Insuring non-verifiable losses

Insurance contracts are often complex and difficult to verify outside the insurance relation. We show that standard one-period insurance policies with an upper limit and a deductible are the optimal incentive-compatible contracts in a competitive market with repeated interaction. Optimal group insurance policies involve a joint upper limit but individual deductibles and insurance brokers can play a role implementing such contracts for the group of clients. Our model provides new insights and predictions about the determinants of insurance

On Potassium and Other Abundance Anomalies of Red Giants in NGC 2419

Globular clusters are of paramount importance for testing theories of stellar evolution and early galaxy formation. Strong evidence for multiple populations of stars in globular clusters derives from observed abundance anomalies. A puzzling example is the recently detected Mg-K anticorrelation in NGC 2419. We perform Monte Carlo nuclear reaction network calculations to constrain the temperature-density conditions that gave rise to the elemental abundances observed in this elusive cluster. We find a correlation between stellar temperature and density values that provide a satisfactory match between simulated and observed abundances in NGC 2419 for all relevant elements (Mg, Si, K, Ca, Sc, Ti, and V). Except at the highest densities ($\rho \gtrsim 10^8$~g/cm$^3$), the acceptable conditions range from $\approx$ $100$~MK at $\approx$ $10^8$~g/cm$^3$ to $\approx$ $200$~MK at $\approx$ $10^{-4}$~g/cm$^3$. This result accounts for uncertainties in nuclear reaction rates and variations in the assumed initial composition. We review hydrogen burning sites and find that low-mass stars, AGB stars, massive stars, or supermassive stars cannot account for the observed abundance anomalies in NGC 2419. Super-AGB stars could be viable candidates for the polluter stars if stellar model parameters can be fine-tuned to produce higher temperatures. Novae, either involving CO or ONe white dwarfs, could be interesting polluter candidates, but a current lack of low-metallicity nova models precludes firmer conclusions. We also discuss if additional constraints for the first-generation polluters can be obtained by future measurements of oxygen, or by evolving models of second-generation low-mass stars with a non-canonical initial composition.Comment: 24 pages, 9 Figure

Before the First Shot is Fired: Hypothetical Use of Alternative Dispute Resolution to Avoid a Re-Enactment of the Hatfields and the McCoys - Kirkham v. Wright

Kirkham v. Wright was chosen as the subject case because it represents the type of dispute that is extremely well suited to resolution through the ADR process. While some argument exists about the law in Kirkham,2 the bulk of the dispute revolves around the application of the law to the facts.\u27 Furthermore, this case was eventually settled after remand,4 which leads to the conclusion that a settlement may have been possible earlier. Additionally, while the attorneys involved would not disclose the legal costs, it is a safe estimate that they ran into the tens of thousands of dollars.\u2

The Physics of Hard Spheres Experiment on MSL-1: Required Measurements and Instrument Performance

The Physics of HArd Spheres Experiment (PHaSE), one of NASA Lewis Research Center's first major light scattering experiments for microgravity research on complex fluids, flew on board the Space Shuttle's Microgravity Science Laboratory (MSL-1) in 1997. Using colloidal systems of various concentrations of micron-sized plastic spheres in a refractive index-matching fluid as test samples, illuminated by laser light during and after crystallization, investigations were conducted to measure the nucleation and growth rate of colloidal crystals as well as the structure, rheology, and dynamics of the equilibrium crystal. Together, these measurements support an enhanced understanding of the nature of the liquid-to-solid transition. Achievement of the science objectives required an accurate experimental determination of eight fundamental properties for the hard sphere colloidal samples. The instrument design met almost all of the original measurement requirements, but with compromise on the number of samples on which data were taken. The instrument performs 2-D Bragg and low angle scattering from 0.4 deg. to 60 deg., dynamic and single-channel static scattering from 10 deg. to 170 deg., rheology using fiber optics, and white light imaging of the sample. As a result, PHaSE provided a timely microgravity demonstration of critical light scattering measurement techniques and hardware concepts, while generating data already showing promise of interesting new scientific findings in the field of condensed matter physics

Effect of allopurinol on all-cause mortality in adults with incident gout: propensity score–matched landmark analysis

Objective: To examine the association between allopurinol use and all-cause mortality for patients with incident gout. Methods: We compared all-cause mortality in incident gout patients who received allopurinol for at least 6 months within the exposure window (1 year or 3 years) with those who did not, using the UK Clinical Practice Research Data-link. Landmark analysis was used to account for immortal time bias and propensity score matching was used to control for potential effects of known confounders. Results: Of 23 332 incident gout patients identified, the propensity score–matched cohorts contained 1016 patients exposed to allopurinol on the date 1 year from diagnosis (landmark date) and 1016 allopurinol non-users. Over a median follow-up period of 10 years after the landmark date, there were 437 allopurinol users and 443 allopurinol non-users who died during follow-up. Allopurinol users and non-users had similar risk for all-cause mortality (hazard ratio 0.99; 95% CI 0.87, 1.12). In the 3-year landmark analysis, 3519 allopurinol users (1280 died) were compared with 3519 non-users (1265 died). The hazard ratio for all-cause mortality was 1.01 (95% CI 0.92, 1.09). Conclusion: This propensity score–matched landmark analysis in a population of incident gout patients in the UK primary care setting found a neutral effect on the risk of all-cause mortality. Our study provides reassurance about the prescription of allopurinol for gout patients early in their disease course to prevent untoward consequences of chronic uncontrolled hyperuricaemia. However, whether higher than the commonly used dose of allopurinol could influence mortality remains to be determined

Improving Assignments for Therapeutic and Prophylactic Treatment Within TB Households. A Potential for Immuno-Diagnosis?

Delays in diagnosis and treatment of pulmonary tuberculosis (TB) can lead to more severe disease and increased transmission. Contact investigation among household contacts (HHCs) of TB patients is crucial to ensure optimal outcomes. In the context of a prospective cohort study in Palamaner, Southern India, this study attempted to assess the potential of 27 different soluble immune markers to accurately assign HHCs for appropriate treatment. A multiplex bead assay was applied on QuantiFERON (QFT)-nil supernatants collected from 89 HHCs grouped by longitudinal QFT status; M. tuberculosis (Mtb) infected (QFT positive at baseline and follow-up, n = 30), recent QFT converters (QFT-negative at baseline, n = 27) and converted to QFT-positivity within 6 months of exposure (at follow-up, n = 24) and QFT consistent negatives (n = 32). The 29 TB index cases represented Active TB. Active TB cases and HHCs with Mtb infection produced significantly different levels of both pro-inflammatory (IFNγ, IL17, IL8, IP10, MIP-1α, MIP1β, and VEGF) and anti-inflammatory (IL9 and IL1RA) cytokines. We identified a 4-protein signature (bFGF, IFNγ, IL9, and IP10) that correctly classified HHCs with Mtb infection vs. Active TB with a specificity of 92.6%, suggesting that this 4-protein signature has the potential to assign HHCs for either full-length TB treatment or preventive TB treatment. We further identified a 4-protein signature (bFGF, GCSF, IFNγ, and IL1RA) that differentiated HHCs with Mtb infection from QFT consistent negatives with a specificity of 62.5%, but not satisfactory to safely assign HHCs to no preventive TB treatment. QFT conversion, reflecting new Mtb infection, induced an elevated median concentration in nearly two-thirds (19/27) of the analyzed soluble markers compared to the levels measured at baseline. Validation in other studies is warranted in order to establish the potential of the immune biosignatures for optimized TB case detection and assignment to therapeutic and preventive treatment of Mtb infected individuals.publishedVersio

Added value of IP-10 as a read-out of <em>Mycobacterium tuberculosis</em>:Specific immunity in young children

We have explored the added value of interferon-γ (IFNγ)–inducible protein 10 as a read-out of Mycobacterium tuberculosis–specific immunity in young Indian children, where the sensitivity of the IFNγ release assays for tuberculosis is poor. Reduced frequency of indeterminate results and an increased sensitivity for tuberculosis suggest a potential for fewer missed cases with a combined IFNγ/inducible protein 10 read-out in a 4th generation IFNγ release assays

Impact of gout on the risk of atrial fibrillation

OBJECTIVES: To examine the risk of atrial fibrillation (AF) at the time of first diagnosis of gout compared with matched controls and to follow incident gout patients and their matched controls after diagnosis to compare their subsequent risk of AF. METHODS: From the UK Clinical Practice Research Data-link, 45 378 incident gout patients and 45 378 age-, sex-, practice-, registration year- and index year-matched controls were identified. Index dates were initial diagnosis date for gout patients and their matched controls. The risk of AF at diagnosis [odds ratios (ORs), using conditional logistic regression] and after the diagnosis of gout [hazard ratios (HRs), using Cox proportional models] were estimated, adjusted for BMI, smoking, alcohol consumption, ischaemic heart disease, heart failure, heart valve disease, hyperthyroidism and other comorbidities and medications. RESULTS: The prevalence of AF at index date in gout patients (male, 72.3%; mean age, 62.4 +/- 15.1 years) was 7.42% (95% CI 7.18, 7.66%) and in matched controls 2.83% (95% CI 2.67, 2.98%). The adjusted OR (95% CI) was 1.45 (1.29, 1.62). The cumulative probability of AF at 1, 2, 5 and 10 years after index date was 1.08, 2.03, 4.77 and 9.68% in gout patients and 0.43, 1.08, 2.95 and 6.33% in controls, respectively (log-rank test, P < 0.001). The adjusted HR (95% CIs) was 1.09 (1.03, 1.16). CONCLUSION: This population-based study indicates that gout is independently associated with a higher risk of AF at diagnosis and the risk is also higher after the diagnosis

Rheumatoid arthritis and excess mortality: down but not out: a primary care cohort study using data from Clinical Practice Research Datalink

Objectives: To examine temporal trends in all-cause and cause-specific mortality in RA. Methods: Data from the Clinical Practice Research Datalink (CPRD) were used. Incident RA cases and four age, sex and general practice matched controls were identified from at-risk cohorts for each calendar year and followed-up for up to five years. Mortality rates and 95% confidence intervals (95% CIs) were computed. Cox-proportional hazard ratios (HRs) were calculated to estimate associations and adjusted for covariates. Temporal trend in mortality was examined using the Joinpoints Regression Program. Data management and analysis were performed using Stata v.14. Results: 21,622 cases with incident RA and 86,488 controls were included. The mortality rate (95%CI) of RA cases and controls was 26.90 (25.87-27.97) and 18.92 (18.48-19.36)/1000 person-years respectively. The mortality rate in RA cases did not change significantly between 1990 and 2004, but reduced by 7.7%/year between 2005 and 2009. However, the mortality rate in controls improved steadily by 2.2%/year between 1990 and 2009. RA associated with 32% excess risk of mortality in the entire cohort (aHR (95%CI) 1.32(1.26-1.38), but this was only 15% in cases incident after 2006 (aHR (95%CI) 1.15(1.03-1.29)). Similarly, the HR of death due to cardiovascular diseases reduced in cases incident in recent years. Conclusion: The mortality rate in RA cases incident after the year 2006 has declined significantly, with a trend towards decline in death from cardiovascular diseases. This could be due to improved management of RA. However, even in cohorts from recent years, RA still associates with higher mortality rates