The time to shut down

At each time, a firm facing uncertainty over future market conditions have to make a decision whether they should continue to produce or stop the process? As the traditional principle, the firm will go out of production when the price of the typical unit does not cover the average variable cost that it must incur to produce the typical unit. In reality the firm can suffer losses today however it can get more gains tomorrow that is enough to make up the losses. It means that this rule seems not be suitable absolutely in an uncertainty environment. And it leads to a rule that the firm only stop producing if average variable costs of unit exceed the price of unit by a positive amount. This paper expects to find this exceeding amount and when a firm will stop producing. Under uncertainty, the price of unit and the average variables cost are assumed to follow a continuous time stochastic process. We wish to apply the optimal stopping time approach in order to solve it.

Implications of bleeding in acute coronary syndrome and percutaneous coronary intervention

The advent of potent antiplatelet and antithrombotic agents over the past decade has resulted in significant improvement in reducing ischemic events in acute coronary syndrome (ACS). However, the use of antiplatelet and antithrombotic combination therapy, often in the settings of percutaneous coronary intervention (PCI), has led to an increase in the risk of bleeding. In patients with non-ST elevation myocardial infarction treated with antithrombotic agents, bleeding has been reported to occur in 0.4%–10% of patients, whereas in patients undergoing PCI, periprocedural bleeding occurs in 2.2%–14% of cases. Until recently, bleeding was considered an intrinsic risk of antithrombotic therapy, and efforts to reduce bleeding have received little attention. There have been increasing data demonstrating that bleeding is associated with adverse outcomes, including myocardial infarction, stroke, and death. Therefore, it is imperative to optimize patient outcomes by adopting pharmacological and nonpharmacological strategies to minimize bleeding while maximizing treatment efficacy. In this paper, we present a review of the bleeding classifications used in large-scale clinical trials in patients with ACS and those undergoing PCI treated with antiplatelets and antithrombotic agents, adverse outcomes, particularly mortality associated with bleeding complications, and suggested predictive risk factors. Potential mechanisms of the association between bleeding and mortality and strategies to reduce bleeding complications are also discussed

New onset diabetes after transplantation (NODAT): an overview

Although renal transplantation ameliorates cardiovascular risk factors by restoring renal function, it introduces new cardiovascular risks including impaired glucose tolerance or diabetes mellitus, hypertension, and dyslipidemia that are derived, in part, from immunosuppressive medications such as calcineurin inhibitors, corticosteroids, or mammalian target of rapamycin inhibitors. New onset diabetes mellitus after transplantation (NODAT) is a serious and common complication following solid organ transplantation. NODAT has been reported to occur in 2% to 53% of all solid organ transplants. Kidney transplant recipients who develop NODAT have variably been reported to be at increased risk of fatal and nonfatal cardiovascular events and other adverse outcomes including infection, reduced patient survival, graft rejection, and accelerated graft loss compared with those who do not develop diabetes. Identification of high-risk patients and implementation of measures to reduce the development of NODAT may improve long-term patient and graft outcome. The following article presents an overview of the literature on the current diagnostic criteria for NODAT, its incidence after solid organ transplantation, suggested risk factors and potential pathogenic mechanisms. The impact of NODAT on patient and allograft outcomes and suggested guidelines for early identification and management of NODAT will also be discussed

Incidences between points and generalized spheres over finite fields and related problems

Let $\mathbb{F}_q$ be a finite field of $q$ elements where $q$ is a large odd prime power and $Q =a_1 x_1^{c_1}+...+a_dx_d^{c_d}\in \mathbb{F}_q[x_1,...,x_d]$, where $2\le c_i\le N$, $\gcd(c_i,q)=1$, and $a_i\in \mathbb{F}_q$ for all $1\le i\le d$. A $Q$-sphere is a set of the form $\lbrace x\in \mathbb{F}_q^d | Q(x-b)=r\rbrace$, where $b\in \mathbb{F}_q^d, r\in \mathbb{F}_q$. We prove bounds on the number of incidences between a point set $\mathcal{P}$ and a $Q$-sphere set $\mathcal{S}$, denoted by $I(\mathcal{P},\mathcal{S})$, as the following. $$| I(\mathcal{P},\mathcal{S})-\frac{|\mathcal{P}||\mathcal{S}|}{q}|\le q^{d/2}\sqrt{|\mathcal{P}||\mathcal{S}|}.$$ We prove this estimate by studying the spectra of directed graphs. We also give a version of this estimate over finite rings $\mathbb{Z}_q$ where $q$ is an odd integer. As a consequence of the above bounds, we give an estimate for the pinned distance problem. In Sections $4$ and $5$, we prove a bound on the number of incidences between a random point set and a random $Q$-sphere set in $\mathbb{F}_q^d$. We also study the finite field analogues of some combinatorial geometry problems, namely, the number of generalized isosceles triangles, and the existence of a large subset without repeated generalized distances.Comment: to appear in Forum Mat

Antithrombotic strategies in patients undergoing percutaneous coronary intervention for acute coronary syndrome

In patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS), both periprocedural acute myocardial infarction and bleeding complications have been shown to be associated with early and late mortality. Current standard antithrombotic therapy after coronary stent implantation consists of lifelong aspirin and clopidogrel for a variable period depending in part on the stent type. Despite its well-established efficacy in reducing cardiac-related death, myocardial infarction, and stroke, dual antiplatelet therapy with aspirin and clopidogrel is not without shortcomings. While clopidogrel may be of little beneficial effect if administered immediately prior to PCI and may even increase major bleeding risk if coronary artery bypass grafting is anticipated, early discontinuation of the drug may result in insufficient antiplatelet coverage with thrombotic complications. Optimal and rapid inhibition of platelet activity to suppress ischemic and thrombotic events while minimizing bleeding complications is an important therapeutic goal in the management of patients undergoing percutaneous coronary intervention. In this article we present an overview of the literature on clinical trials evaluating the different aspects of antithrombotic therapy in patients undergoing PCI and discuss the emerging role of these agents in the contemporary era of early invasive coronary intervention. Clinical trial acronyms and their full names are provided in Table 1

2017 update on pain management in patients with chronic kidney disease

The prevalence of pain has been reported to be \u3e60–70% among patients with advanced and end-stage kidney disease. Although the underlying etiologies of pain may vary, pain per se has been linked to lower quality of life and depression. The latter is of great concern given its known association with reduced survival among patients with end-stage kidney disease.We herein discuss and update the management of pain in patients with chronic kidney disease with and without requirement for renal replacement therapy with the focus on optimizing pain control while minimizing therapy-induced complications