The American Association of Physicists in Medicine began the Medical Physics Leadership Academy Journal Club in the fall of 2020. The initiative was launched to provide a forum for medical physicists to learn about leadership topics using published material, discuss and reflect on the material, and consider incorporating the discussed skills into their professional practice. This report presents the framework for the MPLA Journal Club program, describes the lessons learned over the last 2 years, summarizes the data collected from attendees, and highlights the roadmap for the program moving forward. The discipline involves developing technical and scientific expertise founded on physics, biology, epidemiology, mathematics, computer science, and medicine for the betterment of human health. Although graduate and residency programs have provided comprehensive formal training that propels medical physicists to become scientists and healthcare professionals, technical and scientific training alone is not sufficient to achieve a physicist's full potential as a leader in the field.N = 980 AAPM members) identified the key leadership improvement areas for AAPM's general membership, and a separate survey of residency and graduate training programs was conducted to determine training needs and required material. The leadership improvement domains identified were Personal & Interpersonal, Professional & Developmental, and Executive & Administrative.In response, the American Association of Physicists in Medicine (AAPM) formed the Medical Physics Leadership Academy (MPLA) in 2014 and devoted the 2016 AAPM Summer School to leadership development topics. Impact International , a consulting company specializing in leadership consulting, was brought in to conduct an assessment of the leadership and professional development skills of AAPM members. Participants of the Summer School were invited to participate in a 360‐review assessment to gather additional data about leadership from medical physicists. A total of 50 Emotional Competency InventoriesTo improve the identified focus areas, the MPLA formulated a strategy to provide impactful education, training, resources, and mentorship to the medical physics community, specifically the AAPM membership. Efforts to engage AAPM members were led by the AAPM MPLA Community Subcommittee (MPLA‐CO). One of these key initiatives is the MPLA Journal Club, which launched in 2020.In medical education, a journal club is an educational meeting where individuals discuss scientific articles published in literature.This report presents the framework for the MPLA Journal Club program, describes the lessons learned over the last 2 years, summarizes the data collected from attendees, and highlights the roadmap for the program moving forward.2The two primary theoretical frameworks which this educational program was built was adult learning theory and social constructivist theory.The in person monthly meetings are designed to around small group discussions. The reason for this format is that the program directors believe that learning occurs in a way that is social and can go beyond the basic acquisition of knowledge when there is collaborative dialogue with others. Articulating the ideas verbally in a small group is critical for learning within social constructivism, and this venue provides a venue for all participants to share if willing. Higher levels of understanding leadership topics can be explored when interacting with members with different experiences and perspectives. Group facilitators are assigned to moderate the discussion and be a resource to guide using Vygotsky's idea of the zone of proximal development to identify where the individual learners are and ask follow‐up questions to help build knowledge in a communal setting.3In this section, we share how Journal Club sessions for each year are organized, summarize the communication plan, explain how demographic information was obtained from participants, and present the surveys given to participants after each journal club meeting. The organization of the sessions is presented by the leadership topics, program leadership structure, and the workflow for organizers on a monthly basis. For the communication plan, we discuss both the method and timing of communication. We discuss how groups were facilitated and explain how we divided the registrants into small groups. Finally, we discuss our post‐session survey, outlining the questions that were presented to participants and how we obtained demographic data from respondents.3.13.1.1At the beginning of each year, the MPLA‐CO developed a list of leadership‐based topics that constituted the curriculum for the year. Table The Journal Club Program Organizer oversaw the operations and logistics of the program. This included announcing upcoming Journal Club sessions on the BBS forum as well as the newsletter, managing participant registrations, and supporting the Session Leaders and Facilitators. During each session, the Program Organizer managed the virtual meeting, assigned attendees to small group breakout rooms, and sent out surveys for post‐session evaluations. The Journal Club Program Organizer was Ashley Cetnar in Year 1 and Kelsey Hall in Year 2.Session Leaders were identified for each Journal Club Session and were responsible for curating materials to supplement the group discussion, creating discussion questions to guide participant preparation, fueling a corresponding discussion web bulletin board conversation, and finally, leading the virtual Journal Club meeting. These discussion questions and topic‐based materials, which were typically in the form of freely accessible videos, lectures, or articles, were shared with the MPLA‐CO subcommittee for review at least 2 months before each Journal Club meeting. Once approved, the materials were shared with registered participants and posted to the AAPM website for access by all members. Additionally, Session Leader(s) recorded a promotional video introducing the session's material and provided some thoughts and questions to orient participants to the topic and prepare the group for discussion. Session Leaders were MPLA‐CO members in Year 1 and several additional invited Session Leaders were incorporated within Year 2.Session Facilitators represented individuals assigned by the Program Organizer to help lead small group discussions during the Journal Club. They familiarized themselves with the material and questions, guided the discussions, and ensured everyone had opportunities to participate.3.1.2A series of action items comprised the workflow that must be completed prior to hosting each session of the Journal Club. Table Monthly Journal Club meetings occurred on the second Monday. Registration opened several weeks before each session and was on‐going until the day of the Journal Club. One business day before the meeting, the Program Organizer scheduled small‐group‐facilitators and attendee groups based on the approximate count of participants for the meeting.To have the most effective discussion possible, Session Facilitators were intentionally chosen from a group of experienced members , and the discussion groups were created such that each small group had a range of career experience, age, gender, workplace, and specialty. The demographic information was obtained from the participant's AAPM membership profile. At this point, the schedule with group members was sent out to the Session Facilitators to ensure that no obvious conflicts of interest existed within their discussion group.On the day of the scheduled Journal Club, the attendance list was updated approximately 3 h before the session began. If a registrant cancelled, this was indicated on the master‐list and individuals on the waitlist were invited. The breakout room groups were reorganized to reflect the changes. The AAPM information services team leader was emailed if additional participants needed to be added to the meeting.The Journal Club sessions were hosted from 1:00 to 2:00 PM ET. The Journal Club Program Organizer and Session Leaders typically logged into the meeting 10 min before the session was scheduled to begin. This enabled troubleshooting potential issues prior to the meeting as well as allowed the Program Organizer to begin assigning breakout groups. Each meeting was conducted in three parts: introduction (10 min), breakout group discussions (40 min), and conclusion (10 min). The meetings began promptly a 1:00 PM, with introduction by the Session Leader. While ample prior preparation was dedicated to group organization, we found a need to dedicate this introduction time to make some last‐minute changes to accommodate unanticipated absences or unexpected guests. The Program Organizer typically made attempts to maintain a minimum of four people per breakout room, often requiring a complete last‐minute reshuffle if needed due to attendance gaps. A log of attendance and absences were maintained for the program.A 40‐min timer was set for the small group discussions. These discussions were led by the pre‐assigned Session Facilitator in each group. The larger Journal Club reconvened for 10 min to summarize breakout room discussions. The final 5 min was reserved for closing remarks, and the Program Organizer posted links to the feedback survey as well as the signup form for next month's Journal Club in the meeting chat.One week after Journal Club, the Program Organizer reviewed the survey information, the poll results were downloaded into a spreadsheet for recording and archival by the subcommittee. The Program Organizer made note of any interesting trends and comments to address at the next MPLA community subcommittee meeting. The Program Organizer posted the results to the MPLA Community project management board for committee review. Trello  was used to manage tasks, deadlines, material review, and communication for the program management. Kanban project management concepts were implemented by using columns such as “To Do”, “Doing”, and “Done” Key references and documents were also listed on the Trello board for our team.Finally, each Journal Club cycle was completed with advanced preparation for the following month's topic. By the 15th of the month, information was provided to AAPM for the upcoming topic materials. The Program Organizer coordinated with the upcoming Session Leader(s) to ensure their materials were sent to the AAPM website coordinators to facilitate webpage creation with the appropriate session materials.By the last week of the month, the Program Organizer reviewed the web page to ensure that the materials and hyperlinks were accessible and accurate before release. On the last Monday of the month, the Program Organizer sent an email to the AAPM information services team leader requesting an advertisement for the upcoming session in the AAPM members e‐newsletter (What's New) distributed on the Friday of that week. Information about the upcoming journal club was also posted on the MPLA's social media feed (Twitter and Facebook). Of all methods of advertisement, the e‐newsletter was found to be the largest source of publicity for the event as shown in Figure 3.23.2.1Each Journal Club monthly cycle began with social media posting to promote that month's Journal Club topic. This was done through Twitter where the AAPM HQ and AAPM MPLA accounts both shared the topic, date, and time of the session, shown in Figure Event signups were accumulated using a Google registration form sent via email and/or social media posts, with the majority occurring shortly after the email or social media posts went live. However, some individuals signed‐up on the morning of Journal Club. Each participant received a confirmation message from the Program Organizer following their registration. The confirmation email was the first form of communication upon registering and provided the date, time, topic, materials, and schedule for the session. The email also contained information about cancellation which aided session planning. The template for this communication can be found in 3.2.2The final piece of communication between Journal Club leadership and session participants came in the form of a feedback survey. In the last 5 min of the Journal Club meeting, the link to the feedback survey was posted in the Zoom chat‐box, along with a link for the following month's Journal Club sign‐up page. Finally, within a few hours of the completed session, the feedback survey was also emailed to attendees. The survey content and data collected from survey responses are discussed further in the following sections.3.2.3Each month an additional Google form was created that served as the follow‐up survey that participants completed after the Zoom meeting. Question types included multiple choice and Likert Scale questions to provide feedback for the session. A free response section was included in the survey for general comments. Participants were asked whether they would attend another session, how they initially found out about Journal Club, whether they felt that their voice was heard when they wanted to participate, and whether they would be interested in continuing the discussion in another format after the session. In the rating from 1 to 5, participants were asked several questions about the overall structure and were asked to rate each aspect from terrible (1) to great (5). An example of the survey can be found in Appendix 3.3Survey respondent demographics were obtained from self‐reported data from AAPM member profiles. All Journal Club participants were AAPM members, and guests were not permitted during this initial 2‐year phase of the program. Demographic information was organized by participant by gender, AAPM membership‐type, number of years in medical physics, and medical physics practice specialty. These metrics, paired with survey responses, allowed us to organize the feedback received by the relevant characteristics of our participants.44.1Overall, 172 members of the AAPM registered for at least one MPLA Journal Club session within the first 2 years of the program. The registrants by session and topic are shown in Figure 4.2Demographics evaluated for registrants in the program included membership type, year when a member became a full member, specialty, and gender, based on self‐reported data from the AAPM Member Directory. Full members constituted 69% of registrants as shown in Figure Of the full members, many of the registrants would be considered early career medical physicists based on when they joined the organization as full members shown in Figure Overall, 70% of registrants identified Radiation Oncology as their primary specialty denoted as “Therapy.” Radiology was denoted as “Imaging”, and Nuclear Medicine was denoted by “Nuc Med” with specialties shown for each year of the program in Figure Women constituted 53% of the registrants for the program based on the AAPM demographic database shown in Figure 4.3Registrants were categorized as “attended”, “canceled”, or “no show” based on their attendance which was manually recorded by the Program Organizer for the virtual Journal Club sessions. Overall, there were 132 unique attendees in the first 2 years of the program. Overall, 80% of the registrations resulted in attendance of the session, 8% of the registrants cancelled prior to the session, and 12% did not show up for the registered session. Since the small groups were organized and scheduled with registrants, the percentage of “no show” registrants presented logistical challenges for real‐time optimization of members within groups to foster diverse participants in small group discussions.Between the first 2 years of the program, we identified members attending only one session and those attending more than one session. In the first year, 54% of attendees attended more than one session and this percentage increased to 69% in the second year of the program. We observe an increase in participant retention of 15% as the program has matured.4.4Would you attend another MPLA Journal Club?Did you feel that you were able to have your voice heard when you wanted to participate?How did you initially find out about Journal Club?On a scale from 1 to 5, how relevant and helpful do you think Journal Club was for your job?At the conclusion of each Journal Club session a survey was sent to the attendees seeking feedback on the current session as well as inputs for future meetings. Examples of these questions include:Over the course of the first year, we received 65 survey responses. Sixty four indicated they would attend another MPLA Journal Club, one responded with “maybe”, and none of the respondents indicated they “would not attend another Journal Club”. 100% of participants indicated that they were able to have their voice heard when they wanted to participate during the Journal Club session. In Year 2, there were 66 survey respondents. 100% of responses indicated they would attend another MPLA Journal Club, and 100% indicated they were able to have their voice heard when they wanted to participate.The survey indicated that most attendees learned about the MPLA Journal Club through the AAPM Email Announcement or learned about the program from a colleague  guidelines on leadership, professionalism, and ethics education. An ongoing consideration is that residents may not have experienced the challenges that are often encountered throughout a longer period of time and at later stages of their career. Placement of attendees within each breakout room was considered in advance to maintain a balance in career stages across breakout room attendees to promote rich discussion. However, a balanced group is only possible if mid‐ and late‐ career physicists continue to join the discussions to share their experiences with early career physicists.Finally, upon consideration of feedback from multiple attendees in the first 2 years, the MPLA‐CO voted to rebrand “MPLA Journal Club” to “MPLA Leadership Club” to better reflect the format for the meetings and content discussed in the sessions. Due to members having a negative preconceived notion of what a “Journal Club” would be like in a traditional sense, the committee moved to rebrand the program to encourage more members to participate. The organizers are mindful that the name “Leadership Club” may unnecessarily convey the impression of a closed elite group, which is not the intention of the rebranding. To avoid this misperception, the organizers will clarify the purpose and attendee composition in its future marketing and publicity efforts.6The MPLA Journal Club has been a strong activity conducted by the MPLA to provide leadership training to AAPM members. We plan to continue the MPLA Journal Club (now rebranded as the “MPLA Leadership Club”) for the foreseeable future. The MPLA‐CO subcommittee will continuously review the data gathered, provide recommendations for program improvement, and incorporate suggestions into the execution of the Leadership Club in the coming years of the program.Ashley J. Cetnar—Conceptualization, Methodology, Data Collection, Data Analysis, Writing—Original Draft, Writing—Review & Editing, Supervision. Kelsey Hall—Data Collection, Data Analysis, Writing—Original Draft, Writing—Review & Editing. Emily Y. Hirata, Dongxu Wang, and Cielle E. Collins—Data Analysis, Writing—Original Draft, Writing—Review & Editing. Michelle C. Wells, Izabella L. Barreto, Anuj Kapadia, Sharbacha S. Edward, Yiwen Xu, Joshua M. Wilson, and Jennifer L. Johnson—Resources, Writing—Review & EditingThe authors declare no conflicts of interest.Supporting InformationClick here for additional data file.


In cases involving an occluded artificial blood vessel graft, thrombosis of the vessel can cause lower limb ischemia. When thromboembolism develops, it is essential to rule out the complete occlusion of an artificial blood vessel graft as the cause.A 60‐year‐old woman with bilateral superficial femoral artery occlusion underwent femoral‐popliteal bypass surgery. Six months later, left vascular prosthesis occlusion occurred; 1.5 years later, an occlusive embolus developed in the deep femoral artery. The proximal prosthesis aspect was detached from the native vessel. The limb was salvaged with bypass surgery. The number of patients with lower limb peripheral artery disease has also increased along with the number of patients undergoing dialysis and individuals with risk factors for atherosclerosis, such as diabetes mellitus, hypertension, and hyperlipidemia.Although catheter treatment has been commonly used for revascularization, bypass surgery remains the primary therapeutic approach. Developments in the surgical technique and quality of artificial graft vessels have improved surgical performance. However, vessel grafts are sometimes thrombosed. When occlusions occur in the absence of complications, such as vessel graft infection, the prosthesis is left intact because removal is more invasive. In most cases, leaving the artificial vessel graft in place causes no problems. However, it can lead to occlusive thromboembolism in the native vessel, resulting in acute lower limb ischemia.The etiology of acute lower extremity arterial occlusion has been reported to be embolism in 46%, thrombosis of an occlusive atherosclerotic lesion in 24%, multiple factors in 20%, and stent‐graft thrombosis in 10%.2Our patient was a 60‐year‐old woman with risk factors for arteriosclerosis, including diabetes mellitus, hypertension, and dyslipidemia. In 2009, she underwent bilateral femoral‐popliteal bypass surgery at another hospital after being diagnosed with bilateral superficial femoral artery occlusion. During her 6‐month follow‐up visit, we observed that the synthetic vessel graft in her left leg was occluded. Since collateral circulation from the deep femoral artery developed in the interim, she underwent further follow‐up. In February 2011, approximately 1.5 years after the synthetic vessel graft occlusion in her left thigh was detected, she noticed sudden‐onset left thigh pain and was admitted to our hospital. Occlusion of the left superficial and deep femoral arteries was observed in lower extremity arteriography. The patient was diagnosed with ischemia due to deep femoral artery obstruction and underwent endovascular intervention, following which her symptoms improved. She received anticoagulation therapy to prevent distal microemboli and was discharged.3In November 2011, the patient experienced left thigh pain and was admitted to our hospital. Poor color tone and necrosis of the left toes were noted. This improved after receiving an infusion of prostaglandin E1 (PGE1) and argatroban. Lower extremity arteriography was performed on the fifth day of admission. Left common femoral artery occlusion was observed, and endovascular treatment was performed at the same site  Figure . The patSince it is not possible to improve ischemia in the toes by only dissecting the synthetic vessel graft and attaining blood flow in the deep femoral artery, we elected to bypass the lower limb artery. After detaching the proximal end of the vessel graft, the clot was removed, and the patient underwent bypass surgery from the femoral artery to the popliteal artery below the knee using the great saphenous vein. While removing the vessel prosthesis, a dark red blood clot projecting into the common femoral artery from the blood vessel graft was noted. Stenosis was not observed in the anastomosis, and the intimal thickening was mild. The clot was removed from the deep femoral artery, and the great saphenous vein was attached to the site where the synthetic expanded polytetrafluoroethylene (ePTFE) blood vessel graft was disconnected. The great saphenous vein was endoscopically harvested, reversed, and used. This was connected distally to the popliteal artery below the knee.4After the surgery, the distal extremity pulses were satisfactory. CT revealed adequate blood flow in the bypass graft, and no embolization was observed Figure . The ank5Bypass surgery is one of the primary treatments used to ensure revascularization in patients with arteriosclerosis obliterans. Although bypass improves the quality of artificial blood vessel grafts, occlusions have been reported. When occlusions occur in the absence of complications, such as graft vessel infection, the blood vessel graft is considered harmless and is left intact because removal is more invasive. However, thrombus formation in an artificial vessel graft can cause thromboembolism distal to the anastomosis.Artificial vessel graft thrombosis has reportedly caused late‐onset embolism in the setting of axillo‐femoral bypass.Artificial vessel grafts used in reported cases of axillo‐bifemoral bypass include those made of Dacron and ePTFE grafts. However, thromboembolism can develop regardless of the type of vessel prosthesis. In this case, ePTFE was used.With respect to the cause of embolism, Hartman et al. suggested that the axillary artery is driven downward by an occluded graft,In terms of treatment in the presence of an occluded vessel prosthesis, McLafferty et al. and Mawatari et al. recommend detaching the occluded artificial vessel graft from the native vessel because of the high risk of embolism.Given that few cases have been reported, the tendency of thromboembolism to develop at the proximal or distal end of the vessel prosthesis is unknown. In most reported cases, including the present case, the embolus formed in the proximal aspect of the vessel. Leaving the distal anastomosis of the ePTFE vessel graft connected does not eliminate the possibility of the embolism moving forward. Therefore, a strict follow‐up is necessary. In our case, the patient has not experienced embolism recurrence even 10 years after surgery.In the present case, we observed embolism recurrence. An initially patent deep femoral artery became occluded due to artificial graft vasculature thrombosis after femoral‐popliteal bypass surgery for superficial femoral artery occlusion. The cause of thromboembolism can be eliminated by disconnecting the ePTFE vessel graft to prevent the recurrence of deep femoral artery occlusion and distal vasculature embolism. Due to the subsequent toe necrosis, revascularization was performed using the great saphenous vein. As a result, the necrosis was alleviated, and the embolism did not recur.The current case highlights that, in cases involving an occluded ePTFE blood vessel graft, thrombosis of the vessel can cause lower limb ischemia. When thromboembolism develops, it is essential to rule out the artificial blood vessel graft as the cause since treatment methods such as endovascular intervention, thrombectomy, and anticoagulation do not prevent recurrence in these cases.In recent years, endovascular intervention for lower limb ischemia has often been the first choice of treatment.6The artificial graft vessel may become occluded after femoral‐popliteal bypass surgery for superficial femoral artery occlusion. We discussed a recurring case of acute lower limb ischemia possibly caused by synthetic ePTFE vessel graft thrombosis 1.5 years after the operation.In cases of unexplained acute lower limb ischemia, occlusive artificial vessel graft thrombosis can be considered. In these cases, the management plan should involve endovascular intervention, thrombectomy, and anticoagulation, as well as detachment of the occluded prosthesis from the native vessel.Yamato Tamura: Data curation; methodology; writing – original draft; writing – review and editing. Takehisa Abe: Writing – original draft; writing – review and editing.No funding was received for this study.All authors have no relevant or other potential conflicts of interest.Clinicians at this medical center are not required to obtain IRB approval for case reports.Written informed consent was obtained from the patient for the publication of this manuscript.


X-ray diffraction results indicated that PEC could reduce the relative crystallinity of the composite system, and the higher the PEC content, the lower the relative crystallinity. When the PEC content was 10%, the relative crystallinity of the composite system was only 10.6% after 21 d of cold storage. Fourier transform infrared spectroscopy results proved that the interaction between PEC and WRS was mainly a hydrogen bond interaction. Furthermore, after 21 d of cold storage, the T23 free water signal appeared in the natural WRS paste, while only a small free water signal appeared in the compound system with 2% PEC addition. Moreover, addition of PEC could reduce the starch digestion rate and digestibility. When the content of PEC increased from 0% to 10%, the digestibility decreased from 82.31% to 71.84%. This study provides a theoretical basis for the further application of hydrocolloids in starch-based foods.In recent years, the blending of hydrocolloids and natural starch to improve the properties of natural starch has become a research hotspot. In this study, the effects of pectin (PEC) on the retrogradation properties and in vitro digestibility of waxy rice starch (WRS) were investigated. The results showed that PEC could significantly ( Waxy rice is an important food crop in Asia, especially in China . It has Artemisia sphaerocephala Krasch gum (ASKG) apparently reduced the digestibility of waxy rice starch. When the addition of ASKG was increased from 0 to 15% (w/w), the RDS of WRS samples decreased from 54.9% to 32.9%, respectively, and the RS increased from 28.2% to 38.4%, respectively. Hydrocolloids, such as sodium alginate, guar, and xanthan gum, are rich in hydrophilic groups and have good water binding ability . Studiesp < 0.05) and delayed the retrogradation of starch gel. Zhang et al. [p < 0.05). However, there is still a lack of relevant data on the effect of PEC on the functional properties, long-term retrogradation and digestibility of WRS.Pectin (PEC) is a hydrophilic polysaccharide extracted from higher plant tissues, such as roots, stems, and leaves, which is an excellent hydrocolloid. In the food industry, PEC can be added to food, which plays a role in gelation, thickening and improving the texture of food, and is an excellent food additive. In addition, scholars have found that PEC could influence the gelatinization, retrogradation, and digestion properties of starch . Xie et g et al.  added PEOur previous work found that PEC could influence the gelatinization and freeze–thaw stability of WRS . Thus, tWRS was extracted from milled waxy rice flour which was purchased from Kemen Noodle Manufacturing Co., Ltd. . The amylose content of the WRS was 1.14%. PEC extracted from apples was purchased from Youbaojia Food Co., Ltd. . The degree of esterification of PEC was 13.5%. Isoamylase (Cas: 9067-73-6), pancreatic-amylase (Cas: 9000-90-2), amyloglucosidase (Cas: 9032-08-0) from Aspergillus niger, and glucose oxidase/peroxidase reagent (GOPOD) were all purchased from Megazyme . All other chemical and reagents were of analytical grade .w/v, based on dry basis) was dispersed into distilled water, and PEC with mass of 0%, 2%, 4%, 6%, 8%, and 10%  was added to form the mixtures. The mixtures were mixed and stirred at 100 °C for 30 min until they were fully gelatinized. The starch pastes were then cooled to room temperature and transferred to the sealing bags, and the sealing bags were stored at 4 °C in the refrigerator for 0, 7, 14, and 21 days, respectively.The WRS−PEC complexes were prepared in accordance with the method of Lin et al. , with sow/w, based on starch weight) were prepared. A total of 3 mg of prepared samples were mixed with 6 μL of deionized water and hermetically sealed in an aluminum pan. The samples were equilibrated at 4 °C for 12 h and heated from 30 °C to 100 °C at a rate of 10 °C/min. Subsequently, the gelatinized samples were cooled to room temperature and stored at 4 °C for 7, 14, and 21 days to perform the retrogradation process. Then, DSC thermal scanning was conducted according to the same heating procedure described above to test the retrogradation enthalpy of the samples (ΔrH).The thermal properties of the WRS−PEC complexes were determined using a differential scanning calorimeter  according to the method of Chen et al. , with soThe textural properties of WRS and WRS−PEC complexes were investigated by TA-XT plus texture analyzer  according to the previous method with some modifications . The samcR) was calculated as follows:cA and aA are the crystalline area and the amorphous area of the XRD patterns, respectively.The WRS gels with or without PEC were immediately freeze-dried and stored at 4 °C for 7, 14, and 21 days, then milled to pass through a 100-mesh sieve. X-ray diffraction analysis of samples was performed using a D2 Phaser X-ray diffractometer  operating at 45 kV and 30 mA with Cu Kα radiation (λ = 1.54 Å) according to the previous method with some modification . The sam−1 by accumulating 64 scans at a resolution of 4 cm−1. The infrared spectra were analyzed by Omnic software 8.2 , and the absorbance values at wavelengths of 1047 cm−1, 1022 cm−1, and 995 cm−1 were recorded [FTIR spectra of the freeze-dried WRS−PEC complex powders were obtained on a PerkinElmer spectrometer fitted with an ATR accessory . The spectra were recorded from 4000 to 400 cmrecorded .The water distribution and migration of the WRS−PEC complexes samples stored at 4 °C for 7, 14, and 21 days were measured using an NMR analyzer  according to the previous method . The res2, pH 5.2) to a final concentration of 290 units/mL and 15 units/mL, respectively. The tube was incubated in a 37 °C shaking water bath with a speed of 160 r/min. At designated times , aliquots (50 μL) of samples were taken into a 2 mL microcentrifuge tubes and mixed with 450 μL of absolute ethanol to deactivate digestive enzymes, followed by centrifugation at 10,000× g for 2 min. Then, 0.1 mL of D-glucose standards and sample supernatant containing released D-glucose was added to 3.0 mL of GOPOD reagent and incubated at 40 to 50 °C for 20 min. All absorbances were measured at 510 nm against the reagent blank to calculate the concentration of glucose at different intervals. The percentages of rapidly digestible starch (RDS), slowly digestible starch (SDS), and resistant starch (RS) of each starch sample were calculated as follows:0 represents the initial sample mass (mg), G20 represents the contents of glucose released after 20 min, and G120 represents the contents of glucose released after 120 min, respectively.The in vitro digestibility of complexes was determined based on the Englyst method, with slight modifications . BrieflyC is the starch digestibility at time t, ∞C is the total starch digestibility at the end point, and k is the digestion rate constant.The digestion process was fitted with a first-order kinetic equation, where HI) was calculated based on dividing the area under the hydrolysis curve (0~180 min) of the sample by the area of a standard material (white bread) over the same period [eGI) was calculated using the equation described by Maibam et al. [The hydrolysis index eGI=3p < 0.05.Each test was determined at least three times, and data were expressed as mean ± standard deviation. Statistical significance was analyzed by one-way analysis of variance (ANOVA) by using SPSS 16.0 . The value of significance was considered as rH) of starch mainly reflects the degree of recrystallization of amylopectin. rH of WRS samples with different PEC additions during cold storage at 4 °C. It can be seen from the table that with the extension of refrigeration time, ΔrH of all samples gradually increases, that is, the aging degree of starch increases. After 21 days of cold storage, the ΔrH of natural glutinous rice starch increased to 6.37 J/g. However, with the increase of PEC content, the ΔrH of starch at different refrigerated times decreased, and when the pectin content was 10% and refrigerated for 21 days, the ΔHr of the composite system decreased to 4.29 J/g. This indicated that pectin may inhibit the long-term aging of amylopectin in WRS. Chen et al. [rH of starch, and the larger the addition amount was, the lower the ΔrH of the sample was. Pullulan polysaccharide plays a role in wrapping rice starch, which limits the gelatinization of part of the starch, allowing it to retain many orderly and compact structures in the granules, thereby inhibiting aging. With the increase in PEC content, PEC molecules are wrapped around WRS, competing with starch for water absorption, which limits its gelatinization effect. In the aging process, incomplete gelatinization of starch inhibits amylose leakage, thereby weakening the short-term aging of starch and inhibiting the long-term aging of amylopectin.The essence of the retrogradation process of starch is that the movement of starch molecules is weakened when the gelatinized starch is cooled, and the amylose and amylopectin molecules in the starch are rearranged in the form of hydrogen bonds, resulting in the recrystallization of starch paste. The amylopectin in WRS is the main component, so the WRS paste will mainly undergo long-term aging. The retrogradation enthalpy  reduced the hardness of starch gel. When the addition of PEC was 10%, the hardness of glutinous rice starch paste decreased from 168.25 g to 113.93 g after 21 days of storage. PEC could enter the inside of starch, increasing the distance between starch molecules, then reducing the number of hydrogen bonds formed between starch molecules. At the same time, PEC might form hydrogen bonds with starch molecules through hydroxyl groups in WRS molecules, interfering with the formation of the starch’s orderly structure, limiting the rearrangement of the starch chain, and inhibiting starch recrystallization. Zhang et al. [The increase in hardness of starch-based food is one of the most significant manifestations of starch retrogradation . The harg et al.  added anAs shown in p < 0.05), and the change of relative crystallinity is negatively related to the amount of PEC. When the amount of PEC is 10%, the relative crystallinity of composite system is only 10.55% after 21 days of refrigeration. This might be because the addition of PEC inhibits the formation of hydrogen bonds between starch molecules and hinders the formation of double helix structure of Starch Chain [The greater the relative crystallinity of starch, the greater the proportion of crystallization area in the sample, that is, the higher the degree of retrogradation and regeneration of the sample. It can be seen from ch Chain , and PECch Chain . The aboFourier infrared spectroscopy could be used to determine whether there is an intermolecular hydrogen bond and the strength of the hydrogen bond in the sample. In this experiment, FTIR spectroscopy is used to investigate the force between PEC and WRS. The FTIR spectra of WRS−PEC complex freeze-dried powder refrigerated at 4 °C for 7 days were shown in −1 wave number, which represented the absorption peak of intermolecular hydroxyl stretching vibration [−1 to 3297 cm−1, indicating that the intermolecular hydrogen bond in the complex was gradually strengthened. The intermolecular force between PEC and WRS increased, which inhibited the interaction between starch molecules and slowed down the retrogradation of starch.As shown in ibration  and refl−1, 1022 cm−1, and 995 cm−1 were sensitive to the ordered or crystalline structures, amorphous structures, and double helical structure of starch, respectively [−1 was used to quantify the degree of order in starch samples, and the ratio of absorbances (1022/995) cm−1 was usually used to assess the interactions between water and starch [−1 decreased significantly (p < 0.05) from 0.54 to 0.44, indicating that PEC inhibited the interaction between starch molecules, hindered the rearrangement of starch molecules to form an ordered structure, and then inhibited retrogradation. In addition, as PEC increased from 0% to 10%, the value of (1022/995) cm−1 increased significantly (p < 0.05) from 0.77 to 0.97, indicating that the addition of PEC enhanced the interaction between water molecules and starch.The absorption bands at 1047 cmectively . Furtherd starch . As can w/w) during aging was studied by LF-NMR. The spin–spin relaxation time (T2) map is shown in 2 can be divided into three parts: T21 (<10 ms), T22 (10~1000 ms) and T23 (>1000 ms), which are related to the bound water, non-flowing water, and free water in the system respectively. The proportion of the peak area corresponding to the characteristic peak of each region is recorded as A21, A22, and A23. The larger the peak area of the characteristic peak, the higher the relative moisture content in this part. The length of relaxation time T2 determines the degree of tight binding between water molecules and substances. The more obvious T2 was, the closer it binds to substances, and the mobility of water molecules is bound by starch [Low-field NMR (LF-NMR) technology is a new technology used to study the water distribution and migration in food system in recent years. It can reflect the motion characteristics of water molecules in the reaction system by detecting parameters such as proton relaxation behavior and amplitude . The waty starch .23 characteristic peak of natural glutinous rice starch paste was increasing, indicating that, with the extension of storage time, the retrogradation of starch intensified and the water holding capacity weakened. However, in general, with the increase of PEC addition, T2 of the complex shifted to the left, that is, the combination of water and starch was closer. This shows that the addition of pectin can effectively bind the water molecules in the system, reduce the precipitation of free water, and then inhibit the retrogradation of starch.It can be seen from 21 and T22 of starch paste added with PEC are reduced, indicating that pectin limits the fluidity of water molecules to a certain extent. Ge et al. [2 of the sample gradually decreased with the extension of storage time  decreased the digestibility of WRS. With the increase of PEC content from 2% to 10%, the SDS and RS of the composite system increased from 20.25% and 16.03% to 21.87% and 26.52%, respectively. Meanwhile, the RDS of the composite system decreased significantly. Ma et al. [p < 0.05), and when the addition amount was 10% (w/w), the RDS of corn starch decreased from 73.1% to 51.5%. Gao et al. [The classical Englyst  method wa et al.  added PEo et al.  found thThe digestion and hydrolysis curve of gelatinized natural WRS and WRS−PEC complexes during simulated small intestinal digestion are shown in 2 of all data is greater than 0.97, indicating that the hydrolysis first-order equation is well fitted. ∞C value is the percentage of theoretically digested starch at the end of the reaction, which is related to the equilibrium concentration of digestion. The addition of PEC increased from 0% to 10%, and the ∞C value decreased from 82.31% to 71.84%, which is consistent with the research results of Chen et al. [∞C value decreased after adding pullulan polysaccharide to rice starch. The k value is related to the rate of amylase hydrolysis. The k value of natural glutinous rice starch was the highest (0.073). When the amount of PEC was between 2~10%, the k value decreased from 0.069 to 0.056. These results showed that the addition of PEC significantly reduced the hydrolysis rate and digestion rate of starch. Meanwhile, with the addition of PEC, the eGI of WRS decreased gradually (In order to evaluate the effect of PEC more accurately on the digestibility of WRS, the first-order equation model was used for nonlinear fitting, and the hydrolysis kinetic parameters were calculated . It can n et al. . They foradually . This ma23 free water signal appeared in the natural WRS paste, while only a small free water signal appeared in the compound system with 2% PEC addition. Digestion experiments showed that PEC could improve the digestibility of WRS to some extent and reduce the starch digestion rate and digestibility. When the PEC content increased from 0% to 10%, the digestibility decreased from 82.31% to 71.84%. These results are beneficial for the development of WRS-based products with high quality. Furthermore, this study provides a theoretical basis for the potential application of hydrocolloids in improving the processing properties and storage stability of starch-based foods.In this research, the effects of adding PEC on the retrogradation properties and in vitro digestibility of WRS were investigated. PEC could significantly reduce the retrogradation enthalpy of WRS. The addition of PEC measured by texture analyzer could inhibit starch retrogradation and recrystallization, thereby reducing the hardness of the gel. XRD results showed that the addition of PEC could significantly reduce the relative crystallinity of the composite system, and the higher the PEC content, the lower the relative crystallinity. FTIR results further proved that PEC can effectively inhibit the interaction between starch molecules in the system, reduce the degree of crystallization, and thus achieve the effect of inhibiting the retrogradation of WRS. The results of LF-NMR showed that, after 21 d of cold storage, the T


The aim was to compare the metabolic outcomes, rejection rates (including the need for steroids), patient and graft survival between DBD (Donation after brainstem death) and DCD groups. After excluding early graft losses, data from 162 PTA (DBD = 114 and DCD = 48) were analyzed. Body mass index of the donor was less in DCD group  and the rest of the baseline transplant characteristics were comparable. There were no significant differences in the HbA1c, weight gain, rejection rate, and incidence of secondary diabetic macrovascular complications post-transplant between DBD and DCD recipients. The 1-, 5-, and 10-year patient and graft survival were similar in both the groups. PTA from DCD donors have equivalent metabolic outcomes and survival (patient/graft) as that of DBD donors.Extrapolating data from early DCD (donation after circulatory death) kidney transplantation, pancreas transplants from DCD grafts were feared to have worse metabolic outcomes. Hence, we aimed to address the question of pancreas transplant alone (PTA) from DCD donors–are our concerns justified? A UK transplant registry analysis of 185 PTA performed between 2005 and 2018 was done. All early graft losses (<3 months) were excluded to allow focus on the metabolic outcomes (HbA  Despite the increasing awareness regarding organ donation, scarcity of suitable donor organs is still a problem faced by the transplant community. The median months to transplantation for a pancreas transplant alone (PTA) in the US was 24.1 months in 2016–2017 .Transplanting DCD organs has been a viable option to expand the donor pool. The UK has pioneered pancreas transplantation from DCD donors and in recent years about one-third of pancreas transplants performed are from controlled DCD donors, and the pancreas offer decline rate is better for DCD organs (45%) than DBD organs (54%) . While tConvincing evidence supporting DCD pancreas transplantation is being generated since 2000 –11. NoneIn patients with diabetes, chronic hyperglycaemia is known to be associated with an increased risk of cardiovascular disease, whereas, in patients without diabetes a higher HbA1c even within the normal range is associated with a significantly higher risk of coronary artery disease , 16. Thi1C was recorded as % prior to 2013 and as mmol/mol since then.There are eight designated pancreas transplant centres in the UK and all of them report their follow up data to the UK Transplant Registry, which is a mandatory prospectively run database maintained by the National Health Service Blood and Transplant (NHSBT). The Pancreas Advisory Group, a subsection of NHSBT approved this study and provided access to the data. All patients who underwent PTA in the UK from 1 January 2005 to 31 December 2018 were identified, and pertinent data was obtained from the UK Transplant Registry. HbAAll patients waitlisted for PTA had insulin treated diabetes along with normal or near-normal renal function. They also had at least 2 severe hypoglycaemic episodes within the last 24 months and assessed by a diabetologist to have disabling hypoglycaemia. Body mass index (BMI) > 30 kg/sq.m for patients with type 2 diabetes was an absolute contraindication for PTA, whereas, insulin requirement >100 units/day, BMI > 30 kg/sq.m, and severe aorto-iliac or peripheral vascular disease were relative contraindications. The rest of the contraindications were similar to most of the solid organ transplants and are described elsewhere .2, weight < 15 kg, as well as other contraindications for solid organ transplantation. The UK pancreas offering scheme has been national since 2010, with patient-specific offers and a combined list for solid organ pancreas and islet transplants. The national pancreas allocation scheme is described elsewhere , 1-year [34 (32–37) and 35.5 (32.6–39.4)], 3-year [35.3 (32–37) and 33.3 (32–36.5)], and 5-year post-transplant [36 (34–39) and 34.5 (33–37.7)] and the respective p values were 0.08, 0.25, 0.39, and 0.49  until 5 years post-transplant between the 2 groups .DBD and DCD recipients had similar median post-transplant HbAand 0.49 . The medn = 145) and those with a failed PTA graft with HbA1c recorded at the time of graft failure (n = 14). There was no significant difference in the median HbA1c (millimole/mole) between the groups .HbA1c was also compared between the waitlisted candidates for PTA at the time of registration .Percentage weight gain post-transplant was calculated (weight post-transplant minus weight pre-transplant/100) and compared between the two groups. There was no significant difference in weight (median percentage weight gain) between the two groups at 3-month, 1-year, 3-year, and 5-year post-transplant and the respective and 0.95 . In a mip = 0.51). There were no secondary diabetic complications in both the groups at 1-year, 3-year, and 5-year post-transplant.The incidence of secondary diabetic complications post-transplant was not significantly different between both the two groups at 3-month post-transplant , 1-year , 3-year , and 5-year post-transplant .There was no significant difference in the incidence of rejection between the two groups at 3-month .The overall steroid free maintenance rate was similar irrespective of the graft type  and Era 2 (2010–2014). In both the eras, there was no significant difference in HbA1c or weight gain between the two groups at 3-month, 1-year, 3-year, and 5-year post-transplant  until 5 years post-transplant between the two groups .There was no significant difference in the median serum creatinine (micromole/L) between the DBD and DCD recipients at 3-month [104 (76–140) and 104 (82.7–140)], 1-year [107 (80–133) and 108 (80.2–153.5)], 3-year [115.5 (93.5–147) and 114 (96.2–140.8)], and 5-year [127 (96–162.3) and 110 (96–140.5)] post-transplant and their respective The evolution of the difference in HbA1c, weight gain, and serum creatinine between the two groups is shown in the scatter dot plot .p = 0.95 and p = 0.45, respectively). The 1-, 5-, and 10-year patient survival was 98%, 88%, 78% for DBD and 95%, 85%, 63% for DCD recipients. The 1-, 5-, and 10-year death-censored graft survival was 86%, 59%, 53% for DBD and 88%, 59%, 44% for DCD recipients. The proportion of early graft loss was also similar between the two groups. Data pertaining to early graft loss was not part of the study and hence a detailed analysis of the causes for early graft loss was not possible.On univariate analysis, there was no significant difference in the overall death -censored pancreas graft survival and overall patient survival between the DBD and DCD recipients , 41 patients at 1-year , 26 patients at 3-year , and 18 patients at 5-year post-transplant . Pre-transplant weight was not available for 29 patients . Among those with a functioning graft, percentage weight gain data was not available for 74 patients at 3-month , 57 patients at 1-year , 34 patients at 3-year , and 23 patients at 5-year post-transplant .Graft function was not available for 30 patients  at 3-month and 38 patients at 1-year post-transplant . Among those with a functioning graft, HbAThis is the first study comparing metabolic outcomes alongside survival outcomes between DBD and DCD PTA recipients. Post-transplant HbA1c, in addition to being a marker of graft function, is also known to be an independent predictor of pancreas graft failure . Hence ide novo steroids post-transplant were considered as a surrogate for rejection but whether steroids were introduced as part of modulation of the immunosuppression regime to counteract infections remain unknown. The incidence of rejection was similar in both the groups at all time points and this was in a setting where the HLA mismatch and the use of depleting agent for induction were similar as well. 73% of the DCD recipients were on steroid-free maintenance immunosuppression and was similar to DBD recipients. The rejection episodes reported to the UK Transplant registry were not classified as cellular or antibody mediated or mixed rejection and hence, an in-depth analysis was not possible.When comparing the metabolic outcomes, rejection episodes were considered alongside, as treatment of rejection would influence the metabolic parameters. It is not uncommon to treat rejection episodes based on clinical suspicion and hence, it is difficult to distinguish whether these were actual rejection episodes or graft pancreatitis as both of them present with a similar clinical picture. The need for It is well known that a successful pancreas transplant halts or reverses the progression of secondary diabetic complications , 29. In The registry does not record data on diabetic microvascular complications such as retinopathy and neuropathy post-transplantation. Regarding nephropathy, we have compared creatinine post-transplantation between the DBD and DCD recipients and found no significant difference at all time points. There are concerns regarding the risk of accelerated decline in kidney function after a PTA , 33. EveEvaluation of potential differences in HbA1c, weight gain and serum creatinine were performed at each time point separately due to its simple interpretation and its ability to use all the available data. However, per-time point analysis does not consider the overall difference, and inflates the type-1 error rate due to multiple testing. To counteract these deficiencies and the missing data, imputation techniques were necessary and refraining from their use might have led to biased results , 38. HenAmong the studies reporting survival outcomes of PTA from DCD donors, this study has the highest number of PTA’s performed from DCD donors. This study reports similar 1-, 5-, and 10-year graft and patient survival (unadjusted) for DBD and DCD recipients. In comparison with the previous UK transplant registry analysis by Muthusamy et al. , the 1-yThere was an observed male-to-female recipient ratio of 1:2 in both DBD and DCD groups. This ratio stands at odds with the proportion of male-to-female incidence of type 1 diabetes mellitus based on the results from large population cohort studies , 42. OneDespite the strengths of the study, we acknowledge the following shortcomings. Firstly, this study suffers a bias due to the retrospective nature, that is inherent to all registry analysis; secondly, the sample size is small to perform a multivariate analysis but this would be an issue in most other studies due to the smaller proportion of the patients undergoing PTA especially from DCD donors. Future studies with multinational collaborative data may be able to generate sufficient numbers to allow a robust comparison. Finally, when comparing the metabolic outcomes, hypoglycaemic episodes, concurrent usage of oral hypoglycaemic agents, and other metabolic parameters such as C-peptide and glucose tolerance test were not compared as they were not part of the registry data. Incorporation of the above parameters along with the pancreas extraction times (cross clamp to organ out of the body) in addition to the standardized reporting would be helpful. Future studies could focus on reporting the functional outcomes utilizing the Igls criteria .This is the first study reporting the outcomes of national data on PTA from DCD donors, and also the first study to compare metabolic outcomes alongside survival outcomes between DBD and DCD donors. PTA from DCD donors leads to similar metabolic and long-term survival outcomes to that of transplants from DBD donors. The findings of this study would alleviate the concerns surrounding the use of DCD graft for PTA and thereby supports their usage to expand the donor pool.


To evaluate the effect of zirconia priming with MDP-Salt before MDP containing primers and self-adhesive cement on the shear bond strength.n = 120) were assigned into 2 groups (n = 60 each): Control (No Pretreatment) and Methacryloyloxydecyl dihydrogen phosphate salt  pretreated. Each group was divided into 3 subgroups (n = 20) according to cementation protocol: 1) MDP + Silane primer and conventional resin cement, 2) MDP+ Bisphenyl dimethacrylate (BPDM) primer and conventional resin cement, and 3) MDP containing self-adhesive resin cement. Shear bond strength (SBS) was measured after 10,000 thermocycling. Contact angle was measured for tested groups. Surface topography was assessed using a 3D confocal laser scanning microscope (CLSM). Weibull analysis was performed for SBS and one-way ANOVA for contact angle and surface topography measurements (α = 0.05).Fully sintered high translucent zirconia specimens (p < .05) for all tested subgroups. Self-adhesive cement showed an insignificant difference with MDP + Silane group for both groups (p > .05). MDP + BPDM showed a significantly lower characteristic strength compared to self-adhesive resin cement when both were pretreated with MDP-Salt. No difference between all tested groups in the surface topographic measurements while MDP-Salt showed the highest contact angle.The use of MDP-Salt significantly improved the SBS (MDP-Salt pretreatment can improve bonding performance between zirconia and MDP containing products. Ceramics based on yttria-stabilized tetragonal zirconia polycrystals (Y-TZP) are gaining clinical attraction as they provide superb flexural strength, fracture toughness, excellent esthetics and high tissue biocompatibility , 2. One Zirconia in particular poses as a challenge in bonding due to its polycrystalline nature. Fully sintered zirconia cannot undergo the same etching process as conventional silica-based ceramics to achieve ideal bonding to the tooth structure; hence, silane coupling agent would not be effective in achieving chemical coupling as zirconia does not have a glass phase , 4. MorePure MDP on the alumina air-abraded zirconia surface is considered the gold standard for zirconia adhesion , 7–11. TTo simplify the priming process to various dental substrates, adhesives or primers containing MDP mixed with other molecules in a single-bottle were developed –16. HoweA new MDP-salt was introduced as a cleaner and adhesion promotor for zirconia , 19. TheHigh translucent yttria-stabilized tetragonal zirconia polycrystals  were cut into square specimen (10 × 10 × 3 mm) using a low-speed diamond wafering blade mounted on precision saw machine . Another rod from the same material was milled with 2 mm radius and then cut into 3 mm thick discs to be cemented to a counterpart square specimen. The full composition of used materials is listed in Table 0 according to the manufacturer’s instructions in a high-temperature furnace . All the specimens were polished with 600-grit silicon carbide (SiC) paper then blasted with 50-μm Al2O3 particles  at 25 psi for 20 seconds at a 10 mm distance and 900 angle using a sandblasting device .For shear bond strength test: at total of 120 squares 5Y-PSZ specimens and 120-disc specimens were sintered at 1450 Cn = 60) according to the pretreatment protocol into; Control (No Pretreatment) and MDP-Salt Salt . Each group was divided into 3 subgroups based on the cementation protocol as follow; 1) MDP + Silane: the specimens were primed with Visalys restorative primer  for 60 seconds then a gentle jet of air was applied, then conventional resin cement  was used to cement the disc-shaped zirconia specimen’s counterpart. Light curing was done using LED  for 40 seconds. 2) MDP + BPDM: the specimens were primed with 2 coats of Z-Prime Plus  for 5 seconds then a gentle jet of air was applied, then cementation with conventional resin cement and curing similar to MDP + Silane subgroup. 3) MDP containing cement: self-adhesive resin cement  was used for cementation of the disc-shaped zirconia specimen counterpart without primer and Light cured using LED  for 40 seconds. Specimens’ preparation and grouping for shear bond strength testing explained in Fig. All specimens were cleaned ultrasonically for 2 minutes in distilled water followed by drying with oil-free air. Each large square-shaped specimen was bonded to the smaller round-shaped specimen. Specimens were divided into 2 groups  with a crosshead speed of 1 mm/min. The debonded interface of the specimens was examined after fracture under a stereo microscope  and mode of failure were categorized as; “C” for cohesive failure at the resin cement, “A” for adhesive failure at the ceramic-resin interface, and “M” for mixed failure (more than 30 to70% of C or A).n = 42) were prepared as described in the specimen preparation section to be used in surface topography examination and contact angle measurements. All specimens were alumina blasted. They were assigned into 6 groups (n = 7) according to surface treatment as follow; 1) Control ; 2) MDP Salt, 3) MDP + BPDM, 4) MDP + Silane, 5) MDP Salt+ MDP + BPDM, and 6) MDP Salt+ MDP+ Silane. The surface topographic measurements of the tested groups were measured using a 3D confocal laser scanning microscope  with a 50X lens (scanning area 205 × 273.3 μm). The scanned surface plots were processed with a MultiFile Analyzer . Specimens’ preparation and grouping for surface topography and contact angle testing explained in Fig. 5Y-PSZ square specimens . Three drops were measured, and the average was considered the mean of each specimen which was reported for statistical analysis.To evaluate the effect of MDP Salt on the zirconia surface, X-ray photoelectron spectroscopy  was used for MDP Salt treated specimen and untreated one (control). The Mg Kα X-ray source runs under the following conditions:−7 Pa.Operating pressure = 10Emission current = 10 mA.Accelerating voltage = 10 kV a.Pass energy setting = 100 eV.The chemical states were identified based on peak positions and separations of the high-resolution scans for zirconium, oxygen, carbon, aluminum, silicon, and phosphorus peaks from the surface of the specimens. Specimens’ preparation and grouping for surface elemental analysis explained in Fig. n = 11, each group) as a large effect size resulted (f = 0.592) when the α = 0.05 to detect a power of 95%. The sample size was increased in each group to 20 specimens for the validity of the reliability analysis conducted in the current study. SBS data were statistically analyzed using Weibull analysis . Maximum Likelihood estimation was used for Weibull parameters calculation. The different groups were compared at the characteristic strength (63.2% probability of failure). Following confirmation of the normal distribution with the Shapiro-Wilk test, one-way analysis of variance (ANOVA) was used to compare mean contact angle and surface parameters values, followed by multiple comparisons with Bonferroni correction (α = 0.05).The minimum sample size for SBS was determined based on a pilot study and a previous published work  to be 66p < 0.05. For no-pretreatment group, insignificant difference between cementation protocols were reported (p > 0.05). For MDP-Salt pretreated groups, self-adhesive cement showed a higher significant characteristic strength compared to MDP + BPDM.The results of the Weibull analysis are presented in Table For all tested groups, no pretest failure resulted, and failure mode showed 80–100% adhesive failure.p > 0.05).A representative CLSM image is presented in Fig. The contact angle results are displayed in Table Wide-scan spectra from XPS analysis are presented in Fig. In the current investigation, we examined the effect of MDP-Salt application prior to MDP primers application and MDP containing self-adhesive cement on the bonding performance to zirconia substrate. Based on the current results, the first null hypothesis was rejected as MDP-Salt improved the bonding performance with all MDP containing primers/cement.not alter the mechanical roughness parameters of alumina air-blasted zirconia surface.The tested zirconia primers were MDP-based, with silane or with carboxylic based monomer (BPDM). Both showed similar bonding performance to each other which may be attributed to the presence of MDP as the functional molecule. Additionally, both primers benefited from the pretreatment with MDP-Salt due to increasing the amount of attached MDP molecules to zirconia surface . 1 minutMDP containing self-adhesive resin cement outperformed zirconia primed with MDP+ BPDM when MDP-Salt was used. It may be attributed to the MDP hydrolysis during storage which is promoted by methacrylate products in MDP + BPDM primer , 20. WhiThe idea of using MDP primer prior to cementation with MDP containing self-adhesive cement seems similar to MDP-Salt application, however, previously, MDP + BPDM primer application prior to MDP contained resin cements didn’t showed an improvement in the bonding performance to zirconia . MDP conThe current research is the first to investigate the use of MDP-Salts as an adhesion promotor prior to MDP-containing primers/cements which limits the current work to explanation of the theoretical assumption rather than comparison with earlier published data. Further research still needed to investigate the effect of MDP-salt with longer storage time and hydrothermal aging. Additionally, clinical research still needs to confirm our laboratory findings.MDP-salt can be applied as an adhesion promoter to zirconia prior to primer applications to improve zirconia bonding performance.One-step cementation with MDP containing self-adhesive resin cement can be an effective alternative to 2-step cementation which requires a separate priming step.MDP containing self-adhesive resin cement can also benefit from MDP-Salt pretreatment.Within the limitation of this study, we can conclude that:


Tremella fuciformis polysaccharides on the physicochemical properties of freeze–thawed cone chestnut starch. Various aspects, including water content, crystallinity, particle size, gelatinization, retrogradation, thermal properties, rheological properties, and texture, were examined. The results revealed that moderate freezing and thawing processes increased the retrogradation of starch; particle size, viscosity, shear type, hinning degree, and hardness decreased. After adding Tremella fuciformis polysaccharide, the particle size, relative crystallinity, and gelatinization temperature decreased, which showed solid characteristics. Consequently, the inclusion of Tremella fuciformis polysaccharide effectively countered dehydration caused by freezing and thawing, reduced viscosity, and prevented the retrogradation of frozen–thawed chestnut starch. Moreover, Tremella fuciformis polysaccharide played a significant role in enhancing the stability of the frozen–thawed chestnut starch. These findings highlight the potential benefits of incorporating Tremella fuciformis polysaccharides in starch-based products subjected to freeze–thaw cycles.The purpose of this study was to investigate the effect of  Castanea henryi is one of the most important nuts and is widely distributed in East Asia and southern Europe. The output of Chinese Castanea henryi accounts for about 83% of the world [Castanea henryi (40–60% in dry weight) [Castanea henryi starch are of great significance to functional properties and application in food.he world ,2. Due tCastanea henryi has more rapidly digestible starch and lower-resistant starch after cooking, which is easy to digest by the human body, causing a high blood sugar response that is not conducive to human health [n health ,6. Compan health . When stn health . Therefon health . Short-tn health ,11. Whenn health . Short-tn health . Starch n health . Thus, tn health .Freezing makes starchy foods easier to store. However, the freeze–thaw treatment usually roughens the surface of starch granules and causes them to be crushed due to the pressure exerted on the double helix structure by water separated from the matrix . During Tremella fuciformis polysaccharide (TP) is the biologically active ingredient of Tremella fungus, which is an acidic heteropolysaccharide with α-1,3-mannan as its active center  [Tremella fuciformis polysaccharide extract has a certain viscosity, which could replace traditional thickening stabilizers and improve product stability [Tremella fuciformis polysaccharide has a high biological effect and is widely used in the food, cosmetics, and pharmaceutical industries [The stability of frozen–thawed starch paste could be controlled by accelerating the freezing–thawing speed and adding food additives. Accelerating the freezing and thawing speed and adding food additives could be used to control the stability of frozen–thawed starch paste . It is rs, etc.) . Tremelltability . In addidustries .Castanea henryi starch so as to effectively inhibit the retrogradation characteristics of Castanea henryi starch [Tremella fuciformis polysaccharides may bring unique water retention to starch, which effectively prevents the dehydration of starch during freeze–thawing. However, there is no report on the effect of Tremella fuciformis polysaccharides on freeze–thaw stability of starch. At the same time, there are few studies on starch granules, mostly for the study of starch gel, so this paper discusses the effect of Tremella fuciformis polysaccharides on freeze–thawed Castanea henryi starch to provide theoretical reference for the interaction between Tremella fuciformis polysaccharides and Castanea henryi starch and the effect of Tremella fuciformis polysaccharides on the physical and chemical properties of Castanea henryi starch.Controlling the freeze–thaw stability of starch pastes by adding hydrocolloids has been extensively studied, and the texture of starch-based products could be improved by adding small amounts of oligosaccharides and hydrocolloids . Among ti starch . The strCastanea henryis: Fujian Jianou Mingnong Agricultural Cooperative, white fungus (Tremella fuciformis): purchased from local supermarkets.Fresh Castanea henryi starch could be obtained by sieving with a 120-mesh sieve.Fresh chestnuts were cleaned, and shells were removed. Then mix it with distilled water in a 1:2 ratio. It was ground to a pulp using a pulper , and the starch was washed out using a 100-mesh strainer. The remaining filtrate was mixed and then filtered using a 200-mesh strainer. It was placed at 25 °C for 8 h, and the supernatant and brown suspension were discarded. The bottom powder water of the solution was washed with pure water 5 times, and then it was collected and dried in an electrothermal blast drying oven at 40 °C for one day . Castanea henryi starch and Tremella fuciformis polysaccharide (CHS + TFP) was prepared as follows: the Castanea henryi starch was mixed with Tremella fuciformis polysaccharide at a ratio of 7:3. 30 g of Castanea henryi starch and 30 g of CHS + TFP were mixed with 30 g of distilled water, respectively , then stirred by magnetic force for 30 min, and it was left for 1 h. Freeze–thaw cycle starch was prepared as follows: the starch was placed in the refrigerator  at −20 °C for 22 h and then removed and thawed at 25 °C for 2 h; this process was a cycle. The cycles were performed 0, 3, and 10 times , respectively, to form three experiments. At the end of the freeze–thaw cycle, the starch was placed in a refrigerator at −20 °C for 7 days, removed and thawed at 25 °C, and then dried at 50 °C in hot air for spare parts.A mixture of Tremella fuciformis were washed and dried, dissolved in 1:50 g/mL of deionized water for 2–3 h. It was heated in the water bath at 92 °C for 3 h, then cooled to room temperature and centrifuged at 7000 r/min for 20 min. The supernatant was then freeze-dried and ground into Tremella fuciformis polysaccharide powder for later use.15 g of fresh The particle size distribution of CHS-TFP samples was measured using a laser particle size analyzer . Samples were dissolved in deionized water at room temperature for analysis. The refractive index of the dispersant and sample was 1.33 and 1.53, respectively [−1 thin slices. The sample slices were then placed in a Fourier transform infrared spectrometer  and analyzed by the light-transmission method. The spectra were collected at wavelengths ranging from 400 to 4000 cm−1.The 10 mg samples are mixed with 1 g of potassium bromide in a quartz mortar. After that, the powders were ground and made into a vacuum mold for pressing into the 0.1 mmThe samples were determined and analyzed with an X-ray diffractometer , using the following settings: target Cu Kα radiation (k) = 0.1789 nm, 40 kV tube pressure, 35 mA current, 5–40° scanning measurement range (2θ), and data acquisition step width of 0.05°.cX, %) was calculated using the PeakFit software (Ver. 4.12) according to the following equation:ciA is the area under each crystalline peak with index i, and tA is the total area of the diffraction pattern.The relative crystallinity  was performed with a thermogravimetric analyzer . The three samples were placed in the platinum pan of the TGA furnace, and assessments were accomplished with a heating rate of 10 °C/min from 10 to 800 °C under a nitrogen atmosphere at a flow rate of 20.0 mL/min.T2 was measured using a MesoQMR23-060H-I NMR analyzer  equipped with a 0.5-T permanent magnet corresponding to a proton resonance frequency of 23 MHz at 32 °C. The dried samples were put into cylindrical trays, respectively, and a radio frequency coil with a diameter of 60 mm was placed to collect the attenuation signal from the Carr-Purcell-Meiboom-Gill (CPMG) pulse sequence. The 90° and 180° pulses were respectively at 21 and 41.0 μs, with a τ-value (time between 90° and 180° pulses) of 100 μs. Data from 500 echoes were collected as eight scans for repeated use. Decay data were analyzed using MultiExp stock analysis software .The transverse relaxation time Castanea henryi starch and freeze–thaw starch were weighed and prepared into 50 mL of 1% starch solution. After heating to gelation, they were placed in a measuring cylinder and allowed to stand at about 25 °C for precipitation. The volume of supernatant was recorded every 8 min, and the correlation between the rate of condensate water and time was used to reflect the coagulation.1.00 g of Firstly, 28 g of 8% starch emulsion solution was prepared, and then the determination conditions of the rapid viscosimeter  Tech Master Australia Newport Company, Warriewood, Australia) were set. The conditions were set as follows: when the temperature reached 50 °C for 1.0 min. It was heated to 95 °C at a heating rate of 12 °C/min, and the temperature was maintained for 2.5 min. After that, it was cooled to 50 °C at a rate of 12 °C/min and then maintained for 2.0 min. The speed is 960 r/min in the first 10 s and remains at 160 r/min for the other 10 s. The viscosity curve of starch pastes and related experimental parameters were obtained.Castanea henryi starch and frozen–thawed starch were measured by the rapid viscometer, the starch was completely gelatinized and ready to be measured on the rheometer . Firstly, the conical mold is selected with the model CP50-2, and a conical abrasive tool is installed. Then the corresponding measurement procedure is set up. The plate temperature is set to 25 °C, and the shear rate is 0~200 s−1. The sample, after gelling, is placed in the central position of the beaker. After extrusion, the sample should be cleaned in time to keep the measuring plate clean and tidy. The correlation between viscosity (η) and shear rate (γ) was determined. The Herschel–Bulkley model was used to fit the rheological curve.After the τ represents the shear stress, Pa; τ0 represents the yield stress, Pa; γ represents the shear rate, s−1; K represents the consistency coefficient, Pa·Sn; and n represents the fluid index.In the formula, γ) was selected according to the linear point for testing, and the relationship between storage modulus, loss modulus, and frequency was determined.The mold model CP50-2 was selected. After installation, the corresponding experimental parameters were set. The appropriate amount of gelatinized sample was placed on the measuring platform of the rheometer at 25 °C. Amplitude scanning was carried out at an angular rate of 10 rad/s, and the appropriate response  and Trapezium X software software  were used for measurement. The starch gel was compressed to 25% of its original height using a cylindrical aluminum probe with a diameter of 40 mm. The samples were continuously pressed twice at a time interval of 10 s, and the texture parameters were obtained from the obtained curves, such as hardness (the maximum force in the first compression cycle), cohesiveness (the ratio of the second peak area to the first peak area), springiness (the time between the end of the first compression cycle and the beginning of the second compression cycle), and gumminess (the product of hardness and cohesion).p < 0.05).All statistical analyses were performed using Origin analysis software (2018), and the data were reported as the mean ± standard deviation of at least three measurements. DPS software was used for significance analysis , 2930 cm−1 (C-H stretching vibration), 1645 cm−1 (COO- stretching vibration in a carbohydrate group), 1176 cm−1 , 1082 cm−1 (C-O-H stretching vibration), and 1022 cm−1 (C-O stretching vibration), among others. These typical carbohydrate characteristic peaks indicated that freeze–thaw treatment and the addition of polysaccharides did not alter the chemical composition of starch [Infrared spectroscopy is a valuable technique for studying changes in molecular functional groups and conformation . Any modf starch .Castanea henryi starch-Tremella fuciformis polysaccharide with different treatments are shown in Castanea henryi starch prepared in this study showed the structures of C-type starch contain nanocrystals with orthorhombic and hexagonal crystal structures [Castanea henryi starch indicated that freeze–thaw treatment might increase the degree of retrogradation of starch and make the structure more orderly. However, the effect of freeze–thaw treatment for 3 and 10 times on crystallinity was not significant  of freeze–thawed ructures . Compareructures ,43. Compnificant . After tThermogravimetric analysis (TGA) is a technique that investigates the physicochemical properties of substances as the temperature increases. With the increasing temperature, the starch begins to gel. Further temperature increases caused dehydration of the material (involving both free and bound water), which led to decomposition and reorganization. During the process, chemical bonds may also form new volatile and non-volatile products.Castanea henryi starch obtained through different methods at temperatures ranging from 30 °C to 800 °C are shown in Tremella fuciformis polysaccharides increased the loss of free water.The TGA results of Tremella fuciformis polysaccharide, the weight loss of Castanea henryi starch added with Tremella fuciformis polysaccharide is reduced. Particularly, 10 CHS + TFP shows a 5% lower loss rate than the original, indicating that the inclusion of Tremella fuciformis polysaccharides enhances the water-holding capacity of starch, making it more resistant to thermal degradation. In addition, the required junction temperature of Tremella fuciformis polysaccharide in the second stage is higher than that of the sample without Tremella fuciformis polysaccharide, as shown in The second stage, between 290 °C and 330 °C, is the result of crystallization, water volatilization, and depolymerization reactions. There is rapid weight loss, which may be associated with the thermal degradation of starch or protein . The rapCastanea henryi starch [The maximum value of the peak in the DTG curve represented the maximum mass loss rate, and the peak temperature reflected the thermal stability of the polymer. Compared to unfreeze–thawed native starch, freeze–thaw treatment could improve the thermal stability of i starch .T2), which provides the mobility and states of water molecules in different environments. By fitting and inverting the LF-NMR multi-exponential decay curve, three independent T2 distribution peaks could be generated, representing different states of water molecules. Smaller T2 values indicated stronger binding forces and lower mobility in water. Moisture is typically categorized into three forms in food: bound water, fixed water, and free water. Bound water interacts with specific polymer groups; fixed water exists in a polymer network with weak interaction forces; and free water does not bind to any groups. These three types of water correspond to relaxation times T21, T22, and T23, respectively [LF-NMR (low-field nuclear magnetic resonance) is a technique used to measure the spin relaxation time (ectively .Castanea henryi starch extracted using different methods are presented in T21), indicating that the polar groups were tightly bound to crystal water. As the retrogradation time increases, the original single water distribution gradually transforms into a bimodal distribution, indicating the conversion of bound water to free water during the process.The relaxation decay curves of T21 (A21) is over 97%, and it is as high as 99% for the frozen starch thawed three times, indicating that it contains a large amount of tightly bound water. Compared with the original starch, three freeze–thaw cycles increased T21, which may be due to the reassociation of water and starch molecular chains with the increase of freeze–thaw cycles, leading to the destruction of the original crystallization area of starch and reducing the content of bound water. The addition of Tremella fuciformis polysaccharide reduces T21, which may be due to the reassociation of Tremella fuciformis polysaccharide with the starch molecular chain, and a large number of recombined spiral structures would form a denser gel grid arrangement, resulting in a stronger binding force of water molecules in gel. Contrary to T21, Tremella fuciformis polysaccharide starch that has been frozen and thawed for 10 times at this stage contains more free water, which is easy to migrate and vibrate under the influence of a magnetic field, and it is difficult to return to the ground state.Starch is susceptible to retrogradation during prolonged storage. Retrogradation occurred when starch was heated and gelatinized, leading to the rearrangement of molecules from the disordered to the ordered state. Bound water is then separated from the starch molecules, causing the starch to settle and enter a retrograded state. Retrogradation is often characterized by the turbidity of starch paste .Castanea henryi starch, freeze–thawed starch, and freeze–thawed starch with added Tremella fuciformis polysaccharide after 70 h. The highest water precipitation rates for original Castanea henryi starch, starch after 3 freeze–thaw cycles, and starch after 10 freeze–thaw cycles were 65, 60, and 58%, respectively. The highest water separation rates for starch after 3 freeze–thaw cycles and 10 freeze–thaw cycles, with the addition of Tremella fuciformis polysaccharide, were 63% and 52.27%, respectively.Tremella fuciformis polysaccharide, which may be due to the hydrophilic nature of Tremella fuciformis polysaccharide. It competes with starch for water in the system and hinders the overflow of amylose [Tremella fuciformis polysaccharides continues to decrease the water separation rate. It could be attributed to the reorganization of amylose after ten freeze–thaw cycles, leading to the release of some bound water. The addition of Tremella fuciformis polysaccharide then combines with the released water, effectively suppressing the dehydration phenomenon.The freezing and thawing processes facilitated the dissolution of amylose and the increase in water precipitation after three freeze–thaw cycles with  amylose . HoweverDuring the process of starch gelatinization, water entered the amorphous growth ring. At the same time, the starch granules began to swell, and amylose molecules started to leach out. Only when the amorphous background significantly swelled could sufficient stress be imposed through connecting molecules from amorphous to crystalline regions, initiating the disruption of the crystallites. During this stage, the molecular chains of helix–helices in natural starch might dissociate, followed by helix–helix rearrangement and binding ,51. The Chestnut Tremella starch is shown in Tremella fuciformis polysaccharides have been shown to increase the viscosity of the system, likely due to their accumulation on the surface of starch granules, resulting in changes in hydrogen bonding on the surface [The gelatinization behavior of freeze–thawed  surface .BD (degree of disintegration) and SB (degree of association) reflect the disintegration and association of starch during pasting, respectively, and are important indicators for the decomposition of granules and chains during the process [PV and BD at 3 CHS compared to 0 CHS showed that freeze–thawing treatment would help starch recombination and improve the stability of starch paste against shear. The increase in BD at 3 CHS + TFP compared to 3 CHS may be due to the fact that Tremella polysaccharide polysaccharides improve the solubilization capacity of cone chestnut amylose-polysaccharides, but solubilized starch paste becomes fragile and is more susceptible to mechanical shear damage, and it also improves starch retrogradation [Tremella fuciformis polysaccharides and amylopectin promoted the gelatinization of starch, and the freeze–thaw treatment induced partial destruction of the internal chain arrangement of amylopectin [Tremella fuciformis polysaccharides, leading to further improvements in the properties of the starch system.The parameters  process . The decradation . This isradation . Moreovelopectin . The disCastanea henryi starch paste under steady shear. As the shear rate increased, the shear stress was also increasing with shear-rate flow characteristics. The experimental data for flow curves were fitted to a power law model (R2 ≥ 0.98). The flow behavior indices (n) ranging from 0.39 to 0.42 were all less than 1.0, indicating that the starch exhibits pseudoplastic and shear-thinning behavior.aw model , resultiK value represents the consistency size [Tremella fuciformis polysaccharides, which showed that freezing and thawing cause damage to the starch structure and reduce the viscosity of the sample, while the incorporation of Tremella fuciformis polysaccharides inhibits the leaching of amylose, resulting in a decrease in the consistency coefficient [The ncy size , decreasfficient .The apparent viscosity decreased with the increasing shear rate, with a sharp drop in the early stage, indicating the presence of shear thinning behavior characteristic of pseudoplastic fluids . With thTremella fuciformis polysaccharides increased the apparent viscosity, suggesting that it may form a more stable network structure and increase flow resistance [At 10 freeze–thaw cycles, the dense structure of the crystallization zone is destroyed, causing a more significant decrease in the curve. However, the addition of sistance .G′) and loss modulus (G″) obtained from shear strain scanning. G′) of native starch is higher than the loss modulus (G″), indicating that the starch paste exhibits solid characteristics [The viscoelasticity of starch paste could be characterized by the storage modulus (eristics .After freezing and thawing, the storage modulus increased, suggesting that the treatment may lead to the formation of a more stable system compared to the original starch. It was shown that the treatment may form a more ordered system, possibly due to the double helix structure of the starch side chain rearrangement. This result is also consistent with the previous X-ray and infrared results, indicating that freeze–thaw could increase the order of starch and, at the same time, aggravate the retrogradation of starch.Tremella fuciformis polysaccharides intensified the effect. It indicated that the starch with Tremella fuciformis polysaccharides had undergone 10 freeze–thaw cycles and exhibited a higher damping coefficient. A sample with a high damping coefficient displayed a more pronounced viscous behavior, resembling a flowing liquid. On the other hand, materials with lower damping coefficients exhibited a more pronounced elastic response to applied loads, behaving more like a solid with reduced flow. Therefore, more deformation energy was stored as potential energy within the material, making it more stable [e stable .Tremella fuciformis could increase the gel properties of starch, including hardness, springiness, and cohesiveness. Both freezing and thawing and the addition of Tremella fuciformis polysaccharides improved the gelatinization of the starch paste of Castanea henryi. The addition of Tremella fuciformis polysaccharides induced a more significant change in the gel recovery, possibly due to the interaction between amylopectin and Tremella fuciformis polysaccharides. Studies have shown that the addition of Tremella fuciformis polysaccharides enhances the texture properties of ordinary starch and even maintains a smooth surface of the starch gel [Tremella fuciformis polysaccharide effectively expanded the starch granules, leading to the leaching of soluble starch chains into paste. These dissolved starch chains become entangled and embedded in a continuous gel matrix, thereby reinforcing the gel network [arch gel . The gel network .Castanea henryi straight-chain starch might be disrupted, and the water precipitation rate might decrease. The freeze–thaw cycle could make the starch more easily retrograded. The viscous resistance as well as the apparent viscosity and shear thinning degree are reduced, causing mechanical damage to Castanea henryi starch, while the ice crystal expansion caused by freezing would lead to a reduction in the swelling rate of starch granules. However, the addition of Tremella fuciformis polysaccharide could decrease the particle size, relative crystallinity, and gelatinization temperature, which made the chinquapin starch present solid characteristics.With the increase in the number of freeze–thaw cycles, the structure of Tremella fuciformis polysaccharide and starch could improve the freeze–thaw stability of Castanea henryi starch. Tremella fuciformis polysaccharide could effectively improve the water-holding capacity of starch. At the same time, it could also inhibit the destruction of starch structure by freezing and retrogradation during freeze–thaw cycles. This study could provide a theoretical basis for the application of Tremella fuciformis polysaccharide in Castanea henryi starch.These results showed that the interaction between