Low linoleic acid foods with added DHA given to Malawian children with severe acute malnutrition improve cognition: a randomized, triple-blinded, controlled clinical trial.

BACKGROUND: There is concern that the PUFA composition of ready-to-use therapeutic food (RUTF) for the treatment of severe acute malnutrition (SAM) is suboptimal for neurocognitive recovery. OBJECTIVES: We tested the hypothesis that RUTF made with reduced amounts of linoleic acid, achieved using high-oleic (HO) peanuts without added DHA (HO-RUTF) or with added DHA (DHA-HO-RUTF), improves cognition when compared with standard RUTF (S-RUTF). METHODS: A triple-blind, randomized, controlled clinical feeding trial was conducted among children with uncomplicated SAM in Malawi with 3 types of RUTF: DHA-HO-RUTF, HO-RUTF, and S-RUTF. The primary outcomes, measured in a subset of subjects, were the Malawi Developmental Assessment Tool (MDAT) global z-score and a modified Willatts problem-solving assessment (PSA) intention score for 3 standardized problems, measured 6 mo and immediately after completing RUTF therapy, respectively. MDAT domain z-scores, plasma fatty acid content, anthropometry, and eye tracking were secondary outcomes. Comparisons were made between the novel PUFA RUTFs and S-RUTF. RESULTS: Among the 2565 SAM children enrolled, mean global MDAT z-scores were -0.69 ± 1.19 and -0.88 ± 1.27 for children receiving DHA-HO-RUTF and S-RUTF, respectively (difference 0.19, 95% CI: 0.01, 0.38). Children receiving DHA-HO-RUTF had higher gross motor and social domain z-scores than those receiving S-RUTF. The PSA problem 3 scores did not differ by dietary group (OR: 0.92, 95% CI: 0.67, 1.26 for DHA-HO-RUTF). After 4 wk of treatment, plasma phospholipid EPA and α-linolenic acid were greater in children consuming DHA-HO-RUTF or HO-RUTF when compared with S-RUTF (for all 4 comparisons P values < 0.001), but only plasma DHA was greater in DHA-HO-RUTF than S-RUTF (P < 0.001). CONCLUSIONS: Treatment of uncomplicated SAM with DHA-HO-RUTF resulted in an improved MDAT score, conferring a cognitive benefit 6 mo after completing diet therapy. This treatment should be explored in operational settings. This trial was registered at clinicaltrials.gov as NCT03094247.

Advances and challenges in the high-pressure rheology of complex fluids.

Complex fluids and soft materials are ubiquitous in nature and industry. In industrial processes, these materials often get exposed to high hydrostatic pressures. Some examples include polymer melts, crude oils, gas hydrates, food systems, foams, motor oils, lubricants, etc. In spite of the relevance and utilization of hydrostatic pressure in many industrial applications, the role of pressure on the rheological properties has not been examined extensively in the literature. We review the high-pressure rheometric systems and present advantages and drawbacks of various kinds of rheometers such as capillary rheometer, sliding plate rheometer, falling ball viscometer, and rotational rheometer. By outlining the design complexities, precision, low-torque resolution limits and the inherent error sources of each type are critically evaluated. Furthermore, the high-pressure rheology data, chosen to cover a broad range of pressures and material class ranging from simple Newtonian fluids (incompressible), complex non-Newtonian fluids and compressible fluids featuring various key applications from different industries, are reviewed. The literature suggests, while effect of pressure on the rheological behavior is vital for many applications, compared to the effects of temperature on the rheological behavior, knowledge of the effect of pressure is still in its infancy.

Social Capital From Professional Engineering Organizations and the Persistence of Women and Underrepresented Minority Undergraduates.

Professional engineering organizations (PEOs) have the potential to provide women and underrepresented and minoritized (URM) students with social capital (i.e., resources gained from relationships) that aids their persistence in their engineering undergraduate programs and into the workforce. We hypothesize that women and URM students engineering students who participate in PEOs are more likely to persist in their engineering major and that PEOs contribute to their persistence by providing them access to insider information that supports their persistence. Each year for five years we administered surveys with closed- and open-ended items to examine the association between participating in PEOs and the persistence of a cohort of engineering majors from 11 diverse universities. We used logistic regression and thematic analysis to analyze the data. URM students who participated in PEOs and other engineering related activities were more likely to persist to the second year than URM students who did not (adjusted odds ratio = 2.18, CI: 1.09, 4.37). Students reported that PEOs contributed to their persistence by enabling them to network, reduce gender and race/ethnic isolation, and access professional resources. URM students should be encouraged to participate in PEOs beginning in their first year to increase their integration in their major, which we have found to increase their persistence.

Circulating Insulin-Like Growth Factor-1 Is Positively Associated with Growth and Cognition in 6- to 9-Year-Old Schoolchildren from Ghana.

BACKGROUND: Milk intake stimulates linear growth and improves cognition in children from low-income countries. These effects may be mediated through insulin-like growth factor-1 (IGF-1). OBJECTIVE: The objective was to assess the effect of milk supplement on circulating IGF-1 and to assess IGF-1 as a correlate of growth and cognition in children. METHODS: Secondary data on blood spot IGF-1 from a randomized, double-blind, controlled trial in 6-9-y-old children from rural Ghana were analyzed. Intervention groups received porridge with non-energy-balanced supplements: 8.8 g milk protein/d, 100 kcal/d (Milk8); 4.4 g milk and 4.4 g rice protein/d, 100 kcal/d (Milk/rice); 4.4 g milk protein/d, 48 kcal/d (Milk4); or a control (no protein, 10 kcal/d). IGF-1, length, body composition, and Cambridge Neuropsychological Test Automated Battery (CANTAB) were measured at 3.5 or 8.5 mo. Linear regressions were used to assess the effect of milk interventions on IGF-1 and IGF-1 as a correlate of growth and cognition. RESULTS: The increase in IGF-1 was 15.3 (95% CI: 3.3, 27.3) ng/mL higher in children receiving Milk8 compared with the control. The IGF-1 increases in the isonitrogenous, isoenergetic Milk/rice or the Milk4 groups were not different from the control (P ≥ 0.49). The increase in IGF-1 was associated with improvements in 4 out of 5 CANTAB domains. The strongest associations included reductions in "mean correct latency" from Pattern Recognition Memory and "pre-extradimensional (pre-ED) shift errors" from Intra/Extradimensional Set Shift (P ≤ 0.005). In addition, change in IGF-1 was positively associated with changes in height, weight, and fat-free mass (P ≤ 0.001). CONCLUSIONS: Intake of skimmed milk powder corresponding to one, but not half a glass of milk on school days stimulates IGF-1 in 6-9-y-old Ghanian children. IGF-1 seems to mediate the effect of milk intake on growth and cognition. The association between IGF-1 and cognition in relation to milk intake is novel and opens possibilities for dietary interventions to improve cognition.

Rheology of starch dispersions at high temperatures.

In the food industry, many food products experience extreme processing conditions of high temperature and high shear stresses. The measurements of sample behavior for water-based formulations above 100°C is extremely challenging due to changes in material composition from the boiling of volatile ingredients. We have developed a high-sensitivity, pressurized starch pasting cell (up to 5 bar) which utilizes a design free of mechanical bearings and seals, resulting in an order-of-magnitude improvement in torque sensitivity (1 µN.m in oscillatory and 10 µN.m in shear flows) compared to traditional pressure cells. A pressurized atmosphere in the cell suppresses boiling of the volatile components, allowing the characterization of the structure-property relationships of the sample over a range of testing conditions (-5 to 150°C) which simulate industrial processing and storage conditions. This cell is employed to investigate the pasting properties of a commercial starch dispersed in water. In situ gelatinization of starch dispersions of varying starch particle weight fractions (ϕ) subjected to a high temperature (120°C) at elevated pressure and at a fixed shear rate is studied. A phase transition, from an initial flowable starch slurry to a paste, takes place during which the viscosity evolves by several orders of magnitude. Typical parameters associated with the viscosity evolution during gelatinization such as onset temperature, peak temperature, and peak viscosity are analyzed to probe the impact of high temperature on the gelation process and the rheological properties of the final starch paste. Furthermore, yield stresses of the final paste, measured at 120°C, are examined for varying ϕ through traditional rheological methods such as flow ramps, oscillatory shear, and stress growth, demonstrating the capabilities of this cell for studies of steady shear and nonlinear viscoelastic behavior of the starch pastes. The yield stress values are found to be in good agreement when comparing various testing methods. Yield stresses range from 0.25 to 6.5 Pa for ϕ between 0.05 and 0.15, with 0.05 being the minimum starch weight fraction for which there is any measurable yield stress. The yield stress and the paste viscosity both scale with starch particle weight fraction as (ϕ - ϕc ) m , where ϕc = 0.04 as no yield stress is observed for ϕ ≤ 0.04. The exponent, m, for yield stress is found to be in the range of 1.15-1.4 depending on the analytical method used and the definition of yield stress while for peak and breakdown viscosities it is noted to be 1.6 and 1.1, respectively. The Herschel-Bulkley model is found to fit the flow curves well. The starch pastes are found to exhibit shear-thinning and significant thixotropic behavior.

Effect of the support systems' compliance on total hip modular taper seating stability.

Assembly of a femoral head onto the stem remains non-standardized. The literature shows altering mechanical conditions during seating affects taper strength and lower assembly load may increase fretting corrosion during cyclic tests. This suggests overall performance may be affected by head assembly method. The purpose of this test was to perform bench-top studies to determine influence of peak force magnitude, load rate, and compliance of the system's support structure on initial stability of the taper. Custom manufactured CoCrMo femoral heads and Ti-6Al-4V taper analog samples were assembled with varying peak force magnitudes (2-10.1 kN), load rates (quasi-static vs impaction), and system compliance (rigid vs compliant). A clinically-relevant system compliance design was based off of force data collected during a cadaver impaction study. Tensile loads were then applied to disassemble the taper and quantify initial taper stability. Results indicated that taper stability (assessed by disassembly forces) increased linearly with assembly force and load rate did not have a significant effect on taper stability. When considering system compliance, a 42%-50% larger input energy, dependent on assembly force, was required in the compliant group to achieve a comparable impaction force to the rigid group. Even when this impaction force was achieved, the correlation between the coefficient, defined as distraction force divided by assembly load, was significantly reduced for the compliant test group. The compliant setup was intended to simulate a surgical scenario where patient and surgical factors may influence the resulting compliance. Based on results, surgical procedure and patient variables may have a significant effect on initial taper stability.

Milk Powder Added to a School Meal Increases Cognitive Test Scores in Ghanaian Children.

Background: The inclusion of milk in school feeding is accepted as good nutritional practice, but specific benefits remain uncertain. Objective: The objective was to determine whether consumption of 8.8 g milk protein/d given as milk powder with a multiple micronutrient-enriched porridge resulted in greater increases in linear growth and Cambridge Neuropsychological Test Automated Battery (CANTAB) scores in Ghanaian schoolchildren when compared with 1 of 3 control groups. Methods: A randomized, double-blind, placebo-controlled clinical trial in healthy children aged 6-9 y was conducted comparing 8.8 g milk protein/d with 4.4 g milk protein/d or 4.4 g milk protein + 4.4 g rice protein/d (isonitrogenous, half of the protein from milk and half from rice) or a non-nitrogenous placebo. Primary outcomes were changes in length after 9 mo and CANTAB scores after 4.5 mo; secondary outcomes were body-composition measures. Supplements were added to porridge each school day and consumed for 9 mo. Anthropometric and body-composition measures and CANTAB tests were completed upon enrollment and after 4.5 and 9 mo. Group results were compared by using ANCOVA for anthropometric measures and the Kruskal-Wallis test for CANTAB scores. Results: Children receiving 8.8 g milk protein/d showed greater increases on percentage correct in Pattern Recognition Memory (mean ± SD: 5.5% ± 16.8%; P < 0.05) and Intra/Extradimensional Set Shift completed stages compared with all other food groups (0.6 ± 2.3; P < 0.05). No differences were seen in linear growth between the groups. The children receiving either 4.4 or 8.8 g milk protein/d had a higher fat-free body mass index than those who received no milk, with an effect size of 0.34 kg/m2. Conclusion: Among schoolchildren, the consumption of 8.8 g milk protein/d improved executive cognitive function compared with other supplements and led to the accretion of more lean body mass, but not more linear growth. This trial was registered at www.clinicaltrials.gov">www.clinicaltrials.gov as NCT02757508.

Friction in modern total hip arthroplasty bearings: Effect of material, design, and test methodology.

The purpose of this study was to characterize the effect of a group of variables on frictional torque generated by acetabular components as well as to understand the influence of test model. Three separate test models, which had been previously used in the literature, were used to understand the effect of polyethylene material, bearing design, head size, and material combinations. Each test model differed by the way it simulated rotation of the head, the type of frictional torque value it reported (static vs. dynamic), and the type of motion simulated (oscillating motion vs. continuous motion). It was determined that not only test model may impact product ranking of fictional torque generated but also static frictional torque may be significantly larger than a dynamic frictional torque. In addition to test model differences, it was discovered that the frictional torque values for conventional and highly cross-linked polyethylenes were not statistically significantly different in the more physiologically relevant test models. With respect to bearing design, the frictional torque values for mobile bearing designs were similar to the 28-mm diameter inner bearing rather than the large diameter outer liner. Testing with a more physiologically relevant rotation showed that frictional torque increased with bearing diameter for the metal on polyethylene and ceramic on polyethylene bearings but remained constant for ceramic on ceramic bearings. Finally, ceramic on ceramic bearings produced smaller frictional torque values when compared to metal on polyethylene and ceramic on polyethylene groups.

How Do Propensity Score Methods Measure Up in the Presence of Measurement Error? A Monte Carlo Study.

Considering that the absence of measurement error in research is a rare phenomenon and its effects can be dramatic, we examine the impact of measurement error on propensity score (PS) analysis used to minimize selection bias in behavioral and social observational studies. A Monte Carlo study was conducted to explore the effects of measurement error on the treatment effect and balance estimates in PS analysis across seven different PS conditioning methods. In general, the results indicate that even low levels of measurement error in the covariates lead to substantial bias in estimates of treatment effects and concomitant reduction in confidence interval coverage across all methods of conditioning on the PS.

Wear performance evaluation of a contemporary dual mobility hip bearing using multiple hip simulator testing conditions.

The dual mobility hip bearing concept combines a small bearing with a large diameter bearing through a dual articulation system, potentially increasing the stability of the hip. Bearings with two articulations introduce concerns of whether or not wear might be increased compared to a conventional bearing. We therefore evaluated the wear performance of a dual mobility hip bearing using sequentially cross-linked and annealed polyethylene under the conditions of impingement, abrasion, and when the mobile liner becomes immobilized at either the inner or outer diameter. We found the wear performance of this dual mobility hip is dictated by the conditions experienced by the smaller inner articulation and by the polyethylene material. The highest wearing group wore 75% less than a single articulating conventional gamma/inert polyethylene bearing.

Bearing surfaces for hip arthroplasty - is metal-on-metal a passing fancy?

Metal-on-metal bearings have had popularity that has waxed and waned over the years. The advantages realized relative to wear resistance and strength had been offset by early failures, manufacturing difficulty, and most recently by adverse soft tissue responses to the metallic debris. The bearing's history, evolution, advantages and disadvantages will be discussed in attempt to answer the question: is metal-on-metal a passing fancy?

Metal-on-metal bearings: the problem is edge-loading wear.

Metal-on-metal bearings are promoted as a low wear bearing alternative to traditional hip replacement bearings. While most in vitro studies support this, recent clinical reviews have found a significant number of early revisions in some designs of metal-on-metal bearings related to wear. Metal-on-metal bearings exhibit a bi-phasic wear pattern with high initial wear that generally settles down to low steady state wear. Previous publications from the authors have found that steady state wear occurs due to the formation of a critical conforming contact area. This contact area was found to be surprisingly constant regardless of bearing size, clearance, or even contact mode. The authors hypothesized that steady state wear may never be reached if formation of this critical conforming contact area is disrupted. Several hip simulator tests were performed to assess the wear performance of generic metal-on-metal samples at various angles of inclination. Three-dimensional modeling was performed on the generic bearing design as well as typical resurfacing and hemispherical bearing designs including various sizes and clearance ranges. Simulator results support the hypotheses, and wear rates were linear or accelerating when the critical contact area size could not be achieved due to its proximity to the rim of the bearing. Modeling studies show a correlation between bearing size and design and the maximum inclination angle allowed to reach steady state conditions. Smaller bearing size and shallower cup designs were found to reduce the maximum safe inclination angle and this corresponds to clinical observation of increased failure rates in these bearings. This simple method for assessing runaway wear risk can be utilized in the design of more robust and forgiving metal-on-metal bearings.

Tribological considerations in primary and revision metal-on-metal arthroplasty.

BACKGROUND: Metal-on-metal hip bearings undergo biphasic wear, starting with a short period of high wear (bedding-in) and followed by low steady-state wear. Bedding-in is the process by which the cup wears locally to conform to the geometry of the head. This process reduces the maximum contact stress and allows for appropriate lubrication. A critical area of conformance and wear is required for the bearing to reach a low steady-wear state. Cups were analyzed in this study after primary and revision wear scenarios to determine this critical area for this specific bearing. METHODS: Forty and 56-mm cobalt-chromium resurfacing bearings with 150 and 400-microm clearances were wear tested in a hip simulator for 5 million cycles. The cups underwent an additional 5 million cycles of testing against new heads, simulating a revision scenario. The revision heads were manufactured to cause the highest mismatch with the pre-worn cups, resulting in polar or local annular contact. Cup wear area was determined from weight-loss measurements after each phase of testing. RESULTS: All bearings experienced a biphasic wear performance with a short period of high wear followed by low steady-state wear. A consistent critical area of conformance was reached by all bearings after primary and revision testing conditions, regardless of bearing size, bearing clearance, or contact mode. CONCLUSIONS: An area of conformity (wear) reduces contact pressures, is beneficial for lubrication, and is critical to reach a low steady-state wear rate. This study shows that this critical area is consistent regardless of bearing size, clearance, or contact mode. Bearing designs that allow the proper formation of this conformance area should bed-in and reach a low steady-state wear rate.

Hybrid InGaAsP-InP Mach-Zehnder Racetrack Resonator for Thermooptic Switching and Coupling Control.

An InGaAsP-InP optical switch geometry based on electrical control of waveguide-resonator coupling is demonstrated. Thermooptic tuning of a Mach-Zehnder interferometer integrated with a racetrack resonator is shown to result in switching with ON-OFF contrast up to 18.5 dB. The optical characteristics of this unique design enable a substantial reduction of the switching power, to a value of 26 mW in comparison with 40 mW for a conventional Mach-Zehnder interferometer switch. Modulation response measurements reveal a 3 dB bandwidth of 400 kHz and a rise time of 1.8 micros, comparing favorably with current state-of-the-art thermooptic switches.

Ultra-large bandwidth hollow-core guiding in all-silica Bragg fibers with nano-supports.

We demonstrate a new class of hollow-core Bragg fibers that are composed of concentric cylindrical silica rings separated by nanoscale support bridges. We theoretically predict and experimentally observe hollow-core confinement over an octave frequency range. The bandwidth of bandgap guiding in this new class of Bragg fibers exceeds that of other hollow-core fibers reported in the literature. With only three rings of silica cladding layers, these Bragg fibers achieve propagation loss of the order of 1 dB/m.

Investigation of physical mechanisms in coupling photonic crystal waveguiding structures.

We explain the fundamental physical mechanisms involved in coupling triangular lattice photonic crystal waveguides to conventional dielectric slab waveguides. We show that the two waveguides can be efficiently coupled outside the mode gap frequencies. We especially focus on the coupling of the two structures within the mode gap frequencies and show for the first time that the diffraction from the main photonic crystal structure plays an important role on the reflection of power back into the slab waveguide. The practical importance of this effect and possible strategies to modify it are also discussed.

Systematic design of single-mode coupled-resonator optical waveguides in photonic crystals.

By establishing a direct relation between the dispersion and the field profile of a coupled-resonator optical waveguide (CROW) and those of its constituent cavities, we present a systematic method for the design of a single-mode CROW and for control of its dispersion. The procedure includes the design of a single-mode cavity and control of its frequency by engineering its structure. Then, by chaining these cavities in the proper direction and at an appropriate distance, we achieve the desired dispersion for the CROW.

Asymptotic analysis of dielectric coaxial fibers.

Using an asymptotic analysis, we analytically calculate the dispersion and the field distribution of guided modes in an all-dielectric coaxial fiber. We compare the analytical results with those obtained from numerical calculations and find excellent agreement between them. We demonstrate that both the Bragg reflection and the total internal reflection play important roles in providing confinement and determining the dispersion characteristics of the coaxial fiber modes.

Ring fiber resonators based on fused-fiber grating add-drop filters:application to resonator coupling.

We introduce a fiber ring optical resonator based on adiabatic fused-fiber grating couplers. The coupling of a through fiber to the resonator is controlled by the strength of the fiber Bragg gratings. By using two of these couplers and incorporating erbium-doped (ED) fiber in the ring, we control the internal loss of the ring by pumping the ED fiber. The transmission spectra of the through port and the drop port of a four-port configuration, a ring coupled to two waveguides, are measured. We show that the loss/coupling ratio of the ring-fiber system can be changed and thus that the transmission properties of the fiber can be controlled.