East is east or is it? Racialization of Asian, Middle Eastern, and Pacific Islander persons.

The conventional use of racial categories in health research naturalizes "race" in problematic ways that ignore how racial categories function in service of a White-dominated racial hierarchy. In many respects, racial labels are based on geographic designations. For instance, "Asians" are from Asia. Yet, this is not always a tenable proposition. For example, Afghanistan resides in South Asia, and shares a border with China and Pakistan. Yet, people from Afghanistan are not considered Asian, but Middle Eastern, by the US Census. Furthermore, people on the west side of the Island of New Guinea are considered Asian, whereas those on the eastern side are considered Pacific Islander. In this article, we discuss the complexity of the racial labels related to people originating from Oceania and Asia, and, more specifically, those groups commonly referred to as Pacific Islander, Middle Eastern, and Asian. We begin with considerations of the aggregation fallacy. Just as the ecological fallacy refers to erroneous inferences about individuals from group data, the aggregation fallacy refers to erroneous inferences about subgroups (eg, Hmong) from group data (ie, all Asian Americans), and how these inferences can contribute to stereotypes such as the "model minority." We also examine how group averages can be influenced merely by the composition of the subgroups, and how these, in turn, can be influenced by social policies. We provide a historical overview of some of the issues facing Pacific Islander, Middle Eastern, and Asian communities, and conclude with directions for future research.

Evaluation of Asymmetries in Speech-in Noise Abilities in Audiologic Screening for Vestibular Schwannoma.

OBJECTIVES: Measures of speech-in-noise, such as the QuickSIN, are increasingly common tests of speech perception in audiologic practice. However, the effect of vestibular schwannoma (VS) on speech-in-noise abilities is unclear. Here, we compare the predictive ability of interaural QuickSIN asymmetry for detecting VS against other measures of audiologic asymmetry. METHODS: A retrospective review of patients in our institution who received QuickSIN testing in addition to a regular audiologic battery between September 2015 and February 2019 was conducted. Records for patients with radiographically confirmed, unilateral, pretreatment VSs were identified. The remaining records excluding conductive pathologies were used as controls. The predictive abilities of various measures of audiologic asymmetry to detect VS were statistically compared. RESULTS: Our search yielded 73 unique VS patients and 2423 controls. Receiver operating characteristic curve analysis showed that QuickSIN asymmetry was more sensitive and specific than pure-tone average asymmetry and word-recognition-in-quiet asymmetry for detecting VS. Multiple logistic regression analysis revealed that QuickSIN asymmetry was more predictive of VS (odds ratio [OR] = 1.23, 95% confidence interval [CI] [1.10, 1.38], p < 0.001) than pure-tone average asymmetry (OR = 1.04, 95% CI [1.00, 1.07], p = 0.025) and word-recognition-in-quiet asymmetry (OR = 1.03, 95% CI [0.99, 1.06], p = 0.064). CONCLUSION: Between-ear asymmetries in the QuickSIN appear to be more efficient than traditional measures of audiologic asymmetry for identifying patients with VS. These results suggest that speech-in noise testing could be integrated into clinical practice without hindering the ability to identify retrocochlear pathology.

Formation and surface-stabilizing contributions to bare nanoemulsions created with negligible surface charge.

The stabilization of nanoemulsions, nanosized oil droplets dispersed in water, is commonly achieved through the addition of surfactants and polymers. However, nanoemulsions in the absence of emulsifiers have been observed to acquire a significant negative charge at their surface, which ultimately contributes to their stability. While the source of this negative charge is disputed to this day, its presence is taken as an inherent property of the aqueous-hydrophobic interface. This report provides a look at the molecular structure and bonding characteristics of bare aqueous-hydrophobic nanoemulsion interfaces. We report the creation of bare nanoemulsions with near zero surface charge, which are marginally stable for several days. The process of creating these low-charge nanoemulsions (LCNEs) required rigorous cleaning procedures and proper solvent storage conditions. Using vibrational sum-frequency scattering spectroscopy, we measure the structure and bonding of the interfacial aqueous and hydrophobic phases. The surfaces of these LCNE samples possess a measurable free OH vibration, not found in previous studies and indicative of a clean interface. Tuning the nanoemulsion charge through addition of anionic surfactants, modeling potential surface-active contaminants, we observe the free OH to disappear and a reorientation of the interfacial hydrophobic molecules at micromolar surfactant concentrations. Notably, the free OH vibration provides evidence for stronger dispersion interactions between water molecules and the hydrophobic phase at the LCNE surface compared with similar planar water-alkane interfaces. We propose the stronger bonding interactions, in addition to an ordered interfacial aqueous layer, contribute to the delayed droplet coalescence and subsequent phase separation.

Interfacial Steric and Molecular Bonding Effects Contributing to the Stability of Neutrally Charged Nanoemulsions.

In cosmetic, pharmaceutical, and food applications, many active ingredients have limited bioavailability in an aqueous environment, and in that context, nanoemulsions provide a mechanism for encapsulation, protection, and transport. These dispersed oil droplets are on the order of 100s of nanometers in diameter and owe their long-term stability to emulsifiers that are commonly charged. More recently, applications have been utilizing nonionic species as stabilizing agents due to their enhanced biosafety. DLVO (named after Derjaguin, Landau, Verwey, and Overbeek) theory has been central in the description of colloid stability, which emphasizes repulsive electrostatic forces, while extended DLVO theory also accounts for steric effects. Past studies of nanoemulsions have largely employed charged surfactants and polyelectrolytes, making it difficult to decouple electrostatic and steric effects as they relate to droplet stability. To better understand steric and molecular factors contributing to the stability of "uncharged" droplets, we have created nanoemulsions with sodium dodecyl sulfate (SDS) and poly(N-vinylacetamide) (PNVA). Though SDS is anionic, with PNVA coating the droplet surfaces, the ζ-potentials of these nanoemulsions are ∼0 mV. Despite minimizing electrostatic contributions, these nanoemulsions are stable for upward of a month with interesting dynamics. By employing dynamic light scattering, vibrational sum frequency scattering spectroscopy, and calculating interaction pair potentials using extended DLVO theory, we learn that the thickness of the PNVA layer plays a critical role in stabilizing these "uncharged" nanoemulsions. Beyond the sterics, the molecular conformation of the PNVA strands also contributes to the droplet stability. The adsorbed PNVA strands are shown to form stratified, rigid polymer networks that prevent the nanoemulsions from rapid destabilization.

Knowledge, attitudes, and practices of cervical cancer prevention and pap smears in two low-income communities in Lima, Peru.

BACKGROUND: Cervical cancer is a leading cause of death among Peruvian women. Barriers at multiple levels impact effective screening and treatment, including a lack of knowledge about cervical cancer and how regular screening can reduce morbidity and mortality through earlier detection. The aim of this study is to assess knowledge, attitudes, and practices regarding cervical cancer and its prevention in the peri-urban communities of Oasis and Pampas in southern Lima, Peru that can be used to inform future campaigns about cervical cancer prevention. METHODS: A cross-sectional survey that included several open-ended questions was administered to women in Pampas and Oasis between 2015 and 2016 to evaluate the knowledge, attitudes, and practices regarding cervical cancer and Pap smears. RESULTS: In total, 224 women were interviewed. Knowledge about cervical cancer and Pap smears was high, and attitudes were predominantly positive among most participants. Most participants knew how often they should get Pap smears (89.7%), when to begin seeking screening (74.6%), knew the price of a Pap smear (61.9%), and felt Pap smears were important for their health (70.1%). About one third (29.5%) of premenopausal women reported receiving a Pap smear in the last year. However, open ended questions revealed some knowledge gaps around Pap smears, as well as some stigma associated to Human Papilloma Virus (HPV) infection. CONCLUSION: Although knowledge of cervical cancer prevention was generally high and perceptions were positive among women in peri-urban Peruvian communities, our findings revealed there is a need for education on HPV infection prevalence among sexually active individuals to reduce stigma. Future research should focus on exploring experiences with follow-up and treatment associated with abnormal Pap smears, as well as perspectives from health authorities and professionals about barriers in the early detection and treatment process for cervical cancer.

Egocentric Health Networks and Cardiovascular Risk Factors in the ECHORN Cohort Study.

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the Caribbean region. OBJECTIVE: This study explored the concept of a health network, relationships focused on health-related matters, and examined associations with CVD risk factors in the Eastern Caribbean. DESIGN: The Eastern Caribbean Health Outcomes Research Network Cohort Study is an ongoing longitudinal cohort being conducted in the US Virgin Islands, Puerto Rico, Trinidad and Tobago, and Barbados. PARTICIPANTS: Participants (n = 1989) were English or Spanish-speaking adults 40 years and older, who were residents of the island for at least 10 years, and who intended to live on-island for the next 5 years. MAIN MEASURES: Logistic regression was used to examine associations between health network characteristics and CVD risk factors: physical activity, hypertension, and smoking. A baseline survey asked questions about health networks using name generator questions that assessed who participants spoke to about health matters, whose opinions on healthcare mattered, and who they would trust to make healthcare decisions on their behalf. KEY RESULTS: Health networks were mainly comprised of family members and friends. Healthcare professionals comprised 7% of networks, mean network size was four, and 74% of health network contacts were perceived to be in "good" to "excellent" health. Persons with larger health networks had greater odds of being physically active compared with those with smaller networks (OR = 1.07, CI = 1.01-1.14). CONCLUSIONS: Health networks may be useful to intervention efforts for CVD risk factor reduction. More studies are needed to examine health networks in Caribbean contexts and explore associations with other CVD risk factors.

Probing the Molecular Structure of Coadsorbed Polyethylenimine and Charged Surfactants at the Nanoemulsion Droplet Surface.

Nanoemulsions, nanoscale oil droplets dispersed in an aqueous medium, can be stabilized by polymer-surfactant (PS) mixtures, making them ubiquitous in commercial, industrial, and pharmaceutical applications. It is well-known that the presence of PS layers coadsorbed at the droplet surface plays a significant role in droplet stability and functionality; however, little is understood about the molecular nature of this coadsorption. Such insights are especially important for application in drug delivery where physiological conditions can vary the environmental pH and significantly impact stabilization. Hence, the focus of this study examines the surface properties of ∼300 nm nanoemulsions stabilized by the coadsorption of polyethylenimine (PEI) and charged alkyl surfactants sodium dodecyl sulfate (SDS) and dodecyltrimethylammonium bromide (DTAB). PEI is a common charge-tunable polymer used in nanocarrier templates. This study employs vibrational sum frequency scattering spectroscopy, coupled with ζ-potential and surface pressure measurements performed as a function of varying concentrations and pH. The surface specific spectroscopic results reported herein reveal that PEI adsorption and molecular ordering is influenced by both electrostatic and hydrophobic interactions. While the degree of PEI adsorption is stronger in the presence of anionic SDS than cationic DTAB, for both surfactants, PEI is molecularly disordered in acidic conditions and adopts a persistent net ordering as the solution pH becomes more basic. Both surfactants also display degrees of interfacial conformational ordering that is altered by the presence of the coadsorbed polymer. These results demonstrate the molecular-level diversity in PEI behavior at the droplet interface and provide insight into how such behavior can be controlled to yield nanocarrier technology with specific functions and enhanced efficacy.

Social anxiety is associated with impaired memory for imagined social events with positive outcomes.

Cognitive models of social anxiety disorder suggest that memory biases for negative social information contribute to symptoms of social anxiety (SA). However, it remains unclear whether memory biases in SA are related to social information, specifically, and if so, whether the valence of such information would moderate memory performance. In the present study, 197 community participants were randomised to imagine themselves as the central character in either 10 social or 10 non-social scenarios. In both conditions, half of the scenarios ended with objectively positive outcomes and half ended with objectively negative outcomes. Results demonstrated that higher trait SA was related to memory performance for social scenarios only, and in particular to poorer memory for social scenarios that ended positively. Thus, the impact of SA on memory performance depended on how social information was framed, with higher SA related to poorer memory for positive social experiences. These context-specific effects contribute to the growing literature on positivity deficits in SA.

Avelumab: A Novel Anti-PD-L1 Agent in the Treatment of Merkel Cell Carcinoma and Urothelial Cell Carcinoma.

Long-term treatment in the setting of metastatic Merkel cell carcinoma (MCC) and urothelial carcinoma (UC) has shown that current first-line chemotherapeutic agents are losing effectiveness and that there are limited treatment options available outside of radiation therapy and surgical interventions. The use of immunotherapeutic agents such as monoclonal antibodies has been considered a promising alternative for cancers that progress despite treatment with radiation therapy, surgery, and/or chemotherapeutic agents. Cancer cells escape immune surveillance by interrupting immune checkpoint pathways, resulting in dysregulation of T-cell function and so preventing its antitumor effects. In early 2017, avelumab (BAVENCIO®), a PD-L1-blocking monoclonal antibody agent, was approved for the treatment of metastatic MCC and UC. Trials that evaluated avelumab for the treatment of metastatic MCC and UC were the JAVELIN Merkel 200 Trial and the JAVELIN Solid Tumor trial, respectively. Efficacy results for both trials showed positive overall response rate (ORR) and progression-free survival rate (PFS). A strong safety profile was also established for avelumab. This review provides a brief introduction to checkpoint inhibitors and focuses on the recently approved PD-L1 inhibitor, avelumab.

A Qualitative Exploration of Attitudes Toward Global Positioning System Tracking and Ecological Momentary Assessment Among Individuals in Substance Use Treatment.

BACKGROUND: The use of tracking technology in substance use research can uncover the role of contextual factors, such as social networks and environmental cues, in triggering cravings and precipitating return to use. Few studies have explored the opinions of individuals in substance use treatment related to tracking technology. METHODS: We conducted 30 semi-structured interviews with individuals in substance use treatment facilities in Connecticut and Georgia. Interviews were not limited to individuals with any specific substance use disorder. Interviewers described a hypothetical study involving ecological momentary assessment and global positioning system tracking to examine place-based predictors of substance use. Participants were invited to share reactions to this description. We used thematic analysis to identify themes in participant perceptions of this hypothetical research study. RESULTS: Most participants shared positive opinions about study participation and expressed little to no concern about the tracking components. Participant concerns focused on the security of their information and the potential burden of responding to study questions. Participants largely understood the importance of study participation for promoting greater understanding of substance use and identified potential therapeutic effects of study participation on their own recovery. CONCLUSIONS: Individuals in substance use treatment expressed little concern with research studies or interventions incorporating mobile-tracking elements. Future studies should explore the responsible use of tracking elements in recovery support interventions.

Impact of Cochlear Dose on Hearing Preservation Following Stereotactic Radiosurgery in Treatment of Vestibular Schwannomas: A Multi-Center Study.

OBJECTIVE: Stereotactic radiosurgery (SRS) is a well-established treatment for vestibular schwannomas (VS). Hearing loss remains a main morbidity of VS and its treatments, including SRS. The effects of radiation parameters of SRS on hearing remain unknown. The goal of this study is to determine the effect of tumor volume, patient demographics, pretreatment hearing status, cochlear radiation dose, total tumor radiation dose, fractionation, and other radiotherapy parameters on hearing deterioration. METHODS: Multicenter retrospective analysis of 611 patients who underwent SRS for VS from 1990-2020 and had pre- and post-treatment audiograms. RESULTS: Pure tone averages (PTAs) increased and word recognition scores (WRSs) decreased in treated ears at 12-60 months while remaining stable in untreated ears. Higher baseline PTA, higher tumor radiation dose, higher maximum cochlear dose, and usage of single fraction resulted in higher post radiation PTA; WRS was only predicted by baseline WRS and age. Higher baseline PTA, single fraction treatment, higher tumor radiation dose, and higher maximum cochlear dose resulted in a faster deterioration in PTA. Below a maximum cochlear dose of 3 Gy, there were no statistically significant changes in PTA or WRS. CONCLUSIONS: Decline of hearing at one year in VS patients after SRS is directly related to maximum cochlear dose, single versus 3-fraction treatment, total tumor radiation dose, and baseline hearing level. The maximum safe cochlear dose for hearingtbrowd preservation at one year is 3 Gy, and the use of 3 fractions instead of one fraction was better at preserving hearing.

Distinctive patterns of alterations in proton efflux from goldfish retinal horizontal cells monitored with self-referencing H⁺-selective electrodes.

The H(+) hypothesis of lateral feedback inhibition in the outer retina predicts that depolarizing agents should increase H(+) release from horizontal cells. To test this hypothesis, self-referencing H(+) -selective microelectrodes were used to measure extracellular H(+) fluxes from isolated goldfish horizontal cells. We found a more complex pattern of cellular responses than previously observed from horizontal cells of other species examined using this technique. One class of cells had an initial standing signal indicative of high extracellular H(+) adjacent to the cell membrane; challenge with glutamate, kainate or high extracellular potassium induced an extracellular alkalinization. This alkalinization was reduced by the calcium channel blockers nifedipine and cobalt. A second class of cells displayed spontaneous oscillations in extracellular H(+) that were abolished by cobalt, nifedipine and low extracellular calcium. A strong correlation between changes in intracellular calcium and extracellular proton flux was detected in experiments simultaneously monitoring intracellular calcium and extracellular H(+) . A third set of cells was characterized by a standing extracellular alkalinization which was turned into an acidic signal by cobalt. In this last set of cells, addition of glutamate or high extracellular potassium did not significantly alter the proton signal. Taken together, the response characteristics of all three sets of neurons are most parsimoniously explained by activation of a plasma membrane Ca(2+) ATPase pump, with an extracellular alkalinization resulting from exchange of intracellular calcium for extracellular H(+) . These findings argue strongly against the hypothesis that H(+) release from horizontal cells mediates lateral inhibition in the outer retina.

Novelty preferences depend on goals.

People are sometimes drawn to novel items, but other times prefer familiar ones. In the present research we show, though, that both children's and adults' preferences for novel versus familiar items depend on their goals. Across four experiments, we showed 4- to 7-year-olds (total N = 498) and adults (total N = 659) pairs of artifacts where one was familiar and the other was novel (e.g., a four-legged chair and ten-legged chair). In Experiment 1, children wanted to have familiar artifacts, but to learn about novel ones. Experiment 2 replicated this pattern using a simpler procedure, and found the same pattern in adults. In Experiment 3, 4- to 6-year-olds and adults more strongly preferred familiar items when choosing which they would rather have than when choosing which they would rather try using. Finally, Experiment 4 replicated adults' preferences to have familiar items and learn about novel ones with an additional set of items. Together these findings show that preferences for novelty depend on people's goals. We suggest these effects arise because children and adults are motivated both by the promise of information and the desire for safe options in high commitment decisions that entail risk.

Fully Automated Measurement of Cochlear Duct Length From Clinical Temporal Bone Computed Tomography.

OBJECTIVES/HYPOTHESIS: To present and validate a novel fully automated method to measure cochlear dimensions, including cochlear duct length (CDL). STUDY DESIGN: Cross-sectional study. METHODS: The computational method combined 1) a deep learning (DL) algorithm to segment the cochlea and otic capsule and 2) geometric analysis to measure anti-modiolar distances from the round window to the apex. The algorithm was trained using 165 manually segmented clinical computed tomography (CT). A Testing group of 159 CTs were then measured for cochlear diameter and width (A- and B-values) and CDL using the automated system and compared against manual measurements. The results were also compared with existing approaches and historical data. In addition, pre- and post-implantation scans from 27 cochlear implant recipients were studied to compare predicted versus actual array insertion depth. RESULTS: Measurements were successfully obtained in 98.1% of scans. The mean CDL to 900° was 35.52 mm (SD, 2.06; range, [30.91-40.50]), the mean A-value was 8.88 mm (0.47; [7.67-10.49]), and mean B-value was 6.38 mm (0.42; [5.16-7.38]). The R2 fit of the automated to manual measurements was 0.87 for A-value, 0.70 for B-value, and 0.71 for CDL. For anti-modiolar arrays, the distance between the imaged and predicted array tip location was 0.57 mm (1.25; [0.13-5.28]). CONCLUSION: Our method provides a fully automated means of cochlear analysis from clinical CTs. The distribution of CDL, dimensions, and cochlear quadrant lengths is similar to those from historical data. This approach requires no radiographic experience and is free from user-related variation. LEVEL OF EVIDENCE: 3 Laryngoscope, 132:449-458, 2022.

Influence of electrode to cochlear duct length ratio on post-operative speech understanding outcomes.

OBJECTIVE: To assess whether the pre-operative electrode to cochlear duct length ratio (ECDLR), is associated with post-operative speech recognition outcomes. STUDY DESIGN: A retrospective chart review study. SETTING: Tertiary referral center. PATIENTS: The study included sixty-one adult CI recipients with a pre-operative computed tomography scan and a speech recognition test 12 months after implantation. INTERVENTIONS: The average of two raters' cochlear duct length (CDL) measurements and the length of the recipient's cochlear implant electrode array formed the basis for the electrode-to-cochlear duct length ratio (ECLDR). Speech recognition tests were compared as a function of ECDLR and electrode array length itself. MAIN OUTCOME MEASURES: The relationship between ECDLR and percent correct on speech recognition tests. RESULTS: A second order polynomial regression relating ECDLR to percent correct on the CNC words speech recognition test was statistically significant, as was a fourth order polynomial regression for the AzBio Quiet test. In contrast, there was no statistically significant relationship between speech recognition scores and electrode array length. CONCLUSIONS: ECDLR values can be statistically associated to speech-recognition outcomes. However, these ECDLR values cannot be predicted by the electrode length alone, and must include a measure of CDL.

Spectroscopic Studies of Zwitterionic DDAPS at Planar and Droplet Oil/Water Interfaces.

Developing the knowledge on surfactant interfacial phenomena is highly valuable for the advancement of technological, commercial, and industrial products, as these applications often rely on interfacial and colloidal chemistry. Zwitterionic surfactants are a less toxic alternative to standard charged surfactants. With both positively charged quaternary ammonium and negatively charged sulfonate constituents, zwitterionic DDAPS can have diverse interfacial interactions with various coadditives. In this work, we investigate DDAPS adsorption to a planar oil/water interface and its stabilization of oil-in-water nanoemulsions. By studying both interfacial geometries with surface-specific, nonlinear spectroscopy, we gain deeper insights and a molecular perspective into DDAPS's behavior in the presence of various salts and cosurfactants. From an application standpoint, zwitterionic surfactants are often mixed with other chemicals or used in an environment with pre-existing chemicals (e.g., ocean water during oil remediation). Thus, it is important to understand how such coadditives alter DDAPS's behavior and its performance as an emulsifier. Our results show that DDAPS is nearly uninfluenced by coadditives at a planar oil/water interface, but the identical coadditives are crucial for DDAPS to form and stabilize nanoemulsions. Additionally, the surfactant packing properties vary between interfaces as well as coadditives, indicating that certain interactions with the DDAPS headgroup are stronger and play a greater role in tuning DDAPS's interfacial behavior.

Outcomes in Patients Meeting Cochlear Implant Criteria in Noise but Not in Quiet.

OBJECTIVE: Evaluate outcomes in cochlear implant (CI) recipients qualifying in AzBio noise but not quiet, and identify factors associated with postimplantation improvement. STUDY DESIGN: Retrospective cohort study. SETTING: Tertiary otology/neurotology clinic. PATIENTS: This study included 212 implanted ears. The noise group comprised 23 ears with preoperative AzBio more than or equal to 40% in quiet and less than or equal to 40% in +10 signal-to-noise ratio (SNR). The quiet group included 189 ears with preoperative AzBio less than 40% in quiet. The two groups displayed similar demographics and device characteristics. INTERVENTIONS: Cochlear implantation. MAIN OUTCOME MEASURES: AzBio in quiet and noise. RESULTS: Mean AzBio quiet scores improved in both the quiet group (pre-implant: 12.7%, postimplant: 67.2%, p < 0.001) and noise group (pre-implant: 61.6%, postimplant: 73.8%, p = 0.04). Mean AzBio +10 SNR also improved in the quiet group (pre-implant: 15.8%, postimplant: 59.3%, p = 0.001) and noise group (pre-implant: 30.5%, postimplant: 49.1%, p = 0.01). However, compared with the quiet group, fewer ears in the noise group achieved within-subject improvement in AzBio quiet (≥15% improvement; quiet group: 90.3%, noise group: 43.8%, p < 0.001) and AzBio +10 SNR (quiet group: 100.0%, noise group: 45.5%, p < 0.001). Baseline AzBio quiet (p < 0.001) and Consonant-Nucleus-Consonant (CNC) scores (p = 0.004) were associated with within-subject improvement in AzBio quiet and displayed a higher area under the curve than either aided or unaided pure-tone average (PTA) (both p = 0.01). CONCLUSIONS: CI patients qualifying in noise display significant mean benefit in speech recognition scores but are less likely to benefit compared with those qualifying in quiet. Patients with lower baseline AzBio quiet scores are more likely to display postimplant improvement.

Perceptions of the local food environment and fruit and vegetable intake in the Eastern Caribbean Health Outcomes research Network (ECHORN) Cohort study.

INTRODUCTION: Studies conducted in the US and other high-income countries show that the local food environment influences dietary intakes that are protective for cardiovascular health.However, few studies have examined this relationship in the Caribbean. This study aimed to determine whether perceptions of the local food environment were associated with fruit and vegetable (FV) intake in the Eastern Caribbean, where daily FV intake remains below recommended levels. METHODS: Cross-sectional analysis of Eastern Caribbean Health Outcomes Research Network Cohort Study (ECS) baseline data (2013-2016) from Barbados, Puerto Rico, Trinidad and Tobago, and US Virgin Islands was conducted in 2020. The National Cancer Institute Dietary Screener Questionnaire was adapted to measure daily servings of FV. Existing scales were used to assess participant perceptions of the food environment (availability, affordability, and quality). Chi-square tests and Poisson regression were used for analyses. RESULTS: Participants reported eating one mean daily serving of FV. Mean daily intake was higher among those who perceived FV as usually/always affordable, available, and high quality. Multivariate results showed statistically significant associations between FV and affordability. Persons who perceived FV as affordable had 0.10 more daily servings of FV compared to those who reported FV as not always affordable (p = 0.02). Food insecurity modified the association between affordability and FV intake. CONCLUSIONS: This study highlights the importance of affordability in consumption of FV in the Eastern Caribbean, and how this relationship may be modified by food insecurity.

The Outcome of Cochlear Implantations in Deaf-Blind Patients: A Multicenter Observational Study.

OBJECTIVE: This multicenter study aimed to evaluate the auditory and speech outcomes of cochlear implantation (CI) in deaf-blind patients compared with deaf-only patients. STUDY DESIGN: Retrospective cohort study. SETTING: Multiple cochlear implant centers. PATIENTS: The current study was conducted on 17 prelingual deaf-blind children and 12 postlingual deaf-blind adults who underwent CI surgery. As a control group, 17 prelingual deaf children and 12 postlingual deaf adults were selected. INTERVENTION: Cochlear implantation. MAIN OUTCOME MEASURES: Auditory and linguistic performances in children were assessed using the categories of auditory performance (CAP) and Speech Intelligibility Rating (SIR) scales, respectively. The word recognition score (WRS) was also used to measure speech perception ability in adults. The mean CAP, SIR, and WRS cores were compared between the deaf-only and deaf-blind groups before CI surgery and at "12 months" and "24 months" after device activation. Cohen's d was used for effect size estimation. RESULTS: We found no significant differences in the mean CAP and SIR scores between the deaf-blind and deaf-only children before the CI surgery. For both groups, SIR and CAP scores improved with increasing time after the device activation. The mean CAP scores in the deaf-only children were either equivalent or slightly higher than those of the deaf-blind children at "12 months post-CI" (3.94 ± 0.74 vs 3.24 ± 1.25; mean difference score, 0.706) and "24 months post-CI" (6.01 ± 0.79 vs 5.47 ± 1.06; mean difference score, 0.529) time intervals, but these differences were not statistically significant. The SIR scores in deaf-only implanted children were, on average, 0.870 scores greater than the deaf-blind children at "12 months post-CI" (2.94 ± 0.55 vs 2.07 ± 1.4; p = 0.01, d = 0.97) and, on average, 1.067 scores greater than deaf-blind children at "24 months post-CI" (4.35 ± 0.49 vs 3.29 ± 1.20; p = 0.002; d = 1.15) time intervals. We also found an improvement in WRS scores from the "preimplantation" to the "12-month post-CI" and "24-month post-CI" time intervals in both groups. Pairwise comparisons indicated that the mean WRS in the deaf-only adults was, on average, 10.61% better than deaf-blind implanted adults at "12 months post-CI" (62.33 ± 9.09% vs 51.71 ± 10.73%, p = 0.034, d = 1.06) and, on average, 15.81% better than deaf-blind adults at "24-months post-CI" (72.67 ± 8.66% vs 56.8 ± 9.78%, p = 0.002, d = 1.61) follow-ups. CONCLUSION: Cochlear implantation is a beneficial method for the rehabilitation of deaf-blind patients. Both deaf-blind and deaf-only implanted children revealed similar auditory performances. However, speech perception ability in deaf-blind patients was slightly lower than the deaf-only patients in both children and adults.

Peeling back the layers: Investigating the effects of polyelectrolyte layering on surface structure and stability of oil-in-water nanoemulsions.

HYPOTHESIS: Layer-by-layer deposition of polyelectrolytes is a useful technique for modifying surface functionalities. For drug delivery systems, alternating layers of biopolymers coat nanoemulsions, which house and protect the cargo until the time and destination of delivery. Here, we investigate molecular factors contributing to the stability and interfacial properties of nanoemulsions prepared by a co-adsorption of polymers poly(styrene sulfonate) and polyethylenimine (PEI), and surfactant dodecyltrimethylammonium bromide. We hypothesize the interplay between electrosteric and hydrophobic effects upon multi-polymer co-adsorption contributes to both macroscopic and molecular-level interfacial properties of nanoemulsions. EXPERIMENTS: To probe interfacial layering properties, we use vibrational sum frequency scattering spectroscopy with ζ-potential measurements to determine the adsorptive behavior and molecular conformational arrangement of the polymer layers. Complementing these interfacial studies are dynamic light scattering experiments measuring the nanoemulsion size distribution and polydispersity index over a 30-day period. FINDINGS: Our light scattering, ζ-potential, and spectroscopic results of the nanoemulsion surface show that the duration of droplet stability and the degree of molecular orientation of adsorbed polymers can be tuned by surfactant concentration, PEI concentration, and pH. These results illustrate how molecular surface properties of multi-polymer coated nanoemulsions contribute to synergistic effects and droplet stability, enabling advancements in applications surrounding biopharmaceuticals, cosmetics, and food sciences.