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In a previous study, a modular process risk model, from the raw material reception to the final product storage, was built to estimate the risk of a UHT-aseptic line of not complying with commercial sterility (Pujol et al., 2015). This present study was focused on demonstrating how the model (updated version with uncertainty and variability separated and 2(nd) order Monte Carlo procedure run) could be used to assess quantitatively the influence of management options. This assessment was done in three steps: pinpoint which process step had the highest influence on the risk, identify which management option(s) could be the most effective to control and/or reduce the risk, and finally evaluate quantitatively the influence of changing process setting(s) on the risk. For Bacillus cereus, it was identified that during post-process storage in an aseptic tank, there was potentially an air re-contamination due to filter efficiency loss (efficiency loss due to successive in-place sterilizations after cleaning operations), followed by B. cereus growth. Two options were then evaluated: i) reducing by one fifth of the number of filter sterilizations before renewing the filters, ii) designing new UHT-aseptic lines without an aseptic tank, i.e. without a storage period after the thermal process and before filling. Considering the uncertainty in the model, it was not possible to confirm whether these options had a significant influence on the risk associated with B. cereus. On the other hand, for Geobacillus stearothermophilus, combinations of heat-treatment time and temperature enabling the control or reduction in risk by a factor of ca. 100 were determined; for ease of operational implementation, they were presented graphically in the form of iso-risk curves. For instance, it was established that a heat treatment of 138°C for 31s (instead of 138°C for 25s) enabled a reduction in risk to 18×10(-8) (95% CI=[10; 34]×10(-8)), instead of 578×10(-8) (95% CI=[429; 754]×10(-8)) initially. In conclusion, a modular risk model, as the one exemplified here with a UHT-aseptic line, is a valuable tool in process design and operation, bringing definitive quantitative elements into the decision making process.
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http://dx.doi.org/10.1016/j.ijfoodmicro.2015.05.014 | DOI Listing |
Int J Gynaecol Obstet
September 2025
Department of Gynecology and Obstetrics, Justus Liebig University Giessen, Giessen, Germany.
Even though uterine fibroids are a widespread condition, the range of approved medical treatment options remains limited. In fact, only a few drugs are officially approved for the therapy of fibroids. In both the USA and the European Medicines Agency region, selected gonadotropin-releasing hormone (GnRH) antagonists have been approved for this indication.
View Article and Find Full Text PDFCirculation
September 2025
Division of Cardiology, Columbia University Irving Medical Center, New York, NY (S.A.P.).
Background: Limited treatment options exist for infrapopliteal disease in patients with chronic limb-threatening ischemia (CLTI), a condition associated with a high risk of limb loss. Interventional management of diseased infrapopliteal vessels with percutaneous transluminal angioplasty (PTA) is associated with high rates of restenosis and reintervention. In the LIFE-BTK trial, the drug-eluting resorbable scaffold (DRS) demonstrated superior 12-month efficacy compared with PTA in a selected CLTI population with predominantly noncomplex, mildly to moderately calcified lesions.
View Article and Find Full Text PDFEur J Case Rep Intern Med
August 2025
Dermatology Department, Ain Shams University Hospital, Cairo, Egypt.
Background: Dissecting cellulitis of the scalp (DCS) is a rare, chronic neutrophilic dermatosis that is often refractory to conventional therapies.
Case Report: We present a 29-year-old male with treatment-resistant DCS who achieved rapid and sustained remission following off-label use of tofacitinib, a Janus kinase (JAK) inhibitor. Previous therapies, including antibiotics, corticosteroids, and isotretinoin, had failed.
Eur J Case Rep Intern Med
August 2025
Department of Internal Medicine, Local Health Unit of São João, Porto, Portugal.
Unlabelled: Bariatric surgery has emerged as a highly effective treatment option for individuals with obesity. Severe hypoalbuminaemia is a feared complication after a Roux-en-Y gastric bypass. It is characterised by a low serum albumin level of <25 g/l, neither explained by renal losses, protein-losing enteropathy nor by liver disfunction, and is associated with high morbidity and mortality.
View Article and Find Full Text PDFCase Rep Womens Health
October 2025
The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China.
Progression of a caesarean scar ectopic pregnancy (CSEP) to a live birth is exceptionally rare. Whether the placenta should be removed during a caesarean section for patients with a CSEP complicated by severe placenta accreta spectrum remains unclear. This report presents the case of a 42-year-old multigravida with two prior caesarean sections who presented with CSEP at 6 weeks.
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