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Background: The Dietary Guidelines for Americans (DGA) recommends consuming a variety of “Protein Foods” based on “ounce-equivalent” (oz-eq) portions. No study has assessed the same oz-eq portions of animal- vs. plant-based protein foods on essential amino acid (EAA) bioavailability for protein anabolism in young and older adults. Objectives: We assessed the effects of consuming two oz-eq portions of pork, eggs, black beans, and almonds on postprandial EAA bioavailability in young and older adults. Methods: We conducted two investigator-blinded, randomized crossover trials in young (n = 30; mean age ± SD: 26.0 ± 4.9 y) and older adults (n = 25; mean age ± SD: 64.2 ± 6.6 y). Participants completed four testing sessions where they consumed a standardized meal with two oz-eq of either unprocessed lean pork, whole eggs, black beans, or sliced almonds. Blood samples were taken at baseline and 30, 60, 120, 180, 240, and 300 min postprandially. Plasma EAA bioavailability was based on postprandial integrated positive areas under the curve. Results: Participant age did not affect EAA bioavailability among the four protein foods tested. Two oz-eq portions of pork (7.36 g EAA) and eggs (5.38 g EAA) resulted in greater EAA bioavailability than black beans (3.02 g EAA) and almonds (1.85 g EAA) in young and older adults, separately or combined (p < 0.0001 for all). Pork resulted in greater EAA bioavailability than eggs in young adults (p < 0.0001), older adults (p = 0.0007), and combined (p < 0.0001). There were no differences in EAA bioavailability between black beans and almonds. Conclusions: The same “oz-eq” portions of animal- and plant-based protein foods do not provide equivalent EAA content and postprandial bioavailability for protein anabolism in young and older adults.

Background Almost 60% of adults with amnestic mild cognitive impairment (aMCI) have obstructive sleep apnea (OSA). Treatment with continuous positive airway pressure (CPAP) may delay cognitive decline, but CPAP adherence is often suboptimal. In this study, we report predictors of CPAP adherence in older adults with aMCI who have increased odds of progressing to dementia, particularly due to Alzheimer’s disease. Methods The data are from Memories 2, “Changing the Trajectory of Mild Cognitive Impairment with CPAP Treatment of Obstructive Sleep Apnea.” Participants had moderate to severe OSA, were CPAP naïve, and received a telehealth CPAP adherence intervention. Linear and logistic regression models examined predictors. Results The 174 participants (mean age 67.08 years, 80 female, 38 Black persons) had a mean apnea–hypopnea index of 34.78, and 73.6% were adherent, defined as an average of ≥4 hours of CPAP use per night. Only 18 (47.4%) Black persons were CPAP adherent. In linear models, White race, moderate OSA, and participation in the tailored CPAP adherence intervention were significantly associated with higher CPAP use at 3 months. In logistic models, White persons had 9.94 times the odds of adhering to CPAP compared to Black persons. Age, sex, ethnicity, education, body mass index, nighttime sleep duration, daytime sleepiness, and cognitive status were not significant predictors. Conclusions Older patients with aMCI have high CPAP adherence, suggesting that age and cognitive impairment should not be a barrier to prescribing CPAP. Research is needed to improve adherence in Black patients, perhaps through culturally tailored interventions.

Herein, we present a systematic investigation of the impact of silica nanoparticle (SiNP) size and surface chemistry on the nanoparticle dispersion state and the resulting morphology and vanadium ion permeability of the composite ionomer membranes. Specifically, Nafion containing a mass fraction of 5% silica particles, ranging in nominal diameters from 10 nm to1 μm and with both sulfonic acid- and amine-functionalized surfaces, was fabricated. Most notably, an 80% reduction in vanadium ion permeability was observed for ionomer membranes containing amine-functionalized SiNPs at a nominal diameter of 200 nm. Further, these membranes exhibited an almost 400% increase in proton selectivity when compared to pristine Nafion. Trends in vanadium ion permeability within a particular nominal diameter were seen to be a function of the surface chemistry, where, for example, vanadyl ion permeability was observed to increase with increasing particle size for membranes containing unfunctionalized SiNPs, while it was seen to remain relatively constant for membranes containing amine-functionalized SiNPs. In general, the silica particles tended to exhibit a higher extent of aggregation as the size of the particles was increased. From small-angle neutron scattering experiments, an increase in the spacing of the hydrophobic domains was observed for all composite membranes, though particle size and surface chemistry were seen to have varying impacts on the spacing of the ionic domains of the ionomer.

Here, we present a closed-loop controlled photopolymerization process for fabrication of hydrogels with controlled storage moduli. Hydrogel crosslinking was associated with a significant change in the phase angle of a piezoelectric cantilever sensor and established the timescale of the photopolymerization process. The composition, structure, and mechanical properties of the fabricated hydrogels were characterized using Raman spectroscopy, scanning electron microscopy (SEM), and dynamic mechanical analysis (DMA). We found that the storage moduli of photocured poly(ethylene glycol) dimethacrylate (PEGDMA) and poly(N-isopropylacrylamide) (PNIPAm) hydrogels could be controlled using bang-bang and fuzzy logic controllers. Bang-bang controlled photopolymerization resulted in constant overshoot of the storage modulus setpoint for PEGDMA hydrogels, which was mitigated by setpoint correction and fuzzy logic control. SEM and DMA studies showed that the network structure and storage modulus of PEGDMA hydrogels were dependent on the cure time and temporal profile of UV exposure during photopolymerization. This work provides an advance in pulsed and continuous photopolymerization processes for hydrogel engineering based on closed-loop control that enables reproducible fabrication of hydrogels with controlled mechanical properties.

BackgroundEvaluation and interpretation of the literature on obstructive sleep apnea (OSA) allows for consolidation and determination of the key factors important for clinical management of the adult OSA patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA). MethodsUsing previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidence-based review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus. ResultsThe ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA treatment on multiple OSA-associated comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated. ConclusionThis review of the literature consolidates the available knowledge and identifies the limitations of the current evidence on OSA. This effort aims to create a resource for OSA evidence-based practice and identify future research needs. Knowledge gaps and research opportunities include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy.

BACKGROUND: While total sleep duration and rapid eye movement (REM) sleep duration have been associated with long-term mortality in non-surgical cohorts, the impact of preoperative sleep on postoperative outcomes has not been well-studied. METHODS: In this secondary analysis of a prospective observational cohort study, patients who recorded at least 1 sleep episode using a consumer wearable device in the 7 days before elective colorectal surgery were included. 30-day postoperative outcomes among those who did and did not receive at least 6 hours of total sleep, as well as those who did and did not receive at least 1 hour of rapid eye movement (REM) sleep were compared. RESULTS: 34 out of 95 (35.8%) patients averaged at least 6 hours of sleep per night, while 44 out of 82 (53.7%) averaged 1 hour or more of REM sleep. Patients who slept less than 6 hours had similar postoperative outcomes compared to those who slept 6 hours or more. Patients who averaged less than 1 hour of REM sleep, compared to those who achieved 1 hour or more of REM sleep, had significantly higher rates of complication development (29.0% vs. 9.1%, P=0.02), and return to the OR (10.5% vs. 0%, P=0.04). After adjustment for confounding factors, increased REM sleep duration remained significantly associated with decreased complication development (increase in REM sleep from 50 to 60 min: OR 0.72, P=0.009; REM sleep ≥ 1 hour: OR 0.22, P=0.03). CONCLUSION: In this cohort of patients undergoing elective colorectal surgery, those who developed a complication within 30 days were less likely to average at least 1 hour of REM sleep in the week before surgery than those who did not develop a complication. Preoperative REM sleep duration may represent a risk factor for surgical complications, however additional research is necessary to confirm this relationship.

Background Family caregivers experience psychological distress or physical strain that may lead to an increased risk of cardiovascular disease (CVD) morbidity and mortality. Objective This systematic review aimed to describe the current evidence and gaps in the literature on measures used to assess CVD outcomes in family caregivers, the association of caregiving with CVD incidence/risk outcomes, and associated factors in family caregivers of patients with chronic disease. Methods Medline, PubMed, CINAHL, Web of Science, and Google Scholar were searched for English-language, peer-reviewed studies published from 2008 to 2020 that examined CVD incidence and risk among family caregivers of adults with chronic conditions. Results Forty-one studies were included in this review. The measures used to assess CVD risk were categorized into biochemical, subclinical markers, components of metabolic syndrome, and global risk scores. Compared with noncaregivers, caregivers were more likely to have higher CVD incidence rates and objectively measured risk. Cardiovascular disease risks were also increased by their caregiving experience, including hours/duration of caregiving, caregivers' poor sleep status, psychological symptoms, poor engagement in physical/leisure activities, and care recipient's disease severity. Conclusions Although there were limited longitudinal studies in caregivers of patients with diverse health conditions, we found evidence that caregivers are at high risk of CVD. Further research for various caregiver groups using robust methods of measuring CVD risk is needed. Caregiver factors should be considered in developing interventions aimed at reducing CVD risk for caregivers.

Perfluorosulfonic acid (PFSA) ionomers are ubiquitous as proton-exchange membranes (PEMs) in vanadium redox flow batteries (VRFBs), as they provide high proton conductivity and robust chemical stability. However, traditional PFSA ionomers suffer from high vanadium ion crossover, i.e., low ion selectivity, which reduces the efficiency and lifetime of the battery. Herein, a novel method to fabricate PFSA nanocomposites containing fluorocarbon-decorated silica nanoparticles is presented. These composite ionomers exhibit drastically reduced vanadium ion permeability and an almost two orders of magnitude increase in proton selectivity when compared to the current benchmark commercial ionomer. Small-angle neutron scattering data suggest that the nanostructures of these nanocomposites are drastically different from their pristine counterpart, where the periodic spacing of the hydrophobic domains is significantly reduced, while changes to the ionic structure were seen to be minimal. This work suggests that composite PEMs containing a secondary phase that alters the hydrophobic, nonion-conducting phase of the ionomer may prove to be a fruitful fabrication route to produce ionomer membranes with enhanced performance for use in VRFBs.

Herein, a series of novel, lignin-based hydrogel composites was fabricated by incorporating ultraclean lignins (UCLs), of controlled molecular weight and low dispersity, into poly(vinyl alcohol) (PVA). The UCLs were obtained from a novel liquid–liquid fractionation of high dispersity crude bulk lignins (CBLs) obtained from Kraft black liquor. A complementary series of composite hydrogels was fabricated using these CBLs. Both the CBLs and UCLs were functionalized with vinyl-containing acrylate groups allowing the lignins to chemically crosslink with themselves, forming an interpenetrated network with the thermally-crosslinked network of PVA chains. Successful functionalization of the UCLs was demonstrated by proton and phosphorous nuclear magnetic resonance. PVA–lignin hydrogels containing 20 wt% UCL saw a reduction in methylene blue (MB) permeability by approximately two orders of magnitude when compared to neat PVA. Further, for composite hydrogels containing either 50 wt% UCL or CBL, no MB was detected in the receiving reservoir over the duration of the permeation experiment. In general, an increase in Young's moduli was observed in PVA–lignin hydrogels containing CBLs, where hydrogels composed of 50 wt% CBLs exhibited ∼40% increase when compared to neat PVA. In contrast, a ∼10% reduction in Young's moduli was observed for composite hydrogels containing 20 wt% UCLs or less, though these membranes exhibited the lowest MB permeabilities of all membranes investigated. However, the largest increase in membrane stiffness was observed for composite hydrogels containing 50 wt% UCLs, where a ∼70% increase in Young's modulus was observed. Finally, the concentration and functionalization of the lignins was seen to have a direct impact on the network structure of the soft composites, where in general, the molecular weight between crosslinks is seen to decrease with increasing lignin concentration.

Ion-exchange membranes are critical components of hydrogen fuel cells, where these ionomers can be confined to nanoscale thicknesses, altering the physical properties of these films from that of bulk membranes. Therefore, it is important to develop methods capable of measuring and elucidating the transport mechanisms under thin film confinement compared to bulk Nafion. In this study, water sorption and diffusion in a Nafion thin film were measured using time-resolved in situ polarization modulation infrared reflection absorption spectroscopy (PM-IRRAS). Interfacial mass transport limitations were confirmed to be minimal, while restricted water diffusion was observed, where the effective diffusion coefficient of water in the thin Nafion film was many orders of magnitude lower (between 4 and 5 orders of magnitude) than those reported for bulk membranes and was dependent on the initial hydration state of the Nafion. Furthermore, the response of the hydrophobic domains (Teflon backbone) to the swelling of the hydrophilic domains (ionic clusters) was shown to be orders of magnitude slower than that of bulk Nafion.

Herein, we report a polymerized ionic liquid diblock copolymer with high hydroxide conductivity and nanoscale morphology. Surprisingly, the conductivity is not only higher (over an order of magnitude) than its random copolymer analog at the same ion and water content, but also higher than its homopolymer analog, which has a higher ion and water content than the block copolymer. These results should have a significant impact on low-cost (platinum-free), long-lasting, solid-state alkaline fuel cells.

Mushrooms, unique edible fungi, contain several essential nutrients and bioactive compounds which may positively influence cardiometabolic health. Despite a long history of consumption, the health benefits of mushrooms are not well documented. We conducted a systematic review to assess the effects of and associations between mushroom consumption and cardiometabolic disease (CMD)-related risk factors and morbidities/mortality. We identified 22 articles (11 experimental and 11 observational) from five databases meeting our inclusion criteria. Limited evidence from experimental research suggests mushroom consumption improves serum/plasma triglycerides and hs-CRP, but not other lipids, lipoproteins, measures of glucose control (fasting glucose and HbA1c), or blood pressure. Limited evidence from observational research (seven of 11 articles with a posteriori assessments) suggests no association between mushroom consumption and fasting blood total or LDL cholesterol, glucose, or morbidity/mortality from cardiovascular disease, coronary heart disease, or type 2 diabetes mellitus. Other CMD health outcomes were deemed either inconsistent (blood pressure, HDL cholesterol, and triglycerides) or insufficient (HbA1c/hyperglycemia, hs-CRP, cerebrovascular disease, and stroke). The majority of the articles vetted were rated “poor” using the NHLBI study quality assessment tool due to study methodology and/or poor reporting issues. While new, high-quality experimental and observational research is warranted, limited experimental findings suggest greater mushroom consumption lowers blood triglycerides and hs-CRP, indices of cardiometabolic health.

Advances in gene sequence technology and data analysis have enabled the detection and taxonomic identification of microorganisms in vivo based on their unique RNA or DNA sequences. Standard culture techniques can only detect those organisms that readily grow on artificial media in vitro. Culture-independent technology has been used to provide a more accurate assessment of the richness (total number of species) and diversity (relative abundance of each species) of microorganisms present in a prescribed location. The microbiome has been defined as the genes and genomes of all microbial inhabitants within a defined environment. Microorganisms within a microbiome interact with each other as well as with the host. A microbiome is dynamic and may change over time as conditions within the defined environment become altered. In oral health, neither gingivitis nor periodontitis is present, and the host and microbiome coexist symbiotically without evoking an inflammatory response. The circumstances that cause a shift from immune tolerance to a proinflammatory response remain unknown, and a unified, all-encompassing hypothesis to explain how and why periodontal disease develops has yet to be described. The purpose of this review is to clarify the current understanding of the role played by the oral microbiome in dogs and cats, describe how the microbiome changes in periodontal disease, and offer guidance on the utility of systemic antimicrobial agents in the treatment of periodontitis in companion animals.

Background: Approximately 50% of older adults with cognitive impairment suffer from insomnia. When untreated, pre-existing cognitive problems may be exacerbated and potentially contribute to further cognitive decline. One promising approach to maintain cognitive health is to improve sleep quantity and quality. Objective: To determine feasibility, acceptability, and preliminary efficacy of Sleep Health Using the Internet for Older Adult Sufferers of Insomnia and Sleeplessness (SHUTi OASIS), an Internet-delivered cognitive behavioral therapy for insomnia (CBT-I) program in older adults with mild cognitive impairment (MCI). Methods: Older adults with MCI and insomnia were recruited from hospital-based memory and sleep disorders clinics and enrolled in a single-arm pilot study. Participants completed the six cores of SHUTi OASIS, over nine weeks with two-week baseline and post-assessments using self-reported sleep diaries. Feasibility and acceptability were informed by usage statistics and qualitative interviews; preliminary efficacy was informed by patient-generated sleep data. Results: Twelve participants enrolled and, on average, were 75.8 years of age. Ten participants completed the study and logged in most days. Most participants reported a positive overall experience, and interviews revealed successful and independent program management and completion. There were significant changes on all baseline to post-assessment sleep measures, including clinically meaningful improvements on the Insomnia Severity Index (13.5 to 8.3, p 0.05). Conclusion: This study supports that older adults with cognitive impairment can independently complete CBT-I via the Internet and achieve clinical sleep improvements.

The advent of commercially viable vanadium redox flow batteries has generated interest in improving upon existing membrane materials utilized in this grid-scale energy storage technology. Elucidating structure–transport relationships in perfluorosulfonated ionomer nanocomposites is of particular importance for the development of next-generation membranes, as there is a limited understanding of how nanoparticles alter transport in these membranes. In the present study, we attempt to resolve the impact of silica nanoparticles (SiNPs) on liquid water transport in Nafion–SiNP membranes. Specifically, liquid water sorption and ionomer swelling kinetics in a series of Nafion–SiNP membranes were evaluated using time-resolved attenuated total reflectance–Fourier transform infrared spectroscopy. Anomalous, multistage water uptake and swelling kinetics were observed for both Nafion and Nafion–SiNP membranes at all SiNP loadings. The first stage of the kinetic data was regressed to a diffusion–relaxation model, as w...

Ionomer nanocomposites provide a promising solution to address ion crossover issues inherent to traditional ion-containing membranes used in batteries for grid-scale energy storage (e.g., vanadium ...

While ionomer nanocomposites show promise for advancing the viability of energy storage technologies, such as the vanadium redox flow battery, the improvements in ion selectivity are appreciable on...

Family caregivers experience psychological distress or physical strain that may lead to an increased risk of cardiovascular disease (CVD) morbidity and mortality.This systematic review aimed to describe the current evidence and gaps in the literature on measures used to assess CVD outcomes in family caregivers, the association of caregiving with CVD incidence/risk outcomes, and associated factors in family caregivers of patients with chronic disease.Medline, PubMed, CINAHL, Web of Science, and Google Scholar were searched for English-language, peer-reviewed studies published from 2008 to 2020 that examined CVD incidence and risk among family caregivers of adults with chronic conditions.Forty-one studies were included in this review. The measures used to assess CVD risk were categorized into biochemical, subclinical markers, components of metabolic syndrome, and global risk scores. Compared with noncaregivers, caregivers were more likely to have higher CVD incidence rates and objectively measured risk. Cardiovascular disease risks were also increased by their caregiving experience, including hours/duration of caregiving, caregivers' poor sleep status, psychological symptoms, poor engagement in physical/leisure activities, and care recipient's disease severity.Although there were limited longitudinal studies in caregivers of patients with diverse health conditions, we found evidence that caregivers are at high risk of CVD. Further research for various caregiver groups using robust methods of measuring CVD risk is needed. Caregiver factors should be considered in developing interventions aimed at reducing CVD risk for caregivers.

This research uncovered regulators of tumor killing mediated by MHC-unrestricted cytotoxic lymphocytes., Major histocompatibility complex (MHC)–unrestricted cytotoxic lymphocytes (CLs) such as natural killer (NK) cells can detect and destroy tumor and virus-infected cells resistant to T cell–mediated killing. Here, we performed genome-wide genetic screens to identify tumor-intrinsic genes regulating killing by MHC-unrestricted CLs. A group of genes identified in our screens encode enzymes for the biosynthesis of the glycosylphosphatidylinositol (GPI) anchor, which is not involved in tumor response to T cell–mediated cytotoxicity. Another gene identified in the screens was PBRM1, which encodes a subunit of the PBAF form of the SWI/SNF chromatin-remodeling complex. PBRM1 mutations in tumor cells cause resistance to MHC-unrestricted killing, in contrast to their sensitizing effects on T cell–mediated killing. PBRM1 and the GPI biosynthetic pathway regulate the ligands of NK cell receptors in tumor cells and promote cytolytic granule secretion in CLs. The regulators identified in this work represent potential targets for cancer immunotherapy.

Ionomer nanocomposites provide a promising solution to address ion crossover issues inherent to traditional ion-containing membranes used in batteries for grid-scale energy storage (e.g., vanadium redox flow batteries). Herein, we investigate the impact of nanoparticle surface chemistry on nanoparticle dispersion, membrane morphology, and vanadium ion permeability in a series of Nafion nanocomposites. Specifically, silica nanoparticles (SiNPs) were functionalized with various chemical moieties, seven in total, that electrostatically interact, either attractively or repulsively, with the sulfonic acid groups that coalesce to form the ionic network within Nafion. As seen from electron microscopy analysis of the nanocomposites, SiNPs with sulfonic acid end-functionality were, on average, well dispersed within the ionomer membrane, though increased vanadium ion permeability, as compared to pristine (or unmodified) Nafion, was observed and attributed to changes in the Donnan potential of the system. In contrast, SiNPs with amine end-functionality were, on average, observed to form large aggregates within the ionomer membrane. Surprisingly, nanocomposites containing a higher degree of nanoparticle aggregation demonstrated the lowest vanadium ion permeability. Fractal analysis of the low-Q small-angle neutron scattering data suggests that the interface between the ionomer and the SiNP surface transitions from rough to smooth when the nanoparticle surface is changed from sulfonic acid-functionalized to amine-functionalized.

Purpose of review Sleep is intimately involved in overall health and wellbeing. We provide a comprehensive report on the interplay between systemic diseases and sleep to optimize the outcomes of systemic disorders. Recent findings Spanning the categories of endocrinologic disorders, metabolic/toxic disturbances, renal, cardiovascular, pulmonary, gastrointestinal, infectious diseases, autoimmune disorders, malignancy, and critical illness, the review highlights the prevalent coexisting pathology of sleep across the spectrum of systemic disorders. Although it is rare that treating a sleep symptom can cure disease, attention to sleep may improve quality of life and may mitigate or improve the underlying disorder. Recent controversies in assessing the cardiovascular relationship with sleep have called into question some of the benefits of treating comorbid sleep disorders, thereby highlighting the need for an ongoing rigorous investigation into how sleep interplays with systemic diseases. Summary Systemic diseases often have sleep manifestations and this report will help the clinician identify key risk factors linking sleep disorders to systemic diseases so as to optimize the overall care of the patient.

The epithelial cell rests of Malassez (ERM) were first described in 1817, yet their significance has remained an enigma for more than 200 years. Given their embryological origins and persistence in adult periodontal tissue, recent research has investigated whether the ERM could be useful as stem cells to regenerate tissues lost as a consequence of periodontitis. The objective of this review is to describe results of studies that have vigorously investigated the functional capabilities of ERM, particularly with regard to periodontal ligament homeostasis and prevention of dentoalveolar ankylosis. The significance of the ERM relative to evolution of the dental attachment apparatus will be examined. The current status of use of ERM as stem cells for dental tissue engineering and in other applications will be reviewed.

Polymer extrusion additive manufacturing processes, such as fused filament fabrication (FFF), are now being used to explore the fabrication of thin films and membranes. However, the physics of molten polymer extrusion constrains achievable thin film properties (e.g., mechanical isotropy), material selection, and spatial control of film composition. Herein, we present an approach for fabrication of functional polymer thin films and membranes based on the microextrusion printing of polymer solutions, which we refer to as "solvent-cast printing" (SCP). Constructs fabricated via SCP exhibited a 43% reduction in anisotropy of tensile strength relative to those fabricated using FFF. The constructs fabricated via SCP exhibited a lesser extent of visible layering defects relative to those fabricated by FFF. Further, the swelling dynamics of the films varied depending on the membrane fabrication technique (i.e., SCP vs manual drop casting). The opportunity for expanding material selection relative to FFF processes was demonstrated by printing poly(benzimidazole), a high-performance thermoplastic with high glass-transition temperatures ( T

It has long been accepted that certain oral bacterial species are responsible for the development of periodontal disease. However, the focus of microbial and immunological research is shifting from studying the organisms associated with disease to examining the indigenous microbial inhabitants that are present in health. Microbiome refers to the aggregate genetic material of all microorganisms living in, or on, a defined habitat. Recent developments in gene sequence analysis have enabled detection and identification of bacteria from polymicrobial samples, including subgingival plaque. Diversity surveys utilizing this technology have demonstrated that bacterial culture techniques have vastly underestimated the richness and diversity of microorganisms in vivo, since only certain bacteria grow in vitro. Surveys using gene sequence analysis have demonstrated that the healthy oral microbiome is composed of an unexpectedly high number of diverse species, including putative pathogens. These findings support the view that coevolution microorganisms and macroscopic hosts has occurred in which certain microorganisms have adapted to survive in the oral cavity and host immune tolerance has allowed the establishment of a symbiotic relationship in which both parties receive benefits (mutualism). This review describes gene sequence analysis as an increasingly common, culture-independent tool for detecting bacteria in vivo and describes the results of recent oral microbiome diversity surveys of clinically healthy humans, dogs, and cats. Six bacterial phyla consistently dominated the healthy oral microbiome of all 3 host species. Previous hypotheses on etiology of periodontitis are reviewed in light of new scientific findings. Finally, the consideration that clinically relevant periodontal disease occurs when immune tolerance of the symbiotic oral microbiome is altered to a proinflammatory response will be discussed.

Due to their exceptional orientation of 2D nanofillers, layer-by-layer (LbL) assembled polymer/graphene oxide thin films exhibit unmatched mechanical performance relative to any conventionally produced counterparts with similar composition. Unprecedented mechanical property improvement, by replacing graphene oxide with pristine graphene, is demonstrated in this work. Polyvinylpyrrolidone-stabilized graphene platelets are alternately deposited with poly(acrylic acid) using hydrogen bonding assisted LbL assembly. Transmission electron microscopy imaging and the Halpin-Tsai model are used to demonstrate, for the first time, that intact graphene can be processed from water to generate polymer nanocomposite thin films with simultaneous parallel-alignment, high packing density, and exfoliation. A multilayer thin film with only 3.9 vol% of highly exfoliated, and structurally intact graphene, increases the elastic modulus (E) of a polymer multilayer thin film by 322% (from 1.41 to 4.81 GPa), while maintaining visible light transmittance of ≈90%. This is one of the greatest improvements in elastic modulus ever reported for a graphene-filled polymer nanocomposite with a glassy (E > 1 GPa) matrix. The technique described here provides a powerful new tool to improve nanocomposite properties (mechanical, gas transport, etc.) that can be universally applied to a variety of polymer matrices and 2D nanoplatelets.

Herein, we examine the synergistic impact of both ion clustering and block copolymer morphology on ion conductivity in two polymerized ionic liquid (PIL) diblock copolymers with similar chemistries but different side alkyl spacer chain lengths (ethyl versus undecyl). When saturated in liquid water, water/ion clusters were observed only in the PIL block copolymer with longer alkyl side chains (undecyl) as evidenced by both small-angle neutron scattering and intermediate-angle X-ray scattering, i.e., water/ion clusters form within the PIL microdomain under these conditions. The resulting bromide ion conductivity in the undecyl sample was higher than the ethyl sample (14.0 mS cm(-1)versus 6.1 mS cm(-1) at 50 °C in liquid water) even though both samples had the same block copolymer morphology (lamellar) and the undecyl sample had a lower ion exchange capacity (0.9 meq g(-1)versus 1.4 meq g(-1)). No water/ion clusters were observed in either sample under high humidity or dry conditions. The resulting ion conductivity in the undecyl sample with lamellar morphology was significantly higher in the liquid water saturated state compared to the high humidity state (14.0 mS cm(-1)versus 4.2 mS cm(-1)), whereas there was no difference in ion conductivity in the ethyl sample when comparing these two states. These results show that small chemical changes to ion-containing block copolymers can induce water/ion clusters within block copolymer microdomains and this can subsequently have a significant effect on ion transport.

Internet-based interventions using technology can promote access to treatment and reduce participant burden for sleep disorders. However, preliminary studies examining technology use and compliance in older adults with mild cognitive impairment (MCI) are needed prior to undertaking large-scale interventions. Older adults with MCI were recruited from hospital-based memory and sleep disorders clinics and enrolled in a single-arm intervention pilot study. An Internet-delivered cognitive behavioral therapy for insomnia program collected daily sleep diary data and delivered the automated intervention over nine weeks. Sleep diaries and wrist-worn actigraphs collected sleep data for 14 days, pre- and post-intervention. Descriptive statistics for participant technology use are presented. We have recruited 12 subjects with MCI. Most subjects with MCI accessed the intervention program daily; however, actiwatch compliance varied. Incorporating technology for intervention delivery and data collection in this population is promising, and future work should consider using reminders with wearable technology to increase compliance.

Perfluorosulfonic acid (PFSA) ionomer nanocomposites are a promising solution to address the poor ion selectivity of current membranes utilized in vanadium redox flow batteries. Herein, we investigate the impact of a casting substrate on the nanostructure and vanadium ion transport in bulk ionomer and ionomer nanocomposite membranes (i.e., films with thicknesses of ∼100 μm). Specifically, solution-cast ionomer nanocomposite membranes, containing either unfunctionalized (hydroxyl groups), amine-functionalized, or sulfonic acid-functionalized silica nanoparticles (SiNPs), were fabricated by casting on either a polished quartz or polytetrafluoroethylene (PTFE) substrates. Surprisingly, the choice of the casting substrate was seen to affect the bulk morphology of the PFSA ionomers, resulting in substrate-specific vanadium ion transport, where suppressed ion transport was observed for membranes cast on the polished quartz, when compared to their PTFE-cast counterparts. Additionally, the chemical composition of the substrate-adjacent surface was a function of both the substrate and the surface functionality of the SiNPs. Moreover, it was observed that both the chemical composition of the membrane surface and the substrate-induced changes to the bulk ionomer morphology governed vanadyl ion transport through the PFSA ionomers. Results from this work have direct implications for the design of next-generation ionomer nanocomposites, as the casting substrate used to fabricate these materials, and the orientation of these membranes inside the operating flow battery, can significantly influence transport of vanadium ions.

Introduction Central sleep apnea (CSA) is unique sleep breathing phenotype in patients with advanced chronic heart failure (HF) and portend poor prognosis. The prevalence of CSA in HF patients under contemporary therapy is uncertain. Methods We reviewed consecutive HF patients on optimal medical therapy who underwent clinically indicated diagnostic in-lab polysomnography at a single academic center. Age, sex and BMI matched patients without HF were selected from sleep clinic as a control. Patients with atrial fibrillation were excluded from this study. Apnea subtypes were determined after careful scoring and confirmation by sleep physicians. ‘Any CSA’ was defined by central apnea index (CAI) >5 and >1/hr. ‘True CSA’ was defined if met both CAI≥5/hr and > obstructive apnea index (OAI). Obstructive sleep apnea (OSA) was defined if apnea hypopnea index >15 and OAI>CAI. Multivariate analysis was performed using logistic regression adjusting for age, sex, HF and systolic dysfunction as appropriate. Results In patients with HF (N=95, mean age 59, female: 50%), CSA was low and was comparable to control group (N=94) (HF vs. Non-HF; CSA: 5.3 vs. 4.3%, P=NS; Any CSA 14.7 vs. 17%, P=NS). Only 3 patients with HF had true CSA. In contrast, OSA was common in both groups regardless of obesity status (52.3 vs. 55.3%). In patients with HF, Cheyne Stokes respiration was more frequent in patients with Any CSA vs. without Any CSA (13.3 vs. 3.8%, p=0.04). In multivariate analysis, presence of OSA, but not HF, was associated with Any CSA in entire cohort (Any CSA OR: 3.1 [1.3, 8.1], p=0.02). In patients with HF, male sex was associated with Any CSA (OR: 5.3 [1.1, 40.8], p=0.05). Exclusion of patients with high BMI did not change the results. Conclusion CSA was rare in patients with stable HF on contemporary optimal medical therapy. Support None

Introduction Adherence to continuous positive airway pressure (CPAP) may delay cognitive decline in older adults with obstructive sleep apnea (OSA) and amnestic mild cognitive impairment (MCI), defined as deficits in memory that do not significantly impact daily functioning. The aim of this analysis was to identify predictors of CPAP adherence in this population. Methods Data are from Memories 2, an ongoing multisite clinical trial on the effect of treatment of moderate to severe OSA on cognitive decline in older adults 65-85 years of age who have amnestic MCI. Unadjusted and adjusted linear models were used to examine predictors of mean hours of CPAP use at 3 months. Predictors were age, sex (male/female), race (White/Non-White), education (more than high school, less than high school), Apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS), and CPAP Comfort and Confidence scores at 7 days. Collinearity in the adjusted model for CPAP use at 3 months was examined using the variance inflation factor. Results Of 57 participants, most were male (54%), White (72%), with a mean age of 66.3 years (SD: 6.1). Mean AHI in this sample was 35.1 (SD: 19.9), with mean daily hours of CPAP use at 3 months 5.3 hours (SD: 2.3). Adjusted linear model results demonstrated that younger age (β=-0.13, SE=0.04, p=0.0032), White race (β=2.56, SE=0.58, p Conclusion Tailored interventions to increase self-efficacy during the first 7 days of CPAP treatment, especially in Non-Whites and those older than 74 years, may improve long-term CPAP adherence in older adults with amnestic MCI. Support R01AG054435