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Representation of Viscosity as a constant relating an applied shear stress to the resulting shear velocity.
Source publication
Dysphagia is a swallowing disorder characterized by the difficulty in transferring solid foods and/or liquids from the oral cavity to the stomach, imparing autonomous, and safe oral feeding. The main problems deriving from dysphagia are tracheo-bronchial aspiration, aspiration pneumonia, malnutrition and dehydration. In order to overcome dysphagia-...
Similar publications
Oropharyngeal dysphagia is a swallowing disorder characterized by difficulty in transferring foods and/or liquids from the oral cavity to the stomach, affecting safe oral feeding. The main complications caused by dysphagia are tracheobronchial aspiration, pneumonia, malnutrition, and dehydration. Fibre-optic endoscopic evaluation of swallowing (FEE...
Citations
... The prevalence of the SW-I pattern exhibited a notable increase following liquid ingestion in contrast to solid ingestion. This phenomenon could be attributed to differences in the physical attributes of materials, such as viscosity and shape stability, which influence swallowing dynamics, rendering liquids more challenging to swallow than solids [48]. Moreover, it has been suggested that level 0 food, which is deemed the safest for preventing aspiration, is particularly efficacious in risk assessment [35]. ...
Purpose
Swallowing dysfunction and the risk of aspiration pneumonia are frequent clinical problems in the treatment of head and neck squamous cell carcinomas (HNSCCs). Breathing–swallowing coordination is an important factor in evaluating the risk of aspiration pneumonia. To investigate breathing–swallowing discoordination after chemoradiotherapy (CRT), we monitored respiration and swallowing activity before and after CRT in patients with HNSCCs.
Methods
Non-invasive swallowing monitoring was prospectively performed in 25 patients with HNSCCs treated with CRT and grade 1 or lower radiation-induced dermatitis. Videoendoscopy, videofluoroscopy, Food Intake LEVEL Scale, and patient-reported swallowing difficulties were assessed.
Results
Of the 25 patients selected for this study, four dropped out due to radiation-induced dermatitis. The remaining 21 patients were analyzed using a monitoring system before and after CRT. For each of the 21 patients, 405 swallows were analyzed. Swallowing latency and pause duration after the CRT were significantly extended compared to those before the CRT. In the analysis of each swallowing pattern, swallowing immediately followed by inspiration (SW-I pattern), reflecting breathing–swallowing discoordination, was observed more frequently after CRT (p = 0.0001). In 11 patients, the SW-I pattern was observed more frequently compared to that before the CRT (p = 0.00139). One patient developed aspiration pneumonia at 12 and 23 months after the CRT.
Conclusion
The results of this preliminary study indicate that breathing–swallowing discoordination tends to increase after CRT and could be involved in aspiration pneumonia. This non-invasive method may be useful for screening swallowing dysfunction and its potential risks.
... This may indicate a possible innovative trend in studies related to dysphagia. Dysphagia is a swallowing disorder characterized by difficulty transferring food to the stomach (Sukkar et al., 2018). It mainly affects the elderly and can cause, in addition to reducing quality of life, problems such as choking, suffocation, pneumonia, and even death. ...
Ultrasonication is an innovative green technology with various applications in the food industry. Notably, patent analysis from a technological perspective is essential for monitoring market trends and identifying the technological stage through life cycle modeling. Thus, this study aimed to conduct an investigation using patent documents on the application of ultrasound in the food sector. The Espacenet® database was used with the keywords “Food Processing,” “Ultrasound,” and “Ultrasonication,” along with the code A23. A total of 140 documents were evaluated, with China being the main applicant country. Fruits and vegetables and bioactive compounds were the key technological sectors. Food preservation and extraction processes emerged as the primary applications. The involvement of ultrasound technology in the food industry is entering the maturity stage, as demonstrated by the function adjusted to the BiDoseResp model. This result implies further technological and market development in the food industry in the coming years.
Practical applications
This review addressed the evolution and the current scenario of ultrasound applications in food processing through patent documents deposited between 1979 and 2022, which are rich technological information sources. This approach identified the main technological sectors of food and applications in which ultrasound is most used, as well as the main institutions, inventors, and patent‐filing countries. The major challenges, impacts of the COVID‐19 pandemic, and market trends were also discussed. Through mathematical modeling of patent mapping, it was detected that ultrasonication is integrated into the food sector while maintaining a highly competitive impact. This development indicates a future with significant advancements in the development of ultrasound in the food industry, with increasing participation of emerging countries in technological monopolies and a trend of associating ultrasound with non‐thermal emerging technologies in patented inventions. Food waste, food printing, and food for people with swallowing difficulties are potential areas for further development.
... Several studies point out the influence of variables such as food temperature and consistency (Ekberg et al., 2010;Gosa & Dodrill, 2017;Steele et al., 2015) salivary α-amylase activity, (Haward et al., 2011;Sukkar et al., 2018) tongue strength and pressure, (Geddes et al., 2012;September et al., 2014) and barium-impregnated liquids used in VFSS, causing an impact on the swallowing dynamics (Fink & Ross, 2009;Frazier et al., 2016;Logemann et al., 2005;Stuart & Motz, 2009). Additional studies provide further evidence for the significance of taking these variables into account in the swallowing assessment (Hernandez & Bianchini, 2019;Hernandez et al., 2020;Lefton-Greif et al., 2018;Leonard et al., 2014). ...
... Nevertheless, we can assume that the increased viscosity due to barium impregnation requires greater tongue pressure to push the liquid (Steele et al., 2015) and perhaps a longer oral transit time, partly ensuring greater swallowing safety. On the other hand, they may be affected by salivary α-amylase, modifying the rheological behaviour of the stimulus (Sukkar et al., 2018). Previous studies with dysphagic adults have already reported that little differences, such as between tomato juice and orange juice, have an impact on the physiology of swallowing (Robertson & Pattillo, 1993). ...
Regarding neonates and infants, the videofluoroscopy swallowing study is always conducted with liquids impregnated with a radiopaque material in varied proportions and thickenings. Variations in thickening and barium concentration are known to change the swallowing function. The present study aimed to analyze the rheological and macroscopic properties of barium contrast and liquids commonly used in Brazil with infants under six months old. This study was approved by the Ethics Committee under certificate number 63361616.2.0000.5482. Rheological measurements were performed on samples of breast milk and infant formulas, pure, with thickener, impregnated with liquid barium sulfate, as well as a pure barium sulfate sample. The data collected showed similar viscosity rates between breast milk and the infant formulas Aptamil and Enfamil. Impregnating them with 20% and 33% liquid barium sulfate increased their viscosity. However, they remained in the same classification, despite the quantitative differences in their apparent viscosity. The regular products, in formulation with thickener and thickener plus 20% barium, showed an increase in apparent viscosity close or twice to that of Enfamil A.R. impregnated with 33% barium sulfate. The study allowed a more in-depth understanding of how the products behave at strain rates consistent with the conditions when swallowing. The results indicated in this study confirm the need for knowledge and care in preparing liquids to be offered in videofluoroscopy swallowing studies with neonates and infants. They also emphasize the importance of objectively measuring the viscosities of videofluoroscopic fluids, matching them with the liquids to be prescribed in their diets.
... P+RHS-0d P+RHS-0d P+RHS-7d P+RHS-7d P+RHS-14d P+RHS-14d that they are more elastic (Giura et al., 2021). Additionally, an increase in G' values has been associated with a decrease in the risk of aspiration in dysphagic patients (Sukkar et al., 2018). Resistant starch has been found to have a positive effect on the G' and G" values of thickener agents. ...
Texture-modified foods have become a growing trend in the market and retrograded starch can enhance the rheological properties of foods. This study assessed the effect of adding 10% (w/w) of normal (RNS) or high amylose (RHS) retrograded starches on the physicochemical and rheological properties of commercial peach puree stored at 4°C. The resistant starch content (RS), syneresis, and rheological behavior were evaluated during 14-day storage. Control puree exhibited high syneresis (60%), low consistency (6 Pa·sⁿ), and decreasing viscosity during storage. These characteristics improved after adding retrograded starches. Samples with RNS exhibited higher viscosity, lower syneresis, lower RS (2%), and poor stability; meanwhile, the systems with RHS exhibited greater stability maintaining their viscosity, syneresis, and RS (10%) relatively constant during storage. Therefore, RHS can be recommended to enhance and maintain the physicochemical, nutraceutical, and rheological properties of a food matrix like peach puree during storage.
... The use of thickened fluids is one of the most effective ways to manage and treat dysphagia [1][2][3][4]. Thickened fluids flow slowly, thereby strengthening weak swallowing muscles and allowing people to have better oral and pharyngeal synchronization [5][6][7], reducing the transition speed of fluid flow [8], and preventing aspirations of the bolus into the lungs [9]. Selecting a suitable thickener seems to be important for managing dysphagia as a compensatory therapeutic strategy against aspiration [4,10,11]. ...
... Thickened fluids flow slowly, thereby strengthening weak swallowing muscles and allowing people to have better oral and pharyngeal synchronization [5][6][7], reducing the transition speed of fluid flow [8], and preventing aspirations of the bolus into the lungs [9]. Selecting a suitable thickener seems to be important for managing dysphagia as a compensatory therapeutic strategy against aspiration [4,10,11]. Therefore, discovering new sources of thickeners with appropriate functional features for dysphagia diet products is very attractive. ...
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.
... Oropharyngeal dysphagia is a swallowing disorder characterized by difficulty in transferring foods and/or liquids from the oral cavity to the stomach, affecting safe oral feeding. The main complications caused by dysphagia are tracheobronchial aspiration, pneumonia, malnutrition, and dehydration [1]. ...
Oropharyngeal dysphagia is a swallowing disorder characterized by difficulty in transferring foods and/or liquids from the oral cavity to the stomach, affecting safe oral feeding. The main complications caused by dysphagia are tracheobronchial aspiration, pneumonia, malnutrition, and dehydration. Fibre-optic endoscopic evaluation of swallowing (FEES) is the first choice for studying swallowing disorders, it is easy to use, very well tolerated, allows bedside examination, and is economic. The dysphagia handicap index (DHI) is a 25-item self-administered questionnaire. It is a noninvasive tool measuring the handicapping effect of dysphagia in three aspects: the physical, functional, and emotional aspects of life, so a patient can rate the impact of his swallowing problem. The aim of this study is to test the correlation between DHI scores and fibre-optic endoscopic examination of swallowing and the ability of DHI to predict penetration and aspiration. For all patients, FEES examination was done as an assessment tool for dysphagia and DHI. Testing the correlation between DHI scores and penetration and aspiration on FEES results in a positive significant correlation, so we can apply DHI as a predictor of aspiration and penetration at medical centres where FEES examination is not accessible.
... Test methods introduced by IDDSI framework (spoon and fork pressure test) are defined based on a scientific basis targeted for individuals and nursing uses and maybe the simplest methods but inappropriate for industrial applications, because there are no measuring units defined by IDDSI. Texture Profile Analysis (TPA) which is based on simulation of two first bites on food could provide more detailed textural parameters including hardness, cohesiveness, adhesiveness, springiness, gumminess, and chewiness (Sukkar et al., 2018). With these parameters, the safety criteria of the textural properties of foods could be defined (Dufresne and Germain, 2004). ...
... The mixing of saliva with the puree and the mechanical manipulation of the puree in the mouth resulted in the formation of a food bolus. The presence of saliva has been suggested to increase cohesion and viscoelastic properties of the bolus due to the human mucin components secreted in food-stimulated saliva [21]. Nevertheless, a higher cohesiveness value obtained from instrumental measurements means that an increase in the applied force is required for the puree processing in the mouth to facilitate the mixing of the puree with the saliva to form a bolus prior to swallowing. ...
The creation of 3D printed food with programmed texture has the ambition of getting personalized properties through novel texture perceptions with many different ingredients and is helping the swallowing or mastication problems of vulnerable people. This study is done to determine the correlation between the instrumental and sensory evaluation of 3D-printed protein-fortified puree potatoes. At the moment there are not many studies about this correlation, and this information can be very helpful for food texture development. For people with swallowing difficulties, it is critical to have access to safe food with the desired texture. Therefore, understanding the correlation between texture-modified food will aid in the formulation of safe foods with desired sensory properties. Instrumental measurements of fortified puree were performed by a texture analyzer and the attributes obtained were firmness, consistency, cohesiveness, and index of viscosity. Quantitative descriptive analysis with eight trained panelists was employed to characterize the texture of the the3D-printed protein-fortified puree based on six sensory attributes: firmness, thickness, smoothness, rate of breakdown, adhesive, and difficulty swallowing. Three proteins (soy, cricket, and egg albumin with two different concentrations of 3 and 5%) were evaluated against puree potato without any protein as a control. The correlation results obtained from texture analysis and sensory evaluation were statistically significant (P < 0.05) which can be used to understand the impact of ingredients on textured modified puree to predict the sensory attributes which need a lot of time for training panelists.
... Amylase catalyzes the hydrolysis of α-1,4 glycosidic linkages between glucose units in starch, resulting in amylose and amylopectin breakdown. (Sukkar et al., 2018;Souza, 2010). Hence, the stability of thickener to carbohydrate-hydrolyzing enzymes should be taken into consideration in food preparation for dysphagia patients (Sukkar et al., 2018). ...
... (Sukkar et al., 2018;Souza, 2010). Hence, the stability of thickener to carbohydrate-hydrolyzing enzymes should be taken into consideration in food preparation for dysphagia patients (Sukkar et al., 2018). ...
The aim of this paper was to investigate effects of inulin and ultrasonic homogenization on particle size distribution and microstructure of oil-in-water emulsion gels stabilized by psyllium husk were investigated. The emulsion gel was assessed their utility in meat puree prepared for people with dysphagia. The results showed that increasing inulin percentage resulted in reduced particle size and improved emulsion stability with the optimum at 20% w/w inclusion. Ultrasonic homogenization further enhanced the emulsion stability by reducing the size of emulsion droplet and improving encapsulation of emulsion droplet. Increasing inulin concentrations in the emulsion gels added into purees also corresponded with decreasing total expressible fluid (TEF). The stability of puree against the action of carbohydrate-hydrolyzing enzymes (α-amylase and α-glucosidase) was improved with the addition of emulsion gels. Therefore, these developed emulsion gels could be beneficial in formulating modified-texture food prepare for people with dysphagia.
... Dysphagia is a medical term related to swallowing difficulties. It is becoming a common health concern for our rapidly aging global population as dysfunction of swallowing apparatus may occur more in the elderly (Abu-Ghanem, Chen, & Amin, 2020;Sukkar, Maggi, Travalca, Cupillo, & Ruggiero, 2018;Sura, Madhavan, Carnaby, & Crary, 2012). Such the problem is also highly prevalence in patients with concerning health conditions such as stroke, motor neurone disease, Parkinson's disease, dementia, Alzheimer's, head and neck cancer, or head injury (Abu-Ghanem et al., 2020;Methacanon, Gamonpilas, Kongjaroen, & Buathongjan, 2021). ...
... It is important to point out that the results shown here completely neglected the effect of saliva, which can have significant impact on some active hydrocolloids such as modified starch (Mosca & Chen, 2017). Saliva not only can hydrolyze starch components within the thickening powder formulation (Hanson, Cox, Kaliviotis, & Smith, 2012), but also provides in-mouth lubrication and makes food bolus more cohesive, which is one of the key characteristics required for safe swallowing (Sukkar et al., 2018;Araiza-Calahorra et al., 2022). Therefore, saliva has a dominant role affecting both the rheology and tribology of thickened liquids and its effect should not be overlooked in the design of novel thickeners for dysphagia management. ...