Conjugation is a complex phenomenon involving multiple plasmid, bacterial, and environmental factors. Here we describe an IncI1 plasmid encoding multidrug antibiotic resistance to aminoglycosides, sulfonamides, and third-generation cephalosporins. This plasmid is widespread geographically among animal, human, and environmental sectors.
View Article and Find Full Text PDFImportance: There are reported benefits from vitrectomy for diabetic macular edema (DME); however, data precede anti-vascular endothelial growth therapy (VEGF) therapy, supporting a need to assess the current role of vitrectomy.
Objective: To determine rates of recruitment and efficacy outcomes of vitrectomy plus internal limiting membrane (ILM) peeling adjunctive to treat-and-extend (T&E) anti-VEGF injections for diabetic macular edema (DME).
Design, Setting, And Participants: This was a single-masked, multicenter randomized clinical trial at 21 sites in the United Kingdom from June 2018 to January 2021, evaluating single eyes of treatment-naive patients with symptomatic vision loss from DME for less than 1 year.
Am J Ophthalmol Case Rep
September 2024
Introduction: Calcification of hydrophilic intraocular lenses (IOL) is a rare complication following cataract surgery. Secondary calcification is described as due to host factors or changes in the IOL environment and uveitis, proliferative diabetic retinopathy and sequelae of ocular surgery are recognised potentiators. The impact of systemic connective tissue disease on IOL opacification is yet to described.
View Article and Find Full Text PDFThe COVID-19 pandemic has exacerbated already high rates of poor psychological wellbeing in doctors. Many doctors perceive a stigma associated with acknowledging psychological wellbeing concerns, resulting in a reluctance to seek support for those concerns. The aim of this study was to develop a theoretically-informed and evidence-based composite narrative animation (CNA) to encourage doctors to access support for psychological wellbeing, and to evaluate the acceptability of the CNA.
View Article and Find Full Text PDFRationale: Stereotactic body radiation therapy (SBRT) is the standard of care for inoperable early stage non-small cell lung cancer (NSCLC). Use of image guided thermal ablation (IGTA; including microwave ablation [MWA] and radiofrequency ablation [RFA]) has increased in NSCLC, however there are no studies comparing all three.
Objective: To compare the efficacy of IGTA (including MWA and RFA) and SBRT for the treatment of NSCLC.
This systematic literature review (SLR) was conducted to better understand the impact of disease progression, line of therapy, and clinical response on health-related quality of life (HRQoL) in patients with multiple myeloma (MM). Multiple databases were searched to identify records relating to HRQoL in adult patients with MM. Titles and abstracts were independently screened by 2 reviewers for inclusion based on pre-defined criteria.
View Article and Find Full Text PDFIntroduction: Medical education is essential in strengthening the rural medical workforce globally. Immersive medical education in rural communities guided by good role models and rural-specific curricula promotes rural recruitment of recent graduates. While curricula can be rurally oriented, the mechanism of action is unclear.
View Article and Find Full Text PDFThe increasing burden of chronic diseases, and shortage of health care workers especially in Low and Middle Income countries (LMICs) requires greater collaborative working between health professions. There is a growing body of evidence that interprofessional education (IPE) and interprofessional continuous education (IPCE) can improve collaborative practice thus strengthening health care delivery in low resource settings. The World Health Organization (WHO) promotes this educational strategy in these regions as part of wider programs to improve health care.
View Article and Find Full Text PDFBackground: Chronic low back pain (cLBP) is a complex with a heterogenous clinical presentation. A better understanding of the factors that contribute to cLBP is needed for accurate diagnosis, optimal treatment, and identification of mechanistic targets for new therapies. The Back Pain Consortium (BACPAC) Research Program provides a unique opportunity in this regard, as it will generate large clinical datasets, including a diverse set of harmonized measurements.
View Article and Find Full Text PDFWhilst the in-person clinical immersion of students in their final years of medical programmes was relatively protected from the impact of COVID-19, the ability to deliver in-person clinical teaching was restricted or heavily altered for early-year students. Our challenge as a 3-year BSc (Hons) in Medicine programme at the University of St Andrew's School of Medicine was to continue to immerse and engage students in their clinical training when in-person access to the authentic environment was impossible, restricted, or completely altered from the original image held by students.In this chapter, we aim to discuss the problems faced, the solutions considered within the contextual restraints and then reflect on the successes and failures of the approaches we took in aiding students to visualise themselves in the clinical environment, or when using altered delivery modes that introduced radically different optics on the learning experience.
View Article and Find Full Text PDFBackground: Sequence-based methods for the detection of bacteria such as 16S rRNA amplicon sequencing and metagenomics can provide a comprehensive view of the bacterial microbiome of food. These methods rely on the detection of gene sequences to indicate the presence of viable bacteria. This indirect form of detection can be prone to experimental artefacts.
View Article and Find Full Text PDFIntroduction: In the context of the global pandemic of the SARS-CoV-2 coronavirus (COVID-19), healthcare providers (HCPs) have experienced difficult moral and ethical dilemmas. Research is highlighting the importance of moral injury (MI)-a trauma syndrome related to transgressing personal morals and values-in understanding the psychological harm and occupational impairment experienced by HCPs. To date, MI treatments have largely been developed for military personnel and veterans and rely on in-person one-on-one psychotherapy.
View Article and Find Full Text PDFIntroduction: Supporting doctors' wellbeing is crucial for medical education to help minimise negative long-term impacts on medical workforce retention and ultimately patient care. There is limited study of how doctors' transitions experiences impact wellbeing, particularly socially and culturally. Multiple Multidimensional Transitions (MMT) theory views transitions as dynamic, incorporating multiple contexts and multiple domains.
View Article and Find Full Text PDFVarious methods have been described to isolate third generation cephalosporin (3GC) resistant Enterobacteriaceae from foods, but it is not known how comparable they are between studies. Here, the performance of five enrichment broths and two selective agars are compared for their ability to isolate 3GC resistant Enterobacteriaceae from retail chicken, beef, pork, and veal samples. The results showed equivalence between Enterobacteriaceae enrichment broth (EE), lauryl sulfate broth (LST), and modified typtone soy broth (mTSB).
View Article and Find Full Text PDFMedical curricula encompass two practical-based teaching categories with likelihood of identifying incidental findings (unexpected and previously undiagnosed findings with potential health implications) in live models for demonstration purposes. One relates to clinical skills involving peers and simulated or volunteer patients. The other involves laboratory sessions, with live models, for the purposes of demonstrating scientific principles.
View Article and Find Full Text PDFThis paper aims to outline the development of a theoretically informed and evidence-based intervention strategy to underpin interventions to support the well-being of doctors during COVID-19 and beyond; delineate new ways of working were employed to ensure a rapid and rigorous process of intervention development and present the resulting novel framework for intervention development. The research comprised four workstreams: literature review (WS1), qualitative study (WS2), intervention development and implementation (WS3) and evaluation (WS4). Due to time constraints, we employed a parallel design for WS1-3 with the findings of WS1-2 informing WS3 on a continual basis.
View Article and Find Full Text PDFIntroduction: Physician shortages in rural and remote areas challenge accessibility and delivery of care to rural and remote communities, including within Scotland. Medical education is a reform priority to establish a sustainable medical workforce. Although there is evidence to support aspects of medical education that enhance the likelihood of practising rurally, the mechanism by which these educational initiatives work is not clearly understood.
View Article and Find Full Text PDFObjectives: The aim of this scoping review was to identify pre-existing interventions to support the well-being of healthcare workers during a pandemic or other crisis and to assess the quality of these interventions.
Design: Arksey and O'Malley's five-stage scoping review framework was used to identify the types of evidence available in the field of well-being interventions for healthcare workers during a pandemic. PubMed, PsycINFO, Embase, Scopus, Web of Science, CINAHL and ERIC databases were searched to find interventions for the well-being of doctors during pandemics.
Background: Exposure to occupational stressors and potentially psychologically traumatic events experienced by public safety personnel (eg, paramedics, police, fire, and correctional officers), military members, and veterans can lead to the development of posttraumatic stress injuries and other mental health disorders. Providing emergency services during COVID-19 has intensified the challenges. Owing to COVID-19 restrictions, mental health service providers offering support to these populations have had to rapidly pivot to use digital versus in-person methods of service delivery.
View Article and Find Full Text PDFPurpose: The recent pandemic has identified the need for telemedicine assessment of ophthalmology patients. A vital component of such assessment is visual acuity (VA) measurement. The aim of this study was to determine the feasibility and reliability of computerised 'at home' VA measurements using COMPlog software.
View Article and Find Full Text PDFObjective: To understand how primary care weight-related communication processes are influenced by individual differences in primary care practitioner (PCP) and patient characteristics and communication use.
Methods: Two multilevel logistic regression models were calculated to predict the occurrence of 1) weight-related discussion and 2) weight-related consultation outcomes. Coded communication data (Roter Interaction Analysis System) from 218 video-recorded consultations between PCPs and patients with overweight and obesity in Scottish primary care practices were combined with their demographic data to develop the multilevel models.
Purpose: To analyze the outcomes of revision surgery for idiopathic full-thickness macular holes that have failed to close after primary surgery, and also to assess factors predicting success and to review the relative effect of adjunctive surgical techniques.
Methods: A multicenter retrospective study. Anatomical closure rates and visual acuity change between pre and postrevision surgery were assessed.
Background: Empathy is a cornerstone of patient-centred care. However, empathy levels among health care professionals and medical students are currently suboptimal. An empathy map is a tool which aids in understanding another person's perspective.
View Article and Find Full Text PDFBackground: A necessary shift from in-person to remote delivery of psychotherapy (eg, teletherapy, eHealth, videoconferencing) has occurred because of the COVID-19 pandemic. A corollary benefit is a potential fit in terms of the need for equitable and timely access to mental health services in remote and rural locations. Owing to COVID-19, there may be an increase in the demand for timely, virtual delivery of services among trauma-affected populations, including public safety personnel (PSP; eg, paramedics, police, fire, correctional officers), military members, and veterans.
View Article and Find Full Text PDFNovel mycobacteriophage XianYue was isolated in Northeast Georgia and infects mc155. Actinobacteriophages which share at least 50% nucleotide identity are grouped into clusters, with XianYue in cluster A2. Its genome is 52,907 bp with 91 open reading frames (ORFs) and 62.
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