Quantitative Risk Assessment of Verocytotoxin-Producing Escherichia coli O157 and Campylobacter jejuni Related to Consumption of Raw Milk in a Province in Northern Italy

A quantitative risk assessment was developed to describe the risk of campylobacteriosis and hemolytic uremic syndrome (HUS) linked to consumption of raw milk sold in vending machines in Northern Italy. Exposure assessment considered the microbiological status of dairy farms, expected milk contamination, storage conditions from bulk tank to home storage, microbial growth during storage, destruction experiments, consumption frequency of raw milk, age of consumers, serving size, and consumption preference. The differential risk between milk handled under regulation conditions (4°C throughout all phases) and the worst field handling conditions was considered. The probability of Campylobacter jejuni infection was modeled with a single-hit dose-response beta-Poisson model, whereas for HUS an exponential dose-response model was chosen and two probabilities were used to model the higher susceptibility of children younger than 5 years old. For every 10,000 to 20,000 consumers each year, the models predicted for the best and worst storage conditions, respectively, 2.12 and 1.14 campylobacteriosis cases and 0.02 and 0.09 HUS cases in the 0- to 5-year age group and 0.1 and 0.5 HUS cases in the5-year age group. The expected pediatric HUS cases do not differ considerably from those reported in Italy by the Minister of Health. The model developed may be a useful tool for extending the assessment of the risk of campylobacteriosis and HUS due to raw milk consumption at the national level in Italy. Considering the epidemiological implications of this study, the risk of illness linked to raw milk consumption should not be ignored and could be reduced by the use of simple measures. Boiling milk before consumption and strict control of temperatures by farmers during raw milk distribution have significant effects on campylobacteriosis and HUS and are essential measures for risk management

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Sale of Raw Milk in Northern Italy: Food Safety Implications and Comparison of Different Analytical Methodologies for Detection of Foodborne Pathogens

The safety of raw milk sold in Northern Italy was investigated in relation to hygiene quality parameters and presence of Salmonella spp., Listeria monocytogenes, thermotolerant Campylobacter, and Verocytotoxin producing Escherichia coli O157:H7. The performance of different analytical methods used—official culture method (ISO), modified Bacteriological Analytical Manual cultural method (mBAM), and polymerase chain reaction (PCR)— was evaluated. The presence of Mycobacterium avium subsp. paratuberculosis (Map) was investigated only by PCR. All samples met regulations for alkaline phosphatase and inhibitory substance, while 18% and 44.8% of samples collected from vending machines had, respectively, somatic cell count (SCC) > 300,000/mL and total bacterial count (TBC) > 50,000CFU/mL. The correlation between hygienic quality parameters in samples collected from bulk tank and vending machines showed a significant increase of TBC in vending machines meaning that raw milk was mishandled during distribution and sale. All pathogens investigated were detected in raw milk sold at vending machines; a total of five samples (5%) had at least one pathogen, of which two were detected by PCR and three by mBAM. None of the samples was positive by cultural ISO methods. Even if the comparison of analytical methods showed that none performs significantly better than the others, testing a higher volume of milk (25 versus 210 mL) affects significantly the detection rate of pathogens. Three samples (3%) were positive for Map, suggesting that raw milk is a significant source of Map exposure for consumers. The observed TBC increase and the detection of several pathogenic bacteria pose questions on the safety of raw milk; the use of ISO seems inefficient in detecting a low contamination level of pathogens in milk and consequently not appropriate as official method for testing. In order to ensure consumer’s safety, a new approach for the raw milk chain is required

Isolation of Arcobacter butzleri in environmental and food samples collected in industrial and artisanal dairy plants

This study investigated the presence of Arcobacter species in two cheese factories; a total of 22 environmental samples and 10 food samples were collected from an artisanal and an industrial cheese factory; Arcobacter species were isolated after enrichment, and isolates were identified at species level by multiplex-polymerase chain reaction (PCR) assay. In the artisanal cheese factory, Arcobacter spp. were isolated from several environmental samples, cow and water buffalo raw milk and ricotta cheese. In the industrial plant, Arcobacter spp. were isolated from surfaces not in contact with food and from a cleaned surface in contact with food; no Arcobacter spp. was isolated from food. All isolates were identified as A. butzleri. We report of the presence of A. butzleri in a ready-to-eat cheese produced for retail. In addition, the isolation of A. butzleri in food processing surfaces in the two cheese factories could be assessed as a source of potential contamination for cheese

Isolation of Arcobacter butzleri in environmental and food samples collected in industrial and artisanal dairy plants

This study investigated the presence of Arcobacter species in two cheese factories; a total of 22 environmental samples and 10 food samples were collected from an artisanal and an industrial cheese factory; Arcobacter species were isolated after enrichment, and isolates were identified at species level by multiplex-polymerase chain reaction (PCR) assay. In the artisanal cheese factory, Arcobacter spp. were isolated from several environmental samples, cow and water buffalo raw milk and ricotta cheese. In the industrial plant, Arcobacter spp. were isolated from surfaces not in contact with food and from a cleaned surface in contact with food; no Arcobacter spp. was isolated from food. All isolates were identified as A. butzleri. We report of the presence of A. butzleri in a ready-to-eat cheese produced for retail. In addition, the isolation of A. butzleri in food processing surfaces in the two cheese factories could be assessed as a source of potential contamination for cheese

Highly Efficient Crystallization Induced Emissive Materials Based on a Simple Push-Pull Molecular Structure

Solid state luminescent materials are the subject of ever growing interest both from a scientific and a technological point of view. Aggregation caused quenching (ACQ) processes however represent an obstacle to the development of most luminogens in the condensed phase. This is why particularly fascinating are those materials showing higher emission intensity in the solid state than in solution. Here we report on 4-dialkylamino-2-benzylidene malonic acid dialkyl esters, very simple push-pull molecules, which are weakly emissive in solution but becomes highly emissive in the aggregated phase according to what has been indicated as aggregation induced emission (AIE).Thanks to combined emission and NMR spectroscopies at different temperatures on the prototype compound 4-dimethylamino-2-benzylidene malonic acid dimethyl ester both in solution and in the solid state we give full evidence that a restricted intramolecular rotation (RIR) phemomenon, in particular the rigidification of the rotation around the aryl main axis of the compound, is at the origin of this behavior. Moreover, we show that this compound possesses interesting acidochromic properties opening to sensor and optoelectronic applications