Objective Prediction of Pharyngeal Swallow Dysfunction in Dysphagia through Artificial Neural Network Modelling

This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving'. © 2016 John Wiley & Sons LtdBackground Pharyngeal pressure-flow analysis (PFA) of high resolution impedance-manometry (HRIM) with calculation of the swallow risk index (SRI) can quantify swallow dysfunction predisposing to aspiration. We explored the potential use of artificial neural networks (ANN) to model the relationship between PFA swallow metrics and aspiration and to predict swallow dysfunction. Methods Two hundred consecutive dysphagia patients referred for videofluoroscopy and HRIM were assessed. Presence of aspiration was scored and PFA software derived 13 metrics and the SRI. An ANN was created and optimized over training cycles to achieve optimal classification accuracy for matching inputs (PFA metrics) to output (presence of aspiration on videofluoroscopy). Application of the ANN returned a value between 0.00 and 1.00 reflecting the degree of swallow dysfunction. Key Results Twenty one patients were excluded due to insufficient number of swallows (<4). Of 179, 58 aspirated and 27 had aspiration pneumonia history. The SRI was higher in aspirators (aspiration 24 [9, 41] vs no aspiration 7 [2, 18], p < 0.001) and patients with pneumonia (pneumonia 27 [5, 42] vs no pneumonia 8 [3, 24], p < 0.05). The ANN Predicted Risk was higher in aspirators (aspiration 0.57 [0.38, 0.82] vs no aspiration 0.13 [0.4, 0.25], p < 0.001) and in patients with pneumonia (pneumonia 0.46 [0.18, 0.60] vs no pneumonia 0.18 [0.6, 0.49], p < 0.01). Prognostic value of the ANN was superior to the SRI. Conclusions & Inferences In a heterogeneous cohort of dysphagia patients, PFA with ANN modeling offers enhanced detection of clinically significant swallowing dysfunction, probably more accurately reflecting the complex interplay of swallow characteristics that causes aspiration

Medication review in preventing older adults\u27 fall-related injury: A systematic review & meta-analysis

Background: Medication review is essential in managing adverse drug reactions and improving drug safety in older adults. This systematic review evaluated medication review\u27s role as a single intervention or combined with other interventions in preventing fall-related injuries in older adults. Methods: Electronic databases search was conducted in PubMed, EMBASE, Scopus, and CINAHL. Two reviewers screened titles and abstracts, reviewed full texts, and performed data extraction and risk of bias assessment. Meta-analyses were conducted on studies with similar participants, interventions, outcomes or settings. Results: Fourteen randomized, controlled studies were included. The pooled results indicated that medication review as a standalone intervention was effective in preventing fall-related injuries in community-dwelling older adults (Risk Difference [RD] = -0.06, 95% CI: [-0.11, -0.00], I2 = 61%, p = .04). Medication review also had a positive impact on decreasing the risk of fall-related fractures (RD = -0.02, 95% CI: [-0.04, -0.01], I2 = 0%, p = .01). Discussion: This systematic review and meta-analysis has demonstrated that medication review is effective in preventing fall-related injuries in general, and fractures specifically, in communitydwelling older adults. Future investigations focusing on the process of performing medication review will further inform fall-related injury prevention for older adults

The Alternative for Germany’s radicalization in historical-comparative perspective

This article chronicles the AfD’s rightward repositioning and compares it with the programmatic development of three postwar German parties on the ideological wings. By highlighting factors that tilt the balance of power away from moderate reformers towards hardliners, this comparative analysis sheds light on the conditions that lead a relatively successful party on the ideological wings, such as the AfD, to radicalize its programme. Four variables stand out: whether party hardliners take the blame for the recent election loss; whether they offer a convincing programmatic and strategic alternative to the reformers; whether changes in party composition strengthen hardliners; and whether external factors enhance their weight within the party. The essay concludes that the AfD’s radicalization was unusual, but not exceptional. It is however too early to conclude that the Federal Republic’s distinctive institutions and political culture no longer impose significant costs on parties that shift their programmes away from the centre

Self-gravitating domain walls and the thin-wall limit

We analyse the distributional thin wall limit of self gravitating scalar field configurations representing thick domain wall geometries. We show that thick wall solutions can be generated by appropiate scaling of the thin wall ones, and obtain an exact solution for a domain wall that interpolates between AdS_4 asymptotic vacua and has a well-defined thin wall limit.Solutions representing scalar field configurations obtained via the same scaling but that do not have a thin wall limit are also presented.Comment: 10 pages, revte

Improving Situational Awareness for First Responders via Mobile Computing

This project looks to improve first responder incident command, and an appropriately managed flow of situational awareness using mobile computing techniques. The prototype system combines wireless communication, real-time location determination, digital imaging, and three-dimensional graphics. Responder locations are tracked in an outdoor environment via GPS and uploaded to a central server via GPRS or an 802. II network. Responders can also wireless share digital images and text reports, both with other responders and with the incident commander. A pre-built three dimensional graphics model of the emergency scene is used to visualize responder and report locations. Responders have a choice of information end points, ranging from programmable cellular phones to tablet computers. The system also employs location-aware computing to make responders aware of particular hazards as they approach them. The prototype was developed in conjunction with the NASA Ames Disaster Assistance and Rescue Team and has undergone field testing during responder exercises at NASA Ames

SSRL Emergency Response Shore Tool

The SSRL Emergency Response Shore Tool (wherein SSRL signifies Smart Systems Research Laboratory ) is a computer program within a system of communication and mobile-computing software and hardware being developed to increase the situational awareness of first responders at building collapses. This program is intended for use mainly in planning and constructing shores to stabilize partially collapsed structures. The program consists of client and server components, runs in the Windows operating system on commercial off-the-shelf portable computers, and can utilize such additional hardware as digital cameras and Global Positioning System devices. A first responder can enter directly, into a portable computer running this program, the dimensions of a required shore. The shore dimensions, plus an optional digital photograph of the shore site, can then be uploaded via a wireless network to a server. Once on the server, the shore report is time-stamped and made available on similarly equipped portable computers carried by other first responders, including shore wood cutters and an incident commander. The staff in a command center can use the shore reports and photographs to monitor progress and to consult with structural engineers to assess whether a building is in imminent danger of further collapse

Propiedades químicas, color y humectabilidad de partículas de "Laureliopsis philippiana" (tepa) con y sin tratamiento térmico

The purpose of this work was to determine the effect of a thermal treatment in a vapor water saturated atmosphere, on wood particles of Laureliopsis philippiana. The particles in autoclave at 150 ºC for 90 minutes and with a pressure of 430 kPa were thermally treated, the pressure generated by the evaporation of water in the sealed autoclave. The amount of extractives in soda, ethanol-toluene, cold and hot water, as well as, the percentages of cellulose, holocellulose and lignin, the pH value, the percentages of volatiles and washables acids, and buffer capacity, for both particles without and with treatment, were determined. In thermally treated particles an increase in the percentage of extractives, cellulose and volatiles and water soluble acids was found, as well as, in thermally treated particles an increment of acidity and a higher buffer capacity was found, in comparison with the particles without treatment. The thermal treatment produced a color change in the particles and a reduction in their wettability. Due to the chemical changes found in the treated particles they could present advantages in the particleboard production, allowing a better ureaformaldehyde polymerization.El propósito de este trabajo fue determinar el efecto de un tratamiento térmico, en una atmósfera saturada de vapor de agua, en partículas de madera de la especie Laureliopsis philippiana. Las partículas fueron tratadas en autoclave a 150 ºC por 90 minutos y a una presión de 430 kPa, la cual se generó durante el proceso por la evaporación del agua en el autoclave herméticamente cerrado. Se determinaron la cantidad de extraíbles en soda, etanol tolueno, agua caliente y fría, así también, los porcentaje de celulosa, holocelulosa y lignina, el valor pH, los porcentajes de ácidos volátiles y solubles en agua, y la capacidad tampón, tanto para partículas sin tratamiento como con tratamiento. Para las partículas con tratamiento térmico, se encontró un aumento en el porcentaje de extraíbles, de celulosa, y de ácidos volátiles y lavables, así como también, un aumento de la acidez y de una mayor capacidad tampón, en comparación con las partículas sin tratamiento. El tratamiento térmico produjo un cambio de color en las partículas y una reducción de la humectabilidad. Debido a los cambios químicos encontrados en las partículas tratadas, estas presentarían ventajas en la fabricación de tableros de partículas, favoreciendo el fraguado de la ureaformaldehído

Propiedades químicas, color y humectabilidad de partículas de Laureliopsis philippiana (TEPA) con y sin tratamiento térmico

El propósito de este trabajo fue determinar el efecto de un tratamiento térmico, en una atmósfera saturada de vapor de agua, en partículas de madera de la especie Laureliopsis philippiana. Las partículas fueron tratadas en autoclave a 150 ºC por 90 minutos y a una presión de 430 kPa, la cual se generó durante el proceso por la evaporación del agua en el autoclave herméticamente cerrado. Se determinaron la cantidad de extraíbles en soda, etanol tolueno, agua caliente y fría, así también, los porcentaje de celulosa, holocelulosa y lignina, el valor pH, los porcentajes de ácidos volátiles y solubles en agua, y la capacidad tampón, tanto para partículas sin tratamiento como con tratamiento. Para las partículas con tratamiento térmico, se encontró un aumento en el porcentaje de extraíbles, de celulosa, y de ácidos volátiles y lavables, así como también, un aumento de la acidez y de una mayor capacidad tampón, en comparación con las partículas sin tratamiento. El tratamiento térmico produjo un cambio de color en las partículas y una reducción de la humectabilidad. Debido a los cambios químicos encontrados en las partículas tratadas, estas presentarían ventajas en la fabricación de tableros de partículas, favoreciendo el fraguado de la ureaformaldehído. AbstractThe purpose of this work was to determine the effect of a thermal treatment in a vapor water saturated atmosphere, on wood particles of Laureliopsis philippiana. The particles in autoclave at 150 ºC for 90 minutes and with a pressure of 430 kPa were thermally treated, the pressure generated by the evaporation of water in the sealed autoclave. The amount of extractives in soda, ethanol-toluene, cold and hot water, as well as, the percentages of cellulose, holocellulose and lignin, the pH value, the percentages of volatiles and washables acids, and buffer capacity, for both particles without and with treatment, were determined. In thermally treated particles an increase in the percentage of extractives, cellulose and volatiles and water soluble acids was found, as well as, in thermally treated particles an increment of acidity and a higher buffer capacity was found, in comparison with the particles without treatment. The thermal treatment produced a color change in the particles and a reduction in their wettability. Due to the chemical changes found in the treated particles they could present advantages in the particleboard production, allowing a better ureaformaldehyde polymerization

Serum Concentrations of Myostatin and Myostatin-Interacting Proteins do not differ between young and Scarcopenic elderly men

Peer reviewedPostprin

Sensing Molecules with Metal–Organic Framework Functionalized Graphene Transistors

Graphene is inherently sensitive to vicinal dielectrics and local charge distributions, a property that can be probed by the position of the Dirac point in graphene field-effect transistors. Exploiting this as a useful sensing principle requires selectivity; however, graphene itself exhibits no molecule-specific interaction. Complementarily, metal–organic frameworks can be tailored to selective adsorption of specific molecular species. Here, a selective ethanol sensor is demonstrated by growing a surface-mounted metal–organic framework (SURMOF) directly onto graphene field-effect transistors (GFETs). Unprecedented shifts of the Dirac point, as large as 15 V, are observed when the SURMOF/GFET is exposed to ethanol, while a vanishingly small response is observed for isopropanol, methanol, and other constituents of the air, including water. The synthesis and conditioning of the hybrid materials sensor with its functional characteristics are described and a model is proposed to explain the origin, magnitude, and direction of the Dirac point voltage shift. Tailoring multiple SURMOFs to adsorb specific gases on an array of such devices thus generates a versatile, selective, and highly sensitive platform for sensing applications