An Overview of Hospital Capacity Planning and Optimisation.

Health care is uncertain, dynamic, and fast growing. With digital technologies set to revolutionise the industry, hospital capacity optimisation and planning have never been more relevant. The purposes of this article are threefold. The first is to identify the current state of the art, to summarise/analyse the key achievements, and to identify gaps in the body of research. The second is to synthesise and evaluate that literature to create a holistic framework for understanding hospital capacity planning and optimisation, in terms of physical elements, process, and governance. Third, avenues for future research are sought to inform researchers and practitioners where they should best concentrate their efforts. In conclusion, we find that prior research has typically focussed on individual parts, but the hospital is one body that is made up of many interdependent parts. It is also evident that past attempts considering entire hospitals fail to incorporate all the detail that is necessary to provide solutions that can be implemented in the real world, across strategic, tactical and operational planning horizons. A holistic approach is needed that includes ancillary services, equipment medicines, utilities, instrument trays, supply chain and inventory considerations.

Interjoint Coordination in Kicking a Moving Target: A Comparison Between Elite and Nonelite Taekwondo Players.

Patterns of interjoint coordination in the kicking legs of taekwondo players were investigated to understand movement pattern variability as a functional property of skill level. Elite and nonelite players performed roundhouse kicks against a custom-built moving target fitted with an accelerometer, and movements were recorded by motion capture. Average foot segment velocities of 13.6 and 11.4 m/s were recorded for elite and nonelite players, respectively (P < .05), corresponding to target accelerations of 87.5 and 70.8g (P < .05). Gradient values derived from piecewise linear regression of continuous relative phase curves established the comparative incoordination of nonelite taekwondo players in the form of an overshoot behavior during the crucial period leading to target impact (P < .05). This overshoot was apparent in both knee-hip and ankle-knee continuous relative phase curves. Elite players generated greater limb speed and impact force through more effective limb segment coordination. The combination of continuous relative phase and piecewise linear regression techniques allowed identification of alternate joint control approaches in the 2 groups.

RNAseq Analysis of Rhizomania-Infected Sugar Beet Provides the First Genome Sequence of Beet Necrotic Yellow Vein Virus from the USA and Identifies a Novel Alphanecrovirus and Putative Satellite Viruses.

"Rhizomania" of sugar beet is a soilborne disease complex comprised of beet necrotic yellow vein virus (BNYVV) and its plasmodiophorid vector, Polymyxa betae. Although BNYVV is considered the causal agent of rhizomania, additional viruses frequently accompany BNYVV in diseased roots. In an effort to better understand the virus cohort present in sugar beet roots exhibiting rhizomania disease symptoms, five independent RNA samples prepared from diseased beet seedlings reared in a greenhouse or from field-grown adult sugar beet plants and enriched for virus particles were subjected to RNAseq. In all but a healthy control sample, the technique was successful at identifying BNYVV and provided sequence reads of sufficient quantity and overlap to assemble > 98% of the published genome of the virus. Utilizing the derived consensus sequence of BNYVV, infectious RNA was produced from cDNA clones of RNAs 1 and 2. The approach also enabled the detection of beet soilborne mosaic virus (BSBMV), beet soilborne virus (BSBV), beet black scorch virus (BBSV), and beet virus Q (BVQ), with near-complete genome assembly afforded to BSBMV and BBSV. In one field sample, a novel virus sequence of 3682 nt was assembled with significant sequence similarity and open reading frame (ORF) organization to members within the subgenus Alphanecrovirus (genus Necrovirus; family Tombusviridae). Construction of a DNA clone based on this sequence led to the production of the novel RNA genome in vitro that was capable of inducing local lesion formation on leaves of Chenopodium quinoa. Additionally, two previously unreported satellite viruses were revealed in the study; one possessing weak similarity to satellite maize white line mosaic virus and a second possessing moderate similarity to satellite tobacco necrosis virus C. Taken together, the approach provides an efficient pipeline to characterize variation in the BNYVV genome and to document the presence of other viruses potentially associated with disease severity or the ability to overcome resistance genes used for sugar beet rhizomania disease management.

Mindfulness Meditation and Interprofessional Cardiopulmonary Resuscitation: A Mixed-Methods Pilot Study.

PROBLEM: Mindfulness training includes mindfulness meditation, which has been shown to improve both attention and self-awareness. Medical providers in the intensive care unit often deal with difficult situations with strong emotions, life-and-death decisions, and both interpersonal and interprofessional conflicts. The effect of mindfulness meditation training on healthcare providers during acute care tasks such as cardiopulmonary resuscitation remains unknown. Mindfulness meditation has the potential to improve provider well-being and reduce stress in individuals involved in resuscitation teams, which could then translate into better team communication and delivery of care under stress. A better understanding of this process could lead to more effective training approaches, improved team performance, and better patient outcomes. INTERVENTION: All participants were instructed to use a mindfulness meditation device (Muse™ headband) at home for 7 min twice a day or 14 min daily over the 4-week training period. This device uses brainwave sensors to monitor active versus relaxing brain activity and provides real-time feedback. CONTEXT: We conducted a single-group pretest-posttest convergent mixed-methods study. We enrolled 24 healthcare providers, comprising 4 interprofessional code teams, including physicians, nurses, respiratory therapists, and pharmacists. Each team participated in a simulation session immediately before and after the mindfulness training period. Each session consisted of two simulated cardiopulmonary arrest scenarios. Both quantitative and qualitative outcomes were assessed. OUTCOME: The median proportion of participants who used the device as prescribed was 85%. Emotional balance, as measured by the critical positivity ratio, improved significantly from pretraining to posttraining (p = .02). Qualitative findings showed that mindfulness meditation changed how participants responded to work-related stress, including stress in real-code situations. Participants described the value of time for self-guided practice with feedback from the device, which then helped them develop individual approaches to meditation not reliant on the technology. Time measures during the simulated scenarios improved, specifically, time to epinephrine in Scenario 1 (p = .03) and time to defibrillation in Scenario 2 (p = .02), improved. In addition, team performance, such as teamwork (p = .04), task management (p = .01), and overall performance (p = .04), improved significantly after mindfulness meditation training. Physiologic stress (skin conductance) improved but did not reach statistical significance (p = .11). LESSONS LEARNED: Mindfulness meditation practice may improve individual well-being and team function in high-stress clinical environments. Our results may represent a foundation to design larger confirmatory studies.

Unbiased screen identifies aripiprazole as a modulator of abundance of the polyglutamine disease protein, ataxin-3.

No disease-modifying treatment exists for the fatal neurodegenerative polyglutamine disease known both as Machado-Joseph disease and spinocerebellar ataxia type 3. As a potential route to therapy, we identified small molecules that reduce levels of the mutant disease protein, ATXN3. Screens of a small molecule collection, including 1250 Food and Drug Administration-approved drugs, in a novel cell-based assay, followed by secondary screens in brain slice cultures from transgenic mice expressing the human disease gene, identified the atypical antipsychotic aripiprazole as one of the hits. Aripiprazole increased longevity in a Drosophila model of Machado-Joseph disease and effectively reduced aggregated ATXN3 species in flies and in brains of transgenic mice treated for 10 days. The aripiprazole-mediated decrease in ATXN3 abundance may reflect a complex response culminating in the modulation of specific components of cellular protein homeostasis. Aripiprazole represents a potentially promising therapeutic drug for Machado-Joseph disease and possibly other neurological proteinopathies.

The impact of hop bitter acid and polyphenol profiles on the perceived bitterness of beer.

Thirty-four commercial lager beers were analysed for their hop bitter acid, phenolic acid and polyphenol contents. Based on analytical data, it was evident that the beers had been produced using a range of different raw materials and hopping practices. Principal Components Analysis was used to select a sub-set of 10 beers that contained diverse concentrations of the analysed bitter compounds. These beers were appraised sensorially to determine the impacts of varying hop acid and polyphenolic profiles on perceived bitterness character. Beers high in polyphenol and hop acid contents were perceived as having 'harsh' and 'progressive' bitterness, whilst beers that had evidently been conventionally hopped were 'sharp' and 'instant' in their bitterness. Beers containing light-stable hop products (tetrahydro-iso-α-acids) were perceived as 'diminishing', 'rounded' and 'acidic' in bitterness. The hopping strategy adopted by brewers impacts on the nature, temporal profile and intensity of bitterness perception in beer.

A Novel Microbiome Therapeutic Increases Gut Microbial Diversity and Prevents Recurrent Clostridium difficile Infection.

BACKGROUND: Patients with recurrent Clostridium difficile infection (CDI) have a ≥60% risk of relapse, as conventional therapies do not address the underlying gastrointestinal dysbiosis. This exploratory study evaluated the safety and efficacy of bacterial spores for preventing recurrent CDI. METHODS: Stool specimens from healthy donors were treated with ethanol to eliminate pathogens. The resulting spores were fractionated and encapsulated for oral delivery as SER-109. Following their response to standard-of-care antibiotics, patients in cohort 1 were treated with SER-109 on 2 consecutive days (geometric mean dose, 1.7 × 10(9) spores), and those in cohort 2 were treated on 1 day (geometric mean dose, 1.1 × 10(8) spores). The primary efficacy end point was absence of C. difficile-positive diarrhea during an 8-week follow-up period. Microbiome alterations were assessed. RESULTS: Thirty patients (median age, 66.5 years; 67% female) were enrolled, and 26 (86.7%) met the primary efficacy end point. Three patients with early, self-limiting C. difficile-positive diarrhea did not require antibiotics and tested negative for C. difficile at 8 weeks; thus, 96.7% (29 of 30) achieved clinical resolution. In parallel, gut microbiota rapidly diversified, with durable engraftment of spores and no outgrowth of non-spore-forming bacteria found after SER-109 treatment. Adverse events included mild diarrhea, abdominal pain, and nausea. CONCLUSIONS: SER-109 successfully prevented CDI and had a favorable safety profile, supporting a novel microbiome-based intervention as a potential therapy for recurrent CDI.

Effects of dietary fat profile on gut permeability and microbiota and their relationships with metabolic changes in mice.

OBJECTIVE: To distinguish the effects of dietary fat profile on gut parameters and their relationships with metabolic changes and to determine the capacity of n-3 fatty acids to modify gut variables in the context of diet-induced metabolic dysfunctions. METHODS: Mice received control or high-fat diets emphasizing saturated (HFD-sat), n-6 (HFD-n6), or n-3 (HFD-n3) fatty acids for 8 weeks. In another cohort, mice that were maintained on HFD-sat received n-3-rich fish oil or resolvin D1 supplementation. RESULTS: HFD-sat and HFD-n6 induced similar weight gain, but only HFD-sat increased index of insulin resistance (HOMA-IR), colonic permeability, and mesenteric fat inflammation. Hydrogen sulfide-producing bacteria were one of the major groups driving the diet-specific changes in gut microbiome, with the overall microbial profile being associated with changes in body weight, HOMA-IR, and gut permeability. In mice maintained on HFD-sat, fish oil and resolvin D1 restored barrier function and reduced inflammation in the colon but were unable to normalize HOMA-IR. CONCLUSIONS: Different dietary fat profiles led to distinct intestinal and metabolic outcomes that are independent of obesity. Interventions targeting inflammation successfully restored gut health but did not reverse systemic aspects of diet-induced metabolic dysfunction, implicating separation between gut dysfunctions and disease-initiating and/or -maintaining processes.

A comparison of the closed-face cassette at different orientations while measuring total particles.

The current method for sampling aerosols using the 37-mm closed-face cassette (CFC) sampler is based on the orientation of the cassette at ∼45° from horizontal. There is some concern as to whether this method is appropriate and may be underestimating exposures. An alternative orientation at ∼0° (horizontal) has been discussed. This research compared the CFC's orientation at 45° from horizontal to the proposed orientation at horizontal, 0° in a controlled laboratory setting. The particles used in this study were fused alumina oxide in four sizes, approximately 9.5 µm, 12.8 µm, 18 µm, and 44.3 µm in aerodynamic diameter. For each test, one aerosol was dispersed in a wind tunnel operating at 0.2 m/s with samplers mounted in the breathing zone of a rotating mannequin. A sampling event consisted of four pairs of samplers, placed side by side (one pair at 45° and another at 0° cassette orientation), and exposed for a period of 45 minutes. A total of 12 sampling events, 3 sample events per particle size, were conducted with a total of 94 samples collected. Mass concentration measurements were compared to assess the relationship between the sampler orientations of the cassettes. In addition, the relationship between the mass collected on the cassette filter and on the interior walls of the cassette was also assessed. The results indicated that there was no significant difference between the measured concentrations based on the orientation of the CFCs. The amount of mass collected on the interior walls of the cassettes was relatively low (<5%) compared to expected (up to 100%) wall losses for both orientations.

Lessons learned from the fate of AstraZeneca's drug pipeline: a five-dimensional framework.

Maintaining research and development (R&D) productivity at a sustainable level is one of the main challenges currently facing the pharmaceutical industry. In this article, we discuss the results of a comprehensive longitudinal review of AstraZeneca's small-molecule drug projects from 2005 to 2010. The analysis allowed us to establish a framework based on the five most important technical determinants of project success and pipeline quality, which we describe as the five 'R's: the right target, the right patient, the right tissue, the right safety and the right commercial potential. A sixth factor - the right culture - is also crucial in encouraging effective decision-making based on these technical determinants. AstraZeneca is currently applying this framework to guide its R&D teams, and although it is too early to demonstrate whether this has improved the company's R&D productivity, we present our data and analysis here in the hope that it may assist the industry overall in addressing this key challenge.

Effects of Olympic-style taekwondo kicks on an instrumented head-form and resultant injury measures.

OBJECTIVE: The objective of this study was to assess the effect of taekwondo kicks and peak foot velocity (FVEL) on resultant head linear acceleration (RLA), head injury criterion (HIC15) and head velocity (HVEL). METHODS: Each subject (n=12) randomly performed five repetitions of the turning kick (TK), clench axe kick (CA), front leg axe kick, jump back kick (JB) and jump spinning hook kick (JH) at the average standing head height for competitors in their weight division. A Hybrid II Crash Test Dummy head was fitted with a protective taekwondo helmet and instrumented with a triaxial accelerometer and fixed to a height-adjustable frame. Resultant head linear acceleration, HVEL, FVEL data were captured and processed using Qualysis Track Manager. RESULTS: The TK (130.11 ± 51.67 g) produced a higher RLA than the CA (54.95 ± 20.08 g, p<0.001, d=1.84) and a higher HIC15 than the JH (672.74 ± 540.89 vs 300.19 ± 144.35, p<0.001, ES=0.97). There was no difference in HVEL of the TK (4.73 ± 1.67 m/s) and that of the JB (4.43 ± 0.78 m/s; p=0.977, ES<0.01). CONCLUSIONS: The TK is of concern because it is the most common technique and cause of concussion in taekwondo. Future studies should aim to understand rotational accelerations of the head.

A retail market study of organic and conventional potatoes (Solanum tuberosum): mineral content and nutritional implications.

Whether or not all foods marketed to consumers as organic meet specified standards for use of that descriptor, or are nutritionally different from conventional foods, is uncertain. In a retail market study in a Western US metropolitan area, differences in mineral composition between conventional potatoes and those marketed as organic were analysed. Potatoes marketed as organic had more copper and magnesium (p < 0.0001), less iron (p < 0.0001) and sodium (p < 0.02), and the same concentration of calcium, potassium and zinc as conventional potatoes. Comparison of individual mineral concentrations between foodstuffs sold as organic or conventional is unlikely to establish a chemical fingerprint to objectively distinguish between organic and conventional produce, but more sophisticated chemometric analysis of multi-element fingerprints holds promise of doing so. Although statistically significant, these differences would only minimally affect total dietary intake of these minerals and be unlikely to result in measurable health benefits.

Slow-transit constipation with concurrent upper gastrointestinal dysmotility and its response to transcutaneous electrical stimulation.

PURPOSE: Transcutaneous electrical stimulation (TES) speeds up colonic transit in children with slow-transit constipation (STC). This study examined if concurrent upper gastrointestinal dysmotility (UGD) affected response to TES. METHODS: Radio-nuclear transit studies (NTS) were performed before and after TES treatment of STC as part of a larger randomised controlled trial. UGD was defined as delayed gastric emptying and/or slow small bowel transit. Improvement was defined as increase of ≥1 Geometric Centre (median radiotracer position at each time [small bowel = 1, toilet = 6]). RESULTS: Forty-six subjects completed the trial, 34 had NTS after stimulation (21 M, 8-17 years, mean 11.3 years; symptoms >9 years). Active stimulation increased transit in >50% versus only 25% with sham (p = 0.04). Seventeen children also had UGD. In children with STC and either normal upper GI motility (NUGM) and UGD, NTS improved slightly after 1 month (57 vs. 60%; p = 0.9) and more after 2 months (88 vs. 40%; p = 0.07). However, mean transit rate significantly increased with NUGM, but not UGD (5.0 ± 0.2: 3.6 ± 0.6, p < 0.01). CONCLUSION: Transcutaneous electrical stimulation was beneficial for STC, with response weakly associated with UGD. As measured by NTS, STC children with NUGM responded slightly more, but with significantly greater increased transit compared to those with UGD. Higher numbers are needed to determine if the difference is important.

Review of the application of risk-adjusted charts to analyse mortality outcomes in critical care.

This review describes the methods for displaying riskadjusted mortality data for critical care units. Two applications are considered. The comparison within a cohort of risk-adjusted mortality performance uses standardised mortality ratios (SMRs), league tables, caterpillar plots and funnel plots. Monitoring of riskadjusted performance over time is considered using SMRs, risk-adjusted p (RAP), observed minus expected outcome (VLAD), risk-adjusted cumulative sum (RACUSUM), riskadjusted sequential probability ratio test (RASPRT), and riskadjusted exponentially weighted moving average (RAEWMA) charts. Examples of the charts are provided, and calculation of the statistics and design of the charts are described in the Appendix. This overview is an introduction to the use of riskadjustment methods to track mortality rates. The importance of model performance and relevance of the risk-adjustment models is emphasised. The relative merits of different methods are discussed. Risk-adjusted monitoring plays a role in the context of a holistic quality development strategy. The importance of a planned approach to response and intervention is stressed.

Instructional methods and cognitive and learning styles in web-based learning: report of two randomised trials.

CONTEXT: Adapting web-based (WB) instruction to learners' individual differences may enhance learning. Objectives This study aimed to investigate aptitude-treatment interactions between learning and cognitive styles and WB instructional methods. METHODS: We carried out a factorial, randomised, controlled, crossover, post-test-only trial involving 89 internal medicine residents, family practice residents and medical students at 2 US medical schools. Parallel versions of a WB course in complementary medicine used either active or reflective questions and different end-of-module review activities ('create and study a summary table' or 'study an instructor-created table'). Participants were matched or mismatched to question type based on active or reflective learning style. Participants used each review activity for 1 course module (crossover design). Outcome measurements included the Index of Learning Styles, the Cognitive Styles Analysis test, knowledge post-test, course rating and preference. RESULTS: Post-test scores were similar for matched (mean +/- standard error of the mean 77.4 +/- 1.7) and mismatched (76.9 +/- 1.7) learners (95% confidence interval [CI] for difference - 4.3 to 5.2l, P = 0.84), as were course ratings (P = 0.16). Post-test scores did not differ between active-type questions (77.1 +/- 2.1) and reflective-type questions (77.2 +/- 1.4; P = 0.97). Post-test scores correlated with course ratings (r = 0.45). There was no difference in post-test subscores for modules completed using the 'construct table' format (78.1 +/- 1.4) or the 'table provided' format (76.1 +/- 1.4; CI - 1.1 to 5.0, P = 0.21), and wholist and analytic styles had no interaction (P = 0.75) or main effect (P = 0.18). There was no association between activity preference and wholist or analytic scores (P = 0.37). CONCLUSIONS: Cognitive and learning styles had no apparent influence on learning outcomes. There were no differences in outcome between these instructional methods.

A web-based course on complementary medicine for medical students and residents improves knowledge and changes attitudes.

BACKGROUND: There is a growing need to educate physicians about complementary and alternative medicine (CAM). Few introductory courses in CAM have been described. PURPOSE: To develop and evaluate an introductory course in CAM for medical students and residents. METHOD: We conducted a controlled study evaluating a case-based, Web-based course in CAM, making comparison to no intervention. Participants were 123 internal medicine residents, family medicine residents, and 3rd- and 4th-year medical students at academic residency programs in internal medicine and family medicine and two U.S. medical schools. Outcomes included knowledge of CAM, attitudes toward CAM, and course evaluation information. RESULTS: Eighty-nine learners completed the course. Test scores among a subset of these (n = 57) were higher (M +/- SD = 78.7 +/- 10.1) than scores (50.9 +/- 8.5, p < .001) among a no-intervention control group (n = 34), and remained higher (64.9 +/- 11.4) 3 months later. After the course participants felt more comfortable discussing CAM with patients, recognized a greater role for CAM, and knew better where to find information on CAM (ps < .001 compared to baseline). Course ratings were high, although 26% of learners desired greater feedback. CONCLUSIONS: This brief course in CAM improved knowledge, changed attitudes, and was well received.

Viability of red cells prepared with S-303 pathogen inactivation treatment.

BACKGROUND: A nucleic acid-targeted pathogen inactivation process with S-303 was developed to treat red blood cells (RBCs). STUDY DESIGN AND METHODS: Three studies in healthy subjects investigated posttransfusion recovery, life span, and immunogenic potential of autologous RBCs treated with S-303 and stored for 35 days. A two-arm trial in 42 subjects (1A) examined recovery of 35-day-old S-303 RBCs after a single transfusion. A one-arm study (1B) measured recovery and immune response in 28 subjects after multiple transfusions of S-303 RBCs. A randomized, crossover study (1C) in 29 subjects compared recovery and life span of 35-day-old S-303 RBCs and conventional RBCs. RESULTS: In Studies 1A and 1B, mean recovery of S-303 RBCs ranged from 78.7 to 84.4 percent. In Phase 1C, the mean 24-hour posttransfusion recoveries of S-303 and untreated RBCs were 81.7 +/- 6.3 and 84.5 +/- 6.2 percent (p = 0.05). The median life spans (t(1/2)) of S-303 and control RBCs were identical (37.4 days, p = 0.98). No antibodies to S-303 RBCs were detected. CONCLUSION: The mean 24-hour recovery of 35-day-old S-303 RBCs was less than untreated RBCs, but greater than 75 percent. RBCs treated with S-303 and stored for 35 days exhibited median life span not different from that of conventional RBCs.

On-line MS/MS monitoring of acrylamide generation in potato- and cereal-based systems.

An on-line MS/MS technique was used to study the generation of acrylamide in rye-, wheat-, and potato-based systems during cooking. Acrylamide release to the gas phase was monitored continuously and was correlated with the acrylamide content of samples using a calibration based upon the partition of [1,2,3-(13C3)]acrylamide. On-line results at 180 degrees C were compared with data relating to the same systems obtained through GC-MS analysis. Agreement between the two techniques was notable, both in terms of the temporal profiles of acrylamide generation and when comparing the relative magnitudes of results for potato, wheat, and rye determined by each method. The effects of pH (citric acid) and added amino acids (soy protein hydrolysate) on the generation of acrylamide in hydrated potato flake were modeled at 180 degrees C. It was concluded that a combined treatment of low levels of each additive could result in significant reductions in acrylamide, although the effects of such treatments on sensory properties such as color and flavor remain to be evaluated.

On line monitoring of acrylamide formation.

A system to monitor the formation of acrylamide in model systems and from real food products under controlled conditions of temperature, time and moisture content has been developed. By humidifying the gas that flows through the sample, some control over moisture content can be affected. Results are presented to show the validity and reproducibility of the technique and its ability to deliver quantitative data. The effects of different processing conditions on acrylamide formation and on the development of color, due to the Maillard reaction, are evaluated.

Effects of hydrocolloid thickeners on the perception of savory flavors.

The perceived intensities of savory flavors in hydrocolloid-thickened solutions were investigated using sensory paired comparison tests between two distinct thickener concentrations (high and low viscosities). The perceived saltiness of 3.5 g/L NaCl was found to be significantly reduced (P < 0.01) at the higher thickener concentration of both hydroxypropylmethyl cellulose (HPMC) and lambda-carrageenan, relative to the lower concentration. Mushroom flavor (8 ppm of 1-octen-3-ol with 3 g/L NaCl) was perceived as significantly more intense (P < 0.05) in 1.7 g/L lambda-carrageenan as compared with the same concentration of flavoring in 10.2 g/L lambda-carrageenan. Garlic flavor (2.5 ppm of diallyl disulfide with 2 g/L NaCl) was perceived to be significantly more intense in 2 g/L HPMC (P < 0.01) than in 10 g/L HPMC. However, when the NaCl concentration in the more viscous sample was increased to 3 g/L, the garlic flavor intensities of the two systems were not significantly different, suggesting a perceptual interaction (enhancement) between salt taste and garlic flavor. In vivo aroma release measurements from the same samples, using API-MS, showed that hydrocolloid concentration did not significantly alter the amount of mushroom or garlic aromas released when solutions were consumed. It was concluded that changes in perceived saltiness were driving the reduction in savory flavor perception even though the aroma stimulus was unchanged (a taste-aroma interaction). These findings parallel previous results in sweet hydrocolloid-thickened solutions.