The gastric pathogen Helicobacter pylori causes a spectrum of gastro-duodenal diseases, which may be mediated in part by the outer membrane vesicles (OMVs) constitutively shed by the pathogen. We aimed to determine the proteome of H. pylori OMV to help evaluate the mechanisms whereby these structures confer their known immuno-modulatory and cytotoxic activities to host cells, as such disease-associated activities are also conferred by the bacterium from which the vesicles are derived. We also evaluated the effect of the OMV on gastric/colonic epithelial cells, duodenal explants and neutrophils. A proteomic analysis of the OMV proteins separated by SDS-PAGE from two strains of H. pylori (J99 and NCTC 11637) was undertaken and 162 OMV-associated proteins were identified in J99 and 91 in NCTC 11637 by LC-MS/MS. The vesicles are rich in membrane proteins, porins, adhesins and several molecules known to modulate chemokine secretion, cell proliferation and other host cellular processes. Further, the OMVs are also vehicles for the carriage of the cytotoxin-associated gene A cytotoxin in addition to the previously documented toxin, vacuolating cytotoxin. Taken together, it is evident from the proteome of H. pylori OMV that these structures are equipped with the molecules required to interact with host cells in a manner not dissimilar from the intact pathogen.

PurposeBurnout is a syndrome comprised of three major dimensions, namely, emotional exhaustion, depersonalization, and reduced personal accomplishment. Its etiology appears to be multifactorial, involving work-related and personal factors including personality traits. Personality has been associated with burnout among various physician groups; however, this has not been studied well amongst primary care physicians. This study therefore aimed to investigate the association between personality type and burnout in primary care physicians in Canada and Jamaica.MethodsThis cross-sectional study involved primary care physicians in Canada and Jamaica. Participants completed a questionnaire that included the Maslach Burnout Inventory Human Services Survey and The Big Five Inventory. Responses were analyzed to determine relationships between burnout, personality type, and various demographic factors.ResultsSeventy-seven physicians participated in the study. Approximately 38% of participants reported low levels of accomplishment, 34% reported high levels of emotional exhaustion, and 20% reported high levels of depersonalization, all equating to high levels of burnout. Neuroticism was negatively correlated with personal accomplishment (P<0.01) and positively correlated with emotional exhaustion (P≤0.001) and depersonalization (P<0.01). Agreeableness (P<0.05) and conscientiousness (P<0.05) were positively correlated with accomplishment and both were negatively correlated with depersonalization (P<0.01 and P<0.05, respectively).ConclusionIn this multinational study, we found that burnout was a common problem among primary care physicians. Personality, particularly neuroticism, agreeableness, and conscientiousness, impacts physician burnout. Strategies that modulate the impact of personality on burnout may be beneficial for optimal health care delivery.

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