Intraoral Pressure and Velopharyngeal Function

1998 ◽  
Vol 35 (4) ◽  
pp. 299-303 ◽  
Author(s):  
Robert Mayo ◽  
Donald W. Warren ◽  
David J. Zajac
Keyword(s):  
Cleft Lip ◽  
Pressure Pulse ◽  
Published Data ◽  
Pressure Curve ◽  
Nasal Airflow ◽  
Compensatory Response ◽  
Oral Airway ◽  
The Difference ◽  
Velopharyngeal Function ◽  
Intraoral Pressure

Objective The objective of this study was to determine the influence of velopharyngeal (VP) inadequacy on respiratory speech compensations. Design The pressure-flow technique was used to measure pressure, airflow, and timing variables associated with VP closure during the production of the initial plosive consonant /p/ in a series of the utterance “papa.” Setting The study was conducted in the speech and breathing laboratory of the UNC Craniofacial Center. Participants Eighty-two subjects with cleft lip and/or palate were assessed. The subjects were divided into two groups, those with adequate VP closure (VP size <.010 cm2) and those with inadequate VP closure (VP size >0.10 cm2). The adequate group was comprised of 62 subjects, and 20 subjects were categorized as inadequate. Results Peak intraoral pressure decreased in the inadequate group, but the difference was not significant. Nasal airflow increased (p < .01), but duration of the pressure pulse was the same for both groups. The area under the pressure curve decreased for the inadequate group (p = .04). Conclusion These data contrast with previously reported published data using /p/ in the utterance “hamper.” This suggests that phonetic context influences the compensatory response to velopharyngeal inadequacy. Additionally, while the findings are somewhat similar to studies that involved noncleft subjects whose oral airway was suddenly vented during the production of /p/, there is enough difference to suggest that learning also affects the compensatory outcome.

Perceptual Evaluation of Speech and Velopharyngeal Function in Children with and without Cleft Palate and the Relationship to Nasal Airflow Patterns

2002 ◽  
Vol 39 (4) ◽  
pp. 409-424 ◽  
Author(s):  
Hans Dotevall ◽  
Anette Lohmander-Agerskov ◽  
Hasse Ejnell ◽  
Björn Bake
Keyword(s):  
Cleft Palate ◽  
Sensitivity And Specificity ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Strong Association ◽  
Airflow Rate ◽  
Nasal Airflow ◽  
Perceptual Evaluation ◽  
Velopharyngeal Function ◽  
The Relationship

Objectives The aim was to study the relationship between perceptual evaluation of speech variables related to velopharyngeal function and the pattern of nasal airflow during the velopharyngeal closing phase in speech in children with and without cleft palate. Participants Fourteen children with cleft lip and palate or cleft palate only and 15 controls aged 7 and 10 years. All were native Swedish speakers. Method Three experienced listeners performed a blinded perceptual speech evaluation. Nasal airflow was transduced with a pneumotachograph attached to a nasal mask. The duration from peak to 5% nasal airflow, maximum flow declination rate, and nasal airflow at selected points in time during the transition from nasal to stop consonants in bilabial and velar articulatory positions in sentences were estimated. The analysis was focused on the perceptual ratings of “velopharyngeal function” and “hypernasality.” Results A strong association was found between ratings of “velopharyngeal function” and “hypernasality” and the pattern of nasal airflow during the bilabial nasal-to-stop combination /mp/. Both the sensitivity and specificity were 1.00 for the bilabial temporal airflow measure in relation to ratings of “velopharyngeal function.” The nasal airflow rate during /p/ in /mp/ had a sensitivity of 1.00 and specificity of 0.92 to 0.96 in relation to ratings of “hypernasality.” Conclusion Assessment of the nasal airflow dynamics during the velopharyngeal closing phase in speech presents quantitative, objective data that appear to distinguish between perceptually normal and deviant velopharyngeal function with high sensitivity and specificity.

Objective, Noninvasive Evaluation of Velopharyngeal Function in Cleft and Noncleft Patients

1998 ◽  
Vol 35 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Martin Kunkel ◽  
Ulrich Wahlmann ◽  
Wilfried Wagner
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Noninvasive Evaluation ◽  
Control Group ◽  
Pharyngeal Muscles ◽  
Pharyngeal Flap ◽  
The Difference ◽  
Acoustic Pharyngometry ◽  
Velopharyngeal Function

Objective The purpose of this study was to investigate a new diagnostic method that provides an approach to noninvasive, objective measurement of velopharyngeal movement by acoustic determination of epipharyngeal volume changes with velopharyngeal muscle function. Design This was a case control study, using consecutive samples. Setting This study took place at the Cleft Palate Rehabilitation Center of the University of Mainz, Germany. Patients Subjects were 29 consecutive cleft lip and palate (CLP) patients and 31 controls (21 patients with dysgnathia and 10 healthy volunteers). Intervention A series of transnasal acoustic measurements (pressure wave: 55 dB for 2 milliseconds) of epipharyngeal volume were performed with the pharyngeal muscles relaxed in end-expiration and while the velopharyngeal orifice was closed, with the difference in volume representing maximal pharyngeal movement. Results Cleft palate patients yielded significantly lower values of velopharyngeal movement (6.5 cm3) than did the control group (8.0 cm3)(p < .05; Mann-Whitney U test). Overlapping ranges of values were measured for the C(L)P and control groups. The least mobility (4.75 cm3) was measured in patients who had undergone pharyngeal flap surgery. Different patterns of restriction were observed in patients with and without a pharyngeal flap. Conclusion Acoustic pharyngometry may provide access to noninvasive quantitative measurement of velopharyngeal movement and a better understanding of the pattern of movement in C(L)P-patients. We expect it to be a helpful tool in objectively monitoring the progress of logopedic therapy.

Perceptual Speech Outcomes After Early Primary Palatal Repair in Ugandan Patients With Cleft Palate

2020 ◽  
pp. 105566562098024
Author(s):  
Kim Bettens ◽  
Laura Bruneel ◽  
Cassandra Alighieri ◽  
Daniel Sseremba ◽  
Duncan Musasizib ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Speech Therapy ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
English Speaking ◽  
And Gender ◽  
Early Primary ◽  
Velopharyngeal Function ◽  
Normal Speech

Objective: To provide speech outcomes of English-speaking Ugandan patients with a cleft palate with or without cleft lip (CP±L). Design: Prospective case–control study. Setting: Referral hospital for patients with cleft lip and palate in Uganda. Participants: Twenty-four English-speaking Ugandan children with a CP±L (15 boys, 9 girls, mean 8.4 years) who received palatal closure prior to 6 months of age and an age- and gender-matched control group of Ugandan children without cleft palate. Interventions: Comparison of speech outcomes of the patient and control group. Main Outcome Measures: Perceptual speech outcomes including articulation, resonance, speech understandability and acceptability, and velopharyngeal composite score (VPC-sum). Information regarding speech therapy, fistula rate, and secondary surgery. Results: Normal speech understandability was observed in 42% of the patients, and 38% were judged with normal speech acceptability. Only 16% showed compensatory articulation. Acceptable resonance was found in 71%, and 75% of the patients were judged perceptually to present with competent velopharyngeal function based on the VPC-sum. Additional speech intervention was recommended in 25% of the patients. Statistically significant differences for all these variables were still observed with the control children ( P < .05). Conclusions: Overall, acceptable speech outcomes were found after early primary palatal closure. Comparable or even better results were found in comparison with international benchmarks, especially regarding the presence of compensatory articulation. Whether this approach is transferable to Western countries is the subject for further research.

Association between velopharyngeal function and dental-consonant misarticulations in children with cleft lip/palate

2001 ◽  
Vol 54 (4) ◽  
pp. 290-293 ◽  
Author(s):  
J. Pulkkinen ◽  
M.-L. Haapanen ◽  
J. Laitinen ◽  
M. Paaso ◽  
R. Ranta
Keyword(s):  
Cleft Lip ◽  
Cleft Lip Palate ◽  
Velopharyngeal Function

Determination of Resistance to Abrasive Wear. VIII. Influence of Softeners in Tests with the Akron-Croydon and Du Pont Machines

1949 ◽  
Vol 22 (1) ◽  
pp. 259-262
Author(s):  
J. F. Morley
Keyword(s):  
Unit Area ◽  
Published Data ◽  
The Road ◽  
Abrasive Surface ◽  
Abrasive Power ◽  
The Difference ◽  
On The Road ◽  
The Right ◽  
Abrasion Testing

Abstract These experiments indicate that softeners can influence abrasion resistance, as measured by laboratory machines, in some manner other than by altering the stress-strain properties of the rubber. One possible explanation is that the softener acts as a lubricant to the abrasive surface. Since this surface, in laboratory abrasion-testing machines, is relatively small, and comes repeatedly into contact with the rubber under test, it seems possible that it may become coated with a thin layer of softener that reduces its abrasive power. It would be interesting in this connection to try an abrasive machine in which a long continuous strip of abrasive material was used, no part of it being used more than once, so as to eliminate or minimize this lubricating effect. The fact that the effect of the softener is more pronounced on the du Pont than on the Akron-Croydon machine lends support to the lubrication hypothesis, because on the former machine the rate of wear per unit area of abrasive is much greater. Thus in the present tests the volume of rubber abraded per hr. per sq. cm. of abrasive surface ranges from 0.03 to 0.11 cc. on the du Pont machine and from 0.0035 to 0.0045 cc. on the Akron-Croydon machine. On the other hand, if the softener acts as a lubricant, it would be expected to reduce considerably the friction between the abrasive and the rubber and hence the energy used in dragging the rubber over the abrasive surface. The energy figures given in the right-hand columns of Tables 1 and 3, however, show that there is relatively little variation between the different rubbers. As a test of the lubrication hypothesis, it would be of interest to vary the conditions of test so that approximately the same amount of rubber per unit area of abrasive is abraded in a given time on both machines; this should show whether the phenomena observed under the present test conditions are due solely to the difference in rate of wear or to an inherent difference in the type of wear on the two machines. This could most conveniently be done by considerably reducing the load on the du Pont machine. In the original work on this machine the load was standardized at 8 pounds, but no figures are quoted to show how abrasion loss varies with the load. As an addition to the present investigation, it is proposed to examine the effect of this variation with special reference to rubbers containing various amounts and types of softener. Published data on the influence of softeners on the road wear of tire rubbers do not indicate anything like such large effects as are shown by the du Pont machine. This throws some doubt on the value of this machine for testing tire tread rubbers, a conclusion which is confirmed by information obtained from other workers.

Variation in Skin Cancer Pattern in the Southwestern Region of Pakistan

2021 ◽  
Vol 15 (12) ◽  
pp. 3402-3404
Author(s):  
Hina , Manzoor ◽  
Najeeb Ahmad ◽  
Zafar H Tanveer ◽  
Khush Naseed Ahmed ◽  
Munir , Ahmed ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Skin Cancer ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Published Data ◽  
Non Melanoma Skin Cancer ◽  
Broad Term ◽  
The Difference ◽  
Field Workers ◽  
Melanoma Skin

Background: Skin cancer is a broad term that refers to a variety of different types of cancer. It is usually recognized as non-melanoma and melanoma skin cancer. In many parts of the world, the prevalence is high, with significant ecological and ethical variation. Objectives: Objective was to determine demographic and histological features of skin cancer in Southwest region of Pakistan. Methodology: This retrospective study was carried out on skin cancer 1169 cases of Centre for Nuclear Medicine and Radiotherapy (CENAR) in Quetta. The data from January 2000 to December 2009 (10Years) was retrieved from record. The aim was to determine the importance of skin cancer in this area, its gender wise distribution and its pathological types. Results: Record of total 9308 cancer patients was retrieved from patients presenting to CENAR Quetta. From 9308 case, 1169(12.5%) patients were of skin cancer which was second most prevalent category of cancer in this area. Prevalence was higher in males with 713(61%) cases as compared to females. Pathologically with 634(54%) cases, the most prevalent category was Squamous cell carcinoma (SCC). Conclusion: Skin cancer is wide-spread type of cancer in patients of south-west region of Pakistan. The findings of this study are not aligned with published data. The difference is because of high altitude of the study area, dry climate and long skin exposure particularly in low socio-economic field workers. Keywords: Skin cancer, gender, Melanoma skin cancer (MSC), Squamous cell carcinoma (SCC), Non-melanoma skin cancer (NMSC), Basal cell carcinoma (BCC),

A device employing a neural network for blood pressure estimation from the oscillatory pressure pulse wave and PPG signal

Sensor Review ◽  
2021 ◽  
Vol 41 (1) ◽  
pp. 74-86
Author(s):  
Jian Tian ◽  
Jiangan Xie ◽  
Zhonghua He ◽  
Qianfeng Ma ◽  
Xiuxin Wang
Keyword(s):  
Neural Network ◽  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Pressure Pulse ◽  
Pulse Wave ◽  
Content Type ◽  
The Neural Network ◽  
The Difference ◽  
Oscillatory Pressure ◽  
Mercury Sphygmomanometer

Purpose Wrist-cuff oscillometric blood pressure monitors are very popular in the portable medical device market. However, its accuracy has always been controversial. In addition to the oscillatory pressure pulse wave, the finger photoplethysmography (PPG) can provide information on blood pressure changes. A blood pressure measurement system integrating the information of pressure pulse wave and the finger PPG may improve measurement accuracy. Additionally, a neural network can synthesize the information of different types of signals and approximate the complex nonlinear relationship between inputs and outputs. The purpose of this study is to verify the hypothesis that a wrist-cuff device using a neural network for blood pressure estimation from both the oscillatory pressure pulse wave and PPG signal may improve the accuracy. Design/methodology/approach A PPG sensor was integrated into a wrist blood pressure monitor, so the finger PPG and the oscillatory pressure wave could be detected at the same time during the measurement. After the peak detection, curves were fitted to the data of pressure pulse amplitude and PPG pulse amplitude versus time. A genetic algorithm-back propagation neural network was constructed. Parameters of the curves were inputted into the neural network, the outputs of which were the measurement values of blood pressure. Blood pressure measurements of 145 subjects were obtained using a mercury sphygmomanometer, the developed device with the neural network algorithm and an Omron HEM-6111 blood pressure monitor for comparison. Findings For the systolic blood pressure (SBP), the difference between the proposed device and the mercury sphygmomanometer is 0.0062 ± 2.55 mmHg (mean ± SD) and the difference between the Omron device and the mercury sphygmomanometer is 1.13 ± 9.48 mmHg. The difference in diastolic blood pressure between the mercury sphygmomanometer and the proposed device was 0.28 ± 2.99 mmHg. The difference in diastolic blood pressure between the mercury sphygmomanometer and Omron HEM-6111 was −3.37 ± 7.53 mmHg. Originality/value Although the difference in the SBP error between the proposed device and Omron HEM-6111 was not remarkable, there was a significant difference between the proposed device and Omron HEM-6111 in the diastolic blood pressure error. The developed device showed an improved performance. This study was an attempt to enhance the accuracy of wrist-cuff oscillometric blood pressure monitors by using the finger PPG and the neural network. The hardware framework constructed in this study can improve the conventional wrist oscillometric sphygmomanometer and may be used for continuous measurement of blood pressure.

scholarly journals Anterior Cervical Corpectomy and the Operating Team: A Controversy?

2018 ◽  
Vol 07 (01) ◽  
pp. 008-015
Author(s):  
Alexandrina Nikova ◽  
Theodossios Birbilis
Keyword(s):  
Cervical Myelopathy ◽  
Postoperative Outcome ◽  
Published Data ◽  
Multifactorial Disease ◽  
Surgical Team ◽  
Cervical Corpectomy ◽  
Operating Team ◽  
Anterior Corpectomy ◽  
The Difference ◽  
Anterior Cervical Corpectomy

AbstractCervical myelopathy is multifactorial disease that can lead to many dysfunctions. Surgical treatment is believed to be the best healing choice. The authors searched the published data on Medline on this subject and found a difference between the neurosurgeons and orthopaedics on the topic of anterior corpectomy for cervical myelopathy. The difference between the orthopaedics and neurosurgeons is not big, but it could be relevant to the final outcome, which appears to be better in the neurosurgeons. The complication rate is also variable between the groups, with lower rates of complication reported by the neurosurgeons. Therefore, despite the fact that the postoperative outcome depends on many factors, such as preoperative condition, additional comorbidities, age, and lifestyle, this article also finds that the surgical team, after comparing basic techniques that the team used for anterior cervical corpectomy (ACC), is also responsible to some extent. This, however, is not a competition, and future cooperation between the teams might be beneficial for all.

scholarly journals On the Non-Specific Stimulation of Agglutinins. With Especial Reference to the Enteric Fevers and Typhus Fever

1929 ◽  
Vol 28 (4) ◽  
pp. 418-448 ◽  
Author(s):  
A. Felix
Keyword(s):  
Qualitative Method ◽  
Published Data ◽  
Enteric Infection ◽  
Widal Test ◽  
Enteric Infections ◽  
The Difference ◽  
Specific Stimulation ◽  
Enteric Group ◽  
Typhus Fever ◽  
Stimulation Of

(1) The review of the published data furnishes additional evidence in support of the view that no technique whatsoever, Dreyer's technique included, based on the quantitative method of the agglutination reaction hitherto used, is capable of affording a differentiation between inoculation and infection agglutinins.(2) These techniques are concerned always exclusively in the demonstration of the labilotropic H agglutinins ofB. typhosusandB. paratyphosusA. and B. and it is the behaviour of these agglutinins that is the responsible factor in producing the phenomena.(3) In various febrile conditions in inoculated individuals these H agglutinins undergo a re-stimulation resulting in a curve of agglutination which is indistinguishable from that due to specific stimulation. The re-stimulation of the labilotropic inoculation agglutinins is of the same nonspecific character (i.e.heterologous) in the course of enteric infections as in the course of other febrile diseases.(4) The observation of this non-specific re-stimulation is independent of the technique used; living bacilli and suspensions preserved with phenol or formalin (Dreyer's technique included) do not in this respect behave differently.(5) The proposed qualitative method for the Widal test depends, in inoculated individuals, exclusively upon the behaviour of the stabilotropic O agglutinins. In their presence it is capable of affording the certain diagnosis of an enteric infection; in their absence the negative result of the test is not conclusive; if T.A.B. vaccine has been used it is only possible to diagnose enteric group without being able to differentiate typhoid from paratyphoid A. or B.; if T. vaccine has been used then A. or B. infection can be differentiated but not T.(1) The conclusions previously arrived at by means of the qualitative method of the Widal test were fully confirmed. By eliminating the labilotropic H agglutinins from any consideration—in the case of previously sensibilised individuals—agglutination due to the specific stimulation in active enteric infection can be distinguished definitely from that due to the nonspecific re-stimulation by various febrile diseases.(2) Normal and immune O agglutinins forB. typhosusandB. paratyphosusA. and B., as well as those forB. proteusX 19, are not liable to non-specific stimulation in the course of various febrile diseases.(3) One more of the supposed differences in nature between the Widal test and the Weil-Felix test is thereby eliminated.(4) The difference in the response to non-specific stimulation shown to exist in stabilotropic and labilotropic agglutination seems more likely to be one of degree than one in nature and needs further investigation.

scholarly journals Comparison of direct and geodetic mass balances on a multi-annual time scale

2010 ◽  
Vol 4 (3) ◽  
pp. 1151-1194
Author(s):  
A. Fischer
Keyword(s):  
Mass Balance ◽  
Direct Method ◽  
Mean Difference ◽  
Published Data ◽  
Glacier Mass Balance ◽  
Mass Balances ◽  
Direct Data ◽  
The Mean ◽  
The Difference ◽  
Geodetic Mass Balance

Abstract. Glacier mass balance is measured with the direct or the geodetic method. In this study, the geodetic mass balances of six Austrian glaciers in 19 periods between 1953 and 2006 are compared to the direct mass balances in the same periods. The mean annual geodetic mass balance for all periods is −0.5 m w.e./year. The mean difference between the geodetic and the direct data is −0.7 m w.e., the minimum −7.3 m w.e. and the maximum 5.6 m w.e. The accuracy of geodetic mass balance resulting from the accuracy of the DEMs ranges from 2 m w.e. for photogrammetric data to 0.002 m w.e. for LIDAR data. Basal melt, seasonal snow cover and density changes of the surface layer contribute up to 0.7 m w.e. for the period of 10 years to the difference to the direct method. The characteristics of published data of Griesgletscher, Gulkana Glacier, Lemon Creek glacier, South Cascade, Storbreen, Storglaciären, and Zongo Glacier is similar to these Austrian glaciers. For 26 analyzed periods with an average length of 18 years the mean difference between the geodetic and the direct data is −0.4 m w.e., the minimum −7.2 m w.e. and the maximum 3.6 m w.e. Longer periods between the acquisition of the DEMs do not necessarily result in a higher accuracy of the geodetic mass balance. Specific glaciers show specific trends of the difference between the direct and the geodetic data according to their type and state. In conclusion, geodetic and direct mass balance data are complementary, but differ systematically.

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