Saliva Production and Enjoyment of Real-Food Flavors in People with and Without Dysphagia and/or Xerostomia

Non-food gustatory stimulation has multiple potential therapeutic benefits for people with dysphagia and xerostomia. This study examined palatability and saliva flow associated with dissolvable flavored films. Taste strips with real-food flavors dissolved on the tongues of 21 persons with dysphagia and/or xerostomia and 21 healthy age- and sex-matched adults while sublingual gauze pads absorbed saliva over randomized 3-min trials. Participants rated taste enjoyment for each trial on a hedonic general labeled magnitude scale. Flavored strips elicited more saliva than baseline for both groups, and production was higher for controls than patients (M = 2.386 and 1.091 g, respectively; p = 0.036). Main effects of flavor were observed for saliva production (p = 0.002) and hedonics (p\u3c0.001). Hedonic ratings and saliva production were weakly correlated (r = 0.293, p\u3c0.001). Results support dissolvable taste strips as a tool for providing low-risk taste stimulation in dysphagia and for eliciting an increase in saliva flow that may provide temporary relief from dry mouth symptoms. The preferred flavors were, on average, also the ones that elicited greater saliva production. Taste strips have the potential to be beneficial for swallowing-related neural activity, timing, and safety in dysphagia. Further, they may ameliorate complications of xerostomia

Revisiting the Rainbow: Culturally Responsive Updates to a Standard Clinical Resource

Purpose Cultural responsivity is essential for efficacious and affirming clinical relationships. This may be especially important with historically marginalized clients, such as transgender and gender-diverse (TGD) people seeking behaviorally based affirming communication services. We recommend modifications to standard tools for diagnostics and training that otherwise might undermine our efforts to create an inclusive and affirming environment. Method Modifications to the Rainbow Passage, a standardized paragraph utilized for eliciting speech samples in clinical settings, focused on nongendered terminology and the elimination of content with religious connotations. Results The recommended edits to the Rainbow Passage maintain similar length, cadence, and phonetic balance while considering cultural and health care context for TGD people and other clients. Conclusion Simple linguistic changes to a standardized paragraph maintain clinical benefits and facilitate SLP efforts toward cultural responsivity, client engagement, and good clinical outcomes

Perceptual and instrumental assessments of orofacial muscle tone in dysarthric and normal speakers

Clinical assessment of orofacial muscle tone is of interest for differential diagnosis of the dysarthrias, but standardized procedures and normative data are lacking. In this study, perceptual ratings of tone were compared with instrumental measures of tissue stiffness for facial, lingual, and masticatory muscles in 70 individuals with dysarthria. Perceptual and instrumental tone data were discordant and failed to discriminate between five dysarthria types. These results raised concerns about the validity of Myoton-3 stiffness measures in the orofacial muscles. Therefore, a second study evaluated contracted and relaxed orofacial muscles in 10 neurotypical adults. Results for the cheek, masseter, and lateral tongue surface followed predictions, with significantly higher tissue stiffness during contraction. In contradiction, stiffness measures from the superior surface of the tongue were lower during contraction. Superior-to-inferior tongue thickness was notably increased during contraction. A third study revealed that tissue thickness up to ~10 mm significantly affected Myoton-3 measures. Altered tissue thickness due to neuromuscular conditions like spasticity and atrophy may have undermined the detection of group differences in the original sample of dysarthric speakers. These experiments underscore the challenges of assessing orofacial muscle tone and identify considerations for quantification of tone-related differences across dysarthria groups in future studies

Perceptual and instrumental assessments of orofacial muscle tone in dysarthric and normal speakers

Clinical assessment of orofacial muscle tone is of interest for differential diagnosis of the dysarthrias, but standardized procedures and normative data are lacking. In this study, perceptual ratings of tone were compared with instrumental measures of tissue stiffness for facial, lingual, and masticatory muscles in 70 individuals with dysarthria. Perceptual and instrumental tone data were discordant and failed to discriminate between five dysarthria types. These results raised concerns about the validity of Myoton-3 stiffness measures in the orofacial muscles. Therefore, a second study evaluated contracted and relaxed orofacial muscles in 10 neurotypical adults. Results for the cheek, masseter, and lateral tongue surface followed predictions, with significantly higher tissue stiffness during contraction. In contradiction, stiffness measures from the superior surface of the tongue were lower during contraction. Superior-to-inferior tongue thickness was notably increased during contraction. A third study revealed that tissue thickness up to ~10 mm significantly affected Myoton-3 measures. Altered tissue thickness due to neuromuscular conditions like spasticity and atrophy may have undermined the detection of group differences in the original sample of dysarthric speakers. These experiments underscore the challenges of assessing orofacial muscle tone and identify considerations for quantification of tone-related differences across dysarthria groups in future studies

The Effect of Barium on Perceptions of Taste Intensity and Palatability

Barium may affect the perception of taste intensity and palatability. Such differences are important considerations in the selection of dysphagia assessment strategies and interpretation of results. Eighty healthy women grouped by age (younger, older) and genetic taste status (supertaster, nontaster) rated intensity and palatability for seven tastants prepared in deionized water with and without 40 % w/v barium: noncarbonated and carbonated water, diluted ethanol, and high concentrations of citric acid (sour), sodium chloride (salty), caffeine (bitter), and sucrose (sweet). Mixed-model analyses explored the effects of barium, taster status, and age on perceived taste intensity and acceptability of stimuli. Barium was associated with lower taste intensity ratings for sweet, salty, and bitter tastants, higher taste intensity in carbonated water, and lower palatability in water, sweet, sour, and carbonated water. Older subjects reported lower palatability (all barium samples, sour) and higher taste intensity scores (ethanol, sweet, sour) compared to younger subjects. Supertasters reported higher taste intensity (ethanol, sweet, sour, salty, bitter) and lower palatability (ethanol, salty, bitter) than nontasters. Refusal rates were highest for younger subjects and supertasters, and for barium (regardless of tastant), bitter, and ethanol. Barium suppressed the perceived intensity of some tastes and reduced palatability. These effects are more pronounced in older subjects and supertasters, but younger supertasters are least likely to tolerate trials of barium and strong tastant solutions

Reflection on multilayer mirrors beam profile and coherence properties

The main advantage of Bragg reflection from a multilayer mirror as a monochromator for hard X rays, is the higher photon flux density because of the larger spectral bandpass compared with crystal lattice reflection. The main disadvantage lies in the strong modulations of the reflected beam profile. This is a major issue for micro imaging applications, where multilayer based monochromators are frequently employed to deliver high photon flux density. A subject of particular interest is the origin of the beam profile modifications, namely the irregular stripe patterns, induced by the reflection on a multilayer. For multilayer coatings in general it is known that the substrate and its surface quality significantly influence the performance of mirrors, as the coating reproduces to a certain degree the roughness and shape of the substrate. This proceedings article reviews recent experiments that indicate potential options for producing wave front preserving multilayer mirrors, as well as new details on the particular mirrors our group has extensively studied in the pas

Organ curvature sensing using pneumatically attachable flexible rails in robotic-assisted laparoscopic surgery

In robotic-assisted partial nephrectomy, surgeons remove a part of a kidney often due to the presence of a mass. A drop-in ultrasound probe paired to a surgical robot is deployed to execute multiple swipes over the kidney surface to localise the mass and define the margins of resection. This sub-task is challenging and must be performed by a highly-skilled surgeon. Automating this sub-task may reduce cognitive load for the surgeon and improve patient outcomes. The eventual goal of this work is to autonomously move the ultrasound probe on the surface of the kidney taking advantage of the use of the Pneumatically Attachable Flexible (PAF) rail system, a soft robotic device used for organ scanning and repositioning. First, we integrate a shape-sensing optical fibre into the PAF rail system to evaluate the curvature of target organs in robotic-assisted laparoscopic surgery. Then, we investigate the impact of the PAF rail’s material stiffness on the curvature sensing accuracy, considering that soft targets are present in the surgical field. We found overall curvature sensing accuracy to be between 1.44% and 7.27% over the range of curvatures present in adult kidneys. Finally, we use shape sensing to plan the trajectory of the da Vinci surgical robot paired with a drop-in ultrasound probe and autonomously generate an Ultrasound scan of a kidney phantom