Escherichia coli Isolates That Carry vat, fyuA, chuA, and yfcV Efficiently Colonize the Urinary Tract

Extraintestinal Escherichia coli (ExPEC), a heterogeneous group of pathogens, encompasses avian, neonatal meningitis, and uropathogenic E. coli strains. While several virulence factors are associated with ExPEC, there is no core set of virulence factors that can be used to definitively differentiate these pathotypes. Here we describe a multiplex of four virulence factor-encoding genes, yfcV, vat,fyuA, and chuA, highly associated with uropathogenic E. coli strains that can distinguish three groups of E. coli: diarrheagenic and animal-associated E. colistrains, human commensal and avian pathogenic E. coli strains, and uropathogenic and neonatal meningitis E. coli strains. Furthermore, human intestinal isolates that encode all four predictor genes express them during exponential growth in human urine and colonize the bladder in the mouse model of ascending urinary tract infection in higher numbers than human commensal strains that do not encode the four predictor genes (P = 0.02), suggesting that the presence of the predictors correlates with uropathogenic potential

Dry eye signs and symptoms in aromatase inhibitor treatment and the relationship with pain

Purpose: Aromatase inhibitors (AIs) limit the synthesis of oestrogen in peripheral tissues thus lowering levels of oestrogen. The primary aim was to evaluate whether women treated with AIs have altered dry eye symptoms and signs. A sub-aim was to investigate whether symptoms of dry eye in postmenopausal women were associated with symptoms of non-eye pain, ocular pain and self-rated pain perception.  Methods: This cross-sectional, observational, single visit study recruited 56 postmenopausal women (mean age 64.1 + 7.9 years) and 52 undergoing AI treatment (mean age 66.6 + 9.0). Ocular symptoms (OSDI, MGD14) and pain questionnaires (PSQ, OPAS) were administered and signs of dry eye and meibomian gland dysfunction were evaluated.  Results: Almost half of each group reported dry eye symptoms, defined as OSDI>12 (48% control, 46% AI). The PSQ score was significantly higher in the AI group (p = 0.04). Neither frequency or severity of dry eye (or MGD) symptoms scores were significantly different between groups. In the AI group, meibomian gland expressibility score was worse (p = 0.003); there were no differences in any other signs. Higher OSDI scores were associated with higher OPAS eye-pain scores (r = 0.49, p < 0.001), but not OPAS non-eye pain (r = 0.09, p = 0.35). Pain perception (PSQ) showed a moderate positive association with OPAS eye-pain (r = 0.30, p = 0.003).  Conclusions: In this study elevated ocular symptoms were observed in both the AI treated and the untreated groups, with no difference between the groups. Women undergoing AI treatment for early stage breast cancer had worse meibum expressibility score and increased pain perception compared to an untreated group of women

“I always feel like I’m the first deaf person they have ever met:” Deaf Awareness, Accessibility and Communication in the United Kingdom’s National Health Service (NHS): How can we do better?

Background Barriers to communication significantly reduce access to health services for people with deafness or hearing loss (PDHL). These barriers contribute to reduced healthcare-seeking behaviour, poorer access to health information, and adverse health outcomes. In response, a multidisciplinary working group of patients, clinicians, researchers, and charity representatives was established to investigate accessibility, communication, and deaf awareness within the United Kingdom’s (UK) National Health Service (NHS). Methodology A cross-sectional survey was conducted to explore the communication and accessibility experiences of PDHL NHS patients, and their perceived impact on well-being. The survey used rating scales and open-ended questions and data were analysed using descriptive statistics and thematic analysis. The survey was made available in British Sign Language (BSL). Results The online survey was completed by 556 PDHL, including 50 parents, carers, or family members who had accompanied PDHL friends or relatives to NHS appointments. All respondents had used NHS services within the last 24 months, with 10% identifying BSL as their preferred language. Qualitative analysis of the open-ended responses generated three key themes: 1) Accessibility challenges, 2) Impact of communication difficulties across the service pathway, and 3) Lack of consistent, effective deaf-aware communication. Overall, 64.4% of PDHL NHS patients reported missing 50% or more of the important information provided during their NHS appointments, and 32% were satisfied with the communication skills of healthcare staff. Conclusion This study presents the largest UK-wide dataset of its kind, and findings highlight the widespread non-compliance with the legally mandated Accessible Information Standards (AIS) within NHS services. The communication barriers identified in this study have significant and long-term implications for the well-being of PDHL patients. Utilising these findings, our working group has developed a set of ‘Recommendations For Change’ to improve deaf awareness and effective communication across the NHS

Distance simulation in the health professions: a scoping review

Background Distance simulation is defined as simulation experiences in which participants and/or facilitators are separated from each other by geographic distance and/or time. The use of distance simulation as an education technique expanded rapidly with the recent COVID-19 pandemic, with a concomitant increase in scholarly work. Methods A scoping review was performed to review and characterize the distance simulation literature. With the assistance of an informationist, the literature was systematically searched. Each abstract was reviewed by two researchers and disagreements were addressed by consensus. Risk of bias of the included studies was evaluated using the Risk of Bias 2 (RoB 2) and Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tools. Results Six thousand nine hundred sixty-nine abstracts were screened, ultimately leading to 124 papers in the final dataset for extraction. A variety of simulation modalities, contexts, and distance simulation technologies were identified, with activities covering a range of content areas. Only 72 papers presented outcomes and sufficient detail to be analyzed for risk of bias. Most studies had moderate to high risk of bias, most commonly related to confounding factors, intervention classification, or measurement of outcomes. Conclusions Most of the papers reviewed during the more than 20-year time period captured in this study presented early work or low-level outcomes. More standardization around reporting is needed to facilitate a clear and shared understanding of future distance simulation research. As the broader simulation community gains more experience with distance simulation, more studies are needed to inform when and how it should be used

“I always feel like I’m the first deaf person they have ever met:” Deaf Awareness, Accessibility and Communication in the United Kingdom’s National Health Service (NHS): How can we do better?

BackgroundBarriers to communication significantly reduce access to health services for people with deafness or hearing loss (PDHL). These barriers contribute to reduced healthcare-seeking behaviour, poorer access to health information, and adverse health outcomes. In response, a multidisciplinary working group of patients, clinicians, researchers, and charity representatives was established to investigate accessibility, communication, and deaf awareness within the United Kingdom’s (UK) National Health Service (NHS).MethodologyA cross-sectional survey was conducted to explore the communication and accessibility experiences of PDHL NHS patients, and their perceived impact on well-being. The survey used rating scales and open-ended questions and data were analysed using descriptive statistics and thematic analysis. The survey was made available in British Sign Language (BSL).ResultsThe online survey was completed by 556 PDHL, including 50 parents, carers, or family members who had accompanied PDHL friends or relatives to NHS appointments. All respondents had used NHS services within the last 24 months, with 10% identifying BSL as their preferred language. Qualitative analysis of the open-ended responses generated three key themes: 1) Accessibility challenges, 2) Impact of communication difficulties across the service pathway, and 3) Lack of consistent, effective deaf-aware communication. Overall, 64.4% of PDHL NHS patients reported missing 50% or more of the important information provided during their NHS appointments, and 32% were satisfied with the communication skills of healthcare staff.ConclusionThis study presents the largest UK-wide dataset of its kind, and findings highlight the widespread non-compliance with the legally mandated Accessible Information Standards (AIS) within NHS services. The communication barriers identified in this study have significant and long-term implications for the well-being of PDHL patients. Utilising these findings, our working group has developed a set of ‘Recommendations For Change’ to improve deaf awareness and effective communication across the NHS

Annotation of the Drosophila melanogaster euchromatic genome: a systematic review

BACKGROUND: The recent completion of the Drosophila melanogaster genomic sequence to high quality and the availability of a greatly expanded set of Drosophila cDNA sequences, aligning to 78% of the predicted euchromatic genes, afforded FlyBase the opportunity to significantly improve genomic annotations. We made the annotation process more rigorous by inspecting each gene visually, utilizing a comprehensive set of curation rules, requiring traceable evidence for each gene model, and comparing each predicted peptide to SWISS-PROT and TrEMBL sequences. RESULTS: Although the number of predicted protein-coding genes in Drosophila remains essentially unchanged, the revised annotation significantly improves gene models, resulting in structural changes to 85% of the transcripts and 45% of the predicted proteins. We annotated transposable elements and non-protein-coding RNAs as new features, and extended the annotation of untranslated (UTR) sequences and alternative transcripts to include more than 70% and 20% of genes, respectively. Finally, cDNA sequence provided evidence for dicistronic transcripts, neighboring genes with overlapping UTRs on the same DNA sequence strand, alternatively spliced genes that encode distinct, non-overlapping peptides, and numerous nested genes. CONCLUSIONS: Identification of so many unusual gene models not only suggests that some mechanisms for gene regulation are more prevalent than previously believed, but also underscores the complex challenges of eukaryotic gene prediction. At present, experimental data and human curation remain essential to generate high-quality genome annotations

Hemoglobin Promotes Staphylococcus aureus Nasal Colonization

Staphylococcus aureus nasal colonization is an important risk factor for community and nosocomial infection. Despite the importance of S. aureus to human health, molecular mechanisms and host factors influencing nasal colonization are not well understood. To identify host factors contributing to nasal colonization, we collected human nasal secretions and analyzed their ability to promote S. aureus surface colonization. Some individuals produced secretions possessing the ability to significantly promote S. aureus surface colonization. Nasal secretions pretreated with protease no longer promoted S. aureus surface colonization, suggesting the involvement of protein factors. The major protein components of secretions were identified and subsequent analysis revealed that hemoglobin possessed the ability to promote S. aureus surface colonization. Immunoprecipitation of hemoglobin from nasal secretions resulted in reduced S. aureus surface colonization. Furthermore, exogenously added hemoglobin significantly decreased the inoculum necessary for nasal colonization in a rodent model. Finally, we found that hemoglobin prevented expression of the agr quorum sensing system and that aberrant constitutive expression of the agr effector molecule, RNAIII, resulted in reduced nasal colonization of S. aureus. Collectively our results suggest that the presence of hemoglobin in nasal secretions contributes to S. aureus nasal colonization

Duox, Flotillin-2, and Src42A Are Required to Activate or Delimit the Spread of the Transcriptional Response to Epidermal Wounds in Drosophila

The epidermis is the largest organ of the body for most animals, and the first line of defense against invading pathogens. A breach in the epidermal cell layer triggers a variety of localized responses that in favorable circumstances result in the repair of the wound. Many cellular and genetic responses must be limited to epidermal cells that are close to wounds, but how this is regulated is still poorly understood. The order and hierarchy of epidermal wound signaling factors are also still obscure. The Drosophila embryonic epidermis provides an excellent system to study genes that regulate wound healing processes. We have developed a variety of fluorescent reporters that provide a visible readout of wound-dependent transcriptional activation near epidermal wound sites. A large screen for mutants that alter the activity of these wound reporters has identified seven new genes required to activate or delimit wound-induced transcriptional responses to a narrow zone of cells surrounding wound sites. Among the genes required to delimit the spread of wound responses are Drosophila Flotillin-2 and Src42A, both of which are transcriptionally activated around wound sites. Flotillin-2 and constitutively active Src42A are also sufficient, when overexpressed at high levels, to inhibit wound-induced transcription in epidermal cells. One gene required to activate epidermal wound reporters encodes Dual oxidase, an enzyme that produces hydrogen peroxide. We also find that four biochemical treatments (a serine protease, a Src kinase inhibitor, methyl-ß-cyclodextrin, and hydrogen peroxide) are sufficient to globally activate epidermal wound response genes in Drosophila embryos. We explore the epistatic relationships among the factors that induce or delimit the spread of epidermal wound signals. Our results define new genetic functions that interact to instruct only a limited number of cells around puncture wounds to mount a transcriptional response, mediating local repair and regeneration

Shaping the Future of Infectious Diseases: The Journey to Promote Value, Opportunity, and Positive Messaging

The field of infectious diseases (ID) offers a rewarding career path and is widely viewed as an essential subspecialty in medicine. However, in recent years, these positive aspects have been overshadowed by concerns surrounding low fellowship match rates, undercompensation, and burnout. The Infectious Diseases Society of America Fellowship Training Program Directors Committee met in 2023, discussed the future of ID as a specialty, and sought to develop strategies to highlight the value and opportunities of ID for future generations, as well as underscore the importance of and provide tools for positive messaging to trainees about the subspecialty. This paper presents ideas generated at this meeting and is meant to serve as a reference for ID training program directors, as well as the wider ID community, in uplifting and shaping the future of the field