Confidence Level Of Primary Care Providers In Authorizing Athletic Return-To-Play

The purpose of this study was to identify the level of confidence for primary care providers in authorizing athletic retum-to-play following sports-related injury. The Centers for Disease Control and Prevention (CDC) (as cited in Patel, Yamasaki, & Brown, 2017) reported that 2.6 million children and teens ages 0-19 years are treated annually for sports-related injuries, and 7.2 million high school students participate in sports and suffer an estimated 2 million injuries that require 500,000 doctor visits and 30,000 hospitalizations annually. Although primary care providers are providing care for musculoskeletal and concussive injuries, Benham and Geier (2016) reported that they may not have the confidence, knowledge, or skill to manage common musculoskeletal conditions in their primary care practice. Excellent provisions of such care will require providers who are safe and confident in the management and treatment of sports-related injuries to ensure high-quality patient care (Benham & Geier, 2016). Researchers distributed written surveys, and links to a survey were distributed via social media postings, email, and SurveyMonkey to qualifying participants including Doctors of Medicine (MD), Doctors of Osteopathic Medicine (DO), nurse practitioners (NP), and physician assistants (PA). Data collected indicated that only 47.6% primary care providers were confident with returning youth athletes back-to-play following a sports injury, 34.7% were confident in treating sports-related concussive injuries, and 50% were confident in treating sports-related musculoskeletal injuries. Primary care providers can use this information to expose areas for confidence improvement that can be met with continued education, in-services, and workshops. Schools of medicine and nursing can use these findings to improve musculoskeletal curricula in primary care education. Determining primary care provider confidence level in authorizing athletic retum-to-play is imperative in ensuring patient safety and access to thorough and competent care from initial injury to full resolution

Putting Youth on the Map: A Pilot Instrument for Assessing Youth Well-Being

Extant measures of adolescent well-being in the United States typically focus on negative indicators of youth outcomes. Indices comprised of such measures paint bleak views of youth and orient action toward the prevention of problems over the promotion of protective factors. Their tendency to focus analyses at a state or county geographic scale produces limited information about localized outcome patterns that could inform policymakers, practitioners and advocacy networks. We discuss the construction of a new geo-referenced index of youth well-being based on positive indicators of youth development. In demonstrating the index for the greater Sacramento, California region of the United States, we find that overall youth well-being falls far short of an optimal outcome, and geographic disparities in well-being appear to exist across school districts at all levels of our analysis. Despite its limitations, the sub-county geographic scale of this index provides needed data to facilitate local and regional interventions

SARS-CoV-2 Omicron is an immune escape variant with an altered cell entry pathway

Vaccines based on the spike protein of SARS-CoV-2 are a cornerstone of the public health response to COVID-19. The emergence of hypermutated, increasingly transmissible variants of concern (VOCs) threaten this strategy. Omicron (B.1.1.529), the fifth VOC to be described, harbours multiple amino acid mutations in spike, half of which lie within the receptor-binding domain. Here we demonstrate substantial evasion of neutralization by Omicron BA.1 and BA.2 variants in vitro using sera from individuals vaccinated with ChAdOx1, BNT162b2 and mRNA-1273. These data were mirrored by a substantial reduction in real-world vaccine effectiveness that was partially restored by booster vaccination. The Omicron variants BA.1 and BA.2 did not induce cell syncytia in vitro and favoured a TMPRSS2-independent endosomal entry pathway, these phenotypes mapping to distinct regions of the spike protein. Impaired cell fusion was determined by the receptor-binding domain, while endosomal entry mapped to the S2 domain. Such marked changes in antigenicity and replicative biology may underlie the rapid global spread and altered pathogenicity of the Omicron variant

Sense–Analyze–Respond–Actuate (SARA) Paradigm: Proof of Concept System Spanning Nanoscale and Macroscale Actuation for Detection of Escherichia coli in Aqueous Media

Foodborne pathogens are a major concern for public health. We demonstrate for the first time a partially automated sensing system for rapid (~17 min), label-free impedimetric detection of Escherichia coli spp. in food samples (vegetable broth) and hydroponic media (aeroponic lettuce system) based on temperature-responsive poly(N-isopropylacrylamide) (PNIPAAm) nanobrushes. This proof of concept (PoC) for the Sense-Analyze-Respond-Actuate (SARA) paradigm uses a biomimetic nanostructure that is analyzed and actuated with a smartphone. The bio-inspired soft material and sensing mechanism is inspired by binary symbiotic systems found in nature, where low concentrations of bacteria are captured from complex matrices by brush actuation driven by concentration gradients at the tissue surface. To mimic this natural actuation system, carbon-metal nanohybrid sensors were fabricated as the transducer layer, and coated with PNIPAAm nanobrushes. The most effective coating and actuation protocol for E. coli detection at various temperatures above/below the critical solution temperature of PNIPAAm was determined using a series of electrochemical experiments. After analyzing nanobrush actuation in stagnant media, we developed a flow through system using a series of pumps that are triggered by electrochemical events at the surface of the biosensor. SARA PoC may be viewed as a cyber-physical system that actuates nanomaterials using smartphone-based electroanalytical testing of samples. This study demonstrates thermal actuation of polymer nanobrushes to detect (sense) bacteria using a cyber-physical systems (CPS) approach. This PoC may catalyze the development of smart sensors capable of actuation at the nanoscale (stimulus-response polymer) and macroscale (non-microfluidic pumping)

Genomic reconstruction of the SARS-CoV-2 epidemic in England

AbstractThe evolution of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus leads to new variants that warrant timely epidemiological characterization. Here we use the dense genomic surveillance data generated by the COVID-19 Genomics UK Consortium to reconstruct the dynamics of 71 different lineages in each of 315 English local authorities between September 2020 and June 2021. This analysis reveals a series of subepidemics that peaked in early autumn 2020, followed by a jump in transmissibility of the B.1.1.7/Alpha lineage. The Alpha variant grew when other lineages declined during the second national lockdown and regionally tiered restrictions between November and December 2020. A third more stringent national lockdown suppressed the Alpha variant and eliminated nearly all other lineages in early 2021. Yet a series of variants (most of which contained the spike E484K mutation) defied these trends and persisted at moderately increasing proportions. However, by accounting for sustained introductions, we found that the transmissibility of these variants is unlikely to have exceeded the transmissibility of the Alpha variant. Finally, B.1.617.2/Delta was repeatedly introduced in England and grew rapidly in early summer 2021, constituting approximately 98% of sampled SARS-CoV-2 genomes on 26 June 2021.</jats:p