Recent studies on alternative technologies for deep-fat frying.

Deep fat fried food products have been considered as a vital dietary contributor to certain chronic diseases, including the risk of atherosclerosis, cancer and hypertension. Hence, many food industries are focusing on low fat fried products to attract consumers. In general, oil is absorbed during deep fat frying, and this century old process is used for preparing various kinds of fried food products such as potato chips, banana chips, savory snacks, etc. Vacuum frying, electric field frying and two-stage frying technologies have been developed as an alternatives to traditional frying. These two technologies are suitable for most fried products; however, they may not be suitable for sugar based fruits as they can lead to the formation of browning reactions, which are generally considered unacceptable. This review aims to cover recent work done in the area of vacuum frying and two-stage frying, including the role of pre-treatment and post-treatment novel methods. Additionally, emphasis has been given on recent innovations to improve the quality of vacuum and two-stage frying, particularly concerning the reduction of oil uptake in fried food products.

Effect of activated carbon-based two-stage adsorption on biogenic amine reduction and quality of anchovy fish sauce at industrial scale.

This study was aimed to investigate the effectiveness of activated carbon on reduction in biogenic amines (BAs) via two-stage adsorption process at industrial scale, and the consequent effect was evaluated by the taste and aroma of anchovy fish sauce. Through reaction surface methodology, the optimal working paratmeters were determined to adsorbent composition of 2% activated carbon and 0.9% diatomite under temperature of 27 °C for 97 min. Upon optimized settings at industrial scale, there were effective reductions in tryptamine (by 100%), cadaverine (by 10%), histamine (by 61%), and tyramine (by 96%), while the changes in taste-related amino nitrogen, total nitrogen, free amino acids, and color were minimum. In addition, off-flavor-causing compounds, such as alcohols and acids, were removed by the developed method. From the obtained results, the activated carbon-based two-stage adsorption approach can provide the framework for control of BAs contents in fish-based sauces or stocks at commercial and industrial scales.

Conversion and fate of waste Li-ion battery electrolyte in a two-stage thermal treatment process.

Disposal of electrolytes from waste lithium-ion batteries (LIBs) has gained much more attention with the growing application of LIBs, yet handling spent electrolyte is challengeable due to its high toxicity and the lack of established methods. In this study, a novel two-stage thermal process was developed for treating residual electrolytes resulted from spent lithium-ion batteries. The conversion of fluorophosphate and organic matter in oily electrolyte during low-temperature rotation distillation was investigated. The distribution and migration of the concentrated electrolytes were studied and the corresponding reaction mechanisms were elucidated. Additionally, the influence of alkali on the fixation of fluorine and phosphate was further examined. The results indicated that hydrolyzed carbonate esters and lithium in the electrolyte could combine to form Li2CO3 and the hydrolysable hexafluorophosphate was proven to be stable in the concentrated electrolyte (45 rpm/85 °C, 30 min). It was found that CO2, CO, CH4, and H2 were the primary pyrolysis gases, while the pyrolysis oil consisted of extremely flammable substances formed by the dissociation and recombination of chemical bonds in the electrolyte solvent. After pyrolysis at 300 °C, fluorine and phosphate were present in the form of sodium fluoride and sodium phosphate. The stability of the residue was enhanced, and the environmental risk was reduced. By adding alkali (KOH/Ca(OH)2, 20 %), hexafluorophosphate in the electrolyte was transformed into fluoride and phosphate in the residue, thereby reducing the device's corrosion from fluorine-containing gas. This study provides a viable approach for managing the residual electrolyte in the waste lithium battery recovery process.

First Report of Two-stage Living Donor Liver Transplantation to Avoid Futility and Ensure Double Equipoise in Acute Liver Failure Complicated by Toxic Liver Syndrome.

Acute hepatic failure may occasionally be complicated by toxic liver syndrome. Emergency hepatectomy for stabilization followed by delayed graft implantation is a recognized strategy in such cases in the setting of deceased donor liver transplantation. Living donor liver transplantation adds additional complexity to this scenario as the donor liver is a directed donation and failure to stabilize the patient after emergency hepatectomy can lead to a futile live donor hepatectomy, hepar-divisum, or an orphan graft. We report a case where the two-stage strategy was utilized to circumvent this situation. A patient with toxic liver syndrome underwent emergency hepatectomy and was closely monitored in the operating theater. A live donor hepatectomy was started after the recipient demonstrated cardiovascular and neurological stabilization. Graft implantation was completed after an anhepatic period of 9.45 h. To our knowledge, this is the first reported instance of using the two-stage strategy in living-donor-liver-transplantation for toxic liver syndrome to prevent futile donor surgery and achieve double equipoise.

Mingjing granule inhibits the subretinal fibrovascular membrane of two-stage laser-induced neovascular age-related macular degeneration in rats.

Objective: The study aims to investigate the protective effect of Mingjing granule (MG) in a fibrovascular membrane rat model of neovascular age-related macular degeneration (nAMD) and explore the underlying mechanism. Methods: The nAMD fibrovascular membrane model was established by two-stage laser photocoagulation. BN rats were randomly divided into four groups: the model group was gavaged with distilled water, the anti-VEGF group was given an intravitreous injection of ranibizumab, the MG + anti-VEGF group was gavaged with MG combined with an intravitreous injection of ranibizumab, and the normal group not modeled only fed conventionally. Lesions were evaluated by color fundus photograph, optical coherence tomography, fundus fluorescein angiography, and retinal pigment epithelial-choroid-sclera flat mount. The changes in the retinal structure were observed by histopathology. The expression of inflammatory cell markers F4/80, Iba-1, and glial fibrillary acidic protein (GFAP); the fibrosis-related factors collagen-1, fibronectin, α-smooth muscle actin (α-SMA), and transforming growth factor-beta (TGF-ß); and the complement system-related factors C3a and C3aR in the retina were detected by immunofluorescence or qRT-PCR. Results: The current study revealed that MG + anti-VEGF administration more significantly reduced the thickness of fibrovascular lesions, suppressed vascular leakage (exudation area and mean density value), inhibited the area of fibrovascular lesions, and restrained the formation of the fibrovascular membrane than the anti-VEGF agent alone in the two-stage laser-induced rat model. The fluorescence intensities of F4/80, Iba-1, collagen-1, fibronectin, TGF-ß, and C3aR showed more significant inhibition in MG + anti-VEGF-treated rats than the anti-VEGF agent alone. The mRNA expression levels of F4/80, Iba-1, GFAP, collagen-1, fibronectin, α-SMA, TGF-ß, and C3a showed lower levels in rats treated with MG + anti-VEGF than the anti-VEGF agent alone. Conclusion: Combining MG with anti-VEGF treatment inhibits the growth of the fibrovascular membrane more effectively than using anti-VEGF treatment alone. The mechanism underlying this effect may involve limiting inflammatory cell aggregation, controlling complement system activation, and decreasing the expression of the fibrotic protein.

Modulating metabolism through synthetic biology: Opportunities for two-stage fermentation.

Bio-based production of fuels, chemicals and materials is needed to replace current fossil fuel based production. However, bio-based production processes are very costly, so the process needs to be as efficient as possible. Developments in synthetic biology tools has made it possible to dynamically modulate cellular metabolism during a fermentation. This can be used towards two-stage fermentations, where the process is separated into a growth and a production phase, leading to more efficient feedstock utilization and thus potentially lower costs. This article reviews the current status and some recent results in application of synthetic biology tools towards two-stage fermentations, and compares this approach to pre-existing ones, such as nutrient limitation and addition of toxins/inhibitors.

Degradation of Waste Tetra Pak Packaging with Hydrothermal Treatment in Sub-/Supercritical Water.

Tetra pak packaging is one of the most frequently used types of packaging in the food industry. The recycling of the tetra pak packaging waste presents a difficult task because of its multi-layered, multi-component structure. In this study, the degradation of tetra pak packaging in subcritical (SubCW) and supercritical (SCW) water was investigated. The experiments were carried out in one (SCW) or two stages (SubCW and SCW), whereby the influence of the reaction temperature and time on the yield and composition of the products obtained was investigated. The maximum oil phase yield achieved in a one-stage and a two-stage degradation process was 60.7% and 65.5%, respectively. The oil and gas phases were composed of different types of hydrocarbons. Higher temperature and longer time led to higher amounts of saturated aliphatic hydrocarbons in both the oil and gas phases. The aqueous phase contained sugars (glucose, fructose) and sugar derivatives (levulinic acid, glyceraldehyde, furfurals). Based on these results, the degradation pathway of waste tetra pak packaging in SubCW and SCW was proposed. The results of the study show that the degradation of waste tetra pak packaging with SubCW and SCW is a promising recycling process.

Sequential two-stage cultivation system using novel microalga consortia for treatment of municipal wastewater and simultaneous biomass production: Sustainable environmental management.

Monoculture-based microalgae cultivation systems to treat wastewater are well-reported. Despite that, this method has some limitations in terms of nutrient removal potential, environment adaptation, and low biomass productivity. Conversely, microalgae co-cultivation and a two-stage sequential cultivation system (TSSCS) recently emerged as a promising approach to improve the treatment process and biomass productivity through better adaptation to the environment. However, no outdoor large-scale experiments were reported using this approach which hinders the viability of the process. Thus, in the present study, a sequential two-stage large-scale outdoor novel microalgae consortia experiment was developed. In first stage consortia-assisted sequential cultivation, two ratios of Tetraselmis indica (TS) and one ratio of Picochlorum sp. (PC) (2 TS:1 PC) were cultivated in a 1000-L pond containing 75%-municipal wastewater (MWW) + 25%-ASN-III, while in the second stage, 2 PC:1 TS was cultivated in two different ponds, and each containing 375-L 2 TS:1 PC-treated water + 375-L ASN-III. Outdoor parameters and nutrient removal efficiency (NRE), biomass, and biomolecule productivity such as lipid, photosynthetic pigments, astaxanthin, and ß-carotene were quantified, and cost analysis was performed. At the end of the first and second stages, 2 TS:1 PC and 2 PC:1 TS showed maximum NRE of COD (68.71 and 86.40%), TN (66.98 and 94.73%), and TP (82.70 and 94.36%), respectively. Moreover, 2 TS:1 PC and 2 PC:1 TS Pond 1 and 2 produced maximum dry biomass production; 2.41 and ∼2.54 g/L contained lipid content; 36.89 and 34.90% that have 86.50 and 55.79% FAME content respectively. Similarly, 2 TS:1 PC and 2 PC:1 TS biomass exhibited valuable pigments production of astaxanthin i.e., 0.56 and 0.35 mg/g, and ß-carotene; 4.65 and 2.82 mg/g, respectively. The cost analysis suggested that only microalgal-based MWW treatment was unfeasible, while valorization of produced biomass into co-products could offset the operation costs and could allow the option for the microalgal-based sustainable approach for the treatment of MWW and recovery of valuable resources.

Two-stage surgery for large sacrococcygeal chordomas: How I do it.

Sacrococcygeal chordoma is a malignant, slow-growing, and locally aggressive bone tumor. A wide surgical margin is recommended to prevent local recurrence and metastasis. This disease tends to cause massive defects when rectal resection and sacrectomy are required. Therefore, soft tissue reconstruction is required and a pedicled vertical rectus abdominis muscle flap (VRAM) is a viable option. Important anatomical landmarks, advantages and limitations are discussed and the procedure is described step by step. This case report presents a two-stage operation with an anterior rectal resection and VRAM flap harvest followed by a complementary posterior approach with sacrectomy and soft tissue reconstruction: approach and results. The wound completely healed in six weeks. Three years after surgery, no local recurrence or distal metastasis was detected. This two-stage strategy presents a viable and safe option for large sacrococcygeal chordomas.

An improved meteorological variables-based aerosol optical depth estimation method by combining a physical mechanism model with a two-stage model.

A two-stage model integrating a spatiotemporal linear mixed effect (STLME) and a geographic weight regression (GWR) model is proposed to improve the meteorological variables-based aerosol optical depth (AOD) retrieval method (Elterman retrieval model-ERM). The proposed model is referred to as the STG-ERM model. The STG-ERM model is applied over the Beijing-Tianjin-Hebei (BTH) region in China for the years 2019 and 2020. The results show that data coverage increased by 39.0% in 2019 and 40.5% in 2020. Cross-validation of the retrieval results versus multi-angle implementation of atmospheric correction (MAIAC) AOD shows the substantial improvement of the STG-ERM model over earlier meteorological models for AOD estimation, with a determination coefficient (R2) of daily AOD of 0.86, root mean squared prediction error (RMSE) and the relative prediction error (RPE) of 0.10 and 36.14% in 2019 and R2 of 0.86, RMSE of 0.12 and RPE of 37.86% in 2020. The fused annual mean AOD indicates strong spatial variation with high value in south plain and low value in northwestern mountainous areas of the BTH region. The overall spatial seasonal mean AOD ranges from 0.441 to 0.586, demonstrating strongly seasonal variation. The coverage of STG-ERM retrieved AOD, as determined in this exercise by leaving out part of the meteorological data, affects the accuracy of fused AOD. The coverage of the meteorological data has smaller impact on the fused AOD in the districts with low annual mean AOD of less than 0.35 than that in the districts with high annual mean AOD of greater than 0.6. If available, continuous daily meteorological data with high spatiotemporal resolution can improve the model performance and the accuracy of fused AOD. The STG-ERM model may serve as a valuable approach to provide data to fill gaps in satellite-retrieved AOD products.

Exploration of MPSO-Two-Stage Classification Optimization Model for Scene Images with Low Quality and Complex Semantics.

Currently, complex scene classification strategies are limited to high-definition image scene sets, and low-quality scene sets are overlooked. Although a few studies have focused on artificially noisy images or specific image sets, none have involved actual low-resolution scene images. Therefore, designing classification models around practicality is of paramount importance. To solve the above problems, this paper proposes a two-stage classification optimization algorithm model based on MPSO, thus achieving high-precision classification of low-quality scene images. Firstly, to verify the rationality of the proposed model, three groups of internationally recognized scene datasets were used to conduct comparative experiments with the proposed model and 21 existing methods. It was found that the proposed model performs better, especially in the 15-scene dataset, with 1.54% higher accuracy than the best existing method ResNet-ELM. Secondly, to prove the necessity of the pre-reconstruction stage of the proposed model, the same classification architecture was used to conduct comparative experiments between the proposed reconstruction method and six existing preprocessing methods on the seven self-built low-quality news scene frames. The results show that the proposed model has a higher improvement rate for outdoor scenes. Finally, to test the application potential of the proposed model in outdoor environments, an adaptive test experiment was conducted on the two self-built scene sets affected by lighting and weather. The results indicate that the proposed model is suitable for weather-affected scene classification, with an average accuracy improvement of 1.42%.

Effect of Multiantibiotic-Loaded Bone Cement on the Treatment of Periprosthetic Joint Infections of Hip and Knee Arthroplasties-A Single-Center Retrospective Study.

BACKGROUND: Two-stage septic revision is the prevailing method for addressing late periprosthetic infections. Using at least dual-antibiotic-impregnated bone cement leads to synergistic effects with a more efficient elution of individual antibiotics. Recent data on the success rates of multiantibiotic cement spacers in two-stage revisions are rare. METHODS: We conducted a retrospective follow-up single-center study involving 250 patients with late periprosthetic hip infections and 95 patients with prosthetic knee infections who underwent septic two-stage prosthesis revision surgery between 2017 and 2021. In accordance with the antibiotic susceptibility profile of the microorganisms, a specific mixture of antibiotics within the cement spacer was used, complemented by systemic antibiotic treatment. All patients underwent preoperative assessments and subsequent evaluations at 3, 6, 9, 12, 18, and 24 months post operation and at the most recent follow-up. RESULTS: During the observation period, the survival rate after two-step septic revision was 90.7%. Although survival rates tended to be slightly lower for difficult-to-treat (DTT) microorganism, there was no difference between the pathogen groups (easy-to-treat (ETT) pathogens, methicillin-resistant staphylococci (MRS), and difficult-to-treat (DTT) pathogens). Furthermore, there were no differences between monomicrobial and polymicrobial infections. No difference in the survival rate was observed between patients with dual-antibiotic-loaded bone cement without an additional admixture (Copal® G+C and Copal® G+V) and patients with an additional admixture of antibiotics to proprietary cement. CONCLUSION: Employing multiple antibiotics within spacer cement, tailored to pathogen susceptibility, appears to provide reproducibly favorable success rates, even in instances of infections with DTT pathogens and polymicrobial infections.

Two-stage sparse multi-objective evolutionary algorithm for channel selection optimization in BCIs.

Background: Channel selection has become the pivotal issue affecting the widespread application of non-invasive brain-computer interface systems in the real world. However, constructing suitable multi-objective problem models alongside effective search strategies stands out as a critical factor that impacts the performance of multi-objective channel selection algorithms. This paper presents a two-stage sparse multi-objective evolutionary algorithm (TS-MOEA) to address channel selection problems in brain-computer interface systems. Methods: In TS-MOEA, a two-stage framework, which consists of the early and late stages, is adopted to prevent the algorithm from stagnating. Furthermore, The two stages concentrate on different multi-objective problem models, thereby balancing convergence and population diversity in TS-MOEA. Inspired by the sparsity of the correlation matrix of channels, a sparse initialization operator, which uses a domain-knowledge-based score assignment strategy for decision variables, is introduced to generate the initial population. Moreover, a Score-based mutation operator is utilized to enhance the search efficiency of TS-MOEA. Results: The performance of TS-MOEA and five other state-of-the-art multi-objective algorithms has been evaluated using a 62-channel EEG-based brain-computer interface system for fatigue detection tasks, and the results demonstrated the effectiveness of TS-MOEA. Conclusion: The proposed two-stage framework can help TS-MOEA escape stagnation and facilitate a balance between diversity and convergence. Integrating the sparsity of the correlation matrix of channels and the problem-domain knowledge can effectively reduce the computational complexity of TS-MOEA while enhancing its optimization efficiency.

Systematic review and meta-analysis of single-stage versus two-stage revision for periprosthetic joint infection after knee arthroplasty: a call for a randomised trial.

Purpose: Knee arthroplasty is an effective treatment for severe knee degeneration; however, periprosthetic joint infection (PJI) is one of its serious complications. Single- and two-stage revision are common treatments, but few studies have compared single- and two-stage revision for PJI after knee arthroplasty. This study aimed to compare the reinfection and reoperation rates of single- and two-stage revision through meta-analysis. Methods: The review process was conducted according to the PRISMA guidelines. We searched the PubMed, Medline, Embase and Cochrane Central Register of Controlled Trials databases for trials comparing single- and two-stage revision for PJI after knee arthroplasty from the respective inception dates to April 2023. Two researchers individually screened the studies, performed the literature quality evaluation and data extraction and used Stata 17 software for data analysis. Results: The meta-analysis showed that the reinfection rate was significantly lower in the single-stage revision group than in the two-stage revision group. While the reoperation rates demonstrated no statistically significant difference between the two groups. We presented descriptive results because the discrepancies in the knee function scores and data reported in the studies meant that these data could not be combined in the meta-analysis. Conclusion: Based on the available research, single-stage revision is a reliable option for PJI after knee arthroplasty. However, when developing the best treatment strategy, it is still necessary to consider the individual circumstances and needs of the patient, as well as the risks of postoperative rehabilitation and complications.

Single versus two-stage management of long-bone chronic osteomyelitis in adults: a systematic review and meta-analysis.

BACKGROUND: Chronic osteomyelitis is a debilitating bone infection, characterized by a persistent infection over months to years, poses diagnostic and therapeutic challenges due to its insidious nature and potential for severe bone and soft tissue destruction. This systematic review and meta-analysis aims to review the literature on the treatment of chronic osteomyelitis in long bones and assess cure rates in single versus two-stage surgery. METHODS: Following the PRISMA guidelines and registered with PROSPERO (ID: CRD42021231237), this review included studies that reported on the management of chronic osteomyelitis in long bones using either a planned one-stage or two-stage surgical approach in adult patients. Databases searched included Medline, Embase, Web of Science, CINAHL, HMIC, and AMED, using keywords related to osteomyelitis, long bones, and surgical management. Eligibility criteria focused on adults with chronic osteomyelitis in long bones, with outcomes reported after a minimum follow-up of 12 months. The meta-analysis utilized the random-effects model to pool cure rates. RESULTS: The analysis included 42 studies with a total of 1605 patients. The overall pooled cure rate was 91% (CI 95%) with no significant difference observed between single-stage and two-stage surgeries (X2 = 0.76, P > 0.05). Complications were reported in 26.6% of cases in single-stage procedures and 27.6% in two-stage procedures, with prolonged wound drainage noted as a common issue. Dead space management techniques varied across studies, with antibiotic-loaded calcium sulphate beads used in 30.4% of cases. CONCLUSION: This meta-analysis reveals no significant difference in cure rates between single and two-stage surgical treatments for chronic osteomyelitis in long bones, supporting the efficacy of both approaches. The current treatment strategy should include a combination of debridement, dead space management using local and systematic antibiotics and soft tissue reconstruction if necessary.

Dominance Analysis for Latent Variable Models: A Comparison of Methods With Categorical Indicators and Misspecified Models.

Dominance analysis (DA) is a very useful tool for ordering independent variables in a regression model based on their relative importance in explaining variance in the dependent variable. This approach, which was originally described by Budescu, has recently been extended to use with structural equation models examining relationships among latent variables. Research demonstrated that this approach yields accurate results for latent variable models involving normally distributed indicator variables and correctly specified models. The purpose of the current simulation study was to compare the use of this DA approach to a method based on observed regression DA and DA when the latent variable model is estimated using two-stage least squares for latent variable models with categorical indicators and/or model misspecification. Results indicated that the DA approach for latent variable models can provide accurate ordering of the variables and correct hypothesis selection when indicators are categorical and models are misspecified. A discussion of implications from this study is provided.

Prevention of the Quality Degradation of Antarctic Krill (Euphausia superba) Meal through Two-Stage Drying.

To achieve a krill meal of high quality, a two-stage drying involving hot-air drying and vacuum drying was investigated. Five experimental groups were established according to the different drying conditions in the second stage, including 95 °C and 101 kPa, 95 °C and 60 kPa, 75 °C and 101 kPa, 75 °C and 60 kPa, and 75 °C and 20 kPa. The results showed that reducing the drying temperature and vacuum pressure in the second stage had a significant impact on the drying characteristics, sensory quality, and bioactive compounds of krill meal. Among all five groups, the drying condition of 75 °C and 60 kPa maintained a high drying rate while preserving a phospholipid content of 30.01 mg/kg and an astaxanthin content of 37.41 mg/kg. It also effectively reduced the isomerization of astaxanthin and the oxidation of unsaturated fatty acids. These results suggested that the two-stage drying method may contribute to the production of high-quality krill meal.

Determination of submicron aerosols effective density using two-stage low-pressure impactor and aerosol electrometer based on pre-measured particle size distribution.

A novel methodology was presented for determining the representative effective density of aerosols of a given size distribution, using a lab-made two-stage low-pressure impactor and an aerosol electrometer. Electrical currents upstream (Imeasured, up) and downstream (Imeasured, down) of the 2nd stage of the impactor were measured using a corona charger and the aerosol electrometer. In addition, the electrical currents upstream (Icalculated, up) and downstream (Icalculated, down) of the 2nd stage of the impactor were calculated using the aerosol charging theory. Then, the difference between the ratio of Imeasured,down to Imeasured,up and the ratio of Icalculated,down to Icalculated,up was iterated with varying the presumed effective density until the difference was smaller than 0.001. The methodology was validated using poly-disperse sodium chloride (NaCl) particles. The effective densities of ambient aerosols were then obtained from indoor and outdoor environments and compared with those calculated from a relation between mobility (scanning mobility particle sizer (SMPS) measurement) and aerodynamic (electrical low-pressure impactor (ELPI) measurement) diameters. Compared to the effective densities obtained with SMPS and ELPI measurements, the effective densities obtained using the methodology introduced in this paper differed within 10 % deviation, depending on measurement location. After an averaged effective density for given size distribution is obtained at a measurement location, the number-based size distribution can be easily converted to mass-based size distribution using the representative effective density.

Effect of two-stage low-temperature tempering process assisted by electrostatic field application on physicochemical and structural properties of myofibrillar protein in frozen longissimus dorsi of tan mutton.

The effects of refrigerator tempering, two-stage low-temperature tempering (TLT), and a combination of TLT with electrostatic field tempering (TLT-1500/2000/2500/3000) on the physicochemical and structural properties of the myofibrillar protein (MPs) in Longissimus dorsi of Tan mutton were investigated. The results from differential scanning calorimetry and dynamic rheology indicated that TLT-2000/2500 had the least impact on the thermal stability of MPs. While the carbonyl and dityrosine contents of MPs in TLT-2000/2500 were the lowest, the total sulfhydryl content and Ca2+-ATPase activity were the highest, suggesting that TLT-2000/2500 preserved the properties of MPs more effectively. The smaller and uniformly distributed particle size, highest zeta potential, and SDS-PAGE analysis confirmed that TLT-2000/2500 had minimal impact on the aggregation and degradation of MPs. Additionally, results from surface hydrophobicity, Fourier transform infrared spectroscopy, intrinsic fluorescence, and UV second-derivative absorption spectra suggested that TLT-2000/2500 was more conducive to stabilizing the primary, secondary, and tertiary structures of MPs.

Likelihood based inferences for trials incorporating participant's treatment choice.

Randomized clinical trials are the gold standard for clinical trials as they reduce bias and minimize variability between different arms of a study. One of the drawbacks of these designs is their lack of flexibility to incorporate participant's treatment choice, which may reduce recruitment rates and/or reduce participant's tolerance if they receive a non-preferred treatment. Designs incorporating choice allow a subset of participants to choose their preferred treatment. Most of the current methods to analyze these types of designs are based on an ANOVA approach that do not allow for inclusion of covariates in the model. In this paper, we propose an alternative approach based on likelihood methods that can be used with a broad class of distributions and allow for inclusion of covariates and multiple study arms in the model. Using simulations, we evaluate these methods for a variety of continuous and categorical outcomes. Finally, we illustrate these methods by analyzing change in six minute walking distance from a behavioral intervention study for women with heart disease.