Nurse-To-Patient Ratios in Hospital Staffing: A Queueing Perspective

The immediate motivation of this paper is California Bill AB 394, legislation which mandates fixed nurse-to-patient staffing ratios as a means to address the current crisis in the quality of health care delivery. Modeling medical units as closed queueing systems, we seek to determine whether or not ratio policies are effective at managing nurse workload. Our many-server asymptotic results suggest that ratio policies cannot provide consistently high service quality across medical units of different sizes. As a remedy, we recommend policies that deviate from the restrictive linear nature of ratio policies, employing the 'square root rule' commonly used to staff large service systems. Under some quality of care assumptions, our policies exhibit a type of 'super' pooling effect, in which, for large systems, the requisite workforce is significantly smaller than the nominal patient load

Estimation of capture probabilities using generalized estimating equations and mixed effects approaches

Modeling individual heterogeneity in capture probabilities has been one of the most challenging tasks in capture-recapture studies. Heterogeneity in capture probabilities can be modeled as a function of individual covariates, but correlation structure among capture occasions should be taking into account. A proposed generalized estimating equations (GEE) and generalized linear mixed modeling (GLMM) approaches can be used to estimate capture probabilities and population size for capture-recapture closed population models. An example is used for an illustrative application and for comparison with currently used methodology. A simulation study is also conducted to show the performance of the estimation procedures. Our simulation results show that the proposed quasi-likelihood based on GEE approach provides lower SE than partial likelihood based on either generalized linear models (GLM) or GLMM approaches for estimating population size in a closed capture-recapture experiment. Estimator performance is good if a large proportion of individuals are captured. For cases where only a small proportion of individuals are captured, the estimates become unstable, but the GEE approach outperforms the other methods

The Huntington's disease mutation impairs Huntingtin's role in the transport of NF-κB from the synapse to the nucleus

Expansion of a polyglutamine (polyQ) tract in the Huntingtin (Htt) protein causes Huntington's disease (HD), a fatal inherited neurodegenerative disorder. Loss of the normal function of Htt is thought to be an important pathogenetic component of HD. However, the function of wild-type Htt is not well defined. Htt is thought to be a multifunctional protein that plays distinct roles in several biological processes, including synaptic transmission, intracellular transport and neuronal transcription. Here, we show with biochemical and live cell imaging studies that wild-type Htt stimulates the transport of nuclear factor κ light-chain-enhancer of activated B cells (NF-κB) out of dendritic spines (where NF-κB is activated by excitatory synaptic input) and supports a high level of active NF-κB in neuronal nuclei (where NF-κB stimulates the transcription of target genes). We show that this novel function of Htt is impaired by the polyQ expansion and thus may contribute to the etiology of HD

Solar neutrino with Borexino: results and perspectives

Borexino is a unique detector able to perform measurement of solar neutrinos fluxes in the energy region around 1 MeV or below due to its low level of radioactive background. It was constructed at the LNGS underground laboratory with a goal of solar $^{7}$Be neutrino flux measurement with 5\% precision. The goal has been successfully achieved marking the end of the first stage of the experiment. A number of other important measurements of solar neutrino fluxes have been performed during the first stage. Recently the collaboration conducted successful liquid scintillator repurification campaign aiming to reduce main contaminants in the sub-MeV energy range. With the new levels of radiopurity Borexino can improve existing and challenge a number of new measurements including: improvement of the results on the Solar and terrestrial neutrino fluxes measurements; measurement of pp and CNO solar neutrino fluxes; search for non-standard interactions of neutrino; study of the neutrino oscillations on the short baseline with an artificial neutrino source (search for sterile neutrino) in context of SOX project.Comment: 15 pages, 4 figure

New limits on heavy sterile neutrino mixing in 8B{^{8}\rm{B}}-decay obtained with the Borexino detector

If heavy neutrinos with mass $m_{\nu_{H}}\geq$2$m_e$ are produced in the Sun via the decay ${^8\rm{B}} \rightarrow {^8\rm{Be}} + e^+ + \nu_H$ in a side branch of pp-chain, they would undergo the observable decay into an electron, a positron and a light neutrino $\nu_{H}\rightarrow\nu_{L}+e^++e^-$. In the present work Borexino data are used to set a bound on the existence of such decays. We constrain the mixing of a heavy neutrino with mass 1.5 MeV $\leq m_{\nu_{H}} \le$ 14 MeV to be $|U_{eH}|^2\leq (10^{-3}-4\times10^{-6})$ respectively. These are tighter limits on the mixing parameters than obtained in previous experiments at nuclear reactors and accelerators.Comment: 7 pages, 6 figure

Borexino calibrations: Hardware, Methods, and Results

Borexino was the first experiment to detect solar neutrinos in real-time in the sub-MeV region. In order to achieve high precision in the determination of neutrino rates, the detector design includes an internal and an external calibration system. This paper describes both calibration systems and the calibration campaigns that were carried out in the period between 2008 and 2011. We discuss some of the results and show that the calibration procedures preserved the radiopurity of the scintillator. The calibrations provided a detailed understanding of the detector response and led to a significant reduction of the systematic uncertainties in the Borexino measurements