Exploring the equity of distribution of general medical services funding allocations in Wales: a time-series analysis.

Background: Good access to quality primary care in high-income countries can improve population health. Access to primary care is however often not equal among socioeconomic groups; our analysis sought to explore whether funding, a determinant of service supply, is equitably distributed among GP practices in Wales.

Aim: We sought to explore the relationship between funding and deprivation among GP practices in Wales, to understand the equity of current funding policies.

Delivering value-based healthcare for people with diabetes in a national publicly funded health service: Lessons from Ireland and Wales.

The term value-based healthcare (VBHC) describes an approach to the organization and delivery of care that emphasizes reducing the cost of care while improving outcomes. This involves increased investment earlier in the care pathway e.g.

Value of improving patient safety: health economic considerations for rapid response systems-a rapid review of the literature and expert round table.

Objectives: Failure to rescue deteriorating patients in hospital is a well-researched topic. We aimed to explore the impact of safer care on health economic considerations for clinicians, providers and policymakers.

Design: We undertook a rapid review of the available literature and convened a round table of international specialists in the field including experts on health economics and value-based healthcare to better understand health economics of clinical deterioration and impact of systems to reduce failure to rescue.

Value-based healthcare: is it the way forward?

It is undeniable that the NHS, our universal healthcare system, is struggling to meet the needs and expectations of a population that is very different from its inception in 1948. Costs are rising inexorably and, yet, patient experience of their healthcare is often not what we would want it to be. Inequities still exist, both in terms of access to care and clinical outcome.

Contribution of avoidable mortality to life expectancy inequalities in Wales: a decomposition by age and by cause between 2002 and 2020.

Objectives: To explore the contribution of avoidable mortality to life expectancy inequalities in Wales during 2002-2020.

Design: Observational study.

Setting: Wales, 2002-20, including early data from the COVID-19 pandemic.

The Challenge of maintaining good health outcomes for all during the COVID-19 pandemic-a view from family medicine in Wales, UK.

This article addresses the issue of maintaining essential healthcare services throughout the pandemic and beyond. It suggests a key role for the use of patient-reported outcomes.

First steps in PROMs and PREMs collection in Wales as part of the prudent and value-based healthcare agenda.

Purpose: Patients are experts in their own health and should be treated as equal partners in their care. Patient-reported outcome measures (PROMs) are an effective way of gathering patient feedback and can facilitate effectiveness and cost-effectiveness analysis to improve decision making and service improvement. The PROMs, PREMs & Effectiveness Programme was initiated in 2016 and aimed to develop an electronic platform to facilitate collection of PROMs and Patient-reported experience measures (PREMs) from secondary care patients across Wales.

Clinical Risk Prediction Scores in Coronavirus Disease 2019: Beware of Low Validity and Clinical Utility.

Several risk stratification tools were developed to predict disease progression in coronavirus disease 2019, with no external validation to date. We attempted to validate three previously published risk-stratification tools in a multicenter study. Primary outcome was a composite outcome of development of severe coronavirus disease 2019 disease leading to ICU admission or death censored at hospital discharge or 30 days.

Upcycling aromatic polymers through C-H fluoroalkylation.

The unique properties imparted by planar, rigid aromatic rings in synthetic polymers make these macromolecules useful in a range of applications, including disposable packaging, aerospace materials, flexible electronics, separation membranes, and engineering thermoplastics. The thermal and chemical stability of aromatic polymers, however, makes it difficult to alter their bulk and/or surface properties and results in challenges during recycling. In response, we report a platform approach for the C-H functionalization of aromatic polymers by taking advantage of their innate reactivity with electrophilic radical intermediates.

C-H Functionalization of Commodity Polymers.

Synthetic manipulation of polymer substrates is one of the oldest and most reliable methods to increase the functional diversity of soft materials. Modifying the chemical structure of polymers that are already produced on a commodity scale leverages the current high-volume and low-cost production of commodity plastics for the discovery of modern materials. A myriad of polymer C-H functionalization methods have been developed which enable the modification of material properties on both a laboratory and industrial scale.

Defining an International Standard Set of Outcome Measures for Patients With Hip or Knee Osteoarthritis: Consensus of the International Consortium for Health Outcomes Measurement Hip and Knee Osteoarthritis Working Group.

Objective: To define a minimum Standard Set of outcome measures and case-mix factors for monitoring, comparing, and improving health care for patients with clinically diagnosed hip or knee osteoarthritis (OA), with a focus on defining the outcomes that matter most to patients.

Methods: An international working group of patients, arthroplasty register experts, orthopedic surgeons, primary care physicians, rheumatologists, and physiotherapists representing 10 countries was assembled to review existing literature and practices for assessing outcomes of pharmacologic and nonpharmacologic OA therapies, including surgery. A series of 8 teleconferences, incorporating a modified Delphi process, were held to reach consensus.

The copper active site of CBM33 polysaccharide oxygenases.

The capacity of metal-dependent fungal and bacterial polysaccharide oxygenases, termed GH61 and CBM33, respectively, to potentiate the enzymatic degradation of cellulose opens new possibilities for the conversion of recalcitrant biomass to biofuels. GH61s have already been shown to be unique metalloenzymes containing an active site with a mononuclear copper ion coordinated by two histidines, one of which is an unusual τ-N-methylated N-terminal histidine. We now report the structural and spectroscopic characterization of the corresponding copper CBM33 enzymes.

Self management of haemodialysis for End Stage Renal Disease: a systematic review.

Background: Exploring self management in End Stage Renal Disease is extremely important for patients as they encounter several challenges including ongoing symptoms, complex treatments and restrictions, uncertainty about life and a dependency on technology, all of which impact upon their autonomy particularly after commencement of haemodialysis.

Objective: To summarise the effects of nursing interventions which effect selfmanagement of haemodialysis for patients with End Stage Renal Disease.

Search Strategy: Search terms were chosen after reviewing text words and MeSH terms in relevant articles and databases.

Identification of a novel tubulin-destabilizing protein related to the chaperone cofactor E.

Factors that regulate the microtubule cytoskeleton are critical in determining cell behavior. Here we describe the function of a novel protein that we term E-like based on its sequence similarity to the tubulin-specific chaperone cofactor E. We find that upon overexpression, E-like depolymerizes microtubules by committing tubulin to proteosomal degradation.

Selective contribution of eukaryotic prefoldin subunits to actin and tubulin binding.

Eukaryotic prefoldin (PFD) is a heterohexameric chaperone with a jellyfish-like structure whose function is to deliver nonnative target proteins, principally actins and tubulins, to the eukaryotic cytosolic chaperonin for facilitated folding. Here we demonstrate that functional PFD can spontaneously assemble from its six constituent individual subunits (PFD1-PFD6), each expressed as a recombinant protein. Using engineered forms of PFD assembled in vitro, we show that the tips of the PFD tentacles are required to form binary complexes with authentic target proteins.

Structure of eukaryotic prefoldin and of its complexes with unfolded actin and the cytosolic chaperonin CCT.

The biogenesis of the cytoskeletal proteins actin and tubulin involves interaction of nascent chains of each of the two proteins with the oligomeric protein prefoldin (PFD) and their subsequent transfer to the cytosolic chaperonin CCT (chaperonin containing TCP-1). Here we show by electron microscopy that eukaryotic PFD, which has a similar structure to its archaeal counterpart, interacts with unfolded actin along the tips of its projecting arms. In its PFD-bound state, actin seems to acquire a conformation similar to that adopted when it is bound to CCT.

Localization in the human retina of the X-linked retinitis pigmentosa protein RP2, its homologue cofactor C and the RP2 interacting protein Arl3.

Mutations in the retinitis pigmentosa 2 (RP2) gene cause a severe form of X-linked retinal degeneration. RP2 is a ubiquitous 350 amino acid plasma membrane-associated protein, which shares homology with the tubulin-specific chaperone cofactor C. RP2 protein, like cofactor C, stimulates the GTPase activity of tubulin in combination with cofactor D.

Functional overlap between retinitis pigmentosa 2 protein and the tubulin-specific chaperone cofactor C.

Mutations in the X-linked retinitis pigmentosa 2 gene cause progressive degeneration of photoreceptor cells. The retinitis pigmentosa 2 protein (RP2) is similar in sequence to the tubulin-specific chaperone cofactor C. Together with cofactors D and E, cofactor C stimulates the GTPase activity of native tubulin, a reaction regulated by ADP-ribosylation factor-like 2 protein.