The Effects of Cardiac Specialty Hospitals on the Cost and Quality of Medical Care

The recent rise of specialty hospitals -- typically for-profit firms that are at least partially owned by physicians -- has led to substantial debate about their effects on the cost and quality of care. Advocates of specialty hospitals claim they improve quality and lower cost; critics contend they concentrate on providing profitable procedures and attracting relatively healthy patients, leaving (predominantly nonprofit) general hospitals with a less-remunerative, sicker patient population. We find support for both sides of this debate. Markets experiencing entry by a cardiac specialty hospital have lower spending for cardiac care without significantly worse clinical outcomes. In markets with a specialty hospital, however, specialty hospitals tend to attract healthier patients and provide higher levels of intensive procedures than general hospitals.

The Universal Gaussian in Soliton Tails

We show that in a large class of equations, solitons formed from generic initial conditions do not have infinitely long exponential tails, but are truncated by a region of Gaussian decay. This phenomenon makes it possible to treat solitons as localized, individual objects. For the case of the KdV equation, we show how the Gaussian decay emerges in the inverse scattering formalism.Comment: 4 pages, 2 figures, revtex with eps

Signatures of Dark Matter Scattering Inelastically Off Nuclei

Direct dark matter detection focuses on elastic scattering of dark matter particles off nuclei. In this study, we explore inelastic scattering where the nucleus is excited to a low-lying state of 10-100 keV, with subsequent prompt de-excitation. We calculate the inelastic structure factors for the odd-mass xenon isotopes based on state-of-the-art large-scale shell-model calculations with chiral effective field theory WIMP-nucleon currents. For these cases, we find that the inelastic channel is comparable to or can dominate the elastic channel for momentum transfers around 150 MeV. We calculate the inelastic recoil spectra in the standard halo model, compare these to the elastic case, and discuss the expected signatures in a xenon detector, along with implications for existing and future experiments. The combined information from elastic and inelastic scattering will allow to determine the dominant interaction channel within one experiment. In addition, the two channels probe different regions of the dark matter velocity distribution and can provide insight into the dark halo structure. The allowed recoil energy domain and the recoil energy at which the integrated inelastic rates start to dominate the elastic channel depend on the mass of the dark matter particle, thus providing a potential handle to constrain its mass.Comment: 9 pages, 7 figures. Matches resubmitted version to Phys. Rev. D. One figure added; supplemental material (fits to the structure functions) added as an Appendi

Nonlinear lattice model of viscoelastic Mode III fracture

We study the effect of general nonlinear force laws in viscoelastic lattice models of fracture, focusing on the existence and stability of steady-state Mode III cracks. We show that the hysteretic behavior at small driving is very sensitive to the smoothness of the force law. At large driving, we find a Hopf bifurcation to a straight crack whose velocity is periodic in time. The frequency of the unstable bifurcating mode depends on the smoothness of the potential, but is very close to an exact period-doubling instability. Slightly above the onset of the instability, the system settles into a exactly period-doubled state, presumably connected to the aforementioned bifurcation structure. We explicitly solve for this new state and map out its velocity-driving relation

Microscopic Selection of Fluid Fingering Pattern

We study the issue of the selection of viscous fingering patterns in the limit of small surface tension. Through detailed simulations of anisotropic fingering, we demonstrate conclusively that no selection independent of the small-scale cutoff (macroscopic selection) occurs in this system. Rather, the small-scale cutoff completely controls the pattern, even on short time scales, in accord with the theory of microscopic solvability. We demonstrate that ordered patterns are dynamically selected only for not too small surface tensions. For extremely small surface tensions, the system exhibits chaotic behavior and no regular pattern is realized.Comment: 6 pages, 5 figure

Two-finger selection theory in the Saffman-Taylor problem

We find that solvability theory selects a set of stationary solutions of the Saffman-Taylor problem with coexistence of two \it unequal \rm fingers advancing with the same velocity but with different relative widths $\lambda_1$ and $\lambda_2$ and different tip positions. For vanishingly small dimensionless surface tension $d_0$, an infinite discrete set of values of the total filling fraction $\lambda = \lambda_1 + \lambda_2$ and of the relative individual finger width $p=\lambda_1/\lambda_2$ are selected out of a two-parameter continuous degeneracy. They scale as $\lambda-1/2 \sim d_0^{2/3}$ and $|p-1/2| \sim d_0^{1/3}$. The selected values of $\lambda$ differ from those of the single finger case. Explicit approximate expressions for both spectra are given.Comment: 4 pages, 3 figure

Recombination dramatically speeds up evolution of finite populations

We study the role of recombination, as practiced by genetically-competent bacteria, in speeding up Darwinian evolution. This is done by adding a new process to a previously-studied Markov model of evolution on a smooth fitness landscape; this new process allows alleles to be exchanged with those in the surrounding medium. Our results, both numerical and analytic, indicate that for a wide range of intermediate population sizes, recombination dramatically speeds up the evolutionary advance

Phase-Field Model of Mode III Dynamic Fracture

We introduce a phenomenological continuum model for mode III dynamic fracture that is based on the phase-field methodology used extensively to model interfacial pattern formation. We couple a scalar field, which distinguishes between ``broken'' and ``unbroken'' states of the system, to the displacement field in a way that consistently includes both macroscopic elasticity and a simple rotationally invariant short scale description of breaking. We report two-dimensional simulations that yield steady-state crack motion in a strip geometry above the Griffith threshold.Comment: submitted to PR

Analytic approach to the evolutionary effects of genetic exchange

We present an approximate analytic study of our previously introduced model of evolution including the effects of genetic exchange. This model is motivated by the process of bacterial transformation. We solve for the velocity, the rate of increase of fitness, as a function of the fixed population size, $N$. We find the velocity increases with $\ln N$, eventually saturated at an $N$ which depends on the strength of the recombination process. The analytical treatment is seen to agree well with direct numerical simulations of our model equations