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The use of structural equation models for causal inference from panel data is critiqued in the causal inference literature for unnecessarily relying on a large number of parametric assumptions, and alternative methods originating from the potential outcomes framework have been recommended, such as inverse probability weighting (IPW) estimation of marginal structural models (MSMs). To better understand this criticism, we describe three phases of causal research. We explain (differences in) the assumptions that are made throughout these phases for structural equation modeling (SEM) and IPW-MSM approaches using an empirical example. Second, using simulations we compare the finite sample performance of SEM and IPW-MSM for the estimation of time-varying exposure effects on an end-of-study outcome under violations of parametric assumptions. Although increased reliance on parametric assumptions does not always translate to increased bias (even under model misspecification), researchers are still well-advised to acquaint themselves with causal methods from the potential outcomes framework.

Emotions influence health behaviors and outcomes, yet little research has examined the emotion–health relationship among sexual minorities. The few studies in this area have used general measures of feelings without regard for identity, despite the literature positing emotions as culturally and contextually specific. This critical limitation obscures inferences made in studies that have found emotions to predict mental health outcomes for sexual minorities. This study begins to address this gap by developing and examining the preliminary validation of the Sexual Minority Identity Emotion Scale, a measure of shame and pride specific to the identity experiences of sexual minority adolescents. The initial pool of items emerged from a qualitative study and was refined through a multistep review. The measurement’s factor structure and criterion validity were examined using a nationwide sample of 273 sexual minority adolescents from the United States. The scale has four factors with strong internal reliability, adequate criterion validity, and utility in health research.

Abstract In this Data Descriptor, we present county-level electricity outage estimates at 15-minute intervals from 2014 to 2022. By 2022 92% of customers in the 50 US States, Washington DC, and Puerto Rico are represented. These data have been produced by the Environment for Analysis of Geo-Located Energy Information (EAGLE-I TM ), a geographic information system and data visualization platform created at Oak Ridge National Laboratory to map the population experiencing electricity outages every 15 minutes at the county level. Although these data do not cover every US customer, they represent the most comprehensive outage information ever compiled for the United States. The rate of coverage increases through time between 2014 and 2022. We present a quantitative Data Quality Index for these data for the years 2018–2022 to demonstrate temporal changes in customer coverage rates by FEMA region and indicators of data collection gaps or other errors.

Understanding differences in how demographic groups experience telehealth may be relevant in addressing potential disparities in telehealth usage. We seek to identify and examine themes most pertinent to patients’ negative telehealth experiences by age and race in order to inform interventions to improve patients’ future telehealth experiences. We performed a content analysis of Press Ganey patient experience surveys from adult patients at 17 primary care sites of a large, public healthcare system with visits from April 30, 2020 to August 27, 2021. We used sentiment analysis to identify negative comments. We coded for content themes and analyzed their frequency, stratifying by age and race. We analyzed 745 negative comments. Most frequent themes differed by demographic categories, but overall, the most commonly applied codes were “Contacting the Clinic” (n = 97), “Connectivity” (n = 84), and “Webside Manner” (n = 79). The top three codes accounted for >40% of the negative codes in each race category and >35% of the negative codes in each age category. While there were common negative experiences among groups, patients of different demographics highlighted different aspects of their telehealth experiences for potential improvement.

This study examines whether patients’ telehealth experiences differed during a health system mandate for telehealth encounters due to the COVID-19 pandemic versus after the mandate was relaxed. Patient experience surveys from telehealth visits across 17 adult (age 18+) primary care sites at a large, urban public health system were analyzed during two periods: when a mandate was active (March 1, 2020-June 30, 2020) and when the mandate was relaxed and any appointment modality was available (July 1, 2020-November 30, 2021). Primary outcomes were odds ratios (ORs) comparing top-box percentages of survey responses at multiple levels: individual questions, four domains, and all questions together as a composite. Key findings: Patients had higher odds of selecting top-box answers in the elective telehealth period for the Care Provider (1.09 [95% confidence interval 1.03, 1.16]) and General Assessment (1.13 [1.02, 1.24]) domains and the survey composite (1.08 [1.04, 1.13]), but there was no difference for individual questions. Women reported more positive experiences during the elective telehealth period in the Access (1.22 [1.01, 1.47]), Care Provider (1.32 [1.17, 1.50]), and Telemedicine Technology (1.24 [1.04, 1.50]) domains. Our findings suggest that patients had better telehealth experiences when mandates were relaxed.

Abstract Most cancers occur in older people and the burden in this age group is increasing. Over the past two decades the evidence on how best to treat this population has increased rapidly. However, implementation of new best practices has been slow and needs involvement of policymakers. This perspective paper explains why older people with cancer have different needs than the wider population. An overview is given of the recommended approach for older people with cancer and its benefits on clinical outcomes and cost-effectiveness. In older patients, the geriatric assessment (GA) is the gold standard to measure level of fitness and to determine treatment tolerability. The GA, with multiple domains of physical health, functional status, psychological health and socio-environmental factors, prevents initiation of inappropriate oncologic treatment and recommends geriatric interventions to optimize the patient’s general health and thus resilience for receiving treatments. Multiple studies have proven its benefits such as reduced toxicity, better quality of life, better patient-centred communication and lower healthcare use. Although GA might require investment of time and resources, this is relatively small compared to the improved outcomes, possible cost-savings and compared to the large cost of oncologic treatments as a whole.

A fiber-rich diet is considered beneficial for gut health. An inflamed gut with a dysbiotic bacterial community can result in altered fiber metabolism depending on the fiber’s physicochemical properties. This study examined the effect of fiber’s physicochemical properties on fiber fermentation in the presence of healthy and colitis-associated bacteria. Sixteen fibers with different levels of solubility, complexity, and fermentation rate were used in in vitro fermentation with healthy human gut bacteria. Resistant maltodextrins (RMD), pectin (HMP), inulin (ChIn), and wheat bran (WB) were selected for fermentation using ulcerative colitis (UC)-associated bacteria to assess bacterial dysbiosis effect. UC-associated gut microbiota showed a significant reduction in α-and β-diversity indices compared to healthy-associated microbiota. The differences in the gut microbiota composition and diversity between the donors resulted in decreased fermentation rates with UC-associated bacteria. Fiber fermentation metabolites, short-chain fatty acids (SCFA) and gas production were significantly lower in the presence of UC-associated bacteria for all four fibers tested. Overall, we conclude that dietary fiber properties and microbial dysbiosis are influential in fiber fermentation and metabolite production in the gut.

Abstract The structure and properties of phytoglycogen and glycogen subjected to acid hydrolysis was investigated using amylopectin as a reference. The degradation took place in two stages and the degree of hydrolysis was in the following order: amylopectin > phytoglycogen > glycogen. Upon acid hydrolysis, the molar mass distribution of phytoglycogen or glycogen gradually shifted to the smaller and broadening distribution region, whereas the distribution of amyopectin changed from bimodal to monomodal shape. The kinetic rate constant for depolymerization of phytoglycogen, amylopectin, and glycogen were 3.45 × 10−5/s, 6.13 × 10−5/s, and 0.96 × 10−5/s, respectively. The acid-treated sample had the smaller particle radius, lower percentage of α-1,6 linkage as well as higher rapidly digestible starch fractions. The depolymerization models were built to interpret the structural differences of glucose polymer during acid treatment, which would provide guideline to improve the structure understanding and precise application of branched glucan with desired properties.

Abstract Next generation amplicon sequencing has created a plethora of data from human microbiomes. The accessibility to this scientific data and its corresponding metadata is important for its reuse, to allow for new discoveries, verification of published results, and serving as path for reproducibility. Dietary fiber consumption has been associated with a variety of health benefits that are thought to be mediated by gut microbiota. To enable direct comparisons of the response of the gut microbiome to fiber, we obtained 16S rRNA sequencing data and its corresponding metadata from 11 fiber intervention studies for a total of 2,368 samples. We provide curated and pre-processed genetic data and common metadata for comparison across the different studies.

Recent awareness related to health concerns and environmental sustainability issues have led to changes in consumer preference toward plant-based proteins and the related market has been booming with growing investments and new plant-based alternatives. However, this relatively new market needs to make improvements in the quality of products (e.g., texture, flavor, and color) to match those of meat and cheese products. Specifically, forming an anisotropic structure to have similar textural properties has become one of the biggest challenges. To enable this, advanced and novel technologies (e.g., extrusion, shear-structuring, 3D printing, electrospinning, and freeze-structuring), as well as functional ingredients (e.g., binding/viscoelastic agents, crosslinkers), have been introduced to provide meat-like textures to analogue products. Even though the texture-related problems of meat alternatives have been resolved to some extent with use of methylcellulose or wheat gluten, there is still a search for natural and chemically-free ingredients to align with a desire for “clean label” products. Here, we postulate that corn zein, and perhaps other similar viscoelastic plant proteins, can be used to provide the necessary textural properties to plant-based meat analogues instead of currently used ingredients. In this review, a comprehensive assessment of state-of-the-field processing techniques as well as functional ingredients (both already available and potential ones) necessary to provide the desired characteristics to plant-based protein products is given.

Abstract Background Mammalian cell lines are frequently used as protein expression hosts because of their ability to correctly fold and assemble complex proteins, produce them at high titers, and confer post-translational modifications (PTMs) critical to proper function. Increasing demand for proteins with human-like PTMs, particularly viral proteins and vectors, have made human embryonic kidney 293 (HEK293) cells an increasingly popular host. The need to engineer more productive HEK293 platforms and the ongoing nature of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic presented an opportunity to study strategies to improve viral protein expression in transient and stable HEK293 platforms. Results Initial process development was done at 24 deep well plate (DWP) -scale to screen transient processes and stable clonal cell lines for recombinant SARS-CoV-2 receptor binding domain (rRBD) titer. Nine DNA vectors that drove rRBD production under different promoters and optionally contained Epstein-Barr virus (EBV) elements to promote episomal expression were screened for transient rRBD production at 37 °C or 32 °C. Use of the cytomegalovirus (CMV) promoter to drive expression at 32 °C led to the highest transient protein titers, but inclusion of episomal expression elements did not augment titer. In parallel, four clonal cell lines with titers higher than that of the selected stable pool were identified in a batch screen. Flask-scale transient transfection and stable fed-batch processes were then established that produced rRBD up to 100 mg/L and 140 mg/L, respectively. While a bio-layer interferometry (BLI) assay was crucial for efficiently screening DWP batch titers, an enzyme-linked immunosorbent assay (ELISA) was used to compare titers from the flask-scale batches due to varying matrix effects from different cell culture media compositions. Conclusion Comparing yields from the flask-scale batches revealed that stable fed-batch cultures produced up to 2.1x more rRBD than transient processes. The stable cell lines developed in this work are the first reported clonal, HEK293-derived rRBD producers and have titers up to 140 mg/L. As stable production platforms are more economically favorable for long-term protein production at large scales, investigation of strategies to increase the efficiency of high-titer stable cell line generation in Expi293F or other HEK293 hosts is warranted.

This study found that a prebiotic intervention was well-tolerated and safe, beneficially changed the microbiome, decreased inflammation and a marker of neurodegeneration, with possible clinical effects in Parkinson’s disease (PD) patients. This study offers the rationale for further investigations using prebiotic fibers in PD.

Abstract Insoluble plant cell walls are a main source of dietary fiber. Both chemical and physical fiber structures create distinct niches for gut bacterial utilization. Here, we have taken key fermentable solubilized polysaccharides of plant cell walls and fabricated them back into cell wall-like film forms to understand how fiber physical structure directs gut bacterial fermentation outcomes. Solubilized corn bran arabinoxylan (Cax), extracted to retain some ferulate residues, was covalently linked using laccase to form an insoluble cell wall-like film (Cax-F) that was further embedded with pectin (CaxP-F). In vitro fecal fermentation using gut microbiota from three donors was performed on the films and soluble fibers. Depending on the donor, CaxP-F led to higher relative abundance of recognized beneficial bacteria and/or butyrate producers—Akkermansia, Bifidobacterium, Eubacterium halii, unassigned Lachnospiraceae, Blautia, and Anaerostipes—than free pectin and Cax, and Cax-F. Thus, physical form and location of fibers within cell walls form niches for some health-related gut bacteria. This work brings a new understanding of the importance of insoluble cell wall-associated fibers and shows that targeted fiber materials can be fabricated to support important gut microbiota taxa and metabolites of health significance.