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To assess the effectiveness of glossopharyngeal nerve block (GNB) in the treatment of postoperative pain among patients undergoing tonsillectomy, a systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted. Various databases, including PubMed, Cochrane, Scopus, Web of Science, and Google Scholar, were systematically screened from inception until March 2023. The included studies were assessed using the RoB-2 tool. The outcomes of interest included reporting on at least one of the predetermined efficacy and safety endpoints, such as postoperative pain, the severity of swallowing, and the incidence of postoperative complications such as bleeding, nausea and vomiting, hoarseness, nasal obstruction, dyspnea, foreign body sensation, and dry mouth. Dichotomous data were collected as risk ratios (RR), and continuous data were collected as standardized mean differences (SMD). The overall analyses were conducted using a random-effects model. In total, 492 participants were enrolled in our investigation, with 245 and 247 participants allocated to the GNB and control arms, respectively. When comparing postoperative pain levels during rest and swallowing, the GNB arm showed a significantly reduced effect size compared to the control arm (n = 5 RCTs, SMD= -1.38, 95% CI [-1.82, -0.94], p < 0.001; n = 4 RCTs, SMD= -1.43, 95% CI [-2.15, -0.72], p < 0.001), respectively. Overall, there was no substantial variation in effect size between the GNB and control arms with regard to the severity of difficulty in swallowing (p = 0.7). Additionally, there were no significant differences observed between the GNB and control groups in terms of postoperative complications endpoints (p > 0.05). This thorough analysis showed that GNB had both statistical and clinical advantages for patients after a tonsillectomy. It was found that GNB was an effective, safe, and straightforward method for managing early postoperative pain. [ABSTRACT FROM AUTHOR]

Aims: To reduce reporting time and to determine the exact prevalence of extended-spectrum β-lactamase (ESBL) enzymes and type of ESBL genes among single and multi-β-lactamase producing uropathogens. Methodology and results: Positive urine samples (20.8%) for significant pus cells and GNB were processed directly by modified CLSI phenotypic confirmatory test (MCPCT) for detection of ESBL enzymes and GNB isolates by PCR for ESBL genes. In MCPCT, cefotaxime and ceftazidime discs with and without clavulanic acid were used, dispensing 10 μL of both boronic acid and EDTA. Out of 378 GNB isolates tested, 167 (44.2%) were found positive for ESBL production by the modified CLSI phenotypic confirmatory test. Moreover, these GNB strains were assessed using uniplex and multiplex PCR, which also confirmed the findings of the modified CLSI phenotypic confirmatory test. CTX-M was the predominant gene, followed by TEM, OXA and SHV. Conclusion, significance and impact of study: The significance of the present study is that the modified CLSI phenotypic confirmatory test can be used to detect ESBL producers directly from clinical samples such as urine, cerebro-spinal fluid, blood, pleural fluid and ascetic fluid from which generally single organism is isolated. This method will not only save time but also help clinicians to start the treatment early so that the lives of critically ill patients can be saved. Moreover, MCPCT can provide a more accurate prevalence of ESBL producers than the CPCT method. [ABSTRACT FROM AUTHOR]

Galacto-N-biose (GNB) is an important core structure of glycan of mucin glycoproteins in the gastrointestinal (GI) mucosa. Because certain beneficial bacteria inhabiting the GI tract, such as bifidobacteria and lactic acid bacteria, harbor highly specialized GNB metabolic capabilities, GNB is considered a promising prebiotic for nourishing and manipulating beneficial bacteria in the GI tract. However, the precise interactions between GNB and beneficial bacteria and their accompanying health-promoting effects remain elusive. First, we evaluated the proliferative tendency of beneficial bacteria and their production of beneficial metabolites using gut bacterial strains. By comparing the use of GNB, glucose, and inulin as carbon sources, we found that GNB enhanced acetate production in Lacticaseibacillus casei, Lacticaseibacillus rhamnosus, Lactobacillus gasseri, and Lactobacillus johnsonii. The ability of GNB to promote acetate production was also confirmed by RNA-seq analysis, which indicated the upregulation of gene clusters that catalyze the deacetylation of N-acetylgalactosamine-6P and biosynthesize acetyl-CoA from pyruvate, both of which result in acetate production. To explore the in vivo effect of GNB in promoting acetate production, antibiotic-treated BALB/cA mice were administered with GNB with L. rhamnosus, resulting in a fecal acetate content that was 2.7-fold higher than that in mice administered with only L. rhamnosus. Moreover, 2 days after the last administration, a 3.7-fold higher amount of L. rhamnosus was detected in feces administered with GNB with L. rhamnosus than in feces administered with only L. rhamnosus. These findings strongly suggest the prebiotic potential of GNB in enhancing L. rhamnosus colonization and converting L. rhamnosus into higher acetate producers in the GI tract. IMPORTANCE Specific members of lactic acid bacteria, which are commonly used as probiotics, possess therapeutic properties that are vital for human health enhancement by producing immunomodulatory metabolites such as exopolysaccharides, short-chain fatty acids, and bacteriocins. The long residence time of probiotic lactic acid bacteria in the GI tract prolongs their beneficial health effects. Moreover, the colonization property is also desirable for the application of probiotics in mucosal vaccination to provoke a local immune response. In this study, we found that GNB could enhance the beneficial properties of intestinal lactic acid bacteria that inhabit the human GI tract, stimulating acetate production and promoting intestinal colonization. Our findings provide a rationale for the addition of GNB to lactic acid bacteria-based functional foods. This has also led to the development of therapeutics supported by more rational prebiotic and probiotic selection, leading to an improved healthy lifestyle for humans. [ABSTRACT FROM AUTHOR]

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Abstract Background Catheter-associated urinary tract infections (CAUTIs) due to multidrug-resistant Gram-negative bacilli (GNB) is a common concern globally. Investigating the incidence of CAUTI and associated antibiotic resistance has paramount importance from the health care associated infections perspective. This study therefore assessed the incidence of CAUTIs due to GNB and the production of extended-spectrum beta-lactamase (ESBL) and carbapenemase among inpatients in specialized hospitals of Northwest, Ethiopia. Methods A total of 363 patients with indwelling urinary catheters who were admitted in the hospital for > 48 h were consecutively enrolled and followed from 3 to 18 days. Data were collected through interviewing and review of medical records. Patients who developed at least one of the following: fever (> 38 OC), suprapubic tenderness, or costovertebral angle pain, coupled with a GNB positive urine culture of ≥ 103 CFU/mL with no more than two bacterial species were defined as CAUTI. The ESBL and carbapenemase production were detected and identified by chromogenic medium. Logistic regression analysis was done to identify associated factors. Results From 363 patients followed, the incidence rate of CAUTI was 27.8 per 1000 catheter days. Catheterization for ≥ 8 days (AOR = 10.6, 95%CI:1.8–62.1) and hospitalization for > 10 days (AOR = 8.1, 95%CI: 2.4–27.2) were the factors significantly associated with CAUTIs. E. coli (n = 18, 34.6%), Proteus species (n = 7, 13.5%), and P. aeruginosa (n = 6, 11.5%) were the most frequent GNB. Isolates revealed high rates of resistance to amoxicillin-clavulanic acid (100%), cefazolin (n = 51, 98%), ceftazidime (n = 47, 90%) and cefotaxime (n = 46, 88%). Most of the GNB isolates (86.5%) were multidrug-resistant. Overall, 19.2% and 5.8% of GNB isolates were ESBL and carbapenemase producers, respectively. Conclusions Incidence of CAUTI with Gram-negative bacilli is high. As most of the GNB isolates are MDR and showed a super high rate of resistance to amoxicillin-clavulanic and third-generation cephalosporins, empirical treatment with these substances is virtually ineffective in patients with suspected GNB infection in Ethiopia. The expression of ESBL and carbapenemase among GNB isolates is also a concern. Therefore, improved infection prevention and control measures, careful use of catheters and third generation of cephalosporins are needed to improve patient outcomes and reduce the burden of CAUTIs and the spreading of antimicrobial resistance.

Introduction: Ventilator-associated pneumonias (VAPs) are a complication of mechanical ventilation in the intensive care unit (ICU) that increase length of stay, morbidity, and mortality. While identifying and treating infections early is paramount to improving patient outcomes, more and more data demonstrate limited courses of antibiotics improve outcomes. Prolonged (10–14 day) courses of antibiotics have remained the standard of care for pneumonia due to gram-negative bacilli (GNR). We aimed to review our GNR VAPs to assess risk factors for recurrent GNR infections. Methods: We reviewed trauma patients who developed VAP from 02/2019 through 05/2022. Demographics, injury characteristics, and outcomes were reviewed with a focus on pneumonia details including the cultured pathogen(s), antibiotic(s) used, treatment duration, and presence of recurrent infections. We then compared single episode VAPs to multiple episode VAPs among patients infected by GNRs. Results: Eleven of the fifty trauma patients admitted to the ICU suffered a VAP caused by a GNR. Of these eleven patients, six experienced a recurrent infection, four of which were caused by Pseudomonas aeruginosa and two of which were caused by Enterobacter aerogenes. Among the patients who received ten days of antibiotic treatment, half suffered a recurrence. Although, there was no difference in the microbiology or antibiotic duration between the recurrences and single episodes. Conclusion: Despite prolonged use of antibiotics, we found that the risk of recurrent or persistent infections was high among patients with VAP due to GNB. Further study is needed to determine optimal treatment to minimize the risk of these recurrences. Key message: Ventilator-associated pneumonia due to gram-negative bacilli is a rare but high morbidity complication in intensive care units. Despite prolonged duration of therapy, these infections still appear to account for many recurrent infections and further study into optimal therapy is warranted.

Urinary tract infections (UTIs) are among the most common bacterial infections of the urinary tract, accounting for a high percentage of all infections. The insertion of a catheter into the bladder increases the susceptibility of the patient to tract infection and serves as the initial site of infection by introducing pathogenic organisms into the tract. Indwelling catheters in the bladder facilitate the colonization of uropathogens through various mechanisms. The objective of this study was to compare the different pathogenic bacteria causing UTIs and their antibiotic sensitivity patterns in catheterized and non-catheterized patients. The study included catheterized and non-catheterized patients, regardless of gender, exhibiting clinical signs or symptoms of urinary tract infection. Urine samples were examined and cultured for bacterial growth using standard microbiological procedures. After confirming the pathogens, antibiotic susceptibility testing was conducted on Mueller-Hinton agar using the Kirby-Bauer disc diffusion method. Out of the 200 samples, 88 were catheterized and 112 were non-catheterized. Catheterized patients exhibited a higher infection rate (39, 44.32%) compared to non-catheterized patients (31, 27.68%), and women had a higher infection rate than men. Various organisms were isolated, with Escherichia coli being the most common organism in both catheterized and non-catheterized patients. Among the tested drugs against gram-negative organisms, nitrofurantoin displayed higher sensitivity. The present study demonstrated a higher incidence of bacterial infection in catheterized patients compared to non-catheterized patients, highlighting the importance of avoiding unnecessary catheter insertion. To prevent antimicrobial resistance, it is crucial to implement various infection control policies, care bundle approaches, and regular surveillance.

Objective The goal of this investigation was to look at the frequency and dispersal of bacteria isolated from pus/wound, as well as their susceptibility patterns.

Ischemic Cardiovascular diseases are one of the deadliest diseases in the world. However, the mortality rate can be significantly reduced if we can detect the disease precisely and effectively. Machine Learning (ML) models offer substantial assistance to individuals requiring early treatment and disease detection in the realm of cardiovascular health. In response to this critical need, this study developed a robust system to predict ischemic disease accurately using ML-based algorithms. The dataset obtained from Kaggle encompasses a comprehensive collection of over 918 observations, encompassing 12 essential features crucial for predicting ischemic disease. In contrast, much-existing research relies primarily on datasets comprising only 303 instances from the UCI repository. Six ML-based algorithms, including K Nearest Neighbors (KNN), Random Forest (RF), Logistic Regression (LR), Support Vector Machine (SVM), Gaussian Naïve Bayes (GNB), and Decision Trees (DT), are trained on the ischemic heart data. The effectiveness of the proposed methodologies is meticulously evaluated and benchmarked against cutting-edge techniques, employing a range of performance criteria. The empirical findings manifest that the KNN classifier produced optimized results with 91.8% accuracy, 91.4% recall, 91.9% F1 score, 92.5% precision, and AUC of 90.27%.

Urinary tract infections (UTIs) are among the most common bacterial infections of the urinary tract, accounting for a high percentage of all infections. The insertion of a catheter into the bladder increases the susceptibility of the patient to tract infection and serves as the initial site of infection by introducing pathogenic organisms into the tract. Indwelling catheters in the bladder facilitate the colonization of uropathogens through various mechanisms. The objective of this study was to compare the different pathogenic bacteria causing UTIs and their antibiotic sensitivity patterns in catheterized and non-catheterized patients. The study included catheterized and non-catheterized patients, regardless of gender, exhibiting clinical signs or symptoms of urinary tract infection. Urine samples were examined and cultured for bacterial growth using standard microbiological procedures. After confirming the pathogens, antibiotic susceptibility testing was conducted on Mueller-Hinton agar using the Kirby-Bauer disc diffusion method. Out of the 200 samples, 88 were catheterized and 112 were non-catheterized. Catheterized patients exhibited a higher infection rate (39, 44.32%) compared to non-catheterized patients (31, 27.68%), and women had a higher infection rate than men. Various organisms were isolated, with Escherichia coli being the most common organism in both catheterized and non-catheterized patients. Among the tested drugs against gram-negative organisms, nitrofurantoin displayed higher sensitivity. The present study demonstrated a higher incidence of bacterial infection in catheterized patients compared to non-catheterized patients, highlighting the importance of avoiding unnecessary catheter insertion. To prevent antimicrobial resistance, it is crucial to implement various infection control policies, care bundle approaches, and regular surveillance. [ABSTRACT FROM AUTHOR]

5G demands a significant increment in the number of connected devices. As a result, gNodeBs are constantly pushed to serve more spectrum and smaller sectors. These increased capacity demands are met by using multiband antennas in base stations. One of the key challenges with multiband antennas is the pattern distortions due to the presence of other surrounding antenna element structures. This work provides a novel approach to address the challenge of pattern distortion in the lower frequency band 690–960 MHz due to common-mode (CM) currents in the high- frequency-band antenna element operating in the 1810–2690 MHz band. A common-mode suppression circuit is integrated with the impedance matching network of the high-band antenna element to reduce these common-mode currents. The experimental results verified that the common-mode suppression circuit reduces the common-mode currents at low-band frequencies by moving the common-mode resonance frequency outside the low frequency band, resulting in cleaner low-band patterns meeting pattern specifications. [ABSTRACT FROM AUTHOR]

The aedes mosquito-borne dengue viruses cause dengue fever, an arboviral disease (DENVs). In 2019, the World Health Organization forecasts a yearly occurrence of infections from 100 million to 400 million, the maximum number of dengue cases ever testified worldwide, prompting WHO to label the virus one of the world's top ten public health risks. Dengue hemorrhagic fever can progress into dengue shock syndrome, which can be fatal. Dengue hemorrhagic fever can also advance into dengue shock syndrome. To provide accessible and timely supportive care and therapy, it is necessary to have indispensable practical instruments that accurately differentiate Dengue and its subcategories in the early stages of illness development. Dengue fever can be predicted in advance, saving one's life by warning them to seek proper diagnosis and treatment. Predicting infectious diseases such as dengue is difficult, and most forecast systems are still in their primary stages. In developing dengue predictive models, data from microarrays and RNA-Seq have been used significantly. Bayesian inferences and support vector machine algorithms are two examples of statistical methods that can mine opinions and analyze sentiment from text. In general, these methods are not very strong semantically, and they only work effectively when the text passage inputs are at the level of the page or the paragraph; they are poor miners of sentiment at the level of the sentence or the phrase. In this research, we propose to construct a machine learning method to forecast dengue fever. [ABSTRACT FROM AUTHOR]

Objective: This study aims to compare the diagnostic value of 18Ffluorodeoxyglucose (18F-DG) positron emission tomography (PET)/ computed tomography (CT) (18F-FDG PET/CT) scan and bone marrow biopsy (BMB) for evaluating bone marrow infiltration (BMI) in newly diagnosed pediatric neuroblastoma (NB) and ganglioneuroblastoma (GNB). Methods: We retrospectively reviewed 51 patients with newly diagnosed NB and GNB between June 1, 2019 and May 31, 2022. Each patient had undergone 18F-FDG PET/CT and BMB within 1 week and received no treatment. Clinical data were collected and statistically analyzed, including age, sex, pathologic type, and laboratory parameters. 18F-FDG PET/CT and BMB revealed the result of bone lesions. Results: A concordance analysis showed that, in this study population, 18F-FDG PET/CT and BMB were in moderate agreement (Cohen’s Kappa = 0.444; p = 0.001), with an absolute agreement consistency of 72.5% (37 of 51). The analysis of the receiver operating characteristic (ROC) curve determined that the areas under the ROC curve (AUCs) of SUVBM and SUV/HE-SUVmax were 0.971 (95% CI: 0.911–1.000; p < 0.001) and 0.917 (95% CI: 0.715–1.000; p < 0.001) to predict bone–bone marrow involvement (BMI), respectively. Conclusion: 18F-FDG PET/CT detects BMI with good diagnostic accuracy and can reduce unnecessary invasive inspections in newly diagnosed pediatric NB and GNB, especially patterns C and D. The analysis of the semi-quantitative uptake of 18F-FDG, including SUVBM and SUVBM/HE-SUVmax, enables an effective differentiation between patterns A and B. [ABSTRACT FROM AUTHOR]

The handover authentication and key agreement process between UE and gNBs have some defects, such as two hop forward security and vulnerable to denial of service attack. To solve these problems, this paper proposed a handover authentication and key agreement protocol based on China Remainder Theorem(CRT). The protocol formed a group between source gNB and all possible target gNBs by using the principle of secret sharing. The source gNB and the only target gNB shared the real parameters as "secrets", so that the source gNB transmitted the key parameters NH and NCC to the target gNB safely. The simulation results show that the protocol is secure and has efficiency advantages compared with other similar improved protocols. [ABSTRACT FROM AUTHOR]

Antibiotic-resistant-bacteria are being considered as emerging environmental contaminants where the importance of the surrounding environment in their emergence and dissemination has been emphasized. The aim of this study was to screen for the presence and diversity of carbapenem- and colistin-resistant Gram-negative bacteria (GNBs) in different aquatic environments. Water samples were collected in Batna, Algeria. Carbapenem- and colistin-resistant GNBs were selectively isolated and then identified using matrix-assisted laser desorption and ionization time-of-flight mass spectrometry. After phenotypic antibiotic susceptibility testing, the molecular mechanisms of β-lactams and colistin-resistance were investigated by PCR and sequencing. The clonality of mcr-1 positive Escherichia coli was determined by multi-locus sequence typing. We noticed a high level of resistance in both tap water and wastewater. The most commonly found carbapenem-resistance mechanism was the OXA-48 enzyme, but other carbapenemases were also detected. In addition, the mcr-1 gene was detected in 18 E. coli of different sequence types. Our findings highlight the role of aquatic environments in the dissemination of resistant-bacteria, especially considering that water is a connecting medium between different ecological systems and can easily transmit resistant-bacteria and promote horizontal gene transfer. Thus, the development of effective treatment strategies for eliminating antibiotic-resistance is seriously needed. [ABSTRACT FROM AUTHOR]

Mekonnen Alebel,1 Feleke Mekonnen,2 Wondemagegn Mulu2 1Department of Clinical Laboratory Science, Chagni Hospital, Chagni, Ethiopia; 2Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, EthiopiaCorrespondence: Wondemagegn MuluDepartment of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, P. O. Box: 79, Bahir Dar, EthiopiaEmail wondem_32@yahoo.comBackground: Owing to the specific risk profile of its residents, intensive care units (ICUs) are the best place for selection pressure and the epicenter for resistance development and dissemination. Infections with β-lactamase releasing Gram-negative bacilli (GNB) at ICUs are an emerging global threat. This study dogged the magnitude of extended-spectrum β-lactamase (ESBL) and carbapenemase releasing Gram-negative bacilli infections and associated factors among patients in the ICUs of Felegehiwot Referral Hospital, Ethiopia.Methods: A cross-sectional study was done through February to June 2020. Wound swabs, urine, blood and sputum samples were collected from patients in the ICUs symptomatic for infections while excluding those under coma and shock. Bacterial species were verified using standard microbiological methods. Carbapenemase and ESBL production were identified using modified carbapenem inactivation and combined disk diffusion methods, respectively. Multivariable analysis was calculated for factors associated with ESBL production. P-value < 0.05 was taken as cut-off for statistical significance.Results: Out of 270 patients in the ICU, 67 (24.8%) and 14 (5.2%) had infections with ESBL and carbapenemase releasing GNB, respectively. The most frequent ESBL producing isolates were P. aeruginosa (100%), E. cloacae (100%), K. pneumoniae (82.8%) and E. coli (64%). The predominant carbapenemase producer isolates were K. pneumoniae (27.6%) and E. cloacae (33.3%). Overall, 77 (81.1%) of species were multi-drug resistant. All GNB species were 100% resistant to tetracycline and ampicillin. They are also resistant to cefuroxime, ceftazidime, sulfamethoxazole-trimethoprim and cefotaxime. Prior hospitalization (AOR = 5.5, CI = 2.63– 11.46), support with medical care devices (AOR = 23.7, CI = 4.6– 12) and arterial intravenous catheterization (AOR = 2.7, CI = 1.3– 5.3) had significant association with β-lactamase producing GNB infection.Conclusion: Infection with ESBL and carbapenemase producing Gram-negative bacilli linked with an alarming degree of multi-drug resistant isolates is a major healthcare threat among patients in ICUs. Hence, strict adherence to infection prevention practices and wise use of antibiotics are recommended to slow the spread of antimicrobial resistance.Keywords: ICU, GNB, ESBL, carbapenemase, multi-drug resistance, FHRH, Ethiopia

Objectives: This study aimed to determine the epidemiology of nosocomial infections (NIs) in a pediatric intensive care unit and define the risk factors associated with NIs., Methods: We performed a prospective descriptive and analytical monocentric study on the incidence of NIs in the pediatric intensive care unit between July 2021 and May 2022. Children with NIs (cases) were compared with matched controls without NIs., Results: We analyzed 396 patients; 102 had NIs. The global incidence of NIs is 44.7% (incidence density of 10.6 per 1000 days of hospitalization). The incidence densities of blood stream infection, pneumonia associated with mechanical ventilation, and urinary tract infection were 10 per 1000 days of central venous catheter use, 7.2 per 1000 of mechanical ventilation use, and 11.1 per 1000 days urinary catheter use. The overall microbiological profile of NIs is dominated by gram-negative bacilli in 78%, followed by gram-positive cocci in 13%. The most common agents in sepsis were Klebsiella pneumoniae . In pneumonias, Acinetobacter Baumanii was the most common cause, and, in urinary tract infection, the most frequent agents were gram-negative bacteria, especially Escherichia coli (33.3%). The presence of NIs was associated with a long period of hospitalization, use of invasive devices (central venous catheter, mechanical ventilation, and bladder catheters), and use of antibiotics., Conclusions: The incidence of NIs acquired in this unit was high and was associated with extrinsic and intrinsic factors., Competing Interests: The authors have no competing interests to declare., (© 2024 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.)

Water, as one of the main sources of life, is an important aspect to public health and safety. Up until now there have been many concerns about water pollution especially in developing countries. Heavy polluted water that is not treated well could cause many concerning diseases that can lead to deaths. Contaminants that are of chemical, physical, and biological origins are commonly found in these water sources. Gram negative bacteria (GNB) have been seen to develop multiple drug and antibiotic resistance, causing more fatal infections. This has become a major concern of public health especially as it makes water treatment more challenging. Our study investigates human coagulation factor II that is responsible for blood clotting as a possible method for water treatment against GNB. By investigating the coagulation protein interaction with several bacterial lipopolysaccharides proteins and calculating the binding affinity of the interaction, the results show factor II has a lower binding affinity compared to previously studied factor VII. This shows possibilities of factor II to hydrolyse several gram-negative bacteria to act as a potential treatment against these GNBs.

Fast-response communication is crucial for Vehicular Ad Hoc Network (VANET). In practice, the conventional VANETs, suffering from the high mobility of the vehicles and the ever-growing data to percept and process, cannot meet the demand of fast response currently. In this paper, we study the Dimensioning and Layout Planning (DLP) problem under 5G-based Vehicular Edge Computing Network (VECN) architecture which integrates the 5G Micro Base Station (gNB) and Edge Computing (EC) to reduce the response time. The DLP problem aims to minimize the total placement cost under the constraint of the full coverage. This paper formulates the DLP problem as an integer linear program (ILP) and then proposes a Greedy Algorithm (GA) and a Cost-Effective Heuristic Algorithm (CEHA) toimprove the computation efficiency. The case studies have verified the feasibility and scalability of the DLP formulation and showed that the proposed CEHA is fairly effective and efficient to solve the DLP problem.

Antibiotic-resistant-bacteria are being considered as emerging environmental contaminants where the importance of the surrounding environment in their emergence and dissemination has been emphasized. The aim of this study was to screen for the presence and diversity of carbapenem- and colistin-resistant Gram-negative bacteria (GNBs) in different aquatic environments. Water samples were collected in Batna, Algeria. Carbapenem- and colistin-resistant GNBs were selectively isolated and then identified using matrix-assisted laser desorption and ionization time-of-flight mass spectrometry. After phenotypic antibiotic susceptibility testing, the molecular mechanisms of β-lactams and colistin-resistance were investigated by PCR and sequencing. The clonality of mcr-1 positive Escherichia coli was determined by multi-locus sequence typing. We noticed a high level of resistance in both tap water and wastewater. The most commonly found carbapenem-resistance mechanism was the OXA-48 enzyme, but other carbapenemases were also detected. In addition, the mcr-1 gene was detected in 18 E. coli of different sequence types. Our findings highlight the role of aquatic environments in the dissemination of resistant-bacteria, especially considering that water is a connecting medium between different ecological systems and can easily transmit resistant-bacteria and promote horizontal gene transfer. Thus, the development of effective treatment strategies for eliminating antibiotic-resistance is seriously needed.

Water as one of the main sources of life, holds an important aspect to public health and safety. Up until now there have been many concerns about water pollution especially in developing countries. Heavy polluted water that is not treated well could cause many concerning diseases that can lead to deaths. Contaminants that came from chemical, physical, and biological compounds are commonly found in the water sources. Gram negative bacteria (GNB) has been shown to develop multiple drugs and antibiotics resistant, making the infection more fatal. This has become a major concern on public health especially in water treatment as it becomes more challenging. Our study investigates human coagulation factor II that is responsible for blood clotting as a possible method for water treatment against GNB. By investigating the coagulation protein interaction with several bacterial lipopolysaccharides proteins and calculating the binding affinity of the interaction, the results show factor II has a lower binding affinity compared to previously studied factor VII. This shows possibilities of factor II to hydrolyse several gram-negative bacteria to act as a potential treatment against these GNBs. [ABSTRACT FROM AUTHOR]

The underlaying communication scheme in 5G cellular network is a very promising resource sharing scheme, and it is an effective scheme for improving service performance of 5G and reducing communication load between a cellular link and a device to device (D2D) link. This paper proposes the algorithm to minimize the resource interference that occurs when performing 5G-based multi-class service on gNB(gNodeB) and the cooperative priority-based resource allocation scheduling scheme (CPRAS) to maximize 5G communication service according to the analyzed control conditions of interference. The proposed CPRAS optimizes communication resources for each device, and it optimizes resource allocation according to the service request required for 5G communication and the current state of the network. In addition, the proposed scheme provides a function to guarantee giga-class service by minimizing resource interference between a cellular link and a D2D link in gNB. The simulation results show that the proposed scheme is better system performance than the Pure cellular and Force cellular schemes. In particular, the higher the priority and the higher the cooperative relationship between UE(User Equipment), the proposed scheme shows the more effective control of the resource interference. [ABSTRACT FROM AUTHOR]

• SM-VAP occurred lately after the onset of mechanichal ventilation. • Exposure to carbapenem and carboxy- or ureido-penicillin during the week before VAP and the severity of disease with respiratory and hematological failures were independent risk factors for the SM-VAP occurrence. • The prognosis of patients with SM-VAP was poor and not modified by the adequacy of antimicrobial therapy. • Antibiotics exposure the week before VAP and the severity of disease were independent risk factors for the SM-VAP occurrence. Stenotrophomonas maltophilia (SM) is increasingly identified in intensive care unit (ICU). This study aim to identify risk factors for SM ventilator-associated pneumonia (VAP) and whether it affects ICU mortality Two nested matched case-control studies were performed based in OUTCOMEREA database. The first episodes of SM -VAP patients were matched with two different control groups: VAP due to other micro-organisms (VAP-other) and Pseudomonas aeruginosa VAP (Pyo-VAP). Matching criteria were the hospital, the SAPS II, and the previous duration of mechanical ventilation (MV). Of the 102 SM -VAP patients (6.2% of all VAP patients), 92 were matched with 375 controls for the SM -VAP/other-VAP matching and 84 with 237 controls for the SM -VAP/ Pyo -VAP matching. SM -VAP risk factors were an exposition to ureido/carboxypenicillin or carbapenem during the week before VAP, and respiratory and coagulation components of SOFA score upper to 2 before VAP. SM -VAP received early adequate therapy in 70 cases (68.6%). Risk factors for Day-30 were age (OR = 1.03; p < 0.01) and Chronic heart failure (OR = 3.15; p < 0.01). Adequate treatment, either monotherapy or combination of antimicrobials, did not modify mortality. There was no difference in 30-day mortality, but 60-day mortality was higher in patients with SM -VAP compared to Other-VAP (P = 0.056). In a large series, independent risk factors for the SM -VAP were ureido/carboxypenicillin or carbapenem exposure the week before VAP, and respiratory and coagulation components of the SOFA score > 2 before VAP. Mortality risk factors of SM-VAP were age and chronic heart failure. Adequate treatment did not improve SM -VAP prognosis. Image, graphical abstract [ABSTRACT FROM AUTHOR]

The use of dimensionality reduction techniques is a keystone for analyzing and interpreting high dimensional data. These techniques gather several data features of interest, such as dynamical structure, input-output relationships, the correlation between data sets, covariance, etc. Dimensionality reduction entails mapping a set of high dimensional data features onto low dimensional data. Motivated by the lack of learning models’ performance due to the high dimensionality data, this study encounters five distinct dimensionality reduction methods. Besides, a comparison between reduced dimensionality data and the original one using statistical and machine learning models is conducted thoroughly.

Galacto- N -biose (GNB) is an important core structure of glycan of mucin glycoproteins in the gastrointestinal (GI) mucosa. Because certain beneficial bacteria inhabiting the GI tract, such as bifidobacteria and lactic acid bacteria, harbor highly specialized GNB metabolic capabilities, GNB is considered a promising prebiotic for nourishing and manipulating beneficial bacteria in the GI tract. However, the precise interactions between GNB and beneficial bacteria and their accompanying health-promoting effects remain elusive. First, we evaluated the proliferative tendency of beneficial bacteria and their production of beneficial metabolites using gut bacterial strains. By comparing the use of GNB, glucose, and inulin as carbon sources, we found that GNB enhanced acetate production in Lacticaseibacillus casei , Lacticaseibacillus rhamnosus , Lactobacillus gasseri , and Lactobacillus johnsonii . The ability of GNB to promote acetate production was also confirmed by RNA-seq analysis, which indicated the upregulation of gene clusters that catalyze the deacetylation of N -acetylgalactosamine-6P and biosynthesize acetyl-CoA from pyruvate, both of which result in acetate production. To explore the in vivo effect of GNB in promoting acetate production, antibiotic-treated BALB/cA mice were administered with GNB with L. rhamnosus , resulting in a fecal acetate content that was 2.7-fold higher than that in mice administered with only L. rhamnosus . Moreover, 2 days after the last administration, a 3.7-fold higher amount of L. rhamnosus was detected in feces administered with GNB with L. rhamnosus than in feces administered with only L. rhamnosus . These findings strongly suggest the prebiotic potential of GNB in enhancing L. rhamnosus colonization and converting L. rhamnosus into higher acetate producers in the GI tract., Importance: Specific members of lactic acid bacteria, which are commonly used as probiotics, possess therapeutic properties that are vital for human health enhancement by producing immunomodulatory metabolites such as exopolysaccharides, short-chain fatty acids, and bacteriocins. The long residence time of probiotic lactic acid bacteria in the GI tract prolongs their beneficial health effects. Moreover, the colonization property is also desirable for the application of probiotics in mucosal vaccination to provoke a local immune response. In this study, we found that GNB could enhance the beneficial properties of intestinal lactic acid bacteria that inhabit the human GI tract, stimulating acetate production and promoting intestinal colonization. Our findings provide a rationale for the addition of GNB to lactic acid bacteria-based functional foods. This has also led to the development of therapeutics supported by more rational prebiotic and probiotic selection, leading to an improved healthy lifestyle for humans., Competing Interests: The authors declare no conflict of interest.

Introduction: Ventilator-associated pneumonias (VAPs) are a complication of mechanical ventilation in the intensive care unit (ICU) that increase length of stay, morbidity, and mortality. While identifying and treating infections early is paramount to improving patient outcomes, more and more data demonstrate limited courses of antibiotics improve outcomes. Prolonged (10-14 day) courses of antibiotics have remained the standard of care for pneumonia due to gram-negative bacilli (GNR). We aimed to review our GNR VAPs to assess risk factors for recurrent GNR infections., Methods: We reviewed trauma patients who developed VAP from 02/2019 through 05/2022. Demographics, injury characteristics, and outcomes were reviewed with a focus on pneumonia details including the cultured pathogen(s), antibiotic(s) used, treatment duration, and presence of recurrent infections. We then compared single episode VAPs to multiple episode VAPs among patients infected by GNRs., Results: Eleven of the fifty trauma patients admitted to the ICU suffered a VAP caused by a GNR. Of these eleven patients, six experienced a recurrent infection, four of which were caused by Pseudomonas aeruginosa and two of which were caused by Enterobacter aerogenes . Among the patients who received ten days of antibiotic treatment, half suffered a recurrence. Although, there was no difference in the microbiology or antibiotic duration between the recurrences and single episodes., Conclusion: Despite prolonged use of antibiotics, we found that the risk of recurrent or persistent infections was high among patients with VAP due to GNB. Further study is needed to determine optimal treatment to minimize the risk of these recurrences., Key Message: Ventilator-associated pneumonia due to gram-negative bacilli is a rare but high morbidity complication in intensive care units. Despite prolonged duration of therapy, these infections still appear to account for many recurrent infections and further study into optimal therapy is warranted., Competing Interests: The authors have no relevant conflicts of interest to report., (© 2023 The Authors. Published by Elsevier Inc.)

The ABS braking system uses the coefficient of friction over the slip rate to vary the brake pressure. For this, it references the friction coefficient-slip graph embedded in the ABS control unit. This method is insufficient to determine the friction coefficient suitable for real conditions on slippery surfaces where the peak is uncertain. In this study, machine learning methods such as SVM, MLP, SGD, GNB, and Extremely Randomized Trees that provide road surface type estimation regardless of road type have been developed in order to increase the braking performance of ABS by eliminating this deficiency. In this study, the compatibility between brake pressure and wheel acceleration change is taken as reference. For this, ABS tests are carried out at different speeds on both wet and slippery roads. The results are very promising and Extremely Randomized Trees reached 98% accuracy, 99% precision, 98% recall, and 97% F1-score, especially in test conditions at 30 km/h. Also, Extremely Randomized Trees reached 95% accuracy, 99% precision, 96% recall, and 97% F1-score at 60 km/h. • Brake pressure pulses and wheel acceleration is considered to identify road surface type. • SVM, MLP, SGD, GNB, and Extremely Randomized Trees techniques are realized. • Extremely Randomized Trees outperforms others for all experiments. [ABSTRACT FROM AUTHOR]

Galacto- N -biose (GNB: Galβ1-3GalNAc) is an O-glycan disaccharide core moiety that is a core component of mucin in the gastrointestinal tract; however, the physiological properties of GNB are not well understood. Glutamate excitotoxicity causes neuronal death in acute neurological disorders including stroke, trauma, and neurodegenerative disease. Therefore the discovery of drugs to treat glutamate excitotoxicity is an important goal. Here, we report that GNB is neuroprotective against glutamate-induced excitotoxicity. We treated 14–15 days in vitro cultured rat cortical neurons with 0.1–1000 nM GNB together with 30 µm glutamate for various durations. Short-term (3 h) GNB treatments showed a modest neuroprotective effect against glutamate neurotoxicity, however, long-term (24 h) GNB treatment conferred significant neuroprotective effects, as shown by both MTT and immunocytochemical assays. Prolonged GNB treatment did not alter glutamate-induced calcium influx, but did induce antioxidant-related gene expression. Furthermore, GNB treatment did not induce cell death or alter synaptic connections. These data suggest that GNB is a potential candidate drug that protects against glutamate excitotoxicity without affecting cell viability and synaptic connections. [ABSTRACT FROM AUTHOR]

Lidocaine has been recognized to induce neurotoxicity. However, the molecular mechanism underlying this effect, especially the critical molecules in cells that mediated the lidocaine-induced apoptosis were unclear. In the present study, PC12 cells were administrated with lidocaine for 48 h. Using MTT assay and flow cytometry, we found lidocaine significantly decreased the cell proliferation and S phases in PC12 cells with treatment concentrations, and significantly enhanced cell apoptosis with treatment concentrations. Two-dimensional gel electrophoresis (2-DE) analysis and LC–MS/MS were used to identification of protein biomarkers. Six proteins were identified. Among them, three were up-expressed including ANXA6, GNB2 and STMN1, other three were down-expressed including ubiquitin-linke protein 7 (UBL7), DDAH2 and BLVRB. Using qRT-PCR, we confirmed that lidocaine up-regulated the mRNA expression of STMN1, GNB2, ANXA6 and DDAH2, and found that the GNB2 had the largest change (about increased by 6.4 folds). The up-regulation of GNB2 by lidocaine was also validated by western blot. After transfected with 100 μM GNB2-Rat-453 siRNA, the expression of GNB2 in PC12 cells was almost completely inhibited; and the cell proliferation and cells in S phases were significantly enhanced, cell apoptosis including both early apoptosis and later apoptosis were significantly reduced in the presence of 0.5 mM lidocaine for 48 h. Therefore, neuronal apoptosis was induced by lidocaine and this effect was mediated by GNB2. Further research is needed to assess the clinical relevance and exact mechanism of neuronal apoptosis caused by lidocaine. [ABSTRACT FROM AUTHOR]