Optimal Dividend Payments for the Piecewise-Deterministic Poisson Risk Model

This paper considers the optimal dividend payment problem in piecewise-deterministic compound Poisson risk models. The objective is to maximize the expected discounted dividend payout up to the time of ruin. We provide a comparative study in this general framework of both restricted and unrestricted payment schemes, which were only previously treated separately in certain special cases of risk models in the literature. In the case of restricted payment scheme, the value function is shown to be a classical solution of the corresponding HJB equation, which in turn leads to an optimal restricted payment policy known as the threshold strategy. In the case of unrestricted payment scheme, by solving the associated integro-differential quasi-variational inequality, we obtain the value function as well as an optimal unrestricted dividend payment scheme known as the barrier strategy. When claim sizes are exponentially distributed, we provide easily verifiable conditions under which the threshold and barrier strategies are optimal restricted and unrestricted dividend payment policies, respectively. The main results are illustrated with several examples, including a new example concerning regressive growth rates.Comment: Key Words: Piecewise-deterministic compound Poisson model, optimal stochastic control, HJB equation, quasi-variational inequality, threshold strategy, barrier strateg

Convergence Radii for Eigenvalues of Tri--diagonal Matrices

Consider a family of infinite tri--diagonal matrices of the form $L+ zB,$ where the matrix $L$ is diagonal with entries $L_{kk}= k^2,$ and the matrix $B$ is off--diagonal, with nonzero entries $B_{k,{k+1}}=B_{{k+1},k}= k^\alpha, 0 \leq \alpha < 2.$ The spectrum of $L+ zB$ is discrete. For small $|z|$ the $n$-th eigenvalue $E_n (z), E_n (0) = n^2,$ is a well--defined analytic function. Let $R_n$ be the convergence radius of its Taylor's series about $z= 0.$ It is proved that $$ R_n \leq C(\alpha) n^{2-\alpha} \quad \text{if} 0 \leq \alpha <11/6.$

A short artificial antimicrobial peptide shows potential to prevent or treat bone infections.

Infection of bone is a severe complication due to the variety of bacteria causing it, their resistance against classical antibiotics, the formation of a biofilm and the difficulty to eradicate it. Antimicrobial peptides (AMPs) are naturally occurring peptides and promising candidates for treatment of joint infections. This study aimed to analyze the effect of short artificial peptides derived from an optimized library regarding (1) antimicrobial effect on different bacterial species, (2) efficacy on biofilms, and (3) effect on osteoblast‑like cells. Culturing the AMP-modifications with Escherichia coli, Enterococcus faecalis, Pseudomonas aeruginosa, Staphylococcus aureus (including clinical isolates of MRSA and MSSA) and Staphylococcus epidermidis identified one candidate that was most effective against all bacteria. This AMP was also able to reduce biofilm as demonstrated by FISH and microcalorimetry. Osteoblast viability and differentiation were not negatively affected by the AMP. A cation concentration comparable to that physiologically occurring in blood had almost no negative effect on AMP activity and even with 10% serum bacterial growth was inhibited. Bacteria internalized into osteoblasts were reduced by the AMP. Taken together the results demonstrate a high antimicrobial activity of the AMP even against bacteria incorporated in a biofilm or internalized into cells without harming human osteoblasts

A pentapeptide as minimal antigenic determinant for MHC class I-restricted T lymphocytes

Peptides that are antigenic for T lymphocytes are ligands for two receptors, the class I or II glycoproteins that are encoded by genes in the major histocompatibility complex, and the idiotypic / chain T-cell antigen receptor1–9. That a peptide must bind to an MHC molecule to interact with a T-cell antigen receptor is the molecular basis of the MHC restriction of antigen-recognition by T lymphocytes10,11. In such a trimolecular interaction the amino-acid sequence of the peptide must specify the contact with both receptors: agretope residues bind to the MHC receptor and epitope residues bind to the T-cell antigen receptor12,13. From a compilation of known antigenic peptides, two algorithms have been proposed to predict antigenic sites in proteins. One algorithm uses linear motifs in the sequence14, whereas the other considers peptide conformation and predicts antigenicity for amphipathic -helices15,16. We report here that a systematic delimitation of an antigenic site precisely identifies a predicted pentapeptide motif as the minimal antigenic determinant presented by a class I MHC molecule and recognized by a cytolytic T lymphocyte clone

Socially sensitive lactation: Exploring the social context of breastfeeding

Many women report difficulties with breastfeeding and do not maintain the practice for as long as intended. Although psychologists and other researchers have explored some of the difficulties they experience, fuller exploration of the relational contexts in which breastfeeding takes place is warranted to enable more in-depth analysis of the challenges these pose for breastfeeding women. The present paper is based on qualitative data collected from 22 first-time breastfeeding mothers through two phases of interviews and audio-diaries which explored how the participants experienced their relationships with significant others and the wider social context of breastfeeding in the first five weeks postpartum. Using a thematic analysis informed by symbolic interactionism, we develop the overarching theme of ‘Practising socially sensitive lactation’ which captures how participants felt the need to manage tensions between breastfeeding and their perceptions of the needs, expectations and comfort of others. We argue that breastfeeding remains a problematic social act, despite its agreed importance for child health. Whilst acknowledging the limitations of our sample and analytic approach, we suggest ways in which perinatal and public health interventions can take more effective account of the social challenges of breastfeeding in order to facilitate the health and psychological well-being of mothers and their infants

International journalism and the emergence of transnational publics: between cosmopolitan norms, the affirmation of identity and market forces

Much has been written about transnational public spheres, though our understanding of their shape and nature remains limited. Drawing on three alternative conceptions of newswork as public communication, this article explores the role of international journalists in shaping transnational publics. Based on a series of original interviews, it asks how journalists are oriented in their newswork (e.g. are they cosmopolitan or parochial in their orientation) and how they ‘imagine’ the public. It finds that interviewees imagine a polycentric transnational public and variously frame their work as giving voice to those affected by an issue (imagining the public as a cosmopolitan community of fate), performing and reaffirming a particular kind of identity and belonging (imagining the public as a nation) or pursuing audiences wherever they may be (imagining the public as the de facto audience)

Conceptualizing a distributed, multi-scalar global public sphere through activist communication practices in the World Social Forum

This article contributes to debate about how to conceptualize the global public sphere. Drawing on media practice theory and ethnographic research on media activism in the World Social Forum, it shows how ‘global publics’ can be constituted through a diverse range of activist communication practices that complicate both conventional hierarchies of scale and contemporary theorizations of publics as personalized networks. It develops an understanding of the global public sphere as an emergent formation made up of multiple, interlinked publics at different scales and emphasizes the significance of collective communication spaces for actors at the margins of the global network society

Patients’ and healthcare professionals’ perceptions of blood transfusion

Background: Blood transfusions are frequently provided to patients at risk of severe bleeding or on a repeated basis for patients with anaemia or blood disorders. The treatment perceptions literature indicates that perceptions influence how patients cope with their conditions and adhere to treatment. Healthcare professionals’ (HCPs’) perceptions are likely to influence shared decision-making and their practice. However, how patients and HCPs perceive blood transfusions, and how this may vary across patient groups, is unclear. Objectives: This research aimed to explore patients’ and HCPs’ perceptions of blood transfusion. Specific research questions were: 1) which perceptions of transfusion are reported by patients and HCPs in the literature? 2) to what extent do themes of patients’ perceptions correspond with the broader treatment perceptions literature? 3) what are repeatedly transfused haematology patients’ and HCPs’ perceptions of transfusion? 4) to what extent do HCPs recognise patients’ reported perceptions in their practice and are practice changes to improve patients’ experiences required? Methods: This was a mixed-methods programme of research involving three studies: Study 1: A systematic review of patients’ and HCPs’ perceptions of blood transfusion and development of a conceptual model of blood transfusion perceptions. This was followed by a theoretical mapping exercise to compare the model to existing treatment perceptions frameworks. Study 2: A semi-structured interview study with 14 haematology patients and 14 HCPs about their perceptions of blood transfusion. Study 3: A focus group (n=3) and questionnaire study of 19 HCPs’ views of haematology patients’ perceptions and their views about potential service improvement strategies, subsequently mapped to a behaviour change framework (Behaviour Change Wheel). HCPs’ reported constraints and enablers to implementing these strategies were mapped to the Theoretical Domains Framework (TDF) of behaviour change. Results: Study 1: 41 papers reporting patients’ and HCPs’ perceptions were included in the systematic review (15 patient studies, 26 HCPs). Transfusion was perceived as carrying low to moderate risk, but risk perceptions and negative emotions were associated with the use and consideration of transfusion alternatives. The data were synthesised into six constructs to form a conceptual model: ‘Safety/risk,’ ‘Negative emotions’, ‘Alternatives’, ‘Health benefits’, ‘Necessity’ and ‘Decision making’. Theoretical mapping confirmed these constructs as broadly consistent with constructs from existing treatment perceptions frameworks and models. Study 2: Patients and HCPs reported views about the benefits of transfusion for haematology patients, yet some patients and HCPs reported concerns about the downsides of transfusion. ‘Organisational constraints’ were raised by HCPs about delivering transfusions in pressurised services and patients discussed the burden of receiving repeated transfusions. Study 3: 17 service improvement strategies were proposed, corresponding to seven BCW functions: (e.g. ‘Service provision’ (home transfusion), ‘Environmental restructuring’ (remote blood screening)). Constraints/enablers mapped to the TDF: (e.g. ‘Skills’ (HCP communication skills training), ‘Environmental context and resources’ (funding, time)). Potential techniques to address constraints and enablers included providing ‘Information about health consequences’ to address the domain, ‘Beliefs about consequences’. Conclusion: This research provides a theoretical and empirical overview of blood transfusion perceptions, including themes shared by patients and HCPs and themes that were unique to one of these groups. There is scope to more greatly involve patients in their transfusions where, in haematology, repeated and lengthy transfusion appointments place burden on patients. The conceptual models provide direction for such consultations. Interventions to enhance haematology patients’ experiences and to remediate service pressures can be developed further

Concomitant CIS on TURBT does not impact oncological outcomes in patients treated with neoadjuvant or induction chemotherapy followed by radical cystectomy

© Springer-Verlag GmbH Germany, part of Springer Nature 2018Background: Cisplatin-based neoadjuvant chemotherapy (NAC) for muscle invasive bladder cancer improves all-cause and cancer specific survival. We aimed to evaluate whether the detection of carcinoma in situ (CIS) at the time of initial transurethral resection of bladder tumor (TURBT) has an oncological impact on the response to NAC prior to radical cystectomy. Patients and methods: Patients were identified retrospectively from 19 centers who received at least three cycles of NAC or induction chemotherapy for cT2-T4aN0-3M0 urothelial carcinoma of the bladder followed by radical cystectomy between 2000 and 2013. The primary and secondary outcomes were pathological response and overall survival, respectively. Multivariable analysis was performed to determine the independent predictive value of CIS on these outcomes. Results: Of 1213 patients included in the analysis, 21.8% had concomitant CIS. Baseline clinical and pathologic characteristics of the ‘CIS’ versus ‘no-CIS’ groups were similar. The pathological response did not differ between the two arms when response was defined as pT0N0 (17.9% with CIS vs 21.9% without CIS; p = 0.16) which may indicate that patients with CIS may be less sensitive to NAC or ≤ pT1N0 (42.8% with CIS vs 37.8% without CIS; p = 0.15). On Cox regression model for overall survival for the cN0 cohort, the presence of CIS was not associated with survival (HR 0.86 (95% CI 0.63–1.18; p = 0.35). The presence of LVI (HR 1.41, 95% CI 1.01–1.96; p = 0.04), hydronephrosis (HR 1.63, 95% CI 1.23–2.16; p = 0.001) and use of chemotherapy other than ddMVAC (HR 0.57, 95% CI 0.34–0.94; p = 0.03) were associated with shorter overall survival. For the whole cohort, the presence of CIS was also not associated with survival (HR 1.05 (95% CI 0.82–1.35; p = 0.70). Conclusion: In this multicenter, real-world cohort, CIS status at TURBT did not affect pathologic response to neoadjuvant or induction chemotherapy. This study is limited by its retrospective nature as well as variability in chemotherapy regimens and surveillance regimens.Peer reviewedFinal Accepted Versio