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BAPS: મહેમાનને જમાડવામાં કસર નથી રાખતા તો, ભગવાનને રાજી કરવામાં કોઈ કચાશ રહે ખરી?

ગટરને ગંગાજળમાં ફેરવી દેવાની તાકાત છે રાજીપાના વિચારમાં છે




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ગઢડા: BAPS સંસ્થાના સંતો-હરિભક્તો દ્વારા ઘેલા નદીની સફાઈ

પ્રમુખસ્વામી મહારાજ પોતાના જીવનકાળ દરમ્યાન અવારનવાર સ્વચ્છતા અભિયાનનું આયોજન કરતા, તેઓ સંતો ભક્તોને પણ સેવા કાર્યમાં જોડી સ્વચ્છતા વિષે જાગૃતી લાવવાનું કાર્ય કરતા.




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BAPS: પ્રાર્થના એ ભગવાન સાથેનો અતૂટ અને કરુણાભર્યો સોનેરી સંબંધ

પ્રાર્થના માત્ર શબ્દોમાં જ વર્ણવાય તેવું જરૂરી નથી, જો પ્રાર્થના અંતરથી ગદ્ગદ્ભાવે કરવામાં આવે તો તે પ્રભુ સુધી અવશ્ય પહોંચે છે.




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BAPS : કેટલું નહીં કેવું જીવ્યા એ મહત્વનું છે

દરેકને માણસાઈનું અનુસંધાન નથી તેનાથી ઇતર બધું બનવાનું અનુસંધાન છે. આ અનુસંધાન નથી એટલે જ કહેવું પડે છે, ‘‘હે માનવી ! તુ માનવ થા તો ઘણું.’’




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BAPS : ઇર્ષ્યા ટાળ્યાનો એક અદ્ભૂત ઉપાય

સર્જનહારે માણસને ઘડ્યો ત્યારે વિષનું એક ટીપું પણ મૂકી દીધું




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BAPS: દુઃખનું મૂળ છે અહંકાર, જીવનમાંથી હું હટે તો દુઃખ મટે

આપણે ‘દુઃખે પેટ ને કૂટે માથું’ જેવા પ્રયત્નો કરીએ છીએ. દુઃખનાં મૂળને કાઢ્યાં વગર ફક્ત દુઃખની ડાળીઓને કાપવાનો પ્રયત્ન કરીએ છીએ. જ્યાં સુધી મૂળ ન કપાય, ત્યાં સુઘી ડાળો કાપવાનો શો અર્થ ?




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Does Baptism Save You?

In the lead-up to the Truth Matters conference in October, we will be focusing our attention on the sufficiency, authority, and clarity of Scripture. Of our previous blog series, none better embodies that emphasis than Frequently Abused Verses. The following entry from that series originally appeared on August 15, 2016. -ed.

Faith and repentance are not easy. Submission contradicts the natural disposition of the human heart. And the transforming and sanctifying work of the Holy Spirit is often uncomfortable and difficult.

Salvation would be so much more inviting and enticing to our human understanding if it didn’t require humility, repentance, and the transformation of your entire being. Why can’t it simply be the product of a one-time activity?

For those looking to bypass the difficulty and discomfort of salvation, 1 Peter 3:21 seemingly provides a shortcut in the form of this simple declaration: “Baptism now saves you.” This and a select few other verses are often used to promote “baptismal regeneration”–the view that teaches that one is saved (regenerated) though water baptism.

However, not all proponents of baptismal regeneration see baptism as a shortcut to salvation or a quick fix to the problem of sin. Many view it as a necessary element—in addition to repentance and faith—that completes the work of salvation. And as a proof text, they point to Peter’s words in Acts 2:38, “Peter said to them, ‘Repent, and each of you be baptized in the name of Jesus Christ for the forgiveness of your sins; and you will receive the gift of the Holy Spirit’” (emphasis added).

So what should we make of that—was Peter the first proponent of baptismal regeneration? And moreover, does that mean that no one is truly saved until they’ve been baptized?

To find the answers to those questions, we need to consider what it meant to become a Christian and make a public declaration of your faith in the earliest days of the church. In his commentary on Acts, John MacArthur sheds some light on the issue:

It is difficult for modern readers to grasp the magnitude of the change facing Peter’s Jewish hearers. They were part of a unique community, with a rich cultural and religious history. Despite long years of subjugation to Rome, they were fiercely nationalistic. The nation had rejected Jesus as a blasphemer and executed Him. Now Peter calls on them to turn their back on all that and embrace Jesus as their Messiah.

By calling on each of them to “be baptized in the name of Jesus Christ” Peter does not allow for any “secret disciples” (cf. Matthew 10:32-33). Baptism would mark a public break with Judaism and identification with Jesus Christ. Such a drastic public act would help weed out any conversions which were not genuine. In sharp contrast to many modern gospel presentations, Peter made accepting Christ difficult, not easy. By so doing, he followed the example of our Lord Himself (Luke 14:26-33; 18:18-27). Baptism was always “in the name of Jesus Christ.” That was the crucial identification, and the cost was high for such a confession. [1] John MacArthur, The MacArthur New Testament Commentary: Acts 1-12 (Chicago: Moody Press, 1994), 73.

Baptism doesn’t accomplish or seal your salvation; it’s a public declaration of the work the Lord has already accomplished within. So the whole premise of baptismal regeneration defies the meaning and purpose of baptism. Not only that, the immediate context of Peter’s exhortation eliminates the possibility of anyone successfully using Acts 2:38 as an argument for baptismal regeneration. As John MacArthur explains,

[Baptismal regeneration] ignores the immediate context of the passage. As already noted, baptism would be a dramatic step for Peter’s hearers. By publicly identifying themselves as followers of Jesus of Nazareth, they risked becoming outcasts in their society (cf. John 9:22). Peter calls upon them to prove the genuineness of their repentance by submitting to public baptism. In much the same way, our Lord called upon the rich young ruler to prove the genuineness of his repentance by parting with his wealth (Luke 18:18-27). Surely, however, no one would argue from the latter passage that giving away one’s possessions is necessary for salvation. Salvation is not a matter of either water or economics. True repentance, however, will inevitably manifest itself in total submission to the Lord’s will. [2] The MacArthur New Testament Commentary: Acts 1-12, 73-74.

Moreover, the idea of baptismal regeneration represents a significant contradiction to other passages of Scripture that clearly teach salvation by faith alone. In Acts 16:31, Paul and Silas tell their jailor how he can be saved, “Believe in the Lord Jesus, and you will be saved.” In Galatians 2:16, Paul unmistakably denies salvation by works with these words:

Nevertheless knowing that a man is not justified by the works of the Law but through faith in Christ Jesus, even we have believed in Christ Jesus, so that we may be justified by faith in Christ and not by the works of the Law; since by the works of the Law no flesh will be justified. (cf. Romans 3:28)

Even Christ Himself—in perhaps His most famous quote—denied the need for works to accomplish salvation: “For God so loved the world that He gave His only begotten Son, that whosoever believes in Him shall not perish, but have eternal life” (John 3:16). In fact, the need for baptism would contradict the entirety of Christ’s ministry. As John MacArthur puts it, “After condemning the ritualistic religion of the scribes and Pharisees, our Lord would hardly have instituted one of His own.” [3] The MacArthur New Testament Commentary: Acts 1-12, 74.

John MacArthur describes another reason Peter’s words cannot be read as an endorsement of baptismal regeneration:

This interpretation is not true to the facts of Scripture. Throughout the book of Acts, forgiveness is linked to repentance, not baptism (cf. Acts 3:19; 5:31; 26:20). In addition, the Bible records that some who were baptized were not saved (Acts 8:13, 21-23), while some were saved with no mention of their being baptized (Luke 7:37-50; Matthew 9:2; Luke 18:13-14). The story of the conversion of Cornelius and his friends very clearly shows the relationship of baptism to salvation. It was only after they were saved, as shown by their receiving the Holy Spirit (Acts 10:44-46), that they were baptized (Acts 10:47-48). Indeed, it was because they had received the Spirit (and hence were saved) that Peter ordered them to be baptized (v. 47). That passage clearly shows that baptism follows salvation; it does not cause it. [4] The MacArthur New Testament Commentary: Acts 1-12, 74.

So why do Peter’s words in Acts 2:38 read as an endorsement of baptismal regeneration? The confusion likely stems from the way the Greek preposition eis is translated. While it is often translated “for the purpose of,” it can also mean “because of”—that’s clearly the sense it conveys in Matthew 12:41, as Jesus described how the people of Ninevah repented after hearing Jonah’s preaching. That’s the sense we ought to see in Acts 2:38—Peter exhorted the people to be baptized because of the forgiveness of their sins.

As John MacArthur explains, that understanding is in keeping with the pattern presented throughout Scripture.

The order is clear. Repentance is for forgiveness. Baptism follows that forgiveness; it does not cause it (cf. Acts 8:12, 34-39; 10:34-48; 16:31-33). It is the public sign or symbol of what has taken place on the inside. It is an important step of obedience for all believers, and should closely follow conversion. In fact, in the early church it was inseparable from salvation, so that Paul referred to salvation as being related to “one Lord, one faith, one baptism” (Ephesians 4:5). [5] The MacArthur New Testament Commentary: Acts 1-12, 75.

With that in mind, how do we make sense of the simple declaration we began with: “Baptism now saves you” (1 Peter 3:21)?

As so often is the case in this series on Frequently Abused Verses, context is key. While those four words might seem to say one thing, a look at Peter’s complete statement makes his point abundantly clear.

When the patience of God kept waiting in the days of Noah, during the construction of the ark, in which a few, that is, eight persons, were brought safely through the water. Corresponding to that, baptism now saves you—not the removal of dirt from the flesh, but an appeal to God for a good conscience—through the resurrection of Jesus Christ. (1 Peter 3:20-21)

As John MacArthur explains in his commentary on 1 Peter, it’s illegitimate to use Peter’s words to make a case for salvation through water baptism, because that’s not even the kind of baptism Peter has in mind here.

“Baptism” (from baptizō) simply means “to immerse,” and not just in water. Peter here uses baptism to refer to a figurative immersion into Christ as the ark of safety that will sail over the holocaust of judgment on the wicked. Noah and his family were immersed not just in water, but in the world under divine judgment. All the while they were protected by being in the ark. God preserved them in the midst of His judgment, which is what he also does for all those who trust in Christ. God’s final judgment will bring fire and fury on the world, destroying the entire universe (cf. 2 Peter 3:10-12); but the people of God will be protected and taken into the eternal new heavens and new earth (2 Peter 3:13).

Peter made clear that he did not want readers to think he was referring to water baptism when he specifically said “not the removal of dirt from the flesh” (1 Peter 3:21). That he was actually referring to a spiritual reality when he wrote “baptism now saves” is also clear from the phrase, “an appeal to God for a good conscience—through the resurrection of Jesus Christ” (v. 21). The only baptism that saves people is dry—the spiritual one into the death as well as the resurrection of Christ—of those who appeal to God to place them into the spiritual ark of salvation safety (cf. Romans 10:9-10).

Just as the Flood immersed all people in the judgment of God, yet some passed through safely, so also his final judgment will involve everyone, but those who are in Christ will pass through securely. The experience of Noah’s family in the Flood is also analogous to the experience of everyone who receives salvation. Just as they died to their previous world when they entered the ark and subsequently experienced a resurrection of sorts when they exited the ark to a new post-Flood world, so all Christians die to their old world when they enter the body of Christ (Romans 7:4-6; Galatians 2:19-20; Ephesians 4:20-24). They subsequently enjoy newness of life that culminates one day with the resurrection to eternal life. . . .

Therefore, God provides salvation because a sinner, by faith, is immersed into Christ’s death and resurrection and becomes His own through that spiritual union. Salvation does not occur by means of any rite, including water baptism. [6] John MacArthur, The MacArthur New Testament Commentary: 1 Peter (Chicago: Moody Publishers, 2004) 217-218.

There are no shortcuts or religious rituals that can achieve salvation—in fact, it’s not a product of human works at all. As Paul writes in his letter to the Ephesians, “For by grace you have been saved through faith; and that not of yourselves, it is the gift of God; not as a result of works, so that no one may boast” (Ephesians 2:8-9).




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Pandemic gives Arthur Sinodinos 'baptism of fire' as US ambassador

Our man in Washington is making new friends at a safe distance.




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Sulfamoyl Heteroarylcarboxylic Acids as Promising Metallo-{beta}-Lactamase Inhibitors for Controlling Bacterial Carbapenem Resistance

ABSTRACT

Production of metallo-β-lactamases (MBLs), which hydrolyze carbapenems, is a cause of carbapenem resistance in Enterobacteriaceae. Development of effective inhibitors for MBLs is one approach to restore carbapenem efficacy in carbapenem-resistant Enterobacteriaceae (CRE). We report here that sulfamoyl heteroarylcarboxylic acids (SHCs) can competitively inhibit the globally spreading and clinically relevant MBLs (i.e., IMP-, NDM-, and VIM-type MBLs) at nanomolar to micromolar orders of magnitude. Addition of SHCs restored meropenem efficacy against 17/19 IMP-type and 7/14 NDM-type MBL-producing Enterobacteriaceae to satisfactory clinical levels. SHCs were also effective against IMP-type MBL-producing Acinetobacter spp. and engineered Escherichia coli strains overproducing individual minor MBLs (i.e., TMB-2, SPM-1, DIM-1, SIM-1, and KHM-1). However, SHCs were less effective against MBL-producing Pseudomonas aeruginosa. Combination therapy with meropenem and SHCs successfully cured mice infected with IMP-1-producing E. coli and dually NDM-1/VIM-1-producing Klebsiella pneumoniae clinical isolates. X-ray crystallographic analyses revealed the inhibition mode of SHCs against MBLs; the sulfamoyl group of SHCs coordinated to two zinc ions, and the carboxylate group coordinated to one zinc ion and bound to positively charged amino acids Lys224/Arg228 conserved in MBLs. Preclinical testing revealed that the SHCs showed low toxicity in cell lines and mice and high stability in human liver microsomes. Our results indicate that SHCs are promising lead compounds for inhibitors of MBLs to combat MBL-producing CRE.

IMPORTANCE Carbapenem antibiotics are the last resort for control of severe infectious diseases, bloodstream infections, and pneumonia caused by Gram-negative bacteria, including Enterobacteriaceae. However, carbapenem-resistant Enterobacteriaceae (CRE) strains have spread globally and are a critical concern in clinical settings because CRE infections are recognized as a leading cause of increased mortality among hospitalized patients. Most CRE produce certain kinds of serine carbapenemases (e.g., KPC- and GES-type β-lactamases) or metallo-β-lactamases (MBLs), which can hydrolyze carbapenems. Although effective MBL inhibitors are expected to restore carbapenem efficacy against MBL-producing CRE, no MBL inhibitor is currently clinically available. Here, we synthesized 2,5-diethyl-1-methyl-4-sulfamoylpyrrole-3-carboxylic acid (SPC), which is a potent inhibitor of MBLs. SPC is a remarkable lead compound for clinically useful MBL inhibitors and can potentially provide a considerable benefit to patients receiving treatment for lethal infectious diseases caused by MBL-producing CRE.




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Multicenter Evaluation of the BD Phoenix CPO Detect Test for Detection and Classification of Carbapenemase-Producing Organisms in Clinical Isolates [Bacteriology]

Limited treatment options contribute to high morbidity/mortality rates with carbapenem-resistant, Gram-negative bacterial infections. New approaches for carbapenemase-producing organism (CPO) detection may help inform clinician decision-making on patient treatment and infection control. BD Phoenix CPO detect (CPO detect) detects and classifies carbapenemases in Enterobacterales, Acinetobacter baumannii, and Pseudomonas aeruginosa during susceptibility testing. The clinical performance of CPO detect is reported here. Enterobacterales, Acinetobacter baumannii, and Pseudomonas aeruginosa isolates were evaluated across three sites using CPO detect and a composite reference method (RM); the latter was comprised of the modified carbapenem inactivation method and a MIC screen for ertapenem, imipenem, and meropenem. Multiplex PCR testing was also utilized for Ambler class determination. Positive and negative percentages of agreement (PPA and NPA, respectively) between CPO detect and the RM were determined. The PPA and NPA for Enterobacterales were 98.5% (confidence intervals, 96.6%, 99.4%) and 97.2% (95.8%, 98.2%), respectively. The A. baumannii PPA and NPA, respectively, were 97.1% (90.2%, 99.2%) and 97.1% (89.9%, 99.2%). The P. aeruginosa PPA and NPA, respectively, were 95.9% (88.6%, 98.6%) and 92.3% (86.7%, 95.6%). The PPA values for carbapenemase class designations for all organisms combined and Enterobacterales alone, respectively, were 95.3% (90.2%, 97.8%) and 94.6% (88.8%, 97.5%) for class A, 94.0% (88.7%, 96.6%) and 96.4% (90.0%, 98.8%) for class B, and 95.0% (90.1%, 97.6%) and 99.0% (94.4%, 99.8%) for class D carbapenemases. NPA values for all organisms and Enterobacterales alone ranged from 98.5% to 100%. CPO detect provided accurate detection and classification of CPOs for the majority of isolates of Enterobacterales, Acinetobacter baumannii, and Pseudomonas aeruginosa tested.




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Diversity and Genetic Basis for Carbapenem Resistance in a Coastal Marine Environment [Public and Environmental Health Microbiology]

Resistance to the "last-resort" antibiotics, such as carbapenems, has led to very few antibiotics being left to treat infections by multidrug-resistant bacteria. Spread of carbapenem resistance (CR) has been well characterized for the clinical environment. However, there is a lack of information about its environmental distribution. Our study reveals that CR is present in a wide range of Gram-negative bacteria in the coastal seawater environment, including four phyla, eight classes, and 30 genera. These bacteria were likely introduced into seawater via stormwater flows. Some CR isolates found here, such as Acinetobacter junii, Acinetobacter johnsonii, Brevundimonas vesicularis, Enterococcus durans, Pseudomonas monteilii, Pseudomonas fulva, and Stenotrophomonas maltophilia, are further relevant to human health. We also describe a novel metallo-β-lactamase (MBL) for marine Rheinheimera isolates with CR, which has likely been horizontally transferred to Citrobacter freundii or Enterobacter cloacae. In contrast, another MBL of the New Delhi type was likely acquired by environmental Variovorax isolates from Escherichia coli, Klebsiella pneumoniae, or Acinetobacter baumannii utilizing a plasmid. Our findings add to the growing body of evidence that the aquatic environment is both a reservoir and a vector for novel CR genes.

IMPORTANCE Resistance against the "last-resort" antibiotics of the carbapenem family is often based on the production of carbapenemases, and this has been frequently observed in clinical samples. However, the dissemination of carbapenem resistance (CR) in the environment has been less well explored. Our study shows that CR is commonly found in a range of bacterial taxa in the coastal aquatic environment and can involve the exchange of novel metallo-β-lactamases from typical environmental bacteria to potential human pathogens or vice versa. The outcomes of this study contribute to a better understanding of how aquatic and marine bacteria can act as reservoirs and vectors for CR outside the clinical setting.




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Co-occurrence of Plasmid-Mediated Tigecycline and Carbapenem Resistance in Acinetobacter spp. from Waterfowls and Their Neighboring Environment [Epidemiology and Surveillance]

Tigecycline serves as one of the antibiotics of last resort to treat multidrug-resistant (including carbapenem-resistant) pathogens. However, the recently emerged plasmid-mediated tigecycline resistance mechanism, Tet(X), challenges the clinical efficacy of this class of antibiotics. In this study, we detected 180 tet(X)-harboring Acinetobacter isolates (8.9%, n = 180) from 2,018 samples collected from avian farms and adjacent environments in China. Eighteen tet(X)-harboring isolates (10.0%) were found to cocarry the carbapenemase gene blaNDM-1, mostly from waterfowl samples (94.4%, 17/18). Interestingly, among six Acinetobacter strains, tet(X) and blaNDM-1 were found to colocalize on the same plasmids. Moreover, whole-genome sequencing (WGS) revealed a novel orthologue of tet(X) in the six isolates coharboring tet(X) and blaNDM-1. Inverse PCR suggested that the two tet(X) genes form a single transposable unit and may be cotransferred. Sequence comparison between six tet(X)- and blaNDM-1-coharboring plasmids showed that they shared a highly homologous plasmid backbone even though they were isolated from different Acinetobacter species (three from Acinetobacter indicus, two from Acinetobacter schindleri, and one from Acinetobacter lwoffii) from various sources and from different geological regions, suggesting the horizontal genetic transfer of a common tet(X)- and blaNDM-1-coharboring plasmid among Acinetobacter species in China. Emergence and spread of such plasmids and strains are of great clinical concern, and measures must be implemented to avoid their dissemination.




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Activity of Imipenem-Relebactam against Carbapenem-Resistant Escherichia coli Isolates from the United States in Relation to Clonal Background, Resistance Genes, Coresistance, and Region [Epidemiology and Surveillance]

Imipenem-relebactam (I-R) is a recently developed carbapenem–beta-lactamase inhibitor combination agent that can overcome carbapenem resistance, which has now emerged in Escherichia coli, including sequence type 131 (ST131) and its fluoroquinolone-resistant H30R subclone, the leading cause of extraintestinal E. coli infections globally. To clarify the likely utility of I-R for carbapenem-resistant (CR) E. coli infections in the United States, we characterized 203 recent CR clinical E. coli isolates from across the United States (years 2002 to 2017) for phylogroup, clonal group (including ST131, H30R, and the CTX-M-15-associated H30Rx subset within H30R), relevant beta-lactamase genes, and broth microdilution MICs for I-R and 11 comparator agents. Overall, I-R was highly active (89% susceptible), more so than all comparators except tigecycline and colistin (both 99% susceptible). I-R’s activity varied significantly in relation to phylogroup, clonal background, resistance genotype, and region. It was greatest among phylogroup B2, ST131-H30R, H30Rx, Klebsiella pneumoniae carbapenemase (KPC)-positive, and northeast U.S. isolates and lowest among phylogroup C, New Delhi metallo-β-lactamase (NDM)-positive, and southeast U.S. isolates. Relebactam improved imipenem’s activity against CR isolates within each phylogroup—especially groups A, B1, and B2—and particularly against isolates containing KPC. I-R remained substantially active against isolates coresistant to comparator agents, albeit somewhat less so than against the corresponding susceptible isolates. These findings suggest that I-R should be useful for treating most CR E. coli infections in the United States, largely independent of coresistance, although this likely will vary in relation to the local prevalence of specific E. coli lineages and carbapenem resistance mechanisms.




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Meropenem-Vaborbactam versus Ceftazidime-Avibactam for Treatment of Carbapenem-Resistant Enterobacteriaceae Infections [Clinical Therapeutics]

The comparative efficacy of ceftazidime-avibactam and meropenem-vaborbactam for treatment of carbapenem-resistant Enterobacteriaceae (CRE) infections remains unknown. This was a multicenter, retrospective cohort study of adults with CRE infections who received ceftazidime-avibactam or meropenem-vaborbactam for ≥72 hours from February 2015 to October 2018. Patients with a localized urinary tract infection and repeat study drug exposures after the first episode were excluded. The primary endpoint was clinical success compared between treatment groups. Secondary endpoints included 30- and 90-day mortality, adverse events (AE), 90-day CRE infection recurrence, and development of resistance in patients with recurrent infection. A post hoc subgroup analysis was completed comparing patients who received ceftazidime-avibactam monotherapy, ceftazidime-avibactam combination therapy, and meropenem-vaborbactam monotherapy. A total of 131 patients were included (ceftazidime-avibactam, n = 105; meropenem-vaborbactam, n = 26), 40% of whom had bacteremia. No significant difference in clinical success was observed between groups (62% versus 69%; P = 0.49). Patients in the ceftazidime-avibactam arm received combination therapy more often than patients in the meropenem-vaborbactam arm (61% versus 15%; P < 0.01). No difference in 30- and 90-day mortality resulted, and rates of AE were similar between groups. In patients with recurrent infection, development of resistance occurred in three patients that received ceftazidime-avibactam monotherapy and in no patients in the meropenem-vaborbactam arm. Clinical success was similar between patients receiving ceftazidime-avibactam and meropenem-vaborbactam for treatment of CRE infections, despite ceftazidime-avibactam being used more often as a combination therapy. Development of resistance was more common with ceftazidime-avibactam monotherapy.




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Genomic Epidemiology of Complex, Multispecies, Plasmid-Borne blaKPC Carbapenemase in Enterobacterales in the United Kingdom from 2009 to 2014 [Epidemiology and Surveillance]

Carbapenem resistance in Enterobacterales is a public health threat. Klebsiella pneumoniae carbapenemase (encoded by alleles of the blaKPC family) is one of the most common transmissible carbapenem resistance mechanisms worldwide. The dissemination of blaKPC historically has been associated with distinct K. pneumoniae lineages (clonal group 258 [CG258]), a particular plasmid family (pKpQIL), and a composite transposon (Tn4401). In the United Kingdom, blaKPC has represented a large-scale, persistent management challenge for some hospitals, particularly in North West England. The dissemination of blaKPC has evolved to be polyclonal and polyspecies, but the genetic mechanisms underpinning this evolution have not been elucidated in detail; this study used short-read whole-genome sequencing of 604 blaKPC-positive isolates (Illumina) and long-read assembly (PacBio)/polishing (Illumina) of 21 isolates for characterization. We observed the dissemination of blaKPC (predominantly blaKPC-2; 573/604 [95%] isolates) across eight species and more than 100 known sequence types. Although there was some variation at the transposon level (mostly Tn4401a, 584/604 [97%] isolates; predominantly with ATTGA-ATTGA target site duplications, 465/604 [77%] isolates), blaKPC spread appears to have been supported by highly fluid, modular exchange of larger genetic segments among plasmid populations dominated by IncFIB (580/604 isolates), IncFII (545/604 isolates), and IncR (252/604 isolates) replicons. The subset of reconstructed plasmid sequences (21 isolates, 77 plasmids) also highlighted modular exchange among non-blaKPC and blaKPC plasmids and the common presence of multiple replicons within blaKPC plasmid structures (>60%). The substantial genomic plasticity observed has important implications for our understanding of the epidemiology of transmissible carbapenem resistance in Enterobacterales for the implementation of adequate surveillance approaches and for control.




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Predominant Distribution of OXA-48-Like Carbapenemase in Fecal Colonization [Letters]




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ARGONAUT II Study of the In Vitro Activity of Plazomicin against Carbapenemase-Producing Klebsiella pneumoniae [Mechanisms of Resistance]

Plazomicin was tested against 697 recently acquired carbapenem-resistant Klebsiella pneumoniae isolates from the Great Lakes region of the United States. Plazomicin MIC50 and MIC90 values were 0.25 and 1 mg/liter, respectively; 680 isolates (97.6%) were susceptible (MICs of ≤2 mg/liter), 9 (1.3%) intermediate (MICs of 4 mg/liter), and 8 (1.1%) resistant (MICs of >32 mg/liter). Resistance was associated with rmtF-, rmtB-, or armA-encoded 16S rRNA methyltransferases in all except 1 isolate.




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Neymar Jr Trolls Kylian Mbappe as French Footballer Posts Picture of Himself Playing Basketball

Kylian Mbappe and Neymar Jr's friendship is not limited to Paris Saint Germain but also off the field. The recent example of the same could be the French footballer's recent post on social media. Mbappe posted a picture of himself on social media where he was seen playing basketball. This was quite an ideal opportunity for Neymar Jr to pull his teammate's leg and he hilariously trolled the footballer with a funny comment.





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Kylian Mbappe to Real Madrid &apos;was almost done&apos; before coronavirus crisis, says former PSG star Jerome Rothen

And the France World Cup winner 'won't sign a new contract' with the Ligue1 giants




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What Liverpool will miss out on if Kylian Mbappe joins Real Madrid... predicted by Football Manager

Real Madrid may have missed out on signing Kylian Mbappe this summer due to the coronavirus.




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Transfer news LIVE: Liverpool eye Mbappe deal, Aubameyang update, Chelsea want Mertens; Man Utd, Arsenal gossip

Welcome to the Evening Standard's live blog covering the latest transfer news and rumours from the Premier League and beyond.




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Real Madrid transfer targets: Haaland, Mbappe, Mane? The players Los Blancos really want to sign

The current break due to coronavirus has seen the rumour mill in overdrive. With no football happening on the pitch, transfer talk is dominating the sports pages.




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Kylian Mbappe for just €40m? PSG star&apos;s value could plummet due to the coronavirus, says French MEP

PSG and France star Kylian Mbappe's valuation could drop to as little as €40million because of the coronavirus pandemic, according to French MEP Daniel Cohn-Bendit.




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Cesc Fabregas says PSG star Kylian Mbappe is the one player he would sign as a manager

Former Arsenal and Chelsea midfielder Cesc Fabregas says PSG star Kylian Mbappe is the one player he would sign if he was a manager and money was no object.




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Manchester United star Marcus Rashford can &apos;reach Kylian Mbappe&apos;s level&apos; and fight for Ballon d&apos;Or

Matteo Darmian has backed former Manchester United team-mate Marcus Rashford to "reach the level" of Paris Saint-Germain star Kylian Mbappe in future and even contend for the prestigious Ballon d'Or award.




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Liverpool warned Kylian Mbappe is the wrong fit amid transfer speculation

John Barnes has suggested Kylian Mbappe is not the right fit for Jurgen Klopp's Liverpool side.




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Liverpool boss Jurgen Klopp responds to Kylian Mbappe and Jadon Sancho transfer links

Jurgen Klopp has insisted he is 'completely happy' with the attacking options he has at his disposal at Liverpool.




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Pandemic gives Arthur Sinodinos 'baptism of fire' as US ambassador

Our man in Washington is making new friends at a safe distance.




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Attorney General Eric Holder Speaks at the Shiloh Baptist Church Martin Luther King Jr. Prayer Breakfast

"I wish that Dr. King could be here with us to see the America that he helped to create," said Attorney General Holder.




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Attorney General Eric Holder Speaks at the Ebenezer Baptist Church Worship Service and Martin Luther King Jr. Celebration

"Here, in the church that Reverend King called his home, and in houses of worship across America – his spirit lives," said Attorney General Holder.




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Attorney General Eric Holder Delivers Remarks at the 50th Anniversary of the Sixteenth Street Baptist Church Bombing

We come together today because we’re still striving, as they once did, to realize the dream that Dr. King shared with us 50 years ago last month – on the steps of a memorial to America’s Great Emancipator – when he spoke of an Alabama where children of all races and backgrounds would be able to play together, to learn together, and to grow together.




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Government Settles False Claims Act Allegations Against Florida-Based Baptist Health System for $2.5 Million

Baptist Health System Inc. (Baptist Health), the parent company for a network of affiliated hospitals and medical providers in the Jacksonville, Florida, area, has agreed to pay $2.5 million to settle allegations that its subsidiaries violated the False Claims Act by submitting claims to federal health care programs for medically unnecessary services and drugs.



  • OPA Press Releases

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Associate Attorney General Tony West Delivers Remarks at the Progressive National Baptist Convention

"Because if a government of, by and for the people means anything at all, it means that a ballot has the power to give equal voice to the high and the low; the weak and the strong; those at the bottom as well as the top. It means that in the polling place, the line is just as long for the richest among us as it is for those who often work the hardest but have the least."




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Concurrent germline and somatic pathogenic BAP1 variants in a patient with metastatic bladder cancer




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Julio Baptista's Confederations Cup memories

The two-time winner shares his top memories of starring for Brazil at the Tournament of Champions.




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Real Madrid want Kylian Mbappe to be the next Galatico to lead their young core back to glory days

PETE JENSON: Club president Florentino Perez has stepped back from trying to break the transfer record in recent years but Kylian Mbappe remains someone he'd gladly make an exception for.




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How do PSG lineup for Real Madrid now Neymar, Mbappe and Cavani have returned?

When Real Madrid visited PSG in the first game of the Champions League group stage, the French side were supposed to be short in attack but Angel di Maria and Mauro Icardi filled the void superbly.




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PSG 2-0 Nantes: Kylian Mbappe scores an audacious backheel while Neymar nets from the spot

PSG 2-0 NANTES: France striker Mbappe found the back of the net with a jaw-dropping backheel finish early in the second half and Neymar doubled the tally in the closing stages.




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PSG 'demand Real Madrid include Vinicius Junior in deal for Kylian Mbappe'

Mbappe has long been a subject of interest for the Spanish giants and there is a growing belief that the Frenchman will finally make his move to the Bernabeu in the summer.




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Saint-Etienne 0-4 PSG: Icardi and Mbappe strike to send Ligue 1 leaders seven points clear

Paris Saint Germain's serial goal-getters Kylian Mbappe and Mauro Icardi were at it again as the Ligue 1 leaders extended their advantage to seven points with a resounding victory on Sunday.




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PSG 'line up move for Pep Guardiola' after Thomas Tuchel fell out with Neymar and Kylian Mbappe

Thomas Tuchel is believed to have fallen out with star men Mbappe and Neymar and a soured relationship will intensify the pressure on his position and Guardiola is said to have been picked out.




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Kylian Mbappe insists he does not have a rivalry with PSG team-mate Neymar

Kylian Mbappe has dismissed claims that he and Neymar share a secret hatred for each other and are competing against one another to be top dog at Paris Saint-Germain.




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Paris Saint-Germain 6-1 Saint-Etienne: Icardi, Neymar and Mbappe on target against 10-man visitors

Mauro Icardi continued his devastating scoring form with a hat-trick to inspire Paris Saint-German to a 6-1 thrashing of 10-man St Etienne in the French League Cup quarter-finals on Wednesday.




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Kylian Mbappe just misses an incredible 'rabona' shot for PSG in win over St Etienne

Kylian Mbappe almost scored what would surely have been the best goal of his career so far in the 6-1 thrashing of St Etienne. The Frenchman attempted a rabona from outside the box and it went just wide.




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Can Neymar, Kylian Mbappe and Co finally lead PSG to Champions League glory?

It is one of the lingering questions which come to fruition just about every year now. After countless last-minute exits and near-misses, when will PSG crack the Champions League?




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Kylian Mbappe is upsetting people across France... Dugarry said he'd 'f***ing headbutt' him

MATT SPIRO IN FRANCE: Simply put, France's boy-wonder - who could do no wrong during his first three seasons as a professional - is beginning to divide opinion in his homeland.




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Kylian Mbappe's stunning hat-trick seals comprehensive Coupe de France win over Lyon

A hat-trick from Kylian Mbappe, the second an incredible driving run from deep inside his own half, sealed a comfortable win for PSG over 10-man Lyon in the semi-finals of the Coupe de France.




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Kylian Mbappe, Neymar and their PSG team-mates sit courtside at first-ever NBA game in Paris

Neymar and Kylian Mbappe watched on as reigning MVP Giannis Antetokounmpo helped Milwaukee Bucks beat Charlotte Hornets in the first-ever NBA game to held in Paris.




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Real Madrid plot to pair Erling Haaland AND Kylian Mbappe in new-look attack

Erling Haaland has enjoyed an astonishing breakthrough season in Europe, first at RB Salzburg before joining Borussia Dortmund, where he has scored 12 goals in just 11 matches.




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Chance the Rapper says his wife 'saved his life' by getting baptized and becoming celibate

Chance the Rapper confessed to Nicki Minaj on her radio show that his wife saved his life by becoming celibate while the two were estranged. They subsequently married earlier this year.