Investigation of a Staphylococcus aureus sequence type 72 food poisoning outbreak associated with food-handler contamination in Italy

On August 2019 a staphylococcal food poisoning outbreak occurred in an elderly home in Piedmont, Italy. The epidemiological investigation performed among the per- sons that consumed the meal identified chicken salad as the most likely source of the outbreak. Staphylococcus aureus was isolated from a total of seven samples, namely one vomit sample from a guest of the nursing home, two food samples (chicken salad with and without mayonnaise) and nasal swabs collected from a total of four persons working in the kitchen of the nursing home. The maximum likelihood tree obtained using single nucleotide polymorphisms analysis revealed that the isolates from the aforementioned samples clustered together. Multilocus sequence typing revealed that they belonged to Sequence Type 72. Fourier transform infrared spectroscopy (FTIR) was used in parallel to single nucleotide polymorphisms and whole genome sequencing for the determination of the degree of relatedness of the isolates. The results of the FTIR showed the same clustering obtained with single nucleotide poly- morphisms and whole genome sequencing and revealed the source of infection. This study underlines the importance of both laboratory evidence and epidemiological data for outbreak investigation and further confirms that FTIR is a suitable support for the short-term epidemiological investigation on source attribution in case of a S. aureus infection

Stratification of unresponsive patients by an independently validated index of brain complexity.

OBJECTIVE: Validating objective, brain-based indices of consciousness in behaviorally unresponsive patients represents a challenge due to the impossibility of obtaining independent evidence through subjective reports. Here we address this problem by first validating a promising metric of consciousness-the Perturbational Complexity Index (PCI)-in a benchmark population who could confirm the presence or absence of consciousness through subjective reports, and then applying the same index to patients with disorders of consciousness (DOCs). METHODS: The benchmark population encompassed 150 healthy controls and communicative brain-injured subjects in various states of conscious wakefulness, disconnected consciousness, and unconsciousness. Receiver operating characteristic curve analysis was performed to define an optimal cutoff for discriminating between the conscious and unconscious conditions. This cutoff was then applied to a cohort of noncommunicative DOC patients (38 in a minimally conscious state [MCS] and 43 in a vegetative state [VS]). RESULTS: We found an empirical cutoff that discriminated with 100% sensitivity and specificity between the conscious and the unconscious conditions in the benchmark population. This cutoff resulted in a sensitivity of 94.7% in detecting MCS and allowed the identification of a number of unresponsive VS patients (9 of 43) with high values of PCI, overlapping with the distribution of the benchmark conscious condition. INTERPRETATION: Given its high sensitivity and specificity in the benchmark and MCS population, PCI offers a reliable, independently validated stratification of unresponsive patients that has important physiopathological and therapeutic implications. In particular, the high-PCI subgroup of VS patients may retain a capacity for consciousness that is not expressed in behavior

Nucleating Effect of Carbon Nanoparticles and Their Influence on the Thermal and Chemical Stability of Polypropylene

The effect of carbon nanofibers (CNFs) and carbon nanotubes (CNTs) on the thermal and chemical stability of polypropylene (PP) when subjected to oxidation in a strong acid medium was studied. The effect of CNFs and CNTs on the crystalline morphology and the melting and crystallization temperatures was also studied. The thermal stability increased markedly; the decomposition temperature, for example, increased from 293∘C for pure PP to 312 and 320∘C for PP with CNFs and CNTs, respectively. The crystallization temperature increased perceptibly with the addition of CNTs or CNFs, from 107∘C for pure PP to 112 and 114∘C for PP with CNFs and CNTs, respectively. The oxidative degradation with nitric acid produced a reduction in molecular weight; however, this negative effect was less pronounced in the PP compositions with carbon nanoparticles. After 8 hours in nitric acid, this reduction was from 141,000 to 68,000 (for pure PP), to 75,000 (for PP-CNFs), and 79,500 (for PP-CNTs). X-ray diffraction showed that the alpha type crystallinity remains, irrespective of the nucleating agent. Finally, the intensity ratio between the (040) (at 16.7∘) and the (110) (at 13.9∘) reflections increased, which was taken as an indication of an increasing nucleating efficiency

Nucleating Effect of Carbon Nanoparticles and Their Influence on the Thermal and Chemical Stability of Polypropylene

The effect of carbon nanofibers (CNFs) and carbon nanotubes (CNTs) on the thermal and chemical stability of polypropylene (PP) when subjected to oxidation in a strong acid medium was studied. The effect of CNFs and CNTs on the crystalline morphology and the melting and crystallization temperatures was also studied. The thermal stability increased markedly; the decomposition temperature, for example, increased from 293 • C for pure PP to 312 and 320 • C for PP with CNFs and CNTs, respectively. The crystallization temperature increased perceptibly with the addition of CNTs or CNFs, from 107 • C for pure PP to 112 and 114 • C for PP with CNFs and CNTs, respectively. The oxidative degradation with nitric acid produced a reduction in molecular weight; however, this negative effect was less pronounced in the PP compositions with carbon nanoparticles. After 8 hours in nitric acid, this reduction was from 141,000 to 68,000 (for pure PP), to 75,000 (for PP-CNFs), and 79,500 (for PP-CNTs). X-ray diffraction showed that the alpha type crystallinity remains, irrespective of the nucleating agent. Finally, the intensity ratio between the (040) (at 16.7 • ) and the (110) (at 13.9 • ) reflections increased, which was taken as an indication of an increasing nucleating efficiency

The Labour of Love: Seasonal Migration from Jharkhand to the Brick Kilns of Other States in India

Seasonal casual labour migration in India has conventionally been understood as the result of extreme poverty whereby villagers are forced to become migrants for the dry six months to subsist or merely survive. This article draws on fieldwork in a village in Jharkhand and a brick kiln in West Bengal to argue that migrants do not understand their movement in economic terms alone. Many see the brick kilns as a temporary space of freedom to escape problems back home, explore a new country, gain independence from parents or live out prohibited amorous relationships. It is suggested that Jharkhandi activists and policy-makers’ construction of such migration as a ‘problem’ is as much about their vision of how the new tribal state ought to be as about exploitation. Migration to the kilns is seen by them as a threat to the purity and regulation of the social and sexual tribal citizen. This moralising perspective creates a climate that paradoxically encourages many young people to flee to the brick kilns where they can live ‘freely’. In this way, the new puritanism at home helps to reproduce the conditions for capitalist exploitation and the extraction of surplus value

Stratification of unresponsive patients by an independently validated index of brain complexity

Objective: Validating objective, brain-based indices of consciousness in behaviorally unresponsive patients represents a challenge due to the impossibility of obtaining independent evidence through subjective reports. Here we address this problem by first validating a promising metric of consciousness\u2014the Perturbational Complexity Index (PCI)\u2014in a benchmark population who could confirm the presence or absence of consciousness through subjective reports, and then applying the same index to patients with disorders of consciousness (DOCs). Methods: The benchmark population encompassed 150 healthy controls and communicative brain-injured subjects in various states of conscious wakefulness, disconnected consciousness, and unconsciousness. Receiver operating characteristic curve analysis was performed to define an optimal cutoff for discriminating between the conscious and unconscious conditions. This cutoff was then applied to a cohort of noncommunicative DOC patients (38 in a minimally conscious state [MCS] and 43 in a vegetative state [VS]). Results: We found an empirical cutoff that discriminated with 100% sensitivity and specificity between the conscious and the unconscious conditions in the benchmark population. This cutoff resulted in a sensitivity of 94.7% in detecting MCS and allowed the identification of a number of unresponsive VS patients (9 of 43) with high values of PCI, overlapping with the distribution of the benchmark conscious condition. Interpretation: Given its high sensitivity and specificity in the benchmark and MCS population, PCI offers a reliable, independently validated stratification of unresponsive patients that has important physiopathological and therapeutic implications. In particular, the high-PCI subgroup of VS patients may retain a capacity for consciousness that is not expressed in behavior. Ann Neurol 2016;80:718\u2013729

Coronary stenting and surgery: Perioperative management of antiplatelet therapy in patients undergoing surgery after coronary stent implantation [Stent coronarico e chirurgia: La gestione perioperatoria della terapia antiaggregante nel paziente portatore di stent coronarico candidato a intervento chirurgico]

The management of antiplatelet therapy in patients with coronary stents undergoing surgery is a growing clinical problem and often represents a matter of debate between cardiologists and surgeons. It has been estimated that about 4-8% of patients undergoing coronary stenting need to undergo surgery within the next year. Surgery represents one of the most common reasons for premature antiplatelet therapy discontinuation, which is associated with a significant increase in mortality and major adverse cardiac events, in particular stent thrombosis. In addition, surgery confers an additional risk of perioperative cardiac ischemic events, being high in these patients because of the pro-inflammatory and pro-thrombotic effects of surgery. Current international guidelines recommend to postpone non-urgent surgery for at least 6 weeks after bare metal stent implantation and for 6-12 months after drug-eluting stent implantation. However, these recommendations provide little support with regard to managing antiplatelet therapy in the perioperative phase in case of urgent operations and/or high hemorrhagic risk. Furthermore, ischemic and hemorrhagic risk is not defined in detail on the basis of clinical and procedural characteristics. Finally, guidelines shared with cardiologists and surgeons are lacking. The present consensus document provides practical recommendations on the management of antiplatelet therapy in the perioperative period in patients with coronary stents undergoing surgery. Cardiologists and surgeons contributed equally to its creation. An ischemic risk stratification has been provided on the basis of clinical and procedural data. All surgical interventions have been defined on the basis of the hemorrhagic risk. A consensus on the most appropriate antiplatelet regimen in the perioperative phase has been reached on the basis of the ischemic and hemorrhagic risk. Dual antiplatelet therapy should not be withdrawn for surgery at low bleeding risk, whereas aspirin should be continued perioperatively in the majority of surgical operations. In the event of interventions at high risk for both bleeding and ischemic events, when oral antiplatelet therapy withdrawal is required, perioperative treatment with short-acting intravenous glycoprotein IIb/IIIa inhibitors (tirofiban or eptifibatide) should be considered. \ua9 2012 Il Pensiero Scientifico Editore