East Carolina University

There are limited data on seasonal variations and outcomes in pulmonary embolism (PE). To understand the seasonal variations in PE outcomes. All adult (³18 years) non-elective admissions with a primary diagnosis of PE were identified using the National Inpatient Sample (2016-2022) and assessed by the season of admission-spring (March-May), summer (June-August), fall (September-November), and winter (December-February). The primary outcome was in-hospital mortality across the seasons. Secondary outcomes included total hospitalization costs, hospital length of stay, and discharge disposition. During the 7-year period, 1,278,754 PE admissions were identified. Spring, summer, fall, and winter had 24.1%, 25.0%, 25.3%, and 25.6% admissions, respectively (p < 0.001). The baseline and in-hospital characteristics were comparable across cohorts with no significant clinical differences noted. Mechanical thrombectomy rates were highest in fall (spring 2.5%, summer 3.0%, fall 3.5%, winter 2.7%, p < 0.001), whereas systemic thrombolysis (spring 2.9%, summer 3.0%, fall 2.9%, winter 3.1%, p = 0.04) was highest in the summer. Use of other therapies were comparable. There was no statistical difference in adjusted in-hospital mortality rates among seasons. There were slight variations in hospitalization costs, length of stay, and discharge dispositions across the four cohorts but were not clinically relevant. In this study, there was no significant seasonal variation in in-hospital mortality from PE.

Objective: The current study examined the association between financial hardship experienced during the COVID-19 pandemic and emotional well-being (EWB) among middle-aged and older adults, and assessed whether these associations differed by gender and race/ethnicity.Methods: The analytic sample included 7,172 adults aged 50 years or older who participated in the 2020/2021 COVID-19 modules of the Health and Retirement Study (HRS). Financial hardship was assessed using binary indicators of difficulty paying bills and food insecurity, including food affordability and access. EWB was measured using the ratio of positive to negative experiences. Linear regression models were used to evaluate associations.Results: Difficulty paying bills (β = -0.27; 95% CI [-0.33, -0.21]), food affordability (β = -0.13; 95% CI [-0.22, -0.05]), and food access (β = -0.33; 95% CI [-0.39, -0.24]) were each associated with lower EWB, as indicated by a reduced positivity ratio. Improvement in food affordability between 2020 and 2021 was associated with an increase in the positivity ratio (β = 0.43; 95% CI [0.003, 0.87]). Associations between financial hardship and lower EWB were observed across gender and race/ethnicity strata. However, difficulty paying bills and food insecurity showed differential associations with the positivity ratio across racial/ethnic groups.Conclusions: The findings of this study have implications for interventions aimed at improving the EWB of middle-aged and older adults by focusing on financial hardship during a public health crisis.

Nanoparticle delivery to tumors remains inefficient, with current nanomedicines achieving only 0.7% injected dose per gram (ID/g) of tumor tissue due to uncontrolled protein corona formation that redirects nanoparticles away from target sites. We engineered biomimetic protein coronas to control nanoparticle–protein interactions and enhance tumor targeting. Competitive binding studies using NMR spectroscopy revealed that transferrin (Tf) and fibronectin (Fn) outcompete albumin (BSA) and immunoglobulin G (IgG) for 15 nm gold nanoparticle surfaces, establishing a binding hierarchy that enables predictable corona composition. Precoating nanoparticles with a four-protein combination (BSA+Tf+Fn+IgG) created coronas that achieved a balance between cancer cell uptake and reduced macrophage uptake in vitro. When administered to tumor-bearing mice, these engineered coronas achieved 13 ppm/g tumor accumulation (equivalent to 4% ID/g), representing 6.5-fold improvement over bare nanoparticles and 2.6-fold improvement over PEGylated formulations. Proteomics analysis of secondary coronas formed in human serum revealed that engineered nanoparticles selectively recruit transport and adhesion proteins while limiting immune recognition signatures. The preformed coronas maintained targeting protein retention and reduced complement binding compared to controls. Circular dichroism confirmed minimal protein structural perturbation, preserving receptor-binding functionality for active targeting. The strategy harnesses natural protein adsorption processes to create ″smart″ biological interfaces that simultaneously evade immune clearance and promote tumor cell recognition through transferrin receptor and integrin-mediated pathways. This approach demonstrates the feasibility of treating the corona as a programmable interface, addressing delivery limitations that have hindered clinical translation of cancer nanomedicines.

ABSTRACT Using recently developed proxies for firm‐level political risk and earnings manipulation, we test the limited attention theory. Contrary to Hirshleifer and Teoh's core prediction that investor attention is associated with less managerial manipulation, we find that firm‐level political risk, serving as a proxy for investor attention, is positively associated with manipulative earnings management, using both accruals and real activities. The results are robust to alternative proxies for political risk and earnings manipulation, various techniques addressing endogeneity concerns, and subsamples of firms with different earnings manipulation incentives. Moreover, we find that the negative relation between earnings manipulation and subsequent operating performance is more pronounced among firms exposed to more firm‐level political risk, suggesting that firm‐level political risk is associated with managerial incentives for manipulation more than its association with the monitoring that comes with greater attention.

As fashion retail organizations increasingly integrate emotionally responsive artificial intelligence (AI) into employee-facing systems, understanding the psychological and behavioral implications of “feeling AI” has become essential, particularly its influence on employee creativity, defined as the generation of novel and useful ideas. This study investigates how two feeling AI capabilities, anthropomorphism and personalization, shape employees’ creative self-efficacy and job replacement anxiety, and how these psychological states influence two distinct forms of employee creativity: proactive and responsive creativity. Drawing on the stimulus-organism-response (SOR) framework, a structural model was developed and tested using survey data collected from fashion retail employees (N = 302). Findings reveal that feeling AI does not uniformly enhance workplace creativity; instead, its psychological impacts are context-dependent and behaviorally divergent. This study contributes to fashion and organizational literature by expanding the conceptualization of AI from a technical enabler to a psychological stimulus with dualistic effects. The findings also offer practical guidance for fashion retailers aiming to adopt feeling AI systems that support, rather than stifle, human creativity in a rapidly evolving industry.

The oral microbiome may influence brain health and contribute to cognitive decline. However, little evidence exists on the potential modifying role of the oral microbiome in the relationship between tooth loss and cognitive performance. This study aimed to investigate the interaction effects between tooth loss and oral dysbiotic status on cognitive performance. Data were from the 2011-2012 National Health and Nutrition Examination Survey. The sample included 677 adults aged 60 to 69 y. Cognitive performance was assessed by the Consortium to Establish a Registry for Alzheimer's Disease, the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test. Significant tooth loss was defined as a loss of ≥10 permanent teeth out of 28. A high dysbiotic index was defined as being in the upper tertile of the ratio of periodontal disease-associated bacteria (Treponema, Porphyromonas, and Tannerella) to healthy bacteria (Rothia and Corynebacterium). A multivariable linear regression model showed a significant interaction effect between tooth loss and dysbiotic index on the AFT (b = -1.87, P = 0.03), indicating that participants with a higher dysbiosis index and fewer missing teeth scored lower on the AFT. The effect of tooth loss on verbal fluency depends on oral bacterial imbalances: if there is significant tooth loss, bacterial imbalances may not be important. However, when fewer teeth are lost, high bacterial imbalances may account for lower verbal fluency. These findings suggest that maintaining periodontal health aimed at decreasing oral dysbiosis should be promoted among older adults in the community.Knowledge Transfer Statement:Our findings highlight the importance of preserving the health of the teeth and not just retaining the teeth. Oral health awareness and good oral hygiene practice should be further promoted among older adults in the community.