Phosphorylating Proteins to Replace Casein in Cheese Analogs**

Casein is a unique protein in milk that binds to calcium, fat, and water to make micelles, which form cheese curds. Casein is unlike any other protein because of its unique ability to provide structure and give specific rheological properties to cheese; however, the production of casein is resource intensive and a common allergen. Cheese analogs provide a food source that is less burdensome on the environment and thus more sustainable. Most imitation cheeses incorporate casein because of its unique properties. In order to make an imitation cheese that does not contain casein, phosphorylating substitute proteins could allow for the protein to behave like casein in cheese production. On top of producing a product that can be consumed by those with a casein allergy, using substitute proteins would make production less resource intensive and therefore better for the environment and less expensive

Parenting stress among child welfare involved families: Differences by child placement

The intersection of parenting stress and maltreatment underscores the importance of understanding the factors associated with parenting stress among child welfare involved families. This study takes advantage of a statewide survey of child welfare involved families to examine parent and child characteristics and concrete resources, in relation to parenting stress. Separate multivariate analyses were conducted by placement status given the difference in day-to-day parenting responsibilities for families receiving in-home supervision compared to those whose children are in out-of-home care. Across both groups, parenting stress was predicted by child mental health, a finding with critical implications for intervention to this vulnerable group of families. Parent mental health also predicted parenting stress for the in-home group and food insecurity predicted parenting stress in the out-of-home group. Findings confirm that stress varies by context and that a multi-dimensional framework, considering both psychosocial and concrete resources, is required to capture contributors to parenting stress

Empagliflozin in Patients with Chronic Kidney Disease

Background The effects of empagliflozin in patients with chronic kidney disease who are at risk for disease progression are not well understood. The EMPA-KIDNEY trial was designed to assess the effects of treatment with empagliflozin in a broad range of such patients. Methods We enrolled patients with chronic kidney disease who had an estimated glomerular filtration rate (eGFR) of at least 20 but less than 45 ml per minute per 1.73 m(2) of body-surface area, or who had an eGFR of at least 45 but less than 90 ml per minute per 1.73 m(2) with a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of at least 200. Patients were randomly assigned to receive empagliflozin (10 mg once daily) or matching placebo. The primary outcome was a composite of progression of kidney disease (defined as end-stage kidney disease, a sustained decrease in eGFR to < 10 ml per minute per 1.73 m(2), a sustained decrease in eGFR of & GE;40% from baseline, or death from renal causes) or death from cardiovascular causes. Results A total of 6609 patients underwent randomization. During a median of 2.0 years of follow-up, progression of kidney disease or death from cardiovascular causes occurred in 432 of 3304 patients (13.1%) in the empagliflozin group and in 558 of 3305 patients (16.9%) in the placebo group (hazard ratio, 0.72; 95% confidence interval [CI], 0.64 to 0.82; P < 0.001). Results were consistent among patients with or without diabetes and across subgroups defined according to eGFR ranges. The rate of hospitalization from any cause was lower in the empagliflozin group than in the placebo group (hazard ratio, 0.86; 95% CI, 0.78 to 0.95; P=0.003), but there were no significant between-group differences with respect to the composite outcome of hospitalization for heart failure or death from cardiovascular causes (which occurred in 4.0% in the empagliflozin group and 4.6% in the placebo group) or death from any cause (in 4.5% and 5.1%, respectively). The rates of serious adverse events were similar in the two groups. Conclusions Among a wide range of patients with chronic kidney disease who were at risk for disease progression, empagliflozin therapy led to a lower risk of progression of kidney disease or death from cardiovascular causes than placebo