Social Emotional Development in Children who are Deaf or Hard of Hearing

Purpose: The purpose of this study was to assess social emotional development (SED) in children who are deaf or hard of hearing (HOH). This research focused on three questions: 1) Do children who are deaf or HOH demonstrate delay in SED compared to typically hearing children; 2) Are there certain social emotional skills that the children have difficulty with; and 3) Are there differences in social emotional ability percentile ranks for children who are approximately 15 months versus when they are 31 months of age? Methods: The Greenspan Social Emotional Growth Chart (GSEGC) was used to quantify SED in children who are deaf or HOH. 78 participants, ages 9 to 39 months, had completed GSEGCs. Of those participants, 55 completed the GSEGC at two different times, allowing for comparison between a mean age of 14.5 months and 31.5 months. Results: In the younger group 28.2% and in the older group 21.1% of participants fell below the 10th percentile on the GSEGC; however, over an approximate 1-year time span, SED percentile ranks improved within this sample. Conclusions: Children with hearing loss showed a delay in SED, although delays were less apparent over time. Social emotional skills that were most difficult were related to sound, attention getting, and the use/comprehension of language.</p

2020-04-16 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: Daily NM recap. Public Catholic masses resume. Chaplains stand down. Food delivered to tribal communities. Governors order face coverings use. Campfires restricted. NY hospitalizations fall. Nursing home probe in NJ. GOP call WHO Chief resignation. Africa cases up 51% and deaths up 60%. Sub-Saharan Africa prediction. Resurgence in Japan. UK conditions to reopen. France deaths up. UNMH protests over PPE. Med center financial stress. Hospitals bailout insufficient. 55% US healthcare worker cases hospital spread. Cruise ship transmission. Essential contact tracing. JAMA editors discuss policy. Guideline updates: treatment, emergency dep, ophthalmology, cath lab, telemedicine, liver disease, caregiver, health care facilities, FEMA, homeless services. Calcium channel blocker reduces fatality. Interferon lambda treatment. No benefit for lopinavir/ritonavir or arbidol in RCT. Donate plasma. Mixed results for antivirals on clearance. 37 new trials. Population-scale testing proposed. New rapid assay. Serology + RT-PCR needed. Hemoglobin monitoring. Co-infection of SARS-CoV-2. Urine glucose and proteinuria predict severity. Use damp cloth covers

Tear Cytokine Levels in Contact Lens Wearers With Acanthamoeba Keratitis

PURPOSE: To determine differences in key tear film cytokines between mild and severe cases of acanthamoeba keratitis (AK) and control contact lens (CL) wearers. METHODS: This was a prospective study of CL wearers with AK attending Moorfields Eye Hospital and control CL wearers from the Institute of Optometry, London. Basal tear specimens were collected by 10-μL capillary tubes (BLAUBRAND intraMark, Wertheim, Germany), and tear protein levels were measured with a multiplex magnetic bead array (Luminex 100; Luminex Corporation, Austin, TX) for cytokines interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-17A, IL-17E, IL-17F, IL-22, and interferon gamma and with enzyme-linked immunosorbent assay (Abcam, Cambridge, United Kingdom) for CXCL2. Severe cases of AK were defined as having active infection for over 12 months and at least 1 severe inflammatory event. RESULTS: One hundred and thirty-two tear samples were collected from a total of 61 cases (15 severe and 46 mild–moderate) and 22 controls. IL-8, part of the Toll-like receptor 4 cytokine cascade, was found to be expressed at a detectable level more often in cases of AK than in control CL wearers (P = 0.003) and in higher concentrations in severe cases than in milder forms of the disease (z = −2.35). IL-22, part of the IL-10 family, and a proinflammatory Th17 cytokine, was detected more often in severe cases than in milder forms of AK (P < 0.02). CONCLUSIONS: Profiling patients with AK during disease shows differences in cytokine levels between severe and milder disease that may inform clinical management. The Toll-like receptor 4 and IL-10/Th17 inflammatory pathways should be included in further investigations of this disease

Differential expression of zinc transporters accompanies the differentiation of C2C12 myoblasts

Zinc transporters facilitate metal mobilization and compartmentalization, playing a key role in cellular development. Little is known about the mechanisms and pathways of Zn movement between Zn transporters and metalloproteins during myoblast differentiation. We analyzed the differential expression of ZIP and ZnT transporters during C2C12 myoblast differentiation. Zn transporters account for a transient decrease of intracellular Zn upon myogenesis induction followed by a gradual increase of Zn in myotubes. Considering the subcellular localization and function of each of the Zn transporters, our findings indicate that a fine regulation is necessary to maintain correct metal concentrations in the cytosol and subcellular compartments to avoid toxicity, maintain homeostasis, and for loading metalloproteins needed during myogenesis. This study advances our basic understanding of the complex Zn transport network during muscle differentiation

2020-04-06 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: NM case updates. Several NM policy and legislative actions. Federal vs. state conflict over medical supply lines. Healthcare workers sleep in cars to prevent family exposure. Same-day in-house testing at Cedars-Sinai. Debate over hydroxychloroquine Tx. Death rate differences: Germany and Italy. African innovations. Testing recommended with mild symptoms. CDC guidelines for law enforcement PPE. New WHO first responder training and CDC sign language resources. COVID-19 droplets can travel up to 27 feet. Transmission from the asymptomatic. Humidifiers help. Drug and vaccine progress

Proteomic comparisons of opaque and transparent variants of <i>Streptococcus pneumoniae</i> by two dimensional-differential gel electrophoresis

Streptococcus pneumoniae (the pneumococcus) is a human pathogen, accounting for massive global morbidity and mortality. Although asymptomatic colonization of the nasopharynx almost invariably precedes disease, the critical determinants enabling pneumococcal progression from this niche to cause invasive disease are poorly understood. One mechanism proposed to be central to this transition involves opacity phase variation, whereby pneumococci harvested from the nasopharynx are typically transparent, while those simultaneously harvested from the blood are opaque. Here, we used two dimensional-differential gel electrophoresis (2D-DIGE) to compare protein expression profiles of transparent and opaque variants of 3 pneumococcal strains, D39 (serotype 2), WCH43 (serotype 4) and WCH16 (serotype 6A) in vitro. One spot comprising a mixture of capsular polysaccharide biosynthesis protein and other proteins was significantly up-regulated in the opaque phenotype in all 3 strains; other proteins were differentially regulated in a strain-specific manner. We conclude that pneumococcal phase variation is a complex and multifactorial process leading to strain-specific pathogenicity.Melissa H. Chai, Florian Weiland, Richard M. Harvey, Peter Hoffmann, Abiodun D. Ogunniyi, James C. Pato

Radiographers supporting radiologists in the interpretation of screening mammography: a viable strategy to meet the shortage in the number of radiologists.

BackgroundAn alternative approach to the traditional model of radiologists interpreting screening mammography is necessary due to the shortage of radiologists to interpret screening mammograms in many countries.MethodsWe evaluated the performance of 15 Mexican radiographers, also known as radiologic technologists, in the interpretation of screening mammography after a 6 months training period in a screening setting. Fifteen radiographers received 6 months standardized training with radiologists in the interpretation of screening mammography using the Breast Imaging Reporting and Data System (BI-RADS) system. A challenging test set of 110 cases developed by the Breast Cancer Surveillance Consortium was used to evaluate their performance. We estimated sensitivity, specificity, false positive rates, likelihood ratio of a positive test (LR+) and the area under the subject-specific Receiver Operating Characteristic (ROC) curve (AUC) for diagnostic accuracy. A mathematical model simulating the consequences in costs and performance of two hypothetical scenarios compared to the status quo in which a radiologist reads all screening mammograms was also performed.ResultsRadiographer's sensitivity was comparable to the sensitivity scores achieved by U.S. radiologists who took the test but their false-positive rate was higher. Median sensitivity was 73.3 % (Interquartile range, IQR: 46.7-86.7 %) and the median false positive rate was 49.5 % (IQR: 34.7-57.9 %). The median LR+ was 1.4 (IQR: 1.3-1.7 %) and the median AUC was 0.6 (IQR: 0.6-0.7). A scenario in which a radiographer reads all mammograms first, and a radiologist reads only those that were difficult for the radiographer, was more cost-effective than a scenario in which either the radiographer or radiologist reads all mammograms.ConclusionsGiven the comparable sensitivity achieved by Mexican radiographers and U.S. radiologists on a test set, screening mammography interpretation by radiographers appears to be a possible adjunct to radiologists in countries with shortages of radiologists. Further studies are required to assess the effectiveness of different training programs in order to obtain acceptable screening accuracy, as well as the best approaches for the use of non-physician readers to interpret screening mammography

2020-04-14 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: NMDOH county demographics online. NM emergency business loans. ABQ businesses violations. NM 5 new deaths 62 more cases. May 1 reopening too optimistic. MA contract tracing. Federal Ventilator Reserve. GM mass ventilator production. Ventilator-sharing device. $400M N-95 mask sterilization 60 sites. UNM PPE reprocessing online. Drug quality vulnerable. Managing urgent airway calls. Social distancing until 2022. SARS-Cov-2 blood supply. Contact tracing national blueprint. Mental health endangered. Successful surgical rapid response. Contact tracing medical ethics. Animal coronaviruses: human lessons. IDSA management guidelines. Ophthalmic practice. Pain management. Obstetrics management. Oncology practice. Forward triage. Scoring time-sensitive procedures. Outpatient structural heart disease. Thoracic surgery outcomes. Chest CT screening: epidemics. Sarcoma management. Endocrine diseases. Clinical pharmacists\u27 strategies. Non-invasive ventilation benefits. Essential laboratory testing. Psychiatric service. Hydroxychloroquine negative RCT. JAMA pharmacologic Tx review. Convalescent plasma. Promising antivirals. 55 clinical trials today. NYC hospitalization risk factors. Children milder disease. Blood morphology anomalies. No antimalarial consensus

2020-04-10 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: Extra NM HSD SNAP benefits. NM cases \u3e1000. Meds supply chain threatened. Mass graves in NY. Surgeon General screening app. Presidential briefing. Italian healthcare worker deaths. Taiwan tiered care model. Communicating risks to public. French public demand hydroxychloroquine. Vaccination pause dangers. Retesting needed after discharge. CDC report geography and incidence. UW clinical informatics response. UW preparedness guidelines. Wuhan outbreak control. CDC asymptomatic exposed worker guidelines. Mask innovation. Unemployment spikes. Workforce gaps. Workspace modifications reduce transmission. Guidelines and recommendations: ER physician, surgery, cardiopulmonary resuscitation, chest imaging, geriatrics, critically ill children, postpyloric tube placement, genitourinary malignancies, obstetrics, and home work health. Remdesivir clinically promising. Hydroxychloroquine safe but higher mortality with azithromycin. Lockdown health risks. Post-ICU syndrome. Tetracyline therapy potential. ACE2 review. Repurposing candidates. Patient self-triage tool. Video of aerosol spread and lingering. Modeling challenges. 34 new clinical trials registered today

2020-04-15 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: Daily NM recap. NM Hospital financial challenges. NM absentee voting. NM dairy farmers impact. 19-20 states open May 1? USA halts WHO funding. More NYC deaths. 250K tests AZ first responders. Global pandemic updates. Imported cases China. Masked South Korea elections. Danish children school return. PPE angiography. NYC cancels healthcare workers. GI shedding endoscopes. Blockade reduces transmission. Fever screening. Viral shedding post seroconversion. Radiology mitigations. Endoscopy units. Tracheostomy reduced transmission. Survivors plasma. Medical Imaging. Useful CTs. Electrophysiology procedures. Renin angiotensin blockers. Hemostasis. Dermatologic surgery. Pediatric gastroenterology. Autoimmune liver disease. Orthopedic surgical care. Updated treatment evidence. Asymptomatic detection. CVD pharmacology. Bleach disinfection. Arbidol beats lopinavir/ritonavir. IV immunoglobulin therapy. No HCQ clinical efficacy. Cepharantine inhibition pangolins. Machine learning antivirals. Eat bitter substances. 59 new trials. Combining RNA and antibody tests. No SARS-CoV-2 in patient ward air. Influenza impact prevention. Encephalitis. Low CD4+ and CD8+ severe. G6PD-deficient issues. Cytokine storm. Biosensor detection. Immunopathogenesis