Predictors of musculoskeletal disorders among special education teachers in Sabah, Malaysia.

Special education teachers encounter considerable occupational challenges, yet there is limited information concerning musculoskeletal disorders (MSD) within this group. Therefore, this study aimed to address this gap by determining the prevalence of MSD, investigating associated factors of MSD, and identifying predictors of MSD among special education teachers. A cross-sectional study was conducted among special education teachers in Kota Kinabalu and Penampang, Sabah. Data were collected through self-administered questionnaires and musculoskeletal fitness assessments. Chi-square tests and independent t-tests were utilized to determine factors associated with MSD, while multiple logistic regression was performed to develop a comprehensive predictive model for MSD, which was then validated and tested for model fitness. A total of 122 individuals participated in the study, yielding a response rate of 95 %. The findings revealed a high prevalence of MSD (77.9 %) among special education teachers, with the lower back, shoulder, neck, knee, upper back, and foot being the most affected regions. The multivariable regression model identified several predictors of MSD, including marital status (adjusted odds ratio [aOR] = 4.78, 95 % confidence interval [CI] = 1.49-15.40), body fat percentage (aOR = 1.06, 95 % CI = 1.00-1.12), teaching in prolonged standing for few days a week (aOR = 3.20, 95 % CI = 0.99-10.29) or every day (aOR = 6.20, 95 % CI = 1.44-26.70), mindfulness (aOR = 0.47, 95 % CI = 0.22-0.98), and back extensor strength (aOR = 5.86, 95 % CI = 1.92-17.92). This study highlights the necessity of implementing interventions focusing on the ergonomic, psychological, and musculoskeletal fitness components to mitigate the prevalence of MSD and improve the overall well-being of special education teachers.

Correction: Detection of obstructive sleep apnea using Belun Sleep Platform wearable with neural network-based algorithm and its combined use with STOP-Bang questionnaire.

[This corrects the article DOI: 10.1371/journal.pone.0258040.].

Child maltreatment and alexithymia: A meta-analytic review.

Alexithymia refers to difficulties identifying and describing one's emotions. Growing evidence suggests that alexithymia is a key transdiagnostic risk factor. Despite its clinical importance, the etiology of alexithymia is largely unknown. The present study employs meta-analytic methods to summarize findings on the role of one hypothesized antecedent of adult alexithymia, namely child maltreatment. We obtained effect size estimates from 99 independent samples reported in 78 unique sources that reported both child maltreatment history and adult levels of alexithymia. These studies involved a total of 36,141 participants. Using correlation coefficients as our effect size index, we found that child maltreatment was positively related to overall adult alexithymia (r = .23 [.19, .27]). Notably, emotional abuse (r = .18 [.13, .23]), emotional neglect (r = .21 [.16, .26]), and physical neglect (r = .18 [.15, .22]) were the strongest predictors. Effects were moderated by gender, affiliation with clinical versus nonclinical samples, and publication status. Overall results were robust to publication bias and the presence of outliers. These findings contribute to a more nuanced understanding of the complex connection between different types of child maltreatment and alexithymia, providing greater insight into the early environmental influences on alexithymia. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Spirocercosis and Parvovirus in an Imported Dog: Implications for Biosecurity and Foreign Infectious Disease Risk.

Increased international travel and importation of animals brings with it the potential for spread of infectious diseases. This report details a case in which an 8-month-old male mixed breed dog died shortly after arrival to the United States from complications secondary to spirocercosis, despite having been deemed healthy and approved for international travel. Four weeks following arrival, the dog developed mild tachypnea and diarrhea. Physical examination revealed moderate pyrexia with generalized cerebellar ataxia, moderate anemia, a mature neutrophilia, and severe panhypoproteinemia. Packed red blood cells were administered. The dog was diagnosed with pyothorax and decompensated with septic shock shortly thereafter. Necropsy revealed severe transmural esophagitis with intralesional Spirocerca lupi. Evaluation of the brain revealed cerebellar hypoplasia, and polymerase chain reaction of brain tissue was positive for canine parvovirus. Despite receiving a clean bill of health in its country of origin, this patient ultimately had evidence of 2 different infectious processes that pre-dated its arrival into the United States. While neither of these diseases posed a significant public health risk, this case highlights the role veterinarians play before and after international travel as important barriers against the spread of exotic diseases, and emphasizes that maintaining vigilance is paramount to that task.

Detection of obstructive sleep apnea using Belun Sleep Platform wearable with neural network-based algorithm and its combined use with STOP-Bang questionnaire.

Many wearables allow physiological data acquisition in sleep and enable clinicians to assess sleep outside of sleep labs. Belun Sleep Platform (BSP) is a novel neural network-based home sleep apnea testing system utilizing a wearable ring device to detect obstructive sleep apnea (OSA). The objective of the study is to assess the performance of BSP for the evaluation of OSA. Subjects who take heart rate-affecting medications and those with non-arrhythmic comorbidities were included in this cohort. Polysomnography (PSG) studies were performed simultaneously with the Belun Ring in individuals who were referred to the sleep lab for an overnight sleep study. The sleep studies were manually scored using the American Academy of Sleep Medicine Scoring Manual (version 2.4) with 4% desaturation hypopnea criteria. A total of 78 subjects were recruited. Of these, 45% had AHI < 5; 18% had AHI 5-15; 19% had AHI 15-30; 18% had AHI ≥ 30. The Belun apnea-hypopnea index (bAHI) correlated well with the PSG-AHI (r = 0.888, P < 0.001). The Belun total sleep time (bTST) and PSG-TST had a high correlation coefficient (r = 0.967, P < 0.001). The accuracy, sensitivity, specificity in categorizing AHI ≥ 15 were 0.808 [95% CI, 0.703-0.888], 0.931 [95% CI, 0.772-0.992], and 0.735 [95% CI, 0.589-0.850], respectively. The use of beta-blocker/calcium-receptor antagonist and the presence of comorbidities did not negatively affect the sensitivity and specificity of BSP in predicting OSA. A diagnostic algorithm combining STOP-Bang cutoff of 5 and bAHI cutoff of 15 events/h demonstrated an accuracy, sensitivity, specificity of 0.938 [95% CI, 0.828-0.987], 0.944 [95% CI, 0.727-0.999], and 0.933 [95% CI, 0.779-0.992], respectively, for the diagnosis of moderate to severe OSA. BSP is a promising testing tool for OSA assessment and can potentially be incorporated into clinical practices for the identification of OSA. Trial registration: ClinicalTrial.org NCT03997916 https://clinicaltrials.gov/ct2/show/NCT03997916?term=belun+ring&draw=2&rank=1.

Erlotinib sensitivity of MAPK1p.D321N mutation in head and neck squamous cell carcinoma.

Head and neck squamous cell carcinoma (HNSCC) lacks predictive biomarkers for drug responses. By targeted sequencing, we identified two MAPK1 mutations in recurrent HNSCC, MAPK1p.D321N, and p.R135K. We previously reported an exceptional erlotinib responder with MAPK1p.E322K. Here, by in silico and drug studies, we determined functions of these two recurrence-associated MAPK1 mutations. Residues D321, R135, and E322 are in 3D proximity. MAPK1p.D321N drives marked in vivo erlotinib sensitivity, while p.R135K's effect is moderate.

The comparative efficacy of disinfectant wipes on common-use computer keyboards in a veterinary teaching hospital.

The efficacies of 3 disinfectant wipes at reducing bacterial contamination on keyboards in a veterinary teaching hospital were studied. Thirty common-use keyboards were randomized into "dirty" and "clean" halves. Cultures were obtained from the "dirty" halves. The "clean" halves were disinfected with a randomly assigned wipe [peroxygen (AHP)-, alcohol-, quaternary ammonium (QAC)-based] or untreated (NT) and cultured. Colony-forming units (CFU) were enumerated after 48 hours. Mean reduction in CFU was 91.5%, 65.3%, 94.9%, and 78.8% for the AHP, alcohol, QAC, and NT groups, respectively. There was a significant reduction in CFUs between the dirty and clean keyboard halves within each group but no statistically significant differences were noted between groups. The reduction in CFUs in the NT group was attributed to the mechanical action of wiping the keyboard surface for culture. The use of disinfectant wipes reduced CFUs on keyboards and may be a useful component of veterinary infection control programs.

Efficacité comparative de lingettes désinfectantes sur des claviers d'ordinateurs en usage commun dans un hôpital d'enseignement vétérinaire. L'efficacité de trois lingettes désinfectantes à réduire la contamination bactérienne sur des claviers dans un hôpital d'enseignement vétérinaire fut étudiée. Trente claviers en usage commun furent séparés de manière aléatoire en moitié « sale ¼ et « propre ¼. Des cultures furent obtenues de la moitié « sale ¼. La moitié « propre ¼ fut désinfectée avec une lingette assignée de manière aléatoire [à base de peroxygène (AHP), alcool, ou ammonium quaternaire (QAC)] ou non traitée (NT) et échantillonnée pour culture. Le nombre d'unités formatrices de colonies (CFU) fut énuméré après 48 heures. La réduction moyenne de CFU était de 91,5 %, 65,3 %, 94,9 %, et 78,8 % pour les groupes AHP, alcool, QAC, et NT, respectivement. Il y avait une réduction significative dans les CFUs entre les claviers des moitiés sale et propre dans chaque groupe mais aucune différence statistiquement significative ne fut notée entre les groupes. La réduction en CFU dans le groupe NT fut attribuée à l'action mécanique de frottage de la surface des claviers. L'utilisation de lingettes désinfectantes a réduit le nombre d'UFC sur les claviers et pourrait être une composante utile des programmes de surveillance des infections vétérinaires.(Traduit par Dr Serge Messier).

IL-10 Impairs Local Immune Response in Lung Granulomas and Lymph Nodes during Early Mycobacterium tuberculosis Infection.

Tuberculosis (TB), caused by Mycobacterium tuberculosis, continues to be a major global health problem. Lung granulomas are organized structures of host immune cells that function to contain the bacteria. Cytokine expression is a critical component of the protective immune response, but inappropriate cytokine expression can exacerbate TB. Although the importance of proinflammatory cytokines in controlling M. tuberculosis infection has been established, the effects of anti-inflammatory cytokines, such as IL-10, in TB are less well understood. To investigate the role of IL-10, we used an Ab to neutralize IL-10 in cynomolgus macaques during M. tuberculosis infection. Anti-IL-10-treated nonhuman primates had similar overall disease outcomes compared with untreated control nonhuman primates, but there were immunological changes in granulomas and lymph nodes from anti-IL-10-treated animals. There was less thoracic inflammation and increased cytokine production in lung granulomas and lymph nodes from IL-10-neutralized animals at 3-4 wk postinfection compared with control animals. At 8 wk postinfection, lung granulomas from IL-10-neutralized animals had reduced cytokine production but increased fibrosis relative to control animals. Although these immunological changes did not affect the overall disease burden during the first 8 wk of infection, we paired computational modeling to explore late infection dynamics. Our findings support that early changes occurring in the absence of IL-10 may lead to better bacterial control later during infection. These unique datasets provide insight into the contribution of IL-10 to the immunological balance necessary for granulomas to control bacterial burden and disease pathology in M. tuberculosis infection.

Concurrent infection with Mycobacterium tuberculosis confers robust protection against secondary infection in macaques.

For many pathogens, including most targets of effective vaccines, infection elicits an immune response that confers significant protection against reinfection. There has been significant debate as to whether natural Mycobacterium tuberculosis (Mtb) infection confers protection against reinfection. Here we experimentally assessed the protection conferred by concurrent Mtb infection in macaques, a robust experimental model of human tuberculosis (TB), using a combination of serial imaging and Mtb challenge strains differentiated by DNA identifiers. Strikingly, ongoing Mtb infection provided complete protection against establishment of secondary infection in over half of the macaques and allowed near sterilizing bacterial control for those in which a secondary infection was established. By contrast, boosted BCG vaccination reduced granuloma inflammation but had no impact on early granuloma bacterial burden. These findings are evidence of highly effective concomitant mycobacterial immunity in the lung, which may inform TB vaccine design and development.

Low Levels of T Cell Exhaustion in Tuberculous Lung Granulomas.

The hallmarks of pulmonary Mycobacterium tuberculosis infection are lung granulomas. These organized structures are composed of host immune cells whose purpose is to contain or clear infection, creating a complex hub of immune and bacterial cell activity, as well as limiting pathology in the lungs. Yet, given cellular activity and the potential for frequent interactions between host immune cells and M. tuberculosis-infected cells, we observed a surprisingly low quantity of cytokine-producing T cells (<10% of granuloma T cells) in our recent study of M. tuberculosis infection within nonhuman primate (NHP) granulomas. Various mechanisms could limit T cell function, and one hypothesis is T cell exhaustion. T cell exhaustion is proposed to result from continual antigen stimulation, inducing them to enter a state characterized by low cytokine production, low proliferation, and expression of a series of inhibitory receptors, the most common being PD-1, LAG-3, and CTLA-4. In this work, we characterized the expression of inhibitory receptors on T cells and the functionality of these cells in tuberculosis (TB) lung granulomas. We then used these experimental data to calibrate and inform an agent-based computational model that captures environmental, cellular, and bacterial dynamics within granulomas in lungs during M. tuberculosis infection. Together, the results of the modeling and the experimental work suggest that T cell exhaustion alone is not responsible for the low quantity of M. tuberculosis-responsive T cells observed within TB granulomas and that the lack of exhaustion is likely an intrinsic property of granuloma structure.

Predicting the development of interrogative forms and functions in early years: a corpus-based study of Mandarin-speaking young children.

This study examined the development of and possible predictors of interrogative forms and functions in early childhood Mandarin. All the interrogatives drawn from the Early Child Mandarin Corpus (168 children 2;6, 3;6, 4;6, and 5;6) were analyzed. The main results indicated that (i) there were significant age effects in interrogative forms and functions, with the periods between the ages of 3;6 and 4;6 and between the ages of 2;6 and 3;6 being critical in the early acquisition of interrogative forms and functions, respectively; (ii) the form-function preference was verified, with wh-questions being primarily used to seek information (RfI), and intonation/echo and rhetorical questions being used to request action (RfA); (iii) more than half (59·5%) of the Mandarin interrogatives were used for RfI, whereas only 38·9% of them were used for RfA; and (iv) age, TV viewing time, and parent-child conversation time were the significant predictors of interrogative development.

Active transforming growth factor-ß is associated with phenotypic changes in granulomas after drug treatment in pulmonary tuberculosis.

BACKGROUND: Tuberculosis (TB) chemotherapy clears bacterial burden in the lungs of patients and allows the tuberculous lesions to heal through a fibrotic process. The healing process leaves pulmonary scar tissue that can impair lung function. The goal of this study was to identify fibrotic mediators as a stepping-stone to begin exploring mechanisms of tissue repair in TB. METHODS: Hematoxylin and eosin staining and Masson's trichrome stain were utilized to determine levels of collagenization in tuberculous granulomas from non-human primates. Immunohistochemistry was then employed to further interrogate these granulomas for markers associated with fibrogenesis, including transforming growth factor-ß (TGFß), α-smooth muscle actin (αSMA), phosphorylated SMAD-2/3, and CD163. These markers were compared across states of drug treatment using one-way ANOVA, and Pearson's test was used to determine the association of these markers with one another. RESULTS: TGFß and αSMA were present in granulomas from primates with active TB disease. These molecules were reduced in abundance after TB chemotherapy. Phosphorylated SMAD-2/3, a signaling intermediate of TGFß, was observed in greater amounts after 1 month of drug treatment than in active disease, suggesting that this particular pathway is blocked in active disease. Collagen production during tissue repair is strongly associated with TGFß in this model, but not with CD163+ macrophages. CONCLUSIONS: Tissue repair and fibrosis in TB that occurs during drug treatment is associated with active TGFß that is produced during active disease. Further work will identify mechanisms of fibrosis and work towards mitigating lung impairment with treatments that target those mechanisms.

Effects of B Cell Depletion on Early Mycobacterium tuberculosis Infection in Cynomolgus Macaques.

Although recent studies in mice have shown that components of B cell and humoral immunity can modulate the immune responses against Mycobacterium tuberculosis, the roles of these components in human and nonhuman primate infections are unknown. The cynomolgus macaque (Macaca fascicularis) model of M. tuberculosis infection closely mirrors the infection outcomes and pathology in human tuberculosis (TB). The present study used rituximab, an anti-CD20 antibody, to deplete B cells in M. tuberculosis-infected macaques to examine the contribution of B cells and humoral immunity to the control of TB in nonhuman primates during the acute phase of infection. While there was no difference in the overall pathology, disease profession, and clinical outcome between the rituximab-treated and untreated macaques in acute infection, analyzing individual granulomas revealed that B cell depletion resulted in altered local T cell and cytokine responses, increased bacterial burden, and lower levels of inflammation. There were elevated frequencies of T cells producing interleukin-2 (IL-2), IL-10, and IL-17 and decreased IL-6 and IL-10 levels within granulomas from B cell-depleted animals. The effects of B cell depletion varied among granulomas in an individual animal, as well as among animals, underscoring the previously reported heterogeneity of local immunologic characteristics of tuberculous granulomas in nonhuman primates. Taken together, our data clearly showed that B cells can modulate the local granulomatous response in M. tuberculosis-infected macaques during acute infection. The impact of these alterations on disease progression and outcome in the chronic phase remains to be determined.

Construction of a tetracycline inducible expression vector and characterization of its use in Vibrio cholerae.

We report the construction of a tetracycline inducible expression vector that allows regulated gene expression in the enteric pathogen Vibrio cholerae. The expression vector, named pXB300, contains the tetracycline regulatory elements from Tn10, a multiple cloning site downstream of the tetA promoter and operator sequences, a ColE1 origin of replication, a ß-lactamase resistance gene for positive selection, and the hok/sok addiction system for selection in the absence of antibiotic. The function of the tetracycline expression system was demonstrated by cloning lacZ under control of the tetA promoter and quantifying ß-galactosidase expression in Escherichia coli and V. cholerae. The utility for pXB300 was documented by complementation of V. cholerae virulence mutants during growth under virulence inducing conditions. The results showed that pXB300 allowed high-level expression of recombinant genes with linear induction in response to the exogenous concentration of the inducer anhydrotetracycline. We further show that pXB300 was reliably maintained in V. cholerae during growth in the absence of antibiotic selection.

Prevalence of major depressive disorder among Chinese-Americans in primary care.

An epidemiological study in Los Angeles showed that Chinese Americans had lower rates of depression compared to the U.S. national estimates. This study surveys the prevalence of major depressive disorder (MDD) among Asian-Americans in the primary care setting. A two-phase epidemiological survey was performed in the primary care clinic of a community health center in Boston, MA, which provides treatment to under-served Asian-Americans. Participants were Chinese Americans in the waiting area of the primary care clinic, 18 years of age or older, who spoke any one the four commonly used Chinese dialects. The Chinese version of the Beck Depression Inventory (CBDI) was used for initial screening. All consenting patients who screened positive (CBDI >/= 16) and a fraction of those who screened negative (CBDI < 16) were interviewed by a bilingual and bicultural psychiatrist with the Structured Clinical Interview for DSM-III-R, patient version, for confirmation of the diagnosis of MDD. There were 815 in the primary care clinic that were approached, of which 503 patients (62% female, mean age 50 +/- 17 years) filled out the CBDI in the initial phase of depression screening. Extrapolating the results from the SCID-P interviews, the prevalence of MDD among Asian-Americans in the primary care setting was estimated to be 19.6% +/- 0.06. MDD is common among Asian-Americans in primary care settings. The prevalence of MDD is comparable to or higher than those found in the U.S. nonminority populations.

Drug and ECT treatment of depression in the elderly, 1996-2001: a literature review.

A computer-based literature search of all antidepressant and electroconvulsive therapy (ECT) treatment studies published between 1995 and September 2001 was conducted. In addition, a review of published chapters, review articles, and metaanalyses was also conducted. Articles were categorized into those reporting comparative studies, those in which the therapeutic agent was not compared with another, articles about ECT, and review articles. These recent publications support the conclusions from prior reviews that antidepressants and ECT are effective and safe treatments for depressed elderly patients. Differences in efficacy and side effects appear to be slight among the various types of antidepressants. Research studies of depressed elderly increased markedly since 1995 compared with all previous years although more studies are still necessary.