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The Centers for Disease Control and Prevention (CDC) coordinates investigations of multistate foodborne outbreaks. To better inform future communication efforts with the public during these outbreaks, we conducted a qualitative content analysis of comments on multistate foodborne outbreak Facebook posts distributed on the CDC’s Facebook page September to December 2018. The CDC created 27 Facebook posts for nine multistate foodborne outbreaks (one to eight posts per outbreak), and 2,612 comments were analyzed. The CDC used two Web tools to deliver outbreak information: food safety alerts (FSAs) and investigation notices (INs). Qualitative analyses were conducted separately for Facebook posts resulting from FSAs and INs. Using an inductive coding approach, we identified nine categories of comments: information sharing (e.g., tagging others), actions (e.g., discarding contaminated food), convictions and beliefs (e.g., food-related preconceived notions), questions (e.g., clarifying outbreak location), emotional responses (e.g., worry), blame (e.g., responsibility for outbreak), food specific (e.g., repackaging ground beef and losing identifying information), promoting another cause (e.g., vaccine hesitancy), and unrelated. No differences were found between FSAs and INs. Facebook users helped further disseminate important outbreak information but identified barriers that prevented them from taking recommended actions. Real-time evaluation of social media during outbreaks provides opportunities to refine messaging and improve communication.

Many efforts across the farm-to-fork continuum aim to reduce foodborne disease and outbreaks. Real-time risk communication is an important component of the Centers for Disease Control and Prevention (CDC) efforts, especially during outbreaks. To inform risk communication with the public during multistate foodborne outbreaks, we conducted a series of focus groups of adults in the Washington, D.C., metropolitan area to understand attitudes, perceptions, behaviors, and how people receive information around foodborne disease outbreaks. Results from these focus groups provided insight on factors that might influence consumer perception and behavior during an outbreak. Perceived outbreak proximity and personal consumption of an outbreak vehicle were identified as also reported hearing about multiple outbreaks per year some drivers of perceived risk to an outbreak. Participants through a variety of sources and following recommended actions during an outbreak, implying some existing penetration of current risk messages for multistate foodborne outbreaks. Findings from these focus groups are a first step in increasing understanding of how CDC messages affect the consumers’ ability to access and act upon reliable information to protect their health during outbreaks and serve as a baseline for further evaluation efforts of CDC risk communication strategy for multistate foodborne outbreaks.

Introduction Orthodontically induced inflammatory root resorption (OIIRR) is a common adverse outcome of orthodontic treatment with loss of periodontal support and alveolar bone. The current gold standard for assessment is Microcomputed tomography (MicroCT). However, this is expensive and time consuming. The TRIOS 3® and iTero Element 2® intraoral scanners (IOS) are potential alternatives that have not been explored in an ex vivo setting. The aim of this study was to investigate the potential of IOS to measure OIIRR against MicroCT; to find a more efficient and cost-effective method to assess OIIRR ex-vivo. Methods Twenty premolars extracted as part of routine orthodontic treatment were chosen for analysis. The IOSs were firstly validated as a reproducible. All scans were superimposed to demonstrate inter- and intraoperator variability for each IOS and between scanners. Once reproducibility had been demonstrated, the IOSs were compared with MicroCT scans of each tooth by measuring number, size, position and volume of craters. Results IOS reproducibility demonstrated an intraoperater deviation for TRIOS® and iTero® of 0.058±0.040mm and 0.078±0.044mm, respectively (P= 0.072) and an interoperater variability of 0.070±0.040 mm and 0.110±0.02 mm, respectively (p=0.092). The total number of craters identified by MicroCT, TRIOS® and iTero® was 90, 79 and 69, respectively. When compared to MicroCT, TRIOS detected 90%,88%,84% of craters (P= 0.004) and iTero detected 78%,79%,72% of craters (P=0.001) present at the cervical, middle and apical levels of the tooth root respectively. The volume of craters (mm3) measured by MicroCT and IOS correlated well, with a stronger correlation for TRIOS (r=0.81) than iTero (r=0.71). Conclusion TRIOS® and iTero® IOS are reproducible techniques for the scanning of extracted tooth root surfaces. With respect to the gold standard of MicroCT, TRIOS® compared more favourably than iTero® with respect to crater detection and volume measurement.

Dysferlinopathy is an uncommon, progressive muscular dystrophy that has a wide phenotypic variability and primarily supportive management (Nguyen et al., 2007; Narayanaswami et al., 2014). Amyloid myopathy is a distinct, rare disorder that can present similarly to inflammatory myopathies and requires a high clinical suspicion for early intervention to prolong survival. Amyloid myopathy is typically associated with other systemic manifestations of amyloidosis, but rare cases of isolated amyloid myopathy have been described (Mandl et al., 2000; Hull et al., 2001). Positive Congo red stains on tissue biopsy remain the gold standard for diagnosis (Spuler et al., 1998; Karacostas et al., 2005). A high clinical suspicion and meticulous diagnostic workup that includes novel techniques are necessary for identifying these rare disorders. We report a middle-aged man with progressive leg muscle weakness who was initially treated as having amyloid myopathy but was later diagnosed as having dysferlinopathy by Whole Exome Sequencing (WES) analysis. We also report a novel missense mutation (c.959G>C) to help correlate in any patient with presumed dysferlinopathy and to add to the already known genotype of this disorder.

Telmisartan is an Angiotensin Receptor Blocker (ARB) used for the treatment of hypertension. It belongs to BCS class-II i.e. low solubility and high permeability and exhibits variable bioavailability. The objective of the present study was to prepare surface solid dispersions of telmisartan to improve its aqueous solubility and dissolution rate. Water insoluble carriers like Avicel pH 101, Crospovidone, Sodium starch glycolate, Cab-o-sil, Pregelatinised starch and Potato starch were used to form surface solid dispersion (SSD) of Telmisartan by solvent evaporation method. The surface solid dispersion prepared with Cab-o-sil in the drug : carrier ratio of 1:10 showed highest dissolution rate as compared to pure drug and physical mixture. The SSD on Cab-o-sil was characterized by Powder X-ray diffractometry, Differential scanning calorimetry, Fourier transform infrared spectroscopy and Scanning electron microscopy. DSC studies revealed that there was no chemical interaction between drug and the carrier and XRD studies demonstrated that there was a significant decrease in crystallinity of pure drug .The optimized surface solid dispersion was compressed into tablets and evaluated for Weight variation, Hardness, friability, Drug content, Disintegration time and Dissolution rate. These tablets exhibited higher rates of dissolution and dissolution efficiency as compared to marketed tablets.