INTRODUCTION:Flexible Endoscopic Evaluation of Swallowing (FEES) is one of two diagnostic gold standards for pharyngeal dysphagia in patients with head and neck cancer (HNC). However, an evidence-based summary outcome measure was missing until recently. The Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) for FEES was adapted from DIGESTV2 for videofluoroscopy for this purpose and is a validated analysis method, grading the severity of pharyngeal dysphagia based on the swallowing parameters safety and efficiency. Main aim of this study was to translate and validate DIGEST-FEES into German (DIGEST-FEES-G). METHODS:First, the transcultural translation included forward and backward translations, cognitive interviews, and consensus in an expert committee together with the original developers. Subsequently, the 100 endoscopic examination videos of the DIGEST-FEES original validation study were retrospectively analyzed with DIGEST-FEES-G. RESULTS:After a training phase, inter-rater reliability was almost perfect for overall DIGEST-FEES-G grade (Kw = 0.89), DIGEST-FEES-G-safety (Kw = 0.9) and DIGEST-FEES-G-efficiency (Kw = 0.88). Intra-rater reliability for the DIGEST-FEES-G rating was almost perfect (rater 1: Kw = 0.81-0.88) and substantial to almost perfect (rater 2: Kw = 0.78-0.92). Overall DIGEST-FEES-G grade correlated with the German Murray Secretion Scale (r = 0.47; p < 0.01), German Yale Vallecular Residue (r = 0.74; p < 19 0.01) and German Yale Pyriform Sinus Residue (r = 0.66; p < 0.01). CONCLUSION:The validation and reliability findings of the original study could be replicated for DIGEST-FEES-G which increases validity of the DIGEST-FEES scale. The translated version, DIGEST-FEES-G, provides a psychometrically sound analysis method for the severity grading of pharyngeal dysphagia in HNC for German-speaking practitioners.
This study examined narrative retelling in Palestinian Arabic-speaking adolescents to characterize micro- and macrostructural discourse patterns within a diglossic context. Forty-two typically developing seventh-grade students (mean age = 12.7 years) listened to fables presented in Modern Standard Arabic (MSA) and retold them in Palestinian Arabic (PA), the participants' variety of Spoken Arabic (SA). Narratives were analyzed at the microstructural (verbal productivity, lexical diversity, syntactic complexity) and macrostructural (story grammar and coherence) levels. Results revealed substantial individual variability, with retellings ranging from brief, telegraphic accounts to extended narratives integrating causal links and evaluative commentary. Story grammar scores were generally high, although references to characters' internal states were infrequent. Verbal productivity was positively associated with story grammar, and story grammar showed a strong association with coherence. In contrast, lexical diversity and syntactic complexity were not positively related to coherence. These findings describe typical patterns and ranges of narrative performance in Arabic-speaking adolescents and demonstrate that strong macrostructural organization and coherence can be achieved even in relatively short narratives. This highlights the importance of accounting for diglossic language contexts and discourse conventions when assessing narrative abilities and designing culturally responsive assessment tools.
INTRODUCTION:Age-related decline in laryngeal function can lead to dysphagia and dysphonia. While both swallowing and phonation involve laryngeal closure, their mechanisms and control differ. Laryngeal diadochokinesis (LDDK) provides a simple insight into the neuromotor function of the larynx. We hypothesized that the acoustic characteristics of laryngeal diadochokinesis (LDDK) are associated with performance on the 100-mL water swallowing test. We aimed at acoustically describing the vocal characteristics of LDDK in healthy older adults and investigating its relationship with swallowing function. METHOD:This retrospective study analyzed existing data from a previous study conducted by Katsumata (2021). The participants were 70 healthy community-dwelling older adults who were independent in daily living. Swallowing function was assessed using the 100-mL water swallowing test, classifying participants into two groups: one with declined swallowing function (DSF) and the other with good swallowing function (GSF). Vocal function was evaluated through acoustic analysis of recorded voice samples obtained from the LDDK task. Three parameters (i.e., LDDK repetition rate, voicing duration, and percentage of signal fusion) were measured. RESULTS:The age of the DSF group was significantly older than the GSF group. LDDK measures demonstrated high intra- and inter-examiner reliability. male participants showed significantly longer voicing duration and higher percentage of signal fusion than females. All measured LDDK parameters revealed statistically significant differences between the two groups: slower repetition rate, longer voicing duration, and higher percentage of signal fusion in DSF than in GSF. Voicing duration demonstrated moderate sensitivity for detecting abnormal findings in the 100-mL water swallowing test. CONCLUSIONS:The results of this study suggest that LDDK acoustic parameters are associated with age-related laryngeal changes and are related to the decline in vocal and swallowing functions in community-dwelling older adults.
INTRODUCTION:Preschool sound environments are predominantly shaped by activity noise generated by voices, object impacts, furniture movement, and daily transitions. Although Icelandic preschools typically comply with reverberation standards, staff frequently report excessive noise, high listening effort, and vocal strain. METHODS:This mixed-method pre-post study examined the sources and reducibility of activity noise in three Icelandic preschools using a voice-ergonomic framework. Data included objective noise measurements at child ear height, structured observations, and teacher questionnaires. The intervention combined voice-ergonomic and noise-awareness education for staff and children with targeted organisational, behavioural, and material adjustments. RESULTS:Baseline mapping identified children's voices and object impacts as the dominant noise sources. Following the intervention, measured noise decreased significantly, with mean LAeq reduced by 1.9 dB (p = .013), corresponding to an approximate 35% reduction in acoustic energy. The largest improvements occurred in high-noise areas such as dining rooms. Despite these improvements, voice symptoms and stress remained prevalent, suggesting that substantial vocal demands persisted despite the intervention and that increased voice awareness may also have influenced symptom reporting. CONCLUSION:The findings indicate that activity noise represents the primary acoustic challenge in preschool environments and highlight children's particularly high local noise exposure. The results support the need for more child-centered acoustic standards that extend beyond reverberation time alone and place greater emphasis on favourable signal-to-noise conditions, listening effort, speech communication, and vocal health in preschool environments.
INTRODUCTION:Developmental language disorder (DLD) is a prevalent neurodevelopmental condition with long-term consequences for children's learning, participation, and well-being. Although evidence from high-income settings shows that families often report navigating fragmented and poorly coordinated support systems, little is known about how these systems operate in Latin America from caregivers' perspectives. This study describes support pathways for children with DLD in Santiago, Chile, focusing on how families access, experience, and sustain support across health and education services. METHODS:We conducted an interpretive qualitative study using semi-structured narrative interviews with nine primary caregivers of children aged 6-9 years with a formal diagnosis registered as Specific Language Impairment (SLI) in the Chilean system (administratively aligned with DLD). Interviews were analyzed using reflexive thematic analysis, guided by key concepts from care pathways and therapeutic itineraries that informed the interpretation of transitions, institutional interactions, and meaning-making. RESULTS:Caregivers' narratives described support pathways as dynamic and nonlinear, shaped by interactions between family interpretations, institutional gatekeeping, and structural constraints. Three interconnected stages were identified: (1) initial suspicion and early help-seeking, marked by uncertainty, uneven professional guidance, and trial-and-error navigation; (2) diagnosis and entry into specialized services, in which Special Language Schools functioned as key gateways to diagnostic confirmation and sustained support; and (3) primary education, characterized by discontinuities in intensity, communication, and coordination when support shifted to School Integration Programs (PIE). Across stages, weak intersectoral coordination, socioeconomic barriers to complementary private therapy, and COVID-19-related disruptions accumulated over time, positioning caregivers as informal coordinators of care. Diagnosis also operated as a sociocultural and administrative credential for access to services. CONCLUSION:In Santiago, DLD support pathways rely heavily on education-sector gateways and caregiver-mediated coordination within a mixed and weakly articulated system. Policies should strengthen early guidance and referral mechanisms, institutionalize coordination between primary care, Special Language Schools, and primary education, and reduce inequities by ensuring continuity and adequate intensity of supports without dependence on families' resources.
Introduction: This international German-Polish study was conducted for the purpose of answering two research questions. First, what is the level of cluttering knowledge and what are the attitudes of speech language therapy (SLT) university students toward this fluency condition? Second, can the attitudes toward cluttering of SLT students be changed or improved following a relatively short educational lecture? Methods: Seventy-three SLT university students from Germany (n = 34) and Poland (n = 39) completed the Public Opinion Survey of Human Attributes–Cluttering (POSHA–Cl) pre- and post-intervention in either German or Polish, respectively. As part of the intervention, participants in both groups took part in an online webinar delivered in their native language, focusing on theoretical issues related to the nature, diagnosis, and therapy of cluttering, as well as topics concerning prevention and attitude change toward cluttering. Results: Pre-intervention comparisons confirmed that participants from both countries did not differ significantly in their overall attitudes toward cluttering, however, the German group showed significantly better attitudes on the Beliefs subscore, and the Polish group on the Self Reactions subscore. Both groups showed a statistically significant improvement in their Overall Cluttering Scores following the intervention. The German group improved on Self Reactions as well as the amount and source of knowledge. The Polish group only showed a statistically significant improvement on the amount of knowledge. Conclusion: This experimental study demonstrated that it is possible to positively modify cluttering attitudes of SLT university students. It has implications for the length, content, and experiential components of interventions designed to improve attitudes toward fluency conditions.
Rare sugars such as D-allulose (Alu) provide benefits including low calories and prebiotic potential, but their low glass transition temperatures make spray-drying challenging. In this study, dextrin-based additives-such as maltodextrins (MDs) with dextrose equivalents (DEs) of 25, 11, and 4, as well as resistant maltodextrin (RMD)-were used to evaluate the spray-drying performance of powders containing Alu and D-fructose (Fru). Solutions with each additive at ratios of 30:70, 20:80, and 10:90 were spray-dried at 140 degrees C. Powder yield, moisture content, particle size, density, flowability, wettability, dissolution kinetics, and hygroscopicity were analyzed. For RMD and MD (DE = 11) exhibited favorable yields; notably, RMD yielded over 50 % even with Alu, which has a low glass transition temperature, at a loading exceeding 80 %, while MD (DE = 4) produced yields below 40 %. RMD-based powders showed high yields and good dissolution but increased hygroscopicity, indicating a trade-off between performance and stability.
This study investigated the relationship between starch gelatinization, water mobility, and viscosity development in roux-based sauces prepared with wheat flour, rice flour, and potato starch combined with water, milk, or soy milk. We integrated differential scanning calorimetry (DSC), time-domain nuclear magnetic resonance (TD-NMR) relaxometry, and rapid visco analysis to characterize structural changes during roux and sauce preparation. DSC confirmed that starch gelatinization occurred during sauce preparation but not during roux preparation. TD-NMR analysis at 25 degrees C revealed that potato starch exhibited markedly longer T2 relaxation times and highest viscosity in water-based systems after cooling from 95 degrees C, reflecting a loose network with high water mobility. Protein-water interactions in milk and soy milk reduced T2 values and viscosity (60-70 % reduction) as proteins competed for water. The rice floursoy milk combination demonstrated a comparable texture to conventional formulations, offering a promising allergen-free alternative for individuals with wheat and dairy allergies.
We investigated the effects of four catechins, (-)-epicatechin (EC), (-)-epicatechin gallate (ECg), (-)epigallocatechin (EGC), and (-)-epigallocatechin gallate (EGCg), on intracellular accumulation of 5-aminolevulinic acid-induced protoporphyrin IX (ALA-PpIX) in human lung adenocarcinoma cell line, A549, cultured in vitro. The extent of ALA-PpIX accumulation followed the order: ECg > EGCg > EGC > EC approximate to no catechin (ALA alone). Furthermore, fluorescence imaging of ferrous ions (Fe2+) using Mito-FerroGreen indicated that catechins chelated intracellular Fe2+, with chelating ability ranked as ECg > EGCg > EGC > EC. Accordingly, ECg and EGCg notably enhanced ALA-PpIX accumulation, presumably due to their higher ability to chelate intracellular Fe2+. However, the order of enhancement of ALA-based photodynamic therapy (ALA-PDT) efficacy among the catechins did not correlate to the order of intracellular ALA-PpIX accumulation. This discrepancy may be attributable to the scavenging of singlet oxygen generated from ALA-PpIX under LED light irradiation by the catechins.
A standardized extract of Asparagus officinalis stem (EAS) has shown anti-inflammatory effects. Many central nervous system (CNS) disorders are associated with neuroinflammation. Microglia play an important role in the immune response in the CNS. However, no therapeutic agents targeting microglial regulation have been successfully translated into clinical practice. Therefore, we investigated the effects of EAS on microglial function and CNS health. EAS suppressed the expression of interleukin 1 beta (Il1b) and inducible nitric oxide synthase (inos) in lipopolysaccharide (LPS)-stimulated microglia while promoting the expression of heat shock protein 70 (Hsp70) and vascular endothelial growth factor a (Vegfa). The EASinduced suppression of Il1b and inos was mediated by the inhibition of NF-kappa B activation, whereas the upregulation of Hsp70 and Vegfa was associated with the activation of heat shock transcription factor 1. Additionally, EAS alleviated depression-like behaviors in LPS-administered mice. Our findings suggest the potential therapeutic benefits of EAS for CNS disorders.
This study aimed to clarify the effect of freeze-concentrated glass transitions on the shattering behavior of frozen cabbage leaves. A single impact was applied to frozen leaf samples at various temperatures using a free-falling force gauge. Shattering was not observed at -10 degrees C. The number and mean area of fragments increased and decreased logarithmically, respectively, with decreases in temperature over the range of -15 to -40 degrees C. The number and mean area of fragments observed at -50 degrees C were slightly lower and higher, respectively, than those expected based on the trend seen at higher temperatures. Calorimetric analysis demonstrated that the freeze-concentrated glass transition of cabbage extract occurred at -42 degrees C. Rheological analysis demonstrated that the freeze-concentrated glass transition of hydrated pectin occurred at -11 degrees C. Freeze-concentrated glass transitions will have affected the shattering characteristics of frozen cabbage leaves.
Japanese strawberries are highly valued for their exceptional flavor, driving rapid growth in both domestic and export markets. However, because strawberries are extremely delicate and susceptible to damage from vibrations and temperature fluctuations during distribution, a simple, non-destructive firmness evaluation method is needed. To address this, we developed a portable fluorescence measurement system utilizing chlorophyll autofluorescence spectra and single-point measurement with a compact spectrometer and blue LED. The 61-g device enables field use, and linear regression of 700-840 nm fluorescence intensity achieved strong correlation with measured firmness (R = 0.90), demonstrating its effectiveness for postharvest quality evaluation.
Melatonin (N-acetyl-5-methoxytryptamine, MT) is known to play diverse regulatory roles in fruit ripening and senescence. However, its involvement in avocado ripening remains unclear. This study investigated the effects of exogenous MT application (0.1 and 0.5 mM) on ethylene biosynthesis and cell wall metabolism in '034' avocado fruit stored at 22 +/- 1 degrees C and 75-80 % relative humidity. Treatment with 0.5 mM MT (immersion for 2 hours) significantly suppressed ethylene production and reduced the respiration rate. In addition, MT treatment effectively delayed fruit softening by moderating the activities of pectin methylesterase (PME), polygalacturonase (PG), and cellulase (Cx). These results demonstrate that MT can slow ripening-associated physiological and biochemical changes, suggesting its potential as a postharvest strategy to extend the shelf life of avocado fruit.
BACKGROUND:Speech disfluencies have been widely studied across speech-language pathology (SLP), linguistics, and engineering. However, the parameters used to describe disfluencies vary considerably across studies, partly because disfluencies are conceptualized differently across disciplines - either as observable speech features or as indicators of underlying speech production processes. As a result, the full range of documented disfluency types remains unclear, and cross-study comparisons are often limited. This scoping review systematically synthesizes existing research to map all documented disfluency types, clarify cross-disciplinary and cross-linguistic inconsistencies, and provide an overview of existing classification frameworks. SUMMARY:Following the PRISMA-ScR guidelines for scoping reviews, online databases (PubMed, Ovid Medline, APA PsycInfo, Linguistics & Language Behavior Abstracts: LLBA, Alexander Street Literature, IEEE Xplore, ACM Digital Library) were searched for papers published from 2000 to 2023, with relevant pre-2000 references included if cited in eligible studies. A total of 69 studies met the inclusion criteria, including 30 from SLP, 16 from linguistics, and 23 from engineering. Disfluency types were grouped into seven broad categories: repetition, prolongation, revision, pause, filler, incomplete production, and nonverbal behaviors. Inconsistencies in terminology and definitions were prevalent across fields, and most frameworks were English-centric, with limited adaptation to other languages. Only 29% of studies applied classification systems to non-English languages, including Mandarin, Cantonese, Spanish, and Turkish. KEY MESSAGES:Terminology and definitions of disfluency types lack consistency across SLP, linguistics, and engineering. Developing a unified, cross-disciplinary, and cross-linguistic classification framework may facilitate more consistent research practices and improve the comparability of findings across studies. Such efforts may also support future clinical and technological applications involving speech disfluency analysis.
INTRODUCTION:The Brief Version of the Unhelpful Thoughts and Beliefs about Stuttering Scales (UTBAS-6) is an efficient and reliable way to screen for unhelpful and negative thoughts, as well as negative beliefs and anxiety among people who stutter. It makes it easier to provide information about people who stutter by saving time for speech-language pathologists in clinics. The aim of this study was to construct an Arabic version of the Brief Version of the Unhelpful Thoughts and Beliefs about Stuttering Scales (A-UTBAS-6) and to evaluate its clinical validity, reliability, and internal consistency. METHODS:The developed A-UTBAS-6 was administered to 53 adults who stuttered and 112 adults who did not stutter. Both test-retest reliability and internal consistency were tested. The results for both groups were compared. RESULTS:The internal consistency of the A-UTBAS-6 total score was excellent (Cronbach's α = 0.957), and test-retest reliability was statistically significant (p < 0.001). The scores for the two groups in the A-UTBAS-6 were significantly different (p < 0.001). CONCLUSION:A-UTBAS-6 is a valid tool for the early detection of thoughts and beliefs that are unhelpful and which may accompany speech disorders among Arabic patients who stutter.
INTRODUCTION:Delivering speech and language therapy (SLT) services within mainstream schools remains a global challenge, particularly in contexts with limited professional resources. While multiple service delivery models have been proposed, evidence regarding their feasibility and effectiveness in low-resource educational systems is limited. This study investigated the feasibility and outcomes of selected SLT service delivery models in Iranian regular schools. METHODS:A randomized controlled trial was conducted in six primary schools in Semnan, Iran, involving 340 children in preschool-grade 2. Classes were randomly assigned to one of two service delivery models: (a) self-contained classroom (n = 45), (b) collaborative-consultative teacher-based (n = 42), and control group (n = 195). Interventions lasted 10 weeks and targeted curriculum-based vocabulary, syntax, and narrative skills. Children's language abilities were assessed using the Persian version of the Test of Language Development-Primary, 3rd Edition (TOLD-P3) at baseline, immediately post-intervention, and at 6-month follow-up. Analyses were conducted using repeated-measures ANOVA with Bonferroni adjustments. RESULTS:Both models demonstrated significant improvements in overall language abilities compared with baseline (p < 0.05). The self-contained classroom model produced broader and more consistent gains across semantic, grammatical, and narrative domains. In contrast, the collaborative-consultative teacher-based model showed selective improvements, particularly in grammar and expressive skills. CONCLUSIONS:Findings highlight the feasibility and relative effectiveness of self-contained classroom and teacher-based collaborative-consultative models for supporting children at risk of language difficulties in Iranian mainstream schools. Results underscore the importance of adapting service delivery frameworks to local educational contexts and resource constraints. Future large-scale trials are warranted to confirm these findings and guide national policy on inclusive educational practices.
INTRODUCTION:The purpose of this study was to evaluate the use of peer-mediated instruction for requesting during a snack time routine for children with extensive support needs who were also beginning communicators. METHOD:Participants included three children aged 5 with extensive support needs who used a tablet-based augmentative and alternative communication (AAC) to communicate. Using a nonconcurrent multiple baseline design, participants were taught by peers without extensive support needs, to request for a preferred snack using modeling and a 3-second time delay until responding reached a mastery criterion of 80-100% across three consecutive sessions. RESULTS:Results indicated that all three participants acquired the ability to request from a peer using AAC. CONCLUSION:Limitations and considerations for future research and practice are discussed.
Introduction: Existing research has explored how images can support persons living with aphasia’s (PWA) communication modalities and the information they may derive from specific images. However, there is a gap in understanding how PWA select and use various image types to support their communication. Aim: This study aimed to (i) explore a sample of PWA’s views on image types and preferences; and (ii) describe image selection and use considerations to support their communication. Methods: A custom-designed, adapted 30-item verbal survey was completed individually with 12 participants with mild to moderate chronic aphasia using pictorial supports and aided conversation techniques over a videoconferencing platform. Descriptive and inferential statistics were employed. Results: Participants preferred using coloured photographs (n = 11) and picture scenes (n = 10) obtained from personal photographs, the internet, and social media. Key considerations for image selection included clarity, transparency, and meaningfulness. Image preferences also varied based on message type (i.e., naming vs. action messages). Notably, participants were more confident using images (n = 10) than selecting them (n = 8). Conclusion: This study provides preliminary insights into image selection and use among a small sample of persons with mild to moderate aphasia. The findings suggest that collaborative efforts with PWA to support their image selection process could optimise image use as communication support. However, further research with larger and more diverse samples of persons with varying aphasia severity is warranted to expand on these findings.
