Resistance Response Research Articles

Synchronous enhancement of safety protection and impact perception in intelligent leather

High protection performance and intelligence are gradually becoming indispensable key factors with the ever-improving personal protective equipment. However, protective material that can not only resist but also percept full type of impacts is an urgent need due to complex combat scenarios. This work reports an intelligent leather/shear stiffening gel (SSG)/Kevlar-shear thickening fluid (STF)/non-woven fabric (LSKSN) composite, which exhibits superior and comprehensive impact resistance performance in needle puncture, knife puncture, ballistic impact, and blunt impact. Especially, the LSKSN composite not only improves the puncture resistance performance by 71% but also still maintains a large resistance after being punctured. Moreover, the LSKSN composite possesses a high limit penetrated velocity of 159 m s−1 and can dissipate a high impact energy of 24.6 J, causing the bulletproof to be improved by 22%. Due to the excellent force-buffering performance and rate-dependent energy dissipation characteristics in wide-impact energy, the maximum energy dissipation rate of the LSKSN composite reaches 95%. Simultaneously, the further developed electronic LSKSN (E-LSKSN) composite shows outstanding perceptual capability, which is sensitive to various impacts and can accurately identify the impact types through different resistance changes (10–8000%) and response times (0.1–100 ms). Finally, based on the bending sensing and impact sensing properties of the E-LSKSN composite, a wireless signal transmission system is constructed to monitor the safety and movement status of the human body in real-time, which demonstrates this LSKSN composite possesses high potential in the next generation of intelligent protective equipment.Graphical

Fluoroquinolone-specific resistance trajectories in E. coli and their dependence on the SOS-response

BackgroundFluoroquinolones are indispensable antibiotics used in treating bacterial infections in both human and veterinary medicine. However, resistance to these drugs presents a growing challenge. The SOS response, a DNA repair pathway activated by DNA damage, is known to influence resistance development, yet its role in fluoroquinolone resistance is not fully understood. This study aims to unfold the mechanisms of fluoroquinolone resistance by investigating the impact of the SOS response on bacterial adaptation.ResultsWe exposed Escherichia coli to four fluoroquinolones—ciprofloxacin, enrofloxacin, levofloxacin, and moxifloxacin. Using a recA knockout mutant, deficient in the SOS response, as a control, we assessed how the presence or absence of this pathway affects resistance development. Our findings demonstrated that the rate of resistance evolution varied between the different fluoroquinolones. Ciprofloxacin, enrofloxacin, and moxifloxacin exposures led to the most evident reliance on the SOS response for resistance, whereas levofloxacin exposed cultures showed less dependency. Whole genome analysis indicated distinct genetic changes associated with each fluoroquinolone, highlighting potential different pathways and mechanisms involved in resistance.ConclusionsThis study shows that the SOS response plays a crucial role in resistance development to certain fluoroquinolones, with varying dependencies per drug. The characteristic impact of fluoroquinolones on resistance mechanisms emphasizes the need to consider the unique properties of each antibiotic in resistance studies and treatment strategies. These findings are essential for improving antibiotic stewardship and developing more effective, tailored interventions to combat resistance.

Alginate oligosaccharide induces resistance against Penicillium expansum in pears by priming defense responses.

The research intended to explore the control ability of alginate oligosaccharide (AOS) on Penicillium expansum infection in pear fruit by priming response and its mechanism. The results showed that 100mgL-1 AOS treatment could significantly reduce the incidence of postharvest blue mold and the lesion diameter in pear fruits and maintain their quality. The defense responses induced by AOS treatment alone were relatively mild in pear fruits. Still, AOS-treated pear fruits inoculated with P. expansum showed more intense disease resistance responses. These defense responses included enhanced activities of chitinase (CHI), β-1, 3-glucanase (GLU), peroxidase (POD), polyphenol oxidase (PPO), phenylalanine ammonia-lyase activity (PAL), along with the accumulation of total phenolic compounds, flavonoids and lignin. Additionally, the expression levels of defense-related genes, such as PbGLU, PbCHI, PbPAL, PbPOD and PbPPO, were significantly upregulated. However, AOS did not show a potential inhibitory effect on the in vitro growth of P. expansum. Our results indicated that AOS treatment in the postharvest pear fruit enhances disease resistance by priming its defense responses.

Improving the Selectivity of Metal Oxide Semiconductor Sensors for Mustard Gas Simulant 2-Chloroethyl Ethyl Sulfide by Combining the Laminated Structure and Temperature Dynamic Modulation.

Insufficient selectivity is a major constraint to the further development of metal oxide semiconductor (MOS) sensors for chemical warfare agents, and this paper proposed an improved scheme combining catalytic layer/gas-sensitive layer laminated structure with temperature dynamic modulation for the Mustard gas (HD) MOS sensor. Mustard gas simulant 2-Chloroethyl ethyl sulfide (2-CEES) was used as the target gas, (Pt + Pd + Rh)@Al2O3 as the catalytic layer material, (Pt + Rh)@WO3 as the gas-sensitive layer material, the (Pt + Pd + Rh)@Al2O3/(Pt + Rh)@WO3 sensor was prepared, and the sensor was tested for 2-CEES and 12 battlefield environment simulation gases under temperature dynamic modulation. The results showed that the sensor only showed obvious characteristic peaks in the resistance response curves to HD under certain conditions (100-400 °C, the highest temperature was held for 1 s and the lowest temperature was held for 2 s), and its peak height reached 6.12, which was far higher than other gases, thus realizing the high selectivity of the MOS sensor to 2-CEES. Meanwhile, the sensor also showed good sensitivity, detection limits, response/recovery times, anti-interference, and stability, which further verified the feasibility of the improved scheme.

Smart and Noninvasive SERS Immunosensors for Monitoring Dynamic Expression of Cytokines during Cell Pyroptosis.

Accompanying the occurrence of inflammatory reaction to release cytokines, pyroptosis can activate an immune response for resistance against cancer. Consequently, elevated levels of cytokines released by cancer cells are highly correlated with the effectiveness of cancer treatment. Herein, a noninvasive surface-enhanced Raman spectroscopy (SERS) immunosensor was developed to sensitively and specifically measure the tumor necrosis factor-α (TNF-α), a proinflammatory cytokine, during the cell pyroptosis process. The sandwiched structure of the sensor is functionalized with a TNF-α binding antibody for detecting TNF-α at concentrations as low as 1 pg/mL. Importantly, electrical stimulation (ES) can fleetly trigger cancer cell pyroptosis to induce the overexpression of receptor interacting protein 3 (RIP3), which is a significant protein that regulates the inflammatory response. The overexpression of RIP3 can activate caspase-1 to promote the upregulation of cytokine levels. Notably, the cytokine levels of TNF-α released from cancer cells (MCF-7 cells) were apparently higher than those of normal cells (MCF-10A cells) during pyroptosis detected by the SERS immunosensors. Due to its obvious superiorities of simple fabrication and fast readout without sample pretreatment, the developed SERS platform has a potential application value for diagnosis and treatment of cancer.

Biocomposite Polyvinyl Alcohol/Ferritin Hydrogels with Enhanced Stretchability and Conductivity for Flexible Strain Sensors.

Protein-based hydrogels with stretchability and conductivity have potential applications in wearable electronic devices. However, the development of protein-based biocomposite hydrogels is still limited. In this work, we used natural ferritin to develop a PVA/ferritin biocomposite hydrogel by a repetitive freeze-thaw method. In this biocomposite hydrogel, ferritin, as a nano spring, forms a hydrogen bond with the PVA networks, which reduces the crystallinity of PVA and significantly improves the stretchability of the hydrogel. The fracture strain of the PVA/ferritin hydrogel is 203%, and the fracture stress is 112.2 kPa. The fracture toughness of the PVA/ferritin hydrogel is significantly enhanced to 147.03 kJ/m3, more than 3 times that of the PVA hydrogel (39.17 kJ/m3). In addition, the free residues and iron ions of ferritin endow the biocomposite hydrogel with enhanced ionic conductivity (0.15 S/m). The strain sensor constructed from this hydrogel shows good sensitivity (gauge factor = 1.7 at 150% strain), accurate real-time resistance response, and good long cyclic working stability when used for joint motion monitoring. The results indicate that a PVA/ferritin biocomposite hydrogel prepared by a facile method has enhanced stretchability and conductivity for flexible strain sensors. This work develops a new method for the preparation of protein-based hydrogels for wearable electronic devices.

Dual-Response UV Radiation Detector Based on Color Switching and Photoresistance Response for UV Radiation Monitoring.

Ultraviolet (UV) irradiation is dangerous and can cause serious skin diseases if skin is excessively exposed to it. Thus, it is highly desirable for human health to monitor the UV radiation intensity. In this report, a flexible and stretchable dual-response UV radiation detector is reported by integrating UV-responsive color-switchable WO3 quantum dots (QDs) with an electrical hydrogel. With the radiation intensity of UV increasing from 0.5 to 10 mW/cm2, the color of the hydrogel switched to dark blue gradually due to the excellent photochromic property of WO3 QDs to UV radiation. Furthermore, a linear relationship can be established between color difference and UV radiation intensity. Hence, the color difference of the hydrogel under solar UV irradiation can be used to estimate the solar UV radiation intensity in daily life. In addition, when the UV radiation intensity is greater than 10 mW/cm2, the photochromic hydrogel converts the colorimetric response into the electrical resistance change. Thus, due to its excellent photochromic and electrical resistance response properties for UV irradiation, the prepared hydrogel provides an idea for developing novel detection instruments.

Numerical Simulation of Resistivity Response Characteristics in Seepage Detection of Cutoff Walls Using Cross-Hole Resistivity Tomography

Numerical Simulation of Resistivity Response Characteristics in Seepage Detection of Cutoff Walls Using Cross-Hole Resistivity Tomography

Effect of Stress Aging on Strength, Toughness and Corrosion Resistance of Al-10Zn-3Mg-3Cu Alloy.

The 7000 series aluminum alloy represented by Al-Zn-Mg-Cu has good strength and toughness and is widely used in the aerospace field. However, its high Zn content results in poor corrosion resistance, limiting its application in other fields. In order to achieve the synergistic improvement of both strength and corrosion resistance, this study examines the response of strength, toughness and corrosion resistance of a high-strength aluminum alloy tail frame under aging conditions with external stresses of 135 MPa, 270 MPa and 450 MPa. The results show that with the increase in the external stress level, the strength of the alloy improves, while its corrosion resistance decreases. An optimal balance of strength, toughness and corrosion resistance is achieved at the conditions of 270 MPa-120-24 h. This phenomenon can be attributed to two main factors: first, lattice defects such as vacancy and dislocation are introduced into the stress aging process. The introduction of a vacancy makes it easier for neighboring solute atoms to migrate there. This makes the crystal precipitates more dispersed. Also, the number of precipitates in the matrix increases from 2650 to 3117, and the size is refined from 2.96 nm to 2.64 nm. At the same time, the dislocation entanglement within the crystal structure promotes the dislocation strengthening mechanism and promotes the solute atoms to have enough channels for migration. Since too many dislocations can cause the crystal to become brittle and thus reduce its strength, entangled dislocations hinder the movement of the dislocations, thereby increasing the strength of the alloy. Secondly, under the action of external force, the precipitated phase is discontinuous, which hinders the corrosion expansion at the grain boundary, thus improving the corrosion resistance of the alloy. At low-stress states, the binding force of vacancy is stronger, the precipitation free zone (PFZ) is significantly inhibited, and the intermittent distribution effect of intergranular precipitates is the most obvious. As a result, the self-corrosion current decreases from 1.508 × 10-4 A∙cm-2 in the non-stress state to 1.999 × 10-5 A∙cm-2, representing an order of magnitude improvement. Additionally, the maximum depth of intergranular corrosion is reduced from 274.9 μm in the non-stress state to 237.7 μm.

Epictetus’ stoic philosophy glance at resistance to change

Purpose The purpose of this paper is a selective introduction of specific underlying principles of Epictetan Stoicism in change management, aiming to mitigate resistance to change and achieve positive outcomes through redefining the perception of change by both its agents and recipients. Design/methodology/approach The applied methodology included locating, distilling and extracting selected philosophical fragments, coherent in terms of contextualisation with the field of management and paralleling their content with organisational, strategic and wider social and political objectives, to provide an interdisciplinary enriched perspective on managing resistance to change in any area. Findings The selective combination of Epictetus’ Stoic philosophy with change management literature, focusing on resistance to change, contributes as a beneficial strategic choice, multiplying the available alternatives, not only in managing resistance to change but also in a more general sense. Practical implications Selectively introducing Epictetan Stoic philosophical ideas into the behavioural response of resistance to change could clarify and improve communication to avoid crises and conflicts, as well as extend Epictetan Stoic wisdom to the wider community, beyond organisations and institutions. Although the hyper-competitive, globalised market seems to contradict the tempered Stoic philosophy, from which they radically differ, this research highlights strong points of relational relevance that could facilitate overcoming resistance to change with a much wider impact. Originality/value Epictetus’ Stoic philosophy is already widely deployed in management, but in this project, to the best of the authors’ knowledge, it is selectively cross-discussed for the first time with the theory and practice of resistance to change as a pilot intellectual platform, identifying personal perception and distinction as the primary cognitive compass in the organisational and managerial realm, so that the upcoming change projects would mitigate resistance to change.

Optimised properties of conductive polyaniline-polyvinyl alcohol ink painted on paper for ductile pressure sensor with reduced electrical drift

Polyaniline (PANI) powder in its emeraldine salt form was blended with various concentrations of polyvinyl alcohol (PVA) to create semiconducting inks with desired fluid properties. These inks were coated on cellulose paper, and their resistive responses were tested under different vacuum pressures. Enhanced conductivity and reduced creep behavior were achieved by incorporating an O–H bond between the H of PANI and O of PVA, which stabilizes the polymer structure. This bonding minimizes electrical drift, improving the reliability of the synthesized inks for applications such as designing flexible circuits and fabricating thermoelectric generators. The strain field developed under vacuum is accountable for the observed variation in electrical properties. Due to the increase in strain field, the polaron hopping barrier increases, and as a result, the effective conductivity decreases with a decrease in pressure. These ‘use-and-throw’ sensors are economical, adaptable, and environmentally friendly, ideal for various disposable electronics and sensing applications.

Resveratrol attenuates Cr(VI)-induced disorders of glycolipid metabolism by regulating HNF1b/GPX1 in mice.

Epidemiological studies have indicated that exposure to hexavalent chromium (Cr(VI)) is associated with increased morbidity in the population. Resveratrol (Res) is a polyphenolic compound known for its role in mitigating oxidative stress and inflammation. In this study, we investigated the effects of resveratrol on Cr(VI)-induced disorders of glycolipid metabolism and elucidated its mechanisms. Male C57BL/6 mice were exposed to resveratrol and Cr(VI) for 45 days. Cr(VI) exposure led to elevated blood glucose levels, impaired glucose tolerance and insulin resistance, oxidative and inflammatory responses, and alterations in glycolipid metabolism molecules such as PCK1 and SREBP1, along with inhibition of HNF1b and GPX1. Resveratrol pretreatment increased the expression of HNF1b and GPX1, reduced oxidative and inflammatory responses, and ultimately ameliorated Cr(VI)-induced glycolipid metabolism disorders. These findings suggest potential new targets for the prevention and treatment of dysglycolipidosis.

VvATG18a participates in grape resistance to gray mold induced by BR signaling pathway.

Autophagy plays an important role in responding to necrotrophic pathogens and plant signal hormones. Brassinosteroids (BRs) are a class of natural steroidal phytohormones that effectively regulated the disease resistance responses in grape. However, the molecular mechanism of BR-autophagy networks responsible for activation of host defense against gray mold remained to be elucidated. We reported a novel defense mechanism that BR-regulated autophagy in grape berry against gray mold. Exogenous application of 24-epibrassinolide (eBR) enhanced the grape disease resistance. Meanwhile, the endogenous BR was accumulated and BR signaling pathway was activated in the berries. In addition, transcriptome analysis in eBR-treated grapes infected with gray mold showed that the differentially expressed genes (DEGs) were enriched in the metabolic pathway of BR signaling pathway and autophagy. DNA affinity purification sequencing (Dap-seq), Yeast one-hybrid assay (Y1H) and dual luciferase assays (LUC) verified VvBZR1 bound to the promoter of VvATG18a to induce its gene expression. Overexpressing VvATG18a and VvBZR1 improved the resistance of grapes to gray mold. Overall, this study sheds light on the immune mechanisms underlying the involvement of the autophagy in grape innate immunity, highlighting the pivotal role of VvATG18a in enhancing disease resistance.

Root microbes can improve plant tolerance to insect damage: A systematic review and meta-analysis.

To limit damage from insect herbivores, plants rely on a blend of defensive mechanisms that includes partnerships with beneficial microbes, particularly those inhabiting roots. While ample evidence exists for microbially mediated resistance responses that directly target insects through changing phytotoxin and volatile profiles, we know surprisingly little about the microbial underpinnings of plant tolerance. Tolerance defenses counteract insect damage via shifts in plant physiology that reallocate resources to fuel compensatory growth, improve photosynthetic efficiency, and reduce oxidative stress. Despite being a powerful mitigator of insect damage, tolerance remains an understudied realm of plant defenses. Here, we propose a novel conceptual framework that can be broadly applied across study systems to characterize microbial impacts on expression of tolerance defenses. We conducted a systematic review of studies quantifying the impact of rhizosphere microbial inoculants on plant tolerance to herbivory based on several measures-biomass, oxidative stress mitigation, or photosynthesis. We identified 40 studies, most of which focused on chewing herbivores (n = 31) and plant growth parameters (e.g., biomass). Next, we performed a meta-analysis investigating the impact of microbial inoculants on plant tolerance to herbivory, which was measured via differences in plant biomass, and compared across key microbe, insect, and plant traits. Thirty-five papers comprising 113 observations were included in this meta-analysis, with effect sizes (Hedges' d) ranging from -4.67 (susceptible) to 18.38 (overcompensation). Overall, microbial inoculants significantly reduce the cost of herbivory via plant growth promotion, with overcompensation and compensation comprising 25% of observations of microbial-mediated tolerance. The grand mean effect size 0.99 [0.49; 1.49] indicates that the addition of a microbial inoculant increased plant biomass by ~1 SD under herbivore stress, thus improving tolerance. This effect was influenced most by microbial attributes, including functional guild and total soil community diversity. Overall, results highlight the need for additional investigation of microbially mediated plant tolerance, particularly in sap-feeding insects and across a more comprehensive range of tolerance mechanisms. Such attention would round out our current understanding of anti-herbivore plant defenses, offer insight into the underlying mechanisms that promote resilience to insect stress, and inform the application of microbial biotechnology to support sustainable agricultural practices.

Response of sorghum genotypes to anthracnose (Colletotrichum sublineolum) resistance under field conditions in eastern Ethiopia.

Sorghum anthracnose is one of the major diseases that have negative impacts on sorghum production in Ethiopia. This study was conducted to evaluate the resistance response of sorghum genotypes against sorghum anthracnose and to determine yield performances of sorghum genotypes under field conditions in two consecutive cropping years. Forty-nine sorghum genotypes were tested for their reactions to anthracnose in the East and West Hararghe Zones, East Ethiopia, during the 2017 and 2018 main cropping seasons. The design of the experiment was laid out in triple lattice square design with three replications. Anthracnose severity was assessed on 16 randomly selected and pre-tagged sorghum plants in the middle two rows of each plot. The eight subsequent times of severity assessments were used to evaluate the response of the genotypes to sorghum anthracnose. The ranges of the mean severity of anthracnose in 2017 and 2018 were 35 to 91% and 38 to 93%, respectively. In 2017 and 2018, the area under disease progress curve varied from 1744 to 3865% of days and from 2354 to 4908% of days, respectively. During the two growing seasons, the genotype ETSL 101469 displayed the highest anthracnose severity, followed by BTX-623. In both experimental years, anthracnose had very strong negative relationships with grain yield and thousand seed weight. The current study demonstrated how Ethiopian sorghum genotypes affect anthracnose development in the field conditions. Throughout the two experimental years, the sorghum genotypes ETSL 100335, ETSL 100395, ETSL 10474, ETSL 100523, ETSL 100498, ETSL 100989, ETSL 100597, and ETSL 101000 continuously exhibited lower disease levels than the other genotypes. Therefore, it is advised to use these genotypes as alternate sources of sorghum anthracnose resistance. Nonetheless, further research across location is necessary to validate their anthracnose resistance in a variety of agro-ecologies.

Exosome-derived proteins in gastric cancer progression, drug resistance, and immune response.

Gastric cancer (GC) represents a prevalent malignancy globally, often diagnosed at advanced stages owing to subtle early symptoms, resulting in a poor prognosis. Exosomes are extracellular nano-sized vesicles and are secreted by various cells. Mounting evidence indicates that exosomes contain a wide range of molecules, such as DNA, RNA, lipids, and proteins, and play crucial roles in multiple cancers including GC. Recently, with the rapid development of mass spectrometry-based detection technology, researchers have paid increasing attention to exosomal cargo proteins. In this review, we discussed the origin of exosomes and the diagnostic and prognostic roles of exosomal proteins in GC. Moreover, we summarized the biological functions of exosomal proteins in GC processes, such as proliferation, metastasis, drug resistance, stemness, immune response, angiogenesis, and traditional Chinese medicine therapy. In summary, this review synthesizes current advancements in exosomal proteins associated with GC, offering insights that could pave the way for novel diagnostic and therapeutic strategies for GC in the foreseeable future.

Modular self-emulsifying drug delivery platform to enhance cellular uptake activity in triple-negative breast cancer.

Triple-negative breast cancer (TNBC) presents with resistance phenotypes to certain therapies, such as cisplatin, often requiring higher dosing, with associated acquired tumor resistance, renal toxicity, and variable patient responses. A self-emulsifying drug delivery (SEDD) formulation approach was proposed to overcome the limitations of cisplatin in TNBC, focusing on improving intracellular cisplatin and control siRNA uptake as a proof-of-principle of dual drug delivery. Four SEDD formulations were prepared and optimized for cisplatin (o/w) emulsion and FITC-siRNA (w/o) emulsion using pseudo-ternary phase diagrams to facilitate the formation of water-in-oil-water (w/o/w) emulsions. Formulations were characterized by size, polydispersity (PDI), and surface charge and tested in vitro. Cellular uptake via triplex staining of drug-loaded SEDDs was investigated. SEDDs showed enhanced internalization and promoted selective TNBC cellular uptake. The current study is a proof-of-principle for the successful co-delivery of cisplatin (small molecule) and siRNA (large molecule) via the SEDDs platform.

Copy number variations at the Rhg1 locus and their relationship with resistance to soybean cyst nematode (Heterodera glycines).

Soybean cyst nematode (SCN, Heterodera glycines) is a devastating pest affecting soybean production worldwide. Host resistance is one of the primary practices used to manage SCN. The Rhg1 locus contributes to the strong and effective SCN resistance, with resistance levels predominantly governed by copy number variations (CNVs) and, to lesser extent, sequence variations. This study assessed the host resistance of 100 soybean breeding lines to SCN populations HG type 2.5.7 (S1) and HG type 7 (S2). Two controlled growth chamber experiments involved inoculating plants with 2,000 SCN eggs and juveniles, followed by counting SCN white females and calculating the female index (FI) to classify resistance responses. To determine CNVs at the Rhg1, a SYBR Green-based quantitative PCR (qPCR) assay was optimized and validated using 12 soybean accessions with known copy numbers. The qPCR assay demonstrated 94.36% efficiency for the target gene at Rhg1 locus, Glyma18g02590, with copy number detected by the assay correlating strongly (r=0.994) with whole genome sequencing data in previous study. Copy number of each line was determined using 2-ΔΔCq method relative to Williams 82 (single copy) and correlated with the resistance response. One line, ND20-16996(GT) was resistant (FI<10%) to S2 in both runs, while none were resistant to S1. Copy number among the breeding lines ranged from 1 to 11, with higher copy numbers correlating negatively with female index, indicating greater resistance. The breeding lines with copy number ≥ 9 were either resistant or moderately resistant to S2, and mostly moderately resistant to S1, with few being moderately susceptible (FI=30 to <60%). The lines with low copy numbers (≤3) were mostly susceptible (FI≥60%) to S1, while moderately susceptible or susceptible to S2. These results show the importance of Rhg1 CNVs in determining levels of SCN resistance and selecting resistant soybean lines.

Gender differences in the association between the uric acid to high-density lipoprotein cholesterol ratio and diabetes risk: a mediation analysis of c-reactive protein, triglycerides, and insulin resistance

BackgroundThe uric acid to high-density lipoprotein cholesterol ratio (UHR) has emerged as a novel metabolic marker and is proven to be associated with diabetes risk. However, there is still a lack of systematic research regarding its role in gender differences and underlying mechanisms. This study aims to assess the association of UHR with diabetes risk in the context of gender differences and to investigate its mediation effects through metabolic and inflammatory pathways.MethodsThis study utilized data from NHANES 2005–2010 and included 6,843 adult participants. Multivariate logistic regression was employed to assess the association between UHR and diabetes risk, and restricted cubic spline (RCS) along with correlation analysis was applied to explore its relationship with metabolic risk factors. Multiple mediation analysis was conducted to evaluate the mediating effects of homeostasis model assessment of insulin resistance (HOMA-IR), triglycerides (TG), and C-reactive protein (CRP) on the association between UHR and diabetes risk.ResultsIn the overall population, UHR was significantly positively associated with diabetes risk, but gender-stratified analysis revealed a stronger predictive effect in women. In the unadjusted model, every unit increase in UHR was linked to an 18.6% increase in diabetes risk in women (p < 0.001). In the quartile analysis, women in the highest quartile showed an 8.49-fold increased risk of diabetes (OR = 8.494, 95% CI: 5.542–13.019, p < 0.001), whereas no significant association was observed in men (p > 0.05). Mediation analysis revealed that HOMA-IR was the main mediator of the relationship between UHR and diabetes risk, with mediation effects of 64.55%, 118.38%, and 39.09% in the overall population, men, and women, respectively. Additionally, the mediation effect of TG was stronger in men (36.78%) and weaker in women (17.31%). The mediation effect of CRP was relatively minimal across all groups, accounting for 7.62% in men and 2.67% in women.ConclusionThis study demonstrates that the association between UHR and diabetes risk exhibits gender differences, with higher diabetes risk observed in women, while men show stronger mediation effects in insulin resistance, lipid metabolism, and inflammatory response.

Under-Recognized Medication Loss With the Administration of Small-Volume Intermittent Infusions.

Background: Most antibiotics administered via intermittent IV infusion are diluted in 50 to 100 ml of diluent. The primary infusion set for the BD Alaris® pumps can hold 25 ml of volume in its tubing, potentially contributing up to a 50% drug loss if residual volume is present after administration is complete. In the case of antibiotics, this may lead to significant underdosing, potentially contributing to reduced therapeutic response and emergence of antimicrobial resistance. Many organizations lack departmental policies and procedures for the administration of small-volume intermittent infusions. Developing a clear policy and procedure can increase drug delivery efficiency. Previous studies propose several recommendations, such as using a secondary infusion set, adding carrier fluids, and flushing the line to account for overfill. Objective: Our aim was to implement pilot new guidance in 2 patient units (an ICU and a non-ICU) to address the administration of small-volume intermittent infusions and determine if this results in more complete medication administration. Methods: This was an observational quality improvement initiative assessing the new guidance established for the administration of small-volume intermittent infusions to current practices. The primary outcome of this study was the incidence of residual drug volume in the IV line before the air-detector, IV bag, or IV vial. This was done through observation, and data collected through a survey. Results: In total, 203 IV administrations were observed, 86% of which were antibiotics. There were 124 IV administrations being observed before policy guidance initiation and 79 after initiation. The results showed a statistically significant reduction in the incidence of fluid remaining in the IV line before the air-detector (85% vs 27%; P < .001), the IV bag (59% vs 7.6%; P < .001), and in the IV vial (47% vs 24%; P < .001.). Conclusion: The proposed interventions significantly decreased the incidence of fluid remaining in the IV line before the air detector in the BD Alaris Pump, IV bag, and IV vial, presumably decreasing medication loss.