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In this study, we report the growth of surfactant‐free silver nanoparticles (NPs) on cotton through a facile chemical reduction method, iteratively applied to gradually increase and control the concentration of silver NPs. Our substrates showed enhanced performance in surface enhanced Raman spectroscopy (SERS), catalytic, and antibacterial properties, all attributable to the high concentration of NPs on the cotton and their surfactant‐free nature. While the antibacterial properties improve with increasing growth cycles, SERS and catalytic properties first increase from the first to fourth growth cycles and then decrease for the fifth growth cycle. For substrate with optimum deposition for SERS, rhodamine 6G (R6G) analyte down to nanomolar concentrations were detectable, with a linear correlation of intensity versus concentration and exhibit excellent uniformity in the SERS signal. Furthermore, the catalytic activity of our substrates against the degradation of methyl orange (MO) was impressive with a rate constant of 0.0866 min−1 for the first growth cycle, which increased by ~3.4‐fold to 0.2979 min−1 for the fourth growth cycle. Finally, the substrates showed excellent antibacterial activity towards both Gram‐negative (E. coli) and Gram‐positive (S. aureus) bacteria. For both bacteria, the zone of inhibition increased with increasing growth cycles. [ABSTRACT FROM AUTHOR]

Sex differences may exist in opioid use disorder (OUD) treatment. This study examined the treatment effects of buprenorphine/naloxone (BUP/NX) and methadone (MET) on the Clinical Opiate Withdrawal Scale (COWS) score in individuals with OUD and tested whether the associations differ by sex. We performed a secondary analysis of the data from the National Drug Abuse Treatment Clinical Trials Network (CTN) protocol-0027. A total of 1269 participants (861 males and 408 females) being aged 18 or older with OUD were randomly assigned to receive BUP/NX (n = 740) or MET (n = 529). The paired t test was initially used to compare the COWS scores between pre-dose and post-dose for BUP/NX and MET treatments, separately. The linear mixed model was used to examine the changes in COWS score adjusted for baseline demographic, substance use, and mental health disorders. The interaction of sex and treatment was detected and stratified analysis by sex was conducted. The paired t test showed that both BUP/NX and MET treatments significantly reduced the COWS scores (p values <0.0001). BUP/NX revealed higher COWS scores than MET (p = 0.0008) and females demonstrated significantly higher COWS scores than males (p = 0.0169). Stratified by sex, BUP/NX compared with MET revealed higher COWS scores only in males (p = 0.0043), whereas baseline amphetamines use disorder and major depressive disorder were significantly associated with COWS scores in females (p = 0.0158 and 0.0422, respectively). Both BUP/NX and MET are effective in decreasing opioid withdrawal symptoms via COWS scores, however, treatment plans for OUD by clinical providers should consider sex differences. [ABSTRACT FROM AUTHOR]

Introduction: Dementia and heart failure (HF) are the most common co-existing end-of-life conditions among rural older adults requiring extensive caregiving. Studies conducted in Appalachia have found that caregivers report a lack of information about palliative care and managing complex care at home. They also indicate the need for spiritual support. Purpose: This study aimed to assess the factors contributing to the spiritual well-being of caregivers in the rural Appalachian region. Methods: This descriptive correlational design allowed the collection of surveys from caregivers (N= 20) of loved ones with the diagnosis of HF and dementia. A multiple regression analysis was performed on caregivers' spiritual well-being scores as the dependent variable. Factors impacting caregiving (i.e., measures of caregivers' preparedness for HF and dementia home care and patients' physical, emotional, and palliative care scale needs) were the independent variables. Findings: The average age of these family caregivers was 64.95 years (SD =12.42). These caregivers had a high median score on the spiritual well-being scale (32.5 out of 45). In the regression analysis, a large amount (53%) of variance in spiritual well-being was explained by caregivers' greater preparedness for HF and dementia home care (p < .01) and by informational communications about caregivers' practical care concerns (p < .05). These caregivers age, number of years of caregiving, and patients physical and emotional status did not statistically contribute to caregiver spiritual well-being. Conclusion: The rural Appalachian population values spiritual well-being. There is a need for nurse-led interventions specific to HF and dementia home care to support caregivers' spiritual well-being and provide information about managing in-home care practical concerns. Nurses may also support caregivers' spiritual well-being by holding supportive caregiver discussion groups and setting up home visits and telephone contacts with their spiritual advocates. [ABSTRACT FROM AUTHOR]

The objective of this research was to explore the perceptions of nurses regarding patients with substance use disorder (SUD), healthcare provided, and desired resources to care for this population properly. This study used a crosssectional, descriptive design. Data were collected via an anonymous 12-item survey and three open-ended questions. Data were analyzed using descriptive statistics and conventional content analysis. Nurses with less than 1 year of experience reported more significant challenges when caring for patients with SUD. These challenges included difficulties in managing pain, implementing alternative pain management techniques, and knowing who to contact when problems occur. The study revealed many needs of nurses to provide compassionate care for patients with SUD. Findings indicate a need for education for nurses, especially novice nurses, who care for patients with SUD. [ABSTRACT FROM AUTHOR]

Cilostazol has been reported to reduce the osteoclast differentiation induced in (ApoE-/-) mice model via decreasing the ROS level. To prove this hypothesis 12 wks. old WT and ApoE-/- mice were performed Sham and ovariectomy (OVX) surgery and feed WT mice with normal diet (ND) and ApoE-/- mice model with Atherogenic diet (AD) for 8 Weeks. ApoE-/- mice were injected with I. P injections of Cilostazol (0.5mg/kg) for 8wk. After 8 Wks. Osteoclast differentiation, CROS and bone resorption were analyzed. Cilostazol reduced the osteoclast differentiation and CROS in ApoE-/- mice model with Atherogenic diet (AD). Cilostazol also reduced the bone loss in ApoE-/- mice but the results are not significant as compared to control. Our data highlight the potential role of Cilostazol for attenuating the osteoclast differentiation and bone resorption in ApoE-/- mice model via decreasing the ROS level. The Molecular docking studies between the Cilostazol and RANKL receptors proved that Cilostazol binds tightly to the receptors, showed the highest binding affinities of -7.3, -7.5, -7.7, -8.0, -8.3, and -10.0 kcal/mol. Cilostazol shall be excellent inhibitors against RANKL receptors. [ABSTRACT FROM AUTHOR]

Background: Many factors contribute to continuous positive airway pressure (CPAP) nonadherence, affecting health care burden. The original CPAP-SAVER study enrolled 66 CPAP-naive participants and showed high 1-month adherence and significantly higher apnea beliefs and CPAP attitude for the intervention group. Purpose and methods: Thirty-three participants from the original CPAP-SAVER study were recruited for a 3-year follow-up to determine adherence, examine the intervention effect, and identify adherence-associated factors. Results: Adherence rates dropped to 54.5% at 3 years, with a significant decrease in CPAP use hours (t = -2.37, p =.024) and nights (t = -4.05, p <.001). Group differences in beliefs and attitude were not sustained; however, beliefs (r = 0.57) and attitude (r = 0.44) were significant factors associated with adherence. Life satisfaction was significantly higher at present compared with before wearing CPAP (t = 5.17, p <.001). Implications for practice: The authors recommend intervention with a focus on apnea beliefs, CPAP attitude, and long-term support to promote CPAP adherence. Focus on CPAP attitude and beliefs and enhanced support early in the obstructive sleep apnea (OSA) treatment trajectory may promote long-term adherence and subsequently reduce the health care burden of OSA disease. [ABSTRACT FROM AUTHOR]

This study assesses external business cycle shocks to the economy of Pakistan using a Structural Vector Autoregressive (SVAR) framework consisting of five variables: gross domestic product, public investment, exchange rate, CPI, and openness of trade. The real exchange rate shock seems to be most volatile, and is responsible for significant movement in the rest of the variables in the system. The results indicate that terms of trade and exchange rate shocks have profound impacts on the system, and it can be generally concluded that external shocks have a strong bearing on the economy of Pakistan in both the short and long run. The study found that GDP is positively affected by public spending and terms of trade. Therefore, in general, we conclude that the economy of Pakistan is prone to be affected by external events. [ABSTRACT FROM AUTHOR]

The present day political philosophy is mostly influence by the theories and hypotheses about the nature of the material world developed and propagated in western intellectual corridors. The dominant role it plays has influence on the policies governing the global affairs and pushing its enforcement on developing world through either direct interference of strong economic institutions or the military intervention when deemed necessary. The distortion that is created in the last century has left the young researchers in developing world to seek the local solutions with local socio-political philosophies instead of being told by the western institutions to pursue an agenda that is aligned with the structures of these institutions. This relationship has resulted in production of research that is centered on those aspects that fall in this ambit and creation of new knowledge seems to have halted that can actually bring sustainable solutions for developing countries. In this perspective this study is an effort to bring the contributions of Al Farabi in light to identify the differentiating features of his philosophy that can be helpful in adjustments in socio-political-economic philosophy of the developing world to create indigenous solutions to national problems. [ABSTRACT FROM AUTHOR]

This study analyzes the impact of exchange rate volatility on real export volume and trade flows in Pakistan. The purpose of this paper is to determine long run relationship between exchange rate volatility and export growth where the results indicate that real exchange rate volatility has significant and negative impact on exports in both long and short run. Government should take steps to remove uncertainty in exchange rate volatility. At the same time, inflation and real export volume has also inverse relationship indicating that inflation causes decline in the exports in Pakistan making domestic products expensive for the foreigners. Foreign economic activity and real export volume has positive relationship but the impact is not profound to cause a significant change in the production structure of Pakistan. Government should liberalize foreign trade policies to increase exports. Government should introduce those policies which attract the foreign investors. [ABSTRACT FROM AUTHOR]