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Abstract Bacteriophages are a promising alternative for curtailing infections caused by multi drug resistant (MDR) bacteria. The objective of the present study is to evaluate phage populations from water bodies to inhibit planktonic and biofilm mode of growth of drug resistant Klebsiella pneumoniae in vitro and curtail planktonic growth in vivo in a zebrafish model. Phage specific to K. pneumoniae (MTCC 432) was isolated from Ganges River (designated as KpG). One-step growth curve, in vitro time kill curve study and in vivo infection model were performed to evaluate the ability of phage to curtail planktonic growth. Crystal violet assay and colony biofilm assay were performed to determine the action of phages on biofilms. KpG phages had a greater burst size, better bactericidal potential and enhanced inhibitory effect against biofilms formed at liquid air and solid air interfaces. In vitro time kill assay showed a 3 log decline and a 6 log decline in K. pneumoniae colony counts, when phages were administered individually and in combination with streptomycin, respectively. In vivo injection of KpG phages revealed that it did not pose any toxicity to zebrafish as evidenced by liver/brain enzyme profiles and by histopathological analysis. The muscle tissue of zebrafish, infected with K. pneumoniae and treated with KpG phages alone and in combination with streptomycin showed a significant 77.7% and 97.2% decline in CFU/ml, respectively, relative to untreated control. Our study reveals that KpG phages has the potential to curtail plantonic and biofilm mode of growth in higher animal models.

Abstract Background Pulse wave velocity (PWV), central pulse pressure and augmentation index are arterial stiffness- related hemodynamic parameters but their associations with renal outcome are still controversial. We hereby aim to study, 1) which hemodynamic parameter is independently associated with progressive chronic kidney disease (CKD), 2) the association of 3-year change in PWV with CKD progression and, 3) the additive predictive value of PWV for progressive CKD. Methods Carotid- femoral PWV, central pulse pressure and augmentation index were measured in 1444 participants with type 2 diabetes at baseline and 3 years apart. Progressive CKD was defined as confirmed eGFR decline 40% or greater. Results In the follow-up, 102 participants experienced progressive CKD. All 3 hemodynamic parameters were significantly associated with progressive CKD In univariable analysis. However, only PWV remained statistically significant after adjustment for known clinical risk factors and the other 2 hemodynamic parameters (OR 1.14 [95% CI 1.01–1.29] per m/s increment). One m/s regression (decrement) in PWV in the 3-year follow-up was associated with 26% lower adjusted- risk of progressive CKD (OR 0.74, 95% CI 0.56–0.97). Adding PWV onto traditional risk factor- based model significantly improved classification (net reclassification improvement 0.25, 95% CI 0.05–0.45, P = 0.01) and positive prediction rate (24.5 to 32.3%). Conclusions Of 3 arterial stiffness- related hemodynamic parameters, only PWV is independently associated with progressive CKD. PWV may be a potential intervention target to mitigate risk of CKD progression and also a biomarker to improve risk-stratification of adverse renal outcome in individuals with type 2 diabetes.

Access to highly expensive and innovative medicine is a challenge. Managed entry agreements/ arrangements (MEAs) consist of various forms of confidential agreements between pharmaceutical manufacturers and payers (hospitals, social insurance), which are mainly negotiated when there is uncertainty of the actual clinical benefit of the medicines, but high public expenditures are required. Continued and expanding use of these schemes requires a greater understanding of payer perceptions, experience, and orientation towards their current and future use. This literature review aimed to identify the stakeholders’ concerns with regards to MEAs. A total of 20 articles were identified between 2007 and 2018. MEAs are mostly studied in the first world countries, whereas limited documentation is available for other nations. The reasons for rejection of proposed MEAs could possibly be related to existing low-cost effective treatments, lack of trust between stakeholders, high administrative burden and if the authorities believe they are funding the substantial proportion of the drug’s development cost. Lack of well-designed and easy-to-use data collection methods for MEAs has an impact on the evidence generation. Most articles highlighted the lack of transparency of the agreements which may not benefit other health systems, especially for systems that are dependent on international referencing price. Stakeholders also identified the lack of expertise in assessing the pharmacoeconomic and health outcomes data and challenges in assessing risks up-front due to the complexity of the real-world data. Lack of transparency in most health systems are also a hindrance to further understanding and confidence in the MEAs. However, the views of the stakeholders may also evolve with experience. Though there are challenges in the designing and implementation of MEAs, close networking, improved human capital development especially in the area of health technology assessment and health economics would be able to close the gap in the implementation.

Diabetes is a disorder of metabolism and has been a leading healthcare burden throughout the world. The most typical form of diabetes is type-2 diabetes. It is commonly developed in adults of age 40 and older. The purpose of this study is to identify the plantar pressure distribution in normal subjects, diabetic type-2 subjects with neuropathy, and diabetic type-2 subjects without neuropathy. Foot scan images were obtained using the F-Scan (Tekscan USA) in-shoe measurement system. The eigenvalues were evaluated from principal-component analysis after performing continuous wavelets transformation (CWT). The eigenvalues of CWT in regions 5 and 7 had shown excellent p values of more than 95 per cent confidence level when subjected to an analysis-of-variance test. These parameters were then presented to an artificial neural network (ANN) and a Gaussian mixture model (GMM) for automatic classification. The results show that the ANN classifier performs better than the GMM and is able to identify the unknown class with a sensitivity of 100 per cent and a specificity of 72 per cent. [ABSTRACT FROM AUTHOR]

Sodicity is one of the major salt stresses that impair crop production. Exopolysaccharide-producing sodic tolerant bacteria (EPS-STB) play a significant role in reducing the sodic stress in plants by hampering the uptake of sodium. In this context, this study aims to isolate the EPS-STB for alleviating sodic stress in rice under a sodic environment. Thus, artificial sodicity was created in culture media, and 253 bacteria were isolated from the rice rhizosphere of sodic soils in Trichy and Chinna Salem of Tamil Nadu in India. Fifty bacterial isolates were initially screened based on EPS production, sodic tolerant ability, and plant growth-promoting activities. Further, these bacterial isolates were identified using 16S rDNA sequencing. The results suggested that the isolated bacteria possessed biofilm-forming abilities along with plant growth-promoting activities and osmolyte accumulation under sodic stress conditions. Bacillus rugosus L1C7T, Bacillus paralicheniformis L1C5L, Pseudomonas sp. L5C14T and Franconibacter helveticus L2C1L2 were chosen as better EPS-STB plant growth-promoting bacteria, and their impact on rice under sodic conditions was evaluated. Among the sodic tolerant bacteria, Franconibacter helveticus L2C1L2-inoculated rice plants increased dry matter production compared to the control. Thus, this study showed that the utilization of EPS-STB will become a promising tool to alleviate sodic stress in rice.

Purpose – The purpose of this paper is to study the performance of coatings for corrosion protection. In this research, different compositions of polyaniline (PANI) were added in a pigmented acrylic polyol-silicone coating. The important performance property is corrosion protection. The coatings must be evaluated under corrosive environment. Electrochemical impedance spectroscopy (EIS) is the suitable method to investigate the effect of the addition of PANI in the binder mixture. Design/methodology/approach – The coating resistance, coating capacitance, water uptake and the diffusion coefficient of the coatings were tested for each of the sample. These parameters of the coatings were tested for a period of 60 days of exposure of 3.5 weight per cent solution of sodium chloride salt. EIS results will be further verified by immersion test and salt spray test. Findings – Coating materials developed using 8 and 10 weight per cent of PANI exhibited better coating properties with higher coating resistance for a period 60 days immersion in corrosive environment compared to coatings with lower amount of PANI (2-6 weight per cent). The best coating system obtained the coating resistance value in the range of giga ohms even after the 60th day of exposure. The lowest capacitance value suggested that the coatings have not allowed the electrolyte to permeate to the interface. Water uptake values were found to be in the range of 5 per cent. Salt spray test results showed that the corrosion has initiated at the edges of the scratches only. Practical implications – The study of the effect of conducting polymers in acrylic polyol/silicone resin hybrid binder will be useful for more exploration in coating science. Originality/value – The development of protective hybrid coatings using conducting polymer and TiO2 particles is new. The results show high coating resistance values. [ABSTRACT FROM AUTHOR]

Abstract Background Haptoglobin (Hp) is an abundant plasma protein with anti-oxidant properties. Hp polymorphism is associated with cardio-metabolic dysfunction but the allele conferring risk of developing acute myocardial infarction (AMI) in type 2 diabetes (T2D) patients is unclear. This study aimed to investigate the association of Hp phenotype (Hp 1-1, 2-1 and 2-2) with incident AMI in Chinese T2D patients. Methods This prospective study included Chinese T2D participants from the Singapore Study of Macro-angiopathy and Micro-vascular Reactivity in Type 2 Diabetes (SMART2D) and Diabetic Nephropathy (DN) cohorts. Information on incidence of non-fatal AMI was collected by data linkage with the Singapore Myocardial Infarction Registry. Hp phenotype was determined using enzyme-linked immunosorbent assay. Cox proportional hazards regression models were used to evaluate the association of Hp phenotype with incident AMI, adjusted for traditional risk factors separately in two cohorts, then meta-analysed. Results In total, 2324 Chinese participants (SMART2D; N = 1034, mean age [SD] of 59 [11]) and (DN: N = 1290, mean age [SD] of 58 [12]) were included in this study. There were total of 30 (56 events per 10,000 patient-years) and 99 (128 events per 10,000 patient-years) AMI events in SMART2D and DN cohorts respectively. In meta-analysis, presence of Hp 1 allele conferred 43% (hazard ratio [HR] = 1.43 [95% CI 1.10–1.87], P = 0.008, Phet = 0.413) increased risk of incident AMI, independent of age, sex, smoking, body mass index, HbA1c, diabetes duration, lipids, hypertension, renal function and usage of insulin and RAS antagonist. In adjusted model, compared to Hp 2-2 groups, individuals with Hp 1-1 (HR = 2.18 [95% CI 1.19–3.76], P = 0.010, Phet = 0.193) and Hp 2-1 (HR = 1.45 [95% CI 0.98–2.14], P = 0.065, Phet = 0.576) were at a higher risk of incident AMI. Moreover, compared to Hp 2-2 groups, non-Hp 2-2 groups (Hp 1-1 and Hp 2-1) were at 55% increased risk of incident AMI (HR = 1.55 [95% CI 1.07–2.24], P = 0.021, Phet = 0.940). Conclusions Hp 1-1 phenotype was associated with increased risk of incident AMI, independent of traditional risk factors, in Chinese patients with T2D. Hp phenotyping may allow for identification of T2D individuals at higher risk for onset of AMI. However, further studies are needed to understand the underlying mechanism between Hp alleles and risk for AMI.

Purpose -- The purpose of this paper is to develop different combinations of acrylic polyol and silicone resins with various weight ratios and to test the coating properties using electrochemical impedance spectroscopy (EIS). Design/methodology/approach -- The performance properties such as coating resistance, capacitance, dielectric constant, water uptake and diffusion coefficient were evaluated using EIS with exposure to 3.5 per cent NaCl solution for 60 days. Findings -- The binders developed in this study were coated on cold rolled steel plates. The dry film thickness was found to be in the range of 50 microns. From EIS results, it was found that Acrylic polyol sample with 30 weight per cent of silicone exhibits the best properties, as it has high coating resistance in the range of 109 Ohms for the full period of exposure, whereas all other samples showed poor performance with the exposure time. For these samples, the parameters measured such as the coating resistance of the samples decreased while the coating capacitance, percentage of water uptake and diffusion coefficient of the samples increased after being exposed to corrosive solution for 60 days. The coatings developed by 0, 10 and 60 weight per cent silicone showed high coating capacitance on the first day of exposure, and these systems failed early during the exposure. The water uptake percentage and diffusion coefficient of all samples were found to be less than 50 per cent and below 10-11 cm2 s-1, respectively. An optimum cross-linking between the resins is considered as the main contribution for the best performance shown by the sample that consists of 30 weight per cent of silicone in acrylic matrix that provides maximum barrier properties of the coating. Originality/value -- Developing coatings using hybrid binders (silicone resin and acrylic polyol resin) is new area of research. This will explore more research in the formulation of novel coatings. [ABSTRACT FROM AUTHOR]