Efficacy of soft palatal augmentation prosthesis for oral functional rehabilitation in patients with dysarthria and dysphagia: a protocol for a randomised controlled trial

Introduction Palatal augmentation prosthesis (PAP) is used in patients with articulation and swallowing disorders caused by postoperative loss of tongue tissue due to tongue cancer, cerebrovascular disease sequelae and age-related hypofunction. We have previously reported a newly designed soft PAP fabricated using an thermoplastic material that is particularly appropriate for early intervention. However, the effect of soft PAP on oral function improvement remains to be elucidated. The aim of this study is to investigate whether soft PAP can improve dysarthria and dysphagia occurring as cerebrovascular disease sequelae. Methods and analysis This prospective, randomised, controlled trial will compare the immediate and training effects of rehabilitation using soft PAP with those of rehabilitation without using it. Primary outcomes are the single-word intelligibility test score and pharyngeal transit time (PTT). Secondary outcomes are tongue function (evaluated based on maximum tongue pressure, repetitions of tongue pressure and endurance of tongue pressure), articulation function (evaluated based on speech intelligibility, oral diadochokinesis, Voice-Related Quality of Life (V-RQOL)) and swallowing function (evaluated using Eating Assessment Tool-10). The study results will help determine the efficacy of Soft PAP in improving functional outcomes of word intelligibility and PTT. We hypothesised that early rehabilitation using Soft PAP would more effectively improve articulation and swallowing function compared with conventional rehabilitation without using soft PAP. Ethics and dissemination Ethical approval was obtained from the Okayama University Certified Review Board. The study findings will be published in an open access, peer-reviewed journal and presented at relevant conferences and research meetings

Effect of Gas Pressure on Active Screen Plasma Nitriding Response

An austenitic stainless steel AISI 304 was active screen plasma nitrided using a 304 steel screen to investigate the effect of the gas pressure on the nitriding response. The sample was treated for 18 ks at 723 K in 25 % N2 +75 % H2. The gas pressure was changed to 100, 600, and 1200 Pa. The distance between the screen and the sample was also changed to 10, 30, and 50 mm. The nitrided samples were characterized by observing their appearance and surface roughness by optical microscopy, X-ray diffraction, and microhardness testing. After nitriding, polygonal particles with a normal distribution were observed at the center and edges of all the nitrided sample surfaces. The particles on the sample surface became finer with an increase in the gas pressure. The nitrided layer with a greater and homoge-neous thickness was obtained at a low gas pressure of 100 Pa

Implementasi Permendagri Nomor 15 Tahun 2008 Tentang Pengarusutamaan Gender pada Jenjang Pendidikan Dasar di Kota Malang

Windra Rizkiyana1 & Wahyu Widodo21 Mahasiswa & 2Staf Pengajar Program Pasca Sarjana, Universitas Muhammadiyah MalangAlamat Korespondensi : Jl. Bandung No.1 MalangEmail: [email protected] education, still found a gender gap regarding both aspects of the expansion of educationalaccess and equity, quality and relevance of education and management. The purpose of this studywere: (1) describe the substance Permendagri No. 15 of 2008 on Gender Mainstreaming; (2) describethe implementation of Permendagri No. 15 of 2008 on Gender Mainstreaming in Elementary Educationin Malang; (3) Analyze the obstacles encountered in implementation Permendagri No. 15 of 2008 onGender Mainstreaming in Elementary Education in Malang. This type of research is a descriptiveanalysis, using a qualitative approach that is supported by a quantitative approach. And the techniquesof data acolllection through by interviews and the documents. Study sites are in Malang EducationDepartment. Analysis of the data used is descriptive analysis of qualitative and quantitative theorysupported by Gender Analysis Pathway (GAP), Content Analysis and Root Analysis. Implementationof Permendagri No 15 of 2008 about gender mainstreaming in basic education levels in Malang hasnot been optimal. These proved by the remains of gender inequality or gap that occurs in all threeaspects, that access and educational equity, quality and relevance of education, as well as accountabilityand governance. Constraints encountered in implementation Permendagri No. 15 of 2008 on gendermainstreaming in elementary education in Malang include: (a) Outreach activities that are specificallyabout the PUG in primary education has not been done; (b) The budget is not specifically formainstreaming activities; (c) newly formed working group PUG.Key word: Permendagri No. 15 of 2008, gender mainstreaming, basic educatio

Severe and prolonged ictal paresis in an elderly patient

We report an 84-year-old female who showed a rare manifestation of epilepsy, ictal paresis, a type of simple partial seizure presenting with focal motor dysfunction. While the patient exhibited severe left hemiplegia which lasted for a week, cranial diffusion-weighted MRI demonstrated slightly high intensity in the right posterior quadrant, and electroencephalography (EEG) showed continuous epileptiform discharges located mainly in the right parieto-occipital area, strongly suggesting that the patient was in an ictal state. 99mTc-hexamethylpropylene amine oxime-single photon emission computed tomography (HMPAO-SPECT) showed markedly high blood perfusion in the right parieto-temporo-occipital areas. Considering the distribution of EEG epileptiform activities and HMPAO-SPECT hyperperfusion, it is most likely that the ictal paresis of our patient was associated with epileptic activities at the sensorimotor area which caused either direct or indirect activation of an inhibitory system. Careful clinical consideration of the possibility of ictal paresis is needed in elderly patients, especially in those with preexisting dementia, because paresis can be as severe as complete flaccid hemiplegia and can last as long as for a week