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Objective: The COVID-19 pandemic has adversely impacted medical students' learning experiences. Students in one Australian Rural Clinical School were surveyed to investigate the impact of disruptions to clinical placements and satisfaction with educational changes implemented as a result of the pandemic., Design: Cross-sectional survey., Setting: The University of Queensland Rural Clinical School., Methods: Students undertaking one or two years of study at the participating Rural Clinical School in November 2020., Main Outcome Measure: A 20-item anonymised survey with questions on personal health and safety, quality of clinical training experience, response to changes in learning and student environment, and progression to completion of the medical degree., Results: The survey was completed by 124 students (76% response rate). Students were satisfied with the changes made to their learning to accommodate the disruptions to health service delivery and placements. Final year students were more satisfied with their learning experiences compared to their third-year counterparts., Conclusions: The Rural Clinical School implemented a range of academic and psychological support strategies which appear to have helped with mitigating mental health concerns experienced by students completing rural placements, who are already prone to experiencing social isolation. Strengthening communication between the academic and health service sectors can improve the quality of learning for medical students on placements., (© 2022 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.)

The application of cross-modal interaction is a potential strategy to tackle the challenges related to poor sensory properties, such as thin mouthfeel, in plant-based yogurts. Thus, we aim to study the influence of aroma compounds possibly congruent with sweetness on the perceived sensory profile. Descriptive analysis and temporal dominance of sensations (n = 10 × 4) with a trained panel were conducted with and without a nose clip. One unflavored sample and samples flavored with either lemon or vanilla aromas were included (vanilla; 0.05%; 0.1%; lemon: 0.025%; 0.05%). Odor intensity, thick, sticky, and melting sensation, sweetness, and grain-like flavor were evaluated on an unstructured 10-cm line scale with anchors and reference samples. The results demonstrate how vanilla and lemon aromas suppressed grain-like flavor and enhanced odor intensity and sweetness. The following order was detected among samples in perceived sweetness intensity: unflavored < lemon < vanilla. The two sessions with and without nose clip differed statistically in sweetness, highlighting that the aromas impacted the perceived sweetness but not the mouthfeel in vanilla samples. The study suggests that congruent aromas could modify the perceived sweetness in plant-based yogurts; however, aroma or perceived sweetness does not impact the mouthfeel in plant-based yogurts. While the odor−taste interaction in such products is evident, the study highlights that aroma compounds alone do not modify mouthfeel.

Study Question: What effects did treatment using hyaluronic acid (HA) binding/selection prior to ICSI have on clinical outcomes in the Hyaluronic Acid Binding sperm Selection (HABSelect) clinical trial?, Summary Answer: Older women randomized to the trial's experimental arm (selection of sperm bound to immobilized (solid-state) HA) had the same live birth rates as younger women, most likely a result of better avoidance of sperm with damaged DNA., What Is Known Already: Recent randomized controlled trials (RCTs) investigating the efficacy of HA-based sperm selection prior to ICSI, including HABSelect, have consistently reported reductions in the numbers of miscarriages among couples randomized to the intervention, suggesting a pathological sperm-mediated factor mitigated by prior HA-binding/selection. The mechanism of that protection is unknown., Study Design, Size, Duration: The original HABSelect Phase 3 RCT ran from 2014 to 2017 and included 2752 couples from whom sperm samples used in control (ICSI) and intervention (Physiological IntraCytoplasmic Sperm Injection; PICSI) arms of the trial were stored frozen for later assessment of DNA quality (DNAq). The trial overlapped with its mechanistic arm, running from 2016 to 2018., Participants/materials, Setting, Methods: As miscarriage reduction was a significant secondary outcome of the trial, samples (n = 1247) selected for the mechanistic analysis were deliberately enriched for miscarriage outcomes (n = 92 or 7.4%) from a total of 154 miscarriages (5.6%) among all (n = 2752) couples randomized by stratified random sampling. Values from fresh semen samples for sperm concentration (mml), percentage forward progressive motility and percentage HA-binding score (HBS) were obtained before being processed by differential density gradient centrifugation or (rarely) by swim-up on the day of treatment. Surplus sperm pellets were recovered, aliquoted and cryopreserved for later analysis of DNAq using slide-based Comet, TUNEL, acridine orange (AO) and the sperm chromatin dispersion (SCD) assays. Following their classification into normal and abnormal sample subcategories based on reference values for sperm concentration and motility, relationships with HBS and DNAq were examined by Spearman correlation, Student's t-tests, Mann Whitney U tests, and logistic regression (univariable and multivariable). Parsimonious selection enabled the development of models for exploring and explaining data trends. Potential differences in future cumulative pregnancy rates relating to embryo quality were also explored., Main Results and the Role of Chance: Results from the 1247 sperm samples assayed for HBS and/or DNAq, generated data that were considered in relation to standard physiological measures of (sperm) vitality and to treatment outcomes. All measures of HBS and DNAq discriminated normal from abnormal sperm samples (P < 0.001). SCD correlated negatively with the Comet (r = -0.165; P < 0.001) and TUNEL assays (r = -0.200; P < 0.001). HBS correlated negatively with AO (r = -0.211; P < 0.001), Comet (r = -0.127; P < 0.001) and TUNEL (r = -0.214; P < 0.001) and positively with SCD (r = 0.255; P < 0.001). A model for predicting live birth (and miscarriage) rates included treatment allocation (odds ratio: OR 2.167, 95% CI 1.084-4.464, P = 0.031), female age (OR 0.301, 95% CI 0.133-0.761, P = 0.013, per decade) and the AO assay (OR 0.79, 95% CI 0.60-1. 02.761, P = 0.073, per 10 points rise). A model predicting the expected rate of biochemical pregnancy included male age (OR 0.464, 95% CI 0.314-0.674, P < 0.001, per decade) and the SCD assay (OR 1.04, 95% CI 1.007-1.075, P = 0.018, per 10 point rise). A model for conversion from biochemical to clinical pregnancy did not retain any significant patient or assay variables. A model for post-injection fertilization rates included treatment allocation (OR 0.83, 95% CI 0.75-0.91, P < 0.001) and the Comet assay (OR 0.950, 95% CI 0.91-1.00, P = 0.041)., Limitations, Reasons for Caution: HABSelect was a prospective RCT and the mechanistic study group was drawn from its recruitment cohort for retrospective analysis, without the full benefit of randomization. The clinical and mechanistic aspects of the study were mutually exclusive in that measures of DNAq were obtained from residual samples and not from HA-selected versus unselected sperm. Models for fitting mechanistic with baseline and other clinical data were developed to compensate for variable DNAq data quality. HABSelect used a solid-state version of PICSI and we did not assess the efficacy of any liquid-state alternatives. PICSI reduced fertilization rates and did not improve the outlook for cumulative pregnancy rates., Wider Implications of the Findings: Notwithstanding the interventional effect on fertilization rates and possibly blastocyst formation (neither of which influenced pregnancy rates), poor sperm DNAq, reflected by lower HBS, probably contributed to the depression of all gestational outcomes including live births, in the HABSelect trial. The interventional avoidance of defective sperm is the best explanation for the equalization in live birth rates among older couples randomized to the trial's PICSI arm. As patients going forward for assisted conception cycles globally in future are likely to be dominated by an older demographic, HA-based selection of sperm for ICSI could be considered as part of their treatment plan., Study Funding/competing Interest(s): The study was supported by the National Institute for Health Research (NIHR) EME (Efficacy and Mechanism Evaluation)-11-14-34. National Research Ethics Service approval 11/06/2013: 13/YH/0162. S.L. is CEO of ExamenLab Ltd (company number NI605309)., Trial Registration Number: ISRCTN99214271., (© The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology.)

There is a growing need for plant-based yogurts that meet consumer demands in terms of texture. However, more research is required to understand the relationship between physicochemical and mouthfeel properties in plant-based yogurts. The purpose of this study was to determine the physicochemical properties of five commercial plant-based yogurt alternatives with different chemical compositions, making comparisons to dairy yogurts and thick, creamy, thin, and watery mouthfeel sensations. The physicochemical parameters studied included large and small deformation rheology, particle size, soluble solids, acidity, and chemical composition. Significant differences in flow behavior and small deformation rheology were found between dairy- and plant-based yogurts. Among plant-based yogurts thick, creamy, thin, and watery mouthfeel sensations were strongly associated with steady shear rates and apparent viscosity. The results highlight the importance of large deformation rheology to advance the use of plant-based ingredients in the development of yogurt alternatives. Furthermore, this study demonstrates that dairy- and plant-based yogurts with a similar mouthfeel profiles may have different viscoelastic properties, which indicates that instrumental and sensory methods should not be considered substitutive but complementary methods when developing plant-based yogurts in a cost-effective and timely manner.

Background: There is considerable concern about increasing antidepressant use, with Australians among the highest users in the world. Evidence suggests this is driven by patients on long-term use, rather than new prescriptions. Most antidepressant prescriptions are generated in general practice, and it is likely that attempts to discontinue are either not occurring or are proving unsuccessful., Aim: To explore GPs' insights about long-term antidepressant prescribing and discontinuation., Design and Setting: A qualitative interview study with Australian GPs., Method: Semi-structured interviews explored GPs' discontinuation experiences, decision-making, perceived risks and benefits, and support for patients. Data were analysed using reflexive thematic analysis., Results: Three overarching themes were identified from interviews with 22 GPs. The first, 'not a simple deprescribing decision', spoke to the complex decision-making GPs undertake in determining whether a patient is ready to discontinue. The second, 'a journey taken together', captured a set of steps GPs take together with their patients to initiate and set-up adequate support before, during, and after discontinuation. The third, 'supporting change in GPs' prescribing practices', described what GPs would like to see change to better support them and their patients to discontinue antidepressants., Conclusion: GPs see discontinuation of long-term antidepressant use as more than a simple deprescribing decision. It begins with considering a patient's social and relational context, and is a journey involving careful preparation, tailored care, and regular review. These insights suggest interventions to redress long-term use will need to take these considerations into account and be placed in a wider discussion about the use of antidepressants., (© The Authors.)

Background: There is a growing prevalence of prolonged antidepressant use globally. Social group interventions may be an effective way to manage mild to moderate depression, especially with patients seeking to discontinue antidepressant use. This systematic review evaluates studies that used social group interventions to manage depression., Methods: Studies published up to June 2019 in nine bibliographic databases were identified using search terms related to depression, social interventions, and social participation. Formal therapies for depression (cognitive behaviour therapy, music therapy) were excluded as they have been reviewed elsewhere., Results: 24 studies met inclusion criteria; 14 RCTs, 6 non-randomised controlled trials and 4 pre-post evaluations. In total, 28 social group programs were evaluated, 10 arts-based groups, 13 exercise groups and 5 others. Programs ranged in 'dose' from 5 to 150 hours (M = 31 hours) across 4 to 75 weeks (M = 15 weeks) and produced effect sizes on depression in the small to very large range (Hedge's g = .18 to 3.19, M = 1.14). A regression analysis revealed no participant variables, study variables or intervention variables were related to effect size on depression., Limitations: Risks of bias were found, primarily in the non-randomised studies, which means the findings must be regarded as preliminary until replicated., Conclusion: These findings indicate that social group interventions are an effective way to manage mild to moderate depression symptoms in a variety of populations. This approach may also help to prevent relapse among patients tapering off antidepressant medication., (Crown Copyright © 2020. Published by Elsevier B.V. All rights reserved.)

Cryopreservation of mammalian cells has to date typically been conducted in cryovials, but there are applications where cryopreservation of primary cells in multiwell plates would be advantageous. However excessive supercooling in the small volumes of liquid in each well of the multiwell plates is inevitable without intervention and tends to result in high and variable cell mortality. Here, we describe a technique for cryopreservation of adhered primary bovine granulosa cells in 96-well plates by controlled rate freezing using controlled ice nucleation. Inducing ice nucleation at warm supercooled temperatures (less than 5 °C below the melting point) during cryopreservation using a manual seeding technique significantly improved post-thaw recovery from 29.6% (SD = 8.3%) where nucleation was left uncontrolled to 57.7% (9.3%) when averaged over 8 replicate cultures (p < 0.001). Detachment of thawed cells was qualitatively observed to be more prevalent in wells which did not have ice nucleation control which suggests cryopreserved cell monolayer detachment may be a consequence of deep supercooling. Using an infra-red thermography technique we showed that many aliquots of cryoprotectant solution in 96-well plates can supercool to temperatures below -20 °C when nucleation is not controlled, and also that the freezing temperatures observed are highly variable despite stringent attempts to remove contaminants acting as nucleation sites. We conclude that successful cryopreservation of cells in 96-well plates, or any small volume format, requires control of ice nucleation., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)

Pollination is an ecosystem function of global importance. Yet, who visits the flower of specific plants, how the composition of these visitors varies in space and time and how such variation translates into pollination services are hard to establish. The use of DNA barcodes allows us to address ecological patterns involving thousands of taxa that are difficult to identify. To clarify the regional variation in the visitor community of a widespread flower resource, we compared the composition of the arthropod community visiting species in the genus Dryas (mountain avens, family Rosaceae), throughout Arctic and high-alpine areas. At each of 15 sites, we sampled Dryas visitors with 100 sticky flower mimics and identified specimens to Barcode Index Numbers (BINs) using a partial sequence of the mitochondrial COI gene. As a measure of ecosystem functioning, we quantified variation in the seed set of Dryas. To test for an association between phylogenetic and functional diversity, we characterized the structure of local visitor communities with both taxonomic and phylogenetic descriptors. In total, we detected 1,360 different BINs, dominated by Diptera and Hymenoptera. The richness of visitors at each site appeared to be driven by local temperature and precipitation. Phylogeographic structure seemed reflective of geological history and mirrored trans-Arctic patterns detected in plants. Seed set success varied widely among sites, with little variation attributable to pollinator species richness. This pattern suggests idiosyncratic associations, with function dominated by few and potentially different taxa at each site. Taken together, our findings illustrate the role of post-glacial history in the assembly of flower-visitor communities in the Arctic and offer insights for understanding how diversity translates into ecosystem functioning., (© 2018 The Authors. Molecular Ecology Published by John Wiley & Sons Ltd.)

Objectives: To determine the impact of the presence of a medical student on the satisfaction and process of the general practice consultation from the perspective of the general practitioner (GP), patient and student., Methods: An observational study was conducted in regional general practices accepting third-year medical students. General practitioners, patients and medical students were asked to complete a questionnaire after each consultation. The main outcome measures were: patient satisfaction; GPs' perceived ability to deliver care; medical students' satisfaction with their learning experience; length of consultation; and patient waiting times., Results: Of the 26 GP practices approached, 11 participated in the study (42.3%). Patients returned 477 questionnaires: 252 consultations with and 225 without a student present. Thirteen GPs completed 473 questionnaires: 248 consultations with and 225 without a student. Twelve students attended 255 consultations. Most patients (83.5%) were comfortable with the presence of a student. There were no significant differences between consultations with and without a student regarding the time the patients spent in the waiting room (p = 0.6), the patients' perspectives of how the GPs dealt with their presenting problems (100% versus 99.2%; p = 0.6) and overall satisfaction with the consultation (99.2% versus 99.1%; p = 0.5). Despite these reassuring findings, a significantly higher proportion of patients in consultations without students raised sensitive or personal issues (26.3% versus 12.6%; p < 0.001). There were no statistically significant differences in the lengths of consultations with and without students (81% versus 77% for 6-20 minutes consultation; p = 0.1) or in the GPs' perceptions of how they effectively managed the presenting problem (95.1% versus 96.0%; p = 0.4). Students found that the majority (83.9%) of the 255 consultations were satisfactory for learning., Conclusions: The presence of a medical student during the GP consultation was satisfactory for all participant groups. These findings support the ongoing and increased placement of medical students in regional general practice. Medical educators and GPs must recognise that patients may not raise personal issues with a student present., (© 2016 John Wiley & Sons Ltd.)

Micelles can be formed from coenzyme Q10 (CoQ10) and dipotassium glycyrrhizate (GZK2) by using an inclusion complex of CoQ10 with γ-cyclodextrin (γ-CD). The mechanism of micelle formation was kinetically investigated. Adding GZK2 to a supersaturated solution of the CoQ10/γ-CD inclusion complex led to a linear increase in the solubility of CoQ10 due to the formation of micelles of CoQ10 when the molar ratio of GZK2/γ-CD increased to ∼1.6, after which the concentration remained constant. The equilibrium constant K for micelle formation was 0.68 (-) and the ratio of GZK2 to CoQ10 was 1. These results suggest that the formation of CoQ10 micelles with GZK2 might proceed via the displacement of CoQ10 by GZK2 in the γ-CD cavity followed by the formation of CoQ10 micelles.

Scanning electrochemical microscopy (SECM) combined with a Langmuir trough was used for studying oxygen transfer across protein films at an air-water interface. The method allows the comparison of the oxygen permeability of different emulsifiers without any concerns of interference of atmospheric oxygen. Two milk proteins, β-lactoglobulin and β-casein, were compared, and the permeabilities obtained were for β-casein PD ≈ 2.2 × 10(-7) cm(2)/s and for β-lactoglobulin PD ≈ 0.6 × 10(-7) cm(2)/s, which correspond to the lowest limit of the diffusion coefficients and are 2 orders of magnitude lower than the diffusion coefficient of oxygen in water, yet several orders of magnitude higher than previously reported for milk protein films. The method allows characterization of the oxygen barrier properties of liquid interfacial films, which is of crucial importance for understanding the role of the interface in the inhibition of oxygen transport and developing modified interfaces with higher oxygen blocking efficacy.

The aim of this work was to investigate how the oxidative stability of encapsulated oil is affected by the humidity response of a Na-caseinate-maltodextrin matrix. Furthermore, the effect of modification of the interfacial Na-caseinate layer through cross-linking was studied. For this purpose, two model spray-dried emulsions containing sunflower oil, maltodextrin, and either non-cross-linked or cross-linked Na-caseinate were stored at different relative humidities (RHs; ∼0%, 11%, 33%, 54%, and 75%). Increasing RH improved the oxidative stability of the spray-dried emulsions. This behaviour was mainly linked to the loss of individual powder particles upon caking and collapsing of the matrix at RH 75%. Oxidation of non-encapsulated surface lipids with a proportion of ca. 5% of total lipids was only twofold compared to total lipids. Excess protein on particle surfaces may have delayed oxidation, e.g., by its radical scavenging activity. Under several storage conditions, cross-linking of the protein slightly improved the oxidative stability., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Distribution of protein and oil in aqueous and spray-dried emulsions and the effect of protein cross-linking on emulsion properties and matrix-water interactions were investigated. Sodium caseinate and sunflower oil were used to make emulsions which were spray dried using maltodextrin as a wall material. 3% Na-caseinate concentration showed optimum emulsion and process stability as observed in CLSM images, droplet size data and in the amount of heptane-extractable oil from spray-dried emulsions. Transglutaminase cross-linking prior to emulsification slightly increased the amount of protein both on the oil droplet interface and on the particle surface as confirmed by analysis of continuous phase protein in the feed emulsion and by XPS measurements from the powder surface. DSC and water sorption measurements were used to study the physical state of the matrix. Glass transition occurred between RH 54% and 75% at room temperature and it was not affected by cross-linking., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Sodium caseinate was modified by transglutaminase catalyzed cross-linking reaction prior to the emulsification process in order to study the effect of cross-linking on the oxidative stability of protein stabilized emulsions. The extent of the cross-linking catalyzed by different dosages of transglutaminase was investigated by following the ammonia production during the reaction and using SDS-PAGE gel. O/W emulsions prepared with the cross-linked and non-cross-linked sodium caseinates were stored for 30 days under the same conditions. Peroxide value measurement, oxygen consumption measurement, and headspace gas chromatography analysis were used to study the oxidative stability of the emulsions. The emulsion made of the cross-linked sodium caseinate showed an improved oxidative stability with reduced formation of fatty acid hydroperoxides and volatiles and a longer period of low rate oxygen consumption. The improving effect of transglutaminase catalyzed cross-linking could be most likely attributed to the enhanced physical stability of the interfacial protein layer against competitive adsorption by oil oxidation products.

Whey protein isolate was modified by ethylene diamine in order to shift its isoelectric point to an alkaline pH. The extent of the modification was studied using SDS-PAGE and MALDI-TOF mass spectrometry. The modified whey proteins were used as an emulsifier to stabilize oil-in-water emulsions at acidic and neutral pH ranges, and their emulsifying properties were compared with that of the unmodified whey proteins and with the previously studied ethylene diamine modified sodium caseinate. The emulsifying activity of the modified whey proteins was similar to that of the unmodified ones, but the stability of an emulsion at pH 5 was significantly improved after the modification. Charge and coverage of droplet surface and the displacement of the interfacial proteins by surfactant Tween 20 were further studied as a function of pH. As compared with the unmodified whey proteins, the modified ones were proven to cover the interface more efficiently with extensive surface charge at pH 5, although the interfacial layer was less resistant to the surfactant displacement.

Globular proteins such as β-lactoglobulin (BLG) are poorly accessible to enzymes. We have studied susceptibility of BLG to oxidation by Trichoderma reesei (TrTyr) and Agaricus bisporus (AbTyr) tyrosinases and subsequent intermolecular cross-linking with respect to pH-induced structural changes. We evaluated pH-induced structural changes in BLG using circular dichroism, tryptophan fluorescence and small angle X-ray scattering (SAXS) measurements, where after these results were correlated with the analysis of cross-linking by sodium dodecyl sulphate polyacrylamide gel electrophoresis. Oxygen consumption measurement and changes in radii of gyration determined by SAXS during the enzyme-induced oxidation at the respective reaction conditions were also followed. Intermolecular cross-linking of BLG by TrTyr was found at pH 9 but not at pH 7.5. AbTyr was unable to catalyze cross-linking at pH 7.5 or pH 9. Increased accessibility and cross-linking by TrTyr was addressed to loosening of the three dimensional structure of the protein, increased flexibility of the backbone as well as partial hydrolysis. In addition to basic research of the effect of protein folding on enzymatic cross-linking the research results have significance on the exploitation of TrTyr at alkaline conditions., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Whey protein isolate (WPI) was chemically modified by vanillic acid in order to enhance its cross-linkability by laccase enzyme. Incorporation of methoxyphenol groups created reactive sites for laccase on the surface of the protein and improved the efficiency of cross-linking. The vanillic acid modified WPI (Van-WPI) was characterized using MALDI-TOF mass spectrometry, and the laccase-catalyzed cross-linking of Van-WPI was studied. Furthermore, the vanillic acid modification was compared with the conventional approach to improve laccase-catalyzed cross-linking by adding free phenolic compounds. A small extent of the vanillic acid modification significantly improved the cross-linkability of the protein and made it possible to avoid color formation in a system that is free of small phenolic compounds. Moreover, the potential application of Van-WPI as emulsifier and the effect of cross-linking on the stability of Van-WPI emulsion were investigated. The post-emulsification cross-linking by laccase was proven to enhance the storage stability of Van-WPI emulsion.

Different possibilities for protein crosslinking are examined in this review, with special emphasis on enzymatic crosslinking and its impact on food structure. Among potential enzymes for protein crosslinking are transglutaminase (TG) and various oxidative enzymes. Crosslinking enzymes can be applied in cereal, dairy, meat, and fish processing to improve the texture of the product. Most of the current commercial applications are based on TG. The reaction mechanisms of the crosslinking enzymes differ, which in turn results in different technological properties.

Sodium caseinate was chemically modified in order to alter its isoelectric point (pI). Negatively charged carboxylic groups were introduced to lower the pI, and positively charged amino groups to achieve the opposite. Different chemical amino acid modification approaches were studied and the modified proteins were characterized using free amino group assays, SDS-PAGE, MALDI-TOF mass spectrometry, and zeta potential measurements. Oil-in-water emulsions were prepared using these modified caseinates. The pH stability behavior of the emulsions was monitored, and interestingly, the stability of the emulsion could be modulated through steering the pI of caseinate. Using different modified caseinates, it was possible to create emulsions that were stable in the acid, neutral, and alkaline regions of the pH spectrum. The stability behavior of the emulsions correlated well with the theoretical and experimentally determined pI values of the caseinates. Storage stability of emulsions was also studied at pH values around 7, and emulsions made of modified caseinates showed storage stability similar to that of unmodified caseinate emulsions.

Flaxseed oil was emulsified in whey protein isolate (WPI) and spray-dried. Powder characteristics and oxidative stability of oil at relative humidities (RH) from RH approximately 0% to RH 91% at 37 degrees C were analyzed. Oil droplets retained their forms in drying and reconstitution, but the original droplet size of the emulsion was not restored when the powder was dispersed in water. The particles seemed to be covered by a protein-rich surface layer as analyzed by electron spectroscopy for chemical analysis (ESCA). Oxidation of flaxseed oil dispersed in the WPI matrix was retarded from that of bulk oil but followed the same pattern as bulk oil with respect to humidity. A high rate of oxidation was found for both low and high humidity conditions. The lowest rate of oxidation as followed by peroxide values was found at RH 75%, a condition that is likely to diverge significantly from the monolayer moisture value. A weak baseline transition observed for the WPI matrix in a differential scanning calorimetry (DSC) thermogram suggested a glassy state of the matrix at all storage conditions. This was not consistent with the observed caking of the powder at RH 91%. Scanning electron microscopy (SEM) images revealed a considerable structural change in the WPI matrix in these conditions, which was suggested to be linked with a higher rate of oxygen transport. Possible mechanisms for oxygen transport in the whey protein matrix under variable RHs are discussed.

The stability of encapsulated D-limonene, which was prepared by spray drying, was studied in view of the release characteristics and oxidation stability. Gum arabic, soybean water-soluble polysaccharide, or modified starch, blended with maltodextrin were used as the wall materials. The powders were stored under the conditions of 23-96% relative humidity at 50 degrees C. The release rate and the oxidation rate were closely related to the relative humidity. The relationship was not simple. Initially, the release rate and the oxidation rate increased with increasing water activity, but around the glass transition temperature, the rates decreased sharply to increase again at a further increase of water activity. The results could be explained by a change in the powder structure, where a glass capsule matrix was changed into rubbery state during storage.

In order to determine the relationship between mutations, tissue accumulations, and serum levels of p53 in occupational cancers, we used denaturing gradient gel electrophoresis and DNA sequencing of exons 5-9 of the p53 gene, immunohistochemical analysis for tissue identification of mutant p53 protein, and enzyme-linked immunosorbent assay for serum levels of mutant p53 protein to examine for such alteration in a cohort of individuals with workplace exposure to asbestos or silica, and resultant lung cancers or mesotheliomas. DNA analysis detected mutations in 5 of 18 (28%) tumors, and tissue accumulations of protein were detected in 7 of 20 (35%) tumors; the agreement between mutational and immunohistochemical analyses was significant (kappa = 0.62, P = 0.002). Serum elevations of protein were detected in 4 of 11 (36%) cases with available serum samples; the agreement between tissue alterations and serum elevations was also significant (kappa = 0.71, P = 0.017). In addition, based on the analysis of banked samples, serum results tended to be consistent over time prior to the diagnosis of disease (positive predictive value = 0.67, negative predictive value = 0.83). These results suggest that serum levels of p53 are reasonably accurate in reflecting tissue alterations in p53 at the gene and/ or protein level and may be early biomarkers of disease risk.

Overexpression of the epidermal growth factor receptor (EGFr) has been implicated in the pathogenesis of a wide variety of human malignancies and may be related to asbestos-induced carcinogenesis. Overexpression of the EGFr can be detected immunologically by quantitation of the extracellular domain (ECD) in the extracellular fluid in vitro and in serum in vivo. An enzyme-linked immunosorbent assay (ELISA) for the EGFr ECD was used to examine banked serum samples of 38 asbestosis patients who subsequently developed cancer, 72 age-sex-race-smoking-asbestos exposure matched asbestosis controls without cancer, and 20 age-sex-race-smoking matched nonasbestosis noncancer controls. The mean serum level for the EGFr ECD in the cancer cases (636 +/- 299 fmol/ml) was statistically significantly elevated (P < 0.05) in comparison to the mean level in the asbestosis controls (546 +/- 147 fmol/ml) or the nonasbestosis controls (336 +/- 228 fmol/ml). Defining a positive elevation of the serum EGFr ECD as any value more than 2 standard deviations above the nonasbestosis control mean, 7 (18%) of the cancer cases were positive compared to 4 (6%) of the asbestosis controls and one (5%) of the nonasbestosis controls. In addition, all of these cancer cases had positive serum samples prior to the time of disease diagnosis (average = 5.1 years). These results suggest that serum EGFr ECD may be elevated at an early stage of carcinogenesis in some asbestosis patients and that further prospective study of the utility of this biomarker is warranted.

To assess the effect of malnutrition on gastric acidity and gastric bacterial colonization, we studied 35 severely malnourished Bangladeshi children before (0 wk) and after (3 wk) they received nutritional rehabilitation for 3 wk. These results were compared with those obtained from a similarly examined group of 20 better-nourished Bangladeshi children. Gastric acid output, both basal and after betazole stimulation, was significantly lower in the malnourished group at 0 wk compared with the better-nourished children (p less than 0.01): basal 0.22 vs. 0.52 mEq HCl/h and stimulated 0.90 vs. 2.5 mEq HCl/h. Both the concentration of acid and the rate at which gastric juice was secreted were decreased in the malnourished group but serum gastrin levels were not significantly different. After 3 wk, the malnourished children had improved from 61% (+/- 9.0%; SD) to 81% (+/- 8.1%) of expected weight-for-height and were not significantly different than the better-nourished group (86% +/- 11%). Nevertheless, gastric acid concentration remained depressed in the 3-wk group, although the rate of gastric juice secretion equaled levels observed in the better-nourished group. None of the better-nourished children had detectable gram-negative bacterial colonization of their gastric juice. In contrast, 26 of 32 (81%) malnourished children at 0 wk were colonized--even after betazole stimulation, 11 of 33 (33%) gastric juice samples yielded viable organisms--suggesting that the decrease in gastric acid output greatly reduced the gastric acid barrier. Interestingly, only 9 of 20 (45%) better-nourished children had gastric juice with basal pH values below 4.0, suggesting that the gastric acid barrier may be an intermittent defense factor in Bangladeshi children.