Simple Advanced Preparation Method for Improving the Thickness Stability of Powder Thickening Agents in Dysphagia Management.

Texture modification of foods by using thickening agents is a routine practice for assessing and treating dysphagic patients. However, a powder-thickened fluid's viscosity might change over time, and little has been proposed to overcome this inconsistency. This study aimed to evaluate variations in the thickness of a fluid thickened with a common xanthan gum-based powder and to explore the feasibility of a simple advanced preparation method for thickened liquids to improve thickness stability. Thickened fluids with concentrations of 1.0 g/100 mL, 0.7 g/100 mL, and 0.5 g/100 mL were prepared from both freshly opened and previously opened thickening powders. Fluid thickness was measured every 10 min in a series of International Dysphagia Diet Standardization Initiative flow tests. A significant time-dependent decline in thickness was observed for all three concentrations in both groups, namely those prepared with freshly opened and previously opened thickening powders, and the shortest periods to achieve a stable viscosity after liquid preparation for the two groups were 80 and 70 min, respectively. On diluting the thickened liquids from the base liquid, which was prepared at a concentration of 1.0 g/100 mL and stored at room temperature for 90 min, no significant time-dependent thickness changes were observed over the following 60 min. The simple protocol of preparing the thickest "base" liquid in advance and then diluting it to the desired thickness resulted in a consistent liquid thickness, with the prepared liquids ready to be clinically applied and consumed, with high stability within 60 min.

NO-to-[N2O2]2--to-N2O Conversion Triggered by {Fe(NO)2}10-{Fe(NO)2}9 Dinuclear Dinitrosyl Iron Complex.

Flavodiiron nitric oxide reductases (FNORs) evolved in some pathogens are known to detoxify NO via two-electron reduction to N2O to mitigate nitrosative stress. In this study, we describe how the electronically localized {Fe(NO)2}10-{Fe(NO)2}9 dinuclear dinitrosyl iron complex (dinuclear DNIC) [(NO)2Fe(µ-bdmap)Fe(NO)2(THF)] (2) (bdmap = 1,3-bis(dimethylamino)-2-propanolate) can induce a reductive coupling of NO to form hyponitrite-coordinated tetranuclear DNIC, which then converts to N2O. Upon the addition of 1 equiv of NO into the dinuclear {Fe(NO)2}10-{Fe(NO)2}9 DNIC 2, the proposed side-on-bound [NO]--bridged [(NO)2Fe(µ-bdmap)(κ2-NO) Fe(NO)2] intermediate may facilitate intermolecular (O)N-N(O) bond coupling to yield the paramagnetic tetranuclear quadridentate trans-hyponitrite-bound {[(NO)2Fe(µ-bdmap)Fe(NO)2]2(κ4-N2O2)} that transforms to [Fe(NO)2(µ-bdmap)]2, along with the release of N2O upon Hbdmap (1,3-bis(dimethylamino)-2-propanol) added.

The effects of spaced retrieval training in improving hyperphagia of people living with dementia in residential settings.

AIMS AND OBJECTIVES: To investigate the effectiveness of spaced retrieval for improving hyperphagia in patients with dementia in residential care settings. BACKGROUND: Although 10-30% of patients with dementia have hyperphagia, most studies have focused on eating difficulties. Only a few studies have focused on hyperphagia. Various memory problems cause hyperphagia in patients with dementia. Spaced retrieval, a cognitive technique for information learning, can be used as a training method to improve memory loss. Recent studies showed that patients who received the training successfully memorised information learned in the training and correctly applied it to their daily lives. STUDY DESIGN: Single-blind experiments were performed. METHODS: The 97 subjects with dementia were recruited from seven institutions. All research participants were stratified into three groups according to cognitive impairment severity and Hyperphagic Behavior Scale scores and then randomly assigned to the experimental and control groups. The experimental group received a six-week one-by-one spaced retrieval training for hyperphagia behaviour. The control group received routine care. RESULTS: After the intervention, the frequency and severity of hyperphagia in the patients with dementia, and food intake were significantly lower in the experimental group than in the control group. However, body mass index did not significantly differ. CONCLUSION: Our results suggest that the spaced retrieval training could decrease the frequency and severity of hyperphagia in patients with dementia. The content of this training programme is consistent with the normal manner of eating in daily life and is easy for patients to understand and perform. Therefore, it can be applied in residents' daily lives. RELEVANCE TO CLINICAL PRACTICE: This study confirms the efficacy of the spaced retrieval training protocol for hyperphagia in patients with dementia. In future studies, the follow-up duration can be increased to determine the long-term effectiveness of the intervention.