Fully Characterized Effective Bacteriophages Specific against Antibiotic-Resistant Enterococcus faecalis, the Causative Agent of Dental Abscess.

Background and Objectives: Enterococcus faecalis (E. faecalis) is a primary pathogen responsible for dental abscesses, which cause inflammation and pain when trapped between the crown and soft tissues of an erupted tooth. Therefore, this study aims to use specific phages as an alternative method instead of classical treatments based on antibiotics to destroy multidrug-resistant E. faecalis bacteria for treating dental issues. Materials and Methods: In the current study, twenty-five bacterial isolates were obtained from infected dental specimens; only five had the ability to grow on bile esculin agar, and among these five, only two were described to be extensive multidrug-resistant isolates. Results: Two bacterial isolates, Enterococcus faecalis A.R.A.01 [ON797462.1] and Enterococcus faecalis A.R.A.02, were identified biochemically and through 16S rDNA, which were used as hosts for isolating specific phages. Two isolated phages were characterized through TEM imaging, which indicated that E. faecalis_phage-01 had a long and flexible tail, belonging to the family Siphoviridae, while E. faecalis_phage-02 had a contractile tail, belonging to the family Myoviridae. Genetically, two phages were identified through the PCR amplification and sequencing of the RNA ligase of Enterococcus phage vB_EfaS_HEf13, through which our phages shared 97.2% similarity with Enterococcus phage vB-EfaS-HEf13 based on BLAST analysis. Furthermore, through in silico analysis and annotations of the two phages' genomes, it was determined that a total of 69 open reading frames (ORFs) were found to be involved in various functions related to integration excision, replication recombination, repair, stability, and defense. In phage optimization, the two isolated phages exhibited a high specific host range with Enterococcus faecalis among six different bacterial hosts, where E. faecalis_phage-01 had a latent period of 30 min with 115.76 PFU/mL, while E. faecalis_phage-02 had a latent period of 25 min with 80.6 PFU/mL. They were also characterized with stability at wide ranges of pH (4-11) and temperature (10-60 °C), with a low cytotoxic effect on the oral epithelial cell line at different concentrations (1000-31.25 PFU/mL). Conclusions: The findings highlight the promise of phage therapy in dental medicine, offering a novel approach to combating antibiotic resistance and enhancing patient outcomes. Further research and clinical trials will be essential to fully understand the therapeutic potential and safety profile of these bacteriophages in human populations.

Unravelling the Antimicrobial, Antibiofilm, Suppressing Fibronectin Binding Protein A (fnba) and cna Virulence Genes, Anti-Inflammatory and Antioxidant Potential of Biosynthesized Solanum lycopersicum Silver Nanoparticles.

Background and Objectives: Urinary tract infections [UTIs] are considered the third most known risk of infection in human health around the world. There is increasing appreciation for the pathogenicity of Gram-positive and Gram-negative strains in UTIs, aside from fungal infection, as they have numerous virulence factors. Materials and Methods: In this study, fifty urine samples were collected from patients suffering from UTI. Among the isolates of UTI microbes, six isolates were described as MDR isolates after an antibiotic susceptibility test carried out using ten different antibiotics. An alternative treatment for microbial elimination involved the use of biosynthesized silver nanoparticles (AgNPs) derived from Solanum lycopersicum [S. cumin]. Results: The sizes and shapes of AgNPs were characterized through TEM imaging, which showed spherical particles in a size range of 35-80 nm, of which the average size was 53 nm. Additionally, the silver nanoparticles (AgNPs) demonstrated inhibitory activity against Staphylococcus aureus (OR648079), exhibiting a 31 mm zone of inhibition at a minimum inhibitory concentration (MIC) of 4 mg/mL and a minimum bactericidal concentration (MBC) of 8 mg/mL. This was followed by Aspergillus niger (OR648075), which showed a 30 mm inhibition zone at an MIC of 16 mg/mL and a minimum fungicidal concentration (MFC) of 32 mg/mL. Then, Enterococcus faecalis (OR648078), Klebsiella pneumoniae (OR648081), and Acinetobacter baumannii (OR648080) each displayed a 29 mm zone of inhibition at an MIC of 8 mg/mL and an MBC of 16 mg/mL. The least inhibition was observed against Candida auris (OR648076), with a 25 mm inhibition zone at an MIC of 16 mg/mL and an MFC of 32 mg/mL. Furthermore, AgNPs at different concentrations removed DPPH and H2O2 at an IC50 value of 13.54 µg/mL. Also, AgNPs at 3 mg/mL showed remarkable DNA fragmentation in all bacterial strains except Enterococcus faecalis. The phytochemical analysis showed the presence of different active organic components in the plant extract, which concluded that rutin was 88.3 mg/g, garlic acid was 70.4 mg/g, and tannic acid was 23.7 mg/g. Finally, AgNPs concentrations in the range of 3-6 mg/mL showed decreased expression of two of the fundamental genes necessary for biofilm formation within Staphylococcus aureus, fnbA (6 folds), and Cna (12.5 folds) when compared with the RecA gene, which decreased by one-fold when compared with the control sample. These two genes were submitted with NCBI accession numbers [OR682119] and [OR682118], respectively. Conclusions: The findings from this study indicate that biosynthesized AgNPs from Solanum lycopersicum exhibit promising antimicrobial and antioxidant properties against UTI pathogens, including strains resistant to multiple antibiotics. This suggests their potential as an effective alternative treatment for UTIs. Further research is warranted to fully understand the mechanisms of action and to explore the therapeutic applications of these nanoparticles in combating UTIs.

Elimination of pathogenic multidrug resistant isolates through different metal oxide nanoparticles synthesized from organic plant and microbial sources.

Beta-hemolytic multidrug-resistant bacteria (MDR) are highly regarded as a major public health risk because they are resistant to at least 10 antibiotics in different groups with different mechanisms of action. The present study shows that among 98 bacterial isolates collected from laboratory fecal samples: 15 were beta-hemolytic and tested against 10 different antibiotics. 15 beta-hemolytic; 5 isolates exhibit strong multidrug resistance traits. Isolate 5 Escherichia coli (E. coli), Isolate 7 (E. coli), Isolate 21 (Enterococcus faecium), Isolate 27 (Staphylococcus sciuri), and isolate 36 (E. coli) are largely untested antibiotics. Substances (clear zone >10 mm) Its growth sensitivity to different types of nanoparticles was further evaluated by the agar well diffusion method. AgO, TiO2, ZnO, and Fe3O4 nanoparticles have been separately synthesized by microbial and plant-mediated biosynthesis. By evaluating the antibacterial activity of different nanoparticle types against selected MDR isolates, the results showed that global MDR bacterial growth was inhibited differently depending on the nanoparticle type. TiO2 was the most potent antibacterial nanoparticle type, followed by AgO, while Fe3O4 showed the least efficacy against selected isolates. The MICs of microbially synthesized AgO and TiO2 nanoparticles were 3 µg (67.2 µg/mL) and 9 µg (180 µg/mL) for isolates 5 and 27, respectively, indicating that biosynthetic nanoparticles via pomegranate of antibacterial activity at a higher MIC than microbial-mediated ones, it recorded (300 and 375 µg/ml, respectively) of AgO and TiO2 nanoparticles for isolates 5 and 27. Biosynthesized nanoparticles were examined by TEM, the average sizes of microbial AgO and TiO2 nanoparticles were 30 nm and 70 nm, respectively, and the average sizes of plant mediated AgO and TiO2 NPs were 52 nm and 82 nm respectively. Two most potent extensive MDR isolates (5 and 27) were identified as E. coli and Staphylococcus sciuri by 16s rDNA technology, and the sequencing results of the isolates were deposited with NCBI GenBank under accession numbers ON739202 and ON739204, respectively.

Aorta unfolding index as an indicator for coronary artery disease severity.

BACKGROUND: Aortic unfolding index (AUI) is an independent predictor of cardiovascular events, yet there is scarcity in the literature on its association with the severity of coronary artery disease (CAD). PURPOSE: To investigate the correlation between aortic unfolding and coronary artery disease severity score. MATERIAL AND METHODS: The study included 115 patients with various degrees of CAD who underwent invasive coronary angiography and were retrospectively studied. AUI derived from non-contrast computed tomography (CT) of the chest was correlated to the Gensini score describing the CAD severity. Its sensitivity and specificity in the detection of severe stenosis were examined at various cutoff points. RESULTS: CAD severity was significantly correlated with the patient age and AUI. On multivariate regression analysis, AUI was an independent predictor of severe CAD. The best cutoff value was ≥66, with 94.9% sensitivity and 81.6% specificity. CONCLUSION: AUI ≥66 was a predictor of severe CAD independent of the patient age.

Spatiotemporal Characteristics and Driving Factors of Black Carbon in Augsburg, Germany: Combination of Mobile Monitoring and Street View Images.

The study investigates the spatial pattern of black carbon (BC) at a high spatial resolution in Augsburg, Germany. Sixty two walks were performed to assess the concentrations of equivalent black carbon (eBC), ultraviolet particulate matter (UVPM), and equivalent brown carbon (eBrC) in different seasons and at different times of the day with a mobile platform (i.e., trolley). Along with BC measurements, images of street microenvironments were recorded. Meteorological parameters, including temperature, relative humidity, and wind speed, were monitored. The BC concentrations showed significant spatial heterogeneity and diurnal variations peaking in the morning and at night. The highest BC concentrations were observed near dense traffic. The correlations between BC and street views (buildings, roads, cars, and vegetation) were weak but highly significant. Moreover, meteorological factors also influenced the BC concentration. A model based on street view images and meteorological data was developed to examine the driving factors of the spatial variability of BC concentrations at a higher spatial resolution as different microenvironments based on traffic density. The best results were obtained for UVPM and eBC (71 and 70% explained variability). eBrC (53%), to which other sources besides road traffic can also make significant contributions, is modeled less well.

Recombinant overexpression of the Escherichia coli acetyl-CoA carboxylase gene in Synechocystis sp. boosts lipid production.

Microalgae have received continued attention as a potential source for biofuel production. However, the lack of suitable strains that provide a lipid-rich biomass and tolerate harsh condition inhibits their industrial application. This report describes an effort to transform Synechocystis sp. with genes encoding acetyl-CoA carboxylase (ACC), a key regulatory enzyme in the lipogenesis pathway, from the white mustard plant (Sinapis alba) and the bacterium Escherichia coli DH5α using chitosan nanoparticles. Although a recombinant plasmid encoding S. alba ACC failed to express, successful transformation was achieved with a recombinant plasmid encoding E. coli DH5α ACC. The successful transformant, Synechocystis sp. PAK13, exhibited increased ACC expression compared with its wild-type parent (11.8 vs. 7.2 ng), which significantly increased its lipid content (by 3.6-fold). Synechocystis sp. PAK13 also exhibited a significant (20%) reduction in photosynthetic pigments, a 1.52-fold higher glucose content and a 3.5-fold lower sucrose content than the wild-type. In conclusion, this report introduces a useful strategy to overexpress the ACC gene in microalgae, creating strains with improved lipid production that are suited to industrial applications.

Comparison of Nd: YAG Laser and Combined Intense Pulsed Light and Radiofrequency in the Treatment of Hypertrophic Scars: A Prospective Clinico-Histopathological Study.

INTRODUCTION: Hypertrophic scars are fibroproliferative disorders, seen after burn, trauma, and/or surgery. We aimed to compare the clinical and histopathological results of 1064-nm Nd:YAG laser and combined intense pulsed light and radiofrequency in the treatment of hypertrophic scars. METHODS: Fifty patients with hypertrophic scars were included in this prospective, randomized study. Twenty-five patients were treated with Nd:YAG laser and 25 patients with combined intense pulsed light and radiofrequency (E-light). The scars were evaluated at baseline, during and at 3 months after the final treatment session using the Vancouver scar scale. Biopsy specimens from scars were obtained before, during, and 3 months after the final treatment session and were stained with hematoxylin and eosin stain, Masson's trichrome stain, and immunostaining procedures for collagen I, collagen III, and TGF-ß1. RESULTS: Significant improvements in the total Vancouver scar scale scores before and after the treatment in both groups (P < 0.001); however, a significant difference between both groups (P < 0.001), regarding the E-light, which showed better response than Nd:YAG laser. Hematoxylin and eosin and Masson's trichrome staining showed arrangement and thinning of collagen bundles and reduction in collagen density by in both groups, but the collagen bundles thinning and parallelism were more obvious in the E-light group. Significant decrease in the concentration of collagen I, collagen III, and TGF-ß1 in the E-light group as compared with the laser group (P = 0.005, P = 0.003 and P < 0.001, respectively). CONCLUSIONS: Both modalities were successful in the treatment of hypertrophic scars; however, a significant improvement in the clinical and histopathological findings was detected with the E-light method.

Conversion of a 2D Lepidocrocite-Type Layered Titanate into Its 1D Nanowire Form with Enhancement of Cation Exchange and Photocatalytic Performance.

Layered titanates with one-dimensional (1D) shapes have been an important class of nanomaterials due to their combination of 1D and 2D fascinating properties. Among many layered titanates, lepidocrocite-type layered titanates have significant advantages such as superior intercalation and exfoliation properties, while the synthesis of the 1D-shape forms is still challenging. Here, we report on a facile one-pot hydrothermal conversion of a lepidocrocite-type layered titanate into the corresponding nanowire-shape form. The reaction mechanism involves the decomposition of the starting layered titanate into 1D small segments which assemble into the nanowire. This new nanowire shows properties resulting from the combination of 1D and 2D nanostructural features, excellent cation exchange ability, and high photoinduced charge separation and photocatalytic efficiency. As a demonstration, we evaluate the nanowire as a sequestrating material capable of collecting toxic cations, like Cd2+, from water and photoreducing them (immobilizing them tightly). We find that the nanowire shows an efficient and ultrafast photoimmobilization activity, whereas the starting layered titanate and a benchmark TiO2 photocatalyst (P25) show no activity under the identical conditions. The photoimmobilization rate (within 1 min) is considerably faster than the cation exchange rates reported for state-of-the-art cation exchangers (with no photoimmobilization ability). The nanowire used for photoimmobilization reactions is easily recovered from water by decantation, showing the possible practical use for safe disposal of toxic cations in the environment.

Comprehensive Investigation on Principle Component Large-Scale Wi-Fi Indoor Localization.

The smartphone market is rapidly spreading, coupled with several services and applications. Some of these services require the knowledge of the exact location of their handsets. The Global Positioning System (GPS) suffers from accuracy deterioration and outages in indoor environments. The Wi-Fi Fingerprinting approach has been widely used in indoor positioning systems. In this paper, Principal Component Analysis (PCA) is utilized to improve the performance and to reduce the computation complexity of the Wi-Fi indoor localization systems based on a machine learning approach. The experimental setup and performance of the proposed method were tested in real indoor environments at a large-scale environment of 960 m² to analyze the performance of different machine learning approaches. The results show that the performance of the proposed method outperforms conventional indoor localization techniques based on machine learning techniques.

Three-dimensional assessment of soft tissue changes associated with bone-anchored maxillary protraction protocols.

INTRODUCTION: The aim of this study was to assess the 3-dimensional soft tissue changes in growing Class III patients with maxillary deficiency associated with 2 bone-anchored maxillary protraction protocols in relation to an untreated control group of Class III patients. METHODS: Growing skeletal Class III patients between the ages of 10 and 14 years participated in this study. In group 1 (n = 10), skeletally anchored facemasks were used with miniplates placed at the zygomatic buttress. In group 2 (n = 10), the patients were treated with Class III elastics extending from infrazygomatic miniplates in the maxilla to symphyseal miniplates in the mandible. Group 3 (n = 10) was an untreated control group. Three-dimensional stereophotogrammetry images were acquired before and after treatment, and then superimposed and analyzed. In addition, lateral cephalometric radiographs were analyzed. RESULTS: The maxilla moved forward significantly in groups 1 and 2 compared with the untreated control group (group 1, 4.87 mm; group 2, 5.81 mm). The 3-dimensional soft tissue analysis showed significant treatment effects; the major changes were observed in the upper lips, cheeks, and middle of the face, which had a significant positive sagittal displacement in both treatment groups. The lower lip and chin area showed significant negative sagittal changes that indicated that the soft tissue growth in this area was restrained with backward displacement especially in group 1 more than in group 2. CONCLUSIONS: The 2 bone-anchored maxillary protraction protocols effectively improved the Class III concave soft tissue profile.

Dentoalveolar and arch dimension changes in patients treated with miniplate-anchored maxillary protraction.

INTRODUCTION: The aim of this study was to evaluate dentoalveolar and arch dimension changes in 2 miniplate-anchored maxillary protraction protocols in relation to an untreated control group using 3-dimensional digital models. METHODS: Thirty growing Class III subjects with maxillary deficiency in the late mixed or early permanent dentition phase were randomly divided into 3 groups. In group 1 (n = 10), patients were treated with skeletally anchored facemasks anchored with miniplates placed at the zygomatic buttress. In group 2 (n = 10), patients were treated with Class III elastics extending from infrazygomatic miniplates in the maxilla to symphyseal miniplates in the mandible. Group 3 (n = 10) was an untreated control group. The decision to discontinue orthopedic treatment was made when the patients had 3 to 4 mm of positive anterior overjet. Pretreatment, posttreatment, and observation 3-dimensional digital models were analyzed, superimposed, 3 dimensionally mapped, and sectioned. RESULTS: In this study, there were no significant changes in maxillary arch depth and maxillary or mandibular intermolar width before and after maxillary protraction or after the observation period in the control group. The mandibular arch depth decreased by a small but statistically significant amount only in groups 1 and 3. Superimposition of the pretreatment and posttreatment or observation maxillary 3-dimensional digital models showed minimal clinically significant dentoalveolar changes. CONCLUSIONS: Miniplate-anchored maxillary protraction protocols can accomplish maxillary advancement by eliminating movements of teeth and dentoalveolar changes. No spontaneous improvement in transverse deficiency was detected after correction of the anteroposterior deficiency at this age. Consequently, patients with transverse maxillary deficiency should have rapid maxillary expansion before or during the miniplate-anchored protraction period to improve the transverse deficiency.

Comparative evaluation of 2 skeletally anchored maxillary protraction protocols.

INTRODUCTION: The aim of this study was to evaluate and compare the effects of 2 protocols of bone-anchored maxillary protraction with an untreated control group. METHODS: Thirty growing Class III subjects with maxillary deficiency in the late mixed or early permanent dentition were included in the study. In group 1 (n = 10), skeletally anchored facemasks were used with miniplates placed at the zygomatic buttress. In group 2 (n = 10), the patients were treated with Class III elastics extending from infrazygomatic miniplates in the maxilla to symphyseal miniplates in the mandible. Group 3 (n = 10) was an untreated control group. Pretreatment and posttreatment cephalometric radiographs were analyzed. RESULTS: The treatment periods were 8 and 8.9 months in groups 1 and 2, respectively, and the untreated control group was observed for 9.4 months. The maxilla moved forward significantly in groups 1 and 2 compared with the untreated control group (4.87 mm in group 1, 5.81 mm in group 2); overjet and maxillary incisor display were improved without proclination or mesialization of the maxillary teeth relative to the maxillary base. Soft tissue harmony demonstrated the great improvement. However, group 1 showed more opening rotation of the mandible and lingual inclination of the mandibular incisors than did group 2. CONCLUSIONS: The 2 skeletal anchorage protocols for maxillary protraction effectively resolved the severe maxillary deficiently in growing Class III patients. However, vertical changes and retroclination of the mandibular incisors were better controlled by Class III elastics extending from the infrazygomatic miniplates in the maxilla to the symphyseal miniplates in the mandible (group 2).

Optimization of Phloretin-loaded Nanospanlastics for Targeting of FAS/SREBP1c/AMPK/ OB-Rb Signaling Pathway in HFD-induced Obesity.

OBJECTIVES: Obese patients are at increased risk for CVD, which is the main cause of premature death and has been a major cause of disability and ill health in recent years. PTN, a natural dihydrochalcone flavonoid, has a variety of pharmacological characteristics. This article aimed to prepare PTN-NSLs to evaluate their anti-obesity activity. METHODS: Morphology, Particle size, zeta potential, UV-vis, entrapment efficiency, FT-IR spectra, and an in vitro release study of PTN-NSLs were described. PTN-NSLs were also tested for their anti-obesity properties in obese rats. The LD50 of PTN-NSLs was calculated, as was the 1/20 LD50 prepared for the treatment of obese rats. Also, the level of glycemic, oxidative stress and inflammatory biomarkers were estimated in the obese rat's model. RESULTS: The synthesized PTN-NSLs were uniform, spherically shaped, and well dispersed with no aggregation noted, with a size range of 114.06 ± 8.35 nm. The measured zeta potential value of PTN-NSLs was -32.50.8 mv. Also, the UV spectra of PTN and PTN-NSLs have strong absorption at 225 and 285 nm. Also, the LD50 of PTN-NSLs was found to be 2750 mg/kg.b.w. Moreover, administrating obese rats with PTN-NSLs resulted in improved glycemic features as well as GSH, SOD, GPx, GR, IL10, TBARs, and IL-6 levels, as well as attenuated FAS, SREBP1c, AMPK, ACO, CPT1, and OB-Rb gene expression. CONCLUSIONS: Administration of PTN-NSLs significantly attenuated the levels of glycemic, oxidative stress, and inflammatory biomarkers. The biochemical and PCR findings are aided by histological investigations. Also, the present findings imply that PTN-NSLs might be a promising pharmacological tool for the treatment of obesity-related diseases.

A New Proposed Combined CT and MRI Staging System for Covid-19-Associated Rhino-Orbito-Cerebral Fungal Infection: A Multi-center Study with Pathological Correlation.

RATIONALE AND OBJECTIVES: To propose a combined computed tomography (CT) and magnetic resonance imaging (MRI) based classification system in the management of COVID-19-associated rhino-orbito-cerebral (C-ROC) fungal infection and to assess the reliability of such proposed staging system. MATERIALS AND METHODS: This was a multi-center prospective study conducted on 122 adults with previously confirmed COVID-19 infection. CT and contrast-enhanced MRI (CE-MRI) were performed for all patients. Three radiologists (with experience of 8, 10, and 14 years) independently assessed all images. Then, each patient was assigned a radiological stage based on the five stages of the proposed system according to the radiological extent of the fungal infection. The intra-class correlation coefficient (ICC) test assessed the inter-rater agreement. Based on the pathological evaluation of post-operative specimens, a diagnosis of fungal infection was documented. RESULTS: The most prevalent severity stage among all raters was stage IV in 29.5-31.1% patients. The overall inter-rater agreement of the proposed staging system was excellent (ICC 0.971, 95% CI;0.960-0.979). Moreover, the most common detected pathogen was Mucormycosis (n = 87, 71.3%). Furthermore, there was a statistically significant association between the patients' outcome and the severity stage (P value 0.001) and there was no statistically significant association between ethmoid and sphenoid sinus affection and cranial extension (P value 0.081). CONCLUSION: Our proposed combined CT and MRI severity staging system has a high inter-rater agreement. Moreover, it can aid in the early detection of the C-ROC fungal infection, improve preoperative planning, and subsequently improve the patient's outcome.

Versatility of Local Fasciocutaneous Island Flaps for Resurfacing Soft Tissue Defects Overlying the Achilles Tendon.

Background: Reconstruction of soft tissue defects overlying the Achilles tendon has always been a challenge. Various modalities of reconstruction have been described to resurface such defects. We aimed to assess the functional and cosmetic outcomes of all patients who had undergone reconstruction of small and medium sized soft tissue defects of the Achilles region using local fasciocutaneous island flaps. Methods: This retrospective study was conducted from January 2020 to June 2022. 15 patients with small (≤ 30 cm2) and medium (30-90 cm2) sized soft tissue defects of the tendo-Achilles region, underwent reconstruction with local fasciocutaneous island flaps and had complete medical records, were included. Results: Thirteen patients were male (86.7%). The mean age was 53.2 years. 5 cases (33.3%) had post-traumatic open AT injuries with skin avulsion, while ten patients (66.7%) had suture line complications after open repair of spontaneous Achilles tendon rupture. Defect sizes ranged from 12 to 63 cm2. Reverse sural flap was used in 5 patients (33.3%) and medial plantar flap in 10 patients (66.7%). All flaps survived completely. Complications were detected in 3 patients (20%); 1 distal superficial necrosis in a sural flap and 2 marginal minimal graft loss. Functional outcome was good in 12 patients (80%), excellent in 1 patient (6.7%) and fair in 2 patients (13.3%). 13 patients (86.7%) were satisfied with the cosmetic results. Conclusion: Local fasciocutenous island flaps are reliable and simple solutions for covering small to moderate soft tissue defects overlying the Achilles Tendon, with acceptable functional and cosmetic outcomes.

Green synthesis of silver nanoparticles derived from lemon and pomegranate peel extracts to combat multidrug-resistant bacterial isolates.

BACKGROUND: Multidrug-resistant (MDR) bacteria are acknowledged as one of the main factors contributing to chronic illnesses and fatalities globally. Numerous diseases, including bloodstream infections, pneumonia, urinary tract infections, and surgical site infections, can be brought on by MDR bacteria. Therefore, a crucial topic of continuing research is the development of a novel and different treatment for MDR microbial pathogens. This work is introduce an alternative method for elimination of MDR bacterial isolates which are causative agents of urinary tract infection among people in Egypt. In our study, we need a novel strategy to combat MDR bacteria by green-synthesized metal nanoparticles (MNPs). That is due to the ability of MNPs to penetrate the cell wall and the cell membrane of gram-positive and gram-negative bacteria. METHODS: Clinical isolates of MDR bacteria had their antibiotic susceptibility assessed before being molecularly identified using 16 s rRNA, sequencing, and phylogenetic analysis. Also, genetic profiles of isolated strains were performed using ISSR and SDS-PAGE. Finally, characterized plant-mediated silver nanoparticles derived from lemon and pomegranate peel extracts were evaluated against isolated multidrug-resistant bacterial stains. RESULTS: In our present trial, one-hundred urine samples were collected from 71 females and 29 males complaining of UTI (urinary tract infection) symptoms. One-hundred microbial isolates were isolated, including 88-g negative and only 8-g positive bacteria in addition to four yeast isolates (Candida species). A total of 72% of the isolated bacteria showed MDR activity. The most prevalent MDR bacterial isolates (Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii, Enterococcus faecalis, and Klebsiella pneumoniae) were identified through 16S rDNA PCR sequencing as with accession numbers OP741103, OP741104, OP741105, OP741106, and OP741107, respectively. Lemon and pomegranate-mediated silver nanoparticles [Ag-NPs] were characterized by UV spectroscopy, FTIR, XRD, and TEM with average size 32 and 28 nm, respectively. Lemon and pomegranate-mediated silver nanoparticles [Ag-NPs] showed an inhibitory effect on the selected five MDR isolates at MIC 50 and 30 µg/mL, respectively. These common bacterial isolates were also genetically examined using ISSR PCR, and their total protein level was evaluated using SDS-PAGE, showing the presence of distinct genetic and protein bands for each bacterial species and emphasizing their general and protein composition as a crucial and essential tool in understanding and overcoming MDR behavior in UTI patients. CONCLUSIONS: Lemon and pomegranate-mediated silver nanoparticles [Ag-NPs] were found to have an inhibitory effect on MDR isolates. Therefore, the study suggests that [Ag-NPs] could be a potential treatment for MDR UTI infections caused by the identified bacterial species.

Utilization of Non-Drug-Eluting Devices for Inpatient Percutaneous Coronary Intervention in the United States.

There is a paucity of data on the contemporary use of non-drug-eluting devices (balloon angioplasty or bare-metal stents) in contemporary percutaneous coronary intervention (PCI) in the United States. We utilized the Nationwide Readmissions Database to identify patients hospitalized to undergo PCI with non-drug-eluting devices from 2016 to 2019. The main outcome of interest was the trends in utilization over the study years. Among 1,870,262 PCI procedures, 127,810 (6.8%) were performed with non-drug-eluting devices; 72% of these were in the setting of acute myocardial infarction (MI). The use of non-drug-eluting devices decreased throughout the study period from 12.9% of all PCI in the first quarter of 2016 to 3.4% in the last quarter of 2019 (p <0.001). Factors associated with their use included advanced age and high bleeding risk. Only a small percentage were used as a bridge to coronary artery bypass graft surgery (2%) and for treatment of in-stent restenosis (3%). The in-hospital mortality was 5.8% for the entire cohort and 6.6% when the indication for use was an acute MI. In patients presenting with an acute MI, reinfarction within 30 days was common and occurred in 18% of the patients. In conclusion, the use of non-drug-eluting devices in PCI in the United States decreased from 2016 to 2019. Factors associated with their use included old age and high bleeding risk. Due to suboptimal outcomes in patients currently being treated with non-drug-eluting devices, there remains an unmet clinical need for alternative treatment options.

FolE gene expression for folic acid productivity from optimized and characterized probiotic Lactobacillus delbrueckii.

BACKGROUND: Lactobacillus delbrueckii was one of the most common milk lactic acid bacterial strains (LAB) which characterized as probiotic with many health influencing properties. RESULTS: Among seven isolates, KH1 isolate was the best producer of folic acid with 100 µg/ml after 48 h of incubation; FolE gene expression after 24 h of incubation was in the highest value in case of KH1 with three folds. Lactose was the best carbon source for this KH1, besides the best next isolates KH80 and KH98. The selected three LAB isolates were identified through 16S rDNA as Lactobacillus delbrueckii. These three isolates have high tolerance against acidic pH 2-3; they give 45, 10, and 22 CFUs at pH 3, besides 9, 6, and 4 CFUs at pH2, respectively. They also have resistance against elevated bile salt range 0.1-0.4%. KH1 recorded 99% scavenging against 97.3% 1000 µg/ml ascorbic acid. Docking study exhibits the binding mode of folic acid which exhibited an energy binding of - 8.65 kcal/mol against DHFR. Folic acid formed four Pi-alkyl, Pi-Pi, and Pi-sigma interactions with Ala9, Ile7, Phe34, and Ile60. Additionally, folic acid interacted with Glu30 and Asn64 by three hydrogen bonds with 1.77, 1.76, and 1.96 Å. CONCLUSION: LAB isolates have probiotic properties, antioxidant activity, and desired organic natural source for folic acid supplementation that improve hemoglobin that indicated by docking study interaction.

A Novel Approach of Periodontal Osseous Wall Piezosplitting and Sequential Bone Expansion in Management of Localized Intra-Bony Defects with Wide Angulation-A Randomized Controlled Trial.

Piezoelectric surgical instruments with various mini-sized tips and cutting technology offer a precise and thin cutting line that could allow the wider use of periodontal osseous wall swaging. This randomized controlled trial was designed to investigate the use of a minimally invasive piezo knife to harvest vascularized interseptal bone pedicles in treating intra-bony defects. Sixteen non-smoking patients (mean age 39.6 ± 3.9) with severe chronic periodontitis were randomly assigned into one of two groups (N = 8). The Group 1 (control) patients were treated by bone substitute grafting of the intra-bony defect, whereas the Group 2 patients were treated by intra-bony defect osseous wall swaging (OWS) combined with xenograft filling of the space created by bone tilting. In both groups, the root surfaces were treated with a neutral 24% EDTA gel followed by saline irrigation. Clinical and radiographic measurements were obtained at baseline and 6 months after surgery. The sites treated with osseous wall swaging showed a statistically significant probing-depth reduction and increase in clinical attachment compared with those of the Group 1 patients. The defect base level was significantly reduced for the OWS group compared to that of the Group 1 control. By contrast, the crestal bone level was significantly higher in the OWS group compared to Group 1. The crestal interseptal bone width was significantly higher in Group 2 at 6 months compared to the baseline value and to that of Group 1 (<0.001). The osseous wall swaging effectively improved the clinical hard- and soft-tissue parameters. The use of mini inserts piezo-cutting, sequential bone expanders for osseous wall redirection, and root surface EDTA etching appears to be a reliable approach that could allow the use of OWS at any interproximal dimension.