Theta-burst transcranial magnetic stimulation for dysphagia patients during recovery stage of stroke: a randomized controlled trial.

BACKGROUND: The Theta-burst Transcranial Magnetic Stimulation (TBS) is an emerging modality of Repetitive Transcranial Magnetic Stimulation (rTMS). However, the efficacy of TBS on post-stroke recovery-stage patients with dysphagia remains unclear. AIM: To investigate the effect of intermittent theta burst stimulation (iTBS) and continuous theta burst stimulation (cTBS) in post-stroke dysphagia patients within the recovery stage. DESIGN: Randomized controlled double blinded trial. SETTING: Inpatient. POPULATION: Ninety patients with dysphagia after stroke within 1 to 6 months. METHODS: Patients were divided into the supratentorial group and the brainstem group, and both of groups were further divided into three subgroups, including the sham subgroups, the iTBS subgroups, and the cTBS subgroups. Each of subgroups received 30 min of traditional swallowing rehabilitation treatment every day for 4 weeks. In addition, the iTBS subgroups received iTBS over the cortex of the suprahyoid muscles on the affected hemisphere, the cTBS subgroups received cTBS on the unaffected hemisphere, and the sham subgroups received sham stimulation on unilateral hemisphere. Standardized swallowing assessment (SSA), Oral Motor Function Scale (OMFS) and fiberoptic endoscopic examination of swallowing (FEES) were assessed before and after treatments. RESULTS: In the supratentorial group, compared with the sham and cTBS subgroups, the iTBS subgroups showed significant improvement in SSA, OMFS, vocal folds movement, laryngeal sensation, and Rosenbek Penetration-Aspiration Scale (PAS) (P<0.05). In the brainstem group, compared with the sham subgroup, the iTBS subgroup significantly improved SSA, OMFS, Yale Pharyngeal Residue Severity Rating Scale (YPR-SRS) and PAS (P<0.05), and the cTBS subgroup significantly improved SSA, YPR-SRS and PAS (P<0.05). CONCLUSIONS: This study demonstrated that iTBS might be an effective stimulation pattern to improve the overall swallowing function whether in supratentorial stroke patients or brainstem stroke patients. CLINICAL REHABILITATION IMPACT: iTBS seems to be a promising approach for rehabilitation of overall swallowing function in post-stroke patients.

Influence of Different Ratios of Lactobacillus delbrueckii subsp. bulgaricus and Streptococcus thermophilus on Fermentation Characteristics of Yogurt.

Lactic acid bacteria (LAB) are industrially important bacteria that are widely used in the fermented food industry, especially in the manufacture of yogurt. The fermentation characteristics of LAB are an important factor affecting the physicochemical properties of yogurts. Here, different ratios of L. delbrueckii subsp. bulgaricus IMAU20312 and S. thermophilus IMAU80809 were compared with a commercial starter JD (control) for their effects on viable cell counts, pH values, titratable acidity (TA), viscosity and water holding capacity (WHC) of milk during fermentation. Sensory evaluation and flavour profiles were also determined at the end of fermentation. All samples had a viable cell count above 5.59 × 107 CFU/mL at the end of fermentation, and a significant increase in TA and decrease in pH were observed. Viscosity, WHC and the sensory evaluation results of one treatment ratio (A3) were closer to the commercial starter control than the others. A total of 63 volatile flavour compounds and 10 odour-active (OAVs) compounds were detected in all treatment ratios and the control according to the results from solid-phase micro-extraction-gas chromatography-mass spectrometry (SPME-GC-MS). Principal components analysis (PCA) also indicated that the flavour characteristics of the A3 treatment ratio were closer to the control. These results help us understand how the fermentation characteristics of yogurts are affected by the ratio of L. delbrueckii subsp. bulgaricus to S. thermophilus in starter cultures; this is useful for the development of value-added fermented dairy products.

Effect of Tongue-Pressure Resistance Training in Poststroke Dysphagia Patients With Oral Motor Dysfunction: A Randomized Controlled Trial.

OBJECTIVES: The aims of the study were to investigate the effect of tongue-pressure resistance training in poststroke dysphagia patients with oral motor dysfunction and to examine the therapeutic value of tongue-pressure resistance training in the oral and pharyngeal phases. DESIGN: Patients were divided into an experimental and a control group. Both groups received 30 mins of traditional swallowing rehabilitation treatment every day for 4 wks. In addition, the experimental group received tongue-pressure resistance training for an extra 20 mins/d. Maximum tongue pressure and fiberoptic endoscopic examination of swallowing were assessed before and after treatments. RESULTS: Compared with the control group, the experimental group showed significant improvement in Functional Communication Measure for swallowing, Oral Motor Function Scale, maximum tongue pressure, Murray Secretion Scale, Rosenbek Penetration-Aspiration Scale, and food residue in pyriform sinuses ( P < 0.05). There was no significant difference in food residue in epiglottic vallecula between both groups ( P > 0.05). CONCLUSIONS: This study demonstrated that tongue-pressure resistance training is an effective approach to improve the overall swallowing function in patients with oral motor dysfunction. The improvement of oral motor function could facilitate the recovery of pharyngeal motor function. Tongue-pressure resistance training seems to have more clearance of residue in piriform sinus than epiglottic vallecula.

Silver nanoparticles selectively induce human oncogenic γ-herpesvirus-related cancer cell death through reactivating viral lytic replication.

Silver nanoparticle (nAg), which is one of the most common manufactured nanomaterials, has a wide range of biomedical applications. The human oncogenic γ-herpesviruses, Kaposi's sarcoma-associated herpesvirus (KSHV) and Epstein-Barr Virus (EBV), are etiologically linked to many malignancies. Currently, there are no efficient or specific treatments for these types of tumors, and most patients die because of resistance to conventional cytotoxic chemotherapy. Despite nAg having antitumor and antiviral activities, its effects on oncogenic herpesvirus-related cancer cells remain largely unknown. Here, we reveal that nAg presents higher cytotoxicity against KSHV- or EBV-latently infected cells via reactivating viral lytic replication, which relies on the induction of reactive oxygen species (ROS) generation and autophagy. Moreover, nAg blocks KSHV primary infection by directly destroying virion particles, as well as effectively inhibits colony formation and moderately represses the growth of KSHV-associated tumors in xenograft mouse model. Taken together, these results demonstrate the therapeutic potential of nAg for use in the antiviral infection and treatment of oncogenic herpesvirus-related cancers.