Disentangling the complex racial disparities in health among adult beneficiaries under Medicaid managed care: A structural equation modeling approach

There are few studies of the important issue of racial and ethnic disparities in Medicaid managed care settings. This study addresses this deficiency using data collected by telephone interviews from a randomly stratified sample of adults who were continuously enrolled in North Carolina Medicaid managed care for at least six months prior to sampling in 2006. It uses univariate statistics to describe health status and conducts a Pearson chi-square test to examine health status between non-Hispanic black adults and non-Hispanic white adults. Because chronic conditions were significantly related to health status, the study also computes three separate structural equation models to investigate the complex relationships between race, health status, and a number of other independent variables that theory suggests. The Medicaid managed care adult population had bad health: 50.02% reported “poor” or “fair” health, and 63.60% suffered from a chronic condition. Yet, contrary to most of the literature on race and health, the health status of non-Hispanic black adults in this study was significantly superior to that reported by non-Hispanic white adults. This surprising finding held for both the model of overall sample of adults, which fitted adequately with the sample data (CFI=0.921; RMSEA=.035) and explained 31% of the variance in health, and the model of adults with chronic conditions, which also fitted adequately with the sample data (CFI=0.93; RMSEA=.036) and explained 22% of the variance in health

HDAC1 and 2 regulate endothelial VCAM-1 expression and atherogenesis by suppressing methylation of the GATA6 promoter.

Increased expression of vascular cell adhesion molecule (VCAM)-1 on the activated arterial endothelial cell (EC) surface critically contributes to atherosclerosis which may in part be regulated by epigenetic mechanisms. This study investigated whether and how the clinically available histone deacetylases 1 and 2 (HDAC1/2) inhibitor drug Romidepsin epigenetically modulates VCAM-1 expression to suppress atherosclerosis. Methods: VCAM-1 expression was analyzed in primary human aortic EC (HAEC) treated with Romidepsin or transfected with HDAC1/2-targeting siRNA. Methylation of GATA6 promoter region was examined with methylation-specific PCR assay. Enrichment of STAT3 to GATA6 promoter was detected with chromatin immunoprecipitation. Lys685Arg mutation was constructed to block STAT3 acetylation. The potential therapeutic effect of Romidepsin on atherosclerosis was evaluated in Apoe -/- mice fed with a high-fat diet. Results: Romidepsin significantly attenuated TNFα-induced VCAM-1 expression on HAEC surface and monocyte adhesion through simultaneous inhibition of HDAC1/2. This downregulation of VCAM-1 was attributable to reduced expression of transcription factor GATA6. Romidepsin enhanced STAT3 acetylation and its binding to DNA methyltransferase 1 (DNMT1), leading to hypermethylation of the GATA6 promoter CpG-rich region at +140/+255. Blocking STAT3 acetylation at Lys685 disrupted DNMT1-STAT3 interaction, decreased GATA6 promoter methylation, and reversed the suppressive effects of HDAC1/2 inhibition on GATA6 and VCAM-1 expression. Finally, intraperitoneal administration of Romidepsin reduced diet-induced atherosclerotic lesion development in Apoe -/- mice, accompanied by a reduction in GATA6/VCAM-1 expression in the aorta. Conclusions: HDAC1/2 contributes to VCAM-1 expression and atherosclerosis by suppressing STAT3 acetylation-dependent GATA6 promoter methylation. These findings may provide a rationale for HDAC1/2-targeting therapy in atherosclerotic heart disease

An Intestinal Symbiotic Bacterial Strain of Oscheius chongmingensis Modulates Host Viability at Both Global and Post-Transcriptional Levels

A rhabditid entomopathogenic nematode (EPN), Oscheius chongmingensis, has a stable symbiotic relationship with the bacterial strain Serratia nematodiphila S1 harbored in its intestines and drastically reduced viability when associated with a non-native strain (186) of the same bacterial species. This nematode is thus a good model for understanding the molecular mechanisms and interactions involved between a nematode host and a member of its intestinal microbiome. Transcriptome analysis and RNA-seq data indicated that expression levels of the majority (8797, 87.59%) of mRNAs in the non-native combination of O. chongmingensis and S. nematodiphila 186 were downregulated compared with the native combination, including strain S1. Accordingly, 88.84% of the total uniq-sRNAs mapped in the O. chongmingensis transcriptome were specific between the two combinations. Six DEGs, including two transcription factors (oc-daf-16 and oc-goa-1) and four kinases (oc-pdk-1, oc-akt-1, oc-rtk, and oc-fak), as well as an up-regulated micro-RNA, oc-miR-71, were found to demonstrate the regulatory mechanisms underlying diminished host viability induced by a non-native bacterial strain. Oc-rtk and oc-fak play key roles in the viability regulation of O. chongmingensis by positively mediating the expression of oc-daf-16 to indirectly impact its longevity and stress tolerances and by negatively regulating the expression of oc-goa-1 to affect the olfactory chemotaxis and fecundity. In response to the stress of invasion by the non-native strain, the expression of oc-miR-71 in the non-native combination was upregulated to downregulate the expression of its targeting oc-pdk-1, which might improve the localization and activation of the transcription factor DAF-16 in the nucleus to induce longevity extension and stress resistance enhancement to some extent. Our findings provide novel insight into comprehension of how nematodes deal with the stress of encountering novel potential bacterial symbionts at the physiological and molecular genetic levels and contribute to improved understanding of host–symbiont relationships generally

Wide-Range Linear Iontronic Pressure Sensor with Two-Scale Random Microstructured Film for Underwater Detection

A broad linear range of ionic flexible sensors (IFSs) with high sensitivity is vital to guarantee accurate pressure acquisition and simplify back-end circuits. However, the issue that sensitivity gradually decreases as the applied pressure increases hinders the linearity over the whole working range and limits its wide-ranging application. Herein, we design a two-scale random microstructure ionic gel film with rich porosity and a rough surface. It increases the buffer space during compression, enabling the stress deformation to be more uniform, which makes sure that the sensitivity maintains steady as the pressure loading. In addition, we develop electrodes with multilayer graphene produced by a roll-to-roll process, utilizing its large interlayer spacing and ion-accessible surface area. It benefits the migration and diffusion of ions inside the electrolyte, which increases the unit area capacitance and sensitivity, respectively. The IFS shows ultra-high linearity and a linear range (correlation coefficient ∼ 0.9931) over 0–1 MPa, an excellent sensitivity (∼12.8 kPa–1), a fast response and relaxation time (∼20 and ∼30 ms, respectively), a low detection limit (∼2.5 Pa), and outstanding mechanical stability. This work offers an available path to achieve wide-range linear response, which has potential applications for attaching to soft robots, followed with sensing slight disturbances induced by ships or submersibles

Wide-Range Linear Iontronic Pressure Sensor with Two-Scale Random Microstructured Film for Underwater Detection

A broad linear range of ionic flexible sensors (IFSs) with high sensitivity is vital to guarantee accurate pressure acquisition and simplify back-end circuits. However, the issue that sensitivity gradually decreases as the applied pressure increases hinders the linearity over the whole working range and limits its wide-ranging application. Herein, we design a two-scale random microstructure ionic gel film with rich porosity and a rough surface. It increases the buffer space during compression, enabling the stress deformation to be more uniform, which makes sure that the sensitivity maintains steady as the pressure loading. In addition, we develop electrodes with multilayer graphene produced by a roll-to-roll process, utilizing its large interlayer spacing and ion-accessible surface area. It benefits the migration and diffusion of ions inside the electrolyte, which increases the unit area capacitance and sensitivity, respectively. The IFS shows ultra-high linearity and a linear range (correlation coefficient ∼ 0.9931) over 0–1 MPa, an excellent sensitivity (∼12.8 kPa–1), a fast response and relaxation time (∼20 and ∼30 ms, respectively), a low detection limit (∼2.5 Pa), and outstanding mechanical stability. This work offers an available path to achieve wide-range linear response, which has potential applications for attaching to soft robots, followed with sensing slight disturbances induced by ships or submersibles

Wide-Range Linear Iontronic Pressure Sensor with Two-Scale Random Microstructured Film for Underwater Detection

A broad linear range of ionic flexible sensors (IFSs) with high sensitivity is vital to guarantee accurate pressure acquisition and simplify back-end circuits. However, the issue that sensitivity gradually decreases as the applied pressure increases hinders the linearity over the whole working range and limits its wide-ranging application. Herein, we design a two-scale random microstructure ionic gel film with rich porosity and a rough surface. It increases the buffer space during compression, enabling the stress deformation to be more uniform, which makes sure that the sensitivity maintains steady as the pressure loading. In addition, we develop electrodes with multilayer graphene produced by a roll-to-roll process, utilizing its large interlayer spacing and ion-accessible surface area. It benefits the migration and diffusion of ions inside the electrolyte, which increases the unit area capacitance and sensitivity, respectively. The IFS shows ultra-high linearity and a linear range (correlation coefficient ∼ 0.9931) over 0–1 MPa, an excellent sensitivity (∼12.8 kPa–1), a fast response and relaxation time (∼20 and ∼30 ms, respectively), a low detection limit (∼2.5 Pa), and outstanding mechanical stability. This work offers an available path to achieve wide-range linear response, which has potential applications for attaching to soft robots, followed with sensing slight disturbances induced by ships or submersibles