Health Expenditure Growth: Looking beyond the Average through Decomposition of the Full Distribution

Explanations of growth in health expenditures have restricted attention to the mean. We explain change throughout the distribution of expenditures, providing insight into how growth and its explanation differ along the distribution. We analyse Dutch data on actual health expenditures linked to hospital discharge and mortality registers. Full distribution decomposition delivers findings that would be overlooked by examination of changes in the mean alone. The growth in expenditures on hospital care is strongest at the middle of the distribution and is driven mainly by changes in the distributions of determinants. Pharmaceutical expenditures increase most at the top of the distribution and are mainly attributable to structural changes, including technological progress, making treatment of the highest cost cases even more expensive. Changes in hospital practice styles make the largest contribution of all determinants to increased spending not only on hospital care but also on pharmaceuticals, suggesting important spill over effects

Parents, children and the porous boundaries of the sexual family in law and popular culture

This article focuses on a perceived ideological overlap between popular cultural and judicial treatments of sex and conjugality that contributes to a discursive construction of parenthood and parenting. The author perceives that in both legal and popular cultural texts, there is a sense in which notions of ‘natural’ childhood are discursively constituted as being put at risk by those who reproduce outside of dominant sexual norms, and that signs of normative sexuality (typically in the form of heterosexual coupling) may be treated as a sign of safety. These ideas are rooted in ancient associations between fertility, sexuality and femininity that can also be traced in the historical development of the English language. With the help of commentators such as Martha Fineman, the article situates parents and children within a discourse of family which prioritises conjugality, with consequences for the ways in which the internal and external boundaries of families are delineated

Baryogenesis via lepton number violating scalar interactions

We study baryogenesis through lepton number violation in left-right symmetric models. In these models the lepton number and CP violating interactions of the triplet higgs scalars can give rise to lepton number asymmetry through non-equilibrium decays of the $SU(2)_L$ triplet higgs and the right handed neutrinos. This in turn generates baryon asymmetry during the electroweak anomalous processes.Comment: 14 pages, UTPT-93-1

Exclusive Radiative B-Decays in the Light-Cone QCD Sum Rule Approach

We carry out a detailed study of exclusive radiative rare $B$-decays in the framework of the QCD sum rules on the light cone, which combines the traditional QCD sum rule technique with the description of final state vector mesons in terms of the light-cone wave functions of increasing twist. The decays considered are: $B_{u,d} \to K^* +\gamma, B_{u,d}\to \rho+\gamma, B_d\to \omega+\gamma$ and the corresponding decays of the $B_s$ mesons, $B_s\to \phi+\gamma$ and $B_s\to K^*+\gamma$. Based on our estimate of the transition form factor F_1^{B \to K^*\pg}(0) =0.32\pm0.05, we find for the branching ratio $BR(B \to K^* + \gamma) = (4.8\pm 1.5)\times 10^{-5}$, which is in agreement with the observed value measured by the CLEO collaboration. We present detailed estimates for the ratios of the radiative decay form factors, which are then used to predict the rates for the exclusive radiative B-decays listed above. This in principle allows the extraction of the CKM matrix element $|V_{td}|$ from the penguin-dominated CKM-suppressed radiative decays when they are measured. We give a detailed discussion of the dependence of the form factors on the $b$-quark mass and on the momentum transfer, as well as their interrelation with the CKM-suppressed semileptonic decay form factors in $B\to \rho+\ell+\nu$, which we also calculate in our approach.Comment: 32 pages, 10 uuencoded figures, LaTeX, preprint CERN-TH 7118/9

D∗DπD^*D\pi and B∗BπB^*B\pi couplings in QCD

We calculate the $D^*D\pi$ and $B^*B\pi$ couplings using QCD sum rules on the light-cone. In this approach, the large-distance dynamics is incorporated in a set of pion wave functions. We take into account two-particle and three-particle wave functions of twist 2, 3 and 4. The resulting values of the coupling constants are $g_{D^*D\pi}= 12.5\pm 1$ and $g_{B^*B\pi}= 29\pm 3$. From this we predict the partial width \Gamma (D^{*+} \ra D^0 \pi^+ )=32 \pm 5~ keV . We also discuss the soft-pion limit of the sum rules which is equivalent to the external axial field approach employed in earlier calculations. Furthermore, using $g_{B^*B\pi}$ and $g_{D^*D\pi}$ the pole dominance model for the B \ra \pi and D\ra \pi semileptonic form factors is compared with the direct calculation of these form factors in the same framework of light-cone sum rules.Comment: 27 pages (LATEX) +3 figures enclosed as .uu file MPI-PhT/94-62 , CEBAF-TH-94-22, LMU 15/9

Ward Identities, B-> \rho Form Factors and |V_ub|

The exclusive FCNC beauty semileptonic decay B-> \rho is studied using Ward identities in a general vector meson dominance framework, predicting vector meson couplings involved. The long distance contributions are discussed which results to obtain form factors and |V_ub|. A detailed comparison is given with other approaches.Comment: 30 pages+four postscript figures, an Appendix adde

The current status of species recognition and identification in Aspergillus

The species recognition and identification of aspergilli and their teleomorphs is discussed. A historical overview of the taxonomic concepts starting with the monograph of Raper & Fennell (1965) is given. A list of taxa described since 2000 is provided. Physiological characters, particularly growth rates and the production of extrolites, often show differences that reflect phylogenetic species boundaries and greater emphasis should be placed on extrolite profiles and growth characteristics in species descriptions. Multilocus sequence-based phylogenetic analyses have emerged as the primary tool for inferring phylogenetic species boundaries and relationships within subgenera and sections. A four locus DNA sequence study covering all major lineages in Aspergillus using genealogical concordance theory resulted in a species recognition system that agrees in part with phenotypic studies and reveals the presence of many undescribed species not resolved by phenotype. The use of as much data from as many sources as possible in making taxonomic decisions is advocated. For species identification, DNA barcoding uses a short genetic marker in an organism”s DNA to quickly and easily identify it to a particular species. Partial cytochrome oxidase subunit 1 sequences, which are used for barcoding animal species, were found to have limited value for species identification among black aspergilli. The various possibilities are discussed and at present partial β-tubulin or calmodulin are the most promising loci for Aspergillus identification. For characterising Aspergillus species one application would be to produce a multilocus phylogeny, with the goal of having a firm understanding of the evolutionary relationships among species across the entire genus. DNA chip technologies are discussed as possibilities for an accurate multilocus barcoding tool for the genus Aspergillus

Predicting stroke through genetic risk functions: the CHARGE Risk Score Project.

BACKGROUND AND PURPOSE: Beyond the Framingham Stroke Risk Score, prediction of future stroke may improve with a genetic risk score (GRS) based on single-nucleotide polymorphisms associated with stroke and its risk factors. METHODS: The study includes 4 population-based cohorts with 2047 first incident strokes from 22,720 initially stroke-free European origin participants aged ≥55 years, who were followed for up to 20 years. GRSs were constructed with 324 single-nucleotide polymorphisms implicated in stroke and 9 risk factors. The association of the GRS to first incident stroke was tested using Cox regression; the GRS predictive properties were assessed with area under the curve statistics comparing the GRS with age and sex, Framingham Stroke Risk Score models, and reclassification statistics. These analyses were performed per cohort and in a meta-analysis of pooled data. Replication was sought in a case-control study of ischemic stroke. RESULTS: In the meta-analysis, adding the GRS to the Framingham Stroke Risk Score, age and sex model resulted in a significant improvement in discrimination (all stroke: Δjoint area under the curve=0.016, P=2.3×10(-6); ischemic stroke: Δjoint area under the curve=0.021, P=3.7×10(-7)), although the overall area under the curve remained low. In all the studies, there was a highly significantly improved net reclassification index (P<10(-4)). CONCLUSIONS: The single-nucleotide polymorphisms associated with stroke and its risk factors result only in a small improvement in prediction of future stroke compared with the classical epidemiological risk factors for stroke

Prospective associations of coronary heart disease loci in African Americans using the MetaboChip

Background: Coronary heart disease (CHD) is a leading cause of morbidity and mortality in African Americans. However, there is a paucity of studies assessing genetic determinants of CHD in African Americans. We examined the association of publishe

ASH ISTH NHF WFH 2021 guidelines on the diagnosis of von Willebrand disease

Background: von Willebrand disease (VWD) is the most common inherited bleeding disorder known in humans. Accurate and timely diagnosis presents numerous challenges.Objective: These evidence-based guidelines of the American Society of Hematology (ASH), the International Society on Thrombosis and Haemostasis (ISTH), the National Hemophilia Foundation (NHF), and the World Federation of Hemophilia (WFH) are intended to support patients, clinicians, and other health care professionals in their decisions about VWD diagnosis.Methods: ASH, ISTH, NHF, and WFH established a multidisciplinary guideline panel that included 4 patient representatives and was balanced to minimize potential bias from conflicts of interest. The Outcomes and Implementation Research Unit at the University of Kansas Medical Center (KUMC) supported the guideline-development process, including performing or updating systematic evidence reviews up to 8 January 2020. The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The panel used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, including GRADE Evidence-to-Decision frameworks, to assess evidence and make recommendations, which were subsequently subject to public comment.Results: The panel agreed on 11 recommendations.Conclusions: Key recommendations of these guidelines include the role of bleeding-assessment tools in the assessment of patients suspected of VWD, diagnostic assays and laboratory cutoffs for type 1 and type 2 VWD, how to approach a type 1 VWD patient with normalized levels over time, and the role of genetic testing vs phenotypic assays for types 2B and 2N. Future critical research priorities are also identified.Thrombosis and Hemostasi