As private equity firms continue to increase their ownership stake in various health care sectors in the US, questions arise about potential impacts on the organization and delivery of care. Using a difference-in-differences approach, we investigated changes in service-line provision in private equity–acquired hospitals. Relative to nonacquired hospitals, private equity acquisition was associated with a higher probability of adding specific profitable hospital-based services (interventional cardiac catheterization, hemodialysis, and labor and delivery), profitable technologies (robotic surgery and digital mammography), and freestanding or satellite emergency departments. Moreover, private equity acquisition was associated with an increased probability of providing services that were previously categorized as unprofitable but that have more recently become areas of financial opportunity (for example, mental health services). Finally, private equity–acquired hospitals were less likely to add or continue services that have unreliable revenue streams or that may face competition from nonprofit hospitals (for example, outpatient psychiatry), although fewer shifts were noted among unprofitable services. This may reflect a prevailing shift by acute care hospitals toward outpatient settings for appropriate procedures and synergies with existing holdings by private equity firms.

Purpose: There isgrowing concern surrounding the harmful effects of soccer heading on cognitive function. The present study aims to examine the immediate effects of heading. Methods: 30 recreational male soccer players were divided into three groups that undertook 20 consecutive headers with a soft (8.8 psi), hard (16.2 psi), or no (control) ball. A battery of neuropsychological tests was completed before and after heading: King-Devick, trail-making (TM) (A, B), digit span (DS) and spatial span (SS) (forward, backward). Results: Significant increase in the time (M = 4.44 s) and errors (M = 1.45) for the King-Devick test within the hard and soft groups, although there was no significant difference for TM-A and TM-B. Significant decline for SS forward within the hard and soft groups (M= −16%), although the declines for SS backward (M = −16%), DS forward (M= −23%) and DS backward (M = −25%) were present only for the hard group (ps <.05). Discussion: While outside of regular match-play, this study showed that heading negatively influenced one indicator of a suspected concussion (King-Devick), as well as working memory (DS, SS) that is essential for daily life. These findings contribute to the growing debate surrounding heading safety.

Despite its well-known advantages, per-flow fair queueing has not been deployed in the Internet mainly because of the common belief that such scheduling is not scalable. The objective of the present paper is to demonstrate using trace simulations and analytical evaluations that this belief is misguided. We show that although the number of flows in progress increases with link speed, the number that needs scheduling at any moment is largely independent of this rate. The number of such active flows is a random process typically measured in hundreds even though there may be tens of thousands of flows in progress. The simulations are performed using traces from commercial and research networks with quite different traffic characteristics. Analysis is based on models for balanced fair statistical bandwidth sharing and applies properties of queue busy periods to explain the observed behaviour.