arin users from real-world clinical practice settings.

Refugee arrivals to Europe have numbered more than one million since 2015 with the majority arriving through Greece. The healthcare needs of refugees have placed strains on Greece’s healthcare system which has already been affected by its ongoing economic crisis. At the peak of arrivals during 2016, primary healthcare was primarily provided by humanitarian organizations with specialist referrals into the Greek healthcare system. There is little published literature on the type and impacts of specialist referrals for refugees in Greece. The aim of this retrospective review is to identify the type and impacts of specialist referrals for refugees into Greece’s health system.

This retrospective study reviewed the number and type of specialty referrals from one humanitarian organization providing primary healthcare for refugees in Greece. All consultations during an 8-month period (December 1, 2016-July 31, 2017) were reviewed.

Of 4168 consultations, 42% were patients aged 17 years or younger, 52% were male, and 90% were Syrian. Two hundred and thirty-three patients (11%) required a specialist referral; 25% were for dental (provided by another humanitarian organization), 10% each for obstetrics and gynecology and pediatrics, and 8% for ophthalmology. Respiratory complaints were most frequently seen, and these were more predominant in the winter months. Pediatric consultations varied according to month, likely due to population movements.

Dentistry was noted to be a gap in humanitarian response programming and accounted for the greatest need for specialist input with referrals for women and children accounting for a large proportion of referrals.

Dentistry was noted to be a gap in humanitarian response programming and accounted for the greatest need for specialist input with referrals for women and children accounting for a large proportion of referrals.

Internship is a facilitatory period that hones skills and helps in the evolution of a qualified medical student to a competent doctor. The feeling of a final year student joining as a fresh intern after successfully completing the final professional examination will be directionless without a bridging initiative through a buffer program. Fresh interns need to be oriented to the fundamentals of working effectively with a patient as a whole and not as a separate discipline. This study was done to evaluate the effectiveness of the internship orientation program and to assess the feedback of participants about this program.

This was a study conducted on 235 freshly joined medical interns. The process included evaluation of a well-structured seven-day orientation program by prevalidated structured Multiple Choice Questions (MCQs) and feedback.

All interns performed satisfactorily in the post-test with a mean score of 74.13 ± 7.18. Post-test scores were highest for procedure skills and communication skills, in program for a smooth and swift transition from that of a medical student to professional life. It will orient the interns and lay the foundation for the next level of assignment in building their professional career.

Blood transfusion is an essential medical procedure conducted with various purposes to provide patients with blood needed. The procedure saves patients’ lives, as blood cannot be manufactured artificially and can only be obtained from human blood sources.

To assess the awareness of, perceptions of, motivations regarding, and barriers to blood donation among a sample of Jazan University students in the Kingdom of Saudi Arabia (KSA).

An observational cross-sectional study was conducted among the undergraduate students of Jazan University.

Stratified random sampling was used to collect information from 440 students, and a predesigned, structured questionnaire was used to collect data on the study variables.

Involved descriptive statistics and inferential statistics. SPSS was used for data analysis.

The prevalence of blood donation was 29.0% (95% CI, 25.0-33.3), significantly higher for males at 44.3% (95% CI, 38.3-50.4) than for females at 10.5% (95% CI, 7.3-16.0;

< 0.001), and with odds ratio tions about blood donation and encourage them to join donation campaigns.

Biotechnology has introduced a new physiological state, „brain death,” that continues to attract controversy and confusion. While variability in diagnostic criteria for, and physician practices regarding, „brain death” has been studied, few studies examine physicians’ normative views on the significance of „brain death” and how religiosity implicates these views.

The objective is to assess how Muslim physicians’ views on death, and how their religiosity and acculturation, associate with their perceptions of „brain death.”

A randomized national sample of 626 American Muslim physicians completed a mailed questionnaire assessing sociodemographic characteristics, religiosity, and views about death. Measures of religious practice and acculturation were analyzed as predictors of physician views at the bivariate and multivariable levels. In conducting the multivariate analysis,

-values less than 0.05 were deemed statistically significant.

Two-hundred and fifty-five respondents completed the survey (41% reso determine death and disquiet regarding the meaning of „brain death” in general.

Physician characteristics such as religiosity and acculturation appear to influence their views on what constitutes death and how it should be diagnosed. In our sample of Muslim physicians, there appears to be significant reservation toward equating neurological and cardiopulmonary criteria to determine death and disquiet regarding the meaning of „brain death” in general.RtxA1 is a major cytotoxin of Vibrio vulnificus (V. vulnificus) causing fatal septicemia and necrotic wound infections. Our previous work has shown that RpoS regulates the expression and secretion of V. vulnificus RtxA1 toxin. This study was conducted to further investigate the potential mechanisms of RpoS on RtxA1 secretion. First, V. vulnificus TolCV1 and TolCV2 proteins, two Escherichia coli TolC homologs, were measured at various time points by Western blotting. The expression of TolCV1 was increased time-dependently, whereas that of TolCV2 was decreased. Expression of both TolCV1 and TolCV2 was significantly downregulated in an rpoS deletion mutation. Subsequently, we explored the roles of TolCV1 and TolCV2 in V. vulnificus pathogenesis. Western blot analysis showed that RtxA1 toxin was exported by TolCV1, not TolCV2, which was consistent with the cytotoxicity results. Furthermore, the expression of TolCV1 and TolCV2 was increased after treatment of the host signal bile salt and the growth of tolCV1 mutant was totally abolished in the presence of bile salt. A tolCV1 mutation resulted in significant reduction of V. vulnificus induced-virulence in mice. Taken together, TolCV1 plays key roles in RtxA1 secretion, bile salt resistance, and mice lethality of V. vulnificus, suggesting that TolCV1 could be an attractive target for the design of new medicines to treat V. vulnificus infections.Bacterial Type III Secretion Systems (T3SSs) are specialized multicomponent nanomachines that mediate the transport of proteins either to extracellular locations or deliver Type III Secretion effectors directly into eukaryotic host cell cytoplasm. Shigella, the causing agent of bacillary dysentery or shigellosis, bears a set of T3SS proteins termed translocators that form a pore in the host cell membrane. IpaB, the major translocator of the system, is a key factor in promoting Shigella pathogenicity. Prior to secretion, IpaB is maintained inside the bacterial cytoplasm in a secretion competent folding state thanks to its cognate chaperone IpgC. IpgC couples T3SS activation to transcription of effector genes through its binding to MxiE, probably after the delivery of IpaB to the secretion export gate. Small Angle X-ray Scattering experiments and modeling reveal that IpgC is found in different oligomeric states in solution, as it forms a stable heterodimer with full-length IpaB in contrast to an aggregation-prone homodimer in the absence of the translocator. These results support a stoichiometry of interaction 11 in the IpgC/IpaB complex and the multi-functional nature of IpgC under different T3SS states.

We previously found that microbial disruption in

ventilator-associated pneumonia (PA-VAP) patients are long-lasting. Long-term microbial dysbiosis may lead to changes in metabolites. Short-chain fatty acids (SCFAs) are microbial fermentation products and show beneficial effects in patients with pneumonia. In this study, we aimed to explore the association between circulating SCFA levels and clinical outcomes in patients with PA-VAP.

In this study, we analyzed SCFAs in the serum of 49 patients with PA-VAP by gas chromatography-mass spectrometry analysis. Twenty of these patients died, and 29 survived. The correlation between serum SCFAs and patient survival and immune parameters was analyzed.

We developed a partial least squares discriminant analysis (PLS-DA) model to examine differential SCFAs in 49 patients with PA-VAP. Among the seven SCFAs, only acetic acid was increased in non-survivors (P = 0.031, VIP > 1). Furthermore, high levels of acetic acid (>1.96ug/ml) showed increased 90-day mortality compared to low levels of acetic acid (<1.96ug/ml) in Kaplan-Meier survival analyses (P = 0.027). Increased acetic acid also correlated with reduced circulating lymphocyte and monocyte counts.

Our study showed that increased circulating acetic acid is associated with 90-day mortality in PA-VAP patients. The decrease in lymphocytes and monocytes might be affected by acetic acid and involved in the poor prognosis.

Our study showed that increased circulating acetic acid is associated with 90-day mortality in PA-VAP patients. The decrease in lymphocytes and monocytes might be affected by acetic acid and involved in the poor prognosis.The ability to sense and adequately respond to variable environmental conditions is central for cellular and organismal homeostasis. Eukaryotic cells are equipped with highly conserved stress-response mechanisms that support cellular function when homeostasis is compromised, promoting survival. Two such mechanisms – the unfolded protein response (UPR) and autophagy – are involved in the cellular response to perturbations in the endoplasmic reticulum, in calcium homeostasis, in cellular energy or redox status. Each of them operates through conserved signaling pathways to promote cellular adaptations that include re-programming transcription of genes and translation of new proteins and degradation of cellular components. In addition to their specific functions, it is becoming increasingly clear that these pathways intersect in many ways in different contexts of cellular stress. Viral infections are a major cause of cellular stress as many cellular functions are coopted to support viral replication. Both UPR anden CoV, UPR and autophagy.The genus Enterococcus includes two Gram-positive pathogens of particular clinical relevance E. faecalis and E. faecium. Infections with each of these pathogens are becoming more frequent, particularly in the case of hospital-acquired infections. Like most other bacterial species of clinical importance, antimicrobial resistance (and, specifically, multi-drug resistance) is an increasing threat, with both species considered to be of particular importance by the World Health Organization and the US Centers for Disease Control. The threat of antimicrobial resistance is exacerbated by the staggering difference in the speeds of development for the discovery and development of the antimicrobials versus resistance mechanisms. In the search for alternative strategies, modulation of host-pathogen interactions in general, and virulence inhibition in particular, have drawn substantial attention. Unfortunately, these approaches require a fairly comprehensive understanding of virulence determinants. This requirement is complicated by the fact that enterococcal infection models generally require vertebrates, making them slow, expensive, and ethically problematic, particularly when considering the thousands of animals that would be needed for the early stages of experimentation.