On the Complexity of Dynamic Mechanism Design

We introduce a dynamic mechanism design problem in which the designer wants to offer for sale an item to an agent, and another item to the same agent at some point in the future. The agent's joint distribution of valuations for the two items is known, and the agent knows the valuation for the current item (but not for the one in the future). The designer seeks to maximize expected revenue, and the auction must be deterministic, truthful, and ex post individually rational. The optimum mechanism involves a protocol whereby the seller elicits the buyer's current valuation, and based on the bid makes two take-it-or-leave-it offers, one for now and one for the future. We show that finding the optimum deterministic mechanism in this situation - arguably the simplest meaningful dynamic mechanism design problem imaginable - is NP-hard. We also prove several positive results, among them a polynomial linear programming-based algorithm for the optimum randomized auction (even for many bidders and periods), and we show strong separations in revenue between non-adaptive, adaptive, and randomized auctions, even when the valuations in the two periods are uncorrelated. Finally, for the same problem in an environment in which contracts cannot be enforced, and thus perfection of equilibrium is necessary, we show that the optimum randomized mechanism requires multiple rounds of cheap talk-like interactions

Sepsis biomarkers: a review

Biomarkers can be useful for identifying or ruling out sepsis, identifying patients who may benefit from specific therapies or assessing the response to therapy.Journal ArticleReviewSCOPUS: ar.jinfo:eu-repo/semantics/publishe

SERVICE QUALITY ASYMMETRIC EFFECT ON PATIENT SATISFACTION FOR PRIMARY HEALTHCARE SERVICES

Primary health care services delivery and its effects on patient satisfaction are very important for healthcare managers as it affects healthcare results and organizations operational expenses’ management. Patient satisfaction is typically view it as a multidimensional construct. The purpose of this study is to exploit the theoretical frameworks of three-factor theory in order to identify the service delivery factors affecting patient satisfaction formation and to investigate whether there is an asymmetric service quality-satisfaction relationship. Regression analysis with dummy variables was used to analyze the responses of 407 primary healthcare services’ users, which were collected via personal interviews using a properly designed questionnaire. The results showed empirical support to the three-factor theory in the context of primary health care services by confirming the asymmetric relationship between service delivery performance assessment and patient satisfaction. Implications for practice and directions for future research are then discussed

Pharmacokinetic changes and dosing modification of aminoglycosides in critically ill obese patients: A literature review

The objective of the paper is to review the literature and provide recommendations for use of aminoglycoside antibiotics in critically ill obese patients. Literature search in PubMed for all articles on the use of aminoglycosides in critically ill obese patients was conducted, and all articles related to pharmacokinetics in obesity were reviewed. Bibliographies of all searched manuscripts were also reviewed in an attempt to find additional references. Although aminoglycoside pharmacokinetics have been described in detail, data on aminoglycoside use and appropriate dose modification in critically ill obese patients are very limited. Knowledge on aminoglycoside pharmacokinetics and use in critically ill obese patients is incomplete. Pathophysiologic changes in obesity can result in sub- or supra-therapeutic aminoglycoside plasma concentrations, especially in the presence of sepsis. Rigorous clinical studies are needed to establish aminoglycoside dosing guidelines in critically ill obese patients with sepsis

Hypomagnesemia in critically ill sepsis patients

Magnesium (Mg), also known as “the forgotten electrolyte”, is the fourth most abundant cation overall and the second most abundant intracellular cation in the body. Mg deficiency has been implicated in the pathophysiology of many diseases. This article is a review of the literature regarding Mg abnormalities with emphasis on the implications of hypomagnesemia in critical illness and on treatment options for hypomagnesemia in critically ill patients with sepsis. Hypomagnesemia is common in critically ill patients, and there is strong, consistent clinical evidence, largely from observational studies, showing that hypomagnesemia is significantly associated with increased need for mechanical ventilation, prolonged ICU stay and increased mortality. Although the mechanism linking hypomagnesemia with poor clinical outcomes is not known, experimental data suggest mechanisms contributing to such outcomes. However, at the present time, there is no clear evidence that magnesium supplementation improves outcomes in critically ill patients with hypomagnesemia. Large, well-designed clinical trials are needed to evaluate the role of magnesium therapy for improving outcomes in critically ill patients with sepsis

The use of pulmonary artery catheter in sepsis patients: A literature review

This article was to review the literature regarding the use of the pulmonary artery catheter (PAC) in the management of patients with sepsis and septic shock. A PubMed search was conducted in order to identify publications evaluating the use of PAC as a tool for management and therapeutic guidance in patients with sepsis. The bibliographies of all identified publications were reviewed for additional relevant references. Much information is identified in the literature regarding the indications for pulmonary artery catheterization in the assessment and treatment of patients with sepsis. Although the PAC has been widely used for many years, there is no clear benefit with regard to outcome, and there is controversy regarding its use. It is not clear that use of the PAC contributes to reduced morbidity and mortality in patients with sepsis. The role of the PAC is becoming less clear, as newer, non-invasive techniques are developed for hemodynamic assessment of sepsis patients. Large, well-designed clinical trials are needed to better assess the role and potential benefit from use of the PAC in sepsis