Near-Infrared Dual-Band LSPR Coupling in Oriented Assembly of Doped Metal Oxide Nanocrystal Platelets.

Coupling effects of localized surface plasmon resonance (LSPR) represent an efficient means to tune the plasmonic modes and to enhance the near-field. While LSPR coupling in metal nanoparticles has been extensively explored, limited attention has been given to heavily doped semiconductor nanocrystals. Here, we investigate the LSPR coupling behavior of Cs-doped tungsten oxide (CsxWO3-δ) nanocrystal platelets as they undergo an oriented assembly into parallel stacks. The oriented assembly was achieved by lowering the dispersion stability of the colloidal nanoplatelets, of which the basal surface was selectively ligand-functionalized. This assembly induces simultaneous blue-shifts and red-shifts of dual-mode LSPR peaks without compromising the intensity and quality factor. This stands in contrast to the significant damping, broadening, and overall red-shift of the LSPR observed in random assemblies. Computational simulations successfully replicate the experimental observations, affirming the potential of this coupling phenomenon of near-infrared dual-mode LSPR in diverse applications including solar energy, bio-optics, imaging, and telecommunications.

Systemic Lupus Erythematosus and the Ratio of Omega-3 to Omega-6 Fatty Acids Consumption among Women in the Adventist Health Study-2.

OBJECTIVE: To assess the associations of omega-3 and omega-6 fatty acids consumption, and the ratio between the two, with self-reported doctor told Systemic Lupus Erythematosus (SLE) diagnosis. Further, to assess whether initiation of omega-3 supplements intake was related to time/year of SLE diagnosis. METHODS: Data from 42,398 women in the Adventist Health Study-2 cohort were used for this cross-sectional study. Unconditional logistic regression modeling was used for all analyses with the following candidate covariates: age, race, education, smoking, and body mass index (BMI). RESULTS: Compared to non-cases, participants with a diagnosis of SLE reported higher intakes of total omega-3 fatty acids and about the same intakes of omega-6 fatty acids. Overall, they had higher ratios of omega-3 to omega-6 fatty acids. When assessing odds ratios of SLE diagnosis by quartiles of omega-3 to omega-6 and DHA+EPA to omega-6, there was a positive significant trend (p trend = 0.005). Additionally, among those reporting intake of fish oil, 87% had initiated fish oil consumption around the time of SLE diagnosis. SLE was more likely to occur among Black women compared to White women, among ever smokers compared to never smokers, among overweight women compared to women with normal/underweight, and among women 50-59 years compared to those 30-49 year old. When a smaller 6 year follow-up study identified 64 incident SLE cases and assessed their omega-3 intake at baseline (6 years earlier and before the SLE diagnosis) their intake of omega-3 and fish oil was no different than among non-cases. CONCLUSION: We observed a significant positive association between the ratio of omega-3 to omega-6 fatty acids consumption and prevalence of SLE. Among those with prevalent SLE, their year of starting supplementation of omega-3 and fish oil was closely linked to year of SLE diagnosis. Further, baseline intake of omega-3 fatty acids was not increased among 64 incident SLE cases identified during 6 years of follow-up. Our surprising finding can best be explained by reverse causation. This could be an example of how public health information is assimilated and acted upon by a health conscious public.

Synthetic TGF-ß Signaling Agonist-Treated Dendritic Cells Induce Tolerogenicity and Antirheumatic Effects.

The newly synthesized compound TGF-ß signaling agonist (T74) is a small molecule associated with the TGF-ß receptor signaling pathway. Tolerogenic dendritic cells (tDCs) have been used to examine immunosuppressive and anti-inflammatory effects in multiple autoimmune disease models. The aim of this study was to investigate whether treatment of DCs with T74 has an antirheumatic effect in a mouse model of collagen-induced arthritis (CIA). Bone marrow-derived cells were obtained from DBA/1J mice and differentiated into DCs. T74-treated DCs (T74-DCs) were generated by treating bone marrow-derived DCs with LPS, type II collagen, and T74. T74-DCs expressed lower levels of surface molecules and inflammatory cytokines associated with antigen presentation and T cell stimulation. The ability of T74-DCs to differentiate effector T cells was lower than that of T74-untreated DCs (NT-DCs), but T74-DCs increased the regulatory T (Treg) cell differentiation in vitro. DBA/1J mice received two subcutaneous (s.c.) injections of type II collagen to establish CIA. Mice then received two s.c. injections of T74-DCs or NT-DCs. Joint inflammation was ameliorated in the paws of T74-DC-treated mice. Additionally, Treg populations in T74-DC-treated mice were higher than in NT-DC-treated or PBS-treated CIA mice. Taken together, these results demonstrate that T74 induces tolerance in DCs, and that T74-mediated DCs exert antirheumatic effects via induction of Tregs.

The association between dietary patterns and a doctor diagnosis of systemic lupus erythematosus: the Adventist Health Study-2.

OBJECTIVE: The aim of our study was to assess the association between a diagnosis of Systemic Lupus Erythematosus (SLE) and dietary pattern as well as demographic factors among subjects in the Adventist Health Study-2 (AHS-2) cohort. METHODS: Multivariable logistic regression modeling was used to assess the association between prevalence of self-reported SLE and dietary patterns (vegetarian, pesco-vegetarian and non-vegetarian). Potential confounding variables included were age, gender, race, education, and smoking history among 77,795 AHS-2 participants. RESULTS: There was a dose-response association between the prevalence of SLE with vegetarian diets, ordered by content of animal meats. The stricter vegetarians had 25% lower odds of reporting that they were currently being treated for SLE (OR = 0.75, 95% CI 0.56, 1.02) with intermediate levels for the pesco-vegetarians who eat fish (OR 0.88, 95% CI 0.57, 1.36), compared to non-vegetarians. As expected, there were also significant associations between the prevalence of SLE with sex, race, age, and smoking. Significantly fewer men were diagnosed with SLE compared to women (OR = 0.14, 95% CI: 0.08, 0.22). Compared to non-Hispanic Whites, non-Hispanic Blacks were significantly more likely to report a diagnosis of SLE (OR 1.69, 95% CI 1.29, 2.21). A significantly lower proportion of 30-39 year olds (OR 0.51, 95% CI 0.29, 0.90) reported a diagnosis of SLE when compared to those 60 or older. Also, ever smokers were more likely to report prevalent SLE than those who had never smoked (OR 1.71, 95% CI 1.27, 2.31). CONCLUSION: We found that vegetarians had lower odds of doctor-diagnosed SLE with an increasing trend in prevalence from stricter vegetarians to pesco-vegetarians to non-vegetarians. We also note that the association with other demographic factors in AHS-2 was similar to that found in other studies. Future studies may focus on assessing the incidence and severity of the disease among vegetarians and non-vegetarians.

Lower Utilization of Colorectal Cancer Screening Among Vegetarians, Adventist Health Study-2.

This study aims to examine lifestyle predictors of the utilization of colorectal cancer screening. Using modified Poisson regression, we studied self-reported colorectal cancer screening utilization (colonoscopy or fecal occult blood test) with various dietary and lifestyle characteristics among 33,922 subjects aged 51 + years in the Adventist Health Study-2, a large population-based prospective cohort study. According to the multivariable-adjusted models, vegetarians were less likely to report screening: vegans, prevalence ratio (PR) = 0.80 (95% confidence interval 0.77-0.83); lacto-ovo-vegetarians (0.95 [0.93-0.97]); and semi-vegetarians (0.97 [0.94-0.99]) compared to non-vegetarians. Blacks were more likely than non-Blacks to be screened (1.04 [1.02-1.06]) and males were less likely (0.93 [0.92-0.95]) to utilize the screening tests. Older subjects were more likely to be screened, and unmarried and divorced/widowed subjects were less likely to screen. Education, personal income, and BMI were positively associated with screening, with p-value for trend < 0.001 for all three variables. A family history of colorectal cancer was associated with higher screening prevalence (1.15 [1.12-1.17]). Our stratified analyses on race and gender with dietary patterns showed non-Hispanic White vegans (PR = 0.77 [0.74-0.81]) and male vegans (PR = 0.76 [0.72-0.81]) were least likely compliant with colorectal cancer screening (p = 0.009 and p = 0.04, respectively). Vegans may believe that their personal risk for colorectal cancer is low due to their healthy lifestyle, resulting in lack of compliance to colorectal cancer screening. It remains to be seen whether vegans in AHS-2 also experience higher incidence of colorectal cancer or are diagnosed at a later stage.

TGF-ß/IL-7 Chimeric Switch Receptor-Expressing CAR-T Cells Inhibit Recurrence of CD19-Positive B Cell Lymphoma.

Chimeric antigen receptor (CAR)-T cells are effective in the treatment of hematologic malignancies but have shown limited efficacy against solid tumors. Here, we demonstrated an approach to inhibit recurrence of B cell lymphoma by co-expressing both a human anti-CD19-specific single-chain variable fragment (scFv) CAR (CD19 CAR) and a TGF-ß/IL-7 chimeric switch receptor (tTRII-I7R) in T cells (CD19 CAR-tTRII-I7R-T cells). The tTRII-I7R was designed to convert immunosuppressive TGF-ß signaling into immune-activating IL-7 signaling. The effect of TGF-ß on CD19 CAR-tTRII-I7R-T cells was assessed by western blotting. Target-specific killing by CD19 CAR-tTRII-I7R-T cells was evaluated by Eu-TDA assay. Daudi tumor-bearing NSG (NOD/SCID/IL2Rγ-/-) mice were treated with CD19 CAR-tTRII-I7R-T cells to analyze the in vivo anti-tumor effect. In vitro, CD19 CAR-tTRII-I7R-T cells had a lower level of phosphorylated SMAD2 and a higher level of target-specific cytotoxicity than controls in the presence of rhTGF-ß1. In the animal model, the overall survival and recurrence-free survival of mice that received CD19 CAR-tTRII-I7R-T cells were significantly longer than in control mice. These findings strongly suggest that CD19 CAR-tTRII-I7R-T cell therapy provides a new strategy for long-lasting, TGF-ß-resistant anti-tumor effects against B cell lymphoma, which may lead ultimately to increased clinical efficacy.

Health impacts in pathology workforce during mergers and acquisitions (M&A).

AIMS: To compare burn-out in laboratory professionals (LPs) with exposure to consolidation to those without, and to investigate the role of social support as a moderator in the exposure to mergers and acquisitions (M&A). METHODS: Surveys were sent to the clinical LPs, including 732 with exposure to M&A and 819 without. The dependent variable was burn-out, and the independent variable was exposure to M&A. In investigating the role of social support in exposure group, a logistic regression was used with education, time since M&A, gender, merger types, practice setting, lab hierarchy and race as covariates. RESULTS: Exposure to M&A was associated with higher levels of burn-out (p<0.05). In logistic regression of the workforce exposed to M&A, the odds for LP developing a high level of burn-out are lowered by 7.1% for every unit of increase in social support (OR 0.93; 95% CI 0.88 to 0.98; p=0.004). CONCLUSION: LPs exposed to M&A are more likely to experience higher levels of burn-out but having social support can protect against burn-out, which has policy implications for leadership managing laboratories in times of M&A.

Effects of Mental Illness Amongst Adults in the United States Living With Diabetes Mellitus on Hospital Admissions.

OBJECTIVE: To examine the influence of comorbid mental illness on hospitalization among adults reporting diabetes mellitus. METHODS: This cross-sectional observational study used National Health Interview Survey (NHIS) data from 2000-2018 to examine hospitalization. Mental illness was defined as no to low psychological distress (NLPD), moderate psychological distress (MPD), and serious psychological distress (SPD) as per the Kessler-6 scale. Socio-demographic factors and health status were added as covariates in binary logistic regression. RESULTS: This study involved 48,807 survey participants and reflected an estimated population of 17,524,418 adults with diabetes in the United States, of whom 19.9% were hospitalized in the year prior to the survey. Among those who were hospitalized, 71.5% exhibited None to Low Psychological Distress (NLPD), 17.7% reported Moderate Psychological Distress (MPD), and 10.8% reported Serious Psychological Distress (SPD). Conversely, among non-hospitalized individuals, the percentages were as follows: 83.2% had NLPD, 11.4% had MPD, and 5.3% had SPD. The odds ratio (OR) for hospitalization was found to be OR=1.31 (95% CI: 1.20, 1.43, p<0.0001) for MPD and OR=1.42 (95% CI: 1.28, 1.58, p<0.0001) for SPD, in comparison to those with no or low psychological distress. CONCLUSION: Among adults with diabetes mellitus, those with mental illness were more likely to be hospitalized than those without mental illness. Programs and policies to improve care among adults with both mental illness and diabetes may help to reduce hospitalizations.

Cost Barriers to Health Services in U.S. Adults Before and After the Implementation of the Affordable Care Act.

BACKGROUND: The Affordable Care Act (ACA) was passed in 2010 and implemented in 2014 in the United States (U.S.). It was partly intended to reduce the cost burden to health coverage and care. OBJECTIVE: To determine if ACA implementation reduced the odds of experiencing cost barriers to needed healthcare services for vulnerable groups. METHODOLOGY: National Health Interview Survey Data from the Integrated Public Use Microdata Set (2011-2013; 2015-2017) were used to examine cost barriers to primary health, mental health, dental services, and prescription medications particularly for adults living in poverty, those of color, and unmarried individuals before and after implementation of the ACA. The study sample included 112,245 individuals, representing an annual average of 138 million adults (aged 26 to 64 years of age), including 59,367 survey respondents from 2011 to 2013 and 52,878 from 2015 to 2017. RESULTS: Pre/post-ACA, cost barriers to medical care decreased from 9.6% to 7.0% of adults, mental care from 3.0% to 2.4%, dental care 15.0 to 11.7%, and prescriptions from 9.9% to 7.0% (all comparisons p<.001). Survey design-adjusted regression results indicated significant decreases in the odds of experiencing cost barriers to physical, mental, dental health services and prescription medications after the implementation of the ACA for people living under 200% poverty, unmarried adults, and people of color. While the race was not a substantial barrier post-ACA, living in poverty and being unmarried remained the biggest predictors of cost barriers to services. Cost barriers for all services increased post ACA for adults with private coverage, and among older adults for prescription and dental services. CONCLUSIONS: While the ACA was largely successful in reducing the number of uninsured adults in the U.S., remaining barriers suggest the need to strengthen the ACA and reduce cost barriers to healthcare services for everyone.

Lower Compliance with Cervical Cancer Screening Guidelines Among Vegetarians in North America.

Cervical cancer is preventable and treatable through regular screening and follow-up. However, the utilization of cervical cancer screening may vary widely based on individual lifestyles. The purpose of this study was to examine the differences in the adherence to cervical cancer screening guidelines in various dietary groups. Our study included 21,376 women from the United States and Canada, aged 30-69 from the Adventist Health Study-2, a large population-based prospective cohort study. Modified Poisson regression with robust variance estimation was used to determine the prevalence ratios of cervical cancer screening behavior in participants following five different dietary patterns (non-vegetarians, semi-vegetarians, pesco-vegetarians, lacto-ovo-vegetarians, and vegans). All analyses were adjusted for age, race/ethnicity, marital status, education, personal income, body mass index, smoking, alcohol use, exercise, and family history of all female cancer. Vegetarians, in general, had similar screening prevalence as non-vegetarians. However, vegans were 16% less likely to have had a Pap test compared to non-vegetarians (prevalence ratio (PR) = 0.84, 95% confidence interval 0.81-0.86). Women who were younger, Black, married, more educated, had a family history of all female cancer, had a higher income, and exercise reported higher compliance to a Pap test. It remains to be seen whether vegan women in Adventist Health-2 experience a higher incidence of cervical cancer or are diagnosed at a later stage compared to non-vegetarians.

Social Media Use for Health Purposes by Chronic Disease Patients in the United States.

BACKGROUND: Social media can be a cost-effective instant tool for exchanging health information among those with chronic diseases. However, few studies have analyzed the nexus between chronic disease and patients' use of the internet for health-related purposes. OBJECTIVE: The objective of this study is to determine if chronic disease patients in the United States use social media platforms to share health information and/or join groups of similar condition. MATERIALS AND METHODS: This cross-sectional study conducted a secondary analysis of the Health Information Trends Survey dataset 5 (cycle 1 of 2017 and cycle 2 of 2018) (N = 6650), which is nationally representative of American adults. A series of chi-square tests was carried to examine the association between using social media by chronic disease patients and (a) sharing health information and (b) participating in relevant health groups. Logistic regression analysis was used to determine significant findings. RESULTS: In terms of sharing health information on social media sites, those who were aged 18-49 years (P < 0.0001) and underweight (P = 0.04) were more likely to share health information on social media, while males were less likely to do so (P < 0.0001). In terms of joining relevant health groups on social media, predictors were being aged 35-49 years (P = 0.008), having a Bachelor's or postbaccalaureate degree (P < 0.02) and having depression or anxiety disorder (P = 0.004); males were less likely to join such groups (P = 0.0004). CONCLUSION: Individuals with chronic conditions, except depression or anxiety disorder, were not likely to participate in social media support groups. Future studies should explore how social media can be used to effectively engage those with chronic diseases, which may assist in disease management.

Radio Frequency Induction Welding of Silver Nanowire Networks for Transparent Heat Films.

Transparent heat films (THFs) are attracting increasing attention for their usefulness in various applications, such as vehicle windows, outdoor displays, and biosensors. In this study, the effects of induction power and radio frequency on the welding characteristics of silver nanowires (Ag NWs) and Ag NW-based THFs were investigated. The results showed that higher induction frequency and higher power increased the welding of the Ag NWs through the nano-welding at the junctions of the Ag NWs, which produced lower sheet resistance, and improved the adhesion of the Ag NWs. Using the inductive welding condition of 800 kHz and 6 kW for 60 s, 100 ohm/sq of Ag NW thin film with 95% transmittance at 550 nm after induction heating could be decreased to 56.13 ohm/sq, without decreasing the optical transmittance. In addition, induction welding of the Ag NW-based THFs improved haziness, increased bending resistance, enabled higher operating temperature at a given voltage, and improved stability.

Prevalence, Proportionality, and Cause of Ventilator Alarms in a Pediatric Intensive Care Setting.

BACKGROUND: Clinical alarms play an important role in monitoring physiological parameters, vital signs and medical device function in the hospital intensive care environment. Delays in staff response to alarms are well documented as health care providers become desensitized to increased rates of nuisance alarms. Patients can be at increased risk of harm due to alarm fatigue. Current literature suggests alarms from ventilators contribute significantly to nonactionable alarms. A greater understanding of which specific ventilator alarms are most common and the rates at which they occur is fundamental to improving alarm management. METHODS: A retrospective review was performed on alarms that occurred on the Avea and Servo-i ventilators used in the pediatric ICU and pediatric cardiothoracic ICU at a major metropolitan children's hospital. High- and medium-priority alarms, as classified by the manufacturer, were studied between June 1, 2017, and November 31, 2017. Descriptive data analysis and a 2-proportion z-test were performed to identify proportionality, cause, and prevalence rates in the pediatric ICU and the cardiothoracic ICU. RESULTS: Eleven distinct ventilator alarms were identified during 2,091 d of mechanical ventilation. The Inspiratory Flow Overrange alarm (42.4%) on the Servo-i, Low VTE (20.4%; expiratory tidal volume) and Circuit Integrity alarm (20.0%) on the Avea were the most prevalent causes according to ventilator type. Medium-priority alarms comprised 68.7% of all Servo-i alarms, and high-priority alarms comprised 84% of all Avea alarms. The 2-sample test of proportions was significant for differences between both areas (P < .001). The overall alarm prevalence rate was 22.5 ventilator alarms per ventilator-day per patient. CONCLUSIONS: The cause and proportion of alarms varied by ventilator and care unit. High-priority alarms were most common with the Avea and medium-priority alarms for the Servo-i. The overall combined ventilator alarm prevalence rate was 22.5 alarms per ventilator-day per patient.

Enpp2 Expression by Dendritic Cells Is a Key Regulator in Migration.

Enpp2 is an enzyme that catalyzes the conversion of lysophosphatidylcholine (LPC) to lysophosphatidic acid (LPA), which exhibits a wide variety of biological functions. Here, we examined the biological effects of Enpp2 on dendritic cells (DCs), which are specialized antigen-presenting cells (APCs) characterized by their ability to migrate into secondary lymphoid organs and activate naïve T-cells. DCs were generated from bone marrow progenitors obtained from C57BL/6 mice. Enpp2 levels in DCs were regulated using small interfering (si)RNA or recombinant Enpp2. Expression of Enpp2 in LPS-stimulated mature (m)DCs was high, however, knocking down Enpp2 inhibited mDC function. In addition, the migratory capacity of mDCs increased after treatment with rmEnpp2; this phenomenon was mediated via the RhoA-mediated signaling pathway. Enpp2-treated mDCs showed a markedly increased capacity to migrate to lymph nodes in vivo. These findings strongly suggest that Enpp2 is necessary for mDC migration capacity, thereby increasing our understanding of DC biology. We postulate that regulating Enpp2 improves DC migration to lymph nodes, thus improving the effectiveness of cancer vaccines based on DC.

Leigh Syndrome Mimicking Wernicke's Encephalopathy: A Case Report.

Leigh syndrome or subacute necrotizing encephalomyelopathy is a rare, rapidly progressive neurodegenerative disorder. In general, symptoms such as shortness of breath and decreased cardiac function usually occur within 1 year of life. It is a serious disease with a mortality rate of 75% in 2-3 years. The cause of Leigh syndrome is DNA mutation. Approximately 75% of patients have nuclear DNA mutations while 25% have mitochondrial DNA mutations. Clinical symptoms vary depending on the affected brain area. Neuroimaging plays an important role in diagnosing patients with Leigh syndrome. Late-onset Leigh syndrome is rarer and progresses more slowly compared to the classic form. Here, we report a case of late-onset Leigh's syndrome mimicking Wernicke's encephalopathy.

Understanding the Use of Electronic Means to Seek Personal Health Information Among Adults in the United States.

In this study, we explored who is most likely to use electronic means to seek health information and why; our research was guided by the Health Belief Model (HBM). We used the National Cancer Institute's Health Information Trends Survey (HINTS) dataset for 2017 and 2018 (n=6,697). We found that 67.5% of US adults used electronic means to seek health information and that females (52.4%), non-Hispanic whites (63.8%), those with at least some college education (76.5%), and those with a household income of at least $50,000 per year (58.3%) were most likely to do so. Respondents reporting depression were 42% more likely to use electronic means to seek health information, suggesting that stigma about mental health may direct people with depression to seek online information to avoid face-to-face communication. Using a tablet to track progress on a health-related goal [odds ratio (OR)=2.38, p<0.0001], and using a tablet to make a decision about treating an illness (OR=6.00, p<0.0001) were highly associated with seeking electronic health information. As the internet remains largely unregulated, this suggests that health systems link their patients to trustworthy resources for preventive and treatment-related information, since many already engage in internet-guided health information-seeking.