Attenuation and distortion components of age-related hearing loss: Contributions to recognizing temporal-envelope filtered speech in modulated noise.

Older adults with hearing loss may experience difficulty recognizing speech in noise due to factors related to attenuation (e.g., reduced audibility and sensation levels, SLs) and distortion (e.g., reduced temporal fine structure, TFS, processing). Furthermore, speech recognition may improve when the amplitude modulation spectrum of the speech and masker are non-overlapping. The current study investigated this by filtering the amplitude modulation spectrum into different modulation rates for speech and speech-modulated noise. The modulation depth of the noise was manipulated to vary the SL of speech glimpses. Younger adults with normal hearing and older adults with normal or impaired hearing listened to natural speech or speech vocoded to degrade TFS cues. Control groups of younger adults were tested on all conditions with spectrally shaped speech and threshold matching noise, which reduced audibility to match that of the older hearing-impaired group. All groups benefitted from increased masker modulation depth and preservation of syllabic-rate speech modulations. Older adults with hearing loss had reduced speech recognition across all conditions. This was explained by factors related to attenuation, due to reduced SLs, and distortion, due to reduced TFS processing, which resulted in poorer auditory processing of speech cues during the dips of the masker.

Talker change detection by listeners varying in age and hearing loss.

Despite a vast literature on how speech intelligibility is affected by hearing loss and advanced age, remarkably little is known about the perception of talker-related information in these populations. Here, we assessed the ability of listeners to detect whether a change in talker occurred while listening to and identifying sentence-length sequences of words. Participants were recruited in four groups that differed in their age (younger/older) and hearing status (normal/impaired). The task was conducted in quiet or in a background of same-sex two-talker speech babble. We found that age and hearing loss had detrimental effects on talker change detection, in addition to their expected effects on word recognition. We also found subtle differences in the effects of age and hearing loss for trials in which the talker changed vs trials in which the talker did not change. These findings suggest that part of the difficulty encountered by older listeners, and by listeners with hearing loss, when communicating in group situations, may be due to a reduced ability to identify and discriminate between the participants in the conversation.

Sentence recognition with modulation-filtered speech segments for younger and older adults: Effects of hearing impairment and cognition.

This study investigated word recognition for sentences temporally filtered within and across acoustic-phonetic segments providing primarily vocalic or consonantal cues. Amplitude modulation was filtered at syllabic (0-8 Hz) or slow phonemic (8-16 Hz) rates. Sentence-level modulation properties were also varied by amplifying or attenuating segments. Participants were older adults with normal or impaired hearing. Older adult speech recognition was compared to groups of younger normal-hearing adults who heard speech unmodified or spectrally shaped with and without threshold matching noise that matched audibility to hearing-impaired thresholds. Participants also completed cognitive and speech recognition measures. Overall, results confirm the primary contribution of syllabic speech modulations to recognition and demonstrate the importance of these modulations across vowel and consonant segments. Group differences demonstrated a hearing loss-related impairment in processing modulation-filtered speech, particularly at 8-16 Hz. This impairment could not be fully explained by age or poorer audibility. Principal components analysis identified a single factor score that summarized speech recognition across modulation-filtered conditions; analysis of individual differences explained 81% of the variance in this summary factor among the older adults with hearing loss. These results suggest that a combination of cognitive abilities and speech glimpsing abilities contribute to speech recognition in this group.

Cognitive reappraisal moderates the effect of combat or other exposures on negative behavioral health symptoms.

Understanding the individual differences that can buffer the impact of combat and other adverse exposures on deleterious behavioral health outcomes could lead to more targeted prevention and intervention efforts. Cognitive reappraisal, an antecedent-focused emotion regulation strategy, is linked to positive health outcomes such as lower levels of post-traumatic stress disorder, anxiety, and depression. This study examined the moderating effect of individual differences in cognitive reappraisal use on the association between combat exposure and behavioral health outcomes in active-duty U.S. Soldiers (N = 2,290). This study utilized survey data collected approximately 18 months following a combat deployment to Afghanistan in 2014. Results showed that individual differences in cognitive reappraisal use significantly moderated the effect of combat exposure on anxiety and post-traumatic stress symptoms but not depressive symptoms. Specifically, increasing combat exposures predicted a steeper increase in negative behavioral health symptoms for Soldiers reporting lesser (versus greater) cognitive reappraisal use. These findings highlight a role for cognitive reappraisal as a targetable factor that can mitigate the behavioral health consequences of exposure to combat stressors.

A Novel Zinc (II) Porphyrin Is Synergistic with PEV2 Bacteriophage against Pseudomonas aeruginosa Infections.

Pseudomonas aeruginosa (PsA) is an opportunistic bacterial pathogen that causes life-threatening infections in individuals with compromised immune systems and exacerbates health concerns for those with cystic fibrosis (CF). PsA rapidly develops antibiotic resistance; thus, novel therapeutics are urgently needed to effectively combat this pathogen. Previously, we have shown that a novel cationic Zinc (II) porphyrin (ZnPor) has potent bactericidal activity against planktonic and biofilm-associated PsA cells, and disassembles the biofilm matrix via interactions with eDNA In the present study, we report that ZnPor caused a significant decrease in PsA populations in mouse lungs within an in vivo model of PsA pulmonary infection. Additionally, when combined with an obligately lytic phage PEV2, ZnPor at its minimum inhibitory concentration (MIC) displayed synergy against PsA in an established in vitro lung model resulting in greater protection of H441 lung cells versus either treatment alone. Concentrations above the minimum bactericidal concentration (MBC) of ZnPor were not toxic to H441 cells; however, no synergy was observed. This dose-dependent response is likely due to ZnPor's antiviral activity, reported herein. Together, these findings show the utility of ZnPor alone, and its synergy with PEV2, which could be a tunable combination used in the treatment of antibiotic-resistant infections.

Recognition of spectrally shaped speech in speech-modulated noise: Effects of age, spectral shape, speech level, and vocoding.

This study examined the recognition of spectrally shaped syllables and sentences in speech-modulated noise by younger and older adults. The effect of spectral shaping and speech level on temporal amplitude modulation cues was explored through speech vocoding. Subclinical differences in hearing thresholds in older adults were controlled using threshold matching noise. Older, compared to younger, adults had poorer recognition but similar improvements as the bandwidth of the shaping function increased. Spectral shaping may enhance the sensation level of glimpsed speech, which improves speech recognition in noise, even with mild elevations in hearing thresholds.

Current Status of Sub-micron Cavitation-Enhancing Agents for Sonothrombolysis.

Thrombosis in cardiovascular disease is an urgent global issue, but treatment progress is limited by the risks of current antithrombotic approaches. The cavitation effect in ultrasound-mediated thrombolysis offers a promising mechanical alternative for clot lysis. Further addition of microbubble contrast agents introduces artificial cavitation nuclei that can enhance the mechanical disruption induced by ultrasound. Recent studies have proposed sub-micron particles as novel sonothrombolysis agents with increased spatial specificity, safety and stability for thrombus disruption. In this article, the applications of different sub-micron particles for sonothrombolysis are discussed. Also reviewed are in vitro and in vivo studies that apply these particles as cavitation agents and as adjuvants to thrombolytic drugs. Finally, perspectives on future developments in sub-micron agents for cavitation-enhanced sonothrombolysis are shared.

Evidence for cortical adjustments to perceptual decision criteria during word recognition in noise.

Extensive increases in cingulo-opercular frontal activity are typically observed during speech recognition in noise tasks. This elevated activity has been linked to a word recognition benefit on the next trial, termed "adaptive control," but how this effect might be implemented has been unclear. The established link between perceptual decision making and cingulo-opercular function may provide an explanation for how those regions benefit subsequent word recognition. In this case, processes that support recognition such as raising or lowering the decision criteria for more accurate or faster recognition may be adjusted to optimize performance on the next trial. The current neuroimaging study tested the hypothesis that pre-stimulus cingulo-opercular activity reflects criterion adjustments that determine how much information to collect for word recognition on subsequent trials. Participants included middle-age and older adults (N = 30; age = 58.3 ± 8.8 years; m ± sd) with normal hearing or mild sensorineural hearing loss. During a sparse fMRI experiment, words were presented in multitalker babble at +3 dB or +10 dB signal-to-noise ratio (SNR), which participants were instructed to repeat aloud. Word recognition was significantly poorer with increasing participant age and lower SNR compared to higher SNR conditions. A perceptual decision-making model was used to characterize processing differences based on task response latency distributions. The model showed that significantly less sensory evidence was collected (i.e., lower criteria) for lower compared to higher SNR trials. Replicating earlier observations, pre-stimulus cingulo-opercular activity was significantly predictive of correct recognition on a subsequent trial. Individual differences showed that participants with higher criteria also benefitted the most from pre-stimulus activity. Moreover, trial-level criteria changes were significantly linked to higher versus lower pre-stimulus activity. These results suggest cingulo-opercular cortex contributes to criteria adjustments to optimize speech recognition task performance.

First laboratory confirmation and sequencing of Zaire ebolavirus in Uganda following two independent introductions of cases from the 10th Ebola Outbreak in the Democratic Republic of the Congo, June 2019.

Uganda established a domestic Viral Hemorrhagic Fever (VHF) testing capacity in 2010 in response to the increasing occurrence of filovirus outbreaks. In July 2018, the neighboring Democratic Republic of Congo (DRC) experienced its 10th Ebola Virus Disease (EVD) outbreak and for the duration of the outbreak, the Ugandan Ministry of Health (MOH) initiated a national EVD preparedness stance. Almost one year later, on 10th June 2019, three family members who had contracted EVD in the DRC crossed into Uganda to seek medical treatment. Samples were collected from all the suspected cases using internationally established biosafety protocols and submitted for VHF diagnostic testing at Uganda Virus Research Institute. All samples were initially tested by RT-PCR for ebolaviruses, marburgviruses, Rift Valley fever (RVF) virus and Crimean-Congo hemorrhagic fever (CCHF) virus. Four people were identified as being positive for Zaire ebolavirus, marking the first report of Zaire ebolavirus in Uganda. In-country Next Generation Sequencing (NGS) and phylogenetic analysis was performed for the first time in Uganda, confirming the outbreak as imported from DRC at two different time point from different clades. This rapid response by the MoH, UVRI and partners led to the control of the outbreak and prevention of secondary virus transmission.

Validation of a combined ultrasound and bioluminescence imaging system with magnetic resonance imaging in orthotopic pancreatic murine tumors.

Preclinical mouse solid tumor models are widely used to evaluate efficacy of novel cancer therapeutics. Recent reports have highlighted the need for utilizing orthotopic implantation to represent clinical disease more accurately, however the deep tissue location of these tumors makes longitudinal assessment challenging without the use of imaging techniques. The purpose of this study was to evaluate the performance of a new multi-modality high-throughput in vivo imaging system that combines bioluminescence imaging (BLI) with robotic, hands-free ultrasound (US) for evaluating orthotopic mouse models. Long utilized in cancer research as independent modalities, we hypothesized that the combination of BLI and US would offer complementary advantages of detection sensitivity and quantification accuracy, while mitigating individual technological weaknesses. Bioluminescent pancreatic tumor cells were injected into the pancreas tail of C57BL/6 mice and imaged weekly with the combination system and magnetic resonance imaging (MRI) to serve as a gold standard. BLI photon flux was quantified to assess tumor activity and distribution, and US and MRI datasets were manually segmented for gross tumor volume. Robotic US and MRI demonstrated a strong agreement (R2 = 0.94) for tumor volume measurement. BLI showed a weak overall agreement with MRI (R2 = 0.21), however, it offered the greatest sensitivity to detecting the presence of tumors. We conclude that combining BLI with robotic US offers an efficient screening tool for orthotopic tumor models.

Unique patterns of hearing loss and cognition in older adults' neural responses to cues for speech recognition difficulty.

Older adults with hearing loss experience significant difficulties understanding speech in noise, perhaps due in part to limited benefit from supporting executive functions that enable the use of environmental cues signaling changes in listening conditions. Here we examined the degree to which 41 older adults (60.56-86.25 years) exhibited cortical responses to informative listening difficulty cues that communicated the listening difficulty for each trial compared to neutral cues that were uninformative of listening difficulty. Word recognition was significantly higher for informative compared to uninformative cues in a + 10 dB signal-to-noise ratio (SNR) condition, and response latencies were significantly shorter for informative cues in the + 10 dB SNR and the more-challenging + 2 dB SNR conditions. Informative cues were associated with elevated blood oxygenation level-dependent contrast in visual and parietal cortex. A cue-SNR interaction effect was observed in the cingulo-opercular (CO) network, such that activity only differed between SNR conditions when an informative cue was presented. That is, participants used the informative cues to prepare for changes in listening difficulty from one trial to the next. This cue-SNR interaction effect was driven by older adults with more low-frequency hearing loss and was not observed for those with more high-frequency hearing loss, poorer set-shifting task performance, and lower frontal operculum gray matter volume. These results suggest that proactive strategies for engaging CO adaptive control may be important for older adults with high-frequency hearing loss to optimize speech recognition in changing and challenging listening conditions.

An Analysis of Sonothrombolysis and Cavitation for Retracted and Unretracted Clots Using Microbubbles Versus Low-Boiling-Point Nanodroplets.

The thrombolysis potential of low-boiling-point (-2 °C) perfluorocarbon phase-change nanodroplets (NDs) has previously been demonstrated on aged clots, and we hypothesized that this efficacy would extend to retracted clots. We tested this hypothesis by comparing sonothrombolysis of both unretracted and retracted clots using ND-mediated ultrasound (US+ND) and microbubble-mediated ultrasound (US+MB), respectively. Assessment data included clot mass reduction, cavitation detection, and cavitation cloud imaging in vitro. Acoustic parameters included a 7.9-MPa peak negative pressure and 180-cycle bursts with 5-Hz repetition (the corresponding duty cycle and time-averaged intensity of 0.09% and 1.87 W/cm2, respectively) based on prior studies. With these parameters, we observed a significantly reduced efficacy of US+MB in the retracted versus unretracted model (the averaged mass reduction rate from 1.83%/min to 0.54%/min). Unlike US+MB, US+ND exhibited less reduction of efficacy in the retracted model (from 2.15%/min to 1.04%/min on average). The cavitation detection results correlate with the sonothrombolysis efficacy results showing that both stable and inertial cavitation generated in a retracted clot by US+ND is higher than that by US+MB. We observed that ND-mediated cavitation shows a tendency to occur inside a clot, whereas MB-mediated cavitation occurs near the surface of a retracted clot, and this difference is more significant with retracted clots compared to unretracted clots. We conclude that ND-mediated sonothrombolysis outperforms MB-mediated therapy regardless of clot retraction, and this advantage of ND-mediated cavitation is emphasized for retracted clots. The primary mechanisms are hypothesized to be sustained cavitation level and cavitation clouds in the proximity of a retracted clot by US+ND.

Neural Presbyacusis in Humans Inferred from Age-Related Differences in Auditory Nerve Function and Structure.

A common complaint of older adults is difficulty understanding speech, particularly in challenging listening conditions. Accumulating evidence suggests that these difficulties may reflect a loss and/or dysfunction of auditory nerve (AN) fibers. We used a novel approach to study age-related changes in AN structure and several measures of AN function, including neural synchrony, in 58 older adults and 42 younger adults. AN activity was measured in response to an auditory click (compound action potential; CAP), presented at stimulus levels ranging from 70 to 110 dB pSPL. Poorer AN function was observed for older than younger adults across CAP measures at higher but not lower stimulus levels. Associations across metrics and stimulus levels were consistent with age-related AN disengagement and AN dyssynchrony. High-resolution T2-weighted structural imaging revealed age-related differences in the density of cranial nerve VIII, with lower density in older adults with poorer neural synchrony. Individual differences in neural synchrony were the strongest predictor of speech recognition, such that poorer synchrony predicted poorer recognition of time-compressed speech and poorer speech recognition in noise for both younger and older adults. These results have broad clinical implications and are consistent with an interpretation that age-related atrophy at the level of the AN contributes to poorer neural synchrony and may explain some of the perceptual difficulties of older adults.SIGNIFICANCE STATEMENT Differences in auditory nerve (AN) pathophysiology may contribute to the large variations in hearing and communication abilities of older adults. However, current diagnostics focus largely on the increase in detection thresholds, which is likely because of the absence of indirect measures of AN function in standard clinical test batteries. Using novel metrics of AN function, combined with estimates of AN structure and auditory function, we identified age-related differences across measures that we interpret to represent age-related reductions in AN engagement and poorer neural synchrony. Structure-function associations are consistent with an explanation of AN deficits that arise from age-related atrophy of the AN. Associations between neural synchrony and speech recognition suggest that individual and age-related deficits in neural synchrony contribute to speech recognition deficits.

Critical Capability Needs for Reduction of Transmission of SARS-CoV-2 Indoors.

Coordination of efforts to assess the challenges and pain points felt by industries from around the globe working to reduce COVID-19 transmission in the indoor environment as well as innovative solutions applied to meet these challenges is mandatory. Indoor infectious viral disease transmission (such as coronavirus, norovirus, influenza) is a complex problem that needs better integration of our current knowledge and intervention strategies. Critical to providing a reduction in transmission is to map the four core technical areas of environmental microbiology, transmission science, building science, and social science. To that end a three-stage science and innovation Summit was held to gather information on current standards, policies and procedures applied to reduce transmission in built spaces, as well as the technical challenges, science needs, and research priorities. The Summit elucidated steps than can be taken to reduce transmission of SARS-CoV-2 indoors and calls for significant investments in research to enhance our knowledge of viral pathogen persistence and transport in the built environment, risk assessment and mitigation strategy such as processes and procedures to reduce the risk of exposure and infection through building systems operations, biosurveillance capacity, communication form leadership, and stakeholder engagement for optimal response. These findings reflect the effective application of existing knowledge and standards, emerging science, and lessons-learned from current efforts to confront SARS-CoV-2.

Glimpsing keywords across sentences in noise: A microstructural analysis of acoustic, lexical, and listener factors.

This study investigated how acoustic and lexical word-level factors and listener-level factors of auditory thresholds and cognitive-linguistic processing contribute to the microstructure of sentence recognition in unmodulated and speech-modulated noise. The modulation depth of the modulated masker was changed by expanding and compressing the temporal envelope to control glimpsing opportunities. Younger adults with normal hearing (YNH) and older adults with normal and impaired hearing were tested. A second group of YNH was tested under acoustically identical conditions to the hearing-impaired group, who received spectral shaping. For all of the groups, speech recognition declined and masking release increased for later keywords in the sentence, which is consistent with the word position decreases in the signal-to-noise ratio. The acoustic glimpse proportion and lexical word frequency of individual keywords predicted recognition under different noise conditions. For the older adults, better auditory thresholds and better working memory abilities facilitated sentence recognition. Vocabulary knowledge contributed more to sentence recognition for younger than for older adults. These results demonstrate that acoustic and lexical factors contribute to the recognition of individual words within a sentence, but relative contributions vary based on the noise modulation characteristics. Taken together, acoustic, lexical, and listener factors contribute to how individuals recognize keywords during sentences.

Crayfish Eating in Snakes: Testing How Anatomy and Behavior Affect Prey Size and Feeding Performance.

Quantifying the performance of animals is a powerful methodology for determining the functional consequences of morphological variation. For example, snakes consume prey whole, and variation in the anatomy of their trophic apparatus directly affects gape and limits maximal prey size. However, for the foraging ecology of snakes and other systems, scant data exist regarding how often maximal capacities are taxed in nature. Hence, we quantified: (1) maximal gape, (2) the size of prey relative to maximal gape, and (3) how the type and relative size of prey affected behavior and prey handling times (HTs) for two species of natricine snakes that primarily eat soft- (Regina septemvittata) or hard-shelled (Liodytes alleni) crayfish. Liodytes alleni had significantly larger maximal gape than R. septemvittata with equal snout-vent length. The percentages of large prey (>60% maximal gape area) consumed in the field were low in both R. septemvittata (22%) and L. alleni (2%). However, R. septemvittata, especially juveniles, ate relatively larger prey than L. alleni. Strategies for dealing with the seasonal scarcity of small crayfish differed as juvenile R. septemvittata commonly removed and ate only chelipeds from crayfish too large to swallow whole, whereas juvenile L. alleni ate many small odonate nymphs. During laboratory trials, unlike R. septemvittata, L. alleni usually used its body to restrain prey with behaviors that depended on relative prey size and prey hardness. Liodytes alleni consumed soft-shelled crayfish significantly faster than R. septemvittata and significantly faster than hard-shelled crayfish. Several of the differences in gape, prey size, and prey HTs and behavior between the crayfish-eating snakes resemble those between two phylogenetically distant species of homalopsid snakes that consume either hard- or soft-shelled crabs. In both groups of crustacean-eating snakes, the decreased capture success in captivity and the rare consumption of relatively large hard-shelled crustaceans in the field suggest that the ability to capture this type of prey constrains prey size more commonly than maximal gape. Based on data integrating snake size and gape with the relative mass of intact prey, the predicted potential feeding performance R. septemvittata consuming intact prey exceeded that of the other three species.

Lessons learned in managing risk: Tools and strategies for confident operations from the CLEAN 2020 Summit.

Risk mitigation of COVID-19 in the indoor environment requires an articulated strategy for creating a bridge between science and the business community that focuses on knitting together four core capabilities-environmental microbiology, transmission science, building science, and social science-advancing scientific knowledge. The purpose of this article is to share insights from the CLEAN 2020 Summit, which assembled leaders from business, policy, standards development, science, and engineering working to mitigate risk of transmission in the built environment. The Summit worked to assess current challenges and pain points felt by industries from around the globe as well as innovative solutions applied to meet these challenges. Although SARS-CoV-2 and the COVID-19 diseases are unique, the foundation of knowledge to assess and mitigate the risk of viral transmission in the built environment is robust. There are opportunities to improve science and engineering technology solutions, processes, and procedures to better meet the dynamic needs of the evolving pandemic.

Comparing Speech Recognition for Listeners With Normal and Impaired Hearing: Simulations for Controlling Differences in Speech Levels and Spectral Shape.

Purpose This study investigated methods used to simulate factors associated with reduced audibility, increased speech levels, and spectral shaping for aided older adults with hearing loss. Simulations provided to younger normal-hearing adults were used to investigate the effect of sensation level, speech presentation level, and spectral shape in comparison to older adults with hearing loss. Method Measures were assessed in quiet, steady-state noise, and speech-modulated noise. Older adults with hearing loss listened to speech that was spectrally shaped according to their hearing thresholds. Younger adults with normal hearing listened to speech that simulated the hearing-impaired group's (a) reduced audibility, (b) increased speech levels, and (c) spectral shaping. Group comparisons were made based on speech recognition performance and masking release. Additionally, younger adults completed measures of listening effort and perceived speech quality to assess if differences across simulations in these outcome measures were similar to those for speech recognition. Results Across the various simulations employed, testing in the presence of a threshold matching noise best matched differences in speech recognition and masking release between younger and older adults. This result remained consistent across the other two outcome measures. Conclusions A combination of audibility, speech level, and spectral shape factors is required to simulate differences between listeners with normal and impaired hearing in recognition, listening effort, and perceived speech quality. The use of spectrally shaped and amplified speech in the presence of threshold matching noise best provided this simulated control. Supplemental Material https://doi.org/10.23641/asha.13224632.

Contributions of Voice Expectations to Talker Selection in Younger and Older Adults With Normal Hearing.

Focused attention on expected voice features, such as fundamental frequency (F0) and spectral envelope, may facilitate segregation and selection of a target talker in competing talker backgrounds. Age-related declines in attention may limit these abilities in older adults, resulting in poorer speech understanding in complex environments. To test this hypothesis, younger and older adults with normal hearing listened to sentences with a single competing talker. For most trials, listener attention was directed to the target by a cue phrase that matched the target talker's F0 and spectral envelope. For a small percentage of randomly occurring probe trials, the target's voice unexpectedly differed from the cue phrase in terms of F0 and spectral envelope. Overall, keyword recognition for the target talker was poorer for older adults than younger adults. Keyword recognition was poorer on probe trials than standard trials for both groups, and incorrect responses on probe trials contained keywords from the single-talker masker. No interaction was observed between age-group and the decline in keyword recognition on probe trials. Thus, reduced performance by older adults overall could not be attributed to declines in attention to an expected voice. Rather, other cognitive abilities, such as speed of processing and linguistic closure, were predictive of keyword recognition for younger and older adults. Moreover, the effects of age interacted with the sex of the target talker, such that older adults had greater difficulty understanding target keywords from female talkers than male talkers.

Uganda's experience in Ebola virus disease outbreak preparedness, 2018-2019.

BACKGROUND: Since the declaration of the 10th Ebola Virus Disease (EVD) outbreak in DRC on 1st Aug 2018, several neighboring countries have been developing and implementing preparedness efforts to prevent EVD cross-border transmission to enable timely detection, investigation, and response in the event of a confirmed EVD outbreak in the country. We describe Uganda's experience in EVD preparedness. RESULTS: On 4 August 2018, the Uganda Ministry of Health (MoH) activated the Public Health Emergency Operations Centre (PHEOC) and the National Task Force (NTF) for public health emergencies to plan, guide, and coordinate EVD preparedness in the country. The NTF selected an Incident Management Team (IMT), constituting a National Rapid Response Team (NRRT) that supported activation of the District Task Forces (DTFs) and District Rapid Response Teams (DRRTs) that jointly assessed levels of preparedness in 30 designated high-risk districts representing category 1 (20 districts) and category 2 (10 districts). The MoH, with technical guidance from the World Health Organisation (WHO), led EVD preparedness activities and worked together with other ministries and partner organisations to enhance community-based surveillance systems, develop and disseminate risk communication messages, engage communities, reinforce EVD screening and infection prevention measures at Points of Entry (PoEs) and in high-risk health facilities, construct and equip EVD isolation and treatment units, and establish coordination and procurement mechanisms. CONCLUSION: As of 31 May 2019, there was no confirmed case of EVD as Uganda has continued to make significant and verifiable progress in EVD preparedness. There is a need to sustain these efforts, not only in EVD preparedness but also across the entire spectrum of a multi-hazard framework. These efforts strengthen country capacity and compel the country to avail resources for preparedness and management of incidents at the source while effectively cutting costs of using a "fire-fighting" approach during public health emergencies.