MSPM: A modularized and scalable multi-agent reinforcement learning-based system for financial portfolio management.

Financial portfolio management (PM) is one of the most applicable problems in reinforcement learning (RL) owing to its sequential decision-making nature. However, existing RL-based approaches rarely focus on scalability or reusability to adapt to the ever-changing markets. These approaches are rigid and unscalable to accommodate the varying number of assets of portfolios and increasing need for heterogeneous data input. Also, RL agents in the existing systems are ad-hoc trained and hardly reusable for different portfolios. To confront the above problems, a modular design is desired for the systems to be compatible with reusable asset-dedicated agents. In this paper, we propose a multi-agent RL-based system for PM (MSPM). MSPM involves two types of asynchronously-updated modules: Evolving Agent Module (EAM) and Strategic Agent Module (SAM). An EAM is an information-generating module with a Deep Q-network (DQN) agent, and it receives heterogeneous data and generates signal-comprised information for a particular asset. An SAM is a decision-making module with a Proximal Policy Optimization (PPO) agent for portfolio optimization, and it connects to multiple EAMs to reallocate the corresponding assets in a financial portfolio. Once been trained, EAMs can be connected to any SAM at will, like assembling LEGO blocks. With its modularized architecture, the multi-step condensation of volatile market information, and the reusable design of EAM, MSPM simultaneously addresses the two challenges in RL-based PM: scalability and reusability. Experiments on 8-year U.S. stock market data prove the effectiveness of MSPM in profit accumulation by its outperformance over five different baselines in terms of accumulated rate of return (ARR), daily rate of return (DRR), and Sortino ratio (SR). MSPM improves ARR by at least 186.5% compared to constant rebalanced portfolio (CRP), a widely-used PM strategy. To validate the indispensability of EAM, we back-test and compare MSPMs on four different portfolios. EAM-enabled MSPMs improve ARR by at least 1341.8% compared to EAM-disabled MSPMs.

Skilled Nursing Facility Participation in a Voluntary Medicare Bundled Payment Program: Association With Facility Financial Performance.

IMPORTANCE: Model 3 of the Bundled Payments for Care Improvement (BPCI) is an alternative payment model in which an entity takes accountability for the episode costs. It is unclear how BPCI affected the overall skilled nursing facility (SNF) financial performance and the differences between facilities with differing racial/ethnic and socioeconomic status (SES) composition of the residents. OBJECTIVE: The objective of this study was to determine associations between BPCI participation and SNF finances and across-facility differences in SNF financial performance. DESIGN, SETTING, AND PARTICIPANTS: A longitudinal study spanning 2010-2017, based on difference-in-differences analyses for 575 persistent-participation SNFs, 496 dropout SNFs, and 13,630 eligible nonparticipating SNFs. MAIN OUTCOME MEASURES: Inflation-adjusted operating expenses, revenues, profit, and profit margin. RESULTS: BPCI was associated with reductions of $0.63 million in operating expenses and $0.57 million in operating revenues for the persistent-participation group but had no impact on the dropout group compared with nonparticipating SNFs. Among persistent-participation SNFs, the BPCI-related declines were $0.74 million in operating expenses and $0.52 million in operating revenues for majority-serving SNFs; and $1.33 and $0.82 million in operating expenses and revenues, respectively, for non-Medicaid-dependent SNFs. The between-facility SES gaps in operating expenses were reduced (differential difference-in-differences estimate=$1.09 million). Among dropout SNFs, BPCI showed mixed effects on across-facility SES and racial/ethnic differences in operating expenses and revenues. The BPCI program showed no effect on operating profit measures. CONCLUSIONS: BPCI led to reduced operating expenses and revenues for SNFs that participated and remained in the program but had no effect on operating profit indicators and mixed effects on SES and racial/ethnic differences across SNFs.

A reservoir computing approach for forecasting and regenerating both dynamical and time-delay controlled financial system behavior.

Significant research in reservoir computing over the past two decades has revived interest in recurrent neural networks. Owing to its ingrained capability of performing high-speed and low-cost computations this has become a panacea for multi-variate complex systems having non-linearity within their relationships. Modelling economic and financial trends has always been a challenging task owing to their volatile nature and no linear dependence on associated influencers. Prior studies aimed at effectively forecasting such financial systems, but, always left a visible room for optimization in terms of cost, speed and modelling complexities. Our work employs a reservoir computing approach complying to echo-state network principles, along with varying strengths of time-delayed feedback to model a complex financial system. The derived model is demonstrated to act robustly towards influence of trends and other fluctuating parameters by effectively forecasting long-term system behavior. Moreover, it also re-generates the financial system unknowns with a high degree of accuracy when only limited future data is available, thereby, becoming a reliable feeder for any long-term decision making or policy formulations.

Graduate medical education funding mechanisms, challenges, and solutions: A narrative review.

BACKGROUND: With increased attention on the federal budget deficit, graduate medical education (GME) funding has in particular been targeted as a potential source of cost reduction. Reduced GME funding can further deteriorate the compensation of physicians during their residency training. METHODS: In order to understand the GME funding mechanisms and current challenges, as well as the value of the work accomplished by residents, we searched peer-reviewed, English language studies published between 2000 and 2019. RESULTS: Direct and indirect GME funding is intended to support resident reimbursement and the higher costs associated with supporting a teaching program. However, policy efforts have aimed to reduce federal funding for GME. Furthermore, evidence suggests that residents are inadequately compensated because their salaries do not reflect the number of hours worked and are not comparable to those of other medical staff. CONCLUSIONS: Our review suggests that creative solutions are needed to diversify GME funding and improve resident compensation.

Asynchronous time-space model for evolutionary market.

An economic system is thought to be evolutionary growing. Economists investigate human decision-making by monetary value. However, the emergent property of the economy has not been explained. A model considering the extent of the monetary value is required. In this paper, a time-space model is proposed to elucidate the economic evolution of a market. Since the market activities are always open and realtime, the model of time and space is complicated. For the complexity, the probabilistic boundary and expectations under a low-possibility are introduced. Then, time and space cannot be separated and are defined as an asynchronous relationship. We apply this time-space model to the adaptive agent models of single and double auctions. The results of the numerical simulation indicate the intermittency in a broad area of the control parameter. This result concludes that the extent of monetary value can be a basis of the evolutionary market.

Lack of Strategic Funding and Long-Term Job Security Threaten to Have Profound Effects on Cardiovascular Researcher Retention in Australia.

BACKGROUND: Cardiovascular disease is the leading cause of death in Australia. Investment in research solutions has been demonstrated to yield health and a 9.8-fold return economic benefit. The sector, however, is severely challenged with success rates of traditional peer-reviewed funding in decline. Here, we aimed to understand the perceived challenges faced by the cardiovascular workforce in Australia prior to the COVID-19 pandemic. METHODS: We used an online survey distributed across Australian cardiovascular societies/councils, universities and research institutes over a period of 6 months during 2019, with 548 completed responses. Inclusion criteria included being an Australian resident or an Australian citizen who lived overseas, and a current or past student or employee in the field of cardiovascular research. RESULTS: The mean age of respondents was 42±13 years, 47% were male, 85% had a full-time position, and 40% were a group leader or laboratory head. Twenty-three per cent (23%) had permanent employment, and 82% of full-time workers regularly worked >40 hours/week. Sixty-eight per cent (68%) said they had previously considered leaving the cardiovascular research sector. If their position could not be funded in the next few years, a staggering 91% of respondents would leave the sector. Compared to PhD- and age-matched men, women were less likely to be a laboratory head and to feel they had a long-term career path as a cardiovascular researcher, while more women were unsure about future employment and had considered leaving the sector (all p<0.05). Greater job security (76%) and government and philanthropic investment in cardiovascular research (72%) were highlighted by responders as the main changes to current practices that would encourage them to stay. CONCLUSION: Strategic solutions, such as diversification of career pathways and funding sources, and moving from a competitive to a collaborative culture, need to be a priority to decrease reliance on government funding and allow cardiovascular researchers to thrive.

Switching intention to crypto-currency market: Factors predisposing some individuals to risky investment.

We investigate factors affecting individual investors' switching intention from traditional financial market to crypto-currency financial market. By sampling factors of individual investors related with crypto-currency (CC), the study applies structural equation modeling method (SEM) to investigate their effects on switching intention by integrating PPM and Reinforcement Sensitivity theories (RST) to form a pulling, pushing and mooring effects model. The investigation indicates that crypto-currency market can be regarded as a kind of beneficial supplement of tradition investment market for those individual investors who are with high innovativeness, reward sensitivity, knowledge and perceived risk. This study proves that the individual investors are not only attracted by significant expected return from crypto-currency but also relevant knowledge and risks disclosed by crypto-currency market regulators and distributors. The findings reinforce major roles for both market regulators and individual investors in considering and providing insights for future policy, management and investigations.

K-core robustness in ecological and financial networks.

In many real-world networks, the ability to withstand targeted or global attacks; extinctions; or shocks is vital to the survival of the network itself, and of dependent structures such as economies (for financial networks) or even the planet (for ecosystems). Previous attempts to characterise robustness include nestedness of mutualistic networks or exploration of degree distribution. In this work we present a new approach for characterising the stability and robustness of networks with all-positive interactions by studying the distribution of the k-shell of the underlying network. We find that high occupancy of nodes in the inner and outer k-shells and low occupancy in the middle shells of financial and ecological networks (yielding a "U-shape" in a histogram of k-shell occupancy) provide resilience against both local targeted and global attacks. Investigation of this highly-populated core gives insights into the nature of a network (such as sharp transitions in the core composition of the stock market from a mix of industries to domination by one or two in the mid-1990s) and allow predictions of future network stability, e.g., by monitoring populations of "core" species in an ecosystem or noting when stocks in the core-dominant sector begin to move in lock-step, presaging a dramatic move in the market. Moreover, this "U-shape" recalls core-periphery structure, seen in a wide range of networks including opinion and internet networks, suggesting that the "U-shaped" occupancy histogram and its implications for network health may indeed be universal.

Gender Gap in Industry Relationships and Scholarly Impact Among Academic Urologists in the United States.

OBJECTIVES: To examine the distribution of industry payments to male and female academic urologists and the relationship between industry funding, academic rank, and scholarly impact. MATERIAL AND METHODS: Academic urologists from 131 programs with publicly available websites were compiled. Gender, rank, fellowship training, and scholarly impact metrics were recorded. Data from the 2016 Centers for Medicare and Medicaid Services Open Payments database were paired with faculty names. Comparisons were made using Fisher's Exact, Wilcoxon Rank Sum, and Spearman's Rank-Order tests. Multivariable logistic regression modeling identified predictors of receiving payments in the top quintile. RESULTS: Among 1,657 academic urologists, males comprised 84%. While there were no gender differences in the number of urologists listed in the Open Payments Database, males received more total funding (P < .001) and higher median general payments per capita (P < .03). Males also received higher proportions of research funding (P = .002), speaker fees (P = .03), education fees (P = .03) and higher median consulting fees (P = .003). Overall, males had higher scholarly impact (P < .001), which correlated with total industry payments (rho = 0.27, P < .001). Predictors of accepting the top quintile payments include male gender, associate professorship and H-index score ≥10. CONCLUSION: Most academic urologists accepted at least one industry payment in 2016, but males received more funding than females. There is a positive correlation between total industry payments, H-index, and total publications. More research is needed to understand why gender and scholarly productivity are associated with higher payouts. This is another important area that may influence career advancement and compensation for female urologists.

The Frequency, Nature, and Effects of Coerced Debt Among a National Sample of Women Seeking Help for Intimate Partner Violence.

This study examines the frequency, nature, and effects of coerced debt, defined as non-consensual, credit-related transactions that occur in intimate relationships where one partner uses coercive control to dominate the other. The sample includes 1,823 women who called the National Domestic Violence Hotline. Results suggest that coerced debt, from both coercive and fraudulent transactions, is a common problem and is significantly related to control over financial information, credit damage, and financial dependence on the abuser. This study supports the need for policy reform and victim services aimed at addressing coerced debt, thereby mitigating a potentially significant economic barrier to safety.

Dementia, Help with Financial Management, and Financial Well-Being.

This paper uses the National Health and Aging Trends Study to determine whether older individuals with dementia receive help from their informal caregivers in managing their finances and how this assistance - or the lack of it - is correlated with financial well-being. The study finds that the vast majority of those with dementia do receive help managing their finances. Those with dementia who receive help are indistinguishable from those without dementia in terms of experiencing financial difficulties. However, the minority without help are over twice as likely to experience severe financial hardship, even controlling for other factors.

Socioeconomic differences in mortality among 27 million economically active Germans: a cross-sectional analysis of the German Pension Fund data.

OBJECTIVES: To assess disparities in mortality by socioeconomic status in Germany. DESIGN AND PARTICIPANTS: We analyse a large administrative dataset of the German Pension Fund (DRV), including 27 million person-years of exposure and 42 000 deaths in 2013. The data cover the economically active population, stratified by sex and by East and West. OUTCOME MEASURES: Age-standardised mortality rates and Poisson regression mortality rate ratios (MRRs). RESULTS: The risk of dying increases with decreasing income: the MRRs of the lowest to the highest income quintile are 4.66 (95% CI 4.48 to 4.85) among men and 3.06 (95% CI 2.90 to 3.23) among women. The impact of income attenuates after controlling for education and other explanatory variables, especially for females. In the fully controlled model for females, individual income is a weaker predictor of mortality, but there is a clear educational mortality gradient. In the fully controlled model, the MRRs of the unemployed to the employed are 2.09 (95% CI 2.03 to 2.15) among men and 2.01 (95% CI 1.92 to 2.10) among women. The risk of dying is around half as high among foreigners as among German citizens. The socioeconomic disparities are greater among East than West German men. CONCLUSIONS: Low socioeconomic status is a major determinant of excess adult mortality in Germany. The persisting East-West differences in male adult mortality can be explained by the higher socioeconomic status of men living in the West, rather than by contextual differences between East and West. These differences can be further monitored using DRV data.

The calendar year fallacy: The danger of reliance on calendar year data in end-of-life capacity and financial planning.

Planners, actuaries, and others involved in forecasting capacity and costs must manipulate historical data. Data from calendar/financial year totals have been assumed to be adequate and reliable. This relies on the assumption that year-to-year differences do not arise from patterns concealed in the data. While the seasonal cycle is widely recognized, longer term patterns such as disease outbreaks will act to modify annual demand and costs. Monthly data relating to deaths in local government areas in England and Wales are used to demonstrate curious semipermanent bursts of high behavior. There is no seasonal pattern for the start of these events, and the sudden switch to high deaths can occur at any time, even in immediately adjacent areas. Higher deaths and related demand and costs endure for around 12 months before they suddenly revert to the former level where they stay until the next of these curious high events. In England and Wales (and many other countries), a period of unexplained higher deaths, reduced life expectancy, and health care and life insurance costs since 2011 appears to be coming to an end and looks to have arisen from a coincidence of these events at sub-national level.

Assessing the Impact of Medical Laboratory Resource Allocations on Hospital Finances.

The relationship between resource allocation decisions within medical laboratory cost centers and overall hospital financial performance is empirically investigated using a panel of critical access hospitals in Washington State (2014-2016). In order to increase accessibility to hospital managers and health policy makers, a managerial finance perspective (defining performance using simple financial accounting ratios) is adopted. Results indicate that resource allocation decisions within the medical laboratory cost center have a significant impact on the financial performance of the hospital as a whole. However, the nature of the impact depends on the type of financial metric utilized. For instance, the proportion of the typical medical laboratory's budget that is allocated to rent is negatively and significantly related to the hospital's return on assets. Concomitantly, medical laboratory cost centers that have a larger footprint in the hospital (as measured by square footage) exhibit a significant, positive association with the hospital's current ratio. Thus, physically larger medical laboratories may allow the hospital to better manage its liquid assets.