Incidence of Salmonella serovars isolated from commercial animal feed mills in the United States and serovar identification using CRISPR analysis.

AIMS: In this study, we sought to determine the incidence and diversity of Salmonella in a broad collection of commercial animal feeds collected from animal feed mills across the United States over an 11-month period and utilize CRISPR analysis to identify individual serovars. METHODS AND RESULTS: Over two independent trials, 387 feed samples from 135 different animal feed mills in the United States were screened for Salmonella. A total of 6·2% (24/387) of samples were contaminated with Salmonella, which is concordant with similar studies. Clustered regularly interspaced short palindromic repeats (CRISPR)-typing was used to serotype Salmonella isolates, and serovars Infantis and Tennessee were the most common. CONCLUSIONS: Serogroups O:4 and O:7 were enriched in the feed samples, suggesting that these serogroups are better adapted to surviving in low moisture animal feeds. The study supports the utility of CRISPR to determine serovar type since most of the serovars identified in this study have been also isolated and identified in earlier studies using more classical serotyping methods. SIGNIFICANCE AND IMPACT OF THE STUDY: This work contributes to a growing body of literature concerning the Salmonella prevalence in animal feeds and highlights the need to effectively mitigate pathogens in livestock and poultry feed.

Conserved CRISPR arrays in Salmonella enterica serovar Infantis can serve as qPCR targets to detect Infantis in mixed serovar populations.

Salmonellosis is a leading bacterial cause of foodborne illness, and numerous Salmonella enterica serovars have been responsible for foodborne outbreaks. In the United States outbreaks are often linked to poultry and poultry-related products. The prevalence of Salmonella serovar Infantis has been increasing in poultry processing facilities over the past few years and in 2018 was identified as the causative agent for a large multistate outbreak linked to raw chicken. CRISPR-typing is a subtyping approach based on PCR and the sequencing of two Salmonella loci, CRISPR1 and CRISPR2. CRISPR-typing was used to interrogate 138 recent (2018-2019) isolates and genomes of ser. Infantis. Results show that the CRISPR elements are remarkably conserved in this serovar. The most conserved spacers, and those also unique to ser. Infantis, were used as targets to develop a ser. Infantis-specific qPCR assay. This assay was able to detect ser. Infantis in mixed serovar cultures of Salmonella, down to 0·1% of the population, highlighting the utility of this molecular approach in improving surveillance sensitivity for this important food safety pathogen. SIGNIFICANCE AND IMPACT OF THE STUDY: The incidence of human salmonellosis cases caused by Salmonella enterica serovar Infantis (ser. Infantis) has been increasing, as has its prevalence in broiler chickens, which are a frequent reservoir of Salmonella. A cluster of ser. Infantis genetically linked to an outbreak strain have been identified in numerous processing facilities. A qPCR assay targeting CRISPR elements that are unique to ser. Infantis has been developed and can detect this serovar directly from mixed cultures. This assay is sensitive enough to reveal ser. Infantis within a mixed Salmonella population where it constitutes only 0·1% of the population. The rapid nature of qPCR lends this assay to high-throughput screening of poultry samples to detect this important pathogen.

Internally displaced human resources for health: villager health worker partnerships to scale up a malaria control programme in active conflict areas of eastern Burma.

Approaches to expand malaria control interventions in areas of active conflict are urgently needed. Despite international agreement regarding the imperative to control malaria in eastern Burma, there are currently no large-scale international malaria programmes operating in areas of active conflict. A local ethnic health department demonstrated that village health workers are capable of implementing malaria control interventions among internally displaced persons (IDPs). This paper describes how these internally displaced villagers facilitated rapid expansion of the programme. Clinic health workers received training in malaria diagnosis and treatment, vector control and education at training sites along the border. After returning to programme areas inside Burma, they trained villagers to perform an increasingly comprehensive set of interventions. This iterative training strategy to increase human resources for health permitted the programme to expand from 3000 IDPs in 2003 to nearly 40,000 in 2008. It was concluded that IDPs are capable of delivering essential malaria control interventions in areas of active conflict in eastern Burma. In addition, health workers in this area have the capacity to train community members to take on implementation of such interventions. This iterative strategy may provide a model to improve access to care in this population and in other conflict settings.

Multi-level partnerships to promote health services among internally displaced in eastern Burma.

Ethnic populations in eastern Burma are the target of military policies that result in forced labour, destruction of food supplies, and massive forced displacement. Despite international assistance to Burmese refugees along the Thai-Burma border, traditional humanitarian models have failed to reach these internally displaced persons (IDPs) within Burma. Nevertheless, through the cultivation of a model (cross border local-global partnerships) 300,000 IDPs in eastern Burma now receive critical health services where, otherwise, there would be none. We describe key elements of the partnership model's genesis in eastern Burma. The role of the local partner, Backpack Health Worker Team (BPHWT), is highlighted for its indigenous access to the IDP populations and its maintenance of programmatic autonomy. These local elements are potentiated by international support for technical assistance, training, resources, and advocacy. International policy and investment should prioritize support of locally-driven health initiatives that utilize local-global partnerships to reach not only IDPs but also other war-torn or traditionally inaccessible populations worldwide.

Freud and feminism: a critical appraisal.

This paper traces the contributions made by women to Freud's ideas about women. Freud paid back the gifts he received from women with encouragement and support for their careers and with a theory that was instrumental in freeing women from both domestic bondage and fantasies of inferiority, but which was used by later "Freudians" as justification for returning women to an exclusively domestic life. Paying particular attention to Sabina Spielrein, Lou Andreas-Salomé, and H.D., the paper illustrates some of the contributions of women to early psychoanalysis, and speculates on ways in which Freud's thinking was guided by his belief that women are, and should be considered, equal to men.

Ladies of fashion: pleasure, perversion or paraphilia.

The author considers the reasons why interest in fashion is important in female development. Freud's comment that 'all women are clothes fetishists' and his explanation that a woman uses clothes to show that 'one can find in her everything that one can expect from women' are amplified and challenged by other authors and psychoanalytic evidence. Caper's (1994) focus on the erotic meaning of his patient's clothing is contrasted with the use ego-psychologists have made of 'appropriate' clothing and grooming as markers of mental health and intact functioning. A case of a woman who had a shopping symptom is considered. The roots of the symptom in her fantasy life, its replacement of genital satisfaction, its precursors in interactions with her parents and its use in enacting sado-masochistic fantasies is elaborated in the case material. A second case briefly illustrates the role ascetic refusal of clothing may play in some women's psychic lives. Use of clothing as a way of displaying the body, as an indicator of economic power, as an incitement to envy, and as a sexual enticement is discussed. Examples of understanding of the psychological aspects of interest in clothing are drawn from art, anthropology, sociology, political science and philosophy. The paper concludes with the idea that clothing and shopping for clothing can range from normal pleasure to paraphilia and leaves open the question whether it can be a perversion. Focusing on clinical material about shopping for fashionable clothing, the author shows how shopping can become central in some women's lives as it is important in many. It considers the boundaries between source of pleasure, paraphilia and sexual fetish as they are exemplified in women's attitudes towards clothing and their use of it.

Primary femininity and female genital anxiety.

Primary femininity implies that female development proceeds along lines that generate anxiety about damage and loss similar to the fears of castration that trouble males. The female fears are classified as fear of painful penetration, fear of loss of pleasure, and fear of loss of procreative function. The first two fears are illustrated with clinical material showing the ways in which they manifest themselves in adult women.

Calibration assessment in quantitative electroencephalographic brainmapping and evoked potential studies.

Acquisition of a Cadwell Spectrum 32 resulted in the introduction of quantitative electrophysiological brainmapping techniques in our neurophysiology laboratory. To ascertain the accuracy and consistency of our equipment, we performed the following tests: inputting a calibration signal and measuring the resultant amplitudes for quantitative electroencephalographs (qEEGs) and evoked potentials (EPs) in the mapping and standard montages, inputting a synchronous calibration signal and mapping it at varying times for qEEGs and EPs, as well as re-analysing the same electroencephalographic (EEG) epochs previously selected from 20 control subjects. QEEG amplitudes varied from -5.4% to +5.8% and EPs by 9.5% or less, and after an EP software upgrade, by 5.5% or less. QEEG voltage mapping showed variation of only one color increment across the map, which could, in our example, represent up to 25.2% of the scale used. Re-analysis of previously selected epochs yielded identical results. We have established some of the accuracy and consistency limits of the hard- and software of our system with respect to the quantitative and topographic data. We conclude that such systems need to be calibration-checked in the laboratories in which they are used, with an independent signal generator. Users also need to be aware that scaling of topographic maps could lead to erroneous conclusions, as perceived amplitude changes could affect the interpretation of both initial and serial studies.

The influence of sphincter control and genital sensation on body image and gender identity in women.

The development of one aspect of feeling female is hypothesized to account for certain phenomena in the treatment of young women patients. Fear of loss of genital pleasure experienced as contractions of the anal and genital-urinary sphincters is seen as the central issue in conflicts manifested in genital, oral, and anal modalities. It is suggested that the female's awareness of her genital arises from the generalization of sphincter sensation in the little girl, which is then represented in the body image. The body image is postulated as a link between genital pleasure and the valuing of femininity.

Hilda Doolittle and creativity. Freud's gift.

The problem of work inhibition in a woman is addressed in terms of a specific case. The paper investigates the patient's view of how such an inhibition was cured in a brief analytic treatment of the American poet Hilda Doolittle conducted by Freud in 1933-34.

A romance with pain: a telephone perversion in a woman?

The patient repeatedly and compulsively made stereotyped telephone calls to her mother and other female protective figures. She had a history of genito-urinary infections and operations consequent to urinary retention. These symptoms were relieved gradually in the course of analysis, in which this was interpreted as a sado-masochistic perversion based on a central fantasy of phallic intrusions on the mother. The fantasy was related to turning passive viewing into active exhibitionism, actively seeking to inflict pain on herself and others in an attempt to overcome early painful medical intrusions, misplaced identification with the father, complementary relationship with the passive, compliant mother, and consequent failed identification with the oedipal mother. In the analysis, she attained a gradual reorganization of adaptive functions which allowed identification with the father through her work, reconciliation with the rivalrous siblings, and enjoyment of her female sexuality in heterosexual intercourse with the use of a fetishistic requirement that the man be uncircumcised. The hypothesis was developed that whether called a symptom or a perversion, the treatment was the same so that it was most useful to think of it as a compromise formation rather than attempting to preserve a distinction largely based on moralistic considerations.