Unique diagnostic signatures of concussion in the saliva of male athletes: the Study of Concussion in Rugby Union through MicroRNAs (SCRUM)

ObjectiveTo investigate the role of salivary small non-coding RNAs (sncRNAs) in the diagnosis of sport-related concussion.MethodsSaliva was obtained from male professional players in the top two tiers of England’s elite rugby union competition across two seasons (2017–2019). Samples were collected preseason from 1028 players, and during standardised head injury assessments (HIAs) at three time points (in-game, post-game, and 36–48 hours post-game) from 156 of these. Samples were also collected from controls (102 uninjured players and 66 players sustaining a musculoskeletal injury). Diagnostic sncRNAs were identified with next generation sequencing and validated using quantitative PCR in 702 samples. A predictive logistic regression model was built on 2017–2018 data (training dataset) and prospectively validated the following season (test dataset).ResultsThe HIA process confirmed concussion in 106 players (HIA+) and excluded this in 50 (HIA−). 32 sncRNAs were significantly differentially expressed across these two groups, with let-7f-5p showing the highest area under the curve (AUC) at 36–48 hours. Additionally, a combined panel of 14 sncRNAs (let-7a-5p, miR-143-3p, miR-103a-3p, miR-34b-3p, RNU6-7, RNU6-45, Snora57, snoU13.120, tRNA18Arg-CCT, U6-168, U6-428, U6-1249, Uco22cjg1,YRNA_255) could differentiate concussed subjects from all other groups, including players who were HIA− and controls, immediately after the game (AUC 0.91, 95% CI 0.81 to 1) and 36–48 hours later (AUC 0.94, 95% CI 0.86 to 1). When prospectively tested, the panel confirmed high predictive accuracy (AUC 0.96, 95% CI 0.92 to 1 post-game and AUC 0.93, 95% CI 0.86 to 1 at 36–48 hours).ConclusionsSCRUM, a large prospective observational study of non-invasive concussion biomarkers, has identified unique signatures of concussion in saliva of male athletes diagnosed with concussion.

Constituent elements of prohibited vertical agreements in the competition law of Iran and the European Union

The objective of the investigation is to analyze the constituent elements of vertical agreements prohibited by Iran's competition law, in accordance with Chapter IX of the Law on the Implementation of General Policies and in accordance with Article 44 of the Constitution and, as set out in European Union competition law, Article 101 of the Treaty on the Functioning of the European Union. By vertical agreements it can be said that one of the types of agreements is wanted in the competition law. Any reference between natural or legal persons in the longitudinal direction (whether top to bottom or bottom up) that is not close to the consumer's interest is agreed. These agreements may include free clauses that are not compatible with the objectives of competition law. Methodologically, this is a documentary research close to comparative and legal hermeneutics. It is concluded that, to prohibit vertical agreements, they need to have the anti-competitive object or effect and also have a tangible impact on the closure of competition on the market.

Platform policies in the European Union: Competition and public interest in media markets

This article examines which platform policies the European Commission has developed over the last couple of years and whether its policies are taking into account the differences in platform power. We first identify the main structures of platform power. Secondly, we confront the European Commission’s policies affecting media and communication platforms with those structures. Thirdly, we discuss whether what the European Commission is doing will make sense in the longer run. We end with some conclusions and recommendations for further research and policy. Our main finding is that the approach of the European Commission cannot live up to expectations, simply because it is too fragmented in terms of tackling the different dimensions of platform power together. Moreover, in the focus on detrimental effects of (some) platforms on competition, public interest issues often remain neglected.

Applicability of European Union Competition Law to Health Care Providers: The Dividing Line between Economic and Noneconomic Activities

Ever-increasing health spending, which, according to future projections, continues to outpace economic growth, will further endanger the financial sustainability of health systems. In a quest to improve the efficacy and efficiency of the health system and thus strengthen its financial sustainability, member states are employing market-based mechanisms to finance, manage, and provide health care. However, the introduction of elements of competition is constrained by the application of EU competition law, which raises significant concerns regarding the applicability of competition law and its limits in the field of health care. Due to the lack of a clear definition in EU legislation, the applicability and scope of competition law are determined on a case-by-case basis, which reveals an inconsistent approach by the European Commission and the CJEU regarding the application of competition law to health care providers and has created legal uncertainty. The aim of this article is to analyze relevant decisions by the commission and the CJEU case law in the pursuit of “boundaries” that may trigger the applicability of competition law with regard to health care providers. Based on the findings of the analysis, the article proposes a set of principles or guidelines for determining whether a health care provider should be considered as an undertaking and, as such, subject to EU competition law.