Lactic acid bacteria have been considered to be a very important species during sourdough fermentation. In order to explore the effects of bifidobacteria fermentation on thermal, physico-chemical and structural properties of wheat starch during dough fermentation, starch granules were separated from the fermented dough at different fermentation times, including 0 h, 2 h, 6 h, 9 h and 12 h. The results showed that the morphology of starch granules was destroyed gradually as the fermentation time increased, which appeared as erosion and rupture. With the increase in fermentation time, the solubility showed a significant increase, which changed from 8.51% (0 h) to 9.80% (12 h), and the swelling power was also increased from 9.31% (0 h) to 10.54% (12 h). As for the gelatinization property, the enthalpy was increased from 6.77 J/g (0 h) to 7.56 J/g (12 h), indicating a more stable thermal property of fermented starch, especially for the longer fermentation. The setback value was decreased with short fermentation time, indicating that the starch with a longer fermentation time was difficult to retrograde. The hardness of the gel texture was decreased significantly from 50.11 g to 38.66 g after fermentation for 12 h. The results show that bifidobacteria fermentation is an effective biological modification method of wheat starch for further applications. Starch-based food is the most consumed food in the world and is an especially important part of the staple food of the oriental table . It is rSourdough fermentation is one of the oldest biotechnologies used in the production of cereal foods, which can improve the quality of flour products. Up to now, many research works have been focused on the improvement of flour products’ quality through sourdough fermentation ,7,8,9,10The fermentation process is different from direct treatment with acid or enzymes. Due to the continuous process of fermentation, the degradation of starch chains caused by α-glucoamylase, which is produced/activated during the fermentation process, may proceed gradually during fermentation, resulting in the positive improvement of starch properties, such as the enhancement of thermal properties . As a ub10 CFU/g) was commercially available.Wheat flour  was purchased from a local supermarket ; Bifidobacteria powder  were added to 200 g (db) flour. The mixture was fully stirred in a mixing machine  for 4 min. Then, the dough was fermented for 0 h, 2 h, 6 h, 9 h and 12 h, respectively, at a temperature of 35 °C and relative humidity of 85%. The fermented dough was taken out and then washed with distilled water until the washing liquid was clear with non-cloudy starch slurry. After the starch slurry was centrifuged at 1509.3× The content of damaged starch was determined with the UCDc value using Chopin’s SD matic damaged starch meter . The content of damaged starch can be obtained by calculating the absorption rate of iodine, and the results can be displayed by UCD (Chopin Dubois Unit) and UCDc. UCDc is the UCD corrected by water and protein content. UCD = 0.95·AACC + 10.17. Thus, UCD can also be converted into the AACC expression by using the unit of %. The experiment for each group was repeated three times.A Quanta 250 FEG model scanning electron microscope  was used to investigate changes that occurred on the granular surface at different fermentation times. The starch samples were sprayed onto a double-sided adhesive tape coated with a thin gold layer and then fixed on the sample table. The starch granules were examined at an acceleration voltage of 10 kV.S) and swelling power (SP) of starch were determined according to the method of Liu et al. [g for 15 min to collect the supernatant. The liquid supernatant was dried in a drying oven  at 105 °C to a constant weight. Solubility was expressed as the percentage of dry solid weight based on the weight of the dried sample. The swelling power was calculated as the weight ratio of the wet sediment to the initial dry matter, excluding the water-soluble starch. The experiment for each group was repeated three times. The solubility (S) and swelling power (SP) of starch were calculated according to the following formula, and the average value of the two measurement results was calculated in Equation (1).The solubility  under the following conditions: Cu-Kα radiation (λ = 1.543), Nickel filter, 40 kV and 30 mA. The intensities were measured in the 10–30° diffraction angle range with a 0.03° step size and measuring speed of 4°/min. The experiment for each group was repeated twice. The relative crystallinity was calculated as the ratio of the intensity of diffraction peak to the total intensity.0), peak temperature (TP), conclusion temperature (TC) and enthalpy of gelatinization.The thermal properties of starch samples were determined by using a differential scanning calorimeter . A 2.5 mg  starch sample was placed in an aluminum case, and distilled water was added to obtain a starch/water ratio of 1:3 by weight. The aluminum case was sealed and equilibrated at room temperature for 24 h. Then, it was heated from 20 to 120 °C using a scanning rate of 10 °C /min. A sealed empty case was used as a reference. The experiment for each group was repeated three times. The characteristic temperatures of the transitions were recorded as the onset temperature . About 3 g starch samples (corrected to 14% wet basis) were mixed with 25 mL water and then added to the RVA canister for testing. A programed heating and cooling cycle was used at a constant shear rate, where the starch samples were held at 50 °C for 1 min, heated from 50 °C to 95 °C at 9 °C/min, held at 95 °C for 3 min, cooled to 50 °C at 9 °C/min and held at 50 °C for 5 min. The experiment for each group was repeated three times.After RVA determination, the sample in the reaction cup was placed in a weighing bottle for 24 h at room temperature to form the gel. The texture profile analysis (TPA) of the starch gel was then evaluated by the texture analyzer . A cylindrical probe P/6 was used for the test . The time interval between the two measurements was 3.0 s. The gel texture properties, including hardness, adhesiveness, springiness, cohesiveness, gumminess and resilience, were recorded. The experiment for each group was repeated three times.p < 0.05.For the statistical analysis of the data in this work, Excel and SPSS 20.0 software were used, while the ORIGIN 8.0 software program was used for drawing. The experiment for each group was repeated three times, except for the results of SEM  and XRD (twice). The results were expressed as the mean standard deviation. The data were analyzed by the analysis of variance (ANOVA), and significance was established at The purity of total starch content for each sample was about 97–98%, according to the method of the total starch assay kit, following the approved protocols from Megazyme. Due to the external action, the internal structure and external shape of starch were damaged, even with the appearance of cracks and fragments, which was considered damaged starch. As shown in The surface morphology, size and external characteristics of starch granules can be observed to provide effective information . SEM wasChinsamran et al.  also fouDue to the strong hydrogen bonds, intact starch granules are insoluble in cold water but can absorb water and swell to form a paste solution when being heated in the presence of water upon gelatinization temperature . PartialThe solubility and swelling power of starch separated from bifidobacteria-fermented dough are shown in As X-ray diffraction was used to determine the long-range structure of starch granules. The X-ray diffraction patterns of wheat starch samples with various fermentation times are presented in The change in the relative crystallinity is also presented in P) and conclusion temperature (TP) of gelatinization, as well as the gelatinization temperature range (Tc-To) and enthalpy (∆H). Starch gelatinization refers to the first-phase transition from the semi-crystalline state to the amorphous state in the presence of water and temperature [P compared with native starch, and there was no significant difference between the samples with different fermentation times. It was obvious that the increase in Tp might be due to the destruction of the starch structure by the enzyme or acid hydrolysis produced during the fermentation. Chinsamran et al. [P during fermentation may be related to the increased crystallinity of starch. The DSC results of wheat starch at different fermentation times are shown in perature . The theperature . Studiesperature . It was n et al.  pointed n et al.  also indGelatinization enthalpy was increased during the initial stage of fermentation (from 0 to 6 h) and reached a maximum at 6 h. Then, it was decreased slightly but was still higher than that of native starch, which was attributed to the preferential hydrolysis of the amorphous regions and the improvement of the double helix order, as observed in XRD. A similar result was found in the hydrolysis of corn starch by direct treatment with acid . In addiStarch granules began to swell and break, forming a uniform paste solution when heated in water. As shown in The setback value reveals the ability of amylose to form gel during the cooling process of starch paste and reflects the retrogradation degree as well . As showAfter gelatinization, the starch molecules will rearrange to form a gel network during cooling. Texture profile analysis can simulate the human chewing process and evaluate the textural characteristics . As can It was also noticed that the adhesiveness and chewiness were slightly reduced during fermentation, but no significant difference between 0 h and 12 h of fermentation occurred. Gumminess was also related to the gel network formed by amylose. During the fermentation period from 2 h to 12 h, it dropped dramatically from 24.0 to 19.6 g. Festus et al.  and MajzIn this study, the structural, thermal and physico-chemical properties of wheat starch during bifidobacteria fermentation were investigated. With the increased fermentation time, starch granules exhibited obviously corroded voids and were gradually damaged in large A-type starch granules. The solubility and swelling power were increased by fermentation. Crystallinity was also increased without altering the starch crystalline structure, indicating the destruction in the amorphous regions. The peak temperatures of gelatinization and the enthalpy of gelatinization were increased by fermentation, while setback values were decreased. The decrease in setback values indicated that the tendency of starch to retrograde was improved significantly, which is desirable for extending the shelf life of fermented products. This research indicated that bifidobacteria fermentation was an effective method for the modification of the structure and physico-chemical properties of wheat starch for further applications.


He was one of three co-editors of Baja's Principles and practice of surgery, including pathology in the tropics”, which is popularly referred to as ‘BAJA’ after the initials of the editors' surname Professors EA Badoe, EQ Archampong and MOA Jaja. This textbook is a pre-eminent source of information for generations of medical undergraduates, postgraduates and surgeons, especially in the tropics. He was the Dean of the University of Ghana Medical School from 1984 to 1994 and President of the West African College of Surgeons from 1997 to 1999.He was the Editor-in-Chief of the Ghana Medical Journal from 1973 to 1979. Before this time, he was the Assistant Editor from 1969. These years were difficult in Ghana's history, with military coups, uprisings, and social and economic challenges. This period also witnessed tension between professional groups and the military government of the day over the concept of “Union Government”, which proposed to make Ghana a non-party state. Professor Archampong managed the journal successfully and achieved regular publications. During these difficult times, he was promoted to Associate and Full Professor in 1976 and 1978, respectively. In addition, he obtained a Master of Surgery degree (M.S.) from the University of London (1974) by thesis and was awarded the Fellowship of the International College of Surgeons (USA) in 1975.Professor Archampong excelled in his many spheres of endeavour, receiving academic, national, and international awards.He was a recipient of the National Honours of the Republics of Ghana and Senegal. He was considered an astute administrator with a friendly posture.Professor Archampong will be remembered as an icon in the medical profession, a great teacher, an example of dedication to duty, family, and a Christian gentleman.th December 2021 after a well-attended burial service that included the President and Vice-President of the Republic of Ghana.Professor Archampong was laid to rest on 16May he rest in peace.Editorial OfficeGhana Medical Journaleditor@ghanamedj.org


Patients with single ventricle heart defects receive 3 stages of operations culminating in the Fontan procedure. During the Fontan procedure, a vascular graft is sutured between the inferior vena cava and pulmonary artery to divert deoxygenated blood flow to the lungs via passive flow. Customizing the graft configuration can maximize the long-term benefits. However, planning patient-specific procedures has several challenges, including the ability for physicians to customize grafts and evaluate their hemodynamic performance.The aim of this study was to develop a virtual reality (VR) Fontan graft modeling and evaluation software for physicians. A user study was performed to achieve 2 additional goals: (1) to evaluate the software when used by medical doctors and engineers, and (2) to explore the impact of viewing hemodynamic simulation results in numerical and graphical formats.A total of 5 medical professionals including 4 physicians  and 1 biomedical engineer voluntarily participated in the study. The study was pre-scripted to minimize the variability of the interactions between the experimenter and the participants. All participants were trained to use the VR gear and our software, CorFix. Each participant designed 1 bifurcated and 1 tube-shaped Fontan graft for a single patient. A hemodynamic performance evaluation was then completed, allowing the participants to further modify their tube-shaped design. The design time and hemodynamic performance for each graft design were recorded. At the end of the study, all participants were provided surveys to evaluate the usability and learnability of the software and rate the intensity of VR sickness.The average times for creating 1 bifurcated and 1 tube-shaped graft after a single 10-minute training session were 13.40 and 5.49 minutes, respectively, with 3 out 5 bifurcated and 1 out of 5 tube-shaped graft designs being in the benchmark range of hepatic flow distribution. Reviewing hemodynamic performance results and modifying the tube-shaped design took an average time of 2.92 minutes. Participants who modified their tube-shaped graft designs were able to improve the nonphysiologic wall shear stress (WSS) percentage by 7.02%. All tube-shaped graft designs improved the WSS percentage compared to the native surgical case of the patient. None of the designs met the benchmark indexed power loss.VR graft design software can quickly be taught to physicians with no engineering background or VR experience. Improving the CorFix system could improve performance of the users in customizing and optimizing grafts for patients. With graphical visualization, physicians were able to improve WSS percentage of a tube-shaped graft, lowering the chance of thrombosis. Bifurcated graft designs showed potential strength in better flow split to the lungs, reducing the risk for pulmonary arteriovenous malformations. Congenital heart disease is the most common birth defect found in nearly 1% of births worldwide . At stagAdvances in medical imaging scanning and 3D-printing techniques have been showing great potential for customizing Fontan grafts. One of the customization approaches is known as tissue-engineered vascular grafts (TEVGs), which uses biocompatible material to facilitate the growth of neotissue, including collagen, vascular muscle, and endothelial cells ,6. One o3D-printed scaffolds can be modeled using various approaches including computer-aided design (CAD) software , graft mThe ability to produce graft designs alone is not sufficient to optimize Fontan procedures. Without accounting for the flow inside each graft design, a patient may experience increased risk of medical complications. Multiple studies have emphasized the importance of a low indexed power loss (iPL) ,18, a baThis study was approved by the investigational review board at Children’s National Hospital (reference number: Pro00009721).One anonymized post-Fontan procedure imaging data set was acquired via magnetic resonance imaging. The data set was exported as a DICOM file and then manually segmented into two 3D models using Mimics software : a (1) TCPC model and (2) a heart model without the TCPC anatomy a. CFD siThe VR surgical planning software, CorFix, was developed based on the Unity 3D engine. The software-running platform was an Alienware Aurora R8 (Dell) with an Intel Core i7-9700 processor, a NVIDIA GeForce RTX-2080Ti, and 16 GB of RAM. An Oculus Rift S was used for displaying CorFix in full-immersive VR. Touch controllers (Oculus Rift) were integrated into the system for interacting with the interface. CorFix was previously designed to perform simple diagnosis  and modeling  tasks. This version of CorFix had a modified user interface to accommodate clinicians untrained in VR, modeling software , or CFD. The interface was adapted to allow users to intuitively design patient-specific vascular grafts in a short amount of time and integrate image analysis in the workflow.The Corfix interface was designed to support simple memory recall, allowing for a short, 1-time, 10-minute tutorial. A virtual clipboard was used as an access point for menu and Oculus controller information. The top row contained icons that support the designing of a tube-shaped or bifurcated graft. Icons were designed to match the color and shape of the corresponding geometry and anatomy. In the center of the clipboard, a diagram of the Oculus controller and its functionality were visualized. The bottom row contained menus that are necessary when the design process is completed . A “SaveThe import process saves all information needed to reconstruct the graft designs using the same algorithm used to construct the conduits. It first saves the transform information of the heart, Glenn, and the graft. The location and radii of the Bezier curve are then stored. These data are then exported into 1 CSV  file in the aforementioned order. The design import feature works by parsing the saved file from top to bottom and then reconstructing the scene in that order.The minimum design parameters for a bifurcated graft were 2 anastomosis regions and 1 split region a. For deThese calculated points were connected to the center of the ellipse to make triangular meshes, forming a surface. Two cubic Bezier curves were used to define the pathways and girths of the bifurcated graft. The first Bezier curve used the center of the native IVC surface and a user-defined anastomosis region. The second Bezier curve used the center of another anastomosis region and a user-specified split region of the graft. The formula for the pathways was as follows:P0 and P3 are anchor points which represent the center points of 2 different surfaces; and P1 and P2 are handles which define the direction and strength of the pathways, with the variable t ranging from 0 to 1 (where m 0 to 1 . Users wr1 could be one of the radii from the anastomosis region and r0 could be one of the radii from the native IVC surface. f(t) is the interpolation adjustment factor at t. The letter t represents any location on the Bezier curve. The center points of r0 and r1 are defined as 0 and 1 for t.where ∆ is the difference between the radii from one center point to another. For example, , respectively. The maximum WSS can be changed by scrolling a slider on the clipboard towards the right. The maximum threshold of the slider is automatically identified by calculating the biggest WSS value from the CSV file. All points with nonzero WSS values are rendered using graphics processing unit acceleration and display relevant data regarding that point cloud. The graphics processing unit acceleration approach enables real-time point cloud rendering that corresponds to the slider. The rendered point cloud was grabbable and rotatable for users to study in detail or to match its orientation to their view of current designed graft (Hemodynamic simulation results were outputted in .h5 format. A data import and transform script was developed using MATLAB (MathWorks) since the .h5 format is not supported in Unity. The script consisted of 3 parts: data size, hemodynamic performance summary, and raw WSS values. The data size rows summarized the number of graft designs that were simulated and the total length of the raw WSS values. The hemodynamic performance summary contained information on iPL, %WSS, and HFD on each graft. The raw WSS values are composed of actual WSS values on each x, y, and z coordinate of a graft. These parts are concatenated into 1 CSV file, which is then imported into Unity. As a default, minimum and maximum WSS are set to 0 and 1 ed graft .The hemodynamic performance parameters included iPL, %WSS, and HFD. iPL is a dimensionless value of a pressure difference between the Fontan graft and the PA. It is normalized using a patient’s body surface area. High iPL values have an increased chance of deteriorated cardiac performance and exercise capacity . The iPL is the static pressure, ρ is the density of the blood,  is the velocity, Q is the flow rate, and sQ is the systemic venous flow that is equivalent to the sum of all inlet flow rates. The WSS is defined as a force created against the surface of the graft by the blood. A healthy physiologic range of venous WSS falls between 1 and 10 dyne/cm2. If WSS is below the lower threshold, there could be an increased chance in thrombus formation on the surface of the graft [dyne/cm2 has been identified as the nonphysiologic regions. Its percentage against the total area was calculated for %WSS as follows:where BSA is the body surface area of the patient, he graft . The ratAN is the number of WSS values below 1 dyne/cm2 on the graft, and  is the total number of WSS values. The HFD is a ratio of the flow split to the PA from the Fontan. Unbalanced flow split may result in higher risk of pulmonary arteriovenous malformation [IVC). The number of particles that pass through each side of the PA (NLPA and NRPA) is then counted as follows:where ormation . HFD wasThe number of total particles varies and depends on the surface area of the inlets. The particles are equally spaced from each other. This study set the healthy ranges of each benchmark parameter as below 0.03 for iPL, below 10% for %WSS, and within the range of 40% to 60% for the HFD ratio.Ansys Fluent 19 (ANSYS Inc) was used to make extensions at inlet and outlet boundaries. The inlet, IVC, and SVC, were extruded by 10 times their largest diameter. The outlets, that is the left and right PA, were extruded by 50 mm. These extensions acted as a mechanism for developing a stable blood velocity profile. The CFD simulation was performed by solving steady 3D Navier-Stokes equations with Newtonian fluid and rigid wall assumptions. A calculation for the Reynolds number was implemented to assess the laminar flow of a patient’s anatomy.The institutional review board at the Children’s National Hospital in Washington, DC, approved this study. The study was advertised by sending emails to the groups of residents, fellows, cardiac specialists, and medical engineers. A total of 5 voluntary participants were recruited including 1 fourth-year resident, 1 third-year cardiac fellow, 1 pediatric intensivist, 1 pediatric cardiac surgeon, and 1 biomedical engineer. All participants gave informed consent prior to their participation.Before the experiment, all participants were queried about their knowledge on the Fontan procedure and vascular grafts. Those who did not have a strong understanding about the topics were given a short tutorial. The tutorial covered anatomy of patients with SVHD, surgical repair for SVHD, and the shapes of Fontan grafts in 3 PowerPoint (Microsoft) slides. All participants then received a tutorial on the 3 benchmark parameters that would be calculated to identify the performance of their Fontan graft designs. This tutorial did not include any information about the relationships between each benchmark parameter and the graft design parameters. The participants were informed that %WSS is negatively correlated with iPL. Healthy ranges of each benchmark parameter were visually provided inside the VR environment as a reference. The last tutorial was for the CorFix interface and took about 10 minutes. None of the participants had prior experience with VR, requiring the CorFix tutorial to include information about the hardware (Oculus). During the CorFix tutorial, participants wore the gear and went through the following topics with verbal feedback: importing anatomies, interacting with the anatomies, designing basic tube-shaped and bifurcated Fontan grafts, making anatomies transparent, visualizing CFD results, and modifying the existing tube-shaped design.After it was confirmed there were no further questions about the VR gear or CorFix software, participants created and exported 3D models of 1 bifurcated and 1 tube-shaped Fontan graft . There wAll participants filled out a digital demographic survey prior to the experiment, including questions about their position, level of VR experience, knowledge and experience on the Fontan procedure, and the level of training on fluid dynamics. Three hard-printed surveys were provided at the end of the study. The System Usability Scale (SUS) and the Usefulness, Satisfaction, and Ease of Use Questionnaire (USE) were used to measure the usability of the system. To identify the level of sickness when using VR gear, the Simulator Sickness Questionnaire (SSQ) was provided.Participants spent an average of 5.49 minutes creating 1 tube-shaped graft and 13.40 minutes creating 1 bifurcated graft. An average of 2.92 minutes was spent modifying the tube shape after it was created. This time includes reviewing the native patient model and the 6 design variations. The summary of design times and actual designs are provided in The patient Fontan data set without modifications showed suboptimal hemodynamic performance. with 55.36% of the Fontan anatomy under nonphysiologically optimal WSS, unbalanced HFD with 72.72% of hepatic flow going to the left PA, and an iPL of 0.0086, indicating minimal flow change within the anatomy .Each participant produced 1 tube-shaped and 1 bifurcated Fontan graft. CFD simulations were performed on each of the graft designs. The detailed hemodynamic results are provided in All participants were asked to review 7 Fontan graft design variations based on the native Fontan surgical case. None of 7 design variations were considered optimal for the patient. The variations were created to assist the participants in identifying important design parameters that contribute to each hemodynamic benchmark parameter. After evaluating the design variations, the participants were given the freedom to modify their tube-shaped graft design to attempt to optimize the hemodynamic parameters. All those who modified their tube-shaped Fontan graft were able to reduce %WSS with an average improvement of 7.02%, ranging from 2.32%  to 13.28%  to bolster the interactivity inside the virtual scene. However, many participants struggled with depth perception and interactivity. Grabbing design control points or even clicking buttons on the virtual menu were frequently observed. Developing a feature or a device that could better support tactile feedback may enhance the usability and the innate learnability of the software.The bifurcated graft designs were more successful in improving the hepatic flow distribution to a healthy range compared to the tube-shaped graft designs. During the experiment, all participants were asked to review 7 different tube-shaped Fontan grafts, which were derived from the actual surgical case although none of these design variations were surgically optimal. We hypothesized that the participants would be able to find patterns between design parameters and hemodynamic performance. Our study showed that when participants decided to modify their designs after reviewing other cases, they were able to design a more optimal graft by lowering %WSS. On average, %WSS was reduced by 7.02%. A biomedical engineer with a strong fluid dynamics education background showed the maximum %WSS reduction of 13.28%. Considering how lower %WSS is related to a lower risk of thrombosis for Fontan grafts, this design could provide a significant long-term improvement for the patient. We therefore infer that showing problematic regions in color, like a contour map, may help doctors without an engineering background to sufficiently identify low %WSS. iPL and HFD improvements were not consistent throughout the participants. Unlike %WSS, these hemodynamic parameters were presented only in numerical format. We hypothesize that with supplementary graphical visualization, users may be able to improve iPL and HFD more easily.With the development of graft modeling and evaluation software like CorFix, physicians may be able to easily customize Fontan grafts and find an optimal graft configuration for long-term benefits. We plan to further develop CorFix by adding real-time CFD simulation and automatic graft optimization features for bolstering the graft design and evaluation process. Our next study will incorporate many of these changes and focus on recruiting more cardiac surgeons and testing against a larger number of patient surgical cases.This study had a small sample for recruitment due to the limited number of doctors and their time availability despite 3 months of advertising and 2 additional months during the data collection period. We were able to include individuals with various levels of medical experience, which provides a broad spectrum of users and supports important preliminary insights. Our future study will involve greater participation and a larger number of patient cases to supplement the current results.This paper reports the design of a VR software for patient-specific designs of vascular grafts that demonstrated feasibility and initial usability in a pilot usability study. All participants were able to create patient-specific graft designs with minimal training, needing on average only 5.49 minutes to design 1 tube-shaped graft and 13.40 minutes to design 1 bifurcated graft. Participants rated the design software with a good degree of usefulness, satisfaction, and ease of use. Further design improvements are needed to visualize hemodynamics during the design process, and a larger study is required to fully compare the VR design to current state-of-the-art surgical procedures.


Bacillus licheniformis amylases, can be used as an enzyme. The use of these enzyme preparations in low concentration allows it to obtain cassava starches with increased solubility, which can be easily used in the technology of dairy products. Starch is partially hydrolyzed by amylase preparations and does not significantly affect the chemical composition of the protein part of the Symbilact dairy product. Positive dynamics of the rheological and antioxidant properties of the low-fat dairy product “Symbilact” from the enzyme-modified cassava starch during storage were revealed in the researches. AT starches are more able to correct the structure, especially AT-0.5 and AT-1, but to a less extent increase antioxidant properties. As matter of a fact, BT starches exhibit higher antioxidant potential, but less structure correction.Cassava starch can be an effective texture corrector for dairy products; however, the presence of a starchy taste in such products is undesirable. A possible solution to this problem can be the use of partially hydrolyzed cassava starch; complex microbial amylase preparations, for instance, Amylosubtilin® or  Lactobacillus delbrueckii ssp. bulgaricus, Lactobacillus acidophilus, Streptococcus thermophilus, and Bifidobacterium animalis subsp. lactis are very useful: they affect commodity indicators and increase the utility and nutritional value of the product, as well as its safety. Species of the genus Lactobacillus contribute to the organoleptic properties of fermented foods and participate in the formation of texture [Lactobacillus delbrueckii ssp. bulgaricus improves the structure of fermented milk products, increases stability, prevents syneresis [Lactobacillus acidophilus imparts a pleasant taste and aroma, increases stability, and is able to utilize fructooligosaccharides [Streptococcus thermophiles produces acetaldehyde, which in combination with milk thermolysis products results in the “typical” yogurt flavor. Some Streptococcus thermophilus strains produce exopolysaccharides [Bifidobacterium animalis subsp. lactis is used as live cultures in fermented dairy products that serve as carrier products for them [Russia and Europe produce commercial dairy products based on symbiotic and probiotic starter broth . Such st texture . Many la texture ; they af texture . Lactobayneresis , exhibityneresis , and is yneresis . Lactobacharides  and othecharides , they cacharides . Bifidobfor them . Bifidobfor them , synthesfor them .Lactococcus lactis ssp. cremoris, Lactococcus lactis ssp. lactis var. diacetylactis, and Lactococcus lactis ssp. lactis; according to the literature, they have antagonistic activity to the pathogenic microbiota of the gastrointestinal tract [Lactococcus species improve the taste, aroma, and nutritional value of the fermented milk product [Lactococcus lactis is used as a potential probiotic strain [. Lactococcus lactis ssp. lactis var. diacetylactis is capable of producing diacetyl from citrate, giving a nutty, creamy, and buttery aroma. Lactococcus lactis subsp. lactis can cause fruity aromas from esters, but it can produce bitter peptides from proteins. Lactococcus lactis subsp. cremoris breaks down bitter peptides, which prevents the appearance of a bitter taste in the product [One example of a symbiotic probiotic dairy product is the “Symbilact.” Its starter broth has a complex composition; they are the following: LAB al tract . Bacteri product . Lactococ strain . Lactoco product .Thanks to this combination of microorganisms, Symbilact is recommended in Russia in baby and dietary nutrition; the product has a pleasant sour milk taste and thick consistency. Traditionally, the fat content of dairy products ranges from 2.5 to 4%.Over a long period of time, nutritional standards and the relationship between diet and health have been established . The dieIn this regard, it is important to release on the mass market useful symbiotic low-fat dairy products in order to meet consumer preferences and improve the health of the population. Fat in “traditional” fermented milk drinks, with a mass fraction of fat from 1.5 to 3.2%, plays the role of a thickener and structure-forming agent. The absence of fat globules leads to sensory and textural changes and, especially, a change in the perception of taste in the mouth , which iIn view of this, there is a need to improve the existing technology and the introduction of additional thickening agents in products with low fat content. The problem of “thickening” food is not new. Producers face it when producing yogurts with sweet fruit and berry fillings, where sugar has a “thinning” effect .For natural thickeners and texture correctors , these aManihot esculenta Crantz) is a perennial woody shrub with tuberous roots in the family Euphorbiaceae [The approach implemented in this study assumes the use of enzymatically modified starch in the technology for the production of fat-free “Symbilact.” Cassava  and sensory characteristics of the nonfat sour milk drink “Symbilact.” According to the quality indicators of fat-free fermented milk products, identify modified starches that are most promising for use in nonfat dairy products from the point of view of a corrector of textural and organoleptic characteristics and protective properties.Bacillus licheniformis. The Bacillus licheniformis α-amylase preparation was obtained in accordance with the method of Vafina et al. [Streptococcus thermophilus, Lactobacillus delbrueckii subsp. bulgaricus, Lactobacillus acidophilus, Bifidobacterium animalis subsp. lactis, Lactococcus lactis subsp. cremoris, Lactococcus lactis subsp. lactis, Lactococcus lactis subsp. lactis var. diacetylactis, and lactose) was used to produce dairy products.The cow's skimmed UHT milk  was used for Symbilact. Milk totals are 0.16% fat, 3.18% protein, and 4.7% lactose. Cassava starches that were used in the experiment are the following: native GOST 32902-2014 ; enzyme-modified cassava starches AT-0.05, AT-0.1, AT-0.25, AT-0.5, and AT-1, obtained under the action of various concentrations of Amylosubtilin® ), Russia; G3x (A -1500 U/g); and enzyme-modified cassava starches BT-0.05, BT-0, 1, BT-0.25, BT-0.5, and BT-1, obtained under the action of different concentrations of bacterial amylase a et al. . CommercBacillus licheniformis (BT starch) of different concentrations  and brought up to 50 ml with distilled water and measured at 625 nm after 5 minutes. Calculation of the amylose percentage is calculated by the formula: CA = 85.24 × −13.19.Amylose content was determined by the iodine binding method described by Williams et al.  with modThe amount of protein was measured using the method described in Bradford . Residuaw/v) was dispersed in a preweighed centrifuge tube. The tube was placed in a vortex mixer for 2 min, left at room temperature for 30 minutes, gently stirred during this period, and then centrifuged at 3000 rpm for 15 minutes. The supernatant was then discarded, and the weight of the tube and hydrated sample was measured. The weight was calculated and expressed as the weight of water bound by 100 g dry starch.The methods described by Omojola et al.  were useWSI was the weight of dry solids in the supernatant from the WAC test. The supernatant liquid was then decanted into a tared evaporating dish of known weight. The weight of dried solid after evaporation in an air-circulating oven at 103°C was recorded. The WSI (expressed as grams solids/100 g of starch) was calculated from the weight of dry solids recovered by evaporating the supernatant at 110°C for 12 h.Gelatinization temperature was evaluated using the method of Attama et al. . The staStarches  were added to cow's skimmed milk  at a concentration of 1% and subjected to heating, in a boiling water bath followed by heating at 100°C for 30 min; the mixture was stirred for uniform distribution of starch. The lyophilized dried broth for Symbilact was added to nonfat milk at the rate of 0.1 g/100 ml and fermented at 37°C for 16 hours. Then, it was added as a broth to milk mixtures with starches at the rate of 5% by weight of the mixture. To obtain a fermented dairy food, milk was fermented at 40°C for 8 hours; then, the finished product was cooled at 4–5°C for 20 h for stabilization. Then, the samples were analyzed (1 day), the batch of yogurt was left for storage at 4°C for 28 days, and measurements were also carried out after storage.Analysis of proteins, dry matter, and density in the Symbilact has been described by us earlier . Salts, Y) after cooling to +4°C in 24 hours of storage were centrifuged for 10 minutes at 3000 rpm, +20°C. The released whey (W) was removed and weighed. The WHC of fermented milk is calculated as follows:For water holding capacity (WHC) and syneresis analysis , samplesY). Samples were centrifuged for 5 minutes, 500 rpm in +20°C. The released whey (S) was removed and weighed. Syneresis of fermented milk is calculated as follows:Syneresis was measured after samples (about 20 g) were cooled to +4°C in 24 hours of storage  were measured at 8°C using a Brookfield concentric cylinder viscometer  equipped with rotor no. 3, mixing at 60 rpm. Measurements were carried out in triplicates for each treatment, and results were recorded in mPa·s.L∗, a∗, and b∗) of the Symbilact samples were measured using a colorimeter Chroma Meter (China) [L∗, darkness-lightness (0–100); a∗, greenness-redness (−60–+60); and b∗, blueness-yellowness (−60–+60). Symbilact samples (50 ml) were stirred and placed in an aluminium cylinder (outside diameter 55 mm), with the surface optically flat before measuring, and the sensor was mounted directly on top of the cylinder to prevent ambient light noise.Symbilact samples were evaluated as before by the panelist . At leas (China) . DiffereAntioxidant scavenging capacity was analyzed according to the procedure described by , with soμl of 0.1% FeCl3. The control was prepared similarly; only 1% potassium ferricyanide was replaced with a buffer mixture. The absorption of the reaction mixture was measured at 700 nm. The reducing force was expressed as absorbance at 700 nm relative to the control.The FRAP assay was carried out following the procedure described by  with modP < 0.05. The results were analyzed for statistical significance with two-way ANOVA by GraphPad Prism software at a significance level of P < 0.05. The graphical representation of the principal component analysis (PCA) allows the data to be analyzed on a two-dimensional P1/P2 map by Statistica12 (Statsoft) and to identify the trends between variables at a significance level P < 0.05. When two variables are far from the centre and close together, they correlate significantly. If they are on the opposite side of the centre, then they are significantly negatively correlated.All experiments were carried out in triplicate. Five replicates were performed for DPPH analysis. Significance was established at Amylosubtilin® and Bacillus licheniformis amylase increased by an average of 4 times in comparison with the native one. The highest percentage of amylose was in starches treated with an average concentration of the enzyme . An increase in the concentration of Bacillus licheniformis amylase above 0.830 U/g starch led to a decrease in the proportion of amylose and, apparently, due to its degradation under the action of the enzyme. The content of amylopectin in the samples, respectively, was inversely proportional to amylose. The amount of residual free dextrose in modified starches decreased (1.73-6.27 g dextrose/100 g starch) compared to native (10.55 g dextrose/100 g starch). Its minimum amount was in samples AT-1, BT-1, and BT-0.05 .The enzymes used to modify the starch had different effects on the gelatinization temperature. An increase of Amylosubtilin® concentration during modification led to a monotonic decrease in the temperature of gelatinization of polysaccharides. In the case of BT starches, an increase in the enzyme concentration led to the opposite effect.2O/g starch in the modified versus 2.4 g H2O/g starch in the native. The largest increase in WAC was observed for AT-0.5 samples, BT-0.5, and BT-1. The WSI value of the modified starches was higher than that of the native starches. High concentrations of the enzyme amylase Bacillus licheniformis (2.07 U/g starch and higher) lead to greater degradation of starch, converting them into a more soluble form. Thus, the action of enzymes on starches caused an increase in WAC and WSI.The WAC of starches after modification increased: 2.88-4.88 g HAt the next stage of the study, starches were used to correct the texture of the nonfat sour milk drink Symbilact. The physicochemical composition of Symbilact with different starches is shown in th day of storage, the total protein in Symbilact-AT and BT was in the range of 3.94-4.16%. The added modified starches resulted in an increase in the proportion of proteins in whey. Probably, starch changing water activity influences redistribution of milk protein fractions. After 28 days of storage, the content of this protein decreased in all samples but remained still higher in the samples with modified starches compared to the control. As indicated, the Lactococcus cell includes many proteolytic enzymes that can hydrolyze caseins and peptides.The amount of protein in the product with modified starches was slightly higher than that in the control and Symbilact-native, which is possibly related to an increase in the density of the milk curd. The higher total protein, dry matter, and salt content are due to the increased density of Symbylact due to the addition of starch stabilizers. Probably, starch changing water activity influences redistribution of milk protein fractions. On the 28Perhaps, the presence of modified starches and their incorporation into the matrix of the milk gel contribute to the viability of LAB; as a result, autolytic processes are inhibited and the intracellular enzyme output is suppressed. There is protein conservation in samples with modified starches.In the control, the carbohydrate content is the lowest. Naturally, the introduction of starches as a carbohydrate component increased the level of carbohydrates; in Symbilact-AT and BT, this indicator was in the range of 5.12-5.46%. The largest amount of carbohydrates is in Symbilact-native, which is probably due to the fact that the introduced starch was the least water-soluble. During fermentation and storage, modified starch is more easily hydrolyzed by LAB than native starch, so modified starch can act as an additional carbohydrate substrate, resulting in lactic acid synthesis being intensified. In fact, after 28 days of storage, the amount of carbohydrates in all samples with modified starches decreased. In Symbilact-native, after 28 days, there was the highest value, which may be due to the inaccessibility of native starch for destruction by lactic acid bacteria.The apparent viscosity of the fat-free dairy product is low as there are no fat globules. Lack of fat provokes an increase in syneresis. The addition of enzymatically modified cassava starches had a positive effect on the level of syneresis in the samples . On the WHC of Symbilact was inversely correlated with syneresis . The smaThe introduction of native starch into Symbilact resulted in a 3.2-fold increase in viscosity in comparison with the control. The viscosity of the AT and BT samples was in the range of 1184-1760 mPa·s. After 28 days of storage, the viscosity of all samples with modified starches increased by 1.3-1.7 times; in the control, 1.2 times. In Symbilact with native starch, the apparent viscosity decreased by 1.5 times, probably as a result of starch retrogradation. Statistical analysis of the correlation index between WHC and apparent viscosity was 0.909.Increasing the amount of solids by adding starches led to increased product viscosity; increased amount of lactic acid in variants with modified starches intensified destabilization of casein (paracasein) micelles to aggregate to form a gel. Partially hydrolyzed modified starch can more successfully fill the space between casein micelles than native starch.Samples of Symbilact with modified starches did not differ from the control in appearance ; they haSymbilact with native cassava starch was the least preferable in appearance: it had a loose, nonuniform solid-jelly structure, exfoliated upon stirring, and created an unpleasant feeling of coarse fibers (clumpy texture) when chewed in the mouth. The Symbilact-Nat sample had a fermented milk aroma and an unexpressed taste with a starchy aftertaste.The average taste rating of the Symbilact samples with FMS (FMC) was higher than the Symbilact control, due to their rich creamy taste. The highest total score (18-20 points) was received by the following samples: AT-0.1, AT-0.5, AT-1, BT-0.5, and BT-1. In the presence of modified starches, L of some samples of Symbilact  decreased. The shift in the color range of Symbilact-AT and BT to the red and blue sides may probably be associated with the Maillard reaction (the interaction of milk proteins with starch breakdown products). The addition of starches led to a decrease in the gloss of Symbilact.Bacillus licheniformis amylase. The maximum FRAP of the product was found in BT-0.1 and in whey—in AT-0.5 and BT-0.1.FRAP whey and product of Symbilact with starches at 28 days of storage were higher than that of the control . The greThe addition of enzymatically modified starches led to an increase in whey RSA in most cases by 5-10% compared to control . The useBacillus licheniformis concentrations for partial hydrolysis of starch during modification do not affect the quality of the fresh dairy products. After 28 days of storage, the distance between the samples with AM and BT samples increased, which indicates a change in the properties of the products and an increase in differences in the totality of the analyzed properties. The difference in the stabilizer used and its influence on the final properties of the product are revealed only after some storage time.PCA  showed tIndicators (in pairs) Vis and WHC, density and dry matter, and salts and proteins, between the vectors of which the angle is minimal, demonstrate a high degree of correlation between themselves both on days 1 and 28 of storage. The location of samples AT-0.05 and BT-0.05 changed minimally, which indicates the stability of the fermented milk product.The syneresis (Syn) and carbohydrates (Carbon) indicators are negatively correlated, the angle between them is almost equal to 180°. The longest vector is more important (the indicator is farther from the centre of the graph). Thus, the analyses show that the most important are texture indicators  and chemical composition .A number of researchers have recommended the use of cassava starch because of its neutral taste, high purity, viscosity, good solubility, and swelling capacity , 37. TheB. licheniformis amylase, possessing high alpha-amylase activity, have been described [In previous works, the results of the modification of potato starches with complex preparations of Amylosubtilin and escribed . The difescribed . Postenzescribed . In addiescribed . The enzescribed .The addition of starch affects the redistribution of milk protein fractions towards an increase of protein in whey . StarcheThe improvement in texture of products with enzymatically modified starches is due to their low viscosity, increased WAC, and solubility (WSI) . During The introduction of native starch, which has a high gelling ability and water absorption after heating, causes a high WHC level of Symbilact-Nat, but the retrograde starch during storage of native starch leads to texture defects. When using modified starches, the WHC of Symbilact increased, which may also be associated with the release of hydrophilic free amino acids and short-chain polypeptides during hydrolysis of whey protein  and withAn increase in the viscosity of Symbilact with modified starches was due to the ability of starch to swell , strengtThe textural changes due to the introduction of modified starches had a positive effect on the taste of Symbilact . The resThe increase in the ability of the whey of Symbilates to bind free radicals may be due to antioxidant peptides secreted by lactic acid bacteria during milk fermentation  and exopBacillus licheniformis) starches exhibit higher antioxidant potential, but less structure correction. To sum up, the use of enzymatically modified cassava starches makes it possible to obtain a dairy drink Symbilact based on skim milk with improved texture properties, better taste , and also high antioxidant potential.This study demonstrated changes in the chemical, rheological, and antioxidant properties of the nonfat dairy product Symbilaсt with the addition of enzymatically modified cassava starch. Enzymatically modified starches, unlike native starches, do not inhibit the acid-forming activity of lactic acid bacteria. Starches modified with Amylosubtilin® are better able to correct the structure, especially AT-0.5 and AT-1, but to a lesser extent increase the antioxidant properties of Symbilact. In contrast, BT (modified by amylase


Using CLSM, FTIR, XRD, NMR, FTIR, XPS, and other technologies, the modification effect was verified, and the physical and chemical properties of J-OSA-Starch such as DSC, RVA, transparency, and emulsifying properties were determined. (3) Results: Jet milling pretreatment significantly reduced the particle size of corn starch and improved the reaction efficiency and degree of substitution during esterification with OSA. After pretreatment, the corn starch granules were broken, and the relative crystallinity was significantly reduced. CLSM, FTIR, XPS, and NMR confirmed the esterification of corn starch with OSA, which increased with increasing crushing strength. The thermodynamic properties and viscosity of J-OSA-starch decreased with the increase in the classification speed. Jet milling pretreatment enhanced the clarity, emulsifying activity, and emulsifying stability of OSA-modified corn starch. (4) Conclusions: Jet milling pretreatment can effectively increase the esterification efficiency of starch and OSA. Therefore, jet milling can be used as a pretreatment to improve the esterification of starch OSA and produce modified starch for industrial applications. Starch is a micro or submicron particle formed by amylose, amylopectin, fat, proteins, minerals, salts, and nanocrystals . Starch can be more widely used in the food industry by physical and chemical modification . StudiesAlthough starch with OSA can be used as an additive in food, its application is limited due to the low substitution degree and low reaction efficiency . At presJet milling technology is used to generate high-speed airflow through the nozzle of the compressed gas after drying and purification and drive the particles to move at high speed in the crushing cavity so that the particles are crushed by impact collision, friction, shearing, etc. The qualified particles are collected by the collector, while the coarse particles that do not meet the requirements are returned to the crushing chamber to continue crushing until the required fineness is reached and collected. Compared with the ball mill and vibrating mill, the jet mill has the characteristics of low energy consumption, short pulverization time (1 h), and low pulverization temperature (25 °C). In the crushing cavity, high-speed airflow created by the jet milling technology is driven by the high-speed movement of the particles. As a result, the particles are subjected to impact collision, friction, shear, and other crushing effects, and the crushed particles are classified according to classifier rotational speeds . As a meThe previous research of our group showed that jet milling could break starch granules and significantly increase the specific surface area of starch. This change means that more groups that react with OSA are exposed, which can effectively increase the esterification efficiency. Then the United Nations Food and Agriculture Organization and the World Health Organization (FAO/WHO) stipulated that the OSA ester could be used in food, but the maximum processing capacity of octenyl succinic anhydride should not exceed a 3% level, and the influencing factors such as temperature and pH are sufficient in the esterification modification of different starches. In this study, starch obtained at different classification speeds was subjected to an esterification reaction with OSA, and the effect of pulverization degree on esterification efficiency was studied.w/w) moisture, 0.30% protein, 0.05% fat, and less than 0.1% ash. All other chemicals and reagents were of analytical grade and purchased from Chemical Company, Tianjin.Normal corn starch was obtained from Heilongjiang Longfeng Cron-developing Co., Ltd. . The starch composition was determined according to the methods of the Association of Official Analytical Chemists (AOAC). The normal corn starch (wet weight) contained 13%  was used for pretreatment of corn starch, and the equipment parameters and pulverization conditions were as follows: 3 nozzles, draft fan flow rate of −15 mw/w) was prepared by mixing 200 g of jet milling-pretreated starch sample (dry base) with distilled water. The pH of the starch milk was adjusted to 8.5 with a 2% NaOH solution. A total of 6 g of OSA was weighed, diluted three times with anhydrous ethanol, and added dropwise to the starch suspension within 1.5 h. The reaction pH was monitored and maintained at pH 8.5. The reaction was continued for 1.5 h under stirring. After the reaction, the pH was adjusted to 6.5 with a 2% HCl solution. Starch was washed 2 times using 90% ethanol and distilled water, followed by centrifugation. The samples were dried at 40 °C for 24 h, then ground and passed through a 100-mesh sieve [A starch suspension with a concentration of 30%  as described by Wang . Starch v/v) aqueous isopropanol solution was then added to the mixture and stirred for 10 min. The sample was transferred to a Buchner funnel and filtered, and the residue was washed with 90% isopropanol solution until no chloride ions could be detected with 0.1 mol/L AgNO3 solutions. The sample residue was dissolved in 300 mL of deionized water and heated in boiling water for 20 min, 2 drops of phenolphthalein indicator were added, and the temperature was maintained and rapidly titrated to pink with 0.1 mol/L standard NaOH solution [OSA-starch was accurately weighed to 5.0 g (dry weight), 25 mL of 2.5 mol/L hydrochloric acid-isopropanol solutions were added, and the mixture was stirred continuously at room temperature for 30 min. A 50 mL of 90%  for observation at magnifications of 2000× .w/w) methylene blue (MB+) solution, the sample was stirred magnetically at room temperature for 24 h. The excess MB+ was washed out with methanol. Finally, the starch granules were mixed with a glycerol-water mixture . A drop of the starch suspension was placed on a slide, covered with a coverslip, and the overall distribution of octenyl succinate groups in the starch granules after fluorescent staining was observed . The lens used in this study was 40×/1.25 oil, and the gas laser argon laser emitted at 514 nm [A sample of 0.5 g starch was mixed with 30 mL of deionized water, and the pH was adjusted to about 8.0 with 1 mol/L NaOH solution. After adding 1% , and the detection conditions were as follows: CuKα (1.5406) as the characteristic ray, 40 kV tube voltage, 100 mA current, 2θ interval of measurement angle from 4° to 60°, 0.02° step size, and 4°/min scanning speed . Based o−1 and a resolution frequency of 4 cm−1 [A sample of 3.0 mg starch was mixed with 300 mg of KBr powder, ground, and pressed into tablets. Samples were scanned at 400–4000 cmf 4 cm−1   was used as a standard for energy correction, and the sample was dried to constant weight and filled with inert gas for sealing protection before testing [An X-ray energy spectrometer  was used for the elemental analysis of the starch surface. The test conditions were as follows: Al-Kα line of 1486.6 ev, a line width of 0.8 ev, a vacuum of 5 × 106. A total of 2 mg of deuterated trifluoroacetic acid was added before analysis. 1H NMR spectral conditions  were as follows: analysis temperature of 30 °C, pulse angle of 30°, relaxation time of 10 s, and detection time of 2 s [Maltose-free starch samples of 5 mg each were dissolved in DMSO-de of 2 s .6 (containing tetramethylsilane TMS) and measured at 100.62 MHz, 25 ± 1 °C , using the chemical shift of TMS as a reference [Starch samples were dissolved in DMSO-deference .m/v), sealed, and equilibrated at room temperature for 24 h. The temperature range was 20~100 °C with a constant heating rate of 10 °C/min  [Starch samples of 6.0 mg each (dry basis) were placed into an aluminum tray, and deionized water was added at 1:3  .A starch sample of 3.5 g weight was dispersed in 30 mL of distilled water in an aluminum pot and mixed using a homogenizer, and analyzed by a rapid viscosity analyzer  to obtain starch pasting characteristic values .w/v), heated in a water bath at 30 °C, 70 °C, and 100 °C in water, and then cooled to room temperature. The light transmission of the starch paste was measured using a UV spectrophotometer at a wavelength of 650 nm, and distilled water was used as a reference [The starch suspension was prepared at a concentration of 1% (eference .w/w) starch emulsion, which was placed in a boiling water bath at 100 °C and stirred continuously for 20 min. The gelatinized starch emulsion was cooled to room temperature, 5% of peanut oil was added based on starch weight, homogenized for 1.5 min at 10,000 rpm using a high-speed homogenizer, and repeated twice. Aspirate 50 μL of the starch emulsion was mixed with 5 mL of 0.1% sodium dodecyl sulfate solution. The initial absorbance (A0) of the sample was measured by a UV spectrophotometer at 500 nm using a 0.1% concentration of sodium dodecyl sulfate solution as a blank, and the value obtained was the EA of the sample [A certain amount of starch sample was mixed with deionized water to prepare a 1.5% (A10) was determined again by a UV spectrophotometer. The emulsification stability index (ESI) was calculated using the following equation [The starch sample was allowed to stand for 10 min, and its absorbance at 500 nm (equation .(3)ESI and Duncan’s multiple range test with a confidence interval of 95% were performed using SAS software version 9.2 .90) was 20.06 μm, the median size (D50) was 13.43 μm, and the fine end size (D10) was 5.87 μm. At a classifier speed of 3600 rpm (J5-starch), the particle size parameters were reduced to 13.34 μm, 7.70 μm, and 2.08 μm, respectively. However, the specific surface area (Sw) increased from 0.237 m2/g for the native corn starch to 0.403 m2/g for the jet milling-treated corn starch at a classifier speed of 3600 rpm. It can be seen from Changes in the particle size and specific surface area of corn starch after pretreatment and after OSA modification by jet milling at different classifier rotational speeds are shown in The degree of substitution and substitution efficiency of OSA-starch obtained after the esterification of corn starch with OSA without jet milling pretreatment were 0.0170 and 73.5%, respectively . HoweverChanges in the morphology and surface structure of starch granules were analyzed using a scanning electron microscope, and the microscope images are shown in +) fluorescent stain was used to specifically label the -COO− of the OS group inside and on the surface of OSA-starch granules, thus observing the distribution of the OS group in OSA-starch. −) in OSA-starch was positively correlated with the degree of substitution, i.e., higher substitution showed stronger fluorescence intensity [CLSM is commonly used to study changes in the internal structure of starch granules. In this study, a methylene blue  is an analytical technique for obtaining the distribution of different chemical states of elements on the surface of a sample by measuring the photon energy produced by the sample and is widely used to study changes in the structural and surface groups of modified starch . Figure 1H-NMR and 13C-NMR spectra for the native, jet milling pretreated, and OSA-esterified corn starch samples are shown in 1H-NMR spectra revealed that the OSA groups were introduced into the molecular structure of corn starch during the esterification process. As the classifier speed of the jet milling pretreatment increased, the relative intensity of the spectral peak weakened, where the chemical shift of OH2 was located, and no obvious changes were found in peaks of other chemical shifts, indicating that the esterification reaction of jet milling-pretreated corn starch with OSA might mainly occur on the OH2. For the 13C-NMR spectrum, the chemical shifts of C12 and C13 on the unsaturated double bond were in the range of 110–150; the chemical shifts of C17 and C18 on the carboxyl and ester carbonyl groups were in the range of 155–185, but the overall esterification of the jet milling-pretreated corn starch with OSA was not obvious. These results illustrate the effect of jet milling pretreatment on the OSA modification at the level of starch molecular structure.The 0, TP, TC, and enthalpy values. For the samples esterified by OSA, the thermal absorption peak at 70 °C was restored, which is consistent with the results of increased crystallinity and increased order by XRD and FTIR.From Changes in the pasting characteristics of the native and treated corn starch are presented in From From The corn starch was treated by jet milling technology, and different pretreated starch samples were obtained according to the classification speed. It was found that the pretreatment of jet milling reduced the particle size and relative crystallinity of the starch, increased the specific surface area of the particles, and improved the reaction efficiency with OSA. Degree of substitution. FTIR, XPS, and NMR analyses confirmed that the esterification efficiency of cornstarch with OSA increased with increasing jet milling intensity. The physicochemical properties analysis showed that the thermodynamic and RVA parameters of the J-OSA-starch prepared by jet milling were significantly reduced, and the transparency and emulsification were significantly improved. Based on the obtained results, jet milling can be considered a promising pretreatment method to improve the efficiency of the esterification reaction of starch with OSA to produce OSA-modified starch for industrial applications. Further studies are required to investigate the application properties of jet mill pretreatment and OSA-modified starch.


The influence of baseline HbA1c levels on vein graft outcomes post coronary artery bypass grafting (CABG) remains unclear.The purpose of this study was to assess the association between baseline HbA1c and 1-year vein graft patency, and the effects of antiplatelet therapy on the 1-year vein graft patency after CABG in patients with baseline HbA1c <6.5% vs ≥6.5%.NCT02201771), in which 500 patients were randomly allocated to receive ticagrelor plus aspirin (T+A), ticagrelor alone (T), or aspirin alone (A) for 1 year after CABG. The primary outcome was the vein graft patency (FitzGibbon grade A) at 1 year.We examined the subgroups with baseline HbA1c <6.5% vs ≥6.5% from the DACAB trial (P for interaction = 0.335), whereas T did not show more significant improvement than A in both subgroups.A total of 405 patients with available baseline HbA1c data were included in this subgroup analysis. Of them, there were 233 patients (678 vein grafts) with baseline HbA1c <6.5% and 172 patients (512 vein grafts) with baseline HbA1c ≥6.5%. Compared with the HbA1c <6.5% subgroup, the HbA1c ≥6.5% subgroup showed worse 1-year vein graft patency . T+A showed higher vein graft patency than A in both HbA1c <6.5%  and HbA1c ≥6.5% subgroups , without an interaction effect (In the DACAB trial, lower baseline HbA1c was associated with higher vein graft patency 1 year after CABG. T+A improved 1-year vein graft patency vs A, irrespective of baseline HbA1c.  Diabetes mellitus (DM) is associated with a worse prognosis of coronary artery diseases (CAD).For diabetic patients with 1- or 2-vessel disease, including the proximal left anterior descending artery, 3-vessel disease, or left main coronary artery disease, the current European guidelines made a Class I recommendation on coronary artery bypass grafting (CABG) as the gold standard for myocardial revascularization.Although blood glucose levels are punctual and vary greatly within a given day, glycated hemoglobin (HbA1c) levels represent the glucose levels over the past 90 days and can be used to evaluate glycemic control.Therefore, this post hoc subgroup analysis of the DACAB (Different Antiplatelet Therapy Strategy After Coronary Artery Bypass Graft Surgery) trial aimed to assess the effects of ticagrelor with or without aspirin vs aspirin alone on the 1-year vein graft patency after CABG according to baseline HbA1c levels. The results could provide additional data for the personalization of antiplatelet therapy after CABG.NCT02201771) was a multicenter, open-label, randomized trial of ticagrelor with or without aspirin vs aspirin alone that enrolled patients undergoing elective CABG (75% off-pump) in China.The DACAB trial  with 1,190 vein grafts from the original DACAB trial and available baseline HbA1c data were included in the present analysis. In the ITT analysis, all grafts with missing outcome assessments were considered FitzGibbon grade O.Continuous variables were presented as means ± standard deviations or medians with interquartile ranges. Differences in baseline characteristics between treatment groups within baseline HbA1c <6.5% vs ≥6.5% and among subgroups were compared using the analysis of variance test. Categorical variables were presented as numbers and percentages and were analyzed using the chi-square test or Fisher’s exact test. The analyses were performed on a per-graft and per-patient basis. In the per-graft analysis, as each patient received multiple vein grafts, a generalized estimating equation model was used to analyze the repeated measures of outcomes. A logit link function was applied, and an independent covariance structure was used to model the correlation of the responses from the same patients. The stability of the model was verified using unstructured and exchangeable covariance structures. The estimation of the between-subgroup differences in vein graft patency was presented as odds ratios (ORs) and 95% confidence intervals (CIs). In the per-patient analysis, the patient outcome was classified according to the worst graft outcome in the patient. Logistic regression was used to obtain ORs and corresponding 95% CIs. Confounders were selected based on data availability and the literature, including age, sex, medical history of hypertension and hyperlipidemia, SYNTAX score, target vessel distribution, antiplatelet therapy, and statin use at 1-year after CABG. The consistency of the treatment effect among the subgroups was explored using a treatment × subgroup interaction. An HbA1c cutoff point of 6.5% was used in the analyses. Besides, HbA1c cutoff point of 7%, 7.5%, and 8% was used as sensitive analysis.A 2-sided level of significance of 0.05 was applied. All analyses were performed using SAS 9.4 (SAS Institute).P = 0.035) and statin use at 1 year post CABG . According to available baseline HbA1c data, there are 233 patients (678 vein grafts) in the <6.5% subgroup and 172 patients (512 vein grafts) in the ≥6.5% subgroup . The basP = 0.021) and occlusion . Similar results were observed for vein graft patency in the per-patient analysis   and nonocclusion (FitzGibbon grade A+B) rates were 86.1% and 88.9% in the HbA1c <6.5% subgroup and 77.9% and 81.6% in the HbA1c ≥6.5% subgroup, respectively. Compared with the HbA1c <6.5% subgroup, the HbA1c ≥6.5% subgroup showed worse patency  .Table 2OP > 0.05)  and nonocclusion (FitzGibbon grade A+B) rates were 96.9% and 97.4% in the HbA1c <6.5% subgroup and 97.7% and 98.5% in the HbA1c ≥6.5% subgroup, respectively. There was no difference in artery graft outcomes between the baseline HbA1c <6.5% vs ≥6.5% subgroups  .P = 0.335). There were no significant differences in patency for ticagrelor alone vs aspirin alone in both HbA1c subgroups  and no interaction effect (interaction P = 0.510). Similar results were observed in the per-patient analysis , 81.8% with ticagrelor alone, and 77.4% with aspirin alone. T+A had lower odds of nonpatency compared with aspirin alone in the HbA1c <6.5% subgroup  and in the HbA1c ≥6.5% subgroup . There was no interaction effect between the baseline HbA1c status and antiplatelet treatment . There were no significant differences in occlusion for ticagrelor alone vs aspirin alone in both subgroups  and no interaction effect (interaction P = 0.154). Similar results were observed in the per-patient analysis  and in the ≥6.5% subgroup . There was no interaction effect between baseline HbA1c status and antiplatelet treatment  (Thirteen major adverse cardiovascular events (MACEs), defined as a composite of cardiovascular death, myocardial infarction, and stroke, were observed within 1 year after CABG, with 6 (2.6%) in the HbA1c <6.5% subgroup and 7 (4.1%) in HbA1c ≥6.5% subgroup, respectively. Overall, the incidence of MACE was relatively low for all randomized antiplatelet treatments in both subgroups. There were no significant differences between the baseline HbA1c <6.5% and ≥6.5% subgroups and between antiplatelet treatments  .Table 51P = 0.632). In both HbA1c subgroups, the incidence of bleeding, particularly minimal bleeding, was significantly different among the randomized antiplatelet treatments .The incidence of overall bleeding events was similar between the HbA1c <6.5% and ≥6.5% subgroups  and nonocclusion . The association was also observed when HbA1c was analyzed as a continuous variable. T+A showed a higher vein graft patency rate than A in both HbA1c <6.5% subgroup  and ≥6.5% subgroup , without an interaction effect (P for interaction = 0.035). While, T did not show improvement compared with A in both subgroups. The results indicated that higher baseline HbA1c was associated with lower vein graft patency at 1 year after CABG. T+A improved 1-year vein graft patency vs A in patients who underwent CABG, irrespective of baseline HbA1c.This post hoc study of the DACAB trial aimed to assess the influence of baseline HbA1c levels on early (1-year) vein graft patency after CABG and the effects of a more aggressive antiplatelet therapy  on 1-year vein graft patency in patients with HbA1c <6.5% vs ≥6.5%. In the per-graft analysis, compared with the HbA1c <6.5% subgroup, the HbA1c ≥6.5% subgroup showed worse patency Hence, using HbA1c, which represents the overall glycemic control over the past 3 months,P = 0.037),A previous small-scale study suggested no differences in patency between patients with HbA1c <6.5% and ≥6.5%  at 1 year in the HbA1c <6.5% subgroup and in the ≥6.5% subgroups, and there was no interaction between the HbA1c control and antiplatelet therapy. It suggests that a more aggressive dual antiplatelet therapy is sufficient to counteract the potential negative effects of HbA1c on thrombosis-related vein graft failure. Recently, the POPular CABG (Effect of Ticagrelor On Saphenous Vein Graft Patency in Patients Undergoing Coronary Artery Bypass Grafting Surgery) trial did not observe a decreased vein graft occlusion rate with T+A vs aspirin alone at 1 year after CABG. The OR for occlusion was 0.9 (95% CI: 0.3-2.7) in DM and 1.5 (95% CI: 0.7-2.9) in non-DM, with an interaction NCT03987373). Fifth, we only analyzed the baseline HbA1c levels. The fluctuations in HbA1c levels during the intervention may occur, which was not considered in this post hoc analysis. Finally, the present study was a post hoc analysis of a completed trial, and the study design did not allow any causality determination. Future studies might be longitudinal in design and allow determination of the causes of vein graft failure. In addition, the power analysis of the original trial did not take into account baseline HbA1c.This study has limitations. First, baseline HbA1c levels were missing for 95 of 500 patients. The exclusion of these patients may cause data deviation. Second, most patients underwent off-pump CABG, which represents the current clinical practice status in China. Therefore, the conclusions may not apply to patients undergoing on-pump CABG. Third, we did not collect the data of type 1 and type 2 DM in the DACAB trial. Thus, the graft outcomes of patients with type 1 or type 2 DM were not compared. Fourth, the long-term outcomes are not yet available. Of note, a 5-year follow-up extension study is currently ongoing (PerspectivesCOMPETENCY IN MEDICAL KNOWLEDGE: The influence of baseline HbA1c levels and the interaction effect of antiplatelet therapy on vein graft outcomes post CABG remains unclear. Our subgroup analysis of the DACAB trial showed higher baseline HbA1c was associated with worse vein graft patency 1 year after CABG. Ticagrelor plus aspirin showed higher 1-year vein graft patency compared with aspirin alone, irrespective of baseline HbA1c.TRANSLATIONAL OUTLOOK: For patients with poor baseline glycemic control, the vein graft failure was a matter of concern even in the early term. Compared with aspirin alone, ticagrelor plus aspirin-based dual antiplatelet therapy could improve the 1-year vein graft patency, irrespective of baseline HbA1c. Thus, artery grafts might be a more appropriate choice for these patients, which needs further validation.In the DACAB trial, higher baseline HbA1c was associated with lower vein graft patency 1 year after CABG. T+A improved 1-year vein graft patency vs aspirin, irrespective of baseline HbA1c. Overall, multiple artery grafts might be a more appropriate choice for these patients with poor glycemic control.The DACAB was funded by AstraZeneca; this post hoc analysis was not. Dr Zhu has served as a speaker for AstraZeneca, Johnson & Johnson, Novartis, and Sanofi; and as an investigator on clinical trials sponsored by AstraZeneca, Bayer, Novartis, and Sanofi. Dr Liu has served as a speaker for Pfizer. Dr R. Wang has served as a speaker for AstraZeneca; and as an investigator on clinical trials sponsored by Bayer. Dr. X. Wang has served as a speaker for AstraZeneca and Johnson & Johnson. Dr Cheng has served as a speaker for Medtronic. Dr Zhao has served as a speaker for AstraZeneca, Johnson & Johnson, and Medtronic; and has been an investigator on clinical trials sponsored by AstraZeneca, Bayer, Novartis, and Sanofi. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.