National Football League Skilled and Unskilled Positions Vary in Opportunity and Yield in Return to Play After an Anterior Cruciate Ligament Injury.

BACKGROUND: Anterior cruciate ligament (ACL) injuries pose a significant risk to the careers of players in the National Football League (NFL). The relationships between draft round and position on return to play (RTP) among NFL players are not well understood, and the ability to return to preinjury performance levels remains unknown for most positions. PURPOSE: To test for differences in RTP rates and changes in performance after an ACL injury by position and draft round. We hypothesized that skilled positions would return at a lower rate compared to unskilled positions. We further hypothesized that early draft-round status would relate to a greater rate of RTP and that skilled positions and a lower draft round would correlate with decreased performance for players who return to sport. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: Utilizing a previously established database of publicly available information regarding ACL tears among NFL players, athletes with ACL tears occurring between the 2010 and 2013 seasons were identified. Generalized linear models and Kaplan-Meier time-to-event models were used to test the study hypotheses. RESULTS: The overall RTP rate was 61.7%, with skilled players and unskilled players returning at rates of 64.1% and 60.4%, respectively (P = .74). Early draft-round players and unskilled late draft-round players had greater rates of RTP compared to skilled late draft-round players and both unskilled and skilled undrafted free agents (UDFAs). Skilled early draft-round players constituted the only cohort that played significantly fewer games after an injury. Unskilled UDFAs constituted the only cohort to show a significant increase in the number of games started and ratio of games started to games played, starting more games in which they played, after an injury. CONCLUSION: Early draft-round and unskilled players were more likely to return compared to their later draft-round and skilled peers. Skilled early draft-round players, who displayed relatively high rates of RTP, constituted the only cohort to show a decline in performance. Unskilled UDFAs, who exhibited relatively low rates of RTP, constituted the only cohort to show an increase in performance. The significant effect of draft round and position type on RTP may be caused by a combination of differences in talent levels and in opportunities given to returning to play

Examining the Intersection of Refugee Policies and Contemporary Protracted Displacement

Article 33 of the 1951 Convention Relating to the Status of Refugees states that host nations shall not expel or return a refugee to their home nation ‘where his life or freedom would be threatened.’ However, as demonstrated in three contemporary case studies in protracted displacement the interests of the sovereign state drive nations to craft strategies to limit cross-border refugee mobility. The refoulement of refugees escaping drug cartel violence throughout the Americas, internally displaced Haitians, and Syrian refugees in Jordan are all ‘managed’ by one of two methods. First, some destination nations either strategically blur refugees into other mobility schemes such economic migrants, illegal immigrants, link refugees to terrorist groups or nations outright replace the term refugee with words like guest. The benefit of this nomenclature strategy avoids refugee ‘laws’ altogether. The second strategy outright prevents the need to refoule by regulating or outright stopping refugee border crossings altogether. The border control strategy allows for refugee considerations, however prevents the host nation from engaging in Article 33 violations. Regardless of the strategy, host nations create policies that prioritize the protection and sovereignty of the host nations over the needs of individual refugees and the growing number of refugees in protracted displacement situations

Empowerment or Engagement? Digital Health Technologies for Mental Healthcare

We argue that while digital health technologies (e.g. artificial intelligence, smartphones, and virtual reality) present significant opportunities for improving the delivery of healthcare, key concepts that are used to evaluate and understand their impact can obscure significant ethical issues related to patient engagement and experience. Specifically, we focus on the concept of empowerment and ask whether it is adequate for addressing some significant ethical concerns that relate to digital health technologies for mental healthcare. We frame these concerns using five key ethical principles for AI ethics (i.e. autonomy, beneficence, non-maleficence, justice, and explicability), which have their roots in the bioethical literature, in order to critically evaluate the role that digital health technologies will have in the future of digital healthcare

Rhesus TRIM5α disrupts the HIV-1 capsid at the inter-hexamer interfaces

TRIM proteins play important roles in the innate immune defense against retroviral infection, including human immunodeficiency virus type-1 (HIV-1). Rhesus macaque TRIM5α (TRIM5αrh) targets the HIV-1 capsid and blocks infection at an early post-entry stage, prior to reverse transcription. Studies have shown that binding of TRIM5α to the assembled capsid is essential for restriction and requires the coiled-coil and B30.2/SPRY domains, but the molecular mechanism of restriction is not fully understood. In this study, we investigated, by cryoEM combined with mutagenesis and chemical cross-linking, the direct interactions between HIV-1 capsid protein (CA) assemblies and purified TRIM5αrh containing coiled-coil and SPRY domains (CC-SPRYrh). Concentration-dependent binding of CC-SPRYrh to CA assemblies was observed, while under equivalent conditions the human protein did not bind. Importantly, CC-SPRYrh, but not its human counterpart, disrupted CA tubes in a non-random fashion, releasing fragments of protofilaments consisting of CA hexamers without dissociation into monomers. Furthermore, such structural destruction was prevented by inter-hexamer crosslinking using P207C/T216C mutant CA with disulfide bonds at the CTD-CTD trimer interface of capsid assemblies, but not by intra-hexamer crosslinking via A14C/E45C at the NTD-NTD interface. The same disruption effect by TRIM5αrh on the inter-hexamer interfaces also occurred with purified intact HIV-1 cores. These results provide insights concerning how TRIM5α disrupts the virion core and demonstrate that structural damage of the viral capsid by TRIM5α is likely one of the important components of the mechanism of TRIM5α-mediated HIV-1 restriction. © 2011 Zhao et al

Visual function, traumatic brain injury, and posttraumatic stress disorder

Traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) are signature injuries of the Iraq and Afghanistan conflicts. The conditions can be comorbid and have overlapping signs and symptoms, making it difficult to diagnose and treat each. TBI is associated with numerous changes in vision function, but vision problems secondary to PTSD have not been documented. To address this shortcoming, we reviewed the medical records of 100 patients with a history of TBI, noting PTSD diagnoses, visual symptoms, vision function abnormalities, and medications with visual side effects. Forty-one patients had PTSD and 59 did not. High rates of binocular vision and oculomotor function deficits were measured in patients with a history of TBI, but no significant differences between patients with or without PTSD were evident. However, compared to patients without PTSD, patients with PTSD had more self-reported visual symptoms in all four assessments and the complaint rates were significantly higher for light sensitivity and reading problems. Together, these findings may be beneficial in understanding vision problems in patients with TBI and PTSD as comorbid conditions compared with those with TBI alone

Beliefs about Social Distancing During COVID-19 Stay-At-Home Orders: A Theory-Based Salient Belief Elicitation

Understanding the beliefs about social distancing behaviors is required to inform 2019 coronavirus disease (COVID-19) interventions that are based on theory, research, and evidence. This study investigated the salient beliefs related to social distancing. United States adults (n = 106) recruited from Amazon’s Mechanical Turk completed an online reasoned action approach belief elicitation from April 19 to April 25, 2020. Behavioral beliefs (advantages and disadvantages), normative beliefs (approvers and disapprovers), and control beliefs (facilitators and barriers) related to social distancing were elicited via open-ended questions. A content analysis was performed, and kappa statistics revealed high levels of interrater reliability (α = 0.86-0.96). Results revealed that a perceived salient advantage to social distancing was individual COVID-19 prevention, more so than community prevention. The most cited disadvantage was that social distancing could prevent participants from socially interacting with others, which could negatively impact mental health. Family and friends were the most mentioned approvers, while people who hold conservative ideologies and negative attitudes about COVID-19 were the most frequent disapprovers. Supply accessibility and store policies were the most listed facilitators. Results suggest three implications. First, pandemic-related public health and social marketing campaigns should focus more on individual health benefits than community health benefits. Second, digital public health interventions that address social connectedness and mental health outcomes are critical during pandemics. Third, public health scientists and practitioners should work with local and national media outlets and political leaders to create community-tailored and evidence-based information to increase adherence of mitigation strategies

The Explanatory Value of Abstracting Away from Idiosyncratic and Messy Detail

Some explanations are relatively abstract: they abstract away from the idiosyncratic or messy details of the case in hand. The received wisdom in philosophy is that this is a virtue for any explanation to possess. I argue that the apparent consensus on this point is illusory. When philosophers make this claim, they differ on which of four alternative varieties of abstractness they have in mind. What's more, for each variety of abstractness there are several alternative reasons to think that the variety of abstractness in question is a virtue. I identify the most promising reasons, and dismiss some others. The paper concludes by relating this discussion to the idea that explanations in biology, psychology and social science cannot be replaced by relatively micro explanations without loss of understanding.This work has received funding from the European Research Council under the European Union’s Seventh Framework Programme (FP7/2007-2013)/ERC Grant agreement no 284123.This is the author accepted manuscript. The final version is available from Springer via http://dx.doi.org/10.1007/s11098-015-0554-

A Polymorphism in the α4 Nicotinic Receptor Gene (Chrna4) Modulates Enhancement of Nicotinic Receptor Function by Ethanol

Several studies indicate that ethanol enhances the activity of α4β2 nicotinic acetylcholine receptors (nAChR). Our laboratory has identified a polymorphism in the α4 gene that results in the substitution of an alanine (A) for threonine (T) at amino acid position 529 in the second intracellular loop of the α4 protein. Mouse strains expressing the A variant have, in general, greater nAChR-mediated 86 Rb + efflux in response to nicotine than strains with the T variant. However, the possibility of the polymorphism modulating the effects of ethanol on the 86 Rb + efflux response has not been investigated. Methods : We have used the 86 Rb + efflux method to study the acute effects of ethanol on the function of the α4β2 nAChR in the thalamus in six different mouse strains. Experiments were also performed on tissue samples taken from F2 intercross animals. The F2 animals were derived from A/J mice crossed with a substrain of C57BL/6J mice that carried a null mutation for the gene encoding the β2 nAChR subunit. Results : In strains carrying the A polymorphism (A/J, AKR/J, C3H/Ibg), coapplication of ethanol (10–100 mM) with nicotine (0.03–300 μM) increased maximal ion flux when compared with nicotine alone with no effect on agonist potency. In contrast, ethanol had little effect on the nicotine concentration-response curve in tissue prepared from strains carrying the T polymorphism (Balb/Ibg, C57BL/6J, C58/J). Experiments with the F2 hybrids demonstrated that one copy of the A polymorphism was sufficient to produce a significant enhancement of nAChR function by ethanol (50 mM) in animals that were also β2 +/+. Ethanol had no effect on nicotine concentration-response curves in T/T β2 +/+ animals. Conclusions : The results suggest that the A/T polymorphism influences the initial sensitivity of the α4β2 nAChR to ethanol.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65432/1/01.ALC.0000067973.41153.BC.pd