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BACKGROUND: Alzheimers disease (AD) is a devastating neurodegenerative disorder affecting 44 million people worldwide, leading to cognitive decline, memory loss, and significant impairment in daily functioning. The recent single-cell sequencing technology has revolutionized genetic and genomic resolution by enabling scientists to explore the diversity of gene expression patterns at the finest resolution. Most existing studies have solely focused on molecular perturbations within each cell, but cells live in microenvironments rather than in isolated entities. Here, we leveraged the large-scale and publicly available single-nucleus RNA sequencing in the human prefrontal cortex to investigate cell-to-cell communication in healthy brains and their perturbations in AD. We uniformly processed the snRNA-seq with strict QCs and labeled canonical cell types consistent with the definitions from the BRAIN Initiative Cell Census Network. From ligand and receptor gene expression, we built a high-confidence cell-to-cell communication network to investigate signaling differences between AD and healthy brains. RESULTS: Specifically, we first performed broad communication pattern analyses to highlight that biologically related cell types in normal brains rely on largely overlapping signaling networks and that the AD brain exhibits the irregular inter-mixing of cell types and signaling pathways. Secondly, we performed a more focused cell-type-centric analysis and found that excitatory neurons in AD have significantly increased their communications to inhibitory neurons, while inhibitory neurons and other non-neuronal cells globally decreased theirs to all cells. Then, we delved deeper with a signaling-centric view, showing that canonical signaling pathways CSF, TGFβ, and CX3C are significantly dysregulated in their signaling to the cell type microglia/PVM and from endothelial to neuronal cells for the WNT pathway. Finally, after extracting 23 known AD risk genes, our intracellular communication analysis revealed a strong connection of extracellular ligand genes APP, APOE, and PSEN1 to intracellular AD risk genes TREM2, ABCA1, and APP in the communication from astrocytes and microglia to neurons. CONCLUSIONS: In summary, with the novel advances in single-cell sequencing technologies, we show that cellular signaling is regulated in a cell-type-specific manner and that improper regulation of extracellular signaling genes is linked to intracellular risk genes, giving the mechanistic intra- and inter-cellular picture of AD.

Background: During the COVID-19 pandemic, the main focus of studies was on physical impact of the disease, while psychological impacts were mainly neglected. Identifying the psychological impacts of the COVID-19 pandemic on the general population can help in planning and preparing for future pandemics. The current study aims to investigate the psychological impacts of the COVID-19 pandemic on the general population of Iran. Materials and Methods: This cross-sectional survey study that was conducted online on 1735 Iranian people from April 21 to June 21, 2021. Perceived feelings during the COVID-19 pandemic were measured by Reynolds’s self-report tool. The collected data were analyzed using descriptive statistics (frequency and percentage) and inferential statistics including chi-square test and independent t-test in SPSS software, version 22. The significance level was set at 0.05. Results: The mean age of the respondents was 34.62±11.86 years. The most frequent perceived feelings were boredom (n=764, 44.0%), nostalgia (n=704, 40.6%), worry (n=613, 35.3%), and nervousness (n=591, 34.1%). Females, younger people, unemployed people, unmarried people, and those living in the urban areas experienced significantly higher levels of negative feelings. Conclusion: The psychological impact of the COVID-19 pandemic on Iranian people is high, particularly among female, unmarried, and unemployed people. Therefore, supportive and psychological interventions during the pandemic and psychological rehabilitations after the pandemic are needed.

Parisa Momtaz,1,2 Michael A Postow1,2 1Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; 2Weill Cornell Medical College, New York, NY, USA Abstract: T-lymphocytes have the potential to recognize cancer antigens as foreign and therefore eliminate them. However, immune checkpoints such as cytotoxic T-lymphocyte-associated antigen (CTLA)-4 and programmed cell death (PD)-1 receptor and its ligands (PD-L1, PD-L2) suppress the activity of T-lymphocytes. Advances in the understanding of immunology and its role in cancer have led to the development of immune checkpoint inhibitors that block CTLA-4 and PD-1 and result in durable responses in patients with a wide range of cancers. PD-1 and PD-L1 inhibitors are currently in many stages of clinical investigation, and the anti-PD-1 antibody, pembrolizumab, was recently approved by the US Food and Drug Administration. Many questions remain to be answered, such as the optimal administration schedule, biomarkers that associate with benefit, and potential for use of PD-1 agents in combination approaches. Nonetheless, immunotherapy with PD-1 blocking antibodies is now becoming an integral part in the management of cancer. Keyword: immune checkpoints, immunotherapy, programmed cell death protein-1, cytotoxic T-lymphocyte antigen 4

Methicillin-resistant S. aureus (MRSA) strains circulating among populations and crossing borders constitute a major problem for health control and require a fast and simple genotypic approach. The objective of this study was to determine the prevalence, molecular types and drug resistance pattern of S. aureus isolated from Hospitalized Patients in teaching Hospitals of Ahvaz. this cross-sectional study was from April to September 2023, MRSA strains were identified by phenotypic and molecular methods. The antibiotics studied were), Cefoxitin (15 μg) Gentamicin (10 μg), Ciprofloxacin (5 μg), Erythromycin (15 μg), Clindamycin (2 μg), linzolide(10μg), azithromycin(5 μg). The tests were performed according to the guidelines of clinical and Laboratory Standards Institute (CLSI). It also detected the mecA gene of Methicillin-resistant S. aureus strains (MRSA). 470 Staphylococcus aureus samples from patients hospitalized in different departments of Ahvaz Hospitals included 283 blood culture samples, 75 wound samples, 72 body fluid samples and 40 catheter samples, and 321 (68.3%) MRSA isolates were reported. All these 321 MRSA isolates were tested with ampicillin, ciprofloxacin, clindamycin, linezolid, gentamicin, erythromycin, and azithromycin antibiotics. Also, the results of molecular identification of the mec A gene in 321 strains of S. aureus showed that 312 strains carry the mec A gene. The high prevalence of S. aureus samples can be caused by long-term hospitalization of patients in the ward and excessive use of antibiotics to treat the infection and increased resistance in isolates. As a result, more monitoring of the hospital's infection control department, as well as the expansion of the correct use of antibiotics, seems necessary and important.

Abstract Background The use of synthetic cannabinoids (SC) has become a concerning public health issue due to their potential adverse effects on both physical and mental health. Understanding the effect of cannabis and synthetic cannabinoids use on kidney functions and creatinine phosphokinase-total (CPK) levels is essential for targeted intervention and patient care. Methods This cross-sectional study aimed to assess addiction severity using the Addiction Severity Index (ASI) and kidney functions in 45 patients with SC use disorder and compare them to 45 patients with cannabis use disorder (CUD). Participants were recruited from the addiction outpatient clinics and inpatient ward of the addiction psychiatry unit at “Kasr Al Aini Hospital,” Cairo University. Results There was a statistically significant difference between the 2 groups regarding the Addiction Severity Index domains, where patients with SC use disorder had higher scores in all domains of the ASI. Regarding kidney functions and CPK-total levels, there was a significant difference in the serum CPK-total level (p

Abstract Pseudomonas aeruginosa is a commonly found Gram-negative bacterium in healthcare facilities and is renowned for its ability to form biofilms and its virulence factors that are controlled by quorum sensing (QS) systems. The increasing prevalence of multidrug-resistant strains of this bacterium poses a significant challenge in the field of medicine. Consequently, the exploration of novel antimicrobial agents has become a top priority. This research aims to optimize chitosan derived from white shrimp (Metapenaeus affinis) using the Response Surface Methodology (RSM) computational approach. The objective is to investigate chitosan’s potential as a solution for inhibiting QS activity and biofilm formation in P. aeruginosa ATCC 10,145. Under optimized conditions, chitin was treated with NaOH (1.41 M) for 15.75 h, HCl (7.49% vol) for 2.01 h, and at a deacetylation temperature of 81.15 °C. The resulting chitosan exhibited a degree of deacetylation (DD%) exceeding 93.98%, as confirmed by Fourier-transform infrared (FTIR) spectral analysis, indicating its high purity. The extracted chitosan demonstrated a significant synergistic antibiotic effect against P. aeruginosa when combined with ceftazidime, enhancing its bactericidal activity by up to 15-fold. In addition, sub-MIC (minimum inhibitory concentration) concentrations of extracted chitosan (10 and 100 µg/mL) successfully reduced the production of pyocyanin and rhamnolipid, as well as the swimming motility, protease activity and biofilm formation ability in comparison to the control group (P

Introduction: Considering the importance of the quality of education in universities on the growth and development programs of the country, this study aimed to explain the opinions of students, professors, and educational managers regarding the factors affecting improving education quality at Hamadan University of Medical Sciences. Method: This qualitative study used conventional content analysis to understand the experiences of students, professors, and managers at Hamadan University of Medical Sciences. Participants were selected through purposeful sampling with diversity in considering faculty, educational group, level, age, and gender. The interviews in person included in-depth interviews with 20 students, 8 professors, and 3 educational managers. The responses were analyzed using the Graneheim and Lundman model. Results: The factors affecting the improvement of education quality from the students’ perspective were determined in four main contexts: the professor’s teaching method in class, modern teaching techniques, appropriate interactions between professor and student, and the availability of educational infrastructures. The effective factors from the educational managers’ perspective were identified in two prominent contexts: the professor’s teaching in class and appropriate interactions between professor and student. The effective factors from the professors’ perspective were identified in four main contexts: professors’ motivation, empowering professors, professors’ and students’ characteristics. Conclusion: Improving the quality of education depends on appropriate interactions between professors and students, professors’ teaching methods, modern teaching techniques, and educational infrastructures. Also, the motivation and empowerment of professors and the characteristics of professors and students play a significant role in this field. Therefore, to improve the quality of education, educational managers must pay attention to these factors.

Abstract Background Alzheimer’s disease (AD) is a devastating neurodegenerative disorder affecting 44 million people worldwide, leading to cognitive decline, memory loss, and significant impairment in daily functioning. The recent single-cell sequencing technology has revolutionized genetic and genomic resolution by enabling scientists to explore the diversity of gene expression patterns at the finest resolution. Most existing studies have solely focused on molecular perturbations within each cell, but cells live in microenvironments rather than in isolated entities. Here, we leveraged the large-scale and publicly available single-nucleus RNA sequencing in the human prefrontal cortex to investigate cell-to-cell communication in healthy brains and their perturbations in AD. We uniformly processed the snRNA-seq with strict QCs and labeled canonical cell types consistent with the definitions from the BRAIN Initiative Cell Census Network. From ligand and receptor gene expression, we built a high-confidence cell-to-cell communication network to investigate signaling differences between AD and healthy brains. Results Specifically, we first performed broad communication pattern analyses to highlight that biologically related cell types in normal brains rely on largely overlapping signaling networks and that the AD brain exhibits the irregular inter-mixing of cell types and signaling pathways. Secondly, we performed a more focused cell-type-centric analysis and found that excitatory neurons in AD have significantly increased their communications to inhibitory neurons, while inhibitory neurons and other non-neuronal cells globally decreased theirs to all cells. Then, we delved deeper with a signaling-centric view, showing that canonical signaling pathways CSF, TGFβ, and CX3C are significantly dysregulated in their signaling to the cell type microglia/PVM and from endothelial to neuronal cells for the WNT pathway. Finally, after extracting 23 known AD risk genes, our intracellular communication analysis revealed a strong connection of extracellular ligand genes APP, APOE, and PSEN1 to intracellular AD risk genes TREM2, ABCA1, and APP in the communication from astrocytes and microglia to neurons. Conclusions In summary, with the novel advances in single-cell sequencing technologies, we show that cellular signaling is regulated in a cell-type-specific manner and that improper regulation of extracellular signaling genes is linked to intracellular risk genes, giving the mechanistic intra- and inter-cellular picture of AD.

Abstract Packaging is very important to maintain the quality of food and prevent the growth of microbes. Therefore, the use of food packaging with antimicrobial properties protects the food from the growth of microorganisms. In this study, antibacterial nanocomposite films of polyvinyl alcohol/starch/chitosan (PVA/ST/CS) together with nickel oxide-copper oxide nanoparticles (NiO–CuONPs) are prepared for food packaging. NiO–CuONPs were synthesized by the co-precipitation method, and structural characterization of nanoparticles (NPs) was carried out by XRD, FTIR, and SEM techniques. Composites of PVA/ST/CS, containing different percentages of NPs, were prepared by casting and characterized by FTIR and FESEM. The mechanical properties, diffusion barrier, and thermal stability were determined. The nanoparticles have a round structure with an average size of 6.7 ± 1.2 nm. The cross-section of PVA/ST/CS film is dense, uniform, and without cracks. In the mechanical tests, the addition of NPs up to 1% improved the mechanical properties (TS = 31.94 MPa), while 2% of NPs lowered TS to 14.76 MPa. The fibroblast cells toxicity and the films antibacterial activity were also examined. The films displayed stronger antibacterial effects against Gram-positive bacteria (Staphylococcus aureus) compared to Gram-negative bacteria (Escherichia coli). Furthermore, these films have no toxicity to fibroblast cells and the survival rate of these cells in contact with the films is more than 84%. Therefore, this film is recommended for food packaging due to its excellent mechanical and barrier properties, good antibacterial activity, and non-toxicity.

Abstract Background In parallel with population aging, the prevalence of neurological and neurodegenerative diseases has been dramatically increasing over the past few decades. Neurodegenerative diseases reduce the quality of life of patients and impose a high cost on the health system. These slowly progressive diseases can cause functional, perceptual, and behavioral deficits in patients. Therefore, neurodegenerative impairments have always been an interesting subject for scientists and clinicians. One of these diseases is spinal cord injury (SCI). SCI can lead to irreversible damage and is classified into two main subtypes: traumatic and non‐traumatic, each with very different pathophysiological features. Aims This review aims to gather relevant information about the beneficial effects of curcumin (Cur), with specific emphasis on its anti‐inflammatory properties towards spinal cord injury (SCI) patients. Materials & Methods The review collates data from extensive in‐vitro, in‐vivo, and clinical trials documenting the effects of CUR on SCI. It examines the modulation of pathophysiological pathways and regulation of the inflammatory cascades after CUR administration. Results Various pathophysiological processes involving the nuclear factor erythroid 2‐related factor 2 (Nrf2), nuclear factor kappa B (NF‐kB), and transforming growth factor beta (TGF‐β) signaling pathways have been suggested to exacerbate damages resulting from SCI. CUR administration showed to modulate these signaling pathways which lead to attenuation of SCI complications. Discussion Anti‐inflammatory compounds, particularly CUR, can modulate these pathophysiological pathways and regulate the inflammatory cascades. CUR, a well‐known natural product with significant anti‐inflammatory effects, has been extensively documented in experimental and clinical trials. Conclusion Curcumin's potential to alter key steps in the Nrf2, NF‐kB, and TGF‐β signaling pathways suggests that it may play a role in attenuating SCI complications.

In this study pyrolysis kinetics of jute stick (white jute: Corchorus capsularis; tossa jute: Corchorus olitorius) and tamarind (Tamarindus indica) seed available in Bangladesh have been investigated thermogravimetrically in a nitrogen atmosphere at heating rates of 10 and 60°C/min over a temperature range of 30 to 800°C. The two biomass solid wastes exhibited similar behaviors in that, the weight loss region is shifted to a higher temperature range and the weight loss rate is increased with increasing heating rate. The percentage of total weight loss is higher for jute stick and is lower for tamarind seed. The overall rate equation for the two biomass wastes has been modeled satisfactorily by one simplified equation from which the kinetic parameters of unreacted materials based on the Arrhenius form can be determined. The predicted rate equation compares fairly well with the measured TG and DTG data.

Abstract Food packaging with antibacterial properties has attracted much attention recently. In this study, nickel oxide nanoparticles (NiONPs) were synthesized by co-precipitation and then gelatin/chitosan polymer films (GEL/CS) with different percentages of NiONPs, bio-nanocomposites, were prepared by casting. Morphology, crystal microstructure, molecular interactions and thermal stabilities of the NPs and the composite films were characterized by FESEM, XRD, FTIR and TGA, respectively. The bio-nanocomposite films exhibited excellent barrier, thermal and mechanical properties by addition of an optimized content of NPs. For example, the tensile strength (TS) of the GEL/CS film without NPs was 23.83 MPa and increased to 30.13 MPa by incorporation of 1% NPs. The antibacterial properties and toxicity of the films were investigated. These films show good antibacterial behavior against Gram-positive (Staphylococcus aureus) bacteria compared to Gram-negative (Escherichia coli) bacteria. Furthermore, the films were found to be non-toxic to fibroblast cells that came into contact with the films, with a survival rate of more than 88%. Therefore, these films can be applied for food packaging due to their excellent mechanical, barrier, and antibacterial properties.

The spread of duck hepatitis virus (DHV) in Egypt with its’ most prevalent genotypes (1 and 3) causes vast economic losses in the duck industry despite the regular vaccination with live attenuated vaccines. However, the use of live-vaccines is considered a potential risk for the non-vaccinated birds due to the viral shedding from vaccinated populations. The current study aimed to evaluate the protective efficacy and safety of two inactivated monovalent and one bivalent vaccines against DHV 1 and 3 genotypes. The inactivated monovalent (DHAV-1, DHAV-3) and bivalent (DHAV-1+3) vaccines were produced by using Montanide ISA 70 oil as an adjuvant. Three groups of 4-week-old ducklings (n=50) were vaccinated with one of the three vaccines, respectively. One group of ducklings was used as negative control (n=25). The immune-response of the vaccinated groups was measured by Virus Neutralization Test and expressed with Neutralizing Indices (NIs). The NIs for the bivalent vaccine group (5.6 and 5.4) were higher compared to the monovalent vaccine groups (5.0 and 4.7). In conclusion, the use of inactivated bivalent DHV vaccine could produce higher protective efficacy compared to the monovalent DHAV-1 and DHAV-3 vaccines.

Abstract Introduction This study aimed to develop a modified frailty index (MFI) to predict the risks of revision total hip arthroplasty (THA). Methods Data from the American College of Surgeons - National Surgical Quality Improvement Program were analyzed for patients who underwent revision THA from 2015 to 2020. An MFI was composed of the risk factors, including severe obesity (body mass index > 35), osteoporosis, non-independent function status prior to surgery, congestive heart failure within 30 days of surgery, hypoalbuminemia (serum albumin < 3.5), hypertension requiring medication, type 1 or type 2 diabetes, and a history of chronic obstructive pulmonary disease or pneumonia. The patients were assigned based on the MFI scores (MFI0, no risk factor; MFI1, 1–2 risk factors; MFI2, 3–4 risk factors; and MFI3, 5+ risk factors). Confidence intervals were set at 95% with a P value less than or equal to 0.05 considered statistically significant. Results A total of 17,868 patients (45% male, 55% female) were included and had an average age of 68.5 ± 11.5 years. Odds of any complication, when compared to MFI0, were 1.4 (95% CI [1.3, 1.6]) times greater for MFI1, 3.2 (95% CI [2.8, 3.6]) times greater for MFI2, and 10.8 (95% CI [5.8, 20.0]) times greater for MFI3 (P < 0.001). Odds of readmission, when compared to MFI0, were 1.4 (95% CI [1.3, 1.7]) times greater for MFI1, 2.5 (95% CI [2.1, 3.0]) times greater for MFI2, and 4.1 (95% CI [2.2, 7.8]) times greater for MFI3 (P < 0.001). Conclusion Increasing MFI scores correlate with increased odds of complication and readmission in patients who have undergone revision THA. This MFI may be used to predict the risks after revision THA.

The very virulent infectious bursal disease virus (vvIBDV) induces an acute, highly contagious and immunosuppressive disease in younger chicken causing massive economic losses globally. A major challenge in the field’s clinical diagnosis is distinguishing gross lesions caused by vvIBDV from those induced by classic IBDV (cIBDV), commonly used as live attenuated vaccines. This study introduces a one-step multiplex real-time PCR assay designed to distinguish between vvIBDV and non-vvIBDV viruses. Via simultaneously targeting the VP2 sequence for vvIBDV detection and the VP1 sequence for non-vvIBDV identification, including classic, American variant and the recently emerged novel variant IBDV (nvarIBDV), the assay’s specificity was validated against common avian viral diseases and nonspecific IBDV strains without any observed cross-reactions. It effectively differentiated between vvIBDV and non-vvIBDV field samples, including nvarIBDV, as confirmed by genotyping based on VP2 sequencing. The assay demonstrated a limit of detection ranging from 1.9×1010 to 103 DNA copies for vvIBDV-VP2, 9.2×1010 to 103 DNA copies for classic strains, and 1.2×1011 to 104 DNA copies for nvarIBDV in VP1 detection of non-vvIBDV. In conclusion, this study presents a specific, sensitive, and straight forward multiplex real-time PCR assay.

The utilization of agricultural machinery was fully mechanized for wheat production in Iraq. This study essentially aimed to inspect inputs – outputs energy for wheat production in Salah Al-Deen, Iraq. The data were obtained from 45 wheat farms by using face to face questionnaire method in 2022. The findings from this study were determined in five basic operations (i.e. tillage, sowing, fertilizing. spraying, and harvesting). Direct energy sources (fuel and human) accounted for about 51.39% of the total energy used in cultivation. Energy exemplified in fuel recorded the highest rate of the total expenditure of energy, with 51.09 % (6091.01MJ/ha). Farmers utilized nearly 879.11±39.77 MJ/ha of machinery energy, the highest rate of expenditure of machinery energy was in harvesting, which recorded 38.38 % (337.42 ± 23.89 MJ/ha) of the total energy of machinery used in the study. Results of analyzing the energy of fuel that farmers utilized indicated that operations of tillage were about 25.98 % (1582.29 ± 39.43 MJ/ha) of the total energy of fuel. This rate denoted the highest operation of fuel consumption. Harvesting operations followed it. These operations were implemented through the use of engines powered with diesel were about 23.43% (1427.05 ± 35.68 MJ/ha). The average energy input/output ratio was 4.40 for the wheat crop; while energy intensity was 1.79 MJ/kg for the wheat crop.

Chicken anemia virus (CAV) is a widespread and economically significant pathogen in the poultry industry. In this study 110 samples were collected from various poultry farms in selected Egyptian provinces during 2021–2022 and were tested against CAV by Polymerase Chain Reaction (PCR), revealing 22 positive samples with 20% incidence rate. Full sequence analysis of five selected CAV strains revealed genetic variations in VP1, VP2, and VP3 genes. Phylogenetic analysis grouped the Egyptian strains with reference viruses, mainly in group II, while vaccines like Del-Rose were categorized in group III. Recombination events were detected between an Egyptian strain (genotype II) and the Del-Rose vaccine strain (genotype III), indicating potential recombination between live vaccine strains and field isolates. To evaluate pathogenicity, one Egyptian isolate (F883-2022 CAV) and Del-Rose vaccine were tested in Specific Pathogen Free (SPF) chicks. Chicks in the positive group displayed clinical symptoms, including weakness and stunted growth, with postmortem findings consistent with CAV infection. The vaccine group showed milder symptoms and less severe postmortem changes. This study provides important insights into the genetic diversity of CAV in selected Egyptian poultry farms showing recombination event between field strain and vaccine strains, highlighting the need for advanced vaccination programs, especially for broilers.

Abstract Background Honey exhibits a broad spectrum of antibacterial activity against Gram‐positive and Gram‐negative bacteria, including methicillin‐resistant Staphylococcus aureus (MRSA) ones. Chitosan (Cs) is a mucoadhesive polymer that also has antibacterial properties. Special attention has been paid to the design of polymeric nanoparticles (NPs) as new nano drug delivery systems to overcome bacterial resistance and its problems. Objectives The aim of the present study is to synthesize Cs‐meropenem NPs with/without honey as an antibiofilm and antibacterial agent to inhibit Staphylococcus aureus. Methods This study synthesized meropenem and honey‐loaded Cs nanogels and subsequently characterized them by Field Emission Scanning Electron Microscopy (FESEM), Fourier Transform Infrared Spectroscopy (FTIR), and DLS‐zeta potential. Using the broth microdilution and crystal violet assays, the antibacterial and antibiofilm activity of meropenem and honey‐loaded Cs nanogel, free meropenem, free honey, and free Cs NPs were investigated in vitro against MRSA strains. 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyl‐2H‐tetrazolium bromide (MTT) was also used to test the cytotoxicity of several Cs‐NPs compound against the HEK‐293 regular cell line. Results The average size of meropenem and honey‐Cs‐NPs was reported to be 119.885 nm, and encapsulation efficiency was 88.33 ± 0.97 with stability up to 60 days at 4°C. The NPs showed enhanced antibiofilm efficacy against S. aureus at sub‐minimum inhibitory concentrations. Additionally, the cytotoxicity of meropenem and honey‐encapsulated Cs against the HEK‐293 normal cell line was insignificant. Conclusions Our findings suggested that meropenem and honey‐Cs‐NPs might be potential antibacterial and antibiofilm materials.

Introduction: Leaving against medical advice (AMA) has been associated with higher rates of readmission and worse postoperative outcomes in various surgical fields. Patients who have undergone spine surgery often require careful postoperative follow-up to ensure an uncomplicated recovery. In this study, we aim to investigate the demographic and hospital variables that may have contributed to patients leaving the hospital AMA following spine surgery. Methods: We performed a retrospective analysis of patients receiving spine surgery; we used the data from the Healthcare Cost and Utilization Project (HCUP) database for the years 2011-2020. Demographics, household income status, insurance status, time from admission to operation, length of stay, length of recovery, and discharge disposition were collected and analyzed. Multivariate linear regression was used to determine the odds ratios of each factor and their association to patient decision of leaving AMA. Results: As per our findings, patients aged 30-49 had 1.666 times greater odds of leaving AMA following spine surgery (P