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Sample records for swallow richards rachel

  1. Richard Feynman

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education. Richard Feynman. Articles written in Resonance – Journal of Science Education. Volume 16 Issue 9 September 2011 pp 860-873 Reflections. What is Science? Richard Feynman · More Details Fulltext PDF ...

  2. Rachel the Jewess in Copenhagen

    DEFF Research Database (Denmark)

    Hesselager, Jens

    2012-01-01

    are considered in relation to the local critical discourse on operatic performances at the Royal Theatre in Copenhagen in general – a context which, in 1842, involved the phenomenon of a competing and quite successful Italian opera company at the nearby Court Theatre. This situation generated a general trend...... of positioning “southern” and “Nordic” qualities vis-à-vis one another. The contemporary appreciation of certain “southern” qualities in Rung’s performances is interpreted in relation to this critical discourse, as well as in relation to the “Jewishness” of the character of Rachel. Consequently......, the contextualisation of Rung’s performances here involves investigating the implications of “Jewishness” in Copenhagen at this time and of the ways in which the sound of Rung’s vocal performances may have served to define Rachel as an example of the literary stereotype of the “beautiful Jewess”. Finally...

  3. Richard III

    DEFF Research Database (Denmark)

    Lauridsen, Palle Schantz

    2017-01-01

    Kort analyse af Shakespeares Richard III med fokus på, hvordan denne skurk fremstilles, så tilskuere (og læsere) langt henad vejen kan føle sympati med ham. Med paralleller til Netflix-serien "House of Cards"......Kort analyse af Shakespeares Richard III med fokus på, hvordan denne skurk fremstilles, så tilskuere (og læsere) langt henad vejen kan føle sympati med ham. Med paralleller til Netflix-serien "House of Cards"...

  4. Richard Rorty

    DEFF Research Database (Denmark)

    Hjermitslev, Hans Henrik

    2016-01-01

    anglo-amerikanske filosoffer siden John Dewey og Bertrand Russell i første halvdel af århundredet. Richard begyndte sin akademiske løbebane inden for analytisk filosofi, men gjorde op med store dele af denne retning med Philosophy and the Mirror of Nature i 1979, der hører til blandt de mest...

  5. The Rachel Carson Letters and the Making of Silent Spring

    Directory of Open Access Journals (Sweden)

    John Paull

    2013-06-01

    Full Text Available Environment, conservation, green, and kindred movements look back to Rachel Carson’s 1962 book Silent Spring as a milestone. The impact of the book, including on government, industry, and civil society, was immediate and substantial, and has been extensively described; however, the provenance of the book has been less thoroughly examined. Using Carson’s personal correspondence, this paper reveals that the primary source for Carson’s book was the extensive evidence and contacts compiled by two biodynamic farmers, Marjorie Spock and Mary T. Richards, of Long Island, New York. Their evidence was compiled for a suite of legal actions (1957-1960 against the U.S. Government and that contested the aerial spraying of dichlorodiphenyltrichloroethane (DDT. During Rudolf Steiner’s lifetime, Spock and Richards both studied at Steiner’s Goetheanum, the headquarters of Anthroposophy, located in Dornach, Switzerland. Spock and Richards were prominent U.S. anthroposophists, and established a biodynamic farm under the tutelage of the leading biodynamics exponent of the time, Dr. Ehrenfried Pfeiffer. When their property was under threat from a government program of DDT spraying, they brought their case, eventually lost it, in the process spent US$100,000, and compiled the evidence that they then shared with Carson, who used it, and their extensive contacts and the trial transcripts, as the primary input for Silent Spring. Carson attributed to Spock, Richards, and Pfeiffer, no credit whatsoever in her book. As a consequence, the organics movement has not received the recognition, that is its due, as the primary impulse for Silent Spring, and it is, itself, unaware of this provenance.

  6. The Silent Spring of Rachel Carson.

    Science.gov (United States)

    Kerstetter, Ned

    1996-01-01

    Presents a lesson plan examining Rachel Carson's call to arms concerning the harmful consequences of pesticides. Students view a video documentary on Carson's work and read a synopsis of her book, "Silent Spring." Assessment is provided by various activities including writing assignments, creating posters, and editorial cartoons. (MJP)

  7. Primavera Silenciosa de Rachel Carson,1962

    OpenAIRE

    Pinto-Correia, Teresa

    2011-01-01

    Esta comunicação, inserida no ciclo de conferências “Ambiente. Porquê ler os clássicos?” organizado pela Fundação Calouste Gulbenkian, apresenta uma reflexão sobre o livro “Primavera Silenciosa” (Silent Spring) de Rachel Carson, de 1962. Considerado como uma referência no imaginário ambiental da cultura contemporânea, este livro influenciou o pensamento social e político, pelo seu tema controverso e pela sua abordagem revolucionária, ao expor os efeitos dos pesticidas nos ecossistemas naturai...

  8. Swallowing Trouble

    Science.gov (United States)

    ... it is important to seek treatment to avoid malnutrition and dehydration. How are swallowing disorders treated? Many ... causing discomfort. Other causes may include: hypertension; diabetes; thyroid disease; stroke; progressive neurologic disorder; the presence of ...

  9. Swallowing difficulty

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007543.htm Swallowing difficulty To use the sharing features on this page, ... Duplication for commercial use must be authorized in writing by ADAM Health Solutions. About MedlinePlus Site Map ...

  10. Narrative report Rachel Carson National Wildlife Refuge: Jan. - Dec. 1969

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Rachel Carson National Wildlife Refuge outlines Refuge accomplishments during the 1969 calendar year. The report begins by...

  11. Rachel Carson National Wildlife Refuge: Annual narrative: Calendar year 2000

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Rachel Carson NWR outlines Refuge accomplishments during the 2000 calendar year. The report begins with a summary of the year's...

  12. Rachel Carson National Wildlife Refuge: Annual narrative: Calendar year 2001

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Rachel Carson NWR outlines Refuge accomplishments during the 2001 calendar year. The report begins with a summary of the year's...

  13. Rachel Carson National Wildlife Refuge Annual Narrative Report: 2003

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Rachel Carson National Wildlife Refuge outlines Refuge accomplishments during the 2003 calendar year. The report begins with a...

  14. Rachel Carson National Wildlife Refuge Annual Narrative Report: 2002

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Rachel Carson National Wildlife Refuge outlines Refuge accomplishments during the 2002 calendar year. The report begins with a...

  15. Glaucoma: Eye-to-Eye with Dr. Rachel Bishop

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Glaucoma Eye-to-Eye with Dr. Rachel Bishop Past ... nerves are pale and cupped—signs of advanced glaucoma. Yet the patient wasn't aware of any ...

  16. Richard P Feynman

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education. Richard P Feynman. Articles written in Resonance – Journal of Science Education. Volume 2 Issue 12 December 1997 pp 107-107 Classics. The Theory of Positrons · Richard P Feynman · More Details Fulltext PDF. Volume 16 Issue 9 September 2011 pp ...

  17. Discussion 3: Richard Grant

    OpenAIRE

    Grant, Richard; Murray-Rust, Peter

    2010-01-01

    Richard Grant is a scientist and author of the blog "Confessions of a (former) Lab Rat". He is Associate Editor and contributor to TheScientist/Faculty_of_1000. Richard is a scientist with interests inscientific publishing, copyright, and Open Data.

  18. Professor Richard Feynman colloquium

    CERN Document Server

    1965-01-01

    Richard P. Feynman received the Nobel Prize for physics in 1965. Following the ceremony in Stockholm, Feynman gave the colloquium "Development of the space-time view of quantum electrodynamics" at CERN on 17th December.

  19. Notas de leitura | Homenagem a Anna Rachel Machado

    OpenAIRE

    Ernica,Mauricio; Lousada, Eliane; Cristóvão, Vera Lúcia Lopes; TONELLI, Juliana Reichert Assunção; Tognato, Maria Izabel Rodrigues; Beato-Canato, Ana Paula Marques; Silva, Alessandra Augusta Pereira da; Santos, Luiza Guimarães; Rocha, Suélen Maria; Dantas-Longhi, Simone Maria

    2012-01-01

    Em 20 de maio de 2012 faleceu Anna Rachel Machado, professora da PUC-SP desde 1979 com extenso trabalho de docência, pesquisa e intervenção nos domínios do ensino de língua e da análise do trabalho docente. Em reconhecimento à importância de sua obra, Cadernos Cenpec lhe presta homenagem publicando uma breve nota biográfica e apresentando suas principais obras.Anna Rachel gostava de ser reconhecida como professora, acima de tudo. Com o esforço de guardar um pouco de seu espírito, essa homenag...

  20. Askey, Prof. Richard Allen

    Indian Academy of Sciences (India)

    Fellow Profile. Elected: 1988 Honorary. Askey, Prof. Richard Allen. Date of birth: 4 June 1933. Address: 5915, American Parkway, Apt. 228, Madison, WI 43718, U.S.A.. Contact: Office: (+1-608) 262 2880. Residence: (+1-608) 233 7900. Fax: (+1-608) 263 8891. Email: askey@math.wisc.edu. YouTube; Twitter; Facebook ...

  1. Zare, Prof. Richard N

    Indian Academy of Sciences (India)

    ... Refresher Courses · Symposia · Live Streaming. Home; Fellowship. Fellow Profile. Elected: 2009 Honorary. Zare, Prof. Richard N. Date of birth: 19 November 1939. Address: Department of Chemistry, Stanford University, Stanford, CA 94305-5080, USA Contact: Email: zare@stanford.edu. YouTube; Twitter; Facebook ...

  2. Richard Halliburton's Bearded Tales

    Science.gov (United States)

    Morris, Charles E., III

    2009-01-01

    Fusing the concept of "the beard" with the genre of the tall tale to theorize bearded tales deepens our understanding of closet eloquence, or rhetorical repertories of sexual passing in U.S. history. An examination of adventurer-writer-lecturer Richard Halliburton's sexual provenance and bestselling travel tale, "The Royal Road to Romance" (1925),…

  3. Richard Phillips Feynman

    Indian Academy of Sciences (India)

    Richard Phillips Feynman was the most gifted, brilliant and intuitive genius out of many extremely gifted physicists. Here are descriptions of him by leading physicists of his own, and older as well as younger generations: “He is a second Dirac, only this time more human.” – Eugene Wigner …Feynman was not an ordinary ...

  4. Richards Bay effluent pipeline

    CSIR Research Space (South Africa)

    Lord, DA

    1986-07-01

    Full Text Available 3815 9 D A Lord Department of Oceanography University of Port Elizabeth P 0 Box 1600 PORT ELIZABETH 6000 N D Geldenhuys Department of Environment Affairs Private Bag X9005 CAPE TOWN 8000 Cover: Richards Bay from the air showing city... of major concern identified in the effluent are the large volume of byproduct calcium sulphate (phosphogypsum) which would smother marine life, high concentrations of fluoride highly toxic to marine life, heavy metals, chlorinated organic material...

  5. The Rachel Carson Letters and the Making of Silent Spring

    OpenAIRE

    John Paull

    2013-01-01

    Environment, conservation, green, and kindred movements look back to Rachel Carson’s 1962 book Silent Spring as a milestone. The impact of the book, including on government, industry, and civil society, was immediate and substantial, and has been extensively described; however, the provenance of the book has been less thoroughly examined. Using Carson’s personal correspondence, this paper reveals that the primary sourc...

  6. Speech and Swallowing

    Science.gov (United States)

    ... You are here Home › Speech and Swallowing Problems Speech and Swallowing Problems People with Parkinson’s may notice ... How do I know if I have a speech or voice problem? My voice makes it difficult ...

  7. Literary Legacy: Rachel Carson's Influence on Contemporary Women Nature Writers

    OpenAIRE

    Andersen, Erin

    2017-01-01

    While Rachel Carson is perhaps best known for her book Silent Spring and her work as a scientist and environmentalist, she is often overlooked as an important writer of literature, as evidenced through Silent Spring but also through her three books about the sea. This thesis poses the question: if Carson made such a lasting impact on the way Americans think about the environment through her writing, how has she affected the discipline of nature writing in the US? Through an examination of C...

  8. Richard Lavenham on Future Contingents

    DEFF Research Database (Denmark)

    Øhrstrøm, Peter

    1983-01-01

    Richard Lavenham on Future Contingents’, Cahiers de l’Institut du Moyen-âge Grec et Latin, 44 (1983), p.180-186.......‘Richard Lavenham on Future Contingents’, Cahiers de l’Institut du Moyen-âge Grec et Latin, 44 (1983), p.180-186....

  9. Women, Scientists, Agitators: Magazine Portrayal of Rachel Carson and Theo Colborn.

    Science.gov (United States)

    Corbett, Julia B.

    2001-01-01

    Utilizes a theoretical framework of the media's role in reporting conflict and uncertain science, and feminism and science in a thematic analysis of magazine coverage given Rachel Carson and "the Rachel Carson of '90s," Theo Colborn. Notes that Carson and Colborn's identities as women, scientists, and agitators led critics to charge that…

  10. Swallowed toothbrush: Case series

    Directory of Open Access Journals (Sweden)

    S Kiran

    2016-01-01

    Full Text Available Toothbrush swallowing is rare, and most cases are seen in young women with anorexia nervosa or bulimia or associated with mental retardation or schizophrenia. Prompt removal is recommended because no cases of spontaneous passage have been reported. There is no previously reported case series on swallowed toothbrush in mentally normal young men. Here, we report three cases of swallowed toothbrush found in the esophagus and stomach on endoscopy. In our case series, successful removal of the toothbrush was done without endotracheal intubation or over tube, without any complications. To our knowledge, this is the first documented case series of swallowed toothbrush managed successfully endoscopically.

  11. Richard Rorty in Context

    Directory of Open Access Journals (Sweden)

    Brian Lloyd

    2013-08-01

    Full Text Available Richard Rorty was a strong contextualist in his approach to philosophical and political ideas, yet his own most characteristic arguments are typically evaluated without much reference to the historical circumstances that provoked them. A key participant in the post-1980 revival of pragmatism within North American and European intellectual circles, Rorty reaffirmed the strong connections between American pragmatism and German idealism. This move placed him at odds with scholars who forged the unity of pragmatism—united John Dewey and William James—under the banner of radical empiricism. Those engaged most enthusiastically in celebrating Rorty’s achievements, in short, defend a conception of pragmatism that Rorty sharply criticized and ideas about the history of philosophy that he did not share. His distinctive intellectual agenda is best appreciated after setting it in the context of the history of the American Left and, more specifically, the reckoning with the tumultuous 1960s that animates so many ongoing debates—inside and outside the academy—about cultural and political affairs.

  12. Richard Compton, University of Oxford.

    Science.gov (United States)

    2006-07-01

    The Analyst profiles Richard Compton, Professor of Chemistry at the University of Oxford and the first and only recipient of both the RSC Medals in Electrochemistry and in Electroanalytical Chemistry.

  13. Air Quality Scoping Study for Rachel, Nevada (EMSI April 2007)

    Energy Technology Data Exchange (ETDEWEB)

    Engelbrecht, Johann; Kavouras, Ilias; Campbell, Dave; Campbell, Scott; Kohl, Steven; Shafer, David

    2007-04-01

    The Desert Research Institute (DRI) is performing a scoping study as part of the U.S. Department of Energy’s Yucca Mountain Environmental Monitoring Systems Initiative (EMSI). The main objective is to obtain baseline air quality information for Yucca Mountain and an area surrounding the Nevada Test Site (NTS). Air quality and meteorological monitoring and sampling equipment housed in a mobile trailer (shelter) is collecting data at seven sites outside the NTS, including Ash Meadows National Wildlife Refuge, Sarcobatus Flat, Beatty, Rachel, Caliente, Pahranagat National Wildlife Refuge, and Crater Flat, and at four sites on the NTS. The trailer is stationed at any one site for approximately eight weeks at a time. Letter reports provide summaries of air quality and meteorological data, on completion of each site’s sampling program.

  14. A Mole's Eye View: Marcellus as Mosaic by Rachel Sager

    Science.gov (United States)

    Sager, R.

    2013-12-01

    I am an artist living and working in the energy vortex of Southwestern Pennsylvania and am watching great upheaval, both good and bad, happen to my land and its citizens due to the phenomenon caused by our particular geologic formation; the Marcellus Shale. My work embraces the earth itself through the medium of mosaic, and I have found it to be a great communicator to many groups of people: landowners, gas industry workers, environmentalists. I tell the story of how I came to be so dependent on my native stone, coming from a long line of coal miners and farmers who taught me to be aware of what lies beneath my feet. With my stone hammer, I chop up shale, sandstone, limestone, and coal, transforming it into tiny, expressive pieces that tell stories and help people to grasp geologic concepts that can otherwise be overwhelming and mysterious. I address the industry itself by representing the controversial enterprise of fracking, but also delve intimately into building relationships with the stone that I gather, wash, categorize, cut, and lay into mortar. By depicting these layers of earth, I am building touchable, organic images of geologic time that are highly accessible to the human brain and sensibility. There is something personal and immediate about standing in front of one of these mosaics, being able to touch it that gives the viewer power over an idea that often leaves them feeling in the dark. As a classically trained mosaic artist, I bring back the skills, culture, and tradition of a Euro-centered art form and weave it into my North American geology. Through a highly detailed and dynamic PowerPoint presentation of my work, I help people to see the earth beneath their feet with new eyes. Rachel Sager, artist www.rachelsagermosaics.com Contemporary Art in a Geologic Medium: Rachel Sager Mosaics

  15. Speech and Swallowing

    Science.gov (United States)

    ... of Smell Cognitive Changes Depression Fatigue Constipation & Nausea Hallucinations/Delusions Pain Skeletal & Bone Health Skin Changes Sleep Disorders Speech & Swallowing Problems Urinary Incontinence Vision Changes Weight Management Help Us Make a Difference ...

  16. The National Wildlife Federation's Conservation Hall of Fame: Rachel L. Carson

    Science.gov (United States)

    Brooks, Paul

    1972-01-01

    Tribute to Rachel L. Carson, writer, scientist, and naturalist. Traces her career in college, government work with the Fish and Wildlife Service, and in the literary field. Events surrounding her writing of Silent Spring are enumerated. (BL)

  17. Rachel Carson National Wildlife Refuge: Annual narrative report: Calendar year 1983

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Rachel Carson NWR outlines Refuge accomplishments during the 1983 calendar year. The report begins with a summary of the year's...

  18. Rachel Carson National Wildlife Refuge: Annual narrative report: Calendar year 1984

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Rachel Carson NWR outlines Refuge accomplishments during the 1984 calendar year. The report begins with a summary of the year's...

  19. Rachel Carson National Wildlife Refuge: Annual narrative report: Calendar year 1982

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Rachel Carson NWR outlines Refuge accomplishments during the 1982 calendar year. The report begins with a summary of the year's...

  20. Screening level contaminant survey of the Rachel Carson National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Rachel Carson National Wildlife Refuge lies within the Portsmouth, NH - Portland, ME urban corridor, and is situated within watersheds that reflect the developed...

  1. Rachel Carson National Wildlife Refuge: Annual narrative report: Calendar year 1988

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Rachel Carson NWR outlines Refuge accomplishments during the 1988 calendar year. The report begins with a summary of the year's...

  2. Rachel Carson National Wildlife Refuge: Annual narrative report: Calendar year 1986

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Rachel Carson NWR outlines Refuge accomplishments during the 1986 calendar year. The report begins with a summary of the year's...

  3. Richard Schatzki: a familiar ring.

    Science.gov (United States)

    Patel, Birju; Han, Eugene; Swan, Kenneth

    2013-11-01

    The Schatzki ring was named for Richard Schatzki, a renowned radiologist who described the entity with his colleague, John E. Gary. The purpose of this article is to shed more light on a man who made such a significant contribution and to chronicle developments concerning this important radiologic finding. The Schatzki ring was described long ago, but its cause is poorly understood even today.

  4. Obituary: Dr. Richard Roland Baker

    Directory of Open Access Journals (Sweden)

    Thornton R

    2014-12-01

    Full Text Available Richard Baker died at Easter 2007 after a very short illness. It is sad that he died so soon after his retirement from the British American Tobacco Company at the end of 2005, and just as he was beginning to enjoy his new life, even though tobacco science still had a part to play.

  5. Difficulty Swallowing After Stroke (Dysphagia)

    Science.gov (United States)

    ... Stroke Heroes Among Us Difficulty Swallowing After Stroke (Dysphagia) Updated:Nov 15,2016 Excerpted and adapted from "Swallowing Disorders After a Stroke," Stroke Connection Magazine July/August ...

  6. Richard Antiku kunstikiindumus / Jüri Hain

    Index Scriptorium Estoniae

    Hain, Jüri, 1941-

    2011-01-01

    Arvustus:Raamatu valgusel. Richard Antik 100. Artikleid ja bibliograafia. Koostanud Merike Kiipus ja Piret Noorhani. Tartu : Eesti Kirjandusmuuseum, 2001. Ka Richard Antiku tegevusest kollektsionääri, näitustekorraldaja, kunstikaupmehe ning kunstikriitikuna

  7. Atypical swallowing: a review.

    Science.gov (United States)

    Maspero, C; Prevedello, C; Giannini, L; Galbiati, G; Farronato, G

    2014-06-01

    Atypical swallowing is a myofunctional problem consisting of an altered tongue position during the act of swallowing. High incidence in population, multifactorial etiology and the recurring connection with the presence of malocclusions made it a topic of strong interest and discussion in science. The purpose of this review is to illustrate the current orientation on the topic of atypical swallowing, trying in particular to answer two questions: 1) what kind of connection is there between atypical swallowing and malocclusion; 2) what kind of therapy should be used to solve it. This review was conducted on the Medline database [www.ncbi.nim.nih.gov/pubmed] searching for the keywords "atypical swallowing" and "tongue thrust". We examined all the documents from the year 1990 onwards, excluding the ones about syndromic cases of the central motor system. The causal relation between the two problems seems to be biunique: some authors affirm that this oral habit starts as a compensation mechanism for a preexisting malocclusion (especially in case of open-bite); other texts show that it has a tendency to exacerbate cases of malocclusion; it is also proven that a non-physiological tongue thrust can negatively influence the progress of an ongoing orthodontic therapy. Thereby, the best therapeutic approach seems to be a multidisciplinary one: beside orthodontics, which is necessary to correct the malocclusion, it is essential to set up a myofunctional rehabilitation procedure to correct the oral habit, therefore granting long time permanent results. There is also proof of a substantial difference between the results obtained from early (deciduous or primary mixed dentition) or later treatments. The biunique causal relation between atypical swallowing and malocclusion suggests a multidisciplinary therapeutic approach, orthodontic and myofunctional, to temporarily solve both problems. An early diagnosis and a prompt intervention have a significantly positive influence on the

  8. In memory of the professor Rachel Joffily Abath: Origins, academic life, longing and images

    Directory of Open Access Journals (Sweden)

    Luciana Ferreira da Costa

    2012-04-01

    Full Text Available Given the life trajectory of Professor Rachel Joffily Abath, this text recalls, as synthesis memorial five years after her death, her story and, in particular, her legacy to the Library and Information Science in Brazil. Four perspectives are presented in this paper: the origins and composition of the family of Professor Rachel; the story of her professional academic life, with greater contribution to teaching and research universities - specifically The Federal University of Paraíba and The University Center of João Pessoa -; a statement of the importance and longing; and memories through photographs.

  9. Richard's back: death, scoliosis and myth making.

    Science.gov (United States)

    Lund, Mary Ann

    2015-12-01

    The body of a mediaeval monarch was always under scrutiny, and Richard III's was no exception. In death, however, his body became subject to new forms of examination and interpretation: stripped naked after the battle of Bosworth, his corpse was carried to Leicester and exhibited before being buried. In 2012, it was rediscovered. The revelation that Richard suffered from scoliosis prompts this article to re-evaluate the historical sources about Richard's physique and his posthumous reputation. This article argues that Richard's death and his myth as 'crookback' are inextricably linked and traces attitudes to spinal curvature in the early modern period. It also considers how Shakespeare represented Richard as deformed, and aspects of performance history which suggest physical vulnerability. It then considers Richard's scoliosis from the perspective of medical history, reviewing classical accounts of scoliosis and arguing that Richard was probably treated with a mixture of axial traction and pressure. It demonstrates from the evidence of Richard's medical household that he was well placed to receive hands-on therapies and considers in particular the role of his physician and surgeon, William Hobbes. Finally, it shows how the case of Richard III demonstrates the close relationship between politics and medicine in the period and the contorted process of historical myth making. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  10. Growth curve analysis of birds: the Richards model and procedural problems. [Tachycineta bicolor

    Energy Technology Data Exchange (ETDEWEB)

    Zach, R.; Liner, Y.; Rigby, G.L.; Mayoh, K.R.

    1984-01-01

    Four sigmoid growth curve models for birds were compared using the daily body masses and primary-feather lengths of 35 nestling tree swallows (Tachycineta bicolor). The Richards model was superior to the von Bertalanffy, Gompertz, and logistic models for body mass, but not for primary-feather length. The latter models have fixed growth forms and are special cases of the flexible Richards model. Owing to parameter correlations, the Richards model was very sensitive to the starting parameter values for the numerical computer fitting routines. The lack of data leading up to the asymptote made it difficult to calculate good starting values for primary-feather length. None of the models tested was completely satisfactory for primary-feather length, as indicated by nonrandomly distributed residuals over time. The log transformation was appropriate for body mass. It homogenized the residual variances and increased the explained percentage of variation. The explained percentage of variation was a useful selection criterion for the best-fitting model, especially since it was directly related to randomness in the distribution of the residuals and homogeneity of residual variances. However, even percentages of variation exceeding 99.5%, did not necessarily indicate an excellent fit. The Richards model did not yield more model parameters for growth curve analysis, because the shape parameter and the growth rate constant were almost perfectly correlated.

  11. Utility of a Clinical Swallowing Exam for Understanding Swallowing Physiology.

    Science.gov (United States)

    Rangarathnam, Balaji; McCullough, Gary H

    2016-08-01

    A clinical swallowing examination (CSE) is generally believed to be inadequate for making judgments regarding swallowing physiology compared to objective assessments. A large volume of studies has heavily focused on identifying aspiration using a CSE and research addressing physiologic information gathered from a CSE is sparse. The purpose of this study was to examine the utility of the CSE for assessing physiology compared to videofluoroscopic swallowing studies (VFSS). Data were derived from a prior investigation of sixty adult patients post-stroke tested with CSE and VFSS. The CSE included an examination of historical measures, oral motor/speech/voice, and trial swallows. The VFSS consisted of swallows of controlled portions of thin, thick, puree, and solid boluses. Previous results from these patients demonstrated significant accuracy in making binary estimates of aspiration and the presence of dysphagia. This analysis of data focused on physiologic measures, as well as overall dysphagia severity and diet recommendations. Significant associations between CSE and VFSS ratings were observed for hyolaryngeal elevation, overall swallowing severity, and diet recommendations. These findings were specific for certain bolus consistencies. These data suggest that the CSE may not provide significant physiological information other than hyolaryngeal excursion. This does not preclude the fact that the CSE is important in providing substantial information about overall dysphagia severity. It appears that the CSE is more powerful than simply a "screening" tool. More prospective research designs are warranted to substantiate the strengths of the CSE.

  12. Bank Swallow - Monitoring [ds6

    Data.gov (United States)

    California Department of Resources — The data set represents the annual count of bank swallow burrows at nesting colonies located along the Sacramento River. The data set contains two databases which...

  13. Effect of posture on swallowing.

    African Journals Online (AJOL)

    neck flexed, head/neck extend- ed and lying supine. There are individual differences in swallowing and dys- phagia limit depending on individual condition, prefer- ences and habits. However, different head and neck posi- tions can facilitate ...

  14. Richard Eberhart: A Quest for Identity

    Directory of Open Access Journals (Sweden)

    Dr. J. Karthikeyan

    2014-09-01

    Full Text Available A short history of the life of Richard Eberhart becomes essential for us to understand the magnetic personality of a poet who believed in his younger generation. The secret of his continued popularity rests on his unique strong individuality, romantic mould, spasmodic vigour, his social commitment, simplicity of expression and a deep concern for mankind. The present study is a modest attempt in this direction and proposes to examine the predominant features of Richard Eberhart’s poetry.

  15. Sword swallowing and its side effects.

    Science.gov (United States)

    Witcombe, Brian; Meyer, Dan

    2006-12-23

    To evaluate information on the practice and associated ill effects of sword swallowing. Letters sent to sword swallowers requesting information on technique and complications. Membership lists of the Sword Swallowers' Association International. 110 sword swallowers from 16 countries. We had information from 46 sword swallowers. Major complications are more likely when the swallower is distracted or swallows multiple or unusual swords or when previous injury is present. Perforations mainly involve the oesophagus and usually have a good prognosis. Sore throats are common, particularly while the skill is being learnt or when performances are too frequent. Major gastrointestinal bleeding sometimes occurs, and occasional chest pains tend to be treated without medical advice. Sword swallowers without healthcare coverage expose themselves to financial as well as physical risk. Sword swallowers run a higher risk of injury when they are distracted or adding embellishments to their performance, but injured performers have a better prognosis than patients who suffer iatrogenic perforation.

  16. Swallowing disorders after ischemic stroke

    Directory of Open Access Journals (Sweden)

    Gabriela Camargo Remesso

    2011-10-01

    Full Text Available OBJECTIVE: To investigate occurrences of swallowing disorders after ischemic stroke. METHOD: This was a retrospective study on 596 medical files. The inclusion criterion was that the patients needed to have been hospitalized with a diagnosis of ischemic stroke; the exclusion criteria were the presence of associated cardiac problems and hospital stay already more than 14 days. RESULTS: 50.5% were men and 49.5% women; mean age 65.3 years (SD=±11.7 (p<0.001. Among the risk factors, 79.4% had hypertension, 36.7% had diabetes (p<0.001 and 42.7% were smokers. 13.3% of the patients died. Swallowing disorders occurred in 19.6%, among whom 91.5% had mild difficulty and 8.5% had severe difficulty. 87.1% had spontaneous recovery after a mean of 2.4 months. A lesion in the brainstem region occurred in 6.8% (p<0.001. CONCLUSION: Swallowing disorders occurred in almost 20% of the population and most of the difficulty in swallowing found was mild. The predictors for swallowing disorders were older age, diabetes mellitus and lesions in the brainstem region.

  17. A contrasting study: cliff and bank swallows

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The purpose of the project was to contrast as population of Cliff Swallows and a population of Bank Swallows. Both populations had nests located in a gravel pit near...

  18. Quantum Man: Richard Feynman's Life in Science

    CERN Multimedia

    CERN. Geneva

    2011-01-01

    It took a man who was willing to break all the rules to tame a theory that breaks all the rules. This talk will be based on my new book Quantum Man: Richard Feynman's life in science. I will try and present a scientific overview of the contributions of Richard Feynman, as seen through the arc of his fascinating life. From Quantum Mechanics to Antiparticles, from Rio de Janeiro to Los Alamos, a whirlwind tour will provide insights into the character, life and accomplishments of one of the 20th centuries most important scientists, and provide an object lesson in scientific integrity.

  19. Duplessis, rachel blau. Writing beyond the ending: narrative strategies of twentieth - century women writers. bloomington: indiana university press, 1985. Duplessis, rachel blau. Writing beyond the ending: narrative strategies of twentieth - century women writers. bloomington: indiana university press, 1985.

    Directory of Open Access Journals (Sweden)

    Susana Bornéo Funck

    2008-04-01

    Full Text Available Describing her study as "a culturally necessary production of possible meanings," Rachel Blau DuPlessis undertakes a oitical interpretation of twentieth-century women writers in terms of their attempts to "delegitimize the cultural conventions established by a sex-gender system and its values." Describing her study as "a culturally necessary production of possible meanings," Rachel Blau DuPlessis undertakes a oitical interpretation of twentieth-century women writers in terms of their attempts to "delegitimize the cultural conventions established by a sex-gender system and its values."

  20. Swallowing disorders in Parkinson's disease.

    Science.gov (United States)

    Mamolar Andrés, Sandra; Santamarina Rabanal, María Liliana; Granda Membiela, Carla María; Fernández Gutiérrez, María José; Sirgo Rodríguez, Paloma; Álvarez Marcos, César

    Parkinson's disease is a type of chronic neurodegenerative pathology with a typical movement pattern, as well as different, less studied symptoms such as dysphagia. Disease-related disorders in efficacy or safety in the process of swallowing usually lead to malnutrition, dehydration or pneumonias. The aim of this study was identifying and analyzing swallowing disorders in Parkinson's disease. The initial sample consisted of 52 subjects with Parkinson's disease to whom the specific test for dysphagia SDQ was applied. Nineteen participants (36.5%) with some degree of dysphagia in the SDQ test were selected to be evaluated by volume-viscosity clinical exploration method and fiberoptic endoscopic evaluation of swallowing. Disorders in swallowing efficiency and safety were detected in 94.7% of the selected sample. With regards to efficiency, disorders were found in food transport (89.5%), insufficient labial closing (68.4%) and oral residues (47.4%), relating to duration of ingestion. Alterations in security were also observed: pharynx residues (52.7%), coughing (47.4%), penetration (31.64%), aspiration and decrease of SaO 2 (5.3%), relating to the diagnosis of respiratory pathology in the previous year. The SDQ test detected swallowing disorders in 36.5% of the subjects with Parkinson's disease. Disorders in swallowing efficiency and safety were demonstrated in 94.7% of this subset. Disorders of efficiency were more frequent than those of safety, establishing a relationship with greater time in ingestion and the appearance of respiratory pathology and pneumonias. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  1. Does Barium Influence Tongue Behaviors during Swallowing?

    Science.gov (United States)

    Steele, Catriona M.; van Lieshout, Pascal H. H. M.

    2005-01-01

    The validity of videofluoroscopic swallowing assessments rests on the understanding that thin, nectar-, honey-, and spoon-thick radiopaque liquids resemble nonopaque liquids, both in their consistency and in the variations in swallowing that they elicit. Tongue movements during sequential swallows of opaque and nonopaque liquids were studied in 8…

  2. Pharyngeal Swallowing Mechanics Secondary to Hemispheric Stroke.

    Science.gov (United States)

    May, Nelson H; Pisegna, Jessica M; Marchina, Sarah; Langmore, Susan E; Kumar, Sandeep; Pearson, William G

    2017-05-01

    Computational analysis of swallowing mechanics (CASM) is a method that utilizes multivariate shape change analysis to uncover covariant elements of pharyngeal swallowing mechanics associated with impairment using videofluoroscopic swallowing studies. The goals of this preliminary study were to (1) characterize swallowing mechanics underlying stroke-related dysphagia, (2) decipher the impact of left and right hemispheric strokes on pharyngeal swallowing mechanics, and (3) determine pharyngeal swallowing mechanics associated with penetration-aspiration status. Videofluoroscopic swallowing studies of 18 dysphagic patients with hemispheric infarcts and age- and gender-matched controls were selected from well-controlled data sets. Patient data including laterality and penetration-aspiration status were collected. Coordinates mapping muscle group action during swallowing were collected from videos. Multivariate morphometric analyses of coordinates associated with stroke, affected hemisphere, and penetration-aspiration status were performed. Pharyngeal swallowing mechanics differed significantly in the following comparisons: stroke versus controls (D = 2.19, P mechanics associated with each comparison were visualized using eigenvectors. Whereas current literature focuses on timing changes in stroke-related dysphagia, these data suggest that mechanical changes are also functionally important. Pharyngeal swallowing mechanics differed by the affected hemisphere and the penetration-aspiration status. CASM can be used to identify patient-specific swallowing impairment associated with stroke injury that could help guide rehabilitation strategies to improve swallowing outcomes. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  3. Verset en volharding: die lewe van Rachel Isabella (Tibbie Steyn gedurende die Anglo-Boereoorlog

    Directory of Open Access Journals (Sweden)

    E. Truter

    1999-05-01

    Full Text Available Resistance and perseverance: The life of Rachel Isabella (Tibbie Steyn during the Anglo-Boer WarRachel Isabella (Tibbie Fraser was born in 1865 in Philippolis as daughter of the Rev. Colin McKenzie Fraser (Jr and Isabella Paterson of Scotland, and granddaughter of a Scottish immigrant, the Rev. C.A. Fraser Tibbie was trained as a teacher in Bloemfontein at the “Dames-instituut” (Eunice after which she married advocate Marthinus Theunis Steyn, a prominent Free Stater. When Theunis was elected State President of the Orange Free State in 1896, Tibbie distinguished herself as hostess of the Presidency.Tibbie experienced the vicissitudes of the Anglo-Boer War, fleeing before the victorious British army from one northeastern Free State town to the other. She was captured at the end of July 1900 and was regarded at the “first woman in her position to be taken prisoner”. Tibbie was interned in Bloemfontein and became an example of the adamant resistance of the Afrikaner woman against British domination. She was elected as “one of the worst of a number of irreconcilable women " to be deported from South Africa. The order was, however, rescinded at the last moment, after Kitchener had failed to produce conclusive evidence of any misdemeanours. She tended to her husband during his serious illness in Europe and once back in South Africa, achieved honour in uplifting Afrikaners after the war.

  4. Selected works of Richard P. Stanley

    CERN Document Server

    Stanley, Richard P; Lam, Thomas; Reiner, Victor; Reiner, Victor

    2017-01-01

    Richard Stanley's work in combinatorics revolutionized and reshaped the subject. Many of his hallmark ideas and techniques imported from other areas of mathematics have become mainstays in the framework of modern combinatorics. In addition to collecting several of Stanley's most influential papers, this volume also includes his own short reminiscences on his early years, and on his celebrated proof of The Upper Bound Theorem.

  5. Richard Wright and the Agony over Integration

    Science.gov (United States)

    Cassuto, Leonard

    2008-01-01

    Richard Wright's literary career begins with a lynching and ends with a serial murderer. "Big Boy Leaves Home," the 1936 story that leads off Wright's first book, "Uncle Tom's Children" (1938), renders the vicious mob-execution of a young black man falsely accused of rape. "A Father's Law," Wright's last novel, left unfinished at his unexpected…

  6. Richard Meieri menuülevaade Pariisis

    Index Scriptorium Estoniae

    1999-01-01

    Richard Meieri ülevaatenäitus Pariisi Musee du Jeu de Paume'is. Kolme ossa jagatud väljapanek tutvustab Meierit korporatiivse arhitektuuri, eramajade ning Los Angelese Getty Centre'i autorina. Eksponeeritud 24 maketti, fotod, joonised ja loodusvisandid.

  7. Richard Wagner: Twilight of the Nazi Spell.

    Science.gov (United States)

    Lindemann, Dirk

    1985-01-01

    Richard Wagner was probably the most influential musician of the 19th century. However, his image as an alleged intellectual-spiritual forerunner of national socialism through his music and prose works fosters aversion among critics. Whether Wagner's complicacy of art and ideology has had any lasting consequence on his reputation is discussed. (RM)

  8. Obituary: Richard Joseph Elston, 1960-2004

    Science.gov (United States)

    Jannuzi, Buell Tomasson; Bechtold, Jill

    2004-12-01

    Richard Joseph Elston, known for his development of innovative astronomical instrumentation, died on 26 January 2004 in Gainesville, Florida, after a four-year battle with Hodgkin's lymphoma. A professor of astronomy at the University of Florida, Richard had an unusually broad range of interests and skills, and a willingness to share his passion for astronomy with others, which made him a highly valued member of the astronomical community. Born 1 July 1960, in Albuquerque, New Mexico, Richard was the son of a geologist father and journalist mother. His childhood interest in astronomy and instrumentation matured as he majored in physics and astronomy at the University of New Mexico (BS, 1983) under the mentorship of Michael Zeilik. Richard pursued his PhD in astronomy at the University of Arizona and earned his degree in 1988. He pioneered the use of IR arrays for deep imaging surveys of the sky to study galaxy formation, and completed his thesis Search for Rapidly Forming Galaxies at High Redshift under the direction of George Rieke. Richard's graduate work included the first detection of galaxies at intermediate redshifts with evolved populations too red to have been identifiable from optical imaging surveys alone. In the Astrophysical Journal Letters in 1988, he, George Rieke, and Marcia Rieke reported the discovery of this new class of galaxies, now known as EROs (Extremely Red Objects), important as the possible progenitors of present day elliptical galaxies. Following post-doctoral positions at Kitt Peak National Observatory from 1988 to 1991 and at the Observatories of the Carnegie Institution of Washington from 1991 to 1992, Richard joined the scientific staff of Cerro Tololo Inter-American Observatory in Chile, part of the NSF's National Optical Astronomy Observatory. By 1994, he had become head of CTIO's IR instrumentation program and was leading the development of new instruments for the US astronomical community. In 1996, Richard married astronomer

  9. Potshemu medved rõtshit / Richard Pipes

    Index Scriptorium Estoniae

    Pipes, Richard

    2006-01-01

    Harvardi ülikooli ajalooprofessor Richard Pipes arutleb, miks Venemaa viimase aja käitumises väljendub soovimatus koostööks, sageli ka vaenulikkus. Venemaa võimetus rahvusvahelises kontekstis oma kohta leida, selle ajaloolised juured

  10. Qualitative mathematical analysis of the Richards equation

    NARCIS (Netherlands)

    Gilding, B.H.

    1991-01-01

    The Richards equation is widely used as a model for the flow of water in unsaturated soils. For modelling one-dimensional flow in a homogeneous soil, this equation can be cast in the form of a specific nonlinear partial differential equation with a time derivative and one spatial derivative. This

  11. Recensie "The Great Reset" : Richard Florida

    NARCIS (Netherlands)

    Roy van Dalm

    2010-01-01

    Like the Great Depression and the Long Depression before it, experts have viewed prolonged economic downturns as crises. In The Great Reset , bestselling author Richard Florida argues that we should instead see the recent recession as an opportunity to create entirely new ways of working and living

  12. Swallowing dysfunction in cancer patients

    NARCIS (Netherlands)

    Raber-Durlacher, J.E.; Brennan, M.T.; Verdonck- de Leeuw, I.M.; Gibson, R.J.; Eilers, J.G.; Waltimo, T.; Bots, C.P.; Michelet, M.; Sollecito, T.P.; Rouleau, T.S.; Sewnaik, A.; Bensadoun, R.J.; Fliedner, M.C.; Silverman, S.; Spijkervet, F.K.L.

    2012-01-01

    Purpose Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools,

  13. Swallowing dysfunction in cancer patients

    NARCIS (Netherlands)

    Raber-Durlacher, Judith E.; Brennan, Mike T.; Leeuw, Irma M. Verdonck-de; Gibson, Rachel J.; Eilers, June G.; Waltimo, Tuomas; Bots, Casper P.; Michelet, Marisol; Sollecito, Thomas P.; Rouleau, Tanya S.; Sewnaik, Aniel; Bensadoun, Rene-Jean; Fliedner, Monica C.; Silverman, Sol; Spijkervet, Fred K. L.

    Purpose Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools,

  14. Effect of posture on swallowing.

    African Journals Online (AJOL)

    lowing stroke, motor neuron disease, Parkinson's disease, cerebral palsy, etc.3,4 It can further lead to aspiration pneu- ... umes of water, healthy adults didn't experience piecemeal deglutition or aspiration; however while ... help in treatment of dysphagia by affecting bolus flow to improve speed and safety of swallowing by ...

  15. Richard Florida : loovsektor on majanduskasvu mootor / Richard Florida ; interv. Argo Ideon

    Index Scriptorium Estoniae

    Florida, Richard

    2008-01-01

    USA majandus- ja ühiskonnateadlane Richard Florida loovklassi teooriast, selle osast majanduskasvu tagamisel, seosest ühiskonna tolerantsuse ja ühiskonna majandusliku edukuse vahel, sotsiaalse sidususe takistavast rollist loovuse motiveerimisel

  16. A Study of King Richard III : Richard's Evil Dominates the Play

    OpenAIRE

    東, 勉; Tsutomu, HIGASHI

    2005-01-01

    This paper is one attempt to analyse the structure of Shakespeare's History Richard III and to consider Richard's evilness and the process of his obtaining the English crown and the way of his falling from it. There are many thematic and historical connections between the Henry VI trilogy and this play. This play is usually classified as a History. But this classification is still ambiguous because there are many phases of this play. This play has an ambivalent element between the tragedy and...

  17. Coordination of Mastication, Swallowing and Breathing

    Science.gov (United States)

    Matsuo, Koichiro; Palmer, Jeffrey B.

    2009-01-01

    Summary The pathways for air and food cross in the pharynx. In breathing, air may flow through either the nose or the mouth, it always flows through the pharynx. During swallowing, the pharynx changes from an airway to a food channel. The pharynx is isolated from the nasal cavity and lower airway by velopharyngeal and laryngeal closure during the pharyngeal swallow. During mastication, the food bolus accumulates in the pharynx prior to swallow initiation. The structures in the oral cavity, pharynx and larynx serve multiple functions in breathing, speaking, mastication and swallowing. Thus, the fine temporal coordination of feeding among breathing, mastication and swallowing is essential to provide proper food nutrition and to prevent pulmonary aspiration. This review paper will review the temporo-spatial coordination of the movements of oral, pharyngeal, and laryngeal structures during mastication and swallowing, and temporal coordination between breathing, mastication, and swallowing. PMID:20161022

  18. Margaret and Rachel McMillan: Their Influences on Open-Air Nursery Education and Early Years Teacher Education

    Science.gov (United States)

    Liebovich, Betty

    2014-01-01

    Rachel and Margaret McMillan created an open-air nursery in Deptford, London that has influenced early years education for 100 years. Their vision for young children living in poverty and deprivation to have access to fresh air through outdoor learning, nutritious meals, and an enriching environment to explore and develop has been embraced and…

  19. Neonatal swallowing assessment using fiberoptic endoscopic evaluation of swallowing (FEES).

    Science.gov (United States)

    Vetter-Laracy, Susanne; Osona, Borja; Roca, Antonia; Peña-Zarza, Jose A; Gil, Jose A; Figuerola, Joan

    2018-01-22

    Swallowing disorders which lead to aspiration are common in premature infants with a postmenstrual age (PMA) of >36 weeks. Aspiration is often silent and the unique symptom is desaturation during feeding. The aim of this study was 1) to determine the number of prematures with desaturations during feeding due to aspiration, using Fiberoptic Endoscopic Evaluation of Swallowing (FEES); 2) to relate clinical factors and FEES findings to aspiration; and 3) to describe type and efficacy of suggested treatments. A retrospective review of 62 ex-premature babies with a median PMA of 40 weeks which underwent FEES due to persistent feeding desaturations. Aspiration was related to other FEES findings and to clinical and demographic data. The efficacy of the treatment was evaluated during the FEES and by comparing recorded desaturations during feeding 7 days before and after FEES. A total of 44 (71%) infants were diagnosed with aspiration and/or penetration. No relation was found to demographic or clinical data. The accumulation of saliva and residues post-swallowing were related to aspiration (P thickener seemed to reduce aspiration during FEES and was suggested as a treatment. 13.6% of infants received anti-reflux treatment after FEES and 9.1% required gastrostomy. Aspiration is very frequent in premature infants who present desaturations during feeding and FEES is a useful method for diagnosing and suggesting treatments. © 2018 Wiley Periodicals, Inc.

  20. Method of lines solution of Richards` equation

    Energy Technology Data Exchange (ETDEWEB)

    Kelley, C.T.; Miller, C.T.; Tocci, M.D.

    1996-12-31

    We consider the method of lines solution of Richard`s equation, which models flow through porous media, as an example of a situation in which the method can give incorrect results because of premature termination of the nonlinear corrector iteration. This premature termination arises when the solution has a sharp moving front and the Jacobian is ill-conditioned. While this problem can be solved by tightening the tolerances provided to the ODE or DAE solver used for the temporal integration, it is more efficient to modify the termination criteria of the nonlinear solver and/or recompute the Jacobian more frequently. In this paper we continue previous work on this topic by analyzing the modifications in more detail and giving a strategy on how the modifications can be turned on and off in response to changes in the character of the solution.

  1. Selected papers of Richard Feynman with commentary

    CERN Document Server

    2000-01-01

    These scientific papers of Richard Feynman are renowned for their brilliant content and the author's striking original style. They are grouped by topic: path integral approach to the foundations of quantum mechanics and quantum field theory, renormalized quantum electrodynamics, theory of superfluid liquid helium, theory of the Fermi interaction, polarons, gravitation, partons, computer theory, etc. Comments on Feynman's topics are provided by the editor, together with biographical notes and a complete bibliography of Feynman's publications.

  2. Richard Wollheim 1923-2003 / Marek Volt

    Index Scriptorium Estoniae

    Volt, Marek

    2004-01-01

    Järelehüüe anglo-ameerika filosoofile Richard Wollheimile (5. V 1923-4. XI 2003), kes huvitus maalist ja psühhoanalüüsist ning kuulub XX sajandi analüütilist kunstifilosoofiat enim kujundanud filosoofide hulka. Tema peamised tööd: "Art and Its Objects" (1968), "Painting As an Art" (1987), "On Painting and the Self" (1992). Ilmunud ka raamatus: Volt, Marek. Esteetikast. Tallinn : Sirp, 2006

  3. Surface electromyography pattern of human swallowing

    Directory of Open Access Journals (Sweden)

    Spadaro Alessandro

    2008-03-01

    Full Text Available Abstract Background The physiology of swallowing is characterized by a complex and coordinated activation of many stomatognathic, pharyngeal, and laryngeal muscles. Kinetics and electromyographic studies have widely investigated the pharyngeal and laryngeal pattern of deglutition in order to point out the differences between normal and dysphagic people. In the dental field, muscular activation during swallowing is believed to be the cause of malocclusion. Despite the clinical importance given to spontaneous swallowing, few physiologic works have studied stomatognathic muscular activation and mandibular movement during spontaneous saliva swallowing. The aim of our study was to investigate the activity patterns of the mandibular elevator muscles (masseter and anterior temporalis muscles, the submental muscles, and the neck muscles (sternocleidomastoid muscles in healthy people during spontaneous swallowing of saliva and to relate the muscular activities to mandibular movement. Methods The spontaneous swallowing of saliva of 111 healthy individuals was analyzed using surface electromyography (SEMG and a computerized kinesiography of mandibular movement. Results Fifty-seven of 111 patients swallowed without occlusal contact (SNOC and 54 individuals had occlusal contact (SOC. The sternocleidomastoid muscles showed a slight, but constant activation during swallowing. The SEMG of the submental and sternocleidomastoid muscles showed no differences between the two groups. The SEMG of the anterior temporalis and masseter muscles showed significant differences (p Conclusion The data suggest that there is not a single "normal" or "typical" pattern for spontaneous saliva swallowing. The polygraph seemed a valuable, simple, non-invasive and reliable tool to study the physiology of swallowing.

  4. Growing up in Wartime England—A Selection from "The Rachel Chronicles: A Kind of Memoir"

    Directory of Open Access Journals (Sweden)

    Lilian R. Furst

    2012-10-01

    Full Text Available The following contribution is an excerpt from the unpublished memoirs of Austrian Jewish émigrée, Lilian Renée Furst (1931–2009, a pioneer in the field of comparative literature. This journal issue grew out of an April 2011 conference in her memory, held at the National Humanities Center, on “Jewish emigres and the Shaping of Postwar Culture.” The nexus between her innovative intellectual contributions and her experience as a Jewish émigré reflects one of the conference's central concerns: How, why, and in what fashion did the émigrés' dislocations shape innovative intellectual paths and cosmopolitan visions of Europe and European culture. Born in Austria and educated in England, Furst pursued an intellectual career in the United States, hoping it would allow her to break out of narrow national boundaries. The excerpt of her memoir here illuminates how her life's work as a pioneer in the field of comparative literary studies grew out of her experience with language as a German-speaking refugee in wartime England. Her memoir written in the third person about “Rachel” also reflects her dual identity as Jew and European. Part I by Dr. Anabel Aliaga-Buchenau, the literary executor of the memoir and a former graduate student of Furst, places “The Rachel Chronicles: A Kind of Memoir” in relation to Furst's other autobiographical writing. Part II includes Furst's own introduction to “The Rachel Chronicles,” followed by her chapter on “Growing up in wartime England.” (The whole of her unpublished memoir is available to researchers in the "Personal Papers of Lilian R. Furst," Girton College Archives, Cambridge University (http://janus.lib.cam.ac.uk/db/node.xsp?id=EAD%2FGBR%2F0271%2FGCPP%20Furst. Part III is a bibliography of Furst's writings.

  5. Oral Health and Swallowing Problems

    OpenAIRE

    Furuta, Michiko; Yamashita, Yoshihisa

    2013-01-01

    Oral health impacts systemic health. Therefore, oral care is an important consideration in maintaining quality of life (QOL). Previously, maintenance and improvement of oral hygiene was considered essential for achieving oral health. In addition to oral hygiene, oral care in terms of oral function is now considered to maintain QOL. Ingestion of exogenous nutrients via the oral cavity is fundamental to the function of all higher animals, not only human beings. Chewing and swallowing processes ...

  6. Surface Electromyographic Assessment of Swallowing Function

    Directory of Open Access Journals (Sweden)

    Marziyeh Poorjavad

    2017-03-01

    Full Text Available The reliability of surface electromyographic (sEMG variables during swallowing determines the potential usefulness of these measures in swallowing assessment and treatment. This study aimed to establish the reliability of the sEMG measures of the swallowing function of muscles during different swallowing conditions in healthy young and old volunteers. Two groups of volunteers (24 older adults, 10 younger adults participated in this cross-sectional study during 2014. The activity of masseter, submental, and infrahyoid groups were measured using sEMG during three repetitions of different swallowing tasks. Both the relative and absolute reliability (characterized respectively by ICC, SEM%, and SRD% were calculated for the sEMG indices of muscle activity during swallowing events. Statistical analyses were performed by the SPSS 19.0 and Microsoft Excel 2007 software packages. Statistical significance was set at P≤0.05. The relative reliability calculations showed significant agreements between repetitions for the mean and peak amplitude and the average of median frequency (MDF of the studied muscles function during most swallowing types in both groups. However, the duration and particularly the time to peak of muscle activity showed significant agreements during fewer swallowing conditions. Excluding MDF, we found high SEM% and SRD% for the studied measures (particularly timing measures of muscles function during most swallowing types in both groups. The reliability of sEMG measures was influenced by the age and swallowing types. Our findings suggest that the MDF of muscle function during almost all studied swallowing types can be a reliable measure for the sEMG assessment of swallowing function in both younger and older adults.

  7. The Effects of Removable Denture on Swallowing

    OpenAIRE

    Son, Dae-Sik; Seong, Jin Wan; Kim, Younghoon; Chee, Youngjoon; Hwang, Chang Ho

    2013-01-01

    Objective To investigate the relationship between removable dentures and swallowing and describe risks. Methods Twenty-four patients with removable dentures who were referred for videofluoroscopic swallowing study (VFSS) were enrolled. We evaluated the change of swallowing function using VFSS before and after the removal of the removable denture. The masticatory performance by Kazunori's method, sensation of oral cavity by Christian's method, underlying disease, and National Institutes of Hea...

  8. Lung Volume during Swallowing: Single Bolus Swallows in Healthy Young Adults

    Science.gov (United States)

    Hegland, Karen M. Wheeler; Huber, Jessica E.; Pitts, Teresa; Sapienza, Christine M.

    2009-01-01

    Purpose: This study examined the relationship between swallowing and lung volume initiation in healthy adults during single swallows of boluses differing in volume and consistency. Differences in lung volume according to respiratory phase surrounding the swallow were also assessed. Method: Nine men and 11 women between the ages of 19 and 28 years…

  9. Richard P. Feynman 1918-1988

    OpenAIRE

    Reiff, Patricia H.; Feynman, Joan; Gold, Thomas; Wasserburg, G. J.; Sheeley, Neil R., Jr.; Akasofu, S.-I.

    1988-01-01

    Richard Feynman, simply put, was a genius. His quick wit and uncommon grasp of physics meant that any research area he encountered, he quickly mastered. Despite the fact that his own area of research was not geophysics, his life and work influenced almost all of us. Virtually every physics graduate student who started in the mid 60s or later was exposed to his Lectures on Physics, either by having them as a text for a course or by using them (as I did) to bone up for oral qualifying exams...

  10. Richard Feynman a life in science

    CERN Document Server

    Gribbin, John

    1998-01-01

    This text is a portrayal of one of the greatest scientists of the late 20th-century, which also provides a picture of the significant physics of the period. It combines personal anecdotes, writings and recollections with narrative. Richard Feynman's career included: war-time work on the atomic bomb at Los Alamos; a theory of quantum mechanics for which he won the Nobel prize; and major contributions to the sciences of gravity, nuclear physics and particle theory. In 1986, he was able to show that the Challenger disaster was due to the effect of cold on the booster rocket rubber sealings.

  11. Richard Feynman Quarks, Bombs, and Bongos

    CERN Document Server

    Henderson, Harry

    2010-01-01

    Described by his peers as the "finest physicist of his generation," Richard Feynman defied scientist stereotypes. This brash New York-born American physicist startled the more conservative giants of European physics with his endless ability to improvise. Indeed, later in life, Feynman became an accomplished bongo player. Feynman's legacy to physics was his ability to simplify complex equations and clarify fundamental principles through the use of graphs. He developed the theory of quantum electrodynamics, which illustrates the behavior of electrically charged particles, such as elect

  12. Richard Hamilton: the Very Great Semiographer

    OpenAIRE

    Paul, Frédéric

    2012-01-01

    For fifty years and more, Richard Hamilton has been an enthralling artist. He was not only a Pop Art pioneer, but also one of its earliest theoreticians… before the United States pilfered the idea and turned it into a lucrative trademark—their industrial model inspiring the movement, but the formulae of Cubism and Surrealism, with the re-use of found objects by collage and assemblage, also playing their part. Hamilton is little known outside the United Kingdom, and has been signally overlooke...

  13. Richard D. Mohr and Barbara M. Sattler

    OpenAIRE

    Aujac, Germaine

    2011-01-01

    Une conférence internationale, et interdisciplinaire, avait réuni, du 13 au 17 septembre 2007, à l’université de l’Illinois (Urbana), divers physiciens, philosophes, antiquisants, architectes, pour traiter de « Life, the Universe, Everything – and More : Plato’s Timaeus Today ». Elle a donné lieu à la publication de cet important ouvrage, qui prouve une fois de plus combien est inépuisable le contenu du Timée de Platon. Les vingt-deux contributions ont été regroupées par Richard D. Mohr (qui ...

  14. Seeing Scale: Richard Dunn’s Structuralism

    Directory of Open Access Journals (Sweden)

    Keith Broadfoot

    2012-11-01

    Full Text Available Writing on the occasion of a retrospective of Richard Dunn’s work, Terence Maloon argued that ‘structuralism had an important bearing on virtually all of Richard Dunn’s mature works’, with ‘his modular, “crossed” formats’ being the most obvious manifestation of this. In this article I wish to reconsider this relation, withdrawing from a broad consideration of the framework of structuralism to focus on some of the quite particular ideas that Lacan proposed in response to structuralism. Beginning from a pivotal painting in the 1960s that developed out of Dunn’s experience of viewing the work of Barnett Newman, I wish to suggest a relation between the ongoing exploration of the thematic of scale in Dunn’s work and the idea of the symbolic that Lacan derives from structuralist thought. This relation, I argue, opens up a different way of understanding the art historical transition from Minimalism to Conceptual art.

  15. Swallowing dysfunction in cancer patients.

    Science.gov (United States)

    Raber-Durlacher, Judith E; Brennan, Mike T; Verdonck-de Leeuw, Irma M; Gibson, Rachel J; Eilers, June G; Waltimo, Tuomas; Bots, Casper P; Michelet, Marisol; Sollecito, Thomas P; Rouleau, Tanya S; Sewnaik, Aniel; Bensadoun, Rene-Jean; Fliedner, Monica C; Silverman, Sol; Spijkervet, Fred K L

    2012-03-01

    Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools, prevalence, complications, and impact on quality of life in patients with a variety of different cancers, particularly in those treated with curative chemoradiation for head and neck cancer. The literature search was limited to the English language and included both MEDLINE/PubMed and EMBASE. The search focused on papers reporting dysphagia as a side effect of cancer and cancer therapy. We identified relevant literature through the primary literature search and by articles identified in references. A wide range of assessment tools for dysphagia was identified. Dysphagia is related to a number of factors such as direct impact of the tumor, cancer resection, chemotherapy, and radiotherapy and to newer therapies such as epidermal growth factor receptor inhibitors. Concomitant oral complications such as xerostomia may exacerbate subjective dysphagia. Most literature focuses on head and neck cancer, but dysphagia is also common in other types of cancer. Swallowing impairment is a clinically relevant acute and long-term complication in patients with a wide variety of cancers. More prospective studies on the course of dysphagia and impact on quality of life from baseline to long-term follow-up after various treatment modalities, including targeted therapies, are needed.

  16. Quantitative classification of pediatric swallowing through accelerometry

    Directory of Open Access Journals (Sweden)

    Celeste Merey

    2012-06-01

    Full Text Available Abstract Background Dysphagia or swallowing disorder negatively impacts a child’s health and development. The gold standard of dysphagia detection is videofluoroscopy which exposes the child to ionizing radiation, and requires specialized clinical expertise and expensive institutionally-based equipment, precluding day-to-day and repeated assessment of fluctuating swallowing function. Swallowing accelerometry is the non-invasive measurement of cervical vibrations during swallowing and may provide a portable and cost-effective bedside alternative. In particular, dual-axis swallowing accelerometry has demonstrated screening potential in older persons with neurogenic dysphagia, but the technique has not been evaluated in the pediatric population. Methods In this study, dual-axis accelerometric signals were collected simultaneous to videofluoroscopic records from 29 pediatric participants (age 6.8 ± 4.8 years; 20 males previously diagnosed with neurogenic dysphagia. Participants swallowed 3-5 sips of barium-coated boluses of different consistencies (normally, from thick puree to thin liquid by spoon or bottle. Videofluoroscopic records were reviewed retrospectively by a clinical expert to extract swallow timings and ratings. The dual-axis acceleration signals corresponding to each identified swallow were pre-processed, segmented and trimmed prior to feature extraction from time, frequency, time-frequency and information theoretic domains. Feature space dimensionality was reduced via principal components. Results Using 8-fold cross-validation, 16-17 dimensions and a support vector machine classifier with an RBF kernel, an adjusted accuracy of 89.6% ± 0.9 was achieved for the discrimination between swallows with and with out airway entry. Conclusions Our results suggest that dual-axis accelerometry has merit in the non-invasive detection of unsafe swallows in children and deserves further consideration as a pediatric medical device.

  17. Meet EPA Scientist Richard Zepp, Ph.D.

    Science.gov (United States)

    EPA Senior Research Scientist Dr. Richard Zepp's research interests include nanomaterials transformation in the environment, keeping recreational waters safe, and how climate change might affect ecosystems.

  18. The "Silent Springs" of Rachel Carson: mass media and the origins of modern environmentalism.

    Science.gov (United States)

    Kroll, G

    2001-10-01

    This essay explores the different meanings of the 1960s' pesticide controversy as conveyed by the multiple representations of Rachel Carsons's Silent Spring (1962). I argue that to understand the impact of Carson's work on a heterogeneous audience in the early '60s, we must move beyond an examination of the book, Silent Spring, to consider its other media manifestations, as a serialization for The New Yorker and as a television exposé for "CBS Reports." Each conveyed a unique message stylized for the audience of that particular media. This analysis demonstrates the problems and opportunities for scholars attempting to gauge the influence of a book on the public understanding of science. This argument also suggests that to understand the transition of environmentalism from a grass-roots movement to near universal consensus, we need to examine carefully the role of media in shaping divergent messages for different audiences--a phenomenon that assisted in transforming local environmental issues into a matter of national concern.

  19. Constructing a scientist: expert authority and public images of Rachel Carson.

    Science.gov (United States)

    Hecht, David K

    2011-01-01

    This article uses the voluminous public discourse around Rachel Carson and her controversial bestseller "Silent Spring" to explore Americans' views on science and scientists. Carson provides a particularly interesting case study because of intense and public debates over whether she was a scientist at all, and therefore whether her book should be granted legitimacy as science. Her career defied easy classification, as she acted variously as writer, activist, and environmentalist in addition to scientist. Defending her work as legitimate science, which many though not all commentators did, therefore became an act of defining what both science and scientists could and should be. This article traces the variety of nonscientific images and narratives readers and writers assigned to Carson, such as 'reluctant crusader' and 'scientist-poet'. It argues that nonscientific attributes were central to legitimating her as both admirable person and admirable scientist. It explores how debates over "Silent Spring" can be usefully read as debates over the desirability of putatively nonscientific attributes in the professional work of a scientist. And it examines the nature of Carson's very democratized image for changing notions of science and scientists in 1960s United States politics and culture.

  20. Silent Spring, the 50th anniversary of Rachel Carson’s book

    Science.gov (United States)

    2012-01-01

    Editorial David Pimentel is a professor of ecology and agricultural sciences at Cornell University, Ithaca, NY 14853–0901. His Ph.D. is from Cornell University and had postdoctoral research at the University of Chicago, MIT, and fellowship at Oxford University (England). He was awarded a distinguished honorary degree from the University of Massachusetts. His research spans the fields of energy, population ecology, biological pest control, pesticides, sustainable agriculture, land and water conservation, livestock, and environmental policy. Pimentel has published more than 700 scientific papers and 37 books and has served on many national and government committees including the National Academy of Sciences; President’s Science Advisory Council; U.S Department of Agriculture; U.S. Department of Energy; U.S. Department of Health, Education and Welfare; Office of Technology Assessment of the U.S. Congress; and the U.S. State Department. He is currently Editorial Advisor for BMC Ecology. In this article, he reflects on 50 years since the publication of Rachel Carson’s influential book, Silent Spring. PMID:23016519

  1. El vocabulario sechurano de Richard Spruce

    Directory of Open Access Journals (Sweden)

    Matthias Urban

    2015-12-01

    Full Text Available This paper makes accesible a new transcription of Richard Spruce’s vocabulary of the Sechura language. Collected in the mid-19th century by the British botanist, it constitutes one of only two sources of data for this language of northernmost Peru. A comparison of the original with previously published versions shows serious errors in transcription, in particular in those of Otto von Buchwald and Jacinto Jijón y Camaaño. The article also discusses the probable circumstances of data collection and the publication history of the hitherto known version, and concludes with some first observations on the significance of Spruce’s wordlist for elucidating the linguistic history of the region, in particular with regard to the question of the linguistic situation at Olmos.

  2. Richard Swedberg, The Art of Social Theory

    DEFF Research Database (Denmark)

    Carleheden, Mikael

    2015-01-01

    It is a rare event when a new general field of research opens up within sociology. However, with this book, Richard Swedberg intends to do just that. It is not just another book on social theory. It is a book on ‘theorizing’. And that makes all the difference. Swedberg has chosen the term ‘art......-for-granted division between courses in ‘method’ and courses in ‘theory’. In the former we teach methods in empirical research and in the latter the content of social theory. Omitted are courses in ‘how to theorize’. Theorizing is treated, in research and in coursework, as a tacit skill. It has seldom been subjected...

  3. Has Richard Rorty a moral philosophy?

    Directory of Open Access Journals (Sweden)

    Mohammad Asghari

    2015-06-01

    Full Text Available I try to show that Richard Rorty, although is not a moral philosopher like Kant, nerveless, has moral philosophy that must be taken seriously. Rorty was not engaged with moral philosophy in the systematic manner common among leading modern and contemporary moral philosophers. This paper has two parts: first part, in brief, is concerned with principles of his philosophy such as anti-essentialism, Darwinism, Freudism, and historicism. Second part which be long and detailed, considers many moral themes in Rorty's thought such as critique of Kantian morality, solidarity, moral progress, cruelty and concept of other, etc. Subsequently, I will try to answer the research question of the article namely, has Rorty a moral philosophy?

  4. Conoscenza e etica in Richard Rorty

    Directory of Open Access Journals (Sweden)

    Emilia Romano

    2011-12-01

    Full Text Available The era in which we live, characterized by multiculturalism and complexity, it is a time when it is clear the difficulty of man to orient and to choose their own way. It’s the time of the fall of every certainty, is the era of “post”, after the tradition, after metaphysics, after the truth, and that requires more effort than any other constant reflection. The neopragmatismo seems to be an effective investigative tool for conducting this reflection and a vantage point to carry on a conversation around the issues of education. In particular, the author intended to refer to the work of Richard Rorty, the author who more than others reflected on the encounter between two important pragmatist tradition: that of classical pragmatism and the “continental” or responsible for the development of a new European concept of truth, understood as a critical and interpretative.

  5. Movements of temporomandibular condyles during swallowing.

    Science.gov (United States)

    Čimić, Samir; Šimunković, Sonja Kraljević; Gospić, Renata Kevilj; Badel, Tomislav; Dulčić, Nikša; Ćatić, Amir

    2015-03-01

    There have been studies that investigated mandibular movements and positioning during swallowing, but the results were inconsistent, and still the exact position of the condyles during swallowing is unknown. The purpose of this investigation was to study the kinematics of the mandible and the condyles, and to determine the actual movement paths and position of mandible and condyles during the process of swallowing. The study was performed on a sample of 44 dental students. Measurements were done with an electronic axiograph. After non-occlusing attachment was fixed in the mouth, every subject swallowed for five times from the rest position. The final swallowing position of the left and the right condyles was measured in the sagittal plane. The final swallowing position of the sagittal incisal point was measured in sagittal, frontal and horizontal plane, and data was statistically analyzed. The condyles showed average movement toward posterior (left 0.17 mm, SD 0.28, right 0.16 mm, SD 0.25) and superior (left 0.14 mm, SD 0.20, right 0.14 mm, SD 0.23). Anterior and/or inferior position had 20% of participants. The average sagittal incisal point movement during swallowing was toward anterior (0.30 mm, SD 0.53) and superior (0.81 mm, SD 0.84). The mean mandibular lateral movement was 0.1 mm (SD 0.1). The results of the study suggest that retrusion during swallowing is not the rule, although on average there is a slight tendency of condylar movement toward posterior. Swallowing can be used as auxiliary method for determining vertical dimension of occlusion.

  6. Lung Volume Measured during Sequential Swallowing in Healthy Young Adults

    Science.gov (United States)

    Hegland, Karen Wheeler; Huber, Jessica E.; Pitts, Teresa; Davenport, Paul W.; Sapienza, Christine M.

    2011-01-01

    Purpose: Outcomes from studying the coordinative relationship between respiratory and swallow subsystems are inconsistent for sequential swallows, and the lung volume at the initiation of sequential swallowing remains undefined. The first goal of this study was to quantify the lung volume at initiation of sequential swallowing ingestion cycles and…

  7. Richard Avedon ja Annie Leibovitz laulsid kaanonit / Marika Alver

    Index Scriptorium Estoniae

    Alver, Marika

    2008-01-01

    Richard Avedoni (1923-2004) retrospektiivnäitusest (fotod aastatest 1946-2004) kuraator Helle Crenzien (Lousiana Kaasaegse Kunsti muuseum Taanis), millega kaasnes ka Helen Whitney film "Richard Avedon : darkness and light" ja Annie Leibovitzi (1949) suurprojektist "A photographer's life 1990-2005" Pariisis

  8. Identification of Swallowing Tasks from a Modified Barium Swallow Study That Optimize the Detection of Physiological Impairment

    Science.gov (United States)

    Hazelwood, R. Jordan; Armeson, Kent E.; Hill, Elizabeth G.; Bonilha, Heather Shaw; Martin-Harris, Bonnie

    2017-01-01

    Purpose: The purpose of this study was to identify which swallowing task(s) yielded the worst performance during a standardized modified barium swallow study (MBSS) in order to optimize the detection of swallowing impairment. Method: This secondary data analysis of adult MBSSs estimated the probability of each swallowing task yielding the derived…

  9. Wonders with the Sea: Rachel Carson’s Ecological Aesthetic and the Mid-Century Reader

    Directory of Open Access Journals (Sweden)

    Amanda Hagood

    2013-05-01

    Full Text Available Recent scholarship on the work of the great nature writer, Rachel Carson, posits that her landmark book, Silent Spring (1962—often credited with igniting the modern environmental movement—is best understood in the context of her earlier, extraordinarily popular publications on the natural history of the oceans, which helped establish her as a talented and trustworthy translator of scientific concepts into literary prose. This essay builds upon that idea, showing how Carson’s The Sea Around Us (1951 and The Edge of the Sea (1955 not only shaped public understandings of ocean ecology, but also spurred a public passion for all things oceanographic, best embodied in a wave of “Carsonalia”—consumer items and experiences ranging from hats, to Book of the Month Club editions, to liner notes for the NBC Symphony’s recording of Debussy’s La Mer. While these items inspired and expressed the “sense of wonder” that was critical to Carson’s ecological aesthetic, I argue, they also subsumed the new “frontier” of the world’s oceans into the technological imperialism of the post-World War II United States. As new technologies allowed military and scientific researchers to see deeper into the oceanic depths than ever before, images of the open ocean were domesticated through consumer markets into viewable, readable, and even wearable forms. This commodification of the ocean, and of Carson’s ecocentric message, both enabled and frustrated her attempts to promote ecological literacy. Yet they also reveal much about our contemporary relationship to the world’s oceans, which remain sites of both enduring wonder and extraordinary exploitation.

  10. Obituary: Richard D. Schwartz (1941-2011)

    Science.gov (United States)

    Wilking, Bruce

    2011-12-01

    Richard D. Schwartz, Professor Emeritus of Astronomy, died at his home in Sequim, WA, after a nearly 3 year battle against pancreatic cancer. Richard was born in Pretty Prairie, Kansas. He was active in sports and band and graduated in 1959. After completing a BS at Kansas State, and a Master's degree in Divinity at Union Seminary in NY, he further studied astrophysics, receiving his doctorate from University of Washington in 1973. When Dick arrived at the University of Missouri-St. Louis in 1975, he was the only astronomer in the Department of Physics. He built the astronomy program and initiated the B.S. in physics with an astrophysics option that the majority of physics majors choose. Dick was a wonderful teacher and provided outstanding leadership to the campus. He designed and provided oversight on the construction of the campus observatory that was completed in 1981. Since that time the observatory has served as both a teaching and research facility. It is also used for monthly public open houses that draw hundreds of people annually to the campus to view the moon, stars, and planets. Upon his retirement in 2003, the Board of Curators approved naming the campus observatory the "Richard D. Schwartz Observatory" in honor of his distinctive service to the University of Missouri-St. Louis. Just as important as Dick's service to promote public interest in astronomy was his effort to make the campus observatory a research facility. Dick equipped and maintained the observatory with state-of-art detectors that allowed students to get their first taste of scientific research. From 1991-2003, he managed the campus program for the NASA/Missouri Space Grant Consortium and mentored over 30 research students in projects at the observatory. Some of the results have been published in astronomical journals. Many of those students went on to graduate schools and several have achieved tenure and distinction at major universities. In addition to Dick's service to the University

  11. Management of sword-swallower injuries.

    Science.gov (United States)

    Moberly, A C; Fritsch, M H; Mosier, K M

    2011-02-01

    To report an unusual case of hypopharyngeal perforation in a sword-swallower, with emphasis on management options. Case report and review of the English language literature concerning sword-swallowing injuries to the hypopharynx and oesophagus. A 29-year-old male sword-swallower suffered hypopharyngeal perforation during a performance. The patient received conservative management, with intensive care unit admission, infectious disease consultation, intravenous antibiotics, discontinuation of oral intake and close observation. He progressed well, resumed oral intake on hospital day six, and was discharged home on hospital day eight. Sword-swallowing is an unusual vocation which may lead to potentially devastating injuries. This case report and review of the literature illustrates the management options for such hypopharyngeal and oesophageal injuries.

  12. [The physiologic and the pathologic swallowing process].

    Science.gov (United States)

    Cantemir, S; Laubert, A

    2017-03-01

    It is estimated that 5 million people in Germany currently suffer from swallowing disorders. Due to increasing life expectancy and the good outcome of very premature infants, this number is expected to increase. Swallowing normally occurs in four phases, and for each phase there are diagnostic tools to assess whether the problem is anatomic-organic or functional. A detailed case history is followed by clinical examination of the cranial nerves, the orofacial region, the swallowing reflex, and pharyngeal and esophageal transit. Attention is also paid to age-related changes in the swallowing process, nasal regurgitation, retention at the base of the tongue or in the hypopharynx, and signs of aspiration.

  13. The Andean Swallow (Orochelidon andecola) in Argentina

    OpenAIRE

    Mazar Barnett, Juan; Pugnali, Germán D.; Pearman Morrison, Mark; Bodrati, Alejandro; Moschione, Flavio; Clark, Ricardo; Roesler, Carlos Ignacio; Monteleone, Diego; Casañas, Hernán; Burgos Gallardo, Freddy; Segovia, José; Pagano, Luis; Povedano, Hernán; Areta, Juan Ignacio

    2016-01-01

    During ornithological studies in the provinces of Jujuy, Salta, and San Juan, we recorded the Andean Swallow Orochelidon andecola at 40 localities. These are the first records in Argentina, and also represent the southernmost for the species. Some of these localities are up to 1500 m lower than the previously known elevational limit (now 800 masl), and up to 1100 km southwards. This is a relatively poorly known swallow, and we present novel natural history data. We found evidence of breeding ...

  14. Richard Murphy: Autobiography and the Connemara landscape

    Directory of Open Access Journals (Sweden)

    Elsa Meihuizen

    2015-06-01

    Full Text Available It could be argued that an important feature of Richard Murphy’s work, and of his identity as a poet is the relationship between the creative self and a particular place, where ‘place’ should be understood as referring not just to physical qualities of the natural environment, but in a broader sense to denote an environment in which everything is interrelated and connected, and in which there is no sharp division between the natural and the human. The landscape providing inspiration for Murphy’s poetic imagination is the landscapes and seascapes of Connemara in north-west Ireland. In 1959 he settled in this environment which was to be his base for the next 20 years and from this period and this location emanated the bulk of his poetic oeuvre. For Murphy committing to a life of writing poetry necessarily means being in the Connemara landscape. Returning to this environment in adulthood represents a quest for recovering childhood feelings, of belonging and love, as connected to particular places. Murphy’s Connemara poems could be read as an account of this process of re-placement, as a type of autobiographical text in which the artist creates a ‘double portrait’: in writing about the landscape he also writes about himself, creating a place-portrait which is, at the same time, a self-portrait.

  15. Richard Weinshilboum: Pharmacogenetics: The future is here!

    Science.gov (United States)

    Weinshilboum, Richard

    2003-05-01

    Richard Weinshilboum has a no-nonsense attitude about pharmacogenetics. He is enthusiastic about the practicalities and ramifications of the field's solid accomplishments, but he carefully measures statements that might feed the hype that is en courant about the brave new postgenomic world of drug therapy. Although the terms "pharmacogenomics" and "pharmacogenetics" are often used interchangeably (a linguistic quirk to which Weinshilboum does not object), he consistently avoids the latter, perhaps more glitzy, word. Weinshilboum has spent over thirty years as a clinical pharmacologist, exploring in particular the variability of drug metabolism that occurs among patients as a function of their genetic constitution. The research efforts from his line of work have materialized into clinical application and have helped to set the stage for the individualization of drug treatment according to each patient's genetic constitution-not yet on the genomewide scale that Weinshilboum enthusiastically foresees, but certainly as pertains to multiple genes and drugs for any given patient. The interview with Weinshilboum occurred at this year's annual meeting of ASPET, at which he was conferred the Harry Gold Award in Clinical Pharmacology.

  16. Richard Murphy: a life in writing

    Directory of Open Access Journals (Sweden)

    E. Meihuizen

    2006-07-01

    Full Text Available The Irish poet Richard Murphy published his autobiography “The kick: a life among writers” in 2003. From a slightly different perspective the subtitle of this work could be rewritten as “A life in writing” since it is an account of the agencies that moulded a life devoted to creative writing which forms the book’s essential impetus. The memoir is based on notebooks which Murphy kept throughout his life “to hold the scraps of verse, elusive images, dreams, desires and revelations” to be developed into poetry. Apart from contextualising his poetry by registering the relationships, circumstances and landscapes from which it germinated, Murphy also tells of the creative process itself and the personal poetics underlying this process. This article explores what is regarded as the central determining feature of Murphy’s identity as poet, namely the relationship between the creative self and a particular place, where the concept of “place” is seen as a cultural palimpsest which represents not only physical qualities, but also the shaping and development of the landscape through time according to a certain way of life.

  17. Instrumentation for bedside analysis of swallowing disorders.

    Science.gov (United States)

    Greco, Catiuscia S S; Nunes, Luiz G Q; Melo, Pedro L

    2010-01-01

    Disordered swallowing, or dysphagia, is a common problem seen in patients undergoing treatment for cancer, stroke and neurodegenerative illnesses. This disease is associated with aspiration-induced chest infections. The methods currently used for diagnosis, however, are qualitative or based on expensive equipment. Swallowing accelerometry is a promising low-cost, quantitative and noninvasive tool for the evaluation of swallowing. This work describes the design and application of a bedside instrument able to evaluate swallowing mechanisms and to identify patients at risk of aspiration. Three-axis swallowing accelerometry was used to measure the neck vibrations associated with deglutition, providing analog signals to a virtual instrument developed in LabVIEW environment. In vivo tests in normal subjects as well as tests with disphagic patients showed that the system was able to easily and non-invasively detect changes in the swallowing acceleration pattern associated with increasing values of water volume (p disphagia. We concluded that the developed system could be a useful tool for the objective bedside evaluation of patients at risk of aspiration.

  18. Problematizing Minority Voices: Intertextuality and Ideology in the Court Reporter's Representation of Rachel Jeantel's Voice in the State of Florida v. George Zimmerman Murder Trial

    Science.gov (United States)

    Sullivan, Grace

    2017-01-01

    In 2012, Trayvon Martin was killed by George Zimmerman, who, after a month-long highly-publicized trial, was acquitted of second-degree murder. In this study, I examine the testimony of Martin's childhood friend and key witness for the prosecution, Rachel Jeantel. Although Rachel Jeantel was an ear witness to the altercation between Zimmerman and…

  19. In memoriam: Richard G. Harrison - his life and legacy.

    Science.gov (United States)

    Howard, Daniel J; Grosberg, Richard K; Noor, Mohamed A F; Normark, Benjamin B; Rand, David M; Shaw, Kerry L; Willett, Christopher S

    2016-06-01

    Richard G. Harrison passed away unexpectedly on April 12th, 2016. In this memoriam we pay tribute to the life and legacy of an extraordinary scientist, mentor, friend, husband, and father. © 2016 John Wiley & Sons Ltd.

  20. Kuues väljasuremine / Richard Leakey, Roger Lewin

    Index Scriptorium Estoniae

    Leakey, Richard

    2002-01-01

    Inimtegevuse hävitavast toimest looduslikule mitmekesisusele, mis tingib loodusliku energiatootmise järsu kahanemise, millest omakorda sõltub inimese enda ellujäämine. Lühidalt Richard Leakey'st

  1. Chemical Sensing Regulates Mastication/Swallowing.

    Science.gov (United States)

    Yamamura, Kensuke; Kurose, Masayuki; Okamoto, Keiichiro

    2016-01-01

    Mastication and swallowing are the first stage of digestion involving several motor processes such as food intake, intra-oral food transport, bolus formation and chewing and swallowing reflex. These complicated motor functions are accomplished by the well-coordinated activities in the jaw, hyoid, tongue, facial and pharyngeal muscles. Although the basic activity patterns of these movements are controlled by the brainstem pattern generators, these movements generate various peripheral sensory inputs. Among the sensory inputs, it is well-known that somatic sensory inputs play important roles in reflexively modulating the movements so that the final motor outputs fit the environmental demand. However, little is known about the effects of chemical sensory inputs such as taste and olfaction originating from the ingested foods by these movements. A possible reason could be raised that cognition of the chemical sensory inputs at the higher brain also influences the movements, so it is difficult to discuss the neural mechanisms underlying the observed effect. In this review, we focus on the effects of chemical sensory inputs on the masticatory movements and initiation of swallowing. We first summarize chemical sensory inputs occurring during mastication and swallowing, and their receptive mechanisms. In addition, we will introduce the effect of application of monosodium L-glutamate (MSG) solution as an umami taste to the oropharynx on the swallow initiation which is involuntary controlled and the possible neural mechanisms underlying this effect is discussed.

  2. The interaction between breathing and swallowing in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Erdem, Nazan Simsek; Karaali, Kamil; Ünal, Ali; Kızılay, Ferah; Öğüş, Candan; Uysal, Hilmi

    2016-12-01

    The aim of the study is to determine the association between respiratory swallow patterns in amyotrophic lateral sclerosis (ALS) patients. Furthermore, it aims to clarify the role of the dysphagia limit in defining the relationship between swallowing disorders and respiratory disorders. Functional rating scales were used to describe swallowing and respiratory function. Swallowing was observed using the dysphagia limit. Dysphagia limit is the volume at which a second or more swallows are required to swallow the whole bolus. Laryngeal and chest movement sensors, pulmonary function tests, submental, and diaphragm electromyography activity were used to evaluate the relationship between swallowing and respiratory phase. Of the 27 patients included in the study, 14 were dysphagic and 13 were non-dysphagic. Tests showed normal respiratory function in 11 of the non-dysphagic patients and 3 of the dysphagic patients. There was a high correlation between the dysphagia limit and Amyotrophic Lateral Sclerosis Functional Rating Scale swallowing parameters. Non-dysphagic patients were able to swallow during inspiration but only six patients in the dysphagic group were able to swallow during inspiration. The occurrence of dysphagia in ALS is related to piecemeal deglutition and respiration consistency during swallowing. Detecting the timing of disturbances in the relationship between swallowing and respiration may be a way of identifying dysphagia. Dysphagia limit may be a useful, complementary test for assessing swallowing disturbances in amyotrophic lateral sclerosis.

  3. EFFECT OF GUM CHEWING ON AIR SWALLOWING, SALIVA SWALLOWING AND BELCHING

    Directory of Open Access Journals (Sweden)

    Ana Cristina Viana da SILVA

    2015-09-01

    Full Text Available BackgroundEructation is a physiologic event which allows gastric venting of swallowed air and most of the time is not perceived as a symptom. This is called gastric belching. Supragastric belching occurs when swallowed air does not reach the stomach and returns by mouth a short time after swallowing. This situation may cause discomfort, life limitations and problems in daily life.ObjectiveOur objective in this investigation was to evaluate if gum chewing increases the frequency of gastric and/or supragastric belches.MethodsEsophageal transit of liquid and gas was evaluated by impedance measurement in 16 patients with complaint of troublesome belching and in 15 controls. The Rome III criteria were used in the diagnosis of troublesome belching. The esophageal transit of liquid and gas was measured at 5 cm, 10 cm, 15 cm and 20 cm from the lower esophageal sphincter. The subjects were evaluated for 1 hour which was divided into three 20-minute periods: (1 while sitting for a 20-minute base period; (2 after the ingestion of yogurt (200 mL, 190 kcal, in which the subjects were evaluated while chewing or not chewing gum; (3 final 20-minute period in which the subjects then inverted the task of chewing or not chewing gum. In gastric belch, the air flowed from the stomach through the esophagus in oral direction and in supragastric belch the air entered the esophagus rapidly from proximal and was expulsed almost immediately in oral direction. Air swallows were characterized by an increase of at least 50% of basal impedance and saliva swallow by a decrease of at least 50% of basal impedance, that progress from proximal to distal esophagus.ResultsIn base period, air swallowing was more frequent in patients than in controls and saliva swallowing was more frequent in controls than in patients. There was no difference between the medians of controls and patients in the number of gastric belches and supragastric belches. In six patients, supragastric belches

  4. Remote management of voice and swallowing disorders.

    Science.gov (United States)

    Mashima, Pauline A; Brown, Janet E

    2011-12-01

    Telehealth or telepractice can alleviate shortages of speech-language pathologists, particularly in rural and underserved areas, where specialists in voice and swallowing disorders may not be available. In addition to improving access to services, telehealth offers the opportunity for patients to receive care in their natural environment, as in the case of home health care where treatment can include family members and caregivers. This article presents an overview of telehealth applications in the remote management of voice and swallowing disorders including historical background, current issues, and a brief review of clinical effectiveness studies. Published by Elsevier Inc.

  5. Obituary: Richard B. Dunn, 1927-2005

    Science.gov (United States)

    Keil, Stephen L.; Dooling, David

    2007-12-01

    Dr. Richard B. Dunn, astronomer emeritus at the National Solar Observatory, died of a heart attack on September 29, 2005. He was recognized as one of the foremost experimental solar physicists. His innovative designs for telescopes and instruments led to many important discoveries in solar physics. Born in Baltimore, Maryland, in 1927 and raised in Minneapolis, Minnesota, Dick's parents were Dr. Halbert L. Dunn and Katherine Brandner. Halbert (MD, Ph.D., F.A.P.H.A.) was an physician who became Chief of the National Office of Vital Statistics, Public Health Service. He published a paper "High Level Wellness for Man and Society" that became the founding paper of the field of wellness health care. After their divorce in 1942, Katherine moved to New York and became a social worker. Dick had two older brothers who died before him, Halbert (born in 1921, who became a civil engineer) and Robert (born in 1924, who became an architect). Dick earned a BS in mechanical engineering and an MS in astronomy at the University of Minnesota. At the end of World War II he served in the United States Army in Japan. For his master's degree, Dick undertook the design and construction of a Lyot-type birefringent filter for observations of solar prominences. This early work led to his acceptance at Harvard, where Professor Donald Menzel encouraged him to continue his work with the 15-inch Cambridge telescope. In 1951 he conducted part of his doctoral thesis work at the fledgling Sacramento Peak Observatory in southern New Mexico. The observatory director, Dr. John Evans, was impressed with Dick's outstanding instrumental talents and invited him to join as one of the first scientific staff members. During his first few years at Sac Peak, Dick developed two more birefringent filter systems including one with an integrated coronagraph. With this system, he produced the best prominence and spicule observations ever obtained. Dick's career was dedicated to obtaining solar observations of the

  6. Mother-Blaming in the Shadow of Incest: Commentary on "Motherhood in the Shadow of Incest" by Rachel Lev-Wiesel

    Science.gov (United States)

    Faller, Kathleen Coulborn

    2007-01-01

    This commentary on "Motherhood in the Shadow of Incest" by Rachel Lev-Wiesel, is divided into three sections. In the first section, this author addresses the issue of the role of mothers in incest. Faller contends that, with regard to research findings on the role of mothers' own sexual victimization in her child's experience, previous research…

  7. Nonspecific effects of gap paradigm on swallowing.

    Science.gov (United States)

    Yoneda, Masaki; Saitoh, Kazuya

    2017-02-01

    Analogous to the gap paradigm in experiments for saccadic eye movements with very short reaction times, we hypothesized that the initiation of oropharyngeal swallowing movements guided by visual cues are encouraged under experimental conditions using a similar gap paradigm. A red visual cue indicating to hold a bolus in the mouth and a blue one indicating to swallow the bolus were sequentially provided on a computer display to 11 healthy participants. The gap period between these cues varied from 0 to 800ms. Swallowing kinetics and kinematics were recorded using surface electromyography and a laser displacement sensor, respectively. In comparison with the no-gap paradigm, the delay from the onset of muscle activities to initiation of movement significantly decreased with a 100- (pparadigm of 100-200ms. Wrist flexion was boosted in a similar manner. Thus, the gap effect may be a generalized warning effect. Our findings might provide insights into the contribution of the basal ganglia to volitional swallowing. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Senescent Swallowing: Impact, Strategies and Interventions

    Science.gov (United States)

    Ney, Denise; Weiss, Jennifer; Kind, Amy; Robbins, JoAnne

    2010-01-01

    The risk for disordered oropharyngeal swallowing (dysphagia) increases with age. Loss of swallowing function can have devastating health implications including dehydration, malnutrition, and pneumonia, as well as reduced quality of life. Age-related changes place older adults at risk for dysphagia for two major reasons: One is that natural, healthy aging takes its toll on head and neck anatomy and physiologic and neural mechanisms underpinning swallowing function. This progression of change contributes to alterations in the swallowing in healthy older adults and is termed presbyphagia, naturally diminishing functional reserve. Second, disease prevalence increases with age and dysphagia is a co-morbidity of many age-related diseases and/or their treatments. Sensory changes, medication, sarcopenia and age-related diseases are discussed herein. Relatively recent findings that health complications are associated with dysphagia are presented. Nutrient requirements, fluid intake and nutritional assessment for older adults are reviewed relative to their relations to dysphagia. Dysphagia screening and the pros and cons of tube feeding as a solution are discussed. Optimal intervention strategies for elders with dysphagia ranging from compensatory interventions to more rigorous exercise approaches are presented. Compelling evidence of improved functional swallowing and eating outcomes resulting from active rehabilitation focusing on increasing strength of head and neck musculature is provided. In summary, while oropharyngeal dysphagia may be life-threatening, so are some of the traditional alternatives, particularly for frail, elderly patients. While the state of the evidence calls for more research, this review indicates the behavioral, dietary and environmental modifications emerging in this past decade are compassionate, promising and in many cases preferred alternatives to the always present option of tube feeding. PMID:19483069

  9. The effects of removable denture on swallowing.

    Science.gov (United States)

    Son, Dae-Sik; Seong, Jin Wan; Kim, Younghoon; Chee, Youngjoon; Hwang, Chang Ho

    2013-04-01

    To investigate the relationship between removable dentures and swallowing and describe risks. Twenty-four patients with removable dentures who were referred for videofluoroscopic swallowing study (VFSS) were enrolled. We evaluated the change of swallowing function using VFSS before and after the removal of the removable denture. The masticatory performance by Kazunori's method, sensation of oral cavity by Christian's method, underlying disease, and National Institutes of Health Stroke Scale for level of consciousness were collected. Functional dysphagia scales, including the oral transit time (OTT), pharyngeal transit time (PTT), percentage of oral residue, percentage of pharyngeal residue, oropharyngeal swallow efficiency (OPSE), and presence of aspiration were measured. Four patients dropped out and 20 patients were analyzed (stroke, 13 patients; pneumonia, 3 patients; and others, 4 patients). The mean age was 73.3±11.4 years. There were significant differences before and after the removal of the denture for the OTT. OTT was significantly less after the removal of the denture (8.87 vs. 4.38 seconds, p=0.01). OPSE increased remarkably after the removal of the denture, but without significance (18.24%/sec vs. 25.26%/sec, p=0.05). The OTT and OPSE, while donning a removable denture, were correlated with the masticatory performance (OTT, p=0.04; OPSE, p=0.003) and sensation of oral cavity (OTT, p=0.006; OPSE, p=0.007). A removable denture may have negative effects on swallowing, especially OTT and OPSE. These affects may be caused by impaired sensation of the oral cavity or masticatory performance induced by the removable denture.

  10. Swallowing Disorders in Severe Brain Injury in the Arousal Phase.

    Science.gov (United States)

    Bremare, A; Rapin, A; Veber, B; Beuret-Blanquart, F; Verin, E

    2016-08-01

    The objective of this study was to determine the clinical characteristics of swallowing disorders in severe brain injury in the arousal phase after coma. Between December 1, 2013 and June 30, 2014, eleven patients with severe acquired brain injury who were admitted to rehabilitation center (Male 81.8 %; 40.7 ± 14.6 years) were included in the study. Evaluation of swallowing included a functional examination, clinical functional swallowing test, and naso-endoscopic swallowing test. All patients had swallowing disorders at admission. The first functional swallowing test showed oral (77.8 %) and pharyngeal (66.7 %) food bolus transport disorders; and alterations in airway protection mechanisms (80 %). Swallowing test under endoscopic control showed a disorder in swallowing coordination in 55.6 % of patients tested. Seven (63.6 %) patients resumed oral feeding within an average of 6 weeks after admission to rehabilitation center and 14 weeks after acquired brain injury. Six (85.7 %) of these seven patients continued to require modified solid and liquid textures. Swallowing disorders are a major concern in severe brain injury in the arousal phase. Early bedside assessment of swallowing is essential for detection of swallowing disorders to propose appropriate medical rehabilitation care to these patients in a state of altered consciousness.

  11. Lionel Richard, Goebbels. Portrait d’un manipulateur

    OpenAIRE

    Chambarlhac, Vincent

    2009-01-01

    Lionel Richard livre ici un portrait, non une biographie, de Joseph Goebbels. La distinction importe. La logique biographique suppose souvent l’attention psychologique au sujet, Lionel Richard se méfie de ces reconstructions « où se complaisent tous les sophistes qui se dérobent aux analyses sociales » (p. 271). Ce refus d’une « psychiatrisation de l’Histoire » (idem), s’accompagne de la méfiance envers les sources – les premiers portraits de Goebbels sous le IIIe Reich sont apologétiques – e...

  12. To Have Been a Student of Richard Feynman

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 16; Issue 9. To Have Been a Student of Richard Feynman. Laurie M Brown. Personal Reflections Volume 16 Issue 9 September 2011 pp 874-878. Fulltext. Click here to view fulltext PDF. Permanent link:

  13. Richard Phillips Feynman-Physicist and Teacher Extraordinary

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 16; Issue 9. Richard Phillips Feynman - Physicist and Teacher Extraordinary. N Mukunda. Article-in-a-Box Volume 16 Issue 9 September 2011 pp 796-797. Fulltext. Click here to view fulltext PDF. Permanent link:

  14. Koht, kust tagasi ei tulda / Mark Jenkins ; fotod Cory Richards

    Index Scriptorium Estoniae

    Jenkins, Mark

    2015-01-01

    National Geographicu ekspeditsiooni, mille koosseisu kuulusid Renan Ozturk, Mark Jenkins, Cory Richards, Emily Harrington ja Kilaree O'Neill, püüdlustest tõusta Kagu-Aasia kõrgeima mäe Hkakabo Razi tippu ning mõõta selle täpset kõrgust GPS-i abil

  15. 77 FR 75507 - The Richard C. Holbrooke Award for Diplomacy

    Science.gov (United States)

    2012-12-21

    ... Award for Diplomacy Memorandum for the Secretary of State To honor the legacy of one of America's greatest diplomats and to reaffirm our commitment to diplomacy, I hereby direct you to establish the Richard C. Holbrooke Award for Diplomacy, to be awarded annually. You are authorized to take all necessary...

  16. Richard Nixon's "Pragmatic" Space Race: Metaphorically Crafting a National Identity.

    Science.gov (United States)

    Krug, Linda T.

    President Richard Nixon decided in 1970 to commission the construction of a fleet of reusable space shuttles. Nixon's rhetoric on the space shuttle program (examined here in the light of Kenneth Burke's theory of symbolic action) shows how a philosophy of pragmatism was crafted out of a philosophy of wonderment. That one cannot now remember…

  17. Five Things I Learned from Richard Feynman About Science ...

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 16; Issue 9. Five Things I Learned from Richard Feynman About Science Education. Kathy Ceceri. Personal Reflections Volume 16 Issue 9 September 2011 pp 879-880. Fulltext. Click here to view fulltext PDF. Permanent link:

  18. Richard Kluger's "Simple Justice": Race, Class, and United States Imperialism

    Science.gov (United States)

    Gonzalez, Gilbert G.

    2004-01-01

    Richard Kluger's monumental "Simple Justice" reaffirms the long-held liberal contention that any analysis of the complex social relations in the United States must acknowledge the centrality of racism. Racism historically contributed to shaping of the political culture, social interactions, and legal status of groups throughout the United States.…

  19. Whatever Happened to Richard Reid's List of First Programming Languages?

    Science.gov (United States)

    Siegfried, Robert M.; Greco, Daniel M.; Miceli, Nicholas G.; Siegfried, Jason P.

    2012-01-01

    Throughout the 1990s, Richard Reid of Michigan State University maintained a list showing the first programming language used in introductory programming courses taken by computer science and information systems majors; it was updated for several years afterwards by Frances Van Scoy of West Virginia University. However, it has been 5 years since…

  20. The zooplankton community of Richards Bay Harbour and adjacent ...

    African Journals Online (AJOL)

    During construction of the current Richards Bay Harbour in the early 1970s, the original shallow Mhlathuze Estuary was divided into two separate systems: a new estuary and a deep-water harbour. This study compares the zooplankton communities of the current systems with reference to that of the original, before harbour ...

  1. Aspirating and Nonaspirating Swallow Sounds in Children: A Pilot Study.

    Science.gov (United States)

    Frakking, Thuy; Chang, Anne; O'Grady, Kerry; David, Michael; Weir, Kelly

    2016-12-01

    Cervical auscultation (CA) may be used to complement feeding/swallowing evaluations when assessing for aspiration. There are no published pediatric studies that compare the properties of sounds between aspirating and nonaspirating swallows. To establish acoustic and perceptual profiles of aspirating and nonaspirating swallow sounds and determine if a difference exists between these 2 swallowing types. Aspiration sound clips were obtained from recordings using CA simultaneously undertaken with videofluoroscopic swallow study. Aspiration was determined using the Penetration-Aspiration Scale. The presence of perceptual swallow/breath parameters was rated by 2 speech pathologists who were blinded to the type of swallow. Acoustic data between groups were compared using Mann Whitney U-tests, while perceptual differences were determined by a test of 2 proportions. Combinations of perceptual parameters of 50 swallows (27 aspiration, 23 no aspiration) from 47 children (57% male) were statistically analyzed using area under a receiver operating characteristic (aROC), sensitivity, specificity, and positive and negative predictive values to determine predictors of aspirating swallows. The combination of post-swallow presence of wet breathing and wheeze and absence of GRS and normal breathing was the best predictor of aspiration (aROC = 0.82, 95% CI, 0.70-0.94). There were no significant differences between these 2 swallow types for peak frequency, duration, and peak amplitude. Our pilot study has shown that certain characteristics of swallow obtained using CA may be useful in the prediction of aspiration. However, further research comparing the acoustic swallowing sound profiles of normal children to children with dysphagia (who are aspirating) on a larger scale is required. © The Author(s) 2016.

  2. Speech, language and swallowing in Huntington’ Disease

    Directory of Open Access Journals (Sweden)

    Maryluz Camargo-Mendoza

    2017-04-01

    Full Text Available Huntington’s disease (HD has been described as a genetic condition caused by a mutation in the CAG (cytosine-adenine-guanine nucleotide sequence. Depending on the stage of the disease, people may have difficulties in speech, language and swallowing. The purpose of this paper is to describe these difficulties in detail, as well as to provide an account on speech and language therapy approach to this condition. Regarding speech, it is worth noticing that characteristics typical of hyperkinetic dysarthria can be found due to underlying choreic movements. The speech of people with HD tends to show shorter sentences, with much simpler syntactic structures, and difficulties in tasks that require complex cognitive processing. Moreover, swallowing may present dysphagia that progresses as the disease develops. A timely, comprehensive and effective speech-language intervention is essential to improve the quality of life of people and contribute to their communicative welfare.

  3. Assessing children's swallowing: Parent and professional perceptions

    OpenAIRE

    Cockerill, H.; Van Den Engel-Hoek, L.; Harding, C.

    2016-01-01

    Purpose-For infants and children who have difficulties with eating, drinking and swallowing (dysphagia), there are significant health risks that include aspiration (food and fluid entering the lungs) and poor growth. Videofluoroscopy is often the instrumental method of assessment used to exclude or confirm aspiration. The purpose of this paper is to investigate parental and referrer perceptions of the reasons for and the outcomes of videofluoroscopy. \\ud \\ud Design/methodology/approach-Data w...

  4. Functional connectivity patterns of normal human swallowing: difference among various viscosity swallows in normal and chin-tuck head positions.

    Science.gov (United States)

    Jestrović, Iva; Coyle, James L; Perera, Subashan; Sejdić, Ervin

    2016-12-01

    Consuming thicker fluids and swallowing in the chin-tuck position has been shown to be advantageous for some patients with neurogenic dysphagia who aspirate due to various causes. The anatomical changes caused by these therapeutic techniques are well known, but it is unclear whether these changes alter the cerebral processing of swallow-related sensorimotor activity. We sought to investigate the effect of increased fluid viscosity and chin-down posture during swallowing on brain networks. 55 healthy adults performed water, nectar-thick, and honey thick liquid swallows in the neutral and chin-tuck positions while EEG signals were recorded. After pre-processing of the EEG timeseries, the time-frequency based synchrony measure was used for forming the brain networks to investigate whether there were differences among the brain networks between the swallowing of different fluid viscosities and swallowing in different head positions. We also investigated whether swallowing under various conditions exhibit small-world properties. Results showed that fluid viscosity affects the brain network in the Delta, Theta, Alpha, Beta, and Gamma frequency bands and that swallowing in the chin-tuck head position affects brain networks in the Alpha, Beta, and Gamma frequency bands. In addition, we showed that swallowing in all tested conditions exhibited small-world properties. Therefore, fluid viscosity and head positions should be considered in future swallowing EEG investigations. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Functional connectivity patterns of normal human swallowing: difference among various viscosity swallows in normal and chin-tuck head positions

    Science.gov (United States)

    Jestrović, Iva; Coyle, James L.; Perera, Subashan

    2016-01-01

    Consuming thicker fluids and swallowing in the chin-tuck position has been shown to be advantageous for some patients with neurogenic dysphagia who aspirate due to various causes. The anatomical changes caused by these therapeutic techniques are well known, but it is unclear whether these changes alter the cerebral processing of swallow-related sensorimotor activity. We sought to investigate the effect of increased fluid viscosity and chin-down posture during swallowing on brain networks. 55 healthy adults performed water, nectar-thick, and honey thick liquid swallows in the neutral and chin-tuck positions while EEG signals were recorded. After pre-processing of the EEG timeseries, the time-frequency based synchrony measure was used for forming the brain networks to investigate whether there were differences among the brain networks between the swallowing of different fluid viscosities and swallowing in different head positions. We also investigated whether swallowing under various conditions exhibit small-world properties. Results showed that fluid viscosity affects the brain network in the Delta, Theta, Alpha, Beta, and Gamma frequency bands and that swallowing in the chin-tuck head position affects brain networks in the Alpha, Beta, and Gamma frequency bands. In addition, we showed that swallowing in all tested conditions exhibited small-world properties. Therefore, fluid viscosity and head positions should be considered in future swallowing EEG investigations. PMID:27693396

  6. Anatomical Directional Dissimilarities in Tri-axial Swallowing Accelerometry Signals.

    Science.gov (United States)

    Movahedi, Faezeh; Kurosu, Atsuko; Coyle, James L; Perera, Subashan; Sejdic, Ervin

    2017-05-01

    Swallowing accelerometry is a noninvasive approach currently under consideration as an instrumental screening test for swallowing difficulties, with most current studies focusing on the swallowing vibrations in the anterior-posterior (A-P) and superior-inferior (S-I) directions. However, the displacement of the hyolaryngeal structure during the act of swallowing in patients with dysphagia involves declination of the medial-lateral (M-L), which suggests that the swallowing vibrations in the M-L direction have the ability to reveal additional details about the swallowing function. With this motivation, we performed a broad comparison of the swallowing vibrations in all three anatomical directions. Tri-axial swallowing accelerometry signals were concurrently collected from 72 dysphagic patients undergoing videofluoroscopic evaluation of swallowing (mean age: 63.94 ± 12.58 years period). Participants swallowed one or more thickened liquids with different consistencies including thin-thick liquids, nectar-thick liquids, and pudding-thick liquids with either a comfortable self-selected volume from a cup or a controlled volume by the examiner from a 5-ml spoon. Swallows were grouped based on the viscosity of swallows and the participant's stroke history. Then, a comprehensive set of features was extracted in multiple signal domains from 881 swallows. The results highlighted inter-axis dissimilarities among tri-axial swallowing vibrations including the extent of variability in the amplitude of signals, the degree of predictability of signals, and the extent of disordered behavior of signals in time-frequency domain. First, the upward movement of the hyolaryngeal structure, representing the S-I signals, were actually more variable in amplitude and showed less predictable behavior than the sideways and forward movements, representing the A-P and M-L signals, during swallowing. Second, the S-I signals, which represent the upward movement of the hyolaryngeal structure

  7. Gas swallow during meals in patients with excessive belching.

    Science.gov (United States)

    Caballero, N; Serra, J

    2017-09-01

    Swallowed gas is an important source of abdominal gas, and aerophagia is often believed as a putative cause of gas-related abdominal symptoms. However, altered gas-swallow during meals has not been demonstrated. Our aim was to characterize the number of gas swallows during meals in patients complaining of excessive belching and gaseousness and a control group without abdominal symptoms during a 24-h period. A 24-h pH-impedance monitoring was performed in 10 patients with excessive belching, and 11 patients without digestive symptoms or reflux in the pH-impedance study. During the study, patients followed their daily routine and customary meals, without any specific limitation. In each patient the number and content of swallows and belches were analyzed. Total meal periods were similar in controls (75±26 min) and patients (79±21 min; P=.339), but the number of gaseous swallows was greater in patients (114±13 swallows) than controls (71±8 swallows; P=.007), due to a greater frequency of gaseous swallows during meals (15±2 swallows/10 min vs 10±1 swallows/10 min, respectively; P=.008). During the 24-h study period, 66±13 belches were recorded in patients, but only 13±3 belches in controls (PGas is frequently swallowed during meals. Patients complaining of excessive belching have a different swallow pattern during meals, with an increased ingestion of gas that correlates with increased gastric belching events. © 2017 John Wiley & Sons Ltd.

  8. Importance of the swallowing atypical in them malocclusions

    OpenAIRE

    Jiménez Jiménez, Jonatan; Universidad Nacional Mayor de San Marcos, Facultad de Odontología.

    2017-01-01

    This review aims to determine the atypical swallowing malocclusions. When there are inadequate move-ments of the tongue and / or other structures during oral and pharyngolaryngeal phase of swallowing, talking about atypical swallowing, as a non-physiological habit. Its objectives may be multiple, simul-taneously acting alone or cumulatively. The size of a large tongue has been found as an impediment to correct such alternations, though this is a cause of causing malocclusion. the importance o...

  9. “Without Evidence, there is No Answer”: Uncertainty and Scientific Ethos in the Silent Spring[s] of Rachel Carson

    OpenAIRE

    Kenny Walker

    2013-01-01

    The 50th year anniversary of Rachel Carson’s monumental Silent Spring invites reflection on how the controversy over chemical pesticides shaped environmental discourse in the modern era. This essay focuses on uncertainty as a boundary device that shapes scientific ethos in crucial ways and negotiates a relationship between technical science and public deliberation. Situated in rhetorical analysis, the author takes a comparative approach towards the use of uncertainty and scientific ethos in t...

  10. 76 FR 10936 - Culturally Significant Objects Imported for Exhibition Determinations: “Richard Serra Drawing: A...

    Science.gov (United States)

    2011-02-28

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF STATE Culturally Significant Objects Imported for Exhibition Determinations: ``Richard Serra Drawing: A... ``Richard Serra Drawing: A Retrospective,'' imported from abroad for temporary exhibition within the United...

  11. Assessment of swallowing sounds by digital cervical auscultation in children.

    Science.gov (United States)

    Almeida, Sheila T; Ferlin, Elton L; Parente, Maria Alice M P; Goldani, Helena A S

    2008-04-01

    There is a lack of studies regarding swallowing sounds in children 3 to 11 years of age. This study aimed to assess swallowing sounds by digital cervical auscultation in children of this age group without symptoms of oropharyngeal dysphagia. Digital cervical auscultation was performed in 118 subjects by use of a piezoelectric microphone. The children swallowed 5 mL of liquid and yogurt. The components of perceptual acoustic analysis were discrete initial signal (DIS), main signal of swallowing sound (MS), discrete final signal (DFS), and expiratory return (ER). Duration in seconds was the objective parameter of the swallowing sound signal analyzed. Fifty-six boys and 62 girls were evaluated at a mean (+/- SD) age of 6.9 +/- 2.03 years. A complete DIS-MS-DFS-ER swallowing sequence was found in 60% of the children. There was no significant difference in swallowing sound duration between both food consistencies (p = .189) or between genders either for liquid (p = .327) or yogurt (p = .792). There was no correlation between age and duration of the swallowing sound for liquid or yogurt. We concluded that digital cervical auscultation was able to provide objective information about the swallowing process that could contribute to methodological standardization in children.

  12. A simple bedside test to assess the swallowing dysfunction in Parkinson′s disease

    Directory of Open Access Journals (Sweden)

    S Vinoth Kanna

    2014-01-01

    Full Text Available Background: Swallowing changes are common in Parkinson′s disease (PD. Early identification is essential to avoid complications of aspiration. Objectives: To evaluate the swallowing ability of the PD patients and to correlate it with the indicators of disease progression. Materials and Methods: A total of 100 PD patients (70 males and 30 females aged between 50 years and 70 years with varying stage, duration, and severity were enrolled in a cross-sectional study carried out between January and May 2012. A simple bedside water swallowing test was performed using standard 150 ml of water. Swallowing process was assessed under three categories-swallowing speeds (ml/s, swallowing volume (ml/swallow and swallowing duration (s/swallow. Equal number of age and sex matched controls were also evaluated. Results: All of them completed the task of swallowing. A mean swallowing speed (27.48 ml/s, swallowing volume (28.5 ml/s, and swallowing duration (1.05 s/swallow was established by the control group. The PD patients showed decreased swallowing speed (7.15 ml/s in males and 6.61 ml/s in females, decreased swallowing volume (14.59 ml/swallow and 14 ml/swallow in females, and increased swallowing duration (2.37 s/swallow and 2.42 s/swallow which are statistically significant. There was a significant positive correlation between the severity, duration, and staging of the disease with the swallowing performance and a poor correlation between the subjective reports of dysphagia and the objective performance on water swallow test. Conclusion: The water swallowing test is a simple bedside test to identify the swallowing changes early in PD. It is recommended to do the test in all PD Patients to detect dysphagia early and to intervene appropriately.

  13. Summary of oceanographic and water-quality measurements in Rachel Carson National Wildlife Refuge, Wells, Maine, in 2013

    Science.gov (United States)

    Montgomery, Ellyn T.; Ganju, Neil K.; Dickhudt, Patrick J.; Borden, Jonathan; Martini, Marinna A.; Brosnahan, Sandra M.

    2015-01-01

    Suspended-sediment transport is a critical element controlling the geomorphology of tidal wetland complexes. Wetlands rely on organic material and inorganic sediment deposition to maintain their elevation relative to sea level. The U.S. Geological Survey performed observational deployments to measure suspended-sediment concentration and water flow rates in the tidal channels of the wetlands in the Rachel Carson National Wildlife Refuge in Wells, Maine. The objective was to characterize the sediment-transport mechanisms that contribute to the net sediment budget of the wetland complex. We deployed a meteorological tower, optical turbidity sensors, and acoustic velocity meters at sites on Stephens Brook and the Ogunquit River between March 27 and December 9, 2013. This report presents the time-series oceanographic and atmospheric data collected during those field studies. The oceanographic parameters include water velocity, depth, turbidity, salinity, temperature, and pH. The atmospheric parameters include wind direction, speed, and gust; air temperature; air pressure; relative humidity; short wave radiation; and photosynthetically active radiation.

  14. The Making of a Genius: Richard P. Feynman

    CERN Document Server

    Forstner, Christian

    2012-01-01

    In 1965 the Nobel Foundation honored Sin-Itiro Tomonaga, Julian Schwinger, and Richard Feynman for their fundamental work in quantum electrodynamics and the consequences for the physics of elementary particles. In contrast to both of his colleagues only Richard Feynman appeared as a genius before the public. In his autobiographies he managed to connect his behavior, which contradicted several social and scientific norms, with the American myth of the "practical man". This connection led to the image of a common American with extraordinary scientific abilities and contributed extensively to enhance the image of Feynman as genius in the public opinion. Is this image resulting from Feynman's autobiographies in accordance with historical facts? This question is the starting point for a deeper historical analysis that tries to put Feynman and his actions back into historical context. The image of a "genius" appears then as a construct resulting from the public reception of brilliant scientific research.

  15. Remarks On Richard Shusterman’s Pragmatist Aesthetics

    OpenAIRE

    Wilkoszewska, Krystyna

    2017-01-01

    Owing largely to his influential work on pragmatist aesthetics and somaesthetics Richard Shusterman is one of the most renowned aestheticians in the world. The release of Pragmatist Aesthetics in 1992 greatly influenced the scholarly landscape; judging by the outpouring of translations, reviews, conference papers, MA and PhD theses written on related topics, indeed, one might say that the book inaugurated a new chapter in aesthetics. Shusterman’s training as an analytic philosopher, and prior...

  16. Richard Carwardine and Jay Sexton, eds., The Global Lincoln.

    Directory of Open Access Journals (Sweden)

    Hans Krabbendam

    2012-06-01

    Full Text Available Most countries have their export heroes that transcend their national origin: India has its Ghandi, South Africa its Mandela, England its Churchill, and the US has Abraham Lincoln. While particularly known for his role in the American Civil War, he has developed into an international beacon for liberalism and democracy, especially for nationals deprived of this liberties.This collection of essays, edited by Corpus Christi College (Oxford, UK colleagues Richard Carwardine and Jay Sexton, puts...

  17. A New Robust Solver for Saturated-Unsaturated Richards' Equation

    Science.gov (United States)

    Barajas-Solano, D. A.; Tartakovsky, D. M.

    2012-12-01

    We present a novel approach for the numerical integration of the saturated-unsaturated Richards' equation, a degenerate parabolic partial differential equation that models flow in porous media. The method is based on the mixed (pore pressure-water content) form of RE, written as a set of differential algebraic equations (DAEs) of index-1 for the fully saturated case and index-2 for the partially saturated case. A DAE-based approach allows us to overcome the numerical challenges posed by the degenerate nature of the Richards' equation. The resulting set of DAEs is solved using the stiffly-accurate, single-step, 3-stage implicit Runge-Kutta method Radau IIA, chosen for its favorable accuracy and stability properties, and its ease of implementation. For each time step a nonlinear system of equations on the intermediate Runge-Kutta states of the pore pressure is solved, written so to ensure that the next step pore pressure and water content correspond to one another correctly. The implementation of our approach compares favorably to state-of-the-art DAE-based solvers in both one- and two-dimensional simulations. These solvers use multi-step backward difference formulas together with a pressure-based form of Richards' equation. To the best of our knowledge, our method is the first instance of a successful DAE-based solver that uses the mixed form of Richards' equation. We consider this a promising line of research, with future work to be done on the use of globally convergent methods for the solution of the occurring nonlinear systems of equations.

  18. Historical Investigations of the Richard B. Russell Multiple Resource Area.

    Science.gov (United States)

    1981-11-01

    period of this project as a contemporary c~lebration and a reiteration of an ancient folk construction, Stonehenge . Appropriately, as this document goes to...55, 56m, 59m, 64m, 65-68, 71- Stonehenge 216 72, 75-76, 79-84, 84m, 91, 94- Sutch, Richard 20 95, 100, lOlm, 102, 103, 121m, Swift, James Y. 195 126

  19. Response to Richard Widdess: Music, Meaning and Culture

    Directory of Open Access Journals (Sweden)

    Jerome Lewis

    2012-09-01

    Full Text Available This commentary discusses the anthropological implications of Richard Widess’ paper by summarizing some anthropological approaches to music, especially focusing on the way musical participation inculcates and transmits an aesthetic orientation that guides action across cultural domains such as politics, economics and religion. The paper ends by suggesting that the heart of human culture is more likely to be an aesthetic orientation than a script or set of rules, and traces out some reasons why music does this so well.

  20. Richard Wright, Toni Morrison, and United States book clubs

    Directory of Open Access Journals (Sweden)

    Mark Madigan

    2004-12-01

    Full Text Available This essay focuses on the influence of commercial book clubs in the United States. It will examine the country's oldest commercial book club, the Book-of-the-Month Club (BOMC, Oprah's Book Club (OBC, which bears the name of its founder, television personality Oprah Winfrey, and their roles in the careers of two African-American authors, Richard Wright and Toni Morrison.

  1. Claustre Obert: Richard Stallman, gurú del software lliure

    OpenAIRE

    Serveis Audiovisuals Universitat de València

    2013-01-01

    Richard Stallman, gurú del software lliure ofereix una conferència en la Universitat de València. Com a creador del moviment pel programari lliure en la dècada dels 80, Stallman va desenvolupar el sistema operatiu GNU Linux (www.gnu.org), amb el qual ?per primera vegada en la història? donava als usuaris l?oportunitat de copiar, modificar i distribuir el codi font d?aquest sistema operatiu.

  2. Swallowing difficulties in Duchenne muscular dystrophy: indications for feeding assessment and outcome of videofluroscopic swallow studies

    DEFF Research Database (Denmark)

    Aloysius, A.; Born, P.; Kinali, M.

    2008-01-01

    Feeding difficulties are known to occur with advancing age in Duchenne muscular dystrophy (DMD). We evaluated the role of videofluoroscopy swallow study (VFSS) in a group of 30 DMD patients with feeding difficulties. Indications for feeding assessment were: respiratory infections potentially...

  3. The surgical management and speech and swallowing rehabilitation ...

    African Journals Online (AJOL)

    Advanced tongue cancer may have a devastating effect on a person's ability to speak and to swallow. Very little is known about the surgical management and speech and swallowing rehabilitation of persons with advanced tongue cancer in South Africa. The aim of this study was to obtain information regarding clinical ...

  4. Breeding biology and taxonomy of the Red-breasted Swallow ...

    African Journals Online (AJOL)

    Nocturnal trapping and ringing of swallows around Harare, Zimbabwe, showed that at least five species have adapted their breeding behaviour to manmade road culverts, none more so than the Red-breasted Swallow, Hirundo semirufa, which may be found nesting in the smallest (46cm diameter) of pipe culverts.

  5. Vocalizations of the South African cliff swallow Hirundo spilodera

    African Journals Online (AJOL)

    the impression that all chicks had these facial markings but never actually stated the number that really had these markings. In the South African swallow less than 250/0 of all chicks examined had any white markings, probably too few for facial recognition of chicks to be universal in a South. African cliff swallow colony.

  6. Swallow Characteristics in Patients with Oculopharyngeal Muscular Dystrophy

    Science.gov (United States)

    Palmer, Phyllis M.; Neel, Amy T.; Sprouls, Gwyneth; Morrison, Leslie

    2010-01-01

    Purpose: This prospective investigation evaluates oral weakness and its impact on swallow function, weight, and quality of life in patients with oculopharyngeal muscular dystrophy (OPMD). Method: Intraoral pressure, swallow pressure, and endurance were measured using an Iowa Oral Performance Instrument in participants with OPMD and matched…

  7. Emetic stimulation inhibits the swallowing reflex in decerebrate rats.

    Science.gov (United States)

    Kurozumi, Chiharu; Yamagata, Ryuzo; Himi, Naoyuki; Koga, Tomoshige

    2008-06-01

    The effects of emetic stimulation on the swallowing reflex were investigated in decerebrated rats. Hypoxia, gastric distension and LiCl administration were used as emetic stimulations. The swallowing reflex was elicited by electrical stimulation of the superior laryngeal nerve (SLN, 20 Hz, 3-5 V, 0.3 ms duration) for 20 s. To examine the effect of hypoxia, nitrogen gas was inhaled under artificial ventilation. There were significantly fewer swallows during a decrease in PO(2) than under air ventilation (p<0.05). The number of swallows during 3-ml stomach distension was significantly lower than that before distension (p<0.05). Intravenous administration of LiCl (100 mg/kg) also significantly reduced the number of swallows (p<0.05). The combination of SLN stimulation and emetic stimuli occasionally produced burst activity of abdominal muscles, which might be associated with the gag reflex. Both the gag and swallowing reflexes are well known to be mediated by the nucleus of the solitary tract. The physiological roles of the gag reflex and the swallowing reflex are considered to be reciprocal. Taken together, these results suggest that emetic stimulation inhibits the swallowing pattern generator via the nucleus of the solitary tract, which in turn facilitates the gag reflex.

  8. Prophylactic Swallowing Exercises in Head and Neck Cancer Radiotherapy

    DEFF Research Database (Denmark)

    Mortensen, H R; Jensen, Kenneth; Aksglæde, K

    2015-01-01

    Many head and neck cancer (HNC) survivors experience reduced quality of life due to radiotherapy (RT)-related dysphagia. The aim of this prospective randomized trial was to evaluate the impact of prophylactic swallowing exercises on swallowing-related outcomes in HNC patients treated with curativ...

  9. Swallow-wort (Vincetoxicum spp.) biological control update

    Science.gov (United States)

    Pale swallow-wort (Vincetoxicum rossicum = Cynanchum rossicum) and black swallow-wort (V. nigrum = C. louiseae) are herbaceous, perennial, viney milkweeds introduced from Europe (Apocynaceae-subfamily Asclepiadoideae). Both species are becoming increasingly invasive in a variety of natural and manag...

  10. Current distribution and population size of the Blue Swallow Hirundo ...

    African Journals Online (AJOL)

    Two surveys of Blue Swallows were conducted in the southern Tanzanian highland grasslands in order to determine the habitat preferences and estimate the size of this subpopulation. During the 2008/09 and 2012 surveys, a total distance of 3 635 km was travelled in search of Blue Swallows (at an altitude of above 1 400 ...

  11. Richard Clarke Cabot, M.D., a unitarian critique.

    Science.gov (United States)

    Knights, Ward A

    2011-01-01

    This article is written to correct a historical impression about Richard C. Cabot, one of the founders of Clinical Pastoral Education (CPE). Contrary to the popular understanding that he was a typical Unitarian, the author posits that even though Cabot may have been a typical liberal, in his theology, he was an atypical Unitarian. This article places Cabot in his family and historical contexts, his involvement in CPE, and comments on his theology, noting how this differed from the prevailing Unitarian theology of his day.

  12. R316-million Richards Bay Coal Terminal expansions underway

    Energy Technology Data Exchange (ETDEWEB)

    1990-10-01

    Fabrication is underway on items critical to the R316-million expansion programme newly embarked upon by Richards Bay Coal Terminal (RBCT, South Africa), according to project manager SEMTEC. The expansion will increase the capacity of RBTC from 44 million tons of export quality coal a year to 53-million tons. The scope of work includes the design and fabrication of a tandem tippler, a stacker reclaimer, and new conveyors as well as upgrading the existing conveyor, terminal control and railway system and the supply of new locomotives.

  13. "Symposium" by Richard Dawkins, Gerard 't Hooft, Alain Connes

    CERN Multimedia

    Maximilien Brice

    2004-01-01

    Richard Dawkins will speak on biology, Gerard ‘t Hooft will focus on physics, and Alain Connes will discuss mathematics. CERN scientists probe ever-deeper levels of matter and their interactions, but can we say that the patterns they see are truly fundamental? Does the universe obey the same laws throughout? Since mathematical constructions can be true in the absence of any relation to the physical world, is mathematics more fundamental than physics? Extraterrestrial life would probably look much different from that on Earth, but natural selection still be fundamental to their evolution?

  14. Richard Rorty, o la posibilidad de un etnocentrismo universal

    Directory of Open Access Journals (Sweden)

    Isabel Gamero Cabrera

    2010-04-01

    Full Text Available En el presente artículo intentaremos comprender y analizar las implicaciones actuales de dos tesis del filósofo estadounidense Richard Rorty en relación con su etnocentrismo: La expansión global del sistema democrático liberal como horizonte de su teoría política y la restricción de las creencias de importancia última a la esfera privada. Compararemos esta teoría con las aportaciones de otros dos autores: una interpretación antropológica de los juegos de lenguaje de Wittgenstein y la democracia radical de Mouffe.

  15. Review of Richard Bausch, Hello to the Cannibals

    Directory of Open Access Journals (Sweden)

    Géraldine Chouard

    2006-03-01

    Full Text Available Richard Bausch is credited with five collections of short stories and nine novels that have received various awards in the United States. His latest work, Hello to the Cannibals, blends a historical epic and a more intimate tale. Watch out‑this is a voracious novel.Other CarnageAn ethnologist investigating cannibalistic rites in Africa asks the head of the tribe : « Do you still have cannibals in your tribe ? » « No, we ate the last one yesterday, » answers the head of the tribe. Undoubtedly,...

  16. Free as in Freedom Richard Stallman's Crusade for Free Software

    CERN Document Server

    Williams, Sam

    2011-01-01

    Free as in Freedom interweaves biographical snapshots of GNU project founder Richard Stallman with the political, social and economic history of the free software movement. It examines Stallman's unique personality and how that personality has been at turns a driving force and a drawback in terms of the movement's overall success. Free as in Freedom examines one man's 20-year attempt to codify and communicate the ethics of 1970s era "hacking" culture in such a way that later generations might easily share and build upon the knowledge of their computing forebears. The book documents Stallman'

  17. Ginger Orally Disintegrating Tablets to Improve Swallowing in Older People.

    Science.gov (United States)

    Hirata, Ayumu; Funato, Hiroki; Nakai, Megumi; Iizuka, Michiro; Abe, Noriaki; Yagi, Yusuke; Shiraishi, Hisashi; Jobu, Kohei; Yokota, Junko; Hirose, Kahori; Hyodo, Masamitsu; Miyamura, Mitsuhiko

    2016-01-01

    We previously prepared and pharmaceutically evaluated ginger orally disintegrating (OD) tablets, optimized the base formulation, and carried out a clinical trial in healthy adults in their 20 s and 50s to measure their effect on salivary substance P (SP) level and improved swallowing function. In this study, we conducted clinical trials using the ginger OD tablets in older people to clinically evaluate the improvements in swallowing function resulting from the functional components of the tablet. The ginger OD tablets were prepared by mixing the excipients with the same amount of mannitol and sucrose to a concentration of 1% ginger. Eighteen healthy older adult volunteers aged 63 to 90 were included in the swallowing function test. Saliva was collected before and 15 min after administration of the placebo and ginger OD tablets. Swallowing endoscopy was performed by an otolaryngologist before administration and 15 min after administration of the ginger OD tablets. A scoring method was used to evaluate the endoscopic swallowing. Fifteen minutes after taking the ginger OD tablets, the salivary SP amount was significantly higher than prior to ingestion or after taking the placebo (pginger OD tablets. Our findings showed that the ginger OD tablets increased the salivary SP amount and improved swallowing function in older people with appreciably reduced swallowing function.

  18. Risk factors for swallowing dysfunction in stroke patients

    Directory of Open Access Journals (Sweden)

    Anna Flávia Ferraz Barros Baroni

    2012-06-01

    Full Text Available CONTEXT: Stroke is a frequent cause of dysphagia. OBJECTIVE: To evaluate in a tertiary care hospital the prevalence of swallowing dysfunction in stroke patients, to analyze factors associated with the dysfunction and to relate swallowing dysfunction to mortality 3 months after the stroke. METHODS: Clinical evaluation of deglutition was performed in 212 consecutive patients with a medical and radiologic diagnosis of stroke. The occurrence of death was determined 3 months after the stroke. RESULTS: It was observed that 63% of the patients had swallowing dysfunction. The variables gender and specific location of the lesion were not associated with the presence or absence of swallowing dysfunction. The patients with swallowing dysfunction had more frequently a previous stroke, had a stroke in the left hemisphere, motor and/or sensitivity alterations, difficulty in oral comprehension, alteration of oral expression, alteration of the level of consciousness, complications such as fever and pneumonia, high indexes on the Rankin scale, and low indexes on the Barthel scale. These patients had a higher mortality rate. CONCLUSIONS: Swallowing evaluation should be done in all patients with stroke, since swallowing dysfunction is associated with complications and an increased risk of death.

  19. Tactile thermal oral stimulation increases the cortical representation of swallowing

    Directory of Open Access Journals (Sweden)

    Suntrup Sonja

    2009-06-01

    Full Text Available Abstract Background Dysphagia is a leading complication in stroke patients causing aspiration pneumonia, malnutrition and increased mortality. Current strategies of swallowing therapy involve on the one hand modification of eating behaviour or swallowing technique and on the other hand facilitation of swallowing with the use of pharyngeal sensory stimulation. Thermal tactile oral stimulation (TTOS is an established method to treat patients with neurogenic dysphagia especially if caused by sensory deficits. Little is known about the possible mechanisms by which this interventional therapy may work. We employed whole-head MEG to study changes in cortical activation during self-paced volitional swallowing in fifteen healthy subjects with and without TTOS. Data were analyzed by means of synthetic aperture magnetometry (SAM and the group analysis of individual SAM data was performed using a permutation test. Results Compared to the normal swallowing task a significantly increased bilateral cortical activation was seen after oropharyngeal stimulation. Analysis of the chronological changes during swallowing suggests facilitation of both the oral and the pharyngeal phase of deglutition. Conclusion In the present study functional cortical changes elicited by oral sensory stimulation could be demonstrated. We suggest that these results reflect short-term cortical plasticity of sensory swallowing areas. These findings facilitate our understanding of the role of cortical reorganization in dysphagia treatment and recovery.

  20. Tactile thermal oral stimulation increases the cortical representation of swallowing

    Science.gov (United States)

    Teismann, Inga K; Steinsträter, Olaf; Warnecke, Tobias; Suntrup, Sonja; Ringelstein, Erich B; Pantev, Christo; Dziewas, Rainer

    2009-01-01

    Background Dysphagia is a leading complication in stroke patients causing aspiration pneumonia, malnutrition and increased mortality. Current strategies of swallowing therapy involve on the one hand modification of eating behaviour or swallowing technique and on the other hand facilitation of swallowing with the use of pharyngeal sensory stimulation. Thermal tactile oral stimulation (TTOS) is an established method to treat patients with neurogenic dysphagia especially if caused by sensory deficits. Little is known about the possible mechanisms by which this interventional therapy may work. We employed whole-head MEG to study changes in cortical activation during self-paced volitional swallowing in fifteen healthy subjects with and without TTOS. Data were analyzed by means of synthetic aperture magnetometry (SAM) and the group analysis of individual SAM data was performed using a permutation test. Results Compared to the normal swallowing task a significantly increased bilateral cortical activation was seen after oropharyngeal stimulation. Analysis of the chronological changes during swallowing suggests facilitation of both the oral and the pharyngeal phase of deglutition. Conclusion In the present study functional cortical changes elicited by oral sensory stimulation could be demonstrated. We suggest that these results reflect short-term cortical plasticity of sensory swallowing areas. These findings facilitate our understanding of the role of cortical reorganization in dysphagia treatment and recovery. PMID:19566955

  1. Fabrication of Artificial Food Bolus for Evaluation of Swallowing.

    Directory of Open Access Journals (Sweden)

    Miyu Hosotsubo

    Full Text Available Simple and easy methods to evaluate swallowing are required because of the recently increased need of rehabilitation for dysphagia. "Artificial food bolus", but not "artificial food", would be a valuable tool for swallowing evaluation without considering the mastication effect which is altered according to the individual's oral condition. Thus, this study was carried out to fabricate artificial bolus resembling natural food bolus. The mechanical property and the volume change of food bolus in normal people were firstly investigated. Thirty healthy adults without dysphagia were selected and asked to chew four sample foods (rice cake, peanut, burdock, and gummy candy. The results indicated that Young's modulus of bolus before swallowing was below 150 kPa. The bolus volume before swallowing was below 400 mm3. In addition, the saliva component ratio of each bolus was approximately 30wt%, and the average saliva viscosity of research participants was approximately 10 mPa•s. Based on the obtained data, artificial food bolus was designed and fabricated by using alginate hydrogel as a visco-elastic material and gelatin solution as a viscotic material with a ratio of 7:3 based on weight. Consequently, the swallowing time of fabricated artificial food bolus was measured among the same participants. The results indicated the participants swallowed fabricated food bolus with similar manner reflecting their mechanical property and volume. Thus, this artificial food bolus would be a promising tool for evaluation of swallowing.

  2. Oral medication delivery in impaired swallowing: thickening liquid medications for safe swallowing alters dissolution characteristics.

    Science.gov (United States)

    Manrique, Yady J; Sparkes, Arron M; Cichero, Julie A Y; Stokes, Jason R; Nissen, Lisa M; Steadman, Kathryn J

    2016-09-01

    Acetaminophen (paracetamol) is available in a wide range of oral formulations designed to meet the needs of the population across the age-spectrum, but for people with impaired swallowing, i.e. dysphagia, both solid and liquid medications can be difficult to swallow without modification. The effect of a commercial polysaccharide thickener, designed to be added to fluids to promote safe swallowing by dysphagic patients, on rheology and acetaminophen dissolution was tested using crushed immediate-release tablets in water, effervescent tablets in water, elixir and suspension. The inclusion of the thickener, comprised of xanthan gum and maltodextrin, had a considerable impact on dissolution; acetaminophen release from modified medications reached 12-50% in 30 min, which did not reflect the pharmacopeia specification for immediate release preparations. Flow curves reflect the high zero-shear viscosity and the apparent yield stress of the thickened products. The weak gel nature, in combination with high G' values compared to G'' (viscoelasticity) and high apparent yield stress, impact drug release. The restriction on drug release from these formulations is not influenced by the theoretical state of the drug (dissolved or dispersed), and the approach typically used in clinical practice (mixing crushed tablets into pre-prepared thickened fluid) cannot be improved by altering the order of incorporation or mixing method.

  3. Tachyarrhythmias triggered by swallowing and belching

    Science.gov (United States)

    Wilmshurst, P

    1999-01-01

    Three cases with supraventricular tachyarrhythmias related to oesophageal transit are reported. A 61 year old man had episodes of atrial tachycardia on each swallow of food but not liquid; this has been reported only rarely. A 55 year old man had atrial fibrillation initiated by drinking ice cold beverages; this has not been described previously although atrial tachycardia triggered by drinking ice cold beverages has been described once. A 68 year old man had supraventricular tachycardia initiated by belching; this has not been described previously. These cases illustrate the diversity of atrial tachyarrhythmias that can be precipitated by oesophageal stimulation and suggest that what is regarded as a very rare phenomenon may be found more commonly when sought.

 Keywords: atrial tachycardia; atrial fibrillation; deglutition; eructation; arrhythmias PMID:10026360

  4. Using devices to upregulate nonnutritive swallowing in typically developing infants.

    Science.gov (United States)

    Hegyi Szynkiewicz, Sarah; Mulheren, Rachel W; Palmore, Kathryn W; O'Donoghue, Cynthia R; Ludlow, Christy L

    2016-10-01

    The role of various sensory stimuli for stimulating swallowing in infants may be of importance for assisting infants to develop oral feeding. We evaluated the swallowing mechanism response to two devices for increasing the rate of nonnutritive swallowing in two typically developing infant age groups, ages 2-4 mo and 7-9 mo. One device was a pacifier familiar to the infant; the other was a small vibrator placed on the skin overlying the thyroid cartilage. The rate of nonnutritive swallowing while infants were awake was compared in three 10-min conditions: at rest without stimulation (spontaneous); during nonnutritive sucking with a pacifier; and over 10 min containing 18 epochs of vibratory stimulation for 10 s each. To assess whether vibration on the throat over the laryngeal area altered respiration, the mean cycle length was compared between 10-min intervals either containing vibratory stimulation or without stimulation at rest. Both the pacifier and laryngeal vibration stimulation doubled the rate of swallowing in the infants with a mean age of 3 mo 16 days and infants with a mean age of 8 mo 8 days. No differences occurred in the mean respiratory cycle length between intervals with and without vibration in either age group. Results suggest that nonnutritive sucking, vibration, or both might be beneficial in enhancing swallowing in young infants. Because vibration on the neck would not interfere with oral transfer of liquid, it might provide additional stimulation for swallowing during oral feeding. Both stimulation types should be evaluated for enhancing swallowing in infants with immature swallowing skills. Copyright © 2016 the American Physiological Society.

  5. Functional Connectivity of the Cortical Swallowing Network in Humans

    Science.gov (United States)

    Babaei, Arash; Ward, B. Douglas; Siwiec, Robert; Ahmad, Shahryar; Kern, Mark; Nencka, Andrew; Li, Shi-Jiang; Shaker, Reza

    2014-01-01

    Introduction Coherent fluctuations of blood oxygenation level dependent (BOLD) signal have been referred as “functional connectivity” (FC). Our aim was to systematically characterize FC of underlying neural network involved in swallowing, and to evaluate its reproducibility and modulation during rest or task performance. Methods Activated seed regions within known areas of the cortical swallowing network (CSN) were independently identified in 16 healthy volunteers. Subjects swallowed using a paradigm driven protocol, and the data analyzed using an event-related technique. Then, in the same 16 volunteers, resting and active state data were obtained for 540 seconds in three conditions: 1) swallowing task; 2) control visual task; and 3) resting state; all scans were performed twice. Data was preprocessed according to standard FC pipeline. We determined the correlation coefficient values of member regions of the CSN across the three aforementioned conditions and compared between two sessions using linear regression. Average FC matrices across conditions were then compared. Results Swallow activated twenty-two positive BOLD and eighteen negative BOLD regions distributed bilaterally within cingulate, insula, sensorimotor cortex, prefrontal and parietal cortices. We found that: 1) Positive BOLD regions were highly connected to each other during all test conditions while negative BOLD regions were tightly connected amongst themselves; 2) Positive and negative BOLD regions were anti-correlated at rest and during task performance; 3) Across all three test conditions, FC among the regions was reproducible (r > 0.96, p<10-5); and 4) The FC of sensorimotor region to other regions of the CSN increased during swallowing scan. Conclusions 1) Swallow activated cortical substrates maintain a consistent pattern of functional connectivity; 2) FC of sensorimotor region is significantly higher during swallow scan than that observed during a non-swallow visual task or at rest. PMID

  6. Decoding human swallowing via electroencephalography: a state-of-the-art review.

    Science.gov (United States)

    Jestrović, Iva; Coyle, James L; Sejdić, Ervin

    2015-10-01

    Swallowing and swallowing disorders have garnered continuing interest over the past several decades. Electroencephalography (EEG) is an inexpensive and non-invasive procedure with very high temporal resolution which enables analysis of short and fast swallowing events, as well as an analysis of the organizational and behavioral aspects of cortical motor preparation, swallowing execution and swallowing regulation. EEG is a powerful technique which can be used alone or in combination with other techniques for monitoring swallowing, detection of swallowing motor imagery for diagnostic or biofeedback purposes, or to modulate and measure the effects of swallowing rehabilitation. This paper provides a review of the existing literature which has deployed EEG in the investigation of oropharyngeal swallowing, smell, taste and texture related to swallowing, cortical pre-motor activation in swallowing, and swallowing motor imagery detection. Furthermore, this paper provides a brief review of the different modalities of brain imaging techniques used to study swallowing brain activities, as well as the EEG components of interest for studies on swallowing and on swallowing motor imagery. Lastly, this paper provides directions for future swallowing investigations using EEG.

  7. Decoding human swallowing via electroencephalography: a state-of-the-art review

    Science.gov (United States)

    Jestrović, Iva; Coyle, James L.; Sejdić, Ervin

    2015-10-01

    Swallowing and swallowing disorders have garnered continuing interest over the past several decades. Electroencephalography (EEG) is an inexpensive and non-invasive procedure with very high temporal resolution which enables analysis of short and fast swallowing events, as well as an analysis of the organizational and behavioral aspects of cortical motor preparation, swallowing execution and swallowing regulation. EEG is a powerful technique which can be used alone or in combination with other techniques for monitoring swallowing, detection of swallowing motor imagery for diagnostic or biofeedback purposes, or to modulate and measure the effects of swallowing rehabilitation. This paper provides a review of the existing literature which has deployed EEG in the investigation of oropharyngeal swallowing, smell, taste and texture related to swallowing, cortical pre-motor activation in swallowing, and swallowing motor imagery detection. Furthermore, this paper provides a brief review of the different modalities of brain imaging techniques used to study swallowing brain activities, as well as the EEG components of interest for studies on swallowing and on swallowing motor imagery. Lastly, this paper provides directions for future swallowing investigations using EEG.

  8. Clock gene variation in Tachycineta swallows

    Science.gov (United States)

    Dor, Roi; Cooper, Caren B; Lovette, Irby J; Massoni, Viviana; Bulit, Flor; Liljesthrom, Marcela; Winkler, David W

    2012-01-01

    Many animals use photoperiod cues to synchronize reproduction with environmental conditions and thereby improve their reproductive success. The circadian clock, which creates endogenous behavioral and physiological rhythms typically entrained to photoperiod, is well characterized at the molecular level. Recent work provided evidence for an association between Clock poly-Q length polymorphism and latitude and, within a population, an association with the date of laying and the length of the incubation period. Despite relatively high overall breeding synchrony, the timing of clutch initiation has a large impact on the fitness of swallows in the genus Tachycineta. We compared length polymorphism in the Clock poly-Q region among five populations from five different Tachycineta species that breed across a hemisphere-wide latitudinal gradient (Fig. 1). Clock poly-Q variation was not associated with latitude; however, there was an association between Clock poly-Q allele diversity and the degree of clutch size decline within breeding seasons. We did not find evidence for an association between Clock poly-Q variation and date of clutch initiation in for any of the five Tachycineta species, nor did we found a relationship between incubation duration and Clock genotype. Thus, there is no general association between latitude, breeding phenology, and Clock polymorphism in this clade of closely related birds. Figure 1 Photos of Tachycineta swallows that were used in this study: A) T. bicolor from Ithaca, New York, B) T. leucorrhoa from Chascomús, Argentina, C) T. albilinea from Hill Bank, Belize, D) T. meyeni from Puerto Varas, Chile, and E) T. thalassina from Mono Lake, California, Photographers: B: Valentina Ferretti; A, C-E: David Winkler. PMID:22408729

  9. Swallowed dentures: Two cases and a review

    Science.gov (United States)

    Gachabayov, Mahir; Isaev, Mubariz; Orujova, Lala; Isaev, Emin; Yaskin, Evgeniy; Neronov, Dmitriy

    2015-01-01

    Introduction Denture ingestion or aspiration is a problem requiring awareness of different specialists including dentists, surgeons, otolaryngologists, anesthesiologists etc. in terms of prevention, early diagnosis and adequate treatment. Complications of swallowed dentures include hollow viscus necrosis, perforation, penetration to neighbor organs leading to fistulae, bleeding and obstruction. Presentation of cases First case is a 54-year-old female who accidentally swallowed retractable one-tooth denture during fall about 22 h before admission and clinical manifestation of acute small bowel obstruction developed. The patient underwent laparotomy, enterotomy with retrieval of the foreign body. The second case is a 31-year-old male who accidentally ingested fixed one-tooth prosthesis while eating which impacted in the ileocaecal valve. During the preparation to colonoscopy the denture spontaneously passed out with stools. Discussion Denture ingestion is more common among patients with psychoneurologic deficit, alcohol and drug abusers. Among healthy and younger population denture ingestion is rare. Both reported patients are not elder. Thus dislodgement of removable or fixed dentures is another risk factor of denture ingestion. Most common site of denture impaction is esophagus; small bowel impaction is rare. Moreover, in most reported cases, small bowel impaction of ingested dentures leads to small bowel perforation. In our first case the complication of denture ingestion appeared to be bowel obstruction what is even rarer. Conclusion Fixed dentures can be accidentally ingested as well as removable dentures. Denture loosening leads to accidental denture ingestion. Patients with denture loosening should be recommended to visit dentist as soon as possible. PMID:26635957

  10. Swearing Used in Richard Wright’s Black Boy

    Directory of Open Access Journals (Sweden)

    Giyatmi Giyatmi

    2017-07-01

    Full Text Available This research aims at finding the types of swearing expressions and linguistic forms of English swearing used in Richard Wright’s Black Boy. This is a descriptive qualitative research since it describes the phenomena of swearing used in the novel. The data of the research are all the conversations or sentences used swearing in the novel written by Richard Wright namely Black Boy as the main data source. The method of collecting data in this research is observation and teknik lanjut catat. After all the data had been collected then they are coded using the coding system such as data number/title of novel/chapter/page/data. There is no data reduction since all the data are analyzed in this research. This research used theory triangulation. Kind of swearing expressions found in this novel dealing with God and religion terms, name of  animals and plants, part of body, racial terms, stupidity terms, name of occupation, sexual terms, family terms. The linguistic forms of English swearing used in this novel are word, phrase, and clause. The swearing in the form of words consists of (1 noun referring to place, person, occupation, animal, and idea (2 verb and (3 adjective. Phrase consists of (1 noun phrase with swearing functioning as headword, modifier, and both headword and modifier, (2 adjective phrase with swearing functioning as modifier. Swearing expression is also found in the form of sentence.

  11. The Paradox of the Public Realm in Richard Rorty

    Directory of Open Access Journals (Sweden)

    Martha Palacio Avendaño

    2008-12-01

    Full Text Available The concepto of the public sphere in Richard Rorty's philosophy, inherited of liberal tradition, allows be treated as a part of a game of language called democratic liberalism. One of the rules for validating a move in this game consists in taking for granted the distinction between the public and the private spheres. Richard Rorty thought that democratic liberalism did not need any foundation beyond the way to play it; its only criteria would be the game's practices, according an utopia which would allow us to make more movements in the game. That is, democratic liberalism does not require foundations, but just practices for achieving a social hioe inspired on freedom and pluralism. This kind of utopia, based upon the non-cruelty principle, would make possible an inclusive society where everyone would have a place for their own private vocabulary. In this way, Rorty would have linked freedom and solidarity. However, this language-game reveals the paradox of the link which implies the meaning of the public shere. Herein, freedom is not a sufficient condition of solidarity; hence, there is no place for social inclusion in Rorty's language game.

  12. [Richard von Volkmann, one career of orthopaedic surgeon and poet].

    Science.gov (United States)

    Bumbasirević, M; Lesić, A; Sudjić, V; Zagorac, S

    2010-01-01

    Richard von Volkman was one of the most famous and important surgeons in the 19th century. He pioneered antiseptic procedures and was especially known for his achivements in orthopedic surgery. Von Volkmann was born in Leipzig, Germany and attended medical schools in Giessen, Halle, and Berlin. Starting in 1867, he worked as a professor of surgery at the University of Halle, also leading its surgical clinic. He was active as a surgeon during Seven Weeks' War with Austria in 1866 and the Franco-Prussian war 1870/1871, in the latter as consulting Generalarzt. He was important in the introduction of antiseptic wound treatment in Germany, and through it to the United States of America. Two observations in orthopaedic surgery bear his name to these days: Volkmans contracture and Heuter-Volkmans low. Volkmann also wrote poetry under the name Richard Leander and his book entitled "Dreams by French Firesides" which still has a place in literature. He died of paralysis due to a chronic spinal disease, following a prolonged illness, in the Binswanger institution in Jena in 1889, at the top of his careere.

  13. Mis-swallowing of cleaning naphtha: report of three cases.

    Science.gov (United States)

    Kuo, C Y; Lee, C Y

    1990-01-01

    Cleaning naphtha, a product of Chinese Petroleum Corporation, is a complex hydrocarbon mixture which contains mainly aliphatic hydrocarbons. It is used as a cleaning fluid and solvent. Three toddlers mis-swallowed a mouth of cleaning naphtha accidentally. One developed multiple organ failure before death, another completely recovered without sequelae, and the other died very soon after mis-swallowing. Two fatal cases were both induced vomiting with aspiration immediately after mis-swallowing by their parents. Therefore, inducing vomiting should not be encouraged especially at home, and prevention of aspiration is very important in the management of such cases.

  14. Promoting safe swallowing when puree is swallowed without aspiration but thin liquid is aspirated: nectar is enough.

    Science.gov (United States)

    Leder, Steven B; Judson, Benjamin L; Sliwinski, Edward; Madson, Lindsay

    2013-03-01

    The use of thickened liquids is a common compensatory strategy to improve swallow safety. The purpose of this study was to determine the optimal liquid viscosity to use to promote successful swallowing in a specific subset of dysphagic patients who swallow puree without aspiration but thin liquid with aspiration. A referral-based sample of 84 consecutive inpatients from a large, urban, tertiary-care teaching hospital who met the study criteria was analyzed prospectively. Inclusion criteria were no preexisting dysphagia, a successful pharyngeal swallow without aspiration with puree consistency but pharyngeal dysphagia with aspiration of thin liquid consistency, and stable medical, surgical, and neurological status at the time of transnasal fiberoptic swallow testing and up to 24 h after recommendations for oral alimentation with a modified diet consisting of nectar-like and honey-like thickened liquids. Success with ingesting both nectar-like and honey-like thickened liquids and clinically evident aspiration events were recorded. Care providers were blinded to the study's purpose. All 84 patients were successfully ingesting nectar-like and honey-like thickened liquids at the time of swallow testing and up to 24 h after testing. A specific subset of dysphagic patients who swallowed puree without aspiration but aspirated thin liquid demonstrated 100 % successful swallowing of both nectar-like and honey-like thickened liquids. Therefore, a nectar-like thickened liquid appears to be adequate to promote safe swallowing in these patients and, because of patient preference for the least thick liquid, may enhance compliance and potentially contribute to maintenance of adequate hydration requirements.

  15. Cliff swallow populations in the southern Askinuk Mountains, Alaska

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — During breeding season, cliff swallows are widely distributed throughout Alaska and North America south to Mexico, and they are locally common in western and...

  16. Role of Basal Ganglia in Swallowing Process: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Hamideh Ghaemi

    2016-12-01

    Discussion: Swallowing is a multifaceted performance that needs contribution of the tongue, larynx, pharynx, and esophagus as well as the neurological structures such as neocortex and subcortical regions - BG and brainstem.

  17. Weather-related Tree Swallow Mortality and Reduced Nesting Effort

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report documents the spring 2007 die-off of 216 Tree Swallows in western New York due to a period of unseasonably warm temperatures followed immediately by a...

  18. Automated Detection and Evaluation of Swallowing Using a Combined EMG/Bioimpedance Measurement System

    Directory of Open Access Journals (Sweden)

    Corinna Schultheiss

    2014-01-01

    Full Text Available Introduction. Developing an automated diagnostic and therapeutic instrument for treating swallowing disorders requires procedures able to reliably detect and evaluate a swallow. We tested a two-stage detection procedure based on a combined electromyography/bioimpedance (EMBI measurement system. EMBI is able to detect swallows and distinguish them from similar movements in healthy test subjects. Study Design. The study was planned and conducted as a case-control study (EA 1/019/10, and EA1/160/09, EA1/161/09. Method. The study looked at differences in swallowing parameters in general and in the event of penetration during swallows in healthy subjects and in patients with an oropharyngeal swallowing disorder. A two-stage automated swallow detection procedure which used electromyography (EMG and bioimpedance (BI to reliably detect swallows was developed. Results. Statistically significant differences between healthy subjects and patients with a swallowing disorder were found in swallowing parameters previously used to distinguish between swallowing and head movements. Our two-stage algorithm was able to reliably detect swallows (sensitivity = 96.1%, specificity = 97.1% on the basis of these differences. Discussion. Using a two-stage detection procedure, the EMBI measurement procedure is able to detect and evaluate swallows automatically and reliably. The two procedures (EMBI + swallow detection could in future form the basis for automated diagnosis and treatment (stimulation of swallowing disorders.

  19. Automated detection and evaluation of swallowing using a combined EMG/bioimpedance measurement system.

    Science.gov (United States)

    Schultheiss, Corinna; Schauer, Thomas; Nahrstaedt, Holger; Seidl, Rainer O

    2014-01-01

    Developing an automated diagnostic and therapeutic instrument for treating swallowing disorders requires procedures able to reliably detect and evaluate a swallow. We tested a two-stage detection procedure based on a combined electromyography/bioimpedance (EMBI) measurement system. EMBI is able to detect swallows and distinguish them from similar movements in healthy test subjects. The study was planned and conducted as a case-control study (EA 1/019/10, and EA1/160/09, EA1/161/09). The study looked at differences in swallowing parameters in general and in the event of penetration during swallows in healthy subjects and in patients with an oropharyngeal swallowing disorder. A two-stage automated swallow detection procedure which used electromyography (EMG) and bioimpedance (BI) to reliably detect swallows was developed. Statistically significant differences between healthy subjects and patients with a swallowing disorder were found in swallowing parameters previously used to distinguish between swallowing and head movements. Our two-stage algorithm was able to reliably detect swallows (sensitivity = 96.1%, specificity = 97.1%) on the basis of these differences. Using a two-stage detection procedure, the EMBI measurement procedure is able to detect and evaluate swallows automatically and reliably. The two procedures (EMBI + swallow detection) could in future form the basis for automated diagnosis and treatment (stimulation) of swallowing disorders.

  20. Swallow syncope caused by third-degree atrioventricular block

    DEFF Research Database (Denmark)

    Roust Aaberg, Anne Marie; Eriksson, Anna Elin; Madsen, Per Lav

    2015-01-01

    We report a case of a patient with more than 30 years of repeated syncopes, always following food intake. The patient was diagnosed with a swallow-related third-degree atrioventricular block and successfully treated with an artificial pacemaker.......We report a case of a patient with more than 30 years of repeated syncopes, always following food intake. The patient was diagnosed with a swallow-related third-degree atrioventricular block and successfully treated with an artificial pacemaker....

  1. Changes in Swallowing Symptoms and Esophageal Motility After Thyroid Surgery

    DEFF Research Database (Denmark)

    Sorensen, Jesper Roed; Markoew, Simone; Døssing, Helle

    2018-01-01

    INTRODUCTION: Swallowing difficulties, the pathophysiology behind which is incompletely understood, have been reported in 47-83% of goiter patients referred for thyroidectomy. We aimed at examining the influence of thyroid surgery on swallowing symptoms and esophageal motility. METHODS: Thirty-th...... to esophageal motility disturbances. This information is essential when interpreting dysphagia in patients with nodular goiter, and when balancing patients' expectations to surgical goiter therapy. REGISTRATION NUMBER: NCT03100357 ( www.clinicaltrials.org )....

  2. Observation the swallowing mechanism in elderly patients with pharyngeal dysphagia

    Directory of Open Access Journals (Sweden)

    Claudia Ximena Campo-Cañar

    2010-09-01

    Full Text Available Observation of the swallowing dynamics is an issue that demands close attention by the health professionals involved in the diagnosis and management of patients with dysphagia. This article is a review of the literature aimed to enhance the knowledge regarding the speech therapy assessment of pharyngeal dysphagia in elder adults. The disorder of the swallowing is called dysphagia and it is defined as difficulty swallowing. The dysphagia is often caused by affectation of mechanical or neuromuscular components of the swallowing mechanism. This type of disorder is likely to impact the the oral, pharyngeal and esophageal phases of the swallowing. The speech therapist should take into account assessing aspects such as level of consciousness, vital signs, whether or not the patient is ventilator dependent, means of feeding, if intubated what type of cannula, whether or not the patient uses a speaking valve (if a trach tube is present, nutritional status, the patient’s expressive and receptive language, the anatomical and physiological state of the oral motor structures. When assessing swallowing clinicians should also make sure to develop an adequate beside clinical, voice assessment and videofluoroscopy.

  3. Functional magnetic resonance and swallowing: critical literature review,

    Directory of Open Access Journals (Sweden)

    Maíra Santilli de Lima

    2015-12-01

    Full Text Available ABSTRACT INTRODUCTION: Aspects of the neuroanatomical representation of swallowing have been investigated in humans through brain mapping techniques, such as functional magnetic resonance imaging (fMRI. OBJECTIVE: This critical qualitative review of the literature analyzed international scientific publications in the PubMed database that investigated the activation of the central nervous system in humans during the act of swallowing. METHODS: This investigation was limited to articles that investigated adults older than 18 years, published in English or Portuguese, between January 2002 and December 2013. Publications that did not have access to the full text, that were repeated by overlapping keywords, case studies, literature reviews, letters to the editor, and those not directly related to the topic of the investigation were excluded. RESULTS: A total of 649 articles were identified, of which 21 matched the inclusion criteria. CONCLUSION: The main purpose of the manuscripts that investigate the swallowing process through fMRI were: to characterize swallowing in different pathologies; to compare swallowing in different age groups; to describe brain activation in different stimulation conditions. These studies indicate multiple cortical regions involved in swallowing control. Overall, the studies indicate that fMRI is a non-invasive and quantitative method that allows the investigation of characteristics that are quite often not clinically visible.

  4. Normal erect swallowing. Normal function and incidence of variations.

    Science.gov (United States)

    Curtis, D J; Cruess, D F; Dachman, A H

    1985-10-01

    Of 871 candidates presenting for upper gastrointestinal examinations, 16 met the rigorous criteria established for selecting asymptomatic normal volunteers. Frame-by-frame evaluation of their videorecorded pharyngeal swallow confirmed many observations made previously utilizing cine recording at much higher radiation dosages. In addition, new observations were made: the nasopharynx may not occlude until the bolus is entirely within the pharynx; air mixes with the bolus if the swallow is an "open" type; the epiglottis always inverts in normal individuals regardless of the type of swallow ("open," air filled oro-and hypopharynx into which the swallowed bolus is dropped; "closed," airless oropharynx into which the swallowed bolus is pushed by a continuous peristaltic drive of the tongue and palate, thus reconstituting the pharyngeal space); laryngeal descent may aid in stripping the bolus from the pharynx; the vestibule may not completely close during the swallow and the larynx can still be impervious to the bolus; the peristaltic wave does not begin until the bolus has breeched the cricopharyngeus; the cricopharyngeus may be seen frequently in normal individuals, but does not delay the passage of the bolus; asymmetric flow of the bolus around the larynx is common and may not be the result of epiglottic tilt or head positioning.

  5. Silence and Blindness in Richard Wright’s Native Son

    Directory of Open Access Journals (Sweden)

    Chibuzo Onunkwo

    2017-07-01

    Full Text Available Richard Wright’s Native Son has often been read as a socially-oriented text, seemingly neglecting its existence as a literary construct. Such readings gear towards identifying the text with such societal ills as racism and environmental impact on the individual, as if these are the only business of the text.In this paper, however, attention shifts from such external referents to the text itself, deconstructing the meaning of blindness already ascribed to the text as well as the meaning of silence as it is denotatively known. The uncovering of the textual meaning of each of these concepts will also serve either to compliment a character or to disparage same, and then the interweave of both concepts will result in reading the text as a tragedy. This study will be anchored on the provisions of Derrida’s deconstructive criticism.

  6. Quantenmechanik im Kalten Krieg David Bohm und Richard Feynman

    CERN Document Server

    Forstner, Christian

    2007-01-01

    Mitte des 20. Jahrhunderts entwickelten David Bohm und Richard Feynman zwei grundlegend verschiedene Ansätze der moderne Quantenmechanik: Bohm eine realistische Deutung mit Hilfe verborgener Parameter und Feynman den Pfadintegralformalismus. Dies ist umso bemerkenswerter, weil beide Physiker von ähnlichen Voraussetzungen ausgingen und aus ähnlichen Zusammenhängen stammten. Durch ihren vergleichenden Ansatz bietet diese Studie mehr als einen Beitrag zur Geschichte der Quantentheorie. Mit der Frage nach den sozialen und kulturellen Bedingungen der Theoriebildung ist sie darüberhinaus von wissenschaftssoziologischem und wissenschaftstheoretischem Interesse. Die anfangs ähnliche und später unterschiedliche Einbindung der beiden Wissenschaftler in die Scientific Community erlaubt es überdies zu untersuchen, welchen Anpassungsdruck die jeweilige Gruppe auf den individuellen Wissenschaftler und die Kernbestandteile seiner Forschungen ausübt und welche neuen Freiheitsgrade für die Theoriebildung entstehen, ...

  7. Richard Godden, William Faulkner, An Economy of Complex Words

    Directory of Open Access Journals (Sweden)

    Frédérique Spill

    2008-05-01

    Full Text Available En guise de préambule, Richard Godden s’empresse de préciser que le lien entre économie et langage qui est stipulé dans le titre de son dernier ouvrage critique sur l’œuvre de William Faulkner ne doit pas être compris de manière métaphorique : c’est bien en fonction de leur rapport avec un contexte économique et social spécifique que sont analysées les complexités de l’écriture faulknérienne. Sa démonstration repose sur trois présupposés qui sont clairement exposés dans son introduction : les...

  8. RICHARD WAGNER E O ROMANTISMO ALEMÃO

    Directory of Open Access Journals (Sweden)

    Rainer Câmara Patriota

    2015-07-01

    Full Text Available A cultura musical romântica encontra em Richard Wagner– em sua obra musical e teórica – um de seus maiores protagonistas.A rejeição da Aufklärung e a exaltação da supremacia germânica –elementos constituidores da Weltanschauung romântica alemã –caracterizam fortemente o pensamento e a atitude de Wagner frenteà vida, assumindo conotações ainda mais radicais através de seucontumaz antissemitismo. De modo que pensar Wagner por ocasiãode seu bicentenário também significa retomar uma discussão crucialsobre o romantismo alemão e suas implicações políticas eideológicas.

  9. Naturalismo e existencialismo na teoria moral de Richard Hare

    Directory of Open Access Journals (Sweden)

    Marco Antônio Oliveira de Azevedo

    2009-08-01

    Full Text Available http://dx.doi.org/10.5007/1677-2954.2009v8n2p247Em um artigo de 1966, Amartya Sen procurou mostrar que mesmo Richard Hare, um devoto explícitodo antinaturalismo em ética, ainda que inadvertidamente, incorreu num tipo de naturalismo que Senintitulou de existencial. Neste breve artigo, traço um resumo dessa crítica à teoria de Hare, em especial,da chamada “Lei de Hume”, a qual Sen preferiu apropriadamente intitular “Regra de Hare”. Pretendomostrar como esse tipo peculiar de “existencialismo” nos conduz, ainda que sob o possível protesto deHare e seus seguidores, a conclusões subjetivistas e relativistas sobre a moralidade.

  10. La paradoja de lo público en Richard Rorty

    Directory of Open Access Journals (Sweden)

    Martha Palacio Avendaño

    2008-01-01

    Full Text Available El concepto de lo público en Richard Rorty, heredero de la tradición liberal, admite ser tratado como parte de un juego del lenguaje denominado liberalismo democrático. En ese sentido, una de las reglas de este juego para saber si una jugada es válida consiste en asumir la distinción entre esfera pública y privada. Richard Rorty pensó que este juego no requería fundamentación más allá de la forma de jugarlo, que el criterio en que se apoyaría estaba en las prácticas que tienen lugar dentro del mismo con arreglo a sostener una utopía que permitiera hacer cada vez más jugadas. Esto es, el liberalismo democrático no requería basarse en algo más allá de las prácticas conducentes a lograr una esperanza social alentada por la libertad en defensa del pluralismo. Su utopía liberal, guiada por el principio de la no-crueldad, haría posible una sociedad inclusiva en la que todos tuvieran espacio para su léxico privado. De este modo, Rorty habría vinculado libertad y solidaridad, pero su juego del lenguaje permite advertir la paradoja del vínculo que implicaría el sentido de lo público. Aquí, la libertad no es condición suficiente de la solidaridad, de modo que la inclusión social no tiene cabida en su juego del lenguaje.

  11. Building a Social Movement for Education in England: Responses to Richard Hatcher

    Science.gov (United States)

    Harris, Richard; Little, Gawain

    2016-01-01

    In "FORUM" 57(3), 2015, Richard Hatcher outlined how it was necessary to build a social movement against government education policy and in support of an alternative reform agenda. We, the editors, believe this is an important, and complex, debate. As a contribution to developing further discussion around Richard's ideas we present two…

  12. H.E. Mr Richard J. Fredericks, Ambassador of the United States of America to Switzerland

    CERN Multimedia

    Patrice Loïez

    2001-01-01

    Photo 01 : Prof. L. Maiani, CERN Director-General, gives a piece of LHC super conducting wire to H.E. Mr. Richard J. Fredericks; Photo 02 : Prof. L. Maiani, CERN Director-General, Mr. Jan van der Boon, CERN Director of Administration and H.E. Mr. J. Richard Fredericks

  13. Fostering children affected by AIDS in Richards Bay, South Africa: a ...

    African Journals Online (AJOL)

    This study uses qualitative research to explore the experiences of grandparents fostering children orphaned by AIDS in Richards Bay, KwaZulu-Natal Province, South Africa. The idea was born after a local HIV support organisation (Richards Bay Family Care) observed a trend within their organisation of grandparents ...

  14. Before harbour construction, Richards Bay on the Kwa- Zulu-Natal ...

    African Journals Online (AJOL)

    spamer

    The Mhlathuze (Richards Bay) Estuary on the KwaZulu-Natal coast, South Africa, was substantially altered ... Berm. E. Harbour. Current estuary. Vegetated islands and mangroves. Mhlathuze River. 1 km. N. CAPE. TOWN. SOUTH AFRICA. Richards Bay. Port Elizabeth. Fig. .... ment of Water Affairs and Forestry, unpublished.

  15. W. Richard Scott, Institutions and Organizations: Ideas, Interests, and Identities

    DEFF Research Database (Denmark)

    Jakobsen, Michael

    2014-01-01

    Book review of: W. Richard Scott: Institutions and Organizations: Ideas, Interests, and Identities. 4th edition. Thousand Oaks, CA: SAGE Publications, 2014. xiii, 345 pp.......Book review of: W. Richard Scott: Institutions and Organizations: Ideas, Interests, and Identities. 4th edition. Thousand Oaks, CA: SAGE Publications, 2014. xiii, 345 pp....

  16. Successful Partnering to Transform the College Library: An Interview with Richard Ekman

    Science.gov (United States)

    Hardesty, Larry; Ekman, Richard

    2004-01-01

    In recent years academic librarians have sought to partner with other organizations of higher education to establish areas of mutual interest and to work together to further these areas. Richard Ekman, as president of the Council of Independent Colleges (CIC), has involved librarians in various CIC programs. This past year, under Richard's…

  17. Effects of strengthening exercises on swallowing musculature and function in senior healthy subjects; a prospective effectiveness and feasibility study

    NARCIS (Netherlands)

    Kraaijenga, S.A.C.; van der Molen, L.; Stuiver, M.M.; Teertstra, H.J.; Hilgers, F.J.M.; van den Brekel, M.

    2015-01-01

    Head and neck cancer (HNC) patients may develop dysphagia due to muscle atrophy and fibrosis following chemoradiotherapy. Strengthening of the swallowing muscles through therapeutic exercise is potentially effective for improving swallowing function. We hypothesize that a customized Swallow Exercise

  18. Effects of Strengthening Exercises on Swallowing Musculature and Function in Senior Healthy Subjects: a Prospective Effectiveness and Feasibility Study

    NARCIS (Netherlands)

    Kraaijenga, S. A. C.; van der Molen, L.; Stuiver, M. M.; Teertstra, H. J.; Hilgers, F. J. M.; van den Brekel, M. W. M.

    2015-01-01

    Head and neck cancer (HNC) patients may develop dysphagia due to muscle atrophy and fibrosis following chemoradiotherapy. Strengthening of the swallowing muscles through therapeutic exercise is potentially effective for improving swallowing function. We hypothesize that a customized Swallow Exercise

  19. Gamma radiation effects on nestling Tree Swallows

    Energy Technology Data Exchange (ETDEWEB)

    Zach, R.; Mayoh, K.R.

    1984-10-01

    The sensitivity of Tree Swallows (Tachycineta bicolor) to the stress of ionizing radiation was investigated with growth analysis. Freshly hatched nestlings were temporarily removed from nests, taken to the laboratory and acutely exposed to 0.9, 2.7, or 4.5 Gy gamma radiation. Some of the unirradiated control nestlings were also taken to the laboratory whereas others were left in the nests. Growth of all the nestlings was measured daily and analyzed by fitting growth models. There was no detectable radiation-induced mortality up to fledgling, approx. = 20 d after irradiation. Radiation exposure did not affect the basic growth pattern; the logistic growth model was most suitable for body mass and foot length, and the von Bertalanffy model for primary-feather length, irrespective of treatment. Parameter values from these models indicated pronounced growth depression in the 2.7-Gy and 4.5-Gy groups, particularly for body mass. Radiation also affected the timing of development. The growth depression of the 2.7-Gy group was similar to that caused by hatching asynchrony in unirradiated nestlings. The 4.5-Cy nestlings grew as well as unexposed nestlings that died from natural causes. Chronic irradiation at approx. = 1.0 Cy/d caused more severe growth effects than acute exposure to 4.5 Gy and may have caused permanent stunting. Growth analysis is a potent tool for assessing man-made environmental stresses. Observed body-mass statistics and model parameters seem to be most sensitive to environmental stresses, but coefficients of variation are not necessarily correlated with sensitivity. 34 references, 2 figures, 4 tables.

  20. Effect of wearing a palatal plate on swallowing function.

    Science.gov (United States)

    Toyoshita, Yoshifumi; Koshino, Hisashi; Hirai, Toshihiro; Matsumi, Tamachi

    2009-10-01

    The purpose of this study was to determine the effect of wearing a palatal plate on swallowing function. The subject group consisted of 10 healthy, fully dentate males. Two experimental palatal plates (EPP) were used in this study: one was 1.4mm thick (EPP1), and the other was 2.8mm thick (EPP2). Tongue movements and swallowing sounds were simultaneously recorded. The position of the surface of the tongue was recorded by using ultrasound diagnostic equipment in the sagittal plane. Swallowing tests were performed under three conditions: without EPP (WOE), with EPP1 (WP1), and with EPP2 (WP2). Swallowing index (SI) and tongue contact time (TCT) was calculated. The value of SI was lowest under WOE, and highest under WP2, with a statistically significant difference. There was no statistical significance, however, between SI under WOE and that under WP1. The value of TCT was longest under WOE, and shortest under WP2, with a statistically significant difference. This investigation suggests that the thickness of a palatal plate influences SI and TCT, which correlate with swallowing function.

  1. Hard to Swallow: Developmental Biological Insights into Pediatric Dysphagia

    Science.gov (United States)

    LaMantia, Anthony-Samuel; Moody, Sally A.; Maynard, Thomas M.; Karpinski, Beverly A.; Zohn, Irene E.; Mendelowitz, David; Lee, Norman H.; Popratiloff, Anastas

    2015-01-01

    Pediatric dysphagia—feeding and swallowing difficulties that begin at birth, last throughout childhood, and continue into maturity—is one of the most common, least understood complications in children with developmental disorders. We argue that a major cause of pediatric dysphagia is altered hindbrain patterning during pre-natal development. Such changes can compromise craniofacial structures including oropharyngeal muscles and skeletal elements as well as motor and sensory circuits necessary for normal feeding and swallowing. Animal models of developmental disorders that include pediatric dysphagia in their phenotypic spectrum can provide mechanistic insight into pathogenesis of feeding and swallowing difficulties. A fairly common human genetic developmental disorder, DiGeorge/22q11.2 Deletion Syndrome (22q11DS) includes a substantial incidence of pediatric dysphagia in its phenotypic spectrum. Infant mice carrying a parallel deletion to 22q11DS patients have feeding and swallowing difficulties. Altered hindbrain patterning, neural crest migration, craniofacial malformations, and changes in cranial nerve growth prefigure these difficulties. Thus, in addition to craniofacial and pharyngeal anomalies that arise independently of altered neural development, pediatric dysphagia may reflect disrupted hindbrain patterning and its impact on neural circuit development critical for feeding and swallowing. The mechanisms that disrupt hindbrain patterning and circuitry may provide a foundation to develop novel therapeutic approaches for improved clinical management of pediatric dysphagia. PMID:26554723

  2. Videofluoroscopic evaluation of mastication and swallowing in individuals with TMD.

    Science.gov (United States)

    Maffei, Carla; Mello, Marçal Motta de; Biase, Noemi Grigoletto de; Pasetti, Lilian; Camargo, Paulo A Monteiro; Silvério, Kelly Cristina Alves; Gonçalves, Maria Inês Rebelo

    2012-01-01

    To study mastication and swallowing disorders in patients with temporomandibular disorders (TMD). To investigate mastication and swallowing disorders in patients with severe TMD referred to surgery. Clinical and experimental study involving ten individuals with TMD submitted to deglutition videofluoroscopy. These patients did not have posterior teeth, mastication pain and food replacement in favor of pasty consistence food. The assessment of the oral and pharyngeal phases approached the following aspects: side of onset and preferential side for chewing, premature escape, remains of food residues in the oral cavity or in the pharyngeal recesses, number of necessary swallowing efforts, laryngeal penetration and/or tracheal aspiration. During mastication and the oral phase we observed tongue compensatory movements upon chewing (n = 7; 70%), premature escape (n = 4; 40%), food remains in the cavity after swallowing (n = 5; 50%) and an excessive number of deglutition efforts (n = 5; 50%). On the pharyngeal phase we observed food remains in the valleculae (n = 6; 60%), in the pyriform sinuses (n = 4; 40%); laryngeal penetration (n = 1; 10%) and tracheal aspiration (n = 4; 40%). TMD patients may have alterations in their chewing and swallowing patterns, with laryngeal penetration and/or tracheal aspiration. The study indicates the need for a multidisciplinary assessment because of dysphagia in TMD patients.

  3. Prevalence of swallowing dysfunction screened in Swedish cohort of COPD patients.

    Science.gov (United States)

    Gonzalez Lindh, Margareta; Blom Johansson, Monica; Jennische, Margareta; Koyi, Hirsh

    2017-01-01

    COPD is a common problem associated with morbidity and mortality. COPD may also affect the dynamics and coordination of functions such as swallowing. A misdirected swallow may, in turn, result in the bolus entering the airway. A growing body of evidence suggests that a subgroup of people with COPD is prone to oropharyngeal dysphagia. The aim of this study was to evaluate swallowing dysfunction in patients with stable COPD and to determine the relation between signs and symptoms of swallowing dysfunction and lung function (forced expiratory volume in 1 second percent predicted). Fifty-one patients with COPD in a stable phase participated in a questionnaire survey, swallowing tests, and spirometry. A post-bronchodilator ratio of the forced expiratory volume in 1 second/best of forced vital capacity and vital capacity <0.7 was used to define COPD. Swallowing function was assessed by a questionnaire and two swallowing tests (water and cookie swallow tests). Sixty-five percent of the patients reported subjective signs and symptoms of swallowing dysfunction in the questionnaire and 49% showed measurable ones in the swallowing tests. For the combined subjective and objective findings, 78% had a coexisting swallowing dysfunction. No significant difference was found between male and female patients. Swallowing function is affected in COPD patients with moderate to severe airflow limitation, and the signs and symptoms of this swallowing dysfunction were subjective, objective, or both.

  4. 75 FR 53730 - Culturally Significant Objects Imported for Exhibition Determinations: “Richard Hawkins-Third Mind”

    Science.gov (United States)

    2010-09-01

    ... Imported for Exhibition Determinations: ``Richard Hawkins--Third Mind'' SUMMARY: Notice is hereby given of... determine that the objects to be included in the exhibition ``Richard Hawkins--Third Mind,'' imported from...

  5. Juvenile Cosmology; Or Richard Powers’ Post-Global Doughnut

    Directory of Open Access Journals (Sweden)

    Judith Roof

    2010-02-01

    Full Text Available Le roman de Richard Powers, Operation Wandering Soul (1993, présente le lien subtil qui associe un mondialisme déjà usé et vieillissant à l’enfant perçu comme catégorie dominante. Comme les faces serpentines d’un ruban de Möbius lové autour de l’illimité et de l’intemporel, le texte, tendu entre ses deux infinis – l’univers et l’enfant – révise la portée, la conception, la structure et le style du genre romanesque. Délaissant Aristote pour Einstein, Operation Wandering Soul se place sur le terrain de la cosmologie. Le récit, qui rassemble la kyrielle des grands ralliements juvéniles et leurs vains pèlerinages, concentre l’espace-temps dans une présentation qui évoque la « somme des histoires » de Richard Feynman. La contraction de l’espace-temps opérée par le roman ne fait pas de celui-ci un hymne simpliste au global (catégorie déjà aussi datée que celle des malheureux vétérans du Vietnam, mais capte au contraire la conscience grandissante d’une existence sans origine qui s’étend à perte de vue au-delà de ses coordonnées supposées. Le roman s’enroule sur lui-même tout en s’épanchant au dehors, boucle ses cadres et ses détours tout en desserrant leur emprise. Il fait tourner la roue de ses récits comme des planètes en rotation, la ronde d’un système solaire, le tourbillon d’une galaxie. La conscience que présente Operation Wandering Soul ne se résume donc pas au seul point de vue de l’âme errante qu’est le personnage de Kraft, mais consiste en la somme de tous les temps et de tous les lieux, de leurs strates accumulées comme une conscience en acte, complexe et tissée de réseaux, qui n’appartient à personne et est partagée par tous. Cette accumulation organise le jeu des perspectives multiples qui instaurent l’acte de lecture et sont instaurées par lui. À cet égard, lire constitue ici une physique des oubliés.Richard Powers’ novel Operation Wandering

  6. Perception of Leitmotives in Richard Wagner's Der Ring des Nibelungen

    Directory of Open Access Journals (Sweden)

    David J. Baker

    2017-05-01

    Full Text Available The music of Richard Wagner tends to generate very diverse judgments indicative of the complex relationship between listeners and the sophisticated musical structures in Wagner's music. This paper presents findings from two listening experiments using the music from Wagner's Der Ring des Nibelungen that explores musical as well as individual listener parameters to better understand how listeners are able to hear leitmotives, a compositional device closely associated with Wagner's music. Results confirm findings from a previous experiment showing that specific expertise with Wagner's music can account for a greater portion of the variance in an individual's ability to recognize and remember musical material compared to measures of generic musical training. Results also explore how acoustical distance of the leitmotives affects memory recognition using a chroma similarity measure. In addition, we show how characteristics of the compositional structure of the leitmotives contributes to their salience and memorability. A final model is then presented that accounts for the aforementioned individual differences factors, as well as parameters of musical surface and structure. Our results suggest that that future work in music perception may consider both individual differences variables beyond musical training, as well as symbolic features and audio commonly used in music information retrieval in order to build robust models of musical perception and cognition.

  7. Perception of Leitmotives in Richard Wagner's Der Ring des Nibelungen.

    Science.gov (United States)

    Baker, David J; Müllensiefen, Daniel

    2017-01-01

    The music of Richard Wagner tends to generate very diverse judgments indicative of the complex relationship between listeners and the sophisticated musical structures in Wagner's music. This paper presents findings from two listening experiments using the music from Wagner's Der Ring des Nibelungen that explores musical as well as individual listener parameters to better understand how listeners are able to hear leitmotives, a compositional device closely associated with Wagner's music. Results confirm findings from a previous experiment showing that specific expertise with Wagner's music can account for a greater portion of the variance in an individual's ability to recognize and remember musical material compared to measures of generic musical training. Results also explore how acoustical distance of the leitmotives affects memory recognition using a chroma similarity measure. In addition, we show how characteristics of the compositional structure of the leitmotives contributes to their salience and memorability. A final model is then presented that accounts for the aforementioned individual differences factors, as well as parameters of musical surface and structure. Our results suggest that that future work in music perception may consider both individual differences variables beyond musical training, as well as symbolic features and audio commonly used in music information retrieval in order to build robust models of musical perception and cognition.

  8. Liberalismo e ironía en Richard Rorty

    Directory of Open Access Journals (Sweden)

    Camila Gamboa-Tapias

    2010-03-01

    Full Text Available El planteamiento teórico de Richard Rorty acerca de las culturas liberales como comunidades conscientes de su contingencia histórica, pero también capaces de unirse en un proyecto público de solidaridad humana, constituye una importante propuesta que enriquece la discusión política en la actualidad. Su postura democrática antifundamentalista, su intento de reconciliar lo público con lo privado no mediante la  filosofía, sino a través de la literatura, así como su ironismo para evadir o rechazar debates tradicionales entre los filósofos, lo convierten en un pensador polémico e interesante. En este escrito se analizarán los conceptos rortianos de ironía individual, crítica literaria, comunidad liberal y solidaridad que tienen relevancia  en el campo de la teoría política y la moral.

  9. Forjando nuestras democracias: entre Richard Rorty y Vladimiro Montesinos

    Directory of Open Access Journals (Sweden)

    Miguel Giusti

    2001-07-01

    Full Text Available This article aims at explaining the recent history of Peru, in an exercise in which it is possible to extract lessons about the way Latin American democracies have been(or have not been forged. The text draws a parallel between the ideas developed by Richard Rorty in his recently published book, Forjar nuestro país. El pensamiento de izquierdas en los Estados Unidos del siglo XX, and the events in Fugimori's and Montesinos' Peru. If, according to what Rorty believes, "national pride is for the countries what self esteem is for individuals ... " how would it be possible to narrate a history in which there are few motives to be proud of? Trying to escape fatalism and sarcasm, the text tries to show that Montesino's political course is, symbolically, a summary of the decomposition process of Peruvian democracy. Secondly, the text analyses the movements of the political left wing and deals with the support the regimen received from inside and outside the country, a support that was largely based on the illusion of political stability. Finally, it states, as Rorty does, that in order to forge democracies it is necessary for us to be deeply committed to the defense of the State of Right.

  10. Transcendence, Taxis, Trust: Richard Kearney and Jacques Derrida

    Directory of Open Access Journals (Sweden)

    Ulrich Schmiedel

    2017-03-01

    Full Text Available Whatever else it takes to drive a taxi, it takes trust. Day after day, the driver has to decide whether the other is or is not trustworthy. I take the taxi as a test case to analyze and assess Richard Kearney’s diacritical hermeneutics of the other. I argue that Kearney functionalizes the concept of transcendence in order to connect the transcendence of the finite other to the transcendence of the infinite other. However, in his central critique of the deconstructionists following Jacques Derrida, Kearney counters his connection. While Kearney’s critique of Derrida’s account of absolute alterity is correct and compelling, I argue that Derrida’s critique of a distinction between the trustworthy other and the non-trustworthy other might be more crucial than Kearney contends. Insisting on openness to the other’s otherness, Derrida provokes any hermeneutic of the other to trust in transcendence. The taxi is taken as a test to illustrate the implications which diacritical and deconstructive drivers might have for evaluating the entanglement of ethics and eschatology—inside and outside the taxi.

  11. [Richard Koch's life in national socialism and in Soviet emigration].

    Science.gov (United States)

    Boltres, Daniela; Töpfer, Frank; Wiesing, Urban

    2006-01-01

    The Jewish historian and theorist of medicine, Richard Koch, teaching in Frankfurt/Main, fled in 1936 from National Socialist Germany to the USSR where he lived in the Caucasian spa Essentuki until his death in 1949. Here he worked as a doctor and continued his scientific work, especially on the foundations of medicine in natural philosophy. None of his works of this time were published. Koch was a scientific outsider in the USSR, and he was aware of this. However, he tried to make his views compatible with official doctrines. In 1947 he lost his employment at the medical clinic of Essentuki, and his material situation grew worse. It is still an open question whether this development was related to an increasingly anti-Jewish atmosphere in the USSR that was linked with the Stalinist "purges", as Koch himself appeared to believe. Before his flight from Germany Koch did not show any tendency towards communism or the political left at all. His attitude towards Soviet society and Stalin was mixed: cautious criticism was accompanied by strong expressions of commitment to Stalin and Koch's new Socialist home. The question to what extent Koch's comments showed his true convictions must remain without a definite answer. At least in part they can be understood as precautions in threatening circumstances. The opportunity of a remigration to Germany after 1945, however, was turned down by Koch.

  12. Perception of Leitmotives in Richard Wagner's Der Ring des Nibelungen

    Science.gov (United States)

    Baker, David J.; Müllensiefen, Daniel

    2017-01-01

    The music of Richard Wagner tends to generate very diverse judgments indicative of the complex relationship between listeners and the sophisticated musical structures in Wagner's music. This paper presents findings from two listening experiments using the music from Wagner's Der Ring des Nibelungen that explores musical as well as individual listener parameters to better understand how listeners are able to hear leitmotives, a compositional device closely associated with Wagner's music. Results confirm findings from a previous experiment showing that specific expertise with Wagner's music can account for a greater portion of the variance in an individual's ability to recognize and remember musical material compared to measures of generic musical training. Results also explore how acoustical distance of the leitmotives affects memory recognition using a chroma similarity measure. In addition, we show how characteristics of the compositional structure of the leitmotives contributes to their salience and memorability. A final model is then presented that accounts for the aforementioned individual differences factors, as well as parameters of musical surface and structure. Our results suggest that that future work in music perception may consider both individual differences variables beyond musical training, as well as symbolic features and audio commonly used in music information retrieval in order to build robust models of musical perception and cognition. PMID:28522981

  13. Clinical History of the Theranostic Radionuclide Approach to Neuroendocrine Tumors and Other Types of Cancer: Historical Review Based on an Interview of Eric P. Krenning by Rachel Levine.

    Science.gov (United States)

    Levine, Rachel; Krenning, Eric P

    2017-09-01

    In nuclear medicine, the term theranostics describes the combination of therapy and diagnostic imaging. In practice, this concept dates back more than 50 years; however, among the most successful examples of theranostics are peptide receptor scintigraphy and peptide receptor radionuclide therapy of neuroendocrine tumors. The development of these modalities through the radiolabeling of somatostatin analogs with various radionuclides has led to a revolution in patient management and established a foundation for expansion of the theranostic principle into other oncology indications. This article provides a review of the evolution and development of the theranostic radionuclide approach to the management of neuroendocrine tumors, as described by the inventor of this technique, Eric P. Krenning, in an interview with Rachel Levine. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

  14. Recent Advances in Sensing Oropharyngeal Swallowing Function in Japan

    Directory of Open Access Journals (Sweden)

    Takahiro Ono

    2009-12-01

    Full Text Available Dysphagia (difficulty in swallowing is an important issue in the elderly because it causes aspiration pneumonia, which is the second largest cause of death in this group. It also causes decline in activities of daily living and quality of life. The oral phase of swallowing has been neglected, despite its importance in the evaluation of dysphagia, because adequate protocols and measuring devices are unavailable. However, recent advances in sensor technology have enabled straightforward, non-invasive measurement of the movement of important swallowing-related organs such as the lips and tongue, as well as the larynx. In this article, we report the present state and possibility of clinical application of such systems developed in Japan.

  15. The effect of dairy farm management regime on swallow (Hirundo rustica) abundance in the Netherlands

    NARCIS (Netherlands)

    Lubbe, S.K.; Snoo, de G.R.

    2007-01-01

    Aim To identify differences in Swallow abundance between organically and conventionally managed dairy farms, by examining three factors: farm buildings, food availability and farmer attitudes to Swallows. Methods Organic and conventional dairy farm holdings were compared in pairwise fashion. On

  16. VIDEOFLUOROSCOPIC SWALLOWING STUDY: esophageal alterations in patients with dysphagia

    Directory of Open Access Journals (Sweden)

    Betina SCHEEREN

    2014-09-01

    Full Text Available Context Videofluoroscopic swallowing study is a dynamic exam and allows the evaluation of the complete swallowing process. However, most published studies have only reported alterations in the oropharynx and pharyngoesophageal transition, leaving the analysis of the esophagus as a secondary goal. Objectives The goal of this study was to investigate the prevalence of alterations in the esophageal phase thorough videofluoroscopic swallowing study in patients with dysphagia. Methods Consecutive patients with dysphagia who underwent videofluoroscopic swallowing study including esophageal analysis between May 2010 and May 2012 had their exams retrospectively reviewed. Patients were classified into two groups: Group I - without a pre-established etiological diagnosis and Group II - with neurological disease. During the exam, the patients ingested three different consistencies of food (liquid, pasty and solid contrasted with barium sulfate and 19 items were analyzed according to a protocol. The esophageal phase was considered abnormal when one of the evaluated items was compromised. Results Three hundred and thirty-three (n = 333 consecutive patients were studied - 213 (64% in Group I and 120 (36% in Group II. Esophageal alterations were found in 104 (31% patients, with a higher prevalence in Group I (36.2%, especially on the items esophageal clearance (16.9% and tertiary contractions (16.4%. It was observed that 12% of individuals in Group I only presented alterations on the esophageal phase. Conclusion Evaluation of the esophageal phase of swallowing during videofluoroscopic swallowing study detects abnormalities in patients with cervical dysphagia, especially in the group without pre-established etiological diagnosis.

  17. Tracking the hyoid bone in videofluoroscopic swallowing studies

    Science.gov (United States)

    Kellen, Patrick M.; Becker, Darci; Reinhardt, Joseph M.; van Daele, Douglas

    2008-03-01

    Difficulty swallowing, or dysphagia, has become a growing problem. Swallowing complications can lead to malnutrition, dehydration, respiratory infection, and even death. The current gold standard for analyzing and diagnosing dysphagia is the videofluoroscopic barium swallow study. In these studies, a fluoroscope is used to image the patient ingesting barium solutions of different volumes and viscosities. The hyoid bone anchors many key muscles involved in swallowing and plays a key role in the process. Abnormal hyoid bone motion during a swallow can indicate swallowing dysfunction. Currently in clinical settings, hyoid bone motion is assessed qualitatively, which can be subject to intra-rater and inter-rater bias. This paper presents a semi-automatic method for tracking the hyoid bone that makes quantitative analysis feasible. The user defines a template of the hyoid on one frame, and this template is tracked across subsequent frames. The matching phase is optimized by predicting the position of the template based on kinematics. An expert speech pathologist marked the position of the hyoid on each frame of ten studies to serve as the gold standard. Results from performing Bland-Altman analysis at a 95% confidence interval showed a bias of 0.0+/-0.08 pixels in x and -0.08+/-0.09 pixels in y between the manually-defined gold standard and the proposed method. The average Pearson's correlation between the gold standard and the proposed method was 0.987 in x and 0.980 in y. This paper also presents a method for automatically establishing a patient-centric coordinate system for the interpretation of hyoid motion. This coordinate system corrects for upper body patient motion during the study and identifies superior-inferior and anterior-posterior motion components. These tools make the use of quantitative hyoid motion analysis feasible in clinical and research settings.

  18. Respiratory phase resetting and airflow changes induced by swallowing in humans.

    Science.gov (United States)

    Paydarfar, D; Gilbert, R J; Poppel, C S; Nassab, P F

    1995-01-01

    1. Relationships between the timing of respiration and deglutition were studied in thirty awake healthy subjects at rest. Deglutition was monitored by submental electromyography, pharyngeal manometry and videofluoroscopy. Respiration was recorded by measurement of oronasal airflow and chest wall movement. Three types of deglutition were studied: injected bolus swallows, spontaneous swallows, and visually cued swallows of boluses previously placed in the mouth. 2. The effect of each swallow on respiratory rhythm was characterized by measurement of cophase, defined as the interval between the onset of deglutitive submental EMG activity to the onset of subsequent rescheduled inspirations. Cophase was determined for swallows initiated at different phases of the respiratory cycle. In all subjects deglutition caused phase resetting of respiratory rhythm. Cophase was largest for swallows initiated near the the inspiratory-expiratory (E-I) transition and smallest for swallows initiated near the expiratory-inspiratory (E-I) transition. The pattern of respiratory resetting by deglutition was topologically classified as type 0. This pattern was shown for swallows induced by bolus injection or visual cue, and for spontaneous swallows. 3. The incidence of spontaneous deglutition was influenced by the position of the swallow in the respiratory cycle. Few spontaneous swallows were initiated near the E-I transition whereas most occurred from late inspiration to mid-expiration. 4. Deglutition caused an abrupt decrease in airflow leading to an interval of apnoea, followed by a period of expiration. The duration of deglutition apnoea for spontaneous swallows was shorter than that for 5 ml bolus swallows, and was unaffected by the respiratory phase of swallow initiation. The period of expiration after swallowing was longest for swallows initiated at the I-E transition, and shortest for E-I swallows. 5. The intervals between bolus injection and the onset of deglutition apnoea, and the

  19. Examining user perceptions of SwallowIT: A pilot study of a new telepractice application for delivering intensive swallowing therapy to head and neck cancer patients.

    Science.gov (United States)

    Wall, Laurelie R; Ward, Elizabeth C; Cartmill, Bena; Hill, Anne J; Porceddu, Sandro V

    2017-01-01

    Consumer feedback and end-user perceptions provide important information regarding the clinical acceptability of new telepractice systems. This pilot investigation aimed to evaluate end-user perceptions of a new asynchronous telepractice application, ' SwallowIT', designed to support patients to remotely complete intensive swallowing therapy during curative chemoradiotherapy (CRT) treatment for head and neck cancer (HNC). Insights were sought from 15 patients with oropharyngeal cancer who used SwallowIT to complete supported home swallowing therapy. Perceptions were evaluated via structured questionnaires, completed following initial orientation to SwallowIT and on completion of CRT. Semi-structured phone interviews were conducted ≥3 months post-treatment. The majority of patients reported positive initial perceptions towards SwallowIT for comfort (87%), confidence (87%), motivation (73%) and support (87%). No statistically significant change in perceptions was observed from baseline to end of CRT ( p > 0.05). Thematic analysis of interviews revealed four main themes: the ease of use of SwallowIT, motivating factors, circumstances which made therapy difficult, and personal preferences for service-delivery models. These preliminary findings demonstrate that SwallowIT was well-perceived by the current group of HNC consumers and suggest that SwallowIT may be well-accepted as an alternate service-delivery model for delivering intensive swallowing therapy during CRT.

  20. The Crumbling Two-Story Architecture of Richard Powers’ Fictions

    Directory of Open Access Journals (Sweden)

    Thomas B. Byers

    2010-02-01

    Full Text Available L’alternance de deux récits différents au sein d’une même narration constitue l’une des marques les plus saillantes de la technique narrative de Richard Powers. Cependant, les rapports qu’entretiennent ces deux récits varient sensiblement d’un roman à l’autre. Ils peuvent, d’un point de vue diégétique, reposer sur un même personnage, comme dans Galatea 2.2, ou sur la rencontre ponctuelle de divers protagonistes, comme dans The Echo Maker. Il arrive aussi qu’ils explorent un enchaînement présumé de cause à effet, comme dans Gain. Plus radicalement, dans Plowing the Dark, les deux récits paraissent tisser des liens essentiellement métaphoriques qui excluent plus ou moins toute idée de métonymie. Sur le plan de la signification, les deux récits semblent parfois former une unité lorsque combinaisons, parallèles et oppositions font se lever entre eux des rapports dialectiques. Ce travail met en évidence, dans plusieurs romans de Powers, les diverses permutations de cette structure à double récit et tente de cerner ce qui pourrait en constituer le « reste », élément irréductible à toute unité thématique ou artistique. Si un tel reste existe, quel sens pourrait-il alors revêtir ?A prominent characteristic of Richard Powers’ technique is that his novels generally proceed by the alternating narration of two different stories. The relations of one story to another vary quite widely, however. On the diegetic level, the two may have a common protagonist, as in Galatea 2.2; or they may concern the different but circumstantially intersecting lives of disparate figures, as in The Echo Maker; or they may explore a possible chain of cause and effect, as in Gain. Most radically, in Plowing the Dark, their relation seems to be more or less purely metaphoric, with little or no metonymic connection at all. On the level of meaning, the two stories may seem to form unities by operating in conjunction or parallel or

  1. Ultrasound of oral and masticatory muscles: Why every neuromuscular swallow team should have an ultrasound machine

    NARCIS (Netherlands)

    Engel-Hoek, L. van den; Lagarde, M.L.J.; Alfen, N. van

    2017-01-01

    Patients with neuromuscular disorders often present with swallowing difficulties due to oral phase problems and pharyngeal residue after swallow. It is important to assess the underlying pathology and cause of the swallowing disturbance in this patient group, such as dystrophic changes in oral and

  2. Desire and the Other in Richard Yates's Revolutionary Road

    Directory of Open Access Journals (Sweden)

    Ljubica Matek

    2011-06-01

    Full Text Available Richard Yates’s novel Revolutionary Road did not receive much academic attention despite the fact that it is an exceptionally refined and capturing piece of fiction. It was critically acclaimed following its publication in 1961, nominated for the National Book Award in 1962 and then forgotten. Not surprisingly, the novel was “rediscovered” once a movie adaptation was made in 2008. Revolutionary Road is typically read – quite expectedly – as a story of suburban malaise and a critique of the American (suburban life in the 1950s. However, in an interview, published in Ploughshares in 1972, Yates stated that although he intended the novel to be an indictment of American life in the 1950s because of a general lust for conformity (DeWitt and Clark 66, he never planned the novel to be anti-suburban in any way. On the contrary, he hoped to make it implicit in the text that he is writing about a particular couple, the Wheelers, and what turns out to be specifically “their delusion, their problem” (DeWitt and Clark 66. In that sense, the novel should be read as a psychological exploration of the universal issues of human desire and the relationship of the individual to the pre-established (social system in which he or she lives. Consequently, it becomes clear that Yates’s novel hardly represents an indictment of a way of life, but quite the opposite: an indictment of the individual unable to adapt to the demands of the Other. In Lacanian terms, Revolutionary Road is a story about the unattainable desire to create one’s identity regardless or in spite of the socially constructed Symbolic order.

  3. A time splitting algorithm for numerical solution of Richard's equation

    Science.gov (United States)

    Namin, Masoud Montazeri; Boroomand, Mohammad Reza

    2012-06-01

    SummaryThe Richard's equation mathematically expressing the infiltration problem is a transport type of equation describing two different phenomena namely advection and diffusion being hyperbolic and parabolic type of differential equation, respectively each having their own physical properties thus a single numerical scheme would not essentially be suitable for both. In this paper a numerical algorithm based on time splitting or fractional step method has been proposed and described. This has allowed designing and applying some different numerical schemes more compatible with the mathematical and physical properties of the corresponding phenomenon. In advection part an implicit characteristic based method has been employed to calculate the cell face fluxes and then the new unknowns have been obtained using finite volume method (FVM) explicitly. Two different speed type quantities namely wave celerity and mass velocity have been distinguished in the advection of infiltrated water to the soil, the magnitude of the first being several times larger than the other. The implicit characteristic based method has been designed specifically to cope with the mentioned high wave celerity. An implicit numerical scheme has been employed in which the space derivative term contributed in definition of cell face flux has been discretized in fourth order accurate manner. The extra cells getting involved due to the higher order discretization have been taken in account in a way not to change the tri-diagonal matrix coefficient shape preserving the efficiency of the algorithm. The performance, accuracy and efficiency of the out coming non-iterative numerical algorithm have been successfully examined by some test cases. The relative importance of the advection and diffusion terms in the concerned transport equation and the ration of their contribution in the overall infiltrated flux also have been discussed in detail.

  4. AD-1 with research pilot Richard E. Gray

    Science.gov (United States)

    1982-01-01

    Standing in front of the AD-1 Oblique Wing research aircraft is research pilot Richard E. Gray. Richard E. Gray joined National Aeronautics and Space Administration's Johnson Space Center, Houston, Texas, in November 1978, as an aerospace research pilot. In November 1981, Dick joined the NASA's Ames-Dryden Flight Research Facility, Edwards, California, as a research pilot. Dick was a former Co-op at the NASA Flight Research Center (a previous name of the Ames-Dryden Flight Research Facility), serving as an Operations Engineer. At Ames-Dryden, Dick was a pilot for the F-14 Aileron Rudder Interconnect Program, AD-1 Oblique Wing Research Aircraft, F-8 Digital Fly-By-Wire and Pilot Induced Oscillations investigations. He also flew the F-104, T-37, and the F-15. On November 8, 1982, Gray was fatally injured in a T-37 jet aircraft while making a pilot proficiency flight. Dick graduated with a Bachelors degree in Aeronautical Engineering from San Jose State University in 1969. He joined the U.S. Navy in July 1969, becoming a Naval Aviator in January 1971, when he was assigned to F-4 Phantoms at Naval Air Station (NAS) Miramar, California. In 1972, he flew 48 combat missions in Vietnam in F-4s with VF-111 aboard the USS Coral Sea. After making a second cruise in 1973, Dick was assigned to Air Test and Evaluation Squadron Four (VX-4) at NAS Point Mugu, California, as a project pilot on various operational test and evaluation programs. In November 1978, Dick retired from the Navy and joined NASA's Johnson Space Center. At JSC Gray served as chief project pilot on the WB-57F high-altitude research projects and as the prime television chase pilot in a T-38 for the landing portion of the Space Shuttle orbital flight tests. Dick had over 3,000 hours in more than 30 types of aircraft, an airline transport rating, and 252 carrier arrested landings. He was a member of the Society of Experimental Test Pilots serving on the Board of Directors as Southwest Section Technical Adviser in

  5. A Pilot Study of the Head Extension Swallowing Exercise: New Method for Strengthening Swallowing-Related Muscle Activity.

    Science.gov (United States)

    Oh, Jong-Chi

    2016-10-01

    This pilot study examined the effect of a new head extension swallowing exercise (HESE) on submental muscle activity and tongue strength in healthy volunteers. Fifteen young adults (10 females and 5 males) were instructed to extend their head backwards as much as possible, and while watching the ceiling, swallowed their saliva every 10 s for a duration of 20 min. Twenty-four treatments were performed over 8 weeks. The outcome variables evaluated at baseline, 4 and 8 weeks of training, and 12-week follow-up included mean and peak submental muscle activation amplitudes during normal and effortful swallowing measured via surface electromyography, and anterior and posterior isometric tongue pressures were measured with the Iowa Oral Performance Instrument. Results indicated that the muscle activation amplitudes during effortful swallowing increased significantly at 4 and 8 weeks compared to baseline (p < 0.025). However, the increases in amplitudes during normal swallowing were minor (nonsignificant) after 8 weeks compared to baseline. The isometric pressures of the tongue tip and the posterior part of the oral tongue were significantly higher at 8 weeks compared to baseline (p < 0.025). Thus, the 8-week HESE protocol significantly improved suprahyoid muscle activity during effortful swallowing as well as the isometric tongue pressures. The HESE appears effective in exercising and strengthening the suprahyoid muscles and tongue muscles in healthy participants. Although encouraging, these results need to be replicated in clinical trials for testing the therapeutic effects of the HESE in older adults and patients with dysphagia who present with decreased hyolaryngeal elevation.

  6. How Richard Nixon Pressured Arthur Burns: Evidence from the Nixon Tapes

    National Research Council Canada - National Science Library

    Abrams, Burton A

    2006-01-01

    Evidence from the Nixon tapes, now available to researchers, shows that President Richard Nixon pressured the chairman of the Federal Reserve, Arthur Burns, to engage in expansionary monetary policies...

  7. Lendab nagu kotkas üle maailmas kogutud tarkuse / Richard Aroksaar ; intervjueerinud Ene Riet

    Index Scriptorium Estoniae

    Aroksaar, Richard

    2014-01-01

    Intervjuu eestlase Richard Aroksaarega, kes õppinud psühholoogiat ja raamatukogundust, töötab USA Rahvusparkide Ühenduse raamatukogus (National Park Service Library, NPS) süsteemi raamatukoguhoidja ja administraatorina

  8. Selfish Memes: An Update of Richard Dawkins’ Bibliometric Analysis of Key Papers in Sociobiology

    National Research Council Canada - National Science Library

    Craig Aaen-Stockdale

    2017-01-01

    In the second edition of The Selfish Gene, Richard Dawkins included a short bibliometric analysis of key papers instrumental to the sociobiological revolution, the intention of which was to support...

  9. EDITORIAL: Richard Palmer: celebrating 37 years with Journal of Physics: Condensed Matter Richard Palmer: celebrating 37 years with Journal of Physics: Condensed Matter

    Science.gov (United States)

    Ferry, David

    2009-01-01

    It is with a great deal of both happiness and sadness that I have to announce that we are losing one of the real strengths of the Journal of Physics: Condensed Matter (JPCM). Dr Richard Palmer, our Senior Publisher, announced his retirement, and this issue marks the first without his involvement. Of course, we are happy that he will get to enjoy his retirement, but we are sad to lose such a valuable member of our team. Richard first started work at IOP Publishing in March 1971 as an Editorial Assistant with Journal of Physics B: Atomic and Molecular Physics. After a few months, he transferred to Journal of Physics C: Solid State Physics. During his first year, he was sent on a residential publishing training course and asked to sign an undertaking to stay at IOP Publishing for at least two years. Although Richard refused to sign, as he did not want to commit himself, he has remained with the journal since then. The following year, the Assistant Editor of Journal of Physics C: Solid State Physics, Malcolm Haines, walked out without notice in order to work on his family vineyard in France, and Richard stepped into the breach. In those days, external editors had a much more hands-on role in IOP Publishing and he had to travel to Harwell to be interviewed by Alan Lidiard, the Honorary Editor of Journal of Physics C: Solid State Physics, before being given the job of Assistant Editor permanently. I am told that in those days the job consisted mainly of editing and proofreading and peer review. There was no journal development work. At some point in the early 1980s, production and peer review were split into separate departments and Richard then headed a group of journals consisting of Journal of Physics C: Solid State Physics, Journal of Physics D: Applied Physics and Journal of Physics F: Metal Physics, Semiconductor Science and Technology, Superconductor Science and Technology, Plasma Physics and Controlled Fusion, and later Nanotechnology and Modelling and Simulation

  10. Richard Mollica, Md, Mar. Texto de salud mental global: trauma y recuperación

    OpenAIRE

    Alberto Perales-Cabrera

    2014-01-01

    This is to communicate on the book by Richard Mollica. Md, sea. Text Global Mental Health: Trauma and Recovery. Guidelines for clinical care and field trauma victims worldwide (Textbook of global mental health. Trauma and recovery A companion guide for field and clinical care of traumatized people worldwide). Edited by Harvard Refugee Trauma Program, USA, 2011m electronic version can be obtained for $ 60.00 with: http: // mollica/ www.lulu.com/shop/richard-f-textbook-of-global-mind-healthtrau...

  11. Differences in Swallowing between High and Low Concentration Taste Stimuli

    Directory of Open Access Journals (Sweden)

    Ahmed Nagy

    2014-01-01

    Full Text Available Taste is a property that is thought to potentially modulate swallowing behavior. Whether such effects depend on taste, intensity remains unclear. This study explored differences in the amplitudes of tongue-palate pressures in swallowing as a function of taste stimulus concentration. Tongue-palate pressures were collected in 80 healthy women, in two age groups (under 40, over 60, stratified by genetic taste status (nontasters, supertasters. Liquids with different taste qualities (sweet, sour, salty, and bitter were presented in high and low concentrations. General labeled magnitude scale ratings captured perceived taste intensity and liking/disliking of the test liquids. Path analysis explored whether factors of taste, concentration, age group, and/or genetic taste status impacted: (1 perceived intensity; (2 palatability; and (3 swallowing pressures. Higher ratings of perceived intensity were found in supertasters and with higher concentrations, which were more liked/disliked than lower concentrations. Sweet stimuli were more palatable than sour, salty, or bitter stimuli. Higher concentrations elicited stronger tongue-palate pressures independently and in association with intensity ratings. The perceived intensity of a taste stimulus varies as a function of stimulus concentration, taste quality, participant age, and genetic taste status and influences swallowing pressure amplitudes. High-concentration salty and sour stimuli elicit the greatest tongue-palate pressures.

  12. Swallowing Disorders in Parkinson's Disease: Impact of Lingual Pumping

    Science.gov (United States)

    Argolo, Natalie; Sampaio, Marília; Pinho, Patrícia; Melo, Ailton; Nóbrega, Ana Caline

    2015-01-01

    Background: Lingual pumping (LP) is a repetitive, involuntary, anteroposterior movement of the tongue on the soft palate that is executed prior to transferring the food bolus to the pharynx, but we also observed LP when multiple swallows were taken. LP may be associated with rigidity and bradykinesia in patients with Parkinson's disease (PD). This…

  13. Time budget of South African cliff swallows during breeding

    African Journals Online (AJOL)

    for predicting standard metabolic rate and the cost of flight. The highest daily energy expenditur.e was ... predict standard metabolic rate (SMR) of the South African cliff swallow and the cost of flight was estimated from ... estimation of the time spent in social activities was made. To calculate the cost of building a nest the time ...

  14. Evaluation of swallowing in infants with congenital heart defect.

    Science.gov (United States)

    Pereira, Karine da Rosa; Firpo, Cora; Gasparin, Marisa; Teixeira, Adriane Ribeiro; Dornelles, Silvia; Bacaltchuk, Tzvi; Levy, Deborah Salle

    2015-01-01

    Introduction Surgical repair of congenital heart disease in the first years of life compromises the coordination of the suction, breathing, and swallowing functions. Objective To describe the alterations in swallowing found in infants with congenital heart defect during their hospitalization. Methods Prospective, cross-sectional study in a reference hospital for heart disease. The sample consisted of 19 postsurgical patients who underwent an evaluation of swallowing. The infants included were younger than 7 months and had a diagnosis of congenital heart defect and suspected swallowing difficulties. Results Of the 19 infants with congenital heart defect, the median age was 3.2 months. A significant association was found between suction rhythm and dysphagia (p = 0.036) and between oral-motor oral feeding readiness and dysphagia (p = 0.014). Conclusions The data suggest that dysphagia often occurs after surgery in infants with congenital heart defect. Infants with congenital heart defect had very similar behavior to preterm infants in terms of oral feeding readiness.

  15. Evaluation of Swallowing in Infants with Congenital Heart Defect

    Directory of Open Access Journals (Sweden)

    Pereira, Karine da Rosa

    2014-11-01

    Full Text Available Introduction Surgical repair of congenital heart disease in the first years of life compromises the coordination of the suction, breathing, and swallowing functions. Objective To describe the alterations in swallowing found in infants with congenital heart defect during their hospitalization. Methods Prospective, cross-sectional study in a reference hospital for heart disease. The sample consisted of 19 postsurgical patients who underwent an evaluation of swallowing. The infants included were younger than 7 months and had a diagnosis of congenital heart defect and suspected swallowing difficulties. Results Of the 19 infants with congenital heart defect, the median age was 3.2 months. A significant association was found between suction rhythm and dysphagia (p = 0.036 and between oral-motor oral feeding readiness and dysphagia (p = 0.014. Conclusions The data suggest that dysphagia often occurs after surgery in infants with congenital heart defect. Infants with congenital heart defect had very similar behavior to preterm infants in terms of oral feeding readiness.

  16. Swallow syncope caused by third-degree atrioventricular block.

    Science.gov (United States)

    Aaberg, Anne Marie Roust; Eriksson, Anna Elin; Madsen, Per Lav; Dixen, Ulrik

    2015-10-27

    We report a case of a patient with more than 30 years of repeated syncopes, always following food intake. The patient was diagnosed with a swallow-related third-degree atrioventricular block and successfully treated with an artificial pacemaker. 2015 BMJ Publishing Group Ltd.

  17. Short communications: White-throated Swallow Hirundo albigularis ...

    African Journals Online (AJOL)

    Short communications: White-throated Swallow Hirundo albigularis in Tanzania. NE Baker, EM Baker. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for ...

  18. Effect of posture on swallowing | Alghadir | African Health Sciences

    African Journals Online (AJOL)

    Background: Swallowing is a systematic process. Any structural, physiological or neurological disturbance in this process may cause dysphagia. Although there are studies that report head/neck movements during mastication, there are fewer studies that show the effect of different head/neck postures on difficulty while ...

  19. [Specialties in dentistry. Salivary flow and swallowing in Parkinson's disease

    NARCIS (Netherlands)

    Wierink, C.D.; Spijker, P.C.; Baat, C. de

    2006-01-01

    Parkinson's disease is a slowly progressive and irreversible disorder of the nervous system. Drooling is listed as a secondary symptom of Parkinson's disease. Its cause is insufficiently clear. In the literature 2 possible causes are described: hypersalivation and swallowing abnormalities. These

  20. Time budget of South African cliff swallows during breeding

    African Journals Online (AJOL)

    1973) (see Appendix). The South African cliff swallow spent most of the 24-h day in the nest (Table 1). This included about 9 h spent sleeping in the nest at night. Nest building was a minor component of total activity during the incubation and ...

  1. \\'The snake will swallow you': supernatural snakes and the creation ...

    African Journals Online (AJOL)

    \\'The snake will swallow you': supernatural snakes and the creation of the Khotso legend. Felicity Wood. Abstract. No Abstract. Indilinga: African Journal of Indigenous Knowledge Systems (IAJIKS) Vol. 4(1) 2005: 347-359. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  2. Predictable swallowing function after open horizontal supraglottic partial laryngectomy.

    Science.gov (United States)

    Breunig, Christine; Benter, Philipp; Seidl, Rainer O; Coordes, Annekatrin

    2016-12-01

    After horizontal supraglottic partial laryngectomy, patients have an increased risk of dysphagia as they are not able to close the laryngeal entrance during swallowing, especially if the surgical defect of the tongue base has increased. There is no investigation that studies risk factors for impaired swallow function, or that predicts postoperative swallow outcomes based on radiologically determined tumor dimensions. The present study investigated the impact of the tongue base tumor extension (determined by CT scan in patients undergoing partial laryngectomy) on the recovery rate of swallow function. The retrospective study in a tertiary hospital between 2000 and 2015 included all patients who underwent open horizontal supraglottic partial laryngectomy due to oropharyngeal cancer of the tongue base, or supraglottic laryngeal cancer with tongue base infiltration. All clinicopathological data were collected. The dimension of tongue base infiltration was measured using CT scan. Swallow function was recorded by Fiberoptic Endoscopic Evaluation of Swallowing and determined by evaluating both the duration until nasogastric tube removal and changing of the cuffed tracheostomy tube for an uncuffed speech cannula. The study included 26 patients (44-76 years, median 59 years). The clinical tumor (cT) classification included cT2 and cT3, while the pathologic tumor (pT) classification included pT2 and pT3 in 90% and pT1 and pT4 in 10% respectively. The duration until using the speech cannula was not associated with clinicopathological data, including the investigated radiologic tumor dimensions (biggest tumor diameter, tongue base infiltration depth, width, height, area and volume). The duration until nasogastric tube removal was significantly associated with the tongue base infiltration width (p=0.012), height (p=0.026) and area (pfunction after open horizontal supraglottic partial laryngectomy depends on the tumor extension of the tongue base. The tongue base infiltration

  3. Physiology and Pathophysiology of the Swallowing Area of Human Motor Cortex

    Directory of Open Access Journals (Sweden)

    S. Hamdy

    2001-01-01

    Full Text Available Swallowing problems can affect as many as one in three patients in the period immediately after stroke. Despite this, in the majority of cases, recovery usually occurs to a safe level after a month or two. In this review, we show. how the organization of the cortical projections to swallowing nuscles can account for many of the clinical observations on swallowing after stroke and explain why recovery is common in the long term. In addition, we examine approaches that may be useful in speeding up recovery of swallowing. Swallowing may be a useful model in which to study central nervous reorganization after injury.

  4. Radiation doses to children during modified barium swallow studies

    Energy Technology Data Exchange (ETDEWEB)

    Weir, Kelly A. [University of Queensland, Discipline of Paediatrics and Child Health, School of Medicine, Herston, Queensland (Australia); McMahon, Sandra M. [SpeechNet Speech Pathology Services, Brisbane (Australia); Long, Gillian; Bunch, Judith A. [Royal Children' s Hospital, Department of Medical Imaging, Herston (Australia); Pandeya, Nirmala [Queensland Institute of Medical Research, Herston (Australia); Coakley, Kerry S. [Biomedical Technology Services, Royal Brisbane and Women' s Hospital, Herston (Australia); Chang, Anne B. [Royal Children' s Hospital, Department of Respiratory Medicine, Herston (Australia)

    2007-03-15

    There are minimal data on radiation doses to infants and children undergoing a modified barium swallow (MBS) study. To document screening times, dose area product (DAP) and effective doses to children undergoing MBS and to determine factors associated with increased screening times and effective dose. Fluoroscopic data (screening time, DAP, kVp) for 90 consecutive MBS studies using pulse fluoroscopy were prospectively recorded; effective dose was calculated and data were analyzed for effects of behavior, number of swallow presentations, swallowing dysfunction and medical problems. Mean effective dose for the entire group was 0.0826 {+-} 0.0544 mSv, screening time 2.48 {+-} 0.81 min, and DAP 28.79 {+-} 41.72 cGy cm{sup 2}. Significant differences were found across three age groups ({<=}1.0, >1.0-3.0 and >3.0 years) for effective dose (mean 0.1188, 0.0651 and 0.0529 mSv, respectively; P < 0.001), but not for screening time or DAP. Effective dose was correlated with screening time (P = 0.007), DAP (P < 0.001), number of swallow presentations (P = 0.007), lower age (P = 0.017), female gender (P = 0.004), and height (P < 0.001). Screening time was correlated with total number of swallow presentations (P < 0.001) and DAP (P < 0.001). Screening times, DAP, effective dose, and child and procedural factors associated with higher effective doses are presented for children undergoing MBS studies. (orig.)

  5. Chemical and physical oceanographic profile data collected from CTD casts aboard the Rachel Bordelon in the Gulf of Mexico from 2010-09-04 to 2010-09-13 in response to the Deepwater Horizon oil spill event (NODC Accession 0069078)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Chemical and physical oceanographic profile data were collected aboard the Rachel Bordelon in the Gulf of Mexico from 2010-09-04 to 2010-09-13 in response to the...

  6. A comparison between swallowing sounds and vibrations in patients with dysphagia.

    Science.gov (United States)

    Movahedi, Faezeh; Kurosu, Atsuko; Coyle, James L; Perera, Subashan; Sejdić, Ervin

    2017-06-01

    The cervical auscultation refers to the observation and analysis of sounds or vibrations captured during swallowing using either a stethoscope or acoustic/vibratory detectors. Microphones and accelerometers have recently become two common sensors used in modern cervical auscultation methods. There are open questions about whether swallowing signals recorded by these two sensors provide unique or complementary information about swallowing function; or whether they present interchangeable information. This study aims to compare of swallowing signals recorded by a microphone and a tri-axial accelerometer from 72 patients (mean age 63.94 ± 12.58 years, 42 male, 30 female), who had videofluoroscopic examination. The participants swallowed one or more boluses of thickened liquids of different consistencies, including thin liquids, nectar-thick liquids, and pudding. A comfortable self-selected volume from a cup or a controlled volume by the examiner from a 5 ml spoon was given to the participants. A broad feature set was extracted in time, information-theoretic, and frequency domains from each of 881 swallows presented in this study. The swallowing sounds exhibited significantly higher frequency content and kurtosis values than the swallowing vibrations. In addition, the Lempel-Ziv complexity was lower for swallowing sounds than those for swallowing vibrations. To conclude, information provided by microphones and accelerometers about swallowing function are unique and these two transducers are not interchangeable. Consequently, the selection of transducer would be a vital step in future studies. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Differences in brain networks during consecutive swallows detected using an optimized vertex-frequency algorithm.

    Science.gov (United States)

    Jestrović, Iva; Coyle, James L; Sejdić, Ervin

    2017-03-06

    Patients with dysphagia can have higher risks of aspiration after repetitive swallowing activity due to the "fatigue effect". However, it is still unknown how consecutive swallows affect brain activity. Therefore, we sought to investigate differences in swallowing brain networks formed during consecutive swallows using a signal processing on graph approach. Data were collected from 55 healthy people using electroencephalography (EEG) signals. Participants performed dry swallows (i.e., saliva swallows) and wet swallows (i.e., water, nectar-thick, and honey thick swallows). After standard pre-processing of the EEG time series, brain networks were formed using the time-frequency-based synchrony measure, while signals on graphs were formed as a line graph of the brain networks. For calculating the vertex frequency information from the signals on graphs, the proposed algorithm was based on the optimized window size for calculating the windowed graph Fourier transform and the graph S-transform. The proposed algorithms were tested using synthetic signals and showed improved energy concentration in comparison to the original algorithm. When applied to EEG swallowing data, the optimized windowed graph Fourier transform and the optimized graph S-transform showed that differences exist in brain activity between consecutive swallows. In addition, the results showed higher differences between consecutive swallows for thicker liquids. Copyright © 2016 IBRO. Published by Elsevier Ltd. All rights reserved.

  8. Soft-robotic esophageal swallowing as a clinically-inspired bolus rheometry technique

    Science.gov (United States)

    Dirven, Steven; Allen, Jacqueline; (Peter Xu, Weiliang; Cheng, Leo K.

    2017-03-01

    To investigate the impact of viscosity and peristaltic transport parameters on manometric pressure signatures, a reproducible swallowing process is required. Due to inter- and intra-subject variability from swallow to swallow, the human body does not represent an optimal mechanism for such an investigation. A smooth and continuous swallowing soft-robot has been developed to produce biomimetic swallowing trajectories, and is proposed to operate as a bench-top bolus rheometric investigation method. The method compares conventional viscometry and pressure signature findings from robotic swallowing experiments. The robotic aspect of experimentation involved 450 biomimetic swallows (10 repetitions of 45 unique experiments). The method examined swallowing transport in three dimensions: bolus formulation, peristaltic wavelength, and peristaltic velocity, each of which are known to contribute to safe and effective swallowing in vivo. It is found that the pressure gradients and magnitudes are commensurate with clinical reports on biological swallowing, on the order of 100 mmHg peak, however, the relationship between viscosity and pressure signatures is less clear. Bolus transport cannot be predicted as a function of bolus viscosity alone. Traditional viscometric data at 50 s-1, as used in clinical practice, may not be a strong indicator of swallow effort, safety, or efficacy in vivo.

  9. Submental sEMG and Hyoid Movement during Mendelsohn Maneuver, Effortful Swallow, and Expiratory Muscle Strength Training

    Science.gov (United States)

    Wheeler-Hegland, Karen M.; Rosenbek, John C.; Sapienza, Christine M.

    2008-01-01

    Purpose: This study investigated the concurrent biomechanical and electromyographic properties of 2 swallow-specific tasks (effortful swallow and Mendelsohn maneuver) and 1 swallow-nonspecific (expiratory muscle strength training [EMST]) swallow therapy task in order to examine the differential effects of each on hyoid motion and associated…

  10. Human swallowing simulation based on videofluorography images using Hamiltonian MPS method

    Science.gov (United States)

    Kikuchi, Takahiro; Michiwaki, Yukihiro; Kamiya, Tetsu; Toyama, Yoshio; Tamai, Tasuku; Koshizuka, Seiichi

    2015-09-01

    In developed nations, swallowing disorders and aspiration pneumonia have become serious problems. We developed a method to simulate the behavior of the organs involved in swallowing to clarify the mechanisms of swallowing and aspiration. The shape model is based on anatomically realistic geometry, and the motion model utilizes forced displacements based on realistic dynamic images to reflect the mechanisms of human swallowing. The soft tissue organs are modeled as nonlinear elastic material using the Hamiltonian MPS method. This method allows for stable simulation of the complex swallowing movement. A penalty method using metaballs is employed to simulate contact between organ walls and smooth sliding along the walls. We performed four numerical simulations under different analysis conditions to represent four cases of swallowing, including a healthy volunteer and a patient with a swallowing disorder. The simulation results were compared to examine the epiglottic downfolding mechanism, which strongly influences the risk of aspiration.

  11. The swallowing reflex and its significance as an airway defensive reflex

    Directory of Open Access Journals (Sweden)

    Takashi eNishino

    2013-01-01

    Full Text Available Swallowing function, in humans, is very complex. Swallowing plays, not only an important role in food digestion, but also a major role in preventing the entrance of food and/or other materials into the lower respiratory tract. To achieve this, precise coordination is necessary between breathing and swallowing since the pharynx serves as a common pathway for both respiration and digestion. The swallowing reflex consists of afferent pathways, central integration, and efferent pathways. Any defect or disorder along reflex arc can cause a potential delay or impairment in swallow function. The swallowing reflex can be modulated not only by pathological factors but also by physiological factors. Among these, timing of swallows in relation to the phase of respiration may be the most important factor that determines the occurrence of pulmonary aspiration, since phases of inspiration and the expiration-inspiration transition are the most vulnerable for pulmonary aspiration.

  12. Obituary: Richard L. (Dick) Walker, Jr., 1938-2005

    Science.gov (United States)

    Pier, Jeffrey R.; Mason, Brian

    2005-12-01

    Koch Center for Science, Math, and Technology at Deerfield Academy in Massachusetts. He also consulted with James Turrell, providing astronomical position information for the design of the Roden Crater Project outside of Flagstaff. While he will be remembered for his significant scientific contributions to the field of astronomy, those who knew Dick, both scientists and non-scientists alike, will probably remember him best for his humility, his humanity, and his loyal and abiding friendship. He was a man with a terrific sense of humor and an infectious laugh. It was always an honor and pleasure to be in his company. Richard L. Walker, Jr. is survived by his wife, Patricia, two daughters from his first marriage: Brenda Walker of Las Vegas, NV, and Pamela Hepburn of Holland, OH, as well as four children from Patricia's first marriage: Doug Browning of Lake Havasu City, AZ, Michael Browning of Kingman, AZ, Kim Bructo of Orient, OH, and Jennifer Brown of Lake Havasu City, AZ. He is also survived by ten grandchildren and three great-grandchildren. He was preceded in death by his father Richard, mother Mary, and daughter, Paula Jean Elizabeth Stone.

  13. Aging-related changes in swallowing, and in the coordination of swallowing and respiration determined by novel non-invasive measurement techniques.

    Science.gov (United States)

    Wang, Chin-Man; Chen, Ji-Yih; Chuang, Chiung-Cheng; Tseng, Wen-Chun; Wong, Alice M K; Pei, Yu-Cheng

    2015-06-01

    Previous studies have shown that the process of swallowing changes with aging, a phenomenon known as presbyphagia. These subtle and subclinical age-related changes make older adults more vulnerable to dysphagia during disease insults. However, there are limited studies of the swallowing process in older adults, because measurements are typically invasive or require exposure to X-rays. In the present study, we used integrated non-invasive measurements to determine aging-related changes of swallowing, and in the coordination of swallowing and respiration for a population of healthy participants. The non-invasive system provided measurements of larynx movement with piezoelectric sensors, submental muscle activity with surface electromyography and respiration-swallowing coordination by measurement of nasal airflow. We recruited 112 healthy participants from the community, 35 in a young-age group (age 20-30 years), 38 in a middle-age group (age 31-50 years) and 39 in an old-age group (age 51-70 years). The oropharyngeal swallowing parameters of the old-age group had delayed onset latency and longer swallowing apnea duration relative to the other groups, and these differences were greater for larger boluses. The middle- and old-age groups had less expiratory-expiratory respiratory phase pattern than the young-age group. The probability of piecemeal deglutition was highest in the old-age group and lowest in the young-age group. These results show that the phases of oropharyngeal swallowing and the coordination of swallowing with respiration gradually change with aging. We used integrated non-invasive measurements to document age-related changes in swallowing, and in the coordination of swallowing and respiration in healthy adults. © 2014 The Authors. Geriatrics & Gerontology International published by Wiley Publishing Asia Pty Ltd on behalf of Japan Geriatrics Society.

  14. Fetal swallowing as a protective mechanism against oligohydramnios and polyhydramnios in late gestation sheep.

    Science.gov (United States)

    Brace, Robert A; Anderson, Debra F; Cheung, Cecilia Y

    2013-03-01

    Our objectives were to (1) quantify the relationship between daily swallowed volume and amniotic fluid volume (AF volume) in late gestation ovine fetuses and (2) use the resulting regression equation to explore the role of swallowing in regulating AF volume. Daily swallowed volume ranged from 36 to 1963 mL/d while experimental AF volume ranged from 160 to 6150 mL (n = 115). Swallowed volume was near zero when AF volume was far below normal, a maximum of 635 ± 41 (standard error) mL/d when AF volume was 1682 ± 31 mL and did not increase further with higher AF volumes. Computer simulations predicted that fetal swallowing would (1) return AF volume to normal in 5 to 6 days following an acute volume change in the absence of changes in other amniotic inflows or outflows and (2) stabilize AF volume in 4 to 8 days following sustained alterations in amniotic inflows or outflows other than swallowing. The volume of AF swallowed each day by the fetus is a strong function of AF volume and reaches a maximum when mild polyhydramnios develops. With deviations in AF volume from normal, changes in fetal swallowing protect against oligohydramnios and polyhydramnios because the changes in swallowing over time reduce the extent of the AF volume change. However, with experimental changes in AF volume stabilizing in 1 to 2 days, it appears that swallowing is not the major regulator of AF volume.

  15. “Without Evidence, there is No Answer”: Uncertainty and Scientific Ethos in the Silent Spring[s] of Rachel Carson

    Directory of Open Access Journals (Sweden)

    Kenny Walker

    2013-05-01

    Full Text Available The 50th year anniversary of Rachel Carson’s monumental Silent Spring invites reflection on how the controversy over chemical pesticides shaped environmental discourse in the modern era. This essay focuses on uncertainty as a boundary device that shapes scientific ethos in crucial ways and negotiates a relationship between technical science and public deliberation. Situated in rhetorical analysis, the author takes a comparative approach towards the use of uncertainty and scientific ethos in the Silent Spring controversy. Drawing from Carson’s published book, and from the famous CBS Reports investigative television program seven months after the book’s publication, this essay demonstrates how CBS Reports directly received, and amplified, Carson’s uncertainty frameworks, and used them to drive the public evaluation of scientific ethos. This analysis reveals three ways uncertainty shapes scientific ethos: uncertainty as a probability (ethos of expertise, as a moral certainty (ethos of civic participant, and as an unknown or unconcern (ethos of ignorance. Finally, the author suggests that the circulation of these uncertainty frameworks of scientific ethos helped drive the momentum from the books’ publication, to public evaluation, to policy-making, and suggests these uncertainty frameworks are enduring forces in debates about the role of experts in scientific controversies.

  16. Enhancing effects of flavored nutritive stimuli on cortical swallowing network activity

    Science.gov (United States)

    Babaei, Arash; Kern, Mark; Antonik, Stephen; Mepani, Rachel; Ward, B. Douglas; Li, Shi-Jiang; Hyde, James

    2010-01-01

    A better understanding of the central control of the physiology of deglutition is necessary for devising interventions aimed at correcting pathophysiological conditions of swallowing. Positive modulation of the cortical swallowing network can have clinical ramifications in dysphagia due to central nervous system deficits. Our aim was to determine the effect of nutritive sensory input on the cortical swallowing network. In 14 healthy right-handed volunteers, we utilized a paradigm-driven protocol to quantify the number of activated voxels and their signal intensity within the left hemispheric cortical swallowing network by high-resolution functional MRI (fMRI) during five different swallowing conditions. Swallowing conditions included a dry swallow (saliva) and natural water-, lemon-, popcorn-, and chocolate-flavored liquid swallows. Each flavored liquid was presented simultaneously by its image, scent, and taste in random order and tested over three runs. fMRIs were analyzed in a blinded fashion. Average fMRI blood oxygenation level-dependent signal intensity and number of activated voxels during swallowing concurrent with nutritive gustatory, olfactory, and visual stimulations were significantly increased compared with dry/natural water swallows throughout the cortical swallowing network (P < 0.001 and P < 0.05, respectively). Subregion analysis showed the increased activity for flavored liquids in prefrontal, cingulate gyrus, and sensory/motor cortex, but not in precuneus and insula. Concurrent gustatory, olfactory, and visual nutritive stimulation enhances the activity of the cortical swallowing network. This finding may have clinical implications in management of swallowing disorders due to cortical lesions. PMID:20508154

  17. Clinical Characteristics and Lesions Responsible for Swallowing Hesitation After Acute Cerebral Infarction.

    Science.gov (United States)

    Saito, Tsukasa; Hayashi, Keisuke; Nakazawa, Hajime; Ota, Tetsuo

    2016-08-01

    Some stroke patients with a unilateral lesion demonstrate acute dysphagia characterized by a markedly prolonged swallowing time, making us think they are reluctant to swallow. In order to clarify the clinical characteristics and causative lesions of delayed swallowing, we conducted a retrospective analysis of 20 right-handed patients without a history of swallowing dysfunction who underwent videofluorography on suspicion of dysphagia after a first ischemic stroke. The oral processing time plus the postfaucial aggregation time required to swallow jelly for patients classified as having delayed swallowing was over 10 s. The time required for swallowing jelly was significantly longer than that without the hesitation (median value, 24.1 vs. 8.9 s, P oral processing time plus the postfaucial aggregation time required for patients with delayed swallowing to swallow thickened water was largely over 5 s and significantly longer than that of patients without swallowing hesitation (median value, 10.2 vs. 3.3 s, P acute unilateral infarction could be separated into two different patterns. Because four of the five patients with a rippling tongue movement in the swallowing hesitation pattern had a lesion in the left primary motor cortex, which induces some kinds of apraxia, swallowing hesitation with a rippling tongue movement seems to be a representative characteristic of apraxia. The patients with swallowing hesitation with a temporary stasis of the tongue in this study tended to have broad lesions in the frontal lobe, especially in the middle frontal gyrus, which is thought to be involved in higher cognition.

  18. Speech and swallowing outcomes in buccal mucosa carcinoma

    Directory of Open Access Journals (Sweden)

    Sunila John

    2011-01-01

    Full Text Available Buccal carcinoma is one of the most common malignant neoplasms among all oral cancers in India. Understanding the role of speech language pathologists (SLPs in the domains of evaluation and management strategies of this condition is limited, especially in the Indian context. This is a case report of a young adult with recurrent squamous cell carcinoma of the buccal mucosa with no deleterious habits usually associated with buccal mucosa carcinoma. Following composite resection, pectoralis major myocutaneous flap reconstruction, he developed severe oral dysphagia and demonstrated unintelligible speech. This case report focuses on the issues of swallowing and speech deficits in buccal mucosa carcinoma that need to be addressed by SLPs, and the outcomes of speech and swallowing rehabilitation and prognostic issues.

  19. Innate immune response development in nestling tree swallows

    Science.gov (United States)

    Stambaugh, T.; Houdek, B.J.; Lombardo, M.P.; Thorpe, P.A.; Caldwell, Hahn D.

    2011-01-01

    We tracked the development of innate immunity in nestling Tree Swallows (Tachycineta bicolor) and compared it to that of adults using blood drawn from nestlings during days 6, 12, and 18 of the ???20-day nestling period and from adults. Innate immunity was characterized using an in vitro assay of the ability of whole blood to kill Escherichia coli. The ability of whole blood to kill E. coli increased as nestlings matured. Neither this component of innate immunity nor right wing chord length on day18 were as developed as in adults indicating that development of the innate immune system and growth both continued after fledging. Narrow sense heritability analyses suggest that females with strong immune responses produced nestlings with strong immune responses. These data suggest nestling Tree Swallows allocated sufficient energy to support rapid growth to enable fledging by day 18, but that further development of innate immunity occurred post-fledging. ?? 2011 by the Wilson Ornithological Society.

  20. Pain, masticatory performance and swallowing threshold in orthodontic patients

    Directory of Open Access Journals (Sweden)

    Marcos Porto Trein

    2013-12-01

    Full Text Available OBJECTIVE: The aim of this study was to assess pain, masticatory performance and swallowing threshold of patients undergoing orthodontic treatment. METHODS: Ten patients of both genders (mean age of 17.25 ± 5.21 years, with complete permanent dentition, who underwent orthodontic treatment with fixed appliances were evaluated. The masticatory performance and the swallowing threshold were assessed by patient's individual capacity of fragmenting an artificial test food (Optocal which was chewed and had the resulting particles processed by a standardized sieving method, presenting the median particle size (MPS of crushed units. The intensity of pain / discomfort during chewing was evaluated by means of a visual analog scale. All tests were performed at the following times: T0 - before activating the orthodontic appliance; T1 - 24 hours after activation, and T2 - 30 days after activation. RESULTS: The results showed a significant increase in pain at T1 (T0 - 0.60 ± 0.70 mm; T1 - 66.2 ± 34.5 mm, returning to baseline values at T2 (3.20 ± 3.82 mm. Masticatory performance was also reduced in T1 (MPS 10.15 ± 1.1 mm² in comparison to T0 (MPS 7.01 ± 2.9 mm² and T2 (MPS 6.76 ± 1.3 mm². However, particle size was not affected in the swallowing threshold test (T0 - 5.47 ± 2.37 mm²; T1 - 6.19 ± 2.05 mm²; T2 - 5.94 ± 2.36 mm². CONCLUSION: The orthodontic appliances did not interfere in the size of the particles that would be swallowed, even in the presence of pain.

  1. Difficult to swallow: patient preferences for alternative valproate pharmaceutical formulations

    Directory of Open Access Journals (Sweden)

    Monali Bhosle

    2009-06-01

    Full Text Available Monali Bhosle,1 Joshua S Benner,1 Mitch DeKoven,1 Jeff Shelton21Health Economics and Outcomes Research, IMS Health Inc, Falls Church, VA, USA; 2Answers and Insights Market Research, Inc, Indianapolis, IN, USAObjective: To determine the degree to which swallowing valproate (VP tablets is an issue, the proportion of patients who would prefer an alternative formulation, and the predictors of preference.Methods: A quantitative telephone survey of eligible adults (n = 400, ≥18 years old who currently take (n = 236 or previously took (n = 164 VP tablets within the past 6 months was conducted.Results: More than half of the patients indicated that VP tablets were ‘uncomfortable to swallow’ (68.5%, n = 274 and were ‘very interested’ (65.8%, n = 263 in medications that were easier to swallow. When choosing conceptually between taking VP tablet once/day or an equally safe and effective but significantly smaller soft gel capsule twice per day, the 82.8%, (n = 331 preferred the soft gel capsule. In the multivariate regression analysis, perceiving soft gel capsules to be easier to swallow (OR = 73.54; 95% CI = 15.01 to 360.40 and taking VP more frequently (OR = 2.02; 95% CI = 1.13 to 3.61 were significant predictors of soft gel capsule treatment preference.Conclusion: VP users would prefer a formulation that is easier to swallow, even if it is needed to be taken twice per day. When choosing between medications with similar efficacy and safety, physicians can consider patient preferences to optimize conditions for medication adherence.Keywords: patient preference, valproate formulations, tablet characteristics

  2. Epidermal electronics for electromyography: An application to swallowing therapy.

    Science.gov (United States)

    Constantinescu, Gabriela; Jeong, Jae-Woong; Li, Xinda; Scott, Dylan K; Jang, Kyung-In; Chung, Hyun-Joong; Rogers, John A; Rieger, Jana

    2016-08-01

    Head and neck cancer treatment alters the anatomy and physiology of patients. Resulting swallowing difficulties can lead to serious health concerns. Surface electromyography (sEMG) is used as an adjuvant to swallowing therapy exercises. sEMG signal collected from the area under the chin provides visual biofeedback from muscle contractions and is used to help patients perform exercises correctly. However, conventional sEMG adhesive pads are relatively thick and difficult to effectively adhere to a patient's altered chin anatomy, potentially leading to poor signal acquisition in this population. Here, the emerging technology of epidermal electronics is introduced, where ultra-thin geometry allows for close contouring of the chin. The two objectives of this study were to (1) assess the potential of epidermal electronics technology for use with swallowing therapy and (2) assess the significance of the reference electrode placement. This study showed comparative signals between the new epidermal sEMG patch and the conventional adhesive patches used by clinicians. Furthermore, an integrated reference yielded optimal signal for clinical use; this configuration was more robust to head movements than when an external reference was used. Improvements for future iterations of epidermal sEMG patches specific to day-to-day clinical use are suggested. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

  3. Effect of age on proximal esophageal response to swallowing

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    Roberto Oliveira Dantas

    2010-12-01

    Full Text Available CONTEXT: It has been demonstrated that the ageing process affects esophageal motility. OBJECTIVES: To evaluate the effect of the age on the proximal esophageal response to wet swallows. METHOD: We measured the proximal esophageal response to swallows of a 5 mL bolus of water in 69 healthy volunteers, 20 of them aged 18-30 years (group I, 27 aged 31-50 years (group II, and 22 aged 51-74 years (group III. We used the manometric method with continuous perfusion. The proximal esophageal contractions were recorded 5 cm from a pharyngeal recording site located 1 cm above the upper esophageal sphincter. The time between the onset of the pharyngeal and of the proximal esophageal recording (pharyngeal-esophageal time and the amplitude, duration and area under the curve of the proximal esophageal contraction were measured. RESULTS: The pharyngeal-esophageal time was shorter in group I subjects than in group II and III subjects (P<0.05. The duration of proximal esophageal contractions was longer in group I than in groups II and III (P<0.001. There was no differences between groups in the amplitude or area under the curve of contractions. There were no differences between groups II and III for any of the measurements. CONCLUSION: We conclude that the age may affects the response of the proximal esophagus to wet swallows.

  4. Pattern of tongue pressure on hard palate during swallowing.

    Science.gov (United States)

    Ono, Takahiro; Hori, Kazuhiro; Nokubi, Takashi

    2004-01-01

    Contact of the tongue against the hard palate plays an important role in swallowing. This study aimed to clarify the pattern of contact between the tongue and hard palate by analyzing tongue pressure produced in swallowing 15 ml of water by healthy subjects wearing an experimental palatal plate with seven pressure sensors. Tongue pressure was generated initially by close contact with the anteriomedian part of the hard palate, then with the circumferential part, and finally softly with the posteriomedian part. Tongue pressure reached a peak quickly, then decreased gradually before disappearing almost simultaneously at each measured part of the hard palate. Magnitude and duration were significantly larger in the anteriomedian part compared to the other six parts measured, and was significantly smaller in the posteriomedian part. No laterality was found in tongue pressure produced at the circumferential parts of the hard palate. Our findings indicate that the order of tongue contact against each part of the hard palate as well as duration and magnitude of tongue pressure are coordinated precisely during swallowing. These findings could aid assessment of the tongue movement of dysphagic patients during rehabilitation.

  5. An electrophysiological study of the sequential water swallowing.

    Science.gov (United States)

    Gürgör, N; Arıcı, Ş; Kurt Incesu, Tülay; Seçil, Y; Tokuçoğlu, F; Ertekin, C

    2013-06-01

    Sequential water swallowing (SWS) was mostly investigated by the videofluoroscopic and endoscopic methods. However some physiological features of SWS was rarely evaluated by neurophysiological techniques. Our aim was to investigate some neural and muscular changes on sequences of SWS using electromyography (EMG) methods. Fifty-eight normal adults were investigated. SWS was initiated voluntarily with 50ml and 100ml water volumes from a cup. Submental EMG, respiratory signals, heart rate, and sympathetic skin responses (SSR) were measured during SWS. All parameters were increased significantly during the 100ml SWS. During swallowing apnea period, compensatory respiration cycles occurred in 24% and 48% of participants in the 50ml and 100ml SWS, respectively. Heart rate increased during swallowing apnea. SSR were evoked just before and just after the SWS in more than halves of participants. A foreburst EMG in SM muscles at the initiation of SWS was recorded in 86% of normal participants. Older age was associated with a prolonged duration of the apnea period. All parameters of the SWS could be recorded numerically and objectively using electrphysiological methods. These are similar to those obtained by videofluoroscopic and similar methods. The foreburst activity of the initiation of SWS may represents preparatory activity from the activation of the fast cortical descending motor pathway. Increasing heart rate and the prolonged apnea urged that older people and patients could be carefully tested for respiratory and cardiac rhythm disorders. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Thirty years of blackouts: a case report of swallow syncope

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    Irene Lambiris

    2013-04-01

    Full Text Available Deglutition syncope has been demonstrated in isolated case reports, the first being described over 50 years ago. It is thought to be caused by a hypersensitive vagotonic reflex in response to esophageal dilation after swallowing. It can cause syncope due to complete atrioventricular (AV block and acute reduction of cardiac output. Although rare, its lethality is worthy of discussion, as early recognition can offer complete treatment with placement of a pacemaker. A 54-year-old man presented with 30 years of lightheadedness and syncope, followed by disorientation and tremors, after eating sandwiches or drinking carbonated beverages. He initially was evaluated by a neurologist. Work-up included cardiac 2D transthoracic echocardiogram, electroencephalogram, swallow stud, pulmonary function tests, electrocardiogram, and cardiac stress testing. All tests were within normal limits, and it was determined that he was suffering from convulsive syncope and deglutition syncope. Referral to the cardiac electrophysiology department with tilt-table testing accompanied by swallow evaluation was then recommended. The tests demonstrated marked vagal response resulting in sinus bradycardia with second-degree AV block and pauses up to 3.5 seconds. Patient experienced near syncope. A rate-responsive, dual-chamber Boston Scientific pacemaker with DDDR programming was implanted. Patient has remained asymptomatic at follow-up.

  7. Mastication and swallowing: influence of fluid addition to foods

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    Luciano José Pereira

    2007-02-01

    Full Text Available INTRODUCTION: The production of sufficient saliva is indispensable for good chewing. Recent research has demonstrated that salivary flow rate has little influence on the swallowing threshold. OBJECTIVES: The hypothesis examined in the present study was that adding fluids to foods will influence chewing physiology. Materials and METHODS: Twenty subjects chewed on melba toast, cake, carrot, peanut and Gouda cheese. They also chewed on these foods after addition of different volumes of water or alpha-amylase solution. Jaw muscle activity, number of chewing cycles until swallowing and chewing cycle duration were measured. Repeated measures analysis of variance was applied to test the null hypothesis that there would be no statistically significant difference among the results obtained for the various food types and fluids. Subsequently, contrasts were determined to study the levels of intra-subjects factors (food type and fluid volume. Linear regression was used to determine the changes in muscle activity and cycle duration as a function of the chewing cycles. RESULTS: Fluid addition significantly decreased muscle activity and swallowing threshold for melba, cake and peanut (p0.05. Doubling the volume of tap water had a greater effect. CONCLUSIONS: Fluid addition facilitated chewing of dry foods (melba, cake, but did not influence the chewing of fatty (cheese and wet products (carrot. This study is relevant to improve patients' life quality and the management of chewing and feeding disorders caused by hyposalivation.

  8. Suck, swallow and breathing coordination in infants with infantile colic

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    Hanlie Degenaar

    2015-12-01

    Objective: The objective of the study was to explore the suck, swallow and breathing coordination in infants with infantile colic and compare it with infants without the condition. Method: An assessment protocol for suck, swallow and breathing coordination was compiled from literature. This protocol was performed on a research group of 50 infants, independently diagnosed with infantile colic, and a control group of 28 infants without the condition. All participants were from two rural towns in the North–West province, South Africa, selected with a snowball selection method and strict selection criteria. The study followed a static comparison group design. Results: A significant difference in the key components of feeding and the presence of colic in participants of four age categories were found. The correlation between postural control and the presence of infantile colic were sustained in participants from 2–19 weeks old. Conclusion: Suck, swallow and breathing were found to be significantly associated with infantile colic. The findings should be investigated further. It appears that speech-language therapists may play an expanding role in infantile colic. [pdf to follow

  9. Cine-MRI swallowing evaluation after tongue reconstruction

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    Hartl, Dana M. [Department of Otolaryngology-Head and Neck Surgery, Institute Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France)], E-mail: dmhartl@aol.com; Kolb, Frederic; Bretagne, Evelyne [Department of Otolaryngology-Head and Neck Surgery, Institute Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France); Bidault, Francois; Sigal, Robert [Department of Radiology, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France)

    2010-01-15

    Objective: To determine the feasibility of cine-MRI for non-invasive swallowing evaluation after surgery for lingual carcinoma with reconstruction using microvascular free flaps. Methods: Ten patients with stage IV carcinoma of the mobile tongue and/or tongue base treated by surgical resection and reconstruction with a free flap were evaluated after an average of 4.3 years (range: 1.5-11 years), using cine-MRI in 'single-shot fast spin echo' (SSFSE) mode. Fiberoptic laryngoscopy of swallowing was performed before MRI to detect aspiration. The tolerance and ability to complete the exam were noted. The mobilities of the oral and pharyngeal structures visualized were evaluated as normal, reduced or increased. Results: Cine-MRI was well tolerated in all cases; 'dry' swallow was performed for the 2 patients with clinical aspiration. Tongue base-pharyngeal wall contact was observed in 5 cases. An increased anterior tongue recoil, increased mandibular recoil, increased posterior oropharyngeal wall advancement and an increased laryngeal elevation were observed in 4 cases. One case of a passive 'slide' mechanism was observed. Conclusions: Cine-MRI is a safe, non-invasive technique for the evaluation of the mobility of oral and oropharyngeal structures after free-flap reconstruction of the tongue. For selected cases, it may be complementary to clinical examination for evaluation of dysphagia after surgery and free-flap reconstruction. Further technical advances will be necessary before cine-MRI can replace videofluoroscopy, however.

  10. “Now is the winter of our discontent” : The Uncanny History of Richard III

    OpenAIRE

    Johansson Moberg, John Leo

    2017-01-01

    This paper will use Sigmund Freud’s essay “The Uncanny” to analyse William Shakespeare’s play Richard III. It will be argued that, although the play predates the ideas of Freud, it makes use of several elements of the uncanny to set the scene or to enhance imagery. With the goal to reveal such aspects of the play, a number of specific topics and ideas will be discussed and examined. The dreams of the play will be interpreted; Richard III is noteworthy for its reliance on dreams to replace the...

  11. Richard Gans y la cuantificación del momento dipolar magnético

    OpenAIRE

    Bibiloni, Aníbal Guillermo; Civitarese, Osvaldo E.; Reichenbach, María Cecilia von

    2002-01-01

    Richard Gans, físico de origen alemán, fue el sucesor de Emil Bose en la dirección-organización del Departamento de Física de la Universidad de La Plata. Su llegada, en 1912, constituyó un aporte significativo, para la incipiente actividad científica en la UNLP. Richard Gans, en el momento de su llegada a la Plata, había adquirido ya una sólida reputación científica y estaba en contacto con centros muy activos de investigación. Su trabajo, en problemas relacionados con el magnetismo, era bien...

  12. Anesthesia and increased hypercarbic drive impair the coordination between breathing and swallowing

    Science.gov (United States)

    D'Angelo, Olivia M.; Diaz-Gil, Daniel; Nunn, Danuza; Simons, Jeroen C.P.; Gianatasio, Chloe; Mueller, Noomi; Meyer, Matthew J.; Pierce, Eric; Rosow, Carl; Eikermann, Matthias

    2017-01-01

    Background Coordination between breathing and swallowing helps prevent aspiration of foreign material into the respiratory tract. We examined the effects of anesthesia, and hypercapnia on swallowing-breathing coordination. Methods In a randomized controlled cross-over study, general anesthesia with propofol or sevoflurane was titrated using an up-down method to identify the threshold for suppression of the motor response to electrical stimulation of the forearm. Additional measurements included bispectral index, genioglossus electromyogram, ventilation (pneumotachometer), and hypopharyngeal pressure. During wakefulness and at each level of anesthetic, carbon dioxide was added to increase its end tidal pressure by 4 and 8 mmHg. A swallow was defined as increased genioglossus activity with deglutition apnea and an increase in hypopharyngeal pressure. Spontaneous swallows were categorized as physiological (during expiration or followed by expiration), or pathological (during inspiration or followed by an inspiration). Results A total of 224 swallows were analyzed. Anesthesia increased the proportion of pathological swallows (25.9% versus 4.9%), and decreased the number of swallows per hour (1.7 ± 3.3 versus 28.0 ± 22.3) compared to wakefulness. During anesthesia, hypercapnia decreased hypopharyngeal pressure during inspiration (-14.1±3.7 versus -8.7±2 mmHg), and increased minute ventilation the proportion of pathological swallows (19.1% versus 12.3%), and the number of swallows per hour (5.5 ±17.0. versus 1.3 ± 5.5). Conclusions Anesthesia impaired the coordination between swallowing and respiration. Mild hypercapnia increased the frequency of swallowing during anesthesia and the likelihood of pathological swallowing. During anesthesia, the risk for aspiration may be further increased when ventilatory drive is stimulated. PMID:25275368

  13. Effects of liquid stimuli on dual-axis swallowing accelerometry signals in a healthy population

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    Sejdić Ervin

    2010-02-01

    Full Text Available Abstract Background Dual-axis swallowing accelerometry has recently been proposed as a tool for non-invasive analysis of swallowing function. Although swallowing is known to be physiologically modifiable by the type of food or liquid (i.e., stimuli, the effects of stimuli on dual-axis accelerometry signals have never been thoroughly investigated. Thus, the objective of this study was to investigate stimulus effects on dual-axis accelerometry signal characteristics. Signals were acquired from 17 healthy participants while swallowing 4 different stimuli: water, nectar-thick and honey-thick apple juices, and a thin-liquid barium suspension. Two swallowing tasks were examined: discrete and sequential. A variety of features were extracted in the time and time-frequency domains after swallow segmentation and pre-processing. A separate Friedman test was conducted for each feature and for each swallowing task. Results Significant main stimulus effects were found on 6 out of 30 features for the discrete task and on 5 out of 30 features for the sequential task. Analysis of the features with significant stimulus effects suggested that the changes in the signals revealed slower and more pronounced swallowing patterns with increasing bolus viscosity. Conclusions We conclude that stimulus type does affect specific characteristics of dual-axis swallowing accelerometry signals, suggesting that associated clinical screening protocols may need to be stimulus specific.

  14. Central inhibition of initiation of swallowing by systemic administration of diazepam and baclofen in anaesthetized rats.

    Science.gov (United States)

    Tsujimura, Takanori; Sakai, Shogo; Suzuki, Taku; Ujihara, Izumi; Tsuji, Kojun; Magara, Jin; Canning, Brendan J; Inoue, Makoto

    2017-05-01

    Dysphagia is caused not only by neurological and/or structural damage but also by medication. We hypothesized memantine, dextromethorphan, diazepam, and baclofen, all commonly used drugs with central sites of action, may regulate swallowing function. Swallows were evoked by upper airway (UA)/pharyngeal distension, punctate mechanical stimulation using a von Frey filament, capsaicin or distilled water (DW) applied topically to the vocal folds, and electrical stimulation of a superior laryngeal nerve (SLN) in anesthetized rats and were documented by recording electromyographic activation of the suprahyoid and thyrohyoid muscles and by visualizing laryngeal elevation. The effects of intraperitoneal or topical administration of each drug on swallowing function were studied. Systemic administration of diazepam and baclofen, but not memantine or dextromethorphan, inhibited swallowing evoked by mechanical, chemical, and electrical stimulation. Both benzodiazepines and GABA A receptor antagonists diminished the inhibitory effects of diazepam, whereas a GABA B receptor antagonist diminished the effects of baclofen. Topically applied diazepam or baclofen had no effect on swallowing. These data indicate that diazepam and baclofen act centrally to inhibit swallowing in anesthetized rats. NEW & NOTEWORTHY Systemic administration of diazepam and baclofen, but not memantine or dextromethorphan, inhibited swallowing evoked by mechanical, chemical, and electrical stimulation. Both benzodiazepines and GABA A receptor antagonists diminished the inhibitory effects of diazepam, whereas a GABA B receptor antagonist diminished the effects of baclofen. Topical applied diazepam or baclofen was without effect on swallowing. Diazepam and baclofen act centrally to inhibit swallowing in anesthetized rats. Copyright © 2017 the American Physiological Society.

  15. Spontaneous swallowing frequency has potential to identify dysphagia in acute stroke.

    Science.gov (United States)

    Crary, Michael A; Carnaby, Giselle D; Sia, Isaac; Khanna, Anna; Waters, Michael F

    2013-12-01

    Spontaneous swallowing frequency has been described as an index of dysphagia in various health conditions. This study evaluated the potential of spontaneous swallow frequency analysis as a screening protocol for dysphagia in acute stroke. In a cohort of 63 acute stroke cases, swallow frequency rates (swallows per minute [SPM]) were compared with stroke and swallow severity indices, age, time from stroke to assessment, and consciousness level. Mean differences in SPM were compared between patients with versus without clinically significant dysphagia. Receiver operating characteristic curve analysis was used to identify the optimal threshold in SPM, which was compared with a validated clinical dysphagia examination for identification of dysphagia cases. Time series analysis was used to identify the minimally adequate time period to complete spontaneous swallow frequency analysis. SPM correlated significantly with stroke and swallow severity indices but not with age, time from stroke onset, or consciousness level. Patients with dysphagia demonstrated significantly lower SPM rates. SPM differed by dysphagia severity. Receiver operating characteristic curve analysis yielded a threshold of SPM≤0.40 that identified dysphagia (per the criterion referent) with 0.96 sensitivity, 0.68 specificity, and 0.96 negative predictive value. Time series analysis indicated that a 5- to 10-minute sampling window was sufficient to calculate spontaneous swallow frequency to identify dysphagia cases in acute stroke. Spontaneous swallowing frequency presents high potential to screen for dysphagia in acute stroke without the need for trained, available personnel.

  16. Spontaneous Swallowing Frequency [Has Potential to] Identify Dysphagia in Acute Stroke

    Science.gov (United States)

    Carnaby, Giselle D; Sia, Isaac; Khanna, Anna; Waters, Michael

    2014-01-01

    Background and Purpose Spontaneous swallowing frequency has been described as an index of dysphagia in various health conditions. This study evaluated the potential of spontaneous swallow frequency analysis as a screening protocol for dysphagia in acute stroke. Methods In a cohort of 63 acute stroke cases swallow frequency rates (swallows per minute: SPM) were compared to stroke and swallow severity indices, age, time from stroke to assessment, and consciousness level. Mean differences in SPM were compared between patients with vs. without clinically significant dysphagia. ROC analysis was used to identify the optimal threshold in SPM which was compared to a validated clinical dysphagia examination for identification of dysphagia cases. Time series analysis was employed to identify the minimally adequate time period to complete spontaneous swallow frequency analysis. Results SPM correlated significantly with stroke and swallow severity indices but not with age, time from stroke onset, or consciousness level. Patients with dysphagia demonstrated significantly lower SPM rates. SPM differed by dysphagia severity. ROC analysis yielded a threshold of SPM ≤ 0.40 which identified dysphagia (per the criterion referent) with 0.96 sensitivity, 0.68 specificity, and 0.96 negative predictive value. Time series analysis indicated that a 5 to 10 minute sampling window was sufficient to calculate spontaneous swallow frequency to identify dysphagia cases in acute stroke. Conclusions Spontaneous swallowing frequency presents high potential to screen for dysphagia in acute stroke without the need for trained, available personnel. PMID:24149008

  17. The relationship between limit of Dysphagia and average volume per swallow in patients with Parkinson's disease.

    Science.gov (United States)

    Belo, Luciana Rodrigues; Gomes, Nathália Angelina Costa; Coriolano, Maria das Graças Wanderley de Sales; de Souza, Elizabete Santos; Moura, Danielle Albuquerque Alves; Asano, Amdore Guescel; Lins, Otávio Gomes

    2014-08-01

    The goal of this study was to obtain the limit of dysphagia and the average volume per swallow in patients with mild to moderate Parkinson's disease (PD) but without swallowing complaints and in normal subjects, and to investigate the relationship between them. We hypothesize there is a direct relationship between these two measurements. The study included 10 patients with idiopathic PD and 10 age-matched normal controls. Surface electromyography was recorded over the suprahyoid muscle group. The limit of dysphagia was obtained by offering increasing volumes of water until piecemeal deglutition occurred. The average volume per swallow was calculated by dividing the time taken by the number of swallows used to drink 100 ml of water. The PD group showed a significantly lower dysphagia limit and lower average volume per swallow. There was a significantly moderate direct correlation and association between the two measurements. About half of the PD patients had an abnormally low dysphagia limit and average volume per swallow, although none had spontaneously related swallowing problems. Both measurements may be used as a quick objective screening test for the early identification of swallowing alterations that may lead to dysphagia in PD patients, but the determination of the average volume per swallow is much quicker and simpler.

  18. Objective Measures of Swallowing Function Applied to the Dysphagia Population: A One Year Experience.

    Science.gov (United States)

    Kendall, Katherine A; Ellerston, Julia; Heller, Amanda; Houtz, Daniel R; Zhang, Chong; Presson, Angela P

    2016-08-01

    Quantitative, reliable measures of swallowing physiology can be made from an modified barium swallowing study. These quantitative measures have not been previously employed to study large dysphagic patient populations. The present retrospective study of 139 consecutive patients with dysphagia seen in a university tertiary voice and swallowing clinic sought to use objective measures of swallowing physiology to (1) quantify the most prevalent deficits seen in the patient population, (2) identify commonly associated diagnoses and describe the most prevalent swallowing deficits, and (3) determine any correlation between objective deficits and Eating Assessment Tool (EAT-10) scores and body mass index. Poor pharyngeal constriction (34.5 %) and airway protection deficits (65.5 %) were the most common swallowing abnormalities. Reflux-related dysphagia (36 %), nonspecific pharyngeal dysphagia (24 %), Parkinson disease (16 %), esophageal abnormality (13 %), and brain insult (10 %) were the most common diagnoses. Poor pharyngeal constriction was significantly associated with an esophageal motility abnormality (p < 0.001) and central neurologic insult. In general, dysphagia symptoms as determined by the EAT-10 did not correlate with swallowing function abnormalities. This preliminary study indicates that reflux disease is common in patients with dysphagia and that associated esophageal abnormalities are common in dysphagic populations and may be associated with specific pharyngeal swallowing abnormalities. However, symptom scores from the EAT-10 did not correspond to swallowing pathophysiology.

  19. The importance of the reproducibility of oropharyngeal swallowing in amyotrophic lateral sclerosis. An electrophysiological study.

    Science.gov (United States)

    Cosentino, G; Alfonsi, E; Mainardi, L; Alvisi, E; Brighina, F; Valentino, F; Fierro, B; Sandrini, G; Bertino, G; Berlangieri, M; De Icco, R; Fresia, M; Moglia, A

    2017-05-01

    To investigate electrophysiologically the reproducibility of oropharyngeal swallowing in patients with ALS. We enrolled 26 ALS patients, both with and without clinical signs of dysphagia, and 30 age-matched controls. The reproducibility of the electrophysiological signals related to the oral phase (electromyographic activity of the submental/suprahyoid muscles) and the pharyngeal phase (laryngeal-pharyngeal mechanogram) of swallowing across repeated swallows was assessed. To do this we computed two similarity indexes (SI) by using previously described mathematical algorithms. The reproducibility of oropharyngeal swallowing was significantly reduced both in patients with and in those without clinical signs of dysphagia, with more marked alterations being detected in the dysphagic group. The SI of both phases of swallowing, oral and pharyngeal, correlated significantly with dysphagia severity and disease severity. In ALS different pathophysiological mechanisms can alter the stereotyped motor behaviors underlying normal swallowing, thus reducing the reproducibility of the swallowing act. A decrease in swallowing reproducibility could be a preclinical sign of dysphagia and, beyond a certain threshold, a pathological hallmark of oropharyngeal dysphagia. Electrophysiological assessment is a simple and useful tool for the early detection of swallowing abnormalities, and for the management of overt dysphagia in ALS. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  20. Computational Analysis of Pharyngeal Swallowing Mechanics in Patients with Motor Neuron Disease: A Pilot Investigation.

    Science.gov (United States)

    Garand, K L; Schwertner, Ryan; Chen, Amy; Pearson, William G

    2017-10-20

    Swallowing impairment (dysphagia) is a common sequela in patients with motor neuron disease (MND). The purpose of this retrospective, observational pilot investigation was to characterize how pharyngeal swallowing mechanics are impacted in patients with MND using a comparison with healthy, non-dysphagic control group. Computational analysis of swallowing mechanics (CASM) was used to determine covariate biomechanics of pharyngeal swallowing from videofluoroscopic assessment in 15 patients with MND and 15 age- and sex-matched healthy controls. Canonical variant analysis with post hoc discriminate function analysis (DFA) was performed on coordinate data mapping functional muscle groups underlying pharyngeal swallowing. Differences in swallowing mechanics associated with group (MND; control), motor neuron predominance (upper; lower), onset (bulbar; spinal), and swallow task (thin, pudding) were evaluated and visualized. Pharyngeal swallowing mechanics differed significantly in patients with MND compared with healthy controls (D = 2.01, p mechanics by motor neuron predominance (D = 5.03, p mechanics of patients with MND differ from and are more heterogeneous than healthy controls. These findings suggest patients with MND may compensate reductions in pharyngeal shortening and tongue base retraction by extending the head and neck and increasing hyolaryngeal excursion. This work and further CASM investigations will lead to further insights into development and evaluation of targeted clinical treatments designed to prolong safe and efficient swallowing function in patients with MND.

  1. Pharyngeal electrical stimulation can modulate swallowing in cortical processing and behavior - magnetoencephalographic evidence.

    Science.gov (United States)

    Suntrup, Sonja; Teismann, Inga; Wollbrink, Andreas; Winkels, Martin; Warnecke, Tobias; Pantev, Christo; Dziewas, Rainer

    2015-01-01

    The act of swallowing is a complex neuromuscular function that is processed in a distributed network involving cortical, subcortical and brainstem structures. Difficulty in swallowing arises from a variety of neurologic diseases for which therapeutic options are currently limited. Pharyngeal electrical stimulation (PES) is a novel intervention designed to promote plastic changes in the pharyngeal motor cortex to aid dysphagia rehabilitation. In the present study we evaluate the effect of PES on cortical swallowing network activity and associated changes in swallowing performance. In a randomized, crossover study design 10min of real (0.2-ms pulses, 5Hz, 280V, stimulation intensity at 75% of maximum tolerated threshold) or sham PES were delivered to 14 healthy volunteers in two separate sessions. Stimulation was delivered via a pair of bipolar ring electrodes mounted on an intraluminal catheter positioned in the pharynx. Before and after each intervention swallowing capacity (ml/s) was tested using a 150ml-water swallowing stress test. Event-related desynchronization (ERD) of cortical oscillatory activity during volitional swallowing was recorded applying whole-head magnetoencephalography before, immediately after and 45min past the intervention. A prominent reduction of ERD in sensorimotor brain areas occurred in the alpha and beta frequency ranges immediately after real PES but not after sham stimulation (pefficiency, which is associated with subtle changes in swallowing function in healthy subjects. Our data contribute evidence that swallowing network organization and behavior can effectively be modulated by PES. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. A comparative analysis of DBSCAN, K-means, and quadratic variation algorithms for automatic identification of swallows from swallowing accelerometry signals.

    Science.gov (United States)

    Dudik, Joshua M; Kurosu, Atsuko; Coyle, James L; Sejdić, Ervin

    2015-04-01

    Cervical auscultation with high resolution sensors is currently under consideration as a method of automatically screening for specific swallowing abnormalities. To be clinically useful without human involvement, any devices based on cervical auscultation should be able to detect specified swallowing events in an automatic manner. In this paper, we comparatively analyze the density-based spatial clustering of applications with noise algorithm (DBSCAN), a k-means based algorithm, and an algorithm based on quadratic variation as methods of differentiating periods of swallowing activity from periods of time without swallows. These algorithms utilized swallowing vibration data exclusively and compared the results to a gold standard measure of swallowing duration. Data was collected from 23 subjects that were actively suffering from swallowing difficulties. Comparing the performance of the DBSCAN algorithm with a proven segmentation algorithm that utilizes k-means clustering demonstrated that the DBSCAN algorithm had a higher sensitivity and correctly segmented more swallows. Comparing its performance with a threshold-based algorithm that utilized the quadratic variation of the signal showed that the DBSCAN algorithm offered no direct increase in performance. However, it offered several other benefits including a faster run time and more consistent performance between patients. All algorithms showed noticeable differentiation from the endpoints provided by a videofluoroscopy examination as well as reduced sensitivity. In summary, we showed that the DBSCAN algorithm is a viable method for detecting the occurrence of a swallowing event using cervical auscultation signals, but significant work must be done to improve its performance before it can be implemented in an unsupervised manner. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Somaesthetic Training, Aesthetics, Ethics, and the Politics of Difference in Richard Shusterman's "Body Consciousness"

    Science.gov (United States)

    Powell, Kimberly

    2010-01-01

    In this essay, the author first addresses the theme of disciplined somatic training and its relationship to self-awareness and transformation. Her attention is focused specifically on the chapter on Ludwig Wittgenstein, in which Richard Shusterman presents and then elaborates upon the philosopher's connections between conscious bodily feelings and…

  4. Ripples from a Passing Ship: Memories; and a Legacy of Richard Peters

    Science.gov (United States)

    Harris, Kevin

    2013-01-01

    This paper outlines aspects and dimensions of my "relationship" with Richard Peters from 1966 onward. The underlying suggestion is that, while Peters' contribution to philosophy of education was undeniably of major proportions, both that contribution and his legacy are institutional rather than substantive. (Contains 15 notes.)

  5. Application of Richards\\'s growth model to Brown-headed Parrot ...

    African Journals Online (AJOL)

    Application of Richards\\'s growth model to Brown-headed Parrot Poicephalus cryptoxanthus nestlings. ... Stuart Taylor, Michael R Perrin. Abstract. We generated a generalised growth curve for the Brown-headed Parrot Poicephalus cryptoxanthus. The growth model correlated well with the data from captive-bred chicks and ...

  6. Leonid Breznev and Richard Nixon examine plaques presented by Skylab crew

    Science.gov (United States)

    1973-01-01

    Leonid I. Breznev, General Secretary of the Communist Party, Union of Soviet Socialist Republics, and President Richard M. Nixon, during ceremonies at the Western White House in San Clemente, California, examine plaques presented by Skylab astronauts Charles Conrad Jr., center; Joseph P. Kerwin, second from right; and Paul J. Weitz, left.

  7. In the Mean Season : Richard II and the Nostalgic Politics of Hospitality

    NARCIS (Netherlands)

    Johanson, K.

    2016-01-01

    In Shakespeare’s Richard II, the language of absent hospitality refracts the dire economic and food crises facing mid-1590s England, and it interrogates the contemporary response to the problem of dearth through its use of images of desolation, dearth, and grief. As absent hospitality proves to be a

  8. Understanding Richard Wright's "Black Boy": A Student Casebook to Issues, Sources, and Historical Documents.

    Science.gov (United States)

    Felgar, Robert

    In "Black Boy," Richard Wright triumphs over an ugly, racist world by fashioning an inspiring, powerful, beautiful, and fictionalized autobiography. To help students understand and appreciate his story in the cultural, political, racial, social, and literary contexts of its time, this casebook provides primary historical documents,…

  9. Reshaping a hero: The real life and times of Archibald Richards ...

    African Journals Online (AJOL)

    Further historical investigation reveals that Manuel left out important data and manipulated historical detail in order to present Richards under the title: 'Die onoorwinlike' (the undefeated) (p.11). Manuel was a journalist and a public figure who unambiguously expressed his opposition to what he viewed as communist activity ...

  10. Fluid flow in porous media using image-based modelling to parametrize Richards' equation

    Science.gov (United States)

    Cooper, L. J.; Daly, K. R.; Hallett, P. D.; Naveed, M.; Koebernick, N.; Bengough, A. G.; George, T. S.; Roose, T.

    2017-11-01

    The parameters in Richards' equation are usually calculated from experimentally measured values of the soil-water characteristic curve and saturated hydraulic conductivity. The complex pore structures that often occur in porous media complicate such parametrization due to hysteresis between wetting and drying and the effects of tortuosity. Rather than estimate the parameters in Richards' equation from these indirect measurements, image-based modelling is used to investigate the relationship between the pore structure and the parameters. A three-dimensional, X-ray computed tomography image stack of a soil sample with voxel resolution of 6 μm has been used to create a computational mesh. The Cahn-Hilliard-Stokes equations for two-fluid flow, in this case water and air, were applied to this mesh and solved using the finite-element method in COMSOL Multiphysics. The upscaled parameters in Richards' equation are then obtained via homogenization. The effect on the soil-water retention curve due to three different contact angles, 0°, 20° and 60°, was also investigated. The results show that the pore structure affects the properties of the flow on the large scale, and different contact angles can change the parameters for Richards' equation.

  11. Strauss, Richard. Ariane a Naxos: opera seulement, integrale. Miliza Korjus / Michel Parouty

    Index Scriptorium Estoniae

    Parouty, Michel

    1995-01-01

    Uuest heliplaadist "Strauss, Richard. Ariane a Naxos: opera seulement, integrale. Miliza Korjus (Najade). Orchestre de l'Opea l'Efat de Vienne" Arlecchino ARL 14-16, distribution Dante (3 CD: 390 F). 1935, 1944. TT: 3h 46'17"

  12. Fluid flow in porous media using image-based modelling to parametrize Richards' equation.

    Science.gov (United States)

    Cooper, L J; Daly, K R; Hallett, P D; Naveed, M; Koebernick, N; Bengough, A G; George, T S; Roose, T

    2017-11-01

    The parameters in Richards' equation are usually calculated from experimentally measured values of the soil-water characteristic curve and saturated hydraulic conductivity. The complex pore structures that often occur in porous media complicate such parametrization due to hysteresis between wetting and drying and the effects of tortuosity. Rather than estimate the parameters in Richards' equation from these indirect measurements, image-based modelling is used to investigate the relationship between the pore structure and the parameters. A three-dimensional, X-ray computed tomography image stack of a soil sample with voxel resolution of 6 μm has been used to create a computational mesh. The Cahn-Hilliard-Stokes equations for two-fluid flow, in this case water and air, were applied to this mesh and solved using the finite-element method in COMSOL Multiphysics. The upscaled parameters in Richards' equation are then obtained via homogenization. The effect on the soil-water retention curve due to three different contact angles, 0°, 20° and 60°, was also investigated. The results show that the pore structure affects the properties of the flow on the large scale, and different contact angles can change the parameters for Richards' equation.

  13. Resisting Biopolitics through “Diaphanous Wonder”: Richard Flanagan's Gould's Book of Fish

    NARCIS (Netherlands)

    Wiese, Doro

    2014-01-01

    In Gould's Book of Fish (2003), author Richard Flanagan manages to invent a format in which content and style account for historical events on Sarah Island, Tasmania in the 1820s, yet he does so in a manner that is not in the least objective, disinterested or fact-orientated. The perspective of

  14. Süütuse kaotamine / Richard Branson ; intervjueerinud Peter Fisk ; tõlkinud Endrik Randoja

    Index Scriptorium Estoniae

    Branson, Richard

    2009-01-01

    Turunduskirjanik Peter Fiski intervjuu Suurbritannia ärimagnaadi Sir Richard Bransoniga, milles arutletakse ettevõtja suurimate saavutuste ja suurimate pettuste üle, uuritakse Bransoni võimet juhtida oma 450 ettevõtet, tema suhtumist konkurentsi ning uutesse äriideedesse, samuti tema ajakasutust

  15. Richard Branson : mässaja, kes unistab kosmosest / Triin Thalheim

    Index Scriptorium Estoniae

    Thalheim, Triin, 1982-

    2005-01-01

    TV3 näitab USA tõsielusarja "Miljardärist mässaja: Branson otsib mantlipärijat". Sarja peategelane on maailma rikkamaid mehi, Virgini kontserni omanik Richard Branson, kes otsib oma firmasse noort juhti

  16. Transforming Faith: H. Richard Niebuhr and Paulo Freire on Moral Education

    Science.gov (United States)

    Daniel, Joshua Leonard

    2013-01-01

    Through a contextual comparison of the theological ethics of H. Richard Niebuhr and the educational theory of Paulo Freire, I argue that socialization, while an essential task of moral education, is an insufficient aim. The proper aim of moral education is individual development. The intention of my argument is address tendencies towards…

  17. New Directions for Higher Education: Q&A with Author Richard Arum on Undergrad Learning

    Science.gov (United States)

    DiSalvio, Philip

    2013-01-01

    In April, the "New England Journal of Higher Education" ("NEJHE") launched its "New Directions for Higher Education" series to examine emerging issues, trends, and ideas that have an impact on higher education policies, programs, and practices. In this installment of the series, DiSalvio speaks with Richard Arum,…

  18. A Crisis of Legitimacy: Shakespeare's "Richard II" and the Problems of Modern Executive Leadership

    Science.gov (United States)

    Ciliotta-Rubery, Andrea

    2008-01-01

    "A Crisis of Legitimacy" is a unique comparative examination of the question of legitimate rule, as observed through Shakespeare's "Richard II" and the contemporary presidencies of Bill Clinton and George W. Bush. Largely pedagogical, this article is the result of an active learning exercise, whereby students in a "Politics and Literature" course…

  19. Dr. Richard D. Gragg III to Receive Third Place Gulf Guardian Award in the Individual Category

    Science.gov (United States)

    ATLANTA - Today, the Gulf of Mexico Program announced that Dr. Richard D. Schulterbrandt Gragg III will receive a Third Place 2015 Gulf Guardian Award in the Individual Category. The award will be given tonight at an awards ceremony at the Texas State Aqua

  20. Changes in area of grasslands on the dunes between Richards Bay ...

    African Journals Online (AJOL)

    Grasslands on the dunes between Richards Bay and the Mfolozi river have diminished rapidly during the last 34 years (1973: 2 829 ha, 32%; 1974: 399 ha, 4, 8% of study area). They have been replaced by Acacia karroo Woodland, Secondary Dune Scrub and plantations of Eucalyptus spp. and Pinus spp. The changes ...

  1. Unilateral Superior Laryngeal Nerve Lesion in an Animal Model of Dysphagia and Its Effect on Sucking and Swallowing

    Science.gov (United States)

    Campbell-Malone, Regina; Holman, Shaina D.; Lukasik, Stacey L.; Fukuhara, Takako; Gierbolini-Norat, Estela M.; Thexton, Allan J.; German, Rebecca Z.

    2013-01-01

    We tested two hypotheses relating to the sensory deficit that follows a unilateral superior laryngeal nerve (SLN) lesion in an infant animal model. We hypothesized that it would result in (1) a higher incidence of aspiration and (2) temporal changes in sucking and swallowing. We ligated the right-side SLN in six 2–3-week-old female pigs. Using videofluoroscopy, we recorded swallows in the same pre- and post-lesion infant pigs. We analyzed the incidence of aspiration and the duration and latency of suck and swallow cycles. After unilateral SLN lesioning, the incidence of silent aspiration during swallowing increased from 0.7 to 41.5 %. The durations of the suck containing the swallow, the suck immediately following the swallow, and the swallow itself were significantly longer in the post-lesion swallows, although the suck prior to the swallow was not different. The interval between the start of the suck containing a swallow and the subsequent epiglottal movement was longer in the post-lesion swallows. The number of sucks between swallows was significantly greater in post-lesion swallows compared to pre-lesion swallows. Unilateral SLN lesion increased the incidence of aspiration and changed the temporal relationships between sucking and swallowing. The longer transit time and the temporal coordinative dysfunction between suck and swallow cycles may contribute to aspiration. These results suggest that swallow dysfunction and silent aspiration are common and potentially overlooked sequelae of unilateral SLN injury. This validated animal model of aspiration has the potential for further dysphagia studies. PMID:23417250

  2. The anatomy and physiology of normal and abnormal swallowing in oropharyngeal dysphagia.

    Science.gov (United States)

    Sasegbon, A; Hamdy, S

    2017-11-01

    Eating and drinking are enjoyable activities that positively impact on an individual's quality of life. The ability to swallow food and fluid is integral to the process of eating. Swallowing occupies a dual role being both part of the enjoyment of eating and being a critically important utilitarian activity to enable adequate nutrition and hydration. Any impairment to the process of swallowing can negatively affect a person's perception of their quality of life. The process of swallowing is highly complex and involves muscles in the mouth, pharynx, larynx, and esophagus. The oropharynx is the anatomical region encompassing the oral cavity and the pharynx. Food must be masticated, formed into a bolus and transported to the pharynx by the tongue whereas fluids are usually held within the mouth before being transported ab-orally. The bolus must then be transported through the pharynx to the esophagus without any matter entering the larynx. The muscles needed for all these steps are coordinated by swallowing centers within the brainstem which are supplied with sensory information by afferent nerve fibers from several cranial nerves. The swallowing centers also receive modulatory input from higher centers within the brain. Hence, a swallow has both voluntary and involuntary physiologic components and the term dysphagia is given to difficult swallowing while oropharyngeal dysphagia is difficult swallowing due to pathology within the oropharynx. Problems affecting any point along the complex swallowing pathway can result in dysphagia. This review focuses on the anatomy and physiology behind normal and abnormal oropharyngeal swallowing. It also details the common diseases and pathology causing oropharyngeal dysphagia. © 2017 John Wiley & Sons Ltd.

  3. Influence of attention and bolus volume on brain organization during swallowing.

    Science.gov (United States)

    Jestrović, Iva; Coyle, James L; Perera, Subashan; Sejdić, Ervin

    2017-10-20

    It has been shown that swallowing involves certain attentional and cognitive resources which, when disrupted can influence swallowing function with in dysphagic patient. However, there are still open questions regarding the influence of attention and cognitive demands on brain activity during swallowing. In order to understand how brain regions responsible for attention influence brain activity during swallowing, we compared brain organization during no-distraction swallowing and swallowing with distraction. Fifteen healthy male adults participated in the data collection process. Participants performed ten 1 ml, ten 5 ml, and ten 10 ml water swallows under both no-distraction conditions and during distraction while EEG signals were recorded. After standard pre-processing of the EEG signals, brain networks were formed using the time-frequency based synchrony measure. The brain networks formed were then compared between the two sets of conditions. Results showed that there are differences in the Delta, Theta, Alpha, Beta, and Gamma frequency bands between no-distraction swallowing and swallowing with distraction. Differences in the Delta and Theta frequency bands can be attributed to changes in subliminal processes, while changes in the Alpha and Beta frequency bands are directly associated with the various levels of attention and cognitive demands during swallowing process, and changes in the Gamma frequency band are due to changes in motor activity. Furthermore, we showed that variations in bolus volume influenced the swallowing brain networks in the Delta, Theta, Alpha, Beta, and Gamma frequency bands. Changes in the Delta, Theta, and Alpha frequency bands are due to sensory perturbations evoked by the various bolus volumes. Changes in the Beta frequency band are due to reallocation of cognitive demands, while changes in the Gamma frequency band are due to changes in motor activity produced by variations in bolus volume. These findings could potentially lead to

  4. Dose-dependent deterioration of swallowing function after induction chemotherapy and definitive chemoradiotherapy for laryngopharyngeal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Haderlein, M.; Semrau, S.; Ott, O.; Speer, S.; Fietkau, R. [University Hospital Erlangen, Department of Radiation Oncology, Erlangen (Germany); Bohr, C. [University Hospital Erlangen, Department of Otorhinolaryngology, Head and Neck Surgery, Erlangen (Germany)

    2014-02-15

    To evaluate the influence of clinical, treatment- and dose-dependent factors on posttreatment swallowing function after induction chemotherapy and definitive chemoradiotherapy in a group of homogeneously treated laryngopharyngeal cancer patients. From 28 May 2008 to 15 February 2013, 45 patients with borderline inoperable laryngopharyngeal cancer that had responded well to induction chemotherapy were treated with definitive chemoradiotherapy. Median follow-up was 22 months. Swallowing function and clinical data were prospectively analyzed using the EORTC QLQ-C30 questionnaire. Swallowing structures were retrospectively delineated on the original treatment planning CT. Dose-volume histograms were calculated for swallowing structures and D{sub mean}, D{sub max} and V50-V64 values (in 2 Gy increments) were determined for each patient. Tumor volume and infiltration of the swallowing apparatus was defined by CT before induction chemotherapy. Of the 45 patients, 26 (57.8 %) fully regained swallowing function after chemoradiotherapy. A further 12 patients (26.7 %) were able to manage soft, pureed and/or liquid foods; the remaining 7 (15.6 %) were completely dependent on percutaneous endoscopic gastrostomy (PEG). Posttreatment swallowing function was significantly influenced by D{sub mean} to the superior pharyngeal constrictor muscle (PCM, p = 0.041). Correlations between late dysphagia and dose-volume relationships in the superior PCM and soft palate were also observed, which were significant from V60 (p = 0.043) and V58 for the soft palate and superior PCM, respectively. Of the evaluated clinical and tumor-related factors, only alcohol abuse (p = 0.024) had an influence on posttreatment swallowing function. Almost 50 % of patients had deterioration of swallowing function after definitive chemoradiotherapy for laryngopharyngeal cancer. The dose to anatomical structures responsible for swallowing function appears to play a role. Therefore, in selected patients, target

  5. Fluid mechanics of eating, swallowing and digestion - overview and perspectives.

    Science.gov (United States)

    Engmann, Jan; Burbidge, Adam S

    2013-02-26

    From a very simplistic viewpoint, the human digestive system can be regarded as a long tube (with dramatic variations in diameter, cross-section, wall properties, pumping mechanisms, regulating valves and in-line sensors). We single out a few fluid mechanical phenomena along the trajectory of a food bolus from the mouth to the small intestine and discuss how they influence sensorial perception, safe transport, and nutrient absorption from a bolus. The focus is on lubrication flows between the tongue and palate, the oropharyngeal stage of swallowing and effects of flow on absorption in the small intestine. Specific challenges and opportunities in this research area are highlighted.

  6. Graphic representation of pharyngeal wall motion during swallow: technical note.

    Science.gov (United States)

    Ekberg, O; Borgstrom, P S

    1989-01-01

    Movements of the pharyngeal wall were measured at 12 transverse levels, on consecutive cineradiograms obtained during swallowing of thin, liquid barium, in a single nondysphagic volunteer. By graphic representation of these measurements on the IBM personal computer, it was possible to analyze in detail pharyngeal motor activity in terms of displacement of the pharyngeal wall. The contraction created a fairly steep narrowing of the lumen. The peristaltic wave was more difficult to analyze. Movements of the pharyngeal wall in posteroanterior projection gave good information about the constrictors. Although this technique has several inherent methodologic difficulties, its use may expand our knowledge of pharyngeal peristalsis.

  7. A predictive model for swallowing dysfunction after curative radiotherapy in head and neck cancer

    NARCIS (Netherlands)

    Langendijk, Johannes A.; Doornaert, Patricia; Rietveld, Derek H. F.; Verdonck-de Leeuw, Irma M.; Leemans, C. Rene; Slotman, Ben J.

    Introduction: Recently, we found that swallowing dysfunction after curative (chemo) radiation (CH) RT has a strong negative impact on health-related quality of life (HRQoL), even more than xerostomia. The purpose of this study was to design a predictive model for swallowing dysfunction after

  8. A predictive model for swallowing dysfunction after curative radiotherapy in head and neck cancer.

    NARCIS (Netherlands)

    Langendijk, J.A.; Doornaert, P.A.H.; Rietveld, D.H.F.; de Leeuw, I.M.; Leemans, C.R.; Slotman, B.J.

    2009-01-01

    Introduction: Recently, we found that swallowing dysfunction after curative (chemo) radiation (CH) RT has a strong negative impact on health-related quality of life (HRQoL), even more than xerostomia. The purpose of this study was to design a predictive model for swallowing dysfunction after

  9. Tongue Pressure and Submental Surface Electromyography Measures during Noneffortful and Effortful Saliva Swallows in Healthy Women

    Science.gov (United States)

    Yeates, Erin M.; Steele, Catriona M.; Pelletier, Cathy A.

    2010-01-01

    Purpose: The effortful swallow, a compensatory technique frequently employed by speech-language pathologists for their patients with dysphagia, is still not fully understood in terms of how it modifies the swallow. In particular, although age-related changes are known to reduce maximum isometric tongue pressure, it is not known whether age affects…

  10. Effect of aging on oral and swallowing function after meal consumption.

    Science.gov (United States)

    Hiramatsu, Tetsuya; Kataoka, Hideyuki; Osaki, Mari; Hagino, Hiroshi

    2015-01-01

    Dysphagia may worsen due to fatigue of the infrahyoid and suprahyoid muscle groups as a result of repetitive swallowing during a meal. We investigated the hypothesis that meal consumption may reduce tongue strength and endurance in older adults (OAs). Tongue-palate pressure, oral diadochokinesis, repetitive saliva swallowing, and surface electromyography activity before and after a meal were measured in 23 young adults (YAs) and 23 OA volunteers. There was a statistically significant difference in both tongue pressure and the number of voluntary swallows between YAs and OAs. Peak tongue pressure was significantly lower in OAs than YAs both before and after meal consumption. The most notable finding was that the first time interval (the time from test initiation to the beginning of the first swallow) was prolonged after meal consumption only in OAs, whereas the first time interval showed no difference between YAs and OAs before meal consumption with reference to the repetitive saliva swallowing test. The initiation of swallowing was prolonged by both meal consumption and aging; there was a significant interaction between these two factors. The number of repetitions of the monosyllable/pa/was statistically similar between YAs and OAs before meal consumption, but it was significantly lower in OAs after meal consumption. Aging leads to declining tongue pressure and motor function of the lips. It is possible that swallowing function declines in older individuals when meal consumption is prolonged, especially at the end of mealtime, as a result of their efforts in mastication and swallowing.

  11. Relationships between air swallowing, intragastric air, belching and gastro-oesophageal reflux

    NARCIS (Netherlands)

    Bredenoord, A. J.; Weusten, B. L. A. M.; Timmer, R.; Akkermans, L. M. A.; Smout, A. J. P. M.

    2005-01-01

    BACKGROUND: With each swallow a certain amount of air is transported to the stomach. The stomach protects itself against excessive distention by swallowed air through belching (gas reflux). The mechanism of belching (transient lower oesophageal sphincter relaxation) is also one of the mechanisms

  12. Relationships between air swallowing, intragastric air, belching and gastro-oesophageal reflux

    NARCIS (Netherlands)

    Bredenoord, AJ; Weusten, BLAM; Timmer, R; Akkermans, LMA; Smout, AJPM

    Background: With each swallow a certain amount of air is transported to the stomach. The stomach protects itself against excessive distention by swallowed air through belching (gas reflux). The mechanism of belching (transient lower oesophageal sphincter relaxation) is also one of the mechanisms

  13. Normal swallowing acoustics across age, gender, bolus viscosity, and bolus volume.

    Science.gov (United States)

    Youmans, Scott R; Stierwalt, Julie A G

    2011-12-01

    Cervical auscultation has been proposed as an augmentative procedure for the subjective clinical swallowing examination due to the tangible differences between normal and dysphagic swallowing sounds. However, the research is incomplete regarding cervical auscultation and swallowing acoustics in that the differences between the sounds of normal versus dysphagic swallowing have yet to be fully understood or quantified. The swallows of 96 reportedly healthy adults, balanced for gender and divided into younger, middle, and older age groups, were audio-recorded while ingesting several boluses of varying viscosity and volume. The audio signals were then analyzed to determine their temporal and acoustic characteristics. Results indicated increasing pharyngeal swallowing duration with increasing age, bolus viscosity, and bolus volume. In addition, an increased duration to peak intensity with increasing age was found in one of our two analyses, as well as with some of the more viscous versus less viscous boluses. Men and older persons produced higher peak intensities and peak frequencies than women and younger persons. Thin liquids were produced with more intensity than honey or more viscous boluses, and with greater frequency than mechanical soft solids. Larger volumes resulted in greater peak frequency values. Some of the acoustic measurements appear to be more useful than others, including the duration of the acoustic swallowing signal and the within-subjects peak intensity variable. We noted that differences in swallowing acoustics were more related to changes in viscosity rather than volume. Finally, within-participant observations were more useful than between-participant observations.

  14. Tongue Pressure Modulation during Swallowing: Water versus Nectar-Thick Liquids

    Science.gov (United States)

    Steele, Catriona M.; Bailey, Gemma L.; Molfenter, Sonja M.

    2010-01-01

    Purpose: Evidence of tongue-palate pressure modulation during swallowing between thin and nectar-thick liquids stimuli has been equivocal. This mirrors a lack of clear evidence in the literature of tongue and hyoid movement modulation between nectar-thick and thin liquid swallows. In the current investigation, the authors sought to confirm whether…

  15. The interactions between different tastes on initiation of reflex swallow elicited by electrical stimulation in humans.

    Science.gov (United States)

    Otake, Masanori; Kurose, Masayuki; Uchida, Yoshiaki; Hasegawa, Mana; Yamada, Yoshiaki; Saito, Isao; Yamamura, Kensuke

    2016-09-01

    The act of eating is a source of pleasure for people and is a major factor in maintaining a good quality of life. Several types of products for dysphagia patients are available to decrease aspiration of food that often accompanies daily food intake. The final goal of these products is to improve the ease of forming a food bolus and/or the safety of the swallowing process; however, tastes of products are not a major concern with initiation of swallowing. In the present study, we investigated the effect of bitter taste stimuli (quinine) and the combination of quinine and umami (monosodium glutamate: MSG) applied to the oropharynx on reflex swallows evoked by electrical stimulation to the oropharyngeal mucosa. Each of the distilled water (DW), quinine and quinine-MSG mixture solution (volume of each solutions, 100 µl) was applied 1 s prior to electrical stimulation. No swallow was evoked when each of the solutions was applied without electrical stimulation. The application of DW and lower concentration of quinine (<100 µM) did not affect the latency of reflex swallow, but 100 µM quinine application increased the latency of the reflex swallow. In addition, application of quinine-MSG mixture solution counteracted the increase in latency induced by quinine application alone. These findings suggest that MSG enhances the initiation of swallowing along with its well-known increase in appetite stimulation. Adding MSG might be effective when creating food to promote swallowing.

  16. Prevalence of Auditory Problems in Children with Feeding and Swallowing Disorders

    Science.gov (United States)

    Rawool, Vishakha Waman

    2017-01-01

    Purpose: Although an interdisciplinary approach is recommended for assessment and management of feeding or swallowing difficulties, audiologists are not always included in the interdisciplinary team. The purpose of this study is to report the prevalence of middle ear and hearing problems in children with feeding and swallowing disorders and to…

  17. Prevalence and Severity of Voice and Swallowing Difficulties in Mitochondrial Disease

    Science.gov (United States)

    Read, Jennifer L.; Whittaker, Roger G.; Miller, Nick; Clark, Sue; Taylor, Robert; McFarland, Robert; Turnbull, Douglass

    2012-01-01

    Background: Mutations of mitochondrial DNA (mtDNA) cause a broad spectrum of clinical phenotypes. Anecdotal evidence suggests that voice and swallow problems are a common feature of these diseases. Aims: To characterize accurately the prevalence and severity of voice and swallow problems in a large cohort of patients with mitochondrial disease.…

  18. Extraction of average neck flexion angle during swallowing in neutral and chin-tuck positions

    Directory of Open Access Journals (Sweden)

    Sejdić Ervin

    2009-10-01

    Full Text Available Abstract Background A common but debated technique in the management of swallowing difficulties is the chin tuck swallow, where the neck is flexed forward prior to swallowing. Natural variations in chin tuck angles across individuals may contribute to the differential effectiveness of the technique. Methodology To facilitate the study of chin tuck angle variations, we present a template tracking algorithm that automatically extracts neck angles from sagittal videos of individuals performing chin tuck swallows. Three yellow markers geometrically arranged on a pair of dark visors were used as tracking cues. Results The algorithm was applied to data collected from 178 healthy participants during neutral and chin tuck position swallows. Our analyses revealed no major influences of body mass index and age on neck flexion angles during swallowing, while gender influenced the average neck angle only during wet swallows in the neutral position. Chin tuck angles seem to be independent of anthropometry and gender in healthy adults, but deserve further study in pathological populations. Conclusion The proposed neck flexion angle extraction algorithm may be useful in future studies where strict participant compliance to swallowing task protocol can be assured.

  19. Extraction of average neck flexion angle during swallowing in neutral and chin-tuck positions.

    Science.gov (United States)

    Hung, Delbert; Sejdić, Ervin; Steele, Catriona M; Chau, Tom

    2009-10-07

    A common but debated technique in the management of swallowing difficulties is the chin tuck swallow, where the neck is flexed forward prior to swallowing. Natural variations in chin tuck angles across individuals may contribute to the differential effectiveness of the technique. To facilitate the study of chin tuck angle variations, we present a template tracking algorithm that automatically extracts neck angles from sagittal videos of individuals performing chin tuck swallows. Three yellow markers geometrically arranged on a pair of dark visors were used as tracking cues. The algorithm was applied to data collected from 178 healthy participants during neutral and chin tuck position swallows. Our analyses revealed no major influences of body mass index and age on neck flexion angles during swallowing, while gender influenced the average neck angle only during wet swallows in the neutral position. Chin tuck angles seem to be independent of anthropometry and gender in healthy adults, but deserve further study in pathological populations. The proposed neck flexion angle extraction algorithm may be useful in future studies where strict participant compliance to swallowing task protocol can be assured.

  20. [Swallowing after non-surgical treatment (radiation therapy / radiochemotherapy protocol) of laryngeal cancer].

    Science.gov (United States)

    Portas, Juliana; Socci, Claudia Pereira; Scian, Eliana Perissato; Queija, Débora Dos Santos; Ferreira, Alessandra Sampaio; Dedivitis, Rogério Aparecido; Barros, Ana Paula Brandão

    2011-01-01

    Radiation therapy and radiochemotherapy protocols can cause swallowing difficulties. To evaluate swallowing in patients undergoing radiation therapy and radiochemotherapy protocol only for the treatment of laryngeal tumors. A prospective study of 20 patients, with a mean age of 62 years, at the end of oncological therapy. Six patients (30%) underwent radiation therapy, and 14 patients (70%) underwent combined therapy. The mean time between treatment and an evaluation of swallowing was 8.5 months. Videofluoroscopy was done to assess the preparatory, oral and pharyngeal phases of swallowing. All patients had only an oral diet. Normal swallowing was present in only 25% of patients. The swallowing videofluoroscopic examination identified the following changes: bolus formation (85%), bolus ejection (60%), oral cavity stasis (55%), changes in the onset of the pharyngeal phase (100%), decreased laryngeal elevation (65%), and hypopharyngeal stasis (80%). Laryngeal penetration was observed in 25% of the cases; 40% presented tracheal aspiration. The grade of penetration/aspiration was mild in 60% of cases. Aspiration was silent in 35% of patients. Although 75% of patients had dysphagia, only 25% complained of swallowing difficulties. Patients with laryngeal cancer that underwent radiation therapy/combined treatment can present changes in all swallowing phases, or may be asymptomatic.

  1. Population Trends and Management of the Bank Swallow (Riparia riparia) on the Sacramento River, California

    Science.gov (United States)

    Barrett A. Garrison; Ronald W. Schlorff; Joan M. Humphrey; Stephen A. Laymon; Frank J. Michny

    1989-01-01

    Annual monitoring of Bank Swallows (Riparia riparia) along the Sacramento River, California has been conducted since 1986 to determine population trends, evaluate impacts from bank protection and flood control projects, and implement and monitor mitigation efforts. The population of Bank Swallows in a 50-mile river reach remained static over 3...

  2. Evidence-Based Systematic Review: Effects of Neuromuscular Electrical Stimulation on Swallowing and Neural Activation

    Science.gov (United States)

    Clark, Heather; Lazarus, Cathy; Arvedson, Joan; Schooling, Tracy; Frymark, Tobi

    2009-01-01

    Purpose: To systematically review the literature examining the effects of neuromuscular electrical stimulation (NMES) on swallowing and neural activation. The review was conducted as part of a series examining the effects of oral motor exercises (OMEs) on speech, swallowing, and neural activation. Method: A systematic search was conducted to…

  3. Mechanism of Sequential Swallowing during Straw Drinking in Healthy Young and Older Adults

    Science.gov (United States)

    Daniels, Stephanie K.; Corey, David M.; Hadskey, Leslie D.; Legendre, Calli; Priestly, Daniel H.; Rosenbek, John C.; Foundas, Anne L.

    2004-01-01

    Recent research has revealed differences between isolated and sequential swallowing in healthy young adults; however, the influence of normal aging on sequential swallowing has not been studied. Thus, the purpose of this investigation was to examine the effects of normal aging on deglutition during sequential straw drinking. Videofluoroscopic…

  4. Effects of Pacifier and Taste on Swallowing, Esophageal Motility, Transit and Respiratory Rhythm in Human Neonates

    Science.gov (United States)

    Shubert, Theresa R.; Sitaram, Swetha; Jadcherla, Sudarshan R.

    2015-01-01

    Background Pacifier use is widely prevalent globally despite hygienic concerns and uncertain mechanistic effects on swallowing or airway safety. Aims The effects of pacifier and taste interventions on pharyngo-esophageal motility, bolus transit and respiratory rhythms were investigated by determining the upper esophageal sphincter (UES), esophageal body, esophagogastric junction (EGJ) motor patterns as well as deglutition apnea, respiratory rhythm disturbances and esophageal bolus clearance. Methods Fifteen infants (6 males; median gestation 31 wks and birth weight 1.4 kg) underwent high resolution impedance manometry at 43 (41-44) weeks post-menstrual age. Manometric, respiratory, and impedance characteristics of spontaneous swallows, pacifier associated dry swallowing and taste (pacifier dipped in 3% sucrose) associated swallowing were analyzed. Linear mixed and generalized estimating equation models were used. Data are presented as mean ± SEM, %, or median (IQR). Key Results Pharyngo-esophageal motility, respiratory, and impedance characteristics of 209 swallows were analyzed (85 spontaneous swallows, 63 pacifier associated dry swallows, 61 taste associated swallows). Basal UES and EGJ pressures decreased upon pacifier (P<0.05) and taste interventions (P<0.05); however, esophageal motility, respiratory rhythm, and impedance transit characteristics were similar with both interventions. Conclusions and Inferences Oral stimulus with pacifier or taste interventions decreases UES and EGJ basal pressure, but has no effects on pharyngo-esophageal motility, airway interactions, or esophageal bolus transit. A decrease in central parasympathetic-cholinergic excitatory drive is likely responsible for the basal effects. PMID:26727930

  5. Relationship between ease of swallowing and deglutition-related muscle activity in various postures.

    Science.gov (United States)

    Sakuma, T; Kida, I

    2010-08-01

    The purpose of this study was to investigate the relationship between the ease of swallowing and the deglutition-related muscle activity in various body and head postures by surface electromyography (EMG). Bipolar surface electrodes were placed on the right suprahyoid and infrahyoid muscles of nine healthy adults (19-28 years) while swallowing jelly. Ten postures per subject were examined: five body angulations (0 degrees [supine], 30 degrees, 60 degrees, 90 degrees [upright] and 120 degrees from the horizontal) and two head positions (chin-up and chin-down). The duration and amplitude of suprahyoid and infrahyoid muscle activity were measured by an electromyograph, and the ease of swallowing was subjectively determined by using a rating scale (0 = difficult to swallow, 10 = easy to swallow). The group-average duration and amplitude of muscle activity and the group-average rating scales mostly showed insignificant changes with the body angulations independent of the head positions. Interestingly, the duration and amplitude of muscle activity during swallowing were negatively correlated with the rating scales, indicating that a shorter duration and smaller activity of muscle activity corresponds to easier swallowing. Consequently, the duration and amplitude of suprahyoid and infrahyoid muscle activity measured by surface EMG would be a useful indicator of the easy-to-swallow performance.

  6. Respiratory-swallow training in patients with head and neck cancer.

    Science.gov (United States)

    Martin-Harris, Bonnie; McFarland, David; Hill, Elizabeth G; Strange, Charlton B; Focht, Kendrea L; Wan, Zhuang; Blair, Julie; McGrattan, Katlyn

    2015-05-01

    To test a novel intervention to train swallowing to occur in the midexpiratory to low expiratory phase of quiet breathing to improve swallowing safety and efficiency. Safety and efficacy nonrandomized controlled trial with 1-month follow-up. Ambulatory clinics. Patients (N=30) with head and neck cancer (HNC) and chronic dysphagia completed the intervention. Fifteen of these patients participated in a 1-month follow-up visit. Training protocol based on hierarchy of motor skill acquisition to encourage autonomous and optimal respiratory-swallowing coordination. Visual feedback of respiratory phase and volume for swallowing initiation was provided by nasal airflow and rib cage/abdomen signals. Respiratory-swallow phase pattern, Modified Barium Swallow Impairment Profile (MBSImP) scores, Penetration-Aspiration Scale (PAS) scores, and MD Anderson Dysphagia Inventory scores. Using visual feedback, patients were trained to initiate swallows during the midexpiratory phase of quiet breathing and continue to expire after swallowing. This optimal phase patterning increased significantly after treatment (Pdysphagia, with favorable effects on airway protection and bolus clearance. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  7. Leaf anthracnose, a new disease of swallow-worts from Russia

    Science.gov (United States)

    Black swallow-wort Vincetoxicum nigrum (L.) Moench (synonym=Cynanchum louiseae Kartesz & Gandhi) and pale swallow-wort Vincetoxicum rossicum (Kleopow) Borhidi (synonym=Cynanchum rossicum (Kleopow) Borhidi) are invasive plants belonging to the family Apocynaceae and are the targets of biological cont...

  8. New biological information on the invasive swallow-worts (Vincetoxicum spp.)

    Science.gov (United States)

    Vincetoxicum nigrum (L.) Moench [Cynanchum louiseae Kartesz & Gandhi] (black swallow-wort) and V. rossicum (Kleopow) Barbar. [Cynanchum rossicum (Kleopow) Borhidi] (pale swallow-wort) are herbaceous perennial vines in the Apocynaceae native to Europe. Both species are considered invasive in their in...

  9. Leaf anthracnose, a new disease of swallow-worts caused by Colletotrichum lineola from Russia

    Science.gov (United States)

    Black swallow-wort Vincetoxicum nigrum (L.) Moench and pale swallow-wort Vincetoxicum rossicum (Kleopow) Borhidi (family Apocynaceae subfamily Asclepiadoideae) are invasive plants and are the targets of biological control efforts to control their spread in the USA. In 2010, diseased leaves of a rela...

  10. Soft Electronics Enabled Ergonomic Human-Computer Interaction for Swallowing Training

    Science.gov (United States)

    Lee, Yongkuk; Nicholls, Benjamin; Sup Lee, Dong; Chen, Yanfei; Chun, Youngjae; Siang Ang, Chee; Yeo, Woon-Hong

    2017-04-01

    We introduce a skin-friendly electronic system that enables human-computer interaction (HCI) for swallowing training in dysphagia rehabilitation. For an ergonomic HCI, we utilize a soft, highly compliant (“skin-like”) electrode, which addresses critical issues of an existing rigid and planar electrode combined with a problematic conductive electrolyte and adhesive pad. The skin-like electrode offers a highly conformal, user-comfortable interaction with the skin for long-term wearable, high-fidelity recording of swallowing electromyograms on the chin. Mechanics modeling and experimental quantification captures the ultra-elastic mechanical characteristics of an open mesh microstructured sensor, conjugated with an elastomeric membrane. Systematic in vivo studies investigate the functionality of the soft electronics for HCI-enabled swallowing training, which includes the application of a biofeedback system to detect swallowing behavior. The collection of results demonstrates clinical feasibility of the ergonomic electronics in HCI-driven rehabilitation for patients with swallowing disorders.

  11. Intrarater and interrater reliability for measurements in videofluoroscopy of swallowing

    Energy Technology Data Exchange (ETDEWEB)

    Baijens, Laura, E-mail: laura.baijens@mumc.nl [Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht (Netherlands); Barikroo, Ali, E-mail: a.Barikroo@ufl.edu [Swallowing Research Laboratory, Department of Speech, Language and Hearing Sciences, College of Public Health and Health Professions, University of Florida, Gainesville, FL (United States); Pilz, Walmari, E-mail: walmari.pilz@mumc.nl [Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht (Netherlands)

    2013-10-01

    Objective: Intrarater and interrater reliability is crucial to the quality of diagnostic and therapy-effect studies. This paper reports on a systematic review of studies on intrarater and interrater reliability for measurements in videofluoroscopy of swallowing. The aim of this review was to summarize and qualitatively analyze published studies on that topic. Materials and methods: Those published up to March 2013 were found through a comprehensive electronic database search using PubMed, Embase, and The Cochrane Library. Two reviewers independently assessed the studies using strict inclusion criteria. Results: Nineteen studies were included and then qualitatively analyzed. In several of these, methodological problems were found. Moreover, intrarater and interrater reliability varied with the measure applied. A meta-analysis was not carried out as studies were not of sufficient quality to warrant doing so. Conclusion: In order to achieve reliable measurements in videofluoroscopy of swallowing, it is recommended that raters use well-defined guidelines for the levels of ordinal visuoperceptual variables. Furthermore, in order to make the measurements reliable (intrarater and interrater) it is recommended that, following protocolled pre-experimental training, the raters should have maximum consensus about the definition of the measured variables.

  12. A Mathematical Model for Swallowing of Concentrated Fluids in Oesophagus

    Directory of Open Access Journals (Sweden)

    S. K. Pandey

    2011-01-01

    Full Text Available This model investigates particularly the impact of an integral and a non-integral number of waves on the swallowing of food stuff such as jelly, tomato puree, soup, concentrated fruits juices and honey transported peristaltically through the oesophagus. The fluid is considered as a Casson fluid. Emphasis is on the study of the dependence of local pressure distribution on space and time. Mechanical efficiency, reflux limit and trapping are also discussed. The effect of Casson fluid vis-à-vis Newtonian fluid is investigated analytically and numerically too. The result is physically interpreted as that the oesophagus makes more efforts to swallow fluids with higher concentration. It is observed that the pressure is uniformly distributed when an integral number of waves is there in the oesophagus; but it is non-uniform when a non-integral number of waves is present therein. It is further observed that as the plug flow region widens, the pressure difference increases, which indicates that the averaged flow rate will reduce for a Casson fluid. It is also concluded that Casson fluids are more prone to reflux.

  13. Neural activation of swallowing and swallowing-related tasks in healthy young adults: an attempt to separate the components of deglutition.

    Science.gov (United States)

    Malandraki, Georgia A; Sutton, Bradley P; Perlman, Adrienne L; Karampinos, Dimitrios C; Conway, Charles

    2009-10-01

    Understanding the underlying neural pathways that govern the highly complex neuromuscular action of swallowing is considered crucial in the process of correctly identifying and treating swallowing disorders. The aim of the present investigation was to identify the neural activations of the different components of deglutition in healthy young adults using functional magnetic resonance imaging (fMRI). Ten right-handed young healthy individuals were scanned in a 3-Tesla Siemens Allegra MRI scanner. Participants were visually cued for both a "Swallow" task and for component/control tasks ("Prepare to swallow", "Tap your tongue", and "Clear your throat") in a randomized order (event-related design). Behavioral interleaved gradient (BIG) methodology was used to address movement-related artifacts. Areas activated during each of the three component tasks enabled a partial differentiation of the neural localization for various components of the swallow. Areas that were more activated during throat clearing than other components included the posterior insula and small portions of the post- and pre-central gyri bilaterally. Tongue tapping showed higher activation in portions of the primary sensorimotor and premotor cortices and the parietal lobules. Planning did not show any areas that were more activated than in the other component tasks. When swallowing was compared with all other tasks, there was significantly more activation in the cerebellum, thalamus, cingulate gyrus, and all areas of the primary sensorimotor cortex bilaterally.

  14. Evaluation of an EMG bioimpedance measurement system for recording and analysing the pharyngeal phase of swallowing.

    Science.gov (United States)

    Schultheiss, Corinna; Schauer, Thomas; Nahrstaedt, Holger; Seidl, Rainer O

    2013-07-01

    A neuroprosthetic device for treating swallowing disorders requires an implantable measurement system capable to analysing the timing and quality of the swallowing process in real time. A combined EMG bioimpedance (EMBI) measurement system was developed and is evaluated here. The study was planned and performed as a case-control study. The studies were approved by the Charité Berlin ethics committee in votes EA1/160/09 and EA1/161/09. Investigations were carried out on healthy volunteers in order to examine the usefulness and reproducibility of measurements, the ability to distinguish between swallowing and head movements and the effect of different food consistencies. The correlation between bioimpedance and anatomical and functional changes occurring during the pharyngeal phase of swallowing in non-healthy patients was examined using videofluoroscopy (VFSS). 31 healthy subjects (15♂, 16♀) were tested over the course of 1350 swallows and 19 (17♂, 2♀) non-healthy patients over the course of 54 swallows. The signal curves obtained from both transcutaneous and subcutaneous measurement were similar, characteristic and reproducible (r > 0.5) and correlated with anatomical and functional changes during the pharyngeal phase of swallowing observed using VFSS. Statistically significant differences between head movements and swallowing movements, food volumes and consistencies were found. Neither the conductivity of the food, the sex of the test subject nor the position of the measurement electrodes exerted a statistically significant effect on the measured signal. EMBI is able to reproducibly map the pharyngeal phase of swallowing and changes associated with it both transcutaneously and subcutaneously. The procedure therefore appears to be suitable for use in performing automated evaluation of the swallowing process and for use as a component of an implant.

  15. Evaluating Swallowing Muscles Essential for Hyolaryngeal Elevation by Using Muscle Functional Magnetic Resonance Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Pearson, William G., E-mail: bp1@bu.edu [Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts (United States); Hindson, David F. [Department of Radiology, Boston Medical Center, Boston, Massachusetts (United States); Langmore, Susan E. [Department of Otolaryngology, Boston Medical Center, Boston, Massachusetts (United States); Speech and Hearing Sciences, Boston University, Boston, Massachusetts (United States); Zumwalt, Ann C. [Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts (United States)

    2013-03-01

    Purpose: Reduced hyolaryngeal elevation, a critical event in swallowing, is associated with radiation therapy. Two muscle groups that suspend the hyoid, larynx, and pharynx have been proposed to elevate the hyolaryngeal complex: the suprahyoid and longitudinal pharyngeal muscles. Thought to assist both groups is the thyrohyoid, a muscle intrinsic to the hyolaryngeal complex. Intensity modulated radiation therapy guidelines designed to preserve structures important to swallowing currently exclude the suprahyoid and thyrohyoid muscles. This study used muscle functional magnetic resonance imaging (mfMRI) in normal healthy adults to determine whether both muscle groups are active in swallowing and to test therapeutic exercises thought to be specific to hyolaryngeal elevation. Methods and Materials: mfMRI data were acquired from 11 healthy subjects before and after normal swallowing and after swallowing exercise regimens (the Mendelsohn maneuver and effortful pitch glide). Whole-muscle transverse relaxation time (T2 signal, measured in milliseconds) profiles of 7 test muscles were used to evaluate the physiologic response of each muscle to each condition. Changes in effect size (using the Cohen d measure) of whole-muscle T2 profiles were used to determine which muscles underlie swallowing and swallowing exercises. Results: Post-swallowing effect size changes (where a d value of >0.20 indicates significant activity during swallowing) for the T2 signal profile of the thyrohyoid was a d value of 0.09; a d value of 0.40 for the mylohyoid, 0.80 for the geniohyoid, 0.04 for the anterior digastric, and 0.25 for the posterior digastric-stylohyoid in the suprahyoid muscle group; and d values of 0.47 for the palatopharyngeus and 0.28 for the stylopharyngeus muscles in the longitudinal pharyngeal muscle group. The Mendelsohn maneuver and effortful pitch glide swallowing exercises showed significant effect size changes for all muscles tested, except for the thyrohyoid. Conclusions

  16. Factors associated with swallowing assessment after oral endotracheal intubation and mechanical ventilation for acute lung injury.

    Science.gov (United States)

    Brodsky, Martin B; González-Fernández, Marlís; Mendez-Tellez, Pedro A; Shanholtz, Carl; Palmer, Jeffrey B; Needham, Dale M

    2014-12-01

    Endotracheal intubation is associated with postextubation swallowing dysfunction, but no guidelines exist for postextubation swallowing assessments. We evaluated the prevalence, patient demographic and clinical factors, and intensive care unit (ICU) and hospital organizational factors associated with swallowing assessment after oral endotracheal intubation and mechanical ventilation in patients with acute lung injury (ALI). We performed a secondary analysis of a prospective cohort study in which investigators evaluated 178 eligible patients with ALI who were mechanically ventilated via oral endotracheal tube. The patients were recruited from 13 ICUs at four teaching hospitals in Baltimore, Maryland. Patient demographic and clinical factors, types of ICU, and hospital study sites were evaluated for their association with completion of a swallowing assessment both in the ICU and after the ICU stay before hospital discharge. Factors significantly associated with a swallow assessment were evaluated in a multivariable logistic regression model. Before hospital discharge, 79 (44%) patients completed a swallowing assessment, among whom 59 (75%) had their assessments initiated in ICU and 20 (25%) had their assessments initiated on the hospital ward. Female sex (odds ratio [OR] = 2.01; 95% confidence interval [95% CI] = 1.03-3.97), orotracheal intubation duration (OR = 1.13 per day; 95% CI = 1.05-1.22), and hospital study site (Site 3: OR = 2.41; 95% CI = 1.00-5.78) were independently associated with swallowing assessment. Although Site 3 had a twofold increase in swallowing assessments in the ICU, there was no significant difference between hospitals in the frequency of swallowing assessments completed after ICU discharge (P = 0.287) or in the proportion of patients who failed a swallowing assessment conducted in the ICU (P = 0.468) or on the ward (P = 0.746). In this multisite prospective study, female sex, intubation duration, and

  17. Automatic discrimination between safe and unsafe swallowing using a reputation-based classifier

    Directory of Open Access Journals (Sweden)

    Nikjoo Mohammad S

    2011-11-01

    Full Text Available Abstract Background Swallowing accelerometry has been suggested as a potential non-invasive tool for bedside dysphagia screening. Various vibratory signal features and complementary measurement modalities have been put forth in the literature for the potential discrimination between safe and unsafe swallowing. To date, automatic classification of swallowing accelerometry has exclusively involved a single-axis of vibration although a second axis is known to contain additional information about the nature of the swallow. Furthermore, the only published attempt at automatic classification in adult patients has been based on a small sample of swallowing vibrations. Methods In this paper, a large corpus of dual-axis accelerometric signals were collected from 30 older adults (aged 65.47 ± 13.4 years, 15 male referred to videofluoroscopic examination on the suspicion of dysphagia. We invoked a reputation-based classifier combination to automatically categorize the dual-axis accelerometric signals into safe and unsafe swallows, as labeled via videofluoroscopic review. From these participants, a total of 224 swallowing samples were obtained, 164 of which were labeled as unsafe swallows (swallows where the bolus entered the airway and 60 as safe swallows. Three separate support vector machine (SVM classifiers and eight different features were selected for classification. Results With selected time, frequency and information theoretic features, the reputation-based algorithm distinguished between safe and unsafe swallowing with promising accuracy (80.48 ± 5.0%, high sensitivity (97.1 ± 2% and modest specificity (64 ± 8.8%. Interpretation of the most discriminatory features revealed that in general, unsafe swallows had lower mean vibration amplitude and faster autocorrelation decay, suggestive of decreased hyoid excursion and compromised coordination, respectively. Further, owing to its performance-based weighting of component classifiers, the static

  18. President Richard Nixon visits MSC to award Apollo 13 Mission Operations team

    Science.gov (United States)

    1970-01-01

    President Richard M. Nixon introduces Sigurd A. Sjoberg (far right), Director of Flight Operations at Manned Spacecraft Center (MSC), and the four Apollo 13 Flight Directors during the Presidnet's post-mission visit to MSC. The Flight Directors are (l.-r.) Glynn S. Lunney, Eugene A. Kranz, Gerald D. Griffin and Milton L. Windler. Dr. Thomas O. Paine, NASA Administrator, is seated at left. President Nixon was on the site to present the Presidential Medal of Freedom -- the nation's highest civilian honor -- to the Apollo 13 Mission Operations Team (35600); A wide-angle, overall view of the large crowd that was on hand to see President Richard M. Nixon present the Presidnetial Medal of Freedom to the Apollo 13 Mission Operations Team. A temporary speaker's platform was erected beside bldg 1 for the occasion (35601).

  19. Phlebitis, pulmonary emboli and presidential politics: Richard M. Nixon's complicated deep vein thrombosis.

    Science.gov (United States)

    Pascarella, Luigi; Pappas, Theodore N

    2013-02-01

    In September of 1974, Richard Nixon resigned the Presidency of the United States during an impeachment investigation concerning the Watergate Affair. One month after his resignation, the former President had an exacerbation of his chronic deep vein thrombosis. He also received a Presidential pardon from Gerald Ford on the same day that his recurrent deep vein thrombosis was diagnosed. The political, legal, and medical events that unfolded in the fall of 1974 are the substance of this report. Presidents often receive medical care that stretches the ordinary as a result of their position and the importance of their actions. The events surrounding Richard Nixon's care for deep vein thrombosis and its complications were not unusual for Presidential health care but were closely intertwined with the legal proceedings during the prosecution of the Watergate defendants.

  20. Reading ‘blackface’: A (narrative introduction to Richard Kearney’s notion of carnal hermeneutics

    Directory of Open Access Journals (Sweden)

    Helgard Pretorius

    2016-04-01

    Full Text Available Prominent Irish philosopher Richard Kearney’s notion of ‘carnal hermeneutics’ is introduced by applying it to a case study of a recent event that took place at one of South Africa’s university campuses. The narrative assists in illuminating some of the core principles of carnal hermeneutics and illustrates the applicability of carnal hermeneutics as a ‘diagnostic caring for lived existence’. In the process, an analysis is also given of the event in question, which is connected to what has widely been labelled as ‘blackface’. In conclusion, the contextual, philosophical, ethical, and theological implications of carnal hermeneutics are explored with an eye on theological praxes in South Africa today. Keywords: Carnal Hermeneutics; Hermeneutics; Flesh; Body; Richard Kearney; Merleau-Ponty; Ricoeur; Blackface

  1. Die Musik Richard Wagners im Banat und in Rumänien. Eine Rezeptionsgeschichte

    Directory of Open Access Journals (Sweden)

    Franz Metz

    2015-12-01

    Full Text Available Richard Wagner – an ihm schieden sich die Geister schon während seines Lebens. Dies geschah nicht nur in seinen deutschen Wirkungsorten, sondern auch im Südosten Europas. Schon früh fanden seine Werke auch im Banat und in Bukarest eine weite Verbreitung und das musikliebende Publikum mischte sich damals bereits in Pro- oder Kontra-Wagner-Diskussionen ein. In einem multikulturellen Raum wie das Banat, mit jahrhundertalten multiethnischen Erfahrungen und Traditionen, stieß der Wagnerkultus zuerst auf Ablehnung, später, ab 1930, wurden seine antisemitischen Anschauungen von den faschistischen Kreisen Rumäniens demagogisch missbraucht – ähnlich wie im restlichen Europa. Doch diese besondere Seite der Richard-Wagner-Rezeption hat auch eine faszinierende Auswirkung auf das allgemeine Musikleben in Rumänien und im Banat hinterlassen.

  2. Attributing minds to vampires in Richard Matheson’s I Am Legend

    OpenAIRE

    Nuttall, Louise

    2015-01-01

    For Palmer (2004, 2010), and other proponents of a cognitive narratology, research into real-world minds in the cognitive sciences provides insights into readers’ experiences of fictional minds. In this article, I explore the application of such research to the minds constructed for the vampire characters in Richard Matheson’s (1954) science fiction/horror novel I Am Legend. I draw upon empirical research into ‘mind attribution’ in social psychology, and apply Cognitive Grammar (Langacker, 2...

  3. How Richard Nixon Pressured Arthur Burns: Evidence from the Nixon Tapes

    OpenAIRE

    Burton A. Abrams

    2006-01-01

    Evidence from the Nixon tapes, now available to researchers, shows that President Richard Nixon pressured the chairman of the Federal Reserve, Arthur Burns, to engage in expansionary monetary policies in the run up to the 1972 election. This paper quotes the relevant conversations from the Nixon tapes. Questions remain as to whether Burns followed an expansionary policy in an already-inflationary environment out of conviction or because of political pressure.

  4. Against the Nihilism of Suffering and Death: Richard E. K. Kim and His Works

    OpenAIRE

    Jooyeon Rhee

    2016-01-01

    This article examines the life and works of Richard E. K. Kim (1932–2009), a first-generation Korean diasporic writer in the United States. It focuses on how Kim struggled to overcome the nihilism of suffering and death that derived from colonialism and the Korean War through his literary works. Kim witnessed firsthand these two major historical events, which caused irrevocable psychological and physical damage to many people of his generation. In his autobiographical fiction, he conveys pain...

  5. Richard Swinburne's Inductive Argument for the Existence of God – A Critical Analysis

    OpenAIRE

    Beckman, Emma

    2008-01-01

    This essay discusses and criticizes Richard Swinburne's inductive argument for the existence of God. In his The Existence of God, Swinburne aims at showing that the existence of God is more probable than not. This is an argument taking into consideration the premises of all traditional arguments for the existence of God. Swinburne uses the phenomena and events that constitute the premises of these arguments as evidence in an attempt to show that his hypothesis is more probably true than nor. ...

  6. Sexual Modernity in the Works of Richard von Krafft-Ebing and Albert Moll

    OpenAIRE

    Oosterhuis, Harry

    2012-01-01

    The modern notion of sexuality took shape at the end of the nineteenth century, especially in the works of Richard von Krafft-Ebing and Albert Moll. This modernisation of sexuality was closely linked to the recognition of sexual diversity, as it was articulated in the medical–psychiatric understanding of what, at that time, was labelled as perversion. From around 1870, psychiatrists shifted the focus from immoral acts, a temporary deviation of the norm, to an innate morbid condition. In the l...

  7. Sexuality, neurasthenia and the law: Richard von Krafft-Ebing (1840 - 1902)

    OpenAIRE

    Hauser, R. I.

    1992-01-01

    This thesis is a first biographical account of the German/Austrian psychiatrist Richard von Krafft-Ebing (1840 - 1902). It seeks to paint a more accurate picture than is so far available by bringing together new biographical data including background information on the institutional settings in which he worked. Above all, it explores the full range of Krafft-Ebing's written work and ideas over the whole period of his life. This shows Krafft-Ebing as a man of many interest...

  8. New Polyhedral Discretisation Methods applied to the Richards Equation: CDO Schemes in Code Saturne

    OpenAIRE

    Bonelle, Jérôme; Fournier, Yvan; Moulinec, Charles

    2017-01-01

    This paper shows an application of a vertex-based Compatible Discrete Operator (CDO) scheme to simulate the Richards equation on meshes using polyhedral cells. Second order spatial accuracy is reached for a verification test case using two meshes made of different types of polyhedral cells. A second validation test case dealing with a variably saturated soil inside a vertical column has been simulated, with three advected passive pollutants being released. Results are in good agreement with t...

  9. Swallowing of bolus types by postsurgical head and neck cancer patients.

    Science.gov (United States)

    Stachler, R J; Hamlet, S L; Mathog, R H; Jones, L; Heilbrun, L K; Manov, L J; O'Campo, J M

    1994-01-01

    Clinically, head and neck cancer patients with anterior resections have better postoperative outcomes than do patients with posterior resections. Videofluoroscopy was used to study the swallowing characteristics in postsurgery head and neck cancer patients and normal controls. Most patients received post-operative radiotherapy and chemotherapy, and no cancer recurrence was noted at the time of study, 4-8 months posttreatment. Bolus types included: 3 mL and 10 mL liquid barium, barium paste, and barium-coated cookie. Temporal measurements and a count of the number of swallows required to ingest each material were made from the videotaped data. Statistical analysis using an unbalanced univariate repeated measures ANOVA was performed. The major differences were found between bolus types, with few differences noted between surgical groups (anterior vs posterior resections) and normal controls. Patients took longer to ingest viscous material, accomplishing this by multiple piecemeal and clearing swallows. Coordination of mastication and swallowing of the cookie was different between normal and patient groups. Patients who are able to swallow reasonably well postoperatively maintain normal coordination and timing of swallowing activity and do not vary these parameters to compensate for structural inadequacy. Instead, repeated swallows are used.

  10. Natural capsaicinoids improve swallow response in older patients with oropharyngeal dysphagia.

    Science.gov (United States)

    Rofes, Laia; Arreola, Viridiana; Martin, Alberto; Clavé, Pere

    2013-09-01

    There is no pharmacological treatment for oropharyngeal dysphagia (OD). The aim of this study was to compare the therapeutic effect of stimulation of oropharyngeal transient receptor potential vanilloid type 1 (TRPV1) with that of thickeners in older patients with OD. A clinical videofluoroscopic non-randomised study was performed to assess the signs of safety and efficacy of swallow and the swallow response in (1) 33 patients with OD (75.94 ± 1.88 years) while swallowing 5, 10 and 20 ml of liquid (20.4 mPa.s), nectar (274.4 mPa.s), and pudding (3930 mPa.s) boluses; (2) 33 patients with OD (73.94 ± 2.23 years) while swallowing 5, 10 and 20 ml nectar boluses, and two series of nectar boluses with 150 μM capsaicinoids and (3) 8 older controls (76.88 ± 1.51 years) while swallowing 5, 10 and 20 ml nectar boluses. Increasing bolus viscosity reduced the prevalence of laryngeal penetrations by 72.03% (p capsaicinoids reduced both, penetrations by 50.% (p capsaicinoids strongly improved safety and efficacy of swallow and shortened the swallow response in older patients with OD. Stimulation of TRPV1 might become a pharmacologic strategy to treat OD.

  11. Effect of oral piperine on the swallow response of patients with oropharyngeal dysphagia.

    Science.gov (United States)

    Rofes, Laia; Arreola, Viridiana; Martin, Alberto; Clavé, Pere

    2014-12-01

    Oropharyngeal dysphagia (OD) is a major gastrointestinal motility disorder that causes severe nutritional and respiratory complications in elderly and neurological patients. In an earlier study, we found that stimulation of pharyngeal sensory neurons by capsaicinoids acting on transient receptor potential vanilloid 1 (TRPV1) improved the swallow response of dysphagic patients. The aim of this study was to explore the effect of piperine, a dual TRPV1/TRPA1 agonist, on the swallow response of dysphagic patients. A videofluoroscopic study was performed to assess the signs of impaired safety and efficacy of swallow and the swallow response of 40 dysphagic patients while swallowing one series of nectar control boluses and two series of nectar boluses supplemented with piperine. Patients were randomized into two groups: one group received 150 μM piperine and the other group received 1 mM. Piperine improved the safety of swallow by: (a) reducing the prevalence of unsafe swallows by -34.48% (P = 0.004) at 150 μM and -57.19% (P sensory neurons is a very promising neurostimulation strategy for dysphagic patients.

  12. Characterizing Dysphagia and Swallowing Intervention in the Traumatic Spinal Injury Population

    Science.gov (United States)

    Valenzano, Teresa J.; Waito, Ashley A.; Steele, Catriona M.

    2016-01-01

    Dysphagia is reported to be a common secondary complication for individuals with traumatic spinal injuries. Different etiologies of traumatic spinal injuries may lead to different profiles of swallowing impairment. We conducted a systematic review to determine the characteristics of dysphagia after traumatic spinal injury and to describe interventions currently used to improve swallowing function in this population. A comprehensive multi-engine literature search identified 137 articles of which 5 were judged to be relevant. These underwent review for study quality, rating for level of evidence, and data extraction. The literature describing dysphagia after traumatic spinal injury was comprised predominantly of low level evidence and single case reports. Aspiration, pharyngeal residue, and decreased/absent hyolaryngeal elevation were found to be common characteristics of dysphagia in this population. The most commonly used swallowing interventions included tube feeding, compensatory swallowing strategies, and steroids/antibiotics. Improvement in swallowing function following swallowing intervention was reported in all studies, however there was no control for spontaneous recovery. The results demonstrate a need for high-quality research to profile the pathophysiology of dysphagia after traumatic spinal injury and controlled studies to demonstrate the efficacy of swallowing interventions in this population. PMID:27412004

  13. Evaluation of Swallow Function in Patients with Craniofacial Microsomia: A Retrospective Study.

    Science.gov (United States)

    van de Lande, Lara S; Caron, Cornelia J J M; Pluijmers, Britt I; Joosten, Koen F M; Streppel, Marloes; Dunaway, David J; Koudstaal, Maarten J; Padwa, Bonnie L

    2017-11-04

    Craniofacial microsomia (CFM) is characterized by underdevelopment of the structures derived from the first and second pharyngeal arches resulting in aesthetic, psychological, and functional problems including feeding and swallowing difficulties. The aim of this study is to gain more insight into swallowing difficulties in patients with CFM. A retrospective study was conducted in the population of patients diagnosed with CFM at three major craniofacial units. Patients with feeding difficulties and those who underwent video fluoroscopic swallow (VFS) studies were included for further analyses. The outcome of the VFS-studies was reviewed with regard to the four phases of swallowing. In our cohort, 13.5% of the 755 patients were diagnosed with swallowing difficulties. The outcome of the VFS-studies of 42 patients showed difficulties in the oral and pharyngeal phases with both thin and thick liquids. Patients with more severe mandibular hypoplasia showed more difficulties to form an appropriate bolus compared to patients who were less severely affected. This is the first study to document swallowing problems in patients with CFM. Difficulties were seen in both the oral and pharyngeal phases. We recommend routine screening for swallowing issues by a speech and language therapist in all patients with CFM and to obtain a VFS-study in patients with a type III mandible.

  14. Therapeutic singing as an early intervention for swallowing in persons with Parkinson's disease.

    Science.gov (United States)

    Stegemöller, E L; Hibbing, P; Radig, H; Wingate, J

    2017-04-01

    For persons with Parkinson's disease (PD), secondary motor symptoms such as swallow impairment impact the quality of life and are major contributors to mortality. There is a present need for therapeutic interventions aimed at improving swallow function during the early stages of PD. The purpose of this pilot study was to examine the effects of a group therapeutic singing intervention on swallowing in persons with PD with no significant dysphagia symptoms. Cohort study. University in the United States. Twenty-four participants with PD. Eight weeks of group therapeutic singing. Electromyography (EMG) was used to assess muscle activity associated with swallow pre and post the group singing intervention. Swallow quality of life (SWAL-QOL) and the Unified Parkinson's Disease Rating Scale (UPDRS) were also obtained pre- and post-intervention. Participants reported minimal difficulty with swallowing, yet results revealed a significant increase in EMG outcome measures, as well as significant improvement in UPDRS total and UPDRS motor scores. No significant differences were revealed for SWAL-QOL. Increases in EMG timing measures may suggest that group singing results in the prolongation of laryngeal elevation, protecting the airway from foreign material for longer periods of time during swallow. Combined with the improvement in UPDRS clinical measures, therapeutic singing may be an engaging early intervention strategy to address oropharyngeal dysphagia while also benefiting additional clinical symptoms of PD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Assessment of swallowing and its disorders—A dynamic MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Vijay Kumar, K.V., E-mail: vijaykumarkv@yahoo.in [Department of Speech, Language and Hearing Sciences, SRU (India); Shankar, V., E-mail: drshankarv@yahoo.co.in [Department of Neurology, SRU (India); Santosham, Roy, E-mail: santoshamroy@yahoo.com [Department of Radiology and Imaging Sciences, SRU (India)

    2013-02-15

    Magnetic resonance imaging overcomes the limitations of videofluoroscopy in assessing without radiation exposure. The clinical utility of dynamic MRI for swallowing disorders is not well documented. This study demonstrates the feasibility of using dynamic MRI in assessment of swallowing disorders. Ten normal and three brainstem lesion patients participated in this study. GE Signa HDxt 1.5 Tesla MRI scanner with head-and-neck coil as a receiver and fast imaging employing steady state acquisition sequence was used. The swallow was analyzed in terms of symmetry and amplitude of movements of velum, faucial pillars, tongue, epiglottis and cricopharyngeous and images from the sagittal, coronal and axial planes. In sagittal plane posterior movement of tongue and its compression on velum, elevation of hyoid bone, elevation of larynx and lid action of epiglottis, in the coronal view the symmetrical movements of the faucial pillars and pharyngeal constrictor muscles and in axial plane three anatomical landmarks were targeted based on their role in swallowing, viz. velum, epiglottis and cricopharyngeous were studied. In brainstem lesion individuals, posterior movement of tongue, and elevation of larynx were not seen. Asymmetrical movements of faucial pillars and cricopharyngeous muscle were appreciated in the dynamic MRI. This demonstrates that, dynamic MRI is an efficient tool to understand the swallowing physiology and helps the speech language pathologist in modifying the swallowing maneuvers. Dynamic MRI is an effective tool in assessing swallowing and its disorders. This muscle specific information is not appreciated in videofluoroscopy and this information is necessary to modify the therapy maneuvers.

  16. Influence of the cuff pressure on the swallowing reflex in tracheostomized intensive care unit patients.

    Science.gov (United States)

    Amathieu, R; Sauvat, S; Reynaud, P; Slavov, V; Luis, D; Dinca, A; Tual, L; Bloc, S; Dhonneur, G

    2012-10-01

    Because recovery of an efficient swallowing reflex is a determining factor for the recovery of airway protective reflexes, we have studied the influence of the tracheostomy tube cuff pressure (CP) on the swallowing reflex in tracheotomized patients. Twelve conscious adult intensive care unit (ICU) patients who had been weaned from mechanical ventilation were studied. Simultaneous EMG of the submental muscles with measurement of peak activity (EMGp) and amplitude of laryngeal acceleration (ALA) were performed during reflex swallows elicited by pharyngeal injection of distilled water boluses during end expiration. After cuff deflation, characteristics of the swallowing reflex (latency time: LaT, EMGp, and ALA) were measured at CPs of 5, 10, 15, 20, 25, 30, 40, 50, and 60 cm H(2)O. LaT and CP were linearly related (P<0.01). CP was inversely correlated (P<0.01) to both ALA and EMGp. We demonstrated that LaT, EMGp, and ALA of the swallowing reflex were influenced by tracheostomy tube CP. The swallowing reflex was progressively more difficult to elicit with increasing CP and when activated, the resulting motor swallowing activity and efficiency at elevating the larynx were depressed.

  17. Pre-emptive swallowing stimulation in long-term intubated patients.

    Science.gov (United States)

    Hwang, Chang Ho; Choi, Kyoung Hyo; Ko, Yoon Suk; Leem, Chae Man

    2007-01-01

    To evaluate the effect of pre-emptive swallowing stimulation on the recovery of swallowing function in long-term intubated patients. Patients in the intensive care unit intubated for at least 48 hours due to respiratory distress from March to August 2004 were randomly divided into two groups. Fifteen patients of mean age 55.39+/-17.9 years were stimulated (experimental group) and 18 patients of mean age 61.39+/-13.5 years were not stimulated (control group). The duration of intubation was 15.59+/-6.7 days in the experimental group and 15.79+/-6.5 days in the control group. Duration of stimulation in the experimental group was 7.39+/-3.6 days. After extubation, we compared the severity of dysphagia via video-fluoroscopic swallow study. There were no statistically significant differences in the percentage of aspiration and the swallowed volume between the two groups. However, oral transit time in the experimental group (0.379+/-0.07 seconds) was significantly shorter than that of the control group (0.839+/-0.10 seconds), and the oropharyngeal swallowing efficiency of the experimental group (73.39+/-17.4%/s) was significantly higher than that of the control group (50.19+/-13.0%/s). Pre-emptive swallowing stimulation during intubation assists in the recovery of swallowing function in long-term intubated patients.

  18. Effect of carrot puree in vegetable juice on linguapalatal swallowing pressure.

    Science.gov (United States)

    Moritaka, Hatsue; Mineki, Machiko; Kobayashi, Makoto; Ono, Takahiro; Hori, Kazuhiro

    2017-12-11

    This study aimed to ascertain the influence of various amounts (0-30%) of carrot puree (CP) in vegetable juice on linguapalatal swallowing pressure in healthy volunteers. Twenty healthy women (age range: 20-22 years) swallowed a 17-ml drink in a natural state, and linguapalatal swallowing pressure was measured using a special sensor sheet. Peak magnitude (maximum pressure of the tongue pushing on the hard palate), integrated values of linguapalatal swallowing pressure on the waveform, and duration of linguapalatal swallowing pressure were increased with increases in CP concentrations. The total integrated value for 30% CP vegetable juice was larger than that of vegetable juice with no CP. The apparent viscosity of the vegetable juice with a low CP concentration was smaller than that with a high CP concentration at the same shear rate. These results suggest that vegetable juice containing CP affects mechanoreceptor activity in the mouth and generates a neuromotor response. This study aimed to ascertain the influence of various amounts of carrot puree (CP) in vegetable juice on linguapalatal swallowing pressure measured by using a special sensor sheet in healthy volunteers. Obtained results of this study clearly showed that vegetable juice containing CP affects the movement of the tongue in maneuvering the bolus. Moreover, the results demonstrated that this effect depended on the concentration of CP in the vegetable juice. These findings are expected to provide clinically valuable data on the effect of mechanical stimulation during the oral stage of swallowing. © 2017 Wiley Periodicals, Inc.

  19. Noninvasive Mechanical Ventilation Improves Breathing-Swallowing Interaction of Ventilator Dependent Neuromuscular Patients: A Prospective Crossover Study.

    Science.gov (United States)

    Garguilo, Marine; Lejaille, Michèle; Vaugier, Isabelle; Orlikowski, David; Terzi, Nicolas; Lofaso, Frédéric; Prigent, Hélène

    2016-01-01

    Respiratory involvement in neuromuscular disorders may contribute to impaired breathing-swallowing interactions, swallowing disorders and malnutrition. We investigated whether the use of non-invasive ventilation (NIV) controlled by the patient could improve swallowing performances in a population of neuromuscular patients requiring daytime NIV. Ten neuromuscular patients with severe respiratory failure requiring extensive NIV use were studied while swallowing without and with NIV (while ventilated with a modified ventilator allowing the patient to withhold ventilation as desired). Breathing-swallowing interactions were investigated by chin electromyography, cervical piezoelectric sensor, nasal flow recording and inductive plethysmography. Two water-bolus sizes (5 and 10ml) and a textured yogurt bolus were tested in a random order. NIV use significantly improved swallowing fragmentation (defined as the number of respiratory interruption of the swallowing of a single bolus) (p = 0.003) and breathing-swallowing synchronization (with a significant increase of swallows followed by an expiration) (p controlled NIV improves swallowing parameters in patients with severe neuromuscular respiratory failure requiring daytime NIV, without impairing swallowing comfort. ClinicalTrials.gov NCT01519388.

  20. Evaluation of normal swallowing functions by using dynamic high-density surface electromyography maps.

    Science.gov (United States)

    Zhu, Mingxing; Yu, Bin; Yang, Wanzhang; Jiang, Yanbing; Lu, Lin; Huang, Zhen; Chen, Shixiong; Li, Guanglin

    2017-11-21

    Swallowing is a continuous process with substantive interdependencies among different muscles, and it plays a significant role in our daily life. The aim of this study was to propose a novel technique based on high-density surface electromyography (HD sEMG) for the evaluation of normal swallowing functions. A total of 96 electrodes were placed on the front neck to acquire myoelectric signals from 12 healthy subjects while they were performing different swallowing tasks. HD sEMG energy maps were constructed based on the root mean square values to visualize muscular activities during swallowing. The effects of different volumes, viscosities, and head postures on the normal swallowing process were systemically investigated by using the energy maps. The results showed that the HD sEMG energy maps could provide detailed spatial and temporal properties of the muscle electrical activity, and visualize the muscle contractions that closely related to the swallowing function. The energy maps also showed that the swallowing time and effort was also explicitly affected by the volume and viscosity of the bolus. The concentration of the muscular activities shifted to the opposite side when the subjects turned their head to either side. The proposed method could provide an alternative method to physiologically evaluate the dynamic characteristics of normal swallowing and had the advantage of providing a full picture of how different muscle activities cooperate in time and location. The findings from this study suggested that the HD sEMG technique might be a useful tool for fast screening and objective assessment of swallowing disorders or dysphagia.

  1. Swallowing function after laryngeal cleft repair: more than just fixing the cleft.

    Science.gov (United States)

    Osborn, Alexander J; de Alarcon, Alessandro; Tabangin, Meredith E; Miller, Claire K; Cotton, Robin T; Rutter, Michael J

    2014-08-01

    To evaluate and describe the swallowing function in children after laryngeal cleft repair. Ten-year (2002-2012) retrospective chart review. Academic tertiary care pediatric otolaryngology practice. Records of 60 children who had surgical repair of laryngeal cleft (ages 2 weeks-14 years) and postoperative functional endoscopic evaluation of swallowing or videofluoroscopic swallow studies were examined retrospectively. Twenty-nine children had one postoperative swallow evaluation, 19 children had two, 4 children had three, 5 children had four, and 3 children had five. Median time to the first evaluation was 10.8 weeks (interquartile range [IQR]: 36.5, 231). On the final swallow evaluation, 34 (57%) children demonstrated normal swallowing parameters, 12 (20%) children showed penetration, and 14 (23%) children showed aspiration. Forty-three (72%) children were able to take everything by mouth normally or with minor behavioral modifications, 11 (18%) children required thickened fluids, and six (10%) children were kept nil per os (NPO). Mean improvement on the penetration-aspiration (pen-asp) scale was 2.13. On multivariable analysis, neurodevelopmental issues and gastronomy tube use were associated with the need for NPO status. Despite a high rate of surgical success, a substantial minority of children have persistent swallowing dysfunction after laryngeal cleft repair. Swallowing dysfunction after repair is multifactorial and arises from concomitant neurologic, anatomic, or other comorbidities that contribute to oropharyngeal and pharyngeal dysphagia. Based on our results, we recommend a testing schedule for postoperative swallowing evaluations after cleft repair. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  2. The prevalence of pediatric voice and swallowing problems in the United States.

    Science.gov (United States)

    Bhattacharyya, Neil

    2015-03-01

    Determine the prevalence of pediatric voice and swallowing problems in the United States. The 2012 National Health Interview Survey pediatric voice and language module was analyzed, identifying children reporting a voice or swallowing problem in the preceding 12 months. In addition to demographic data, specific data regarding visits to health care professionals for voice or swallowing problems, diagnoses given, and severity of voice or swallowing problem were analyzed. An estimated 839 ± 89 thousand children (1.4% ± 0.1%) reported a voice problem. Overall, 53.5% ± 1.9% were given a diagnosis for the voice problem and 22.8% ± 4.6% received voice services. Laryngitis (16.6% ± 5.5%) and allergies (10.4% ± 4.0%) were the most common diagnoses. A total of 16.4% graded the voice problem as a "big" or "very big" problem. An estimated 569 ± 63 thousand children (0.9% ± 0.1%) reported a swallowing problem. A total of 12.7% ± 3.8% received swallowing services and 13.4% ± 1.6% were given a diagnosis for their swallowing problem. Neurological problems were the most common diagnoses (11.1% ± 4.5%). A total of 17.9% graded the swallowing problem as a "big" or "very big" problem. These data provide the first insight into the prevalence of childhood voice and swallowing problems, which affect approximately 1% of children annually. A relative minority seek care for their problem, despite the disease impact. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  3. Swallowing transit times and valleculae residue in stable chronic obstructive pulmonary disease

    Science.gov (United States)

    2014-01-01

    Background Breathing and swallowing are physiologically linked to ensure effortless gas exchange during oronasal breathing and to prevent aspiration during swallowing. Studies have indicated consistent aspiration in chronic obstructive pulmonary disease, mainly related to delayed swallowing reflex and problems with lingual propulsion and pharyngeal peristalsis as a result of bilateral weakness and incoordination of the related muscles. The purpose of the present study was to evaluate swallowing transit times and valleculae residue characteristics of stable COPD patients who have no swallowing complaints. Methods Our study population included 20 stable patients with COPD and no swallowing complaints and 20 healthy controls. Swallowing was assessed through videofluoroscopic examination and involved the analysis of the following parameters: (1) pharyngeal stages of deglutition; (2) the duration of bolus movement through the oral cavity and pharynx (i.e. transit times); (3) valleculae residue ratio; (4) penetration/aspiration. Results Participants of the study did not present any signs of penetration-aspiration for any of the tested consistencies. Patients with COPD presented longer pharyngeal transit times during the ingestion of the liquid consistency and during the ingestion of the paste consistency. Regarding the duration of tongue base contact with the posterior pharyngeal wall, COPD patients also presented longer durations for the liquid and paste consistencies. No significant difference was observed for the distribution of individuals among the different valleculae residue severity levels. Conclusions Our study suggests that stable COPD patients may present physiological adaptations as a protective swallowing maneuver to avoid aspiration/penetration of pharyngeal contents. Moreover, valleculae residue cannot be seen as an isolated factor when trying to explain swallowing alterations in this population. PMID:24739506

  4. [Clinical characterisation and course following therapeutic intervention for swallowing disorders in hospitalised paediatric patients].

    Science.gov (United States)

    Salinas-Valdebenito, Luis; Núñez-Farias, Alicia C; Milagros, Angeli; Escobar-Henríquez, Raúl G

    Swallowing disorders are common in hospitalised patients and are an added difficulty when it comes to discharging them from hospital. Suitable characterisation performed by means of assessments conducted by a neurologist and a speech and language therapist allows for more accurate therapeutic decision-making. To describe swallowing disorders from the speech and language therapy evaluation performed on admission until discharge in paediatric patients and their relation with the therapeutic intervention that was implemented. We performed a retrospective analysis consisting in the examination of the medical records of 38 paediatric patients hospitalised between May 2007 and June 2008. Functional clinical evaluation was carried out in 100% of patients, and a video swallow study was conducted in 34%. Swallowing disorders were characterised as mild, moderate and severe, according to the stage that was altered and aspiratory risk to the airway. A speech therapist provided therapeutic intervention, and parents and caregivers were given special training. Swallowing disorders were chiefly associated to prematurity. The most frequently used therapeutic techniques were: tactile stimulation, providing patterns and training of parents. In the speech and language therapy evaluation performed on admission, 37% of disorders were severe, 21% were moderate and 42% were mild disorders. In most of the newborn infants, progress was favourable, as shown by a shift to normal swallowing in 48% and to mild in 8%. In the 17 preterm newborn infants, there was a change to normal swallowing in 65% and to mild in 12%. Swallowing disorders in this group of patients is mainly associated to prematurity. Systematic therapeutic intervention would help in the recovery from swallowing disorders, especially in preterm newborn infants.

  5. Implication of the vagus nerve in breathing pattern during sequential swallowing in rats.

    Science.gov (United States)

    Ouahchi, Yacine; Duclos, Celia; Marie, Jean Paul; Verin, Eric

    2017-10-01

    The ventilatory pattern during sequential swallowing is influenced by the vagal activity. As the vagus nerve is paired and mixed, we aimed (1) to determine if vagal implication in swallowing and breathing coordination is symmetric. (2) to study the importance of vagal afferences in swallowing and breathing coordination. Sixty two Wistar rats (7-11weeks, 260-400g) were studied by barometric plethysmography. In the first part of the study, we determined the effects of a right cervical vagotomy and the effects of a left cervical vagotomy on ventilatory pattern at rest and during sequential swallowing (14 rats with right vagotomy, 14 rats with left vagotomy and 14 rats with sham surgery). Comparisons of ventilatory variables were made between right and left vagotomized animals. Thereafter, we determined the effects of electrical vagus nerve stimulation (VNS) on ventilatory pattern at rest and during sequential swallowing (10 rats with electrical VNS and 10 rats with sham VNS). We showed that a right or a left cervical vagotomy does not alter ventilation at rest, but induces during sequential swallowing a decrease in respiratory rate (RR) (p0.05). Electrical VNS had no effect on ventilation at rest, but it minimized during sequential swallowing a decrease in RR related to a local alteration of the vagus nerve after placement of the electrodes as shown following sham VNS. In conclusion, the implication of vagus nerve in breathing pattern during sequential swallowing seems symmetric and influenced by activation of the vagal afferent pathway. These data can be useful when testing electrical VNS in swallowing disorders. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. virgin galactic explores cern SIR RICHARD BRANSON AND VIRGIN GALACTIC PARTICIPANTS ON THEIR FAVOURITE THINGS ABOUT VISITING CERN

    CERN Multimedia

    2016-01-01

    Virgin Galactic visited CERN with a group of future astronauts and Sir Richard Branson. During their visit the group was shown around various experiments, including the Globe, SM18, AMS and the CERN Control Centre.

  7. Fiberoptic endoscopic evaluation of swallowing in swallowing disorders – fees-. Case report at Popayán, Colombia.

    Directory of Open Access Journals (Sweden)

    Rodrigo Molina-García

    2011-09-01

    Full Text Available Dysphagia is a frequently pathological condition in pa­tients with stroke and carries a substantial risk of dehy­dration, malnutrition and aspiration pneumonia. So far there are two methods for diagnosis; Videofluoroscopy (VFC and Fiberoptic Endoscopic Evaluation of Swa­llowing (FEES. The first is considered the gold standard method, with a high cost, radiation exposure that requires the transfer of the patient to radiology, the patient’s abili­ty to follow simple commands and time required to com­plete. VFC does not replicate physiological conditions in which the patient is routinely, so it is considered that its representation is limited, the second test is an alternative procedure to be more economical, safe, well tolerated, wi­dely available, lasting approximately 20 minutes and with the possibility of doing it in the patient’s bed. Unlike FVC, to evaluate the presence of pharyngeal, this correlates with the risk of aspiration. Clinical report: The objective of this report is to present a male patient, 33 years old, who admitted to a health institution because it presents a clini­ cal picture compatible with stroke, as findings found right hemiplegia and swallowing disorder, as required gastros­tomy tubes. We performed Fiberoptic Endoscopic Evalua­tion of Swallowing (FEES as a diagnostic method, which allowed visualization of the anatomic and functional en­vironment, the type of food consistency could be secure in their feeding process, thus avoiding silent aspirations and insights that could lead an aspiration pneumonia. It also allowed the group to make recommendations for nutritio­nal support, physiotherapy and speech therapy for ambu­latory management of the patient.

  8. Final report: Initial ecosystem response of salt marshes to ditch plugging and pool creation: Experiments at Rachel Carson National Wildlife Refuge (Maine)

    Science.gov (United States)

    Adamowicz, S.C.; Roman, C.T.

    2002-01-01

    This study evaluates the response of three salt marshes, associated with the Rachel Carson National Wildlife Refuge (Maine), to the practice of ditch plugging. Drainage ditches, originally dug to drain the marsh for mosquito control or to facilitate salt hay farming, are plugged with marsh peat in an effort to impound water upstream of the plug, raise water table levels in the marsh, and increase surface water habitat. At two study sites, Moody Marsh and Granite Point Road Marsh, ditch plugs were installed in spring 2000. Monitoring of hydrology, vegetation, nekton and bird utilization, and marsh development processes was conducted in 1999, before ditch plugging, and then in 2000 and 2001 (all parameters except nekton), after ditch plugging. Each study site had a control marsh that was monitored simultaneously with the plugged marsh, and thus, we employed a BACI study design (before, after, control, impact). A third site, Marshall Point Road Marsh, was plugged in 1998. Monitoring of the plugged and control sites was conducted in 1999 and 2000, with limited monitoring in 2001, thus there was no ?before? plug monitoring. With ditch plugging, water table levels increased toward the marsh surface and the areal extent of standing water increased. Responding to a wetter substrate, a vegetation change from high marsh species (e.g., Spartina patens) to those more tolerant of flooded conditions (e.g., Spartina alterniflora) was noted at two of the three ditch plugged sites. Initial response of the nekton community (fishes and decapod crustaceans) was evaluated by monitoring utilization of salt marsh pools using a 1m2 enclosure trap. In general, nekton species richness, density, and community structure remained unchanged following ditch plugging at the Moody and Granite Point sites. At Marshall Point, species richness and density (number of individuals per m2) were significantly greater in the experimental plugged marsh than the control marsh (open water habitat vs. 11% of

  9. Swallowing abnormalities in multiple sclerosis: correlation between videofluoroscopy and subjective symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Wiesner, W.; Steinbrich, W. [Institute of Diagnostic Radiology, University Hospital of Basel (Switzerland); Wetzel, S.G.; Radue, E.W. [Institute of Neuroradiology, University Hospital Basel (Switzerland); Kappos, L.; Hoshi, M.M. [Department of Neurology, University Hospital of Basel (Switzerland); Witte, U. [Section of Logopedia, University Hospital of Basel (Switzerland)

    2002-04-01

    The purpose of this study was to evaluate if subjective symptoms indicating an impaired deglutition correlate with videofluoroscopic findings in patients with multiple sclerosis (MS). Videofluoroscopic examinations of 18 MS patients were analyzed by a radiologist and a logopedist and compared with the symptoms of these patients. Four patients complained about permanent dysphagia. Six patients reported mild and intermittent difficulties in swallowing, but were asymptomatic at the time of videofluoroscopy. Eight patients had no symptoms regarding their deglutition. All patients (n=4) who complained of permanent dysphagia showed aspiration. All patients (n=6) with mild and intermittent difficulties in swallowing showed undercoating of the epiglottis and/or laryngeal penetration. Of those 8 patients without any swallowing symptoms, only 2 had a normal videofluoroscopy. Swallowing abnormalities seem to be much more frequent in patients with MS than generally believed and they may easily be missed clinically as long as the patients do not aspirate. (orig.)

  10. SWALLOWING DISORDERS IN CLINICAL PRACTICE: FUNCTIONAL ANATOMY, ASSESSMENT AND REHABILITATION STRATEGIES

    Directory of Open Access Journals (Sweden)

    STANESCU Ioana

    2014-09-01

    Full Text Available Swallowing is a complex process consisting in transporting food from mouth to the stomach; it involves voluntary and reflex activity of more than 30 nerves and muscles, requiring complex neuromuscular coordination and brainstem and cortical centers for controle. Dysphagia is defined as a alteration in the swallowing process, which cause difficulty in transporting saliva and aliments from the mouth trough the pharynx and esophagus into the stomach . It is a frequent symptom, affecting especially old people, people with neurological diseases, cancers of head and neck or severe reflux . Dysphagia can result from a wide variety of functional or structural deficits of the oral cavity, pharynx, larynx or esophagus, which could e caused by neurological conditions. Dysphagia carries serious health risks: malnutrition, dehydration, increase risk of infections. Effective dysphagia management requires an interdisciplinary approach; the goal of rehabilitation is to identify and treat abnormalities of swallowing while maintaining safe and efficient nutrition. KEY WORDS: swallowing, dysphagia, functional anatomy, rehabilitation, neuroplasticity

  11. Lost and found…Tracking a swallowed denture: Role of radiology

    Directory of Open Access Journals (Sweden)

    Yogita Khalekar

    2017-01-01

    Full Text Available Denture ingestion or aspiration is a problem requiring awareness of different specialists including dentists, surgeons, otolaryngologists, and anesthesiologists for prevention, early diagnosis and adequate treatment. Complications of swallowed dentures include hollow viscous necrosis, perforation, and penetration to neighbouring organs leading to fistulae, bleeding and obstruction. Here, we present the case of a 65 year old female patient who swallowed the denture, which was detected by barium swallow and removed by endoscopy. Hence, the management of swallowed denture needs a multidisciplinary approach with the help of a dentist, otolaryngologist and anesthesiologists. Dentists should recommend patients to visit them for planned check ups or revisit them in case of denture dislodgement or loosening as soon as possible to prevent such life threatening events.

  12. Time-Frequency Analysis and Hermite Projection Method Applied to Swallowing Accelerometry Signals

    Directory of Open Access Journals (Sweden)

    Ervin Sejdić

    2010-01-01

    Full Text Available Fast Hermite projections have been often used in image-processing procedures such as image database retrieval, projection filtering, and texture analysis. In this paper, we propose an innovative approach for the analysis of one-dimensional biomedical signals that combines the Hermite projection method with time-frequency analysis. In particular, we propose a two-step approach to characterize vibrations of various origins in swallowing accelerometry signals. First, by using time-frequency analysis we obtain the energy distribution of signal frequency content in time. Second, by using fast Hermite projections we characterize whether the analyzed time-frequency regions are associated with swallowing or other phenomena (vocalization, noise, bursts, etc.. The numerical analysis of the proposed scheme clearly shows that by using a few Hermite functions, vibrations of various origins are distinguishable. These results will be the basis for further analysis of swallowing accelerometry to detect swallowing difficulties.

  13. Randomized trial of two swallowing assessment approaches in patients with acquired brain injury

    DEFF Research Database (Denmark)

    Kjaersgaard, Annette; Nielsen, Lars Hedemann; Sjölund, Bengt H.

    2014-01-01

    OBJECTIVE: To examine whether patients assessed for initiation of oral intake only by Facial-Oral Tract Therapy had a greater risk of developing aspiration pneumonia during neurorehabilitation than patients assessed by Fibreoptic Endoscopic Evaluation of Swallowing. DESIGN: Randomized controlled ...

  14. Contribution of the lateral lemniscus to the control of swallowing in decerebrate cats.

    Science.gov (United States)

    Ota, R; Takakusaki, K; Katada, A; Harada, H; Nonaka, S; Harabuchi, Y

    2013-12-19

    Lateral lemniscus, a relay nucleus of auditory sensation, is involved in the control of phonatory movements such as human speech and vocalization of animals. The present study was designed to test whether neurons in the lateral lemniscus contributed to the control of swallowing, one of non-phonic oro-pharyngolaryngeal movements. In acutely decerebrated cats (n=15), swallowing was induced by electrical stimulation (20-80μA at 10Hz for 20s with rectangular pulses of 0.2ms duration) delivered to the superior laryngeal nerve (SLN). Repetitive electrical stimulation (30-50μA at 50Hz for 10-20s) applied to the dorsal nucleus of the lateral lemniscus (LLD) increased the number and reduced the latency to the onset of the SLN-induced swallowing. On the other hand, stimulation of the ventral nucleus of the lateral lemniscus and the paralemniscal area, corresponding to the ventrolateral part of the parabrachial nucleus and the Kölliker-Fuse nucleus, often suppressed the SLN-induced swallowing. Microinjection of NMDA (0.1-0.15μl, 5.0-10mM) into the LLD through a stereotaxically placed glass micropipette facilitated the SLN-induced swallowing, i.e., the number was increased and the latency of swallowing was reduced. We also injected muscimol (a gamma amino-butyric acid (GABA)A receptor agonist), bicuculline (a GABAA receptor antagonist) and baclofen (a GABAB receptor agonist) into the LLD (0.1-0.15μl and 5.0mM for each substance). It was observed that an injection of muscimol suppressed the SLN-induced swallowing. However, an injection of bicuculline facilitated the swallowing. An injection of baclofen did not alter the swallowing. These results suggest the presence of functional topography in the lateral lemniscus and the paralemniscal area in relation to the control of swallowing. The facilitatory LLD-effects on swallowing are modulated by glutamatergic and GABAergic receptors on neurons in the LLD. Copyright © 2013 IBRO. Published by Elsevier Ltd. All rights reserved.

  15. Accumulation of PCB congeners in nestling tree swallows (Tachycineta bicolor) on the Hudson River, New York

    Science.gov (United States)

    Echols, Kathy R.; Tillitt, Donald E.; Nichols, John W.; Secord, Anne L.; McCarty, John P.

    2004-01-01

    Tree swallows (Tachycineta bicolor) were used as a sentinel species to monitor the contamination and bioavailability of polychlorinated biphenyls (PCBs) in the Hudson River watershed. Several tree swallow nest box colonies around and downstream from Hudson Falls, NY, were studied. Tree swallow eggs, adults, and 5-, 10-, and 15-day-old nestlings were collected and analyzed for 103 PCB congeners. Emergent insects collected by net (primarily Odonata) or as a food bolus (primarily Diptera) taken from the mouths of adult tree swallows returning to the nest were analyzed in the same manner. Total PCB concentrations (wet weight) in eggs from two contaminated sites ranged from 9000 to 25 000 ng/g and accumulated to 32 000 and 96 000 ng/g in 15-day-old nestling at two contaminated sites. The congener patterns of PCBs in eggs, nestlings, and adults were compared to those found in emergent insects (Odonata and Diptera) using principal components analysis. The PCB patterns of the biota differed from that of Aroclor technical mixtures. PCB patterns in adult tree swallows were similar to those in eggs, while the patterns in dietary insects were similar to nestling tree swallows. Uptake rate constants were determined for tree swallow nestlings and compared between the two contaminated sites. The estimated PCB congener uptake rate constants were 0.008-0.02 d-1 based on uptake in nestlings until day 15 post-hatch. The rate constants were comparable between the two study areas and may be used to predict nestling contamination at other locations. Our studies confirm the utility of nestling tree swallows to evaluate localized PCB contamination.

  16. Deleterious sucking habits and atypical swallowing in children with otitis media with effusion.

    Science.gov (United States)

    Ralli, Giovanni; Ruoppolo, Giovanni; Mora, Renzo; Guastini, Luca

    2011-10-01

    The aim of this study was to investigate the possible correlation between otitis media with effusion, bad sucking habits and atypical swallowing in children affected by otitis media with effusion. 65 children, aged from 7 to 12 years, observed in the ENT Department of the "La Sapienza" University of Rome, were enrolled in the study group (group A). All children were affected by otitis media with effusion for more than 3 months. As control group, 60 healthy children, aged from 7 to 12 years were identified (group B). All the children underwent medical history, with evaluation of the sucking habits, ENT examination, tympanometry, orthodontic examination and evaluation of swallowing. In the orthodontic examination the variables analyzed were: maximum mouth opening, right and left mandibular lateral movements and mandibular protrusion. Atypical swallowing was considered to occur when lip activity produced strong tension in the perioral musculature, and/or the tip of the tongue was placed or pushed against the anterior teeth during swallowing. In the group A, atypical swallowing was found in 33/65 subjects out of the 65 children (50.7%). In the control group (group B) 16/60 children (26.6%) showed atypical swallowing. Compared with group B, deleterious sucking habits were significantly higher (phabits were present in almost all children with atypical swallowing (28/33 in group A and 12/16 in group B). Our data suggest a correlation between otitis media with effusion, deleterious sucking habits and prevalence of atypical swallowing. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  17. Effect of aging on oral and swallowing function after meal consumption

    Directory of Open Access Journals (Sweden)

    Hiramatsu T

    2015-01-01

    Full Text Available Tetsuya Hiramatsu,1,2 Hideyuki Kataoka,3 Mari Osaki,4 Hiroshi Hagino3,4 1Department of Speech Pathology and Audiology, Matsue Co-medical College, Matsue, Japan; 2Graduate School of Medical Sciences, Tottori University, 3School of Health Science, Faculty of Medicine, Tottori University, 4Rehabilitation Division, Tottori University Hospital, Yonago, Japan Background/purpose: Dysphagia may worsen due to fatigue of the infrahyoid and suprahyoid muscle groups as a result of repetitive swallowing during a meal. We investigated the hypothesis that meal consumption may reduce tongue strength and endurance in older adults (OAs.Methods: Tongue–palate pressure, oral diadochokinesis, repetitive saliva swallowing, and surface electromyography activity before and after a meal were measured in 23 young adults (YAs and 23 OA volunteers.Results: There was a statistically significant difference in both tongue pressure and the number of voluntary swallows between YAs and OAs. Peak tongue pressure was significantly lower in OAs than YAs both before and after meal consumption. The most notable finding was that the first time interval (the time from test initiation to the beginning of the first swallow was prolonged after meal consumption only in OAs, whereas the first time interval showed no difference between YAs and OAs before meal consumption with reference to the repetitive saliva swallowing test. The initiation of swallowing was prolonged by both meal consumption and aging; there was a significant interaction between these two factors. The number of repetitions of the monosyllable/pa/was statistically similar between YAs and OAs before meal consumption, but it was significantly lower in OAs after meal consumption.Conclusion: Aging leads to declining tongue pressure and motor function of the lips. It is possible that swallowing function declines in older individuals when meal consumption is prolonged, especially at the end of mealtime, as a result of their

  18. Swallowing dysfunction among patients with laryngeal cleft: More than just aspiration?

    Science.gov (United States)

    Strychowsky, Julie E; Dodrill, Pamela; Moritz, Ethan; Perez, Jennifer; Rahbar, Reza

    2016-03-01

    The Modified Barium Swallow (MBS) is the most widely utilized instrumental assessment of swallowing disorders in children; however, the exact role in the evaluation of laryngeal clefts remains controversial. This study was an IRB-approved retrospective review on patients diagnosed with laryngeal cleft from 2002 to 2014. The objective was to describe the range of swallowing dysfunction that may be present in patients with laryngeal clefts both pre- and post-intervention (conservative management versus surgery). A speech-language pathologist reviewed MBS studies and medical records to determine Penetration-Aspiration Scale (PAS) and Functional Oral Intake Scale (FOIS) scores. One hundred seventy-five patients who underwent laryngeal cleft repair during the study period (type 1, n=111; type 2, n=54; type 3, n=9; type 4, n=1) were included. Fifty patients who were managed conservatively (type 1) were also included. Swallowing impairment was demonstrated in all phases of swallowing for all cleft types. Oral phase impairment ranged from 27-67% pre-intervention to 19-75% post-intervention, triggering impairment from 24-42% pre-intervention to 24-75% post-intervention, and pharyngeal phase impairment (laryngeal penetration and aspiration) from 57-100% pre-intervention to 40-100% post-intervention. Laryngeal penetration and aspiration on thin and thick liquids, silent aspiration, PAS, and FOIS scores are reported. Significant improvements in swallowing function (p<0.05) were documented in all of the conservatively and surgically managed sub-groups. The MBS study is a useful tool for evaluating swallowing function in patients with laryngeal cleft and provides information beyond the lack or presence of aspiration. Understanding impairments in all phases of swallowing may be beneficial for perioperative management. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Age-related Differences in Tongue-Palate Pressures for Strength and Swallowing Tasks

    OpenAIRE

    Fei, Tiffany; Polacco, Rebecca Cliffe; Hori, Sarah E.; Molfenter, Sonja M.; Peladeau-Pigeon, Melanie; Tsang, Clemence; Steele, Catriona M.

    2013-01-01

    The tongue plays a key role in the generation of pressures for transporting liquids and foods through the mouth in swallowing. Recent studies suggest that there is an age-related decline in tongue strength in healthy adults. However, whether age-related changes occur in tongue pressures generated for the purpose of swallowing remains unclear. Prior literature in this regard does not clearly explore the influence of task on apparent age-related differences in tongue pressure amplitudes. Furthe...

  20. Favorable Swallowing Outcomes following Vagus Nerve Sacrifice for Vagal Schwannoma Resection.

    Science.gov (United States)

    Patel, Mira A; Eytan, Danielle F; Bishop, Justin; Califano, Joseph A

    2017-02-01

    Objective To determine the impact of unilateral vagal sacrifice for vagal schwannoma on postoperative swallowing function. Study Design Case series, chart review. Setting Academic medical institution. Subjects and Methods Ten patients underwent vagus nerve sacrifice for vagal schwannoma resection. Archived pathology records dating from 1985 through 2012 at our institution were retrospectively queried for cases of vagal schwannoma with vagus nerve sacrifice. Medical records were abstracted for demographic and disease information as well as cranial nerve and swallowing function. Preoperative and postoperative cranial nerve function, subjective and objective measures of swallowing function, Functional Oral Intake Scale (FOIS) level, and need for vocal fold medialization were variables collected. Data were analyzed with summary statistics. Results The patients who underwent vagal sacrifice for vagal schwannoma at our institution had a mean age of 42.3 years (median, 44 years; range, 15-63 years) and follow-up of 35.6 months (median, 9 months; range, 1-115 months). Most presented with no preoperative cranial nerve deficit or difficulty swallowing. Immediately postoperatively, 90% had a vagus nerve deficit, but 50% had no subjective difficulty swallowing, and 70% had a FOIS level of 7 at postoperative hospital discharge. Within 1 month after surgery, 70% had normal swallowing function according to a modified barium swallow study. A full diet was tolerated by mouth within an average of 2.7 days (median, 2 days; range, 1-6 days) after surgery in this cohort. Seventy percent required vocal fold medialization postoperatively for incomplete glottic closure. Conclusion Vagal nerve sacrifice during resection of vagal schwannoma can be performed with normal postoperative swallowing function.

  1. Impact of rhythmic oral activity on the timing of muscle activation in the swallow of the decerebrate pig.

    Science.gov (United States)

    Thexton, Allan J; Crompton, A W; Owerkowicz, Tomasz; German, Rebecca Z

    2009-03-01

    The pharyngeal swallow can be elicited as an isolated event but, in normal animals, it occurs within the context of rhythmic tongue and jaw movement (RTJM). The response includes activation of the multifunctional geniohyoid muscle, which can either protract the hyoid or assist jaw opening; in conscious nonprimate mammals, two bursts of geniohyoid EMG activity (GHemg) occur in swallow cycles at times consistent with these two actions. However, during experimentally elicited pharyngeal swallows, GHemg classically occurs at the same time as hyoglossus and mylohyoid activity (short latency response) but, when the swallow is elicited in the decerebrate in the absence of RTJM, GHemg occurs later in the swallow (long latency response). We tested the hypothesis that it was not influences from higher centers but a brain stem mechanism, associated with RTJM, which caused GHemg to occur earlier in the swallow. In 38 decerebrate piglets, RTJM occurred sporadically in seven animals. Before RTJM, GHemg had a long latency, but, during RTJM, swallow related GHemg occurred synchronously with activity in hyoglossus and mylohyoid, early in the swallow. Both early and late responses were present during the changeover period. During this changeover period, duplicate electrodes in the geniohyoid could individually detect either the early or the late burst in the same swallow. This suggested that two sets of geniohyoid task units existed that were potentially active in the swallow and that they were differentially facilitated or inhibited depending on the presence or absence of rhythmic activity originating in the brain stem.

  2. Stable carbon and nitrogen isotopes of tree swallows influenced by oil sands aquatic reclamation

    Energy Technology Data Exchange (ETDEWEB)

    Farwell, A.; Dixon, D. [Waterloo Univ., ON (Canada); Harms, J. [Saskatchewan Univ., Saskatoon, SK (Canada); Smits, J. [Calgary Univ., AB (Canada)

    2010-07-01

    This presentation reported on a study in which tree swallows (Tachycineta bicolor) were studied to evaluate reclamation strategies used by oil sand operators in Alberta. Wetland reclamation involves the transformation of tailings water and solids into functioning aquatic ecosystems. Naphthenic acids (NAs) and polycyclic aromatic compounds (PACs) in tailing/reclamation material are toxic constituents that pose concern for growth rate, reproductive function and immune function in tree swallows. Exposure to xenobiotics from these tailings-based sites was determined by increased detoxification enzyme (EROD) activity. The dietary exposure of tree swallows to oil sands constituents was determined through stable isotope analysis. Previous studies revealed trends of 13C depletion and 15N enrichment in benthic invertebrates from reclaimed wetlands on the oil sands. Since most food consumed by tree swallow nestlings is aquatic, the isotope signatures in tree swallows should provide evidence of exposure to oil sands constituents. Tree swallow feather and muscle tissues were examined in this study to determine if stable isotopes could be used to identify dietary contributions from oil sands reclamation sites versus reference sites containing no tailings materials.

  3. Cine MRI of swallowing in patients with advanced oral or oropharyngeal carcinoma: a feasibility study.

    Science.gov (United States)

    Kreeft, Anne Marijn; Rasch, Coen R N; Muller, Sara H; Pameijer, Frank A; Hallo, Eeke; Balm, Alfons J M

    2012-06-01

    Treatment of oral and oropharyngeal cancer may cause dysphagia. Purpose is to examine whether cine magnetic resonance imaging (MRI) yields additional information compared to standard examination in the evaluation of posttreatment dysphagia and mobility of oral and oropharyngeal structures. Thirty-four cine MRIs were made in 23 patients with advanced oral and oropharyngeal cancer, consisting of an MR image every 800 ms during swallowing which is compared to videofluoroscopy and quality of life questionnaires. A scoring system was applied to assess mobility on cine MR and videofluoroscopy leading to a score ranging from 9 to 17. Cine MRI of the swallowing in a midsagittal plane visualized the tumor (if located in the same plane), important anatomic structures and surgical reconstructions. Posttreatment mobility on cine MRI and videofluoroscopy was significantly diminished compared to pretreatment, mean pretreatment cine MRI score was 10.8 and posttreatment 12.4 (p = 0.017). Impaired mobility on cine MRI was significantly correlated to more swallowing problems (Spearman's correlation coefficient 0.73, p = 0.04), on videofluoroscopy not. Cine MRI is a promising new technique as an adjunct to standard examinations for evaluation of swallowing in patients with oral and oropharyngeal cancer. Cine MRI directly visualizes the dynamics of swallowing and allows evaluation of pre- and posttreatment differences. Abnormal findings are significantly correlated with subjective swallowing complaints of patients.

  4. A model experiment to study swallowing of spherical and elongated particles

    Science.gov (United States)

    Marconati, Marco; Raut, Sharvari; Charkhi, Farshad; Burbidge, Adam; Engmann, Jan; Ramaioli, Marco

    2017-06-01

    Swallowing disorders are not uncommon among elderly and people affected by neurological diseases. For these patients the ingestion of solid grains, such as pharmaceutical oral solid formulations, could result in choking. This generally results in a low compliance in taking solid medications. The effect of the solid medication size on the real or perceived ease of swallowing is still to be understood from the mechanistic viewpoint. The interplay of the inclusion shape and the rheology of the liquid being swallowed together with the medication is also not fully understood. In this study, a model experiment was developed to study the oropharyngeal phase of swallowing, replicating the dynamics of the bolus flow induced by the tongue (by means of a roller driven by an applied force). Experiments were performed using a wide set of solid inclusions, dispersed in a thick Newtonian liquid. Predictions for a simple theory are compared with experiments. Results show that an increase in the grain size results in a slower dynamics of the swallowing. Furthermore, the experiments demonstrated the paramount role of shape, as flatter and more streamlined inclusions flow faster than spherical. This approach can support the design of new oral solid formulations that can be ingested more easily and effectively also by people with mild swallowing disorders.

  5. Intensive swallowing and orofacial contracture rehabilitation after severe burn: A pilot study and literature review.

    Science.gov (United States)

    Clayton, Nicola A; Ward, Elizabeth C; Maitz, Peter K

    2017-02-01

    Dysphagia following severe burns can be significant and protracted, yet there is little evidence describing the rehabilitation principles, process or outcomes. Outline current evidence and detail the clinical outcomes of two cases who underwent a multifaceted intensive treatment programme aimed at rehabilitating dysphagia by strengthening swallow function and minimising orofacial contractures after severe head and neck burns. Two men (54 and 18 years) with full-thickness head and neck burns and inhalation injury underwent intensive orofacial scar management and dysphagia rehabilitation. Therapy was prescribed, consisting of scar stretching, splinting and pharyngeal swallow tasks. Horizontal and vertical range of movement (HROM; VROM), physiological swallow features, functional swallowing outcomes and related distress, were collected at baseline and routinely until dysphagia resolution and scar stabilisation. At presentation, both cases demonstrated severely reduced HROM and VROM, profound dysphagia and moderate dysphagia related distress. Therapy adherence was high. Resolution of dysphagia to full oral diet, nil physiological swallowing impairment, and nil dysphagia related distress was achieved by 222 and 77 days post injury respectively. VROM and HROM achieved normal range by 237 and 204 days. Active rehabilitation achieved full functional outcomes for swallowing and orofacial range of movement. A protracted duration of therapy can be anticipated in this complex population. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  6. Development of a Portable Non-Invasive Swallowing and Respiration Assessment Device

    Directory of Open Access Journals (Sweden)

    Wann-Yun Shieh

    2015-05-01

    Full Text Available Dysphagia is a condition that happens when a person cannot smoothly swallow food from the mouth to the stomach. It causes malnourishment in patients, or can even cause death due to aspiration pneumonia. Recently, more and more researchers have focused their attention on the importance of swallowing and respiration coordination, and the use of non-invasive assessment systems has become a hot research trend. In this study, we aimed to integrate the timing and pattern monitoring of respiration and swallowing by using a portable and non-invasive approach which can be applied at the bedside in hospitals or institutions, or in a home environment. In this approach, we use a force sensing resistor (FSR to detect the motions of the thyroid cartilage in the pharyngeal phase. We also use the surface electromyography (sEMG to detect the contraction of the submental muscle in the oral phase, and a nasal cannula to detect nasal airflow for respiration monitoring during the swallowing process. All signals are received and processed for swallowing event recognition. A total of 19 volunteers participated in the testing and over 57 measurements were made. The results show that the proposed approach can effectively distinguish the swallowing function in people of different ages and genders.

  7. Swallowing outcomes following surgical and non-surgical treatment for advanced laryngeal cancer.

    Science.gov (United States)

    Burnip, E; Owen, S J; Barker, S; Patterson, J M

    2013-11-01

    Treatment for advanced laryngeal cancer includes surgery, and/or chemoradiotherapy or radiotherapy. Each of these treatments results in major changes to the swallowing mechanism. Dysphagia is strongly correlated with poorer quality of life. A good understanding of outcomes is needed for well-informed treatment decisions. This study reports on patients' swallowing outcomes following surgical and non-surgical treatments based on the results of three different swallowing tests. A total of 123 data sets were collected in out-patient clinics across two hospitals in North East England. There were no significant differences between treatment groups for patient-reported swallowing outcomes or swallowing performance. However, patients who had undergone chemoradiotherapy or radiotherapy (with or without laryngectomy) had significantly more diet restrictions than other groups. Long-term dysphagia is a common outcome of treatment for advanced laryngeal cancer. Patients treated with chemoradiotherapy and laryngectomy reported the worst overall outcomes. More longitudinal prospective research with large treatment groups is needed to investigate swallowing outcomes following different treatment methods.

  8. Swallowing function outcomes following nonsurgical therapy for advanced-stage laryngeal carcinoma.

    Science.gov (United States)

    Dworkin, James Paul; Hill, Samuel L; Stachler, Robert J; Meleca, Robert J; Kewson, Danny

    2006-01-01

    The purposes of this study were to (1) evaluate swallowing function using both subjective and objective measures in patients treated nonsurgically for stages III and IV laryngeal squamous cell carcinoma, (2) assess the effect of time from treatment completion on swallowing function, and (3) assess sequelae associated with modality of treatment. To achieve these objectives, a retrospective study of 14 patients was conducted. Fiberoptic endoscopic evaluation of swallowing (FEES) was performed and evaluated by three independent judges for seven functional criteria: standing secretions, valleculae spillage, valleculae residue, postcricoid residue, laryngeal penetration, aspiration, and cough. Patient interviews were performed to establish patient perception of swallowing and his/her current posttreatment diet. Results revealed that each patient exhibited swallowing abnormalities in at least one of the seven objective functional categories studied. Ten patients suffered from variable degrees of dysphagia, ranging from mild to severe, on all measures. No significant differences were noted between those patients with less than or greater than 12 months posttreatment. Common treatment sequelae included PEG tube placement for nutritional supplementation, tracheostomy placement for airway security and/or pulmonary toilet, repeated episodes of aspiration pneumonia requiring hospital admission, and radiation-induced oropharyngeal stricture. Further studies using subjective and objective swallowing function measures for patients treated with alternative chemoradiation regimens versus surgery (with or without adjuvant therapies) for advanced stage laryngeal cancer are needed.

  9. A model experiment to study swallowing of spherical and elongated particles

    Directory of Open Access Journals (Sweden)

    Marconati Marco

    2017-01-01

    Full Text Available Swallowing disorders are not uncommon among elderly and people affected by neurological diseases. For these patients the ingestion of solid grains, such as pharmaceutical oral solid formulations, could result in choking. This generally results in a low compliance in taking solid medications. The effect of the solid medication size on the real or perceived ease of swallowing is still to be understood from the mechanistic viewpoint. The interplay of the inclusion shape and the rheology of the liquid being swallowed together with the medication is also not fully understood. In this study, a model experiment was developed to study the oropharyngeal phase of swallowing, replicating the dynamics of the bolus flow induced by the tongue (by means of a roller driven by an applied force. Experiments were performed using a wide set of solid inclusions, dispersed in a thick Newtonian liquid. Predictions for a simple theory are compared with experiments. Results show that an increase in the grain size results in a slower dynamics of the swallowing. Furthermore, the experiments demonstrated the paramount role of shape, as flatter and more streamlined inclusions flow faster than spherical. This approach can support the design of new oral solid formulations that can be ingested more easily and effectively also by people with mild swallowing disorders.

  10. Swallowing Disorders after Oral Cavity and Pharyngolaryngeal Surgery and Role of Imaging

    Directory of Open Access Journals (Sweden)

    Caterina Giannitto

    2017-01-01

    Full Text Available Head and neck squamous cell carcinoma is the sixth most common cancer diagnosed worldwide and the eighth most common cause of cancer death. Malignant tumors of the oral cavity, oropharynx, and larynx can be treated by surgical resection or radiotheraphy with or without chemotheraphy and have a profound impact on quality of life functions, including swallowing. When surgery is the chosen treatment modality, the patient may experience swallowing impairment in the oral and pharyngeal phases of deglutition. A videofluoroscopic study of swallow enables the morphodynamics of the pharyngeal-esophageal tract to be accurately examined in patients with prior surgery. These features allow an accurate tracking of the various phases of swallowing in real time, identifying the presence of functional disorders and of complications during the short- and long-term postoperative recovery. The role of imaging is fundamental for the therapist to plan rehabilitation. In this paper, the authors aim to describe the videofluoroscopic study of swallow protocol and related swallowing impairment findings in consideration of different types of surgery.

  11. Viscosity threshold that allows safe swallow in elderly with post-stroke dysphagia

    Directory of Open Access Journals (Sweden)

    Rodolfo Peña

    2017-08-01

    Full Text Available Objective: To determine the viscosity threshold that allows safe swallowing in older adults with post-stroke dysphagia. Method: Cross-sectional analytical study. 6 patients over 60 years old with dysphagia participated. Were given six viscosities (50mPa s, 110mPa s, 170mPa s, 230mPa s, 290mPa s and 350mPa s made from no carbonated water and a corn starch-based thickener. Swallowing safety signs (wet voice, cough and oxygen saturation were assessed in each viscosity by Fiberoptic Endoscopic Evaluation of Swallowing (FEES. Viscosities’ performances in swallowing safety signs were compared in order to know which viscosity would be the safest. Results: 100% of swallowing safety signs did not appear in any viscosity assessed. Conclusions: It is not possible to determine the viscosity threshold that allows safe swallowing in patients with post-stroke dysphagia in the viscosities assessed. We discuss about multiple factors that had had affect our results: size sample, use of FEES to assess low viscosities, and viscosities’ intervals used.

  12. Efficacy of EMG/bioimpedance-triggered functional electrical stimulation on swallowing performance

    Directory of Open Access Journals (Sweden)

    Corinna Schultheiss

    2016-08-01

    Full Text Available In order to support swallowing, the efficacy of functional electrical stimulation for different stimulation settings of the submental musculature has been investigated. The stimulation was administrated at rest and synchronously to voluntary initiated swallows. The onset of a swallow was detected in real-time by a combined electromyography/ bioimpedance measurement at the neck in order to trigger the stimulation. The amplitude and speed of larynx elevation caused by the FES has been assessed by the observed change in bioimpedance whereas a reduction of bioimpedance corresponds to an increase in larynx elevation. Study results from 40 healthy subjects revealed that 73% of the subjects achieved a larger and faster larynx elevation during swallowing with triggered FES and therefor a better protection of their airways. However, we also observed a decrease in larynx elevation compared to normal swallowing in 11 out of the 40 subjects what might not benefit from such a treatment. The largest improvement of larynx elevation and speed during swallowing could be achieved with three stimulation channels formed by four electrodes in the submental region.

  13. Contemporary management of voice and swallowing disorders in patients with advanced lung cancer.

    Science.gov (United States)

    Brady, Grainne C; Carding, Paul N; Bhosle, Jaishree; Roe, Justin W G

    2015-06-01

    Advanced lung cancer can cause changes to swallowing and communication function. Direct tumour invasion, dyspnoea and deconditioning can all impact on swallowing function and communication. Cancer treatment, if administered, may cause or compound symptoms. In this study, the nature of swallowing and communication difficulties in patients with advanced lung cancer will be discussed, and management options including medical management, speech and language therapy (SLT) intervention, and surgical interventions will be considered. Advanced lung cancer can result in voice and swallowing difficulties, which can increase symptom burden and significantly impact on quality of life (QOL). There is a growing evidence base to support the use of injection laryngoplasty under local anaesthetic to offer immediate improvement in voice, swallowing and overall QOL. There is limited literature on the nature and extent of voice and swallowing impairment in patients with lung cancer. Well designed studies with robust and sensitive multidimensional dysphagia and dysphonia assessments are required. Outcome studies examining interventions with clearly defined treatment goals are required. These studies should include both functional and patient-reported outcome measures to develop the evidence base and to ensure that interventions are both timely and appropriate.

  14. Diagnosis and authority in the early-twentieth-century medical practice of Richard C. Cabot.

    Science.gov (United States)

    Crenner, Christopher

    2002-01-01

    This paper examines diagnostic practices using the early twentieth-century medical literature and the patient correspondence and records from the clinic of Richard Cabot. What shaped medicine's rapidly growing persuasive authority in the twentieth century? Diagnostic expertise demonstrated the doctor's control over disease but offered a service of ambiguous value to patients. Cabot and his peers offered differing views on how new diagnostic techniques would influence their relationships to their patients. In his busy private clinic Cabot put into effect an exacting diagnostic process, modeled on his innovative Clinicopathological Conferences. The people who came to the clinic often sought his technical expertise but accepted his diagnostic practices and opinions sometimes only provisionally.

  15. Planeación estratégica enfocada en el presupuesto de Impresos Richard

    OpenAIRE

    Ladino Beltrán , Luis Miguel; Rodríguez Cuervo , Lorena

    2015-01-01

    Dada la dinámica del entorno en el que se desenvuelven las empresas actualmente, es fundamental que realicen su planeación estratégica teniendo en cuenta la importancia del presupuesto como herramienta administrativa. Desde esta perspectiva, este proyecto se basa en el proceso de planeación estratégica, con énfasis en el presupuesto, de Impresos Richard LTDA; empresa con 30 años de experiencia en el mercado de las artes gráficas. Gracias a la investigación realizada, fue posible identificar o...

  16. Through The Large Glass: Richard Hamilton’s Reframing of Marcel Duchamp

    Directory of Open Access Journals (Sweden)

    Bryony Bery

    2016-12-01

    Full Text Available Combining art historical and technical perspectives, this paper examines Richard Hamilton’s 1965–6 reconstruction of Marcel Duchamp’s Large Glass and the wider repercussions that Hamilton’s actions have had on our understanding of replication and the idea of authorship. The dramatic history of the work is unpacked thoroughly and provides a platform for thinking about the precariousness of materials and meanings, and the slippages that occur when replicas become part of the story of a work, an artist and an institution.

  17. The Projection of Racism in Richard Wright’sBlack Boy

    OpenAIRE

    SADEQ, Darbaz Azeez

    2016-01-01

    purpose of this study is to demonstrate violence in the novel Black Boy by Richard Wright through examining ways of violence against black community during the times when the Jim Crow Laws were implemented. According to the Constitution of the United States of America, everyone is born with equal rights. However, the term ‘equality’ was non-existent or irrelevant in the states of Southern America. In the southern states, the Jim Crow Laws were unanimously being amended and forced upon the inh...

  18. Diagnosis and treatment of polycystic ovary syndrome (PCOS): an interview with Richard Legro.

    Science.gov (United States)

    Legro, Richard

    2015-03-27

    In this podcast, we talk to Professor Richard Legro about the recommendations for the diagnosis and treatment of polycystic ovary syndrome (PCOS) based on clinical practice guidelines and discuss the challenges of diagnosis PCOS at specific age groups. The controversies associated with treatment of PCOS, including therapies for infertility as this is a problem commonly observed in PCOS subjects, are highlighted together with future directions on the topic. The podcast for this interview is available at. http://www.biomedcentral.com/content/supplementary/s12916-015-0299-2-s1.mp3.

  19. "Walhall ist Wallstreet" : Geld und Gold in Richard Wagners "Ring des Nibelungen"

    OpenAIRE

    Zegowitz, Bernd

    2012-01-01

    Richard Wagner hatte ein gebrochenes Verhältnis zum Geld: Er benötigte viel, hatte aber meist so wenig, dass er auf Pump leben musste. Nicht selten war er auf der Flucht vor seinen Gläubigern. Die Erfindung des Geldes hielt er für einen Sündenfall, das Eigentum für die Wurzel allen Übels. Im »Ring des Nibelungen « spiegelt er im Mythos vom Fluch des Goldes die moderne Erfahrung der Macht des Geldes.

  20. Antonín Dvořák and Richard Wagner

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    Gabrijelova Jarmila

    2006-01-01

    Full Text Available The essay deals with the relation of prominent Czech composer Antonín Dvořák (1841–1904 to the personality and work of Richard Wagner (1813–1883. As opposed to the common opinions linking Dvořák’s name with Wagner‘s ideological opponents and placing his ‘Wagnerian’ period in the early phase of his career only, our examination shows that Dvořák’s interest in Wagner and his music was of deep and lasting nature and was significant for him throughout the whole of his life.

  1. Border Consciousness and Artivist Aesthetics: Richard Lou’s Performance and Multimedia Artwork

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    Guisela Latorre

    2012-05-01

    Full Text Available This essay explores Richard Lou’s distinguished career as an artist, from his early work in San Diego/Tijuana in the 1980s to his current installation and performance pieces on topics such as hybrid identities, counter-storytelling, nationalism, and cultures of oppression. The diversity of his themes, coupled with the multiplicity of the artistic media he utilizes, points to the decisively unstable and overlapping identities he possesses as an artist yet firmly establishes the decolonizing and politically transformative mission of his œuvre.

  2. Richard Christopher Carrington: Briefly Among the Great Scientists of His Time

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    Cliver, Edward W.; Keer, Norman C.

    2012-09-01

    We recount the life and career of Richard Christopher Carrington (1826 - 1875) and explore his pivotal relationship with Astronomer Royal George Biddell Airy. Carrington was the pre-eminent solar astronomer of the 19th century. During a ten year span, he determined the position of the Sun's rotation axis and made the following discoveries: i) the latitude variation of sunspots over the solar cycle, ii) the Sun's differential rotation, and iii) the first solar flare (with Hodgson). Due to the combined effects of family responsibilities, failure to secure a funded position in astronomy (reflecting Airy's influence), and ill health, Carrington's productive period ended when he was at the peak of his powers.

  3. Taste and Temperature in Swallowing Transit Time after Stroke

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    Paula C. Cola

    2012-09-01

    Full Text Available Background: Oropharyngeal dysphagia is common in individuals after stroke. Taste and temperature are used in dysphagia rehabilitation. The influence of stimuli, such as taste and temperature, on swallowing biomechanics has been investigated in both healthy individuals and in individuals with neurological disease. However, some questions still remain unanswered, such as how the sequence of offered stimuli influences the pharyngeal response. The goal of the present study was to determine the influence of the sequence of stimuli, sour taste and cold temperature, on pharyngeal transit time during deglutition in individuals after stroke. Methods: The study included 60 individuals with unilateral ischemic stroke, 29 males and 31 females, aged 41–88 years (mean age: 66.2 years examined 0–50 days after ictus (median: 6 days, with mild to moderate oropharyngeal dysphagia. Exclusion criteria were hemorrhagic stroke patients, patients with decreased level of consciousness, and clinically unstable patients, as confirmed by medical evaluation. The individuals were divided into two groups of 30 individuals each. Group 1 received a nonrandomized sequence of stimuli (i.e. natural, cold, sour, and sour-cold and group 2 received a randomized sequence of stimuli. A videofluoroscopic swallowing study was performed to analyze the pharyngeal transit time. Four different stimuli (natural, cold, sour, and sour-cold were offered. The images were digitalized and specific software was used to measure the pharyngeal transit time. Since the values did not present regular distribution and uniform variances, nonparametric tests were performed. Results: Individuals in group 1 presented a significantly shorter pharyngeal transit time with the sour-cold stimulus than with the other stimuli. Individuals in group 2 did not show a significant difference in pharyngeal transit time between stimuli. Conclusions: The results showed that the sequence of offered stimuli influences

  4. Regaining water swallowing function in the rehabilitation of critically ill patients with intensive-care-unit acquired muscle weakness.

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    Thomas, Simone; Sauter, Wolfgang; Starrost, Ulrike; Pohl, Marcus; Mehrholz, Jan

    2017-03-21

    Treatment in intensive care units (ICUs) often results in swallowing dysfunction. Recent longitudinal studies have described the recovery of critically ill people, but we are not aware of studies of the recovery of swallowing function in patients with ICU-acquired muscle weakness. This paper aims to describe the time course of regaining water swallowing function in patients with ICU-acquired weakness in the post-acute phase and to describe the risks of regaining water swallowing function and the risk factors involved. This cohort study included patients with ICU-acquired muscle weakness in our post-acute department, who were unable to swallow. We monitored the process of regaining water swallowing function using the 3-ounce water swallowing test. We included 108 patients with ICU-acquired muscle weakness. Water swallowing function was regained after a median of 12 days (interquartile range =17) from inclusion in the study and after a median of 59 days (interquartile range= 36) from the onset of the primary illness. Our multivariate Cox Proportional Hazard model yielded two main risk factors for regaining water swallowing function: the number of medical tubes such as catheters at admission to the post-acute department (adjusted hazard ratio [HR] = 1.282; 95% confidence interval [CI]: 1.099-1.495) and the time until weaning from the respirator in days (adjusted HR =1.02 per day; 95%CI: 0.998 to 1.008). We describe a time course for regaining water swallowing function based on daily tests in the post-acute phase of critically ill patients. Risk factors associated with regaining water swallowing function in rehabilitation are the number of medical tubes and the duration of weaning from the respirator. Implications for rehabilitation Little guidance is available for the management of swallowing dysfunction in the rehabilitation of critically ill patients with intensive-care-units acquired muscle weakness. There is a time dependent pattern of recovery from

  5. Swallowing and respiratory distress in hospitalized patients with bronchiolitis.

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    Maffey, Alberto; Moviglia, Teresita; Mirabello, Catalina; Blumenthal, Lidia; Gentile, Luis; Niremberg, Mabel; Gilligan, Guillermo; Teper, Alejandro

    2013-12-01

    The aim of this study was to evaluate the risk of airway and/or pulmonary food or saliva aspiration in infants with moderate respiratory distress who are hospitalized with respiratory syncytial virus (RSV) bronchiolitis. This prospective, descriptive study was conducted during two epidemic RSV seasons at the Ricardo Gutiérrez Children's Hospital in Buenos Aires, Argentina. Included were otherwise healthy infants in their first wheezing episode with a modified Tal clinical score between 5 and 9. Swallowing was evaluated using a dynamic technetium-99 m colloid radionuclide salivagram using a gamma camera, followed by video fluoroscopy using nonionic and ionic contrast material. Fifteen patients (7 boys) were included. Age at evaluation (mean ± SD) was 4.3 ± 1.5 months; clinical score was 7.5 ± 1.4. Patients required (mean ± SD) supplemental oxygen and hospitalization 7.5 ± 3.7 and 8.8 ± 4.3 days, respectively. All technetium-99 m salivagram (10/10, as the gamma camera equipment was out of service during part of the study) and video fluoroscopy (15/15) studies were normal. No episodes of aspiration or laryngeal penetration were detected in any patient. Our study found that infants hospitalized with moderate respiratory distress due to RSV bronchiolitis did not show aspiration.

  6. Severe breathing and swallowing difficulties during routine restorative dentistry.

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    Lococo, Filippo; Trabucco, Laura; Leuzzi, Giovanni; Salvo, Fulvio; Paci, Massimiliano; Sgarbi, Giorgio; Ferrari, Anna Maria

    2015-04-30

    Although sporadically reported after dental examination, subcutaneous emphysema may be erroneously confused with an allergic, or anaphylactic, reaction. We herein report a case of a 57-year-old Caucasian woman who came to our attention after restorative treatment for a carious mandibular right second primary molar. During dental examination, an air driven hand-piece was used to restore occlusal caries. Suddenly, swallowing and breathing difficulties and a facial swelling involving the neck and, partially, the face occurred. She was urgently transported to the Emergency Department with the suspicious of allergic reaction. Clinical examination revealed palpable crepitus at the level of the head, neck and pre-sternal region but no inflammation, trismus or fluid collection was detected. A Chest X-ray first and a computed tomography scan later showed air in the deeper regions from the peri-mandibular and retro-mandibular spaces to the sub-maxillary and latero-cervical area along the vascular sulcus and retropharyngeal space descending into the mediastinal space. So, the patient was admitted for respiratory monitoring and started intravenous administration of largespectrum antibiotics and analgesics. Her hospital course was unremarkable and 5 days later she was discharged after regression of symptoms and complete radiological resolution. Three months after discharge, the patient was clinically free of recurrence. Dental care, Pneumomediastinum, Restorative dentistry.

  7. [Functional endoscopic evaluation of swallowing in infants with deglutition disorders].

    Science.gov (United States)

    Partida-Justo, I; Israel Grijalva-Otero, J E; Ramírez-Figueroa, J L; Sepúlveda-Vildosola, A C; Zurita-Cruz, J N

    2017-10-25

    Functional endoscopic evaluation of swallowing (FEES) is a recognized method for Deglutition Disorders (DD) in adults, with anecdotal experience in children, obtaining not conclusive results. To compare the accuracy of test FEES in infants with high suspicion of altered DD seen in a third level hospital with the gold standard Videofluoroscopic (VF). The results and findings by FEES and VF of 66 children with clinical diagnosis of DD were compared. An estimate of the sensitivity and specificity of FEES was performed. As well as calculating positive predictive value (PPV), negative predictive value (NPV) and likelihood ratios. 60 patients enrolled, 4 and FEES showed high sensitivity to identify the presence of aspiration and penetration (9 98%) and high specificity for the arrest of spillage and waste (94% and 95%). Gastroesophageal reflux to make the diagnosis of DD with FEES had a sensitivity of 80% and specificity of 84%. Spill and penetration had the highest agreement with respect to the gold standard of 0.81. FEES in infants diagnosed with DD had a sensitivity of 80.8% and specificity 85.3%. 0696 concordance regarding to the VFD in the diagnosis of DD, and to identify suction stroke had a kappa of 0815.

  8. Swallowing performance after radiation therapy for carcinoma of the esophagus

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    O' Rourke, I.C.; Tiver, K.; Bull, C.; Gebski, V.; Langlands, A.O.

    1988-05-15

    The purpose of the study reported in this article was to tabulate the incidence and etiologic factors of importance in the development of strictures after radiotherapy for carcinoma of the esophagus and to analyze the outcome of patients who develop such strictures. Eighty patients were treated with radiotherapy, 50 having radical and 30 having palliative treatment. Sixty-nine patients had squamous cell carcinoma, four had adenocarcinoma, one had sarcoma, one had mucoepidermoid carcinoma, and five had undifferentiated tumors. Forty percent developed no stricture, 30% had benign fibrotic stricture, and 28% developed malignant stricture. The etiologic factors analysed included age, pretreatment swallowing score, histology and length (size) of tumor; stage of disease, dose of radiotherapy, and use of chemotherapy. None of these factors were shown to be of etiologic importance. The survival of patients who developed benign strictures was found to be significantly longer (1-year survival 88%) than those who developed no stricture (50%) or malignant stricture (19%). Using a success score for palliation of dysphagia, it was found that the majority of patients (71%) who developed a benign stricture had a moderately successful outcome--they were able to tolerate a full or soft diet and required dilatation with a median duration between dilatations of 5 months. Patients who developed a malignant stricture were palliated poorly by dilatation alone, and most required esophageal intubation.

  9. The mechanics and behavior of cliff swallows during tandem flights.

    Science.gov (United States)

    Shelton, Ryan M; Jackson, Brandon E; Hedrick, Tyson L

    2014-08-01

    Cliff swallows (Petrochelidon pyrrhonota) are highly maneuverable social birds that often forage and fly in large open spaces. Here we used multi-camera videography to measure the three-dimensional kinematics of their natural flight maneuvers in the field. Specifically, we collected data on tandem flights, defined as two birds maneuvering together. These data permit us to evaluate several hypotheses on the high-speed maneuvering flight performance of birds. We found that high-speed turns are roll-based, but that the magnitude of the centripetal force created in typical maneuvers varied only slightly with flight speed, typically reaching a peak of ~2 body weights. Turning maneuvers typically involved active flapping rather than gliding. In tandem flights the following bird copied the flight path and wingbeat frequency (~12.3 Hz) of the lead bird while maintaining position slightly above the leader. The lead bird turned in a direction away from the lateral position of the following bird 65% of the time on average. Tandem flights vary widely in instantaneous speed (1.0 to 15.6 m s(-1)) and duration (0.72 to 4.71 s), and no single tracking strategy appeared to explain the course taken by the following bird. © 2014. Published by The Company of Biologists Ltd.

  10. Swallow-induced esophageal shortening in patients without hiatal hernia is associated with gastroesophageal reflux.

    Science.gov (United States)

    Masuda, T; Singhal, S; Akimoto, S; Bremner, R M; Mittal, S K

    2017-12-21

    Longitudinal esophageal body shortening with swallow-induced peristalsis has been reported in healthy individuals. Esophageal shortening is immediately followed by esophageal re-elongation, and the lower esophageal sphincter (LES) returns to the baseline position. High-resolution manometry (HRM) allows for objective assessment of extent of shortening and duration of shortening. In patients without hiatal hernia at rest, swallow-induced esophageal shortening can lead to transient hiatal hernia (tHH) which at times may persist after the completion of swallow. This manometric finding has not been investigated in the literature, but a question arises whether this swallow-induced transient herniation can effect on the likelihood of gastroesophageal reflux. This study aims to assess the relationship between gastroesophageal reflux and the subtypes of swallow-induced esophageal shortening, i.e. tHH and non-tHH, in patients without hiatal hernia at rest. After Institutional Review Board (IRB) approval, we queried a prospectively maintained database to identify patients who underwent HRM evaluation and 24-hour pH study between January to December 2015. Patients with type-I esophagogastric junction (EGJ) morphology (i.e. no hiatal hernia) according to the Chicago classification v3.0 were included. The patterns of the esophageal shortening with swallows were divided into two subtypes, i.e. tHH and non-tHH. tHH was defined as an EGJ double high-pressure zones (≥1 cm) at the second inspiration after the termination of swallow-induced esophageal body contraction. The number of episodes of tHH was counted per 10 swallows and tHH size was measured for each patient. In total, 41 patients with EGJ morphology Type-I met the inclusion criteria. The mean age was 47.2 years, 35 patients (85.4%) were women, and the mean body mass index was 33.9 kg/m2. The mean number of tHH episodes was 3 out of 10 swallows; mean maximal tHH size was 1.3 cm. Patients who had tHH in ≥3 out of 10

  11. SU-D-BRA-01: Feasibility Study for Swallowing Prediction Using Pressure Sensors

    Energy Technology Data Exchange (ETDEWEB)

    Cho, M; Kim, T; Kim, D; Kang, S; Kim, K; Shin, D; Noh, Y; Suh, T [The Catholic University of Korea College of Medicine, Department of Biomedical Engineering, Research Institute of Biomedical Engineering, Seoul (Korea, Republic of); Kim, S [Virginia Commonwealth University, Richmond, VA (United States)

    2016-06-15

    Purpose: To develop a swallowing prediction system (SPS) using force sensing sensors and evaluate its feasibility. Methods: The SPS developed consists of force sensing sensor units, a thermoplastic mask, a signal transport device and a control PC installed with an in-house software. The SPS is designed to predict the pharyngeal stage of swallowing because it is known that internal organ movement occurs in pharyngeal stage. To detect prediction signal in the SPS, the force sensing sensor units were attached on both the submental muscle region and thyroid cartilage region of the thermoplastic mask. While the signal from the thyroid cartilage region informs the action of swallowing, the signal from the submental muscle region is utilized as a precursor for swallowing. Since the duration of swallowing is relatively short, using such precursor (or warning) signals for machine control is considered more beneficial. A volunteer study was conducted to evaluate the feasibility of the system. In this volunteer study, we intended to verify that the system could predict the pharyngeal stage of the swallowing. We measured time gaps between obtaining the warning signals in the SPS and starting points of the pharyngeal stage of swallowing. Results: The measured data was examined whether the time gaps were in reasonable order to be easily utilized. The mean and standard deviation values of these time gaps were 0.550 s ± 0.183 s. in 8 volunteers. Conclusion: The proposed method was able to predict the on-set of swallowing of human subjects inside the thermoplastic mask, which has never been possible with other monitoring systems such as camera-based monitoring system. With the prediction ability of swallowing incorporated into the machine control mechanism (in the future), beam delivery can be controlled to skip swallowing periods and significant dosimetric gain is expected in head & neck cancer treatments. This work was supported by the Radiation Technology R&D program (No. 2015M

  12. Construction of Fluid - solid Coupling Model with Improved Richards - BP & Its Engineering Application

    Science.gov (United States)

    Xie, Chengyu; Jia, Nan; Shi, Dongping; Lu, Hao

    2017-10-01

    In order to study the slurry diffusion law during grouting, Richards unsaturated-saturated model was introduced, the definition of the grouting model is clear, the Richards model control equation was established, And the BP neural network was introduced, the improved fluid-solid coupling model was constructed, Through the use of saturated - unsaturated seepage flow model, As well as the overflow boundary iterative solution of the mixed boundary conditions, the free surface is calculated. Engineering practice for an example, with the aid of multi - field coupling analysis software, the diffusion law of slurry was simulated numerically. The results show that the slurry diffusion rule is affected by grouting material, initial pressure and other factors. When the slurry starts, it flows in the cracks along the upper side of the grouting hole, when the pressure gradient is reduced to the critical pressure, that is, to the lower side of the flow, when the slurry diffusion stability, and ultimately its shape like an 8. The slurry is spread evenly from the overall point of view, from the grouting mouth toward the surrounding evenly spread, it gradually reaches saturation by non-saturation, and it is not a purely saturated flow, when the slurry spread and reach a saturated state, the diffusion time is the engineering grouting time.

  13. Richard Lindau y el museo de arte japonés de Barcelona

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    Bru Turull, Ricard

    2012-03-01

    Full Text Available Richard Lindau resided as a diplomat in Japan between 1866 and 1868, where he acquired in Edo (Tokyo an extensive and exceptional collection of Japanese art. After being named German consul in Barcelona (1876, Lindau offered his collection to the public by opening his residence in the centre of the city as a Japanese Museum. This paper aims to recover the history of this forgotten collection, which constituted one of the first private museums of Japanese art in Southern Europe.

    Richard Lindau residió como diplomático en Japón entre 1866 y 1868, durante los años de transición entre el shogunato Tokugawa y el nuevo sistema imperial Meiji. Lindau estuvo en el archipiélago nipón en el momento oportuno para adquirir una excepcional colección de arte japonés. Trasladado a Barcelona en 1876 como cónsul de Alemania, Lindau ofreció la colección al público abriendo su residencia y anunciándola como Museo Japonés. Este artículo recupera la historia de la colección olvidada de uno de los primeros museos privados de arte japonés del sur de Europa.

  14. Wooing-Scenes in “Richard III”: A Parody of Courtliness?

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    Agnieszka Stępkowska

    2009-11-01

    Full Text Available In the famous opening soliloquy of Shakespeare’s Richard III, Richard mightily voices his repugnance to “fair well-spoken days” and their “idle pleasures”. He realizes his physical deformity and believes that it sets him apart from others. He openly admits that he is “not shaped for sportive tricks, nor made to court an amorous looking-glass”. Yet, his monstrosity constitutes more perhaps of his aggressive masculine exceptionality rather than of his deformity. Richard’s bullying masculinity manifests itself in his contempt for women. In the wooing scenes we clearly see his pugnacious pursuit of power over effeminate contentment by reducing women to mere objects. Additionally, those scenes are interesting from a psychological viewpoint as they brim over with conflicting emotions. Therefore, the paper explores two wooing encounters of the play, which belong the best examples of effective persuasion and also something we may refer to as ‘the power of eloquence’.

  15. ‘What say the citizens’ in Shakespeare’s Richard III?

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    Ann Kaegi

    2013-03-01

    Full Text Available Shakespeare’s residency in London coincided with a period in which the City underwent unprecedented demographic growth and commercial expansion. By the 1590s two thirds to three quarters of the adult males resident in the City were citizens, at the time a uniquely urban identity that denoted a person who possessed ‘the freedom’ and was thereby entitled to the economic and political privileges of enfranchised inhabitants of a city or borough. These phenomena were transforming urban popular culture, yet their impact is largely unregistered in studies of Shakespeare and popular culture. The article seeks to direct attention to the presence and significance of the citizen, citizen languages and the culture of citizenship in Richard III, the play in which the word ‘citi- zen’ appears more often than in any other Shakespearean drama yet is rarely the focus of critical enquiry. The relative critical neglect of the citizens and of ‘citizen language’ more generally in Richard III stems from the widespread perception that its freemen are ultimately complicit in Richard’s tyranny. The paper challenges such views and focuses attention on Richard’s sustained effort to play the citizen to secure the crown.

  16. Impact of proprioception during the oral phase on initiating the swallowing reflex.

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    Takeda, Hikaru; Saitoh, Kazuya

    2016-07-01

    We hypothesized that proprioceptive signals during the oral phase play a pivotal role in the initiation of pharyngeal phase during volitional swallowing. Therefore, we tested if swallowing could be modified by changing the amount of proprioceptive feedback from a number of different receptors while holding a food bolus in the mouth and clenching. Basic research. Surface electromyography (sEMG) recordings of the masticatory muscles were obtained during volitional swallowing movements from seven healthy adults with no clinical history of swallowing difficulties. The swallowing procedure involved holding 5 ml of jelly on the tongue before swallowing it completely, according to visual cues on a computer display. Initiation of the swallowing reflex was detected by an anterior shift of the thyroid cartilage using a laser displacement sensor and by submental sEMG signals. To vary the proprioceptive input, the participants were instructed to occlude their teeth at various intensities (weak, intermediate, and strong) while holding the 5-ml jelly bolus on the tongue. Rectified and integrated sEMG (iEMG) signals obtained from the submental area showed two upward deflections. Contractile forces of the masseter muscles showed significant negative values for Pearson correlation coefficient against time intervals from the onset of the second submental iEMG deflection to the onset of the anterior shift of the thyroid cartilage in six of the seven participants (average -0.534, standard deviation 0.176). Contractile forces of the masseter muscles during occlusion tended to correlate negatively with electromechanical delays on suprahyoid muscle contraction. NA Laryngoscope, 126:1595-1599, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  17. Effects of early intervention of swallowing therapy on recovery from dysphagia following stroke.

    Science.gov (United States)

    Bakhtiyari, Jalal; Sarraf, Payam; Nakhostin-Ansari, Noureddin; Tafakhori, Abbas; Logemann, Jeri; Faghihzadeh, Soghrat; Harirchian, Mohammad Hossein

    2015-07-06

    Dysphagia is common after stroke. The onset time of swallowing rehabilitation following stroke has an important role in the recovery of dysphagia and preventing of its complications, but it was either highly variable or was not stated in previous trials. The aim of this study was investigation effects of onset time of swallowing therapy on recovery from dysphagia following stroke. Sixty dysphagia patients due to stroke range of age 60-74 (67.1 ± 3.8), participated in this randomized clinical trial study. The patients allocated in Early, Medium and Late groups, on the base of initiation of swallowing therapy after the stroke. After basic clinical and video fluoroscopic swallowing study assessments, traditional swallowing therapy was initiated 3 times per week for 3 months. The outcome measures were North-Western dysphagia patient check sheet, functional oral intake scale, video fluoroscopy, and frequency of pneumonia. Statistical analysis was done by repeated measure ANOVA, Bonferroni and χ(2) tests. Three groups of patients in terms of demographic and clinical characteristics were similar in the pre-treatment P > 0.050. Onset time of swallowing therapy after stroke was effective on swallowing recovery on the main outcome variables. So that in first group patients, recovery was rather than other groups P < 0.050. Furthermore, the frequency of pneumonia in the early group was less than other groups and in the early group no patients experienced pneumonia P = 0.002. Our data suggested that early interventions for dysphagia in stroke have an important role in recovery from dysphagia and prevention of complications like aspiration pneumonia.

  18. Comparison of ease of swallowing of dietary supplement products for age-related eye disease.

    Science.gov (United States)

    Brotherman, Donald P; Bayraktaroglu, Tolgar O; Garofalo, Renee J

    2004-01-01

    To examine patients' perceptions on the relative importance of the physical characteristics and appearance of dietary supplements, and to evaluate two supplements with the same combination of vitamins and minerals used in the Age-Related Eye Disease Study (AREDS) with respect to ease of swallowing and other features in elderly patients. A single-site, single-visit, crossover design, subject-masked comparison of two dietary supplements (ICaps AREDS Formula--Alcon; Ocuvite PreserVision-Bausch & Lomb). Ophthalmology practice. 50 patients aged 50 years or older. Patients ranked the importance of eight physical characteristics of a vitamin tablet or capsule (ease of swallowing, size, shape, color, smell, coating, texture, and taste) irrespective of the test products used in the study and then took both test products randomly and were asked to indicate which product they preferred based on the same eight characteristics. Overall patient preference and preference for swallowing two tablets at once. The highest rated (most important) characteristic in a vitamin supplement was ease of swallowing, with a median score of 9.0 on a 0-10 visual analogue scale. The characteristic of least importance was tablet color, with the lowest median score of 1.0. Statistically significant differences were detected between the products with regard to preferences for ease of swallowing, swallowing two tablets at once, size, and coating (P preferred the ICaps AREDS formula to Ocuvite PreserVision with respect to these characteristics and overall preference (P preferences. Based on the results of this study, ease of swallowing is the most important characteristic of dietary supplement tablets for elderly patients, followed by taste, size, and smell. Significant differences in preference exist between the study products, which contain similar formulations but have different physical characteristics.

  19. Effects of coal fly ash on tree swallow reproduction in Watts Bar Reservoir, Tennessee.

    Science.gov (United States)

    Walls, Suzanne J; Meyer, Carolyn B; Iannuzzi, Jacqueline; Schlekat, Tamar H

    2015-01-01

    Coal-fly ash was released in unprecedented amounts (4.1 × 10(6) m(3) ) into the Emory River from the Tennessee Valley Authority Kingston Fossil Plant on Watts Bar Reservoir in Tennessee. Tree swallows were exposed to ash-related constituents at the ash release via their diet of emergent aquatic insects, whose larval forms can accumulate constituents from submerged river sediments. Reproduction of tree swallow colonies was assessed over a 2-year period by evaluating whether 1) ash constituent concentrations were elevated in egg, eggshell, and nestling tissues at colonies near ash-impacted river reaches compared to reference colonies, 2) production of fledglings per nesting female was significantly lower in ash-impacted colonies versus reference colonies, and 3) ash constituent concentrations or diet concentrations were correlated with nest productivity measures (clutch size, hatching success, and nestling survival, and fledglings produced per nest). Of the 26 ash constituents evaluated, 4 (Se, Sr, Cu, and Hg) were significantly elevated in tissues potentially from the ash, and 3 (Se, Sr, and Cu) in tissues or in swallow diet items were weakly correlated to at least one nest-productivity measure or egg weight. Tree swallow hatching success was significantly reduced by 12%, but fledgling production per nest was unaffected due to larger clutch sizes in the impacted than reference colonies. Bioconcentration from the ash to insects in the diet to tree swallow eggs appears to be low. Overall, adverse impacts of the ash on tree swallow reproduction were not observed, but monitoring is continuing to further ensure Se from the residual ash does not adversely affect tree swallow reproduction over time. Integr Environ Assess Manag 2015;11:56-66. © 2014 SETAC. © 2014 SETAC.

  20. Voluntary Modulation of Hemodynamic Responses in Swallowing Related Motor Areas: A Near-Infrared Spectroscopy-Based Neurofeedback Study.

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    Silvia Erika Kober

    Full Text Available In the present study, we show for the first time that motor imagery of swallowing, which is defined as the mental imagination of a specific motor act without overt movements by muscular activity, can be successfully used as mental strategy in a neurofeedback training paradigm. Furthermore, we demonstrate its effects on cortical correlates of swallowing function. Therefore, N = 20 healthy young adults were trained to voluntarily increase their hemodynamic response in swallowing related brain areas as assessed with near-infrared spectroscopy (NIRS. During seven training sessions, participants received either feedback of concentration changes in oxygenated hemoglobin (oxy-Hb group, N = 10 or deoxygenated hemoglobin (deoxy-Hb group, N = 10 over the inferior frontal gyrus (IFG during motor imagery of swallowing. Before and after the training, we assessed cortical activation patterns during motor execution and imagery of swallowing. The deoxy-Hb group was able to voluntarily increase deoxy-Hb over the IFG during imagery of swallowing. Furthermore, swallowing related cortical activation patterns were more pronounced during motor execution and imagery after the training compared to the pre-test, indicating cortical reorganization due to neurofeedback training. The oxy-Hb group could neither control oxy-Hb during neurofeedback training nor showed any cortical changes. Hence, successful modulation of deoxy-Hb over swallowing related brain areas led to cortical reorganization and might be useful for future treatments of swallowing dysfunction.

  1. [The terata on the world map of Richard de Haldingham (about 1280). An attempt at an interpretation].

    Science.gov (United States)

    Schierhorn, H

    1982-01-01

    Richard de Haldingham's world map originates from the years about 1280 and is preserved in the cathedral of Hereford/Hereforshire (England). This map is a curious and in its type an old rare document for the early history of teratology. Richard's map not only reflects the antique view of universe during the Roman emperor Augustus Caesar, but also demonstrates plenty of mythical creatures and human monstrosities. As far as possible these terata (and imaginary monsters) are related to recent wellknown malformations. Their figurative representations are "raised" and idealized; they are situated above all in regions "far away". About it Richard as well as the other antique and medieval authors are tending to generalize (a single observed mis-shapen man becomes in the tradition during long years or centuries to a whole family or tribe of cyclops or nyctalops for instance).

  2. Swallowing disorders in nursing home residents: how can the problem be explained?

    Directory of Open Access Journals (Sweden)

    Nogueira D

    2013-02-01

    Full Text Available Dália Nogueira,1 Elizabeth Reis21Speech Therapy Department, Escola Superior de Saúde de Alcoitão, Estoril, Portugal; 2Department of Quantitative Methods, Lisbon University Institute ISCTE/IUL, Lisbon, PortugalBackground: The swallowing mechanism changes significantly as people age, even in the absence of chronic diseases. Presbyphagia, a term that refers to aging-related changes in the swallowing mechanism, may be linked to many health conditions and presents itself in distinct ways. Swallowing disorders are also identified as a major problem amongst the elderly population living in nursing homes.Methods: The study sought to determine the prevalence of swallowing disorders in nursing home residents, to identify the relationship between self-perceived swallowing disorders, cognitive functions, autonomy, and depression, and also to analyze which variables explain the score of the Dysphagia Self-Test (DST. For this purpose, the researchers chose to apply a survey conveying questions on demographic aspects, general health, eating and feeding, as well as instruments to assess functional performance and the 3 ounce Water Swallow Test.Results: The sample consisted of 272 elderly people living in eight nursing homes in Portugal. Six did not sign the informed consent form. Of the total, 29% were totally dependent, 33% were depressed, 45% had cognitive impairment, and 38% needed help with feeding. About 43% of the individuals reported having problems related to eating. Regarding the DST, 40% showed signs of dysphagia. With respect to the 3 ounce Water Swallow Test, 38% revealed at least one of the symptoms, wet voice being the most prevalent. Correlation measures showed that age had no linear association with the DST score although correlation with the Barthel Index and Mini Mental State Examination was found to be significant. A linear regression model was estimated with the DST score as the dependent variable and the MMSE and BI scores, gender, age

  3. On the Physiology of Normal Swallowing as Revealed by Magnetic Resonance Imaging in Real Time

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    Arno Olthoff

    2014-01-01

    Full Text Available The aim of this study was to assess the physiology of normal swallowing using recent advances in real-time magnetic resonance imaging (MRI. Therefore ten young healthy subjects underwent real-time MRI and flexible endoscopic evaluations of swallowing (FEES with thickened pineapple juice as oral contrast bolus. MRI movies were recorded in sagittal, coronal, and axial orientations during successive swallows at about 25 frames per second. Intermeasurement variation was analyzed and comparisons between real-time MRI and FEES were performed. Twelve distinct swallowing events could be quantified by real-time MRI (start time, end time, and duration. These included five valve functions: oro-velar opening, velo-pharyngeal closure, glottal closure, epiglottic retroflexion, and esophageal opening; three bolus transports: oro-velar transit, pharyngeal delay, pharyngeal transit; and four additional events: laryngeal ascent, laryngeal descent, vallecular, and piriform sinus filling and pharyngeal constriction. Repetitive measurements confirmed the general reliability of the MRI method with only two significant differences for the start times of the velo-pharyngeal closure (t(8=-2.4, P≤0.046 and laryngeal ascent (t(8=-2.6, P≤0.031. The duration of the velo-pharyngeal closure was significantly longer in real-time MRI compared to FEES (t(8=-3.3, P≤0.011. Real-time MRI emerges as a simple, robust, and reliable tool for obtaining comprehensive functional and anatomical information about the swallowing process.

  4. Analysis of oropharyngeal dysphagia through fibroendoscopy evaluation of swallowing in patients with Parkinson's disease.

    Science.gov (United States)

    Correa-Flores, Melissa; Arch-Tirado, Emilio; Villeda-Miranda, Alicia; Rocha-Cacho, Karina Elizabeth; Verduzco-Mendoza, Antonio; Hernández-López, Xochiquetzal

    2012-01-01

    Parkinson's disease (PD) has a high incidence in Mexico and is estimated at approximately 500,000 patients. One of the main clinical manifestations of PD is dysphagia, which is the difficult passage of food from the mouth to the stomach. The aim of this study was to assess oropharyngeal dysphagia through fibroendoscopy evaluation of swallowing in patients with PD. We conducted a census sample of patients with PD: 17 males and 10 females, aged >49 years. Clinical history, physical examination and neurological evaluation of swallowing fibroendoscopy were carried out. Of the symptomatic patients, 16 patients (59.25%) reported dysphagia. Fibroendoscopic evaluation demonstrated swallowing disorders in 25 patients (92.59%). The main findings were poor bolus control in 19 patients (70.37%), deficits in bolus propulsion in 25 patients (92.59%), impaired swallowing in 14 patients (51.85%), fractional swallowing in 11 patients (40.74%), reduced epiglottic tilting in 11 patients (48.14%), food residue in vallecula in 24 patients (88.88%) and piriform sinus in 19 patients (70.37%). There was no correlation between duration of PD and degree of involvement of oropharyngeal dysphagia. Oropharyngeal dysphagia in patients with PD is a common symptom and can range from the oral cavity to the upper esophageal sphincter. Early onset of severe dysphagia is exceptional in this disease and should alert the clinician to the diagnostic possibility of parkinsonism.

  5. Barium swallow study in routine clinical practice: a prospective study in patients with chronic cough.

    Science.gov (United States)

    Nin, Carlos Shuler; Marchiori, Edson; Irion, Klaus Loureiro; Paludo, Artur de Oliveira; Alves, Giordano Rafael Tronco; Hochhegger, Daniela Reis; Hochhegger, Bruno

    2013-01-01

    To assess the routine use of barium swallow study in patients with chronic cough. Between October of 2011 and March of 2012, 95 consecutive patients submitted to chest X-ray due to chronic cough (duration > 8 weeks) were included in the study. For study purposes, additional images were obtained immediately after the oral administration of 5 mL of a 5% barium sulfate suspension. Two radiologists systematically evaluated all of the images in order to identify any pathological changes. Fisher's exact test and the chi-square test for categorical data were used in the comparisons. The images taken immediately after barium swallow revealed significant pathological conditions that were potentially related to chronic cough in 12 (12.6%) of the 95 patients. These conditions, which included diaphragmatic hiatal hernia, esophageal neoplasm, achalasia, esophageal diverticulum, and abnormal esophageal dilatation, were not detected on the images taken without contrast. After appropriate treatment, the symptoms disappeared in 11 (91.6%) of the patients, whereas the treatment was ineffective in 1 (8.4%). We observed no complications related to barium swallow, such as contrast aspiration. Barium swallow improved the detection of significant radiographic findings related to chronic cough in 11.5% of patients. These initial findings suggest that the routine use of barium swallow can significantly increase the sensitivity of chest X-rays in the detection of chronic cough-related etiologies.

  6. Application of Kinesio Taping method for newborn swallowing difficultly: A case report and literature review.

    Science.gov (United States)

    Lin, Chien-Lin; Wu, Wei-Ting; Chang, Ke-Vin; Lin, Hong-Yi; Chou, Li-Wei

    2016-08-01

    Preterm infants are at an increased risk of sucking problems, swallowing difficulty, and poor nourishment. During the neonatal period, the neurobehavioral organization of a preterm baby is poor compared with that of appropriate gestational age infants. Kinesio Taping has been widely used for edema control, joint protection, and proprioception training. With the help of augmentation of the sensory input for muscle facilitation and inhibition through tapping, the coordination of the target muscle groups can be improved. Until now, no research is available on the use of Kinesio Taping for the swallowing difficulty of infant. We reported a preterm infant suffering from brain edema at birth and swallowing difficultly until 40 weeks. The swallowing reflex was delayed. Moreover, lip closure and rooting reflex combined with the dysfunction grade of jaw movement were poor. We performed KT methods on the baby under the theory of the direction of the tape for facilitate or inhibit the muscle. After the Kinesio Taping treatment, the sucking function was improved with good lip closure.One week later, the baby was discharged without the use of an oral gastric tube. Kinesio Taping contributed significantly to the improvement of impaired sucking and swallowing and could be implemented as a regular rehabilitative approach for infants suffering from these difficulties.

  7. Experimental infection of cliff swallows (Petrochelidon pyrrhonota) with varying doses of West Nile virus

    Science.gov (United States)

    Oesterle, P.T.; Nemeth, N.M.; VanDalen, Kaci K.; Sullivan, H.; Bentler, K.T.; Young, G.R.; McLean, R.G.; Clark, L.; Smeraski, C.; Hall, Jeffrey S.

    2009-01-01

    Cliff swallows (Petrochelidon pyrrhonota) were inoculated with differing doses of West Nile virus (WNV) to evaluate their potential role as reservoir hosts in nature. Swallows often nest in large colonies in habitats and months associated with high mosquito abundance and early WNV transmission in North America. Additionally, cliff swallow diet consists of insects, including mosquitoes, leading to an additional potential route of WNV infection. The average peak viremia titer among infected cliff swallows was 106.3 plaque-forming units (PFU)/mL serum and the reservoir competence index was 0.34. There was no correlation between dose and probability of becoming infected or viremia peak and duration. Oral shedding was detected from 2 to 14 days post-inoculation with an average peak titer of 1044 PFU/swab. These results suggest that cliff swallows are competent reservoir hosts of WNV and therefore, they may play a role in early seasonal amplification and maintenance of WNV. Copyright ?? 2009 by The American Society of Tropical Medicine and Hygiene.

  8. Barium swallow study in routine clinical practice: a prospective study in patients with chronic cough

    Directory of Open Access Journals (Sweden)

    Carlos Shuler Nin

    2013-12-01

    Full Text Available OBJECTIVE: To assess the routine use of barium swallow study in patients with chronic cough.METHODS: Between October of 2011 and March of 2012, 95 consecutive patients submitted to chest X-ray due to chronic cough (duration > 8 weeks were included in the study. For study purposes, additional images were obtained immediately after the oral administration of 5 mL of a 5% barium sulfate suspension. Two radiologists systematically evaluated all of the images in order to identify any pathological changes. Fisher's exact test and the chi-square test for categorical data were used in the comparisons.RESULTS: The images taken immediately after barium swallow revealed significant pathological conditions that were potentially related to chronic cough in 12 (12.6% of the 95 patients. These conditions, which included diaphragmatic hiatal hernia, esophageal neoplasm, achalasia, esophageal diverticulum, and abnormal esophageal dilatation, were not detected on the images taken without contrast. After appropriate treatment, the symptoms disappeared in 11 (91.6% of the patients, whereas the treatment was ineffective in 1 (8.4%. We observed no complications related to barium swallow, such as contrast aspiration.CONCLUSIONS: Barium swallow improved the detection of significant radiographic findings related to chronic cough in 11.5% of patients. These initial findings suggest that the routine use of barium swallow can significantly increase the sensitivity of chest X-rays in the detection of chronic cough-related etiologies.

  9. Impacts of palatal coverage on bolus formation during mastication and swallowing and subsequent adaptive changes.

    Science.gov (United States)

    Sato, T; Furuya, J; Tamada, Y; Kondo, H

    2013-10-01

    Palatal coverage is often required for elderly edentulous patients with complete dentures. The purpose of this study was to clarify impacts of palatal coverage on bolus formation and subsequent adaptive changes. Subjects were 18 healthy young dentulous adults who wore 1·5-mm-thick palatal plates. Subjects were asked to feed 12 g of bicoloured rice as usual, and the bolus formation by mastication and swallowing in the pharynx was observed using a nasal videoendoscopy. The bolus formation index (BFI), number of mastication strokes until swallowing, visual analogue scale about swallowing easiness and masticatory performance using colour-changeable gum were measured under three conditions: before placement of the palatal plate (day 0), immediately after placement (day 1) and after 7 days of wearing the plate (day 7). BFI and visual analogue scale on day 1 were significantly lower than those on day 0, but those on day 7 significantly recovered to the level of day 0. The number of mastication strokes did not change from day 0 to day 1, however, that on day 7 was significantly higher. Masticatory performance on days 1 and 7 was significantly lower than that on day 0. Although palatal coverage inhibits bolus formation during feeding, subjects increased the number of mastication strokes until swallowing threshold as they adapted to palatal coverage over time. This adaptive change was due to compensate for the lowered masticatory performance to achieve bolus formation for comfortable swallowing. © 2013 John Wiley & Sons Ltd.

  10. Swallowing rehabilitation of dysphagic tracheostomized patients under mechanical ventilation in intensive care units: a feasibility study.

    Science.gov (United States)

    Rodrigues, Katia Alonso; Machado, Flávia Ribeiro; Chiari, Brasília Maria; Rosseti, Heloísa Baccaro; Lorenzon, Paula; Gonçalves, Maria Inês Rebelo

    2015-01-01

    The aim of the present study was to assess the feasibility of the early implementation of a swallowing rehabilitation program in tracheostomized patients under mechanical ventilation with dysphagia. This prospective study was conducted in the intensive care units of a university hospital. We included hemodynamically stable patients under mechanical ventilation for at least 48 hours following 48 hours of tracheostomy and with an appropriate level of consciousness. The exclusion criteria were previous surgery in the oral cavity, pharynx, larynx and/or esophagus, the presence of degenerative diseases or a past history of oropharyngeal dysphagia. All patients were submitted to a swallowing rehabilitation program. An oropharyngeal structural score, a swallowing functional score and an otorhinolaryngological structural and functional score were determined before and after swallowing therapy. We included 14 patients. The mean duration of the rehabilitation program was 12.4 ± 9.4 days, with 5.0 ± 5.2 days under mechanical ventilation. Eleven patients could receive oral feeding while still in the intensive care unit after 4 (2 - 13) days of therapy. All scores significantly improved after therapy. In this small group of patients, we demonstrated that the early implementation of a swallowing rehabilitation program is feasible even in patients under mechanical ventilation.

  11. Sensory and instrumental analysis for slipperiness and compliance of food during swallowing.

    Science.gov (United States)

    Seo, H-S; Hwang, I K; Han, T R; Kim, I S

    2007-11-01

    In spite of its importance, there have been few attempts to evaluate the sensory attributes of the food bolus during swallowing. In the current study, the slipperiness, the degree of slide for the food bolus through the mucosal surface of the oro-pharynx, and the compliance, how easily the shape of a food bolus can be transformed for automatic and comfortable swallowing, were derived among several sensory attributes related to the swallowing. Therefore, the study aims were twofold: (1) to develop the methods of sensory and instrumental analyses for determining the slipperiness and compliance of the food bolus during swallowing and (2) to examine the appropriateness of the newly designed devices by correlating the data between the sensory and instrumental analyses. Six commercial food products were evaluated by 10 trained panelists for each attribute. The devices for assessing each attribute were developed in consideration of the oro-pharyngeal movements. The sensory and instrumental analyses showed high correlation and regression coefficients as well as intensity differences of the 6 samples for each attribute. In conclusion, the slipperiness and the compliance were suitable for acquiring a better understanding of the sensory attributes of the food bolus during swallowing, and the newly developed devices showed a high potential for determining those attributes.

  12. Multisensor classification system for triggering FES in order to support voluntary swallowing

    Directory of Open Access Journals (Sweden)

    Benjamin Riebold

    2016-08-01

    Full Text Available In dysphagia the ability of elevating the larynx and hyoid is usually impaired. Electromyography (EMG and Bioimpedance (BI measurements at the neck can be used to trigger functional electrical stimulation (FES of swallowing related muscles. Nahrstaedt et al.1 introduced an algorithm to trigger the stimulation in phase with the voluntary swallowing to improve the airway closure and elevation speed of the larynx and hyoid. However, due to non-swallow related movements like speaking, chewing or head turning, stimulations might be unintentionally triggered. So far a switch was used to enable the BI/EMG-triggering of FES when the subject was ready to swallow, which is inconvenient for practical use. In this contribution, a range image camera system is introduced to obtain data of head, mouth, and jaw movements. This data is used to apply a second classification step to reduce the number of false stimulations. In experiments with healthy subjects, the amount of potential false stimulations could be reduced by 47% while 83% of swallowing intentions would have been correctely supported by FES.

  13. Effect of Bolus Viscosity on the Safety and Efficacy of Swallowing and the Kinematics of the Swallow Response in Patients with Oropharyngeal Dysphagia: White Paper by the European Society for Swallowing Disorders (ESSD).

    Science.gov (United States)

    Newman, Roger; Vilardell, Natàlia; Clavé, Pere; Speyer, Renée

    2016-04-01

    Fluid thickening is a well-established management strategy for oropharyngeal dysphagia (OD). However, the effects of thickening agents on the physiology of impaired swallow responses are not fully understood, and there is no agreement on the degree of bolus thickening. To review the literature and to produce a white paper of the European Society for Swallowing Disorders (ESSD) describing the evidence in the literature on the effect that bolus modification has upon the physiology, efficacy and safety of swallowing in adults with OD. A systematic search was performed using the electronic Pubmed and Embase databases. Articles in English available up to July 2015 were considered. The inclusion criteria swallowing studies on adults over 18 years of age; healthy people or patients with oropharyngeal dysphagia; bolus modification; effects of bolus modification on swallow safety (penetration/aspiration) and efficacy; and/or physiology and original articles written in English. The exclusion criteria consisted of oesophageal dysphagia and conference abstracts or presentations. The quality of the selected papers and the level of research evidence were assessed by standard quality assessments. At the end of the selection process, 33 articles were considered. The quality of all included studies was assessed using systematic, reproducible, and quantitative tools (Kmet and NHMRC) concluding that all the selected articles reached a valid level of evidence. The literature search gathered data from various sources, ranging from double-blind randomised control trials to systematic reviews focused on changes occurring in swallowing physiology caused by thickened fluids. Main results suggest that increasing bolus viscosity (a) results in increased safety of swallowing, (b) also results in increased amounts of oral and/or pharyngeal residue which may result in post-swallow airway invasion, (c) impacts the physiology with increased lingual pressure patterns, no major changes in impaired

  14. Harmonic analysis, partial differential equations and applications in honor of Richard L. Wheeden

    CERN Document Server

    Franchi, Bruno; Lu, Guozhen; Perez, Carlos; Sawyer, Eric

    2017-01-01

    This is a collection of contributed papers by many eminent Harmonic Analysts and specialists of Partial Differential equations. The papers focus on weighted norm equalities for singular integrals, focusing wave equations, degenerate elliptic equations, Navier-Stokes flow in two dimensions and Poincare-Sobolev inequalities in the setting of metric spaces equipped with measures among others. Many topics considered in this volume stem from the interests of Richard L. Wheeden whose contributions to Potential Theory, singular integral theory and degenerate elliptic PDE theory this volume honors. Luis Caffarelli, Sagun Chanillo, Bruno Franchi, Cristian Guttierez, Xiaojun Huang, Carlos Kenig, Ermanno Lanconelli, Eric Sawyer and Alexander Volberg, are some of the many contributors to this volume. .

  15. Destruction of the Phoenix/Hibiscus and Barringtonia racemosa Communities at Richards Bay, Natal, South Africa

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    P. J. Weisser

    1982-12-01

    Full Text Available The destruction of the Phoenix!Hibiscus and Barringtonia racemosa Communities described by Venter in 1972 on the southern shores of Richards Bay is reported. The cause was the artificial openingof a new mouth about 5,5 km south of the original mouth, which increased tidal range and salinity. These swamp communities occupied a narrow band about 6 ha in area behind the Bruguiera gymnorrhiza Community. An estimated 95 % of the communities was affected and only on the landward border were some isolated remnants of species such as Acrostichum aureum, Hibiscus tiliaceus and Phoenix reclinata detected .Young stands of  Phragmites australis, seedlings of  Bruguiera gymnorrhiza and Avicennia marina and epipelic algae are recoIonizing the affected area. 

  16. Influences of ancient Greek spirit on music romanticism as exemplifies in Richard Wagner's Gesamtkunstwerk

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    Siopsi Anastasia

    2005-01-01

    Full Text Available The romantics' ideal of the arts' collaboration (Mischgedichte finds its most substantial equivalent in Richard Wagner's (1813-1883 "total work of art" (Gesamtkunstwerk. This theory for the restoration of the 'lost' unity of arts was elaborated in many theoretical essays of Wagner and 'applied' in his music dramas. Unity of arts, as well as unity of arts with nature existed according to Wagner in Ancient Greece while drama was the epitome of all expressive elements of nature. This "new art of the future", which Wagner envisaged, would restore the 'wholeness' of ancient Greek drama. It is the purpose, therefore, of this study to analyze mainly from an aesthetic point of view the influences of ancient Greek spirit on romantic thought, by focusing on Wagner's work.

  17. Analytical and grid-free solutions to the Lighthill-Whitham-Richards traffic flow model

    KAUST Repository

    Mazaré, Pierre Emmanuel

    2011-12-01

    In this article, we propose a computational method for solving the Lighthill-Whitham-Richards (LWR) partial differential equation (PDE) semi-analytically for arbitrary piecewise-constant initial and boundary conditions, and for arbitrary concave fundamental diagrams. With these assumptions, we show that the solution to the LWR PDE at any location and time can be computed exactly and semi-analytically for a very low computational cost using the cumulative number of vehicles formulation of the problem. We implement the proposed computational method on a representative traffic flow scenario to illustrate the exactness of the analytical solution. We also show that the proposed scheme can handle more complex scenarios including traffic lights or moving bottlenecks. The computational cost of the method is very favorable, and is compared with existing algorithms. A toolbox implementation available for public download is briefly described, and posted at http://traffic.berkeley.edu/project/downloads/lwrsolver. © 2011 Elsevier Ltd.

  18. Marie-Christine Agosto. Richard Brautigan. Les fleurs de néant.

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    Jean-Bernard Basse

    2006-04-01

    Full Text Available Richard Brautigan, si on lui reconnaît un certain humour, est souvent associé avec condescendance au phénomène hippy et considéré comme un auteur démodé, superficiel. Celui qui écrivait dans Cahier d’un Retour de Troie : « Les mots sont des fleurs de néant » est pourtant l’un de ces écrivains que l’on pourrait qualifier de mineurs essentiels, et seuls ceux qui l’ont peu ou mal lu s’étonneront de ce que Marie-Christine Agosto ait choisi de donner comme sous-titre « Les fleurs de néant » au pet...

  19. Femineidad y ficción en la obra operística de Richard Strauss

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    María José Sánchez Usón

    2014-01-01

    Full Text Available Tras la muerte de Wagner y Brahms, Richard Straussemergió como uno de los compositores más importantesy populares de la música del siglo XX. Su trayectoria vitaly profesional, azarosa y turbulenta, al igual que las décadasque vivió, estuvo marcada por la realidad femenina.Es innegable que las mujeres de la vida de Strauss, todasde fuerte y distintiva personalidad, dejaron en él huellastan hondas que fue necesario llevarlas a escena, no sólocomo una aportación valiosa a la tipología caracterológicafemenina, sino también como un ejercicio terapéuticopersonal. Así, mujeres reales y mujeres ficticias se confundenen sus obras en un proceso creativo único: el delhombre-artista.

  20. FEMINEIDAD Y FICCIÓN EN LA OBRA OPERÍSTICA DE RICHARD STRAUSS

    Directory of Open Access Journals (Sweden)

    María José Sánchez Usón

    2014-05-01

    Full Text Available After the death of Wagner and Brahms, Richard Strauss emerged as one of the most important and popular in the history of music of the 20th. century composers. His eventful and turbulent life and professional career, as well as the decades that he lived, were marked by the female reality. It is undeniable that the women in the life of Strauss, were strong and had distinctive personalities, they left marks on him so deep that he felt necessary to take them to the scene, not only as a valuable contribution to the female character type, but also as a personal therapeutic exercise. Thus, real and fictional women are confused in their works in a unique creative process: of the man-artist

  1. Book review: Unholy trinity: The IMF, World Bank and WTO Richard Peet

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    M Breitenbach

    2014-05-01

    Full Text Available In this timely book Richard Peet and his team lay the foundation with an excellent analysis of the process of globalisation and the resultant emergence of the global economy. The authors are especially critical of the increasing influence of institutions like the International Monetary Fund (IMF, World Bank and World Trade Organisation (WTO on the economy and the consequences experienced by peoples, cultures and the environment. The single ideology of neo-liberalism is blamed for the undesirable outcomes. This book considers concepts of power, political interest, hegemony, discourse, responsibility and the power of practicality, in critically examining the IMF, World Bank and WTO. The conclusion is reached that “all three institutions play roles greatly different from those originally agreed to under the charters that set them up”.

  2. Longitudinal study on a rehabilitative model for correction of atypical swallowing.

    Science.gov (United States)

    Giuca, M R; Pasini, M; Pagano, A; Mummolo, S; Vanni, A

    2008-12-01

    The aim of the study is to analyse the prevalence of anomalous function of the orofacial muscles and their aetiological factors in a small sample of paediatric patients, to evaluate the correlation between anomalous functions of the orofacial muscles and malocclusions, and finally to verify the effects of a myofunctional protocol, composed of a series of exercises aimed at correcting the anomalous function and position of the tongue. The protocol that has been used in this research is a re-elaboration of the diagnostic and therapeutic methods set by two authors, Daniel Garliner and Aurelio Levrini. A group of 57 children (aged 5 to 13, mean age 8.2) with atypical swallowing diagnosis, has been treated for almost 3 years. Physiologic swallowing was achieved in 47% of the children treated. The results show the benefits of the myofunctional therapy in the treatment of children with abnormal swallowing.

  3. Anatomy and Physiology of Feeding and Swallowing – Normal and Abnormal

    Science.gov (United States)

    Matsuo, Koichiro; Palmer, Jeffrey B.

    2008-01-01

    SYNOPSIS Eating and swallowing are complex behaviors involving volitional and reflexive activities of more than 30 nerves and muscles. They have two crucial biological features: food passage from the oral cavity to stomach and airway protection. The swallowing process is commonly divided into oral, pharyngeal, and esophageal stages according to the location of the bolus. The movement of the food in the oral cavity and to the oropharynx differs between eating solid food and drinking liquid. Dysphagia can result from a wide variety of functional or structural deficits of the oral cavity, pharynx, larynx or esophagus. The goal of dysphagia rehabilitation is to identify and treat abnormalities of feeding and swallowing while maintaining safe and efficient alimentation and hydration. PMID:18940636

  4. Simulation of swallowing dysfunction and mechanical ventilation after a Montgomery T-tube insertion.

    Science.gov (United States)

    Trabelsi, O; Malvè, M; Mena Tobar, A; Doblaré, M

    2015-01-01

    The Montgomery T-tube is used as a combined tracheal stent and airway after laryngotracheoplasty, to keep the lumen open and prevent mucosal laceration from scarring. It is valuable in the management of upper and mid-tracheal lesions, while invaluable in long and multisegmental stenting lesions. Numerical simulations based on real-patient-tracheal geometry, experimental tissue characterization, and previous numerical estimation of the physiological swallowing force are performed to estimate the consequences of Montgomery T-tube implantation on swallowing and assisted ventilation: structural analysis of swallowing is performed to evaluate patient swallowing capacity, and computational fluid dynamics simulation is carried out to analyze related mechanical ventilation. With an inserted Montgomery T-tube, vertical displacement (Z-axis) reaches 8.01 mm, whereas in the Y-axis, it reaches 6.63 mm. The maximal principal stress obtained during swallowing was 1.6 MPa surrounding the hole and in the upper contact with the tracheal wall. Fluid flow simulation of the mechanical ventilation revealed positive pressure for both inhalation and exhalation, being higher for inspiration. The muscular deflections, considerable during normal breathing, are nonphysiological, and this aspect results in a constant overload of the tracheal muscle. During swallowing, the trachea ascends producing a nonhomogeneous elongation. This movement can be compromised when prosthesis is inserted, which explains the high incidence of glottis close inefficiency. Fluid simulations showed that nonphysiological pressure is established inside the trachea due to mechanical ventilation. This may lead to an overload of the tracheal muscle, explaining several related problems as muscle thinning or decrease in contractile function.

  5. Adapting human videofluoroscopic swallow study methods to detect and characterize dysphagia in murine disease models.

    Science.gov (United States)

    Lever, Teresa E; Braun, Sabrina M; Brooks, Ryan T; Harris, Rebecca A; Littrell, Loren L; Neff, Ryan M; Hinkel, Cameron J; Allen, Mitchell J; Ulsas, Mollie A

    2015-03-01

    This study adapted human videofluoroscopic swallowing study (VFSS) methods for use with murine disease models for the purpose of facilitating translational dysphagia research. Successful outcomes are dependent upon three critical components: test chambers that permit self-feeding while standing unrestrained in a confined space, recipes that mask the aversive taste/odor of commercially-available oral contrast agents, and a step-by-step test protocol that permits quantification of swallow physiology. Elimination of one or more of these components will have a detrimental impact on the study results. Moreover, the energy level capability of the fluoroscopy system will determine which swallow parameters can be investigated. Most research centers have high energy fluoroscopes designed for use with people and larger animals, which results in exceptionally poor image quality when testing mice and other small rodents. Despite this limitation, we have identified seven VFSS parameters that are consistently quantifiable in mice when using a high energy fluoroscope in combination with the new murine VFSS protocol. We recently obtained a low energy fluoroscopy system with exceptionally high imaging resolution and magnification capabilities that was designed for use with mice and other small rodents. Preliminary work using this new system, in combination with the new murine VFSS protocol, has identified 13 swallow parameters that are consistently quantifiable in mice, which is nearly double the number obtained using conventional (i.e., high energy) fluoroscopes. Identification of additional swallow parameters is expected as we optimize the capabilities of this new system. Results thus far demonstrate the utility of using a low energy fluoroscopy system to detect and quantify subtle changes in swallow physiology that may otherwise be overlooked when using high energy fluoroscopes to investigate murine disease models.

  6. Non-invasive monitoring of chewing and swallowing for objective quantification of ingestive behavior

    Science.gov (United States)

    Sazonov, Edward; Schuckers, Stephanie; Lopez-Meyer, Paulo; Makeyev, Oleksandr; Sazonova, Nadezhda; Melanson, Edward L.; Neuman, Michael

    2008-01-01

    A methodology of studying of ingestive behavior by non-invasive monitoring of swallowing (deglutition) and chewing (mastication) has been developed. The target application for the developed methodology is to study the behavioral patterns of food consumption and producing volumetric and weight estimates of energy intake. Monitoring is non-invasive based on detecting swallowing by a sound sensor located over laryngopharynx or by a bone conduction microphone and detecting chewing through a below-the-ear strain sensor. Proposed sensors may be implemented in a wearable monitoring device, thus enabling monitoring of ingestive behavior in free living individuals. In this paper, the goals in the development of this methodology are two-fold. First, a system comprised of sensors, related hardware and software for multimodal data capture is designed for data collection in a controlled environment. Second, a protocol is developed for manual scoring of chewing and swallowing for use as a gold standard. The multi-modal data capture was tested by measuring chewing and swallowing in twenty one volunteers during periods of food intake and quiet sitting (no food intake). Video footage and sensor signals were manually scored by trained raters. Inter-rater reliability study for three raters conducted on the sample set of 5 subjects resulted in high average intra-class correlation coefficients of 0.996 for bites, 0.988 for chews, and 0.98 for swallows. The collected sensor signals and the resulting manual scores will be used in future research as a gold standard for further assessment of sensor design, development of automatic pattern recognition routines, and study of the relationship between swallowing/chewing and ingestive behavior. PMID:18427161

  7. MRI of the Swallow Tail Sign: A Useful Marker in the Diagnosis of Lewy Body Dementia?

    Science.gov (United States)

    Shams, S; Fällmar, D; Schwarz, S; Wahlund, L-O; van Westen, D; Hansson, O; Larsson, E-M; Haller, S

    2017-09-01

    There are, to date, no MR imaging diagnostic markers for Lewy body dementia. Nigrosome 1, containing dopaminergic cells, in the substantia nigra pars compacta is hyperintense on SWI and has been called the swallow tail sign, disappearing with Parkinson disease. We aimed to study the swallow tail sign and its clinical applicability in Lewy body dementia and hypothesized that the sign would be likewise applicable in Lewy body dementia. This was a retrospective cross-sectional multicenter study including 97 patients (mean age, 65 ± 10 years; 46% women), consisting of the following: controls (n = 21) and those with Lewy body dementia (n = 19), Alzheimer disease (n = 20), frontotemporal lobe dementia (n = 20), and mild cognitive impairment (n = 17). All patients underwent brain MR imaging, with susceptibility-weighted imaging at 1.5T (n = 46) and 3T (n = 51). The swallow tail sign was assessed independently by 2 neuroradiologists. Interrater agreement was moderate (κ = 0.4) between raters. An abnormal swallow tail sign was most common in Lewy body dementia (63%; 95% CI, 41%-85%; P Lewy body dementia with an odds ratio of 9 (95% CI, 3-28; P Lewy body dementia showed a sensitivity of 63%, a specificity of 79%, a negative predictive value of 89%, and an accuracy of 76%; values were higher on 3T compared with 1.5T. The usefulness of the swallow tail sign was rater-dependent with the highest sensitivity equaling 100%. The swallow tail sign has diagnostic potential in Lewy body dementia and may be a complement in the diagnostic work-up of this condition. © 2017 by American Journal of Neuroradiology.

  8. Speech and swallowing following tongue cancer surgery and free flap reconstruction--a systematic review.

    Science.gov (United States)

    Lam, Lisetta; Samman, Nabil

    2013-06-01

    This was a systematic review of the current research on speech and swallowing outcomes and the factors affecting these outcomes after primary resection of tongue cancer and free flap reconstruction. A structured search in various electronic databases and relevant journals was performed. Retrieved articles were critically appraised in three rounds according to the level of evidence, the methodological quality, and the specific domain of speech and swallowing. A total of 21 articles were in the final review and the findings were categorized according to the area of tongue resection. For patients with resection and free flap reconstruction limited to either the oral tongue or the base of tongue (BOT), significant decline in speech and swallowing function was evident in the early postoperative phase, but the majority recovered close to preoperative level after 1 year. Poorer speech and swallowing outcomes were found following resections involving both oral and base of tongue (OBOT) regardless of the type of free flap reconstruction. Results overall were influenced by multiple factors including tumor size, area of resection, method of reconstruction and the use of adjuvant therapy. The use of free flaps in the immediate reconstruction of the tongue after tumor resection should aim at the maintenance of the mobility of the residual tongue and restoration of tongue bulk in order to optimize the recovery of speech and swallowing function. Future research in this field should employ standardized and reliable evaluation of speech and swallowing outcomes using multiple modalities in well-designed cohort studies with longer follow-up. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Hybrid fuzzy logic committee neural networks for recognition of swallow acceleration signals.

    Science.gov (United States)

    Das, A; Reddy, N P; Narayanan, J

    2001-02-01

    Biological signals are complex and often require intelligent systems for recognition of characteristic signals. In order to improve the reliability of the recognition or automated diagnostic systems, hybrid fuzzy logic committee neural networks were developed and the system was used for recognition of swallow acceleration signals from artifacts. Two sets of fuzzy logic-committee networks (FCN) each consisting of seven member networks were developed, trained and evaluated. The FCN-I was used to recognize dysphagic swallow from artifacts, and the second committee FCN-II was used to recognize normal swallow from artifacts. Several networks were trained and the best seven were recruited into each committee. Acceleration signals from the throat were bandpass filtered, and several parameters were extracted and fed to the fuzzy logic block of either FCN-I or FCN-II. The fuzzified membership values were fed to the committee of neural networks which provided the signal classification. A majority opinion of the member networks was used to arrive at the final decision. Evaluation results revealed that FCN correctly identified 16 out of 16 artifacts and 31 out of 33 dysphagic swallows. In two cases, the decision was ambiguous due to the lack of a majority opinion. FCN-II correctly identified 24 out of 24 normal swallows, and 28 out of 29 artifacts. In one case, the decision was ambiguous due to the lack of a majority opinion. The present hybrid intelligent system consisting of fuzzy logic and committee networks provides a reliable tool for recognition and classification of acceleration signals due to swallowing.

  10. A new subfascial approach in open thyroidectomy: efficacy for postoperative voice, sensory, and swallowing symptoms. A randomized controlled study.

    Science.gov (United States)

    Jung, Seung Pil; Kim, Sung Hoon; Bae, Soo Youn; Lee, Se Kyung; Kim, Sangmin; Choi, Min-Young; Kim, Jiyoung; Kim, Minkuk; Kil, Won Ho; Choe, Jun-Ho; Kim, Jung-Han; Nam, Seok Jin; Kim, Jee Soo

    2013-11-01

    After open thyroidectomy, patients usually complain of voice, sensory, and swallowing symptoms. We approached the thyroid via the subfascial method to reduce these symptoms and compared postthyroidectomy symptoms with the conventional subplatysmal method. Eighty-six patients undergoing thyroidectomy were recruited and randomized into either a conventional subplatysmal approach group (subplatysmal, 42 patients) group or a subanterior fascia of strap muscle approach group (subfascial, 44 patients). Voice symptoms were assessed using the Voice Handicap Index questionnaire and acoustic voice analysis. Sensory alterations were evaluated by the light touch and pain touch methods. Swallowing symptoms were assessed using the Swallowing Impairment Score (SIS) questionnaire, barium swallowing time, and hyoid bone movement range. Each variable was measured preoperatively, and at 2 weeks and 3 months after thyroidectomy. In both groups, the subjective symptoms of voice, sensation, and swallowing were significantly worsened at 2 weeks after operation, but improved 3 months after operation. Patients in the subplatysmal group had worse SIS scores than patients in the subfascial group (p = 0.016) and delayed barium swallowing time 2 weeks after operation (p = 0.008 compared to preoperative level). In the cohort over 50 years of age, SIS score did not recover to preoperative levels in the subplatysmal group 3 months after operation (p = 0.005 compared to preoperative level). The subfascial approach may be an effective method for reducing postthyroidectomy swallowing symptoms based on swallowing impairment score, especially in patients over 50 years of age.

  11. Changes in Swallowing after Anterior Cervical Discectomy and Fusion with Instrumentation: A Presurgical versus Postsurgical Videofluoroscopic Comparison

    Science.gov (United States)

    Muss, Lydia; Wilmskoetter, Janina; Richter, Kerstin; Fix, Constanze; Stanschus, Soenke; Pitzen, Tobias; Drumm, Joerg; Molfenter, Sonja

    2017-01-01

    Purpose: The purpose of this study was to explore the impact of anterior cervical discectomy and fusion (ACDF) with anterior instrumentation on swallowing function and physiology as measured on videofluoroscopic swallowing studies. Method: We retrospectively analyzed both functional measures (penetration-aspiration, residue) and…

  12. Nitric Oxide and Histamine Signal Attempts to Swallow: A Component of Learning that Food Is Inedible in "Aplysia"

    Science.gov (United States)

    Katzoff, Ayelet; Miller, Nimrod; Susswein, Abraham J.

    2010-01-01

    Memory that food is inedible in "Aplysia" arises from training requiring three contingent events. Nitric oxide (NO) and histamine are released by a neuron responding to one of these events, attempts to swallow food. Since NO release during training is necessary for subsequent memory and NO substitutes for attempts to swallow, it was suggested that…

  13. Sensory regulation of swallowing and airway protection: a role for the internal superior laryngeal nerve in humans

    Science.gov (United States)

    Jafari, Samah; Prince, Rebecca A; Kim, Daniel Y; Paydarfar, David

    2003-01-01

    During swallowing, the airway is protected from aspiration of ingested material by brief closure of the larynx and cessation of breathing. Mechanoreceptors innervated by the internal branch of the superior laryngeal nerve (ISLN) are activated by swallowing, and connect to central neurones that generate swallowing, laryngeal closure and respiratory rhythm. This study was designed to evaluate the hypothesis that the ISLN afferent signal is necessary for normal deglutition and airway protection in humans. In 21 healthy adults, we recorded submental electromyograms, videofluoroscopic images of the upper airway, oronasal airflow and respiratory inductance plethysmography. In six subjects we also recorded pressures in the hypopharynx and upper oesophagus. We analysed swallows that followed a brief infusion (4–5 ml) of liquid barium onto the tongue, or a sip (1–18 ml) from a cup. In 16 subjects, the ISLN was anaesthetised by transcutaneous injection of bupivacaine into the paraglottic compartment. Saline injections using the identical procedure were performed in six subjects. Endoscopy was used to evaluate upper airway anatomy, to confirm ISLN anaesthesia, and to visualise vocal cord movement and laryngeal closure. Comparisons of swallowing and breathing were made within subjects (anaesthetic or saline injection vs. control, i.e. no injection) and between subjects (anaesthetic injection vs. saline injection). In the non-anaesthetised condition (saline injection, 174 swallows in six subjects; no injection, 522 swallows in 20 subjects), laryngeal penetration during swallowing was rare (1.4 %) and tracheal aspiration was never observed. During ISLN anaesthesia (16 subjects, 396 swallows), all subjects experienced effortful swallowing and an illusory globus sensation in the throat, and 15 subjects exhibited penetration of fluid into the larynx during swallowing. The incidence of laryngeal penetration in the anaesthetised condition was 43 % (P deglutition, especially for

  14. Richard Avedon's "In the American West" and Jean-Paul Sartre: An Existential Approach to Art and Value.

    Science.gov (United States)

    Dubiel, Richard M.

    1989-01-01

    Examines Richard Avedon's photographic exhibit "In the American West" both as a work of art and as an important link to contemporary philosophical thought, particularly that of Jean-Paul Sartre, through its depiction of the human condition. Notes that the exhibit used as a teaching resource engages students in questions concerning art…

  15. Re-Reconsidering Research on Learning from Media: Comments on Richard E. Clark's "Point of View" Column on Serious Games

    Science.gov (United States)

    Parker, J. R.; Becker, Katrin; Sawyer, Ben

    2008-01-01

    Everything old is new again. In a recent "Point of View" editorial commentary in "Educational Technology," Richard E. Clark revisits the now-famous media-effects debate with a focus on serious games. Clark argues that serious games have little to offer that improves upon traditional methods. This article responds to those claims. While Clark's…

  16. Dr. Richard J. Whelan: Seeing the Field of Emotional and Behavior Disorders through the Lens of a Pioneer

    Science.gov (United States)

    Kaff, Marilyn S.; Teagarden, Jim; Zabel, Robert H.

    2011-01-01

    Dr. Richard J. Whelan is a distinguished professor emeritus at the University of Kansas. His earliest professional experiences were at the Children's Hospital (Southard School) of the Menninger Clinic, where he served as a recreational therapist, teacher, and director of education. During his career at the University of Kansas and the KU Medical…

  17. Muusikamaailm : Suur klaveripidu Ruhrimaal. Kissingeni festival tippudega. Sulasoli 80. aastapäev. Richard Rodgers 100 / Priit Kuusk

    Index Scriptorium Estoniae

    Kuusk, Priit, 1938-

    2002-01-01

    6. juuni-17. augustini Ruhrimaal toimuvast klaverifestivalist. Bad Kissingenis toimuvatest suvepidustustest. Soome Lauljate ja Mängijate Liit tähistab asutamise 80. aastapäeva. Helilooja Richard Rodgersi sünnist möödub 100 aastat

  18. A soil moisture accounting-procedure with a Richards' equation-based soil texture-dependent parameterization

    Science.gov (United States)

    Given a time series of potential evapotranspiration and rainfall data, there are at least two approaches for estimating vertical percolation rates. One approach involves solving Richards' equation (RE) with a plant uptake model. An alternative approach involves applying a simple soil moisture accoun...

  19. New Directions for Higher Education: Q&A with Richard Ekman on Challenges, Misconceptions Facing Independent Colleges

    Science.gov (United States)

    DiSalvio, Philip

    2014-01-01

    In April 2013, "NEJHE" launched its "New Directions for Higher Education series" to examine emerging issues, trends and ideas that have an impact on higher education policies, programs and practices. In this installment, DiSalvio interviews Richard Ekman, president of the Council of Independent Colleges (CIC), an association of…

  20. Swallowing and speech function after intraoral soft tissue reconstruction with lateral upper arm free flap and radial forearm free flap.

    Science.gov (United States)

    Hara, I; Gellrich, N-C; Duker, J; Schön, R; Fakler, O; Smelzeisen, R; Honda, T; Satoru, O

    2003-06-01

    Swallowing, speech, and morbidity were assessed postoperatively in 25 patients, 18 of whom had had intraoral defects reconstructed by lateral upper arm free flaps (LUFF) and 7 by radial forearm free flaps (RFFF). Video fluoroscopy was used to assess swallowing, the Freiburger audiometric test to assess speech; and measurement of arm circumference to assess donor site morbidity. A questionnaire was used to evaluate swallowing, speech, and donor site morbidity subjectively. The degree of impairment in swallowing depended on the site of resection. Anterior and posterior resections affected swallowing more than lateral resections. Anterior resection and the use of LUFFs reduced intelligibility. There was no significant difference in impairment between LUFF and RFFF. We conclude that the LUFFs are superior to RFFFs because they can be closed primary and the incidence of donor site morbidity is slight.

  1. Efficacy Quotient Tindakan ESWL Piezolith Richard Wolf 3000 pada Penderita Batu Ureter di RSUPN Dr. Cipto Mangunkusumo, 2008–2011

    Directory of Open Access Journals (Sweden)

    Vinny Verdini

    2017-01-01

    Full Text Available Extracorporeal shockwave lithotripsy (ESWL saat ini telah menjadi metode yang paling umum dalam tatalaksana aktif batu ureter. Sejak Maret 2008, RSCM telah menggunakan mesin ESWL piezolith 3000 richard wolf dan belum diketahui nilai efficacy quotient (EQ. Penelitian ini bertujuan untuk menentukan nilai EQ dari tindakan ESWL menggunakan mesin piezolith richard wolf 3000 pada batu ureter dan hubungan angka bebas batu dengan lokasi batu, jumlah batu, beban batu, opasitas batu, obstruksi, dan fungsi ginjal. Studi cross sectional ini dilakukan pada bulan Januari 2008-Desember 2011 dan data dianalisis dengan statistik multivariat. Terdapat 113 (95 % dari 119 pasien yang dinyatakan bebas batu setelah tindakan ESWL pertama. Didapatkan nilai EQ 0,89. Hanya ukuran batu yang mempengaruhi angka bebas batu dalam penelitian ini (p<0,05. Disimpulkan bahwa prosedur ESWL menggunakan mesin richard wolf piezolith 3000 memiliki nilai EQ dan angka bebas batu yang lebih baik daripada mesin-mesin sebelumnya dan mesin lain yang sejenis. Faktor yang mempengaruhi keberhasilan adalah ukuran batu ureter yang ditatalaksana.Kata Kunci: batu ureter, ESWL, efficacy quotient, angka bebas batu. Efficacy Quotient of ESWL Piezolith Richard Wolf 3000 Machine in Patientswith Ureteral Stones in Dr. Cipto MangunkusumoNational Hospital 2008 - 2011AbstractExtracorporeal shockwave lithotripsy (ESWL is the most common method of ureteral stone management. Since 2008, RSCM has ben using ESWL piezolith 3000 richard wolf and efficacy quotient (EQ value have not yet studied. The study aims was to determine the efficacy quotient (EQ of ESWL using piezolith richard wolf 3000 machine for ureteral stone by analyzing free-stone rate with location of stones, number of stones, stone burden, stone opacity, obstruction and kidney function. This cross sectional study was carried out in January 2008-December 2011, with multivariate analytical study. Ninety five percent (n=113 of 119 patients were

  2. Prospective clinical study on long-term swallowing function and voice quality in advanced head and neck cancer patients treated with concurrent chemoradiotherapy and preventive swallowing exercises.

    Science.gov (United States)

    Kraaijenga, Sophie A C; van der Molen, Lisette; Jacobi, Irene; Hamming-Vrieze, Olga; Hilgers, Frans J M; van den Brekel, Michiel W M

    2015-11-01

    Concurrent chemoradiotherapy (CCRT) for advanced head and neck cancer (HNC) is associated with substantial early and late side effects, most notably regarding swallowing function, but also regarding voice quality and quality of life (QoL). Despite increased awareness/knowledge on acute dysphagia in HNC survivors, long-term (i.e., beyond 5 years) prospectively collected data on objective and subjective treatment-induced functional outcomes (and their impact on QoL) still are scarce. The objective of this study was the assessment of long-term CCRT-induced results on swallowing function and voice quality in advanced HNC patients. The study was conducted as a randomized controlled trial on preventive swallowing rehabilitation (2006-2008) in a tertiary comprehensive HNC center with twenty-two disease-free and evaluable HNC patients as participants. Multidimensional assessment of functional sequels was performed with videofluoroscopy, mouth opening measurements, Functional Oral Intake Scale, acoustic voice parameters, and (study specific, SWAL-QoL, and VHI) questionnaires. Outcome measures at 6 years post-treatment were compared with results at baseline and at 2 years post-treatment. At a mean follow-up of 6.1 years most initial tumor-, and treatment-related problems remained similarly low to those observed after 2 years follow-up, except increased xerostomia (68%) and increased (mild) pain (32%). Acoustic voice analysis showed less voicedness, increased fundamental frequency, and more vocal effort for the tumors located below the hyoid bone (n = 12), without recovery to baseline values. Patients' subjective vocal function (VHI score) was good. Functional swallowing and voice problems at 6 years post-treatment are minimal in this patient cohort, originating from preventive and continued post-treatment rehabilitation programs.

  3. Relationship between swallow-specific quality of life and fiber-optic endoscopic evaluation of swallowing findings in patients with head and neck cancer.

    Science.gov (United States)

    Florie, Michelle; Baijens, Laura; Kremer, Bernd; Kross, Kenneth; Lacko, Martin; Verhees, Femke; Winkens, Bjorn

    2016-04-01

    The purpose of this study was to determine the relationship between swallow-specific quality of life (QOL) using the MD Anderson Dysphagia Inventory (MDADI) and the swallowing function using a standardized fiber-optic endoscopic evaluation of swallowing (FEES) protocol in patients with dysphagia with head and neck cancer. Sixty-three patients with dysphagia and head and neck cancer were enrolled in the study. Patients completed the MDADI questionnaire and underwent a standardized FEES examination. Ordinal FEES variables were measured. Descriptive statistics and 1-way analysis of variance tests were carried out. For all FEES variables, the observer agreement level was sufficient (kappa ≥0.7).These preliminary results show statistically significant mean differences of MDADI subscales between the ordinal scale levels for several FEES variables. The MDADI questionnaire can be used to assess the impact of dysphagia on the patients' health-related QOL. Despite clear trends, it remains unclear if the MDADI questionnaire can be used as an indicator for the severity of oropharyngeal dysphagia. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1848-E1856, 2016. © 2015 Wiley Periodicals, Inc.

  4. PREFACE: Celebrating 20 years of Journal of Physics: Condensed Matter—in honour of Richard Palmer Celebrating 20 years of Journal of Physics: Condensed Matter—in honour of Richard Palmer

    Science.gov (United States)

    Ferry, David; Dowben, Peter; Inglesfield, John

    2009-11-01

    This year marks the 20th anniversary of the launch of Journal of Physics: Condensed Matter in 1989. The journal was formed from the merger of Journal of Physics C: Solid State Physics and Journal of Physics F: Metal Physics which had separated in 1971. In the 20 years since its launch, Journal of Physics: Condensed Matter has more than doubled in size, while raising standards. Indeed, Journal of Physics: Condensed Matter has become one of the leading scientific journals for our field. This could not have occurred without great leadership at the top. No one has been more responsible for this growth in both size and quality than our Senior Publisher, Richard Palmer. Richard first started work at IOP in March 1971 as an Editorial Assistant with J. Phys. B After a few months, he transferred to J. Phys.C The following year, the Assistant Editor of J. Phys. C, Malcolm Haines, left suddenly in order to work on his family vineyard in France, and Richard stepped into the breach. In those days, external editors had a much more hands-on role in IOP Publishing and he had to travel to Harwell to be interviewed by Alan Lidiard, the Honorary Editor of J. Phys. C, before being given the job of Assistant Editor permanently. Since J. Phys. C and J. Phys. F re-merged to form Journal of Physics: Condensed Matter, Richard gradually shed his other journal responsibilities, except for Reports on Progress in Physics, to build up Journal of Physics: Condensed Matter. He has worked closely with four Editors-in-Chief of J. Phys. C and five of Journal of Physics: Condensed Matter. When Richard announced his retirement this past winter, we met it with a great deal of both happiness and sadness. Of course, we are happy that he is going to be allowed to enjoy his retirement, but we remain very sad to lose such a valuable member of our team, especially the one who had provided the heart and soul of the journal over its 20 years. We will be able to rely upon the team which Richard ably trained as

  5. Richards growth model and viability indicators for populations subject to interventions

    Directory of Open Access Journals (Sweden)

    Selene Loibel

    2010-12-01

    Full Text Available In this work we study the problem of modeling identification of a population employing a discrete dynamic model based on the Richards growth model. The population is subjected to interventions due to consumption, such as hunting or farming animals. The model identification allows us to estimate the probability or the average time for a population number to reach a certain level. The parameter inference for these models are obtained with the use of the likelihood profile technique as developed in this paper. The identification method here developed can be applied to evaluate the productivity of animal husbandry or to evaluate the risk of extinction of autochthon populations. It is applied to data of the Brazilian beef cattle herd population, and the the population number to reach a certain goal level is investigated.Neste trabalho estudamos o problema de identificação do modelo de uma população utilizando um modelo dinâmico discreto baseado no modelo de crescimento de Richards. A população é submetida a intervenções devido ao consumo, como no caso de caça ou na criação de animais. A identificação do modelo permite-nos estimar a probabilidade ou o tempo médio de ocorrência para que se atinja um certo número populacional. A inferência paramétrica dos modelos é obtida através da técnica de perfil de máxima verossimilhança como desenvolvida neste trabalho. O método de identificação desenvolvido pode ser aplicado para avaliar a produtividade de criação animal ou o risco de extinção de uma população autóctone. Ele foi aplicado aos dados da população global de gado de corte bovino brasileiro, e é utilizado na investigação de a população atingir um certo número desejado de cabeças.

  6. A Continent-Wide Migratory Divide in North American Breeding Barn Swallows (Hirundo rustica.

    Directory of Open Access Journals (Sweden)

    Keith A Hobson

    Full Text Available Populations of most North American aerial insectivores have undergone steep population declines over the past 40 years but the relative importance of factors operating on breeding, wintering, or stopover sites remains unknown. We used archival light-level geolocators to track the phenology, movements and winter locations of barn swallows (Hirdundo rustica; n = 27 from populations across North America to determine their migratory connectivity. We identified an east-west continental migratory divide for barn swallows with birds from western regions (Washington State, USA (n = 8 and Saskatchewan, Canada (n = 5 traveling shorter distances to wintering areas ranging from Oregon to northern Colombia than eastern populations (Ontario (n = 3 and New Brunswick (n = 10, Canada which wintered in South America south of the Amazon basin. A single swallow from a stable population in Alabama shared a similar migration route to eastern barn swallows but wintered farther north in northeast Brazil indicating a potential leap frog pattern migratory among eastern birds. Six of 9 (67% birds from the two eastern populations and Alabama underwent a loop migration west of fall migration routes including around the Gulf of Mexico travelling a mean of 2,224 km and 722 km longer on spring migration, respectively. Longer migration distances, including the requirement to cross the Caribbean Sea and Gulf of Mexico and subsequent shorter sedentary wintering periods, may exacerbate declines for populations breeding in northeastern North America.

  7. Variability of NTCP prediction of swallowing organs at risk, due to variation in delineation guidelines

    NARCIS (Netherlands)

    Gort, E.M.; Brouwer, C.L.; Lotz, H.T.; Steenbakkers, R.J.H.M.; Wopken, K.; Van Der Laan, H.P.; Langendijk, J.A.

    2012-01-01

    Purpose/Objective: In daily practice, several different delineation guidelines can be used for the delineation of organs at risk that are involved in swallowing (SWOARs). Based on these delineation guidelines, predictive models have been developed for the different aspects of post treatment

  8. Predictive modelling for swallowing dysfunction after primary (chemo)radiation : Results of a prospective observational study

    NARCIS (Netherlands)

    Christianen, Miranda E M C; Schilstra, Cornelis; Beetz, Ivo; Muijs, C.T.; Chouvalova, Olga; Burlage, Fred R.; Doornaert, P.; Koken, P.W.; Leemans, C.R.; Rinkel, R.N.; de Bruijn, M.J.; de Bock, G.H.; Roodenburg, J.L.; van der Laan, B.F.; Slotman, B.J.; Verdonck-de Leeuw, I.M.; Bijl, Hendrik P.; Langendijk, J.A.

    2012-01-01

    Background and purpose: The purpose of this large multicentre prospective cohort study was to identify which dose volume histogram parameters and pre-treatment factors are most important to predict physician-rated and patient-rated radiation-induced swallowing dysfunction (RISD) in order to develop

  9. Predictive modelling for swallowing dysfunction after primary (chemo)radiation: Results of a prospective observational study

    NARCIS (Netherlands)

    Christianen, M.E.M.C.; Schilstra, C.; Beetz, I.; Muijs, C.T.; Chouvalova, O.; Burlage, F.R.; Doornaert, P.A.H.; Koken, P.W.; Leemans, C.R.; Rinkel, R.N.P.M.; de Bruijn, M.J.; de Bock, G.H.; Roodenburg, J.L.N.; van Laan, B.F.A.M.; Slotman, B.J.; de Leeuw, I.M.; Bijl, H.P.; Langendijk, J.A.

    2012-01-01

    Background and purpose: The purpose of this large multicentre prospective cohort study was to identify which dose volume histogram parameters and pre-treatment factors are most important to predict physician-rated and patient-rated radiation-induced swallowing dysfunction (RISD) in order to develop

  10. Recent advances in laryngeal sensorimotor control for voice, speech and swallowing.

    Science.gov (United States)

    Ludlow, Christy L

    2004-06-01

    This article reviews advances in knowledge on laryngeal sensorimotor control affecting the assessment, understanding, and treatment of laryngeal motor control disorders in voice, speech, and swallowing. Three topics are covered: new knowledge on laryngeal innervation and central nervous system control from basic research studies, the role of laryngeal sensation in normal swallowing and dysphagia in patients, and new approaches to the restoration of laryngeal motor control after recurrent laryngeal nerve disorders. A significant advance this year was tracing the efferent pathways from the cortex to the brainstem in monkeys. This provided new information on subcortical and brainstem connections in the laryngeal efferent pathways. Laryngeal sensory feedback continued to receive attention, and the role of sensory feedback in the control of the pharyngeal phase of swallowing is now well established. Further developments in neuromotor monitoring of the recurrent laryngeal nerve during thyroidectomy were seen, and a large case series recommended that these techniques become standard practice for surgery for thyroid benign recurrence or malignancy. Finally, the first tissue engineering papers in the field of vocal fold tissue and nerve restoration were published this year, beginning an exciting new approach to restoration of laryngeal motor control. Considerable attention has been given to laryngeal muscle physiology, denervation, and sensation in neurolaryngology. Relatively limited understanding is available regarding the central nervous system integrative control of laryngeal function for speech, respiration, and swallowing.

  11. Swallowing sounds in speech therapy practice: a critical analysis of the literature.

    Science.gov (United States)

    Ferrucci, Juliana Lopes; Mangilli, Laura Davison; Sassi, Fernanda Chiarion; Limongi, Suelly Cecilia Olivan; Andrade, Claudia Regina Furquim de

    2013-12-01

    This study aimed to investigate international scientific papers published on the subject of cervical auscultation and its use in speech therapy. The study involved a qualitative review of the literature spanning the last 10 years. Articles were selected from the PubMed database using the following keywords: cervical auscultation, swallowing and swallowing disorders. Research was included that was conducted on adult humans (over 18 years of age) and was written in English. Each citation retrieved from the database was analyzed independently by each of the study researchers to ascertain its relevance for inclusion in the study. The methodology involved formulating the research question, locating and selecting studies and critically evaluating the articles according to the precepts of the Cochrane Handbook. As a result, 35 studies were identified; 13 articles were analyzed because they allowed access to the full text and were related directly to the subject. We found that the studies were performed with groups of healthy subjects and subjects with different types of base pathology. Some studies compared the patterns found in the different groups. Some of the research sought to study the pattern of swallowing sounds with different factors - evaluator experience, the specificity and sensitivity of the method and how to improve the technique of cervical auscultation through the use of instruments other than the stethoscope. The conclusion of this critical analysis is that cervical auscultation is an important tool to be used in conjunction with other assessment methods in the routine clinical evaluation of swallowing.

  12. Swallows Rugby Football Club, South Africa: The story of a century ...

    African Journals Online (AJOL)

    Swallows Rugby Football Club, South Africa: The story of a century, 1911-2011. ... Limited secondary sources pertinent to the topic were accessed and analysed for the purpose of cross-referencing the emerging \\facts. from the interviews and primary sources. Content analysis was administered on the collected data; ...

  13. Occurrence of communication and swallowing problems in neurological disorders: analysis of forty patients.

    Science.gov (United States)

    Jani, Mansi Pankaj; Gore, Geeta Bharat

    2014-01-01

    Communication and swallowing problems are common as a result of neurological conditions like stroke, traumatic brain injury, neoplasms of the nervous systems, viral encephalitis, diseases affecting neuromuscular junction and neuro degenerative conditions. The most frequently encountered problems are dysarthria, aphasia, dysphagia and apraxia of speech. Although these disorders are mentioned in literature, very few studies describing the occurrence in different neurological conditions are available in Indian context. Hence, a need was felt to carry out such a study. A heterogenous group of forty patients with neurological conditions were assessed for presence of speech, language and swallowing problems. A percent analysis was carried out to determine the occurrence of aphasia, dysarthria and dysphagia in general, in specific diseases and also to describe type of aphasia and dysarthria according to the characteristics presented. It was seen that the most frequently occurring disorder was dysarthria (60%), followed by dysphagia (55%) and aphasia (18%). It was also noted that dysarthria and dysphagia co-existed in around 45% patients with neurological diseases. It can be concluded that speech, language and swallowing problems are frequent in individuals with neurological conditions. Speech language pathologist plays an important role as a member of the rehabilitation team in a neurological setup with respect to identifying these problems and initiating intervention at the earliest. Hence, it is necessary for speech language pathologist to be well versed with the features each disorder may present with in terms of communication and swallowing.

  14. Surface Electromyography for Speech and Swallowing Systems: Measurement, Analysis, and Interpretation

    Science.gov (United States)

    Stepp, Cara E.

    2012-01-01

    Purpose: Applying surface electromyography (sEMG) to the study of voice, speech, and swallowing is becoming increasingly popular. An improved understanding of sEMG and building a consensus as to appropriate methodology will improve future research and clinical applications. Method: An updated review of the theory behind recording sEMG for the…

  15. Development of a system to monitor laryngeal movement during swallowing using a bend sensor.

    Directory of Open Access Journals (Sweden)

    Qiang Li

    Full Text Available BACKGROUND: Swallowing dysfunction (also known as dysphagia, which results in a deterioration of nutritional intake, slows rehabilitation and causes aspiration pneumonia, is very common following neurological impairments. Although videofluorographic (VF examination is widely used for detecting aspiration, an objective and non-invasive method for assessing swallowing function has yet to be established because of a lack of adequate devices and protocols. In this paper, a bend sensor whose resistance is altered by bending was introduced to monitor swallowing-related laryngeal movement. METHODS: Six healthy male volunteers were recruited in the present study. Specific time points on the signal waveform produced by the bend sensor were defined to describe laryngeal movement by differential analysis. Additionally, the physiological significance of the obtained waveform was confirmed by analyzing the sequential correlations between the signal waveform from the bend sensor and hyoid bone kinetics simultaneously recorded by VF. RESULTS: Seven time points were successfully defined on the signal waveform to reference laryngeal movement. Each time point was well correlated with certain VF events, with evidence of no significant time lags, and there were positive correlations between waveform time points and matched VF events. Furthermore, obvious similarities were noticed between the duration of each phase on the signal waveform and the duration of the matched hyoid bone activity. CONCLUSIONS: The present monitoring system using a bend sensor might be useful for observing the temporal aspects of laryngeal movement during swallowing, and it was well coordinated with hyoid bone movement.

  16. A study of brain networks associated with swallowing using graph-theoretical approaches.

    Directory of Open Access Journals (Sweden)

    Bo Luan

    Full Text Available Functional connectivity between brain regions during swallowing tasks is still not well understood. Understanding these complex interactions is of great interest from both a scientific and a clinical perspective. In this study, functional magnetic resonance imaging (fMRI was utilized to study brain functional networks during voluntary saliva swallowing in twenty-two adult healthy subjects (all females, [Formula: see text] years of age. To construct these functional connections, we computed mean partial correlation matrices over ninety brain regions for each participant. Two regions were determined to be functionally connected if their correlation was above a certain threshold. These correlation matrices were then analyzed using graph-theoretical approaches. In particular, we considered several network measures for the whole brain and for swallowing-related brain regions. The results have shown that significant pairwise functional connections were, mostly, either local and intra-hemispheric or symmetrically inter-hemispheric. Furthermore, we showed that all human brain functional network, although varying in some degree, had typical small-world properties as compared to regular networks and random networks. These properties allow information transfer within the network at a relatively high efficiency. Swallowing-related brain regions also had higher values for some of the network measures in comparison to when these measures were calculated for the whole brain. The current results warrant further investigation of graph-theoretical approaches as a potential tool for understanding the neural basis of dysphagia.

  17. Time budget of South African cliff swallows during breeding | Earlé ...

    African Journals Online (AJOL)

    The use of time by the South African cliff swallow was determined and use of energy calculated by using equations for predicting standard metabolic rate and the cost of flight. The highest daily energy expenditure was during the feeding of nestlings when 9,22 h were spent foraging. The cost of 127 kJ for building a nest is ...

  18. Swallowing and Dysphagia Rehabilitation: Translating Principles of Neural Plasticity into Clinically Oriented Evidence

    Science.gov (United States)

    Robbins, JoAnne; Butler, Susan G.; Daniels, Stephanie K.; Gross, Roxann Diez; Langmore, Susan; Lazarus, Cathy L.; Martin-Harris, Bonnie; McCabe, Daniel; Musson, Nan; Rosenbek, John

    2008-01-01

    Purpose: This review presents the state of swallowing rehabilitation science as it relates to evidence for neural plastic changes in the brain. The case is made for essential collaboration between clinical and basic scientists to expand the positive influences of dysphagia rehabilitation in synergy with growth in technology and knowledge. The…

  19. Barium versus Nonbarium Stimuli: Differences in Taste Intensity, Chemesthesis, and Swallowing Behavior in Healthy Adult Women

    Science.gov (United States)

    Nagy, Ahmed; Steele, Catriona M.; Pelletier, Cathy A.

    2014-01-01

    Purpose: The authors examined the impact of barium on the perceived taste intensity of 7 different liquid tastant stimuli and the modulatory effect that these differences in perceived taste intensity have on swallowing behaviors. Method: Participants were 80 healthy women, stratified by age group (60) and genetic taste status…

  20. [Cine-MRI contribution to assess swallowing mechanism and oro-pharyngeal dysphagia].

    Science.gov (United States)

    Fauvet, F; Charpiot, A; Schultz, P; Riehm, S; Vetter, D; Veillon, F; Hémar, P; Debry, C

    2008-01-01

    This study aimed at evaluating the performance of Cine-MRI to assess swallowing in patients previously treated for head and neck cancer. 10 healthy control subjects and a cohort of 10 patients with 8 partial glossectomies, 1 total laryngectomy and 1 glossolaryngectomy underwent imaging from October 2005 to February 2007. The MRI examinations were performed on a 1.5 Tesla system (Siemens Avanto), with True-Fisp sequences (TR = 170 ms, TE = 1 ms, slice thickness = 10 mm) at a rate of 8 pictures per second, during dry swallowing. Results are relevant for real-time spatial resolution from lips to larynx and dynamic motions analyses of tongue, velum, posterior pharyngeal wall and larynx during dry swallowing. Oro-pharyngo-laryngeal occlusion deficiency induces aspiration in case of partial glossectomy. Total laryngectomy modifies tongue, velum and pharynx landmarks. Cine-MRI i) provides functional insight from the oral cavity to the larynx, ii) gives accurate informations about impairments due to the pathology and its treatment, iii) completes others investigations like fiberoptic endoscopy or transit time, iiii) allows a precise analysis of the muscular movements involved in the deficient swallowing mechanism, in order to optimize rehabilitative strategies and results.