Standards Initiative Research Articles

Translation, and validation of Dysphagia Outcome and Severity Scale (DOSS): Swedish version

BackgroundSwallowing dysfunction (dysphagia) significantly impacts patient and medical outcomes. In Sweden, there is no comprehensive outcome measure for dysphagia that incorporates holistic assessment and dysphagia impact on a person’s impairment, function and participation. The Dysphagia Outcome and Severity Scale (DOSS) was developed and validated (in English) and incorporates the World Health Organisation’s (WHO) aforementioned, International Classification of Functioning (ICF) aspects. This study translated then evaluated the validity and reliability of the Swedish version, DOSS-S.MethodTranslation occurred based on WHO recommendations. The Content Validity Index (CVI) of the translated version (DOSS-S) was assessed twice by 11 (multi-professional) dysphagia experts. Criterion validity and rater reliability was calculated using 18 Speech Pathologists assessing patient cases from International Dysphagia Diet Standardization Initiative—Functional Diet Scale (IDDS-FDS) research.ResultsVery high CVI values (0.96–0.99) for the linguistic correlation, and high CVI values (0.84–0.94) for applicability correlation were achieved. High criterion validity of DOSS-S with IDDSI-FDS was demonstrated (rs = 0.89, p < 0.01), with very high inter and intra rater reliabilities (ICC > 0.90).ConclusionThe DOSS-S demonstrated very high validity values, and very high inter and intra rater reliability. This research contributes to improved dysphagia management by providing interprofessional dysphagia clinicians with a validated scale to identify patient progression, communicate dysphagia status between regions and countries, and document patient outcomes using an ICF framework.

A Critical Analysis of the Robustness of Radiomics to Variations in Segmentation Methods in 18F-PSMA-1007 PET Images of Patients Affected by Prostate Cancer.

Radiomics shows promising results in supporting the clinical decision process, and much effort has been put into its standardization, thus leading to the Imaging Biomarker Standardization Initiative (IBSI), that established how radiomics features should be computed. However, radiomics still lacks standardization and many factors, such as segmentation methods, limit study reproducibility and robustness. We investigated the impact that three different segmentation methods (manual, thresholding and region growing) have on radiomics features extracted from 18F-PSMA-1007 Positron Emission Tomography (PET) images of 78 patients (43 Low Risk, 35 High Risk). Segmentation was repeated for each patient, thus leading to three datasets of segmentations. Then, feature extraction was performed for each dataset, and 1781 features (107 original, 930 Laplacian of Gaussian (LoG) features, 744 wavelet features) were extracted. Feature robustness and reproducibility were assessed through the intra class correlation coefficient (ICC) to measure agreement between the three segmentation methods. To assess the impact that the three methods had on machine learning models, feature selection was performed through a hybrid descriptive-inferential method, and selected features were given as input to three classifiers, K-Nearest Neighbors (KNN), Support Vector Machines (SVM), Linear Discriminant Analysis (LDA), Random Forest (RF), AdaBoost and Neural Networks (NN), whose performance in discriminating between low-risk and high-risk patients have been validated through 30 times repeated five-fold cross validation. Our study showed that segmentation methods influence radiomics features and that Shape features were the least reproducible (average ICC: 0.27), while GLCM features the most reproducible. Moreover, feature reproducibility changed depending on segmentation type, resulting in 51.18% of LoG features exhibiting excellent reproducibility (range average ICC: 0.68-0.87) and 47.85% of wavelet features exhibiting poor reproducibility that varied between wavelet sub-bands (range average ICC: 0.34-0.80) and resulted in the LLL band showing the highest average ICC (0.80). Finally, model performance showed that region growing led to the highest accuracy (74.49%), improved sensitivity (84.38%) and AUC (79.20%) in contrast with manual segmentation.

Multicenter Randomized Controlled Trial of APERTO-Paclitaxel Drug-Eluting Balloon Angioplasty Versus Standard Percutaneous Transluminal Angioplasty in Dysfunctional Hemodialysis Grafts and Native Fistulae.

to assess the safety and efficacy of APERTO-Paclitaxel-coated balloon angioplasty versus standard angioplasty for the treatment of dysfunctional hemodialysis shunts and native arteriovenous fistulae. consecutive patients with dysfunctional dialysis related to underlying efferent vein stenosis were included and randomized 1:1 to either APERTO-paclitaxel drug-coated balloon (study arm) or standard percutaneous transluminal angioplasty (control arm). Primary endpoint is time from treatment until dialysis access dysfunction according to standardized Kidney Disease Outcomes Quality Initiative (KDOQI)-guidelines and assessed by Kaplan-Meier survival curves and tested for significance with log-rank analysis. Secondary endpoints include device, technical, and clinical success of the index angioplasty procedure. The study included 103 patients (n=51 study-group) with a de novo (n=33) dysfunctional native arteriovenous fistula (n=79) in the forearm (n=60). The majority of included patients were male with a mean age of 69.8 years, presenting with a dysfunctioning autologous arteriovenous fistula in the forearm. Device-related complications did not occur in any of the included patients. Functional hemodialysis access without need for re-intervention at 1 year after index procedure was found in n=10 (19.6%) and n=5 (9.6%) of patients treated with, respectively, paclitaxel drug-coated balloon and percutaneous transluminal angioplasty (p=0.612). A nonsignificant benefit of paclitaxel drug-coated balloon (n=5; 25%) over percutaneous transluminal angioplasty (n=1; 11%) was found (p=0.953) in de novo lesions in autologous fistulas. APERTO-paclitaxel drug-coated balloon is a safe balloon catheter to manage dysfunctional hemodialysis access; however, longer period of adequate hemodialysis circuit functioning after endovascular index stenosis treatment, using APERTO-paclitaxel drug-coated balloon versus percutaneous transluminal angioplasty could not be demonstrated. APERTO-paclitaxel drug-coated balloon catheter is a safe device to manage dysfunctional hemodialysis access. Compared to conventional angioplasty balloon, the APERTO drug-coated balloon will not result in longer period of adequate hemodialysis circuit functioning. A non-significant benefit of APERTO drug-coated balloon was found in de novo lesions in autologous fistulas.

Measurement of very low-molecular weight metabolites by traveling wave ion mobility and its use in human urine samples

The collision cross-sections (CCS) measurement using ion mobility spectrometry (IMS) in combination with mass spectrometry (MS) offers a great opportunity to increase confidence in metabolite identification. However, owing to the lack of sensitivity and resolution, IMS has an analytical challenge in studying the CCS values of very low-molecular-weight metabolites (VLMs ≤ 250 Da). Here, we describe an analytical method using ultrahigh-performance liquid chromatography (UPLC) coupled to a traveling wave ion mobility-quadrupole-time-of-flight mass spectrometer optimized for the measurement of VLMs in human urine samples. The experimental CCS values, along with mass spectral properties, were reported for the 174 metabolites. The experimental data included the mass-to-charge ratio (m/z), retention time (RT), tandem MS (MS/MS) spectra, and CCS values. Among the studied metabolites, 263 traveling wave ion mobility spectrometry (TWIMS)-derived CCS values (TWCCSN2) were reported for the first time, and more than 70% of these were CCS values of VLMs. The TWCCSN2 values were highly repeatable, with inter-day variations of <1% relative standard deviation (RSD). The developed method revealed excellent TWCCSN2 accuracy with a CCS difference (ΔCCS) within ±2% of the reported drift tube IMS (DTIMS) and TWIMS CCS values. The complexity of the urine matrix did not affect the precision of the method, as evidenced by ΔCCS within ±1.92%. According to the Metabolomics Standards Initiative, 55 urinary metabolites were identified with a confidence level of 1. Among these 55 metabolites, 53 (96%) were VLMs. The larger number of confirmed compounds found in this study was a result of the addition of TWCCSN2 values, which clearly increased metabolite identification confidence.

Routes to standardisation for tau protein measurement in CSF

AbstractBackgroundCSF biomarkers are the target of several commercially available in vitro diagnostic (IVD) kits allowing an early diagnosis of Alzheimer’s disease (AD) and eventually the monitoring of treatment effects in clinical trials. Tau hyper‐phosphorylation is one of the main hallmarks of AD and its measurement provides higher accuracy to stratify patients at an early‐stage.Due to the rapid advancements in proteomics, standardisation of measurements can be achieved through the development of reference measurement procedures (RMPs) and certified reference materials (CRMs).MethodSI‐traceable protein and peptide primary calibrators were developed for t‐tau and p‐tau: mass fraction was determined by amino acid analysis and purity was assessed by LC‐MS at high resolution. CSF pools at different tau concentration were used for the development and validation of LC‐IDMS candidate RMP and their commutability was assessed.ResultAn LC‐IDMS candidate reference method was develop and validated in CSF for t‐tau using a SI‐traceable candidate protein primary calibrator. Three different CSF pools (low, medium, high) were successfully quantified with a relative expanded uncertainty below 10%. The commutability of 13 matrix‐based CRMs was assessed involving 8 immunoassays from 5 IVD providers by measuring 40 single CSF donations.According to the AT(N) classification, high levels of p‐tau(181) are highly correlated to tau pathology and commercially available immunoassays are able to target this specific epitope. We conducted a feasibility study on the development of a candidate reference method for p‐tau(181) in CSF relying on a SI‐traceable peptide primary calibrator and an antibody‐free sample preparation workflow.New assays targeting p‐tau(217) in CSF and plasma were also developed, making it necessary the organisation of standardisation initiatives. We sourced and characterised multiple phosphopeptide primary calibrators as well as a GSK3beta‐phosphorylated protein primary calibrator for the development of an LC‐MS RMP including an immunoprecipitation step in the sample preparation workflow.Conclusiontau is considered as a priority for the IFCC WG on NDD and the development of SI traceable RMPs and CRMs is essential to underpin a worldwide standardisation of results. This will help IVD providers to address the traceability requirements of the IVDR thus facilitating regulatory approvals of the kits.

Radiomics for predicting survival in patients with locally advanced rectal cancer: a systematic review and meta-analysis.

Radiomics has recently received considerable research attention for providing potential prognostic biomarkers for locally advanced rectal cancer (LARC). We aimed to comprehensively evaluate the methodological quality and prognostic prediction value of radiomic studies for predicting survival outcomes in patients with LARC. The Cochrane, Embase, Medline, and Web of Science databases were searched. The radiomics quality score (RQS), Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD) checklist, the Image Biomarkers Standardization Initiative (IBSI) guideline, and the Prediction Model Risk of Bias Assessment Tool were used to assess the quality of the selected studies. A further meta-analysis of hazard ratio (HR) regarding disease-free survival (DFS) and overall survival (OS) was performed. Among the 358 studies reported, 15 studies were selected for our review. The mean RQS score was 7.73±4.61 (21.5% of the ideal score of 36). The overall TRIPOD adherence rate was 64.4% (251/390). Most of the included studies (60%) were assessed as having a high risk of bias (ROB) overall. The pooled estimates of the HRs were 3.14 [95% confidence interval (CI): 2.12-4.64, P<0.01] for DFS and 3.36 (95% CI: 1.74-6.49, P<0.01) for OS. Radiomics has potential to noninvasively predict outcome in patients with LARC. However, the overall methodological quality of radiomics studies was low, and the adherence to the TRIPOD statement was moderate. Future radiomics research should put a greater focus on enhancing the methodological quality and considering the influence of higher-order features on reproducibility in radiomics.

Cross-Chain Bridges: A Potential Solution to Standardising Distributed Ledger Technology in Payment Systems

Despite standardisation initiatives, the modern financial landscape continues to be characterised by heterogeneous payment systems. This issue persists even with the emergence of distributed ledger technology in the market. Independent groups of developers are producing their own permissioned blockchain solutions without clear directions for standardisation that could be associated to the lack of a clear position from central banks and regulatory organisations regarding these technologies. The unresolved problem of transaction finality in distributed ledgers adds to the difficulty of reconciling separate distributed platforms. One potential solution is the implementation of cross-chain bridges, which can establish connections between platforms and potentially enable seamless experiences for end users and applications. The paper discusses the advantages and issues associated with these bridges.

Current status of heart failure management in Vietnam

Heart failure is a growing public health issue with high mortality and hospitalization rates. Comprehensive management programs are needed to improve outcomes and reduce costs. In Vietnam, there are gaps in guideline-directed medical therapy, lack of a multidisciplinary approach, inadequate patient education, and poor continuity from inpatient to outpatient care. However, management programs are evolving with 29 hospitals having established programs. Initial results show improved use of medications, reduced hospitalizations and mortality, and better quality of life in some programs. Challenges remain around resources, costs, patient diversity, and lack of standardization. Standardization initiatives like EuroHeart are working to define common data sets and care standards internationally. Effective programs require optimized hospital treatment, comprehensive discharge planning, structured follow up, and patient selfmanagement support. Further government support, healthcare professional training, public education, research, and regional collaborations are needed to advance heart failure care in Vietnam.

A Single Arm Phase II Pilot Study of Low Dose Vemurafenib Plus Rituximab in the Front-Line and Relapsed/Refractory Treatment of Hairy Cell Leukemia

Introduction: Hairy Cell Leukemia (HCL) is a rare, low-grade B-cell malignancy that is characterized by cytopenias, infections and splenomegaly. Given the chronic and incurable nature of this disorder, limiting therapy-related toxicity is of paramount importance. Though purine nucleoside analogs have an established track record of durable efficacy, they are associated with significant myelosuppression and immunosuppression as well as late secondary malignancies. Mechanistic exploitation of aberrant BRAF V600E activation with vemurafenib in combination with CD20 targeting with rituximab has provided an effective means of eradicating leukemic cells without significant myelosuppression or immunosuppression. However, vemurafenib at the standard dose of 960 mg twice daily is often poorly tolerated and frequently requires dose reduction. We conducted a pilot study of rituximab and low-dose vemurafenib (240 mg twice daily) in patients with untreated or relapsed HCL, with a focus on providing a non-cytotoxic regimen that minimizes toxicity with potentially comparable treatment outcomes. Methods: This phase 2, open-label, single-arm, investigator-initiated pilot trial was designed, conducted, and managed at Scripps Clinic in La Jolla, California. We enrolled adult patients with HCL and mutated BRAF V600E who met standard treatment initiation criteria defined by an ANC ≤1.0, Hgb ≤ 10.0 or PLT ≤100K. The treatment plan consisted of eight weeks of oral vemurafenib 240 mg twice daily and eight intravenous rituximab infusions at 375 mg per square meter of body-surface area administered every two weeks. The primary outcome was complete hematologic response. Secondary endpoints included time to complete hematologic response, clearance of minimal residual disease determined by BRAF V600E allele frequency in the bone marrow, safety and progression-free, relapse-free and MRD-free survival. Results: From March 2022 to July 2023, a total of six patients were enrolled in the study. Three patients had previously received a purine analog and three patients were previously untreated. The median age of patients was 61 years, and all were male. At the interim efficacy analysis, all five (5/5) evaluable patients had demonstrated a complete hematologic response with resolution of cytopenias and splenomegaly. 6-month bone marrow biopsy data were available for 3 patients. In 2 of these patients, MRD assessment by allele-specific PCR for BRAF V600E was absent in the bone marrow. In the third patient, though residual disease was present by MRD assessment, he had a hematologic response and requires no subsequent treatment to date. At a median follow-up time of 303 days, the relapse-free survival rate was 100%. There were no adverse grade 3 or 4 adverse events and no vemurafenib dose limiting toxicity was observed. Conclusions: Interim results to-date suggest that rituximab and low-dose vemurafenib (240 mg twice daily) have efficacy and good tolerability in patients with untreated or relapsed HCL. With accruing patient data and further enrollment on study, more information will guide the durability, efficacy and tolerability of this treatment approach.

Investigation of 3D printing product of powder-based white mushroom incorporated with soybean protein isolate as dysphagia diet

The elderly people are prone to dysphagia due to weakened muscle strength. 3D food printing could modify the nutritional ratio and shape design to produce personalized nutritious food suitable for patients with dysphagia. White mushroom (Agaricus bisporus) is rich in a variety of active ingredients such as polysaccharides and polyphenols which are beneficial to human body, but its unique texture is not suitable for patients with dysphagia to chew. This study investigated the impact of different concentrations of soybean protein isolate (SPI, 3%, 5%, 7%, w/w) on 3D food printing of white mushroom powder and carried out the hierarchical representation of dysphagia diet within the framework of International Dysphagia Diet Standardization Initiative (IDDSI). The results illustrated that SPI addition to white mushroom gel reduced water mobility and promoted hydrogen bond formation, which significantly improved the mechanical strength and cohesiveness of printing inks, including yield stress, viscosity and hardness. IDDSI tests showed that the SPI addition of 3% and 5% helped the printing ink pass the spoon tilt test and the fork drip test, which could be classified as level 5 minced and moist food under the consideration of the fork pressure test. The 3D printing results indicated that the 7% SPI addition made the yield stress too high and was not easy for extrusion, resulting in the appearance defects of the printed sample. The addition of 3% SPI could make the printed sample have smooth surface and excellent self-supporting capacity. This work provides insights of white mushroom 3D printing technology as a more visually appealing dysphagia diet.

Regulation of Protein Flexibility and Promoting the Cod Protein Gel Formation Using Ultrasound Treatment.

In order to obtain a soft-textured protein gel suitable for the elderly, the cod protein gel was prepared by improving the protein flexibility under ultrasound treatment. It has been found that the increase in ultrasonic power, protein flexibility, particle size, ζ-potential, surface hydrophobicity, and α-helix content of preheated cod protein exhibited an increasing trend. The improvement of protein flexibility promoted uniformity and density of the gel network, water retention, and texture properties. The flexibility of preheated cod protein increased to 0.189, the water holding capacity of the gel reached up to 99.41%, and the hardness increased to 49.12 g, as the ultrasonic power level increased to 400 W. Protein flexibility was correlated well with the cohesiveness of the gel. The storage modulus (G') initially decreased and then increased during the heating-cooling process. The attractive forces forming between the flexible protein molecules during cooling in the ultrasound treatment groups promoted protein self-assembly aggregation and formed the cod protein gel. The gel obtained at 100-400 W could be categorized as Level 6─soft and bite-sized according to the International Dysphagia Diet Standardization Initiative (IDDSI) framework, indicating that the cod protein gel has potential as an easy-to-swallow diet for the elderly.

A Guide to Expanding the Use of Buprenorphine Beyond Standard Initiations for Opioid Use Disorder.

Buprenorphine has become an important medication in the context of the ongoing opioid epidemic. However, complex pharmacologic properties and varying government regulations create barriers to its use. This narrative review is intended to facilitate buprenorphine use-including non-traditional initiation methods-by providers ranging from primary care providers to addiction specialists. This article briefly discusses the opioid epidemic and the diagnosis and treatment of opioid use disorder (OUD). We then describe the basic and complex pharmacologic properties of buprenorphine, linking these properties to their clinical implications. We guide readers through the process of initiating buprenorphine in patients using full agonist opioids. As there is no single recommended approach for buprenorphine initiation, we discuss the details, advantages, and disadvantages of the standard, low-dose, bridging-strategy, and naloxone-facilitated initiation techniques. We consider the pharmacology of, and evidence base for, buprenorphine in the treatment of pain, in both OUD and non-OUD patients. Throughout, we address the use of buprenorphine in children and adolescent patients, and we finish with considerations related to the settings of pregnancy and breastfeeding.

Modification of maize starch by dry heating treatment (DHT) and its use as gelling ingredients in fruit-based 3D-printed food for dysphagic people

This study explores the use of 3D printing technology to obtain food products for individuals with dysphagia. Maize starch was modified using dry heating treatment (DHT), under 30 different conditions (110–150 °C, 1–6 h), to be used as gelling ingredients for fruit-based foods. The modified starches were assessed in relation to their 3D printing potential and the texture necessities of dysphagic diets (following the International Dysphagia Diet Standardization Initiative - IDDSI). The DHT conditions with better performance were then used for gelling two fruit juices with extreme pHs (orange and watermelon). The DHT treatment improved the printability of the modified maize starch, with the conditions at 140 °C for 6 h, 150 °C for 4 h and 5 h demonstrating the best performance. Furthermore, the gels produced using these modified starches and fruit juices were classified according to the IDDSI standards as level 5 (printed gels) and 6 (molded gels). Structure and properties of modified starches were also evaluated. In summary, this study highlights the potential of modified starches as gelling agents in 3D printing for creating food products tailored to individuals with dysphagia, thus expanding the application of starches in food production.

Advancing "Carbon Peak" and "Carbon Neutrality" in China: A Comprehensive Review of Current Global Research on Carbon Capture, Utilization, and Storage Technology and Its Implications.

Carbon capture, utilization, and storage (CCUS) technology plays a pivotal role in China's "Carbon Peak" and "Carbon Neutrality" goals. This approach offers low-carbon, zero-carbon, and even negative-carbon solutions. This paper employs bibliometric analysis using the Web of Science to comprehensively review global CCUS progress and discuss future development prospects in China. The findings underscore it as a prominent research focus, attracting scholars from both domestic and international arenas. China notably leads the global landscape in terms of research paper output, with the Chinese Academy of Sciences holding a prominent position in total published papers. The research predominantly centers on refining geological storage techniques and optimizing oil and gas recovery rates. Among the CCUS pathways, enhanced oil recovery technology stands out due to its relative maturity and commercial applicability, particularly within the conventional oil and gas reservoirs. The application potential of enhanced gas recovery technology, especially in the Sichuan and Ordos Basins in China, necessitates robust research and demonstration efforts. Within China's current energy landscape, "Blue Hydrogen" emerges as the primary solution for hydrogen production in conjunction with CCUS technology. The underground coal gasification approach holds significant promise as a hydrogen production avenue, albeit with inherent ecological and environmental challenges tied to geological storage that require meticulous consideration. The establishment of effective risk identification and evaluation methodologies for geological storage is imperative. The trajectory ahead involves a strategic convergence of policy, technology, and market dynamics to enhance China's CCUS policy framework, legislative framework, standardization initiatives, and pioneering technological advancements. These collective efforts converge to outline an exclusive development pathway in China. This study assumes a pivotal role in accelerating CCUS technology research and deployment, enhancing oil and gas recovery efficiency, and ultimately realizing the overarching goals of a "Dual Carbon" future.

A Century of Efforts in Standardizing Pashto

Pashto standardization initiatives did not begin long ago, nonetheless. The military designations were changed to Pashto in the 19th century, during the second reign of Amir Sher Ali Khan, but in the last century, efforts to make Pashto the official language have moved ahead. In the last 100 years, during the time of His Highness Amanullah Khan, məraka də paʂtʊ was established and published dictionaries and two books called "jawαzinəi paʂtʊ" and "paʂtʊ pʂwoja". The dictionaries have been destroyed, but the last two books remain. The names of Pashto months and other things came from these books, and they created new words for politicians and courtiers. We do not use most of the məraka də paʂtʊ words now, but instead we use other words because these words are not easy and are not clear in terms of meaning. After the mərakə də paʂtʊ, the Kandahar Literary Association worked in the field of creating new words. Later, the paʂtʊ ʈolәna (Pashto community) held several meetings on orthography, the first of which was held in 1321 and the others in 1327 and 1337. paʂtʊ ʈolәna has done a lot of work on orthography instead of creating new words (neologism). After the paʂtʊ ʈolәna, Peshawar Pashto Academy has also done commendable work in the field of orthography. In 1992, they held the Bara Gully seminar and many meetings after that. As individuals, Wazir Mohammad Gul Khan Momand, Habibi, Hussain Kawsar Ghoryakhil, Abdul Samad Khan Achakzai, Zyar, and others did the work, which involved both neologism and orthography. These works do have issues with the standardization of Pashto, but the benefits and good things outweigh the negatives. The plan for language enrichment and standardization has gained importance recently. Any language that does not have this strategy is gradually losing its structure. It is anticipated that institutions of higher learning and individuals will take note of this.

3D printed protein/polysaccharide food simulant for dysphagia diet: Impact of cellulose nanocrystals

With the intensified aging population, the demand for dysphagia diet is growing rapidly. The food texture in a dysphagia diet needs to be adjusted to be easy-to-swallow. Thus, most food is transformed in mashed form, which is not visually appealing and reduces patients’ appetite, resulting in a malnutrition risk. Three-dimensional (3D) food printing is an efficient technique to fabricate food designs with an attractive appearance and tailored nutritional content. In this work, we developed cellulose nanocrystal (CNC)-based protein/polysaccharide aqueous food inks using two commonly used proteins, namely gelatin B (GB) and whey protein isolate (WPI) for 3D printing, in combination with a polysaccharide frequently found in dysphagia diet, i.e. xanthan gum (XG). To ensure proper printability and shape retention, 2 wt% GB, 8 wt% XG and 8 wt% WPI were selected. Adding 1.0 wt% CNC in GB/XG and 1.5 wt% in WPI/XG improved the viscosity, yield stress and self-supporting ability of the inks, leading to higher shape fidelity right after printing and better shape retention for at least 96 h when stored at 4 °C. Additionally, the thermal stability of GB/XG mixed gels was also largely enhanced by CNC addition, resulting in a high shape retention with ∼90% of its original side area even at 50 °C. As a demonstration, some complex 3D shapes fabricated using both GB/XG/1.0CNC and WPI/XG/1.5CNC inks by single and multi-material DIW printing could also well retain their structures after heating at 50 °C for 5 min. Texture profile can also be tailored by both CNC concentrations and post-processing temperatures. Holding the temperature at 4 °C on the GB/XG/1.5CNC sample turned it from a non-approved classification into a level 5-minced and moist dysphagia diet formulation, according to the International Dysphagia Diet Standardization Initiative (IDDSI) test framework. This work provides rheological and processing guidelines for designing attractive food creations for dysphagic patients using 3D printing.

Sensory properties of thickened tomato soup enhanced with different sources of protein (whey, soy, hemp, and pea).

Thickened soup formulations were created with different proteins (hemp, soy, pea, and whey) to improve protein and fluid intake. The formulations consisted of a control soup, and soups with 6% whey protein, 6% hemp protein, 6% pea protein, and 6% soy protein by volume. The suitability of the samples for those living with dysphagia was evaluated using the international dysphagia diet standardization initiative (IDDSI) spoon tilt test and a sensory trial (51 older adults and 51 younger adults). The sensory trial used nine-point hedonic scales and check-all-that-apply to evaluate the different formulations. The sample with the whey addition was not significantly different than the control in terms of liking of flavor and texture, but it decreased the participants' overall liking. The hemp, pea, and soy decreased overall liking as well as liking of flavor and texture. They were associated with off-flavors, aftertaste, and astringency. The responses from the older and younger adults were compared and significant differences were found in their liking of the texture, with the older adults finding the formulations' texture significantly more acceptable. Overall, the study identified that hemp, pea, and soy did not create acceptable thickened soup formulations and the hemp and pea formulations did not achieve a consistency level that is acceptable for those living with dysphagia.

Quantitative Textural and Rheological Data on Different Levels of Texture-Modified Food and Thickened Liquids Classified Using the International Dysphagia Diet Standardisation Initiative (IDDSI) Guideline.

Diet modification is a common compensation strategy to promote swallowing safety in patients with swallowing difficulties. The International Dysphagia Diet Standardisation Initiative (IDDSI) guideline provides qualitative descriptions on texture-modified food and thickened liquid. This study aimed to establish quantitative textural and rheological data on different IDDSI levels based on common Chinese ingredients and dishes. Textural and rheological properties of 226 samples of various food textures and 93 samples of various liquid consistencies were obtained using a texture profile analysis (TPA) and viscometer, respectively. The establishment of such quantitative data can be used for future texture-modified food product development and research purposes.

Investing in Retail Food Safety: Assessing the NEHA-FDA Retail Flexible Funding Model Grant Program’s Distribution Through an SDOH Lens

Social Determinants of Health (SDOH) have a major impact on community health and quality of life. Healthy People 2030 has an increased focus on SDOH, given their contribution to health disparities and inequalities as a social phenomenon. Despite advances in food hygiene and sanitation, structural disparities related to SDOH leave food systems vulnerable.The Voluntary National Retail Food Regulatory Program Standards (VNRFRPS), otherwise known as the Retail Program Standards initiative is part of the Food and Drug Administration (FDA)’s strategy for prevention-based food safety to reduce foodborne illness. The National Environmental Health Association (NEHA) and the U.S. Food and Drug Administration (FDA) work in partnership to administer the NEHA-FDA Retail Flexible Funding Model (RFFM) Grant Program. The program provides funding to State, Local, Tribal, and Territorial (SLTT) retail food regulatory agencies as they achieve and advance conformance with the VNRFRPS. In its first year (Calendar Year 2022) of the 3-year cycle, the grant program awarded $6.87M in funding to over 200 jurisdictions nationwide.The research note shares preliminary findings of utilizing Geographic Information Systems (GIS) to map the first-year SLTT grant program awardees, with a selection of their jurisdiction’s Social Determinants of Health (SDOH) metrics. Integration and analysis of program-specific grant funding and mapping with the relevant health determinants provide an opportunity to understand further the need for comprehensive program investments for greater impact and improvements in public health.

Thickened fluids classification based on the rheological and tribological characteristics

Abstract In this study, a new scheme for the classification of thickened-fluids based on xanthan gum-cress seed gum was developed. For this purpose, the mechanical characteristics, including steady shear, small amplitude oscillatory shear, large amplitude oscillatory shear, and tribological parameters, were measured and classified into four clusters using the K-means approach. The findings showed that the first cluster contained the highest coefficient of friction value (0.529 ± 0.008), and the fourth cluster comprised the highest consistency coefficient (19.42 ± 0.01 Pa s n ), strain-stiffening ratio (0.42 ± 0.01), yield stress (28.61 ± 0.10 Pa), and frequency dependency of viscous modulus (12.18 ± 0.02). The results also indicated that the classification of in vitro thickened liquid characteristics could be developed based on the interconnection between tribology and rheology. The presented methodology is capable of comparison of test results across the International dysphagia diet standardization initiative and line-spread test.