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Abstract The resistance to antibiotics in Gram-negative bacilli causing sepsis is a warning sign of failure of therapy. Klebsiella pneumoniae (K. pneumoniae) and Escherichia coli (E. coli) represent major Gram-negative bacilli associated with sepsis. Quinolone resistance is an emerging resistance among E. coli and K. pneumoniae. Therefore, the present study aimed to study the presence of plasmid-mediated quinolone resistance (PMQR) genes qnrA, qnrB, and qnrS by polymerase chain reaction (PCR) in E. coli and K. pneumoniae isolated from pediatric patients with sepsis. This was a retrospective cross-sectional study that included pediatric patients with healthcare-associated sepsis. The E. coli and K. pneumoniae isolates were identified by microbiological methods. PMQR genes namely qnrA, qnrB, and qnrS were detected in E. coli and K. pneumoniae isolates by PCR. The results were analyzed by SPPS24, and the qualitative data was analyzed as numbers and percentages and comparison was performed by Chi-square test, P was significant if

Multiple myeloma (MM) is a prevalent yet incurable hematologic malignancy. Despite the proven efficacy of proteasome inhibitors in treating MM, resistance to Bortezomib-based treatments persists in a subset of patients. This case control study explores the potential of circulating endothelial progenitor cells (EPCs) as biomarkers for predicting response to Proteasome Inhibitor based therapy combined with Dexamethasone in MM patients. This study was conducted on 105 MM patients receiving bortezomib plus dexamethasone therapy and 90 healthy individuals as a control group. Utilizing 8-color multi-parameter flow cytometry, we assessed the levels of circulating EPCs, identified through CD34 FITC and CD309 PE markers at diagnosis and after one treatment cycle (4 weeks). Our findings revealed that patients exhibiting poor response to therapy showed significantly higher CD34/CD309 values than those with a good response (p < 0.001). The delineation of response based on CD34/CD309 expression was established with a cutoff ≤ 0.9 for percentage (yielding 100% sensitivity and 94.1% specificity) and ≤ 12.5 for absolute value (also with 100% sensitivity and 94.1% specificity). These results underscore the potential of EPC population levels, as quantified by CD34/CD309, to serve as a predictive biomarker for immunomodulatory treatment in MM patients undergoing Proteasome Inhibitor and Dexamethasone therapy. [ABSTRACT FROM AUTHOR]

Recently, the design and implementation of new healthcare systems have gained an interest in both industry and academia. The amalgamation between the Internet of Things, cloud, edge computing, and big data helps the proliferation of new scenarios for smart medical services and applications. Deep learning is currently paying a lot of attention for its utilization with big healthcare data. To this end, the main objective of this study is to propose a Deep Learning H2O (DLH2O) framework for improving the performance and selection of the optimal features to predict emergency cases. The proposed DLH2O framework consists of data preprocessing layer, feature selection layer and deep learning layer. The DLH2O framework aims to find the optimal subset of features and minimize the error of the classification through a proposed new variant of the Whale Optimization Algorithm (WOA) called ACP-WOA. The proposed changes have been done on the following parameters a, a2, A, and C which should affect both exploration and exploitation of WOA. The experiments conducted in order to test the validity of DLH2O Framework. In regard to the datasets, five experiments are performed for this purpose. The results demonstrate the superiority of ACP-WOA compared to the other state-of-the-art meta-heuristic algorithms in terms of time, error, and scalability. The proposed ACP-WOA is also tested on CEC2017 benchmark functions and proves its superiority over WOA in terms of accuracy.

Introduction: Acinetobacterb aumannii ( A. baumannii ) is an important pathogen in health care associated infections. Quinolone resistance has emerged in this pathogen., Aims & Objectives: The aim of the present study was to determine the presence of mutations of gyrA gene and parC genes by Restriction Fragment Length Polymorphism Polymerase Chain Reaction (RFLP-PCR) among clinical isolates of A. baumanii ., Materials and Methods: The study was carried out on 140 clinical isolates of A. baumannii . The isolates were subjected to molecular study of mutations of gyrA gene and parC genes by RFLP-PCR beside determination of Minimal Inhibitory Concentration (MIC) by macro dilution tube method., Results: The isolates of A. baumannii were resistant to ciprofloxacine and levofloxacin at MIC >4 µg/ml. The most isolates had MIC >128 µg/ml (42.3%). All resistant strains to ciprofloxacin of A. baumannii had mutations in gyrA and parC . The most frequent mutations were combined mutations in both genes (85.5%) and 5% had single mutation either in gyrA or parC . The most frequently combined mutations were associated with MIC >128 µg/ml (42.3%)., Conclusion: From this study we can conclude that resistance to ciprofloxacin was common in clinical isolates of A. baumannii . The most frequent mutations were present in gyrA and parC . However, mutations in parC alone were not uncommon. Further large scale studies are required to elucidate the resistance pattern of A. baumannii and its molecular mechanisms.