Waiting time distribution in public health care: empirics and theory

Excessive waiting times for elective surgery have been a long-standing concern in many national healthcare systems in the OECD. How do the hospital admission patterns that generate waiting lists affect different patients? What are the hospitals characteristics that determine waiting times? By developing a model of healthcare provision and analysing empirically the entire waiting time distribution we attempt to shed some light on those issues. We first build a theoretical model that describes the optimal waiting time distribution for capacity constraint hospitals. Secondly, employing duration analysis, we obtain empirical representations of that distribution across hospitals in the UK from 1997–2005. We observe important differences on the ‘scale’ and on the ‘shape’ of admission rates. Scale refers to how quickly patients are treated and shape represents trade-offs across duration-treatment profiles. By fitting the theoretical to the empirical distributions we estimate the main structural parameters of the model and are able to closely identify the main drivers of these empirical differences. We find that the level of resources allocated to elective surgery (budget and physical capacity), which determines how constrained the hospital is, explains differences in scale. Changes in benefits and costs structures of healthcare provision, which relate, respectively, to the desire to prioritise patients by duration and the reduction in costs due to delayed treatment, determine the shape, affecting short and long duration patients differently

Global Analysis of the Higgs Candidate with Mass ~ 125 GeV

We analyze the properties of the Higgs candidate with mass ~ 125 GeV discovered by the CMS and ATLAS Collaborations, constraining the possible deviations of its couplings from those of a Standard Model Higgs boson. The CMS, ATLAS and Tevatron data are compatible with Standard Model couplings to massive gauge bosons and fermions, and disfavour several types of composite Higgs models unless their couplings resemble those in the Standard Model. We show that the couplings of the Higgs candidate are consistent with a linear dependence on particle masses, scaled by the electroweak scale ~ 246 GeV, the power law and the mass scale both having uncertainties ~ 20%.Comment: 22 pages, 9 figures, v2 incorporates experimental data released during July 2012 and corrected (and improved) treatment of mass dependence of coupling

Multiple Neural Oscillators and Muscle Feedback Are Required for the Intestinal Fed State Motor Program

After a meal, the gastrointestinal tract exhibits a set of behaviours known as the fed state. A major feature of the fed state is a little understood motor pattern known as segmentation, which is essential for digestion and nutrient absorption. Segmentation manifests as rhythmic local constrictions that do not propagate along the intestine. In guinea-pig jejunum in vitro segmentation constrictions occur in short bursts together with other motor patterns in episodes of activity lasting 40–60 s and separated by quiescent episodes lasting 40–200 s. This activity is induced by luminal nutrients and abolished by blocking activity in the enteric nervous system (ENS). We investigated the enteric circuits that regulate segmentation focusing on a central feature of the ENS: a recurrent excitatory network of intrinsic sensory neurons (ISNs) which are characterized by prolonged after-hyperpolarizing potentials (AHPs) following their action potentials. We first examined the effects of depressing AHPs with blockers of the underlying channels (TRAM-34 and clotrimazole) on motor patterns induced in guinea-pig jejunum, in vitro, by luminal decanoic acid. Contractile episode durations increased markedly, but the frequency and number of constrictions within segmenting bursts and quiescent period durations were unaffected. We used these observations to develop a computational model of activity in ISNs, excitatory and inhibitory motor neurons and the muscle. The model predicted that: i) feedback to ISNs from contractions in the circular muscle is required to produce alternating activity and quiescence with the right durations; ii) transmission from ISNs to excitatory motor neurons is via fast excitatory synaptic potentials (EPSPs) and to inhibitory motor neurons via slow EPSPs. We conclude that two rhythm generators regulate segmentation: one drives contractions within segmentation bursts, the other the occurrence of bursts. The latter depends on AHPs in ISNs and feedback to these neurons from contraction of the circular muscle

Anomalous Couplings in Double Higgs Production

The process of gluon-initiated double Higgs production is sensitive to non-linear interactions of the Higgs boson. In the context of the Standard Model, studies of this process focused on the extraction of the Higgs trilinear coupling. In a general parametrization of New Physics effects, however, an even more interesting interaction that can be tested through this channel is the (ttbar hh) coupling. This interaction vanishes in the Standard Model and is a genuine signature of theories in which the Higgs boson emerges from a strongly-interacting sector. In this paper we perform a model-independent estimate of the LHC potential to detect anomalous Higgs couplings in gluon-fusion double Higgs production. We find that while the sensitivity to the trilinear is poor, the perspectives of measuring the new (ttbar hh) coupling are rather promising.Comment: 22 pages, 9 figures. v2: plots of Figs.8 and 9 redone to include experimental uncertainty on the Higgs couplings, references adde

Adenosquamous carcinoma of breast in a 19 years old woman: a case report

<p>Abstract</p> <p>Background</p> <p>Adenosquamous carcinoma of the breast is a rare form of metaplastic breast carcinoma. We report such a case in a 19 years old female.</p> <p>Case presentation</p> <p>Case notes and histopathology were reviewed. Adenosquamous carcinoma was diagnosed on wide local excision and patient underwent skin-sparing mastectomy with Latissimus dorsi flap reconstruction.</p> <p>Conclusions</p> <p>Adenosquamous carcinoma of the breast is a rare form of metaplastic breast carcinoma. Data on correct management, follow-up and prognosis are very limited but given the high potential for local recurrence, aggressive surgery may be the only option.</p

A Light Stop with Flavor in Natural SUSY

The discovery of a SM-like Higgs boson near 125 GeV and the flavor texture of the Standard Model motivate the investigation of supersymmetric quiver-like BSM extensions. We study the properties of such a minimal class of models which deals naturally with the SM parameters. Considering experimental bounds as well as constraints from flavor physics and Electro-Weak Precision Data, we find the following. In a self-contained minimal model - including the full dynamics of the Higgs sector - top squarks below a TeV are in tension with b->s{\gamma} constraints. Relaxing the assumption concerning the mass generation of the heavy Higgses, we find that a stop not far from half a TeV is allowed. The models have some unique properties, e.g. an enhancement of the h-> b\bar{b},\tau\bar{{\tau}} decays relative to the h->\gamma{\gamma} one, a gluino about 3 times heavier than the stop, an inverted hierarchy of about 3-20 between the squarks of the first two generations and the stop, relatively light Higgsino neutralino or stau NLSP, as well as heavy Higgses and a W' which may be within reach of the LHC.Comment: LaTeX, 22 pages, 4 figures; V2: references adde

Complete Higgs sector constraints on dimension-6 operators

Constraints on the full set of Standard Model dimension-6 operators have previously used triple-gauge couplings to complement the constraints obtainable from Higgs signal strengths. Here we extend previous analyses of the Higgs sector constraints by including information from the associated production of Higgs and massive vector bosons (H+V production), which excludes a direction of limited sensitivity allowed by partial cancellations in the triple-gauge sector measured at LEP. Kinematic distributions in H+V production provide improved sensitivity to dimension-6 operators, as we illustrate here with simulations of the invariant mass and pT distributions measured by D0 and ATLAS, respectively. We provide bounds from a global fit to a complete set of CP-conserving operators affecting Higgs physics

Flavor Violating Higgs Decays

We study a class of nonstandard interactions of the newly discovered 125 GeV Higgs-like resonance that are especially interesting probes of new physics: flavor violating Higgs couplings to leptons and quarks. These interaction can arise in many frameworks of new physics at the electroweak scale such as two Higgs doublet models, extra dimensions, or models of compositeness. We rederive constraints on flavor violating Higgs couplings using data on rare decays, electric and magnetic dipole moments, and meson oscillations. We confirm that flavor violating Higgs boson decays to leptons can be sizeable with, e.g., h -> tau mu and h -> tau e branching ratios of order 10% perfectly allowed by low energy constraints. We estimate the current LHC limits on h -> tau mu and h -> tau e decays by recasting existing searches for the SM Higgs in the tau-tau channel and find that these bounds are already stronger than those from rare tau decays. We also show that these limits can be improved significantly with dedicated searches and we outline a possible search strategy. Flavor violating Higgs decays therefore present an opportunity for discovery of new physics which in some cases may be easier to access experimentally than flavor conserving deviations from the Standard Model Higgs framework.Comment: 39 pages, 12 figures, 3 tables; v2: Improved referencing, updated mu -> 3e bounds to include large loop contributions, corrected single top constraints; conclusions unchanged; matches version to be published in JHEP; v3: included 2-loop contributions in mu -> e conversion, improved discussion of tau -> 3 mu and of EDM constraints on FV top-Higgs couplings; conclusions unchange

Higgs After the Discovery: A Status Report

Recently, the ATLAS and CMS collaborations have announced the discovery of a 125 GeV particle, commensurable with the Higgs boson. We analyze the 2011 and 2012 LHC and Tevatron Higgs data in the context of simplified new physics models, paying close attention to models which can enhance the diphoton rate and allow for a natural weak-scale theory. Combining the available LHC and Tevatron data in the ZZ* 4-lepton, WW* 2-lepton, diphoton, and b-bbar channels, we derive constraints on the effective low-energy theory of the Higgs boson. We map several simplified scenarios to the effective theory, capturing numerous new physics models such as supersymmetry, composite Higgs, dilaton. We further study models with extended Higgs sectors which can naturally enhance the diphoton rate. We find that the current Higgs data are consistent with the Standard Model Higgs boson and, consequently, the parameter space in all models which go beyond the Standard Model is highly constrained.Comment: 37 pages; v2: ATLAS dijet-tag diphoton channel added, dilaton and doublet-singlet bugs corrected, references added; v3: ATLAS WW channel included, comments and references adde