Disconnect between the effects of serelaxin on renal function and outcome in acute heart failure.

BACKGROUND: We aimed to study whether improvement in renal function by serelaxin in patients who were hospitalized for acute heart failure (HF) might explain any potential effect on clinical outcomes. METHODS: We included 6318 patients from the RELAXin in AHF-2 (RELAX-AHF2) study. Improvement in renal function was defined as a decrease in serum creatinine of ≥ 0.3 mg/dL and ≥ 25%, or increase in estimated glomerular filtration rate of ≥ 25% between baseline and day 2. Worsening renal function (WRF) was defined as the reverse. We performed causal mediation analyses regarding 180-day all-cause mortality (ACM), cardiovascular death (CVD), and hospitalization for HF/renal failure. RESULTS: Improvement in renal function was more frequently observed with serelaxin when compared with placebo [OR 1.88 (95% CI 1.64-2.15, p < 0.0001)], but was not associated with subsequent clinical outcomes. WRF occurred less frequent with serelaxin [OR 0.70 (95% CI 0.60-0.83, p < 0.0001)] and was associated with increased risk of ACM, worsening HF and the composite of CVD and HF or renal failure hospitalization. Improvement in renal function did not mediate the treatment effect of serelaxin [CVD HR 1.01 (0.99-1.04), ACM HR 1.01 (0.99-1.03), HF/renal failure hospitalization HR 0.99 (0.97-1.00)]. CONCLUSIONS: Despite the significant improvement in renal function by serelaxin in patients with acute HF, the potential beneficial treatment effect was not mediated by improvement in renal function. These data suggest that improvement in renal function might not be a suitable surrogate marker for potential treatment efficacy in future studies with novel relaxin agents in acute HF. Central illustration. Conceptual model explaining mediation analysis; treatment efficacy of heart failure therapies mediated by renal function.

Iceberg melting substantially modifies oceanic heat flux towards a major Greenlandic tidewater glacier.

Fjord dynamics influence oceanic heat flux to the Greenland ice sheet. Submarine iceberg melting releases large volumes of freshwater within Greenland's fjords, yet its impact on fjord dynamics remains unclear. We modify an ocean model to simulate submarine iceberg melting in Sermilik Fjord, east Greenland. Here we find that submarine iceberg melting cools and freshens the fjord by up to ~5 °C and 0.7 psu in the upper 100-200 m. The release of freshwater from icebergs drives an overturning circulation, resulting in a ~10% increase in net up-fjord heat flux. In addition, we find that submarine iceberg melting accounts for over 95% of heat used for ice melt in Sermilik Fjord. Our results highlight the substantial impact that icebergs have on the dynamics of a major Greenlandic fjord, demonstrating the importance of including related processes in studies that seek to quantify interactions between the ice sheet and the ocean.

Expanding role of percutaneous cholecystostomy and interventional radiology for the management of acute cholecystitis: An analysis of 144 patients.

PURPOSE: To investigate the rates of interval cholecystectomy and recurrent cholecystitis after initial percutaneous cholecystostomy (PC) and identify predictors of patient outcome after PC. MATERIALS AND METHODS: A total of 144 patients with acute cholecystitis who were treated with PC were included. There were 96 men and 48 women, with a mean age of 71±13 (SD) years (range: 25-100 years). Patient characteristics, diagnostic imaging studies and results of laboratory tests at initial presentation, clinical outcomes after the initial PC treatment were reviewed. RESULTS: Among the 144 patients, 56 patients were referred for acute acalculous and 88 patients for calculus cholecystitis. Five procedure-related major complications (3.6%) were observed including bile peritonitis (n=3), hematoma (n=1) and abscess formation (n=1). Recurrent acute cholecystitis after initial clinical resolution and PC tube removal was observed in 8 patients (6.0%). The rate of interval cholecystectomy was 33.6% (47/140) with an average interval period of 100±482 (SD) days (range: 3-1017 days). PC was a definitive treatment in 85 patients (60.7%) whereas 39 patients (27.9%) had elective interval cholecystectomy without having recurrent cholecystitis. The clinical outcomes after PC did not significantly differ between patients with calculous cholecystitis and those with acalculous cholecystitis. Multiple prior abdominal operations were associated with higher rates of recurrent cholecystitis. CONCLUSION: For both acute acalculous and calculous cholecystitis, PC is an effective and definitive treatment modality for more than two thirds of our study patients over 3.5-year study period with low rates of recurrent disease and interval cholecystectomy.

Plasticity, elasticity, and adhesion energy of plant cell walls: nanometrology of lignin loss using atomic force microscopy.

The complex organic polymer, lignin, abundant in plants, prevents the efficient extraction of sugars from the cell walls that is required for large scale biofuel production. Because lignin removal is crucial in overcoming this challenge, the question of how the nanoscale properties of the plant cell ultrastructure correlate with delignification processes is important. Here, we report how distinct molecular domains can be identified and how physical quantities of adhesion energy, elasticity, and plasticity undergo changes, and whether such quantitative observations can be used to characterize delignification. By chemically processing biomass, and employing nanometrology, the various stages of lignin removal are shown to be distinguished through the observed morphochemical and nanomechanical variations. Such spatially resolved correlations between chemistry and nanomechanics during deconstruction not only provide a better understanding of the cell wall architecture but also is vital for devising optimum chemical treatments.

Life, lifestyle and location: examining the complexities of psychological distress in young adult Indigenous and non-Indigenous Australians.

Mental health is fundamental to an individual's health and well-being. Mental health disorders affect a substantial portion of the Australian population, with the most vulnerable time in adolescence and young adulthood. Indigenous Australians fare worse than other Australians on almost every measure of physical and mental health. Cross-sectional data from young adults (21-27 years) participating in the Life Course Program, Northern Territory, Australia, is presented. Rates of psychological distress were high in remote and urban residing Indigenous and urban non-Indigenous young adults. This rate was more pronounced in young women, particularly in Indigenous remote and urban residing women. Young adults with high psychological distress also had lower levels of positive well-being, higher perceived stress levels, experienced a higher number of major life events and were at an increased risk of suicidal ideation and/or self-harm. This study supports the need for a continued focus on early screening and treatment at this vulnerable age. The significant association seen between psychological distress and other markers of emotional well-being, particularly risk of suicidal ideation and/or self-harm, highlights the need for a holistic approach to mental health assessment and treatment. A concerted focus on improving the environs of young adults by lowering levels of stress, improving access to adequate housing, educational and employment opportunity, will assist in improving the emotional health of young adults.

Combining physiological, environmental and locational sensors for citizen-oriented health applications.

This work investigates the potential of combining the outputs of multiple low-cost sensor technologies for the direct measurement of spatio-temporal variations in phenomena that exist at the interface between our bodies and the environment. The example used herein is the measurement of personal exposure to traffic pollution, which may be considered as a function of the concentration of pollutants in the air and the frequency and volume of that air which enters our lungs. The sensor-based approach described in this paper removes the 'traditional' requirements either to model or interpolate pollution levels or to make assumptions about the physiology of an individual. Rather, a wholly empirical analysis into pollution exposure is possible, based upon high-resolution spatio-temporal data drawn from sensors for NO2, nasal airflow and location (GPS). Data are collected via a custom smartphone application and mapped to give an unprecedented insight into exposure to traffic pollution at the individual level. Whilst the quality of data from low-cost miniaturised sensors is not suitable for all applications, there certainly are many applications for which these data would be well suited, particularly those in the field of citizen science. This paper demonstrates both the potential and limitations of sensor-based approaches and discusses the wider relevance of these technologies for the advancement of citizen science.

Opto-nanomechanical spectroscopic material characterization.

The non-destructive, simultaneous chemical and physical characterization of materials at the nanoscale is an essential and highly sought-after capability. However, a combination of limitations imposed by Abbe diffraction, diffuse scattering, unknown subsurface, electromagnetic fluctuations and Brownian noise, for example, have made achieving this goal challenging. Here, we report a hybrid approach for nanoscale material characterization based on generalized nanomechanical force microscopy in conjunction with infrared photoacoustic spectroscopy. As an application, we tackle the outstanding problem of spatially and spectrally resolving plant cell walls. Nanoscale characterization of plant cell walls and the effect of complex phenotype treatments on biomass are challenging but necessary in the search for sustainable and renewable bioenergy. We present results that reveal both the morphological and compositional substructures of the cell walls. The measured biomolecular traits are in agreement with the lower-resolution chemical maps obtained with infrared and confocal Raman micro-spectroscopies of the same samples. These results should prove relevant in other fields such as cancer research, nanotoxicity, and energy storage and production, where morphological, chemical and subsurface studies of nanocomposites, nanoparticle uptake by cells and nanoscale quality control are in demand.

Karhunen-Loève treatment to remove noise and facilitate data analysis in sensing, spectroscopy and other applications.

Resolving weak spectral variations in the dynamic response of materials that are either dominated or excited by stochastic processes remains a challenge. Responses that are thermal in origin are particularly relevant examples due to the delocalized nature of heat. Despite its inherent properties in dealing with stochastic processes, the Karhunen-Loève expansion has not been fully exploited in measurement of systems that are driven solely by random forces or can exhibit large thermally driven random fluctuations. Here, we present experimental results and analysis of the archetypes (a) the resonant excitation and transient response of an atomic force microscope probe by the ambient random fluctuations and nanoscale photothermal sample response, and (b) the photothermally scattered photons in pump-probe spectroscopy. In each case, the dynamic process is represented as an infinite series with random coefficients to obtain pertinent frequency shifts and spectral peaks and demonstrate spectral enhancement for a set of compounds including the spectrally complex biomass. The considered cases find important applications in nanoscale material characterization, biosensing, and spectral identification of biological and chemical agents.

Health-related quality of life following radical prostatectomy: long-term outcomes.

PURPOSE: To identify the health-related quality of life (HRQoL) domains that radical prostatectomy (RP) impacts most negatively and to define the recovery of these domains over 30 months of observation. PATIENTS AND METHODS: A total of 1,200 RP patients completed the Patient-Oriented Prostate Utility Scale-Psychometric (PORPUS-P; range 0-100, higher is better), a prostate cancer-specific HRQoL measure, prior to RP and at 0-3 (T1), 3-9 (T2), 9-18 (T3) and 18-30 (T4) months post-RP. HRQoL changes were examined using paired t tests and a mixed-effect growth curve model. Multivariable analyses were performed to investigate demographic and treatment factors predicting the change in HRQoL. RESULTS: Mean baseline PORPUS-P score, 83.1, fell to 66.5 (p < 0.001) at T1. Over time HRQoL improved but did not return to baseline (T4 mean 76.4, p < 0.001). Domain analysis revealed that sexual function (p < 0.001), sexual drive (p < 0.001), energy (p = 0.001) and bladder control (p < 0.001) failed to return to baseline at T4. Sexual function demonstrated the greatest impairment overall. The multivariable model revealed Black men experienced greater losses in global HRQoL compared with White men (coefficient -2.77, 95% CI -5.00 to -0.54, p = 0.015). High baseline HRQoL, pro-erectile aid use and bilateral nerve-sparing were significantly associated with smaller reductions in HRQoL post-RP. CONCLUSION: Overall HRQoL, sexual drive, sexual function, energy and bladder control do not return to preoperative levels within 30 months post-RP. Black patients experience the greatest reductions in HRQoL. HRQoL losses may be ameliorated by use of pro-erectile aids. These findings help to identify at-risk patient populations and inform survivorship programs.

Prospective comparison of the impact of robotic-assisted laparoscopic radical prostatectomy versus open radical prostatectomy on health-related quality of life and decision regret.

INTRODUCTION: There is no conclusive evidence that the robotic-assisted laparoscopic radical prostatectomy (RARP) is superior to conventional open radical prostatectomy (ORP) when it comes to recovery of urinary and sexual function, and that the former surgical option results in less decision regret. METHODS: Patients scheduled for both surgical procedures were surveyed prior to surgery, and then again at 6 and 12 months following treatment using the sexual and urinary modules of the Expanded Prostate Cancer Index Composite (EPIC) measure. Decision regret was measured at 12 months. Propensity score regression adjustment was used to account for differences between treatment groups by summarizing all covariate information into a single probability and to simulate randomization. RESULTS: At 12 months, urinary summary scores approached baseline levels, while urinary bother scores had returned to baseline. Sexual summary and bother mean scores decreased by about half of what they were at baseline for both treatment groups at 6 and 12 months. No significant differences in the groups' sexual summary and bother domains were identified at either 6 or 12 months. Both groups' scores for decision regret were low. Moderate correlations (r(2) range -0.333 to -0.368) were between current levels of urinary and sexual function and decision regret at 12 months. CONCLUSION: The results of our study found no significant difference in health-related quality of life outcomes based on surgical procedure at 12 months. Moreover, patients in both groups reported low levels of decision regret at 12 months. Further multi-site prospective studies are required to address this study's limitations.

Masculinities and patient perspectives of communication about active surveillance for prostate cancer.

OBJECTIVE: The purpose of this study is to describe connections between masculinities and patient perspectives of active surveillance (AS) related communication with male physicians. METHOD: An interpretive descriptive qualitative design was used to explore patient-physician communication from the perspectives of 25 men on AS. In-depth, semistructured interviews were recorded, transcribed verbatim, and coded. Key concepts were described and a masculinities gender framework guided analyses of patients' perspectives. RESULTS: Patient-physician communication of diagnosis, treatment options, and specificities of AS featured prominently within participants' interviews. Most participants reported brevity in patient-physician communication amid accepting the physician's communication style and recommendations. Participants' accounts suggested "therapeutic" communications as contingent on positioning physicians as authoritative and assigning them control, while patients were stoic in accepting AS. However, some participants reported being confused about their diagnosis details and specific AS protocols, and resisted traditional physician-patient hierarchies, desiring more collaborative decision-making processes. In this regard communications emerged as "threat," in that participants lacked and/or lost confidence in their physician and were uncertain and anxious about the legitimacy of AS. These findings were interpreted within a gender framework, showing how patients drew on an array of masculine ideals, including stoicism, denying illness, and respecting expertise in different ways. CONCLUSIONS: Our novel findings illuminate complexities of men's perspectives about patient-physician communication in AS, and offer insights about how masculinities influence what can be understood as potentially helpful and unhelpful communication among this emergent patient population.

The Personal Patient Profile-Prostate decision support for men with localized prostate cancer: a multi-center randomized trial.

OBJECTIVE: The purpose of this trial was to compare usual patient education plus the Internet-based Personal Patient Profile-Prostate, vs. usual education alone, on conflict associated with decision making, plus explore time-to-treatment, and treatment choice. METHODS: A randomized, multi-center clinical trial was conducted with measures at baseline, 1-, and 6 months. Men with newly diagnosed localized prostate cancer (CaP) who sought consultation at urology, radiation oncology, or multi-disciplinary clinics in 4 geographically-distinct American cities were recruited. Intervention group participants used the Personal Patient Profile-Prostate, a decision support system comprised of customized text and video coaching regarding potential outcomes, influential factors, and communication with care providers. The primary outcome, patient-reported decisional conflict, was evaluated over time using generalized estimating equations to fit generalized linear models. Additional outcomes, time-to-treatment, treatment choice, and program acceptability/usefulness, were explored. RESULTS: A total of 494 eligible men were randomized (266 intervention; 228 control). The intervention reduced adjusted decisional conflict over time compared with the control group, for the uncertainty score (estimate -3.61; (confidence interval, -7.01, 0.22), and values clarity (estimate -3.57; confidence interval (-5.85,-1.30). Borderline effect was seen for the total decisional conflict score (estimate -1.75; confidence interval (-3.61,0.11). Time-to-treatment was comparable between groups, while undecided men in the intervention group chose brachytherapy more often than in the control group. Acceptability and usefulness were highly rated. CONCLUSION: The Personal Patient Profile-Prostate is the first intervention to significantly reduce decisional conflict in a multi-center trial of American men with newly diagnosed localized CaP. Our findings support efficacy of P3P for addressing decision uncertainty and facilitating patient selection of a CaP treatment that is consistent with the patient values and preferences.

Coaching and guidance with patient decision aids: A review of theoretical and empirical evidence.

BACKGROUND: Coaching and guidance are structured approaches that can be used within or alongside patient decision aids (PtDAs) to facilitate the process of decision making. Coaching is provided by an individual, and guidance is embedded within the decision support materials. The purpose of this paper is to: a) present updated definitions of the concepts "coaching" and "guidance"; b) present an updated summary of current theoretical and empirical insights into the roles played by coaching/guidance in the context of PtDAs; and c) highlight emerging issues and research opportunities in this aspect of PtDA design. METHODS: We identified literature published since 2003 on shared decision making theoretical frameworks inclusive of coaching or guidance. We also conducted a sub-analysis of randomized controlled trials included in the 2011 Cochrane Collaboration Review of PtDAs with search results updated to December 2010. The sub-analysis was conducted on the characteristics of coaching and/or guidance included in any trial of PtDAs and trials that allowed the impact of coaching and/or guidance with PtDA to be compared to another intervention or usual care. RESULTS: Theoretical evidence continues to justify the use of coaching and/or guidance to better support patients in the process of thinking about a decision and in communicating their values/preferences with others. In 98 randomized controlled trials of PtDAs, 11 trials (11.2%) included coaching and 63 trials (64.3%) provided guidance. Compared to usual care, coaching provided alongside a PtDA improved knowledge and decreased mean costs. The impact on some other outcomes (e.g., participation in decision making, satisfaction, option chosen) was more variable, with some trials showing positive effects and other trials reporting no differences. For values-choice agreement, decisional conflict, adherence, and anxiety there were no differences between groups. None of these outcomes were worse when patients were exposed to decision coaching alongside a PtDA. No trials evaluated the effect of guidance provided within PtDAs. CONCLUSIONS: Theoretical evidence continues to justify the use of coaching and/or guidance to better support patients to participate in decision making. However, there are few randomized controlled trials that have compared the effectiveness of coaching used alongside PtDAs to PtDAs without coaching, and no trials have compared the PtDAs with guidance to those without guidance.

Providing information about options in patient decision aids.

BACKGROUND: Legal, ethical, and psychological arguments indicate that patients need to receive information about their health situations before their care decisions are made. Patient decision aids (PtDAs) are designed to help patients make decisions; therefore, they should provide information that results in patients understanding their health situation. We reviewed studies that assessed the impact of PtDAs on patient knowledge and on their feeling of being uninformed. METHODS: Our data sources were a published Cochrane Collaboration review that included randomized controlled trials (RCTs) published before 2010 and a systematic review we conducted of RCTs published in 2010. We included trials that compared 1) PtDAs to usual care, and 2) PtDAs with simple information to PtDAs with more detailed information. Outcomes included patients' knowledge and their feeling of being uninformed. Data were analyzed quantitatively and qualitatively. Meta-analyses of similar studies estimated the size of differences. RESULTS: Thirty-nine RCTs compared a PtDA to usual care and all showed higher knowledge scores for patients in the PtDA groups; a meta-analysis estimated the advantage at 14 (of 100) points. Sixteen (of 39) studies used the Feeling Uninformed subscale; a meta-analysis estimated a reduction of 7 (of 100) points in the PtDA group over usual care. Twenty-one studies compared simple- to more-detailed information in PtDAs. There was a small overall advantage for more detailed information on knowledge scores; a meta-analysis estimated the advantage at 5 (of 100) points. Only one study found higher mean knowledge scores for simpler information. Nine (of 21) studies reported using the Feeling Uninformed subscale and a meta-analysis suggested a reduction of 3 (of 100) points for the more-detailed PtDAs over those with simpler information. Only one study found that simpler information resulted in patients feeling more informed. CONCLUSIONS: It appears that PtDAs result in patients having higher knowledge scores and in reduced feelings of being uninformed over patients who receive usual care. It also appears that PtDAs with more detailed information generally result in slightly higher knowledge and lower "Feeling Uninformed" scores than those with simpler information, but the differences are small and can be reversed under some circumstances.

Assessing couples' preferences for postoperative sexual rehabilitation before radical prostatectomy.

OBJECTIVES: To evaluate the readiness of couples to engage in a sexual rehabilitation programme (SRP) before radical prostatectomy (RP) and to identify barriers to participation in an SRP after RP. To identify couples' current levels of sexual function and intimacy. PATIENTS AND METHODS: Patients completed the International Index of Erectile Function (IIEF) and their partners completed the Female Sexual Function Index (FSFI) to measure sexual function. Couples completed the Miller Social Intimacy Scale (MSIS) to measure intimacy in relationships. All participants were seen by a sexual health clinician after completing the measures to discuss barriers to participation in an SRP, and to receive an education session. RESULTS: Study participants comprised 143 patients and 104 partners. Patients <60 years old had significantly higher sexual function (P < 0.002) compared with those patients aged 60 years and older. Partners' sexual function scores were suggestive of need for further medical evaluation. Partners' participation was cited by patients as important to them enrolling in an SRP. Couples' intimacy levels were strongly correlated (P < 0.0001). CONCLUSIONS: Results suggest that less than 50% of patients are interested in receiving information about the impact of RP on sexual function before surgery. Female sexual function should be assessed as part of any SRP because they may require medical treatment if they are to support rehabilitation efforts for their spouses. Baseline assessment of a couple's sexual function and willingness to participate in an SRP should be performed preoperatively.

Impact of health information-seeking behavior and personal factors on preferred role in treatment decision making in men with newly diagnosed prostate cancer.

BACKGROUND: Prostate cancer (PC) patients continue to have unmet information needs at the time of diagnosis and are often unable to communicate their preferences to physicians at the time of the treatment consultation. OBJECTIVE: The objective of the study was to determine the impact of health information-seeking behavior (HISB) and personal factors on patients' preferred role in treatment decision making (TDM). METHODS: Participants consisted of 150 men with newly diagnosed PC seen at 2 urology clinics in western Canada. A survey questionnaire was used to gather information on HISB, personal factors influencing treatment choice, and decision control. RESULTS: More than 90% of the participants reported a preference to play either an active or collaborative role in TDM and having either an "intense" or "complementary" HISB. No significant association was found between HISB and preferred role in TDM. Impact of treatment on survival and urinary function and the urologist's recommendation were identified as the 3 main factors influencing the treatment decision. CONCLUSIONS: At the time of diagnosis, the majority of men want to be involved in TDM and have access to information. Our findings suggest that the type and amount of information men want to access are dependent on HISB. Assessing factors having an impact on TDM may prove useful to guide patient-clinician treatment discussions. IMPLICATIONS FOR PRACTICE: This survey provides clinicians with a method to assess information and decision preferences of men with newly diagnosed PC and factors having an influence on treatment choice.

Promoting calcium and vitamin D intake to reduce the risk of osteoporosis in men on androgen deprivation therapy for recurrent prostate cancer.

PURPOSE: The aim of this study was to measure the impact of a patient education intervention aimed at increasing dietary intake of calcium and vitamin D in patients currently on androgen deprivation therapy (ADT) for the treatment of prostate cancer. METHODS: Sixty-one participants attended a one-time dietitian-delivered group education session focusing on diet and lifestyle strategies to reduce the risk of bone loss while on ADT. Dietary intake was assessed using the diet history questionnaire at baseline and again at approximately 1 year post-intervention. Demographics, medical history (including comorbidities), awareness of developing bone loss while on ADT, and information resources utilized were recorded at baseline. RESULTS: Fifty-one participants completed both time points. Over one third of men did not meet minimum current clinical guidelines for calcium or vitamin D intake at baseline. Sixty-three percent of men reported they were aware that osteoporosis was a known side effect of ADT therapy. Only supplemental calcium intake was significantly increased after the intervention. Men aware of their risk of developing bone loss while on ADT reported higher baseline calcium intake (p ≤ 0.05). Men undergoing ADT for less than 1 year at the time of intervention had significantly higher total calcium intake at follow-up compared to men on ADT for longer than 1 year (p = 0.038). Nonsignificant trends indicated that calcium and vitamin D intakes changed to a greater degree in those undergoing ADT for less than 1 year as well. CONCLUSIONS: Total calcium and vitamin D did not change significantly as a result of the intervention. Results suggest that promotion of dietary changes may be more effective if delivered closer to the initiation of therapy.

Measuring decisional control preferences in men newly diagnosed with prostate cancer.

The Control Preferences Scale is widely used in decision research to measure patient preferences for participation in treatment decision making with health care providers. Following anecdotal reports of confusion with the scale the authors conducted an exploratory interview study to examine perceptions of the meaning and applicability of the Control Preferences Scale for men with localized prostate cancer seeking treatment in a multidisciplinary urology clinic. The preliminary data suggest potential validity challenges when the Control Preferences Scale is used in a multidisciplinary prostate cancer care setting, including the clinical context of localized prostate cancer and the meaning of shared decision making.

Nanometrology of delignified Populus using mode synthesizing atomic force microscopy.

The study of the spatially resolved physical and compositional properties of materials at the nanoscale is increasingly challenging due to the level of complexity of biological specimens such as those of interest in bioenergy production. Mode synthesizing atomic force microscopy (MSAFM) has emerged as a promising metrology tool for such studies. It is shown that, by tuning the mechanical excitation of the probe-sample system, MSAFM can be used to dynamically investigate the multifaceted complexity of plant cells. The results are argued to be of importance both for the characteristics of the invoked synthesized modes and for accessing new features of the samples. As a specific system to investigate, we present images of Populus, before and after a holopulping treatment, a crucial step in the biomass delignification process.

Optomechanical spectroscopy with broadband interferometric and quantum cascade laser sources.

The spectral tunability of semiconductor-metal multilayer structures can provide a channel for the conversion of light into useful mechanical actuation. Responses of suspended silicon, silicon nitride, chromium, gold, and aluminum microstructures are shown to be utilized as a detector for visible and IR spectroscopy. Both dispersive and interferometric approaches are investigated to delineate the potential use of the structures in spatially resolved spectroscopy and spectrally resolved microscopy. The thermoplasmonic, spectral absorption, interference effects, and the associated energy deposition that contributes to the mechanical response are discussed to describe the potential of optomechanical detection in future integrated spectrometers.