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Medication multiple experiences of elderly patient with multiple chronic condition: A qualitative meta-synthesis
Purpose To determine the experience of medication multiple in elderly patients with multiple chronic condition by systematically reviewing, retrieving, and synthesizing data from qualitative studies. Methods Nine databases were systematically searched for relevant contributions from the time of construction until October 30, 2024. All qualitative studies in English and Chinese exploring the real-life experiences, feelings, etc, of medication multiple in elderly patients with multiple chronic condition were included. The Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ).Two independent reviewers selected the studies and assessed the quality of each study, and the included studies were inductively analysed and interpreted then reported as a meta‐synthesis. Results A total of 10 studies revealed 13 sub-themes and 4 descriptive themes:Difficulties and challenges in Polypharmacy, Multi-party support facilitates Polypharmacy in elderly patients with multiple chronic condition,Positive attitude towards taking medication. Conclusion The health outcomes of elderly patients with coexisting chronic diseases can be significantly impacted by polypharmacy difficulties and challenges as well as lower medication adherence.Increasing medicine knowledge among older patients with concomitant chronic diseases, bolstering medication-taking beliefs, and motivating family members to support the patient are all ways to improve medication adherence. [REGISTRATION: PROSPERO ID: CRD42024628547]
Exploration of the social determinants of diarrhoea, rotavirus vaccine uptake, and vaccine ‘fatigue’ in Ethiopia, Kenya, and Malawi
Diarrhoea due to rotavirus remains a significant cause of child mortality in developing regions. Caregivers’ perspectives on the social determinants of gastroenteritis and childhood vaccination, including the rotavirus vaccine, were explored through focus group discussions in Ethiopia (n = 6), Kenya (n = 14), and Malawi (n = 10), using a combination of thematic and framework analysis approaches. The results show that diarrhoea was perceived to be a burden in all three countries, particularly among infants, due to challenges in WASH (water, sanitation, and hygiene) infrastructures and poverty. Prevention strategies mentioned by the caregivers focussed on enhancing WASH interventions without mention of vaccination. Participants however expressed a lack of agency to address WASH at community level in informal settlements where the studies were conducted. Antibiotics were seen as “strong medications” and often purchased without prescription for treatment of diarrhoea, raising concerns on Anti-Microbial Resistance (AMR), while home remedies such as rice porridge were used for less severe diarrhoea symptoms. Perceived or experiential benefits and safety of previous vaccines promoted vaccine uptake in all three countries. On the other hand, limited understanding of vaccines, concerns about side effects, perceived excessive vaccination, mistrust of vaccines or suspicions of existing vaccines undermined individuals’ willingness to vaccinate children. Our results highlight that a lack of attention to socio-determinants of poor health in contexts where there are several vaccines and yet a high incidence of vaccine-preventable diseases may undermine vaccine confidence. Multi-sectoral interventions to tackle social determinants of diarrhoea and improve community understanding of vaccines are required to improve overall community health outcomes.
The experience of cerebral palsy stigma amongst adults living in the UK and Ireland: A qualitative co-designed project
Background There is evidence that cerebral palsy (CP) could be linked to stigma and discrimination, however current evidence is limited to small qualitative studies. The goal of this co-designed survey was to elicit information on experiences of stigma and discrimination amongst a larger sample of adults in the UK and Ireland. Methods Quantitative questions about sources of stigma and qualitative questions designed to elicit information on experiences of stigma were shared via an online survey. Results Eighty-six people completed the qualitative survey, and 5 themes were generated that captured experiences of stigma and discrimination. Theme 1 (rigid stereotypes) captured the lack of awareness about the heterogeneity of CP. Theme 2 (impact on participation) highlighted the difficulties that participants had with participation, particularly in terms of accessibility and sexual relationships. Theme 3 (interpersonal difficulties) included the difficulties people with CP had in interactions with the public such as feel visible in some situations, invisible in others and being infantilised. Theme 4 (systematic discrimination) highlighted discrimination in the workplace, healthcare and broader environment. Theme 5 (negative emotional impact) captured the negative emotional impact that experiences of stigma and discrimination had. Quantitative responses from 48 participants indicated that stigma was a common experience (experienced by 87.5% of respondents), and the most common sources of stigma were the public, classmates and coworkers. Conclusions Results indicate that CP is linked to experiences of stigma and discrimination which arise from a lack of understanding of the heterogeneity of CP, a public lack of awareness of how to communicate with people with disabilities, inaccessible environments and negative societal attitudes towards visible impairments. Suggested ways to tackle these issues include improving understanding of CP and removing barriers to accessibility.
The flavonoid rutin protects against imidacloprid-induced osmotic and electric disruptions in Africanized honey bees
Honey bees (Apis mellifera) are essential pollinators threatened by sublethal effects of pesticides such as imidacloprid, a widely used neonicotinoid that disrupts the central nervous system. However, many of the systemic effects are poorly understood, especially on the physiological homeostasis of the honey bee. We evaluated the effects of oral administration of imidacloprid and the flavonol rutin on the properties of extracellular fluid (ECF) in Apis mellifera. We measured water content, evaporation rate, electrical impedance, and ion mobility of the ECF. Our results show impacts of imidacloprid consumption, such as water content decrease, slowed evaporation, and altered electrical characteristics of the thorax segment. All these events suggest disruption of osmotic and electrochemical balance. Particularly, the rutin consumption partially mitigated the imidacloprid effects in a dose-dependent manner, enhancing detoxification. Our results point out that imidacloprid alters ionic and osmotic homeostasis beyond neural targets; and on the other hand, rutin may protect against these disruptions through physiological mechanisms beyond neuroprotection. These findings highlight new alternatives and evaluations for protecting pollinators via dietary strategies.
Development efficiency of green logistics in Guangdong province based on Super-SBM and GML index
Under China’s national sustainability strategy, the logistics industry is confronted with the imperative of high-quality green development. Given its status as the leading economic province and a national logistics hub, investigating green logistics development in Guangdong province holds paramount strategic importance. To comprehensively evaluate green logistics development efficiency of 21 cities in Guangdong from 2016 to 2022, this study employed the super-efficiency slacks-based measure model (Super-SBM) with undesirable outputs, the Global Malmquist–Luenberger (GML) productivity index and a four-quadrant analysis based on static and dynamic efficiency. With its integrated framework, this study dynamically assesses and meticulously classify green logistics efficiency in Guangdong, thereby offering unique perspectives and deep insights for regional policy formulation. The results reveal three key aspects. First, Guangdong’s overall green logistics efficiency remains relatively low with a slight downward trend, exhibiting significant regional and inter-city disparities. The Pearl River Delta(PRD) region, particularly Shenzhen and Guangzhou, consistently shows the highest and increasing efficiency, contrasting sharply with other regions. Second, technological progress is identified as the primary driver of changes in green logistics efficiency. Third, the four-quadrant analysis reveals distinct patterns among the 21 cities, classifying them into four categories: “high-efficiency-growth” (e.g., Shenzhen and Guangzhou), “high-efficiency-regression” (e.g., Dongguan), “low-efficiency-growth” (e.g., Zhuhai and Zhaoqing), and “low-efficiency-regression” (e.g., Meizhou and Shantou). Finally, this study puts forward key policy recommendations to promote green logistics development in Guangdong, including driving green transformation through the realignment of industrial and economic foundations, strengthening core cities’ green logistics leadership and regional collaboration, enhancing technological innovation capacity, and implementing precise and targeted support for cities across all four quadrants.
Impact of digital technology on herders’ grassland leasing-in decisions in Inner Mongolia, China
Against the backdrop of grassland ecological degradation, grassland transfer has become a crucial pathway for optimizing livestock resource allocation and promoting sustainable pastoral development. Based on survey data from 383 herder households in the farming–pastoral ecotone of Inner Mongolia, China, this study applies Heckman models, mediation models, and moderation models to examine the impact of digital technology on herders’ grassland leasing-in decisions and the underlying mechanisms. The results indicate that digital technology significantly increases both the probability and the scale of grassland leasing-in among herders. Moreover, digital technology indirectly promotes grassland leasing-in by enhancing scale efficiency. Notably, strong social networks weaken the facilitating role of digital technology in grassland transfer, whereas weak social networks strengthen it. The impact of digital technology on grassland leasing-in is especially pronounced under environmental regulations with weak incentives but strong constraints. Finally, compared with ordinary herders, digital technology has a significantly positive effect on grassland leasing-in only for new-type operators. In addition, the impact of digital technology is more pronounced among groups with higher levels of education.
Minoritized students and their faculty research mentors view benevolence differently in the relationship
There are many benefits for students who participate in undergraduate research experiences, including increased retention and persistence in science, technology, engineering, and mathematics (STEM). By doing research, minoritized students increase their likelihood of pursuing graduate school and STEM careers. The benefits of research experiences are partially mediated by students’ interactions with their faculty research mentor. Building trust in the relationship requires students to believe that their faculty mentors are both competent and caring. Here, we used a mixed-methods approach to evaluate the relationship between students and their research mentors. We surveyed both minoritized students’ and their faculty mentors’ perceptions of the mentor’s ability and benevolence. Students rated the faculty mentors’ abilities higher than how mentors rated themselves. In contrast, students rated the faculty mentors’ benevolence significantly lower than how mentors rated themselves. In follow-up interviews focused on benevolence, students emphasized that faculty mentors demonstrated caring through instrumental support (i.e., research skills or career guidance); faculty mentors described providing psychosocial (i.e., social or emotional) support to students. Our results show that there was a difference in how minoritized students and their faculty mentors communicate care in mentor-mentee relationships in research. Findings from this study indicate how faculty mentors may better support minoritized students in undergraduate research experiences.
Cultural heritage of the Qin-Shu Ancient Road in Shaanxi: Spatial distribution characteristics and influencing factors
This study investigates the spatial and temporal distribution and the influencing factors of 579 cultural heritage sites along the Qin–Shu Ancient Road in Shaanxi Province, employing kernel density estimation, buffer analysis, and geographic detectors. Three key findings emerge: (1) The spatial pattern is characterized by a “line-belt-core” structure, with a belt-like aggregation along the Xi’an-Baoji-Hanzhong axis. Core concentrations are found in Xi’an (181 sites), Hanzhong (159 sites), and Ankang (122 sites), with secondary concentrations in Baoji (72 sites) and Shangluo (36 sites). The spatial distribution of heritage types—such as ancient road relics, traditional villages, historic architecture, cave temples and rock carvings, modern historic sites, and tomb complexes—is influenced by topography and human factors. (2) The spatiotemporal evolution occurs in three stages: “natural selection,” “technological breakthrough,” and “cultural adaptation.” It begins with linear valley distributions during the Prehistoric-Qin-Han period, expands through mountainous regions with plank-road engineering in the Wei-Jin-Sui-Tang period, and shifts towards settlements and tomb complexes from the Song to Qing dynasties, marking a transition from transport corridors to integrated cultural landscapes. (3) Natural factors—such as elevation, precipitation, slope, aspect, and proximity to hydrological networks—are the primary drivers, while anthropogenic factors, including ancient route alignment and regional GDP, have a secondary influence. Significant interactions were observed between elevation and aspect, elevation and precipitation, and between hydrological proximity, aspect, and precipitation. These findings offer both theoretical insights and practical guidance for heritage conservation planning and the development of regional cultural tourism along the Qin-Shu Ancient Road.
Assessment of industrial fault diagnosis using rough approximations of fuzzy hypersoft sets
Reliable and timely fault diagnosis is critical for the safe and efficient operation of industrial systems. However, conventional diagnostic methods often struggle to handle uncertainties, vague data, and interdependent multi-criteria parameters, which can lead to incomplete or inaccurate results. Existing techniques are limited in their ability to manage hierarchical decision structures and overlapping information under real-world conditions. To address these limitations, this paper proposes a novel diagnostic framework based on Hypersoft Fuzzy Rough Set (HSFRS) theory.This hybrid approach integrates the flexibility of hypersoft sets for modeling multi-parameter relationships, the strength of fuzzy logic in handling vagueness, and the approximation capabilities of rough set theory to manage data uncertainty. Using a pseudo fuzzy binary relation, we define lower and upper approximation operators for fuzzy subsets within the parameter space. An enhanced Bingzhen and Weimin model-based decision-making algorithm is developed to support intelligent diagnosis. A case study involving a conveyor belt system is presented, evaluating eight fault states using five primary parameters and twenty sub-parameters. The results confirm the robustness, interpretability, and effectiveness of the proposed model in complex industrial scenarios by ranking the states based on fuzzy hypersoft closeness degrees.
Investigating the optimal reactive balance training intensity in people with chronic stroke: Study protocol for a randomized control trial
Stroke significantly contributes to long-term disability, one of the problems is with impaired balance control, increasing the risk of falls. The risk of falls may be mitigated using reactive balance training (RBT) which has been shown to effectively reduce fall risk by enhancing reactive stepping following repeated balance perturbations. However, the optimal RBT intensity for people with chronic stroke remains unknown. The purpose of this assessor-blinded randomized controlled trial is to investigate the optimal intensity of RBT by comparing high-intensity, moderate-intensity, and walking control groups among 63 individuals with chronic stroke. Participants will undergo four consecutive days of training, with outcomes assessed pre- and post-training and at a one-year follow-up. The primary outcomes are reactive stepping ability, measured using number of steps required to recover balance from a novel perturbation. Secondary outcomes include rates of adverse events, functional balance, falls efficacy, and participation in daily activities. We hypothesize that high-intensity RBT will yield faster adaptations and greater retention compared to moderate-intensity and walking. Determining the optimal RBT intensity could substantially enhance clinical guidelines for stroke rehabilitation, optimize therapy efficiency, and improve patient outcomes by reducing fall risk and improving functional independence. ClinicalTrials.gov ID: NCT06555016.
Navigating Hepatitis C care: Knowledge gaps and access barriers among young women who inject drugs in rural Appalachia
Background Hepatitis C virus (HCV) and injection drug use among young women are dramatically rising in the rural United States. From 2004 to 2017, heroin use among non-pregnant women increased 22.4% biennially, mirroring increases in HCV cases, especially among younger populations. Young women who inject drugs (YWID, ages 18–35) face elevated HCV risk due to biological, behavioral, and socio-cultural factors. Barriers to HCV testing and treatment services further delay diagnoses, fuel transmission, and limit access to harm reduction services. This study applies the Theoretical Domains Framework (TDF) to identify factors influencing HCV testing and treatment among YWID in rural Appalachia Ohio. Methods We conducted in-depth interviews with YWID (n = 30) in 2023 to understand their HCV testing and treatment experiences in rural Appalachia Ohio. Interviews were transcribed, inductively coded, and analyzed using grounded theory. Identified themes were mapped onto the TDF domains. Results Key TDF domains influencing HCV care included knowledge, beliefs about consequences, and intentions. While YWID knew where to get tested, they expressed uncertainty about treatment value and access while actively using drugs. Social influences, stigma, and mistreatment by healthcare providers created barriers to treatment. Environmental context and resources, such as transportation, also influenced access to care. Conclusions YWID in rural Appalachia face barriers to HCV care, such as gaps in knowledge about HCV treatment, which is compounded by gendered stigma, and logistical challenges. Rapidly changing treatment restrictions led to misinformation about treatment access. These gaps highlight the need for interventions specifically designed to address YWID lived experiences.
Kidney stone disease increases the risk of cardiovascular events
Introduction Kidney stone disease is associated with numerous cardiovascular risk factors. However, the findings across studies are non-uniformly consistent, and the control of confounding variables remains suboptimal. This study aimed to investigate the association between kidney stone and cardiovascular disease. Methods We conducted an observational study using data from the National Health and Nutrition Examination Survey conducted between 2007 and 2010. Weighted multivariable-adjusted logistic regression was used to evaluate the association between kidney stones and cardiovascular event risk. Moreover, in observational studies, Mendelian randomization (MR) was applied to avoid reverse causality and reduce the influence of potential confounding factors. Inverse-variance weighted (IVW) was the main analytical method. Results After controlling for cardiovascular and kidney stone risk factors among 7210 US adults, along with other potential confounding variables, patients with kidney stones exhibited a significantly elevated risk of acute myocardial infarction (AMI) (odds ratio [OR], 1.88 [95% confidence interval [CI], 1.09–3.26], P < 0.05). However, a non-significant association was observed with heart failure, hypertension, or stroke. MR analyses further indicated that genetically predicted kidney stones were causally associated with an increased risk of coronary heart disease (OR, 1.07 [95% CI, 1.04–1.53], P = 0.028), myocardial infarction (OR, 1.08 [95% CI,1.02–1.15], P = 0.015), hypertension (OR 1.01 [95% CI, 1.00–1.02], P = 0.042) and ischemic stroke (OR, 0.86 [95% CI, 0.75–0.98], P = 0.022) in IVW models, with non-significant associations detected for heart failure. Conclusions The occurrence of kidney stones has been associated with an elevated risk of myocardial infarction within the context of cardiovascular events. However, cross-sectional analyses yield results that are inconsistent with those obtained from Mendelian randomization analyses regarding outcomes such as heart failure, hypertension, and stroke.
Factors associated with prolonged hospitalizations for COVID-19 during the first three waves of the pandemic: Evidence from a Southeastern State of Brazil
A comprehensive understanding of the factors influencing the epidemiological dynamics of COVID-19 across the pandemic waves—particularly in terms of disease severity and mortality—is critical for optimizing healthcare services and prioritizing high-risk populations. Here we aim to analyze the factors associated with short-term and prolonged hospitalization for COVID-19 during the first three pandemic waves. We conducted a retrospective observational study using data from individuals reported in the e-SUS-VS system who were hospitalized for COVID-19 in a state in a southeast state of Brazil. Hospitalization duration was classified as short or prolonged based on a 7-day cutoff, corresponding to the median length of hospital stay during the second pandemic wave. Bivariate analyses were performed using the chi-square test for heterogeneity. Logistic regression models were used to estimate odds ratios (ORs) and their respective 95% confidence intervals (CIs), with statistical significance set at 5%. When analyzing hospitalization duration across the three waves, we found that 51.1% (95%CI: 49.3–53) of hospitalizations in the first wave were prolonged. In contrast, short-duration hospitalizations predominated in the second (54.7%; 95% CI: 52.4–57.0) and third (51.7%; 95% CI: 50.2–53.2) waves. Factors associated with prolonged hospitalization varied by wave. During the first wave, older adults (≥60 years) (OR=1.67; 95%CI: 1.35–2.06), individuals with ≥10 symptoms (OR=2.03; 95%CI: 1.04–3.94), obese individuals (OR=2.0; 95%CI: 1.53–2.74), and those with ≥2 comorbidities (OR=2.22; 95%CI: 1.71–2.89) were more likely to experience prolonged hospitalization. In the second wave, he likelihood of extended hospital stays was higher among individuals aged ≥60 years (OR=2.04; 95%CI: 1.58–2.62) and those with ≥2 comorbidities (OR=1.77; 95%CI: 1.29–2.41). In the third wave, prolonged hospitalization was more frequent among older adults (OR=1.89; 95%CI: 1.65–2.17,), individuals with 5–9 symptoms (OR=1.52; 95%CI: 1.20–1.92), obese individuals (OR=2.2; 95%CI: 1.78–2.73), and those with comorbidities (OR=1.45; 95%CI: 1.22–1.72 and OR=2.0; 95%CI: 1.69–2.45). In conclusion, we identified variations in hospitalization patterns across the pandemic waves, although the differences were relatively subtle. These variations likely reflect gradual shifts in the risk factors associated with prolonged hospital stays. Our findings highlight t the importance of implementing targeted public health interventions, particularly those designed to reduce disease severity and improve clinical outcomes among vulnerable populations at greater risk of extended hospitalization.
Exploring the limits of exercise capacity in adults with type II diabetes
Objective This study investigates the mechanisms behind exercise capacity in adults with type 2 diabetes mellitus (T2DM), focusing on central and peripheral components, as described by the Fick equation. Methods A cross-sectional study of 141 adults with T2DM was conducted, using cardiopulmonary exercise testing, near-infrared spectroscopy (NIRS) and exercise echocardiography. Participants with sufficient-quality NIRS data were stratified into tertiles based on percentage predicted VO₂peak. Group comparisons and stepwise regression were used to examine the contributions of central and peripheral components to VO₂peak. Results Sixty-seven participants had insufficient quality NIRS data. Those with lower-quality data were more likely to be female (p < 0.001) and had a lower exercise capacity (p < 0.001). Among participants with good-quality NIRS data, those in the lowest fitness tertile were older (p < 0.01), had a longer diabetes duration (p = 0.04), lower eGFR (p < 0.001) and more frequent use of beta-blockers (p = 0.02) and diuretics (p = 0.04). Significant differences were observed in peak cardiac output (p < 0.001) and NIRS-derived parameters across fitness groups. Multivariate regression identified cardiac output as the strongest predictor of VO₂peak, while peripheral oxygen extraction did not improve model performance. Conclusion Cardiac output is the primary determinant of exercise capacity in adults with T2DM. This suggests that muscle perfusion may be the main limiting factor in relatively fit individuals with T2DM. However, cardiac output and local muscle perfusion are not directly equivalent, as mechanical factors, such as intramuscular pressure during high-intensity exercise, may prevent maximal perfusion.
CaOx crystal nuclei are formed in rat outer cortex proximal tubules by a potential fibrinogen-dependent mechanism
Calcium oxalate (CaOx) stones are prevalent in urinary tract stone disease. While their formation can be induced in rats by administering ethylene glycol and vitamin D, the initial nucleation and formation processes are unclear. Here, we aimed to determine where CaOx crystals initially form, examine the associated histological and morphological changes, and clarify the genes whose expression varies at those sites and their function. Male Wistar rats were divided into four groups: control, ethylene glycol, vitamin D, and ethylene glycol plus vitamin D (EG + VitD). Crystal development locations were mapped on kidney tissue sections, and the initial crystal site distribution was revealed. CaOx crystal formation was observed only in the EG + VitD group kidneys, predominantly in the proximal tubules in the outer renal cortex. The tubular luminal area was significantly increased (P < 0.05), especially in proximal tubules, correlating with the crystal occurrence number. Moreover, aquaporin1 and calbindin staining identified the tubular segments hosting initial crystal formation, and the tubular dilation was calculated. DNA microarray was analyzed on cortical and medullary kidney tissues to detect stone formation-related gene expression changes. Genes with variable expression were further examined using RT-PCR and immunohistochemistry to analyze their distribution. FGA, Slc7a9, Slc7a7, and TRPV5 were significantly upregulated in the renal cortex, and FGA was significantly upregulated in the proximal tubules, consistent with the crystal formation sites. Early phase crystallization primarily occurs in the proximal tubules. In silico analysis, FGA protein has multiple oxalic acid-binding sites, making it a potential new factor promoting CaOx crystal formation.
Understanding financial hardship in families of people living with dementia: Protocol for a scoping review to identify subjective self-report measures that evaluate financial hardship
Background Financial hardship (including financial stress, financial strain, asset depletion, and financial toxicity) is a highly relevant construct among the 6.9 million people living with Alzheimer’s disease and related dementias (ADRD) in the United States and their family networks. This scoping review will identify existing measures and approaches for capturing financial strain among these families. Methods and Analysis This scoping review will be reported in accordance with PRISMA-ScR guidelines. Searches will be conducted in Embase (Embase.com), Medline (Ovid), CINAHLComplete (EbscoHost), AgeLine (EbscoHost), APA PsycInfo (EbscoHost), Scopus, and Web of Science Core Collection databases to identify tools, measures, or approaches for measuring self-reported financial hardship among family members of people living with ADRD. Data elements from both the National Health and Aging Trends Study and the associated National Study of Caregiving will also be considered. Two independent raters will screen the search results and discrepancies with be resolved by a third rater. Extraction will include the use of artificial intelligence-based software and verification by an independent human rater; any changes that are made to the AI-generated extraction will be reviewed by a second independent rater. A frequency analysis will be conducted to analyze the data, and a summary of the psychometric properties of each of the identified measures will be presented. Ethics and Dissemination The findings from this review will be disseminated through peer-reviewed publications and conference presentations. Ultimately, this work will inform the development of a new patient-reported outcome measurement system designed to provide a comprehensive assessment of the different aspects of financial hardship for families of people living with ADRD. Scoping Review Registration In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P), the following protocol was registered via https://osf.io on March 14, 2025 (registration DOI: https://doi.org/10.17605/OSF.IO/J26KT).
Synergistic antibacterial action of AgNP-ampicillin conjugates: Evading β-lactamase degradation in ampicillin-resistant clinical isolates
Objectives Antibiotic resistance towards penicillin has been attempted to counter by chemically modifying ampicillin through the conjugation with silver nanoparticles (AgNPs). The current study optimizes the conditions for synthesizing and characterizing AgNP-ampicillin to quantify the conjugation extent, evaluate the antibacterial efficacy, and explore the underlying antibacterial mechanisms. Materials and methods AgNPs were synthesized from silver nitrate by chemical reduction method, silica-coated with tetraethyl orthosilicate (TEOS) and amine functionalized by (3-aminopropyl) triethoxysilane (APTES), which was then conjugated with ampicillin via the carbodiimide chemistry. UV-visible spectroscopy and DLS were employed to confirm the synthesis of AgNPs, while FT-IR and TGA were used to confirm ampicillin functionalization and conjugation, and SEM and EDX spectroscopy provided morphological insight. Microbial assays were conducted against Bacillus subtilis, Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa to determine the inhibition zones, MIC, MBC, MPC, MBIC, MBEC, FIC index, and time-dependent efficacy of AgNP-ampicillin. Cytotoxicity was assessed on Vero cells while molecular docking was performed using AutoDock Vina. Results and discussions The synthesized conjugates demonstrated an approximate conjugation efficiency of 57.7%, with four ampicillin molecules conjugated per AgNP. The AgNP-ampicillin conjugates exhibited enhanced antibacterial activity against the studied clinical isolates compared to AgNPs or ampicillin alone, as evidenced by significant differences in inhibition areas in One-way ANOVA (F=18-25.68, p<0.05), while Tukey’s post-hoc analysis suggested synergistic effects. AgNP-ampicillin demonstrated enhanced bacteriostatic and bactericidal activity against both planktonic and biofilm-forming cells with mutant prevention ability, and upto 1.25 times faster bacterial elimination compared to ampicillin and AgNPs alone. Synergistic effects of AgNP-ampicillin were confirmed by an FIC index (≤0.5), and effective protection of ampicillin from β-lactamase degradation was established through molecular docking. Cytotoxicity testing confirmed >95% Vero cell viability, indicating minimal toxicity. Conclusion The AgNP-ampicillin conjugates exhibited enhanced antibacterial efficacy, biofilm disruption, and protection against β-lactamase degradation while maintaining low toxicity.
Long sequence temporal knowledge tracing for student performance prediction via integrating LSTM and informer
Knowledge tracing can reveal students’ level of knowledge in relation to their learning performance. Recently, plenty of machine learning algorithms have been proposed to exploit to implement knowledge tracing and have achieved promising outcomes. However, most of the previous approaches were unable to cope with long sequence time-series prediction, which is more valuable than short sequence prediction that is extensively utilized in current knowledge-tracing studies. In this study, we propose a long-sequence time-series forecasting pipeline for knowledge tracing that leverages both time stamp and exercise sequences. Firstly, we introduce a bidirectional LSTM model to tackle the embeddings of exercise-answering records. Secondly, we incorporate both the students’ exercising recordings and the time stamps into a vector for each record. Next, a sequence of vectors is taken as input for the proposed Informer model, which utilizes the probability-sparse self-attention mechanism. Note that the probability sparse self-attention module can address the quadratic computational complexity issue of the canonical encoder-decoder architecture. Finally, we integrate temporal information and individual knowledge states to implement the answers to a sequence of target exercises. To evaluate the performance of the proposed LSTKT model, we conducted comparison experiments with state-of-the-art knowledge tracing algorithms on a publicly available dataset. This model demonstrates quantitative improvements over existing models. In the Assistments2009 dataset, it achieved an accuracy of 78.49% and an AUC of 78.81%. For the Assistments2017 dataset, it reached an accuracy of 74.22% and an AUC of 72.82%. In the EdNet dataset, it attained an accuracy of 68.17% and an AUC of 70.78%.
Characteristics of a tattooed population and a possible role of tattoos as a risk factor for chronic diseases: Results from the LIFE-Adult-Study
Tattoos and permanent make-up (PMU) gain increasing popularity among the general population. There are indications that pigments or their fragments may translocate within the body, however knowledge about possible systemic adverse effects related to tattoos is very limited. We investigated the prevalence of systemic chronic health effects including cardiovascular diseases, cancer and liver toxicity and their relationship with the presence and characteristics of tattoos and PMU as part of the LIFE-Adult-study, a population-based cohort study. The control group without tattoos was from the same cohort and adjusted for confounders based on age, sex, smoking-status, body mass index, alcohol consumption and socioeconomic status. Of 4,248 participants, 7.4% (n = 320) had either a tattoo (4.7%; n = 199) or a permanent make-up (3.1%; n = 135), or both (n = 14). Thereof 5% (16/320) reported medical complications, i.e. pain, itch, swelling, infections, or allergic reactions, in relation to their tattoos or PMUs. Regarding systemic chronic health effects, increased risk ratios among the tattooed population were found for cardiovascular diseases and liver toxicity. For non-melanoma skin cancer, results from the tattoo questionnaire gave no indication for any tumour development at the site of the tattoo. Our results demonstrate an increased risk for cardiovascular and liver effects in participants bearing a tattoo. Strong differences in the observed effects between men and women point on the presence of a sex-specific bias. Even if no statistically robust conclusion can be drawn due to the small sample size, the results suggest that cardiovascular outcomes and liver toxicity in tattooed individuals should be investigated further using prospective designs in larger cohorts.
Evaluating antibody mediated opsonophagocytosis of bacteria via lab protocol: RAW 264.7 cell phagocytosis assay
Assessing the phagocytosis of microbes by macrophages is an important component of studies of novel immunotherapeutics, antimicrobial drugs, immune effectors, or any immunology related research. Here we define two protocols for measuring in vitro phagocytosis by RAW 246.7 cells – a photographic phagocytosis assay that allows optical measurement of bacterial cells inside of the RAW 246.7 cell by staining fixed cells and visually quantifying the bacteria that have been phagocytosed, as well as a killing assay, which measures the viable bacteria released from lysed cells following exposure and phagocytosis via colony forming unit analysis. These methods differ from previously available protocols for measuring phagocytosis, as they are more generalizable to a variety of microbes and experimental designs and use readily available cell lines and materials to produce robust results. We demonstrate the utility of our methods by showing how opsonization by our novel, therapeutic monoclonal antibodies drive phagocytosis and killing of the gram-negative bacteria, Acinetobacter baumannii.