A Markov Sensitivity Model for Examining the Impact of Cost Allocations in Hospitals

The cost allocation process in hospitals typically entails an accounting step-down procedure whereby costs are allocated from non-revenue producing service centres to revenue centres. The resulting revenue centre costs are then compared with the third party (Blue Cross, Medicare, Medicaid) allowable costs. Any costs in excess of the allowable costs are not reimbursable. This procedure has been conceptualized using a Markov chain in a recent journal article. The purpose of this paper is to demonstrate how the Markov model may be used to assess the impact of various changes in the original data without having to recalculate the entire step-down process via a Markov model or any other procedure. The changes include an alternate step-down model, a different cost allocation basis for one or more service centres, and the expansion or contraction of one or more service centres.     

Asymptotic behavior of the solutions of certain parabolic equations

Some laws in physics describe the change of a flux and are represented by parabolic equations of the form (*) \documentclass{article}\pagestyle{empty}\begin{document}$$\frac{{\partial u}}{{\partial t}}=\frac{\partial}{{\partial x_j }}(\eta \frac{{\partial u}}{{ax_j}}-vju),$$\end{document} j≤m, where η and v_j are functions of both space and time. We show under quite general assumptions that the solutions of equation (*) with homogeneous Dirichlet boundary conditions and initial condition u(x, 0) = u_o(x) satisfy The decay rate d > 0 only depends on bounds for η, v and G § R^m the spatial domain, while the constant c depends additionally on which norm is considered. For the solutions of equation (*) with homogeneous Neumann boundary conditions and initial condition u₀(x) ≥ 0 we derive bounds d₁u₁ ≤ u(x, t) ≤ d₂u₂, Where d_i, i = 1, 2, depend on bounds for η, v and G, and the u_i are bounds on the initial condition u₀.     

The mass spectra of some silver salts

Fifteen of twenty-four silver(I) carboxylates examined give useful electron impact mass spectra. The compounds vaporize at moderate temperatures, apparently mainly as dimer with traces of higher oligomer in only a few cases. The molecular ion for the dimer is generally weak or absent, with the most abundant silver containing ion being [Ag₂(O₂CR)]⁺ in most cases. Metastable defocusing and deuterium labeling experiments on silver acetate have established some of the fragmentation pathways. The reported loss of carbon dioxide from perfluorocarboxylates to give intense peaks for organosilver ions was not observed in this study. Attempts to obtain spectra on the silver salts of organic materials other than carboxylic acids were successful in several cases. Silver trifluoromethanesulfonate, although much less volatile, gives a spectrum and fragmentation very much like the carboxylates, whereas silver trifluoromethanethiolate gives a complex spectrum which suggests tetramer as a major gas phase species. Of three compounds examined which have silver to nitrogen bonding only silver(II) phthalocyanine is sufficiently volatile to give a spectrum without decomposition. The field desorption spectra of the four compounds examined all show the ions Ag_nX_{n ? 1} for X=acetate (n=1 ? 6), X=p-chlorobenzoate (n=1 ? 4), X=methanesulfonate (n=1 ? 7) and X=p-toluenesulfonate (n=1 ? 5).     

Some ab initio calculations related to the predissociation of the C2Σu+ state of N2+

Ab initio calculations in the “first-order wavefunction” CI approximation have been performed for several states of N₂⁺ with ²Σ_u⁺, ²Σ_u^?, ⁴Π_u symmetry. A calculation of the electronic factor of the vibronic interaction between the B²Σ_u⁺ and C²Σ_u⁺ states seems to support the suggestion of Tellinghuisen and Albritton that the C state is predissociated by the continuum of the B state through nuclear momentum coupling.     

Hydroxamic acid polymers

A polymer bearing hydroxamic acid groups and having a high affinity for iron(III) was prepared through the following procedure. Acryloylalanine (III), prepared by the reaction of acryloyl chloride with alanine, was treated with N-hydroxysuccinimide in the presence of dicyclohexylcarbodiimide to give the N-hydroxysuccinimide ester (IV). The ester IV was polymerized by using AIBN in dioxane to give polymer V. Treatment of polymer V with methylhydroxylamine in DMF gave the hydroxamic acid polymer II. The water-soluble polymer II was purified by dialysis or by gel-permeation chromatography (GPC) on Sephadex G-25. Analytical GPC on Sephadex G-200 and Sepharose 4B indicate that the average molecular weight of the polymer is in the range of 5 × 10⁵ to 1 × 10⁶. The presence of hydroxamic acid groups is confirmed by the intense red-brown color produced by the addition of iron(III) to a 50% aqueous DMF solution of the polymer under acidic conditions. In pure water the polymer-iron complex precipitates as a tan solid. Iron-binding studies of the polymer reveal that the iron(III) trihydroxamic acid complex FeA₃ forms at low concentrations of iron. At higher iron levels a lower order of stability is apparent, which can be accounted for by the conversion of FeA₃ to FeA₂⁺. In contrast, the FeA₃ complex of the trihydroxamic acid deferoxamine-B is stable at all iron levels. These results are consistent with the polymer structure, which for steric reasons would favor a stable complex, FeA₂⁺, between iron and two adjacent hydroxamic acid groups. An FeA₃ complex would be expected to have a lower stability as a result of either bond angle strain and atomic compression, or a lower probability in bringing a third hydroxamic acid into position to form the octahedral complex.     

Synthesis and antimalarial effects of 5,6-dichloro-2-[(4-||4-(diethylamino)-i-methylbutyl] amino||-6-methyl-2-pyrirnidinyl)amino] benzimidazole and related benzimidazoles and lH-imidazo[4,5-b] pyridines

A group of fifty-five 2-[(4-11[(dialkylamino)alkyI]amino11-6-methyl-2-pyrimidinyl)amino]-benzimidazoles (VII) was synthesized in 3-88% yield by the condensation of the requisite 2-[(2-benzimidazolyl)amino]-4-chloro-6-methylpyrimidine (VI) with the appropriate polyamine in ethanol-hydrochloric acid or neat with excess amine containing potassium iodide. The 2-[(2-benzimidazolyl)amino]-6-methyl-4-pyrirnidinol precursors (V), obtained in 11-51% yield by cyclization of 2-(cyanoamino)-4-hydroxy-6-methylpyrimidine with a suitably substituted o-phenylenediamine, were chlorinated with phosphorus oxychloride to give the intermediate 2-[(2-benzimidazolyl)amino]-4-chloro-6-rnethylpyrimidines (VI) (27-99%). Oxidation of 5,6-dichloro-2-[(4-11[4-(diethylamino)-l-methylbutyl] amino 11-6-methyl-2-pyrimidinyl) amino ]benzimidazole ( 29 ) with m-chloroperbenzoic acid gave the distal N⁴'-oxide ( 31 ) (19%). Fusion of 2,3-uiaminopyridine with 2-(cyanoamino)-4-hydroxy-6-methylpyrimidine provided 2-[(4-hydroxy-6-tnethyl-2-pyrimidinyl)amino]-lH-imitlazo[4,5-b]pyrimidine (VIII) (30%), which upon chlori-nation with phosphorus oxychloride (63%) followed by amination with i N, N-diethylethylene-diamine afforded 2-(4-11[2-(diethylamino)ethyl] amino 11-6-methyl-2-pyrimidinyl)-lH-imidazo [4,5-b]pyridine (X) (8%). Thirty-eight of the novel 2-[(4-amino-6-methyl-2-pyrimidinyl)amino]-benzimidazoles possessed “curative” activity against Plasmodium berghei at single subcutaneous doses ranging from 20.640 mg./kg. Orally, thirty-one compounds exhibited suppressive activity against P. berghei comparable with or superior to the reference drugs 1-(p-chlorophenyl)-3-(4-11[2-(diethylarnino)ethyl]amino 11-6-methyl-2-pyrimidinyl)guanidine (I) and quinine hydrochloride, while twelve of them were 5 to 28 times as potent as I and quinine hydrochloride. Eight compounds also displayed strong suppressive activity against P. gallinaceum in chicks. 5,6-Dichloro-2-[(4-112-(diethylamino)ethyl]amino11-6-methyl-2-pyrimidinyl] benzimidazole (18) showed marked activity against a cycloguanil-resistant line of P. berghei, and the most promising member of the series, namely 5,6-dichloro-2-[(4-11[4-(diethylamino)-l-methylbutyl]amino11-6-methyl-2-pyrimidinyl)amino]benzimidazole ( 29 ) (Q = 28), was designated for preclinical toxico-logical studies and clinical trial. Structure-activity relationships are discussed.     

Rapid shear viscosity calculation by momentum impulse relaxation molecular dynamics

Recently, Arya et al. [J. Chem. Phys. 113, 2079 (2000)] introduced a new molecular dynamics method to rapidly compute the viscosity of fluids. The technique, termed momentum impulse relaxation (MIR), involves the imposition of a Gaussian velocity profile on an equilibrated system, after which the decay in the profile is monitored as a function of time. The shear viscosity is computed by matching the rate of decay of the velocity profile to the corresponding solution of the Navier-Stokes equation. The method was originally applied to simple systems (argon and n-butane) and found to give a comparable accuracy to conventional equilibrium and nonequilibrium methods with more than an order of magnitude reduction in computing time. In this work, we extend and generalize the method to examine larger molecules with higher viscosities than have been examined previously. A detailed analysis of the method is given, including the effect the velocity boundary conditions have on the viscosity, the sensitivity of the results to the velocity profile fitting procedure, the effect of preequilibration of the Gaussian profile, and the effect the system size and box shape have on the accuracy and speed of the method. It is shown that the MIR method can be extended to treat multiatom systems without loss of accuracy or computational efficiency.     

Magnetic circular dichroism studies XXXII

CNDO calculations of the MCD spectra of 7- and 9-methyladenine have been carried out in two approximations. A minor modification of the CNDO/S method of Jaffé and coworkers shows an improvement over Jaffé's parameterization with respect to band separations and the signs of the MCDB terms, but is not applicable ton→ π* transitions.     

β-Substituted ketene thioacetals as β-lithioacrylate equivalents. The synthesis of (±)-eldanolide

Lithiation of 1,1-bis(phenylthio)-3-phenylthio-1-propene 3 and reaction with a range of electrophiles gave exclusively the γ-substituted product 4. This reagent has been used in a short synthesis of the pheromone, (±)-eldanolide.