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Introduction | myopia, Myopia | MYOPIA, EYE DISEASES, MYOPIA | Myopia is one of the most common eye diseases and is of worldwide concern.Currently, several interventions have been proposed to prevent the onset of myopia, such as increased outdoor time,Repeated low-level red-light (RLRL) therapy delivered by a device emitting 650-nm visible red light has been proposed as an alterna... | PMC10134010 |
Methods | This 12-month, 2-group, single-blinded, school-based randomized clinical trial was conducted in Shanghai, China. Children from 10 primary schools were enrolled between April 1, 2021, and June 30, 2021. Examinations were conducted at baseline and at the 3-, 6-, 9-, and 12-month follow-up visits. This trial was completed... | PMC10134010 | ||
Eligibility Criteria | astigmatism, strabismus, ocular abnormalities, anisometropia | SYSTEMIC DISEASE, ASTIGMATISM, STRABISMUS, MYOPIA, -11, ANISOMETROPIA | Eligible participants were primary school students in grades 1 to 4 (aged 6-11 years) with premyopia, defined as a cycloplegic spherical equivalent refraction (SER) of the more myopic eye in the range of −0.50 to 0.50 (inclusive) diopters (D) and having at least 1 parent with an SER in either eye of −3.00 D or less. Ch... | PMC10134010 |
Randomization and Masking | The randomization was stratified by grade and allocated to individuals at a ratio of 1:1. The randomization list was generated using R software, version 3.6 (R Group for Statistical Computing). To avoid stigmatization for being selected or not, children, parents, and teachers were educated on the purpose of the study a... | PMC10134010 | ||
Intervention | Children in the intervention group received the RLRL intervention, while those in the control group did not. The RLRL intervention was provided by a desktop device (Eyerising, Suzhou Xuanjia Optoelectronics Technology; eFigure 1 in | PMC10134010 | ||
Intervention Compliance Monitoring | During semesters, children in the intervention group completed treatment at school. During summer and winter vacations, guardians were trained by teachers to supervise the intervention at home. The device was linked to the internet with an automated diary function to record the treatment history. In addition, 2 investi... | PMC10134010 | ||
Data Collection | Diabetic Retinopathy | CYCLOPLEGIA, CYCLOPLEGIA, DIABETIC RETINOPATHY | Clinical examinations were performed at baseline and at 3-, 6-, 9-, and 12-month follow-up visits. Baseline demographic characteristics were collected via questionnaire; the information was obtained from school teachers with permission from the participants and their guardians.Uncorrected visual acuity (UCVA) and best-... | PMC10134010 |
Outcomes | myopic, myopia, choroidal thickness | MYOPIA, MYOPIA, SECONDARY | The primary outcome was the 12-month cumulative incidence of myopia in both groups. Myopia was defined as the cycloplegic SER (sphere plus half of cylinder) of −0.50 D or less in the more myopic eye. Secondary outcomes of the study were the changes in SER, AL, choroidal thickness, UCVA, and BCVA over 1 year. Data from ... | PMC10134010 |
Adverse Events | hemorrhage, atrophy | PROLIFERATION, MACULAR HOLE, HEMORRHAGE, ATROPHY | At baseline, all children in the intervention group completed 1 session of the RLRL intervention. The children were asked to close their eyes until the bright spot, also known as the Fundus images by swept-source OCT were independently evaluated by 2 accredited senior ophthalmologists. Any fundus abnormality and its gr... | PMC10134010 |
Sample Size | myopia | MYOPIA | The sample size estimation was conducted based on the assumption of a 2-sided α level of .05, 90% power, and the expected effect size. The incidence of myopia among primary school students with premyopia was approximately 42% per year, | PMC10134010 |
Statistical Analysis | Statistical analyses were performed using SAS, version 9.4 (SAS Institute Inc). Outcomes were analyzed by means of an intention-to-treat method and a per-protocol method. The intention-to-treat analysis included participants in both groups at baseline, while the per-protocol analysis included participants in the contro... | PMC10134010 | ||
Results | A total of 278 children (28.1%) were included in the trial: 139 children (mean [SD] age, 8.3 [1.1] years; 71 boys [51.1%]) in the intervention group and 139 children (mean [SD] age, 8.3 [1.1] years; 68 boys [48.9%]) in the control group ( | PMC10134010 | ||
Flowchart of the Study | MAY | Because of the COVID-19 pandemic and the associated sudden lockdown in Shanghai from March to May 2022, the number of participants at the 9-month visit and compliance with the treatment during the last 3 months in the intervention group were affected significantly when the children did not bring the devices home from s... | PMC10134010 | |
Primary Outcome | MYOPIA | The 12-month incidence rate of myopia was 40.8% (49 of 120) in the intervention group and 61.3% (68 of 111) in the control group ( | PMC10134010 | |
Refractive and Biometric Outcomes at 12-Month Follow-up (Intention-to-Treat Analysis) | Abbreviations: AL, axial length; D, diopters; NA, not applicable; SER, spherical equivalent refraction.The intervention group included those who continued the intervention and those with interrupted intervention.Risk difference, absolute efficacy = value in control group − value in intervention group.Relative risk = va... | PMC10134010 | ||
Secondary Outcomes | For the intervention group, the mean (SD) SER change over 12 months was –0.35 (0.54) D. For the control group, the corresponding mean (SD) change was –0.76 (0.60) D. The absolute mean difference in SER change between the 2 groups was –0.41 D (95% CI, –0.56 to –0.26 D; The 12-month mean (SD) AL increase was 0.30 (0.27) ... | PMC10134010 | ||
Axial Length (AL) Change Between the Intervention and Control Groups Over 12 Months | hyperopic | REGRESSION | The proportions of children showing SER regression (hyperopic shift of >0.25 D, which cannot be explained as the measurement errors in refraction device) in the intervention group were 51.2% (62 of 121) at the 6-month follow-up visit and 19.0% (23 of 121) at the 12-month follow-up visit, while the corresponding proport... | PMC10134010 |
Vision Function and Choroidal Thickness at the 12-Month Follow-up (Intention-to-Treat Analysis) | choroidal thickness | Abbreviations: BCVA, best corrected visual acuity; CT, choroidal thickness; UCVA, uncorrected visual acuity.The intervention group included those who continued the intervention and those with interrupted intervention.The | PMC10134010 | |
Effect of the COVID-19 Pandemic | The baseline characteristics between the continued intervention group and the interrupted intervention group were well balanced (eTable 4 in | PMC10134010 | ||
Adverse Events | Two participants withdrew from the study because the afterimage duration exceeded 6 minutes at baseline. According to swept-source OCT images, no other structural damage was noted in the intervention and control groups. | PMC10134010 | ||
Sensitivity and Subgroup Analyses | MYOPIA | Subgroup analyses comparing the efficacy of intervention for myopia prevention and control (incidence, SER changes, and AL changes) by different baseline SER groups and age groups were performed. Better efficacy was observed among children with an SER of 0.01 to 0.50 D than among those with an SER of −0.50 to 0.00 D (r... | PMC10134010 | |
Refractive and Biometric Outcomes at 12-Month Follow-up in Different Baseline SER Groups (Adjusted for Baseline Age) | Abbreviations: AL, axial length; D, diopters; SER, spherical equivalent refraction.The intervention group included those who continued the intervention and those with interrupted intervention.Absolute efficacy = value in control group − value in intervention group; relative efficacy = (value in control group − value in... | PMC10134010 | ||
Discussion | myopia | MYOPIA | To our knowledge, this was the first trial to date to investigate the efficacy of the RLRL intervention in myopia prevention. In this 12-month randomized clinical trial, the RLRL intervention achieved an absolute difference of 20.4% in incidence of myopia, representing a 33.4% relative reduction in incident myopia. For... | PMC10134010 |
Effect of RLRL Intervention on Myopia Incidence | myopia | MYOPIA | The efficacy of a 33.4% to 54.1% relative reduction in the incidence of myopia with the RLRL intervention should be interpreted carefully. Increased outdoor time has been consistently shown to have an efficacy rate ranging from 11.0% to 54.3% in preventing myopia onset within 1 year. | PMC10134010 |
Effect of RLRL Intervention on Myopic Shift | myopic | MYOPIA | We found that the RLRL intervention significantly reduced the myopic shifts in terms of AL and SER compared with the control group (difference, 0.17 mm and –0.41 D, respectively). In the subgroup analysis of individuals with premyopia from a randomized clinical trial in Taiwan, a 1-year outdoor intervention achieved re... | PMC10134010 |
Influencing Factors of RLRL Intervention Efficacy | MYOPIA, MYOPIA | Our results showed that the effect of the RLRL intervention on myopia prevention was different among baseline SER groups. The RLRL intervention was more effective among children with an SER of 0.01 to 0.50 D at baseline than those with an SER of −0.50 to 0.00 D at baseline. In 2021, the International Myopia Institute d... | PMC10134010 | |
Safety | blindness | RETINA, BLINDNESS | After this 12-month RLRL intervention, no functional damage as indicated by BCVA was observed. No children reported having glare, flash blindness, or afterimages longer than 6 minutes after treatment. An afterimage induced by prior adaptation to a visual stimulus is believed to be due to bleaching of photochemical pigm... | PMC10134010 |
Limitations | MYOPIA | This study had several limitations. First, the open-label design may bias the results. Future studies comparing a light treatment simulator with a much lower power should exclude potential placebo effects. Second, because of the outbreak of the COVID-19 pandemic in Shanghai, approximately 70% of the children in the int... | PMC10134010 | |
Conclusions | myopia | MYOPIA | This randomized clinical trial found that RLRL is a novel and effective intervention for myopia prevention, with good user acceptability and a 54.1% reduction in incident myopia within 12 months for children with premyopia. Our findings have public health significance, especially for myopia prevention in countries with... | PMC10134010 |
1. Introduction | Depression, Anxiety | The use of electronic patient-reported outcomes has increased recently, and smartphones offer distinct advantages over other devices. However, previous systematic reviews have not investigated the reliability of the Center for Epidemiologic Studies Depression Scale (CES-D), Generalized Anxiety Disorder-7 (GAD-7), and K... | PMC10049019 | |
2. Materials and Methods | PMC10049019 | |||
2.1. Study Design | This study was conducted using a randomized crossover design to assess the format equivalence of the paper and smartphone versions of the CES-D, GAD-7, and K6. | PMC10049019 | ||
2.2. Participants and Procedure | RECRUITMENT | The study participants were recruited between October 2022 and December 2022 from Gunma University in Gunma, Japan. The recruitment was made by posting posters at Gunma University. Study participation was also encouraged via e-mail and social networking services. Individuals aged ≥18 years who were native Japanese spea... | PMC10049019 | |
2.3. Randomization | Participants were randomly assigned in a 1:1 ratio to complete either the paper version first or the smartphone version first before answering the questionnaire (CES-D, GAD-7, and K6). The randomization list was generated by a permuted block method (block size 4) using a computer (Microsoft Excel) by a third party unre... | PMC10049019 | ||
2.4. Sample Size | The ISPOR guidelines report that 43 participants with no missing data are needed to declare an ICC of ≥0.7 at 80% power and 95% confidence level if the ICC observed in two measurements is expected to be 0.85, using the approximation used by Walter et al. [ | PMC10049019 | ||
2.5. Measures | PMC10049019 | |||
2.5.1. CES-D | depressive symptoms | The CES-D is a 20-item self-report questionnaire used to measure depressive symptoms [ | PMC10049019 | |
2.5.2. GAD-7 | anxiety disorder | The GAD-7 is a 7-item self-report questionnaire used to measure generalized anxiety disorder, on a 0–3 Likert scale (0 = not at all sure, 1 = several days, 2 = over half the days, and 3 = nearly every day) [ | PMC10049019 | |
2.5.3. K6 | The K6 is a 6-item self-report questionnaire used to measure psychological distress, using a 0–4 Likert scale (0 = none of the time, 1 = a little of the time, 2 = some of the time, 3 = most of the time, and 4 = all of the time) [ | PMC10049019 | ||
2.6. Software | Electronic versions of CES-D, GAD-7, and K6 were provided on participants’ smartphones using Google Forms. The questionnaires were presented in the order CES-D, GAD-7, and K6. The questions, answer choices, and order of questions in the electronic version are the same as those in the paper version of the three scales. ... | PMC10049019 | ||
2.7. Statistical Analysis | In this study, the switch from the paper version to the smartphone version corresponds to the light to moderate adjustment suggested by the ISPOR guidelines [ | PMC10049019 | ||
3. Results | PMC10049019 | |||
3.1. Characteristics of the Study Participants | Of the 100 participants who met eligibility, 100 completed the paper and smartphone versions of the questionnaire and provided complete data. In the paper-first group, 50 participants first completed a paper-version questionnaire. In the smartphone-first group, 50 participants first completed the smartphone version que... | PMC10049019 | ||
3.2. Mean and LMM Results | The mean values for each group and the LMM results are shown in | PMC10049019 | ||
3.3. Equivalence | The ICC | PMC10049019 | ||
3.4. Internal Consistency | Cronbach’s alpha values for the CES-D score were 0.82 (95% CI 0.77–0.87) and 0.81 (95% CI 0.75–0.86) for the smartphone and paper versions, respectively. Cronbach’s alpha values for the GAD-7 score were 0.80 (95% CI 0.75–0.86) and 0.80 (95% CI 0.75–0.86) for the smartphone and paper versions, respectively. Cronbach’s a... | PMC10049019 | ||
4. Discussion | This study evaluated the equivalence of the embodiments to the CES-D, GAD-7, and K6 evaluated in smartphone and paper versions. The results suggest that CES-D and K6 have good equivalence, with ICCThe Cronbach’s alpha for the GAD-7 on smartphones was 0.80 (95% CI 0.75–0.86), indicating that it has the same internal con... | PMC10049019 | ||
Author Contributions | Conceptualization, K.H. and H.U.; methodology, K.H. and H.U.; formal analysis, H.U.; investigation, H.T. and N.K.; resources, K.H.; data curation, K.H. and H.U.; writing—original draft preparation, K.H. and H.U.; writing—review and editing, K.H., H.T., N.K., H.U., K.T. and S.K.; project administration, K.H.; funding ac... | PMC10049019 | ||
Institutional Review Board Statement | The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethical Review Board for Medical Research Involving Human Subjects of Gunma University (Approval no. HS2022-109). | PMC10049019 | ||
Informed Consent Statement | Informed consent was obtained from all participants involved in the study. Written informed consent has been obtained from the participants to publish this paper. | PMC10049019 | ||
Data Availability Statement | The datasets used and/or analysed during the current study available from the corresponding author on reasonable request. | PMC10049019 | ||
Conflicts of Interest | The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the result. | PMC10049019 | ||
References | Depression, Anxiety, K6.CES-D | Flowchart of trial.Baseline characteristics of the two groups.Data are means (standard deviation) or numbers (%).Means (SD) and LMMs results.CES-D: Center for Epidemiologic Studies Depression Scale; GAD-7: Generalized Anxiety Disorder-7; K6: Kessler Screening Scale for Psychological Distress; SD: standard deviation; LM... | PMC10049019 | |
1. Introduction | AMD | DISEASES, CARDIOVASCULAR DISEASES | There is an urgent need to implement intervention programs to promote adherence to the Mediterranean diet (AMD) in university students to prevent non-communicable diseases. A powerful tool for this is smartphone apps. Furthermore, it is necessary to determine the subgroups that are most likely to benefit from these tec... | PMC10096856 |
2. Materials and Methods | PMC10096856 | |||
2.1. Design Overview | The present study is a continuation of previous research and follows the same study protocol, which has been described by Béjar et al. [ | PMC10096856 | ||
2.2. Setting and Participants | wasting, diabetes | WASTING, RECRUITMENT, CHRONIC DISEASES, DIABETES | The Faculties of Medicine, Pharmacy and Communication at the University of Seville (Andalusia, Spain, South of Europe) were included in the study.Confidentiality was guaranteed in accordance with the Organic Law on the Protection of Personal Data and the Law 14/2007 on Spanish biomedical research.Inclusion criteria: Bo... | PMC10096856 |
2.3. Randomization and Masking | Four random classrooms were selected in each school (Medicine, Pharmacy and Communication): twelve classes in all. Of the four selected classrooms in each school, two were assigned to each group (CG and IG), according to the following sequence: first class: IG; second class: CG; third class: IG; and fourth class: CG. I... | PMC10096856 | ||
2.4. Intervention | CG: ‘non-feedback’ e-12HR version.IG: ‘feedback’ e-12HR version.The structure and functions of the e-12HR application (‘non-feedback’ e-12HR and ‘feedback’ e-12HR versions) have been described, in detail, by Béjar et al. (in “e-12HR App” in the | PMC10096856 | ||
2.5. Follow-Up and Outcome Measures | In order to assess the effect of the app (‘feedback’ e-12HR), follow-up was carried out at week one (baseline), week two, week three and week four of monitoring.Main result variable: the change in the AMD score at weeks two, three and four of monitoring.Secondary result variables: the personal information variables, an... | PMC10096856 | ||
Adherence to the MD | Every week during the four-week study period, the AMD index score (specifically, Mediterranean Diet Serving Score (MDSS) index [ | PMC10096856 | ||
2.6. Sample Size Calculation | The sample size estimation was made for the main result variable: the change in the MDSS index. Considering a standard deviation of 2.7 points in the MDSS index and a dropout rate of 20.6% (from a previous study using e-12HR [The sample size was calculated using the nQuery Advisor Release 7.0 program. | PMC10096856 | ||
2.7. Usability Rating Questionnaire for e-12HR | After the four-week monitoring period, a member of the research group sent e-mails to students (with a usability rating questionnaire for the e-12HR app [ | PMC10096856 | ||
2.8. Ethical Considerations | Participants were required to sign the informed consent prior to inclusion in the study, according to the Declaration of Helsinki.The study was approved by the University of Seville’s Research Ethics Committee on 30 March 2022 (internal identifier: 2813-N-21). Trial Registration: ClinicalTrials.gov, identifier NCT05532... | PMC10096856 | ||
2.9. Statistical Analysis | The results were displayed as numbers (percentages) for qualitative variables and as means (standard deviations) for quantitative variables.The data were tested for normality using the nonparametric Kolmogorov–Smirnov test.In order to compare proportions, the chi-square test (or Fisher exact test) was carried out as ap... | PMC10096856 | ||
3. Results | PMC10096856 | |||
3.1. Sample and Adherence to the Study | diabetic | A total of 491 students signed the informed consent forms; however, two students were excluded for being diabetic (one student from the IG and one from the CG), failing to meet the selection criteria. Of those who signed, 104 (64 in the CG and 40 in the IG) were considered to be non-responsive, as they did not complete... | PMC10096856 | |
3.3. MDSS Index | For both groups (CG and IG), scoring for the MDSS was calculated manually by the research team [ | PMC10096856 | ||
3.4. Effect of the Intervention | PMC10096856 | |||
3.4.1. Effect of the Intervention in Terms of Variation in MDSS Index and Percentage of Participants with Moderate/High (≥9) MDSS Index in the Whole Study Sample | There were significant statistical differences for both the MDSS index and the percentage of participants with moderate/high (≥9) MDSS index (CG versus IG) in weeks two, three and four, with higher values in the IG (no significant differences in week one): for the MDSS index with 1.25, 1.78 and 1.93 points of improveme... | PMC10096856 | ||
3.4.3. Effect of the Intervention in Terms of Variation in MDSS Index in Different Subgroups of the Study Sample | The differences were statistically significant considering the MDSS index (CG versus IG): in weeks two, three and four for the subgroups <20 years, female, Health Science and <25 kg/m | PMC10096856 | ||
3.5. Usability Rating Questionnaire for e-12HR | This questionnaire was answered by 127 students (66 from the CG and 61 from the IG).The responses of the users are shown in Considering the 127 participants who answered the questionnaire, all (100%) reported that e-12HR was easy to complete, and most of them indicated that: (1) the application contained understandable... | PMC10096856 | ||
4. Discussion | Velicer, AMD | Few randomized and controlled clinical trials have analyzed the effectiveness of promoting the MD (in Spanish adults) of smartphone apps with certain similarities to e-12HR [The main findings of this work were (significant intergroup statistical modifications): First: in relation to the main objective, in the entire sa... | PMC10096856 | |
Future Research Related to the Current Study | AMD | In those subgroups of the population that have improved AMD with the use of e-12HR, the research team intends to evaluate the possible increase in the MDSS index by combining the use of the app with counseling (counseling focused on food groups that have not improved consumption with the use of e-12HR, such as eggs, wh... | PMC10096856 | |
5. Conclusions | AMD | The results of this study support recommending the use of e-12HR in university students as a tool to improve AMD in the short term, in the total sample and in all its subgroups, except ≥25 kg/m | PMC10096856 | |
Author Contributions | Conceptualization, L.M.B.; methodology, L.M.B.; software (app design), L.M.B.; formal analysis, A.Q.-F., M.d.M.R.-A. and M.D.G.-P.; investigation, L.M.B., P.M.-R., A.Q.-F., M.d.M.R.-A. and M.D.G.-P.; resources, L.M.B., P.M.-R., A.Q.-F., M.d.M.R.-A. and M.D.G.-P.; data curation, M.D.G.-P.; writing—original draft prepara... | PMC10096856 | ||
Institutional Review Board Statement | The study was conducted in accordance with the Declaration of Helsinki and approved by the University of Seville’s Research Ethics Committee on 30 March 2022 (identifier: 2813-N-21). | PMC10096856 | ||
Informed Consent Statement | Informed consent was obtained from all subjects involved in the study. | PMC10096856 | ||
Data Availability Statement | The data used in the current study are available on reasonable request from the corresponding author. | PMC10096856 | ||
Conflicts of Interest | The authors declare no conflict of interest. | PMC10096856 | ||
Abbreviations | PMC10096856 | |||
Appendix A | Usability Rating Questionnaire for e-12HR.1: Strongly agree. 2: Agree. 3: Neither agree nor disagree. 4: Disagree. 5: Strongly disagree. | PMC10096856 | ||
1. Introduction | gastrointestinal tract, upper gastrointestinal tract | Almonds are rich in unsaturated lipids, which play a role in some of the reported benefits of almond consumption for human health. Almond lipids are poorly bioaccessible due to almonds’ unique physicochemical properties that influence particle size distribution (PSD) following mastication, allowing much intracellular l... | PMC9919979 | |
2. Materials and Method | PMC9919979 | |||
2.1. Study Design | This study was a randomised, crossover design mastication study in healthy volunteers consisting of a single study visit with two mastication sessions. A mastication study is required as mastication has a key role in reducing PSD and reflects the presentation of almonds as they appear in the gut in vivo. It has been de... | PMC9919979 | ||
2.2. Participants | Participants were those who had previously completed an RCT investigating the impact of almond consumption on gut health [ | PMC9919979 | ||
2.3. Collection of Mastication Samples | pain | Incomplete dentition, presence of dentures/false teeth and/or recent dental treatment were considered as confounding factors that may impact (1) normal masticatory behaviour due to pain or discomfort in part of the mouth or (2) particle recovery due to lodgement of particles in oral crevices. These data were collected ... | PMC9919979 | |
2.4. Mechanical Sieving | Samples were thawed at 4 °C and loaded onto a stack of pre-weighed ultra-sonically cleaned sieves (Endecotts Ltd., London, UK) with the following aperture sizes from top to bottom: 3350, 2000, 1000, 500, 250, 125, 63 and 45 µm, a 20 µm nylon mesh and a sieve base. The sample was washed with deionised water before being... | PMC9919979 | ||
2.5. Laser Diffraction | Samples were thawed at 4 °C. Particles >2000 µm and <20 µm were removed by mechanical sieving prior to analysis to avoid interference with the laser diffraction instrument as described previously [Laser diffraction was performed on a Mastersizer 2000 instrument fitted with a Hydro 2000 G dispersant unit (Malvern Panaly... | PMC9919979 | ||
2.6. Predicted Lipid Bioaccessibility | A theoretical model for predicting lipid bioaccessibility in almonds has been developed previously [ | PMC9919979 | ||
2.7. Statistical Analysis | Data were analysed on IBM SPSS Statistics (version 26; IBM, Portsmouth, UK). Descriptive statistics were used to summarise demographic characteristics and outcome data. For continuous outcomes, mean and standard deviation were calculated.Summary data for PSD were presented as mean % weight (mechanical sieving) or mean ... | PMC9919979 | ||
3. Results | PMC9919979 | |||
3.1. Particpant Characteristics | The consort diagram is presented in | PMC9919979 | ||
3.2. Masticatory Parameters | Data were gathered on each participant’s dentition, the results of which are presented in | PMC9919979 | ||
3.3. Particle Size Distribution Assessed by Mechanical Sieveing | The mean total weight of particles recovered was significantly different ( | PMC9919979 | ||
3.4. Particle Size Distribution Assessed by Laser Diffraction | The PSD of masticated whole and ground almonds as assessed by laser diffraction is illustrated in | PMC9919979 | ||
3.5. Predicted Lipid Bioaccessibility | Lipid bioaccessibility of masticated whole and ground almonds was predicted using the theoretical model with data obtained from particle size analysis by mechanical sieving (The model indicated a threshold particle size value (P) of approximately 54 µm for almonds. Thus, to obtain complete lipid release, all particles ... | PMC9919979 | ||
4. Discussion | weight loss | SEPARATION | This mastication study was conducted to test the hypotheses that mastication of commercially ground almonds would result in a PSD with smaller particles in comparison to whole almonds, and that this would influence subsequent predicted lipid bioaccessibility. Our results support the above hypotheses; there were differe... | PMC9919979 |
5. Conclusions | In conclusion, we confirm that mastication does not provide sufficient mechanical disruption to result in a PSD that facilitates complete lipid release from whole almonds. In addition, commercial processing of almonds by grinding results in a post-mastication PSD with a larger proportion of smaller particles, and a sub... | PMC9919979 | ||
Author Contributions | Conceptualisation and methodology, K.W., S.E.B., E.D. and A.C.C. in consultation with T.G.; investigation, A.C.C. and E.S.H.; data curation, A.C.C.; formal analysis, A.C.C. under supervision of K.W. and S.E.B., and support from T.G. (predicted lipid bioaccessibility); writing—original draft preparation, A.C.C.; writing... | PMC9919979 |
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