Social determinants of health and their impact on postcolectomy surgery readmissions: a multistate analysis, 2009-2014.

Aim: To examine the effect of race/ethnicity, insurance status and median household income on postoperative readmissions following colectomy. Patients & methods: Multivariate analysis of hospital discharge data from California, Florida, Maryland and New York from 2009 to 2014. Primary outcomes included adjusted odds of 30- and 90-day readmissions following colectomy by race, insurance status and median income quartile. Results: Total 330,840 discharges included. All 30-day readmissions were higher for black patients (adjusted odds ratio [aOR]: 1.07). Both 30- and 90-day readmissions were higher for Medicaid (aOR: 1.30 and 1.26) and Medicare (aOR: 1.30 and 1.29). The 30- and 90-day readmissions were lower in the highest income quartiles. Conclusion: Race, insurance status and median household income are all independent predictors of disparity in readmissions following colectomy.

Versatile biomimetic conductive polypyrrole films doped with hyaluronic acid of different molecular weights.

Electrically conductive polypyrrole (PPy) is an intriguing biomaterial capable of efficient electrical interactions with biological systems. Especially, biomimetic PPy-based biomaterials incorporating biomolecules, such as hyaluronic acid (HA), can impart the characteristic biological interactions with living cells/tissues to the conductive biomaterials. Here we report the effects of the molecular weight (MW) of HA on PPy-based biomaterials. We utilized HA of a wide range of MW (35 × 103 Da-3 × 106 Da) as dopants during the electrochemical production of PPy/HA films and their characterization of materials and cellular interactions. With increases in the MWs of HA dopants, PPy/HA exhibited more hydrophilic, higher electrochemical activity and lower impedance. In vitro studies revealed that PPy films doped with low MW HA were supportive to cell adhesion and growth, while PPy films doped with high MW HA were resistant to cell attachment. Subcutaneous implantation of the PPy/HA films for 4 weeks revealed that all the PPy/HA films were tissue compatible. We successfully demonstrate the importance of HA dopant MWs in modulating the chemical and electrical properties of the materials and cellular responses to the materials. Such materials have potential for various biomedical applications, including as tissue engineering scaffolds and as electrodes for neural recording and neuromodulation. STATEMENT OF SIGNIFICANCE: Hyaluronic acid (HA)-doped polypyrrole (PPy) films were electrochemically synthesized as novel biomimetic conductive materials capable of efficient electrical signaling and preferential biological interactions. Molecular weights (MWs) of HA varied in a wide range (35 × 103-2 × 106 Da) and critically determine chemical, electrochemical, and biological properties of PPy/HA. Especially, PPy films with low MW HA markedly support cell adhesion and growth, while PPy films with high MW HA are resistant to cell attachment. Furthermore, PPy/HA exhibits greatly improved tissue compatibility and in vivo EMG signal recording ability. We for the first time demonstrate that biomimetic PPy/HA-based biomaterials can serve as versatile and effective platforms for various biomedical applications, such as tissue engineering scaffolds and bioelectrodes.

Electrochemical deposition of conductive and adhesive polypyrrole-dopamine films.

Electrode surfaces have been widely modified with electrically conductive polymers, including polypyrrole (PPY), to improve the performance of electrodes. To utilize conductive polymers for electrode modification, strong adhesion between the polymer films and electrode substrates should be ensured with high electrical/electrochemical activities. In this study, PPY films were electrochemically polymerized on electrodes (e.g., indium tin oxide (ITO)) with dopamine as a bio-inspired adhesive molecule. Efficient and fast PPY electrodeposition with dopamine (PDA/PPY) was found; the resultant PDA/PPY films exhibited greatly increased adhesion strengths of up to 3.7 ± 0.8 MPa and the modified electrodes had electrochemical impedances two to three orders of magnitude lower than that of an unmodified electrode. This electrochemical deposition of adhesive and conductive PDA/PPY offers a facile and versatile electrode modification for various applications, such as biosensors and batteries.

Impedance changes according to the degree of atopi dermatitis in mice.

Variations in electrical impedance over frequency might be used to distinguish the degree of atopic dermatitis (AD), even if the mechanisms of the skin barrier impairment due to AD are still unknown. We observed the skin bioimpedance of normal mice and of abnormal mice having atopic with instrument measuring electrical impedance. Electrical impedance was measured from 20 Hz to 1 MHz at many frequencies and normalized with several indices such as IMP, PIX, IMIX, RIX, and et al. to reduce variation in subjects. The results showed the high relationship between subjective score and indices, especially, the capacitance change and impedance ratio, abs(Z(1 kHz))/abs(Z(10 kHz)). These results indicate electrical impedance may be a promising clinical diagnostic tool to monitor prognosis of skin care for atopic dermatitis. Using developed software application we easily acquired complex impedance data from the instrument and got the analysis results for very kinds of frequency. This may be useful in various bioimpedance studies such as skin cancer assessment or body composition analysis, or etc.

Dietary conjugated linoleic acid increases the mRNA ratio of Bax/Bcl-2 in the colonic mucosa of rats.

Previously we have shown that dietary conjugated linoleic acid (CLA) significantly decreased colon tumor incidence in rats injected with 1,2-dimenthylhydrazine (DMH). The present study was performed to explore the mechanisms responsible for the anticarcinogenic effect of CLA. Four groups of rats received either vehicle or intramuscular injections of DMH at the dose of 15 mg/kg body weight twice per week for 6 weeks and were fed a diet containing either 0% or 1.0% CLA ad libitum for 14 weeks. Dietary CLA decreased cellular proliferation and induced apoptosis in the colonic mucosa of both vehicle and DMH-treated rats. Mucosal levels of prostaglandin (PG) E(2), thromboxane B(2), and 1,2-diacylglycerol decreased in rats fed the 1% CLA diet, whereas cyclooxygenase-2 levels were not affected. Arachidonate content of mucosal phospholipids decreased significantly in rats fed the 1% CLA diet. Reverse transcriptase-polymer chain reaction analysis revealed that the Bax/Bcl-2 transcript ratio was significantly increased in rats fed 1% CLA. To examine whether the 1% CLA diet reduces tumor incidence, the DMH-treated rats were continuously fed the assigned diets for 30 weeks. Tumor incidence was significantly decreased in the CLA-fed group. In conclusion, our findings are consistent with the hypothesis that CLA decreases the incidence of colon cancer by decreasing cellular proliferation and inducing apoptosis of the colonic mucosa. These effects may be due in part to decreased PGE(2) levels and increased Bax/Bcl-2 ratios.

Trans-10,cis-12-conjugated linoleic acid inhibits Caco-2 colon cancer cell growth.

A commercially available mixture of conjugated linoleic acid (CLA) isomers decreases colon cancer cell growth. We compared the individual potencies of the two main isomers in this mixture [cis-9,trans-11 (c9t11) and trans-10,cis-12 (t10c12)] and assessed whether decreased cell growth is related to changes in secretion of insulin-like growth factor II (IGF-II) and/or IGF-binding proteins (IGFBPs), which regulate Caco-2 cell proliferation. Cells were incubated in serum-free medium with different concentrations of the individual CLA isomers. t10c12 CLA dose dependently decreased viable cell number (55 +/- 3% reduction 96 h after adding 5 microM t10c12 CLA). t10c12 CLA induced apoptosis and decreased DNA synthesis, whereas c9t11 CLA had no effect. Immunoblot analysis of 24-h serum-free conditioned medium using a monoclonal anti-IGF-II antibody revealed that Caco-2 cells secreted both a mature 7,500 molecular weight (M(r)) IGF-II and higher M(r) forms of IGF-II. The levels of the higher M(r) and the mature form of IGF-II were decreased 50 +/- 3% and 22 +/- 2%, respectively, by 5 microM t10c12 CLA. c9t11 CLA had no effect. Ligand blot analysis of conditioned medium using 125I-labeled IGF-II revealed that t10c12 CLA slightly decreased IGFBP-2 production; c9t11 CLA had no effect. Exogenous IGF-II reversed t10c12 CLA-induced growth inhibition and apoptosis. These results indicate that CLA-inhibited Caco-2 cell growth is caused by t10c12 CLA and may be mediated by decreasing IGF-II secretion in Caco-2 cells.