Rationale Mycobacterium abscessus is a significant threat to individuals with cystic fibrosis (CF) due to innate drug resistance and potential transmission between patients. Recent studies described global dominant circulating clones of M. abscessus, but detailed genomic surveys have not yet been described for the United States (US). Objectives We examined the genetic diversity of respiratory M. abscessus isolates from US patients with CF and evaluated the potential for transmission events within CF Care Centers. Methods Whole genome sequencing was performed on 558 M. abscessus isolates from 266 patients with CF attending 48 CF Care Centers in 28 US states as part of a nationwide surveillance program. US isolates were also compared to 64 isolate genomes from 13 previous studies to evaluate the prevalence of recently described dominant circulating clones. Results More than half of study patients with CF and M. abscessus had isolates within four dominant clones; two clones of M. abscessus subsp. abscessus (MAB)lp to explain the widespread presence of dominant clones in the US, including the potential for broad distribution in the environment. Single site studies using systematic, evidence-based approaches will be needed to establish the contributions of healthcare-associated transmission versus shared environmental exposures.Fuel sulfur emissions control areas have been established in a few marine coastal regions to reduce environmental impacts from combustion of high sulfur residual fuel oil (RFO). For example, in August of 2012 the U.S. began enforcing fuel sulfur limits on certain large commercial marine vessels up to 200 nautical miles (nm) of its coasts as part of a North American Emissions Control Area (NA-ECA) and in January of 2014 the U.S. began enforcing fuel sulfur limits on these vessels within up to 50 nm of Puerto Rico and the U.S. Virgin Islands as part of the U.S. Caribbean Sea ECA (USCAR-ECA). This work evaluates ECA effectiveness at reducing PM2.5 from combustion of RFO by using both spatial analysis, comparing PM2.5 source apportionment at IMPROVE monitoring sites largely impacted by air from either inside or outside of an ECA, along with temporal analysis, comparing RFO combustion impacts pre and post ECA enforcement at sites largely impacted by air from inside an ECA. Source apportionment was performed using Positive Matrix Factorization (PMF) on chemically speciated PM2.5 data from 2009 to 2018. Results for 7 coastal U.S. IMPROVE sites influenced by marine air masses within the NA-ECA showed an annual mean reduction of PM2.5 from RFO combustion of 79.0% (range, 60.2% to 91.5%) when comparing impacts from the pre-ECA (RFO average 2.7% S) period of 2009 - 2011 to the ECA 0.1% fuel S period of 2015 - 2018. In contrast, the Virgin Islands, Big Bend, and Baengnyeong Island South Korea IMPROVE sites were impacted by RFO combustion and were largely or wholly influenced by air masses from outside of an emissions control area.  https://www.selleckchem.com/products/lipofermata.html  These sites saw a statistically significant 14.0% increase, a 21.0% decrease, or no statistically significant change, respectively, when comparing time periods pre and post ECA enforcement.Background Smartphone is an indispensable miracle of artificial intelligence in the hands of global netizens. Medical students overburdened and sleep-deprived due to the curricular demands can have serious health effects due to further sleep deprivation caused by problematic smartphone use, affecting their work proficiency as practicing physicians. This study aimed to evaluate the association of smartphone addiction and quality of sleep among medical students across all semesters, along with other background variables.Methodology This cross-sectional study was conducted on 224 medical students of a tertiary care teaching hospital in North India using a self-administered questionnaire with four parts -Socio-demographic characteristics, General health questionnaire (GHQ-12), Smartphone addiction scale-short version (SAS-SV), and Pittsburgh sleep quality index (PSQI).Results The prevalence of smartphone addiction is was found out to be 33.33% in females and 46.15% in males. In the study, 63.39% were poor sleepers as assessed by their PQSI scores, and 62.05% reported poor health status as per their GHQ scores. There was a positive correlation between overall PQSI scores and smartphone use duration per day, SAS-SV scores, and GHQ scores.Conclusion The high prevalence of excessive smartphone usage among medical students is a cause for concern and is detrimental to their health and sleep quality. The research addresses current lacunae in correlating smartphone addiction with smartphone usage before sleeping and right after waking up. Risky behavior adoption and pervasive mood changes associated with excessive smartphone use are addressed with equal representation across semesters. The study recommends increasing self-awareness for help-seeking to regulate smartphone usage and providing counseling services for students in their formative years.Chlorine and chloramine are widely used to maintain the microbial safety after drinking water treatment plants. Particles existing in the treated water may react with these chemical disinfectants, and impact the efficacy of disinfection. However, the protective effects of particles without-disinfectant demand on bacteria in the chlorination/chloramination are not well known. In this study, two laboratory-derived bacteria (Staphylococcus aureus and Escherichia coli) and two no-disinfectant demand particles (Fe2O3 and kaolin) in drinking water were selected to build particle-associated bacteria (PAB) systems, and their resistance to chlorine/chloramine was further assessed. Flow cytometry (FCM) was employed to image PAB systems and assess the removal rate of bacteria. The results were that particles showed protective effects on bacteria in half of chlorine experiments and 90% of chloramination. The protection was related to the combination form of particles and bacteria tied to neither particle species nor size, and there was no positive relationship between the protection effect and water turbidity. S. aureus attached to Fe2O3 had stronger resistance than kaolin, and kaolin protected E. coli better than Fe2O3. The same trend was observed in both chemical disinfectants, and more significant resistance had been shown in chloramination than chlorination. FCM images which gave a qualitative description on the combination states of different PAB systems may be a clue to explain the strength of the resistance. Environmental bacterial strains and particles are recommended in the future to explore practical applications.