A methodology for measuring the relative effectiveness of healthcare services

^** Email: giorgio.vittadini{at}unimib.it^*** Email: simona.minotti{at}unicatt.it In this paper we propose a methodology for measuring the ‘relativeeffectiveness’ of healthcare services (i.e. the effectof hospital care on patients) under general conditions, in which:) a healthcare outcome underlies qualitative and quantitativeobservable indicators; ß) we are interested in studyingthe simultaneous dependency of multiple outcomes on covariates(where the outcomes can also be correlated to each other); )the relative effectiveness is adjusted for hospital-specificcovariates; ) we hypothesise a general distribution for randomdisturbances and the random parameters of relative effectiveness.For this topic, a generalisation of the SURE (seemingly unrelatedregression equations) multilevel model is proposed. The solutionsare obtained by means of Bayesian inference methods. Since thereis currently no software available to estimate this model, anSAS procedure based on Markov Chain Monte Carlo methods hasbeen developed by the authors, in line with Goldstein &Spiegelhalter (1996, J. R. Stat. Soc. Ser. A, 159, 385–443),Spiegelhalter et al. (1996, Bayesian Using Gibbs Sampling Manual.Cambridge: MRC Biostatistic Unit, Institute of Public Health)and Albert & Chib (1997, J. Am. Stat. Assoc., 92, 916–925).In addition, a new theoretical result regarding the joint posteriordistribution for the parameters is provided. The model proposedhas been implemented for an effectiveness study of a selectionof Lombard hospitals.     

Discriminantal arrangement, 3 × 3 minors of Plücker matrix and hypersurfaces in Grassmannian Gr(3,n)

We show that points in specific degree-2 hypersurfaces in the Grassmannian $Gr(3,n)$ correspond to generic arrangements of n hyperplanes in ${\mathbb{C}}^3$ with associated discriminantal arrangement having intersections of multiplicity three in codimension two.     

Perturbation Method for Particle-like Solutions of the Einstein–Dirac Equations

The aim of this work is to prove by a perturbation method the existence of solutions of the coupled Einstein–Dirac equations for a static, spherically symmetric system of two fermions in a singlet spinor state. We relate the solutions of our equations to those of the nonlinear Choquard equation and we show that the nondegenerate solution of Choquard’s equation generates solutions of the Einstein–Dirac equations.     

Feedback Stabilization for a Scalar Conservation Law with PID Boundary Control

This paper deals with a scalar conservation law in 1-D space dimension, and in particular, the focus is on the stability analysis for such an equation. The problem of feedback stabilization under proportional-integral-derivative (PID for short) boundary control is addressed. In the proportional-integral (PI for short) controller case, by spectral analysis, the authors provide a complete characterization of the set of stabilizing feedback parameters, and determine the corresponding time delay stability interval. Moreover, the stability of the equilibrium is discussed by Lyapunov function techniques, and by this approach the exponential stability when a damping term is added to the classical PI controller scheme is proved. Also, based on Pontryagin results on stability for quasipolynomials, it is shown that the closed-loop system subject to PID control is always unstable.     

Variational technique and principal solution in half-linear oscillation criteria

We investigate oscillatory properties of half-linear differential equations. The investigated half-linear equation is viewed as a perturbation of another (nonoscillatory) equation of the same form and perturbation is allowed both in the absolute term and in the derivative term. First, the Sturmian type theorem for solutions of the associated Riccati equation is established. In the second part of the paper we prove new half-linear oscillation criteria using the variational technique.     

A semi-Markov process with an inverse Gaussian distribution as sojourn time

Let X_n denote the state of a device after n repairs. We assume that the time between two repairs is the time τ taken by a Wiener process {W(t), t ? 0}, starting from w₀ and with drift μ < 0, to reach c ∈ [0, w₀). After the nth repair, the process takes on either the value X_n?1 + 1 or X_n?1 + 2. The probability that X_n = X_n?1 + j, for j = 1, 2, depends on whether τ ? t₀ (a fixed constant) or τ > t₀. The device is considered to be worn out when X_n ? k, where k ∈ {1, 2, …}. This model is based on the ones proposed by Rishel (1991) [1] and Tseng and Peng (2007) [2]. We obtain an explicit expression for the mean lifetime of the device. Numerical methods are used to illustrate the analytical findings.     

Mechanistic investigations in α‐hydroxycarbonyls reduction by BH4‐

BH₄^‐, a well‐known and widely used reducing agent for carbonyl compounds, has been reported to have the ability to participate in dihydrogen bonding, an interaction with applications in catalysis, stereoselectivity and crystal engineering. Specifically, α‐hydroxycarbonyls are activated for reduction by dihydrogen bonding that occurs between BH₄^‐ and hydroxyl group. We explored the effect of the interaction on the mechanism of these reactions by examining their activation parameters. We found that dihydrogen bonding activates α‐hydroxycyclopentanone for reduction with NBu₄BH₄ by lowering the activation enthalpy by 6.6 kcal/mol. While the activation entropy is a significant component of the barrier, the changes resulting from the occurrence of dihydrogen bonding are manifested predominantly in the enthalpy term. Computational studies suggest that, while internal hydrogen bonding is allowed by the flexibility of the carbon backbone, that interaction is outweighed by dihydrogen bonding once BH₄^‐ is present in the system. Experimentally, a red shift of the hydroxyl frequency is observed upon addition of BH₄^‐ to the reaction mixture, suggesting a dihydrogen bonding interaction. The flexibility of the substrate's skeleton or the selectivity of the hydride sites in BH₄^‐ does not account for the lack of directing effect of the dihydrogen bonding. When a substrate with a rigid naphthalene backbone moiety, 2‐hydroxyacenaphthylen‐1(2H)‐one, is reduced, the stereochemical outcome is very similar to the one corresponding to the α‐hydroxycyclopentanone. Copyright © 2012 John Wiley & Sons, Ltd.     

Casorati Inequalities for Statistical Submanifolds in Kenmotsu Statistical Manifolds of Constant ϕ-Sectional Curvature with Semi-Symmetric Metric Connection

In this paper, we prove some inequalities between intrinsic and extrinsic curvature invariants, namely the normalized δ-Casorati curvatures and the scalar curvature of statistical submanifolds in Kenmotsu statistical manifolds of constant ϕ-sectional curvature that are endowed with semi-symmetric metric connection. Furthermore, we investigate the equality cases of these inequalities. We also describe an illustrative example.