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

Counting supersymmetric branes

Maximal supergravity solutions are revisited and classified, with particular emphasis on objects of co-dimension at most two. This class of solutions includes branes whose tension scales with g_s^{-\sigma} for \sigma>2. We present a group theory derivation of the counting of these objects based on the corresponding tensor hierarchies derived from E11 and discrete T- and U-duality transformations. This provides a rationale for the wrapping rules that were recently discussed for \sigma<4 in the literature and extends them. Explicit supergravity solutions that give rise to co-dimension two branes are constructed and analysed.Comment: 1+33 pages. To the memory of Laurent Houart. v2: Published version with added reference

An Over-Massive Black Hole in the Compact Lenticular Galaxy NGC1277

All massive galaxies likely have supermassive black holes at their centers, and the masses of the black holes are known to correlate with properties of the host galaxy bulge component. Several explanations have been proposed for the existence of these locally-established empirical relationships; they include the non-causal, statistical process of galaxy-galaxy merging, direct feedback between the black hole and its host galaxy, or galaxy-galaxy merging and the subsequent violent relaxation and dissipation. The empirical scaling relations are thus important for distinguishing between various theoretical models of galaxy evolution, and they further form the basis for all black hole mass measurements at large distances. In particular, observations have shown that the mass of the black hole is typically 0.1% of the stellar bulge mass of the galaxy. The small galaxy NGC4486B currently has the largest published fraction of its mass in a black hole at 11%. Here we report observations of the stellar kinematics of NGC 1277, which is a compact, disky galaxy with a mass of 1.2 x 10^11 Msun. From the data, we determine that the mass of the central black hole is 1.7 x 10^10 Msun, or 59% its bulge mass. Five other compact galaxies have properties similar to NGC 1277 and therefore may also contain over-sized black holes. It is not yet known if these galaxies represent a tail of a distribution, or if disk-dominated galaxies fail to follow the normal black hole mass scaling relations.Comment: 7 pages. 6 figures. Nature. Animation at http://www.mpia.de/~bosch/blackholes.htm

Search for Exotic Strange Quark Matter in High Energy Nuclear Reactions

We report on a search for metastable positively and negatively charged states of strange quark matter in Au+Pb reactions at 11.6 A GeV/c in experiment E864. We have sampled approximately six billion 10% most central Au+Pb interactions and have observed no strangelet states (baryon number A < 100 droplets of strange quark matter). We thus set upper limits on the production of these exotic states at the level of 1-6 x 10^{-8} per central collision. These limits are the best and most model independent for this colliding system. We discuss the implications of our results on strangelet production mechanisms, and also on the stability question of strange quark matter.Comment: 21 pages, 9 figures, to be published in Nuclear Physics A (Carl Dover memorial edition

Small RNA analysis in Sindbis virus infected human HEK293 cells

In contrast to the defence mechanism of RNA interference (RNAi) in plants and invertebrates, its role in the innate response to virus infection of mammals is a matter of debate. Since RNAi has a well-established role in controlling infection of the alphavirus Sindbis virus (SINV) in insects, we have used this virus to investigate the role of RNAi in SINV infection of human cells

Modeling Checkpoint-Based Movement with the Earth Mover's Distance

Movement data comes in various forms, including trajectory data and checkpoint data. While trajectories give detailed information about the movement of individual entities, checkpoint data in its simplest form does not give identities, just counts at checkpoints. However, checkpoint data is of increasing interest since it is readily available due to privacy reasons and as a by-product of other data collection. In this paper we propose to use the Earth Mover’s Distance as a versatile tool to reconstruct individual movements or flow based on checkpoint counts at different times. We analyze the modeling possibilities and provide experiments that validate model predictions, based on coarse-grained aggregations of data about actual movements of couriers in London, UK. While we cannot expect to reconstruct precise individual movements from highly granular checkpoint data, the evaluation does show that the approach can generate meaningful estimates of object movements. B. Speckmann and K. Verbeek are supported by the Netherlands Organisation for Scientific Research (NWO) under project nos. 639.023.208 and 639.021.541, respectively. This paper arose from work initiated at Dagstuhl seminar 12512 “Representation, analysis and visualization of moving objects”, December 2012. The authors gratefully acknowledge Schloss Dagstuhl for their support

Exoplanet Atmosphere Measurements from Transmission Spectroscopy and other Planet-Star Combined Light Observations

It is possible to learn a great deal about exoplanet atmospheres even when we cannot spatially resolve the planets from their host stars. In this chapter, we overview the basic techniques used to characterize transiting exoplanets - transmission spectroscopy, emission and reflection spectroscopy, and full-orbit phase curve observations. We discuss practical considerations, including current and future observing facilities and best practices for measuring precise spectra. We also highlight major observational results on the chemistry, climate, and cloud properties of exoplanets.Comment: Accepted review chapter; Handbook of Exoplanets, eds. Hans J. Deeg and Juan Antonio Belmonte (Springer-Verlag). 22 pages, 6 figure

Fourientations and the Tutte polynomial

A fourientation of a graph is a choice for each edge of the graph whether to orient that edge in either direction, leave it unoriented, or biorient it. Fixing a total order on the edges and a reference orientation of the graph, we investigate properties of cuts and cycles in fourientations which give trivariate generating functions that are generalized Tutte polynomial evaluations of the form (k + m)[superscript n−1](k + l)[superscript gT](αk + βl + m/k + m , γ k + l + δm/ k + l) for α, γ ∈ {0, 1, 2} and β, δ ∈ {0, 1}. We introduce an intersection lattice of 64 cut–cycle fourientation classes enumerated by generalized Tutte polynomial evaluations of this form. We prove these enumerations using a single deletion–contraction argument and classify axiomatically the set of fourientation classes to which our deletion–contraction argument applies. This work unifies and extends earlier results for fourientations due to Gessel and Sagan (Electron J Combin 3(2):Research Paper 9, 1996), results for partial orientations due to Backman (Adv Appl Math, forthcoming, 2014. arXiv:1408.3962), and Hopkins and Perkinson (Trans Am Math Soc 368(1):709–725, 2016), as well as results for total orientations due to Stanley (Discrete Math 5:171–178, 1973; Higher combinatorics (Proceedings of NATO Advanced Study Institute, Berlin, 1976). NATO Advanced Study Institute series, series C: mathematical and physical sciences, vol 31, Reidel, Dordrecht, pp 51–62, 1977), Las Vergnas (Progress in graph theory (Proceedings, Waterloo silver jubilee conference 1982), Academic Press, New York, pp 367–380, 1984), Greene and Zaslavsky (Trans Am Math Soc 280(1):97–126, 1983), and Gioan (Eur J Combin 28(4):1351–1366, 2007), which were previously unified by Gioan (2007), Bernardi (Electron J Combin 15(1):Research Paper 109, 2008), and Las Vergnas (Tutte polynomial of a morphism of matroids 6. A multi-faceted counting formula for hyperplane regions and acyclic orientations, 2012. arXiv:1205.5424). We conclude by describing how these classes of fourientations relate to geometric, combinatorial, and algebraic objects including bigraphical arrangements, cycle–cocycle reversal systems, graphic Lawrence ideals, Riemann–Roch theory for graphs, zonotopal algebra, and the reliability polynomial. Keywords: Partial graph orientations, Tutte polynomial, Deletion–contraction, Hyperplane arrangements, Cycle–cocycle reversal system, Chip-firing, G-parking functions, Abelian sandpile model, Riemann–Roch theory for graphs, Lawrence ideals, Zonotopal algebra, Reliability polynomialNational Science Foundation (U.S.) (Grant 1122374

Formation of Supermassive Black Holes

Evidence shows that massive black holes reside in most local galaxies. Studies have also established a number of relations between the MBH mass and properties of the host galaxy such as bulge mass and velocity dispersion. These results suggest that central MBHs, while much less massive than the host (~ 0.1%), are linked to the evolution of galactic structure. In hierarchical cosmologies, a single big galaxy today can be traced back to the stage when it was split up in hundreds of smaller components. Did MBH seeds form with the same efficiency in small proto-galaxies, or did their formation had to await the buildup of substantial galaxies with deeper potential wells? I briefly review here some of the physical processes that are conducive to the evolution of the massive black hole population. I will discuss black hole formation processes for `seed' black holes that are likely to place at early cosmic epochs, and possible observational tests of these scenarios.Comment: To appear in The Astronomy and Astrophysics Review. The final publication is available at http://www.springerlink.co

Up-regulation of Toll-like receptors 2, 3 and 4 in allergic rhinitis

BACKGROUND: Toll-like receptors enable the host to recognize a large number of pathogen-associated molecular patterns such as bacterial lipopolysaccharide, viral RNA, CpG-containing DNA and flagellin. Toll-like receptors have also been shown to play a pivotal role in both innate and adaptive immune responses. The role of Toll-like receptors as a primary part of our microbe defense system has been shown in several studies, but their possible function as mediators in allergy and asthma remains to be established. The present study was designed to examine the expression of Toll-like receptors 2, 3 and 4 in the nasal mucosa of patients with intermittent allergic rhinitis, focusing on changes induced by exposure to pollen. METHODS: 27 healthy controls and 42 patients with seasonal allergic rhinitis volunteered for the study. Nasal biopsies were obtained before and during pollen season as well as before and after allergen challenge. The seasonal material was used for mRNA quantification of Toll-like receptors 2, 3 and 4 with real-time polymerase chain reaction, whereas specimens achieved in conjunction with allergen challenge were used for immunohistochemical localization and quantification of corresponding proteins. RESULTS: mRNA and protein representing Toll-like receptors 2, 3 and 4 could be demonstrated in all specimens. An increase in protein expression for all three receptors could be seen following allergen challenge, whereas a significant increase of mRNA only could be obtained for Toll-like receptor 3 during pollen season. CONCLUSION: The up-regulation of Toll-like receptors 2, 3 and 4 in the nasal mucosa of patients with symptomatic allergic rhinitis supports the idea of a role for Toll-like receptors in allergic airway inflammation