N=1 extension of minimal model holography

The CFT dual of the higher spin theory with minimal N = 1 spectrum is determined. Unlike previous examples of minimal model holography, there is no free parameter beyond the central charge, and the CFT can be described in terms of a non-diagonal modular invariant of the bosonic theory at the special value of the 't Hooft parameter lambda=1/2. As evidence in favour of the duality we show that the symmetry algebras as well as the partition functions agree between the two descriptions.Comment: 28 page

Issues and Challenges in Managing Patients with Dementia and Dysphagia

Dysphagia is a frequent complication of patients with dementia. Failure to receive adequate and safe nutrition contributes to the progression of the disease and impacts survival. Because of the potential compromise to cognitive status, clinicians must work aggressively prior to the patientʼs inability to cooperate with rehabilitation strategies that might assist them in avoiding the complications dysphagia often precipitates. Therefore, strategies that are designed to prevent dysphagia should be the focus of interventions that target nutritional integrity and swallowing safety. Avoiding the consequences of dysphagia has important implications for the cost of healthcare for patients with dementia)

Dysphagia: Clinical Management in Adults and Children

Get all the information you need to confidently manage dysphagia in professional practice with Dysphagia: Clinical Management in Adults and Children, 2nd Edition! This logically organized, evidence-based resource reflects the latest advancements in dysphagia in an approachable and user-friendly manner to help you master the clinical evaluation and diagnostic decision-making processes. New coverage of the latest insights and research along with expanded information on infant and child swallowing will help prepare you for the conditions you’ll face in the clinical setting. Plus, the realistic case scenarios and detailed review questions threaded throughout the book will help you develop the clinical reasoning skills needed for professional success.https://inspire.redlands.edu/oh_books/1001/thumbnail.jp

Dysphagia : clinical management in adults and children /

Previous edition: St. Louis: Elsevier, 2016.Includes bibliographical references and index.Description based on online resource; title from digital title page (viewed on October 14, 2020).PART I: FOUNDATIONS ; 1. Dysphagia Unplugged ; 2. Normal Swallowing in Adults; PART II: DYSPHAGIA IN ADULTS; Section 1: Causes and Characteristics of Dysphagia ; 3. Aging and Dysphagia NEW! ; 4. Adult Neurologic Disorders; 5. Dysphagia and Head and Neck Cancer; 6. Esophageal Disorders; 7. Respiratory Disorders; 8. Iatrogenic Disorders; Section 2: Evaluation of Swallowing ; 9. Clinical Evaluation of Adults; 10. Imaging Swallowing Examinations: Videofluoroscopy and Endoscopy; Section 3: Approaches to Treatment ; 11. Treatment for Adults; 12. Ethical Considerations; PART III: DYSPHAGIA IN INFANTS AND CHILDREN ; 13. Typical Feeding and Swallowing Development in Infants and Children; 14. Disorders Affecting Feeding and Swallowing in Infants and Children; 15. Evaluating Feeding and Swallowing in Infants and Children; 16. Treatment of Feeding and Swallowing Difficulties in Infants and Children; Appendix (A-H); Glossary.Elsevie

Functional Benefits Of Dysphagia Therapy Using Adjunctive Semg Biofeedback

This article describes a retrospective analysis of functional outcome, time in therapy, and cost per unit of functional change in patients who received therapy for pharyngeal dysphagia. Twenty-five patients presenting dysphagia following stroke and 20 patients with dysphagia following treatment for head/neck cancer completed a systematic therapy program supplemented with surface electromyographic (sEMG) biofeedback. Eighty-seven percent (39/45) of all patients increased their functional oral intake of food/liquid including 92% of stroke patients and 80% of head/neck cancer patients. Patients with dysphagia following stroke demonstrated greater improvement than those in the head/neck cancer group. Patients in the stroke group completed more therapy sessions thus increasing the total cost of therapy, but they made more functional progress resulting in lower costs per unit of functional change than patients in the head/neck cancer group. Limitations of this study are described in reference to implications for future clinical research on the efficacy of this therapy approach

Prediction of Aspiration by Perceptual Evaluation of Pre-swallow Wet Voice and Wet Expiratory Sounds in Adults Diagnosed with Head and Neck Cancer

This study investigated the relationships between the perceptual evaluation of “wetness” of both pre-swallow voice and expiratory sound and video fluoroscopic swallowing study (VFSS) findings. Pre-swallow phonation of the vowel “a” and expiratory sounds were recorded immediately before VFSS in 51 patients with head and neck cancer. During VFSS, subjects were requested to swallow 3 ml of a jelly-like, radiopaque test food. A total of 61 samples of “a” phonations and expiratory sounds were investigated in this study. These sound samples were randomized and presented to 12 examiners with various years of experience in dysphagia management. The examiners perceptually evaluated the wetness of sound samples using a 5-point “wetness” grade. VFSS findings were evaluated using the 8-point penetration aspiration (PA) scale. The relationships between the wetness of sound samples and VFSS findings were analyzed. Penetration/aspiration without materials ejected out of the airway can be predicted by the wetness of sound samples. In this study, both the pre-swallow wet voice and wet expiratory sounds were suitable for predicting penetration/aspiration after swallowing. High inter-rater and intra-rater reliabilities were verified in the high – and low-experience examiners, with no significant difference evident between these groups. These findings suggest that clinicians could predict penetration/aspiration in head and neck cancer patients by perceptually evaluating the wetness of pre-swallow voice and expiratory sounds regardless of clinical experience

Identifying the Timing of Swallowing Sounds Using Videoendoscopy Findings in Healthy Adults

Cervical auscultation is a useful tool for detecting dysphagia; however, the sites where swallowing sounds are produced are unknown. In this study, we investigated the relationship between swallowing sounds and videoendoscopy (VE) images in healthy adults to identify the timing of swallowing sounds. Fifteen healthy young adults participated in the study. Each participant was seated in an upright position while a stethoscope probe with an inserted microphone was placed at the center of his or her lower neck to detect swallowing sounds during the VE. The detected sounds were recorded simultaneously with the VE images while the subjects swallowed 4g of liquid or jelly. Swallowing duration, swallowing sound duration, and VE findings at the beginning and end of swallowing sounds were analyzed. One hundred and thirty-four sound samples produced by a single swallowed bolus were obtained and analyzed. The mean swallowing duration for each material ranged from 1.25 to 2.39s. Swallowing duration was significantly longer for jelly compared with liquids (p<0.01). Swallowing sound duration was approximately 0.5s in all samples, and there were no significant differences between materials. Most swallowing sounds started during velopharyngeal closure (109/134, 81.3%), and most swallowing sounds ended during velopharyngeal closure (98/134, 73.1%). For all materials, swallowing sounds did not start when the materials flowed into the pyriform sinuses, and very few sounds corresponded with epiglottic movements. These results show that many movements associated with physiologic events―including hyoid bone and laryngeal excursion, and opening of the upper esophageal sphincter―may be involved in the production of swallowing sounds

Acoustic Characteristics of Voluntary Expiratory Sounds After Swallow for Detecting Dysphagia

This research was designed to investigate the acoustic characteristics of voluntary expiratory sounds after swallow for detecting dysphagia. Forty-nine patients with complaints of swallow difficulty received a videofluorographic (VF) examination. They were divided into three groups: nine who did not have any apparent disease (Group N), 22 patients with head and neck cancer (Group H&N) and 18 patients with other diseases including cerebrovascular disease (Group OD). After liquid barium swallows, they exhaled voluntarily without voicing. Videofluorographic findings were classified into four groups: normal (Normal), acceptable swallow (Acceptable), swallow with residue (Resid) and swallows with penetration or aspiration (Pen/Asp). The duration of expiratory sounds was measured on the time waveform. Frequency characteristics of expiratory sounds were obtained using one-third octave band analysis ranging from 62·5 to 2000·0 Hz of central frequency. The averaged level of the 1000·0-Hz band was chosen as the reference band level (RB level). The revised averaged level of each band was obtained by subtracting the RB level from the averaged level of each band. Zero decibel of the revised magnitude of the 125·0-Hz band was set as the critical value to differentiate dysphagia (Resid or Pen/Asp) from no dysphagia (Normal or Acceptable). Comparison of this assessment with VF findings showed a significant percentage agreement (85·4%). These results suggest that frequency characteristics of post-swallow expiratory sounds can differentiate dysphagia from no dysphagia among multiple dysphagic patient groups