Problem statement: The modeling of claims count is one of the most important topics in actuarial theory and practice. Many attempts were implemented in expanding the classes of mixed and compound distributions, especially in the distribution of exponential family, resulting in a better fit on count data. In some cases, it is proven that mixed distributions, in particular mixed Poisson and mixed negative binomial, provided better fit compared to other distributions. Approach: In this study, we introduce a new mixed negative binomial distribution by mixing the distributions of negative binomial (r,p) and Lindley (θ), where the reparameterization of p = exp(-λ) is considered. Results: The closed form and the factorial moment of the new distribution, i.e., the negative binomial-Lindley distribution, are derived. In addition, the parameters estimation for negative binomial-Lindley via the method of moments (MME) and the Maximum Likelihood Estimation (MLE) are provided. Conclusion: The application of negative binomial-Lindley distribution is carried out on two samples of insurance data. Based on the results, it is shown that the negative binomial-Lindley provides a better fit compared to the Poisson and the negative binomial for count data where the probability at zero has a large value.

Oral tadalafil was administered easily and tolerated well and improved mean pulmonary artery pressure (MPAP) in children with PAH, which suggests that oral tadalafil may be more effective and safer than sildenafil in the treatment of PAH.

Background:Development of fibrinous pericarditis after pericardiotomy is a well-recognized reaction. Within a few post-operative days, the inflammated surface of pericardium begins to fuse to the overlying sternum.Objectives:Our aim was to assess the prevalence, risk factors, time course and therapy response of pericardial effusion (PE) after cardiac surgeries in children.Patients and Methods:PE occurrence was assessed prospectively in 486 children who underwent cardiac surgery for congenital heart diseases by serial echocardiography. Clinical manifestations were observed and response to different therapies was analyzed.Results:The prevalence of PE was about 10% for all cardiac surgeries. Symptoms were exclusively seen in patients who had moderate to large effusions. The mean onset of pericardial effusion was 11 (± 8) days after surgery procedure, with 87 % (42 of 48) of cases being diagnosed on or before day 13 after operation. The prevalence of effusion after Fontan-type procedures and AVSD repair (29 %, 5 of 17 for both) was significantly higher than other types of cardiac surgeries. Aspirin administration was effective in 77 % and prednisone in 90 % of the cases.Conclusions:PE may be developed as late as weeks after cardiac surgeries. PE after palliative cardiac surgeries is not uncommon. Low doses of aspirin and corticosteroids are usually effective for treating this complication.

This article develops a functional form of the generalized Poisson regression model that parametrically nests the Poisson and the two well known generalized Poisson regression models (GP-1 and GP-2). The proposed model is applied on theMalaysian motor insurance claim count data.