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Abstract Vitamins are organic elements that are essential for physiological functions. Synthetic vitamins are added to commercial pet food with complete and balanced claims to meet the requirements established by the AAFCO. Vitamins are a group of diverse compounds that vary in their stability and susceptibility to destruction by physical and chemical agents. Vitamin stability in premixes and finished foods during storage can be affected by multiple stresses such as mixture composition, humidity, temperature, light and chemical reactions such as oxidation. Trace minerals blended with vitamins can cause redox reactions that can significantly impact the stability of vitamins. Vitamin manufacturers have made improvements in fat soluble vitamin stability, including vitamin A & D3 cross-linked beadlets and vitamin E acetate that are more stable to heat and storage compared to non-cross linked natural forms. Despite the advent of more heat stable vitamin sources, thermal processes such as extrusion and retort still have an effect on vitamins and is primarily a function of temperature, time, pH, moisture content and the presence of compounds such as sulfite and thiaminase enzyme from fish that can exacerbate thiamine losses. Thiaminase enzyme is believed to be destroyed by cooking fish to 83◦C, however its effect on thiamine destruction was not effective until the fish was cooked to 121◦C. Studies on the effect of extrusion and retort process on severity of vitamin stability are scarce, however, existing literatures indicate that thiamine stability is less with retort compared to extrusion process. Among twenty-two commercial cat foods that were recalled for low thiamine since 2010, seventeen of them were canned cat food and 5 extruded dry cat foods. This review will examine vitamin stability during storage, retort process and during finished product shelf life, and will also provide formulation considerations.

Vitamins are organic elements that are essential for physiological functions. Synthetic vitamins are added to commercial pet food with complete and balanced claims to meet the requirements established by the AAFCO. Vitamins are a group of diverse compounds that vary in their stability and susceptibility to destruction by physical and chemical agents. Vitamin stability in premixes and finished foods during storage can be affected by multiple stresses such as mixture composition, humidity, temperature, light and chemical reactions such as oxidation. Trace minerals blended with vitamins can cause redox reactions that can significantly impact the stability of vitamins. Vitamin manufacturers have made improvements in fat soluble vitamin stability, including vitamin A & D3 cross-linked beadlets and vitamin E acetate that are more stable to heat and storage compared to non-cross linked natural forms. Despite the advent of more heat stable vitamin sources, thermal processes such as extrusion and retort still have an effect on vitamins and is primarily a function of temperature, time, pH, moisture content and the presence of compounds such as sulfite and thiaminase enzyme from fish that can exacerbate thiamine losses. Thiaminase enzyme is believed to be destroyed by cooking fish to 83°C, however its effect on thiamine destruction was not effective until the fish was cooked to 121°C Studies on the effect of extrusion and retort process on severity of vitamin stability are scarce, however, existing literatures indicate that thiamine stability is less with retort compared to extrusion process. Among twenty-two commercial cat foods that were recalled for low thiamine since 2010, seventeen of them were canned cat food and 5 extruded dry cat foods. This review will examine vitamin stability during storage, retort process and during finished product shelf life, and will also provide formulation considerations.

Significant improvement in thiamin retention of canned cat food has not been achieved by altering processing conditions. Some ingredients, such as yeasts, may supply thiamin able to withstand thermal processing. Therefore, the study objective was to evaluate yeast ingredients as thiamin sources for canned cat food. Six yeast ingredients were screened for thiamin content, and values ranged from 9.9–4,283.8 mg/kg dry matter basis (DMB). Treatments for thermal processing were arranged as a 2×4 factorial with 2 levels of vitamin premix (with or without) and 4 yeast ingredients (NY = none and LBV, BY, or EA from the ingredient screening). Replicates (n = 3) were processed in a horizontal still retort to an average lethality of 79.23 minutes. Thiamin degradation was analyzed as a mixed model with pre-retort thiamin content as a covariate and production day as a random effect. Main effects of vitamin premix and yeast and their interaction were significant at P -values less than 0.05. The Fisher’s LSD post hoc comparison test was used to separate means. On average, experimental formulas retained 33.75% thiamin. The main effect of vitamin premix (average -42.9 mg/kg DMB) was not significant ( P > 0.05). Thiamin degradation between NY (-31.3 mg/kg DMB) and BY (-33.8 mg/kg DMB) was similar ( P > 0.05) whereas EA (-40.5 mg/kg DMB) and LBV (-55.6 mg/kg DMB) lost more ( P < 0.05) thiamin than NY. The experimental formula of EA with vitamin premix (-70.3 mg/kg DMB) lost more ( P < 0.05) thiamin than no yeast, BY, or EA without vitamin premix (average -17.4 mg/kg DMB) and all others (average -57.3 mg/kg DMB) were intermediate ( P > 0.05). In summary, thiamin from yeast ingredients didn’t exhibit better thermal stability than thiamin mononitrate. However, those ingredients with similar degradation levels or uniquely high thiamin levels may provide added value.

Clinical work-up for suspected cardiac chest pain is resource intensive. Despite expectations, high-sensitivity cardiac troponin assays have not made decision making easier. The impact of recently validated rapid triage protocols including the 0-hour/1-hour hs-cTn protocols on care and outcomes may be limited by the heterogeneity in interpretation of troponin profiles by clinicians. We have developed machine learning (ML) models which digitally phenotype myocardial injury and infarction with a high predictive performance and provide accurate risk assessment among patients presenting to EDs with suspected cardiac symptoms. The use of these models may support clinical decision-making and allow the synthesis of an evidence base particularly in non-T1MI patients however prospective validation is required. We propose that integrating validated real-time artificial intelligence (AI) methods into clinical care may better support clinical decision-making and establish the foundation for a self-learning health system. This prospective, multicenter, open-label, cluster-randomized clinical trial within blinded endpoint adjudication across 12 hospitals (n = 20,000) will randomize sites to the clinical decision-support tool or continue current standard of care. The clinical decision support tool will utilize ML models to provide objective patient-specific diagnostic probabilities (ie, likelihood for Type 1 myocardial infarction [MI] versus Type 2 MI/Acute Myocardial Injury versus Chronic Myocardial Injury etc.) and prognostic assessments. The primary outcome is the composite of cardiovascular mortality, new or recurrent MI and unplanned hospital re-admission at 12 months post index presentation. Supporting clinicians with a decision support tool that utilizes AI has the potential to provide better diagnostic and prognostic assessment thereby improving clinical efficiency and establish a self-learning health system continually improving risk assessment, quality and safety. ANZCTR, Registration Number: ACTRN12620001319965, https://www.anzctr.org.au/.