in Western societies. Variants in the genes encoding complement factor H (CFH), complement component 3 (C3) and age-related maculopathy susceptibility 2 (ARMS2) have repeatedly been shown to confer significant risks for AMD; however, their role in disease progression and thus their potential relevance for interventional therapeutic approaches remains unknown. Here, we analyzed association between variants in CFH, C3 and ARMS2 and disease progression of geographic atrophy (GA) due to AMD. A quantitative phenotype of disease progression was computed based on longitudinal observations by fundus autofluorescence imaging. In a subset of 99 cases with pure bilateral GA, variants in CFH (Y402H), C3 (R102G), and ARMS2 (A69S) are associated with disease (P = 1.6x10(-9), 3.2x10(-3), and P = 2.6x10(-12), respectively) when compared to 612 unrelated healthy control individuals. In cases, median progression rate of GA over a mean follow-up period of 3.0 years was 1.61 mm(2)/year with high concordance between fellow eyes. No association between the progression rate and any of the genetic risk variants at the three loci was observed (P>0.13). This study confirms that variants at CFH, C3, and ARMS2 confer significant risks for GA due to AMD. In contrast, our data indicate no association of these variants with disease progression which may have important implications for future treatment strategies. Other, as yet unknown susceptibilities may influence disease progression

Data from: Patterns of transposable element variation and clinality in Drosophila

Natural populations often exist in spatially diverse environments and may experience variation in the strength and targets of natural selection across their ranges. Drosophila provides an excellent opportunity to study the effects of spatially varying selection in natural populations, as both D. melanogaster and D. simulans live across a wide range of environments in North America. Here, we characterize patterns of variation in transposable elements (TEs) from six populations of D. melanogaster and nine populations of D. simulans sampled from multiple latitudes across North America. We find a nearly two-fold excess of TEs in D. melanogaster relative to D. simulans, with this difference largely driven by TEs segregating at the lowest and highest allele frequencies. We find no effect of latitude on either total TE abundance or average TE allele frequencies in either species. Moreover, we show that, as a class of mutations, the most common patterns of TE variation do not coincide with the sampled latitudinal gradient, nor are they consistent with local adaptation acting on environmental differences found in the most extreme latitudes. We also do not find a cline in ancestry for North American D. melanogaster—for either TEs or SNPs—suggesting a limited role for demography in shaping patterns of TE variation. Though we find little evidence for widespread clinality among TEs in Drosophila, this does not necessarily imply a limited role for TEs in adaptation. We discuss the need for improved models of adaptation to large-scale environmental heterogeneity, and how these might be applied to

Automatic capture and presentation creation from multimedia lectures

Abstract- For more than a decade, the RIPPLES grou

Analysis and Decomposition of Complex Real-Time Processes with a Real-Time Schemata Model

International Telemetering Conference Proceedings / September 28-30, 1976 / Hyatt House Hotel, Los Angeles, CaliforniaIn this paper a formal model for real-time processes is expanded to analyze structured, complex algorithms. Structured forms have inherent modularity and the authors discuss advantages of mapping such processes on distributed micro or mini processor networks. Processes under consideration are subject to random interrupts by independent I/O demands. Degradation of total system performance due to these demands is discussed. Extentions and ongoing research are mentioned.International Foundation for TelemeteringProceedings from the International Telemetering Conference are made available by the International Foundation for Telemetering and the University of Arizona Libraries. Visit http://www.telemetry.org/index.php/contact-us if you have questions about items in this collection

The Evaluation Of Massively Parallel Array Architectures

THE EVALUATION OF MASSIVELY PARALLEL ARRAY ARCHITECTURES September, 1994 Martin C. Herbordt, B.A., University of Pennsylvania M.S., University of Massachusetts Amherst Ph.D., University of Massachusetts Amherst Directed by: Professor Charles C. Weems Although massively parallel arrays have been proposed since the 1950&apos;s and built since the 1960&apos;s, they have undergone very few systematic studies and these have covered only a small fraction of the design space. The major problems limiting previous studies are: computational cost of detailed and accurate simulations; programming cost of creating a test suite that compiles to the various target architectures and runs on them with comparable efficiency; and diversity of the architectural design space, especially communication networks. These issues are addressed in the construction of ENPASSANT, an evaluation environment for massively parallel array architectures that obtains performance measures of candidate designs with respect to real..

Adjusted 12-month health care costs and utilization for patients in the Lyme disease sample with one or more post-treatment Lyme disease symptom (PTLDS)-related diagnosis, as compared to patients in Lyme disease sample with no post-treatment Lyme disease symptom-related diagnoses.

<p>Note: Above table includes Lyme disease sample only. Lyme disease sample includes only those persons with a test order and antibiotic treatment within 30 days of the test order, a diagnosis and antibiotic treatment within 30 days of the diagnosis, or a diagnosis, test order and antibiotic treatment within 30 days. The Lyme disease sample includes only those with 18 consecutive months of enrollment, including a 6-month “clean period” of enrollment prior to Lyme disease episode in which they were neither diagnosed with nor tested for Lyme disease. Lyme disease sample restricted to persons under 65 years of age, with commercial health insurance plans</p><p>^* Adjusted impact calculations based on GLM regression analysis using the Huber/White sandwich estimator of variance and adjusting for year, region, age, and sex, and controlling for high-cost non-Lyme disease-related conditions.</p><p>^† Adjusted ratio calculations for outpatient and emergency visits are based on negative binomial regression analysis using the Huber/White sandwich estimator of variance and adjusting for year, region, age, and sex, and controlling for high-cost non-Lyme disease-related conditions.</p><p>Adjusted 12-month health care costs and utilization for patients in the Lyme disease sample with one or more post-treatment Lyme disease symptom (PTLDS)-related diagnosis, as compared to patients in Lyme disease sample with no post-treatment Lyme disease symptom-related diagnoses.</p