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Background: Staphylococcus aureus clinical isolates with vancomycin MICs of 2 µg/ml have been associated with vancomycin therapeutic failure and the heterogenous vancomycin-intermediate S. aureus (hVISA) phenotype. While carriage of van genes has usually been associated with higher level of MIC and frank vancomycin resistance, the unrecognized risk of hetero-resistance is frequently underestimated. Methods used for assessing vancomycin susceptibility have also shown different concordance and variable performance and accessibility in routine clinical diagnostics posing a challenge to inform treatment selection in hospital settings. Methods: A total of 195 clinical samples were obtained among which 100 S. aureus isolates were identified. Ninety-six MRSA isolates have been identified using cefoxitin disc and mecA gene detection. The vanA and vanB genes have been screened for in the studied isolates using conventional PCR amplification. Examination of reduced vancomycin susceptibility has been performed using vancomycin screen agar, Broth Micro Dilution method (BMD), and VITEK2. Blood isolates were screened for hVISA using PAP-AUC method. Results: Vancomycin screening agar applied to 96 MRSA isolates revealed 16 isolates with reduced vancomycin susceptibility. Further MIC testing revealed that 7 isolates were VISA and only 1 isolate was identified as VRSA using both BMD MIC method and VITEK2. Among 24 tested blood isolates, 4 isolates (16.7%) revealed the hVISA phenotype as identified using PAP-AUC method. Using PCR, vanA gene was identified in 5 S. aureus isolates (5%). Three of them were VSSA while the other two isolates were VISA. Conclusion: In this study, we report the very low prevalence of VRSA among the tested S. aureus clinical isolates (1%) and the existence of hVISA phenotype among studied S. aureus blood isolates at the rate of 16.7% in our setting. Fifty percent (8/16) of isolates that demonstrated reduced vancomycin susceptibility using vancomycin agar screen tested susceptible using both broth dilution method and VITEK2. These finding together with the concerning silent carriage of vanA gene among VSSA and VISA (5%) may underly hidden and uninvestigated factors contributing to vancomycin treatment failure that warrant cautious vancomycin prescription. [ABSTRACT FROM AUTHOR]

Viral encephalitis is characterized by a series of immunological reactions that can control virus infection in the brain, but dysregulated responses may cause excessive inflammation and brain damage. Microglia are brain-resident myeloid cells that are specialized in surveilling the local CNS environment and in case of viral brain infection they contribute to the control of the infection and to restriction of viral dissemination. Here, we report that after exposure to neurotropic vesicular stomatitis virus (VSV), murine in vitro microglia cultures showed rapid upregulation of a broad range of pro-inflammatory and antiviral genes, which were stably expressed over the entire 8 h infection period. Additionally, a set of immunomodulatory genes was upregulated between 6 and 8 h post infection. In microglia cultures, the induction of several immune response pathways including cytokine responses was dependent on mitochondrial antiviral-signaling protein (MAVS). Consequently, in Mavs-deficient microglia the control of virus propagation failed as indicated by augmented virus titers and the accumulation of viral transcripts. Thus, in the analyzed in vitro system, MAVS signaling is critically required to achieve full microglia activation and to mediate profound antiviral effects. In Mavs-deficient mice, intranasal VSV instillation caused higher disease severity than in WT mice and virus dissemination was noticed beyond the olfactory bulb. Virus spread to inner regions of the olfactory bulb, i.e., the granular cell layer, correlated with the recruitment of highly inflammatory non-microglia myeloid cells into the olfactory bulb in Mavs−/− mice. Furthermore, increased cytokine levels were detected in the nasal cavity, the olfactory bulb and in other brain regions. Thus, microglial MAVS signaling is critically needed for virus sensing, full microglia activation, and for orchestration of protective immunity in the virus-infected CNS. [ABSTRACT FROM AUTHOR]

Abstract Background Staphylococcus aureus clinical isolates with vancomycin MICs of 2 µg/ml have been associated with vancomycin therapeutic failure and the heterogenous vancomycin-intermediate S. aureus (hVISA) phenotype. While carriage of van genes has usually been associated with higher level of MIC and frank vancomycin resistance, the unrecognized risk of hetero-resistance is frequently underestimated. Methods used for assessing vancomycin susceptibility have also shown different concordance and variable performance and accessibility in routine clinical diagnostics posing a challenge to inform treatment selection in hospital settings. Methods A total of 195 clinical samples were obtained among which 100 S. aureus isolates were identified. Ninety-six MRSA isolates have been identified using cefoxitin disc and mecA gene detection. The vanA and vanB genes have been screened for in the studied isolates using conventional PCR amplification. Examination of reduced vancomycin susceptibility has been performed using vancomycin screen agar, Broth Micro Dilution method (BMD), and VITEK2. Blood isolates were screened for hVISA using PAP-AUC method. Results Vancomycin screening agar applied to 96 MRSA isolates revealed 16 isolates with reduced vancomycin susceptibility. Further MIC testing revealed that 7 isolates were VISA and only 1 isolate was identified as VRSA using both BMD MIC method and VITEK2. Among 24 tested blood isolates, 4 isolates (16.7%) revealed the hVISA phenotype as identified using PAP-AUC method. Using PCR, vanA gene was identified in 5 S. aureus isolates (5%). Three of them were VSSA while the other two isolates were VISA. Conclusion In this study, we report the very low prevalence of VRSA among the tested S. aureus clinical isolates (1%) and the existence of hVISA phenotype among studied S. aureus blood isolates at the rate of 16.7% in our setting. Fifty percent (8/16) of isolates that demonstrated reduced vancomycin susceptibility using vancomycin agar screen tested susceptible using both broth dilution method and VITEK2. These finding together with the concerning silent carriage of vanA gene among VSSA and VISA (5%) may underly hidden and uninvestigated factors contributing to vancomycin treatment failure that warrant cautious vancomycin prescription.

Abstract Viral encephalitis is characterized by a series of immunological reactions that can control virus infection in the brain, but dysregulated responses may cause excessive inflammation and brain damage. Microglia are brain-resident myeloid cells that are specialized in surveilling the local CNS environment and in case of viral brain infection they contribute to the control of the infection and to restriction of viral dissemination. Here, we report that after exposure to neurotropic vesicular stomatitis virus (VSV), murine in vitro microglia cultures showed rapid upregulation of a broad range of pro-inflammatory and antiviral genes, which were stably expressed over the entire 8 h infection period. Additionally, a set of immunomodulatory genes was upregulated between 6 and 8 h post infection. In microglia cultures, the induction of several immune response pathways including cytokine responses was dependent on mitochondrial antiviral-signaling protein (MAVS). Consequently, in Mavs-deficient microglia the control of virus propagation failed as indicated by augmented virus titers and the accumulation of viral transcripts. Thus, in the analyzed in vitro system, MAVS signaling is critically required to achieve full microglia activation and to mediate profound antiviral effects. In Mavs-deficient mice, intranasal VSV instillation caused higher disease severity than in WT mice and virus dissemination was noticed beyond the olfactory bulb. Virus spread to inner regions of the olfactory bulb, i.e., the granular cell layer, correlated with the recruitment of highly inflammatory non-microglia myeloid cells into the olfactory bulb in Mavs −/− mice. Furthermore, increased cytokine levels were detected in the nasal cavity, the olfactory bulb and in other brain regions. Thus, microglial MAVS signaling is critically needed for virus sensing, full microglia activation, and for orchestration of protective immunity in the virus-infected CNS.

International students are not only agents for the internationalisation of a campus environment but also a crucial source of income for universities and a country's economy. Thus, their recruitment and retention are vital and prioritised by university leadership and policymakers. However, scant attention has been given to investigating international student withdrawal, even more so on visa-related matters. This paper focuses on the lived experiences of five former students from Syria who withdrew from education pursuits in Malaysia due to visa-related issues. This phenomenological study found the absence of clear knowledge of immigration procedures among institution staff and unsympathetic treatment towards international students were the primary reasons behind withdrawals. These findings suggest negative student experiences affect not only current students but also potential students. Whilst the findings add to existing knowledge and future studies, the study marks the first in-depth investigation concerning the impact of visa-related issues on international student withdrawal. [ABSTRACT FROM AUTHOR]

This article offers a critical analysis of the current literature on visa studies, particularly with regard to its methodological limitations and how they impact our understanding of worldwide migration patterns with the fortress Europe conception. The first half of the manuscript is a critical review of studies that study visas. Although, numerous studies initially relied on the insights of authors such as John Torpey and Marc B. Salter, who examined the rise of passports and visas to regulate global flows of people, later studies chose to use a dyadic methodology, which is a reflection of a reductionist understanding of global flows and networks. The second half uses the Demig Visa database to show that the EU, which has been hailed as creating an area for free movement of,‘people, goods and services’, proved to be an obstacle for many countries in Asia and Africa, including neighbouring Mediterranean countries, which had enjoyed visa-free travel until the EU ‘Europeanized’ its immigration policy with the Schengen agreement in the mid-1980s. In summary, the subsequent EU ‘Great Shutdown’ does not stop population flows, but rather attempts to direct the flows at will. [ABSTRACT FROM AUTHOR]

Copyright of Hungarian Law Enforcement / Magyar Rendészet is the property of National University of Public Service and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

It is human instinct to move from one place to another. This migration phenomenon will be followed by a movement of various aspects of life such as ideology, politics, economy, society, culture, security, demography, human resources, the environment, and various other aspects of life. Along with the times, international migration carried out by people is increasing; this is directly proportional to the advancement of technological civilization that produces innovations in the fields of information, transportation, and communication. This paper uses a qualitative approach. This research will produce descriptive data in the form of paragraphs explaining the events studied. The result of this study is that in order to influence the policy of granting visas to other countries, the country must take a persuasive approach, namely by having a high level of soft power so that it is in a bargaining position. Soft power and visa granting policies are both continuous and directly proportional. This can be proven by the top position of passport strength of a country also occupying the top position on the soft power index. [ABSTRACT FROM AUTHOR]

Background: Australia imposes restrictions for people living with HIV (PLHIV) applying for permanent residency (PR), including spending less than AUD51,000 on medical costs over 10 years. Some PLHIV opted for suboptimal and cheaper antiretroviral therapy (ART) regimens to increase their chances of receiving PR. We collated a case series to examine PLHIV on suboptimal ART because of visa issues. Methods: We identified all patients applying for a PR in Australia who obtained nevirapine, efavirenz or zidovudine between July 2022 and July 2023 from the Melbourne Sexual Health Centre. Pathology results and records detailing psychological issues relating to the patients' wishes to remain on suboptimal ART were extracted from clinical records by two researchers. Results: We identified six patients with a mean age of 39 years migrating from Asian and European countries. Three patients used efavirenz, and three used nevirapine. All desired to remain on cheaper, suboptimal ART to stay below visa cost thresholds, which they considered to aid favourably with their application. Four displayed stress and anxiety arising from visa rejections, appeal deadlines and the lengthy visa application process. Conclusions: Despite access to more effective and safer ART, we identified patients who chose to remain on cheaper ART to improve chances of obtaining an Australian visa, potentially putting their health at risk. We found significant evidence of stress and anxiety among patients. There is a need to review and revise current migration policies and laws in Australia that discriminate against PLHIV and jeopardise public health. Even in the modern day, people living with HIV (PLHIV) are often subjected to poorer physical and mental health outcomes. Such health outcomes were identified in this case series, whereby six patients were noted to be experiencing significant stress, anxiety and medication side effects from electing to receive cheap, suboptimal HIV treatments to remain below Australian visa medical cost thresholds. These findings reinforce the need to review Australian migration laws which currently discriminate against PLHIV. [ABSTRACT FROM AUTHOR]

Abstract Background Brain-heart infusion agar supplemented with 4 µg/mL of vancomycin (BHI-V4) was commonly used for the detection of heterogeneous (hVISA) and vancomycin-intermediate Staphylococcus aureus (VISA). However, its diagnostic value remains unclear. This study aims to compare the diagnostic accuracy of BHI-V4 with population analysis profiling with area under the curve (PAP-AUC) in hVISA/VISA. Methods The protocol of this study was registered in INPLASY (INPLASY2023120069). The PubMed and Cochrane Library databases were searched from inception to October 2023. Review Manager 5.4 was used for data visualization in the quality assessment, and STATA17.0 (MP) was used for statistical analysis. Results In total, eight publications including 2153 strains were incorporated into the meta-analysis. Significant heterogeneity was evident although a threshold effect was not detected across the eight studies. The summary receiver operating characteristic (SROC) was 0.77 (95% confidence interval [CI], 0.74–0.81). The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic score and diagnostic odds ratio were 0.59 (95% CI: 0.46–0.71), 0.96 (95%CI: 0.83–0.99), 14.0 (95% CI, 3.4–57.1), 0.43 (95%CI, 0.32–0.57), 3.48(95%CI, 2.12–4.85) and 32.62 (95%CI, 8.31-128.36), respectively. Conclusion Our study showed that BHI-V4 had moderate diagnostic accuracy for diagnosing hVISA/VISA. However, more high-quality studies are needed to assess the clinical utility of BHI-V4.

Background: Brain-heart infusion agar supplemented with 4 µg/mL of vancomycin (BHI-V4) was commonly used for the detection of heterogeneous (hVISA) and vancomycin-intermediate Staphylococcus aureus (VISA). However, its diagnostic value remains unclear. This study aims to compare the diagnostic accuracy of BHI-V4 with population analysis profiling with area under the curve (PAP-AUC) in hVISA/VISA. Methods: The protocol of this study was registered in INPLASY (INPLASY2023120069). The PubMed and Cochrane Library databases were searched from inception to October 2023. Review Manager 5.4 was used for data visualization in the quality assessment, and STATA17.0 (MP) was used for statistical analysis. Results: In total, eight publications including 2153 strains were incorporated into the meta-analysis. Significant heterogeneity was evident although a threshold effect was not detected across the eight studies. The summary receiver operating characteristic (SROC) was 0.77 (95% confidence interval [CI], 0.74–0.81). The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic score and diagnostic odds ratio were 0.59 (95% CI: 0.46–0.71), 0.96 (95%CI: 0.83–0.99), 14.0 (95% CI, 3.4–57.1), 0.43 (95%CI, 0.32–0.57), 3.48(95%CI, 2.12–4.85) and 32.62 (95%CI, 8.31-128.36), respectively. Conclusion: Our study showed that BHI-V4 had moderate diagnostic accuracy for diagnosing hVISA/VISA. However, more high-quality studies are needed to assess the clinical utility of BHI-V4. [ABSTRACT FROM AUTHOR]

The article examines the European Union's response to Russia's 2022 invasion of Ukraine in the field of migration, arguing that EU visa and refugee policies encompassed a distinctive foreign policy and soft power dimension. On one hand, by restricting visa policy for Russia, the EU signalled the delegitimization and isolation of the Kremlin. On the other hand, by adopting temporary protection for Ukrainians, it sent a clear message of support to Ukraine, while also portraying the EU as the defender of freedom and democracy. Through an analysis of EU documents released in the first month of the war, the article thus posits that both visa and refugee measures were employed as soft power tools, contributing to the juxtaposition of an aggressive and isolated Russia, against a responsible and united EU. [ABSTRACT FROM AUTHOR]

Copyright of Central Asian Economic Review is the property of Narxoz University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Peste des petits ruminants is an acute and highly contagious disease caused by the Peste des petits ruminants virus (PPRV). Host proteins play a crucial role in viral replication. However, the effect of fusion (F) protein-interacting partners on PPRV infection is poorly understood. In this study, we found that the expression of goat plasminogen activator urokinase (PLAU) gradually decreased in a time- and dosedependent manner in PPRV-infected goat alveolar macrophages (GAMs). Goat PLAU was subsequently identified using co-immunoprecipitation and confocal microscopy as an F protein binding partner. The overexpression of goat PLAU inhibited PPRV growth and replication, whereas silencing goat PLAU promoted viral growth and replication. Additionally, we confirmed that goat PLAU interacted with a virus-induced signaling adapter (VISA) to antagonize F-mediated VISA degradation, increasing the production of type I interferon. We also found that goat PLAU reduced the inhibition of PPRV replication in VISA-knockdown GAMs. Our results show that the host protein PLAU inhibits the growth and replication of PPRV by VISA-triggering RIG-I-like receptors and provides insight into the host protein that antagonizes PPRV immunosuppression. IMPORTANCE The role of host proteins that interact with Peste des petits ruminants virus (PPRV) fusion (F) protein in PPRV replication is poorly understood. This study confirmed that goat plasminogen activator urokinase (PLAU) interacts with the PPRV F protein. We further discovered that goat PLAU inhibited PPRV replication by enhancing virus-induced signaling adapter (VISA) expression and reducing the ability of the F protein to degrade VISA. These findings offer insights into host resistance to viral invasion and suggest new strategies and directions for developing PPR vaccines. [ABSTRACT FROM AUTHOR]

ABSTRACT Staphylococcus aureus is a leading cause of healthcare-associated infections globally. Vancomycin-resistant S. aureus (VRSA), those with high-level resistance [minimum inhibitory concentration (MIC) of 16–32 µg/mL vancomycin], are uncommon, whereas vancomycin-intermediate S. aureus (VISA; MIC of 4–8 µg/mL), are isolated more frequently and develop during long-term and/or repeated use of the antibiotic. VISA can be difficult to eradicate and infections may persist. Our knowledge of mechanisms that underlie the development of VISA is incomplete. We used a genomics approach to investigate the VISA phenotype in three prominent S. aureus lineages. All VISA clinical isolates tested had increased cell wall thickness compared with vancomycin-susceptible S. aureus strains. Growth rates of clonal complex (CC) 5, CC8, and CC45 clinical isolates were reduced in 2 µg/mL vancomycin compared to media alone. Culture in 2 and 4 µg/mL vancomycin sequentially for two weeks reduced susceptibility to daptomycin, televancin, tigecycline, and vancomycin in a majority of CC5, CC8, and CC45 isolates tested. We identified alleles reported previously to contribute to the VISA phenotype, but unexpectedly, these alleles were unique to each CC. A subtherapeutic concentration of vancomycin elicited changes in the VISA transcriptome—common and unique—among the three CCs tested. Multiple genes, including those encoding a glycerate kinase, an M50 family metallopeptidase, and an uncharacterized membrane protein, were upregulated among all three lineages and not reported previously as associated with VISA. Although there are lineage-specific changes in DNA sequence, our findings suggest changes in the VISA transcriptome constitute a general response to stress that confers reduced susceptibility to multiple antibiotics.IMPORTANCEOur understanding of the mechanisms that underlie the development of vancomycin-intermediate Staphylococcus aureus (VISA) is incomplete. To provide a more comprehensive view of this process, we compared genome sequences of clonal complex (CC) 5, CC8, and CC45 VISA clinical isolates and measured changes in the transcriptomes of these isolates during culture with a subtherapeutic concentration of vancomycin. Notably, we identified differentially expressed genes that were lineage-specific or common to the lineages tested, including genes that have not been previously reported to contribute to a VISA phenotype. Changes in gene expression were accompanied by reduced growth rate, increased cell wall thickness, and reduced susceptibility to daptomycin, televancin, tigecycline, and vancomycin. Our results provide support to the idea that changes in gene expression contribute to the development of VISA among three CCs that are a prominent cause of human infections.

When feasible, third-country nationals request within EU Member States’ diplomatic or consular representations a visa on the basis of their need of international protection, in order to be granted legal access to the issuing State’s territory precisely to apply for international protection upon arrival. The focal point is whether States can be required to issue these visas in order to comply with their human rights obligations. This contribution demonstrates that the European Court of Human Rights holding that States do not hold any obligation in the context of humanitarian visa proceedings is unconvincing.

Background: Achilles tendinitis is a habitual overuse injury, particularly in the field of sports which may involve lunging and jumping activities. This study focuses on how well brief flexibility exercises help subjects with Achilles Tendinitis and improves their functional activity and decreases the pain. Purpose: The Purpose of the study is to determine the effect of flexibility exercise in reducing pain and in improving functional activity among subjects with Achilles tendinitis. Materials and Methods: This is a Quasi-Experimental study where subjects with Achilles Tendinopathy were selected on the basis of the selection criteria. The subjects were briefed about the procedure and informed consent was acquired. Pre-test scores for pain and functional ability were recorded using NPRS and VISA, the same as post-test values after 4 weeks of intervention. The entire process was performed from November 2022 to March 2023. Result: From the test values according to the VISA and NPRS it results that flexibility exercise for Achilles tendinitis helps in reducing pain and it gives the best result in improving functional activity. Conclusion: According to the data gathered, flexibility training for four weeks with twelve sessions enhances physical activity and reduces discomfort in patients with Achilles tendinopathy. [ABSTRACT FROM AUTHOR]

Purpose: The extensive use of vancomycin has led to the development of Staphylococcus aureus strains with varying degrees of resistance to vancomycin. The present study aimed to explore the molecular causes of vancomycin resistance by conducting a proteomics analysis of subcellular fractions isolated from vancomycin-intermediate resistant S. aureus (VISA) and vancomycin-sensitive S. aureus (VSSA) strains. Methods: We conducted proteomics analysis of subcellular fractions isolated from 2 isogenic S. aureus strains: strain 11 (VSSA) and strain 11Y (VISA). We used an integrated quantitative proteomics approach assisted by bioinformatics analysis, and comprehensively investigated the proteome profile. Intensive bioinformatics analysis, including protein annotation, functional classification, functional enrichment, and functional enrichment-based cluster analysis, was used to annotate quantifiable targets. Results: We identified 128 upregulated proteins and 21 downregulated proteins in strain 11Y as compared to strain 11. The largest group of differentially expressed proteins was composed of enzymatic proteins associated with metabolic and catalytic activity, which accounted for 32.1% and 50% of the total proteins, respectively. Some proteins were indispensable parts of the regulatory networks of S. aureus that were altered with vancomycin treatment, and these proteins were related to cell wall metabolism, cell adhesion, proteolysis, and pressure response. Conclusion: Our proteomics study revealed regulatory proteins associated with vancomycin resistance in S. aureus. Some of these proteins were involved in the regulation of cell metabolism and function, which provides potential targets for the development of strategies to manage vancomycin resistance in S. aureus. [ABSTRACT FROM AUTHOR]

The study assesses free movement of persons on bilateral trade between Kenya and its trading partners in the Common Market for Eastern and Southern Africa. The study employed the Panel Correlated Standard Error method to estimate augmented gravity model. The data used covered 17 partners between 2012 and 2021. The findings indicate that the free movement of persons stimulates Kenya's bilateral trade in the Common Market for Eastern and Southern Africa. A unit improvement in the implementation of the no-visa policy requirement stimulates the volume of Kenya's bilateral trade with the partner country by 0.25 per cent. From the findings, Kenya and other Common Market for Eastern and Southern Africa member States could consider fasttracking the full implementation of free movement of persons efforts put forward by each State to ease the cost of trade in the region. [ABSTRACT FROM AUTHOR]

The number of international medical graduates (IMG) in radiology residencies has varied from year to year even as the number of candidates continues to grow. It is unclear from which countries the IMGs are arriving and what visas are being used to accommodate them. We sent a survey to 195 program directors (PD) in diagnostic radiology (DR) inquiring about the number and nationality of IMG residents in their program, their attitudes about IMG candidates, the performance of their IMG trainees, and the visas that are offered. We received responses from 121 of 195 (62.1%) DR programs (121/149 = 81.2% of actionable emails). 80/121 (66.1%) had at least one IMG in their DR residency program and the countries of origin included India (36), Iran (30), Saudi Arabia (24), Egypt (16), Canada (14), Brazil (14), and Pakistan (9), as the most common. While most programs (76/104, 73.1%) offered J1 visas, 23/99 (23.2%) provided H-1B visas to trainees. IMG DR residents overall performed as well as American graduates, with an equal number of PDs saying IMGs performed better and worse than American graduates. PDs' issues with IMGs centered on visas: (1) expense, (2) lack of familiarity, (3) Educational Commission for Foreign Medical Graduates regulations, and (4) time commitment in submitting paperwork. Most radiology IMG residents originate from India and Middle Eastern countries. Once enrolled, IMG residents perform similarly to US graduates. However, adding IMG candidates to the training program requires overcoming bureaucratic and monetary hurdles around visas. Most DR international medical graduate residents are from India or the Middle East. Although their performance is the same as American graduates in general, PDs note the monetary and bureaucratic hassles accompanying their recruitment. [ABSTRACT FROM AUTHOR]

Methicillin resistant Staphylococcus aureus (MRSA) is highly divergent antibiotic resistant bacteria earmarked as “High” in global pathogens’ priority list varying the severity and resistance geographically. Here, MRSA were screened using mecA gene with Cefoxitin and other 27 antibiotics of 19 classes using disc diffusion method from a highly humid climate of India. Multiple Antibiotic Resistance (MAR) index was calculated. Minimum Inhibitory Concentration (MIC) was determined against 11 classes of antibiotics. Detection of major virulence genes tst-1 and lukPV were done. A total of 95.24% Hospital Associated (HA)-MRSA, 56.14% Community Associated (CA)-MRSA and 82.53 % Livestock Associated (LA)-MRSA were detected. Cefoxitin, Oxacillin, Ciprofloxacin, Fusidic acid and Ticarcillin-Clavulinic acid resistance was observed in more than 60% of HA-MRSA, CA-MRSA and LA-MRSA. Across the hosts, Mupirocin, Gentamicin, Linezolid, Co-trimoxazole, and Rifampicin were found effective. Vancomycin Intermediate Staphylococcus aureus (VISA) detected in CA-MRSA & LA-MRSA. Multidrug Resistant (MDR) was found very high but extensively drug-resistant (XDR) was detected moderately. No pan drug-resistant (PDR) was detected. Virulence gene tst-1 and lukPV were detected in 7.69% and 32.69% MRSA isolates. The gene tst-1 is reported for the first time in pre and post-caesarian samples from Gynaecology department in this region with high MDR. This study showed S. aureus and subsequent prevalence of MRSA is higher in this region then national data. 2nd generation Cephalosporins were found effective which is very encouraging due to their limited uses. Detection of tst-1 in caesarian samples is a serious threat as neonatal transmission of MRSA from mother is reported.

Classical swine fever (CSF) and porcine epidemic diarrhea (PED) are highly contagious viral diseases that pose a significant threat to piglets and cause substantial economic losses in the global swine industry. Therefore, the development of a bivalent vaccine capable of targeting both CSF and PED simultaneously is crucial. In this study, we genetically engineered a recombinant classical swine fever virus (rCSFV) expressing the antigenic domains of the porcine epidemic diarrhea virus (PEDV) based on the modified infectious cDNA clone of the vaccine strain C-strain. The S1N and COE domains of PEDV were inserted into C-strain cDNA clone harboring the mutated 136th residue of Npro and substituted 3′UTR to generate the recombinant chimeric virus vC/SM3′UTRN-S1NCOE. To improve the efficacy of the vaccine, we introduced the tissue plasminogen activator signal (tPAs) and CARD domain of the signaling molecule VISA into vC/SM3′UTRN-S1NCOE to obtain vC/SM3′UTRN-tPAsS1NCOE and vC/SM3′UTRN-CARD/tPAsS1NCOE, respectively. We characterized three vaccine candidates in vitro and investigated their immune responses in rabbits and pigs. The NproD136N mutant exhibited normal autoprotease activity and mitigated the inhibition of IFN-β induction. The introduction of tPAs and the CARD domain led to the secretory expression of the S1NCOE protein and upregulated IFN-β induction in infected cells. Immunization with recombinant CSFVs expressing secretory S1NCOE resulted in a significantly increased in PEDV-specific antibody production, and coexpression of the CARD domain of VISA upregulated the PEDV-specific IFN-γ level in the serum of vaccinated animals. Notably, vaccination with vC/SM3′UTRN-CARD/tPAsS1NCOE conferred protection against virulent CSFV and PEDV challenge in pigs. Collectively, these findings demonstrate that the engineered vC/SM3′UTRN-CARD/tPAsS1NCOE is a promising bivalent vaccine candidate against both CSFV and PEDV infections. [ABSTRACT FROM AUTHOR]

Purpose: Methicillin-resistant Staphylococcus aureus, a common bacterial pathogen causes various infections. The acquisition of various antimicrobial-resistant genes in S. aureus has led to the transformation of this bacterium into a superbug. Vancomycin resistance among MRSA isolates is an emerging threat in empirical therapy of various infections. The study was hence aimed to find out the susceptibility status of S. aureus isolates toward vancomycin and detect mecA, vanA, and vanB genes among the isolates. Methods: A total of 1245 clinical samples from the participants attending a tertiary care hospital in Kathmandu were processed. S. aureus isolated from the samples were subjected to antibiotic susceptibility patterns using the modified Kirby-Bauer disk diffusion method. Agar dilution method was used to determine the minimum inhibitory concentration of vancomycin. The antibiotic-resistant genes such as mecA, vanA, and vanB among S. aureus isolates were screened by a conventional polymerase chain reaction. Results: Of 1245 samples, 80 S. aureus were identified. Out of which, 47.5% (38/80) were phenotypically confirmed MRSA isolates. mec A gene was detected in 84.2% (32/38) of MRSA isolates. 10.5% (4/38) were confirmed as vancomycin-intermediate S. aureus (VISA) by MIC determination. None of the isolates was positive for the vanA gene; however, 2 isolates were found to possess the vanB gene. The 2 isolates have vancomycin MIC breakpoints of 4 to 8 μg/mL. Conclusion: There might be a spreading of vancomycin resistance among S. aureus, creating serious public health problems. Therefore, measures to limit vancomycin resistance should be considered in healthcare facilities as immediately as possible. [ABSTRACT FROM AUTHOR]

Copyright of Journal of International Students is the property of Journal of International Students and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Staphylococcus aureus is a drug resistant pathogen with zoonotic potential commonly isolated from humans and animals. The aim of this study was to compare the occurrence of drug resistance, resistance genes, sequence types (STs), and genotypes of S. aureus isolated from humans, livestock, and wildlife in eastern Poland. A high percentage of isolates resistant to penicillin (63%), erythromycin (39%), clindamycin (37%), tetracycline (31%), and methicillin (MRSA-19%), an intermediate resistant to vancomycin (VISA-13%), and a multidrug resistant (MDR-39%) was obtained. Multilocus sequence typing analysis showed the presence of 35 different STs (with dominance ST 15, ST 45, ST 7, and ST 582 in human, and ST 398 and ST 8139 in porcine and cattle isolates, respectively), including 9 new ones that had never been reported before (ST 8133-8141). Identical genotypic patterns were detected among porcine and cattle isolates as well as from humans and cattle. A high percentage of MDR, MRSA, and VISA in humans and livestock combined with the presence of the same genotypes among S. aureus isolated from human and cattle indicates the circulation of strains common in the region and their zoonotic potential. There is a need to develop new strategies to counteract this phenomenon according to the One Health policy. [ABSTRACT FROM AUTHOR]

Methicillin resistant Staphylococcus aureus (MRSA) is highly divergent antibiotic resistant bacteria earmarked as “High” in global pathogens’ priority list varying the severity and resistance geographically. Here, MRSA were screened using mecA gene with Cefoxitin and other 27 antibiotics of 19 classes using disc diffusion method from a highly humid climate of India. Multiple Antibiotic Resistance (MAR) index was calculated. Minimum Inhibitory Concentration (MIC) was determined against 11 classes of antibiotics. Detection of major virulence genes tst-1 and lukPV were done. A total of 95.24% Hospital Associated (HA)-MRSA, 56.14% Community Associated (CA)-MRSA and 82.53 % Livestock Associated (LA)-MRSA were detected. Cefoxitin, Oxacillin, Ciprofloxacin, Fusidic acid and Ticarcillin-Clavulinic acid resistance was observed in more than 60% of HA-MRSA, CA-MRSA and LA-MRSA. Across the hosts, Mupirocin, Gentamicin, Linezolid, Co-trimoxazole, and Rifampicin were found effective. Vancomycin Intermediate Staphylococcus aureus (VISA) detected in CA-MRSA & LA-MRSA. Multidrug Resistant (MDR) was found very high but extensively drug-resistant (XDR) was detected moderately. No pan drug-resistant (PDR) was detected. Virulence gene tst-1 and lukPV were detected in 7.69% and 32.69% MRSA isolates. The gene tst-1 is reported for the first time in pre and post-caesarian samples from Gynaecology department in this region with high MDR. This study showed S. aureus and subsequent prevalence of MRSA is higher in this region then national data. 2nd generation Cephalosporins were found effective which is very encouraging due to their limited uses. Detection of tst-1 in caesarian samples is a serious threat as neonatal transmission of MRSA from mother is reported. [ABSTRACT FROM AUTHOR]

Introduction: Intravenous vancomycin (VAN) is the primary treatment for systemic infections due to methicillin-resistant Staphylococcus aureus (MRSA). Pharmacokinetic/pharmacodynamic target (PK/PD) indices for VAN therapies are more difficult to achieve for MRSA isolates with a minimum inhibitory concentration (MIC) greater than 1 µg mL-1. This research investigated the in vitro antimicrobial PD interaction of disulfiram (DSF) with VAN as a potential adjuvant therapy for infections due to these bacteria. Methods: The antimicrobial interaction was assessed by differential analysis using checkerboard titration testing, time-kill studies, flow cytometry, and the post-antibiotic effect (PAE) experiment. Ten MRSA strains with MICs ranging from 1 to >256 µg mL-1 for VAN were evaluated. A comprehensive PD assessment of the VAN/DSF interaction was performed using the VANintermediate (VISA) strain Mu50 (MIC 8 µg mL-1). Results: The addition of DSF lowered the MIC and minimum bactericidal concentration (MBC) of VAN in either a synergistic or additive manner for the MRSA panel. Optimal bactericidal effects and suppression of VISA Mu50 growth were observed with a 4/8 µg mL-1 combination of VAN/DSF, but not the individual drugs. Flow cytometry further confirmed the enhanced killing action on a cellular level; however, the addition of DSF had an overall antagonistic effect on the PAEs for VAN. Discussion: This research established that DSF exhibits additive to synergistic killing action with VAN for MRSA. Conversely, antagonism was observed on the PAE of VAN with DSF addition for the Mu50 strain. Flow cytometry further confirmed the enhanced bactericidal effect on a cellular level while revealing that DSF may counteract the muropeptide fortification mechanism against VAN in VISA. [ABSTRACT FROM AUTHOR]

International medical graduates (IMGs) are medical graduates who have received their degree from international medical schools. IMGs must undertake a 3-step process to apply to the National Residency Matching Program match. First, they must obtain a valid standard certificate from the Educational Commission for Foreign Medical Graduates. Following certification, they must apply for and secure a position in a residency training program. Third, they must obtain a visa that would enable them to commence their training. In this article, we delve thoroughly into these stepladders to provide IMGs with a clear roadmap of the process as well as contacts to key agencies that may provide more comprehensive assistance.

International medical graduates (IMGs) are graduates of medical schools located outside the United States (U.S.) and Canada. IMGs face various challenges on the road to U.S. residency training. These challenges include sitting for the United States Medical Licensing Examinations (USMLEs) to obtain certification from the Educational Commission for Foreign Medical Graduates (ECFMG). After that, IMGs are faced with a foreign application process whereby they must apply for and secure a position in a residency program through the Electronic Residency Application System (ERAS) and the National Resident Matching Program (NRMP). Once accepted into a residency program, IMGs who are not US citizens or legal permanent residents are challenged with securing a visa to be able to practice in the U.S. In this article, we elaborate on these processes and highlight the challenges IMGs may face along the way.

INTRODUCTION: EExcept vancomycin-resistant Staphylococcus aures (VRSA) and vancomycin intermediate S. aureus (VISA), one of the important causes of failure in the treatment of staphylococcal infections is considered to be vancomycin heterogeneous-intermediate resistant S. aureus (hVISA). But detecting hVISA is a labor-intensive and specialized procedure. In our study, it was aimed to determine the hVISA rates in Methicilline-Resistant Staphylococcus aureus (MRSA) strains isolated from a tertiary university hospital and to compare the population analysis profile (PAP) method with the Satola test METHODS: Sixty MRSA isolates were taken to the study. First of all, the MIC values of all isolates were determined using the broth microdilution method. Then the Brain Heart Infusion agar screening method developed by Satola and the PAP method, which is accepted as the gold standard, were compared for detecting hVISA. RESULTS: All isolates were found to be sensitive to vancomycin. Satola method was perfomed and 28 isolates (46.66%) were determined as hVISA at the 48th hour. These strains detected as hVISA were re-evaluated in the PAP method. Among these only 20% (12/60 of all isolates) strains were identified as hVISA. DISCUSSION AND CONCLUSION: In our study, hVISA rates were investigated for the first time in our region using Satola's method and PAP method. In the light of the data obtained, when the Satola test and PAP were compared, it was determined that the false positive rate was high in the Satola test.

Vancomycin and daptomycin are first-line drugs for the treatment of complicated methicillin-resistant Staphylococcus aureus (MRSA) infections, including bacteremia. However, their effectiveness is limited not only by their resistance to each antibiotic but also by their associated resistance to both drugs. It is unknown whether novel lipoglycopeptides can overcome this associated resistance. Resistant derivatives from five S. aureus strains were obtained during adaptive laboratory evolution with vancomycin and daptomycin. Both parental and derivative strains were subjected to susceptibility testing, population analysis profiles, measurements of growth rate and autolytic activity, and whole-genome sequencing. Regardless of whether vancomycin or daptomycin was selected, most of the derivatives were characterized by a reduced susceptibility to daptomycin, vancomycin, telavancin, dalbavancin, and oritavancin. Resistance to induced autolysis was observed in all derivatives. Daptomycin resistance was associated with a significant reduction in growth rate. Resistance to vancomycin was mainly associated with mutations in the genes responsible for cell wall biosynthesis, and resistance to daptomycin was associated with mutations in the genes responsible for phospholipid biosynthesis and glycerol metabolism. However, mutations in walK and mprF were detected in derivatives selected for both antibiotics. [ABSTRACT FROM AUTHOR]

Complementary pathways have been offered as a possible solution for facilitating legal admission of people in need of international protection. The current debates about these pathways are characterised by a conceptual and legal quagmire since various issues are invoked and conflated. The objective of this article is to dissect the relevant issues in light of the existing relevant legal frameworks to achieve better clarity. For this purpose, the pathways are compared with resettlement and territorial asylum, to demonstrate their distinctiveness. This possible distinctiveness (i.e., the combination of protection-related and not protection-related considerations) disrupts the existing legal categories for regulating migration. The article shows how the European Convention on Human Rights, EU law and domestic law might respond to this disruption, by examining the granting of visas, the right to leave any country, the right to non-refoulement , the right to family life and relevant procedural rights. [ABSTRACT FROM AUTHOR]

Background: Vancomycin-intermediate Staphylococcus aureus (VISA) emerges typically in the healthcare-associated methicillin-resistant S. aureus and more rarely in community-acquired S. aureus (CA-MRSA). VISA is a serious concern for public health due to its association with persistent infections, the failure of vancomycin treatment, and poor clinical outcomes. Currently, the burden of VISA is somewhat high, even though vancomycin is the mainstay treatment for severe MRSA infections. The molecular mechanisms of reduced glycopeptide susceptibility in S. aureus are constantly under investigation but have still not yet been fully characterized. Methods: Our goal was to investigate the reduced glycopeptide susceptibility mechanisms emerging in a VISA CA-MRSA versus its vancomycin-susceptible (VSSA) CA-MRSA parents in a hospitalized patient undergoing glycopeptide treatment. Comparative integrated omics, Illumina MiSeq whole-genome sequencing (WGS), RNA-Seq, and bioinformatics were performed. Results: Through a comparison of VISA CA-MRSA vs. its VSSA CA-MRSA parent, mutational and transcriptomic adaptations were found in a pool of genes involved, directly or indirectly, in the biosynthesis of the glycopeptide target conferring or supporting the VISA phenotype, and its cross-resistance with daptomycin. This pool included key genes responsible for the biosynthesis of the peptidoglycan precursors, i.e., D-Ala, the D-Ala-D-Ala dipeptide termini of the pentapeptide, and its incorporation in the nascent pentapeptide, as key targets of the glycopeptide resistance. Furthermore, accessory glycopeptide-target genes involved in the pathways corroborated the key adaptations, and thus, supported the acquisition of the VISA phenotype i.e., transporters, nucleotide metabolism genes, and transcriptional regulators. Finally, transcriptional changes were also found in computationally predicted cis-acting small antisense RNA triggering genes related both to the key or accessory adaptive pathways. Conclusion: Our investigation describes an adaptive resistance pathway acquired under antimicrobial therapy conferring reduced glycopeptide susceptibility in a VISA CA-MRSA due to a comprehensive network of mutational and transcriptional adaptations in genes involved in pathways responsible for the biosynthesis of glycopeptide's target or supporters of the key resistance path. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Public Law / Zeitschrift für Öffentliches Recht is the property of Verlag Oesterreich GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Objective: This study explored the predictive relationship among international student trauma responses, visa status anxiety, and perceived institutional support. Researchers also sought to understand the relationship between help seeking behaviors and trauma exposure responses. Participants: International students (n = 172) from U.S. colleges and universities enrolled since March 2020. Methods: Data were collected via an electronic survey administered during the fall 2020 academic term. Results: The model was found to be significant, explaining 67% of the variance of student trauma responses. Anxiety surrounding students’ ability to stay in the U.S. was found to be the greatest contributor to the model. Additionally, particular clusters of trauma symptomatology were significantly correlated with help seeking from specific individuals within student networks. Finally, students reported moderate levels of mental health help seeking behaviors, with friends and family being the most likely sources sought out for help. Conclusions: Despite focus on students’ health and wellness concerns related to the COVID-19 pandemic, visa policy uncertainty was a primary driver of self-reported trauma symptomatology at the onset of the pandemic. [ABSTRACT FROM AUTHOR]

Copyright of Van Tip Dergisi is the property of Yuzuncu Yil University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Civil-law non-employment contracts are abused when employing Polish citizens and foreigners. Contrary to Poles, non-Polish citizens are exposed to linguistic difficulties (the law does not specify a standard of a translation of their contracts), and an application for Polish short-term simplified immigration employment system (a declaration on entrusting work to a foreigner in the territory of the Republic of Poland) does not contain information about differences between civil law and employment contracts. Based on a synthetic theoretical-conceptual analysis the author claims that Polish law exposes foreigners to a higher risk of discrimination. The article aims to prove that mismatch between excessively long court proceedings and short validity of residence permits, as well as linking validity of a visa with employment in a specific employer deprive foreigners from a possibility to effectively personally participate in court proceeding in their employment case. Previous analysis related to seasonal works performed by foreigners had not focused on the nature of the contracts. This article is, therefore, innovative research. It verifies if Polish law discourages employers from abusing civil contracts with such foreigners, if it is in line with the ILO Recommendation No. 198, and if it meets Polish constitutional standard regarding legal clarity. The innovativeness of the research theme can also be derived from the fact that although declarations are the most popular foreigner’s employment scheme in Poland and in the European Union, previous research have not focused on human rights of beneficiaries of the declaration scheme.

Cardiology conferences represent a major avenue for learning, career advancement, and professional networking. Yet, costs of attending these conferences represent a major barrier, particularly for trainees and participants from low-middle-income countries (LMICs). Our study aimed to analyze the registration fees of major cardiology conferences worldwide. We included conferences organized by international cardiovascular societies and those representing global regions. We did not include individual national or institutional conferences due to inability to systematically identify them. We collected 2024 registration fees from official conference websites, taking 2023 or 2022 fees if unavailable, and categorized them according to career stage and society membership status. Where specified, we chose 'early-bird' fees. All fees were converted to US dollars according to currency exchange rates per the International Monetary Fund on December 4, 2023, or if unavailable, per the last reported US Treasury Data. Other data collected included host country, virtual option availability, and LMIC discounts. 30 (65.2 %) conferences provided discounts for medical students, regardless of membership status, while 1 (2.2 %) provided discounts only for student-members. 36 (78.2 %) conferences offered discounts for residents/fellows, while 2 (4.3 %) offered discounts only for resident/fellow-members. Median fees for students and residents/fellows with membership were $255 and $287 (in US dollars), respectively while median fees for non-members were $303.5 and $397, respectively. 31 (67.4 %) conferences provided discounts for staff- members. Median fees for staff were $701 and $800 for members and non-members, respectively. Only 12 (26.1 %) conferences mentioned a virtual component, with 11 offering discounted registration compared with in-person rates. 7 (15.2 %) conferences had special in-person fees for LMIC-based registrants. 5 offered the same discounted rate regardless of training stage, while 2 offered additional discounts for trainees. We found that conference registration costs were substantial, including for trainees, with only a minority of conferences providing discounted rates for LMICs. Professional societies must reduce registration costs, potentially by implementing a tiered system based on training stage and country of origin. Further, to augment LMIC participation, dedicated scholarships and mentorship programs for LMIC-based registrants are needed. [ABSTRACT FROM AUTHOR]

IntroductionIntravenous vancomycin (VAN) is the primary treatment for systemic infections due to methicillin-resistant Staphylococcus aureus (MRSA). Pharmacokinetic/pharmacodynamic target (PK/PD) indices for VAN therapies are more difficult to achieve for MRSA isolates with a minimum inhibitory concentration (MIC) greater than 1 µg mL-1. This research investigated the in vitro antimicrobial PD interaction of disulfiram (DSF) with VAN as a potential adjuvant therapy for infections due to these bacteria.MethodsThe antimicrobial interaction was assessed by differential analysis using checkerboard titration testing, time-kill studies, flow cytometry, and the post-antibiotic effect (PAE) experiment. Ten MRSA strains with MICs ranging from 1 to >256 µg mL-1 for VAN were evaluated. A comprehensive PD assessment of the VAN/DSF interaction was performed using the VAN-intermediate (VISA) strain Mu50 (MIC 8 µg mL-1).ResultsThe addition of DSF lowered the MIC and minimum bactericidal concentration (MBC) of VAN in either a synergistic or additive manner for the MRSA panel. Optimal bactericidal effects and suppression of VISA Mu50 growth were observed with a 4/8 µg mL-1 combination of VAN/DSF, but not the individual drugs. Flow cytometry further confirmed the enhanced killing action on a cellular level; however, the addition of DSF had an overall antagonistic effect on the PAEs for VAN.DiscussionThis research established that DSF exhibits additive to synergistic killing action with VAN for MRSA. Conversely, antagonism was observed on the PAE of VAN with DSF addition for the Mu50 strain. Flow cytometry further confirmed the enhanced bactericidal effect on a cellular level while revealing that DSF may counteract the muropeptide fortification mechanism against VAN in VISA.

ABSTRACT Protein posttranslational modifications (PTMs) play important roles in regulating numerous biological functions of prokaryotic and eukaryotic organisms. Lysine succinylation (Ksucc) and acetylation (Kac) are two important PTMs that have been identified in various bacterial species. However, the biological functions of Ksucc and Kac in vancomycin-intermediate S. aureus (VISA) remain unclear. In this study, we systematically identified 3,260 Ksucc sites in 799 proteins and 7,935 Kac sites across 1,710 proteins in the VISA strain XN108. Functional analyses revealed that both Ksucc and Kac sites were highly enriched in several critical metabolic pathways, including ribosomal metabolism, tricarboxylic acid cycle, and glycolysis. Furthermore, a remarkable cross talk between Ksucc and Kac modifications was observed that almost 75% of the succinylated sites were also frequently acetylated. In addition, we identified SaCobB, a Sirtuin 2-like lysine deacetylase, as a bifunctional enzyme with both deacetylation and desuccinylation activities in S. aureus. We demonstrated the first lysine succinylome and acetylome in a VISA and identified SaCobB, a functional enzyme taking part in the regulation of Ksucc and Kac in S. aureus. Our findings provide valuable information for further study on the regulatory mechanisms of PTMs in S. aureus. IMPORTANCE Lysine succinylation (Ksucc) and acetylation (Kac) are two important protein posttranslational modifications (PTMs) that regulate numerous biological functions in prokaryotes and eukaryotes. However, the functions of Ksucc and Kac in Staphylococcus aureus are seldom described. Understanding of Ksucc and Kac modifications in S. aureus will facilitate the development of new strategies to control infections. Herein, we quantified both Ksucc and Kac in a vancomycin-intermediate S. aureus (VISA) strain XN108, analyzed the interaction between these two PTMs, and identified SaCobB as a bifunctional enzyme with both deacetylation and desuccinylation activities. This study is the first description of dual PTMs, Ksucc and Kac profiles, in the VISA. The findings could provide valuable information for the following researches on the regulatory roles of PTMs in S. aureus.

Summary: Background: Reduced vancomycin susceptibility in Staphylococcus aureus (S. aureus) is considered a more pathogenic strain characteristic and is associated with treatment failure. We aimed to characterise the epidemiology of intraoperative transmission of S. aureus isolates with reduced vancomycin susceptibility. Methods: S. aureus isolates (N=173) collected from 274 randomly selected operating room environments at three major academic medical centres in 2009–2010 were characterised by vancomycin minimum inhibitory concentration (MIC). We aimed to characterise the transmission dynamics for VISA and isolates with relatively reduced vancomycin (MIC= 2μg/mL) susceptibility at the range of therapeutic differentiation. Results: Intraoperative S. aureus MIC was 1.38 ± 0.34 μg/mL. No VISA isolates were identified (95% upper confidence limit 2.1%) and those with an MIC of 2 μg/mL accounted for 12.72% (22/173) of all isolates. MIC=2 μg/mL isolates were more frequently cultured from the hands of healthcare providers [19.3% (16/83)] versus otherwise [6.7% (6/90)], with unadjusted risk ratio 2.89, P=0.021, and from patients with >2 major comorbidities [25.0% (8/32)] versus otherwise [9.9% (14/141)], with unadjusted risk ratio 2.52, P=0.035. Both were significant when tested simultaneously. The adjusted relative risk for provider hands was 2.77 (95% CI 1.15 to 6.69, P=0.024). The adjusted relative risk for patients with >2 major comorbidities was 2.37 (95% CI 1.11 to 5.05, P=0.026). MIC=2μg/mL was not associated with greater risk of clonal transmission (unadjusted P=0.34, adjusted P=0.18). Conclusion: Intraoperative VISA is a rare event. S. aureus isolates MIC=2μg/mL isolates were not associated with increased risk of intraoperative transmission. The epidemiology of detected intraoperative transmission is consistent with Centers for Disease Control guidelines.

Evidence on the labor‐market effect of immigration focuses on permanent migrants, though a large share of international labor mobility is temporary and seasonal. This paper estimates the marginal native employment effect of policy restrictions on foreign seasonal farm workers in the United States. It exploits two natural experiments: a legal requirement to give hiring preference to natives, and an exogenous change in natives' next‐best employment options during the Great Recession of 2007–2008. The local elasticity of natives' occupational labor supply is 0.0015, implying a minimal marginal effect of seasonal work visa restrictions on native employment. [ABSTRACT FROM AUTHOR]