Global genomic epidemiology of chromosomally mediated non-enzymatic carbapenem resistance in Acinetobacter baumannii: on the way to predict and modify resistance

IntroductionAlthough carbapenemases are frequently reported in resistant A. baumannii clinical isolates, other chromosomally mediated elements of resistance that are considered essential are frequently underestimated. Having a wide substrate range, multidrug efflux pumps frequently underlie antibiotic treatment failure. Recognizing and exploiting variations in multidrug efflux pumps and penicillin-binding proteins (PBPs) is an essential approach in new antibiotic drug discovery and engineering to meet the growing challenge of multidrug-resistant Gram-negative bacteria.MethodsA total of 980 whole genome sequences of A. baumannii were analyzed. Nucleotide sequences for the genes studied were queried against a custom database of FASTA sequences using the Bacterial and Viral Bioinformatics Resource Center (BV-BRC) system. The correlation between different variants and carbapenem Minimum Inhibitory Concentrations (MICs) was studied. PROVEAN and I-Mutant predictor suites were used to predict the effect of the studied amino acid substitutions on protein function and protein stability. Both PsiPred and FUpred were used for domain and secondary structure prediction. Phylogenetic reconstruction was performed using SANS serif and then visualized using iTOL and Phandango.ResultsExhibiting the highest detection rate, AdeB codes for an important efflux-pump structural protein. T48V, T584I, and P660Q were important variants identified in the AdeB-predicted multidrug efflux transporter pore domains. These can act as probable targets for designing new efflux-pump inhibitors. Each of AdeC Q239L and AdeS D167N can also act as probable targets for restoring carbapenem susceptibility. Membrane proteins appear to have lower predictive potential than efflux pump-related changes. OprB and OprD changes show a greater effect than OmpA, OmpW, Omp33, and CarO changes on carbapenem susceptibility. Functional and statistical evidence make the variants T636A and S382N at PBP1a good markers for imipenem susceptibility and potential important drug targets that can modify imipenem resistance. In addition, PBP3_370, PBP1a_T636A, and PBP1a_S382N may act as potential drug targets that can be exploited to counteract imipenem resistance.ConclusionThe study presents a comprehensive epidemiologic and statistical analysis of potential membrane proteins and efflux-pump variants related to carbapenem susceptibility in A. baumannii, shedding light on their clinical utility as diagnostic markers and treatment modification targets for more focused studies of candidate elements

Optimizing photo-mineralization of aqueous methyl orange by nano-ZnO catalyst under simulated natural conditions.

Photo-degradation of organic contaminants into non-hazardous mineral compounds is emerging as a strategy to purify water and environment. Tremendous research is being done using direct solar light for these purposes. In this paper we report on optimum conditions for complete mineralization of aqueous methyl orange using lab-prepared ZnO nanopowder catalyst under simulated solar light. Nano-scale ZnO powder was prepared in the lab by standard methods, and then characterized using electronic absorption spectra, photolumenscence emission (PL) spectra, XRD, and SEM. The powder involved a wurtzite structure with ~19 nm particles living in agglomerates. Photo-degradation progressed faster under neutral or slightly acidic conditions which resemble natural waters. Increasing catalyst concentration increased photodegradation rate to a certain limit. Values of catalyst turn over number and degradation percentage increased under higher light intensity, whereas the quantum yield values decreased. The photocatalytic efficiency of nano-ZnO powders in methyl orange photodegradation in water with solar light has been affected by changing the working conditions. More importantly, the process may be used under natural water conditions with pH normally less than 7, with no need to use high concentrations of catalyst or contaminant. The results also highlight the negative impact of possible high concentrations of CO2 on water purification processes. Effects of other added gaseous flows to the reaction mixture are also discussed. ZnO nano-particles are useful catalyst for complete mineralization of organic contaminants in water. Photo-degradation of organic contaminants with ZnO nano-particles, methyl orange being an example, should be considered for future large scale water purification processes under natural conditions

Concrete with Recycled Aggregate: Evaluation of Mechanical Properties

This paper discusses the suitability of producing concrete with 100% recycled aggregate to meet durability and strength requirements for different applications. Aggregate strength, gradation, absorption, specific gravity, shape, and texture are some of the physical and mechanical characteristics that contribute to the strength and durability of concrete. In general, quality of the recycled aggregate depends on the loading and environmental conditions that the demolished structures were exposed to. Therefore, the experimental program consisted of two tasks. The first task was focused on the evaluation of physical and mechanical properties of the recycled aggregate over 6 months to determine variability in aggregate properties. The second task was directed towards evaluation of concrete portieres produced with fine and coarse recycled aggregate. Several concrete mixes were prepared with combinations of different aggregate grades and the results were compared to that of a control mix. Workability and compressive strength were performed to assess the suitability of these mixes for different applications

Handling severe asthma exacerbations: current guidelines and techniques: A review of research for pharmacists and emergency medical services

Background: Asthma affects approximately 300 million people globally, with a significant prevalence of uncontrolled cases contributing to rising hospitalizations and healthcare costs. In Saudi Arabia, 64% of asthma patients experience uncontrolled symptoms. Effective management of severe asthma exacerbations is critical, yet many patients remain inadequately controlled even in advanced care settings. Aim: This review aims to synthesize current guidelines and techniques for handling and management of severe asthma exacerbations, focusing on optimizing therapeutic strategies and improving patient outcomes via pharmacists and Emergency medical services. Methods: The review systematically examines existing guidelines, including the Saudi Initiative for Asthma (SINA) and other international protocols. It evaluates various treatments such as inhaled bronchodilators, systemic steroids, anticholinergic agents, and newer therapies like magnesium sulfate and heliox. The review also considers the effectiveness of different diagnostic and monitoring tools. Results: Effective management of severe asthma exacerbations involves a multi-faceted approach. Key strategies include the use of inhaled bronchodilators (MDIs preferred over nebulizers), systemic steroids for moderate to severe cases, and oxygen therapy to address hypoxemia. Anticholinergic agents and magnesium sulfate may be used for severe exacerbations, though their benefits vary.&nbsp

COVID-19 severe conditions: EMS, pharmacists, and health informatics strategies and community impact: Review article

Background: COVID-19, caused by SARS-CoV-2, has emerged as a global pandemic since late 2019, with significant impacts on health systems and communities worldwide. The virus, which affects respiratory and other systems, has seen the emergence of several variants, including Delta and Omicron, each with distinct impacts on transmissibility and disease severity. Aim: This review aims to provide an updated overview of COVID-19's severe conditions, the strategies used by Emergency Medical Services (EMS), pharmacists, and health information for controlling and management, and the overall community impact. Methods: A comprehensive literature review was conducted using PubMed and Google Scholar up to December 31, 2021. Search terms included 'COVID,' 'COVID-19,' 'SARS-CoV-2,' and 'coronavirus,' focusing on retrospective and prospective studies, systematic reviews, meta-analyses, and clinical guidelines. The review included 194 pertinent sources, emphasizing emergency medicine-related research. Results: The review highlights the rapid global spread of COVID-19, the emergence and impact of variants like Delta and Omicron, and their association with increased transmissibility and severe disease outcomes. Key findings include the Delta variant’s higher viral loads and association with severe illness, and the Omicron variant’s high transmissibility and potential reduced severity of disease. Hospitalization and mortality rates have evolved with advancements in treatment and vaccination.&nbsp

Construction of N-CDs and Calcein-Based Ratiometric Fluorescent Sensor for Rapid Detection of Arginine and Acetaminophen

In our study, a unique ratiometric fluorescent sensor for the rapid detection of arginine (Arg) and acetaminophen (AP) was constructed by the integration of blue fluorescent N-CDs and yellowish-green fluorescent calcein. The N-CD/calcein ratiometric fluorescent sensor exhibited dual emission at 435 and 519 nm under the same excitation wavelength of 370 nm, and caused potential Förster resonance energy transfer (FRET) from N-CDs to calcein. When detecting Arg, the blue fluorescence from the N-CDs of the N-CD/calcein sensor was quenched by the interaction of N-CDs and Arg. Then, the fluorescence of our sensor was recovered with the addition of AP, possibly due to the stronger association between AP and Arg, leading to the dissociation of Arg from N-CDs. Meanwhile, we observed an obvious fluorescence change from blue to green, then back to blue, when Arg and AP were added, exhibiting the “on–off–on” pattern. Next, we determined the detection limits of the N-CD/calcein sensor to Arg and AP, which were as low as 0.08 μM and 0.02 μM, respectively. Furthermore, we discovered that the fluorescence changes of the N-CD/calcein sensor were only responsible for Arg and AP. These results suggested its high sensitivity and specificity for Arg and AP detection. In addition, we have successfully achieved its application in bovine serum samples, indicating its practicality. Lastly, the logic gate was generated by the N-CD/calcein sensor and presented its good reversibility. Overall, we have demonstrated that our N-CD/calcein sensor is a powerful sensor to detect Arg and AP and that it has potential applications in biological analysis and imaging

Cardiac and pulmonary emergencies: Protocols for effective management and treatment via pharmacists, emergency medical services, and the role of health informatics in future responses

Background: The aging population in the U.S. is rapidly increasing, with those aged 65 and older expected to reach 95 million in the next 40 years. This demographic shift leads to a higher prevalence of cardiopulmonary emergencies, which are commonly encountered in emergency departments (EDs). This paper explores four prevalent conditions—atrial fibrillation (AF), congestive heart failure (CHF), pulmonary embolism (PE), and pneumonia—and their specific considerations in elderly patients. Aim: To review the management protocols for these cardiopulmonary conditions in older adults and to highlight the unique challenges and considerations associated with their treatment and management via pharmacists and ED. The review also focus on the main role of health information system in the future responses to cardiac and pulmonary conditions. Methods: The study involves a comprehensive review of current literature on the epidemiology, pathophysiology, and management of AF, CHF, PE, and pneumonia in elderly patients. The focus is on treatment protocols, diagnostic strategies, and the impact of age-related factors on disease management. Results: Effective management of these conditions requires tailored approaches due to age-related physiological changes. For AF, anticoagulation therapy is crucial but must be carefully balanced against bleeding risks.

Utilization of Jamun Fruit (Syzygium cumini L.) for Value Added Food Products

The goal of this study is to draw attention to the vital nutrients, health advantages, and potential for encouraging the consumption of jamun fruits (Syzygium cumini L.) and making the most of their useful features to create valuable goods. In the current study, efforts have been made to evaluate the jamun fruit’s physicochemical characteristics and bioactive components. Moreover, ready-to-serve beverages, squash, syrup, and jam, have been prepared, and their quality has been monitored throughout the storage. Jamun fruit had an ovoid or spherical form and was a dark purple tint. The initial analysis of fruits showed 83.59% moisture, 17.56 °Brix, 3.63 pH, 328.50 mg cyd-3-Glu/100 g anthocyanin, 219.21 mg GAE/100 g total phenolics, 91.33 mg QE/100 g total flavonoids, and 91.33% antioxidant activity. High-performance liquid chromatography examination, revealed the existence of three main anthocyanin pigments, delphinidin 3, 5-diglucoside, petunidin 3, 5-diglucoside, and malvidin 3, 5-diglucoside, which were measured at 175.80, 156.50, and 83.12 mg/100 g, respectively. While the main phenolic compounds present were chlorogenic, gallic, caffeic, vanillic, and catechin, with respective concentrations of 14.22, 12.18, 10.33, 6.44, and 4.13 mg/100 g. Total soluble solids, pH, and total sugars increased with the storage of jamun products, but acidity, total phenolic, and anthocyanin contents declined. In conclusion, jamun is a fruit that has promise for the future of producing useful goods. The various jamun fruit-based products met good standards and were sensory-acceptable