Medicine and Health Sciences Commons^™

Ptpn11 Deletion In A Novel Cartilage Cell Causes Metachondromatosis By Activating Hedgehog Signaling, Qian Wu

UCHC Articles - Research

SHP2, encoded by PTPN11, is required for survival, proliferation and differentiation of various cell types^1,2. Germ line activating mutations in PTPN11 cause Noonan Syndrome, while somatic PTPN11 mutations cause childhood myeloproliferative disease and contribute to some solid tumors. Recently, heterozygous inactivating mutations in PTPN11 were found in metachondromatosis, a rare inherited disorder featuring multiple exostoses, endochondromas, joint destruction and bony deformities^3,4. The detailed pathogenesis of this disorder has remained unclear. Here, we used a conditional knockout allele (Ptpn11^fl) and Cre recombinase (Cre) transgenic mice to delete Ptpn11 specifically in …

Oncogenic Transformation Of Mammary Epithelial Cells By Transforming Growth Factor Beta Independent Of Mammary Stem Cell Regulation, Karen A. Dunphy, Jae-Hong Seo, Daniel J. Kim, Amy L. Roberts, James Direnzo, Amanda Balboni

Dartmouth Scholarship

BackgroundTransforming growth factor beta (TGFβ) is transiently increased in the mammary gland during involution and by radiation. While TGFβ normally has a tumour suppressor role, prolonged exposure to TGFβ can induce an oncogenic epithelial to mesenchymal transition (EMT) program in permissive cells and initiate the generation of cancer stem cells. Our objective is to mimic the transient exposure to TGFβ during involution to determine the persistent effects on premalignant mammary epithelium.

A Joint Matrix Completion And Filtering Model For Influenza Serological Data Integration., Xiao-Tong Yuan, Tong Zhang, Xiu-Feng Wan

CVM Publications

Antigenic characterization based on serological data, such as Hemagglutination Inhibition (HI) assay, is one of the routine procedures for influenza vaccine strain selection. In many cases, it would be impossible to measure all pairwise antigenic correlations between testing antigens and reference antisera in each individual experiment. Thus, we have to combine and integrate the HI tables from a number of individual experiments. Measurements from different experiments may be inconsistent due to different experimental conditions. Consequently we will observe a matrix with missing data and possibly inconsistent measurements. In this paper, we develop a new mathematical model, which we refer to …

Assessing For And Understanding The Impact Of Hearing Loss In Children, Sally A. Arnold Ph.D.

NYS Child Welfare/Child Protective Services Training Institute

Hearing loss in children may occur unnoticed if the family isn’t knowledgeable about hearing loss and the child is not routinely seen for medical exams or by a school or a service provider. The child welfare caseworker may be in a position to spot a potential hearing loss and make an appropriate referral.

This PowerPoint describes:

Indicators of hearing loss when assessing children;

Hearing milestones by age;

The types of hearing loss;

Appropriate referrals if a hearing loss is suspected.

This PowerPoint can be useful not just for the caseworker’s knowledge, but may be useful in helping parents understand why …

Efektivitas Kebijakan Daerah Dalam Penurunan Angka Kematian Ibu Dan Bayi, Wiko Saputra, Victoria Fanggidae, Ah Mafthuchan

Kesmas

Di Indonesia, desentralisasi sektor kesehatan tidak selalu berdampak baik pada upaya penurunan angka kematian ibu, bayi dan anak balita. Desentralisasi tidak hanya memberi kewenangan pengembangan kebijakan lokal spesifik yang tepat, tetapi juga kebijakan yang tidak mendukung kebijakan nasional sehingga berdampak pencapaian yang rendah. Penelitian ini bertujuan mengetahui efektivitas desentralisasi kesehatan dalam mendorong pemerintah daerah menurunkan angka kematian ibu dan bayi. Penelitian ini menggunakan metode kualitatif wawancara semi terstruktur, observasi, dan diskusi kelompok terarah pada informan kunci yang terlibat dalam penyusunan dan pelaksanaan kebijakan daerah. Tiga kabupaten dipilih secara purposif berdasarkan expert judgement meliputi Kabupaten Pasuruan, Kabupaten Takalar dan Kabupaten Kupang. …

Prevalensi Dan Faktor Risiko Tuli Akibat Bising Pada Operator Mesin Kapal Feri, Jumali Jumali, Sumadi Sumadi, Sylvia Andriani, Misbahul Subhi, Damianus Suprijanto, Wuri Diah Handayani, Abdul Chodir, Fadilatus Sukma Ika Noviarmi, Leli Indahwati

Kesmas

Kebisingan ruang mesin dapat menyebabkan gangguan pendengaran. Tujuan penelitian ini adalah menganalisis prevalensi tuli akibat bising Noise Induced Hearing Loss (NIHL) dan faktor yang memengaruhi pada operator mesin kapal feri penyeberangan Ketapang-Gilimanuk. Penelitian observasional dengan pendekatan cross sectional ini menggunakan metode pengumpulan data dengan wawancara, pengukuran intensitas kebisingan ruang mesin dan pemeriksaan audiometri terhadap operator. Besar sampel adalah 66 operator dari 36 kapal feri yang memenuhi kriteria inklusi dipilih secara acak. Hasil studi menunjukkan 36% kapal memiliki intensitas kebisingan ² 85 dBA dan 64% > 85 dBA. Pemeriksaan audiometri dengan nada murni pada 66 operator didapatkan 34,85% responden mengalami NIHL. Hasil …

Sampel Susu Formula Dan Praktik Pemberian Air Susu Ibu Eksklusif, Tuti Nuraini, Madarina Julia, Djaswadi Dasuki

Kesmas

Cakupan pemberian air susu ibu (ASI) eksklusif di Kota Pagar Alam, tahun 2011 sekitar 43% tergolong rendah. Sebaliknya, pemberian susu formula meningkat tiga kali lipat dari 10,3% menjadi 32,5%. Iklan susu formula telah menyentuh bidan swasta dan puskesmas melalui pendekatan produsen susu formula dan pemberian susu formula secara gratis kepada ibu menyusui. Penelitian yang bertujuan mengetahui determinan kegagalan praktik pemberian ASI eksklusif di Kota Pagar Alam Provinsi Sumatera Selatan ini menggunakan desain studi unmatching kasus kontrol. Populasi adalah seluruh ibu yang mempunyai bayi berusia 7-12 bulan. Penarikan sampel dilakukan dengan metode proportional random sampling. Variabel terikat praktik adalah pemberian ASI …

Frekuensi Pemeriksaan Kehamilan, Konseling Laktasi, Dan Pemberian Air Susu Ibu Eksklusif, Moudy Emma Unaria Djami, Noormartany Noormartany, Dany Hilmanto

Kesmas

Pemberian air susu ibu (ASI) eksklusif pada bayi penting karena erat hubungannya dengan kelangsungan hidup bayi, pertumbuhan dan perkembangan yang optimal serta peningkatan kualitas generasi berikutnya. Penelitian ini bertujuan menentukan hubungan frekuensi pemeriksaan kehamilan dan konseling laktasi dengan pemberian ASI eksklusif. Rancangan penelitian adalah kohor historikal. Analisis multivariabel dilakukan menilai hubungan dan faktor paling dominan antara variabel bebas (frekuensi pemeriksaan kehamilan dan konseling laktasi), variabel perancu (pengetahuan, pendidikan, pekerjaan, paritas dan tingkat pendapatan keluarga) dan variabel terikat (ASI eksklusif). Pada analisis regresi logistik ditemukan pengetahuan sebagai faktor paling dominan dalam pemberian ASI eksklusif (OR = 4,30; 95% CI = 1,98 …

Profil Penderita Otitis Media Supuratif Kronis, Harry Agustaf Asroel, Debi Rumondang Siregar, Askaroellah Aboet

Kesmas

Otitis media supuratif kronis merupakan penyakit telinga umum di negaranegara berkembang. Komplikasi otitis media supuratif kronis tipe bahaya mempunyai tanda dan gejala klinis yang khas.Tujuan penelitian ini adalah mengetahui profil penderita otitis media supuratif kronis (OMSK) tipe bahaya di RSUP H. Adam Malik. Penelitian deskriptif terhadap 119 penderita dari tahun 2006-2010. Sekitar 28,57% penderita dijumpai pada tahun 2010, sekitar 31,93% terjadi pada usia 11-20 tahun, sekitar 53,78% laki-laki, dan sekitar 38,66% pada telinga kanan. Sebanyak 68,91% terjadi akibat riwayat otitis media berulang dan 61,34% dengan keluhan utama telinga berair. Gejala dan tanda klinis yang sering terjadi adalah telinga berair (76,47%) …

Association Study Of Common Genetic Variants And Hiv- 1 Acquisition In 6,300 Infected Cases And 7,200 Controls, Paul J. Mclaren, Cedric Coulonges, Stephan Ripke, Leonard H. Van Den Berg, Susan Buchbinder, Mary Carrington, Andrea Cossarizza, Judith Dalmau, Steven G. Deeks, Olivier Delaneau, Andrea De Luca, James J. Goedert, David W. Haas, Joshua T. Herbeck, Sekar Kathiresan, Gregory D. Kirk, Olivier Lambotte, Ma Luo, Simon Mallal, Danielle Van Manen, Javier Martinez-Picado, Florencia Pereyra, Francis A. Plummer, Guido Poli, Ying Qi, Pierre Rucart, Manj S. Sandhu, Patrick R. Shea, Hanneke Schuitemaker, Ioannis Theodorou, Fredrik Vannberg, Jan Veldink, Bruce D. Walker, Amy C. Weintrob, Cheryl Winkler, Steven M. Wolinsky, Amalio Telenti, David B. Goldstein, Paul I. W. De Bakker, Jean-Francois Zagury, Jacques Fellay

Biology Faculty Articles

Multiple genome-wide association studies (GWAS) have been performed in HIV-1 infected individuals, identifying common genetic influences on viral control and disease course. Similarly, common genetic correlates of acquisition of HIV-1 after exposure have been interrogated using GWAS, although in generally small samples. Under the auspices of the International Collaboration for the Genomics of HIV, we have combined the genome-wide single nucleotide polymorphism (SNP) data collected by 25 cohorts, studies, or institutions on HIV-1 infected individuals and compared them to carefully matched population-level data sets (a list of all collaborators appears in Note S1 in Text S1). After imputation using the …

Estradiol Regulation Of Nucleotidases In Female Reproductive Tract Epithelial Cells And Fibroblasts, Zheng Shen, John V. Fahey, Jack E. Bodwell, Marta Rodriguez-Garcia, Richard M. Rossoll, Sarah G. Crist, Mickey V. Patel, Charles R. Wira

Dartmouth Scholarship

The use of topical and oral adenosine derivatives in HIV prevention that need to be maintained in tissues and cells at effective levels to prevent transmission prompted us to ask whether estradiol could influence the regulation of catabolic nucleotidase enzymes in epithelial cells and fibroblasts from the upper and lower female reproductive tract (FRT) as these might affect cellular TFV-DP levels. Epithelial cells and fibroblasts were isolated from endometrium (EM), endocervix (CX) and ectocervix (ECX) tissues from hysterectomy patients, grown to confluence and treated with or without estradiol prior to RNA isolation. The expression of nucleotidase (NT) genes was measurable …

Pengetahuan Dan Perilaku Ibu Rumah Tangga Dalam Pengelolaan Sampah Plastik, Ririn Setyowati, Surahma Asti Mulasari

Kesmas

Pencemaran lingkungan akibat sampah plastik semakin mengkhawatirkan apabila tidak ada usaha untuk mengatasinya. Masyarakat yang kurang pengetahuan dan berperilaku buruk dalam pengelolaan sampah plastik dapat menimbulkan gangguan kesehatan dan lingkungan. Penelitian ini bertujuan mengetahui hubungan antara tingkat pengetahuan ibu rumah tangga dengan perilaku mengelola sampah plastik. Penelitian dilakukan di Dusun Kedesen, Desa Kradenan, Kecamatan Kaliwungu, Kabupaten Semarang Tahun 2012. Penelitian ini menggunakan rancangan studi cross sectional, dengan sampel berjumlah 74 orang yang diambil secara secara acak sederhana. Pengumpulan data dilakukan dengan wawancara terstruktur menggunakan kuesioner. Data dianalisis menggunakan analisis univariat dan analisis bivariat dengan uji statistik Kai Kuadrat (X2). Penelitian …

P2x4 Assembles With P2x7 And Pannexin-1 In Gingival Epithelial Cells And Modulates Reactive Oxygen Species Production And Inflammasome Activation, Shu-Chen Hung, Chul Hee Choi, Najwane Said-Sadier, Larry Johnson, Kalina Rosenova Atanasova, Hanen Sellami, Özlem Yilmaz, David M. Ojcius

All Dugoni School of Dentistry Faculty Articles

We have previously reported that Porphyromonas gingivalis infection of gingival epithelial cells (GEC) requires an exogenous danger signal such as ATP to activate an inflammasome and caspase-1, thereby inducing secretion of interleukin (IL)-1β. Stimulation with extracellular ATP also stimulates production of reactive oxygen species (ROS) in GEC. However, the mechanism by which ROS is generated in response to ATP, and the role that different purinergic receptors may play in inflammasome activation, is still unclear. In this study, we revealed that the purinergic receptor P2X₄ is assembled with the receptor P2X₇ and its associated pore, pannexin-1. ATP induces ROS …

Exploring Electric Field-Induced Changes In Astrocyte Behavior, Doel Dhar

Theses and Dissertations

Electric fields, which are generated by the movement of charged ions across membranes, are found in all biological systems and can influence cellular components ranging from amino acids to biological macromolecules. Physiological field strengths range from 1 – 200 mV/mm, and these electric fields are especially elevated at sites of cellular growth during development and regeneration. It has previously been demonstrated that elevated electric fields induce alignment of astrocyte processes in vitro, enhancing the rate of neurite outgrowth. It is believed that electric fields of varying physiological strength affect other astrocytic responses associated with regeneration. To characterize the duration over …

Metaphor Use In Interpersonal Communication Of Body Perception In The Context Of Breast Cancer, Jennifer Mary Fillion

Dissertations and Theses

Female breast cancer patients are often confused, frustrated, and devastated by changes occurring in their bodies and the treatment process. Many women express frustration and concern with the inability to know what the next phases of their life will bring. Previous research also states that many women struggle to communicate with others about treatment as well as side effects. This research examined how woman are use metaphors to describe their experience with breast cancer, specifically throughout the treatment period related to body image struggles. I qualitatively conducted interviews with women who were either currently in treatment or just finishing. My …

Crystal Structure Of The N-Acetyltransferase Domain Of Human N-Acetyl-L-Glutamate Synthase In Complex With N-Acetyl-L-Glutamate Provides Insights Into Its Catalytic And Regulatory Mechanisms, Gengxiang Zhao, Zhongmin Jin, Norma M. Allewell, Mendel Tuchman, Dashuang Shi

Pediatrics Faculty Publications

N-acetylglutamate synthase (NAGS) catalyzes the conversion of AcCoA and L-glutamate to CoA and N-acetyl-L-glutamate (NAG), an obligate cofactor for carbamyl phosphate synthetase I (CPSI) in the urea cycle. NAGS deficiency results in elevated levels of plasma ammonia which is neurotoxic. We report herein the first crystal structure of human NAGS, that of the catalyticN-acetyltransferase (hNAT) domain with N-acetyl-L-glutamate bound at 2.1 Å resolution. Functional studies indicate that the hNAT domain retains catalytic activity in the absence of the amino acid kinase (AAK) domain. Instead, the major functions of the AAK domain appear to be providing …

Content Analysis Of Cognitive Distortions In Pedophiles' Online Forum Posts, Lyndsie Johnson

Theses and Dissertations

Historically, sexual encounters between adults and children were rarely reported to authorities, and thus considered a rare problem. However, as many as 33% of girls and 14% of boys experience sexual encounters with adults and as a result may experience consequences such as aversive feelings regarding the act of sex, substance abuse, and self-mutilation. Such consequences lead research to examine pedophile's cognitive distortions. This exploratory study examined pedophiles' website forum posts to determine if any posters demonstrated cognitive distortions. Four independent raters used content analysis to determine which cognitive distortions were demonstrated by the examined pedophiles. Results suggested that cognitive …

An Integrated Clinico-Metabolomic Model Improves Prediction Of Death In Sepsis., Raymond J. Langley, Ephraim L. Tsalik, Jennifer C. Van Velkinburgh, Seth W. Glickman, Brandon J. Rice, Chunping Wang, Bo Chen, Lawrence Carin, Arturo Suarez, Robert P. Mohney, Debra H. Freeman, Mu Wang, Jinsam You, Jacob Wulff, J Will Thompson, M Arthur Moseley, Stephanie Reisinger, Brian T. Edmonds, Brian Grinnell, David R. Nelson, Darrell L. Dinwiddie, Neil A. Miller, Carol J. Saunders, Sarah Soden, Angela J. Rogers, Lee Gazourian, Laura E. Fredenburgh, Anthony F. Massaro, Rebecca M. Baron, Augustine M K Choi, G Ralph Corey, Geoffrey S. Ginsburg, Charles B. Cairns, Ronny M. Otero, Vance G. Fowler, Emanuel P. Rivers, Christopher W. Woods, Stephen F. Kingsmore

Manuscripts, Articles, Book Chapters and Other Papers

Sepsis is a common cause of death, but outcomes in individual patients are difficult to predict. Elucidating the molecular processes that differ between sepsis patients who survive and those who die may permit more appropriate treatments to be deployed. We examined the clinical features and the plasma metabolome and proteome of patients with and without community-acquired sepsis, upon their arrival at hospital emergency departments and 24 hours later. The metabolomes and proteomes of patients at hospital admittance who would ultimately die differed markedly from those of patients who would survive. The different profiles of proteins and metabolites clustered into the …

Nln/Jeffries Simulation Framework: State Of The Science Summary, Patricia K. Ravert, Julie Mcafoees

Faculty Publications

In summer 2011, a research task force from the International Association of Clinical Simulation and Learning (INACSL), in consultation with Dr. Pamela Jeffries, invited international nursing researchers and educators to participate in a project to evaluate state-of-the-science and existing research regarding the simulation model/framework (Jeffries, 2005, Jeffries, 2007). The model/framework was developed to define simulation education variables and provide an organized guide. The 21 researchers and educators worked on one of five teams, one for each of the five existing major model/framework constructs (Teacher, Student, Educational Practices, Outcomes, and Simulation Design Characteristics).

Characterization Of Cyclic Di-Gmp Binding By The Sole Borrelia Burgdorferi And Borrelia Hermsii Pilz Domain-Containing Proteins, Katherine Louise Mallory

Theses and Dissertations

Borrelia burgdorferi and Borrelia hermsii cause Lyme disease and relapsing fever, respectively. These spirochetes are maintained in an enzootic cycle, involving tick vectors and mammalian hosts. Differential gene expression is central in their survival in various environmental conditions. C-di-GMP has been demonstrated to be important in bacterial adaptation. Borrelia deletion mutant phenotypes have shown that c-di-GMP regulates motility, infectivity, and enzootic cycle progression. As the only known receptors encoded by Borrelia, PlzA and PlzC characterization is necessary in delineating c-di-GMP roles within the cell. In this study, biochemical, biophysical, and FRET methods demonstrated that these proteins exhibit a structural rearrangement …

Computational And Experimental Insights Into The Mechanism Of Substrate Recognition And Feedback Inhibition Of Protoporphyrinogen Oxidase, Ge-Fei Hao, Ying Tan, Sheng-Gang Yang, Zhi-Fang Wang, Chang-Guo Zhan, Zhen Xi, Guang-Fu Yang

Pharmaceutical Sciences Faculty Publications

Protoporphyrinogen IX oxidase (PPO; EC 1.3.3.4) is an essential enzyme catalyzing the last common step in the pathway leading to heme and chlorophyll biosynthesis. Great interest in PPO inhibitors arises from both its significance to agriculture and medicine. However, the discovery of PPO inhibitors with ultrahigh potency and selectivity is hampered due to lack of structural and mechanistic understanding about the substrate recognition, which remains a longstanding question central in porphyrin biology. To understand the mechanism, a novel binding model of protogen (protoporphyrinogen IX, the substrate) was developed through extensive computational simulations. Subsequently, amino acid residues that are critical for …

Efferent Copy And Corollary Discharge Motor Control Behavior Associated With A Hopping Activity, Wangdo Kim, António P. Veloso, Filipa João, Sean S. Kohles

Mechanical and Materials Engineering Faculty Publications and Presentations

Hoppers respond not only to stimuli from the ground surfaces but also to cues generated by their own behaviors. This leads to desensitization because although the afferent and reafferent signals have distinct causes, they are carried by the same sensory channels. From a behavioral viewpoint, it may be necessary to distinguish between signals from the two causes especially when monitoring changes in the external environment separate from those due to self-movement. We were able to separate afferent sensory stimuli from self-generated, reafferent signals using an action oriented perception system and dynamic programming approach. This effort addressed the question of how …

Gene Expression-Based Biomarkers For Anopheles Gambiae Age Grading, Mei Hui Wang, Osvaldo Marinotti, Daibin Zhong, Anthony A. James, Edward Walker, Tom Guda, Eliningaya J. Kweka, John Githure, Guiyun Yan

All Peer-Reviewed Publications

Information on population age structure of mosquitoes under natural conditions is fundamental to the understanding of vectorial capacity and crucial for assessing the impact of vector control measures on malaria transmission. Transcriptional profiling has been proposed as a method for predicting mosquito age for Aedes and Anopheles mosquitoes, however, whether this new method is adequate for natural conditions is unknown. This study tests the applicability of transcriptional profiling for age-grading of Anopheles gambiae, the most important malaria vector in Africa. The transcript abundance of two An. gambiae genes, AGAP009551 and AGAP011615, was measured during aging under laboratory and field conditions …

Ex Vivo Reprogramming Of Tumor-Reactive Immune Cells From Fvbn202 Mice Bearing Lung Metastatic Mammary Carcinoma: An Immunotherapeutic Opportunity Revealed Against Recurrence, Charles Hall

Theses and Dissertations

Metastatic breast cancer treatment has seen few advances in recent years, yet treatment resistance continues to rise, causing disease recurrence. A pilot study was performed to determine the efficacy of ex vivo expansion and reprogramming of tumor-reactive immune cells from experimental metastatic tumor-sensitized mice. Also, phenotypic changes in tumors due to metastasis or tumor microenvironment influences were characterized. Metastatic neu+ mouse mammary carcinoma (mMMC) and its distant relapsing neu-antigen-negative variant (mANV) were investigated in FVBN202 mice. Tumor-reactive central memory CD8+ T cells and activated NK/NKT cells were successfully reprogrammed and expanded during 6-day expansion from mMMC- and/or mANV-sensitized mice, resulting …

Creation And Implementation Of An Emergency Medicine Education And Training Program In Turkey: An Effective Educational Intervention To Address The Practitioner Gap, Jennifer Whitfield Bellows, Katherine A. Douglass, Atilla Ridvan, Jeffrey Smith, G. Bobby Kapur

Emergency Medicine Faculty Publications

Background

The specialty of Emergency Medicine has enjoyed recognition for nearly 20 years in Turkey. However, the majority of underserved and rural Turkish emergency departments are staffed by general practitioners who lack formal training in the specialty and have few opportunities to increase emergency medicine-specific knowledge and skills.

Methods

To address this “practitioner gap,” the authors developed a four-phase comprehensive emergency medicine education and training program for general practitioners practicing in government hospitals in Turkey.

Results

From April 2006 until June 2009, 42 courses were taught by 62 trainers across seven regions in Turkey. A total of 2,262 physicians were …

What's Happening: July 22, 2013, Maine Medical Center

What's Happening

No abstract provided.

Dose Ratios Between High Dose Oral Morphine Or Equivalents And Oral Methadone, Megan S. Chatham, Elizabeth S. Dodds Ashley, Jefferson S. Svengsouk, Katherine Juba

Pharmacy Faculty/Staff Publications

Background: Methadone is a commonly used opioid in hospice and palliative care for patients with refractory pain. Various methadone dose conversion methods utilize progressively higher morphine equivalent dose (MED) to methadone dose ratios to compensate for increased methadone potency with escalating opioid doses.

Objective: The purpose of this study was to determine the dose ratio between equianalgesic doses of high dose oral morphine (daily doses >1200 mg morphine or MED) and oral methadone.

Methods: This study was a retrospective chart review of 324 patients who received methadone at Strong Memorial Hospital or the associated outpatient clinic during a nine-month period …

On The Just And Accurate Representation Of Transgender Persons In Research, Alexis Dinno, Molly C. Franks, Jenn Burleton, Tyler C. Smith

Community Health Faculty Publications and Presentations

Transgender people deserve representation in population-based research, particularly health research, whether the research is programmatic or academic. Unfortunately, the existing academic literature includes very little about the particular health burdens and risks experienced by transgender people, such as institutional or interpersonal anti-transgender discrimination. While several anti-transgender biases are manifest in the published literature, one deserving particular attention by researcher is that transgender individuals seldom have an opportunity to self-identify as such both because sex and gender are typically collapsed into a single question in interviews and on surveys (e.g. ‘Sex: male or female.’), and because change in the individual’s sex …

Attributing Effects To Interactions, Tyler J. Vanderweele, Eric J. Tchetgen Tchetgen

Harvard University Biostatistics Working Paper Series

A framework is presented which allows an investigator to estimate the portion of the effect of one exposure that is attributable to an interaction with a second exposure. We show that when the two exposures are independent, the total effect of one exposure can be decomposed into a conditional effect of that exposure and a component due to interaction. The decomposition applies on difference or ratio scales. We discuss how the components can be estimated using standard regression models, and how these components can be used to evaluate the proportion of the total effect of the primary exposure attributable to …

Medicare Advantage Update: Benefits, Enrollment, And Payments After The Aca, Kathryn Linehan

National Health Policy Forum

In 2012, the Medicare program paid private health plans $136 billion to cover about 13 million beneficiaries who received Part A and B benefits through the Medicare Advantage (MA) program rather than traditional fee-for-service (FFS) Medicare. Private plans have been a part of the program since the 1970s. Debate about the policy goals—Should they cost less per beneficiary than FFS Medicare? Should they be available to all beneficiaries? Should they be able to offer additional benefits?—has long accompanied Medicare's private plan option. This debate is reflected in the history of Medicare payment policy, and policy decisions over the …