Dynamic changes in diffusion measures improve sensitivity in identifying patients with mild traumatic brain injury.

The goal of this study was to investigate patterns of axonal injury in the first week after mild traumatic brain injury (mTBI). We performed a prospective cohort study of 20 patients presenting to the emergency department with mTBI, using 3.0T diffusion tensor MRI immediately after injury and again at 1 week post-injury. Corresponding data were acquired from 16 controls over a similar time interval. Fractional anisotropy (FA) and other diffusion measures were calculated from 11 a priori selected axon tracts at each time-point, and the change across time in each region was quantified for each subject. Clinical outcomes were determined by standardized neurocognitive assessment. We found that mTBI subjects were significantly more likely to have changes in FA in those 11 regions of interest across the one week time period, compared to control subjects whose FA measurements were stable across time. Longitudinal imaging was more sensitive to these subtle changes in white matter integrity than cross-sectional assessments at either of two time points, alone. Analyzing the sources of variance in our control population, we show that this increased sensitivity is likely due to the smaller within-subject variability obtained by longitudinal analysis with each subject as their own control. This is in contrast to the larger between-subject variability obtained by cross-sectional analysis of each individual subject to normalized data from a control group. We also demonstrated that inclusion of all a priori ROIs in an analytic model as opposed to measuring individual ROIs improves detection of white matter changes by overcoming issues of injury heterogeneity. Finally, we employed genetic programming (a bio-inspired computational method for model estimation) to demonstrate that longitudinal changes in FA have utility in predicting the symptomatology of patients with mTBI. We conclude concussive brain injury caused acute, measurable changes in the FA of white matter tracts consistent with evolving axonal injury and/or edema, which may contribute to post-concussive symptoms.

Breast cancer screening in patients with cancers other than breast.

BACKGROUND: Screening mammography can detect early breast cancers and reduce subsequent cancer mortality. However, there is a lack of consensus as to when to discontinue screening. The absence of clear-cut guidelines on when not to screen means that many patients with advanced malignancies continue screening despite unclear benefit. METHODS: We performed a retrospective cohort study of female patients diagnosed with a non-breast malignancy to explore the incidence and effects of screening mammography. Female patients diagnosed with a non-breast malignancy stage II or higher between 2007 and 2012 were identified through the Vermont Cancer Registry and cross-referenced with mammography screening logs from January 1, 2007 to September 30, 2014. Additional data were collected through chart review, in May 2016. RESULTS: Twenty-six percent of women (398/1501) with a stage II or greater cancer (other than breast) diagnosed between 2007 and 2012 had a screening mammogram within the first 5 years of their diagnosis. Of these 398 women, 193 (48.5%) were alive without cancer, 132 (33.2%) had died, and 73 (18.3%) were alive with cancer at the time of chart review. Of those who died, 84 (63.6%) had a stage III or IV cancer. Eighteen (4.5%) had a breast biopsy following a screening mammogram suspicious for cancer, resulting in 13 (3.3%) benign diagnoses and 5 (1.3%) breast cancer diagnoses. No patient died of breast cancer. CONCLUSIONS: Except for highly curable cancers, female patients diagnosed with an advanced non-breast malignancy experienced mortality that outweighs a breast cancer mortality benefit from screening mammography as estimated from prior studies.

Influence of molecular structure on the antimicrobial function of phenylenevinylene conjugated oligoelectrolytes.

Conjugated oligoelectrolytes (COEs) with phenylenevinylene (PV) repeat units are known to spontaneously intercalate into cell membranes. Twelve COEs, including seven structures reported here for the first time, were investigated for the relationship between their membrane disrupting properties and structural modifications, including the length of the PV backbone and the presence of either a tetraalkylammonium or a pyridinium ionic pendant group. Optical characteristics and interactions with cell membranes were determined using UV-Vis absorption and photoluminescence spectroscopies, and confocal microscopy. Toxicity tests on representative Gram-positive (Enterococcus faecalis) and Gram-negative (Escherichia coli) bacteria reveal generally greater toxicity to E. faecalis than to E. coli and indicate that shorter molecules have superior antimicrobial activity. Increased antimicrobial potency was observed in three-ring COEs appended with pyridinium ionic groups but not with COEs with four or five PV repeat units. Studies with mutants having cell envelope modifications indicate a possible charge based interaction with pyridinium-appended compounds. Fluorine substitutions on COE backbones result in structures that are less toxic to E. coli, while the addition of benzothiadiazole to COE backbones has no effect on increasing antimicrobial function. A weakly membrane-intercalating COE with only two PV repeat units allowed us to determine the synthetic limitations as a result of competition between solubility in aqueous media and association with cell membranes. We describe, for the first time, the most membrane disrupting structure achievable within two homologous series of COEs and that around a critical three-ring backbone length, structural modifications have the most effect on antimicrobial activity.

Tuning cell surface charge in E. coli with conjugated oligoelectrolytes.

Cationic conjugated oligoelectrolytes (COEs) varying in length and structural features are compared with respect to their association with E. coli and their effect on cell surface charge as determined by zeta potential measurements. Regardless of structural features, at high staining concentrations COEs with longer molecular dimensions associate less, but neutralize the negative surface charge of E. coli to a greater degree than shorter COEs.

Phenylenevinylene conjugated oligoelectrolytes as fluorescent dyes for mammalian cell imaging.

Conjugated phenylenevinylene oligoelectrolytes, which consist of a phenylenevinylene core equipped at each end with hydrophilic pendent groups, are shown to be good candidates for mammalian cell membrane staining. When used in the micromolar concentration range, they express low to moderate cell toxicity for selected regular and cancerous cell lines as tested for adherent and suspension cells.

Synthesis, characterization, and biological affinity of a near-infrared-emitting conjugated oligoelectrolyte.

A near-IR-emitting conjugated oligoelectrolyte (COE), ZCOE, was synthesized, and its photophysical features were characterized. The biological affinity of ZCOE is compared to that of an established lipid-membrane-intercalating COE, DSSN+, which has blue-shifted optical properties making it compatible for tracking preferential sites of accumulation. ZCOE exhibits diffuse staining of E. coli cells, whereas it displays internal staining of select yeast cells which also show propidium iodide staining, indicating ZCOE is a "dead" stain for this organism. Staining of mammalian cells reveals complete internalization of ZCOE through endocytosis, as supported by colocalization with LysoTracker and late endosome markers. In all cases DSSN+ persists in the outer membranes, most likely due to its chemical structure more closely resembling a lipid bilayer.

Modeling cell membrane perturbation by molecules designed for transmembrane electron transfer.

Certain conjugated oligoelectrolytes (COEs) modify biological function by improving charge transfer across biological membranes as demonstrated by their ability to boost performance in bioelectrochemical systems. Molecular level understanding of the nature of the COE/membrane interactions is lacking. Thus, we investigated cell membrane perturbation by three COEs differing in the number of aromatic rings and presence of a fluorine substitution. Molecular dynamic simulations showed that membrane deformation by all COEs resulted from membrane thinning as the lipid phosphate heads were drawn toward the center of the bilayer layer by positively charged COE side chains. The four-ringed COE, which most closely resembled the lipid bilayer in length, deformed the membrane the least and was least disruptive, as supported by toxicity testing (minimum inhibitory concentration (MIC) = 64 µmol L(-1)) and atomic force microscopy (AFM). Extensive membrane thinning was observed from three-ringed COEs, reducing membrane thickness to <3.0 nm in regions where the COEs were located. Severe localized membrane pitting was observed when the central aromatic ring was unfluorinated, as evident from AFM and simulations. Fluorinating the central aromatic ring delocalized thinning but induced greater membrane disorder, indicated by changes in deuterium order parameter of the acyl chains. The fluorinated three-ringed compound was less toxic (MIC 4 µmol L(-1)) than the nonfluorinated three-aromatic-ringed COE (MIC 2 µmol L(-1)); thus, hydrophobic polar interactions resulting from fluorine substitution of OPV COEs dissipate membrane perturbations. Correlating specific structural features with cell membrane perturbation is an important step toward designing non-antimicrobial membrane insertion molecules.

Self-assembly of poly{1,4-phenylene-[9,9-bis(4-phenoxy-butylsulfonate)]fluorene-2,7-diyl} with oppositely charged phenylenevinylene oligoelectrolytes.

The interaction of the water-soluble conjugated polyelectrolyte (CPE) poly{1,4-phenylene-[9,9-bis(4-phenoxy-butylsulfonate)]fluorene-2,7-diyl} (PBS-PFP) (degree of polymerization, DP, ∼3-6) with various concentrations of a homologous series of oppositely charged amphiphilic phenylenevinylene oligomers was investigated in water:dioxane mixtures and in aqueous micellar solutions of the non-ionic surfactant n-dodecylpentaoxyethylene glycol ether. The excellent spectral overlap between the CPE fluorescence and the conjugated oligoelectrolyte (COE) absorption indicates that energy transfer between these is a highly favored process, and can be tuned by changing the COE chain length. This is supported by time-resolved fluorescence data. The overall results provide support for different types of self-assembly, which are sensitive to the solvent environment and to the size of the phenylenevinylene oligoelectrolyte chain. It is suggested that large aggregates are formed in water:dioxane mixtures, while decorated core-shell structures are present in the surfactant solutions.

Increased ion conductance across mammalian membranes modified with conjugated oligoelectrolytes.

Variation in conjugated oligoelectrolyte (COE) repeat units is shown to affect the rate of COE insertion into mammalian membrane patches and membrane patch stabilities. These findings suggest that it is possible to find COE structures that do not destroy membranes while at the same time allow for more facile transmembrane movement of ions/substrates.

Aggregation properties of p-phenylene vinylene based conjugated oligoelectrolytes with surfactants.

The amphiphilic properties of conjugated oligoelectrolytes (COE) and their sensitivity to the polarity of their microenvironment lead to interesting aggregation behavior, in particular in their interaction with surfactants. Photoluminescence (PL) spectroscopy, liquid-phase atomic force microscopy, small-angle neutron scattering, small-angle X-ray scattering, and grazing-incidence X-ray diffraction were used to examine interactions between cationic p-phenylene vinylene based oligoelectrolytes and surfactants. These techniques indicate the formation of COE/surfactant aggregates in aqueous solution, and changes in the photophysical properties are observed when compared to pure aqueous solutions. We evaluate the effect of the charge of the surfactant polar headgroup, the size of the hydrophobic chain, and the role of counterions. At low COE concentrations (micromolar), it was found that these COEs display larger emission quantum efficiencies upon incorporation into micelles, along with marked blue-shifts of the PL spectra. This effect is most pronounced in the series of anionic surfactants, and the degree of blue shifts as a function of surfactant charge is as follows: cationic < nonionic < anionic surfactants. In anionic surfactants, such as sodium dodecyl sulfate (SDS), the PL spectra show vibronic resolution above the critical micelle concentration of the surfactant, suggesting more rigid structures. Scattering data indicate that in aqueous solutions, trimers appear as essentially 3-dimensional particles, while tetra- and pentamers form larger, cylindrical particles. When the molar ratio of nonionic C12E5 surfactant to 1,4-bis(4-{N,N-bis-[(N,N,N-trimethylammonium)hexyl]amino}-styryl)benzene tetraiodide (DSBNI) is close to one, the size of the formed DSBNI-C12E5 particles corresponds to the full coverage of individual oligomers. When these particles are transferred into thin films, they organize into a cubic in-plane pattern. If anionic SDS is added, the formed DSBNI-SDS particles are larger than expected for full surfactant coverage, and particles may thus contain several oligomers. This tendency is attributed to the merging of DSBNI oligomers due to the charge screening and, thus, reduced water solubility.

Improving charge collection in Escherichia coli-carbon electrode devices with conjugated oligoelectrolytes.

It is important to tailor biotic-abiotic interfaces in order to maximize the utility of bioelectronic devices such as microbial fuel cells (MFCs), electrochemical sensors and bioelectrosynthetic systems. The efficiency of electron-equivalent extraction (or injection) across such biotic-abiotic interfaces is dependent on the choice of the microbe and the conductive electrode material. In this contribution, we show that spontaneous intercalation of a conjugated oligoelectrolyte, namely 4,4'-bis(4'-(N,N-bis(6''-(N,N,N-trimethylammonium)hexyl)amino)-styryl)stilbene tetraiodide (DSSN+), into the membranes of Escherichia coli leads to an increase in current generation in MFCs containing carbon-based electrodes. A combination of scanning electron microscopy (SEM) and confocal microscopy was employed to confirm the incorporation of DSSN+ into the cell membrane and biofilm formation atop carbon felt electrodes. Current collection was enhanced by more than 300% with addition of this conjugated oligoelectrolyte. The effect of DSSN+ concentration on electrical output was also investigated. Higher concentrations, up to 25 µM, lead to an overall increase in the number of charge equivalents transferred to the charge-collecting electrode, providing evidence in support of the central role of the synthetic system in improving device performance.

Conjugated oligoelectrolytes increase power generation in E. coli microbial fuel cells.

A series of conjugated oligoelectrolytes with structural variations is used to stain E. coli. By taking advantage of a high-throughput screening platform that incorporates gold anodes, it is found that MFCs with COE-modified E. coli generate significantly higher power densities, relative to unmodified E. coli. These findings highlight the potential of using water-soluble molecules inspired by the work on organic semiconductors to improve electrode/microbe interfaces.