Outbreaks caused by highly industrialized food companies are characterized by cross-border, trans-regional, rapid and unpredictable, related to serious disease and economic burden. A cluster of cases with monophasic salmonella enterica serovar Typhimurium ST34 infection suspected to be associated with consumption of contaminated chocolate products have been reported in several Europe countries since December 2021. After retrospective investigations, the buttermilk circuit in the Belgian factory was suspected to be the point of origin of the contamination. This outbreak could provide a reference for the risk management of foodborne pathogens contamination in China. The objective of this paper was to summarize the process and characteristics of the outbreak of monophasic S. Typhimurium caused by contaminated chocolate products, analyze the characteristics of ST34 monophasic S. Typhimurium and the microbial management measures in the process of chocolate products, and systematically discuss the suggestions for the risk management of foodborne pathogens contamination and countermeasures for the rapid development of industrialization of food enterprises in China, in order to provide scientific and technological support for the prevention and control, prediction and early warning of sudden cases in China.
Humans ; Salmonella typhimurium ; Serogroup ; Salmonella Infections/prevention & control* ; Chocolate ; Retrospective Studies ; Salmonella enterica ; Disease Outbreaks/prevention & control* ; Risk Management

OBJECTIVE: To observe the clinical efficacy of thunder-fire moxibustion combined with mifepristone for ovarian chocolate cyst dysmenorrhea with kidney deficiency and blood stasis. METHODS: Seventy patients were randomly divided into an observation group and a control group, 35 cases in each group. The patients in the the control group were treated with oral administration of mifepristone, 10 mg each time, once a day; based on the treatment of the control group, the patients in the observation group were treated with thunder-fire moxibustion at Guanyuan (CV 4), Zigong (EX-CA 1), Xuehai (SP 10), once every other day. Both the groups were treated for 3 months. The Cox menstrual symptom scale (CMSS) score, the maximum cross-sectional area of ectopic cyst, and the serum levels of transforming growth factor-β1 (TGF-β1) and interleukin-17 (IL-17) were observed before and after treatment in the two groups. The clinical efficacy was evaluated. RESULTS: Compared before treatment, the severity scores and duration scores of CMSS as well as the serum levels of TGF-β1 were reduced after treatment in the two groups ( CONCLUSION Thunder-fire moxibustion combined with mifepristone could significantly improve dysmenorrhea symptoms, shorten dysmenorrhea time and promote atrophy of ovarian heterotopic cyst in patients with ovarian chocolate cyst dysmenorrhea of kidney deficiency and blood stasis, and the mechanism may be related to the reduction of serum levels of TGF-β1 and IL-17.
Acupuncture Points ; Chocolate ; Cysts ; Dysmenorrhea/drug therapy* ; Female ; Humans ; Kidney ; Mifepristone ; Moxibustion

Aims: Plant growth promoting rhizobacteria (PGPR) is a group of bacteria that colonise plant roots and enhance plant growth by a diverse range of mechanisms. This study aims to determine the capabilities of PGPR isolated from cocoa tree roots and their efficiency in enhancing plant growth under greenhouse conditions. Methodology and results: Eight samples of healthy cocoa tree roots were collected from different locations in Malaysia. Isolated bacteria were screened based on nitrogen fixation, phosphate and potassium solubilization, and catalase activity. The efficiency of purified PGPR was evaluated from pot experiments of cocoa seedlings under greenhouse conditions. Out of 122 isolates, 18 isolates showed several traits of nitrogen fixation, phosphorus and potassium solubilization and were further screened for other plant growth promoting (PGP) traits like catalase and production of indole acetic acid (IAA). Out of all the PGP trait tests, seven isolates showed the most prominent results for in vitro tests and were further tested in vivo for growth promotion of cocoa seedlings under greenhouse conditions. In the presence of bacterial isolates with 2.5 g of inorganic fertilizer, Leclercia adecarboxylata resulted in increases in plant height, leaf number, root length, stem fresh weight and total fresh and dry weight of cocoa seedlings by 15.68%, 17.14%, 9.48%, 5.67%, 11.84% and 25.12%, respectively. Conclusion, significance and impact of study Based on the result, L. adecarboxylata incorporated with selected carrier material improve cocoa seedling growth and biomass. This formulation also reduces the production cost of inorganic fertilizer and increase the application and development of biofertilizer.
Cacao--growth & ; development ; Rhizosphere

OBJECTIVES: This study aimed to reveal the epidemiologic characteristics of the outbreak of gastroenteritis caused by Salmonella enterica serovar Thompson in Busan Metropolitan City and to identify points for improvement to prevent of food-borne disease outbreak.METHODS: This was a case-control study. The control group comprised asymptomatic students in the same classes of the cases. The presence or absence of symptoms, ingestion of each food provided by school meal service, and commonly ingested foods in addition to those foods in meal service were investigated. Moreover, specimens collected from rectal swab, preserved foods, and environmental surface were tested.RESULTS: Of the 6,092 subjects, 1,111 (1,083 students, 22 school personnel, and 6 foodservice employees) were included in the case group; this corresponded to an 18.4% attack rate. Symptoms included diarrhea (n=1,051, 94.6%), abdominal pain (n=931, 83.8%), febrile sensation (n=502, 45.2%), and vomiting (n=275, 24.8%). The epidemic curves of each 10 schools were unimodal. Investigation of food intake showed a significantly high odds ratio for chocolate cake in 5 out of the 10 schools. Laboratory test detected Salmonella enterica serovar Thompson both in rectal swab specimens of 9 schools and in collected preserved chocolate cakes of 9 schools. Pulsed-field gel electrophoresis test result showed that Salmonella enterica seorvar Thompson isolated from human and foods were the same.CONCLUSIONS: The source of infection for the Salmonella enterica serovar Thompson outbreak in the 10 schools of Busan Metropolitan City is chocolate cake. Traceback investigation for origin of contaminated food in food-borne disease outbreak and safety control during food production should be more enhanced.
Abdominal Pain ; Busan ; Cacao ; Case-Control Studies ; Diarrhea ; Eating ; Electrophoresis, Gel, Pulsed-Field ; Food, Preserved ; Foodborne Diseases ; Gastroenteritis ; Humans ; Korea ; Meals ; Odds Ratio ; Salmonella enterica ; Salmonella Infections ; Salmonella ; Sensation ; Serogroup ; Vomiting

There have been few studies investigating the association between atopic dermatitis (AD) and prenatal exposure to heavy metals. We aimed to evaluate whether prenatal exposure to heavy metals is associated with the development or severity of AD in a birth cohort study. A total of 331 subjects were followed from birth for a median duration of 60.0 months. The presence and severity of AD were evaluated at ages 6 and 12 months, and regularly once a year thereafter. The concentrations of lead, mercury, chromium, and cadmium in umbilical cord blood were measured by inductively coupled plasma mass spectrometry. Cord blood mononuclear cells (CBMCs) were isolated and stimulated for analysis of cytokine production using ELISA. Heavy metal levels in cord blood were not associated with the development of AD until 24 months of age. However, a positive correlation was observed between the duration of AD and lead levels in cord blood (p=0.002). AD severity was also positively associated with chromium concentrations in cord blood (p=0.037), while cord blood levels of lead, mercury, and cadmium were not significantly associated with AD severity (p=0.562, p=0.054, and p=0.055, respectively). Interleukin-13 production in CBMCs was positively related with lead and chromium levels in cord blood (p=0.021 and p=0.015, respectively). Prenatal exposure to lead and chromium is associated with the persistence and severity of AD, and the immune reaction toward a Th2 polarization.
Cacao ; Cadmium ; Chromium ; Cohort Studies ; Dermatitis, Atopic ; Enzyme-Linked Immunosorbent Assay ; Fetal Blood ; Interleukin-13 ; Mass Spectrometry ; Metals, Heavy ; Parturition ; Plasma ; Umbilical Cord

OBJECTIVES: This study aimed to reveal the epidemiologic characteristics of the outbreak of gastroenteritis caused by Salmonella enterica serovar Thompson in Busan Metropolitan City and to identify points for improvement to prevent of food-borne disease outbreak. METHODS: This was a case-control study. The control group comprised asymptomatic students in the same classes of the cases. The presence or absence of symptoms, ingestion of each food provided by school meal service, and commonly ingested foods in addition to those foods in meal service were investigated. Moreover, specimens collected from rectal swab, preserved foods, and environmental surface were tested. RESULTS: Of the 6,092 subjects, 1,111 (1,083 students, 22 school personnel, and 6 foodservice employees) were included in the case group; this corresponded to an 18.4% attack rate. Symptoms included diarrhea (n=1,051, 94.6%), abdominal pain (n=931, 83.8%), febrile sensation (n=502, 45.2%), and vomiting (n=275, 24.8%). The epidemic curves of each 10 schools were unimodal. Investigation of food intake showed a significantly high odds ratio for chocolate cake in 5 out of the 10 schools. Laboratory test detected Salmonella enterica serovar Thompson both in rectal swab specimens of 9 schools and in collected preserved chocolate cakes of 9 schools. Pulsed-field gel electrophoresis test result showed that Salmonella enterica seorvar Thompson isolated from human and foods were the same. CONCLUSIONS: The source of infection for the Salmonella enterica serovar Thompson outbreak in the 10 schools of Busan Metropolitan City is chocolate cake. Traceback investigation for origin of contaminated food in food-borne disease outbreak and safety control during food production should be more enhanced.
Abdominal Pain ; Busan ; Cacao ; Case-Control Studies ; Diarrhea ; Eating ; Electrophoresis, Gel, Pulsed-Field ; Food, Preserved ; Foodborne Diseases ; Gastroenteritis ; Humans ; Korea ; Meals ; Odds Ratio ; Salmonella enterica ; Salmonella Infections ; Salmonella ; Sensation ; Serogroup ; Vomiting

PURPOSE: This study examined the effects of a mobile app-based program to reduce the dietary sugar intake according to the stages of the behavioral change in dietary sugar reduction in female college students. METHODS: The program used in this study can monitor the dietary sugar intake after recording the dietary intake and provide education message for the reduction of dietary sugar intake. In an eight-week pre-post intervention study, 68 female college students were instructed to record all the food they consumed daily and received weekly education information. At pre-post intervention, the subjects were asked to answer the questionnaire about sugar-related nutrition knowledge, sugar-intake behavior, and sugar-intake frequency. For statistical analysis, ANOVA and a paired t-test were used for comparative analysis according Precontemplation (PC), Contemplation ·Preparation (C ·P), and A ·M (Action ·Maintenance) stage. RESULTS: Significant differences were observed in the frequency of snacking, experience of nutrition education, and preference for sweetness according to the stages of behavior change in dietary sugar reduction. After finishing an intervention, the sugar-related nutrition knowledge score was increased significantly in the stages of Precontemplation (PC) and Contemplation ·Preparation (C ·P). The score of the sugar intake behavior increased significantly in all stages. The intake frequency of chocolate, muffins or cakes, and drinking yogurt decreased significantly in the PC stage and the intake frequency of biscuits, carbonated beverages, and fruit juice decreased significantly in the C ·P stage. Subjects in the PC and C ·P stages had an undesirable propensity in nutrition knowledge, sugar-intake behavior, and sugar-intake frequency compared to the A ·M stage, but this intervention improved significantly their nutrition knowledge, sugar-intake behavior, and sugar-intake frequency. CONCLUSION: This program can be an effective educational tool in the stages of PC and C ·P, and is expected to further increase the usability and sustainability of mobile application if supplemented appropriately to a health platform program.
Cacao ; Carbonated Beverages ; Drinking ; Education ; Female ; Fruit and Vegetable Juices ; Humans ; Mobile Applications ; Snacks ; Yogurt

Chryseobacterium hominis is non-fermenting Gram-negative rod that was first identified as a novel species in 2007. Here, we report the first clinical case of C. hominis bacteremia, which was confirmed by MALDI-TOF MS and 16S rRNA gene sequencing. A 16-year-old boy diagnosed with acute lymphoblastic leukemia was hospitalized for three months. Two sets of blood culture test through a peripherally inserted central catheter (PICC), which was inserted a month ago, was performed when his white blood cell count declined and he had a high fever. Colonies of medium sizes that looked round, mucoid, sticky, and grayish on blood and chocolate agar plates were observed. Identification of bacteria using the VITEK MALDI-TOF MS system (BioMérieux, France) was not successful and the VITEK 2 system (BioMérieux, USA) indicated Sphingomonas paucimobilis, with a questionable level of confidence (92%). However, Microflex LT Biotyper (Bruker Daltonics, Germany) showed C. homins (log score: 1.81) and sequence of 16S rRNA showed a 100% identity with C. hominis. Piperacillin-tazobactam was administered since the isolate was susceptible to piperacillin-tazobactam but C. hominis showed growth in the next four follow-up culture of blood drawn through PICC. The fever subsided only after PICC was changed. The clinical prognosis and antimicrobial susceptibility test of C. hominis should be further studied.
Adolescent ; Agar ; Bacteremia ; Bacteria ; Cacao ; Catheters ; Chryseobacterium ; Fever ; Follow-Up Studies ; Genes, rRNA ; Humans ; Leukocyte Count ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prognosis ; Sphingomonas

BACKGROUND: Hypoglycemia is an important complication in the treatment of patients with diabetes. We surveyed the insight by patients with diabetes into hypoglycemia, their hypoglycemia avoidance behavior, and their level of worry regarding hypoglycemia. METHODS: A survey of patients with diabetes, who had visited seven tertiary referral centers in Daegu or Gyeongsangbuk-do, Korea, between June 2014 and June 2015, was conducted. The survey contained questions about personal history, symptoms, educational experience, self-management, and attitudes about hypoglycemia. RESULTS: Of 758 participants, 471 (62.1%) had experienced hypoglycemia, and 250 (32.9%) had experienced hypoglycemia at least once in the month immediately preceding the study. Two hundred and forty-two (31.8%) of the participants had received hypoglycemia education at least once, but only 148 (19.4%) knew the exact definition of hypoglycemia. Hypoglycemic symptoms identified by the participants were dizziness (55.0%), sweating (53.8%), and tremor (40.8%). They mostly chose candy (62.1%), chocolate (37.7%), or juice (36.8%) as food for recovering hypoglycemia. Participants who had experienced hypoglycemia had longer duration of diabetes and a higher proportion of insulin usage. The mean scores for hypoglycemia avoidance behavior and worry about hypoglycemia were 21.2±10.71 and 23.38±13.19, respectively. These scores tended to be higher for participants with higher than 8% of glycosylated hemoglobin, insulin use, and experience of emergency room visits. CONCLUSION: Many patients had experienced hypoglycemia and worried about it. We recommend identifying patients that are anxious about hypoglycemia and educating them about what to do when they develop hypoglycemic symptoms, especially those who have a high risk of hypoglycemia.
Avoidance Learning ; Cacao ; Candy ; Daegu ; Dizziness ; Education ; Emergency Service, Hospital ; Gyeongsangbuk-do ; Hemoglobin A, Glycosylated ; Humans ; Hypoglycemia ; Insulin ; Korea ; Self Care ; Sweat ; Sweating ; Tertiary Care Centers ; Tremor

BACKGROUND/OBJECTIVES: There are limited studies investigating the eating patterns of children's favorite foods. The present study aimed to evaluate a wide range of children's favorite foods, derive its eating patterns, and identify factors related to the patterns. SUBJECTS/METHODS: A nationwide cross-sectional study included 5,458 students in elementary, middle, and high schools. The survey was conducted at each school to evaluate children's favorite food intake, including the intake frequency of 31 food items or food groups, and its related factors, such as demographic, economic, and environmental characteristics and awareness of policies on children's favorite foods. Factor analysis using varimax rotation method and logistic regression analysis were conducted. RESULTS: Two factors were derived as major eating patterns from data of children's favorite foods: the ‘unhealthy eating pattern’ which mainly involves confectionery, chocolate, ramen, fried food, etc.; and the ‘healthy eating pattern’ which mainly involves soybean milk, vegetables, fruit juice, and nuts. A stepwise selection procedure through the regression analysis revealed that allowance, use of screen media, less awareness of policies on children's favorite foods, and less interest in health were positively related to the tendency of unhealthy or less-healthy eating patterns (P < 0.05). CONCLUSIONS: This study examined that the eating patterns of children's favorite foods were associated with certain environmental characteristics and awareness about the related policies. These findings suggest that a nutrition education program regarding children's favorite foods needs to be conducted according to the characteristics of students to develop their healthy eating habits and proper choice of favorite foods.
Cacao ; Child ; Cross-Sectional Studies ; Diet ; Eating* ; Education ; Fruit and Vegetable Juices ; Humans ; Korea* ; Logistic Models ; Methods ; Milk ; Nuts ; Soybeans ; Vegetables