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BACKGROUND Antibiotic pollution carried by reclaimed water infiltration is one of the sources of groundwater pollution, which has become a problem that cannot be ignored in the safety of urban groundwater resources. The effects of antibiotics on microbial communities and their functions in complex and fragile groundwater environments deserve attention. OBJECTIVES To explore the differences of groundwater environmental factors in different seasons and the distribution characteristics of antibiotic pollution, and to explore the influence mechanism of antibiotics on a microbial community. METHODS Based on the high-throughput sequencing method of 16S rRNA gene, the microbial community structure in urban groundwater in the infiltration area of reclaimed water in March and September was studied. Combined with field investigation and indoor analysis, the ion (K+, Na+, Ca2+, Mg2+, NH4+, F-, Cl-, SO42-, NO3-, NO2-, HCO3-, CO32-) concentration in the sample was measured, and the main antibiotic (ciprofloxacin, norfloxacin, ofloxacin, moxifloxacin, sulfapyridine, sulfacetamide) concentration was measured by ultra-high performance liquid chromatography-tandem mass spectrometry. RESULTS (1) In the study area, the concentration of antibiotics in groundwater in March was higher than that in September, mainly sulfacetamide and ciprofloxacin. In addition to seasonal factors, human activities may be another factor affecting the distribution of antibiotics. (2) The microbial community was mainly composed of Proteobacteria (81.04%), Bacteroidota (7.60%), and Firmicutes (4.21%). 3-nitrogen (NH4+, NO3-, NO2-) and antibiotics were important factors affecting the microbial community structure in the study area. Different antibiotics had different effects on the microbial community. Among them, sulfapyridine, norfloxacin, ofloxacin and moxifloxacin had the greatest impact on microorganisms, while ciprofloxacin and sulfacetamide had less impact. (3) Co-occurrence network analysis found that the two dominant functional groups had a high degree of connection with antibiotics, namely, antibiotics had a potential impact on the main microbial functional groups and their functions in the study area. CONCLUSIONS The study provides support for understanding the impact mechanism of antibiotics on a groundwater microbial community and the ecological risk.

Background: The use of acupuncture in cancer treatment is expanding. Nevertheless, the efficacy and safety of acupuncture in alleviating cancer-related hiccups remains uncertain and inconclusive. Methods: We conducted a systematic search across eight databases: PubMed, China National Knowledge Infrastructure Database, WanFang, China Science and Technology Journal Database, SinoMed, Web of Science, Cochrane, and Embase, covering the period from their inception to July 2023. Literature was screened based on predefined PICOS inclusion and exclusion criteria, and the risk of bias was assessed using the Cochrane Risk of Bias tool. Data synthesis was performed using Review Manager 5.3 software and R studio 4.4. Additionally, we conducted a frequency analysis of acupoint usage. Results: A total of nine randomized controlled trials (RCTs) involving 580 patients were included in the analysis. The risk of bias assessment indicated a high risk of bias in all nine RCTs, primarily due to blinding of participants and personnel and random sequence generation (selection bias). The meta-analysis revealed that acupuncture significantly reduced the symptoms of cancer-related hiccups compared to pharmacological treatment (relative risk (RR) = 1.83, 95% confidence interval (CI) [1.53, 2.20], p < 0.001 , I2 = 27%). In terms of onset time, acupuncture demonstrated a shorter duration of onset compared to pharmacological treatment (mean difference (MD) = −8.71, 95% CI [−23.32 5.89], p < 0.01 , I2 = 100%). Furthermore, acupuncture exhibited a significant improvement in sleep, eating, and appetite scores compared to pharmacological treatment (MD = 0.68, 95% CI [0.07, 1.29], p = 0.03 ; MD = 0.68, 95% CI [0.07, 1.30], p = 0.03 ; MD = 0.66, 95% CI [0.08, 1.25, p = 0.03 ]). The frequency of acupoint usage was analyzed, with ST36 and PC6 being the most frequently used acupoints. Regarding adverse events, acupuncture exhibited favorable safety profiles compared to other control groups. Conclusion: The meta-analysis results suggest that acupuncture has a positive effect on the efficacy rate for cancer-related hiccups, as well as improvements in quality of life and time to effect response. However, due to the high risk of bias and quality limitations of the included studies, no conclusive evidence currently supports the efficacy of acupuncture. High-quality, evidence-based research is still needed to confirm the effectiveness of acupuncture in treating cancer-related hiccups. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/ , CRD42023451403. [ABSTRACT FROM AUTHOR]

Background: Although numerous studies have explored acupuncture for alleviating Parkinson's disease (PD) symptoms, specific methods focusing on reducing anxiety in these patients are lacking. Preliminary research indicates that acupuncture may improve anxiety in patients with Parkinson's; however, high-quality evidence is lacking. Therefore, we conducted a meta-analysis and trial sequential analysis (TSA) to assess the efficacy of acupuncture in managing anxiety symptoms in PD. Methods: We systematically searched eight databases for randomized controlled trials (RCTs) evaluating the efficacy of acupuncture for the treatment of anxiety in patients with PD. Primary outcomes were measured using the Hamilton Anxiety Scale (HAMA) and the Self-Rating Anxiety Scale (SAS). Secondary outcomes included the Parkinson's Disease Questionnaire-39 (PDQ-39) and the Unified Parkinson's Disease Rating Scale (UPDRS). Risk of bias was assessed using the Cochrane RoB 2.0 tool, and certainty of evidence was assessed using the GRADE system. The Trial Sequential Analysis (TSA) was used to assess the sufficiency of the evidence. Results: Our meta-analysis included 14 studies. The Manual acupuncture (MA) + routine drug treatment (RDT) group improved more than the RDT alone group. MA was more effective than sham acupuncture. MA+ traditional Chinese medicine (TCM) was also more effective than TCM. Auricular therapy (AT) was not as effective as control therapy (CT). The Electroacupuncture (EA) + routine drug treatment (RDT) group was not as effective as RDT. PDQ-39 and UPDRS subgroup analysis showed that the acupuncture group had better clinical efficacy than CT. The GRADE assessment rated the overall certainty of evidence for anxiety outcomes as low, PDQ-39 as very low and UPDRS as low. TSA results indicate insufficient evidence; further high-quality RCTs are needed to substantiate these findings. Conclusion: Our analysis suggests that MA combined with RDT may help ameliorate anxiety in PD patients, although the evidence is weak due to low quality RCTs. EA and AT showed no significant effects, highlighting the need for more rigorous studies with better controls and longer follow-up. The potential of acupuncture for PD-related anxiety should be considered with caution until stronger evidence becomes available. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/. [ABSTRACT FROM AUTHOR]

Objectives: While extensive research has examined the rehabilitation challenges faced by stroke survivors, there is limited literature addressing the difficulties encountered by older adult stroke survivors and their caregivers in accessing rehabilitation and long-term care within the Chinese community. This study aimed to investigate the specific challenges related to access, quality, and coordination of rehabilitation and long-term care experienced by older adult stroke survivors and their caregivers within the Chinese community. Methods: A qualitative phenomenological design was employed to explore the lived experiences of stroke survivors and their caregivers within the Chinese community. A purposive sampling method was used to recruit participants from June to August 2023. Participants engaged in face-to-face semi-structured interviews. The data were analyzed using an inductive thematic analysis approach to identify and understand key themes and sub-themes. Results: The study involved 38 participants, consisting of 21 older adult stroke survivors (13 males, 8 females) and 17 family caregivers (7 males, 10 females), recruited from five Chinese community health service stations. The analysis identified four distinct themes and 11 sub-themes that encapsulated the challenges faced by participants. These themes include (1) Difficulties in accessing medical services (insufficient medical resources, lack of rehabilitation resources, and time-consuming processes), (2) Challenges in daily life (inconvenience in daily mobility, inadequate financial support, and difficulties in applying for home care services), (3) Psychosocial stress (loneliness, powerlessness, and worry about burdening others), (4) Insufficient information (lack of awareness of available community services, and limited public health education activities). Conclusion: Older adult stroke survivors and their caregivers in Chinese communities face significant challenges. To improve their well-being and quality of life, it is crucial to address these challenges through enhanced access to healthcare, better support for daily living, and more effective information dissemination. Meeting these needs requires a coordinated effort from healthcare providers, community stakeholders, and policymakers to develop and implement effective, long-term care solutions. [ABSTRACT FROM AUTHOR]

The modification of cigarette filters with nanozymes has gradually emerged as a promising strategy for reducing the harmful effects of smoking by eliminating excessive harmful free radicals and remediating oxidative stress‐induced pulmonary injury. However, currently, available nanozymes‐integrated filters usually ignore safety concerns and fail to address the pungent odor of smoke, making it challenging to develop an individual system with high safety and effectiveness while considering these important factors. Herein, a novel smoke purifier (CDs/ME@MOF) is developed by alternatively introducing carbon dots nanozymes with excellent free radicals scavenging activity and Menthone masking the miscellaneous gas into a biocompatible γ‐cyclodextrin‐based metal–organic framework. The CDs/ME@MOF can act as a profitable additive incorporated with cigarette filters to achieve over 90% scavenging efficiency for cigarette smoke radicals and reduce the odor irritation. In the mice model, the CDs/ME@MOF composites demonstrated the significant inflammation suppression, antioxidant levels promotion, and notable lung tissues protection effect through elimination of free radicals. This work highlights the potential of CDs/ME@MOF as a safe, environmentally friendly, and multipurpose additive for modifying cigarette filter. [ABSTRACT FROM AUTHOR]

This study addresses a long-standing and well-recognized problem in Knowledge Management (KM) research, namely, that the KM research community is fragmented. Journeying across boundaries is hazardous because there is a lack of mutual understanding on conceptual, methodological and theoretical issues. The authors believe that researchers may make more robust claims to the validity of their work if they are aware of their own epistemic commitments and those of others. Consequently we address the problem of fragmentation by identifying heuristics for both individual choice (diversity) and collective coherence (integration) in KM research. We propose a framework for inquiry that supports diversity and integration through a synthesis of concepts from Churchman's inquiring systems and Habermas's critical social theory. The key architectural element in this framework is a three-level structure comprised of Habermas's three knowledge interests (technical, practical and emancipatory). Framework development consists of describing how four other design elements (Habermas's three rationalities, Churchman's roles, knowledge dynamics, and research paradigms) relate to these three levels. Some initial suggestions are made for the practical use of the framework for the purpose of ethical inquiry. Keywords Churchman; critical heuristics; Habermas; knowledge management, INTRODUCTION 'Knowledge management, as a field of study, has suffered from issues of definition since before the term caught the attention of practicing managers and IS professionals. Put simply, it [...]

Introduction: This study aimed to develop and validate a risk prediction model for predicting the likelihood of coagulation in patients undergoing anticoagulant-free hemodialysis (HD). Anticoagulant-free HD technique is necessary in patients with contraindications to systemic therapy. Coagulation is a complication of this technique. Unfortunately, no predictive model is currently available to assess the risk of coagulation in anticoagulant-free HD. Methods: We retrospectively analyzed the clinical data from 299 HD sessions involving 164 patients who underwent anticoagulant-free HD between January 2022 and June 2023. To identify the risk factors for coagulation in anticoagulant-free HD, a univariate analysis was performed on 18 independent variables. Logistic regression was used to establish predictive models by identifying factors contributing to coagulation in anticoagulant-free HD. A calibration curve was drawn using regression coefficients and 1,000 bootstrap repetitions to validate our model internally. The performance of the prediction model was evaluated using receiver operating characteristic, area under the curve (AUC), and decision curve analysis (DCA). Results: The incidence of coagulation in patients on anticoagulant-free HD was 35.1%. Logistic regression analysis showed that platelet (PLT), hematocrit (HCT) levels, dialysate type, and age were risk factors for coagulation in anticoagulant-free HD patients (p < 0.05). The Hosmer-Lemeshow test showed p = 0.29, and the AUC is 0.76 (95% CI 0.70–0.80). The optimal critical value was 0.40, yielding a sensitivity of 61.0%, a specificity of 80.4%, and a Youden index of 0.41. Conclusion: In anticoagulant-free HD, there were numerous risk factors and a 35.1% occurrence of coagulation. The constructed coagulation risk prediction model exhibited good predictive and clinical utility and could serve as a reference for the initial assessment and screening of coagulation risk in anticoagulant-free HD. [ABSTRACT FROM AUTHOR]

Objective: To review the current research status and hotspots of acupuncture-assisted tumor chemotherapy and provide references for clinical and basic research in this field., Methods: The relevant literature on acupuncture-assisted tumor chemotherapy from the inception of the China National Knowledge Infrastructure (CNKI) and Web of Science (WoS) databases to December 10, 2023, was retrieved. CiteSpace6.2.R4 and VOSviewer1.6.20 software was used to analyze publication volume, authors, institutions, source journals, and keywords, etc. and to create visualized mapping., Results: A total of 2 116 articles were included (1 829 from CNKI and 287 from WoS), showing an overall upward trend in publication volume. The scope of acupuncture-assisted tumor chemotherapy has expanded, with a growing variety of research types. In CNKI, the most prolific authors and institutions were from Henan University of CM, forming core research teams. In WoS, the most prolific author was Bao T, and the leading institution was Kyung Hee University in South Korea, although author and institution distribution was more scattered, with close inter-regional collaboration. There were 602 keyword nodes in CNKI and 383 in WoS, with high-frequency keywords in both databases mainly focusing on treatment protocols, cancer types, and chemotherapy-related adverse reactions. CNKI publications highlighted frequent use of acupoints, with more diverse acupoint protocol options, while WoS focused more on different research methods. Recent CNKI studies have focused on improving immune function and quality of life, while "systematic review" emerged as a key term in WoS., Conclusion: Research on acupuncture-assisted tumor chemotherapy should further strengthen collaboration and communication, focus on improving clinical evidence, and promote wider application of acupuncture in integrative oncology research.