Combining fracture mechanics and rheology to investigate the impact of micro-aeration on chocolate oral processing.

This study presents a rigorous mechanical characterisation investigation on milk chocolate with varying porosities, at different temperatures and strain rate levels. Uniaxial compression tests at temperatures varying from 20 °C to 30 °C were performed to measure the bulk properties of chocolate as a function of porosity and temperature. Fracture experiments were also conducted to compute the fracture energy at temperature levels between 20 °C and 30 °C for all tested samples. Additionally, rheological experiments are conducted to compute the viscosity of the different chocolates at 37 °C. This combined experimental analysis of solid mechanics, fracture mechanics, and rheology aims to define the impact of temperature and chocolate's phase change from solid to liquid on its mechanical properties. Moreover, the impact of micro-aeration on the relationship between material properties and temperature is discussed. The results demonstrate a significant impact of both temperature and micro-aeration on the chocolate's material properties; fracture stresses decrease with micro-aeration due to the presence of micro-pores creating weak links in the chocolate matrix, the critical strain energy release rate decreases with micro-aeration at temperatures up to 25 °C and increases at temperatures above 30 °C. Finally, the viscosity at 37 °C increases with increasing porosity due to the obstruction of the flow by micro-pores acting as "solid" particles. The results highlight how the impact of micro-aeration on the material properties of chocolate alters as the testing temperature rises and the material changes phase. The relationships between the micro-aeration and material properties and the dependence of temperature on the different mechanical properties are used to explain the difference in textural attributes as obtained from temporal dominance sensation tests. This study seeks to contribute valuable insights into the field of chocolate technology, emphasizing the need for a combined engineering approach to understand the structural breakdown of chocolate during oral processing as mechanisms such as chewing, melting, mixing and shearing occur.

Experimental and numerical evaluation of the effect of micro-aeration on the thermal properties of chocolate.

Thermal properties, such as thermal conductivity, specific heat capacity and latent heat, influence the melting and solidification of chocolate. The accurate prediction of these properties for micro-aerated chocolate products with varying levels of porosity ranging from 0% to 15% is beneficial for understanding and control of heat transfer mechanisms during chocolate manufacturing and food oral processing. The former process is important for the final quality of chocolate and the latter is associated with sensorial attributes, such as grittiness, melting time and flavour. This study proposes a novel multiscale finite element model to accurately predict the temporal and spatial evolution of temperature across chocolate samples. The model is evaluated via heat transfer experiments at temperatures varying from 16 °C to 45 °C. Both experimental and numerical results suggest that the rate of heat transfer within the micro-aerated chocolate is reduced by 7% when the 15% micro-aerated chocolate is compared to its solid counterpart. More specifically, on average, the thermal conductivity decreased by 20% and specific heat capacity increased by 10% for 15% micro-aeration, suggesting that micro-pores act as thermal barriers to heat flow. The latter trend is unexpected for porous materials and thus the presence of a third phase at the pore's interface is proposed which might store thermal energy leading to a delayed release to the chocolate system. The developed multiscale numerical model provides a design tool to create pore structures in chocolate with optimum melting or solidifying response.

Effect of micro-aeration on the mechanical behaviour of chocolates and implications for oral processing.

Aeration in foods has been widely utilised in the food industry to develop novel foods with enhanced sensorial characteristics. Specifically, aeration at the micron-sized scale has a significant impact on the microstructure where micro-bubbles interact with the other microstructural features in chocolates. This study aims to determine the effect of micro-aeration on the mechanical properties of chocolate products, which are directly correlated with textural attributes such as hardness and crumbliness. Uniaxial compression tests were performed to determine the mechanical properties such as Poisson's ratio, Young's modulus and macroscopic yield strength together with fracture tests to estimate the fracture toughness. In vivo mastication tests were also conducted to investigate the link between the fracture properties and fragmentation during the first two chewing cycles. The uniaxial stress-strain data were used to calibrate a viscoplastic constitutive law. The results showed that micro-aeration significantly affects mechanical properties such as Young's modulus, yield and fracture stresses, as well as fracture toughness. In addition, it enhances the brittle nature of the chocolate, as evidenced by lower fracture stress but also lower fracture toughness leading to higher fragmentation, in agreement with observations in the in vivo mastication tests. As evidenced by the XRT images and the stress-strain measurements micro-aeration hinders the re-arrangement of the microscopic features inside the chocolate during the material's deformation. The work provides a new insight of the role of bubbles on the bulk behaviour of complex multiphase materials, such as chocolates, and defines the mechanical properties which are important input parameters for the development of oral processing simulations.

Assessment of poly-L-lysine dendrigrafts for virus concentration in water: use of MS2 bacteriophage as proof of concept.

AIMS: Virus detection has often been difficult due to a low concentration in water. In this study, we developed a new procedure based on concentration of virus particles on an innovative support: poly-L-lysine dendrigrafts (DGL), coupled with directed nucleic acid extraction and real-time PCR quantification. METHODS AND RESULTS: This method was evaluated using the bacteriophage MS2 as a model virus. This virus exhibited the size and structural properties of human pathogenic enteric viruses and has often been used to assess new supports of concentration. Moreover, this bacteriophage is also a faecal contamination indicator. In this study, many water filtration conditions were tested (volume of water, concentration, etc.), and more than 80% of bacteriophage were recovered after filtration on polymer, in most conditions. We demonstrated that the method was linear (slope = 0·99 ± 0·04 and Y intercept when x = -0·02 ± 0·28), valid (as manipulators, tested concentrations, volumes of sample and batch of polymer did not have any influence on concentration) and sensitive (allowing to concentrate up to 16,600-fold 1 l of sample and to detect and quantify down to 750 GC l(-1) and 7500 GC l(-1), respectively). CONCLUSIONS: To conclude, this support exhibits high interest to retain viruses and to allow to detect low concentration of virus in water. SIGNIFICANCE AND IMPACT OF THE STUDY: This study gives valuable advance in the methods of concentration and diagnosis of virus in water.

Which factors determine the wear rate of large-diameter metal-on-metal hip replacements? Multivariate analysis of two hundred and seventy-six components.

BACKGROUND: Determining the relationship between clinical factors and engineering analysis of retrieved hip implants can help our understanding of the mechanism of device failure. This is particularly important for metal-on-metal hip arthroplasties because the most common cause of failure is unexplained. We sought to understand the variation in wear rates in a large series of retrieved metal-on-metal hip arthroplasty components. METHODS: We prospectively recorded preoperative, intraoperative, and postoperative data to study the effect on both head and cup wear rates of the following variables: patient sex, cause of failure, manufacturer type, resurfacing or modular design, blood cobalt and chromium levels, edge-loading, femoral head size, and cup inclination angle. We analyzed 276 components (138 femoral head and acetabular cup couples) retrieved from failed metal-on-metal hip replacements. RESULTS: We found a high rate of edge-loading (64%), but only forty-three (31%) of 138 hips had a cup inclination angle of >55°. Multivariate analysis showed that the most important factor responsible for the variation in wear rate was the presence or absence of edge-loading, even when adjusted for cup inclination angle. Strong positive correlations were found between acetabular cup and femoral head wear rates and between wear rates and both blood cobalt and chromium ion levels. CONCLUSIONS: Multivariate analysis of nine factors found that edge-loading was the most important predictor of wear rate and occurred in two-thirds of failed metal-on-metal hip replacements. The majority did not have excessive cup inclination angles: 68% had an inclination angle of ≤55°. This finding, together with the relatively low median wear rate of the components in our study, suggests that cup position and/or wear rate may not be the only outcome related to failure of metal-on-metal hip replacements.

Rapid quantification of viable fungi in hospital environments: analysis of air and surface samples using solid-phase cytometry.

BACKGROUND: Environmental surveillance is important in high-risk areas of hospitals to prevent fungal infections in immunosuppressed patients. Conventional culture methods for enumerating environmental fungi are time-consuming. AIM: In this field study, a solid-phase cytometry technique (SPC) and a more conventional culture-based method to quantify fungal contamination of hospital air and surface samples were compared. METHODS: For the air sampling, a liquid cyclone air sampler was used with a flow rate of 300 L/min for 10 min in each of four hospital locations. Surface swabbing was done in two locations, with two different swab types. Samples from all areas were processed by SPC and by culture on malt extract agar. FINDINGS: The mean airborne concentrations of viable fungi determined by SPC were about 1.5-fold higher than the mean concentrations obtained with the culture-based method. These differences for air samples were significant in three hospital environments. No significant difference was observed for surface samples between the two swab types and between the two analytical methods. One of the prominent advantages of SPC was its rapidity in comparison with the culture-based method (5 h versus 5 days). CONCLUSION: In this study, we showed that SPC allows for rapid monitoring of viable fungi in hospital environments. SPC can thus be used to provide an early warning and a rapid implementation of corrective measures. Viable fungi detection may be an important tool to assess infectious risk in wards with immunosuppressed patients.

Lubrication of metal-on-metal hip joints: the effect of protein content and load on film formation and wear.

Lubricant films were measured for a series of bovine serum and protein containing (albumin, globulin) saline solutions for CoCrMo femoral component sliding against a glass disc. Central film thickness was measured by optical interferometry as a function of time (constant mean speed: 0 and 10 mm/s) and variable mean speed (0-50 mm/s). The effect of load (5-20 N) on film thickness was also studied. The development of the wear scar on the CoCrMo surface was monitored by measuring the width of the contact zone during the film thickness tests. The results showed film thickness increased with time for both the static and sliding tests. Films formed in the static, loaded test were typically in the range of 3-40 nm. The globulin containing solutions formed the thickest films. In the sliding tests a wear scar rapidly formed on the implant component for the bovine serum and albumin fluids, negligible wear was observed for the globulin solutions. Film thickness increased with sliding time for all test solutions and was much greater than predicted by isoviscous EHL models. The film increase was found to correlate with increasing wear scar size and thus decreasing contact pressure. A new lubricating mechanism is proposed whereby during sliding the fluid undergoes bulk phase separation rheology, so that an elevated protein phase forms in the inlet zone. This protein phase is a high-viscosity biphasic matrix, which is periodically entrained into the contact forming a thick protective hydro-gel film. One of the main findings of this study is that film thickness was very sensitive to load; to a much greater extent than predicted by EHL models. Thus film formation in MoM hip joints is very susceptible to high contact pressures which might be due to implant misalignment and edge-loading.

A comparison of explanted Articular Surface Replacement and Birmingham Hip Resurfacing components.

The Articular Surface Replacement (ASR) hip resurfacing arthroplasty has a failure rate of 12.0% at five years, compared with 4.3% for the Birmingham Hip Resurfacing (BHR). We analysed 66 ASR and 64 BHR explanted metal-on-metal hip replacements with the aim of understanding their mechanisms of failure. We measured the linear wear rates of the acetabular and femoral components and analysed the clinical cause of failure, pre-revision blood metal ion levels and orientation of the acetabular component. There was no significant difference in metal ion levels (chromium, p = 0.82; cobalt, p = 0.40) or head wear rate (p = 0.14) between the two groups. The ASR had a significantly increased rate of wear of the acetabular component (p = 0.03) and a significantly increased occurrence of edge loading (p < 0.005), which can be attributed to differences in design between the ASR and BHR. The effects of differences in design on the in vivo wear rates are discussed: these may provide an explanation as to why the ASR is more sensitive to suboptimal positioning than the BHR.

Inlet protein aggregation: a new mechanism for lubricating film formation with model synovial fluids.

This paper reports a fundamental study of lubricant film formation with model synovial fluid components (proteins) and bovine serum (BS). The objective was to investigate the role of proteins in the lubrication process. Film thickness was measured by optical interferometry in a ball-on-disc device (mean speed range of 2-60 mm/s). A commercial cobalt-chromium (CoCrMo) metal femoral head was used as the stationary component. The results for BS showed complex time-dependent behaviour, which was not representative of a simple fluid. After a few minutes sliding BS formed a thin adherent film of 10-20 nm, which was attributed to protein absorbance at the surface. This layer was augmented by a hydrodynamic film, which often increased at slow speeds. At the end of the test deposited surface layers of 20-50 nm were measured. Imaging of the contact showed that at slow speeds an apparent 'phase boundary' formed in the inlet just in front of the Hertzian zone. This was associated with the formation of a reservoir of high-viscosity material that periodically moved through the contact forming a much thicker film. The study shows that proteins play an important role in the film-forming process and current lubrication models do not capture these mechanisms.

High-throughput typing method to identify a non-outbreak-involved Legionella pneumophila strain colonizing the entire water supply system in the town of Rennes, France.

Two legionellosis outbreaks occurred in the city of Rennes, France, during the past decade, requiring in-depth monitoring of Legionella pneumophila in the water network and the cooling towers in the city. In order to characterize the resulting large collection of isolates, an automated low-cost typing method was developed. The multiplex capillary-based variable-number tandem repeat (VNTR) (multiple-locus VNTR analysis [MLVA]) assay requiring only one PCR amplification per isolate ensures a high level of discrimination and reduces hands-on and time requirements. In less than 2 days and using one 4-capillary apparatus, 217 environmental isolates collected between 2000 and 2009 and 5 clinical isolates obtained during outbreaks in 2000 and 2006 in Rennes were analyzed, and 15 different genotypes were identified. A large cluster of isolates with closely related genotypes and representing 77% of the population was composed exclusively of environmental isolates extracted from hot water supply systems. It was not responsible for the known Rennes epidemic cases, although strains showing a similar MLVA profile have regularly been involved in European outbreaks. The clinical isolates in Rennes had the same genotype as isolates contaminating a mall's cooling tower. This study further demonstrates that unknown environmental or genetic factors contribute to the pathogenicity of some strains. This work illustrates the potential of the high-throughput MLVA typing method to investigate the origin of legionellosis cases by allowing the systematic typing of any new isolate and inclusion of data in shared databases.

The relationship between the angle of version and rate of wear of retrieved metal-on-metal resurfacings: a prospective, CT-based study.

We measured the orientation of the acetabular and femoral components in 45 patients (33 men, 12 women) with a mean age of 53.4 years (30 to 74) who had undergone revision of metal-on-metal hip resurfacings. Three-dimensional CT was used to measure the inclination and version of the acetabular component, femoral version and the horizontal femoral offset, and the linear wear of the removed acetabular components was measured using a roundness machine. We found that acetabular version and combined version of the acetabular and femoral components were weakly positively correlated with the rate of wear. The acetabular inclination angle was strongly positively correlated with the rate of wear. Femoral version was weakly negatively correlated with the rate of wear. Application of a threshold of > 5 µm/year for the rate of wear in order to separate the revisions into low or high wearing groups showed that more high wearing components were implanted outside Lewinnek's safe zone, but that this was mainly due to the inclination of the acetabular component, which was the only parameter that significantly differed between the groups. We were unable to show that excess version of the acetabular component alone or combined with femoral version was associated with an increase in the rate of wear based on our assessment of version using CT.

Retrieval analysis of 240 metal-on-metal hip components, comparing modular total hip replacement with hip resurfacing.

This study compared component wear rates and pre-revision blood metal ions levels in two groups of failed metal-on-metal hip arthroplasties: hip resurfacing and modular total hip replacement (THR). There was no significant difference in the median rate of linear wear between the groups for both acetabular (p = 0.4633) and femoral (p = 0.0872) components. There was also no significant difference in the median linear wear rates when failed hip resurfacing and modular THR hips of the same type (ASR and Birmingham hip resurfacing (BHR)) were compared. Unlike other studies of well-functioning hips, there was no significant difference in pre-revision blood metal ion levels between hip resurfacing and modular THR. Edge loading was common in both groups, but more common in the resurfacing group (67%) than in the modular group (57%). However, this was not significant (p = 0.3479). We attribute this difference to retention of the neck in resurfacing of the hip, leading to impingement-type edge loading. This was supported by visual evidence of impingement on the femur. These findings show that failed metal-on-metal hip resurfacing and modular THRs have similar component wear rates and are both associated with raised pre-revision blood levels of metal ions.

Flow-driven transition and associated velocity profiles in a nematic liquid-crystal cell.

The alignment properties and distribution of flow speed during Poiseuille flow through a microchannel of a nematic liquid crystal in a cell with homeotropic surface alignment has been measured using a combination of conoscopy, fluorescence confocal polarizing microscopy, and time-lapse imaging. Two topologically distinct director profiles, with associated fluid velocity fields, are found to exist with the preferred state dictated by the volumetric flow rate of the liquid crystal. The results show excellent agreement with model data produced using the Ericksen-Leslie nematodynamics theory.

Barriers to the reporting and management of needlestick injuries among surgeons.

OBJECTIVE: Needlestick injuries are common within surgical practice and carry the risk of transmission of blood borne viruses. Key to reducing this risk is an accessible system of reporting and involvement of occupational health services. We aimed to identify surgeons' attitude and experience dealing with such injuries and identify why in many cases needlestick injuries go unreported. METHODS: 70 questionnaires were hand delivered to surgeons and trainees across 3 UK hospitals and a variety of surgical specialties. The number of injuries and reporting practice was identified. Surgeons were asked to identify from a list the reasons why they did not report their injuries and record importance on a 5-point scale (0-4). RESULTS: 52 surgeons and trainees replied (75%). 42 (81%) had suffered at least 1 needlestick injury with 4 (8%) reporting more than 20. 8 (19%) had reported all their injuries to occupational health with no significant difference in reporting between consultants and trainees (P = 0.2). 12 (23%) felt that reporting of injuries helped to reduce transmission rates. 18 (35%) said that a needlestick had caused them moderate or significant anxiety. The top reasons for not reporting were (0-4). (1) Process too time consuming (2.7), (2) transmission risk very low (2.6), (3) do not want to disrupt operating list (2.0), (4) post exposure prophylaxis ineffective (1.3). CONCLUSIONS: Most surgeons and trainees do not report all their needlestick injuries to occupational health despite many reporting injury related anxiety. The process is felt to take too long and the perceived risk of viral transmission is low.

Sea urchin spine injuries of the hand.

Sea urchin spine injuries are common. They usually cause local pain and swelling that subsides. Chronic granulation is rare. We report two cases of sea urchin granulomata involving finger metacarpophalangeal joints. Both resolved following surgery.

A large multi-pathogen waterborne community outbreak linked to faecal contamination of a groundwater system, France, 2000.

A large waterborne outbreak of infection that occurred during August 2000 in a local community in France was investigated initially via a rapid survey of visits to local physicians. A retrospective cohort study was then conducted on a random cluster sample of residents. Of 709 residents interviewed, 202 (28.5%) were definite cases (at least three liquid stools/day or vomiting) and 62 (8.7%) were probable cases (less than three liquid stools/day or abdominal pain). Those who had drunk tap water had a three-fold increased risk for illness (95% CI 2.4-4.0). The risk increased with the amount of water consumed (chi-square trend: p < 0.0001). Bacteriological analyses of stools were performed for 35 patients and virological analyses for 24 patients. Campylobacter coli, group A rotavirus and norovirus were detected in 31.5%, 71.0% and 21% of samples, respectively. An extensive environmental investigation concluded that a groundwater source to this community had probably been contaminated by agricultural run-off, and a failure in the chlorination system was identified. This is the first documented waterborne outbreak of infection involving human C. coli infections. A better understanding of the factors influencing campylobacter transmission between hosts is required.

Real-time RT-PCR for norovirus screening in shellfish.

Real-time RT-PCR, combining amplification and detection of virus-specific amplicons, is a promising tool for norovirus detection in environmental or food samples such as shellfish. We developed a real-time RT-PCR assay based on one-step detection using single primer sets and probes for norovirus genogroups I and II. Seventy and seven RT-PCR units of genogroup I and II reference norovirus strains, respectively, were detected in artificially contaminated oysters. Validation of the new method on 150 archived naturally contaminated shellfish confirmed the utility of the genogroup II primer set to detect a large range of different strains circulating in France since 1995, but genogroup I strains were detected infrequently.

A double-blind comparison of balsalazide, 6.75 g, and sulfasalazine, 3 g, as sole therapy in the management of ulcerative colitis.

BACKGROUND: Sulfasalazine is accepted therapy for active ulcerative colitis, but side-effects and intolerance are common. Balsalazide is an azo-bonded pro-drug which also releases 5-aminosalicylic acid into the colon, but uses an inert carrier molecule. AIM: To compare the safety and efficacy of sul- fasalazine, 3 g, with balsalazide, 6.75 g, in the initial daily treatment of mild to moderate ulcerative colitis. METHODS: A randomized, multicentre, double-blind, parallel group study was performed, with a treatment duration of 8 weeks. Patients on previous maintenance treatment were excluded. The trial medication was the sole treatment for the colitis. Efficacy was assessed by patient diaries, symptom assessment, sigmoidoscopic appearance and histology. RESULTS: Fifty patients were recruited: 26 allocated to the balsalazide group and 24 to the sulfasalazine group. More patients withdrew due to adverse events in the sulfasalazine group (nine patients vs. one patient in the balsalazide group, P=0.004). Improvement occurred in both groups, with a tendency to a faster response with balsalazide. Of the patients taking balsalazide, 61% achieved clinical and sigmoidoscopic remission. CONCLUSIONS: Balsalazide, 6.75 g, is effective as the sole treatment for patients with mild to moderately active ulcerative colitis, with significantly fewer withdrawals due to side-effects than in a similar group of patients taking sulfasalazine, 3 g.

Gerontological nurse specialists.

This article focuses on the development of a new role highlighted in The NHS Plan (DoH 2000a), nurse specialist for older people or gerontological nurse specialist.