Bioengineered Textiles and Nonwovens – the convergence of bio-miniaturisation and electroactive conductive polymers for assistive healthcare, portable power and design-led wearable technology

Today, there is an opportunity to bring together creative design activities to exploit the responsive and adaptive ‘smart’ materials that are a result of rapid development in electro, photo active polymers or OFEDs (organic thin film electronic devices), bio-responsive hydrogels, integrated into MEMS/NEMS devices and systems respectively. Some of these integrated systems are summarised in this paper, highlighting their use to create enhanced functionality in textiles, fabrics and non-woven large area thin films. By understanding the characteristics and properties of OFEDs and bio polymers and how they can be transformed into implementable physical forms, innovative products and services can be developed, with wide implications. The paper outlines some of these opportunities and applications, in particular, an ambient living platform, dealing with human centred needs, of people at work, people at home and people at play. The innovative design affords the accelerated development of intelligent materials (interactive, responsive and adaptive) for a new product & service design landscape, encompassing assistive healthcare (smart bandages and digital theranostics), ambient living, renewable energy (organic PV and solar textiles), interactive consumer products, interactive personal & beauty care (e-Scent) and a more intelligent built environment

Improved Functional Outcome After Peripheral Nerve Stimulation of the Impaired Forelimb Post-stroke

Lack of blood flow to the brain, i.e., ischemic stroke, results in loss of nerve cells and therefore loss of function in the effected brain regions. There is no effective treatment to improve lost function except restoring blood flow within the first several hours. Rehabilitation strategies are widely used with limited success. The purpose of this study was to examine the effect of electrical stimulation on the impaired upper extremity to improve functional recovery after stroke. We developed a rodent model using an electrode cuff implant onto a single peripheral nerve (median nerve) of the paretic forelimb and applied daily electrical stimulation. The skilled forelimb reaching test was used to evaluate functional outcome after stroke and electrical stimulation. Anterograde axonal tracing from layer V pyramidal neurons with biotinylated dextran amine was done to evaluate the formation of new neuronal connections from the contralesional cortex to the deafferented spinal cord. Rats receiving electrical stimulation on the median nerve showed significant improvement in the skilled forelimb reaching test in comparison with stroke only and stroke with sham stimulation. Rats that received electrical stimulation also exhibited significant improvement in the latency to initiate adhesive removal from the impaired forelimb, indicating better sensory recovery. Furthermore, axonal tracing analysis showed a significant higher midline fiber crossing index in the cervical spinal cord of rats receiving electrical stimulation. Our results indicate that direct peripheral nerve stimulation leads to improved sensorimotor recovery in the stroke-impaired forelimb, and may be a useful approach to improve post-stroke deficits in human patients

A Cohort Study of Public Health Insurance Coverage Loss among Oregon Adolescents

ABSTRACT Introduction: Churning on and off and/or experiencing coverage gaps is common among public health insurance recipients. Although the Affordable Care Act (ACA) provisions to extend parental coverage for adolescents transitioning to young adulthood on private insurance plans were implemented in 2010, no such protection was mandated for adolescents with public health insurance. Methods: Oregon public health insurance enrollment and electronic health record data from community health centers were used to conduct a retrospective, observational cohort study of Oregon adolescents (17-19 years of age) with public coverage [January 1, 2011-December 31, 2013 (n=51,988)] to assess loss. Time-to-event methods determined the association of coverage loss with sociodemographic characteristics. Results: Although adolescents are vulnerable to coverage loss as they age out of child public health insurance coverage, \u3e35% of 19 year olds in this study kept their coverage for up to one year after their 19th birthday. Conclusions: Our findings suggest that the support many community health centers offer to help their patients maintain insurance coverage may be having an impact, especially during this important transition period. Additional research to understand how these 19 year olds were able to keep coverage will provide recommendations for future adolescents as they transition to young adulthood

PI3K-δ and PI3K-γ Inhibition by IPI-145 Abrogates Immune Responses and Suppresses Activity in Autoimmune and Inflammatory Disease Models

SummaryPhosphoinositide-3 kinase (PI3K)-δ and PI3K-γ are preferentially expressed in immune cells, and inhibitors targeting these isoforms are hypothesized to have anti-inflammatory activity by affecting the adaptive and innate immune response. We report on a potent oral PI3K-δ and PI3K-γ inhibitor (IPI-145) and characterize this compound in biochemical, cellular, and in vivo assays. These studies demonstrate that IPI-145 exerts profound effects on adaptive and innate immunity by inhibiting B and T cell proliferation, blocking neutrophil migration, and inhibiting basophil activation. We explored the therapeutic value of combined PI3K-δ and PI3K-γ blockade, and IPI-145 showed potent activity in collagen-induced arthritis, ovalbumin-induced asthma, and systemic lupus erythematosus rodent models. These findings support the hypothesis that inhibition of immune function can be achieved through PI3K-δ and PI3K-γ blockade, potentially leading to significant therapeutic effects in multiple inflammatory, autoimmune, and hematologic diseases

Children’s Receipt of Health Care Services and Family Health Insurance Patterns

PURPOSE Insured children in the United States have better access to health care services; less is known about how parental coverage affects children’s access to care. We examined the association between parent-child health insurance coverage patterns and children’s access to health care and preventive counseling services

Pediatric Endocrinology Milestones 2.0—guide to their implementation

Abstract The Milestones were initiated by the Accreditation Council for Graduate Medical Education (ACGME) to provide a framework for monitoring a trainee’s progression throughout residency/fellowship. The Milestones describe stepwise skill progression through six core domains of clinical competency: Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Practice-based Learning and Improvement, Professionalism, and Systems-based Practice. Since their introduction in 2013, several barriers to implementation have emerged. Thus, the ACGME launched the Milestones 2.0 project to develop updated specialty-specific milestones. The Pediatric Endocrinology Milestones 2.0 project aimed to improve upon Milestones 1.0 by addressing common limitations, providing resources for faculty to easily incorporate milestones into their assessment of trainees, and adding sub-competencies in health disparities, patient safety, and physician well-being. This paper reviews the development of the Pediatric Endocrinology Milestones 2.0 including the major changes from Milestones 1.0, development of the Supplemental Guide, and how Milestones 2.0 can be applied at the program level. Although use of the Milestones are required only for ACGME programs, the tools provided in Milestones 2.0 are applicable to fellowship programs worldwide

Abstract 3204: Association between oxidative damage and early adverse skin reactions following postoperative adjuvant radiotherapy in breast cancer patients

Abstract Breast cancer is the most frequently diagnosed cancer and the second leading cause of cancer death in American women. Lumpectomy followed by radiotherapy (RT) has significantly improved survival. However, about 30% of patients develop a grade 2 or worse early or late skin reaction, pain, breast edema and poor cosmetic results that impact quality of life. Inter-individual variability in the development of RT-induced adverse reactions in normal tissue is well-documented for both acute and late effects. Therefore, identifying individuals which may have severe reactions could assist the radiation oncologist in tailoring a treatment regimen which provides adequate care with minimal undesirable effects. One of the hallmarks of radiation induced DNA damage is the oxidation of the nucleotide guanine. Repair and excretion of this modified base known as 8-hydroxydeoxyguanosine (8-OHdG) serves as a biomarker of oxidative stress and DNA damage. In an ongoing study, we investigated the urinary level of 8-OHdG (presented as ng/mg creatinine) in urine of the first 103 breast cancer patients undergoing adjuvant RT following breast conservation surgery. The normal skin toxicity at 3 weeks and at the end of treatment was assessed and associated with 8-OHdG levels. There was a significant correlation between pre- (55.8+35.2) and post-RT (55.5+37.4) urinary 8-OHdG levels (Pearson correlation coefficient=0.44; p&amp;lt;0.001). Within our patient population, Non-Hispanic Whites had a significantly higher 8-OHdG level (80.9+52.6) compared to Hispanic Whites (48.2+25.2, p=0.001) and Black or African Americans (43.7+20.9, p=0.008). With limited sample size, at 3 weeks of post-RT, patients with no apparent skin reaction showed a non-significantly lower pre-RT 8-OHdG (46.4+23.5) compared to patients with a grade 1 or 2 skin toxicity (57.8+37.5, p=0.18). Similar trend was also observed for post-RT 8-OHdG (45.6+20.7 vs. 57.7+40.3; p=.20). At the end of RT, patients with detectable skin toxicity had a baseline 8-OHdG level of 56.0+35.6 while patients without a skin reaction had a baseline level of 39.6+17.6. In summary, our preliminary data with limited sample size showed significant racial/ethnic differences in urinary 8-OHdG levels and promising but not significant association between 8-OHdG levels and skin toxicity grade. Larger studies are warranted to validate these interesting findings. The outcome of the ongoing study (n=1000) will target effective intervention and treatment strategies, and ultimately improve quality of life and progression-free survival in high-risk breast cancer patient populations. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3204. doi:10.1158/1538-7445.AM2011-3204</jats:p