Produce handling and processing practices.

In the past decade, outbreaks of human illness associated with the consumption of raw vegetables and fruits (or unpasteurized products produced from them) have increased in the United States. Changes in agronomic, harvesting, distribution, processing, and consumption patterns and practices have undoubtedly contributed to this increase. Pathogens such as Listeria monocytogenes, Clostridium botulinum, and Bacillus cereus are naturally present in some soil, and their presence on fresh produce is not rare. Salmonella, Escherichia coli O157:H7, Campylobacter jejuni, Vibrio cholerae, parasites, and viruses are more likely to contaminate fresh produce through vehicles such as raw or improperly composted manure, irrigation water containing untreated sewage, or contaminated wash water. Contact with mammals, reptiles, fowl, insects, and unpasteurized products of animal origin offers another avenue through which pathogens can access produce. Surfaces, including human hands, which come in contact with whole or cut produce represent potential points of contamination throughout the total system of growing, harvesting, packing, processing, shipping, and preparing produce for consumption. Treatment of produce with chlorinated water reduces populations of pathogenic and other microorganisms on fresh produce but cannot eliminate them. Reduction of risk for human illness associated with raw produce can be better achieved through controlling points of potential contamination in the field; during harvesting; during processing or distribution; or in retail markets, food-service facilities, or the home

Infections associated with eating seed sprouts: an international concern.

Recent outbreaks of Salmonella and Escherichia coli O157:H7 infections associated with raw seed sprouts have occurred in several countries. Subjective evaluations indicate that pathogens can exceed 107 per gram of sprouts produced from inoculated seeds during sprout production without adversely affecting appearance. Treating seeds and sprouts with chlorinated water or other disinfectants fails to eliminate the pathogens. A comprehensive approach based on good manufacturing practices and principles of hazard analysis and critical control points can reduce the risk of sprout-associated disease. Until effective measures to prevent sprout-associated illness are identified, persons who wish to reduce their risk of foodborne illness from raw sprouts are advised not to eat them; in particular, persons at high risk for severe complications of infections with Salmonella or E. coli O157:H7, such as the elderly, children, and those with compromised immune systems, should not eat raw sprouts

Perceived coercion in psychiatric hospital admission: validation of the French-language version of the MacArthur Admission Experience Survey.

The MacArthur Admission Experience Survey (AES) is a widely used tool to evaluate the level of perceived coercion experienced at psychiatric hospital admission. The French-language AES was prepared using a translation/back-translation procedure. It consists of 16 items and 3 subscores (perceived coercion, negative pressures and voice). This study aimed to assess the psychometric properties of the French-language AES. 152 inpatients were evaluated. Reliability was estimated using internal consistency coefficients and a test-retest procedure. Internal validity was assessed using a two-parameter logistic item response model. Convergent validity was estimated using correlations between the AES scores and the Coercion Ladder (CL), the Coercion Experience Scale (CES) and the Global Assessment of Functioning (GAF) scale. Discriminatory power was evaluated by comparing the scores of patients undergoing voluntary or compulsory admission. The French-language AES showed good internal consistency and test-retest reliability. Internal validity of the three-factor model was excellent. Correlations between AES and CL, CES and GAF scores suggested good convergent validity. AES scores were significantly higher among patients subject to compulsory psychiatric hospital admission than among those admitted voluntarily. Overall, the French-language version of the AES demonstrated very good psychometric proprieties

Cybertools improve reaction time in open heart surgery

OBJECTIVE: Head-up displays allow the surgeons to simultaneously view the patient and the patient's vital parameters (ECG, blood pressure, etc.) using vision-through over a wireless net, potentially enhancing the speed, accuracy and safety of surgical decisions. The aim was to assess surgical reaction time to AFIB, bigeminy, trigeminy, VTACH, and VFIB and concentration during a surgical intervention comparing standard and cyber tools monitoring. METHODS: Using a patient simulator for beating heart surgery able to emulate heart signals and motion (arrhythmias) a group of surgeons performed coronary bypass procedures. Measurements of reaction time, efficiency of the surgeon, time elapsed to display a coronary angiography in a realistic surgical environment were taken. RESULTS: The duration to accomplish the experiment is not different between groups (cyber vs. standard) reaction times, however, are significantly decreased for cyber by a mean of 33%. There is also a measured time difference for displaying a coronary angiography within the head-up display as compared to a remote console. CONCLUSIONS: During surgery, modern cyber tools allow for significant improvements of reaction time and concentration due to real time access to vital information

Adipose energy stores, physical work, and the metabolic syndrome: lessons from hummingbirds

Hummingbirds and other nectar-feeding, migratory birds possess unusual adaptive traits that offer important lessons concerning obesity, diabetes and the metabolic syndrome. Hummingbirds consume a high sugar diet and have fasting glucose levels that would be severely hyperglycemic in humans, yet these nectar-fed birds recover most glucose that is filtered into the urine. Hummingbirds accumulate over 40% body fat shortly before migrations in the spring and autumn. Despite hyperglycemia and seasonally elevated body fat, the birds are not known to become diabetic in the sense of developing polyuria (glucosuria), polydipsia and polyphagia. The tiny (3–4 g) Ruby-throated hummingbird has among the highest mass-specific metabolic rates known, and loses most of its stored fat in 20 h by flying up to 600 miles across the Gulf of Mexico. During the breeding season, it becomes lean and maintains an extremely accurate energy balance. In addition, hummingbirds can quickly enter torpor and reduce resting metabolic rates by 10-fold. Thus, hummingbirds are wonderful examples of the adaptive nature of fat tissue, and may offer lessons concerning prevention of metabolic syndrome in humans

Alfalfa Seed Decontamination in Salmonella Outbreak

Based on in vitro data, the U.S. Food and Drug Administration recommends chemical disinfection of raw sprout seeds to reduce enteric pathogens contaminating the seed coats. However, little is known about the effectiveness of decontamination at preventing human disease. In 1999, an outbreak of Salmonella enterica serotype Mbandaka occurred in Oregon, Washington, Idaho, and California. Based on epidemiologic and pulsed-field gel electrophoresis evidence from 87 confirmed cases, the outbreak was linked to contaminated alfalfa seeds grown in California’s Imperial Valley. Trace-back and trace-forward investigations identified a single lot of seeds used by five sprout growers during the outbreak period. Cases of salmonellosis were linked with two sprout growers who had not employed chemical disinfection; no cases were linked to three sprout growers who used disinfection. This natural experiment provides empiric evidence that chemical disinfection can reduce the human risk for disease posed by contaminated seed sprouts

Risky Traitor Tracing and New Differential Privacy Negative Results

In this work we seek to construct collusion-resistant traitor tracing systems with small ciphertexts from standard assumptions that also move toward practical efficiency. In our approach we will hold steadfast to the principle of collusion resistance, but relax the requirement on catching a traitor from a successful decoding algorithm. We define a $f$-risky traitor tracing system as one where the probability of identifying a traitor is $f(\lambda,n)$ times the probability a successful box is produced. We then go on to show how to build such systems from prime order bilinear groups with assumptions close to those used in prior works. Our core system achieves, for any $k > 0$, $f(\lambda,n) \approx \frac{k}{n + k - 1}$ where ciphertexts consists of $(k + 4)$ group elements and decryption requires $(k + 3)$ pairing operations. At first glance the utility of such a system might seem questionable since the $f$ we achieve for short ciphertexts is relatively small. Indeed an attacker in such a system can more likely than not get away with producing a decoding box. However, we believe this approach to be viable for four reasons: 1. A risky traitor tracing system will provide deterrence against risk averse attackers. In some settings the consequences of being caught might bear a high cost and an attacker will have to weigh his utility of producing a decryption $D$ box against the expected cost of being caught. 2. Consider a broadcast system where we want to support low overhead broadcast encrypted communications, but will periodically allow for a more expensive key refresh operation. We refer to an adversary produced algorithm that maintains the ability to decrypt across key refreshes as a persistent decoder. We show how if we employ a risky traitor tracing systems in this setting, even for a small $f$, we can amplify the chances of catching such a ``persistent decoder\u27\u27 to be negligibly close to 1. 3. In certain resource constrained settings risky traitor tracing provides a best tracing effort where there are no other collusion-resistant alternatives. For instance, suppose we had to support 100K users over a radio link that had just 10KB of additional resources for extra ciphertext overhead. None of the existing $\sqrt N$ bilinear map systems can fit in these constraints. On the other hand a risky traitor tracing system provides a spectrum of tracing probability versus overhead tradeoffs and can be configured to at least give some deterrence in this setting. 4. Finally, we can capture impossibility results for differential privacy from $\frac{1}{n}$-risky traitor tracing. Since our ciphertexts are short ($O(\lambda)$), we get the negative result which matches what one would get plugging in the obfuscation based tracing system Boneh-Zhandry (CRYPTO 2014) solution into the prior impossibility result of Dwork et al. (STOC 2009)

National Outbreak of Salmonella Serotype Saintpaul Infections: Importance of Texas Restaurant Investigations in Implicating Jalapeño Peppers

BACKGROUND: In May 2008, PulseNet detected a multistate outbreak of Salmonella enterica serotype Saintpaul infections. Initial investigations identified an epidemiologic association between illness and consumption of raw tomatoes, yet cases continued. In mid-June, we investigated two clusters of outbreak strain infections in Texas among patrons of Restaurant A and two establishments of Restaurant Chain B to determine the outbreak's source. METHODOLOGY/PRINCIPAL FINDINGS: We conducted independent case-control studies of Restaurant A and B patrons. Patients were matched to well controls by meal date. We conducted restaurant environmental investigations and traced the origin of implicated products. Forty-seven case-patients and 40 controls were enrolled in the Restaurant A study. Thirty case-patients and 31 controls were enrolled in the Restaurant Chain B study. In both studies, illness was independently associated with only one menu item, fresh salsa (Restaurant A: matched odds ratio [mOR], 37; 95% confidence interval [CI], 7.2-386; Restaurant B: mOR, 13; 95% CI 1.3-infinity). The only ingredient in common between the two salsas was raw jalapeño peppers. Cultures of jalapeño peppers collected from an importer that supplied Restaurant Chain B and serrano peppers and irrigation water from a Mexican farm that supplied that importer with jalapeño and serrano peppers grew the outbreak strain. CONCLUSIONS/SIGNIFICANCE: Jalapeño peppers, contaminated before arrival at the restaurants and served in uncooked fresh salsas, were the source of these infections. Our investigations, critical in understanding the broader multistate outbreak, exemplify an effective approach to investigating large foodborne outbreaks. Additional measures are needed to reduce produce contamination