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BackgroundWe previously reported that impaired type I IFN activity, due to inborn errors of TLR3- and TLR7-dependent type I interferon (IFN) immunity or to autoantibodies against type I IFN, account for 15-20% of cases of life-threatening COVID-19 in unvaccinated patients. Therefore, the determinants of life-threatening COVID-19 remain to be identified in ~ 80% of cases.MethodsWe report here a genome-wide rare variant burden association analysis in 3269 unvaccinated patients with life-threatening COVID-19, and 1373 unvaccinated SARS-CoV-2-infected individuals without pneumonia. Among the 928 patients tested for autoantibodies against type I IFN, a quarter (234) were positive and were excluded.ResultsNo gene reached genome-wide significance. Under a recessive model, the most significant gene with at-risk variants was TLR7, with an OR of 27.68 (95%CI 1.5-528.7, P = 1.1 × 10-4) for biochemically loss-of-function (bLOF) variants. We replicated the enrichment in rare predicted LOF (pLOF) variants at 13 influenza susceptibility loci involved in TLR3-dependent type I IFN immunity (OR = 3.70[95%CI 1.3-8.2], P = 2.1 × 10-4). This enrichment was further strengthened by (1) adding the recently reported TYK2 and TLR7 COVID-19 loci, particularly under a recessive model (OR = 19.65[95%CI 2.1-2635.4], P = 3.4 × 10-3), and (2) considering as pLOF branchpoint variants with potentially strong impacts on splicing among the 15 loci (OR = 4.40[9%CI 2.3-8.4], P = 7.7 × 10-8). Finally, the patients with pLOF/bLOF variants at these 15 loci were significantly younger (mean age [SD] = 43.3 [20.3] years) than the other patients (56.0 [17.3] years; P = 1.68 × 10-5).ConclusionsRare variants of TLR3- and TLR7-dependent type I IFN immunity genes can underlie life-threatening COVID-19, particularly with recessive inheritance, in patients under 60 years old.

Attosecond noncollinear four-wave-mixing spectroscopy with one attosecond extreme ultraviolet (XUV) pulse and two few-cycle near-infrared (NIR) pulses was used to measure the autoionization decay lifetimes of inner valence electronic excitations in neon atoms. After a 43-48-eV XUV photon excites a 2s electron into the 2s2p6(np) Rydberg series, broadband NIR pulses couple the 2s2p63p XUV-bright state to neighboring 2s2p63s and 2s2p63d XUV-dark states. Controllable delays of one or both NIR pulses with respect to the attosecond XUV pulse reveal the temporal evolution of either the dark or bright states, respectively. Experimental lifetimes for the 3s, 3p, and 3d states are measured to be 7±2, 48±8, and 427±40 fs, respectively, with 95% confidence. Accompanying calculations with two independent ab initio theoretical methods, newstock and astra, verify the findings. The results support the expected trend that the autoionization lifetime should be longer for states that have a smaller penetration in the radial region of the 2s core hole, which in this case is for the higher angular momentum Rydberg orbitals. The underlying theory thus links the lifetime results to electron correlation and provides an assessment of the direct and exchange terms in the autoionization process.

Attosecond noncollinear four wave mixing spectroscopy with one attosecondextreme ultraviolet (XUV) pulse and two few-cycle near-infrared (NIR) pulseswas used to measure the autoionization decay lifetimes of inner valenceelectronic excitations in neon atoms. After a 43-48 eV XUV photon excites a 2selectron into the 2s2p6[np] Rydberg series, broadband NIR pulses couple the2s2p6[3p] XUV-bright state to neighboring 2s2p6[3s] and 2s2p6[3d] XUV-darkstates. Controllable delays of one or both NIR pulses with respect to theattosecond XUV pulse reveal the temporal evolution of either the dark or brightstates, respectively. Experimental lifetimes for the 3s, 3p, and 3d states aremeasured to be 7 +/- 2 fs, 48 +/- 8 fs, and 427 +/- 40 fs, respectively, with95% confidence. Accompanying calculations with two independent ab initiotheoretical methods, NewStock and ASTRA, verify the findings. The resultssupport the expected trend that the autoionization lifetime should be longerfor states that have a smaller penetration in the radial region of the 2s corehole, which in this case is for the higher angular momentum Rydberg orbitals.The underlying theory thus links the lifetime results to electron correlationand provides an assessment of the direct and exchange terms in theautoionization process.

Purpose: Low retention of school-based speech-language pathologists (SLPs) is a growing problem that can have drastic consequences at the school and student levels. Factors contributing to this shortage include features of the work environment, role ambiguity, low salaries, and a demanding workload with higher caseloads, which can result in limited time for paperwork and lesson planning for optimal service delivery models. The purpose of this study was to determine the current levels and predictors of occupational stress and burnout SLPs are experiencing in the school setting. Method: Using a cross-sectional survey design, 453 school-based SLPs from across the United States reported their workload manageability, career intentions, access to social support, and their stress and burnout levels. Multiple linear regression was used to determine the relation between the variables of interest and the occupational stress and burnout scores. Data were collected in September to December of 2020, at the height of the COVID-19 pandemic. Results: SLPs, on average, reported overall stress levels in the somewhat noticeable range, moderate access to social support, high levels of emotional exhaustion, low-to-moderate feelings of depersonalization, and moderate-to-high feelings of personal accomplishments. Based on a standardized burnout scale, SLPs in this sample are characterized as feeling ineffective and overextended. Results of linear regression models suggest that the perception of work manageability was the best predictor of Total Stress score, Emotional Exhaustion score, and Depersonalization score, in this sample. Conclusions: Data from this study offer the beginning steps to making an informed change for school-based SLPs' workplaces. Results indicated that SLPs in the school setting are feeling ineffective and overextended. The perception of their workload manageability was the most significant predictor for their reported stress and burnout levels. Suggestions for SLP supervisors, administrators, and other stakeholders are discussed.

IntroductionInfluenza virus infection can cause a range of clinical symptoms, including respiratory failure (RF) and even death. The mechanisms responsible for the most severe forms of the disease are not yet well understood. The objective is to assess the initial immune response upon admission and its potential impact on infection progression.MethodsWe conducted a prospective observational study of patients with influenza virus infection who required admission to a tertiary hospital in the 2017/18 and 2018/19 flu seasons. Immune markers, surrogate markers of neutrophil activation, and blood levels of DNase I and Apolipoprotein-H (ApoH) were determined in the first serum sample available during hospital care. Patients were followed until hospital discharge or death. Initially, 792 patients were included. From this group, 107 patients with poor evolution were selected, and a random control group was matched by day of admission.ResultsPatients with poor outcomes had significantly reduced ApoH levels, a soluble protein that regulate both complement and coagulation pathways. In multivariate analysis, low plasma levels of ApoH (OR:5.43; 2.21-13.4), high levels of C- reactive protein (OR:2.73: 1.28-5.4), hyperferritinemia (OR:2.83; 1.28-5.4) and smoking (OR:3.41; 1.04-11.16), were significantly associated with a worse prognosis. RF was independently associated with low levels of ApoH (OR: 5.12; 2.02-1.94), while high levels of IL15 behaved as a protective factor (OR:0.30; 0.12-0.71).DiscussionTherefore, in hospitalized influenza patients, a dysregulated early immune response is associated with a worse outcome. Adequate plasma levels of ApoH are protective against severe influenza and RF and High levels of IL15 protect against RF.

The present case study illustrates the use of explicit text structure intervention for expository reading comprehension with three adolescents with language learning disabilities (LLD). We investigated whether it was feasible to provide direct instruction on the identification of signal words that denote compare-contrast relations between concepts, the purpose and nature of expository text structures, and the use of graphic organizers to assist in retell of target passages and compare-contrast text comprehension. The intervention was effective in improving participants' text structure identification, signal word recognition, and comprehension of compare-contrast text. This preliminary case study demonstrates that a short-term text structure intervention is feasible and can benefit adolescents with LLD who struggle with expository reading comprehension. Implications for clinical and educational services and future directions for research are provided.

Abstract Background We previously reported that impaired type I IFN activity, due to inborn errors of TLR3- and TLR7-dependent type I interferon (IFN) immunity or to autoantibodies against type I IFN, account for 15–20% of cases of life-threatening COVID-19 in unvaccinated patients. Therefore, the determinants of life-threatening COVID-19 remain to be identified in ~ 80% of cases. Methods We report here a genome-wide rare variant burden association analysis in 3269 unvaccinated patients with life-threatening COVID-19, and 1373 unvaccinated SARS-CoV-2-infected individuals without pneumonia. Among the 928 patients tested for autoantibodies against type I IFN, a quarter (234) were positive and were excluded. Results No gene reached genome-wide significance. Under a recessive model, the most significant gene with at-risk variants was TLR7, with an OR of 27.68 (95%CI 1.5–528.7, P = 1.1 × 10−4) for biochemically loss-of-function (bLOF) variants. We replicated the enrichment in rare predicted LOF (pLOF) variants at 13 influenza susceptibility loci involved in TLR3-dependent type I IFN immunity (OR = 3.70[95%CI 1.3–8.2], P = 2.1 × 10−4). This enrichment was further strengthened by (1) adding the recently reported TYK2 and TLR7 COVID-19 loci, particularly under a recessive model (OR = 19.65[95%CI 2.1–2635.4], P = 3.4 × 10−3), and (2) considering as pLOF branchpoint variants with potentially strong impacts on splicing among the 15 loci (OR = 4.40[9%CI 2.3–8.4], P = 7.7 × 10−8). Finally, the patients with pLOF/bLOF variants at these 15 loci were significantly younger (mean age [SD] = 43.3 [20.3] years) than the other patients (56.0 [17.3] years; P = 1.68 × 10−5). Conclusions Rare variants of TLR3- and TLR7-dependent type I IFN immunity genes can underlie life-threatening COVID-19, particularly with recessive inheritance, in patients under 60 years old.

This systematic review article summarizes the effects of explicit text structure instruction on expository text comprehension for adolescents with learning disabilities or at risk for reading failure. A thorough literature search with four databases and backward citation search identified nine studies published in the past 22 years for inclusion in the review. The findings revealed medium to large effect sizes on expository reading comprehension outcome measures, providing moderately strong evidence in support of text structure intervention for adolescents with a diagnosis or risk of reading disabilities. Text structure instruction was more effective than standard instruction or business as usual conditions on students' comprehension of a variety of expository text types and content area texts. Directions for further research, limitations, and educational implications are discussed.

The simple single-channel static-exchange approximation completely ignores correlation between the continuum and molecular ion electrons. In molecular systems with symmetry equivalent atoms, the single-channel approximation can seriously fail in core ionization when using delocalized orbitals to represent the core hole states. We present cross sections and molecular frame photoelectron angular distributions with both localized and delocalized core orbitals in CF4 F (1s) ionization. We show that only a full coupled-channel calculation can recover an accurate description of the physics of inner-shell photoionization when using delocalized orbitals, whereas nearly the same result can be obtained from independent single-channel static-exchange calculations when localized core orbitals are used. A grid-based variational method described here makes such single-channel calculations possible on larger systems without local-exchange approximations. Illustrative calculations on the core ionization of SF6 are presented to illustrate the power of the grid-based method.

Introduction: The COVID‐19 pandemic has changed healthcare service delivery. We examined the overall impact of COVID‐19 on people living with HIV in British Columbia (BC), Canada, with a special focus on the potential impact of COVID‐19 on antiretroviral treatment interruptions (TIs). Methods: Purposive sampling was used to enrol people living with HIV aged ≥19 years across BC into the STOP HIV/AIDS Program Evaluation study between January 2016 and September 2018. Participants completed surveys at baseline enrolment and 18 and 36 months later. Additional COVID‐19 questions were added to the survey in October 2020. TIs were defined as >60 days late for antiretroviral therapy (ART) refill using data from the BC HIV Drug Treatment Program. Generalized linear mixed models were used to examine trends in TIs over time and associations with reported health service access. Results: Of 581 participants, 6.1%–7.7% experienced a TI during each 6‐month period between March 2019 and August 2021. The frequency of TIs did not statistically increase during the COVID‐19 epidemic. Among the 188 participants who completed the COVID‐19 questionnaire, 32.8% reported difficulty accessing healthcare during COVID‐19, 9.7% reported avoiding continuing a healthcare service due to COVID‐19‐related concerns, and 74.6% reported using virtual healthcare services since March 2020. In multivariable analysis, the odds of a TI in any 6‐month period were not significantly different from March to August 2019. None of the reported challenges to healthcare services were associated with TIs. Conclusions: Although some participants reported challenges to accessing services or avoidance of services due to COVID‐19, TIs were not more likely during COVID‐19 than before. [ABSTRACT FROM AUTHOR]

We describe astra (attosecond transitions), a close-coupling approach to molecular ionization that uses many-body transition-density matrices between ionic states with arbitrary spin and symmetry, in combination with hybrid integrals between Gaussian and numerical orbitals, to efficiently evaluate photoionization observables. Within the transition-density-matrix approach, the evaluation of interchannel coupling is exact and does not depend on the size of the configuration-interaction space of the ions. Thanks to these two crucial features, astra opens the way to studying highly correlated and comparatively large targets at a manageable computational cost. Here, astra is used to predict the parameters of bound and autoionizing states of the boron atom and of the N_{2} molecule, as well as the total photoionization cross section of boron, the nitrogen molecule (N_{2}), and formaldehyde (H_{2}CO). Our results are in excellent agreement with theoretical and experimental values from the literature.

Purpose: School-based speech-language pathologists (SLPs) are responsible for providing services to about 55% of students with disabilities in the school setting across the nation. A shortage of qualified school-based SLPs continues to persist in the United States. Research has aimed to identify factors that lead to diminished career intentions, occupational stress, and ultimately, job burnout. However, there is a dearth of literature regarding the prevention of job burnout in the school setting. In this tutorial, we provide school-based SLPs with strategies that aim to reduce and prevent burnout symptoms related to occupational stress and satisfaction. We (a) define and describe burnout, (b) discuss the possible stressors and job-related challenges that are within SLPs' control of change, (c) provide evidence-based strategies that may alleviate occupational stress related to workload factors before and after burnout has occurred, and (d) provide examples of ways to advocate within the profession. Conclusions: SLPs are encouraged to make minor adjustments in their work settings. Suggested strategies include recognizing overwhelm, incorporating broader and workload-specific changes to daily routines, and engaging in advocacy efforts. Two resources, one for evaluation and another for consolidating information about a caseload, are provided.

Electron correlation and multielectron effects are fundamental interactions that govern many physical and chemical processes in atomic, molecular and solid state systems. The process of autoionization, induced by resonant excitation of electrons into discrete states present in the spectral continuum of atomic and molecular targets, is mediated by electron correlation. Here we investigate the attosecond photoemission dynamics in argon in the 20-40 eV spectral range, in the vicinity of the 3s-1np autoionizing resonances. We present measurements of the differential photoionization cross section and extract energy and angle-dependent atomic time delays with an attosecond interferometric method. With the support of a theoretical model, we are able to attribute a large part of the measured time delay anisotropy to the presence of autoionizing resonances, which not only distort the phase of the emitted photoelectron wave packet but also introduce an angular dependence.

Direct measurement of autoionization lifetimes by using time-resolved experimental techniques is a promising approach when energy-resolved spectroscopic methods do not work. Attosecond time-resolved experiments have recently provided the first quantitative determination of autoionization lifetimes of the lowest members of the well-known Hopfield series of resonances in N2. In this work, we have used the recently developed XCHEM approach to study photoionization of the N2 molecule in the vicinity of these resonances. The XCHEM approach allows us to describe electron correlation in the molecular electronic continuum at a level similar to that provided by multireference configuration interaction methods in bound state calculations, a necessary condition to accurately describe autoionization, shakeup, and interchannel couplings occurring in this range of photon energies. Our results show that electron correlation leading to interchannel mixing is the main factor that determines the magnitude and shape of the N2 photoionization cross sections, as well as the lifetimes of the Hopfield resonances. At variance with recent speculations, nonadiabatic effects do not seem to play a significant role. These conclusions are supported by the very good agreement between the calculated cross sections and those determined in synchrotron radiation and attosecond experiments.

Introduction: pregnancy in adolescence is a concern of these times, motherhood in adolescents means risk for their health and that of their child. Objective: to describe morbidity and mortality in newborns born to adolescent mothers admitted to the Neonatology service of the "Abel Santamaría Cuadrado" General Teaching Hospital of Pinar del Río in the period 2019-2020. Methods: a descriptive and cross-sectional observational research was carried out in the Neonatology service of the General Teaching Hospital "Abel Santamaría Cuadrado" of Pinar del Río, during the years 2019 - 2020. The sample universe consisted of 270 newborns born to adolescent mothers, descriptive statistics were used. Results: mothers with late adolescence predominated (71,5 %), carriers of pregnancy-induced hypertension (24,8 %) and in their offspring newborns born at term (73,7 %), normopeso (76,3 %), with adequate intrauterine growth (67 %), born by transvaginal delivery (75,2 %), in good condition (85,5 %), with metabolic disorders being the most frequent complications (18,1 %), followed by perinatal infections (16,7 %). Among the deceased there was a predominance of children born to mothers in late adolescence. Conclusions: adolescent pregnancy has a negative impact on the health status of their offspring by increasing morbidity and mortality in the neonatal period. The most frequent complications were metabolic disorders, followed by perinatal infections and respiratory distress. Bronchopneumonia predominated among the deceased. Pregnancy-induced hypertension was the main associated disease in the mother.

In British Columbia (BC), Canada, older adults living with HIV (OALHIV — i.e., age ≥50) now constitute over 50% of all people accessing HIV treatment. In addition to living with HIV, OALHIV face significant adversity from sociostructural factors. Popular notions of resilience view resilience as an individual attribute (Coutu, 2002), commonly placing the responsibility for overcoming adversity on the individual. This community-based research on the home and community care of OALHIV involved semi-structured interviews with 27 OALHIV in BC. Interviews were analyzed thematically. Resilience was a key theme across 23 of the 27 interviews with OALHIV. This research moves beyond an individualistic notion of resilience to discuss interpersonal, neighbourhood/community, and multi-levels of resilience, including the importance of public policy and epidemic levels of resilience led by government and healthcare organizations to support OALHIV and the general population to age with dignity.

In recent decades, our planet has undergone dramatic environmental changes resulting in the loss of numerous species. This contrasts with species that can adapt quickly to rapidly changing ambient conditions, which require physiological plasticity and must occur rapidly. The Western honeybee (Apis mellifera) apparently meets this challenge with remarkable success, as this species is adapted to numerous climates, resulting in an almost worldwide distribution. Here, coordinated individual thermoregulatory activities ensure survival at the colony level and thus the transmission of genetic material. Recently, we showed that shivering thermogenesis, which is critical for honeybee thermoregulation, depends on octopamine signaling. In this study, we tested the hypothesis that the thoracic neuro-muscular octopaminergic system strives for a steady-state equilibrium under cold stress to maintain endogenous thermogenesis. We can show that this applies for both, octopamine provision by flight muscle innervating neurons and octopamine receptor expression in the flight muscles. Additionally, we discovered alternative splicing for AmOARβ2. At least the expression of one isoform is needed to survive cold stress conditions. We assume that the thoracic neuro-muscular octopaminergic system is finely tuned in order to contribute decisively to survival in a changing environment.

The theoretical description of observables in attosecond pump-probe experiments requires a good representation of the system's ionization continuum. For polyelectronic molecules, however, this is still a challenge, due to the complicated short-range structure of correlated electronic wave functions. Whereas quantum chemistry packages (QCP) implementing sophisticated methods to compute bound electronic molecular states are well-established, comparable tools for the continuum are not widely available yet. To tackle this problem, we have developed a new approach that, by means of a hybrid Gaussian-B-spline basis, interfaces existing QCPs with close-coupling scattering methods. To illustrate the viability of this approach, we report results for the multichannel ionization of the helium atom and of the hydrogen molecule that are in excellent agreement with existing accurate benchmarks. These findings, together with the versatility of QCPs to describe a broad range of chemical systems, indicate that this is a valid approach to study the ionization of polyelectronic systems in which correlation and exchange symmetry play a major role.

© 2016 American Physical Society.Time delays of electrons emitted from an isotropic initial state with the absorption of a single photon and leaving behind an isotropic ion are angle independent. Using an interferometric method involving XUV attosecond pulse trains and an IR-probe field in combination with a detection scheme, which allows for full three-dimensional momentum resolution, we show that measured time delays between electrons liberated from the 1s2 spherically symmetric ground state of helium depend on the emission direction of the electrons relative to the common linear polarization axis of the ionizing XUV light and the IR-probing field. Such time delay anisotropy, for which we measure values as large as 60 as, is caused by the interplay between final quantum states with different symmetry and arises naturally whenever the photoionization process involves the exchange of more than one photon. With the support of accurate theoretical models, the angular dependence of the time delay is attributed to small phase differences that are induced in the laser-driven continuum transitions to the final states. Since most measurement techniques tracing attosecond electron dynamics involve the exchange of at least two photons, this is a general and significant effect that must be taken into account in all measurements of time delays involving photoionization processes.

Introduction: Influenza virus infection can cause a range of clinical symptoms, including respiratory failure (RF) and even death. The mechanisms responsible for the most severe forms of the disease are not yet well understood. The objective is to assess the initial immune response upon admission and its potential impact on infection progression. Methods: We conducted a prospective observational study of patients with influenza virus infection who required admission to a tertiary hospital in the 2017/18 and 2018/19 flu seasons. Immune markers, surrogate markers of neutrophil activation, and blood levels of DNase I and Apolipoprotein-H (ApoH) were determined in the first serum sample available during hospital care. Patients were followed until hospital discharge or death. Initially, 792 patients were included. From this group, 107 patients with poor evolution were selected, and a random control group was matched by day of admission. Results: Patients with poor outcomes had significantly reduced ApoH levels, a soluble protein that regulate both complement and coagulation pathways. In multivariate analysis, low plasma levels of ApoH (OR:5.43; 2.21-13.4), high levels of C-reactive protein (OR:2.73: 1.28-5.4), hyperferritinemia (OR:2.83; 1.28-5.4) and smoking (OR:3.41; 1.04-11.16), were significantly associated with a worse prognosis RF was independently associated with low levels of ApoH (OR: 5.12; 2.02-1.94), while high levels of IL15 behaved as a protective factor (OR:0.30; 0.12-0.71). Discussion: Therefore, in hospitalized influenza patients, a dysregulated early immune response is associated with a worse outcome. Adequate plasma levels of ApoH are protective against severe influenza and RF and High levels of IL15 protect against RF. [ABSTRACT FROM AUTHOR]

El presente artículo propone el diseño y simulación de una antena de microcinta con polarización circular en la banda de 2.4 GHz. La polarización circular es lograda usando un método atractivo, posicionando la microcinta alimentadora en el eje lateral de un parche hexagonal, haciendo contacto con el mismo. Esto logra una buena adaptación a la línea de 50 ohm y una forma del patrón de radiación que puede resultar útil. El uso de materiales de bajo costo y la simple estructura de esta antena la hace propicia para ser sometida a distintas técnicas para el incremento de los anchos de banda. Todo el proceso de diseño, simulación y optimización se realizó en el software CST Studio Suite 2021 y auxiliándose del PCAAD.

En el presente artículo se abordan criterios enfocados en la visión sociológica y antropológica de los espacios urbanos en la novelística de autores cienfuegueros. Desde esta premisa se tiene en cuenta que al interpretarse un texto literario para establecer los posibles nuevos significados de los fenómenos sociales relatados por los escritores, este está mediado por las experiencias previas, la carga conceptual e intelectual de los sujetos sociales que la asumen y su capacidad para identificar los fenómenos sociales, relacionarlos con otros conocidos o asociarlos con eventos pasados; los cuales se comprenderán mejor desde su espacio de acción. En tal sentido, se plantea como objetivo analizar desde una perspectiva socio-antropológica el espacio de la ciudad de Cienfuegos en su relación con la realidad urbana y social que se representan en las novelas La última playa y Naturaleza muerta con abejas de Atilio Caballero y La catedral de los negros y Monasterio de Marcial Gala. The present article studies the urban spaces in novels of authors in the Cienfuegos city, with a sociological and anthropological vision. From this premise to analyze a literary text is very important, to establish the new meanings of the social phenomena related by the writers, it is mediated by the previous experiences, the conceptual load and intellectual of the social character and their capacity to identify the social phenomena and to associate them with last events. The present work has as objective to analyze from a sociological and anthropological perspective the space of the city of Cienfuegos in their relationship with the urban and social reality in the novels The last beach and Dead nature with bees of Atilio Caballero and The cathedral of the black ones and Monastery of Marcial Gala.