Outbreak of perichondritis associated with ear piercings and a contaminated water system.

In September 2023, the UK Health Security Agency's (UKHSA) South West Health Protection Team received notification of patients with perichondritis. All five cases had attended the same cosmetic piercing studio and a multi-disciplinary outbreak control investigation was subsequently initiated. An additional five cases attending the same studio were found.

Trust, entrusting and the role of trustworthiness for adult survivors of child sexual abuse.

Background: Survivors of Child Sexual Abuse (CSA) are reported to have difficulties in trusting. Yet no previous study investigating CSA survivors' subjective experiences of trust exists and there is a paucity of clinical research into constructs and definitions of "trust."

Aims: To use a phenomenological lens to investigate CSA survivors' descriptions of trust relationships and trustworthy others by privileging their subjective experience.

A retrospective audit with subsequent cost and environmental analysis of a denosumab self-injection program.

The Metabolic Bone Health Department, Cardiff and Vale University Health Board, serves a local population of approximately 445 000 people. A retrospective audit of attendance data regarding the denosumab treatment clinic (the traditional treatment pathway) and the denosumab Self-Injection Program (SIP) was conducted to determine whether the SIP is both cost-effective and environmentally beneficial, compared to the traditional treatment pathway. Cost analysis was then conducted by the Finance Department.

Outbreak of associated with contamination of saline products distributed internationally, the United Kingdom, 2024.

We describe an outbreak of in the United Kingdom, with isolates genetically indistinguishable from a 2023 Australian outbreak linked to internationally distributed saline solutions. Confirmed cases (n = 3) had bacteraemia, clinically relevant infection, indwelling venous lines and frequent healthcare contact. Multi-stakeholder intervention was required including product recall and risk communications.

sequence type 147: a high-risk clone increasingly associated with plasmids carrying both resistance and virulence elements.

The first hybrid resistance/virulence plasmid, combining elements from virulence plasmids described in hypervirulent types of with those from conjugative resistance plasmids, was described in an isolate of sequence type (ST) 147 from 2016. Subsequently, this type has been increasingly associated with these plasmids. The extent of carriage of hybrid virulence/resistance plasmids in nosocomial isolates of requires further investigation.

Clonal expansion and rapid characterization of ST1788, an otherwise uncommon strain spreading in Wales, UK.

A multidrug-resistant strain of () sequence type (ST) 1788, an otherwise uncommon ST worldwide, was isolated from 65 patients at 11 hospitals and 11 general practices across South and West Wales, UK, between February 2019 and November 2021. A collection of 97 ST1788 isolates (including 94 from Wales) was analysed to investigate the diversity and spread across Wales and to identify molecular marker(s) to aid development of a strain-specific real-time PCR. Whole genome sequencing (WGS) was performed with Illumina technology and the data were used to perform phylogenetic analyses.

Effects of a low-carbohydrate diet in adults with type 1 diabetes management: A single arm non-randomised clinical trial.

Public interest in low-carbohydrate (LC) diets for type 1 diabetes (T1D) management has increased. This study compared the effects of a healthcare professional delivered LC diet compared to habitual diets higher in carbohydrates on clinical outcomes in adults with T1D. Twenty adults (18-70 yrs) with T1D (≥6 months duration) with suboptimal glycaemic control (HbA1c>7.

Investigating Pseudomonas aeruginosa population structure and frequency of cross-infection in UK cystic fibrosis clinics - a reference laboratory perspective.

Background: We aimed to describe the UK Pseudomonas aeruginosa population structure amongst people with cystic fibrosis (PWCF), and to examine evidence for cross-infection.

Methods: Variable Number Tandem Repeat (VNTR) typing was performed on 4640 isolates from 2619 PWCF received from 55 hospital laboratories between 2017 and 2019. A combination of whole genome sequence (WGS)-based analysis of four clusters from one hospital, and epidemiological analysis of shared strains in twelve hospitals evaluated cross-infection.

Increasing extreme melt in northeast Greenland linked to foehn winds and atmospheric rivers.

The Greenland Ice Sheet has been losing mass at an increased rate in recent decades. In northeast Greenland, increasing surface melt has accompanied speed-ups in the outlet glaciers of the Northeast Greenland Ice Stream, which contain over one meter of sea level rise potential. Here we show that the most intense northeast Greenland melt events are driven by atmospheric rivers (ARs) affecting northwest Greenland that induce foehn winds in the northeast.

Avoiding psychological (re)traumatisation in dentistry when working with patients who are adult survivors of child sex abuse.

Introduction Seven percent of the adult population in the UK, including one in six women, report unwanted sexual experiences before the age of 16. The impacts of psychological trauma following child sexual abuse (CSA) creates difficulties for many survivors in accessing dental care due to fears of reminders of abuse, the power imbalance with the dentist and triggered traumatic responses.Aims To analyse and report CSA survivor perspectives of dental care and offer suggestions for practice.

Strengthening Mental Abilities with Relational Training (SMART) in multiple sclerosis (MS): study protocol for a feasibility randomised controlled trial.

Background: Multiple sclerosis (MS) is a chronic condition of the central nervous system, affecting around 1 in every 600 people in the UK, with 130 new diagnoses every week. Cognitive difficulties are common amongst people with MS, with up to 70% experiencing deficits in higher-level brain functions-such as planning and problem-solving, attention, and memory. Cognitive deficits make it difficult for people with MS to complete everyday tasks and limit their abilities to work, socialise, and live independently.

Do plasmids containing heavy metal resistance genes play a role in neonatal sepsis and invasive disease caused by and ?

species are some of those most implicated in neonatal sepsis. However, many isolates from infections appear unremarkable; they are generally susceptible to antibiotics and often of sporadic types not associated with virulence. Investigation is needed to identify if such isolates have virulence characteristics.

Wide distribution of carrying IncF plasmids containing and resistance genes from hospitalized patients in England.

. The New Delhi metallo-β-lactamase (NDM) variant NDM-5 was first described in 2011 in an isolate of . We noted that a high proportion of isolates of positive for carbapenemase genes submitted to the UK Health Security Agency (formerly Public Health England) between 2019 and mid-2021 carried the allele, with many co-harbouring , rendering them highly resistant to aminoglycosides as well as to most β-lactams.

Neuropsychological evaluation and rehabilitation in multiple sclerosis (NEuRoMS): protocol for a mixed-methods, multicentre feasibility randomised controlled trial.

Background: Cognitive problems affect up to 70% of people with multiple sclerosis (MS), which can negatively impact mood, ability to work, and quality of life. Addressing cognitive problems is a top 10 research priority for people with MS. Our ongoing research has systematically developed a cognitive screening and management pathway (NEuRoMS) tailored for people with MS, involving a brief cognitive evaluation and rehabilitation intervention.

Usability and acceptability of a cognitive training intervention (SMART) for people with multiple sclerosis (MS): A prefeasibility formative evaluation.

Background: Multiple sclerosis (MS) is a chronic autoimmune, inflammatory neurological disease of the central nervous system (CNS), increasing in incidence and prevalence across both developed and developing countries. Cognitive difficulties are common in MS sufferers with 70% experiencing difficulties in higher-level brain functioning such as planning, attention, problem solving, and memory. Computerised cognitive training programmes may hold promise as a treatment option for improving cognitive function in people with MS, subject to exploring and addressing potential barriers to usability and acceptability.

Development and Evaluation of Molecular Pen-Side Assays without Prior RNA Extraction for Peste des Petits Ruminants (PPR) and Foot and Mouth Disease (FMD).

Animal diseases such as peste des petits ruminants (PPR) and foot and mouth disease (FMD) cause significant economic losses in endemic countries and fast, accurate in-field diagnostics would assist with surveillance and outbreak control. The detection of these pathogens is usually performed at reference laboratories, tested using assays that are recommended by The World Organisation for Animal Health (OIE), leading to delays in pathogen detection. This study seeks to demonstrate a proof-of-concept approach for a molecular diagnostic assay that is compatible with material direct from nasal swab sampling, without the need for a prior nucleic acid extraction step, that could potentially be applied at pen-side for both PPR and FMD.

Hospital outbreak of carbapenem-resistant Enterobacterales associated with a plasmid carried mostly by ST399.

A hospital outbreak of carbapenem-resistant Enterobacterales was detected by routine surveillance. Whole genome sequencing and subsequent analysis revealed a conserved promiscuous carrying plasmid as the defining factor within this outbreak. Four different species of Enterobacterales were involved in the outbreak.

NDM-1 carbapenemase resistance gene vehicles emergent on distinct plasmid backbones from the IncL/M family.

Objectives: To assess the genetic contexts surrounding blaNDM-1 genes carried on IncM plasmids harboured by six carbapenemase-producing Enterobacterales (CPE) isolates referred to the UK Health Security Agency's Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit.

Methods: Between 2014 and 2018, the AMRHAI Reference Unit undertook WGS of CPE isolates using Illumina NGS. Nanopore sequencing was used for selected isolates and publicly available plasmid references were downloaded.

A case of neck abscess caused by rare hypervirulent Klebsiella pneumoniae, capsular type K20 and sequence type 420.

Background: This case report describes a neck abscess caused by a strain of Hypervirulent Klebsiella pneumoniae in a middle aged man with diabetes without a history of travel to East and South East Asia. This case report is of notable significance as Hypervirulent Klebsiella pneumoniae neck abscesses are rarely seen in the UK and are very infrequently documented in individuals who have not first travelled to the high prevalence areas of East and South East Asia.

Case Presentation: This case report describes a 53 year old diabetic man who contracted a Hypervirulent Klebsiella pneumoniae neck abscess which led to the development of sepsis.

Transmission, adaptation and geographical spread of the Liverpool epidemic strain.

The Liverpool epidemic strain (LES) is an important transmissible clonal lineage of that chronically infects the lungs of people with cystic fibrosis (CF). Previous studies have focused on the genomics of the LES in a limited number of isolates, mostly from one CF centre in the UK, and from studies highlighting identification of the LES in Canada. Here we significantly extend the current LES genome database by genome sequencing 91 isolates from multiple CF centres across the UK, and we describe the comparative genomics of this large collection of LES isolates from the UK and Canada.

Dietary Interventions Are Beneficial for Patients with Chronic Pain: A Systematic Review with Meta-Analysis.

Background: The standard Western diet is high in processed hyperpalatable foods that displace nutrient-dense whole foods, leading to inflammation and oxidative stress. There is limited research on how these adverse metabolic drivers may be associated with maladaptive neuroplasticity seen in chronic pain and whether this could be attenuated by a targeted nutritional approach. The aim of this study was to review the evidence for whole-food dietary interventions in chronic pain management.

Adults with and without type 1 diabetes have similar energy and macronutrient intakes: an analysis from the Australian Health Survey 2011-2013.

The aim of this study was to describe and compare the mean usual dietary intakes of adults with type 1 diabetes (T1D) and without diabetes living in Australia. Our hypothesis was that adults with T1D have similar dietary intake profiles to adults without diabetes. Data from the National Nutrition and Physical Activity Survey 2011-2012, which formed part of the Australian Health Survey 2011-13, were used and participants ≥18 years of age with T1D and without diabetes were included in the analyses.