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BACKGROUND: Mental health disorders are linked to prolonged concussion symptoms. However, the association of premorbid anxiety/depression symptoms with postconcussion return-to-play timelines and total symptom burden is unclear. OBJECTIVE: To examine the association of self-reported premorbid anxiety/depression symptoms in collegiate student-athletes with (1) recovery times until asymptomatic, (2) return-to-play, and (3) postconcussion symptom burden. STUDY DESIGN: Athletes in the Concussion Assessment, Research and Education Consortium completed baseline concussion assessments (Sport Concussion Assessment Tool [SCAT3] and Brief Symptom Inventory-18 [BSI-18]). Athletes were tested postinjury at

Americans with more education vote at higher rates. Some studies have found evidence of a causal relationship, while others have not. The available data also tell us little about why and how education increases voting. The authors looked the educational trajectories and adult voting records of students who attend charter schools in Boston. The authors looked at the voting records of charter and non-charter students and find substantial differences. Specifically, 41 percent of all charter-school students vote in their first presidential election compared to 35 percent of students who did not attend a charter, an increase of 17 percent. When the authors looked more closely at the data, the charter effect is a female phenomenon. Female high-school students are 11 percentage points more likely to vote in adulthood if they attended a charter school, while the impact for males is nil. These findings are in line with widening gender gaps in educational attainment and political participation. The authors used state education and voting records to compare academic outcomes and election turnout for students who are and are not offered a charter seat and adjust our estimates based on who actually attends a charter school. The authors then investigated whether these educational gains extend beyond the classroom to civic participation. They found no impact on voter registration -- about 78 percent of students in both groups are registered to vote by age 21, with about 45 percent of students registered by their 19th birthday. However, the authors did find differences in voter turnout. Charter school students are more likely to vote than non-charter students, with the biggest difference in the first presidential election in which they are eligible to vote.

In the first half of the twentieth century, deaths from infectious disease, especially among the very young, fell dramatically in American cities. However, as infant mortality fell and life expectancy rose, racial inequality in urban infectious disease mortality grew. In this paper, we show that the fall in mortality and the rise in racial inequality in mortality reflected two countervailing processes. The dramatic decline in infant mortality from waterborne diseases drastically reduced the total urban infectious disease mortality rate of both Black and white Americans while having a comparatively small effect on the total racial disparity in urban infectious disease mortality. In contrast, the unequal fall in tuberculosis mortality, particularly in the prime of life, widened racial inequality in infectious disease mortality in US cities.

Educators increasingly extol failure as a necessary component of learning and growth. However, students frequently experience failure as a source of fear and anxiety that impedes risk-taking and experimentation. This essay examines the dissonance between these "generative" and "stigmatized" paradigms of failure, and it offers ideas for better negotiating this dissonance. After conceptualizing the two paradigms, I examine various factors that reinforce failure's stigmatization. I emphasize "precarious meritocracy," a neoliberal ethos driven by hypercompetitive individualism that makes success a zero-sum game, and that causes especially significant harms on students who are already socially stigmatized. Efforts to ameliorate paradigm dissonance tend to focus on changing student dispositions or lowering the stakes of failure. I instead propose "wise interventions" that include analyzing the systemic roots of stigmatized failure and making failure a more communal experience. I then briefly address the systemic transformations necessary to cultivate generative failure more broadly.

The EFSA Panel on Food Additives, Flavourings, Processing Aids and Materials in Contact with Food (AFC Panel) and the subsequent Panel on Food Contact Materials, Enzymes, Flavourings and Processing Aids (CEF Panel) have undertaken evaluations of the safety of flavourings (both chemically defined substances and mixtures such as smoke flavourings) and food contact materials (FCM), as well as assessments on other substances used in food. The major progress in methodologies for the evaluation of the safety of these substances is highlighted in this article. By December 2011, scientific opinions had been adopted for 247 substances for food contact materials, mainly plastics. Adoption of a series of opinions on active and/or intelligent packaging substances and on recycling processes of plastics is planned between July 2012 and December 2013. Panel opinions, EFSA statements/reports and guidance documents were published on specific issues and on substances for which there was an urgent request for safety evaluation (for example isopropylthioxanthone (ITX), bisphenol A (BPA), phthalates, epoxidised soybean oil (ESBO), benzophenone and 4-methylbenzophenone). By 2009, the AFC and CEF Panels had completed the safety review of 2 067 flavourings substances used in the EU. Additional data, which were requested for 404 substances, are currently under evaluation or have been generated. Eleven smoke flavourings have been evaluated, and the CEF Panel has prepared a guidance document on the future data required for the evaluation of flavourings.

Newborn screening (NBS) dramatically improves outcomes in severe childhood disorders by treatment before symptom onset. In many genetic diseases, however, outcomes remain poor because NBS has lagged behind drug development. Rapid whole-genome sequencing (rWGS) is attractive for comprehensive NBS because it concomitantly examines almost all genetic diseases and is gaining acceptance for genetic disease diagnosis in ill newborns. We describe prototypic methods for scalable, parentally consented, feedback-informed NBS and diagnosis of genetic diseases by rWGS and virtual, acute management guidance (NBS-rWGS). Using established criteria and the Delphi method, we reviewed 457 genetic diseases for NBS-rWGS, retaining 388 (85%) with effective treatments. Simulated NBS-rWGS in 454,707 UK Biobank subjects with 29,865 pathogenic or likely pathogenic variants associated with 388 disorders had a true negative rate (specificity) of 99.7% following root cause analysis. In 2,208 critically ill children with suspected genetic disorders and 2,168 of their parents, simulated NBS-rWGS for 388 disorders identified 104 (87%) of 119 diagnoses previously made by rWGS and 15 findings not previously reported (NBS-rWGS negative predictive value 99.6%, true positive rate [sensitivity] 88.8%). Retrospective NBS-rWGS diagnosed 15 children with disorders that had been undetected by conventional NBS. In 43 of the 104 children, had NBS-rWGS-based interventions been started on day of life 5, the Delphi consensus was that symptoms could have been avoided completely in seven critically ill children, mostly in 21, and partially in 13. We invite groups worldwide to refine these NBS-rWGS conditions and join us to prospectively examine clinical utility and cost effectiveness.

The topic of this symposium, capacitating community, invites CLJ readers to consider what makes community possible. This piece showcases one means, small conferences, via a retrospective on the Writing Innovation Symposium (WIS), a regional event with national scope that has hosted writers and writing educators annually in Milwaukee, WI, since 2018. Through a quilted conversation pieced from hours of small-group discussion, twenty-nine participants across academic and nonacademic ranks, roles, and ranges of experience offer insight into the WIS as well as the nature and value of professional community.

In the first half of the twentieth century, racial inequality in the rate of death from infectious disease was immense. In every year from 1906 to 1920, Black Americans in cities died from infectious diseases at a rate higher than that of urban White Americans during the 1918 influenza pandemic. We decompose mortality into three broad causes of death to determine which causes were most influential. Our results suggest that racial inequality in infectious mortality was primarily driven by TB and flu--the two major respiratory causes of death. Waterborne causes, by contrast, played a minor role in explaining the disparity.

While many genetic diseases have effective treatments, they frequently progress rapidly to severe morbidity or mortality if those treatments are not implemented immediately. Since front-line physicians frequently lack familiarity with these diseases, timely molecular diagnosis may not improve outcomes. Herein we describe Genome-to-Treatment, an automated, virtual system for genetic disease diagnosis and acute management guidance. Diagnosis is achieved in 13.5 h by expedited whole genome sequencing, with superior analytic performance for structural and copy number variants. An expert panel adjudicated the indications, contraindications, efficacy, and evidence-of-efficacy of 9911 drug, device, dietary, and surgical interventions for 563 severe, childhood, genetic diseases. The 421 (75%) diseases and 1527 (15%) effective interventions retained are integrated with 13 genetic disease information resources and appended to diagnostic reports ( https://gtrx.radygenomiclab.com ). This system provided correct diagnoses in four retrospectively and two prospectively tested infants. The Genome-to-Treatment system facilitates optimal outcomes in children with rapidly progressive genetic diseases.

Background Feelings of emptiness are commonly reported as deeply distressing experiences. Despite established relationships between emptiness and many mental health difficulties, alongside self-harm and suicide, further study into this phenomenon has been restricted by vague definition and clinical measures with limited utility. Recently the first definition validated by individuals with lived experience of emptiness has been conceptualised, providing an opportunity to create a new measure of emptiness. Aims This study aimed to psychometrically evaluate the 31-item Psychological Emptiness Scale (PES), identifying redundancy, and thus creating a psychometrically robust scale with optimised clinical utility. Method Utilising an online survey design, 768 participants completed the 31 items of the initial PES alongside other measures of mental health. Exploratory factor analysis was conducted, and item response theory employed to identify item redundancy and reduce test burden. Expert clinicians provided ratings of each item's clinical relevance and, combined with the psychometric analysis, led to the removal of a number of items. Confirmatory factor analysis was then undertaken. Reliability including test–retest, validity and sensitivity of the measure were evaluated. Results A two-factor structure encompassing ‘nothingness’ and ‘detachment’ was identified, and found to have acceptable fit. The resulting 19-item PES was found to have internal consistency (α = 0.95), convergent validity and test–retest reliability. Conclusions This study demonstrated strong psychometric properties of the PES. The PES has potential to support research into the role of emptiness in psychological distress and treatment in clinical practice.

BackgroundFacilitated by the inability to vaccinate, and an immature immune system, COVID-19 remains a leading cause of death among children. Vaccinated lactating mothers produce specific SARS-CoV-2 antibodies in their milk, capable of neutralizing the virus in vitro. Our objective for this study is to assess the effect of COVID-19 booster dose on SARS-CoV-2 antibody concentration and viral neutralization in milk, plasma, and infant stool.MethodsThirty-nine mothers and 25 infants were enrolled from December 2020 to May 2022. Milk, maternal plasma, and infants' stool were collected at various time-points up to 12 months following mRNA COVID-19 vaccination. A subgroup of 14 mothers received a booster dose. SARS-CoV-2 antibody levels and their neutralization capacities were assessed.ResultsBooster vaccination led to significantly higher IgG levels within human milk and breastfed infants' stool. In vitro neutralization of VSV-gfp-SARS-CoV-2-S-gp, a laboratory safe SARS-CoV-2 like pseudovirus, improved following the booster, with a 90% increase in plasma neutralization and a 60% increase in milk neutralization. We found that post-booster neutralization by human milk was highly correlated to SARS-CoV-2 IgG level. In support of our correlation result, Protein G column depletion of IgG in milk yielded a significant reduction in viral neutralization (p = 0.04).DiscussionThe substantial increase in neutralizing IgG levels in milk and breastfed infants' stool post-booster, coupled with the decrease in milk neutralization capabilities upon IgG depletion, underscores the efficacy of booster doses in augmenting the immune response against SARS-CoV-2 in human milk.