Influence of Transglutaminase Crosslinking on Casein Protein Fractionation during Low Temperature Microfiltration.

Low temperature microfiltration (MF) is applied in dairy processing to achieve higher protein and microbiological quality ingredients and to support ingredient innovation; however, low temperature reduces hydrophobic interactions between casein proteins and increases the solubility of colloidal calcium phosphate, promoting reversible dissociation of micellar ß-casein into the serum phase, and thus into permeate, during MF. Crosslinking of casein proteins using transglutaminase was studied as an approach to reduce the permeation of casein monomers, which typically results in reduced yield of protein in the retentate fraction. Two treatments (a) 5 °C/24 h (TA) and (b) 40 °C/90 min (TB), were applied to the feed before filtration at 5 °C, with a 0.1 µm membrane. Flux was high for TA treatment possibly due to the stabilising effect of transglutaminase on casein micelles. It is likely that formation of isopeptide bonds within and on the surface of micelles results in the micelles being less readily available for protein-protein and protein-membrane interactions, resulting in less resistance to membrane pores and flow passage, thereby conferring higher permeate flux. The results also showed that permeation of casein monomers into the permeate was significantly reduced after both enzymatic treatments as compared to control feed due to the reduced molecular mobility of soluble casein, mainly ß-casein, caused by transglutaminase crosslinking.

Influence of Processing Temperature on Membrane Performance and Characteristics of Process Streams Generated during Ultrafiltration of Skim Milk.

The effects of processing temperature on filtration performance and characteristics of retentates and permeates produced during ultrafiltration (UF) of skim milk at 5, 20, and 50 °C were investigated. The results indicate that despite higher flux at 50 °C, UF under these conditions resulted in greater fouling and rapid flux decline in comparison with 5 and 20 °C. The average casein micelle diameter was higher in retentate produced at 5 and 20 °C. The retentate analysed at 5 °C displayed higher viscosity and shear thinning behaviour as compared to retentate analysed at 20 and 50 °C. Greater permeation of calcium and phosphorus was observed at 5 and 20 °C in comparison with 50 °C, which was attributed to the inverse relationship between temperature and solubility of colloidal calcium phosphate. Permeation of α-lactalbumin was observed at all processing temperatures, with permeation of ß-lactoglobulin also evident during UF at 50 °C. All UF retentates were shown to have plasmin activity, while lower activity was measured in retentate produced at 5 °C. The findings revealed that UF processing temperature influences the physicochemical, rheological, and biochemical properties of, and thereby govern the resulting quality and functionality of, retentate- and permeate-based dairy ingredients.

Update on Biosimilar Insulins: A US Perspective.

The development of biosimilar insulin products has slowly evolved with only two follow-on biologics currently available to patients in the US. Both Basaglar® (insulin glargine) and Admelog® (insulin lispro) have undergone extensive testing, and have gained significant use by patients in the US. Despite the availability of these follow-on products, the price of insulin has remained stubbornly high. New regulatory guidance under the Biologics Price Competition and Innovations Act that came into effect in March 2020 introduced an abbreviated pathway for the approval of biosimilar insulins and introduced the option to apply for interchangeability of the biosimilar insulin with the reference product. This abbreviated clinical testing may open the doors for numerous follow-on insulin products, with unknown supply-chain and fiscal ramifications. This review will highlight the development process of biosimilar insulin in the US and the recent regulatory changes that can aid this process. We will also discuss challenges for prescribers and patients who are navigating this ever-changing landscape. These new regulations for biosimilar insulins will have ramifications for patients, healthcare providers, and third-party payers, though the direction and scope of these changes is unclear.

Maternal Race/Ethnicity and Postpartum Diabetes Screening: A Systematic Review and Meta-Analysis.

Introduction: Fifty percent of women with gestational diabetes mellitus (GDM) may progress to type 2 diabetes with highest risk among black women. This study aims to characterize postpartum diabetes screening rates among U.S. women with GDM by racial and ethnic group to characterize potential disparities. Materials and Methods: A standardized search of Ovid-Medline, Embase, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane, ProQuest, and Clinicaltrials.gov was conducted through October 12, 2018. Of 1,555 titles reviewed, 27 studies met inclusion criteria. Meta-proportion routines with random-effects models estimated pooled postpartum screening proportion effect size (ES) with 95% confidence interval (CI) by racial and ethnic group. Heterogeneity was measured using Cochrane's Q and Higgins I2 tests. Data were stratified by intervention and data source. Results: There were 96,439 women, of whom 81,930 had race/ethnicity recorded. Heterogeneity was high (I2 = 99.7%). Postpartum screening rates were low (pooled ES 42% [95% CI 35%-48%]). Point estimates for pooled screening proportions were lower among white (pooled ES 35% [95% CI 28%-42%]) and black (pooled ES 33% [95% CI 24%-42%]) women than among Hispanic (pooled ES 45% [95% CI 37%-53%]) and Asian (pooled ES 50% [95% CI 41%-58%]) women. Interventions to improve screening were most common and effective among Hispanic women. Discussion: Postpartum screening for diabetes after GDM remains low, and black women have among the lowest postpartum screening rates despite highest risk for type 2 diabetes progression. Reporting of race/ethnicity, screening methods, and screening time frames varied across studies. Conclusion: Future studies must standardize racial/ethnic data reporting and examine interventions that address postpartum diabetes screening and prevention.

Clinical utility of the HEART score in patients admitted with chest pain to an inner-city hospital in the USA.

BACKGROUND: Chest pain is one of the most common presentations to a hospital, and appropriate triaging of these patients can be challenging. The HEART score has been used for such purposes in some countries and only a few validation studies from the USA are available. We aim to determine the utility of the HEART score in patients presenting with chest pain to an inner-city hospital in the USA. PATIENTS AND METHODS: We retrospectively screened 417 consecutive patients admitted with chest pain to the observation/telemetry units at Einstein Medical Center Philadelphia. After applying inclusion and exclusion criteria, 299 patients were included in the analysis. Patients were divided into low-risk (0-3) and intermediate-high (≥4)-risk HEART score groups. Baseline characteristics, thrombolysis in myocardial infarction score, need for revascularization during index hospitalization, and major adverse cardiovascular events (MACE) at 6 weeks and 12 months were recorded. RESULTS: There were 98 and 201 patients in the low-score group and intermediate-high-score group, respectively. Compared with the low-score group, patients in the intermediate-high-risk group had a higher incidence of revascularization during the index hospital stay (16.4 vs. 0%; P=0.001), longer hospital stay, higher MACE at 6 weeks (9.5 vs. 0%) and 12 months (20.4 vs. 3.1%), and higher cardiac readmissions. HEART score of at least 4 independently predicted MACE at 12 months (odds ratio 7.456, 95% confidence interval: 2.175-25.56; P=0.001) after adjusting for other risk factors in regression analysis. CONCLUSION: HEART score of at least 4 was predictive of worse outcomes in patients with chest pain in an inner-city USA hospital. If validated in multicenter prospective studies, the HEART score could potentially be useful in risk-stratifying patients presenting with chest pain in the USA and could impact clinical decision-making.

Quantitative descriptive analysis and principal component analysis for sensory characterization of Indian milk product cham-cham.

Promising development and expansion in the market of cham-cham, a traditional Indian dairy product is expected in the coming future with the organized production of this milk product by some large dairies. The objective of this study was to document the extent of variation in sensory properties of market samples of cham-cham collected from four different locations known for their excellence in cham-cham production and to find out the attributes that govern much of variation in sensory scores of this product using quantitative descriptive analysis (QDA) and principal component analysis (PCA). QDA revealed significant (p < 0.05) difference in sensory attributes of cham-cham among the market samples. PCA identified four significant principal components that accounted for 72.4 % of the variation in the sensory data. Factor scores of each of the four principal components which primarily correspond to sweetness/shape/dryness of interior, surface appearance/surface dryness, rancid and firmness attributes specify the location of each market sample along each of the axes in 3-D graphs. These findings demonstrate the utility of quantitative descriptive analysis for identifying and measuring attributes of cham-cham that contribute most to its sensory acceptability.

Self-nanoemulsifying drug delivery system of docosahexanoic acid: development, in vitro, in vivo characterization.

CONTEXT: Docosahexanoic acid (DHA) is an essential omega-3 fatty acid for normal brain development and its use has increased considerably in recent years. OBJECTIVE: The aim of this study is to develop and evaluate self-nanoemulsifying drug delivery systems (SNEDDS) of DHA for improved palatability, dispersibility and bioavailability. METHODS: The SNEDDS were prepared and evaluated for miscibility, employing different combinations of olive oil and soyabean oil as oil phase, Span 80, Span 20, soya phosphatidylcholine, Labrafil M 1944 CS as surfactants while Tween 80, PEG 400, Cremophor RH40 and propylene glycol as cosurfactants. Thermodynamically stable SNEDDS were characterized for dispersibility, self-emulsification time, droplet size, zeta potential along with sensory analysis. The optimized formulation was subjected to ex vivo and in vivo evaluation such as intestinal permeability, memory performance test, brain concentration and histopathology studies. RESULTS: The optimized SNEDDS formulation showed emulsification time of 27 ± 4.7 s with droplet size of 17.6 ± 3.5 nm and zeta potential of -37.6 ± 0.5 mV. Intestinal absorption study depicted 18.3%, 21.5%, 41.5%, 98.7% absorption of DHA with SNEDDS-based formulation in comparison to 8.2%, 15.1%, 28.8%, 46.1% absorption of DHA with oil-based marketed formulation after 0.5, 1, 2 and 4 h. DHA concentration in brain homogenate was found to be increased to 2.6-fold in comparison to DHA-marketed formulation. This could be ascribed to enhanced dispersibility and bioavailability of DHA from nanosized formulation. CONCLUSION: The developed formulation led to enhanced dispersibility and bioavailability of DHA due to the formation of nanodroplets.

Effect of Acacia Gum, NaCl, and Sucrose on Physical Properties of Lotus Stem Starch.

Consumer preferences in east Asian part of the world pave the way for consumption of lotus stem starch (LSS) in preparations such as breakfast meals, fast foods, and traditional confectioneries. The present study envisaged the investigation and optimization of additives, that is, acacia gum, sodium chloride (NaCl), and sucrose, on water absorption (WA), water absorption index (WAI), and water solubility index (WSI) of LSS employing response surface methodology (RSM). Acacia gum resulted in increased water uptake and swelling of starch; however, NaCl reduced the swelling power of starch by making water unavailable to starch and also due to starch-ion electrostatic interaction. Sucrose restricted the water absorption by binding free water and decreased amylose leaching by building bridges with starch chains and thus forming rigid structure.