Spray drying and ultrasonication processing of camel whey protein concentrate: Characterization and impact on bioactive properties.

The production of whey protein concentrates (WPCs) from camel milk whey represents an effective approach to valorize this processing by-product. These concentrates harbor active ingredients with significant bioactive properties. Camel WPCs were spray-dried (SD) at inlet temperature of 170, 185 and 200°C, or Ultrasonicated (US) for 5, 10 and 15 min, then freeze-dried to obtain fine powder. The impact of both treatments on protein degradation was studied by sodium dodecyl sulfate-PAGE and reverse-phase ultraperformance liquid chromatography (RP-UPLC) techniques. Significantly enhanced protein degradation was observed after US treatment when compared with SD. Both SD and US treatments slightly enhanced the WPCs samples' antioxidant activities. The US exposure for 15 min exhibited highest 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) scavenging activity (12.12 mmol TE/g). Moreover, US treatment for 10 min exhibited the highest in vitro anti-diabetic properties (α-amylase and α-glucosidase inhibition), and dipeptidyl-peptidase-IV inhibitory activity among all samples. In addition, the ultrasonication for 10 min and SD at 170°C showed the lowest IC50 values for in vitro anti-hypercholesterolemic activities in terms of pancreatic lipase and cholesteryl esterase inhibition. Conclusively, these green techniques can be adapted in the preservation and processing of camel milk whey into active ingredients with high bioactive properties.

Foaming properties of milk samples collected at various processing stages in a dairy processing factory across two seasons.

BACKGROUND: A foam layer makes an essential contribution to the quality of cappuccino-style drinks. Poor foaming of milk occurs quite often, however, especially in summer. The reasons for this are still unknown. Although a substantial number of studies on the foaming process of milk have been reported, these studies have been laboratory based and have used laboratory or pilot-scale equipment to simulate the processing conditions of a dairy processing factory. This study collected about 40 different samples across different processing stages in a dairy factory over two seasons (two batches per season) and investigated their composition and physical and foaming properties by mechanical mixing and steam injection. RESULTS: The results showed that milk samples collected in summer had a significantly higher content of fat, free fatty acids, and Ca2+ ions, and larger particle sizes but a markedly lower concentration of protein and solid non-fat, and surface tension than the samples collected in spring. These differences provided spring milk with a higher steam injection foamability than summer milk. However, steam injection foam stability, and mechanical mixing foamability and foam stability were not affected by seasonal factors. Milk samples collected in different batches within a season were almost identical with regard to the properties that were investigated. CONCLUSION: The variations in composition and physical properties of milk collected between two seasons could be the reasons for their difference in foamability but not for foam stability. Processes such as standardization, homogenization, and pasteurization improved markedly the foaming properties of milk. © 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Algorithms for Treating Dyslipidemia in Youth.

PURPOSE OF REVIEW: The goal of this article is to review algorithms for treating dyslipidemia in youth, discuss pitfalls, propose enhanced algorithms to address pitfalls, and consider future directions. RECENT FINDINGS: The presence of modifiable and non-modifiable cardiovascular disease (CVD) risk factors during childhood is associated with CVD-related events in adulthood. Recent data has shown that childhood initiation of statin therapy in youth < 18 years of age with familial hypercholesterolemia reduces the risk of adult CVD. However, pediatric dyslipidemia remains undertreated in part due to a lack of primary health care providers with adequate understanding of screening guidelines and pediatric lipidologists with experience in treatment and follow-up of this unique population. Management algorithms have been published by the National Heart, Lung, and Blood Institute and American Heart Association as tools to empower clinicians to manage dyslipidemia. We propose enhanced algorithms, which incorporate recently approved pharmacotherapy to address the management gaps. Future algorithms based upon clinical risk scores may enhance treatment and improve outcomes. Algorithms for dyslipidemia management which target youth < 18 years of age are tools which empower clinicians to manage dyslipidemia in this unique population. Enhanced algorithms may help address pitfalls. We acknowledge the need for further risk assessment tools in pediatrics for tailored dyslipidemia management.

Effect of shearing-induced lipolysis on foaming properties of milk.

BACKGROUND: The attraction of cappuccino-style beverages is attributed to the foam layer, as it greatly improves the texture, appearance, and taste of these products. Typical milk has a low concentration of free fatty acids (FFAs), but their concentration can increase due to lipolysis during processing and storage, which is detrimental to the foamability and foam stability of milk. There are contradictory results in reported studies concerning the effects of FFAs on the foaming properties of milk due to differences in milk sources, methods inducing lipolysis, and methods of creating foam. In this study, the foaming properties and foam structure of milk samples whose lipolysis was induced by ultra-turraxing, homogenisation, and microfluidisation (1.5-3.5 µ-equiv. mL-1 FFAs) were investigated. RESULTS: Compared with others, microfluidised milk samples had the smallest particle size, lowest absolute zeta potential, and highest surface tension; thus exhibited high foamability and foam stability, and very small and homogeneous air bubbles in foam structure. For all shearing methods, increasing FFA content from 1.5 to 3.5 µ-equiv. mL-1 markedly decreased the surface tension, foamability, and foam stability of milk samples. The FFA level that led to undesirable foam structure was 1.5 µ-equiv. mL-1 for ultra-turraxed milk samples and 2.5 µ-equiv. mL-1 for homogenised and microfluidised ones. CONCLUSION: Shearing-induced lipolysis greatly affected the physical properties of milk samples and subsequently their foaming properties and foam structure. At the same FFA level, lipolysis induced by microfluidisation was much less detrimental to the foaming properties of milk than lipolysis induced by ultra-turraxing and homogenisation. © 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Functionality of bovine milk proteins and other factors in foaming properties of milk: a review.

For many dairy products such as cappuccino-style beverages, the top foam layer determines the overall product quality (e.g. their appearance, texture, mouthfeel and coffee aroma release rate) and the consumer acceptance. Proteins in milk are excellent foaming agents, but the foaming properties of milk are greatly affected by several factors such as the protein content, ratio of caseins to whey proteins, casein micelle size, pH, minerals, proteolysis, presence of low molecular weight compounds (lipids and their hydrolyzed products) and high molecular weight compounds (polysaccharides); milk processing conditions (e.g. homogenization, heat treatment and aging); and foaming method and temperature. These factors either induce changes in the molecular structure, charge and surface activity of the milk proteins; or interfere and/or compete with milk proteins in the formation of highly viscoelastic film to stabilize the foam. Some factors affect the foamability while others determine the foam stability. In this review, functionality of milk proteins in the production and stabilization of liquid foam, under effects of these factors is comprehensively discussed. This will help to control the foaming process of milk on demand for a particular application, which still is difficult and challenging for researchers and the dairy industry.

Enhanced uptake of potassium or glycine betaine or export of cyclic-di-AMP restores osmoresistance in a high cyclic-di-AMP Lactococcus lactis mutant.

The broadly conserved bacterial signalling molecule cyclic-di-adenosine monophosphate (c-di-AMP) controls osmoresistance via its regulation of potassium (K+) and compatible solute uptake. High levels of c-di-AMP resulting from inactivation of c-di-AMP phosphodiesterase activity leads to poor growth of bacteria under high osmotic conditions. To better understand how bacteria can adjust in response to excessive c-di-AMP levels and to identify signals that feed into the c-di-AMP network, we characterised genes identified in a screen for osmoresistant suppressor mutants of the high c-di-AMP Lactococcus ΔgdpP strain. Mutations were identified which increased the uptake of osmoprotectants, including gain-of-function mutations in a Kup family K+ importer (KupB) and inactivation of the glycine betaine transporter transcriptional repressor BusR. The KupB mutations increased the intracellular K+ level while BusR inactivation increased the glycine betaine level. In addition, BusR was found to directly bind c-di-AMP and repress expression of the glycine betaine transporter in response to elevated c-di-AMP. Interestingly, overactive KupB activity or loss of BusR triggered c-di-AMP accumulation, suggesting turgor pressure changes act as a signal for this second messenger. In another group of suppressors, overexpression of an operon encoding an EmrB family multidrug resistance protein allowed cells to lower their intracellular level of c-di-AMP through active export. Lastly evidence is provided that c-di-AMP levels in several bacteria are rapidly responsive to environmental osmolarity changes. Taken together, this work provides evidence for a model in which high c-di-AMP containing cells are dehydrated due to lower K+ and compatible solute levels and that this osmoregulation system is able to sense and respond to cellular water stress.

Effect of camel milk protein hydrolysates against hyperglycemia, hyperlipidemia, and associated oxidative stress in streptozotocin (STZ)-induced diabetic rats.

This study investigated the effect of camel milk protein hydrolysates (CMPH) at 100, 500 and 1,000 mg/kg of body weight (BW) for 8 wk on hyperglycemia, hyperlipidemia, and associated oxidative stress in streptozotocin-induced diabetic rats. Body weights and fasting blood glucose levels were observed after every week until 8 wk, and oral glucose tolerance test (OGTT) levels and biochemical parameters were evaluated after 8 wk in blood and serum samples. Antioxidant enzyme activity and lipid peroxidation in the liver were estimated, and histological examination of the liver and pancreatic tissues was also conducted. Results showed that CMPH at 500 mg/kg of BW [camel milk protein hydrolysate, mid-level dosage (CMPH-M)] exhibited potent hypoglycemic activity, as shown in the reduction in fasting blood glucose and OGTT levels. The hypolipidemic effect of CMPH was indicated by normalization of serum lipid levels. Significant improvement in activity of superoxide dismutase and catalase, and reduced glutathione levels were observed, along with the attenuation of malondialdehyde content in groups fed CMPH, especially CMPH-M, was observed. Decreased levels of liver function enzymes (aspartate aminotransferase and alanine aminotransferase) in the CMPH-M group was also noted. Histology of liver and pancreatic tissue displayed absence of lipid accumulation in hepatocytes and preservation of ß-cells in the CMPH-M group compared with the diabetic control group. This is the first study to report anti-hyperglycemic and anti-hyperlipidemic effect of CMPH in an animal model system. This study indicates that CMPH can be suggested for its therapeutic benefits for hyperglycemia and hyperlipidemia, thus validating its use for better management of diabetes and associated comorbidities.

SARS-CoV-2 in human milk is inactivated by Holder pasteurisation but not cold storage.

AIM: As the COVID-19 pandemic evolves, human milk banks world-wide continue to provide donor human milk to vulnerable infants who lack access to mother's own milk. Under these circumstances, ensuring the safety of donor human milk is paramount, as the risk of vertical transmission of SARS-CoV-2 is not fully understood. Here, we investigate the inactivation of SARS-CoV-2 in human milk by pasteurisation and the stability of SARS-CoV-2 in human milk under cold storage. METHODS: SARS-CoV-2 was experimentally inoculated into human milk samples from healthy donors or into a control medium. Triplicates of each sample were layered onto uninfected cells after Holder pasteurisation (63°C for 30 min), heating to 56°C for 30 min, or after 48 h of storage at 4°C or -30°C. Infectious titres of virus were determined at 72 h post-infection by endpoint titration. RESULTS: Following heating to 63°C or 56°C for 30 min, replication competent (i.e. live) SARS-CoV-2 was undetected in both human milk and the control medium. Cold storage of SARS-CoV-2 in human milk (either at 4°C or -30°C) did not significantly impact infectious viral load over a 48 h period. CONCLUSION: SARS-CoV-2 is effectively inactivated by Holder pasteurisation, suggesting that existing milk bank processes will effectively mitigate the risk of transmission of SARS-COV-2 to vulnerable infants through pasteurised donor human milk. The demonstrated stability of SARS-CoV-2 in refrigerated or frozen human milk may assist in the development of guidelines around safe expressing and storing of milk from COVID-19 infected mothers.

Improving transparency and scientific rigor in academic publishing.

Progress in basic and clinical research is slowed when researchers fail to provide a complete and accurate report of how a study was designed, executed, and the results analyzed. Publishing rigorous scientific research involves a full description of the methods, materials, procedures, and outcomes. Investigators may fail to provide a complete description of how their study was designed and executed because they may not know how to accurately report the information or the mechanisms are not in place to facilitate transparent reporting. Here, we provide an overview of how authors can write manuscripts in a transparent and thorough manner. We introduce a set of reporting criteria that can be used for publishing, including recommendations on reporting the experimental design and statistical approaches. We also discuss how to accurately visualize the results and provide recommendations for peer reviewers to enhance rigor and transparency. Incorporating transparency practices into research manuscripts will significantly improve the reproducibility of the results by independent laboratories.

Use of gases in dairy manufacturing: A review.

Use of gases (air, carbon dioxide and nitrogen) has been practiced in the manufacture of dairy products (i.e., ice cream, whipped cream and butter) to improve their texture, mouthfeel and shelf-life extension. Many attempts have also been made to incorporate other gases such as hydrogen, nitrous oxide, argon, xenon, and helium into the dairy systems for various product functionalities such as whipping, foaming, texture, aroma enhancement, and therapeutic properties. The gases can be dissolved in aqueous and fat phases or remain in the form of bubbles stabilized by protein or fat particles. The gas addition or infusion processes are typically simple and have been used commercially. This review focuses on the use of various gases in relation to their individually physical properties along with their specific roles in manufacturing and controlling quality of dairy products. It also recaps on how gases are included in the dairy systems. The information is important in understanding of addition of specific gas(es) into food systems, particularly dairy products, that potentially provide intervention opportunities for modifying and/or creating innovative food structures and functionalities.

Cyclic-di-AMP synthesis by the diadenylate cyclase CdaA is modulated by the peptidoglycan biosynthesis enzyme GlmM in Lactococcus lactis.

The second messenger cyclic-di-adenosine monophosphate (c-di-AMP) plays important roles in growth, virulence, cell wall homeostasis, potassium transport and affects resistance to antibiotics, heat and osmotic stress. Most Firmicutes contain only one c-di-AMP synthesizing diadenylate cyclase (CdaA); however, little is known about signals and effectors controlling CdaA activity and c-di-AMP levels. In this study, a genetic screen was employed to identify components which affect the c-di-AMP level in Lactococcus. We characterized suppressor mutations that restored osmoresistance to spontaneous c-di-AMP phosphodiesterase gdpP mutants, which contain high c-di-AMP levels. Loss-of-function and gain-of-function mutations were identified in the cdaA and gdpP genes, respectively, which led to lower c-di-AMP levels. A mutation was also identified in the phosphoglucosamine mutase gene glmM, which is commonly located within the cdaA operon in bacteria. The glmM I154F mutation resulted in a lowering of the c-di-AMP level and a reduction in the key peptidoglycan precursor UDP-N-acetylglucosamine in L. lactis. C-di-AMP synthesis by CdaA was shown to be inhibited by GlmM(I154F) more than GlmM and GlmM(I154F) was found to bind more strongly to CdaA than GlmM. These findings identify GlmM as a c-di-AMP level modulating protein and provide a direct connection between c-di-AMP synthesis and peptidoglycan biosynthesis.

Alginate gel particles-A review of production techniques and physical properties.

The application of hydrocolloid gel particles is potentially useful in food, chemical, and pharmaceutical industries. Alginate gel particles are one of the more commonly used hydrocolloid gel particles due to them being biocompatible, nontoxic, biodegradable, cheap, and simple to produce. They are particularly valued for their application in encapsulation. Encapsulation in alginate gel particles confers protective benefits to cells, DNA, nutrients, and microbes. Slow release of flavors, minerals, and drugs can also be achieved by encapsulation in gel particles. The particle size and shape of the gel particles are crucial for specific applications. In this review, current methods of producing alginate gel particles will be discussed, taking into account their advantages, disadvantages, scalability, and impact on particle size. The physical properties of alginate gel particles will determine the effectiveness in different application conditions. This review will cover the current understanding of the alginate biopolymer, gelation mechanisms and factors affecting release properties, gel strength, and rheology of the alginate gel particle systems.

Evaluation of tilapia skin gelatin as a mammalian gelatin replacer in acid milk gels and low-fat stirred yogurt.

Tilapia skin gelatin (TSG) was studied in a 3-stage process (cooling, annealing, and heating) for pure gelatin gels and in a 4-stage process (acidification, cooling, annealing, and heating) for acid milk gels and cultured yogurt. The aim was to evaluate the use of TSG as a replacement for mammalian gelatin in yogurt. In pure TSG gels, stronger gels with higher melting temperatures were formed with increasing TSG concentrations. Compared with bovine gelatin (BG), which gelled at a concentration of 2.5%, TSG gels had lower gelling (14.1°C) and melting (24°C) temperatures but comparable storage moduli during annealing. In acid milk gels, addition of TSG increased the firmness of the gels with increasing concentration. Gelling and melting points of TSG in milk gels were observed at sufficient concentrations during cooling and heating. Strands and sheets were observed in the electron micrographs of milk gels with 1% TSG and a very dense structure was observed with 2.5% TSG. Yogurt with 0.4% TSG had similar viscosity, consistency, pseudoplasticity, and thixotropy as yogurt containing 0.4% BG; no difference was perceived by sensory panelists according to a triangle test. Addition of 0.4% TSG completely prevented whey separation from the acid milk gel and yogurt. The results suggest that TSG could be a suitable replacement for mammalian gelatin in low-fat stirred yogurt.

Psychosocial aspects of type 1 diabetes in Latino- and Asian-American youth.

Latino and Asian-Americans represent the fastest growing immigrant populations in the United States. We aimed to review the current knowledge on the psychosocial factors that influence type 1 diabetes (T1D) care, education, and outcomes in Latino and Asian-American youth immigrants in the United States, as well as culturally sensitive programs to address health disparities. We conducted a narrative, conceptual review of studies on T1D in Latino and Asian-American youth and relevant studies in type 2 diabetes and adults. Approximately 50% of both Latino and Asian-American youth with T1D are in suboptimal glycemic control. Socioeconomic status, literacy, English proficiency, acculturation, access to health care, family functioning, mental health, and nutrition influence T1D care and outcomes. However, the degree to which these complex, inter-related and dynamic factors affect long-term T1D outcomes is largely unknown. Culturally sensitive programs for Latino or Asian-American youth with T1D are scarce in the United States. Research is needed among Latino and Asian-American youth with T1D so that comprehensive, culturally sensitive diabetes education, and care programs can be developed to decrease disparities in the health burden of these groups.

A Case of Reversible Cardiomyopathy Managed Successfully.

Cardiomyopathy accounts for 0.7% of cardiac deaths in the United States. Dilated cardiomyopathy as the primary manifestation of hyperthyroidism is a rare phenomenon. Presenting the case of a middle-aged African American woman with a history of hypertension and asthma, who experienced progressive shortness of breath. Extensive work-up revealed dilated cardiomyopathy with hyperfunctioning thyroid gland that responded well to antithyroid therapy. An interval echocardiogram showed significant reversal of cardiac dysfunction. The reversible nature of this disease entity was again proven when the patient was successfully treated for heart failure for the second time a few months later and was again found to have normalization of cardiomyopathic changes.

Life-threatening metabolic coma caused by levofloxacin.

Patients with diabetes mellitus are often susceptible to hypoglycemic episodes while on therapy. Most of these are attributed to inappropriate dosing of hypoglycemic agents, dietary indiscretion, or acute illness. Medications being used concomitantly should be reviewed closely when the etiology of hypoglycemia is unclear. A fifty-six-year-old woman with a history of diabetes mellitus (on metformin monotherapy) was found unresponsive at home. Her fingerstick glucose was 15 mg/dL for which she received 50% dextrose intravenously. The patient never had any previous documented hypoglycemic episodes. She had recently been diagnosed with pneumonia and was prescribed oral levofloxacin therapy. The patient had taken 4 doses of levofloxacin before the onset of hypoglycemia. These episodes recurred over the next 2 days needing close intensive care unit monitoring, dextrose infusion, and glucagon administration. Basic blood/urine investigations, cortisol and thyroid profile were normal except for low blood glucose and renal insufficiency (serum creatinine 1.4 mg/dL and creatinine clearance 42 mL/min). HbA1c was 6.8% (4.4%-6.4%), insulin 51.3 µU/mL (2.6-24.9 µU/mL), IGF-1 301 ng/mL (27-223 ng/mL), and C peptide 9.3 ng/mL (0.8-3.5 ng/mL). These levels were elevated but were deemed nondiagnostic because of fluctuating glucose values after glucagon administration. A blood screen for sulfonylureas and metaglinides was negative. A seventy-two-hour fast was performed to rule out hyperinsulinemic hypoglycemic syndromes; however, blood glucose values remained consistently above 120 mg/dL during this period. Thus, after exclusion of other causes, we utilized the adverse drug reaction probability scale and concluded that hypoglycemia was probably related to recent use of levofloxacin.

Esophageal dissecans: a rare life-threatening presentation of recurrent pemphigus vulgaris.

Esophagitis dissecans superficialis (EDS) is a rare condition characterized by sloughing of the mucosal layer of the esophageal lining, usually triggered by an environmental/immune insult. It is associated with blistering diseases such as pemphigus vulgaris (PV), bullous pemphigoid, and epidermolysis bullosa. Oral mucosa is the most commonly (50%) affected site in PV, but esophageal involvement has only been rarely reported. The most common presentation of EDS includes dysphagia and odynophagia, but overt gastrointestinal bleeding is a distinctly uncommon. We present a unique case of EDS presenting with melena in which diagnostic endoscopy enabled to diagnose and establish link with patient's remote history of PV. Early suspicion and identification of this treatable condition can reduce morbidity and mortality in these patient populations by decreasing severity and recurrence of bleeding.

Infliximab-induced aseptic meningitis.

Infliximab is a commonly used biologic agent in the treatment of various autoimmune diseases. Although it is generally well tolerated in most patients, infliximab has been associated with some rare but serious adverse events. Aseptic meningitis is one such distinctly uncommon side effect. We present the case of middle-aged white patient, who presented with fever and headache within a few days of starting the infliximab therapy and was diagnosed with infliximab-induced aseptic meningitis after a complete workup. To our knowledge, this is the fifth case of infliximab-induced aseptic meningitis reported in literature. Because of atypical presentation, the diagnosis can be easily missed. It is vital to increase awareness of this potentially severe side effect among internists and community physicians.

Safety profile of high-dose statin therapy in geriatric patients with stroke.

OBJECTIVES: Use of high-dose statin therapy (HDST) in patients with stroke became standard clinical practice after the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) study, in which the mean age of the study population was approximately 63 years. Little data are available on the adverse effects of statins when used in high doses in adults older than 65 years. The objective of this study was to assess the magnitude of adverse effects of HDST in geriatric patients. METHODS: This single-center, retrospective, case-control study was conducted at Upstate Medical University, Syracuse, New York. All patients older than 65 years admitted between 2008 and 2011 to the hospital's Upstate Stroke Center with acute stroke were eligible. Electronic medical records of 200 eligible patients were reviewed to collect demographic, clinical, and laboratory data. Patients on HDST (cases) were compared with those on low doses (controls) using the χ, Fisher exact (two-sided), and Student t tests. RESULTS: One hundred cases (mean age 80.5 ± 7.7 years) were compared with 100 controls (mean age 78.9 ± 6.4 years). Sixty-seven percent were taking simvastatin. Ninety percent of the cases compared with 81% of the controls had ischemic stroke. The prevalence of elevated alanine aminotransferase (13%) and myositis (4%) was significantly higher in the cases than in the controls. Fourteen percent of the cases reported myalgias, 9% had nausea, and 6% had diarrhea. Seventy-three cases had low-density lipoprotein levels <100 mg% and 41% of the cases had mean glycated hemoglobin levels ≥ 6.5%. CONCLUSIONS: The use of HDST in older adult patients with acute stroke is associated with a significantly increased burden of liver enzyme elevation and myalgias.