Smartphone-based DIY home microsurgical training with 3D printed microvascular clamps and Japanese noodles

We have recently incorporated simple modifications of the konjac flour noodle model to enable DIY home microsurgical training by (i) placing a smartphone on a mug to act as a microscope with at least 3.5-5x magnification, and (ii) rather than cannulating with a 22G needle as described by others, we have found that cannulation with a 23G needle followed by a second pass with an 18G needle will create a lumen (approx. 0.83 mm) without an overly thick and unrealistic “vessel” wall. The current set-up however, did not allow realistic evaluation of anastomotic patency as the noodles became macerated after application of standard microvascular clamps, which also did not facilitate practice of back-wall anastomoses. In order to simulate the actual operative environment as much as possible, we introduced the use of 3D printed microvascular clamps. These were modified from its previous iteration (suitable for use in silastic and chicken thigh vessels) and video recordings were submitted for internal validation by senior surgeons. A “wet” operative field where the knojac noodle lumen can be distended or collapsed, unlike other non-living models, was noted by senior surgeons. With the 3D clamps, the noodle could now be flipped over for back-wall anastomosis and allowed patency testing upon completion as it did not become macerated, unlike that from clinical microvascular clamps. The perceived advantages of this model are numerous. Not only does it comply with the 3Rs of simulation-based training, it can also reduce the associated costs of training by up to a hundred-fold or more when compared to a traditional rat course, and potentially, be extended to low-middle income countries (LMICs) without routine access to microsurgical training for capacity development. That it can be utilised remotely also bodes well with the current limitations on face to-face training due to COVID restrictions and lockdowns.

Amorphophallus konjac: A Novel Alternative Flour on Gluten-Free Bread

The demand for gluten-free products is rising, but their production with similar quality as their gluten counterparts is challenging. This study aimed to develop gluten-free bread samples using different concentrations of Amorphophallus konjac flour (0%, 12.5%, 25%, 37.5%, and 50% of the total flour content) and to evaluate their nutritional and physicochemical properties. Proteins, lipids, carbohydrates, moisture, ash content, fibers, resistant starch, firmness, specific volume, and color were evaluated using official methods. Protein varied from 2.95% to 4.94%, the energy value from 347.93 to 133.55 kcal/100 g, dietary fiber from 8.19 to 17.90%, and resistant starch from 0.67% to 0.75% on wet basis. The addition of konjac flour positively influenced the specific volume. Higher concentrations of konjac flour in the formulations led to lower calories of the bread due to the significant addition of water to the dough. The bread samples with konjac showed high fiber content due to the composition of the flour. They had lower levels of carbohydrates, which can positively influence the glycemic index. Konjac flour provided dough mold, growth, and better texture for gluten-free bread. The best formulations were prepared in concentrations up to 37.5% konjac. The 50% konjac bread showed slightly reduced specific volume and pale color.

A pilot plant scale of Yellow Konjac (Amorphophallus muelleri Blume) flour production by a centrifugal mill using response surface methodology

This study aimed at investigating the effects of polishing conditions on the physicochemical properties of polished yellow konjac flour (PYKF) with a centrifugal mill using Central Composite Design-Response Surface Methodology (CCD-RSM). Micro-mill milled yellow konjac flour (MMYKF) mass and polishing cycles were the independent variables, with four observed responses (calcium oxalate, viscosity, degree of whiteness (DoW), and glucomannan). The lower limit (-1) and upper limit (+1) for MMYKF mass in this study are 10 and 15 kg, respectively, while the -1 and +1 for the polishing cycle are three times, and seven times, respectively. The optimum prediction occurred at 10 kg of MMYKF mass and six times the polishing cycle with the following characteristics: 0.52 ±0.00% w.b. calcium oxalate, 20362.00 ±16.00 cP viscosity, 62.22 ±0.01 DoW, and 69.43 ±0.02% d.b. glucomannan content, which agreed with the verification data with p-value >0.05 for all observed responses using the paired T-test. Polishing using a centrifugal mill is feasible and promises to be scaled up to industrial scale for yellow konjac flour polishing before the wet extraction process.