Pneumonia: Drug-Related Problems and Hospital Readmissions

Pneumonia is one of the most common infectious diseases and the fourth leading cause of death globally. According to US statistics in 2019, pneumonia is the most common cause of sepsis and septic shock. In the US, inpatient pneumonia hospitalizations account for the top 10 highest medical costs, totaling $9.5 billion for 960,000 hospital stays. The emergence of antibiotic resistance in the treatment of infectious diseases, including the treatment of pneumonia, is a globally alarming problem. Antibiotic resistance increases the risk of death and re-hospitalization, prolongs hospital stays, and increases treatment costs, and is one of the greatest threats in modern medicine. Drug-related problems (DRPs) in pneumonia - such as suboptimal antibiotic indications, prolonged treatment duration, and drug interactions - increase the rate of antibiotic resistance and adverse effects, thereby leading to an increased burden in treatment. In a context in which novel and effective antibiotics are scarce, mitigating DRPs in order to reduce antibiotic resistance is currently a prime concern. A variety of interventions proven useful in reducing DRPs are antibiotic stewardship programs, the use of biomarkers, computerized physician order entries and clinical decision support systems, and community-acquired pneumonia scores

Impacts of Payment for Forest Ecosystem Services in Protecting Forests in Dak Lak Province, Vietnam

Vietnam’s Payment for Forest Ecosystem Services (PFES) scheme has the goal of protecting remaining natural forests by providing financial support to people involved in forest protection. However, studying the case of Dak Lak province in the Central Highlands region of Vietnam shows that even after eight years of PFES implementation, achieving this goal remains a challenge. Although PFES does provide a stable income source and higher payments than state forest protection programs, enables the mobilization of more personnel resources for patrolling forest and relieves a great burden on the state budget in terms of investment in forest protection and development, forest cover in Dak Lak province is still decreasing, mainly due to conversion for other land uses, especially commercial agricultural and industrial crops. These drivers are rooted in national socio-economic planning aimed at boosting economic growth and in local people’s need to sustain their livelihoods. In addition, our paper shows that illegal logging is still widespread in Dak Lak. Weak law enforcement in areas of forest managed by state forest authorities and state companies also contributes to deforestation. However, these drivers are neither fully recognized nor addressed, and instead, the blame for deforestation is laid on local communities. PFES alone cannot protect forests in Dak Lak province. It needs to be backed up by political commitment to address underlying drivers of deforestation, improved social programs to help local people diversify their income sources and clarity over land use

Herbal Extract Effects on White Spot Syndrome Virus (WSSV) in Shrimp (Penaeus monodon)

Synthetic drugs and chemicals used in aquaculture cause disadvantageous side effects, while medicines made from medicinal herbs are non-toxic, easy to use, and pollution- free. Many medicinal herbs have potent antiviral properties. The extract of Phyllanthus amarus is a lignan composed of the compounds: niranthin, phyllanthin, and hypophyllanthin which have an impact on the white spot syndrome virus (WSSV) in the shrimp, Penaeus monodon. The virucidal activities of the three substances were tested by mixing them with WSSV, followed by injection into healthy shrimp. The quantity of WSSV DNA on the gills of tested shrimp was measured before and seven days after injecting the mixture. The quantity decreased significantly after injection. Anti-virucidal activities were also assessed by observation of the mortality rates of injected shrimp. The lignan compound inactivated the virus when injected in P. monodon at a dose of 100 mg per kilogram body weight. The survival rate of the lignan injected shrimp was 96.67% , compared to the positive control in which it was only 3.33%

Advanced cell-based products generated via automated and manual manufacturing platforms under the quality by design principle: Are they equivalent or different?

Mesenchymal stem/stromal cells (MSCs) are multipotent stem cells that can be isolated from bone marrow, adipose tissue, the umbilical cord, dental pulp, etc. These cells have unique properties that give them excellent therapeutic potential, including immunoregulation, immunomodulation, and tissue regeneration functions. MSC-based products are considered advanced therapy medicinal products (ATMPs) under European regulations (1394/2007); thus, they must be manufactured under good manufacturing practices and via effective manufacturing methods. The former can be achieved via a proper laboratory design and compliance with manufacturing protocols, whereas the latter requires an approach that ensures that the quality of the products is consistent regardless of the manufacturing procedure. To meet these daunting requirements, this study proposes an exchangeable approach that combines optimized and equivalent manufacturing processes under the Quality by Design (QbD) principle, allowing investigators to convert from small laboratory-scale to large-scale manufacturing of MSC-based products for clinical applications without altering the quality and quantity of the cell-based products

Emergence of New Delhi metallo-beta-lactamase 1 and other carbapenemase-producing Acinetobacter calcoaceticus-baumannii complex among patients in hospitals in Ha Noi, Viet Nam

Contains fulltext : 170312.pdf (publisher's version ) (Open Access)Acinetobacter baumannii is an important cause of multidrug-resistant hospital acquired infections in the world. Here, we investigate the presence of NDM-1 and other carbapenemases among carbapenem-resistant A. baumannii isolated between August 2010 and December 2014 from three large hospitals in Hanoi, Vietnam. We identified 23/582 isolates (4 %) (11 from hospital A, five from hospital B, and seven from hospital C) that were NDM-1 positive, and among them 18 carried additional carbapenemase genes, including seven isolates carrying NDM-1, IMP-1, and OXA-58 with high MICs for carbapenems. Genotyping indicated that NDM-1 carrying A. baumannii have expanded clonally in these hospitals. Five new STs (ST1135, ST1136, ST1137, ST1138, and ST1139) were identified. One isolate carried NDM-1 on a plasmid belonging to the N-repA replicon type; no NDM-1-positive plasmids were identified in the other isolates. We have shown the extent of the carbapenem resistance and the local clonal spread of A. baumannii carrying NDM-1 in these hospitals; coexistence of NDM-1 and IMP-1 is reported for the first time from Vietnam here, and this will further seriously limit future therapeutic options

Ethanol CO2 reforming on La2O3 and CeO2-promoted Cu/Al2O3 catalysts for enhanced hydrogen production

3%Ce- and 3%La-promoted 10%Cu/Al2O3 catalysts were synthesized via a sequential incipient wetness impregnation approach and implemented for ethanol CO2 reforming (ECR) at 948–1023 K and stoichiometric feed ratio. CeO2 and La2O3 promoters reduced CuO crystallite size from 32.4 to 27.4 nm due to diluting impact and enhanced the degree of reduction of CuO → Cu0. Irrespective of reaction temperature, 3%La–10%Cu/Al2O3 exhibited the highest reactant conversions, H2 and CO yields followed by 3%Ce–10%Cu/Al2O3 and 10%Cu/Al2O3. The greatest C2H5OH and CO2 conversions of 87.6% and 55.1%, respectively were observed on 3%La–10%Cu/Al2O3 at 1023 K whereas for all catalysts, H2/CO ratios varying from 1.46 to 1.91 were preferred as feedstocks for Fischer-Tropsch synthesis. Activation energy for C2H5OH consumption was also reduced with promoter addition from 53.29 to 47.05 kJ mol−1. The thorough CuO → Cu0 reduction by H2 activation was evident and the Cu0 active phase was resistant to re-oxidation during ECR for all samples. Promoters addition reduced considerably the total carbon deposition from 40.04% to 27.55% and greatly suppressed non-active graphite formation from 26.94% to 4.20% because of their basic character and cycling redox enhancement

Improvements in hydrogen production from methane dry reforming on filament-shaped mesoporous alumina-supported cobalt nanocatalyst

The mesoporous gamma-alumina (g-Al2O3) synthesized via evaporation-induced self-assembly method (EISA) using inorganic salt, Al(NO3)3$9H2O precursor and water-ethanol solvent mixture was implemented as a support for Co catalyst in methane dry reforming at 973e1073 K under 1 atm. The g-Al2O3 support possessed filament-shaped morphology with surface area of 173.4 m2 g1 and cobalt nanoparticles were successfully dispersed on support with small crystallite size of 7.8 nm. The stability of 10%Co/Al2O3 was evident for CH4 and CO2 conversions at 1023 and 1073 K. CH4 conversion could reach to 76.2% while 81.6% was observed for CO2 conversion at 1073 K. Although graphitic and amorphous carbons were unavoidably formed on used catalyst, 10%Co/Al2O3 exhibited an outstanding performance comparable to noble metals with the desired ratio of H2/CO for downstream Fischer-Tropsch process