High Level Of Hygiene Research Articles

BACTERIOLOGICAL ASSESSMENT OF SOME COMMERCIALLY SOLD YOGHURT IN UTURU, ABIA STATE, NIGERIA: A PRELIMINARY STUDY

A preliminary study was carried out to determine the bacteriological quality of commercial yogurt sold in Uturu, Abia State, Nigeria. This involved isolation, characterization and antibiotics susceptibility of bacteria isolated from some commercially sold yoghurt in Uturu. Five different brands of yoghurt coded A to E were microbiologically analyzed using standard microbiological methods. The total viable count ranged from 0.9×102 cfu/ml – 2.0x103 cfu/ml, coliform count ranged from 0.4×102 cfu/ml – 1.0×103 cfu/ml, total staphylococcal count ranged from 1.1×101 to 1.8×102. Bacterial isolated include Staphylococcus species, Streptococcus species, Bacillus species and Lactobacillus species. The antibiotics susceptibility pattern of the bacterial isolates proved that drovid had the highest zones of inhibition from 31.8±1.2 mm to 36.1±0.3 mm, followed by oflaxacin (29.5±0.1 mm to 35.0±0.8 mm). The presence of coliform and Staphylococcus in the yoghurt may be as a result of unclean water used in the production, contaminated milk and unhygienic condition of the handlers. It is recommended that yoghurt producers, sellers and handlers should ensure a high level of hygiene and avoid long exposure of yoghurt before selling to consumers.

Extended-spectrum beta-lactamase-producing Klebsiella pneumoniae and risk factors associated with high total bacterial count in bulk tank milk from dairy farms in Colombia

The objective of the study was to evaluate the frequency and genetic characteristics of ESBL-producing Escherichia coli and Klebsiella spp. and the risk factors associated with a high total bacterial count in bulk tank milk samples of dairy farms in three municipalities of the Antioquia Department, Colombia. Fifteen samples were positive for E. coli and Klebsiella spp. Subsequent analysis of the 16 S rRNA gene sequences confirmed these isolates included E. coli (n = 3), K. oxytoca (n = 11), and K. pneumoniae (n = 1). None of the isolates was positive for ESBL identification by phenotypic methods, but the only the isolate of K. pneumoniae was positive for the blaSHV61 gene by sequence analysis. The antibiotic susceptibility evaluation for all Klebsiella spp. isolates identified resistance to fosfomycin (50%; 6/12) and ampicillin (100%; 12/12). While most of the herds maintain adequate hygienic quality, specific risk factors such as having more than 60 milking cows, frequent changes in milkers, milking in paddocks, and using a chlorinated product for pre-dipping have been identified as associated with a high total bacterial count > 100,000 CFU/mL in bulk tank milk. However, certain variables including the milker being the owner of the animals and the proper washing and disinfection of the milking machine contribute to maintain a high level of hygiene and quality in the raw milk stored in the tanks. In conclusion, the frequency of ESBL producers was relatively low, with only K. pneumoniae testing positive for the blaSHV ESBL type. The presence of these bacteria in milk tanks represents a potential risk to public health for consumers of raw milk and its derivatives.

Wireless handheld focused ultrasound in student teaching during the COVID-19 pandemic: Initial results of a pilot study1.

The study aim was to investigate the use of a novel device, the Vscan Air™, for rapidly and effectively performing ultrasound in student teaching during the COVID-19 pandemic. As part of the ultrasound practical course with integrated hands-on activity required by the regular medical curriculum, 100 medical students were instructed in the use of the Vscan Air™, including duplex mode. They then evaluated the quality of the ultrasound images obtained by the Vscan Air™ from previously selected organs. 100 students were interviewed (female n = 68, male n = 32; age >18 years n = 100). The rated image quality never fell below a mean of 3 for the examined organs and portal vein flow (liver 4,58; spleen 3,99; kidneys 4,29; aorta 4,16; Douglas/rectovesical space 4,14; portal vein 4,43; pancreas 3,53; Focused Assessment with Sonography for Trauma 4,38). Scores below 3 were found sporadically in ultrasounds of the spleen (n = 4), kidneys (n = 3), Douglas/rectovesical space (n = 2), and pancreas (n = 15). The liver was rated the lowest for 59 ratings. The portal vein was evaluated in 68 cases. The hepatic artery and hepatic veins could be also visualized in all 68 examinations. The aorta was evaluated in 62 cases. The Vscan Air™ technology offered adequate image quality and provided a new, fast and patient-oriented technique to support continuous ultrasound examinations and education of students, especially during a pandemic. Particularly noteworthy is the uncomplicated compliance with the required high level of hygiene.

Salmonella in horses at slaughter and public health effects in Italy

The study assessed the role of equids at slaughter as faecal carriers of Salmonella enterica and the occurrence of contaminated equid carcasses during the slaughter process in Northern Italy (Emilia-Romagna Region). From June to November 2021, 152 equids (146 horses, 5 donkeys and 1 mule) were tested for Salmonella both in caecal contents and through carcass swabs. Antimicrobial resistance (AMR) of recovered strains was tested against 15 antimicrobials. Salmonella was detected in 3/152 of the caecal contents (2.0 %), while all carcass samples were negative. S. enterica serovars Enteriditis, Typhimurium and Stanleyville were identified. The only AMR isolate was S. Typhimurium with AMR profile AmCStxT.Considering the consumption of raw horse meat (i.e., minced raw meat named “pesto di cavallo” and dried and smoked strips named “sfilacci di cavallo”) in different areas of Northern Italy, we also investigated the possible link between horse meat eating and salmonellosis cases in the human population in the same area. Specifically, we compared the Salmonella strains collected during the study with those routinely processed in the laboratory surveillance system for human salmonellosis in Emilia-Romagna (a region with about 4.5 million inhabitants). The comparison was based on whole genome sequencing data through core genome multi-locus sequence typing (cgMLST) used in routine surveillance. A genomic match in cgMLST was found between the strain of S. enterica serovar Enteritidis isolated from a horse caecal content and an enduring outbreak of 17 human cases in Emilia-Romagna during the study period. The consequent epidemiological investigation highlighted that a number of cases with known food history reported the consumption of horse meat and traced different batches of the consumed meat, released weeks apart from each other, to the slaughter investigated in the study. The results of the epidemiological investigation suggested the role of horses in the S. enterica serovar Enteritidis outbreak affecting raw horse meat consumers.This study shows that, despite the low prevalence on equid carcasses, S. enterica in horse meat can represent a risk to consumers. From the perspective of the slaughter activities, this highlights the need to maintain a high level of hygiene during the entire process, starting from the hygiene at lairage up to the slaughtering phase and dressing of carcasses.

A Susceptible Vaccinated Exposed Infected Hospitalized and Removed/Recovered (SVEIHR) Model Framework for COVID-19

In reaction to the severe socio-economic effects and upheavals that the Covid-19 sickness had on the world within the first few weeks of its introduction, everyone involved had to act quickly to look for possible solutions for preventing the ensuing epidemics. A prompt response is more critical given Nigeria's subpar social, economic, and healthcare infrastructure. Investigated was the efficacy of various pharmacological, non-pharmaceutical, or a combination of both therapies in flattening the Covid-19 incidence curve. In order to investigate the impact of these interventions, a deterministic SVEIHR model was created and applied. The Nigerian Center for Disease Control (NCDC) portal's Covid-19 data were used to parametrize the model. For simulations using a system dynamic simulation, estimated parameters were employed. The fundamental reproduction number, R0, was used to evaluate the success of our suggested intervention in effectively managing COVID-19 transmission. The simulation results demonstrated that the use of only non-pharmaceutical interventions, such as the use of face masks, a light lockdown, and hand washing at baseline or high levels, is insufficient, with the R0 varying from vaccination at the vaccination rate of 0.5% with non-pharmaceutical interventions at any level of compliance, and a combination of vaccination at 0.05% and high hygiene level were effective in flattening the Covid-19 disease incidence curve in Nigeria, returning a R0 less than 1. Furthermore, maintaining a high level of cleanliness, which includes hand washing and the use of a face mask, would be sufficient to stop the spread of Covid-19 disease and eventually flatten Covid-19 disease incidence curve in Nigeria, given a low turnout of 0.05% for vaccination and the easing of lockdown.

Characterisation of antibiotic resistant Staphylococcus species and molecular identification of mecA and toxic shock syndrome toxin-1 (tsst-1) genes of Staphylococcus aureus isolates from cows' milk

Staphylococcus aureus (S. aureus) is one of the most important causes of foodborne illness. Due to the interest of people to use traditional dairy products, especially milk, in the current descriptive study the frequency of S. aureus, antibiotic resistance pattern and presence of toxic shock syndrome toxin-1 gene (tsst-1 gene) in these isolated strains was investigated. Thirty-nine strains (26%) of S. aureus were identified from the samples studied, of which 6 (15.38%) were resistant to methicillin, and 9 (23.07%) were positive for mecA gene. Also, 31 (20.7%) coagulase-negative staphylococci isolates were identified. Out of the 39 strains of S. aureus, the presence of tsst gene was detected in 1 strain (2.56%). Therefore, S. aureus contamination indicates a risk to public health and can be significantly controlled using a high level of hygiene and professional training in the handling of raw milk.

Microbiological Quality of Typical Traditional Fermented Milk from Northern Uganda and Western Kenya

In this study, the microbiological quality of traditionally fermented milk from Northern Uganda and Western Kenya was analysed. Six samples of typical traditionally fermented milk were collected randomly from traditional cattle keepers in Karamojong (UG 1) and Acholi (UG 2) in Northern Uganda and Kalenjin in Western Kenya (KE). The microbial quality of the collected samples was assessed through the use of conventional methods for total aerobic mesophilic bacteria, total coliform, lactic acid bacteria, Staphylococcus aureus, Listeria monocytogenes, yeasts, and mould counts. The mean aerobic mesophilic bacterial counts were 5.14 × 109 coliform forming units (cfu)/mL. The mean counts for mesophilic lactobacilli ranged from 106 to 108 cfu/mL. The mean thermophilic lactobacilli count ranged from 107 to 109 cfu/mL, while the mean thermophilic lactococci counts ranged from 106 to 109 cfu/mL. On the other hand, the Streptococci counts were between 106 and 108 cfu/mL. The mean count for the non-sorbitol E. coli was 3.87 × 103 cfu/mL. These results suggest that although the pH of the traditional yoghurt in this study was low, the acidity was not sufficient to inhibit growth of microorganisms in the product. Although it is difficult to avoid the microbial contamination of milk during milking, it is of the utmost importance to maintain a very high level of hygiene in dairy farming practices, and the correct cleaning of teats during milking is very important for good udder health and optimum milk quality, and to ensure safety. The results regarding microbial contamination pose public health concerns, and therefore the appropriate government agencies must pay attention to ensure that the environment in which yoghurt is produced is in the best condition to reduce contamination.

Thermodynamics and Viscoelastic Property of Interface Unravel Combined Functions of Cationic Surfactant and Aromatic Alcohol against Gram-Negative Bacteria.

Lipopolysaccharides (LPSs), the major constituents of the outer membranes of Gram-negative bacteria, play a key role in protecting bacteria against antibiotics and antibacterial agents. In this study, we investigated how a mixture of cationic surfactants and aromatic alcohols, the base materials of widely used sanitizers, synergistically act on LPSs purified from Escherichia coli using isothermal titration calorimetry (ITC), surface tension measurements, and quartz crystal microbalance with dissipation (QCM-D). ITC data measured in the absence of Ca2+ ions showed the coexistence of exothermic and endothermic processes. The exotherm can be interpreted as the electrostatic binding of the cationic surfactant to the negatively charged LPS membrane surface, whereas the endotherm indicates the hydrophobic interaction between the hydrocarbon chains of the surfactants and LPSs. In the presence of Ca2+ ions, only an exothermic reaction was observed by ITC, and no entropically driven endotherm could be detected. Surface tension experiments further revealed that the co-adsorption of surfactants and LPS was synergistic, while that of surfactants and alcohol was negatively synergistic. Moreover, the QCM-D data indicated that the LPS membrane remained intact when the alcohol alone was added to the system. Intriguingly, the LPS membrane became highly susceptible to the combination of cationic surfactants and aromatic alcohols in the absence of Ca2+ ions. The obtained data provide thermodynamic and mechanical insights into the synergistic function of surfactants and alcohols in sanitation, which will enable the identification of the optimal combination of small molecules for a high hygiene level for the post-pandemic society.

Safety Evaluation of FONIO (Digitaria exilis)/Ricebean (Vigna Umbellata) Based Complementary Food

This study evaluated the oligosaccharides, phytochemicals, dietary fiber, microbial count, pH and acidity of fonio (Digitaria exilis)/ricebean (Vigna umbellata) based complementary foods in order to ascertain the safety of the formulations. A 3 by 4 by 4 factorial design was used. A 70:30 (treated fonio): (72 h sprouted and dehulled ricebean) blend containing 30 % peeled dried carrot and 30 % crayfish (FNBN) was formulated. A similar blend with additional 20 % milk (FNBP), a third blend containing unsprouted and undehulled ricebean (FNBU) and a fourth containing only treated fonio and sprouted ricebean (FNBM) were also formulated. The level of stachyose and raffinose in the diets ranged from 0.21±0.00 -0.40±0.02 % and 0.05±0.00 -0.10±0.01 % respectively. The levels of stachyose and raffinose in the sprouted samples (FNBP, FNBN and FNBM) were comparable (p>0.05) and low suggesting absence of flatulence. The residual phytochemicals in the formulations ranged from 0.160±0.00-0.28±0.00 % (alkaloid), 0.17±0.02-0.35±0.01 % (flavonoid) and 0.39±0.02-0.530±0.01 % (saponin). These low values indicate absence of allergy. The dietary fiber contents of the blends were lower (p<0.05) than the recommended 5 % for complementary food indicating that the digestive system of the infants can handle it. The low bacterial load and zero fungal growth observed in the products depict high level of hygiene and sanitary quality while the near neutral pH and low acidity suggest caution during handling and feeding of the infant. These conditions favour growth of spoilage and pathogenic microorganisms. Results of the study show a high measure of safety of the formulations.

Role of Surfactants Against Covid‐19: A Scientific Approach

Pandemic emerged due to the spread of SARS-COV-2 has become a most serious problem faced by today's world. Even after about 8 months, neither there is any decrease in its magnitude or in the spread. In some countries, it has reached the peak of its horrors, while some countries are still forced to guess only what will be the peak maxima of number of Covid-19 patients. People are compelled to maintain social distancing, cleanliness, and high level of hygiene. Right from the beginning of this epidemic, it has been concluded that washing hands every hour with soap (surfactants) can help people to protect themselves from this disease. Surfactants can play a major role in stopping the spread of this epidemic? In this review article, the role of surfactants to stop the spread of Covid-19 has been discussed. In addition, some of the other prospects of surfactants in Covid-19 such as a drug delivery of pulmonary drugs have also been explained.

Prevalence, virulence factors, and antimicrobial resistance profiles of Shiga toxin-producing Escherichia coli isolated from broiler chickens in Egypt.

Pathogenic Escherichia coli is one of the world's most important zoonotic foodborne pathogens and poses a serious threat to public health. We examined the prevalence, virulence genes, and antibiotic resistance profile of Shiga toxin (Stx)-producing E. coli (STEC) isolated from broiler chickens in the Kafr El-Sheikh governorate, Egypt. A total of 410 samples (230 cloacal swabs, 180 internal organs) were collected to isolate E. coli. A total of 29 (7.07%) E. coli isolates were recovered and identified, and 18 of them harbored Stx genes (stx). Out of 18 isolates, five (17.24%) carried the stx 1 gene, five (17.24%) carried the stx 2 gene, four (13.79%) carried both stx 1 and stx 2 genes, and four (13.79%) carried stx 1 , stx 2 , and eae A genes. Overall, complete anti-biotic resistance was observed against amoxicillin, ampicillin, cefpodoxime, and cefoperazone; high resistance was observed against ampicillin/sulbactam, nalidixic acid, cefuroxime, aztreonam, ciprofloxacin, ceftriaxone, chloramphenicol, sulfamethoxazole/trimethoprim, and ceftazidime; moderate resistance against gentamicin; low resistance against cefoxitin; lower resistance was detected against norfloxacin, cefotetan, and amikacin; and the lowest resistance against imipenem. All E. coli isolates demonstrated multidrug resistance against at least four antibiotic classes. Out of 29 E. coli isolates, STEC accounted for 18 isolates, of which the O78, O26:H11, O128:H2, O1:H7, O119:H6, and O91:H21 serogroups were predominant. All E. coli isolates were multidrug resistant and therefore pose a potential public health concern as these virulent, resistant strains may spread to humans. Thus, high levels of hygiene and biosecurity are required by chicken handlers to decrease the danger of infection spreading to humans.

Impact of packaging system on the microbial quality of chilled rabbit meat over 21 days of storage.

The pace of life is accelerating, so we are seeking ways to optimize the shelf life of products. To achieve this goal, the microbiological quality of rabbit meat was assessed at 7, 14, and 21 days under refrigerated conditions, utilizing two storage methods, modified atmosphere packaging (MAP) and vacuum packaging (VAC). Maintaining high levels of hygiene is critical not only during slaughter but also during subsequent technological processes and meat storage. The research concluded that the MAP method was more effective at extending the shelf-life of fresh rabbit meat than the VAC method. Additionally, increasing the CO2 concentrations in meat significantly decreased the Pseudomonas bacteria population (after 14 and 21 days of storage). Conversely, the gaseous mixture containing 70% O2 significantly decreased the Enterobacteriaceae population in the sample after 21 days of storage. Moreover, the MAP storage method considerably impeded microbial growth, particularly the total yeast and mold count, lactic acid bacteria count, and Pseudomonas spp. count. This study's findings demonstrate that rabbit meat can be stored for 21 days in a modified atmosphere containing appropriate concentrations of gases such as gaseous carbon dioxide and oxygen.

MO716: A Different Pet Test: The Relationship between Pet Ownership and Peritonitis Risk in the Peritoneal Dialysis Outcomes and Practice Patterns Study

Abstract BACKGROUND AND AIMS In the USA, 64% of homes have dogs or cats (38% dogs and 25% cats in 2017-8). As a home-based treatment, peritoneal dialysis (PD) patients run the risk of developing zoonotic diseases from their pets. The 2016 International Society for Peritoneal Dialysis Guidelines recommend that domestic animals should not be in the area while the PD exchange is performed. The primary aim of this study was to see how common it was for PD patients to have pets and to examine the association between pet ownership and peritonitis risk in the Peritoneal Dialysis and Outcomes Practice Patterns Study (PDOPPS). METHOD PDOPPS is an international prospective cohort study of adult PD patients across eight countries—Australia, Canada, Japan, New Zealand, South Korea, Thailand, the UK, and the USA. Patient demographics and comorbid conditions were collected at study enrolment and patient questionnaires collected information on household pets. Peritonitis episodes were collected using uniform and standardized data collection tools, procedures and processes. Risk of peritonitis was modelled using a Cox proportional hazards regression adjusted for patient demographics, 14 comorbid conditions, serum albumin, and residual urine volume and stratifying on country and prior peritonitis episodes during follow-up. RESULTS In total, 3655 PD patients provided information about household pets (out of a total of 4473 participants who filled out patient questionnaires amongst a total of 12 447 eligible patients). Among patients who reported on pet ownership, the percentage of patients owning only dogs was 19%, only cats 7%, and 6% with dogs and cats. Most countries, including the USA, had less than 50% of PD patient households having pets, lower than the US general population. Notable differences could be seen between countries in the profile of pets at home, including low numbers of pet ownership in South Korea and greater numbers of dogs than cats in the USA, Thailand, Japan and the UK (Fig. 1). Over a median follow-up for this cohort of 14 months and a total exposure time of 55 475 patient-months, 1347 peritonitis episodes were detected with an overall peritonitis rate of 0.29 episodes/patient-year. Having pets was associated with a hazard ratio of 1.09 (95% confidence interval 0.96–1.25) compared to no pet ownership. Figure 2 compares various combinations of pet ownership to PD patients with no pets as the reference group. However, among patients who lived alone, the peritonitis risk associated with pet ownership versus no pets appeared elevated, especially for people who owned both dogs and cats, although the P-value for the interaction was 0.72 (Fig. 2). CONCLUSION Utilizing this large cohort study, our results suggest limited increased peritonitis risk with pet ownership was seen among patients who live with others. However, our findings do suggest that for patients who live alone, higher peritonitis rates may be seen in those who have a pet. While it would be prudent to ensure maintenance of a high level of hygiene, our results suggest that pet ownership should not be an obstacle to choosing PD.

Screening and molecular characterization of Trichomonas vaginalis genotypes isolated from married women in northern Iran.

Trichomonas vaginalis is an anaerobic protozoan parasite that causes trichomonosis in human. It is one of the most common non-viral sexually transmitted infections. It has been found to be most prevalent in patients referred to sexually transmitted disease clinics. In recent years, molecular methods have been used to identify genotypes of this parasite in different parts of the world and so far 6 types of T. vaginalis have identified. The aim of this study was to investigate the prevalence and genotype identification of T. vaginalis from married women in northern Iran. A total of 450 vaginal specimens were taken from married women, referring to health centers in northern Iran. Demographic information of women was collected through a questionnaire. The samples were first examined microscopically and then monitored in Dorsch culture medium for up to 10 days. Actin genes of positive samples were amplified by PCR. Finally, PCR products were used to determine the sequence and genotype of the parasite. Overall, 0.7% (3/450) samples were positive for T. vaginalis. All of the three infected women were housewives. After sequencing, the genotype of these parasites were type H (66.7%) (Accession no; MW414672-MW414673) and type E (33.3%) (Accession no: MW414671). Low prevalence of T. vaginalis in north of Iran indicate high level of hygiene in sexual intercourse and avoiding from high risk sexual behaviors, and also it seems that genotype H is dominant type of the parasite in the study area.

Exposure of cleaning workers to chemical agents and physical conditions in swimming pools and spas

Swimming pools and spas require a high hygiene level, and therefore constant cleaning. In this study, cleaning workers’ exposure to volatile organic compounds (VOCs), trichloramine (TCA), and particulate matter (PM) in the swimming pools and spas were evaluated. Also, statistical methods were employed to determine what activities affect the exposure to disinfection byproducts (DBPs). The study was conducted in 32 swimming pools and spas. The measurement locations were pool areas, bathrooms, and locker rooms, both during cleaning and opening hours. During the cleaning, the total volatile organic compound (TVOC) concentrations were low, on average 96, 251, and 91 µg/m3 for locker rooms, bathrooms, and pool areas, respectively. Similarly, during the opening hours, the TVOC concentrations were on average 78, 125, and 83 µg/m3, for locker rooms, bathrooms, and pool areas, respectively. This is in line with previous studies investigating cleaning work in other environments. The most prevalent compounds during the cleaning were 2-(2-butoxyethoxy)ethanol (DEGBE), 2-(2-ethoxyethoxy)ethanol (DEGEE), 2-butyl-1-octanol, trichloromethane (chloroform), decamethylcyclopentasiloxane (D5), and carbon tetrachloride. The most prevalent compounds during the opening hours were D5, D-limonene, carbon tetrachloride (bathrooms and pool areas), and trichloromethane (bathrooms and pool areas). The TCA concentrations during the cleaning in the bathrooms and pool areas were on average 60 and 67 µg/m3, respectively, and during the opening hours, 28 and 122 µg/m3, respectively. The use of disinfectants was found to increase the TCA concentration in the bathrooms, while the other cleaning products did not. Even though the TCA concentrations were below the WHO’s guideline and the Finnish occupational exposure limit value of 500 µg/m3, the measured TCA levels were occasionally high enough to pose a risk of irritative symptoms. The PM concentrations were low, both in the real-time monitoring (aerodynamic diameter, Dae ≤ 15 µm) and inhalable dust samples (Dae ≤ 100 µm). Highest measured inhalable dust concentration was 350 µg/m3, well below the Finnish occupational limit value of 5,000 µg/m3 for organic inhalable dust.

Risk Analysis of COVID-19 Infections in Kolkata Metropolitan City: A GIS-Based Study and Policy Implications.

The COVID‐19 pandemic has affected daily lives of people around the world. People have already started to live wearing masks, keeping a safe distance from others, and maintaining a high level of hygiene. This paper deals with an in‐depth analysis of riskness associated with COVID‐19 infections in Kolkata Municipal Corporation (KMC) at the subcity (ward) level. Attempts have been made to identify the areas with high or low risk of infections using GIS‐based geostatistical approach. Cosine Similarity Index has been used to rank different wards of KMC according to the degree of riskness. Four indices were computed to address intervention objectives and to determine “Optimized Prevention Rank” of wards for future policy decisions. The highest risk areas were located in the eastern and western part of the city, to a great extent overlapped with wards containing larger share of population living in slums and/or below poverty level. On the other hand, highly infected areas lie in central Kolkata and in several wards at the eastern and northeastern periphery of the KMC. The “Optimized Prevention Rank” have indicated that the lack of social awareness along with lack of social distancing have contributed to the increasing number of containments of COVID‐19 cases. The rankings of the wards would no doubt provide the policy makers a basis to control further spread of the disease. Since effective antiviral drugs are already in the market, the best application of our research would be in the ensuing vaccination drive against further COVID‐19 infections.

Mucoperiodontal lesions: improvement of prosthodontic treatment considering initial indicators of patients' oral health

To assess the need for prosthodontic treatment and to substantiate the features and perspectives for optimizing prosthodontic treatment in patients with mucoperiodontal manifestations of lichen planus (LP). For assessment of the need and identification of problematic aspects of prosthetic treatment 74 patients (48.3% of the primary sample of all patients with oral LP) with oral LP-associated mucoperiodontal lesions (MPL) participated in a multicenter open cohort prospective controlled clinical trial with elements of retrospective analysis. The prospective part of the study summarizes the results of prosthodontic treatment of 41 patients (8 men and 33 women aged 45-70 years) carried out using improved therapeutic and diagnostic algorithms applied to the specifics of the MPL forms and stages. The use of standard protocols of prosthodontic treatment without taking into account the status of oral mucosa in patients with oral LP was associated with the development of nonspecific (prosthetic stomatitis - 25.8%; contact-allergic stomatitis - 22.6%; focal hyperplasia - 16.1%; decubital ulcers - 12.9%, etc.) and oral LP-associated specific reactions (Kebner's symptom - 35.5%; transformation of the typical form into complicated ones - 22.6%; desquamative gingivitis and gingival lichenization - 19.4% each; gum recession - 16.5%) with the involvement of skin and mucous membranes of other localizations (6.5%) and the appearance of symptoms of carcinophobia/dentophobia (25.8%). Prosthetic treatment according to improved protocols for the management of patients with oral LP indicated a decrease in the frequency of nonspecific oral mucosal reactions (by 70.7%, p<0.001), single (4.8%) specific reactions, improvement of masticatory efficiency by 32.8-55.3% (p<0.01), harmonization of speech function, maintenance of a high level of hygiene of prostheses, a significant reduction in the time of adaptation to removable dentures and increased satisfaction with the results of treatment on the GRS scale (1.06±0.3 points after treatment; 3.8±0.5 points before treatment; p<0.001). The best dynamics of clinical and sociological indicators was noted in persons with prosthetic replacement structures based on implants.

Characteristics of visiting urban open spaces in Sana’a city in Yemen

Knowledge of the characteristics of visiting and using urban open spaces is the key to the effective design, development, and management of these spaces. Although research has conducted many studies related to the use and importance of urban environments in Europe, America, Australia, China, and some East Asian countries, there is a lack in such studies in the Middle East, especially in Yemen. This study covers a part of the knowledge gap by verifying the characteristics of visiting and using three selected open spaces in Sana’a city in Yemen through self-reporting of the users of these spaces. The study shows that Yemenis go to open spaces for recreation, family seating, playing with children, and walking. Furthermore, users prefer spaces that provide appropriate and adequate seating areas, various and modern entertainment facilities, a high level of hygiene and maintenance, and safe spaces that are free from intruders. This knowledge benefits the urban designers and developers in Yemen to rehabilitate degraded open areas and design new public spaces.

Cytotoxicity profile of Cronobacter species isolated from food and clinical specimens in Brazil.

The objective of this study was to evaluate the cytotoxic activity of Cronobacter strains isolated from foods (n=50) and clinical samples (n=6) in Brazil and genotype selected strains (n=18) using multi-locus sequence typing (MLST) METHODS AND RESULTS: The cytotoxic activity of C. sakazakii (n=29), C. dublinensis (n=13), C. malonaticus (n=6), C. turicensis (n=6) and C. muytjensii (n=2) was screened using Vero, RK13, Hep2c, NCTC clone 929 and BHK-21 cell lines. Selected Cronobacter strains were assigned to C. sakazakii ST 21, C. turicensis ST 252, C. sakazakii ST 647, and three newly assigned STs: C. turicensis STs 738-740. The maximum death caused by non-heat-treated filtrates was 20·4, 86·2, 47·0 and 84·0%, in Vero, RK13, Hep2c and NCTC clone 929 cells, respectively. These were caused by C. sakazakii strains C291 and C292 (ST 494) which had been isolated during neonatal Cronobacter meningitis infection, and C110 (ST 395) isolated from flaxseed flour. Thermal treatment (100°C/20min) significantly reduced the cytotoxicity activity in NCTC clone 929 and Vero cells (P≤2×10-6 ), but not in RK13 (P=0·12) and Hep2c (P=0·85), indicating the cytotoxin(s) were probably proteinaceous. Electron microscopy revealed that cytotoxic compounds from C. sakazakii induced several cell death characteristics, including loss of cell-cell contact, microvilli reduction and cellular lysis. Autophagic vacuoles and mitochondrial damage were the most common ultrastructural features observed. It was concluded that Cronobacter strains, especially C. sakazakii, could produce heat-labile cytotoxic compounds in cell filtrates. This study providing insights into the pathogenesis of the Cronobacter genus. Cytotoxins were identified in excreted filtrates of C. sakazakii strains isolated from food and clinical specimens. The presence of Cronobacter strains that can produce cytotoxins in foods can be a potential threat to human health and highlight the need for high levels of hygiene.

Raw milk producers with high levels of hygiene and safety.

There is world-wide increasing interest in the consumption of unprocessed, natural food commodities including fresh (unpasteurised) milk and milk products. Consumers are actively seeking out raw milk, partly due to health reasons, but also for taste, freshness, closeness to the producer and to support local agriculture. The need for high levels of hygiene and safety in farms producing raw milk for direct consumption has long been recognised and has led to federal and industry-initiated systems for safe raw milk production. Raw milk producers in North America and Europe have demonstrated that raw milk, intended for direct consumption, can be produced safe and hygienic. The aim of this paper is to describe practices that have been developed for safe raw milk production. The German Vorzugsmilch is a federally regulated programme for legal raw milk production that was established already in the 1930s to provide raw milk with high hygienic standards controlled for zoonotic diseases to consumers. The Raw Milk Institute is a non-profit organisation established in California that has developed a voluntary safe raw milk programme in North America. RAWMI has developed a risk analysis and management system for raw milk dairy farmers to assist farmers in making individually tailored solutions for various production systems. In British Colombia, Canada, small herd share farms have employed good manufacturing practices, a risk management approach and performed monthly samples for pathogens and indicator bacteria to demonstrate safety and consistency. The major components of the raw milk systems applied, and the results of regular milk microbial indicator bacteria are presented. For the German system, the results from standard monthly pathogen tests are compared to zoonotic pathogen tests from other milk sources. The overall results indicate that raw milk can be produced with a high level of hygiene and safety in various systems.