Vagus nerve magnetic modulation facilitates dysphagia recovery in patients with stroke involving the brainstem - A proof of concept study.

BACKGROUND & AIMS: Stroke involving the brainstem (SBS) causes severe oropharyngeal dysphagia (OD). Research on the therapeutic efficacy of vagus nerve modulation (VNM) by using repetitive transcranial magnetic stimulation (rTMS) in SBS patients with OD has been limited thus far. We aimed to assess the effect of VNM by using rTMS in improving swallowing function after SBS. METHOD: We conducted a sham-controlled, double-blinded, parallel pilot study in 28 SBS patients with OD randomly allocated to a real rTMS group (n = 13; TMSreal) or a sham group (n = 15; TMSsham). For VNM, 5-Hz rTMS was applied to the left mastoid in 10 sessions. We evaluated all patients for swallowing function before and after rTMS conditioning, assessed on the 8-point Penetration-Aspiration Scale (PAS) through videofluoroscopy and the Australian Therapy Outcome Measures-Swallowing scale (AusTOMs). We measured the amplitude and latency of cricopharyngeal motor evoked potentials (CP-MEPs) as the neurophysiological parameters. RESULTS: TMSreal exhibited significant improvement in all swallowing outcomes-neurophysiological, radiological, and functional-compared with TMSsham: We noted higher CP-MEP amplitude (p = 0.004), shorter CP-MEP latency (p = 0.004), a lower PAS score (p = 0.001), and a higher AusTOMs score (p < 0.001) following rTMS in TMSreal. Moreover, the neurophysiological improvements were significantly correlated with the functional outcomes (p < 0.05). CONCLUSIONS: Our results encourage the application of VNM by using rTMS for improving swallowing function after SBS. The immediate therapeutic effects suggest that this novel intervention can be an effective complementary therapy to traditional oropharyngeal rehabilitation. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02893033.

Risk factors and effects of voice problems for teachers.

The objective of this study was to investigate risk factors of voice problems for teachers with voice disorders as compared to teachers without voice disorders. Many studies have reported risk factors and effects of teachers' voice problems from different professions. Few researchers have investigated these phenomena among people of the same occupation. The purposes of the study are (1) to investigate risk factors of voice problems for Taiwanese teachers with voice disorders as compared to teachers without voice disorders; and (2) to investigate effects of voice problems on daily life in the two groups. A prospective study was designed for this research. One hundred and seventeen questionnaires were collected from schoolteachers. The subjects were divided into a voice disorder group (VD group) and a no voice disorder group (NVD group) from questionnaires. The Chi-square test was used to examine the significant differences of VD and NVD groups in demographic characteristics, living habits, teaching characteristics, health condition, voice symptoms, physical discomfort, and daily life. Logistic regression was used to find risk factors and effects of voice problems for teachers. Subjects in the VD group were at significantly higher risk of using a loud voice in teaching than the subjects in the NVD group. Subjects in the VD group had significantly greater effects in changing overall job opinions, reduction of overall communicative ability, decreasing phone calls, reduction of overall social ability, influence on overall emotional state, and the frequency of being upset than subjects in the NVD group. These results imply the need for a preventive voice care program for teachers.

Asyntactic thematic role assignment by Mandarin aphasics: a test of the Trace-Deletion Hypothesis and the Double Dependency Hypothesis.

This study examines the comprehension patterns of various sentence types by Mandarin-speaking aphasic patients and evaluates the validity of the predictions from the Trace-Deletion Hypothesis (TDH) and the Double Dependency Hypothesis (DDH). Like English, the canonical word order in Mandarin is SVO, but the two languages differ in that the head noun precedes the relative clause in English, but it follows the relative clause in Chinese. According to the Default Principle as stated in the TDH, the word order discrepancy will make subject relative clauses more difficult to comprehend for Mandarin agrammatics than object relative clauses, but the DDH predicts that agrammatic patients from the two languages have the same pattern of selective deficits. The results of this study support the prediction of the TDH.

Potassium Sorbate Inhibition of Microorganisms Isolated from Seafood 1.

Microorganisms isolated from seafood showed various degrees of sensitivity toward potassium sorbate (PS). At pH 7.0, PS concentration of 0.53% completely inhibited growth of Moraxella sp., while 2.73% was needed to inhibit Arthrobacter sp. Pseudomonas I sp., which was relatively resistant to PS (inhibitory concentration = 1.62%), was not affected by 0.3% PS after freeze-thaw treatment (-78°C for 8 min and 20°C for 20 min), but showed a delay in onset of logarithmic growth for up to 20 h after heating at 50°C for 5 min. The inhibitory effect of PS on sub-lethally injured Pseudomonas I was greater in basal medium (Minimum Broth, Davis) than in a rich medium (tryptone-peptone-extract, TPE). Alteromonas putrefaciens , which was sensitive to PS (inhibitory concentration = 0.74%), was also sensitive to freeze-thaw and mild heat. The lag period for quick-frozen cells was extended by 14 h in the presence of 0.05% PS. Heating at 45°C for 10 sec was sufficient to cause complete inhibition of growth by 0.05% PS in MBD, and 8 h delay in the onset of logarithmic growth in TPE. Selective and inhibitory effects of PS, therefore, could be further enhanced in frozen or heat-treated seafood.

Inhibition of Microbial Growth in English Sole ( Parophrys retulus ) 1.

The influence of potassium sorbate on growth of microorganisms in seafood was tested by treating English sole ( Parophrys retulus ) homogenate with 0, 0.1 and 1.0% potassium sorbate. Viable counts during 1.1-C storage revealed that 0.1% potassium sorbate delayed the onset of logarithmic growth of bacteria for 1 day compared to no delay for the untreated control. The generation time of 1.7 days and a maximum growth level of 109 cells per g were unchanged by the presence of 0.1% potassium sorbate. The 1.0% sorbate treatment extended the lag period to 6 days. The generation time was increased to 2.1 days and the maximum level of growth reached was 107 cells per g on the 14th day. Tests of the microbial flora of the fish revealed that Pseudomonas spp., which comprised 17.1 %of the total at 0 day, increased to 96.0% of the microbial population in 14 days at 1.1 C for the untreated sample. During the same period the Pseudomonas population reached 100% for the 0.1% sorbate-treated sample, and to 98.2% for the 1.0% sorbate-treated sample. Potassium sorbate at the concentrations employed, therefore, did not seem to alter the typical microbial spoilage pattern.