Evaluation and improvement of technological and nutritional properties of plant-based milk substitutes

Plant-based milk substitutes are suspensions of extracted and disintegrated plant material in water. However, nutritional values and physico-chemical properties of these products vary greatly and depend largely on the raw material. Plant-based milk substitutes are perceived to be healthy by consumers, but this study unveiled that most products lack in quality. Only soya-based products showed good nutritional and functional properties. Accordingly, this thesis addresses the investigation of several techniques to improve the nutritional and physico-chemical properties of plant-based milk substitutes. Fermentation in conjunction with enzymatic treatments was used as a tool for sugar reduction in a quinoa-based product. Leuconostoc citreum TR116 was identified as a potent mannitol producer, whereby some of the sweetness was preserved during fermentation. The glucose content was reduced by 40% and the glycaemic load by 35% compared to the untreated control. Moreover, a quinoa-based milk substitute was treated with proteolytic enzymes to improve protein stability and functionality. It was found that endoproteases were the most effective to increase the protein solubility. At the same time, product properties, like foaming or colloidal stability were not affected considerably. The protein content of most commercial plant-based milk substitutes was found to be less than 0.5%. Therefore, lentil protein isolates were investigated as a protein enriching ingredient. Isoelectric precipitation and ultrafiltration were investigated as potential extraction methods for the production of protein isolates from brown lentils. Overall, both lentil protein isolates exhibited promising performances, while scoring better environmental standards when compared to cow milk proteins. Ultrafiltration resulted in a more pure protein isolate (93.7%) that exhibited better functional properties, such as solubility, emulsifying stability and gelling properties. Based on these results the lentil protein isolate obtained by ultrafiltration was chosen to create emulsions with a protein and fat content similar to cow’s milk. With high-pressure homogenisation at 900 bar and a heat treatment at 85 °C for 2 minutes emulsions with good colloidal stability (2%/h), appearance, textural and organoleptic profiles were created. These studies assessed the broad range of products available and provided a variety of methods for the formulation of nutritional and functional improved plant-based milk substitutes

Evaluation of physicochemical and glycaemic properties of commercial plant-based milk substitutes

The market for plant-based dairy-type products is growing as consumers replace bovine milk in their diet, for medical reasons or as a lifestyle choice. A screening of 17 different commercial plant-based milk substitutes based on different cereals, nuts and legumes was performed, including the evaluation of physicochemical and glycaemic properties. Half of the analysed samples had low or no protein contents (<0.5 %). Only samples based on soya showed considerable high protein contents, matching the value of cow’s milk (3.7 %). An in-vitro method was used to predict the glycaemic index. In general, the glycaemic index values ranged from 47 for bovine milk to 64 (almond-based) and up to 100 for rice-based samples. Most of the plant-based milk substitutes were highly unstable with separation rates up to 54.39 %/h. This study demonstrated that nutritional and physicochemical properties of plant-based milk substitutes are strongly dependent on the plant source, processing and fortification. Most products showed low nutritional qualities. Therefore, consumer awareness is important when plant-based milk substitutes are used as an alternative to cow’s milk in the diet

Past, present and future: the strength of plant-based dairy substitutes based on gluten-free raw materials

Plant-based foods are gaining popularity and the market is developing fast. This trend is based on several factors, like the change of lifestyle, interest in alternative diets, and the increasing awareness about sustainable production of food and especially proteins. Plant-based dairy substitutes can serve as an option to traditional food products, meeting many of these interests. However, the market is in its infancy and needs to progress. Trends show, that the market will change from being focused on mainly soya, almond and rice-based products, due to their unsustainable farming, and nutritional concerns, like genetic modification and low protein content. The market is likely to shift towards alternative plants to meet consumers' needs and desire for healthy, flavourful and intriguing products. In this regard, the aspect of allergy-free, like gluten-free products gain in importance. Research studies are approaching the nutritional quality of plant-based dairy substitutes, such as improving the protein quality and glycaemic properties. Furthermore, the application of these products or plant proteins as functional ingredients or substitutes for cow's milk in dairy products like cheese and yoghurt are disseminated. However, there is still a need for much more diversified studies in order to overcome stability, textural, nutritional and sensory problems

Usability evaluation of a self-management mobile application for individuals with a mild traumatic brain injury

OBJECTIVE: Mild traumatic brain injuries (mTBIs) are common and may result in persisting symptoms. Mobile health (mHealth) applications enhance treatment access and rehabilitation. However, there is limited evidence to support mHealth applications for individuals with an mTBI. The primary purpose of this study was to evaluate user experiences and perceptions of the Parkwood Pacing and Planning™ application, an mHealth application developed to help individuals manage their symptoms following an mTBI. The secondary purpose of this study was to identify strategies to improve the application. This study was conducted as part of the development process for this application. METHODS: A mixed methods co-design encompassing an interactive focus group and a follow-up survey was conducted with patient and clinician-participants (n = 8, four per group). Each group participated in a focus group consisting of an interactive scenario-based review of the application. Additionally, participants completed the Internet Evaluation and Utility Questionnaire (UQ). Qualitative analysis on the interactive focus group recordings and notes was performed using phenomenological reflection through thematic analyses. Quantitative analysis included descriptive statistics of demographic information and UQ responses. RESULTS: On average, clinician and patient-participants positively rated the application on the UQ (4.0 ± .3, 3.8 ± .2, respectively). User experiences and recommendations for improving the application were categorized into four themes: simplicity, adaptability, conciseness, and familiarity. CONCLUSION: Preliminary analyses indicates patients and clinicians have a positive experience when using the Parkwood Pacing and Planning™ application. However, modifications that improve simplicity, adaptability, conciseness, and familiarity may further improve the user\u27s experience

Formation, stability and sensory characteristics of a lentil based milk substitute as affected by homogenisation and pasteurisation

This study aimed to investigate the suitability of lentil protein and emulsions thereof for the formulation of a milk substitute. The effect of high-pressure homogenisation and heat treatments on functional and physico-chemical properties of lentil protein solutions (3.3% w/w) and the emulsions, containing fat contents similar to commercial cow’s milk, was studied. Dynamic high-pressure treatments of 180 and 900 bar greatly affected physical and structural properties of the lentil proteins: the particle size was reduced by 100-fold to 129.00 nm for samples homogenised at 900 bar, leading to an almost complete solubilisation. Surface properties of lentil protein changed, as shown in an increase of hydrophobicity and decrease of free sulfhydryl groups, while changes in secondary structure and aggregation did not develop. Little impact was observed of the heat-treatment at 65 or 85 °C, however, colour changed from a faint pink hue to be more white in appearance. The obtained emulsions exhibited good colloidal stability at both homogenisation pressures, while overall product quality was best when treated at 900 bar. Sensory analyses showed the formulated lentil-based milk substitute had textural and organoleptic profiles comparable to commercial plant-based milk substitutes, including soya-based products. Lentil protein isolates showed great potential to be used formulating milk substitutes with a high-protein content, similar to cow’s milk

Polyol-producing lactic acid bacteria isolated from sourdough and their application to reduce sugar in a quinoa-based milk substitute

The interest for plant-based dairy substitutes is expanding rapidly and consumers are opting for nutritious and healthy dairy alternatives. The reduction of sugar using different exogenous enzymes in combination with lactic acid fermentation in a quinoa-based milk substitute was explored in this study. Different amylolytic enzymes were used to release sugar from the raw material, which were further metabolised to mannitol, due to fermentation with two heterofermentative lactic acid bacteria. Using these two biotechnological techniques enables the reduction of sugar, while also preserving some of the sweetness. Leuconostoc citreum TR116, and Lactobacillus brevis TR055 were isolated from sourdough. Both strains showed high viable cell counts with L citreum TR116 > 8.4 and L. brevis TR055 > 9.3 log cfu/mL, and a reduction in pH to 3.7 and 3.5 respectively. When fructose was available, mannitol was produced in conjunction with acetic acid in addition to lactic acid. Due to these processes, the original glucose value was reduced from 50 mmol/100 g to approximately 30 mmol/100 g, which equates to a glucose reduction of 40%. In respect to mannitol production, both strains performed well: L citreum TR116 showed a conversion factor of 1:1 from fructose to mannitol, while L. brevis TR055 showed a lower yield, with a conversion factor of 1:0.8. Glycaemic load was reduced by more than a third, bringing it down to the low range with a value of about 10. Overall, enzymatic modification in conjunction with mannitol-producing lactic acid bacteria shows great potential for further possible application in the development of nutritious and sugar reduced plant-based milk substitutes

Immune checkpoint expression on immune cells of HNSCC patients and modulation by chemo- and immunotherapy

Endogenous control mechanisms, including immune checkpoints and immunosuppressive cells, are exploited in the process of tumorigenesis to weaken the anti-tumor immune response. Cancer treatment by chemotherapy or immune checkpoint inhibition can lead to changes of checkpoint expression, which influences therapy success. Peripheral blood lymphocytes (PBL) and tumor-infiltrating lymphocytes (TIL) were isolated from head and neck squamous cell carcinoma (HNSCC) patients (n = 23) and compared to healthy donors (n = 23). Immune checkpoint expression (programmed cell death ligand 1 (PD-1), tumor necrosis factor receptor (TNFR)-related (GITR), CD137, tumor necrosis factor receptor superfamily member 4 (TNFRSF4) (OX40), t-cell immunoglobulin and mucin-domain containing-3 (TIM3), B- and T-lymphocyte attenuator (BTLA), lymphocyte-activation gene 3 (LAG3)) was determined on immune cells by flow cytometry. PD-L1 expression was detected on tumor tissue by immunohistochemistry. Immune cells were treated with immuno- and chemotherapeutics to investigate treatment-specific change in immune checkpoint expression, in vitro. Specific changes of immune checkpoint expression were identified on PBL and TIL of HNSCC patients compared to healthy donors. Various chemotherapeutics acted differently on the expression of immune checkpoints. Changes of checkpoint expression were significantly less pronounced on regulatory T cells compared to other lymphocyte populations. Nivolumab treatment significantly reduced the receptor PD-1 on all analyzed T cell populations, in vitro. The specific immune checkpoint expression patterns in HNSCC patients and the investigated effects of immunomodulatory agents may improve the development and efficacy of targeted immunotherapy

Membrane filtration and isoelectric precipitation technological approaches for the preparation of novel functional and sustainable protein isolate from lentils

Isoelectric precipitation and ultrafiltration were investigated for their potential to produce protein products from lentils. Higher protein concentrations were obtained when ultrafiltration was used (>90%), whereas isoelectric precipitation resulted in higher contents of dietary fibre and some minerals (i.e., sodium and phosphorus). Differences in the functional properties between the two ingredients where found as the isoelectric precipitated ingredient showed lower protein solubilities over the investigated pH range (from 3 to 9) which can be linked to the slightly higher hydrophobicity values (2688.7) and total sulfhydryl groups (23.9 μM/g) found in this sample. In contrast, the protein ingredient obtained by ultrafiltration was superior with regard to its solubility (48.3%; pH 7), fat-binding capacity (2.24 g/g), water holding capacity (3.96 g/g), gelling properties (11%; w/w), and foam-forming capacity (69.6%). The assessment of the environmental performance showed that both LPIs exhibited promising properties and low carbon footprints in comparison to traditional dairy proteins

Automated Non-Sterile Pharmacy Compounding: A Multi-Site Study in European Hospital and Community Pharmacies with Pediatric Immediate Release Propranolol Hydrochloride Tablets

Pharmacy compounding, the art and science of preparing customized medications to meet individual patient needs, is on the verge of transformation. Traditional methods of compounding often involve manual and time-consuming processes, presenting challenges in terms of consistency, dosage accuracy, quality control, contamination, and scalability. However, the emergence of cutting-edge technologies has paved a way for a new era for pharmacy compounding, promising to redefine the way medications are prepared and delivered as pharmacy-tailored personalized medicines. In this multi-site study, more than 30 hospitals and community pharmacies from eight countries in Europe utilized a novel automated dosing approach inspired by 3D printing for the compounding of non-sterile propranolol hydrochloride tablets. CuraBlend® excipient base, a GMP-manufactured excipient base (pharma-ink) intended for automated compounding applications, was used. A standardized study protocol to test the automated dosing of tablets with variable weights was performed in all participating pharmacies in four different iterative phases. Integrated quality control was performed with an in-process scale and NIR spectroscopy supported by HPLC content uniformity measurements. In total, 6088 propranolol tablets were produced at different locations during this study. It was shown that the dosing accuracy of the process increased from about 90% to 100% from Phase 1 to Phase 4 by making improvements to the formulation and the hardware solutions. The results indicate that through this automated and quality controlled compounding approach, extemporaneous pharmacy manufacturing can take a giant leap forward towards automation and digital manufacture of dosage forms in hospital pharmacies and compounding pharmacies