pi Women's Champions League entries confirmed By www.uefa.com Published On :: Tue, 11 Jun 2019 16:39:00 GMT A record 62 clubs from 50 countries have entered the 2019/20 edition: see who is aiming for Vienna. Full Article general
pi Developing a Growth Mindset in Our Students By blogs.edweek.org Published On :: Mon, 06 May 2019 00:00:00 +0000 As we continue to build the leaders of the future, we must ensure their own belief in their abilities. This is the only way we can ensure their successful futures and ours. Full Article Growth+Mindset
pi Rock 'n' roll pioneer Little Richard dies at age 87: Rolling Stone By www.reuters.com Published On :: Sat, 09 May 2020 14:55:00 GMT Source: www.reuters.com - Saturday, May 09, 2020 Little Richard, the self-proclaimed "architect of rock 'n' roll" who built his ground-breaking sound with a boiling blend of boogie-woogie, rhythm and blues and gospel, died on Saturday at the age of 87, Rolling Stone magazine reported.All Related Full Article
pi As dating apps try to pivot to virtual events, some users are trying to get people to violate social distancing rules By feedproxy.google.com Published On :: Sat, 09 May 2020 12:50:00 GMT Source: www.businessinsider.com - Saturday, May 09, 2020 Dating apps like Tinder, Bumble, and Hinge have reported increased use amid the coronavirus pandemic, while touting virtual dating alternatives for users instead of meeting up in person. Swaths of users are still encouraging matches to break quarantine to have sex and go on dates, despite social distancing guidelines and fines to comply with them. An illustrator on Instagram has been collecting screenshots of these situations, and told Business Insider that users will brand themselves as "badasses," dispute the effectiveness of isolating, and lash out in anger and hurl abusive language when they're rejected. Spokespeople for Grindr, Tinder and Bumble told Business Insider they've informed users to adhere to social-distancing guidelines, but did not respond to inquiries about actions they're taking against users in places where violating lockdown orders can be against the law. Visit Business Insider's homepage for more stories . As millions remain confined to their homes to prevent the spread of coronavirus, the desire for human contact and connection has risen dramatically and led some to search for ways to break those social distancing rules. Popular dating apps — including Tinder , Bumble , and Hinge — have reported significant increases during the outbreak of swiping activity, matches between users, and messages exchanged. It's also led to the introduction of a breed of users who are interested in shirking lockdown orders, anAll Related Full Article
pi 5 Things I Found On Ancipient.com By ninetymilesfromtyranny.blogspot.com Published On :: Sat, 09 May 2020 12:36:00 GMT Source: ninetymilesfromtyranny.blogspot.com - Saturday, May 09, 2020 What is Ancipient.com ? It Is A Pro-American (Nationalist), Pro-Trump, Pro-American Exceptionalism, And Pro-Western Values automated news aggregation website. Ancipient.com is an automated, curated, rules based news aggregation website. If I wanted it to sound sexy, I could say it uses artificial intelligence to select news articles. It does not. It uses negative and positive keywords, data rules and curation to select news articles. When other news aggregaters have not updated any new news in hours, you can always depend on my trusty robot ancipient to work 24/7 to keep you updated. Ancipient is a new word, it means: an·cip·i·ent /anˈsipēənt/ adjective in an initial stage of understanding; beginning to understand or learn. "he could feel ancipient knowledge growing" (of a person) learning, and improving their understanding on a topic or topics. Oh Yeah, The Links I Promised: Russia, China spinning coronavirus conspiracies to blame West Georgetown sues US for not giving money to illegal immigrant families Release the hounds! Singapore deploys ROBOT DOG to help enforce social distancing (PHOTOS, VIDEO) 'Palestinian' Authority hiding terrorist salaries from donor countries in financial reports Sens. Cotton, Cruz, Hawley & Grassley Press Trump to Suspend Most Visas Take a look at Ancipient.com and check it out!All Related Full Article
pi Cremer group developing sensors to detect coronavirus in enclosed spaces By news.psu.edu Published On :: Tue, 28 Apr 2020 10:06 -0400 Professor of Chemistry Paul Cremer is developing a biosensor platform that could be used to perform real-time, continuous detection of SARS-CoV-2, the virus that causes COVID-19. Full Article
pi Los ISPs Más Rápidos 2015: Mexico By www.pcmag.com Published On :: Ya paso otro año así que le daremos otro vistazo a nuestra busca perpetua por el ISP mas veloz en México Full Article
pi Maniche's Portugal piledriver By www.uefa.com Published On :: Mon, 16 Jan 2012 08:02:00 GMT We go back to UEFA EURO 2004 as Maniche recalls his memorable semi-final strike. Full Article
pi Cirilo's pivot guide By www.uefa.com Published On :: Mon, 06 Feb 2012 11:38:00 GMT The Russia and MFK Dinamo Moskva forward offers you a futsal masterclass. Full Article
pi Fin24.com | Eyeing Saudi riches, Wall Street gets back to business as usual despite Khashoggi aftermath By www.fin24.com Published On :: Sun, 04 Nov 2018 13:23:43 +0200 For a moment, Wall Street seemed to be inching away from Saudi Arabia. Now, it’s already inching back. Full Article
pi Fin24.com | OPINION | Coronavirus survival guide for entrepreneurs: Get to rational quickly By www.fin24.com Published On :: Sun, 26 Apr 2020 17:01:03 +0200 Allon Raiz is CEO of business incubator Raizcorp. In this series of articles, he offers entrepreneurs advice on surviving a crisis. Full Article
pi Fin24.com | OPINION | Banks could be the next Big Tech By www.fin24.com Published On :: Mon, 27 Apr 2020 09:14:39 +0200 Banks can be as powerful and valued as the big technology firms. Yes, those trillion-dollar titans. Full Article
pi Fin24.com | OPINION | Could coronavirus threaten the benefits of stokvels for SA savers? By www.fin24.com Published On :: Wed, 29 Apr 2020 15:20:16 +0200 Stokvels are an important strategy for financial survival, so it's crucial to find a way to make them work during the pandemic, says Dr Norman Chivasa. Full Article
pi Fin24.com | OPINION | Coronavirus survival guide for entrepreneurs: Build an opportunity matrix By www.fin24.com Published On :: Wed, 29 Apr 2020 18:34:13 +0200 Now, more than ever, we need to be listening for market signals and ensuring that our businesses are primed to both take advantage of opportunities and to mitigate risks, says Allon Raiz. Full Article
pi Fin24.com | OPINION | Time to recover like a millennial By www.fin24.com Published On :: Thu, 30 Apr 2020 18:05:04 +0200 For companies to survive and even thrive beyond the coronavirus pandemic, they’re going to have think more like the millennial generation, says Dr Anushka Bogdanov. Full Article
pi Fin24.com | OPINION | Inequality, the part of the scary movie they don't show you By www.fin24.com Published On :: Fri, 01 May 2020 17:17:55 +0200 There’s always been massive inequality in South Africa, but those who have the money and power still aren’t getting it, says Carmen Williams. Full Article
pi Fin24.com | OPINION | Air travel shutdowns herald peak oil demand By www.fin24.com Published On :: Thu, 30 Apr 2020 20:53:27 +0200 The future choices made by airlines matter a great deal for the oil market, say Liam Denning and Brooke Sutherland. Full Article
pi Fin24.com | OPINION | What the theft of the Mona Lisa teaches us about investing By www.fin24.com Published On :: Sun, 03 May 2020 07:35:02 +0200 Handyman Vincenzo Perugia walked out of the Louvre with a rolled-up painting under his smock. What ensured should be a lesson to us all, says Hannes Viljoen. Full Article
pi Fin24.com | OPINION | Beer for health workers, fashion face masks: How businesses innovate during Covid-19 By www.fin24.com Published On :: Mon, 04 May 2020 17:44:02 +0200 Where businesses are fighting to survive, agility is the name of the game, says Mignon Reynecke. Full Article
pi Fin24.com | OPINION | Why coronavirus is punishing the economy more than Spanish flu By www.fin24.com Published On :: Thu, 07 May 2020 06:01:32 +0200 To history buffs, the Covid-19 pandemic must seem eerily familiar, says Noah Smith. Full Article
pi Fin24.com | OPINION | Tracking the spread of fake news in SA By www.fin24.com Published On :: Fri, 08 May 2020 15:19:32 +0200 A team of social media analysts at an SA business school is tracking misinformation, disinformation, distortion and lies online. Full Article
pi Fin24.com | OPINION | When coronavirus is a matter of life or debt By www.fin24.com Published On :: Fri, 08 May 2020 19:32:08 +0200 Argentina is a case study in what happens when an economy already on its knees implements an aggressive lockdown, says Mac Margolis. Full Article
pi UN peacekeeping: Congo on the brink of full-scale war By feedproxy.google.com Published On :: Sun, 25 Jul 2004 22:00:00 GMT Full Article
pi Escaping the Conflict Trap: Promoting Good Governance in the Congo By feedproxy.google.com Published On :: Wed, 19 Jul 2006 22:00:00 GMT Full Article
pi Burundi: Arusha Spirit Must Prevail By feedproxy.google.com Published On :: Sat, 30 Aug 2008 22:00:00 GMT Full Article
pi Chad: Escaping from the Oil Trap By feedproxy.google.com Published On :: Tue, 25 Aug 2009 22:00:00 GMT Full Article
pi Le gouvernement tchadien est tombé dans le piège pétrolier By feedproxy.google.com Published On :: Fri, 04 Sep 2009 22:00:00 GMT Full Article
pi Central African Republic: Keeping the Dialogue Alive By feedproxy.google.com Published On :: Mon, 11 Jan 2010 23:00:00 GMT Full Article
pi Congo: No Stability in Kivu despite Rapprochement with Rwanda By feedproxy.google.com Published On :: Mon, 15 Nov 2010 23:00:00 GMT The attempt by Congo and Rwanda to end the deadly conflict in eastern Congo by a secret presidential deal and military force is failing and must be changed fundamentally by the Kinshasa government and the international community. Full Article
pi Imaginación para salvar República Centroafricana. Cómo actuar con rapidez y eficacia para evitar la somalización del país. By feedproxy.google.com Published On :: Sun, 24 Nov 2013 23:00:00 GMT Los conflictos en los países pequeños suelen agravarse debido a la indiferencia internacional. Sin embargo, en el caso de la República Centroafricana (RCA), el problema es ligeramente distinto. Hay una importante presencia internacional en este Estado, pero los actores principales han decidido mantenerse al margen y esperar en vez de intervenir activamente en la crisis. Full Article
pi The CAR Crisis: Thinking Beyond Traditional Peacekeeping By feedproxy.google.com Published On :: Mon, 16 Jun 2014 22:00:00 GMT The crisis that has been occurring in CAR is certainly the most dramatic in its history: more than 600 000 Central Africans are internally displaced or sought refuge in neighbouring countries; according to the United Nations, 1.7 million live in a constant situation of food insecurity and 878 000 need immediate medical assistance; Muslim communities are fleeing Bangui and the western region, subsistence economy no longer exists and the de facto partition of the country, caused by the sectarian violence, is gradually becoming a reality. Full Article
pi Cameroon: Africa's Pivot By feedproxy.google.com Published On :: Sun, 31 May 2015 22:00:00 GMT Since President Paul Biya came to power in 1982, Cameroon has been a sleepy regime with a soft and aging dictator, a nation all but forgotten in a remote corner of the African continent. This has dramatically changed with the spillover of Boko Haram from Nigeria into Cameroon in 2014 and its transformation into a regional threat. Now there is not a single day without reports of Boko Haram attacks in northern Cameroon. Even before it realized what it meant, the Cameroonian regime had become part of the fight against terrorism. After initially downplaying the problem, Cameroon’s leaders are now discovering the challenges and dangers of this new war. This rising, external threat sheds a new light on a forgotten country with a strategic position in Africa. The geography of Cameroon is both its blessing and its curse—a pivot between West and Central Africa, divided by language, culture, and history, its very existence depending on a regional stability so often beyond its grasp. Full Article
pi Élections en 2015 : un piège pour la Centrafrique By feedproxy.google.com Published On :: Mon, 21 Sep 2015 22:00:00 GMT En Centrafrique, la course aux élections qui prévoit des scrutins présidentiel et législatif avant la fin de l’année est aussi irréaliste que dangereuse. Alors que le plan initial de la transition a complètement déraillé, l’obstination des internationaux, et plus particulièrement de la France, à faire voter les Centrafricains à l’ombre des groupes armés, avec une administration territoriale squelettique et des haines inter-communautaires tenaces ressemble plus à une fuite en avant qu’à un processus de transition accompli. Full Article
pi Topics By feedproxy.google.com Published On :: Sat, 08 May 2010 00:00:00 +0000 Full Article Assessment+Accountability+Achievement
pi Assessment of drug resistance during phase 2b clinical trials of presatovir in adults naturally infected with respiratory syncytial virus [Antiviral Agents] By aac.asm.org Published On :: 2020-02-18T08:15:40-08:00 Background: This study summarizes drug resistance analyses in 4 recent phase 2b trials of the respiratory syncytial virus (RSV) fusion inhibitor presatovir in naturally infected adults.Methods: Adult hematopoietic cell transplant (HCT) recipients, lung transplant recipients, or hospitalized patients with naturally acquired, laboratory-confirmed RSV infection were enrolled in 4 randomized, double-blind, placebo-controlled studies with study-specific presatovir dosing. Full-length RSV F sequences amplified from nasal swabs obtained at baseline and postbaseline were analyzed by population sequencing. Substitutions at RSV fusion inhibitor resistance-associated positions are reported.Results: Genotypic analyses were performed on 233 presatovir-treated and 149 placebo-treated subjects. RSV F variant V127A was present in 8 subjects at baseline. Population sequencing detected treatment-emergent substitutions in 10/89 (11.2%) HCT recipients with upper and 6/29 (20.7%) with lower respiratory tract infection, 1/35 (2.9%) lung transplant recipients, and 1/80 (1.3%) hospitalized patients treated with presatovir; placebo-treated subjects had no emergent resistance-associated substitutions. Subjects with substitutions at resistance-associated positions had smaller decreases in viral load during treatment relative to those without, but similar clinical outcomes.Conclusions: Subject population type and dosing regimen may have influenced RSV resistance development during presatovir treatment. Subjects with vs without genotypic resistance development had decreased virologic responses but comparable clinical outcomes. Full Article
pi A histone methyltransferase inhibitor can reverse epigenetically acquired drug resistance in the malaria parasite Plasmodium falciparum [Mechanisms of Resistance] By aac.asm.org Published On :: 2020-03-16T08:17:37-07:00 Malaria parasites invade and replicate within red blood cells (RBCs), extensively modifying their structure and gaining access to the extracellular environment by placing the plasmodial surface anion channel (PSAC) into the RBC membrane. Expression of members of the cytoadherence linked antigen gene 3 (clag3) family is required for PSAC activity, a process that is regulated epigenetically. PSAC is a well-established route of uptake for large, hydrophilic antimalarial compounds and parasites can acquire resistance by silencing clag3 gene expression, thereby reducing drug uptake. We found that exposure to sub-IC50 concentrations of the histone methyltransferase inhibitor chaetocin caused substantial changes in both clag3 gene expression and RBC permeability, reversing acquired resistance to the antimalarial compound blasticidin S that is transported through PSAC. Chaetocin treatment also altered progression of parasites through their replicative cycle, presumably by changing their ability to modify chromatin appropriately to enable DNA replication. These results indicate that targeting histone modifiers could represent a novel tool for reversing epigenetically acquired drug resistance in P. falciparum. Full Article
pi An engineered double lipid II binding motifs-containing lantibiotic displays potent and selective antimicrobial activity against E. faecium [Chemistry; Biosynthesis] By aac.asm.org Published On :: 2020-03-16T08:17:37-07:00 Lipid II is an essential precursor of the bacterial cell wall biosynthesis and thereby an important target for various antibiotics. Several lanthionine-containing peptide antibiotics target lipid II with lanthionine-stabilized lipid II-binding motifs. Here, we used the biosynthesis system of the lantibiotic nisin to synthesize a two lipid II binding motifs-containing lantibiotic, termed TL19, which contains the N-terminal lipid II binding motif of nisin and the distinct C-terminal lipid II binding motif of one peptide of the two-component haloduracin (i.e. HalA1). Further characterization demonstrated that (i) TL19 exerts 64-fold stronger antimicrobial activity against E. faecium than nisin (1-22), which has only one lipid II binding site, and (ii) both the N- and C-terminal domains are essential for the potent antimicrobial activity of TL19, as evidenced by mutagenesis of each single and double domains. These results show the feasibility of a new approach to synthesize potent lantibiotics with two different lipid II binding motifs to treat specific antibiotic-resistant pathogens. Full Article
pi Significant efficacy of single low dose primaquine compared to stand alone artemisinin combination therapy in reducing gametocyte carriage in Cambodian patients with uncomplicated multidrug resistant Plasmodium falciparum malaria [Epidemiology and Surveil By aac.asm.org Published On :: 2020-03-16T08:17:37-07:00 Since 2012, single low dose of primaquine (SLDPQ, 0.25mg/kg) has been recommended with artemisinin-based combination therapies, as first-line treatment of acute uncomplicated Plasmodium falciparum malaria, to interrupt its transmission, especially in low transmission settings of multidrug, including artemisinin, resistance. Policy makers in Cambodia have been reluctant to implement this recommendation due to primaquine safety concerns and lack of data on its efficacy.In this randomized controlled trial, 109 Cambodians with acute uncomplicated P. falciparum malaria received dihydroartemisinin-piperaquine (DP) alone or combined with SLDPQ on the first treatment day. Transmission-blocking efficacy of SLDPQ was evaluated on Days 0, 1, 2, 3, 7, 14, 21, 28 and recrudescence by reverse transcriptase polymerase chain reaction (RT-PCR) (gametocyte prevalence) and membrane-feeding assays with Anopheles minimus mosquitoes (gametocyte infectivity). Without the influence of recrudescent infections, DP+SLDPQ reduced gametocyte carriage 3 fold compared to DP. Of 48 patients tested on Day 0, only three patients were infectious to mosquitoes (~6%). Post-treatment, three patients were infectious: on D14 (3.5%, 1/29), and on the first and seventh day of recrudescence (8.3%, 1/12 for each); this overall low infectivity precluded our ability to assess its transmission blocking efficacy.Our study confirms effective gametocyte clearance of SLDPQ when combined with DP in multidrug resistant P. falciparum and the negative impact of recrudescent infections due to poor DP efficacy. Artesunate-mefloquine (ASMQ) has replaced DP and ASMQ-SLDPQ has been deployed to treat all P. falciparum symptomatic patients to further support the elimination of multidrug resistant P. falciparum in Cambodia. Full Article
pi Comparison of Cefepime/Cefpirome and Carbapenem Therapy for Acinetobacter Bloodstream Infection: A Multicentre Study [Clinical Therapeutics] By aac.asm.org Published On :: 2020-03-16T08:17:37-07:00 Carbapenems are currently the preferred agents for the treatment of serious Acinetobacter infections. However, whether cefepime/cefpirome can be used to treat Acinetobacter bloodstream infection (BSI) if it is active against the causative pathogens is not clear. This study aimed to compare the efficacy of cefepime/cefpirome and carbapenem monotherapy in patients with Acinetobacter BSI. The population included 360 patients with monomicrobial Acinetobacter BSI receiving appropriate antimicrobial therapy admitted to four medical centres in Taiwan in 2012–2017. The predictors of 30-day mortality were determined by Cox regression analysis. The overall 30-day mortality rate in the appropriate antibiotic treatment group was 25.0% (90/360 patients), respectively. The crude 30-day mortality rates for cefepime/cefpirome and carbapenem therapy were 11.5% (7/61 patients) and 26.3% (21/80 patients), respectively. The patients receiving cefepime/cefpirome/carbapenem therapy were infected by Acinetobacter nosocomialis (51.8%), A. baumannii (18.4%) and A. pittii (12.1%). After adjusting for age, Sequential Organ Failure Assessment (SOFA) score, invasive procedures, and underlying diseases, cefepime/cefpirome therapy was not independently associated with a higher or lower 30-day mortality compared to the carbapenem therapy. SOFA score (hazard ratio [HR], 1.324; 95% confidence interval [CI], 1.137–1.543; P < 0.001) and neutropenia (HR, 7.060; 95% CI, 1.607–31.019; P = 0.010) were independent risk factors for 30-day mortality of patients receiving cefepime/cefpirome or carbapenem monotherapy. The incidence density of 30-day mortality for cefepime/cefpirome versus carbapenem therapy was 0.40% versus 1.04%. The therapeutic response of cefepime/cefpirome therapy was comparable to that of carbapenems among patients with Acinetobacter BSI receiving appropriate antimicrobial therapy. Full Article
pi Fosmanogepix (APX001) is Effective in the Treatment of Pulmonary Murine Mucormycosis Due to Rhizopus arrhizus [Experimental Therapeutics] By aac.asm.org Published On :: 2020-03-23T08:47:35-07:00 Mucormycosis is a life-threatening infection with high mortality that occurs predominantly in immunocompromised patients. Manogepix (MGX) is a novel antifungal that targets Gwt1, an early step in the conserved glycosylphosphotidyl inositol (GPI) post-translational modification pathway of surface proteins in eukaryotic cells. Inhibition of inositol acylation by MGX results in pleiotropic effects including inhibition of maturation of GPI-anchored proteins necessary for growth and virulence. MGX has been previously shown to have in vitro activity against some strains of Mucorales. Here we assessed the in vivo activity of the prodrug fosmanogepix, currently in clinical development for the treatment of invasive fungal infections, against two Rhizopus arrhizus strains with high (4.0 μg/ml) and low (0.25 μg/ml) minimum effective concentration (MEC) values. In both invasive pulmonary infection models, treatment of mice with 78 mg/kg or 104 mg/kg fosmanogepix, along with 1-aminobenzotriazole to enhance the serum half-live of MGX in mice, significantly increased median survival time and prolonged overall survival by day 21 post infection when compared to placebo. In addition, administration of fosmanogepix resulted in a 1-2 log reduction in both lung and kidney fungal burden. For the 104 mg/kg fosmanogepix dose, tissue clearance and survival were comparable to clinically relevant doses of isavuconazole (ISA), which is FDA approved for the treatment of mucormycosis. These results support continued development of fosmanogepix as a first in class treatment for invasive mucormycosis. Full Article
pi Reconciling the potentially irreconcilable? Genotypic and phenotypic amoxicillin-clavulanate resistance in Escherichia coli [Mechanisms of Resistance] By aac.asm.org Published On :: 2020-03-23T08:47:35-07:00 Resistance to amoxicillin-clavulanate, a widely used beta-lactam/beta-lactamase inhibitor combination antibiotic, is rising globally, yet susceptibility testing remains challenging. To test whether whole-genome sequencing (WGS) could provide a more reliable assessment of susceptibility than traditional methods, we predicted resistance from WGS for 976 E. coli bloodstream infection isolates from Oxfordshire, UK, comparing against phenotypes from the BD Phoenix (calibrated against EUCAST guidelines). 339/976 (35%) isolates were amoxicillin-clavulanate resistant. Predictions based solely on beta-lactamase presence/absence performed poorly (sensitivity 23% (78/339)) but improved when genetic features associated with penicillinase hyper-production (e.g. promoter mutations, copy number estimates) were considered (sensitivity 82% (277/339); p<0.0001). Most discrepancies occurred in isolates with peri-breakpoint MICs. We investigated two potential causes; the phenotypic reference and the binary resistant/susceptible classification. We performed reference standard, replicated phenotyping in a random stratified subsample of 261/976 (27%) isolates using agar dilution, following both EUCAST and CLSI guidelines, which use different clavulanate concentrations. As well as disagreeing with each other, neither agar dilution phenotype aligned perfectly with genetic features. A random-effects model investigating associations between genetic features and MICs showed that some genetic features had small, variable and additive effects, resulting in variable resistance classification. Using model fixed-effects to predict MICs for the non-agar dilution isolates, predicted MICs were in essential agreement (±1 doubling dilution) with observed (BD Phoenix) MICs for 691/715 (97%) isolates. This suggests amoxicillin-clavulanate resistance in E. coli is quantitative, rather than qualitative, explaining the poorly reproducible binary (resistant/susceptible) phenotypes and suboptimal concordance between different phenotypic methods and with WGS-based predictions. Full Article
pi Metronidazole-Treated Porphyromonas gingivalis Persisters Invade Human Gingival Epithelial Cells and Perturb Innate Responses [Mechanisms of Resistance] By aac.asm.org Published On :: 2020-03-23T08:47:35-07:00 Periodontitis as a biofilm-associated inflammatory disease is highly prevalent worldwide. It severely affects oral health and yet closely links to systemic diseases like diabetes and cardiovascular disease. Porphyromonas gingivalis as a ‘keystone' periodontopathogen drives the shift of microbe-host symbiosis to dysbiosis, and critically contributes to the pathogenesis of periodontitis. Persisters are a tiny subset of biofilm-associated microbes highly tolerant to lethal treatment of antimicrobials, and notably metronidazole-tolerant P. gingivalis persisters have recently been identified by our group. This study further explored the interactive profiles of metronidazole-treated P. gingivalis persisters (M-PgPs) with human gingival epithelial cells (HGECs). P. gingivalis cells (ATCC 33277) at stationary phase were treated with lethal dosage of metronidazole (100 μg/ml, 6 hours) for generating M-PgPs. The interaction of M-PgPs with HGECs was assessed by microscopy, flow cytometry, cytokine profiling and qPCR. We demonstrated that the overall morphology and ultra-cellular structure of M-PgPs remained unchanged. Importantly, M-PgPs maintained the capabilities to adhere to and invade into HGECs. Moreover, M-PgPs significantly suppressed pro-inflammatory cytokine expression in HGECs at a comparable level with the untreated P. gingivalis cells, through the thermo-sensitive components. The present study reveals that P. gingivalis persisters induced by lethal treatment of antibiotics could maintain their capabilities to adhere to and invade into human gingival epithelial cells, and perturb the innate host responses. Novel strategies and approaches need to be developed for tackling P. gingivalis and favourably modulating the dysregulated immuno-inflammatory responses for oral/periodontal health and general wellbeing. Full Article
pi Rapid-Release Griffithsin Fibers for the Dual Prevention of HSV-2 and HIV-1 Infections [Antiviral Agents] By aac.asm.org Published On :: 2020-03-30T10:04:32-07:00 The biologic Griffithsin (GRFT) has recently emerged as a candidate to safely prevent sexually transmitted infections (STIs) including human immunodeficiency virus (HIV-1) and herpes simplex virus 2 (HSV-2). However, to date, there are few delivery platforms that are available to effectively deliver biologics to the female reproductive tract (FRT). The goal of this work was to evaluate rapid-release polyethylene oxide (PEO), polyvinyl alcohol (PVA) and polyvinylpyrrolidone (PVP) fibers, that incorporate GRFT, in in vitro (HIV-1 and HSV-2) and in vivo (HSV-2) infection models. GRFT loading was determined via ELISA, and the bioactivity of GRFT fibers was assessed using in vitro HIV-1 pseudovirus and HSV-2 plaque assays. Afterwards, the efficacy of GRFT fibers was assessed in a murine model of lethal HSV-2 infection. Finally, murine reproductive tracts and vaginal lavages were evaluated for histology and cytokine expression, 24 and 72 hr after fiber administration, to determine safety. All rapid-release formulations achieved high levels of GRFT incorporation and were completely efficacious against in vitro HIV-1 and HSV-2 infections. Importantly, all rapid-release GRFT fibers provided potent protection in a murine model of HSV-2 infection. Moreover, histology and cytokine levels, evaluated from collected murine reproductive tissues and vaginal lavages treated with blank fibers, showed no increased cytokine production or histological aberrations, demonstrating the preliminary safety of rapid-release GRFT fibers in vaginal tissue. Full Article
pi Pharmacokinetics-pharmacodynamics of enmetazobactam combined with cefepime in a neutropenic murine thigh infection model [Pharmacology] By aac.asm.org Published On :: 2020-04-06T08:49:25-07:00 Third-generation cephalosporin (3GC)-resistant Enterobacteriaceae are classified as critical priority pathogens, with extended-spectrum β-lactamases (ESBLs) as principal resistance determinants. Enmetazobactam (formerly AAI101) is a novel ESBL inhibitor developed in combination with cefepime for empiric treatment of serious Gram-negative infections in settings where ESBLs are prevalent. Cefepime-enmetazobactam has been investigated in a phase 3 trial in patients with complicated urinary tract infections or acute pyelonephritis. This study examined pharmacokinetic-pharmacodynamic (PK-PD) relationships of enmetazobactam, in combination with cefepime, for ESBL-producing isolates of Klebsiella pneumoniae in 26-hour murine neutropenic thigh infection models. Enmetazobactam dose fractionation identified time above a free threshold concentration (fT > CT) as the PK-PD index predictive of efficacy. Nine ESBL-producing isolates of K. pneumoniae, resistant to cefepime and piperacillin-tazobactam, were included in enmetazobactam dose-ranging studies. The isolates encoded CTX-M-type, SHV-12, DHA-1 and OXA-48 β-lactamases and covered a cefepime-enmetazobactam MIC range from 0.06 to 2 μg/ml. Enmetazobactam restored the efficacy of cefepime against all isolates tested. Sigmoid curve fitting across the combined set of isolates identified enmetazobactam PK-PD targets for stasis and for a 1-log10 bioburden reduction of 8% and 44% fT > 2 μg/ml, respectively, with a concomitant cefepime PK-PD target of 40 – 60% fT > cefepime-enmetazobactam MIC. These findings support clinical dose selection and breakpoint setting for cefepime-enmetazobactam. Full Article
pi Pharmacodynamics of Cefepime Combined with the Novel Extended-Spectrum Beta Lactamase (ESBL) Inhibitor Enmetazobactam for Murine Pneumonia caused by ESBL-Producing Klebsiella pneumoniae [Pharmacology] By aac.asm.org Published On :: 2020-04-06T08:49:25-07:00 Klebsiella pneumoniae that produce extended spectrum beta lactamases (ESBLs) are a persistent public health threat. There are relatively few therapeutic options and there is undue reliance on carbapenems. Alternative therapeutic options are urgently required. A combination of cefepime and the novel beta lactamase inhibitor enmetazobactam is being developed for treatment of serious infections caused by ESBL-producing organisms. The pharmacokinetics-pharmacodynamics (PK-PD) of cefepime-enmetazobactam against ESBL-producing K. pneumoniae was studied in a neutropenic murine pneumonia model. Dose ranging studies were performed. Dose fractionation studies were performed to define the relevant PD index for the inhibitor. The partitioning of cefepime and enmetazobactam into the lung was determined by comparing area under the concentration time curve (AUC) in plasma and epithelial lining fluid. The magnitude of drug exposure for cefepime-enmetazobactam required for logarithmic killing in the lung was defined using 3 ESBL-producing strains. Cefepime 100 mg/kg q8h i.v. had minimal antimicrobial effect. When this background regimen of cefepime was combined with enmetazobactam half-maximal effect was induced with enmetazobactam 4.71 mg/kg q8h i.v. The dose fractionation study suggest both fT>threshold and fAUC:MIC are potentially relevant PD indices. The AUCELF:AUCplasma for cefepime and enmetazobactam was 73.4% and 61.5%, respectively. A ≥2-log kill in the lung was achieved with a plasma and ELF cefepime fT>MIC of ≥20% and enmetazobactam fT>2 mg/L of ≥20% of the dosing interval. These data and analyses provide the underpinning evidence for the combined use of cefepime and enmetazobactam for nosocomial pneumonia. Full Article
pi Novel ionophores active against La Crosse virus identified through rapid antiviral screening [Antiviral Agents] By aac.asm.org Published On :: 2020-04-13T08:15:30-07:00 Bunyaviruses are significant human pathogens, causing diseases ranging from hemorrhagic fevers to encephalitis. Among these viruses, La Crosse virus (LACV), a member of the California serogroup, circulates in the eastern and midwestern United States. While LACV infection is often asymptomatic, dozens of cases of encephalitis are reported yearly. Unfortunately, no antivirals have been approved to treat LACV infection. Here, we developed a method to rapidly test potential antivirals against LACV infection. From this screen, we identified several potential antiviral molecules, including known antivirals. Additionally, we identified many novel antivirals that exhibited antiviral activity without affecting cellular viability. Valinomycin, a potassium ionophore, was among our top targets. We found that valinomycin exhibited potent anti-LACV activity in multiple cell types in a dose-dependent manner. Valinomycin did not affect particle stability or infectivity, suggesting that it may preclude virus replication by altering cellular potassium ions, a known determinant of LACV entry. We extended these results to other ionophores and found that the antiviral activity of valinomycin extended to other viral families including bunyaviruses (Rift Valley fever virus, Keystone virus), enteroviruses (Coxsackievirus, rhinovirus), flavirivuses (Zika), and coronaviruses (HCoV-229E and MERS-CoV). In all viral infections, we observed significant reductions in virus titer in valinomycin-treated cells. In sum, we demonstrate the importance of potassium ions to virus infection, suggesting a potential therapeutic target to disrupt virus replication.Importance No antivirals are approved for the treatment of bunyavirus infection. The ability to rapidly screen compounds and identify novel antivirals is one means to accelerate drug discovery for viruses with no approved treatments. We used this approach to screen hundreds of compounds against La Crosse virus, an emerging bunyavirus that causes significant disease, including encephalitis. We identified several known and previously unidentified antivirals. We focused on a potassium ionophore, valinomycin, due to its promising in vitro antiviral activity. We demonstrate that valinomycin, as well as a selection of other ionophores, exhibits activity against La Crosse virus as well as several other distantly related bunyaviruses. We finally observe that valinomycin has activity against a wide array of human viral pathogens, suggesting that disrupting potassium ion homeostasis with valinomycin may be a potent host pathway to target to quell virus infection. Full Article
pi Population pharmacokinetics of piperacillin following continuous infusion in critically ill patients: Impact of renal function on target attainment [Clinical Therapeutics] By aac.asm.org Published On :: 2020-04-13T08:15:30-07:00 Pharmacokinetic changes are often seen in patients with severe infections. Administration by continuous infusion has been suggested to optimize antibiotic exposure and pharmacokinetic/pharmacodynamic (PK/PD) target attainment for β-lactams. In an observational study, unbound piperacillin concentrations (n=196) were assessed in 78 critically ill patients following continuous infusion of piperacillin/tazobactam (ratio 8:1). The initial dose of 8, 12 or 16 g (piperacillin component) was determined by individual creatinine clearance (CRCL). Piperacillin concentrations were compared to the EUCAST clinical breakpoint MIC for Pseudomonas aeruginosa (16 mg/L), and the following PK/PD targets were evaluated: 100% fT>1xMIC and 100% fT>4xMIC. A population pharmacokinetic model was developed using NONMEM 7.4.3 consisting of a one-compartment disposition model with linear elimination separated into non-renal and renal (linearly increasing with patient CRCL) clearances. Target attainment was predicted and visualized for all individuals based on the utilized CRCL dosing algorithm. The target of 100% fT>1xMIC was achieved for all patients based on the administered dose, but few patients achieved the target of 100% fT>4xMIC. Probability of target attainment for a simulated cohort of patients showed, that increasing the daily dose by 4 g increments (piperacillin component) did not result in substantially improved target attainment for the 100% fT>4xMIC target. To conclude, in patients with high CRCL combined with high-MIC bacterial infections, even a CI regimen with a daily dose of 24 g may be insufficient to achieve therapeutic concentrations. Full Article
pi Epidemiological study on prevalence, serovar diversity, multi-drug resistance and CTX-M-type extended-spectrum {beta}-lactamases of Salmonella spp. from patients with diarrhea, food of animal origin, and pets in several provinces of China [Epidemiology an By aac.asm.org Published On :: 2020-04-20T08:36:46-07:00 A total of 2,283 Salmonella spp. isolates were recovered from 18,334 samples including patients with diarrhea, food of animal origin and pets across 5 provinces of China. The highest prevalence of Salmonella spp. was detected in chicken meats (39.3%, 486/1,237). Fifteen serogroups and 66 serovars were identified, with Typhimurium and Enteritidis being the most dominant. Most (85.5%, 1,952/2,283) isolates exhibited resistant to ≥ 1 antimicrobial and 56.4% were multi-drug resistant (MDR). A total of 222 isolates harbored extended-spectrum β-lactamases (ESBLs), 200 of which were CTX-M-type that were mostly detected from chicken meat and turtle fecal. Overall, eight blaCTX-M genes were identified, with blaCTX-M-65, blaCTX-M-123, blaCTX-M-14, blaCTX-M-79, and blaCTX-M-130 being the most prevalent. Totally, 166 of the 222 ESBL-producing isolates had amino acid substitutions in GyrA (S83Y, S83F, D87G, D87N, and D87Y) and ParC (and S80I), whilst the PMQR-encoding genes oqxA/B, qepA, and qnrB/S were detected in almost all isolates. Of the fifteen sequence types (STs) identified in the 222 ESBLs, ST17, ST11, ST34, and ST26 ranked among the top 5 in the number of isolates. Our study revealed considerable serovars diversity, high prevalence of co-occurrence of MDR determinants, including CTX-M-type ESBLs, QRDRs mutations and PMQR genes. This is the first report of CTX-M-130 Salmonella spp. from patients with diarrhea and QRDRs mutations from turtle fecal samples. Our study emphasizes the importance of actions, both in the health care settings and in the veterinary medicine sector, to control the dissemination of MDR, especially the CTX-M Salmonella spp. isolates. Full Article
pi Genetic Mutations Associated with Isoniazid Resistance in Mycobacterium tuberculosis in Mongolia [Epidemiology and Surveillance] By aac.asm.org Published On :: 2020-04-20T08:36:47-07:00 Globally, mutations in the katG gene account for the majority of isoniazid-resistant strains of Mycobacterium tuberculosis. Buyankhishig et al analyzed a limited number of Mycobacterium tuberculosis strains in Mongolia and found that isoniazid resistance was mainly attributable to inhA mutations. The GenoType® MTBDRplus assay was performed for isolates collected in the First National Tuberculosis Prevalence Survey and the Third Anti-Tuberculosis Drug Resistance Survey to investigate genetic mutations associated with isoniazid resistance in Mycobacterium tuberculosis in Mongolia. Of the 409 isoniazid-resistant isolates detected by the GenoType® MTBDRplus assay, 127 (31.1%) were resistant to rifampicin, 294 (71.9%) had inhA mutations without katG mutations, 113 (27.6%) had katG mutations without inhA mutations, and two (0.5%) strains had mutations in both the inhA and katG genes. Of the 115 strains with any katG mutation, 114 (99.1%) had mutations in codon 315 (S315T). Of the 296 trains with any inhA mutation, 290 (98.0%) had a C–15T mutation. The proportion of isoniazid-resistant strains with katG mutations was 25.3% among new cases and 36.2% among retreatment cases (p=0.03), as well as 17.0% among rifampicin-susceptible strains and 52.8% among rifampicin-resistant strains (p<0.01). Rifampicin resistance was significantly associated with the katG mutation (adjusted odds ratio 5.36, 95% CI 3.3–8.67, p<0.001). Mutations in inhA predominated in isoniazid-resistant tuberculosis in Mongolia. However, the proportion of katG mutations in isolates from previously treated cases was higher than that among new cases, and that in cases with rifampicin resistance was higher than that in cases without rifampicin resistance. Full Article
pi Cardiovascular safety and population pharmacokinetic properties of piperaquine in African patients with uncomplicated falciparum malaria - a pooled multicentre analysis [Clinical Therapeutics] By aac.asm.org Published On :: 2020-04-20T08:36:47-07:00 Dihydroartemisinin-piperaquine has shown excellent efficacy and tolerability in malaria treatment. However, concerns have been raised of potentially harmful cardiotoxic effects associated with piperaquine. The population pharmacokinetics and cardiac effects of piperaquine were evaluated in 1,000 patients, mostly children enrolled in a multicentre trial from 10 sites in Africa. A linear relationship described the QTc-prolonging effect of piperaquine, estimating a 5.90ms mean QTc-prolongation per 100ng/mL increase in piperaquine concentration. The effect of piperaquine on absolute QTc-interval estimated a mean maximum QTc-interval of 456ms (EC50=209ng/mL). Simulations from the pharmacokinetic-pharmacodynamic models predicted 1.98-2.46% risk of having QTc-prolongation > 60ms in all treatment settings. Although piperaquine administration resulted in QTc-prolongation, no cardiovascular adverse events were found in these patients. Thus, the use of dihydroartemisinin-piperaquine should not be limited by this concern. Full Article