Changes in Creep Behaviour and Microstructure of Model Mozzarella Cheese During Working

The effect of shear work input on the microstructure, fat particle size and creep behavior of model Mozzarella type cheeses was studied. Cheese samples were prepared in a twin screw cooker at 70 °C by mixing protein and fat phases together with different amounts of shear work input. Major changes in cheese structure were observed while working at 150 rpm and 250 rpm screw speeds. Confocal microstructures plus macroscopic observations showed systematic changes in structure with increased shear work inputs with unmixed buttery liquid observed at kg−1, typical Mozzarella type microstructures (elongated fat-serum channels) at 6–15 kJ kg−1 and homogeneously distributed, small size fat droplets at \u3e58 kJ kg−1. At very high shear work inputs, \u3e 75 kJ kg−1, striations or anisotropy in the microstructures had disappeared and small micro-cracks were evident. A 4-element Burger\u27s model was found adequate for fitting the creep data of model cheese at 70 °C but a 6-element model was required at 20 °C. As shear work input increased retarded compliance decreased and zero shear viscosity increased indicating the more elastic behavior of the cheeses with higher shear work input. Changes in the protein matrix appear to be the main reason for increased elastic behavior

Effect of Shear Work Input on Steady Shear Rheology and Melt Functionality of Model Mozzarella Cheeses

Model Mozzarella cheeses with varied amounts of shear work input were prepared by working molten cheese mass at 70 °C in a twin screw cooker. Rheology and melt functionality were found to be strongly dependent on total shear work input. A non-linear increase in consistency coefficient (K from power law model) and apparent viscosity and decrease in flow behaviour index (n from power law model) were observed with increasing amounts of accumulated shear work, indicating work thickening behaviour. An exponential work thickening equation is proposed to describe this behaviour. Excessively worked cheese samples exhibited liquid exudation, poor melting and poor stretch. Nonfat cheese exhibited similar but smaller changes after excessive shear work input. We concluded that the dominant contributor to the changes in properties with increased shear work was shear induced structural changes to the protein matrix. A good correlation was found between the steady shear rheological properties and the melting properties of the cheeses

Strain Hardening and Anisotropy During Tensile Testing of Sheared Model Mozzarella Cheeses

We studied the tensile fracture properties of model Mozzarella cheeses with varying amounts of shear work input (3.3–73.7 kJ/kg). After manufacture, cheeses were elongated by manual rolling at 65°C followed by tensile testing at 21°C on dumbbell-shaped samples cut both parallel and perpendicular to the rolling direction. Strain hardening parameters were estimated from stress–strain curves using 3 different methods. Fracture stress and strain for longitudinal samples did not vary significantly with shear work input up to 26.3 kJ/kg and then decreased dramatically at 58.2 kJ/kg. Longitudinal samples with shear work input \u3c30 kJ/kg demonstrated significant strain hardening by all 3 estimation methods. At shear work inputs \u3c30 kJ/kg, strong anisotropy was observed in both fracture stress and strain. After a shear work input of 58.2 kJ/kg, anisotropy and strain hardening were absent. Perpendicular samples did not show strain hardening at any level of shear work input. Although the distortion of the fat drops in the cheese structure associated with the elongation could account for some of the anisotropy observed, the presence of anisotropy in the elongated nonfat samples reflected that shear work and rolling also aligned the protein structure

Measurement Techniques for Steady Shear Viscosity of Mozzarella-Type Cheeses at High Shear Rates and High Temperature

While measuring steady shear viscosity of Mozzarella-type cheeses in a rotational rheometer at 70 °C, three main difficulties were encountered; wall slip, structural failure during measurement and viscoelastic time dependent effects. Serrated plates were the most successful surface modification at eliminating wall slip. However, even with serrated plates shear banding occurred at higher shear rates. Because of the viscoelastic nature of the cheeses, a time dependent viscous response occurred at shear rates \u3c1 \u3es−1, requiring longer times to attain steady shear conditions. Prolonged continuous shearing altered the structure of the molten cheeses. The effects of structural change were greatly reduced by minimising the total accumulated strain exerted on the sample during flow curve determination. These techniques enabled successful measurement of steady shear viscosity of molten Mozzarella-type cheeses at 70 °C at shear rates up to 250 s−1

Convenient synthesis of EDOT-based dyes by CH-activation and their application as dyes in dye-sensitized solar cells

Precursors to three new 3,4-ethylenedioxythiophene (EDOT) incorportaing dyes have been synthesised via a one-pot C–H activation route using N,N-dimethylaniline as a donor group. We have extended this methodology to provide a convenient one-pot route to dye EDOT-Ph. The electrochemical and optical properties of the new dyes have been correlated with IV and EQE data for 1 cm2 dye-sensitized solar cell (DSSC) devices prepared using these dyes. The device data show that dye performance is strongly affected by the amount of chenodeoxycholic acid (CDCA) co-sorbent used. The best performance is for EDOT-Ph (η = 4.0%) at 10 mM CDCA compared to (η = 6.0% and η = 5.8%) for N719 and D205 control cells

Length of carotid stenosis predicts peri-procedural stroke or death and restenosis in patients randomized to endovascular treatment or endarterectomy.

BACKGROUND: The anatomy of carotid stenosis may influence the outcome of endovascular treatment or carotid endarterectomy. Whether anatomy favors one treatment over the other in terms of safety or efficacy has not been investigated in randomized trials. METHODS: In 414 patients with mostly symptomatic carotid stenosis randomized to endovascular treatment (angioplasty or stenting; n = 213) or carotid endarterectomy (n = 211) in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS), the degree and length of stenosis and plaque surface irregularity were assessed on baseline intraarterial angiography. Outcome measures were stroke or death occurring between randomization and 30 days after treatment, and ipsilateral stroke and restenosis ≥50% during follow-up. RESULTS: Carotid stenosis longer than 0.65 times the common carotid artery diameter was associated with increased risk of peri-procedural stroke or death after both endovascular treatment [odds ratio 2.79 (1.17-6.65), P = 0.02] and carotid endarterectomy [2.43 (1.03-5.73), P = 0.04], and with increased long-term risk of restenosis in endovascular treatment [hazard ratio 1.68 (1.12-2.53), P = 0.01]. The excess in restenosis after endovascular treatment compared with carotid endarterectomy was significantly greater in patients with long stenosis than with short stenosis at baseline (interaction P = 0.003). Results remained significant after multivariate adjustment. No associations were found for degree of stenosis and plaque surface. CONCLUSIONS: Increasing stenosis length is an independent risk factor for peri-procedural stroke or death in endovascular treatment and carotid endarterectomy, without favoring one treatment over the other. However, the excess restenosis rate after endovascular treatment compared with carotid endarterectomy increases with longer stenosis at baseline. Stenosis length merits further investigation in carotid revascularisation trials

Comparisons of depression, anxiety, well-being, and perceptions of the built environment amongst adults seeking social, intermediate and market-rent accommodation in the former London Olympic Athletes' Village.

The Examining Neighbourhood Activities in Built Living Environments in London (ENABLE London) study provides a unique opportunity to examine differences in mental health and well-being amongst adults seeking social, intermediate (affordable rent), and market-rent housing in a purpose built neighbourhood (East Village, the former London 2012 Olympic Athletes' Village), specifically designed to encourage positive health behaviours. Multi-level logistic regression models examined baseline differences in levels of depression, anxiety and well-being across the housing groups. Compared with the intermediate group, those seeking social housing were more likely to be depressed, anxious and had poorer well-being after adjustment for demographic and health status variables. Further adjustments for neighbourhood perceptions suggest that compared with the intermediate group, perceived neighbourhood characteristics may be an important determinant of depression amongst those seeking social housing, and lower levels of happiness the previous day amongst those seeking market-rent housing. These findings add to the extensive literature on inequalities in health, and provide a strong basis for future longitudinal work that will examine change in depression, anxiety and well-being after moving into East Village, where those seeking social housing potentially have the most to gain

A biomarker-stratified comparison of top-down versus accelerated step-up treatment strategies for patients with newly diagnosed Crohn's disease (PROFILE):a multicentre, open-label randomised controlled trial

Background: Management strategies and clinical outcomes vary substantially in patients newly diagnosed with Crohn's disease. We evaluated the use of a putative prognostic biomarker to guide therapy by assessing outcomes in patients randomised to either top-down (ie, early combined immunosuppression with infliximab and immunomodulator) or accelerated step-up (conventional) treatment strategies. Methods: PROFILE (PRedicting Outcomes For Crohn's disease using a moLecular biomarker) was a multicentre, open-label, biomarker-stratified, randomised controlled trial that enrolled adults with newly diagnosed active Crohn's disease (Harvey-Bradshaw Index ≥7, either elevated C-reactive protein or faecal calprotectin or both, and endoscopic evidence of active inflammation). Potential participants had blood drawn to be tested for a prognostic biomarker derived from T-cell transcriptional signatures (PredictSURE-IBD assay). Following testing, patients were randomly assigned, via a secure online platform, to top-down or accelerated step-up treatment stratified by biomarker subgroup (IBDhi or IBDlo), endoscopic inflammation (mild, moderate, or severe), and extent (colonic or other). Blinding to biomarker status was maintained throughout the trial. The primary endpoint was sustained steroid-free and surgery-free remission to week 48. Remission was defined by a composite of symptoms and inflammatory markers at all visits. Flare required active symptoms (HBI ≥5) plus raised inflammatory markers (CRP &gt;upper limit of normal or faecal calprotectin ≥200 μg/g, or both), while remission was the converse—ie, quiescent symptoms (HBI &lt;5) or resolved inflammatory markers (both CRP ≤ the upper limit of normal and calprotectin &lt;200 μg/g) or both. Analyses were done in the full analysis (intention-to-treat) population. The trial has completed and is registered (ISRCTN11808228). Findings: Between Dec 29, 2017, and Jan 5, 2022, 386 patients (mean age 33·6 years [SD 13·2]; 179 [46%] female, 207 [54%] male) were randomised: 193 to the top-down group and 193 to the accelerated step-up group. Median time from diagnosis to trial enrolment was 12 days (range 0–191). Primary outcome data were available for 379 participants (189 in the top-down group; 190 in the accelerated step-up group). There was no biomarker–treatment interaction effect (absolute difference 1 percentage points, 95% CI –15 to 15; p=0·944). Sustained steroid-free and surgery-free remission was significantly more frequent in the top-down group than in the accelerated step-up group (149 [79%] of 189 patients vs 29 [15%] of 190 patients, absolute difference 64 percentage points, 95% CI 57 to 72; p&lt;0·0001). There were fewer adverse events (including disease flares) and serious adverse events in the top-down group than in the accelerated step-up group (adverse events: 168 vs 315; serious adverse events: 15 vs 42), with fewer complications requiring abdominal surgery (one vs ten) and no difference in serious infections (three vs eight). Interpretation: Top-down treatment with combination infliximab plus immunomodulator achieved substantially better outcomes at 1 year than accelerated step-up treatment. The biomarker did not show clinical utility. Top-down treatment should be considered standard of care for patients with newly diagnosed active Crohn's disease. Funding: Wellcome and PredictImmune Ltd.</p

Quality of Health Care for Children in Australia, 2012-2013.

Importance: The quality of routine care for children is rarely assessed, and then usually in single settings or for single clinical conditions. Objective: To estimate the quality of health care for children in Australia in inpatient and ambulatory health care settings. Design, Setting, and Participants: Multistage stratified sample with medical record review to assess adherence with quality indicators extracted from clinical practice guidelines for 17 common, high-burden clinical conditions (noncommunicable [n = 5], mental health [n = 4], acute infection [n = 7], and injury [n = 1]), such as asthma, attention-deficit/hyperactivity disorder, tonsillitis, and head injury. For these 17 conditions, 479 quality indicators were identified, with the number varying by condition, ranging from 9 for eczema to 54 for head injury. Four hundred medical records were targeted for sampling for each of 15 conditions while 267 records were targeted for anxiety and 133 for depression. Within each selected medical record, all visits for the 17 targeted conditions were identified, and separate quality assessments made for each. Care was evaluated for 6689 children 15 years of age and younger who had 15 240 visits to emergency departments, for inpatient admissions, or to pediatricians and general practitioners in selected urban and rural locations in 3 Australian states. These visits generated 160 202 quality indicator assessments. Exposures: Quality indicators were identified through a systematic search of local and international guidelines. Individual indicators were extracted from guidelines and assessed using a 2-stage Delphi process. Main Outcomes and Measures: Quality of care for each clinical condition and overall. Results: Of 6689 children with surveyed medical records, 53.6% were aged 0 to 4 years and 55.5% were male. Adherence to quality of care indicators was estimated at 59.8% (95% CI, 57.5%-62.0%; n = 160 202) across the 17 conditions, ranging from a high of 88.8% (95% CI, 83.0%-93.1%; n = 2638) for autism to a low of 43.5% (95% CI, 36.8%-50.4%; n = 2354) for tonsillitis. The mean adherence by condition category was estimated as 60.5% (95% CI, 57.2%-63.8%; n = 41 265) for noncommunicable conditions (range, 52.8%-75.8%); 82.4% (95% CI, 79.0%-85.5%; n = 14 622) for mental health conditions (range, 71.5%-88.8%); 56.3% (95% CI, 53.2%-59.4%; n = 94 037) for acute infections (range, 43.5%-69.8%); and 78.3% (95% CI, 75.1%-81.2%; n = 10 278) for injury. Conclusions and Relevance: Among a sample of children receiving care in Australia in 2012-2013, the overall prevalence of adherence to quality of care indicators for important conditions was not high. For many of these conditions, the quality of care may be inadequate