Nurses' confidence in starting a new venture, startup or project in the context of nurse-led hackathons: Results of prehackathon survey.

BACKGROUND: A hackathon framework has been successfully applied to solving health care challenges, including COVID-19, without much documented evidence of nurses' baseline or acquired confidence. PURPOSE: To understand differences in baseline confidence levels in starting a new venture, startup or project in the context of nurse-led hackathons. METHOD: A retrospective secondary analysis of a presurvey of hackathon participants from two NurseHack4Health (NH4H) events held in 2021. DISCUSSION: Male nurses and international nurses were more confident than the U.S.-based nurses. When comparing the 75% of participants who had not attended a hackathon previously to the 25% of participants who had, there was an increased confidence level among non-nurses and among participants with the previous hackathon, datathon, and ideation experience. CONCLUSION: If hackathons can help nurses identify strengths, add new expertise and boost confidence, it may empower nurses to pursue their ideas more effectively, aid professional growth, and provide affirmation of innovator self-identity.

Multifaceted role of the registered nurse on an oral immunotherapy clinical team.

Oral immunotherapy (OIT) emerged into clinical practice, and its delivery highlights the multifaceted expertise of registered nurses (RN) as central to allergy/immunology interprofessional collaborative teams. The allergist-RN model of clinical evidenced-based OIT provision is presented. RN competencies, role components, and intervention examples are included to assist RNs and allergists in maximizing RN capabilities. RNs' patient-centered focus, and the ability to evaluate and incorporate physical, psychological, and sociological patient aspects are assets to OIT teams. RNs can establish best practices, initiate scholarly inquiry, and disseminate new knowledge to interdisciplinary colleagues. RNs also implement allergist-prescribed standing protocols within their legal practice scope by using their clinical judgment during evaluation of a patient receiving OIT. The same RN may serve as a nurse clinician, patient and family educator, case manager, research collaborator, and OIT program manager. Allergy/immunology practices use diverse staffing models, which thus require adaptation of presented descriptions per clinical team needs and resources.

Factors associated with college students' willingness and readiness to act in a food allergic emergency (WilRAFAE).

Objective: Food allergies are on the rise in the U.S. Factors associated with willingness and readiness to act in a food allergic emergency on a college campus are currently unknown. Participants: College students in one Catholic college enrolled during spring of 2017. Methods: A previously piloted survey was distributed by e-mail. Results: Four hundred seventy-four individuals responded. All readiness components correlated, and all willingness components correlated with each other. Age, having children, college major had statistically significant correlations with readiness and willingness to act. Readiness was highly predictive of willingness to act in an FAE. Thirty-five percent of variability in willingness to act was explained by age, being health professions students, desire to be trained, social desirability, and readiness. Students in nonhealth related majors expressed high willingness, but low readiness. Conclusion: A pool of willing, trained to act individuals should be considered on college campuses including availability of unassigned epinephrine auto-injector.

Parent perspectives on food allergy management and safety during the COVID-19 pandemic.

Background: U.S. national emergency was declared in mid-March 2020 due to the coronavirus disease 2019 (COVID-19) pandemic. Subsequently, a period of stay-at-home orders, regulatory changes, evolving medical recommendations, and food supply chain disruptions occurred. There is little published research on how such changes affected food allergy management for children with this diagnosis. Objective: The study goal was to identify parent perspectives with regard to if and/or how pandemic-related regulatory changes and evolving medical recommendations have affected food allergy management. Methods: A survey was distributed to parents of children with food allergy. An electronic Internet forms survey link was available for completion during July 2020. Data were presented as descriptive statistics, cleaned, and coded into a spreadsheet before analysis. Frequencies and percentage were calculated to describe participants' characteristics and responses. Results: Of 377 responses, 359 met inclusion criteria. Concerns about COVID-19 exposure were expressed in 65.7% about accessing an emergency department and 73.6% had school reentry concerns; 66% had not discussed recommended anaphylaxis management algorithm changes with a provider; 85.8% had not discussed the temporary U.S. Food and Drug Administration food labeling policy with a provider. Most (62%) reported shortages of preferred safe food brands. 62% spent more time cooking safe foods from scratch. With regard to the recommendation by the U.S. Centers for Disease Control and Prevention (CDC) for classroom dining, 57.7% planned to request modifications. With regard to the CDC's recommendation to use inhalers versus nebulizers, 37.7% had not discussed the topic with a provider. Ninety-two written comments were analyzed and grouped into seven themes. Conclusion: New pandemic-related regulations, food supply chain disruptions, and evolving medical recommendations resulted in intensified burdens for respondents, including the increased time needed to complete food allergy management and school reentry concerns. Study results can inform clinical team members (e.g., physicians, nurses, dieticians) of effects that pandemic-related changes may have on this patient population, with subsequent consideration of patient-specific screening, education, and shared decision-making with regard to risk mitigation needs.

Parent perspectives on school food allergy policy.

BACKGROUND: Food allergy affects up to 8% of children in the U.S. There is minimal research to date on food allergy policies that are currently in place in schools and the opinions of parents of children with food allergy on the effectiveness of or need for these policies. METHODS: An electronic survey was disseminated to parents of children with food allergy. Frequencies were calculated to describe respondent characteristics and responses. Chi-square tests were performed to examine associations between school and child characteristics and outcomes. RESULTS: Of the 289 parent respondents, 27.4% were unsure or felt school was unsafe for their child with food allergy. While the majority felt that the polices in their child's school were helpful, most also believed that implementation of additional polices was necessary, including availability of stock epinephrine (94.2%), lunch menus with allergen information (86%), ingredient labels on food items (81%), and direct food allergy education for students (86%). There were significant differences in school food allergy policy depending on the age of the student body, private versus public school, and geographic location. CONCLUSIONS: While most schools reportedly have one or more food allergy policies in place, many parents have concerns over the safety of their child at school and feel that additional policies are necessary to improve the safety of the school environment for children with food allergy. The availability of stock epinephrine, improved allergen labeling of food and menus and increased food allergy education may be key policy areas on which to focus.

School nurse perspectives on school policies for food allergy and anaphylaxis.

BACKGROUND: Although school health care professionals are integral to the management of students with food allergy, their views on school food allergy policies have not yet been reported. OBJECTIVE: To characterize food allergy policies currently being used in schools and their utility and potential barriers to implementation from the perspective of school health care professionals. METHODS: An electronic survey was disseminated to school nurses at the 2016 National Association of School Nurses meeting and through the Allergy and Asthma Network listserv. Frequencies were calculated to describe participant characteristics and responses. Unadjusted associations were examined using χ2 tests; adjusted associations were examined using multiple logistic regression models. RESULTS: A total of 242 completed surveys were included in the analysis. Thirty-two percent of nurses reported an allergic reaction in their school in the past year. Most schools used a variety of policies, including anaphylaxis training for staff (96.7%), stock epinephrine availability (81.7%), designated lunch areas (62.2%), and food guidelines for classrooms (61.8%). Barriers to implementation included financial, time, and attitudinal considerations. Schools with pre-K or kindergarten students had higher odds of having designated lunch areas (adjusted odds ratio [OR], 2.1; 95% confidence interval [CI], 1.0-4.1; P < .05). The odds of having emergency epinephrine available were higher in schools with a full-time nurse (OR, 2.6; 95% CI, 1.1-6.3; P < .05) and in schools reporting at least 1 severe reaction in the past year (OR, 3.2; 95% CI, 1.2-8.5; P < .05). CONCLUSION: With one-third of school nurses reporting an allergic reaction in the past year, schools use many strategies to minimize allergen exposures and increase anaphylaxis preparedness. Most school nurses favor these policies and acknowledge barriers to implementation.

Global landscape of cell envelope protein complexes in Escherichia coli.

Bacterial cell envelope protein (CEP) complexes mediate a range of processes, including membrane assembly, antibiotic resistance and metabolic coordination. However, only limited characterization of relevant macromolecules has been reported to date. Here we present a proteomic survey of 1,347 CEPs encompassing 90% inner- and outer-membrane and periplasmic proteins of Escherichia coli. After extraction with non-denaturing detergents, we affinity-purified 785 endogenously tagged CEPs and identified stably associated polypeptides by precision mass spectrometry. The resulting high-quality physical interaction network, comprising 77% of targeted CEPs, revealed many previously uncharacterized heteromeric complexes. We found that the secretion of autotransporters requires translocation and the assembly module TamB to nucleate proper folding from periplasm to cell surface through a cooperative mechanism involving the ß-barrel assembly machinery. We also establish that an ABC transporter of unknown function, YadH, together with the Mla system preserves outer membrane lipid asymmetry. This E. coli CEP 'interactome' provides insights into the functional landscape governing CE systems essential to bacterial growth, metabolism and drug resistance.

Proteome-wide dataset supporting the study of ancient metazoan macromolecular complexes.

Our analysis examines the conservation of multiprotein complexes among metazoa through use of high resolution biochemical fractionation and precision mass spectrometry applied to soluble cell extracts from 5 representative model organisms Caenorhabditis elegans, Drosophila melanogaster, Mus musculus, Strongylocentrotus purpuratus, and Homo sapiens. The interaction network obtained from the data was validated globally in 4 distant species (Xenopus laevis, Nematostella vectensis, Dictyostelium discoideum, Saccharomyces cerevisiae) and locally by targeted affinity-purification experiments. Here we provide details of our massive set of supporting biochemical fractionation data available via ProteomeXchange (PXD002319-PXD002328), PPIs via BioGRID (185267); and interaction network projections via (http://metazoa.med.utoronto.ca) made fully accessible to allow further exploration. The datasets here are related to the research article on metazoan macromolecular complexes in Nature [1].

Panorama of ancient metazoan macromolecular complexes.

Macromolecular complexes are essential to conserved biological processes, but their prevalence across animals is unclear. By combining extensive biochemical fractionation with quantitative mass spectrometry, here we directly examined the composition of soluble multiprotein complexes among diverse metazoan models. Using an integrative approach, we generated a draft conservation map consisting of more than one million putative high-confidence co-complex interactions for species with fully sequenced genomes that encompasses functional modules present broadly across all extant animals. Clustering reveals a spectrum of conservation, ranging from ancient eukaryotic assemblies that have probably served cellular housekeeping roles for at least one billion years, ancestral complexes that have accrued contemporary components, and rarer metazoan innovations linked to multicellularity. We validated these projections by independent co-fractionation experiments in evolutionarily distant species, affinity purification and functional analyses. The comprehensiveness, centrality and modularity of these reconstructed interactomes reflect their fundamental mechanistic importance and adaptive value to animal cell systems.

The crystal structure of pyrimidine/thiamin biosynthesis precursor-like domain-containing protein CAE31940 from proteobacterium Bordetella bronchiseptica RB50, and evolutionary insight into the NMT1/THI5 family.

We report a 2.0 Å structure of the CAE31940 protein, a proteobacterial NMT1/THI5-like domain-containing protein. We also discuss the primary and tertiary structure similarity with its homologs. The highly conserved FGGXMP motif was identified in CAE31940, which corresponds to the GCCCX motif located in the vicinity of the active center characteristic for THi5-like proteins found in yeast. This suggests that the FGGXMP motif may be a unique hallmark of proteobacterial NMT1/THI5-like proteins.

Genome sequence and functional genomic analysis of the oil-degrading bacterium Oleispira antarctica.

Ubiquitous bacteria from the genus Oleispira drive oil degradation in the largest environment on Earth, the cold and deep sea. Here we report the genome sequence of Oleispira antarctica and show that compared with Alcanivorax borkumensis--the paradigm of mesophilic hydrocarbonoclastic bacteria--O. antarctica has a larger genome that has witnessed massive gene-transfer events. We identify an array of alkane monooxygenases, osmoprotectants, siderophores and micronutrient-scavenging pathways. We also show that at low temperatures, the main protein-folding machine Cpn60 functions as a single heptameric barrel that uses larger proteins as substrates compared with the classical double-barrel structure observed at higher temperatures. With 11 protein crystal structures, we further report the largest set of structures from one psychrotolerant organism. The most common structural feature is an increased content of surface-exposed negatively charged residues compared to their mesophilic counterparts. Our findings are relevant in the context of microbial cold-adaptation mechanisms and the development of strategies for oil-spill mitigation in cold environments.

Identification of protein complexes in Escherichia coli using sequential peptide affinity purification in combination with tandem mass spectrometry.

Since most cellular processes are mediated by macromolecular assemblies, the systematic identification of protein-protein interactions (PPI) and the identification of the subunit composition of multi-protein complexes can provide insight into gene function and enhance understanding of biological systems(1, 2). Physical interactions can be mapped with high confidence vialarge-scale isolation and characterization of endogenous protein complexes under near-physiological conditions based on affinity purification of chromosomally-tagged proteins in combination with mass spectrometry (APMS). This approach has been successfully applied in evolutionarily diverse organisms, including yeast, flies, worms, mammalian cells, and bacteria(1-6). In particular, we have generated a carboxy-terminal Sequential Peptide Affinity (SPA) dual tagging system for affinity-purifying native protein complexes from cultured gram-negative Escherichia coli, using genetically-tractable host laboratory strains that are well-suited for genome-wide investigations of the fundamental biology and conserved processes of prokaryotes(1, 2, 7). Our SPA-tagging system is analogous to the tandem affinity purification method developed originally for yeast(8, 9), and consists of a calmodulin binding peptide (CBP) followed by the cleavage site for the highly specific tobacco etch virus (TEV) protease and three copies of the FLAG epitope (3X FLAG), allowing for two consecutive rounds of affinity enrichment. After cassette amplification, sequence-specific linear PCR products encoding the SPA-tag and a selectable marker are integrated and expressed in frame as carboxy-terminal fusions in a DY330 background that is induced to transiently express a highly efficient heterologous bacteriophage lambda recombination system(10). Subsequent dual-step purification using calmodulin and anti-FLAG affinity beads enables the highly selective and efficient recovery of even low abundance protein complexes from large-scale cultures. Tandem mass spectrometry is then used to identify the stably co-purifying proteins with high sensitivity (low nanogram detection limits). Here, we describe detailed step-by-step procedures we commonly use for systematic protein tagging, purification and mass spectrometry-based analysis of soluble protein complexes from E. coli, which can be scaled up and potentially tailored to other bacterial species, including certain opportunistic pathogens that are amenable to recombineering. The resulting physical interactions can often reveal interesting unexpected components and connections suggesting novel mechanistic links. Integration of the PPI data with alternate molecular association data such as genetic (gene-gene) interactions and genomic-context (GC) predictions can facilitate elucidation of the global molecular organization of multi-protein complexes within biological pathways. The networks generated for E. coli can be used to gain insight into the functional architecture of orthologous gene products in other microbes for which functional annotations are currently lacking.

Crystal structure of a putative isochorismatase hydrolase from Oleispira antarctica.

Isochorismatase-like hydrolases (IHL) constitute a large family of enzymes divided into five structural families (by SCOP). IHLs are crucial for siderophore-mediated ferric iron acquisition by cells. Knowledge of the structural characteristics of these molecules will enhance the understanding of the molecular basis of iron transport, and perhaps resolve which of the mechanisms previously proposed in the literature is the correct one. We determined the crystal structure of the apo-form of a putative isochorismatase hydrolase OaIHL (PDB code: 3LQY) from the antarctic γ-proteobacterium Oleispira antarctica, and did comparative sequential and structural analysis of its closest homologs. The characteristic features of all analyzed structures were identified and discussed. We also docked isochorismate to the determined crystal structure by in silico methods, to highlight the interactions of the active center with the substrate. The putative isochorismate hydrolase OaIHL from O. antarctica possesses the typical catalytic triad for IHL proteins. Its active center resembles those IHLs with a D-K-C catalytic triad, rather than those variants with a D-K-X triad. OaIHL shares some structural and sequential features with other members of the IHL superfamily. In silico docking results showed that despite small differences in active site composition, isochorismate binds to in the structure of OaIHL in a similar mode to its binding in phenazine biosynthesis protein PhzD (PDB code 1NF8).

Structure of the Shigella T3SS effector IpaH defines a new class of E3 ubiquitin ligases.

IpaH proteins are E3 ubiquitin ligases delivered by the type III secretion apparatus into host cells upon infection of humans by the Gram-negative pathogen Shigella flexneri. These proteins comprise a variable leucine-rich repeat-containing N-terminal domain and a conserved C-terminal domain harboring an invariant cysteine residue that is crucial for activity. IpaH homologs are encoded by diverse animal and plant pathogens. Here we demonstrate that the IpaH C-terminal domain carries the catalytic activity for ubiquitin transfer and that the N-terminal domain carries the substrate specificity. The structure of the IpaH C-terminal domain, determined to 2.65-A resolution, represents an all-helical fold bearing no resemblance to previously defined E3 ubiquitin ligases. The conserved and essential cysteine residue lies on a flexible, surface-exposed loop surrounded by conserved acidic residues, two of which are crucial for IpaH activity.