A Comparative Study of Auditory-Perceptual Speech Measures for the Early Detection of Mild Speech Impairments.

BACKGROUND AND PURPOSE: The aim of the study was to compare transcription-based speech intelligibility and scaled speech severity for the detection of mild speech impairments, by studying these metrics across talkers with Parkinson's disease (PD), age- and sex-matched older adults, and younger adults. An additional aim was to determine the impact of listener experience on these clinical measures. METHODS: Fifteen speakers from each experimental group were asked to read aloud 11 randomly generated sentences from the Speech Intelligibility Test at their typical speaking rate and loudness. Two groups of four listeners each, stratified as experienced or inexperienced listeners based on their clinical experience, judged the sentence samples. To estimate intelligibility, both listener groups were asked to orthographically transcribe exactly what they heard for each sentence. For severity estimates, the listener groups were asked to rate the sentences for overall quality based on voice, resonance, articulation, and prosody, using a visual analog scale. RESULTS: Transcription-based intelligibility and scaled severity scores of the PD group differed significantly from those of the older and younger adults. Between-age group differences in intelligibility and scaled severity were not observed. Listener experience had an impact on scaled speech severity, but not speech intelligibility. Between-group differences in speech severity were driven by the inexperienced group and not the experienced listener group. IMPLICATIONS: Both transcription-based intelligibility and scaled severity estimates appear to be sensitive to relatively mild speech impairments in PD. Obtaining scaled severity is less labor intensive than transcription; therefore, visual analog scaling may be the preferred paradigm for clinical use. However, listener experience and training are important considerations for scaling techniques to be implemented clinically.

Dynamic transcriptional response of Escherichia coli to inclusion body formation.

Escherichia coli is used intensively for recombinant protein production, but one key challenge with recombinant E. coli is the tendency of recombinant proteins to misfold and aggregate into insoluble inclusion bodies (IBs). IBs contain high concentrations of inactive recombinant protein that require recovery steps to salvage a functional recombinant protein. Currently, no universally effective method exists to prevent IB formation in recombinant E. coli. In this study, DNA microarrays were used to compare the E. coli gene expression response dynamics to soluble and insoluble recombinant protein production. As expected and previously reported, the classical heat-shock genes had increased expression due to IB formation, including protein folding chaperones and proteases. Gene expression levels for protein synthesis-related and energy-synthesis pathways were also increased. Many transmembrane transporter and corresponding catabolic pathways genes had decreased expression for substrates not present in the culture medium. Additionally, putative genes represented over one-third of the genes identified to have significant expression changes due to IB formation, indicating many important cellular responses to IB formation still need to be characterized. Interestingly, cells grown in 3% ethanol had significantly reduced gene expression responses due to IB formation. Taken together, these results indicate that IB formation is complex, stimulates the heat-shock response, increases protein and energy synthesis needs, and streamlines transport and catabolic processes, while ethanol diminished all of these responses.

The effects of protein solubility on the RNA Integrity Number (RIN) for recombinant Escherichia coli.

High quality, intact messenger RNA (mRNA) is required for DNA microarray and reverse transcriptase polymerase chain reaction analysis and is generally obtained from total RNA isolations. The most widely recognized measure of RNA integrity is the RNA Integrity Number (RIN) obtained from the Agilent Bioanalyzer, as it provides sizing, quantification, and quality control measures. This work describes comparisons of the RIN values obtained for recombinant E. coli. Uninduced recombinant E. coli cultures were examined, as well as induced cultures that produced either a soluble or insoluble recombinant protein. The uninduced cultures and the induced cultures producing soluble protein had higher RIN values than the induced cultures producing insoluble protein. These lower RIN values for E. coli producing the insoluble protein indicate that cellular degradation of the ribosomal RNA species is the likely cause of the lower RIN values. As the use of DNA microarrays and other gene expression tools increase in usage in the industrial recombinant protein production community, these results suggest the need for further studies to determine acceptable RIN ranges for gene expression analysis and effects of various culture conditions on RIN values for recombinant E. coli.

Detection of SARS-CoV-2 and HHV-8 from a large pericardial effusion in an HIV-positive patient with COVID-19 and clinically diagnosed Kaposi sarcoma: a case report.

BACKGROUND: Pericardial effusion is a late manifestation of HIV more commonly observed in individuals with depressed CD4 counts. Although Mycobacterium tuberculosis remains to be one of the most frequently identified pathogens in the pericardial fluid among people living with HIV, less commonly described etiologies include SARS-CoV-2 that causes coronavirus disease and human herpesvirus-8 which is associated with Kaposi sarcoma. Isolation of more than one pathogen in normally sterile sites remains challenging and rare. We report the first documentation of both SARS-CoV-2 and HHV-8 in the pericardial fluid. CASE PRESENTATION: We present the case of a young man in his 20s with a recent history of clinically diagnosed pulmonary tuberculosis who was admitted for progressive dyspnea and cough. He had multiple violaceous cutaneous lesions on the face, neck, and trunk and diffused lymphadenopathies. He tested positive for SARS-CoV-2 on admission. The patient was clinically diagnosed with pneumonia, Kaposi sarcoma, and HIV/AIDS. Empiric broad spectrum antimicrobial regimen was subsequently initiated. HIV with low CD4 count was confirmed during hospitalization. Echocardiography revealed a large pericardial effusion, in impending cardiac tamponade. Frond-like fibrin strands, extending to the parietal pericardium, were also observed. Pericardiostomy yielded hemorrhagic, exudative effusion with lymphocytic predominance. SARS-CoV-2 and HHV-8 were detected in the pericardial fluid, and bacterial, fungal, and tuberculous studies were negative. The patient had clinical improvement after pericardial drainage. However, despite our best clinical care, he developed a nosocomial infection leading to clinical deterioration and death. CONCLUSION: Detection of SARS-CoV-2 and HHV-8 in the pericardial fluid is rare, and interpretation of their significance in clinical care is challenging. However, coronavirus disease and Kaposi sarcoma must be considered and adequately addressed in immunocompromised adults presenting with large pericardial effusion.

SARS-CoV-2 seroprevalence and infection rate in Manila, Philippines prior to national vaccination program implementation: a repeated cross-sectional analysis.

BACKGROUND: SARS-CoV-2 seroepidemiological studies are used to guide public health decision making and to prepare for emerging infectious diseases. Disease occurrence estimates are limited in the Philippines, the country with the highest reported number of coronavirus disease-related deaths in the Western Pacific region. We aimed to estimate SARS-CoV-2 seroprevalence and infection rate among outpatient clinic attendees in Metro Manila prior to the implementation of the national coronavirus disease vaccination program. METHODS: We conducted repeated cross-sectional surveys at the animal bite clinic in San Lazaro Hospital, Manila, the Philippines across four periods, 3 months apart, between May 2020 and March 2021. Multivariable logistic regression was used to assess associations between different characteristics and infection status including seropositivity. RESULTS: In total 615 participants were enrolled, ranging from 115 to 174 per period. Seroprevalence quadrupled between the first (11.3%) and second (46.8%) periods and plateaued thereafter (third-46.0%, fourth-44.6%). Among seropositive participants, total antibody concentration was comparable throughout the first to third periods but declined between the third and fourth periods. Infection prevalence was comparable across enrollment periods (range 2.9-9.5%). Post-secondary education [aOR 0.42 (95% CI 0.26, 0.67)] was protective, and frontline work [aOR 1.81 (95% CI 1.18, 2.80)] was associated with increased odds of seropositivity. Frontline work status [aOR 2.27 (95% CI 1.10, 4.75)] and large household size [aOR 2.45 (95% CI 1.18, 5.49)] were associated with increased odds of infection. CONCLUSIONS: The quadrupling of seroprevalence over 3 months between the first and second enrollment periods coincided with the high burden of infection in Metro Manila in early 2020. Our findings suggest a limit to the rise and potential decline of population-level SARS-CoV-2 infection-induced immunity without introduction of vaccines. These results may add to our understanding of how immunity develops against emerging infectious diseases including coronaviruses.

Using problem-based learning for occupational and environmental health nursing education: pesticide exposures among migrant agricultural workers.

Problem-based learning, which emphasizes group collaboration to solve real-world case scenarios, is an instructional approach that is well suited to occupational and environmental health nursing education. Learners actively work through case studies rather than passively receive information presented through lectures. Problem-based learning methods promote critical thinking skills and motivate learning, preparing learners for professional practice in complex, ever-changing environments. Despite these advantages, problem-based learning is under-utilized in nursing education compared to more traditional lecture methods. This article presents key concepts of problem-based learning, discusses problem-based learning in educating occupational and environmental health nurses, and describes the development of a problem-based learning case aimed at increasing occupational and environmental health nurses capacity to address pesticide exposure among migrant and seasonal agricultural workers.

Relationship between system-level characteristics of assisted living facilities and the health and safety of unlicensed staff.

This study examined system-level characteristics of assisted living facilities and the association between these characteristics and the health and safety outcomes of unlicensed staff. Forty-two unlicensed direct care workers completed a survey related to system-level stressors and the individual stress responses of staff. Measurement tools included the Work Stressor Inventory (WSI), General Health Questionnaire (GHQ-12), and Maslach Burnout Inventory (MBI). High levels of emotional exhaustion, psychiatric distress, and work-related injuries were reported by unlicensed staff. Providing care to residents with dementia-related behaviors and supporting families were the most frequently reported work stressors. System-level factors were significantly associated with staff role competence, job commitment, and emotional exhaustion. These results support the need for continued exploration, development, and evaluation of strategies to reduce occupational stressors at multiple levels in assisted living facilities.

Detection of Articulatory Deficits in Parkinson's Disease: Can Systematic Manipulations of Phonetic Complexity Help?

Purpose This study sought to determine the feasibility of using phonetic complexity manipulations as a way to systematically assess articulatory deficits in talkers with progressive dysarthria due to Parkinson's disease (PD). Method Articulatory kinematics were recorded using three-dimensional electromagnetic articulography from 15 talkers with PD (58-84 years old) and 15 healthy controls (55-80 years old) while they produced target words embedded in a carrier phrase. Majority of the talkers with PD exhibited a relatively mild dysarthria. For stimuli selection, phonetic complexity was calculated for a variety of words using the framework proposed by Kent (1992), and six words representative of low, medium, and high phonetic complexity were selected as targets. Jaw, posterior tongue, and anterior tongue kinematic measures that were used to test for phonetic complexity effects included movement speed, cumulative path distance, movement range, movement duration, and spatiotemporal variability. Results Significantly smaller movements and slower movement speeds were evident in talkers with PD, predominantly for words with high phonetic complexity. The effect sizes of between-groups differences were larger for several jaw kinematic measures than those of the tongue. Discussion and Conclusion Findings suggest that systematic manipulations of phonetic complexity can support the detection of articulatory deficits in talkers with PD. Phonetic complexity should therefore be leveraged for the assessment of articulatory performance in talkers with progressive dysarthria. Future work will be directed toward linking speech kinematic and auditory-perceptual measures to determine the clinical significance of the current findings.

Genetic risk assessment, counseling and testing.

Hereditary cancer risk assessment, counseling, and testing are becoming ever more complex as the understanding of the genetic components of disease grows. The demand for highly trained professionals with expertise in this field, such as genetic counselors, is also growing. Surgical oncologists are likely to encounter patients with hereditable cancer syndromes in their practice and should be able to identify patients appropriate for genetic assessment and counseling.

An exploration of Hispanic workers' perspectives about risks and hazards associated with orchard work.

Orchard workers are a population at risk for serious and disabling occupational injuries and illnesses. The purpose of this descriptive, exploratory study was to gather information about orchard workers' perceptions and experiences related to their work to better understand factors that contribute to their occupational risk. The sample consisted of 180 Hispanic orchard workers from 3 counties in Washington State; about a third of these reported at least 1 occupational injury. A Likert scale was used to gather workers' perceptions about individual, work-related, and environmental factors that have the potential to contribute to the occurrence of occupational injuries and illnesses. Psychosocial factors emerged as particularly important influences on workers' health and safety. Injured workers were more likely than noninjured workers to feel (1) that they are more likely to be fired, (2) that the "boss cares more about the fruit than the worker," (3) that their employer was demanding, and (4) that orchard work was dangerous. There is a compelling need to develop and test interventions that address factors that adversely affect orchard workers' health and safety.

A theoretical model for understanding mental health, substance use, and work performance among Asian immigrants.

Mental illness and substance use disorders are prevalent among workers. Each year businesses lose billions of dollars to decreased work performance associated with these issues. This article discusses a theoretical model that depicts relationships between social discrimination, job concerns, and social support and workers' mental health problems and substance use and work performance. The focus is Asian immigrant workers, a population underrepresented in the literature. This model serves to assist occupational health nurses in the practice and research arenas better understand the complexities of mental health problems and substance use among Asian immigrant workers. Occupational health nurses are in a prime position to recognize, identify, and respond to at-risk workers. Examples of areas that might be considered by occupational health nurses when using this model are included.

Factors affecting Thai workers' use of hearing protection.

This study used an ecological model to examine Thai workers' beliefs and attitudes toward using occupational hearing protection. Data collection involved focus group sessions with 28 noise-exposed workers at four factories in Chiang Mai Province and an interview with a safety officer at each organization. Detailed content analysis resulted in the identification of three types of factors influencing the use of hearing protection: intrapersonal, including preventing impaired hearing, noise annoyance, personal discomfort, and interference with communication; interpersonal, including coworker modeling, supervisor support, and supervisor modeling; and organizational, including organizational rules and regulations, provision of hearing protection devices, dissemination of knowledge and information, noise monitoring, and hearing testing. Effective hearing protection programs depend on knowledge of all of these factors. Strategies to promote workers' use of hearing protection should include the complete range of factors having the potential to affect workers' hearing.

Ecological model of disaster management.

The ecological model of disaster management provides a framework to guide occupational health nurses who are developing disaster management programs.This ecological model assumes that disaster planning, preparedness, response, and recovery occur at various levels of the organization. These nested, increasingly complex organizational levels include individual and family, workplace, community, state, tribal, federal, and global levels. The ecological model hypothesizes that these levels interact and these dynamic interactions determine disaster planning, preparedness, response, and recovery outcomes. In addition to the features of the hazard or disaster, it is also assumed that parallel disaster planning, preparedness, and response elements, logistical challenges, and flexibility, sustainability, and rehabilitation elements occur at each level of the ecological model. Finally, the model assumes that evaluation of response and recovery efforts should inform future planning and preparedness efforts.

Direct measurement of T cell receptor affinity and sequence from naïve antiviral T cells.

T cells recognize and kill a myriad of pathogen-infected or cancer cells using a diverse set of T cell receptors (TCRs). The affinity of TCR to cognate antigen is of high interest in adoptive T cell transfer immunotherapy and antigen-specific T cell repertoire immune profiling because it is widely known to correlate with downstream T cell responses. We introduce the in situ TCR affinity and sequence test (iTAST) for simultaneous measurement of TCR affinity and sequence from single primary CD8(+) T cells in human blood. We demonstrate that the repertoire of primary antigen-specific T cells from pathogen-inexperienced individuals has a surprisingly broad affinity range of 1000-fold composed of diverse TCR sequences. Within this range, samples from older individuals contained a reduced frequency of high-affinity T cells compared to young individuals, demonstrating an age-related effect of T cell attrition that could cause holes in the repertoire. iTAST should enable the rapid selection of high-affinity TCRs ex vivo for adoptive immunotherapy and measurement of T cell response for immune monitoring applications.

Single molecule nanoparticles of the conjugated polymer MEH-PPV, preparation and characterization by near-field scanning optical microscopy.

We have developed a straightforward method for producing a stable, aqueous suspension of hydrophobic, fluorescent pi-conjugated polymer nanoparticles consisting primarily of individual conjugated polymer molecules. Features of the method are the facile preparation, purity, unique optical properties, and small size (approximately 5-10 nm) of the resulting nanoparticles. The results of TEM, scanning force microscopy, and near-field scanning optical microscopy of particles cast from the suspension indicate that the particles are single conjugated polymer molecules. The NSOM results yield estimates of the optical cross-sections of individual conjugated polymer molecules. The UV-vis absorption spectra of the nanoparticle suspensions indicate a reduction in conjugation length attributed to deformations of the polymer backbone. Fluorescence spectra of the aqueous nanoparticle suspensions indicate interactions between segments of the polymer chain and intramolecular energy transfer.

Hallazgos de laboratorio en pacientes con COVID-19 atendidos en el área de emergencia pediátrica del Hospital General IESS del Sur de abril a junio del 2020 / Laboratory findings in patients with COVID-19 treated in the pediatric emergency area of the Hospital General IESS del Sur of April and June 2020

Introducción: SARS COV-2 afecta en menor prevalencia a los niños, y tiene una presentación clínica leve mayoritariamente. El objetivo del presente estudio fue describir los hallazgos de los exámenes de sangre, orina y heces en pacientes con COVID-19 atendidos en el área de emergencia pediátrica del Hospital General del Sur de Quito de abril a junio del 2020. Método: Estudio descriptivo, trasversal. Dependiendo del caso clínico desde Enfermedad Leve a casos críticos se les realizó biometría hemática, química sanguínea, tiempos de coagulación, reactantes inflamatorios como proteína C reactiva y procalcitonina, elemental más microscópico de orina y coprológico. Los participantes fueron confirmados mediante hisopado nasofaríngeo por reacción en cadena de la polimerasa de transcripción inversa en tiempo real para Covid 19. Se utiliza estadística descriptiva. Resultados: Fueron incluidos 54 pacientes en edades comprendidas entre 29 días y 17 años 11 meses. La biometría hemática fue normal en el 72% de pacientes, la proteína C reactiva <5ng/dl en el 71 % y procalcitonina <0.5ng/ml en el 100% de los casos. La aspartato aminotransferasa como alanino aminotransferasa fueron normales el 79 y 85% respectivamente, tiempo parcial de tromboplastina y tiempo de protrombina fueron normales en el 56% de los niños. Conclusiones: Los exámenes de laboratorio son inespecíficos en pacientes que cursan con esta enfermedad. Sin embargo son una herramienta para la toma de decisiones oportunas

Introduction: SARS COV-2 affects children in lesser prevalence, and has a mild clinical presentation mostly. The objective of the present study was to describe the findings of blood, urine and stool tests in patients with COVID-19 treated in the pediatric emergency area of the General Hospital of the South of Quito from April to June 2020. Method: Descriptive, cross-sectional study. Depending on the clinical case, from Mild Disease to critical cases, hematic biometry, blood chemistry, coagulation times, inflammatory reactants such as C-reactive protein and procalcitonin, elemental plus urine microscopic and stool, were performed. Participants were confirmed by realtime reverse transcription polymerase chain reaction nasopharyngeal swab for Covid 19. Descriptive statistics are used. Results: 54 patients between 29 days and 17 years 11 months were included. Blood counts were normal in 72% of patients, C-reactive protein <5ng / dl in 71% and procalcitonin <0.5ng / ml in 100% of cases. Aspartate aminotransferase and alanine aminotransferase were normal in 79 and 85% respectively, partial thromboplastin time and prothrombin time were normal in 56% of children. Conclusions: Laboratory tests are nonspecific in patients with this disease. However, they are a tool for making timely decisions

Developing blended online and classroom strategies to deliver an occupational health nursing overview course in a multi-state region in the United States.

This article describes how hybrid online and classroom learning approaches were used to design and offer an occupational health nursing review course throughout a multi-state region of the northwest United States. In response to demand from practicing occupational health nurses for board certification preparation, a series of asynchronous and synchronous continuing education modules was created covering a range of occupational health nursing topics. This review course illustrates how innovative educational delivery models can serve the needs of occupational health nurses challenged by geographic and time constraints.

Hispanic adolescent farmworkers' perceptions associated with pesticide exposure.

The migrant farmworker population in the United States is a vulnerable and understudied population whose characteristics are constantly shifting. The number of youth involved in agriculture work is increasing, and they, in particular, may be at increased risk for occupational hazards, such as pesticide exposure. The present study utilized an ecological framework for focus group discussions with 33 adolescent migrant farmworkers in Oregon. Adolescents' risk perception and health beliefs associated with pesticide exposure are examined on four levels of environmental influence: microenvironment, organizational environment, social/community environment, and macroenvironment. Adolescents provided insight on such topics as perceived vulnerability of illness due to pesticide exposure, attitudes toward farmwork, influence of their boss, knowledge of occupational hazards, safety training, and barriers to occupational choice. Cultural influences on occupational safety and health are discussed and increased attention to safety training is recommended.