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Political frictions significantly affect both pricing and supply in the long-term care insurance (LTCI) market. Comparing the same insurer's requests submitted for the same policy at the same time to different state regulators, we find that they are 13% more likely to be approved and receive 4% more of the requested amount after an election year. Over time, regulatory pushback on premium increase requests leads to persistently lower cash reserves and increases the probability of company dropout. An insurer who receives one-standard-deviation less of their requested increase is 20% more likely to leave the market next year. [ABSTRACT FROM AUTHOR]

We propose a novel measure of intermediary risk exposure based on the fraction of all trade that is conducted between dealers, called the interdealer trade (IDT) measure. Intuitively, when dealers' aggregate risk exposure rises, they trade more with each other to redistribute inventory shocks. Consistent with risk exposures relating to expected returns, market-specific IDT measures add incremental return predictability across five different markets. For example, one-standard-deviation increases in the Treasury and foreign exchange (FX) IDT measures, respectively, forecast a 1.8% higher annual excess return on a five-year bond and a 3.7% higher annual excess return on currency-specific FX trades. This paper was accepted by David Sraer, finance. Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2021.01831. [ABSTRACT FROM AUTHOR]

Background: There is increasing evidence that exposure to PM2.5 and its constituents is associated with an increased risk of gestational diabetes mellitus (GDM), but studies on the relationship between exposure to PM2.5 constituents and the risk of GDM are still limited. Methods: A total of 17,855 pregnant women in Guangzhou were recruited for this retrospective cohort study, and the time-varying average concentration method was used to estimate individual exposure to PM2.5 and its constituents during pregnancy. Logistic regression was used to assess the relationship between exposure to PM2.5 and its constituents and the risk of GDM, and the expected inflection point between exposure to PM2.5 and its constituents and the risk of GDM was estimated using logistic regression combined with restricted cubic spline curves. Stratified analyses and interaction tests were performed. Results: After adjustment for confounders, exposure to PM2.5 and its constituents (NO3−, NH4+, and OM) was positively associated with the risk of GDM during pregnancy, especially when exposure to NO3− and NH4+ occurred in the first to second trimester, with each interquartile range increase the risk of GDM by 20.2% (95% CI: 1.118–1.293) and 18.2% (95% CI. 1.107–1.263), respectively. The lowest inflection points between PM2.5, SO42−, NO3−, NH4+, OM, and BC concentrations and GDM risk throughout the gestation period were 18.96, 5.80, 3.22, 2.67, 4.77 and 0.97 µg/m3, respectively. In the first trimester, an age interaction effect between exposure to SO42−, OM, and BC and the risk of GDM was observed. Conclusions: This study demonstrates a positive association between exposure to PM2.5 and its constituents and the risk of GDM. Specifically, exposure to NO3−, NH4+, and OM was particularly associated with an increased risk of GDM. The present study contributes to a better understanding of the effects of exposure to PM2.5 and its constituents on the risk of GDM. [ABSTRACT FROM AUTHOR]

Somatic mutations that accumulate in normal tissues are associated with ageing and disease.sup.1,2. Here we performed a comprehensive genomic analysis of 1,737 morphologically normal tissue biopsies of 9 organs from 5 donors. We found that somatic mutation accumulations and clonal expansions were widespread, although to variable extents, in morphologically normal human tissues. Somatic copy number alterations were rarely detected, except for in tissues from the oesophagus and cardia. Endogenous mutational processes with the SBS1 and SBS5 mutational signatures are ubiquitous among normal tissues, although they exhibit different relative activities. Exogenous mutational processes operate in multiple tissues from the same donor. We reconstructed the spatial somatic clonal architecture with sub-millimetre resolution. In the oesophagus and cardia, macroscopic somatic clones that expanded to hundreds of micrometres were frequently seen, whereas in tissues such as the colon, rectum and duodenum, somatic clones were microscopic in size and evolved independently, possibly restricted by local tissue microstructures. Our study depicts a body map of somatic mutations and clonal expansions from the same individual. Laser-capture microdissection and mini-bulk exome sequencing are combined to analyse somatic mutations in morphologically normal tissues from nine organs from five donors, revealing variation in mutation burdens, mutational signatures and clonal expansions., Author(s): Ruoyan Li [sup.1] [sup.2] , Lin Di [sup.1] [sup.2] , Jie Li [sup.3] [sup.4] , Wenyi Fan [sup.5] , Yachen Liu [sup.5] , Wenjia Guo [sup.5] , Weiling Liu [...]

Background We previously have shown that there was a strong correlation between failed facemask ventilation, failed ventilation through a supraglottic airway, and difficult tracheal intubation. The primary aim of this study was to evaluate whether or not an established method to predict difficult ventilation through a supraglottic airway was also useful for predicting failed facemask ventilation. Methods This was a single-center, retrospective observational study. We studied 28,081 anesthetized patients in whom ventilation through a facemask, and supraglottic airway was attempted as the initial technique during induction of anesthesia, between May 2011 and March 2016. For each patient, the score which had been validated to be useful for predicting difficult ventilation through a supraglottic airway was calculated. The score ranged between 0 and 7 points, and we defined a low risk when the score was 0-3, and a high risk when the score was 4-7. To measure and compare the predictive accuracy of the score, we generated a receiver operating characteristic curve and compared the area under the curve (AUC). Results The incidence of failed facemask ventilation was significantly higher in patients with high-risk predictive score than in patients with low-risk predictive score [0.38% vs 0.056%, odds ratio 6.8 (95% CI 2.6-18.1, p value = 0.002)], and the sensitivity of the score was 25%, while the specificity was 95%, with a negative predictive value of 99%. The AUC of the score was 0.71 (95% CI 0.58-0.83). Conclusions The predictive score for difficult ventilation through a supraglottic airway is also useful to predict failed facemask ventilation., Author(s): Tomoyuki Saito [sup.1], Takashi Asai [sup.1], Asuka Taguchi [sup.1], Chew Tsong Huey Sophia [sup.2], Weiling Liu [sup.3], Kyu Kyu Thinn [sup.3], Lian Kah Ti [sup.3] [sup.4] Author Affiliations: (1) [...]