Impact of panelist\u27s age on the ease of swallow and sensory perception of texture-modified broccoli purees

Swallowing disorders affect approximately 8% of the global population. It is more prevalent in the elderly, leading to malnutrition and dehydration. Different strategies have been investigated to design new texture-modified food products that would reduce or mitigate the suffering from these swallowing disorders. Despite the recent interest and research in this area, there are, however, still a lot of unknowns regarding the specific sensory insights by this targeted group. The aim of this work was to understand if the ease of swallow and related sensory characteristics are perceived differently by “young” and “elderly” healthy individuals. Broccoli purees with different textural properties were created by changing the fluid component (water or xanthan solution) or processing conditions. Samples were evaluated by an elderly panel (n\ua0=\ua019, average age\ua0=\ua068.9 years) and a young panel (n\ua0=\ua016, average age\ua0=\ua025.4 years). Multivariate data analysis strategies were used to understand the intrapanel sample discrimination and to compare between panels. Results showed a similar overall discrimination between samples between young and elderly panels. The use of xanthan improved the ease of swallow in both age groups. In the absence of xanthan gum, processing conditions determined the ease of swallow, which was related to the particle size distribution. Nevertheless, small differences were found between panels. For example, the elderly panel was more sensitive when discriminating samples based on the ease of swallow (p\ua0=.005). Therefore, panelist age seems to be relevant when designing tailored foods enhancing the ease of swallow for the elderly populations. Practical Applications: The present study highlights new insights on the relevance of age and sensory capabilities when designing new texture-modified food products. It also provides new insights regarding the key sensory attributes to consider and how these are affected by the type of food processing

The effect of electro-hydrodynamic shockwaves on the quality of striploin and brisket beef muscles during long-term storage

Shockwaves generate instantaneous high pressures, which could affect meat shelf-life or quality. This study assessed microbiological counts, pH, drip, cook and moisture loss and texture of striploin (longissimus lumborum) and brisket (pectoralis profundus) treated with electrical shockwave (25 kV, 8 pulses) and subsequently stored (−0.5 °C) for 0, 4, 8, 12, 16 and 20 weeks. Shockwave did not affect total viable counts (p>0.05), with all samples considered microbiologically acceptable (0.05). Shockwave × storage time increased moisture losses in striploin (p<0.01) and brisket (p<0.01) at week 0 but this decreased over subsequent storage weeks. Shockwave technology did not affect meat shelf-life and has potential for beef tenderisation

A novel formulation of inhaled sodium cromoglicate (PA101) in idiopathic pulmonary fibrosis and chronic cough: a randomised, double-blind, proof-of-concept, phase 2 trial

Background Cough can be a debilitating symptom of idiopathic pulmonary fibrosis (IPF) and is difficult to treat. PA101 is a novel formulation of sodium cromoglicate delivered via a high-efficiency eFlow nebuliser that achieves significantly higher drug deposition in the lung compared with the existing formulations. We aimed to test the efficacy and safety of inhaled PA101 in patients with IPF and chronic cough and, to explore the antitussive mechanism of PA101, patients with chronic idiopathic cough (CIC) were also studied. Methods This pilot, proof-of-concept study consisted of a randomised, double-blind, placebo-controlled trial in patients with IPF and chronic cough and a parallel study of similar design in patients with CIC. Participants with IPF and chronic cough recruited from seven centres in the UK and the Netherlands were randomly assigned (1:1, using a computer-generated randomisation schedule) by site staff to receive PA101 (40 mg) or matching placebo three times a day via oral inhalation for 2 weeks, followed by a 2 week washout, and then crossed over to the other arm. Study participants, investigators, study staff, and the sponsor were masked to group assignment until all participants had completed the study. The primary efficacy endpoint was change from baseline in objective daytime cough frequency (from 24 h acoustic recording, Leicester Cough Monitor). The primary efficacy analysis included all participants who received at least one dose of study drug and had at least one post-baseline efficacy measurement. Safety analysis included all those who took at least one dose of study drug. In the second cohort, participants with CIC were randomly assigned in a study across four centres with similar design and endpoints. The study was registered with ClinicalTrials.gov (NCT02412020) and the EU Clinical Trials Register (EudraCT Number 2014-004025-40) and both cohorts are closed to new participants. Findings Between Feb 13, 2015, and Feb 2, 2016, 24 participants with IPF were randomly assigned to treatment groups. 28 participants with CIC were enrolled during the same period and 27 received study treatment. In patients with IPF, PA101 reduced daytime cough frequency by 31·1% at day 14 compared with placebo; daytime cough frequency decreased from a mean 55 (SD 55) coughs per h at baseline to 39 (29) coughs per h at day 14 following treatment with PA101, versus 51 (37) coughs per h at baseline to 52 (40) cough per h following placebo treatment (ratio of least-squares [LS] means 0·67, 95% CI 0·48–0·94, p=0·0241). By contrast, no treatment benefit for PA101 was observed in the CIC cohort; mean reduction of daytime cough frequency at day 14 for PA101 adjusted for placebo was 6·2% (ratio of LS means 1·27, 0·78–2·06, p=0·31). PA101 was well tolerated in both cohorts. The incidence of adverse events was similar between PA101 and placebo treatments, most adverse events were mild in severity, and no severe adverse events or serious adverse events were reported. Interpretation This study suggests that the mechanism of cough in IPF might be disease specific. Inhaled PA101 could be a treatment option for chronic cough in patients with IPF and warrants further investigation

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p&lt;0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p&lt;0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p&lt;0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP &gt;5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification

Physical, cognitive, and mental health impacts of COVID-19 after hospitalisation (PHOSP-COVID): a UK multicentre, prospective cohort study

Background The impact of COVID-19 on physical and mental health and employment after hospitalisation with acute disease is not well understood. The aim of this study was to determine the effects of COVID-19-related hospitalisation on health and employment, to identify factors associated with recovery, and to describe recovery phenotypes. Methods The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a multicentre, long-term follow-up study of adults (aged ≥18 years) discharged from hospital in the UK with a clinical diagnosis of COVID-19, involving an assessment between 2 and 7 months after discharge, including detailed recording of symptoms, and physiological and biochemical testing. Multivariable logistic regression was done for the primary outcome of patient-perceived recovery, with age, sex, ethnicity, body-mass index, comorbidities, and severity of acute illness as covariates. A post-hoc cluster analysis of outcomes for breathlessness, fatigue, mental health, cognitive impairment, and physical performance was done using the clustering large applications k-medoids approach. The study is registered on the ISRCTN Registry (ISRCTN10980107). Findings We report findings for 1077 patients discharged from hospital between March 5 and Nov 30, 2020, who underwent assessment at a median of 5·9 months (IQR 4·9–6·5) after discharge. Participants had a mean age of 58 years (SD 13); 384 (36%) were female, 710 (69%) were of white ethnicity, 288 (27%) had received mechanical ventilation, and 540 (50%) had at least two comorbidities. At follow-up, only 239 (29%) of 830 participants felt fully recovered, 158 (20%) of 806 had a new disability (assessed by the Washington Group Short Set on Functioning), and 124 (19%) of 641 experienced a health-related change in occupation. Factors associated with not recovering were female sex, middle age (40–59 years), two or more comorbidities, and more severe acute illness. The magnitude of the persistent health burden was substantial but only weakly associated with the severity of acute illness. Four clusters were identified with different severities of mental and physical health impairment (n=767): very severe (131 patients, 17%), severe (159, 21%), moderate along with cognitive impairment (127, 17%), and mild (350, 46%). Of the outcomes used in the cluster analysis, all were closely related except for cognitive impairment. Three (3%) of 113 patients in the very severe cluster, nine (7%) of 129 in the severe cluster, 36 (36%) of 99 in the moderate cluster, and 114 (43%) of 267 in the mild cluster reported feeling fully recovered. Persistently elevated serum C-reactive protein was positively associated with cluster severity. Interpretation We identified factors related to not recovering after hospital admission with COVID-19 at 6 months after discharge (eg, female sex, middle age, two or more comorbidities, and more acute severe illness), and four different recovery phenotypes. The severity of physical and mental health impairments were closely related, whereas cognitive health impairments were independent. In clinical care, a proactive approach is needed across the acute severity spectrum, with interdisciplinary working, wide access to COVID-19 holistic clinical services, and the potential to stratify care. Funding UK Research and Innovation and National Institute for Health Research

Use of high pressure to reduce cook loss and improve texture of low-salt beef sausage batters

Methods were investigated to reduce the salt content of beef-containing smallgoods as high-salt intake has been identified as a public health risk for most individuals. Raw meat batters were manufactured from retail beef mince (4-7% fat) using various NaCl concentrations (0-2%), and were packed into casings and subjected to high pressure processing (up to 400 MPa for 2 min at 10 degrees C). Following pressure treatment, samples were cooked to an internal temperature of 72 degrees C and cooled. Cooked products were assessed for cooking loss. colour and physical consistency by texture profile analysis. Flavour and overall acceptability were assessed by sensory panels. High pressure processing (HPP) was found to produce a dramatic improvement in the moisture retention of the cooked products. Control (unpressurised) sausages containing 2% NaCl had a similar cook loss (9.3%) to pressure-treated sausages containing just 1% NaCl, whereas unpressurised samples with 1% NaCl had a cook loss of 24.9%. The hardness and gumminess of pressure-treated samples was higher compared to untreated samples, at all salt concentrations. The greatest differences in texture with pressure treatment were seen in the 1% NaCl samples. Pressure treatment generally caused no changes in the colour of either the raw or cooked product; however there was a slight increase in "whiteness" with pressure treatment. Sensory panels reported a greater acceptability in both appearance and texture of pressure-treated sausages of lower salt content compared with non-pressure-treated samples. Examination of extracted proteins using SDS-PAGE and of muscle proteins by thermal analysis indicated that pressure contributed to enhanced binding through protein solubilisation and gelation through partial protein unfolding. The application of high pressure to beef sausages with low-salt content resulted in reduced cooking losses and improved texture.Industrial relevance: Enhanced meat binding through extraction of salt-soluble proteins is an essential step in the formulation of meat products such as sausages and emulsion-type products. The ability to reduce salt and achieve high binding and water retention through use of HPP is important in being able to produce healthier foods. Crown Copyright (C) 2009 Published by Elsevier Ltd. All rights reserved

Cohesiveness and flowability of particulated solid and semi-solid food systems

Cohesiveness and flowability of particulated food systems is of particular interest in the oral processing and swallowing of food products, especially for people suffering from dysphagia. Although cohesiveness of a bolus is an essential parameter in swallowing, a robust technique for objective measurement of cohesiveness of particulated semi- or soft-solids is still lacking. In our approach the ring shear tester is used to measure the cohesiveness and flowability of a model particulated food system based on fresh green pea powders and pastes with controlled moisture content. The focus is on how the cohesiveness and flowability of dry pea particles change as they absorb moisture, swell and soften, while continuously agglomerating until a paste like bolus is achieved. Differently hydrated pea powders start to granulate with increasing moisture content resulting in decreasing flowability and increasing cohesiveness until a critical moisture content of approximately 73 wt% is reached. Above the critical moisture content, cohesiveness starts to decrease and flowability increases, i.e. indicating the transition into the rheological domain of concentrated suspension flow. Besides moisture content we also show that water adsorption capacity i.e. hydration properties and resulting degree of particle softness tremendously influences the flowability factor and cohesiveness of powder systems. Thus ring shear tester can be used to provide guidelines for food paste formulation with controlled cohesiveness

Rapid Evaporative Ionization Mass Spectrometry: A Review on Its Application to the Red Meat Industry with an Australian Context

The red meat supply chain is a complex network transferring product from producers to consumers in a safe and secure way. There can be times when fragmentation can arise within the supply chain, which could be exploited. This risk needs reduction so that meat products enter the market with the desired attributes. Rapid Evaporative Ionisation Mass Spectrometry (REIMS) is a novel ambient mass spectrometry technique originally developed for rapid and accurate classification of biological tissue which is now being considered for use in a range of additional applications. It has subsequently shown promise for a range of food provenance, quality and safety applications with its ability to conduct ex vivo and in situ analysis. These are regarded as critical characteristics for technologies which can enable real-time decision making in meat processing plants and more broadly throughout the sector. This review presents an overview of the REIMS technology, and its application to the areas of provenance, quality and safety to the red meat industry, particularly in an Australian context

Prevalence of physical frailty, including risk factors, up to 1 year after hospitalisation for COVID-19 in the UK: a multicentre, longitudinal cohort studyResearch in context

Summary: Background: The scale of COVID-19 and its well documented long-term sequelae support a need to understand long-term outcomes including frailty. Methods: This prospective cohort study recruited adults who had survived hospitalisation with clinically diagnosed COVID-19 across 35 sites in the UK (PHOSP-COVID). The burden of frailty was objectively measured using Fried's Frailty Phenotype (FFP). The primary outcome was the prevalence of each FFP group—robust (no FFP criteria), pre-frail (one or two FFP criteria) and frail (three or more FFP criteria)—at 5 months and 1 year after discharge from hospital. For inclusion in the primary analysis, participants required complete outcome data for three of the five FFP criteria. Longitudinal changes across frailty domains are reported at 5 months and 1 year post-hospitalisation, along with risk factors for frailty status. Patient-perceived recovery and health-related quality of life (HRQoL) were retrospectively rated for pre-COVID-19 and prospectively rated at the 5 month and 1 year visits. This study is registered with ISRCTN, number ISRCTN10980107. Findings: Between March 5, 2020, and March 31, 2021, 2419 participants were enrolled with FFP data. Mean age was 57.9 (SD 12.6) years, 933 (38.6%) were female, and 429 (17.7%) had received invasive mechanical ventilation. 1785 had measures at both timepoints, of which 240 (13.4%), 1138 (63.8%) and 407 (22.8%) were frail, pre-frail and robust, respectively, at 5 months compared with 123 (6.9%), 1046 (58.6%) and 616 (34.5%) at 1 year. Factors associated with pre-frailty or frailty were invasive mechanical ventilation, older age, female sex, and greater social deprivation. Frail participants had a larger reduction in HRQoL compared with before their COVID-19 illness and were less likely to describe themselves as recovered. Interpretation: Physical frailty and pre-frailty are common following hospitalisation with COVID-19. Improvement in frailty was seen between 5 and 12 months although two-thirds of the population remained pre-frail or frail. This suggests comprehensive assessment and interventions targeting pre-frailty and frailty beyond the initial illness are required. Funding: UK Research and Innovation and National Institute for Health Research