Factors Influencing Vision Health and Eye Care among Older Adults in Northeast Tennessee.

OBJECTIVES: The purpose of this study was to examine the factors associated with vision impairment (VI), age-related eye disease (ARED), and frequency of eye examinations among older adults. METHODS: A cross-sectional study (N = 166) was designed to identify barriers in vision and eye care services among adults 50 years and older in four counties in Appalachian Tennessee. Surveys were administered in March 2023. Simple and multiple logistic regression analyses were used to determine the risk factors of VI and ARED and the frequency of eye examinations. RESULTS: In two out of the three regression models, predictors such as traveling >10 mi to an eye care provider, barriers to eye care, and a lack of exposure to eye health information emerged as significant factors. Individuals who traveled >10 mi to an eye care provider were more than twice as likely than individuals who traveled shorter distances to have VI and not maintain routine eye care (adjusted odds ratio [AOR] 2.69, 95% confidence interval [CI] 1.08-6.75; AOR 2.82, 95% CI 1.05-7.55, respectively). Reporting barriers to eye care doubled the odds of ARED (AOR 2.33, 95% CI 1.02-5.34) and substantially increased the odds of reporting a 3-year or longer interval since the last eye examination (AOR 7.45, 95% CI 1.85-29.96) compared with having no barriers to eye care. Moreover, limited exposure to eye health information tripled the odds of VI (AOR 3.26, 95% CI 1.15-9.24) and not maintaining routine eye care (AOR 3.07, 95% CI 0.97-9.70) compared with more exposure to eye health information. Other predictors also were uncovered in the analysis. CONCLUSIONS: This study contributes to the scarce literature on risk factors associated with vision health among older adults in Appalachia.

Connections Network: Harnessing the Collective Influence of Grassroots Leaders to Address Health-Related Problems in Hawkins and Hancock County, TN.

In March 2021, grassroots leaders in two counties in northeast Tennessee formed a new network called Connections. Leaders are working to strengthen the capacity of the network and member organizations by promoting partnerships as vital to address effectively rural social determinants of health. Connections provides network members with capacity-building tools and resources, including two funding opportunities, to achieve their missions and sustain impact. Network members are also aligning around common goals to address the socioeconomic conditions affecting health outcomes. Connections will utilize findings from network activities and collaborations to identify synergies that can accelerate improvements in community health and well-being.

Spatio-temporal information and knowledge representation of disease incidence and respective intervention strategies.

The supplementation of medical data with environmental data offers rich new insights that can improve decision-making within health systems and the healthcare profession. In this study, we simulate disease incidence for various scenarios using a mathematical model. We subsequently visualise the infectious disease spread in human populations over time and geographies. We demonstrate this for malaria, which is one of the top three causes of mortality for children under the age of 5 years in sub-Saharan Africa, and its associated interventions within Kenya. We demonstrate how information can be collected, analysed, and presented in new ways to inform key decision makers in understanding the prevalence of disease and the response to interventions.

Sensing of protein molecules through nanopores: a molecular dynamics study.

Solid-state nanopores have been shown to be suitable for single molecule detection. While numerous modeling investigations exist for DNA within nanopores, there are few simulations of protein translocations. In this paper, we use atomistic molecular dynamics to investigate the translocation of proteins through a silicon nitride nanopore. The nanopore dimensions and profile are representative of experimental systems. We are able to calculate the change in blockade current and friction coefficient for different positions of the protein within the pore. The change in ionic current is found to be negligible until the protein is fully within the pore and the current is lowest when the protein is in the pore center. Using a simple theory that gives good quantitative agreement with the simulation results we are able to show that the variation in current with position is a function of the pore shape. In simulations that guide the protein through the nanopore we identify the effect that confinement has on the friction coefficient of the protein. This integrated view of translocation at the nanoscale provides useful insights that can be used to guide the design of future devices.

Selective particle trapping using an oscillating microbubble.

The ability to isolate and sort analytes within complex microfluidic volumes is essential to the success of lab-on-a-chip (LOC) devices. In this study, acoustically-excited oscillating bubbles are used to selectively trap particles, with the selectivity being a function of both particle size and density. The operating principle is based on the interplay between the strong microstreaming-induced drag force and the attractive secondary Bjerknes force. Depending upon the size of the bubble, and thus its resonant frequency, it is possible to cause one force to dominate over the other, resulting in either particle attraction or repulsion. A theoretical analysis reveals the extent of the contribution of each force for a given particle size; in close agreement with experimental findings. Density-based trapping is also demonstrated, highlighting that denser particles experience a larger secondary Bjerknes force resulting in their attraction. This study showcases the excellent applicability and versatility of using oscillating bubbles as a trapping and sorting mechanism within LOC devices.

Exploitation of surface acoustic waves to drive size-dependent microparticle concentration within a droplet.

Ultrafast particle and cell concentration is essential to the success of subsequent analytical procedures and the development of miniaturized biological and chemical sensors. Here, surface acoustic wave (SAW) devices were used to excite a MHz-order acoustic wave that propagates into a microlitre droplet to drive spatial concentration and separation of two different sized suspended microparticles. The rapid concentration process, occurring within just three seconds to facilitate spatial partitioning between the two particle species, exploited two acoustic phenomena acting on the suspended particles: the drag force arising from acoustic streaming and the acoustic radiation force, both driving particles in different directions. This study elucidates the very intricate and interesting interplay of physics between fluid drag and acoustic forcing on the particles within a droplet, and, for the first time, demonstrates the existence of a frequency-dependent crossover particle size that can be used to effect species partitioning: depending on the operating frequency of the SAW device and the particle size, it is possible to cause one phenomenon to dominate over the other. A theoretical analysis revealed the extent to which each force would affect the particle trajectory (particle size range: 2-31 µm), subsequently verified through experimentation. Based on these findings, 6 and 31 µm polystyrene particles were successfully partitioned in a water droplet using a 20 MHz SAW device. This study reveals the suitability of using acoustic actuation methods for the useful partitioning of particle species within a discrete fluid volume.