The Role of Lipid Intrinsic Curvature in the Droplet Interface Bilayer.

Model bilayers are constructed from lipids having different intrinsic curvatures using the droplet interface bilayer (DIB) method, and their static physicochemical properties are determined. Geometrical and tensiometric measurements are used to derive the free energy of formation (ΔF) of a two-droplet DIB relative to a pair of isolated aqueous droplets, each decorated with a phospholipid monolayer. The lipid molecules employed have different headgroup sizes but identical hydrophobic tail structure, and each is characterized by an intrinsic curvature value (c0) that increases in absolute value with decreasing size of headgroup. Mixtures of lipids at different ratios were also investigated. The role of curvature stress on the values of ΔF of the respective lipid bilayers in these model membranes is discussed and is illuminated by the observation of a decrement in ΔF that scales as a near linear function of c02. Overall, the results reveal an association that should prove useful in studies of ion channels and other membrane proteins embedded in model droplet bilayer systems that will impact the understanding of protein function in cellular membranes composed of lipids of high and low curvature.

Effects of noise exposure on stress hormone changes during task performance in young Korean men: quasi-experimental study.

Numerous studies have suggested that noise exposure might be associated with changes in stress hormone levels. However, quantitative evidence for these effects in humans is rare and remains controversial. This study aimed to investigate the acute effects of exposure to noise and its different levels on stress hormone changes in task performance. Quasi-experimental noise exposure environment was established for 90 male university student volunteers in their twenties, and each was exposed to different noise levels during task performance. The stress hormones tested included cortisol, adrenocorticotropic hormone (ACTH), adrenaline, and noradrenaline. A one-way ANOVA was performed to investigate differences in hormone levels measured in the three groups according to the noise exposure levels (35, 45, or 75 dB). Analysis of covariance (ANCOVA) was used to adjust for confounding factors that might affect hormone levels. After adjusting for confounders, significant exposure-dependent differences were found in hormone levels in salivary cortisol, serum cortisol, serum ACTH, and serum adrenaline. The amount of hormonal increase in 75 dB exposure group compared to 35 or 45 dB groups was detected. Similar results were also seen in the rate of change analysis. Our findings indicate that short-term noise exposure during task performance elevates stress hormone levels. Further, the extent of stress hormone alterations varies with noise exposure levels. Changes in hormone levels are an objective measure that may be used to identify health effects and stress responses in various noise environments.

Nontraditional Roles of Magnesium Ions in Modulating Sav2152: Insight from a Haloacid Dehalogenase-like Superfamily Phosphatase from Staphylococcus aureus.

Methicillin-resistant Staphylococcus aureus (MRSA) infection has rapidly spread through various routes. A genomic analysis of clinical MRSA samples revealed an unknown protein, Sav2152, predicted to be a haloacid dehalogenase (HAD)-like hydrolase, making it a potential candidate for a novel drug target. In this study, we determined the crystal structure of Sav2152, which consists of a C2-type cap domain and a core domain. The core domain contains four motifs involved in phosphatase activity that depend on the presence of Mg2+ ions. Specifically, residues D10, D12, and D233, which closely correspond to key residues in structurally homolog proteins, are responsible for binding to the metal ion and are known to play critical roles in phosphatase activity. Our findings indicate that the Mg2+ ion known to stabilize local regions surrounding it, however, paradoxically, destabilizes the local region. Through mutant screening, we identified D10 and D12 as crucial residues for metal binding and maintaining structural stability via various uncharacterized intra-protein interactions, respectively. Substituting D10 with Ala effectively prevents the interaction with Mg2+ ions. The mutation of D12 disrupts important structural associations mediated by D12, leading to a decrease in the stability of Sav2152 and an enhancement in binding affinity to Mg2+ ions. Additionally, our study revealed that D237 can replace D12 and retain phosphatase activity. In summary, our work uncovers the novel role of metal ions in HAD-like phosphatase activity.

Distribution of volatile organic compounds by distance from industrial complexes and potential health impact on the residents.

Volatile organic compounds (VOCs) are the air pollutants emitted from the petrochemical industry known to pose adverse health effects on workers. The database based on the third phase of The Environmental Health Study in the Korean National Industrial Complexes (EHSNIC) in Ulsan conducted from 2018 to 2021 was used. Subjects were divided into the exposed and control group according to the estimated pollution level and distances from the industrial complexes. Ambient benzene, ethylbenzene, and xylene were significantly higher in the exposed group compared to the controls, as well as their metabolites. Risk of chronic disease and atopic dermatitis was higher in the exposed group which was supported by higher serum inflammatory markers and high hazard index of the exposed region. These results can draw attention to people engaged with environmental plans and used as primary data when making policies to reduce pollutant levels around industrial complexes.

Aspirin Interacts with Cholesterol-Containing Membranes in a pH-Dependent Manner.

Aspirin has been used for broad therapeutic treatment, including secondary prevention of cardiovascular disease associated with increased cholesterol levels. Aspirin and other nonsteroidal anti-inflammatory drugs have been shown to interact with lipid membranes and change their biophysical properties. In this study, mixed lipid model bilayers made from 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphatidylcholine (POPC) or 1,2-dioleoyl-sn-glycero-3-phosphatidylcholine (DOPC) comprising varying concentrations of cholesterol (10:1, 4:1, and 1:1 mole ratio of lipid:chol), prepared by the droplet interface bilayer method, were used to examine the effects of aspirin at various pH on transbilayer water permeability. The presence of aspirin increases the water permeability of POPC bilayers in a concentration-dependent manner, with a greater magnitude of increase at pH 3 compared to pH 7. In the presence of cholesterol, aspirin is similarly shown to increase water permeability; however, the extent of the increase depends on both the concentration of cholesterol and the pH, with the least pronounced enhancement in water permeability at high cholesterol levels at pH 7. A fusion of data from differential scanning calorimetry, confocal Raman microspectrophotometry, and interfacial tensiometric measurements demonstrates that aspirin can promote significant thermal, structural, and interfacial property perturbations in the mixed-lipid POPC or DOPC membranes containing cholesterol, indicating a disordering effect on the lipid membranes. Our findings suggest that aspirin fluidizes phosphocholine membranes in both cholesterol-free and cholesterol-enriched states and that the overall effect is greater when aspirin is in a neutral state. These results confer a deeper comprehension of the divergent effects of aspirin on biological membranes having heterogeneous compositions, under varying physiological pH and different cholesterol compositions, with implications for a better understanding of the gastrointestinal toxicity induced by the long term use of this important nonsteroidal anti-inflammatory molecule.

Clinical and Economic Impact of Pharmacists' Intervention on Care of Pediatric Hematology and Oncology Patients.

INTRODUCTION: Children with cancer may be one of the most vulnerable groups to drug-related adverse events because they possess characteristics of patients with cancer as well as pediatric patients. To evaluate the clinical and economic impact of pharmacists' intervention on the care of pediatric hematology and oncology patients in the inpatient and outpatient settings of a children's hospital. METHODS: The pharmacist-intervention records from 2017 were retrospectively reviewed. Intervention rate, type of drug-related problems, acceptance rate, and frequently involved drugs in pharmacist interventions were analyzed. One physician and one pharmacist evaluated the clinical significance of each intervention. A cost-benefit analysis was conducted from hospital and patient perspective. The benefit from cost savings by reducing the number of prescribed drugs that are disposed was estimated as the benefit from hospital perspective. The benefit from cost avoidance based on the potential to avoid an adverse drug event (ADE) was estimated as the benefit from patient perspective. The cost of reviewing prescriptions was estimated based on the pharmacists' salary and the time involved. RESULTS: In 2017, 2361 interventions were performed in 381 pediatric patients with cancer. The acceptance rate was 97.2%. More than half of the interventions were regarded as clinically "significant" (58.8%) and "very significant" (14.6%). The cost-benefit of US$28,705 was determined from hospital perspective, with a cost-benefit ratio of 1.45:1. The cost-benefit of US$35,611 was calculated from patient perspective, with a cost-benefit ratio of 1.55:1. CONCLUSIONS: Pharmacists' intervention in the care of hematology and oncology pediatric patients was effective in preventing clinically significant ADEs and had a positive economic impact on the health-care budget from both hospital and patient perspective.

Developing a Multimodal Monitoring System for Geriatric Depression: A Feasibility Study.

The Internet of Medical Things is promising for monitoring depression symptoms. Therefore, it is necessary to develop multimodal monitoring systems tailored for elderly individuals with high feasibility and usability for further research and practice. This study comprised two phases: (1) methodological development of the system; and (2) system validation to evaluate its feasibility. We developed a system that includes a smartphone for facial and verbal expressions, a smartwatch for activity and heart rate monitoring, and an ecological momentary assessment application. A sample of 21 older Koreans aged 65 years and more was recruited from a community center. The 4-week data were collected for each participant (n = 19) using self-report questionnaires, wearable devices, and interviews and were analyzed using mixed methods. The depressive group (n = 6) indicated lower user acceptance relative to the nondepressive group (n = 13). Both groups experienced positive emotions, had regular life patterns, increased their self-interest, and stated that a system could disturb their daily activities. However, they were interested in learning new technologies and actively monitored their mental health status. Our multimodal monitoring system shows potential as a feasible and useful measure for acquiring mental health information about geriatric depression.

Trans-Resveratrol Decreases Membrane Water Permeability: A Study of Cholesterol-Dependent Interactions.

Resveratrol (RSV), a biologically active plant phenol, has been extensively investigated for cancer prevention and treatment due to its ability to regulate intracellular targets and signaling pathways which affect cell growth and metastasis. The non-specific interactions between RSV and cell membranes can modulate physical properties of membranes, which in turn can affect the conformation of proteins and perturb membrane-hosted biological functions. This study examines non-specific interactions of RSV with model membranes having varying concentrations of cholesterol (Chol), mimicking normal and cancerous cells. The perturbation of the model membrane by RSV is sensed by changes in water permeability parameters, using Droplet Interface Bilayer (DIB) models, thermotropic properties from Differential Scanning Calorimetry, and structural properties from confocal Raman spectroscopy, all of which are techniques not complicated by the use of probes which may themselves perturb the membrane. The nature and extent of interactions greatly depend on the presence and absence of Chol as well as the concentration of RSV. Our results indicate that the presence of RSV decreases water permeability of lipid membranes composed of 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC), indicating a capability for RSV in stiffening fluidic membranes. When Chol is present, however, (at 4:1 and 2:1 mol ratio DOPC to cholesterol), the addition of RSV has no significant effect upon the water permeability. DSC thermograms show that RSV interacts with DOPC and DOPC/Chol bilayers and influences their thermotropic phase behavior in a concentration-dependent manner, by decreasing the main phase transition temperature and enthalpy, with a phase separation shown at the higher concentrations of RSV. Raman spectroscopic studies indicate an ordering effect of RSV on DOPC supported bilayer, with a lesser extent of ordering in the presence of Chol. Combined results from these investigations highlight a differential effect of RSV on Chol-free and Chol-enriched membranes, respectively, which results constitute a bellwether for increased understanding and effective use of resveratrol in disease therapy including cancer.

Preliminary report of de novo adipogenesis using novel bioabsorbable implants and image evaluation using a porcine model.

Our bioabsorbable poly-L-lactic acid (PLLA) mesh implants containing collagen sponge are replaced with adipose tissue after implantation, and this is an innovative method for breast reconstruction. In this preliminary study, we investigated the formation of adipose tissue and evaluated the process via multimodal images in a porcine model using an implant aggregate to generate the larger adipose tissue. The implant aggregate consists of PLLA mesh implants containing collagen sponge and a poly-glycolic acid woven bag covering them. We inserted the implant aggregates under the porcine mammary glands. Magnetic resonance imaging (MRI), ultrasonography (USG), and 3-dimensional (3D) surface imaging and histological evaluations were performed to evaluate the formation of adipose tissue over time. The volume of the implant aggregate and the formed adipose tissue inside the implant aggregate could be evaluated over time via MRI. The space within the implant aggregate was not confirmed on USG due to the acoustic shadow of the PLLA threads. The change in volume was not confirmed precisely using 3D surface imaging. Histologically, the newly formed adipose tissue was confirmed on the skin side of the implant aggregate. This implant aggregate has the ability to regenerate adipose tissue, and MRI is an appropriate method for the evaluation of the volume of the implant aggregation and the formation of adipose tissue.

The association of plasma cytokines including VEGF with recurrent wheezing in allergic patients.

BACKGROUND: Various cytokines have been studied to determine their functions in the pathogenesis of allergic diseases and their potential as therapeutic targets, but the roles and clinical applicability of many of these cytokines still remain unclear. OBJECTIVE: We aimed to measure the plasma levels of eight cytokines known to be relevant to allergic diseases, and to determine their association with the diagnostic characteristics of allergic patients. METHODS: The levels of a panel of eight cytokines (IL-5, IL-10, IL12p70, Leptin, CXCL5/ENA-78, CCL2/MCP-1, PDGFBB, and VEGF) were measured in plasma obtained from 83 allergic patients. We investigated whether the cytokine levels differed between children and adults. Statistical analyses were then performed to examine their association with the diagnostic characteristics of allergic patients. RESULTS: The levels of leptin, CCL2/MCP-1, PDGFBB, and VEGF were significantly higher in adult patients with allergic rhinitis than in children. Among patients with asthma, the levels of leptin and PDGFBB were elevated in adults. PDGFBB and VEGF levels were significantly associated with asthma. Interestingly, there was a significant association between VEGF level and recurrent wheezing regardless of the analyzed conditions. The levels of VEGF and PDGFBB or CCL2/MCP-1 showed a significant increase together in the presence of recurrent wheezing in child patients. CONCLUSIONS: The plasma levels of four cytokines, particularly VEGF, showed significant associations with some diagnostic characteristics in allergic patients. We suggested that plasma VEGF, which performs pleiotropic functions in allergic responses, could serve as a serological marker relevant to recurrent wheezing in allergic patients.

Janus Nanosheets with Face-Selective Molecular Recognition Properties from DNA-Peptide Conjugates.

Chemical and functional anisotropy in Janus materials offer intriguing possibilities for constructing complex nanostructures and regulating chemical and biological reactions. Here, the authors report the fabrication of Janus nanosheets from molecular building blocks composed of two information-carrying biopolymers, DNA and peptides. Experimental and structural modeling studies reveal that DNA-peptide diblock conjugates assemble into Janus nanosheets with distinct DNA and peptide faces. The surprising level of structural control is attributed to the exclusive parallel ß-sheet formation of phenylalanine-rich peptides. This approach is extended to triblock DNA1-peptide-DNA2 conjugates, which assemble into nanosheets presenting two different DNA on opposite faces. The Janus nanosheets with independently addressable faces are utilized to organize an enzyme pair for concerted enzymatic reactions, where enhanced catalytic activities are observed. These results demonstrate that the predictable and designable peptide interaction is a promising tool for creating Janus nanostructures with regio-selective and sequence-specific molecular recognition properties.

Ibuprofen and the Phosphatidylcholine Bilayer: Membrane Water Permeability in the Presence and Absence of Cholesterol.

The interactions between drugs and cell membranes can modulate the structural and physical properties of membranes. The resultant perturbations of the membrane integrity may affect the conformation of the proteins inserted within the membrane, disturbing the membrane-hosted biological functions. In this study, the droplet interface bilayer (DIB), a model cell membrane, is used to examine the effects of ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), on transbilayer water permeability, which is a fundamental membrane biophysical property. Our results indicate that the presence of neutral ibuprofen (pH 3) increases the water permeability of the lipid membranes composed of 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC). When cholesterol is present with the DOPC, however, the water permeability is not influenced by addition of ibuprofen, regardless of the cholesterol content in DOPC. Given the fact that cholesterol is generally considered to impact packing in the hydrocarbon chain regions, our findings suggest that a potential competition between opposing effects of ibuprofen molecules and cholesterol on the hydrocarbon core environment of the phospholipid assembly may influence the overall water transport phenomena. Results from confocal Raman microspectroscopy and interfacial tensiometry show that ibuprofen molecules induce substantial structural and dynamic changes in the DOPC lipid bilayer. These results, demonstrating that the presence of ibuprofen increases the water permeability of pure DOPC but not that of DOPC-cholesterol mixtures, provide insight into the differential effect of a representative NSAID on heterogeneous biological membranes, depending upon the local composition and structure, results which will signal increased understanding of the gastrointestinal damage and toxicity induced by these molecules.

Extremely Low-Profile Monopolar Microstrip Antenna with Wide Bandwidth.

In this paper, we propose a new monopolar microstrip antenna for a high-speed moving swarm sensor network. The proposed antenna shows an extremely thin substrate thickness supported with an omni-directional radiation pattern and wide operation frequency bandwidth. First, to achieve the low-profile monopolar microstrip antenna, the symmetrical center feeding network and the gap-coupled six arrayed patches which form a hexagonal microstrip radiator were utilized. The partially loaded ground-slots under the top patches were employed to improve the radiation performance and adjust the impedance bandwidth. Second, to obtain the broad bandwidth of the low-profile monopolar microstrip antenna, the degenerated non-fundamental TM02 modes, that is, even and odd TM02 modes, were carefully analyzed. To verify the feasibility of the degenerated TM02 mode operation, the parametric study of the proposed antenna was theoretically investigated and implemented with the optimized parameter dimensions. Finally, the fabricated antenna showed a 0.254 mm-thick substrate and demonstrates 1.5-wavelength resonant monopolar radiation with broad impedance bandwidth of 855 MHz and its factional bandwidth of 15.24% at the resonant frequency of 5.57 GHz.

Primary Care, Health Promotion, and Disease Prevention with Michigan Medicaid Expansion.

BACKGROUND: Medicaid expansion in Michigan, known as the Healthy Michigan Plan (HMP), emphasizes primary care and preventive services. OBJECTIVE: Evaluate the impact of enrollment in HMP on access to and receipt of care, particularly primary care and preventive services. DESIGN: Telephone survey conducted during January-November 2016 with stratified random sampling by income and geographic region (response rate = 53.7%). Logistic regression analyses accounted for sampling and nonresponse adjustment. PARTICIPANTS: 4090 HMP enrollees aged 19-64 with ≥ 12 months of HMP coverage MAIN MEASURES: Surveys assessed demographic factors, health, access to and use of health care before and after HMP enrollment, health behaviors, receipt of counseling for health risks, and knowledge of preventive services' copayments. Utilization of preventive services was assessed using Medicaid claims. KEY RESULTS: In the 12 months prior to HMP enrollment, 33.0% of enrollees reported not getting health care they needed. Three quarters (73.8%) of enrollees reported having a regular source of care (RSOC) before enrollment; 65.1% of those reported a doctor's office/clinic, while 16.2% reported the emergency room. After HMP enrollment, 92.2% of enrollees reported having a RSOC; 91.7% had a doctor's office/clinic and 1.7% the emergency room. One fifth (20.6%) of enrollees reported that, before HMP enrollment, it had been over 5 years since their last primary care visit. Enrollees who reported a visit with their primary care provider after HMP enrollment (79.3%) were significantly more likely than those who did not report a visit to receive counseling about health behaviors, improved access to cancer screening, new diagnoses of chronic conditions, and nearly all preventive services. Enrollee knowledge that some services have no copayments was also associated with greater utilization of most preventive services. CONCLUSIONS: After enrolling in Michigan's Medicaid expansion program, beneficiaries reported less forgone care and improved access to primary care and preventive services.

Associations Between Dietary Patterns and Handgrip Strength: The Korea National Health and Nutrition Examination Survey 2014-2016.

Objective: The age-related decline in handgrip strength (HGS) is an important indicator of weakening muscle strength concomitant with aging and sarcopenia. This study was to investigate the association between dietary patterns and HGS.Methods: In this cross-sectional study of 7,624 adults aged 19-64 years who were enrolled in the Korea National Health and Nutrition Examination Survey 2014-2016, we assessed HGS with a digital hand dynamometer while the participants adopted a standing position with their arms lowered. Their diets were examined with a food frequency questionnaire which included 112 food items and were categorized into 26 food groups. To determine the associations between dietary patterns and HGS, we employed a weighted multivariable linear regression model.Results: We identified two dietary patterns: the Prudent and the Western dietary patterns. Individuals in the highest tertile of the Prudent dietary pattern had the highest HGS scores (ß = 0.54, p < 0.001). No difference was found among the tertiles of the Western dietary pattern. Sex-specific stratification (2,953 men, 4,671 women) indicated that both sexes showed significant associations with HGS according to the tertiles of their factor loading scores in the Prudent dietary pattern (men, ß = 0.49, p = 0.014; women, ß = 0.51, p < 0.001).Conclusion: This cross-sectional study of 7,624 adults revealed a significantly positive association between HGS and the Prudent dietary pattern, even after adjusting for potential confounding factors.

Good to the Last Drop: Interfacial Droplet Chemistry, from Crystals to Biological Membranes.

The study of the liquid-liquid interface has a long and storied history yet still holds important implications for science and technology. Although deep examination of this buried interface poses challenges, recent progress in experimental and theoretical methodology has allowed for advanced understanding of the molecular bases of such interfaces. This Account will focus on the behavior of surfaces of aqueous microdroplets immersed in an immiscible phase, exhibiting physicochemical behavior dependent on the presence of interfacial self-assembled structures. Amphiphiles spontaneously form self-assembled nanostructures at the liquid interface, creating a soft liquid surface for the aqueous microdroplet that can modulate its behavior. A prominent characteristic of a micron-sized droplet is its elevated surface area/volume ratio, a feature that presents opportunities for investigating the role of the interface in aspects of droplet chemistry. In two notable examples, a surfactant self-assembly can act as a template for crystal nucleation of droplet solutes at the monolayer level, while at the level of a bilayer, formed when two monolayer-covered droplets are made to adhere, the apposition of monolayers bears remarkable similarities to cell membranes. Each type of system provides arbitrary control of important factors, both for studying crystallization nucleation and for modeling semipermeable lipid membranes at an interdroplet contact zone, the droplet interface bilayer (DIB). The droplet bilayer allows for direct observation of species transport across an unsupported bilayer and versatile parameter control to expore the effects of membrane lipid structure on bilayer transport. It is demonstrated that molecular shape for monoglycerides and phospholipids influences the surface characteristics of monolayers and bilayers. Additionally, subtle interfacial interactions between aqueous contents (ions, solutes) and the monolayer/bilayer are shown to have a marked influence on lipid packing and permeability. It is anticipated that this successful demonstration of surface engineering at the micron scale will deliver cogent insights into many biologically relevant phenomena, such as membrane transport and biomineralization.

Diagnosis and Care of Chronic Health Conditions Among Medicaid Expansion Enrollees: a Mixed-Methods Observational Study.

BACKGROUND: It is uncertain how Medicaid expansion under the Affordable Care Act influences the diagnosis of chronic health conditions, and the care and health of enrollees with chronic conditions. OBJECTIVE: Describe the prevalence of new and pre-existing chronic health conditions among Medicaid expansion enrollees. Examine whether perceived changes in specific types of access and self-rated health status differed between enrollees with chronic conditions and those without. Examine how gaining Medicaid coverage affected chronic disease management and well-being. DESIGN: Mixed-methods study including a telephone survey and semi-structured interviews. SETTING: Michigan's Medicaid expansion, the "Healthy Michigan Plan" (HMP). PARTICIPANTS: 4090 survey respondents (response rate 54%) with ≥ 12 months HMP enrollment and 67 interviewees with ≥ 6 months enrollment. MAIN MEASURES: Self-reported chronic condition diagnoses, changes in physical/mental health, and healthcare access. Descriptive survey data were adjusted for survey design and nonresponse. Semi-structured interview questions about how gaining HMP coverage led to changes in health status. KEY RESULTS: Among enrollees, 68% had a self-reported diagnosis of a chronic health condition; 42% of those were newly diagnosed since HMP enrollment. In multivariable models, enrollees with chronic conditions were significantly more likely to report improved physical (adjusted odds ratio (aOR) 1.70, 95% CI (1.40, 2.07)) and mental health (aOR 1.75, (1.43, 2.15)) since HMP enrollment than enrollees without chronic conditions. Among enrollees with chronic conditions, the strongest predictors of improvements in health were having seen a primary care physician, improved mental health care access, and improved medication access. Interviewees with chronic conditions described how increased access to health care led to improvements in both physical and mental health. CONCLUSIONS: Enrollees with expanded Medicaid coverage commonly reported detection of previously undiagnosed chronic conditions. Perceived health status and access improved more often among enrollees with chronic health conditions. Improved access was associated with improved physical and mental health among this vulnerable group.

Changes in Health and Ability to Work Among Medicaid Expansion Enrollees: a Mixed Methods Study.

BACKGROUND: Michigan expanded Medicaid under the Affordable Care Act (Healthy Michigan Plan [HMP]) to improve the health of low-income residents and the state's economy. OBJECTIVE: To understand HMP's impact on enrollees' health, ability to work, and ability to seek employment DESIGN: Mixed methods study, including 67 qualitative interviews and 4090 computer-assisted telephone surveys (response rate 53.7%) PARTICIPANTS: Non-elderly adult HMP enrollees MAIN MEASURES: Changes in health status, ability to work, and ability to seek employment KEY RESULTS: Half (47.8%) of respondents reported better physical health, 38.2% better mental health, and 39.5% better dental health since HMP enrollment. Among employed respondents, 69.4% reported HMP helped them do a better job at work. Among out-of-work respondents, 54.5% agreed HMP made them better able to look for a job. Among respondents who changed jobs, 36.9% agreed HMP helped them get a better job. In adjusted analyses, improved health was associated with the ability to do a better job at work (aOR 4.08, 95% CI 3.11-5.35, p < 0.001), seek a job (aOR 2.82, 95% CI 1.93-4.10, p < 0.001), and get a better job (aOR 3.20, 95% CI 1.69-6.09, p < 0.001), but not with employment status (aOR 1.08, 95% CI 0.89-1.30, p = 0.44). In interviews, several HMP enrollees attributed their ability to get or maintain employment to improved physical, mental, and dental health because of services covered by HMP. Remaining barriers to work cited by enrollees included older age, disability, illness, and caregiving responsibilities. CONCLUSIONS: Many low-income HMP enrollees reported improved health, ability to work, and job seeking after obtaining health insurance through Medicaid expansion.

Impact of the Terms "Regular" or "Pasable" as Spanish Translation for "Fair" of the Self-Rated Health Question Among US Latinos: A Randomized Experiment.

Objectives. To examine measurement comparability of a Spanish version of self-rated health (SRH) with pasable as an alternative to regular for the response category "fair" in the English version.Methods. We translated "fair" into 2 Spanish versions: regular and pasable. We implemented a split-half experiment in 3 surveys independently conducted from October 2015 to January 2016, from April to November 2016, and from August to November 2017. Within each survey, we randomly assigned Spanish-interviewed Latino respondents to 1 of the 2 SRH versions. The total sample included 3261 Latino and 738 non-Latino White adults in the United States.Results. Spanish-interviewed Latinos reported substantively more favorable health on SRH with pasable than with regular. When pasable instead of regular was used for SRH, we observed a larger difference between respondents reporting positive versus negative SRH on objective health measures, including the frequency of doctor's visits. Furthermore, when we accounted for correlates of health, Latino-White disparities were attenuated with pasable.Conclusions. We recommend using pasable instead of regular for SRH Spanish translations to improve measurement equivalence in cross-lingual and cross-cultural research.

Dietary Patterns Related to Appendicular Skeletal Muscle Mass: The Korea National Health and Nutrition Examination Survey 2008-2011.

OBJECTIVE: Muscle mass plays an important role in healthy aging among elderly adults. We investigated the association between dietary patterns and appendicular skeletal muscle mass (ASM) among 3,488 adults ages 60 years or older. METHODS: The Korea National Health and Nutrition Examination Survey (KNHANES) data for 2008-2011 were analyzed. Dietary information from a food frequency questionnaire was utilized. To identify dietary patterns, factor analysis was performed. Dual-energy x-ray absorptiometry was used to ascertain ASM. To examine the association between dietary patterns and ASM, a multivariable regression model was used after adjusting for potential confounding factors. RESULTS: Two dietary patterns were identified: Healthy and Western dietary patterns. The Healthy dietary pattern was characterized as high frequencies of intake in vegetables, fish, fruits, seaweeds, legumes, mushrooms, whole grains, potatoes, eggs, dairy products, and red meat. In contrast, the Western dietary pattern was characterized by high intake of red meat, bread, noodles, fast food, rice cake, poultry, and soft drinks. Men showed a significant association between the Healthy dietary pattern and higher ASM, even after adjusting for covariates (p value =0.034). CONCLUSION: In this cross-sectional study, we observed that men ages 60 years and older with the Healthy dietary pattern had higher muscle mass.