What determines accuracy of chemical identification when using microspectroscopy for the analysis of microplastics?

Fourier transform infrared (FTIR) and Raman microspectroscopy are methods applied in microplastics research to determine the chemical identity of microplastics. These techniques enable quantification of microplastic particles across various matrices. Previous work has highlighted the benefits and limitations of each method and found these to be complimentary. Within this work, metadata collected within an interlaboratory method validation study was used to determine which variables most influenced successful chemical identification of un-weathered microplastics in simulated drinking water samples using FTIR and Raman microspectroscopy. No variables tested had a strong correlation with the accuracy of chemical identification (r = ≤0.63). The variables most correlated with accuracy differed between the two methods, and include both physical characteristics of particles (color, morphology, size, polymer type), and instrumental parameters (spectral collection mode, spectral range). Based on these results, we provide technical recommendations to improve capabilities of both methods for measuring microplastics in drinking water and highlight priorities for further research. For FTIR microspectroscopy, recommendations include considering the type of particle in question to inform sample presentation and spectral collection mode for sample analysis. Instrumental parameters should be adjusted for certain particle types when using Raman microspectroscopy. For both instruments, the study highlighted the need for harmonization of spectral reference libraries among research groups, including the use of libraries containing reference materials of both weathered plastic and natural materials that are commonly found in environmental samples.

Decoding Wheat Endosphere-Rhizosphere Microbiomes in Rhizoctonia solani-Infested Soils Challenged by Streptomyces Biocontrol Agents.

The endosphere and the rhizosphere are pertinent milieus with microbial communities that perturb the agronomic traits of crop plants through beneficial or detrimental interactions. In this study, we challenged these communities by adding Streptomyces biocontrol strains to wheat seeds in soils with severe Rhizoctonia solani infestation. Wheat plants were grown in a glasshouse standardized system, and the bacterial and fungal microbiomes of 233 samples of wheat roots (endosphere) and rhizosphere soils were monitored for 20 weeks, from seed to mature plant stage. The results showed highly dynamic and diverse microbial communities that changed over time, with Sphingomonas bacteria and Aspergillus, Dipodascus, and Trichoderma fungi increasing over time. Application of biocontrol Streptomyces strains promoted plant growth and maturation of wheat heads and modulated the root microbiome, decreasing Paenibacillus and increasing other bacterial and fungal OTUs. The soils with the highest levels of R. solani had increased reads of Thanatephorus (Rhizoctonia anamorph) and increased root disease levels and increased Balneimonas, Massilia, Pseudomonas, and unclassified Micrococcaceae. As we enter the era of biologically sustainable agriculture, it may be possible to reduce and limit the effects of serious fungal infestations by promoting a beneficial microbiome through the application of biocontrol agents during different periods of plant development.

Members of Minority and Underserved Communities Set Priorities for Health Research.

Policy Points Engaging and involving underrepresented communities when setting research priorities could make the scientific research agenda more equitable, more just, and more responsive to their needs and values. Groups and individuals from minority and underserved communities strongly prioritized child health and mental health research, often choosing to invest at the highest possible level. Groups consisting of predominantly Native American or Arab American participants invested in culture and beliefs research at the highest level, while many groups did not select it at all. The priority given to culture and beliefs research by these groups illustrates the importance of paying special attention to unique preferences, and not just commonly held views, when getting public input on spending priorities for research. CONTEXT: A major contributor to health disparities is the relative lack of resources-including resources for science-allocated to address the health problems of those with disproportionately greater needs. Engaging and involving underrepresented communities in setting research priorities could make the scientific research agenda more equitable, more just, and more responsive to their needs and values. We engaged minority and underserved communities in informed deliberations and report here their priorities for health research. METHODS: Academic-community partnerships adapted the simulation exercise CHAT for setting health research priorities. We had participants from minority and medically underserved communities (47 groups, n = 519) throughout Michigan deliberate about health research priorities, and we used surveys and CHAT software to collect the demographic characteristics and priorities selected by individuals and groups. FINDINGS: The participants ranged in age (18 to 88), included more women than men, and were overrepresented by minority groups. Nearly all the deliberating groups selected child health and mental health research (93.6% and 95.7%), and most invested at the highest level. Aging, access, promote health, healthy environment, and what causes disease were also prioritized by groups. Research on mental health and child health were high priorities for individuals both before and after group deliberations. Access was the only category more likely to be selected by individuals after group deliberation (77.0 vs 84.0%, OR = 1.63, p = .005), while improve research, health policy, and culture and beliefs were less likely to be selected after group deliberations (all, p < .001). However, the level of investment in many categories changed after the group deliberations. Participants identifying as Black/African American were less likely to prioritize mental health research, and those of Other race were more likely to prioritize culture and beliefs research. CONCLUSIONS: Minority and medically underserved communities overwhelmingly prioritized mental health and child health research in informed deliberations about spending priorities.

Toward personalized medicine of lung cancer: response to nontargeted therapy in invasive pulmonary adenocarcinoma as a function of tumor cell differentiation.

We evaluated clinical parameters, histomorphology, and thyroid transcription factor 1 (TTF-1) immunoreactivity in 40 epidermal growth factor receptor (EGFR) mutation- and anaplastic lymphoma kinase (ALK) rearrangement-negative invasive pulmonary adenocarcinomas. Tumors were histomorphologically quantitated by a pulmonary pathologist and TTF-1 immunohistochemistry applied. EGFR mutation and ALK rearrangement status was determined with polymerase chain reaction/DNA sequencing and fluorescence in situ hybridization, respectively. Treatment response was related to type of treatment (P < .005) and clinical stage (P = .001). EGFR mutation- and ALK rearrangement-negative pulmonary adenocarcinomas containing papillary/micropapillary histology showed greater morphologic heterogeneity (P < .001), greater TTF-1 immunoreactivity (P = .004), and were more common in treatment responders (P < .05). These findings support that patients with pulmonary adenocarcinomas that are subject to nontargeted therapies may respond to treatment as a function of tumor cell differentiation with TTF-1 as a potential biomarker of this response.

Impact of communication on preventive services among deaf American Sign Language users.

BACKGROUND: Deaf American Sign Language (ASL) users face communication and language barriers that limit healthcare communication with their providers. Prior research has not examined preventive services with ASL-skilled clinicians. PURPOSE: The goal of this study was to determine whether provider language concordance is associated with improved receipt of preventive services among deaf respondents. METHODS: This cross-sectional study included 89 deaf respondents aged 50-75 years from the Deaf Health Survey (2008), a Behavioral Risk Factor Surveillance System survey adapted for use with deaf ASL users. Association between the respondent's communication method with the provider (i.e., categorized as either concordant-doctor signs or discordant-other) and preventive services use was assessed using logistic regression adjusting for race, gender, income, health status, health insurance, and education. Analyses were conducted in 2010. RESULTS: Deaf respondents who reported having a concordant provider were more likely to report a greater number of preventive services (OR=3.42, 95% CI=1.31, 8.93, p=0.0122) when compared to deaf respondents who reported having a discordant provider even after adjusting for race, gender, income, health status, health insurance, and education. In unadjusted analyses, deaf respondents who reported having a concordant provider were more likely to receive an influenza vaccination in the past year (OR=4.55, p=0.016) when compared to respondents who had a discordant provider. CONCLUSIONS: Language-concordant patient-provider communication is associated with higher appropriate use of preventive services by deaf ASL users.

Hospital discharge against advice after myocardial infarction: deaths and readmissions.

BACKGROUND: Approximately 1% of patients leave hospitals against medical advice, but the clinical significance of premature hospital discharge is unknown, particularly after admission for acute myocardial infarction (AMI). METHODS: We used California hospital discharge data (1998-2000) to compare readmissions and mortality among patients admitted for AMI who were discharged against medical advice with those who weren't. Effects were adjusted for age, race, income, comorbidity, insurance, and hospital characteristics. We also examined whether the effects of premature hospital discharge were partly explained by lower rates of coronary revascularization. RESULTS: There were 1079 patients (1.1% of the sample) with AMI on admission who left against medical advice. Compared with those who didn't leave against medical advice, these patients were younger, more often male, low income, black, insured through Medicaid or uninsured, and had less physical comorbidity, but greater mental health comorbidity. Their mean length of stay was shorter (4 vs 8 days) than those who stayed. They were transferred less often. They received fewer cardiac procedures, including coronary revascularization. In multivariate analyses, they had 60% higher risk for death or re-admission for AMI or unstable angina up to 2 years postdischarge than patients with standard discharge (hazard ratio 1.59; 95% confidence interval, 1.43-1.77). Adjustment for revascularization attenuated, but did not eliminate, this risk (hazard ratio 1.39; 95% confidence interval, 1.25-1.55). CONCLUSIONS: Discharge against medical advice after AMI is associated with appreciable morbidity and mortality. These results should be used to manage AMI patients contemplating such discharge.

Soul food light: culturally competent diabetes education.

PURPOSE: The purpose of this study was to test effects of a culturally competent, dietary self-management intervention on physiological outcomes and dietary behaviors for African Americans with type 2 diabetes. METHODS: A longitudinal experimental study was conducted in rural South Carolina with a sample of 97 adult African Americans with type 2 diabetes who were randomly assigned to either usual care or the intervention. The intervention consisted of 4 weekly classes in low-fat dietary strategies, 5 monthly peer-professional group discussions, and weekly telephone follow-up. The culturally competent approach reflected the ethnic beliefs, values, customs, food preferences, language, learning methods, and health care practices of southern African Americans. RESULTS: Body mass index and dietary fat behaviors were significantly lowered in the experimental group. At 6 months, weight decreased 1.8 kg (4 lb) for the experimental group and increased 1.9 kg (4.2 lb) for the control group, a net difference of 3.7 kg (8.2 lb). The experimental group reduced high-fat dietary habits to moderate while high-fat dietary habits of the control group remained essentially unchanged. A trend in reduction of A1C and lipids was observed. CONCLUSIONS: Results suggest the effectiveness of a culturally competent dietary self-management intervention in improving health outcomes for southern African Americans, especially those at risk due to high-fat diets and body mass index >or= 35 kg/mm(2). Given the burgeoning problem of obesity in South Carolina and the nation, the time has come to focus on aggressive weight management. Diabetes educators are in pivotal positions to assume leadership in achieving this goal for vulnerable, rural populations.

Culturally competent dietary education for southern rural African Americans with diabetes.

PURPOSE: The purpose of this article is to describe a culturally competent, dietary self-management intervention designed to improve physiological outcomes, diabetes self-management, and costs of care for high-risk African Americans with type 2 diabetes. METHODS: A longitudinal, quasi-experimental design was used to evaluate the effectiveness of the intervention for 23 adult African Americans from a physician practice group in rural South Carolina. The intervention consisted of 4 low-fat dietary education classes, 6 discussion groups, and follow-up. Intervention sessions were provided by a dietitian and nurse case managers and framed as social events; families were encouraged to participate. RESULTS: Data suggest that the intervention significantly improved fat-related dietary habits, A1C values, fasting blood glucose, and frequency of acute care visits. A trend in reduction of lipids and weight also was observed. CONCLUSIONS: Culturally competent dietary self-management provides a meaningful approach to focused diabetes education for rural African Americans. Integrating nursing case management provides an innovative method of addressing the more global issues of delivery of care to underserved rural populations and decreasing the high costs of care.