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Surface water is suspected of playing a role in the development and spread of antimicrobial-resistant (AR) bacteria, including human pathogens. In our previous study, 496 Escherichia coli isolates were recovered from water samples collected over a 2-year period from the Upper Oconee watershed, Athens, GA, United States, of which 34 (6.9%) were AR isolates. Of these, six isolates were selected based on their multidrug resistance (MDR) phenotypes, the presence of mobile genetic elements, and their pathogenic potential and were subjected to whole-genome sequence (WGS) analysis to enhance our understanding of environmental MDR E. coli isolates. This study is the first report on genomic characterization of MDR E. coli from environmental water in the United States through a WGS approach. The sequences of the six MDR E. coli isolates were analyzed and the locations of their AR genes were identified. One of the E. coli isolates was an ST131 epidemic strain, which also produced an extended-spectrum β-lactamase encoded by the blaCTX-M-15 gene, carried on a plasmid that is a member of a very rarely reported family of phage-like plasmids. This is the first time an in-depth sequence analysis has been done on a blaCTX-M-15- containing phage-like plasmid, the presence of which suggests a new emerging mechanism of AR gene transmission. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction Methods Results Conclusions Consumer demand for pasture raised, antibiotic‐free poultry products has led to an increase in pastured poultry operations within the United States. Given the level of environmental interaction and the potential increase in exposure to foodborne pathogens in these settings, a greater understanding of the prevalence and diversity of Campylobacter populations inherent within pastured poultry flocks is needed.To achieve this, 40 pastured poultry flocks from nine farms were sampled using a farm‐to‐fork strategy, and Campylobacter was isolated and characterised from preharvest (faeces, soil) through postharvest (caeca, whole carcass rinse) to the final product the consumer would purchase (whole carcass rinse).Campylobacter was isolated from 872 of 1820 samples, showing an overall prevalence of 47.91%. The caeca showed the highest (p < 0.05) Campylobacter load (4.64 log10 CFU/mL) and prevalence (95.5%), while the final product whole carcass rinses had the lowest (p < 0.05) Campylobacter load (0.32 log10 CFU/mL) and prevalence (15.45%), suggesting that the Campylobacter load in the caeca may not be indicative of the Campylobacter load on the final product. Of the 872 positive samples, 337 Campylobacter isolates were selected for further characterisation. Campylobacter jejuni and Campylobacter coli comprised 74.18% (250/337) and 21.95% (74/337) of the selected isolates respectively. While the Campylobacter isolates displayed resistance to several antibiotics, the most common resistance for both C. jejuni and C. coli was against tetracycline (55.86% and 70.31% respectively). Multidrug resistance phenotypes (≥ 3 antibiotic classes) were relatively low for both C. jejuni (2.80%) and C. coli (9.45%).Campylobacter load, prevalence and diversity were more affected by farm location than by the type of sample from which the Campylobacter was isolated. Overall, these results indicated a need for farm‐specific Campylobacter mitigation strategies to ensure the safety of these increasingly in‐demand poultry products. [ABSTRACT FROM AUTHOR]

Rationale: Bertolotti syndrome (BS) is characterized by radiculopathy caused by structural anomalies. Despite the structural deformity, conservative treatment is predominantly recommended due to surgery-related complications. Because of the diagnosis complexity, the incidence and contributing factors of BS, remain controversial. We report the case of a patient with BS who was treated with integrative Korean medicine (IKM). Moreover, we evaluated the epidemiological characteristics of lumbosacral transitional vertebrae (LSTV) from medical records of patients diagnosed with LSTV at 4 different medical clinics of Korean medicine., Patient Concerns: A 33-year-old male patient with low back pain and severe radiculopathy was diagnosed with BS (Castellvi Type II) on magnetic resonance imaging at a local orthopedic clinic. Additionally, the medical records of patients with BS who had been treated with IKM in 4 different institutions of Korean medicine were analyzed, and the characteristics of patients suffering from BS were identified., Diagnoses, Interventions, and Outcomes: The patient underwent IKM treatment for 40 days as an inpatient. The patient's condition was assessed using the Euroqol 5-dimension index and Oswestry Disability Index, and symptom severity was measured using the Numeric Rating Scale. IKM was effective in improving pain and functional disability without causing any adverse effects. In a retrospective review of medical records, the study identified symptom trends reported by patients with LSTV., Lessons: IKM demonstrates potential efficacy in BS management, with notable trends in LSTV-related symptomatology warranting further investigation., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: University students frequently report elevated levels of stress and mental health difficulties. Thus, the need to build coping capacity on university campuses has been highlighted as critical to mitigating the negative effects of prolonged stress and distress among students. Since the COVID-19 pandemic, web-based stress management resources such as infographics and web-based workshops have been central to supporting university students' mental health and well-being. However, there is a lack of research on students' satisfaction with and uptake of these approaches. Furthermore, mental health stigma has been suggested to have not only fueled the emergence of these web-based approaches to stress management but may also influence students' help-seeking behaviors and their satisfaction with and uptake of these resources., Objective: This study explored potential differences in students' satisfaction and strategy use in response to an interactive infographic (an emerging resource delivery modality) presenting stress management strategies and a web-based workshop (a more common modality) presenting identical strategies. This study also examined the relative contribution of students' strategy use and family-based mental health stigma in predicting their sustained satisfaction with the 2 web-based stress management approaches., Methods: University students (N=113; mean age 20.93, SD 1.53 years; 100/113, 88.5% women) completed our web-based self-report measure of family-based mental health stigma at baseline and were randomly assigned to either independently review an interactive infographic (n=60) or attend a synchronous web-based workshop (n=53). All participants reported their satisfaction with their assigned modality at postintervention (T1) and follow-up (T2) and their strategy use at T2., Results: Interestingly, a 2-way mixed ANOVA revealed no significant group × time interaction or main effect of group on satisfaction. However, there was a significant decrease in satisfaction from T1 to T2, despite relatively high levels of satisfaction being reported at both time points. In addition, a 1-way ANOVA revealed no significant difference in strategy use between groups. Results from a hierarchical multiple regression revealed that students' strategy use positively predicted T2 satisfaction in both groups. However, only in the web-based workshop group did family-based mental health stigma predict T2 satisfaction over and above strategy use., Conclusions: While both approaches were highly satisfactory over time, findings highlight the potential utility of interactive infographics since they are less resource-intensive than web-based workshops and students' satisfaction with them is not impacted by family-based mental health stigma. Moreover, although numerous intervention studies measure satisfaction at a single time point, this study highlights the need for tracking satisfaction over time following intervention delivery. These findings have implications for student service units in the higher education context, emphasizing the need to consider student perceptions of family-based mental health stigma and preferences regarding delivery format when designing programming aimed at bolstering students' coping capacity., (©Sohyun Cho, Laurianne Bastien, Julia Petrovic, Bilun Naz Böke, Nancy L Heath. Originally published in JMIR Formative Research (https://formative.jmir.org), 04.04.2024.)

Surface water is suspected of playing a role in the development and spread of antimicrobial-resistant (AR) bacteria, including human pathogens. In our previous study, 496 Escherichia coli isolates were recovered from water samples collected over a 2-year period from the Upper Oconee watershed, Athens, GA, United States, of which 34 (6.9%) were AR isolates. Of these, six isolates were selected based on their multidrug resistance (MDR) phenotypes, the presence of mobile genetic elements, and their pathogenic potential and were subjected to whole-genome sequence (WGS) analysis to enhance our understanding of environmental MDR E. coli isolates. This study is the first report on genomic characterization of MDR E. coli from environmental water in the United States through a WGS approach. The sequences of the six MDR E. coli isolates were analyzed and the locations of their AR genes were identified. One of the E. coli isolates was an ST131 epidemic strain, which also produced an extended-spectrum β-lactamase encoded by the bla CTX-M-15 gene, carried on a plasmid that is a member of a very rarely reported family of phage-like plasmids. This is the first time an in-depth sequence analysis has been done on a bla CTX-M-15 - containing phage-like plasmid, the presence of which suggests a new emerging mechanism of AR gene transmission.