Perezhawkins0827

Purpose The goal of this study was to explore interview data related to occupational stress in U.S. audiologists. This study is part of a larger project The Lived Experience of the Audiologist, which seeks to develop a richer understanding of audiologists' lived experience via interview and survey research. Method Demographic and interview data related to occupational stress were examined from 28 virtual interviews of clinical audiologists in the United States. Qualitative data relative to workplace stressors were subjected to thematic analysis. Stress ratings were examined via descriptive statistics, correlation, and comparison with demographics. Results Self-ratings of average-day and worst-day stress were not related to work setting, years of experience, or U.S. region. Participant descriptions of workplace stressors yielded seven main themes time, patients, administration, financial, lack of support, colleagues, and work-life balance. Some participants attributed stress response to personality traits. Conclusions Audiologists' quotes illustrate the human impact of stressors in the workplace. The most commonly reported workplace stressors were lack of time, patient-related issues, administration, and financial issues. Time and administration as common causes of stress were consistent with prior studies conducted in other countries; however, patient-related and financial stressors were more prominent stressors for U.S. audiologists. Stress ratings were not related to work setting, location, or years of experience in the current study. Participants often linked their perception of stress to personality traits, a phenomenon that has been explored as a factor in the exploration of occupational stress in other fields, but not in audiology. Future research in stress and burnout should examine personality traits in addition to extensive demographics.CD4+ T cells expressing choline acetyltransferase (ChAT) have recently been shown to cause a drop in systemic blood pressure when infused into mice. The aim of this study was to determine if ChAT-expressing T cells could regulate coronary vascular reactivity. Preconstricted segments of epicardial and intramyocardial porcine coronary arteries relaxed in response to Jurkat T cells (JT) that overexpressed ChAT (JTChAT cells). The efficacy of the JTChAT cells was similar in epicardial and intramyocardial vessels with a maximum dilator response to 3 × 105 cells/mL of 38.0 ± 6.7% and 38.7 ± 7.25%, respectively. In contrast, nontransfected JT cells elicited a weak dilator response, followed by a weak contraction. The response of JTChAT cells was dependent on the presence of the endothelial cells. In addition, the response could be significantly reduced by Nω-nitro-l-arginine methyl ester (l-NAME) and 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ) in the presence of indomethacin. JTChAT cells, but not JT cells, inhe coronary circulation. The present findings offer an additional possibility that a deficiency of ChAT-expressing T cells could contribute to reduced coronary blood flow and ischemic events in the myocardium.Oral and gum health have long been associated with incidence and outcomes of cardiovascular disease. Periodontal disease increases myocardial infarction (MI) mortality by seven-fold through mechanisms that are not fully understood. The goal of this study was to evaluate whether lipopolysaccharide (LPS) from a periodontal pathogen accelerates inflammation post-MI through memory T-cell activation. We compared 4 groups (no MI, chronic LPS, day 1 post-MI, and day 1 post-MI with chronic LPS (LPS+MI); n=68 mice) using the mouse heart attack research tool 1.0 database and tissue bank coupled with new analyses and experiments. LPS+MI increased total CD8+ T-cells in the left ventricle versus the other groups (p less then 0.05 versus all). Memory CD8+ T-cells (CD44+CD27+) were 10-fold greater in LPS+MI compared to MI alone (p=0.02). Interleukin (IL)-4 stimulated splenic CD8+ T-cells away from an effector phenotype and towards a memory phenotype, inducing secretion of factors associated with the Wnt/β-catenin signaling that promoted monocyte migration and decreased viability. To dissect the effect of CD8+ T-cells post-MI, we administered a major histocompatibility complex-I blocking antibody starting 7 days before MI, which prevented effector CD8+ T-cell activation without affecting the memory response. The reduction in effector cells diminished infarct wall thinning but had no effect on macrophage numbers or MertK expression. LPS+MI+IgG attenuated macrophages within the infarct without effecting CD8+ T-cells suggesting these two processes were independent. Overall, our data indicate that effector and memory CD8+ T-cells at post-MI day 1 are amplified by chronic LPS to potentially promote infarct wall thinning.Federal investment in emergency preparedness has increased notably since the 9/11 attacks, yet it is unclear if and how US hospital readiness has changed in the 20 years since then. In particular, understanding effective aspects of hospital emergency management programs is essential to improve healthcare systems' readiness for future disasters. The authors of this article examined the state of US hospital emergency management, focusing on the following question During the COVID-19 pandemic, what aspects of hospital emergency management, including program components and organizational characteristics, were most effective in supporting and improving emergency preparedness and response? We conducted semistructured interviews of emergency managers and leaders at 12 urban and rural hospitals across the country. Through qualitative analysis of content derived from examination of transcripts from our interviews, we identified 7 dimensions of effective healthcare emergency management (1) identify capable leaders; (2) assure robust institutional support; (3) design effective, tiered communications systems; (4) embrace the hospital incident command system to delineate roles and responsibilities; (5) actively promote collaboration and team building; (6) appreciate the necessity of training and exercises; and (7) balance structure and flexibility. These dimensions represent the unique and critical intersection of organizational factors and emergency management program characteristics at the core of hospital emergency preparedness and response. Extending these findings, we provide several recommendations for hospitals to better develop and sustain what we call a response culture in supporting effective emergency management.Purpose Despite numerous recent advances in retinal gene therapy using adeno-associated viruses (AAVs) as delivery vectors, there remains a crucial need to identify viral vectors with the ability to transduce specific retinal cell types and that have a larger carrying capacity than AAV. In this study, we evaluate the retinal tropism of 2 chimeric helper-dependent adenoviruses (HDAds), helper-dependent adenovirus serotype 5 (HDAd5)/3 and HDAd5/35, both ex vivo using human retinal explants and in vivo using rats. Methods We transduced cultured human retinal explants with HDAd5/3 and HDAd5/35 carrying an eGFP vector and evaluated tropism and transduction efficiency using immunohistochemistry. To assess in vivo transduction efficiency, subretinal injections were performed in wild-type Sprague-Dawley rats. For both explants and subretinal injections, we delivered 10 μL (1 × 106 vector genomes/mL) and assessed tropism at 7- and 14-days post-transduction, respectively. Results HDAd5/3 and HDAd5/35 both transduced human retinal ganglion cells (RGCs) and Müller cells, but not photoreceptors, in human retinal explants. However, subretinal injections in albino rats resulted in transduction of the retinal pigmented epithelium only, highlighting species-specific differences in retinal tropism and the value of a human explant model when testing vectors for eventual human gene therapy. Conclusions Chimeric HDAds are promising candidates for the delivery of large genes, multiple genes, or neuroprotective factors to Müller cells and RGCs. These vectors may have utility for targeted therapy of neurodegenerative diseases primarily involving retinal ganglion or Müller cell types, such as glaucoma or macular telangiectasia type 2.Objective Some countries treat carrying condoms as evidence of prostitution, commonly referred to as "condoms-as-evidence" policy/practice. This policy has deleterious outcomes on the health and safety of sex workers worldwide. This study evaluates the impact of a simulation game that advocates against the policy in an effort to increase advocacy attitudes and intentions against condoms-as-evidence policies and practices. Materials and Methods A between-subjects randomized experiment (N = 70) was conducted to evaluate the effectiveness of the intervention game relative to a pamphlet. The game, Cops & Rubbers, is a simulation-based tabletop game situating participants in the role of a sex worker trying to balance competing financial, safety, and health-related goals. The research for and development of the pamphlet was funded by Open Society Foundations to highlight the impact of the condoms-as-evidence policy and elicit advocacy efforts. Results Although the game elicited similar levels of advocacy attitudes toward the pamphlet, it elicited significantly higher advocacy intentions than the pamphlet. Conflicting results were witnessed in psychological reactance. Conclusion The present results demonstrate the utility of games as an advocacy tool for health and human rights among a polarizing topic such as sex worker advocacy. These results have both practical utility and research implications. From a practical standpoint, we demonstrate that the game can increase advocacy intentions and tangibly contribute to human rights and health issues. Furthermore, these results have the potential to inform novel game design strategies to influence persuasive outcomes in transformational games.Optimizing the CT acquisition parameters to obtain diagnostic image quality at the lowest possible radiation dose is crucial in the radiosensitive pediatric population. The image quality of low-dose CT can be severely degraded by increased image noise with filtered back projection (FBP) reconstruction. Iterative reconstruction (IR) techniques partially resolve the trade-off relationship between noise and radiation dose but still suffer from degraded noise texture and low-contrast detectability at considerably low-dose settings. Furthermore, sophisticated model-based IR usually requires a long reconstruction time, which restricts its clinical usability. With recent advances in artificial intelligence technology, deep learning-based reconstruction (DLR) has been introduced to overcome the limitations of the FBP and IR approaches and is currently available clinically. AG-14361 DLR incorporates convolutional neural networks-which comprise multiple layers of mathematical equations-into the image reconstruction process to reduce image noise, improve spatial resolution, and preserve preferable noise texture in the CT images. For DLR development, numerous network parameters are iteratively optimized through an extensive learning process to discriminate true attenuation from noise by using low-dose training and high-dose teaching image data. After rigorous validations of network generalizability, the DLR engine can be used to generate high-quality images from low-dose projection data in a short reconstruction time in a clinical environment. Application of the DLR technique allows substantial dose reduction in pediatric CT performed for various clinical indications while preserving the diagnostic image quality. The authors present an overview of the basic concept, technical principles, and image characteristics of DLR and its clinical feasibility for low-dose pediatric CT. ©RSNA, 2021.