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Head impact exposure (HIE) in youth football is a public health concern. The objective of this study was to determine if one season of HIE in youth football was related to cognitive changes.
Over 200 participants (ages 9–13) wore instrumented helmets for practices and games to measure the amount of HIE sustained over one season. Pre- and post-season neuropsychological tests were completed. Test score changes were calculated adjusting for practice effects and regression to the mean and used as the dependent variables. Regression models were calculated with HIE variables predicting neuropsychological test score changes.
For the full sample, a small effect was found with season average rotational values predicting changes in list-learning such that HIE was related to negative score change: standardized beta (β) = -.147, t(205) = -2.12, and p = .035. When analyzed by age clusters (9–10, 11–13) and adding participant weight to models, the R2 values increased. Splitting groups by weight (median split), found heavier members of the 9–10 cohort with significantly greater change than lighter members. Additionaly, significantly more participants had clinically meaningful negative changes: X2 = 10.343, p = .001.
These findings suggest that in the 9–10 age cluster, the average seasonal level of HIE had inverse, negative relationships with cognitive change over one season that was not found in the older group. The mediation effects of age and weight have not been explored previously and appear to contribute to the effects of HIE on cognition in youth football players.
The coronavirus disease 2019 (COVID-19) has greatly impacted health-care systems worldwide, leading to an unprecedented rise in demand for health-care resources. In anticipation of an acute strain on established medical facilities in Dallas, Texas, federal officials worked in conjunction with local medical personnel to convert a convention center into a Federal Medical Station capable of caring for patients affected by COVID-19. A 200,000 square foot event space was designated as a direct patient care area, with surrounding spaces repurposed to house ancillary services. Given the highly transmissible nature of the novel coronavirus, the donning and doffing of personal protective equipment (PPE) was of particular importance for personnel staffing the facility. Furthermore, nationwide shortages in the availability of PPE necessitated the reuse of certain protective materials. This article seeks to delineate the procedures implemented regarding PPE in the setting of a COVID-19 disaster response shelter, including workspace flow, donning and doffing procedures, PPE conservation, and exposure event protocols.
We describe an ultra-wide-bandwidth, low-frequency receiver recently installed on the Parkes radio telescope. The receiver system provides continuous frequency coverage from 704 to 4032 MHz. For much of the band (
), the system temperature is approximately 22 K and the receiver system remains in a linear regime even in the presence of strong mobile phone transmissions. We discuss the scientific and technical aspects of the new receiver, including its astronomical objectives, as well as the feed, receiver, digitiser, and signal processor design. We describe the pipeline routines that form the archive-ready data products and how those data files can be accessed from the archives. The system performance is quantified, including the system noise and linearity, beam shape, antenna efficiency, polarisation calibration, and timing stability.
The active inference framework offers an attractive starting point for understanding cultural cognition. Here, we argue that affective dynamics are essential to include when constructing this type of theory. We highlight ways in which interactions between emotional responses and the perception of those responses, both within and between individuals, can play central roles in both motivating and constraining sociocultural practices.
Weed management is a major challenge in organic crop production, and organic farms generally harbor larger weed populations and more diverse communities compared with conventional farms. However, little research has been conducted on the effects of different organic management practices on weed communities and crop yields. In 2014 and 2015, we measured weed community structure and soybean [Glycine max (L.) Merr.] yield in a long-term experiment that compared four organic cropping systems that differed in nutrient inputs, tillage, and weed management intensity: (1) high fertility (HF), (2) low fertility (LF), (3) enhanced weed management (EWM), and (4) reduced tillage (RT). In addition, we created weed-free subplots within each system to assess the impact of weeds on soybean yield. Weed density was greater in the LF and RT systems compared with the EWM system, but weed biomass did not differ among systems. Weed species richness was greater in the RT system compared with the EWM system, and weed community composition differed between RT and other systems. Our results show that differences in weed community structure were primarily related to differences in tillage intensity, rather than nutrient inputs. Soybean yield was lower in the EWM system compared with the HF and RT systems. When averaged across all four cropping systems and both years, soybean yield in weed-free subplots was 10% greater than soybean yield in the ambient weed subplots that received standard management practices for the systems in which they were located. Although weed competition limited soybean yield across all systems, the EWM system, which had the lowest weed density, also had the lowest soybean yield. Future research should aim to overcome such trade-offs between weed control and yield potential, while conserving weed species richness and the ecosystem services associated with increased weed diversity.
The use of statistical/machine learning (ML) approaches to materials science is experiencing explosive growth. Here, we review recent work focusing on the generation and application of libraries from both experiment and theoretical tools. The library data enables classical correlative ML and also opens the pathway for exploration of underlying causative physical behaviors. We highlight key advances facilitated by this approach and illustrate how modeling, macroscopic experiments, and imaging can be combined to accelerate the understanding and development of new materials systems. These developments point toward a data-driven future wherein knowledge can be aggregated and synthesized, accelerating the advancement of materials science.
Natural disasters often damage or destroy the protective public health service infrastructure (PHI) required to maintain the health and well-being of people with noncommunicable diseases (NCDs). This interruption increases the risk of an acute exacerbation or complication, potentially leading to a worse long-term prognosis or even death. Disaster-related exacerbations of NCDs will continue, if not increase, due to an increasing prevalence and sustained rise in the frequency and intensity of disasters, along with rapid unsustainable urbanization in flood plains and storm-prone coastal zones. Despite this, the focus of disaster and health systems preparedness and response remains on communicable diseases, even when the actual risk of disease outbreaks post-disaster is low, particularly in developed countries. There is now an urgent need to expand preparedness and response beyond communicable diseases to include people with NCDs.
The developing evidence-base describing the risk of disaster-related exacerbation of NCDs does not incorporate the perspectives, concerns, and challenges of people actually living with the conditions. To help address this gap, this research explored the key influences on patient ability to successfully manage their NCD after a natural disaster.
A survey of people with NCDs in Queensland, Australia collected data on demographics, disease, disaster experience, and primary concern post-disaster. Descriptive statistics and chi-square tests with a Bonferroni-adjustment were used to analyze data.
There were 118 responses to the survey. Key influences on the ability to self-manage post-disaster were access to medication, medical services, water, treatment and care, power, and food. Managing disease-specific symptoms associated with cardiovascular disease, diabetes, mental health, and respiratory diseases were primary concerns following a disaster. Stress and anxiety, loss of sleep, weakness or fatigue, and shortness of breath were common concerns for all patients with NCDs. Those dependent on care from others were most worried about shortness of breath and slow healing sores. Accessing medication and medical services were priorities for all patients post-disaster.
The key influences on successful self-management post-disaster for people with NCDs must be reflected in disaster plans and strategies. Achieving this will reduce exacerbations or complications of disease and decrease demand for emergency health care post-disaster.
Natural disasters often damage the public health infrastructure required to maintain the wellbeing of people with noncommunicable diseases. This increases the risk of an acute exacerbation or complications, potentially leading to a worse long-term prognosis or even death. Disaster-related exacerbations of noncommunicable diseases will continue, if not increase, due to an increasing disease prevalence, sustained rise in the frequency and intensity of disasters, and rapid unsustainable urbanization in disaster-prone areas. However, the traditional focus of public health and disaster systems remains on communicable diseases, despite a low risk. There is now an urgent need to expand the public health response to include noncommunicable diseases.
To explore the key influences on patient ability to successfully manage their noncommunicable disease after a natural disaster.
A survey of people with noncommunicable diseases in Queensland, Australia, collected data on demographics, disease/condition, disaster experience, and primary concern post-disaster. Descriptive statistics and chi-square tests with Bonferroni-adjustment were used to analyze data.
There were 118 responses to the survey. Key influences on the ability to self-manage post-disaster were access to medication, medical services, water, treatment and care, power, and food. Managing disease-specific symptoms associated with cardiovascular disease, diabetes, mental health, and respiratory diseases were primary concerns following a disaster. Stress and anxiety, loss of sleep, weakness or fatigue and shortness of breath were common concerns for all noncommunicable diseases. Those dependent on care from others were most worried about shortness of breath and slow healing sores. Accessing medication and medical services were priorities for all patients post-disaster.
The key influences on successful self-management post disaster for people with noncommunicable diseases must be reflected in disaster plans and strategies. Achieving this will reduce exacerbations or complications of disease and decrease demand for emergency health care post-disaster.
OBJECTIVES/SPECIFIC AIMS: Neurologic disorders are among the most significant health challenges facing society today. Although different neurologic disorders are often thought to be distinct from one another, evidence suggests similar processes may contribute to pathology in different diseases. Previous studies suggest that common disease mechanisms contribute to the development of epilepsy and tauopathy. The purpose of this study is to better characterize this relationship and explore potential therapeutic avenues to slow disease progress. METHODS/STUDY POPULATION: This study uses the pilocarpine-induced status epilepticus model of temporal lobe epilepsy to explore the effect of severe seizures on tau pathology. Brains were collected from mice at 6 or 24 hours after induced status epilepticus. Homogenates were analyzed via Western blot to look for changes in tau phosphorylation or activity of two major regulators of tau phosphorylation, GSK3β and PP2A. These data show that changes in tau phosphorylation dynamics occur at a much earlier time point after status epilepticus than has previously been described. RESULTS/ANTICIPATED RESULTS: GSK3β activity increased within 6 hours and remained elevated by 24 hours. PP2A activity initially decreased but returned to normal by 24 hours. These data show that changes in tau phosphorylation dynamics occur at a much earlier time point after status epilepticus than has previously been described. DISCUSSION/SIGNIFICANCE OF IMPACT: The current project supports previous observations that seizures promote tau phosphorylation in vivo, but suggests that changes begin much earlier than previously thought. Further work is needed to understand how post-seizure changes in tau phosphorylation develop over longer periods of time. Additionally, future work will characterize the effect of tauopathy on electrical activity in vivo and in vivo.
To inform the development of a national clinical guideline for Chronic Obstructive Pulmonary Disease (COPD), prioritized by the National Clinical Effectiveness Committee in Ireland, a systematic review was conducted to examine the cost-effectiveness of pulmonary rehabilitation programs (PRPs), outreach programs (OPs), and long-term oxygen therapy (LTOT), compared with usual care.
Medline, Embase, the Cochrane Library and grey literature sources were searched up to 19 June 2018. Studies evaluating cost-effectiveness published post-2008 in English were included. Screening, data extraction, and quality assessment using the Consensus Health Economic Criteria and International Society for Pharmacoeconomics questionnaires were conducted independently by two reviewers. Costs were converted to 2017 Irish Euro using consumer price indices for health and purchasing power parity.
From 8,661 articles identified, seven studies (one comparing both PRPs and LTOT) were included (PRPs: five; OPs: one; LTOT: two). PRP cost-utility analyses (n = 4) reported conflicting results due to considerable heterogeneity in program and study design, with incremental cost-effectiveness ratios (ICERs) ranging between EUR 12,391 and EUR 509,122 per quality adjusted life-year (QALY) gained. The remaining study investigated hospitalizations avoided and found outpatient and community-based PRPs to be dominant, while home-based PRP produced an ICER of EUR 1,913. OPs were found to be less costly, but also less effective. However, the results of the underpinning trial were neither statistically nor clinically significant. LTOT was found to be cost-effective, with ICERs of EUR 17,603 and EUR 26,936 per QALY gained.
Applying a willingness-to-pay threshold of EUR 45,000 per QALY gained, this systematic review found that, compared with usual care, there is inconsistent but generally favorable evidence for PRPs, no clear evidence for the cost-effectiveness of OPs, and that LTOT is likely to be cost-effective. However, there was a lack of methodologically robust studies included in the review and most were not directly transferable to the Irish context.
To inform the development of a national clinical guideline for Chronic Obstructive Pulmonary Disease (COPD), prioritised by the National Clinical Effectiveness Committee (NCEC) in Ireland, a systematic review was conducted to examine the cost-effectiveness of long-acting beta2-agonists (LABAs) in combination with long-acting muscarinic antagonists (LAMAs) compared with LAMA or LABA monotherapy.
Medline, Embase, the Cochrane Library and grey literature sources were searched up to 19 June 2018. Studies evaluating cost-effectiveness published post-2008 in English were included. Screening, data extraction, and quality assessment using the Consensus Health Economic Criteria (CHEC-list) and International Society for Pharmacoeconomics (ISPOR) questionnaires were conducted independently by two reviewers. Costs were adjusted to 2017 Irish Euro using consumer price indices and purchasing power parity as per national guidelines.
From a total of 8,661 articles identified, nine studies (all cost-utility analyses) were included in the review. Studies ranged from low to high quality and compared LAMA/LABA combination therapy with LAMA monotherapy. The results reported were mixed, ranging from combination therapy being dominated by (that is, more costly and less effective than) LAMA monotherapy to being dominant (that is, less costly and more effective). However, when excluding low quality, less applicable studies, the remaining six studies reported incremental cost-effectiveness ratios (ICERs) of between EUR 2,770 and EUR 26,462 per quality-adjusted life year (QALY) gained. Only one study additionally compared LABA monotherapy as a comparator, reporting combination therapy to be even more cost-effective than in the LAMA monotherapy comparison.
Applying a cost-effectiveness willingness-to-pay threshold of EUR 45,000 per QALY gained, this systematic review found that LAMA/LABA combination therapy is cost-effective compared with LAMA or LABA monotherapy in COPD patients.
There is growing concern about the declining physician-scientist workforce. NIH recently provided a national dashboard describing the biomedical research workforce, but local strategies are needed.
We used curated local and national data to develop a workforce dashboard.
Many trends at Oregon Health & Science University (OHSU) were similar to those nationally, such as the increasing percentage of Research Project Grant (RPG)-holding PhDs and the aging RPG population, but differences were also apparent. At OHSU, nearly ¾ of physician-scientist RPGs hold MD-only, compared with nationally, where nearly half are MD/PhD. OHSU also lags in the percentage of RPGs held by women physician-scientists.
Our analysis also permitted us to gain a more complete picture of research funding that has been done nationally. We used these data to develop a dashboard that allows our institution to develop policies to increase the numbers of physician-scientists. The data generation approaches and dashboard are likely to be useful at other institutions, as well.
Investigation of Lake Quinault in western Washington, including a reflection seismic survey, analysis of piston cores, and preliminary mapping in the steep, landslide-prone Quinault River catchment upstream of the lake, reveals evidence for three episodes of earthquake disturbance in the past 3000 yr. These earthquakes triggered failures on the lake’s underwater slopes and delta front, as well as subaerial landsliding, partial channel blockage, and forced fluvial sediment aggradation. The ages of the three Lake Quinault disturbance events overlap with those of coseismically subsided, coastal marsh soils nearby in southwest Washington that are interpreted to record ruptures of the Cascadia megathrust. Absent from Lake Quinault, however, are signals of obvious disturbance from five additional subduction earthquakes inferred to have occurred during the period of record. The lack of evidence for these events may reflect the limitations of the data set derived from the detrital, river-dominated lake stratigraphy but may also have bearing on debates about segmentation and the distribution of slip along the Cascadia subduction zone during prior earthquakes.
Tillage is a foundational management practice in many cropping systems. Although effective at reducing weed populations and preparing a crop seedbed, tillage and cultivation can also dramatically alter weed community composition. We examined the impact of soil tillage timing on weed community structure at four sites across the northeastern United States. Soil was tilled every 2 wk throughout the growing season (late April to late September 2013), and weed seedling density was quantified by species 6 wk after each tillage event. We used a randomized complete block design with four replicates for each tillage-timing treatment; a total of 196 plots were sampled. The timing of tillage was an important factor in shaping weed community composition and structure at all sites. We identified three main periods of tillage timing that resulted in similar communities. Across all sites, total weed density tended to be greatest and weed evenness tended to be lowest when soils were tilled early in the growing season. From the earliest to latest group of timings, total abundance decreased on average from 428±393 to 159±189 plants m−2, and evenness increased from 0.53±0.25 to 0.72±0.20. The effect of tillage timing on weed species richness varied by site. Our results show that tillage timing affects weed community structure, suggesting that farmers can manage weed communities and the potential for weed interference by adjusting the timing of their tillage and cropping practices.
The study aim was to undertake a qualitative research literature review to analyze available databases to define, describe, and categorize public health infrastructure (PHI) priorities for tropical cyclone, flood, storm, tornado, and tsunami-related disasters.
Five electronic publication databases were searched to define, describe, or categorize PHI and discuss tropical cyclone, flood, storm, tornado, and tsunami-related disasters and their impact on PHI. The data were analyzed through aggregation of individual articles to create an overall data description. The data were grouped into PHI themes, which were then prioritized on the basis of degree of interdependency.
Sixty-seven relevant articles were identified. PHI was categorized into 13 themes with a total of 158 descriptors. The highest priority PHI identified was workforce. This was followed by water, sanitation, equipment, communication, physical structure, power, governance, prevention, supplies, service, transport, and surveillance.
This review identified workforce as the most important of the 13 thematic areas related to PHI and disasters. If its functionality fails, workforce has the greatest impact on the performance of health services. If addressed post-disaster, the remaining forms of PHI will then be progressively addressed. These findings are a step toward providing an evidence base to inform PHI priorities in the disaster setting. (Disaster Med Public Health Preparedness. 2016;10:598–610)
Alcohol gives you infinite patience for stupidity.
– Sammy Davis, Jr.
Makayla Greathouse, a Virginia Tech student in Professor Scott Geller's senior seminar on self-motivation in 2012, told this story:
Danny Gilliam lived right above my apartment. We spent a lot of time hanging out. One Saturday night, Danny and his roommates were about to leave for a party. We shared several minutes of conversation and laughs, and they went on their way.
Around 2:30 a.m. I saw a good friend crying outside of my apartment and immediately approached her to see what was wrong. The news knocked me off my feet. Danny Gilliam was dead.
It took me days to process what happened. I watched his family move out his belongings with tear-streaked faces. I watched his roommates go through denial, anger and depression. Losing a roommate – a best friend – is heartbreaking. The mood of our building was solemn. It would take months for life to return to a new reality.
Makayla's good friend Michael had been at Whipple Drive, where the incident happened. Michael reported:
I was at a friend's house and the party above us was huge, probably two hundred people. Suddenly everyone rushed out and we decided to see what had happened. We didn't see cop cars anywhere and when we asked the fleeing partiers what's going on, they just said, “Someone fell.” I went around the building, and saw a body on the ground. Someone had fallen from a balcony while trying to climb the roof. Three friends were there, all in hysterics. I told someone to call 911 and as a first responder, I began CPR and checked his vitals. The police soon arrived and performed CPR, as well. The guy didn't make it; we tried everything but it was too late.
Why did everyone flee the scene?
Many students who consume alcohol in college are underage; they are scared of getting caught. So many people were present; I'm sure many thought someone else would take care of Danny. Perhaps bystander apathy took place.
Proactive bystander intervention could have saved Danny's life that night. If someone had stopped him from climbing the balcony, he wouldn't have fallen. There are so many ways Danny could have been convinced to get down. …
The effects of acute aerobic exercise on cognitive functions in humans have been the subject of much investigation; however, these studies are limited by several factors, including a lack of randomized controlled designs, focus on only a single cognitive function, and testing during or shortly after exercise. Using a randomized controlled design, the present study asked how a single bout of aerobic exercise affects a range of frontal- and medial temporal lobe-dependent cognitive functions and how long these effects last. We randomly assigned 85 subjects to either a vigorous intensity acute aerobic exercise group or a video watching control group. All subjects completed a battery of cognitive tasks both before and 30, 60, 90, or 120 min after the intervention. This battery included the Hopkins Verbal Learning Test-Revised, the Modified Benton Visual Retention Test, the Stroop Color and Word Test, the Symbol Digit Modalities Test, the Digit Span Test, the Trail Making Test, and the Controlled Oral Word Association Test. Based on these measures, composite scores were formed to independently assess prefrontal cortex- and hippocampal-dependent cognition. A three-way mixed Analysis of Variance was used to determine whether differences existed between groups in the change in cognitive function from pre- to post-intervention testing. Acute exercise improved prefrontal cortex- but not hippocampal-dependent functioning, with no differences found between delay groups. Vigorous acute aerobic exercise has beneficial effects on prefrontal cortex-dependent cognition and these effects can last for up to 2 hr after exercise. (JINS, 2015, 21, 791–801)
William Ansah Sessarakoo, the son of a powerful Fante slave trader on the Gold Coast, was tricked and sold into slavery in Barbados by a British ship’s captain during the 1740s. He was emancipated and brought to Britain in 1748, where he enjoyed a brief period of national celebrity before returning to the Gold Coast in 1750. This paper examines the specific political and cultural circumstances surrounding his remarkable journey, through the lens of the media generated about him during his time in Britain. It demonstrates that the most extensive contemporaneous account of Sessarakoo’s story, The Royal African, was in reality an attempt to generate popular support for a moribund Royal African Company and incorporate slave trading into narratives of national identity, based on notions of economic responsibility and honour. Adhering to conventions typified in Thomas Southerne’s stage adaptation of Oroonoko, further popular representations of Sessarakoo emphasised his aristocratic status and putatively inherited ‘noble’ characteristics. In doing so, they emphasised perceived differences between him and the majority of African peoples, who were deemed suitable for enslavement. The paper closes with an examination of some of the effects of Sessarakoo’s visit on Euro-African trade and diplomacy on the Gold Coast.