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

Note and Comment

Power of the US Supreme Court to Enforce Judgments Against States - In the year 1460, when the perogatives of sovereignty or at least of the Crown were asserted in England much more vigorously than they are today, the Counseill of the right high and mighty Prynce Richard Duc of York, brought into the Parliament Chambre a writyng conteignyng the clayme and title of the right, that the seid Duc pretended unto the Corones of Englond and of Fraunce, and Lordship of Trelond, and the same writyng delyvered to the Right Reverent Fader in God George Bishop of Excestre, Chaunceller of Englond, desiryng hym that the same writyng myght be opened to the Lordes Spirituelx and Temporelx assembled in this present Parlement, and that the seid Duc myght have brief and expedient answere thereof. Whereupon the lords, apparently embarrassed by this extraordinary manifestation of confidence in them, declared that the said writyng shuld be radde and herd, not to be answered without the Kyngs commaundement, for so moche as the mater is so high, and of soo grete wyght and poyse.\u27 Vhen four days later the petition was again urgently presented therupon incontynent all the seid Lordes Spirituelx and Temporelx went to the Kyngs high presence, and therunto opened and declared the seid mater, by the mouth of his said Chaunceller of Englond. The King was graciously pleased to command the lords that they should serche for to fynde in asmuch as in them was, all such thyngs as myght be objecte and leyde ayenst the cleyme and title of the seid Duc. And though the King\u27s command could scarcely be regarded as indicating a judicial inquiry, the lords in their extremity sent for the Kyngs Justices into the Parlement Chambre, to have their avis and Counsell in this behalf, * * * * sadly to take avisament therin, and to serche and fynde all such objections as myght be leyde ayenst the same, in fortefying of the Kynges right. Duke of York\u27s Claim to the Crown, 5 Rot. ParI., 375, I Wambaugh\u27s Cas. Const. Law, I

Unique Residues Involved in Activation of the Multitasking Protease/Chaperone HtrA from Chlamydia trachomatis

DegP, a member of the HtrA family of proteins, conducts critical bacterial protein quality control by both chaperone and proteolysis activities. The regulatory mechanisms controlling these two distinct activities, however, are unknown. DegP activation is known to involve a unique mechanism of allosteric binding, conformational changes and oligomer formation. We have uncovered a novel role for the residues at the PDZ1:protease interface in oligomer formation specifically for chaperone substrates of Chlamydia trachomatis HtrA (DegP homolog). We have demonstrated that CtHtrA proteolysis could be activated by allosteric binding and oligomer formation. The PDZ1 activator cleft was required for the activation and oligomer formation. However, unique to CtHtrA was the critical role for residues at the PDZ1:protease interface in oligomer formation when the activator was an in vitro chaperone substrate. Furthermore, a potential in vivo chaperone substrate, the major outer membrane protein (MOMP) from Chlamydia, was able to activate CtHtrA and induce oligomer formation. Therefore, we have revealed novel residues involved in the activation of CtHtrA which are likely to have important in vivo implications for outer membrane protein assembly

Acquiring, archiving, analyzing and exchanging seismic data in real time at the Seismological Research Center of the OGS in Italy

The Centro di Ricerche Sismologiche (CRS, Seismological Research Center) of the Istituto Nazionale di Oceanografia e di Geofisica Sperimentale (OGS, Italian National Institute for Oceanography and Experimental Geophysics) in Udine (Italy) after the strong earthquake (magnitude M=6.4) occurred in 1976 in the Italian Friuli-Venezia Giulia region, started to operate the North-east Italy (NI) seismic network: it currently consists of 11 very sensitive broad band and 23 more simple short period seismic stations, all telemetered to and acquired in real time at the OGS-CRS data center in Udine. Real time data exchange agreements in place with other Italian, Slovenian, Austrian and Swiss seismological institutes lead to a total number of 89 seismic stations acquired in real time, which makes the OGS the reference institute for seismic monitoring of Northeastern Italy. Since 2002 OGS-CRS is using the Antelope software suite as the main tool for collecting, analyzing, archiving and exchanging seismic data in the framework of the EU Interreg IIIA project “Trans-national seismological networks in the South-Eastern Alps”. SeisComP is also used as a real time data exchange server tool. At OGS-CRS we then adapted existing programs and created new ones like: a customized web-accessible server to manually relocate earthquakes, a script for automatic moment tensor determination, scripts for web publishing of earthquake parametric data, waveforms, state of health parameters and shaking maps, noise characterization by means of automatic spectra analysis, plus scripts for email/SMS/fax alerting. A new OGS-CRS real time web site has also been recently designed and made operative in the framework of the DPC-INGV S3 Project

Can video improve grant review quality and lead to more reliable ranking?

Multimedia video is rapidly becoming mainstream, and many studies indicate that it is a more effective communication medium than text. In this project we AIM to test if videos can be used, in place of text-based grant proposals, to improve communication and increase the reliability of grant ranking. We will test if video improves reviewer comprehension (AIM 1), if external reviewer grant scores are more consistent with video (AIM 2), and if mock Australian Research Council (ARC) panels award more consistent scores when grants are presented as videos (AIM 3). This will be the first study to evaluate the use of video in this application. The ARC reviewed over 3500 Discovery Project applications in 2015, awarding 635 Projects. Selecting the “best” projects is extremely challenging. This project will improve the selection process by facilitating the transition from text-based to video-based proposals. The impact could be profound: Improved video communication should streamline the grant preparation and review processes, enable more reliable ranking of applications, and more accurate identification of the “next big innovations”

Discrimination of Methionine Sulfoxide and Sulfone by Human Neutrophil Elastase

Human neutrophil elastase (HNE) is a uniquely destructive serine protease with the ability to unleash a wave of proteolytic activity by destroying the inhibitors of other proteases. Although this phenomenon forms an important part of the innate immune response to invading pathogens, it is responsible for the collateral host tissue damage observed in chronic conditions such as chronic obstructive pulmonary disease (COPD), and in more acute disorders such as the lung injuries associated with COVID-19 infection. Previously, a combinatorially selected activity-based probe revealed an unexpected substrate preference for oxidised methionine, which suggests a link to oxida-tive pathogen clearance by neutrophils. Here we use oxidised model substrates and inhibitors to confirm this observation and to show that neutrophil elastase is specifically selective for the di-oxygenated methionine sulfone rather than the mono-oxygenated methionine sulfoxide. We also posit a critical role for ordered solvent in the mechanism of HNE discrimination between the two oxidised forms methionine residue. Preference for the sulfone form of oxidised methionine is especially significant. While both host and pathogens have the ability to reduce methionine sulfoxide back to methionine, a biological pathway to reduce methionine sulfone is not known. Taken to-gether, these data suggest that the oxidative activity of neutrophils may create rapidly cleaved elas-tase “super substrates” that directly damage tissue, while initiating a cycle of neutrophil oxidation that increases elastase tissue damage and further neutrophil recruitment

Identification of a Cryptic Prokaryotic Promoter within the cDNA Encoding the 5′ End of Dengue Virus RNA Genome

Infectious cDNA clones of RNA viruses are important research tools, but flavivirus cDNA clones have proven difficult to assemble and propagate in bacteria. This has been attributed to genetic instability and/or host cell toxicity, however the mechanism leading to these difficulties has not been fully elucidated. Here we identify and characterize an efficient cryptic bacterial promoter in the cDNA encoding the dengue virus (DENV) 5′ UTR. Following cryptic transcription in E. coli, protein expression initiated at a conserved in-frame AUG that is downstream from the authentic DENV initiation codon, yielding a DENV polyprotein fragment that was truncated at the N-terminus. A more complete understanding of constitutive viral protein expression in E. coli might help explain the cloning and propagation difficulties generally observed with flavivirus cDNA

Fermi Large Area Telescope Constraints on the Gamma-ray Opacity of the Universe

The Extragalactic Background Light (EBL) includes photons with wavelengths from ultraviolet to infrared, which are effective at attenuating gamma rays with energy above ~10 GeV during propagation from sources at cosmological distances. This results in a redshift- and energy-dependent attenuation of the gamma-ray flux of extragalactic sources such as blazars and Gamma-Ray Bursts (GRBs). The Large Area Telescope onboard Fermi detects a sample of gamma-ray blazars with redshift up to z~3, and GRBs with redshift up to z~4.3. Using photons above 10 GeV collected by Fermi over more than one year of observations for these sources, we investigate the effect of gamma-ray flux attenuation by the EBL. We place upper limits on the gamma-ray opacity of the Universe at various energies and redshifts, and compare this with predictions from well-known EBL models. We find that an EBL intensity in the optical-ultraviolet wavelengths as great as predicted by the "baseline" model of Stecker et al. (2006) can be ruled out with high confidence.Comment: 42 pages, 12 figures, accepted version (24 Aug.2010) for publication in ApJ; Contact authors: A. Bouvier, A. Chen, S. Raino, S. Razzaque, A. Reimer, L.C. Reye

Comparison between the HCV IRES domain IV RNA structure and the Iron Responsive Element

Background: Serum ferritin and hepatic iron concentrations are frequently elevated in patients who are chronically infected with the hepatitis C virus (HCV), and hepatic iron concentration has been used to predict response to interferon therapy, but these correlations are not well understood. The HCV genome contains an RNA structure resembling an iron responsive element (IRE) in its internal ribosome entry site (IRES) structural domain IV (dIV). An IRE is a stem loop structure used to control the expression of eukaryotic proteins involved in iron homeostasis by either inhibiting ribosomal binding or protecting the mRNA from nuclease degradation. The HCV structure, located within the binding site of the 40S ribosomal subunit, might function as an authentic IRE or by an IRE-like mechanism.----- Results: Electrophoretic mobility shift assays showed that the HCV IRES domain IV structure does not interact with the iron regulatory protein 1 (IRP1) in vitro. Systematic HCV IRES RNA mutagenesis suggested that IRP1 cannot accommodate the shape of the wild type HCV IRES dIV RNA structure.----- Conclusion The HCV IRES dIV RNA structure is not an authentic IRE. The possibility that this RNA structure is responsible for the observed correlations between intracellular iron concentration and HCV infection parameters through an IRE-like mechanism in response to some other cellular signal remains to be tested