AbstractKlebsiella pneumoniae is one of the leading causes of nosocomial infections. Carbapenem-resistant (CR) K. pneumoniae are on the rise in India. The biofilm forming ability of K. pneumoniae further complicates patient management. There is still a knowledge gap on the association of biofilm formation with patient outcome and carbapenem susceptibility, which is investigated in the present study.K. pneumoniae isolates from patients admitted in critical care units with catheters and ventilators were included. K. pneumoniae (n = 72) were tested for antimicrobial susceptibility as recommended by CLSI 2019 and subjected to 96-well microtitre plate biofilm formation assay. Based on optical density at 570 nm isolates were graded as strong, moderate and weak biofilm formers. Subset of strong biofilm formers were subjected to whole genome sequencing and a core genome phylogenetic analysis in comparison with global isolates were performed. Biofilm formation was compared for an association with the carbapenem susceptibility and with patient outcome. Statistical significance, correlations and graphical representation were performed using SPSS v23.0.Phenotypic analyses showed a positive correlation between biofilm formation and carbapenem resistance. Planktonic cells observed to be susceptible in vitro exhibited higher MICs in biofilm structure. The biofilm forming ability had a significant association with the morbidity/mortality. Infections by stronger biofilm forming pathogens significantly (P<0.05) resulted in fewer ‘average days alive’ for the patient (3.33) in comparison to those negative for biofilms (11.33). Phylogenetic analysis including global isolates revealed the clear association of sequence types with genes for biofilm mechanism and carbapenem resistance. Carbapenemase genes were found specific to each clade. The known hypervirulent clone-ST23 with wcaG, magA, rmpA, rmpA2 and wzc with a lack of mutation for hyper-capsulation might be poor biofilm formers. Interestingly, ST15, ST16, ST307 and ST258 – reported global high-risk clones were wcaJ negative indicating the high potential of biofilm forming capacity. Genes wabG and treC for CPS, bcsA and pgaC for adhesins, luxS for quorum sensing were common in all clades in addition to genes for aerobactin (iutA), allantoin (allS), type I and III fimbriae (fimA, fimH, mrkD) and pili (pilQ, ecpA).This study is the first of its kind to compare genetic features of antimicrobial resistance with a spectrum covering most of the genetic factors for K. pneumoniae biofilm. These results highlight the importance of biofilm screening to effectively manage nosocomial infections by K. pneumoniae. Further, data obtained on epidemiology and associations of biofilm and antimicrobial resistance genetic factors will serve to enhance our understanding on biofilm mechanisms in K. pneumoniae.

All around the world, Coffee place an important position in the beverages. It contains phenolic acid as well as polyphenols. It has the property of antioxidant; mood enhances mood, and also increases alertness, reduces weight, ef iciency against hypertension, and antitumor property because of its polyphenols and phenolic constituents. Chlorogenic acids (CGA) are the main components found in the fraction of phenols from green coffee beans. CGA has several therapeutic properties, which include antioxidant activities and also has hepatoprotective, hypoglycemic, and antiviral properties. Several essential compounds found in CGA in green coffee beans are caffeoylquinic acids, caffeoylquinic acids, feruloyl quinic acids, p-coumaroylquinic acids, and quinic acid. Therefore, this review highlighted the health bene its and anticancer activities of Green coffee bean.

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The effect of constellation size on energy efficiency of Multi carrier Direct Sequence code-division multiple-access (MC DS/ CDMA) system for M-QAM modulation is studied using a game theoretic approach. A non cooperative game is proposed in which each user seeks to choose its transmit power, transmit symbol rate as well as the constellation size in order to maximize its own utility while satisfying its delay quality of service (QoS) constraint. The utility function used here measures the number of reliable bits transmitted per joule of energy consumed and it is particularly suitable for energy-constrained networks. It is shown that in order to maximize the user's utility, a user must choose the lowest constellation size that can accommodate the user's delay constraint. This strategy is different from one that could maximize spectral efficiency. Using this approach, the trade offs among energy efficiency, delay, throughput and constellation size are also studied and quantified.