Exploratory analysis of swallowing behaviour in community-dwelling older adults using a wearable device: Differences by age and ingestant under different task loads.

Objective: To develop a new method of evaluating swallowing behaviour. Methods: Sixty-nine healthy participants were divided into a younger (16 males and 16 females, mean age 39.09 ± 12.16 years) and older (18 males and 19 females, mean age 71.43 ± 5.50 years) group. The participants ingested water and yoghurt twice (directed and free swallowing) at rest and after performing simple daily life tasks (calculation and exercise). To measure swallowing frequency, we employed a smartphone-based, portable and neck-worn swallowing-sound-monitoring device. This device monitors swallowing behaviour continuously by collecting biological sounds from the neck without imposing behavioural restrictions. A neural network model of swallowing sound identification by deep learning was used for the subsequent evaluation. This device was used to obtain two types of saliva-swallowing sounds associated with different ingestants, at rest and after performing a stimulating task. Furthermore, we assessed the associated subjective psychological states. Results: The younger group showed a higher directed swallowing frequency (for both water and yoghurt) than the older group did. Regarding the type of ingestant, the swallowing frequency for yoghurt was higher during free swallowing in both the young and the older groups. 'Feeling calm' was reported significantly more often in the older group after swallowing yoghurt following exercise. Conclusions: Swallowing status in daily life was measured non-invasively using a wearable mobile device. It is important to consider the type of ingestant, daily living activities, and age when assessing swallowing.

Development and validation of a novel system that combines a new masticatory simulator and analysis method for modeling the human gummy candy masticatory process.

During mastication, food undergoes state and texture changes influenced by various mechanical properties, including compression and fracturing of the molar teeth, mixing with saliva, and oral temperature. Prior studies have explored mastication simulators, however, no studies have assessed the forces and duration applied to the molars by the food during bolus formation. In this study, we developed a novel system that integrates a masticatory simulator and analysis method to evaluate mechanical properties. We developed ORAL-MAPS which is equipped with 6-axis force sensor, pneumatic pressure control mechanism, vertical movement, molar-like module, artificial saliva injection unit, and temperature control apparatus. A gap exists between the upper and lower unit at the closest point, allowing the sensor to measure vertical upward force and duration from food, while compressed air provides constant downward pressure. We hypothesized a correlation between the total integrated muscle activity ratio obtained from the human masseter muscle electromyography (iEMG). We compared the normalized impulse obtained from ORAL-MAPS with the normalized total iEMG obtained from human studies with four different types of gummy candies. As a result, the normalized total impulse of gummy candies A, B, C, and D were 1.00 ± 0.00, 1.29 ± 0.06, 0.95 ± 0.00, and 0.39 ± 0.0, respectively. The normalized total iEMG of the same gummy candies were 1.00 ± 0.00, 1.23 ± 0.15, 0.98 ± 0.09, and 0.45 ± 0.07, respectively. Thus, no significant difference was observed between the normalized total impulse obtained in vitro and the normalized total iEMG values for masticating the gummy candies B, C, and D (p > .05).

Numerical simulation of interaction between organs and food bolus during swallowing and aspiration.

The mechanism of swallowing is still not fully understood, because the process of swallowing is a rapid and complex interaction among several involved organs and the food bolus. In this work, with the aim of studying swallowing and aspiration processes noninvasively and systematically, a computer simulation method for analyzing the involved organs and water (considered as the food bolus) is proposed. The shape and motion of the organs involved in swallowing are modeled in the same way as in our previous study, by using the Hamiltonian moving particle simulation (MPS) method and forced displacements on the basis of motion in a healthy volunteer. The bolus flow is simulated using the explicit MPS method for fluid analysis. The interaction between the organs and the bolus is analyzed using a fluid-structure coupling scheme. To validate the proposed method, the behavior of the simulated bolus flow is compared qualitatively and quantitatively with corresponding medical images. In addition to the healthy motion model, disorder motion models are constructed for reproducing the aspiration phenomenon by computer simulation. The behaviors of the organs and the bolus considered as the food bolus in the healthy and disorder motion models are compared for evaluating the mechanism of aspiration.

Development of a numerical simulator of human swallowing using a particle method (part 1. Preliminary evaluation of the possibility of numerical simulation using the MPS method).

The aim of the present study was to evaluate the possibility of numerical simulation of the swallowing process using a moving particle simulation (MPS) method, which defined the food bolus as a number of particles in a fluid, a solid, and an elastic body. In order to verify the accuracy of the simulation results, a simple water bolus falling model was solved using the three-dimensional (3D) MPS method. We also examined the simplified swallowing simulation using a two-dimensional (2D) MPS method to confirm the interactions between the liquid, solid, elastic bolus, and organ structure. In a comparison of the 3D MPS simulation and experiments, the falling time of the water bolus and the configuration of the interface between the liquid and air corresponded exactly to the experimental measurements and the visualization images. The results showed that the accuracy of the 3D MPS simulation was qualitatively high for the simple falling model. Based on the results of the simplified swallowing simulation using the 2D MPS method, each bolus, defined as a liquid, solid, and elastic body, exhibited different behavior when the organs were transformed forcedly. This confirmed that the MPS method could be used for coupled simulations of the fluid, the solid, the elastic body, and the organ structures. The results suggested that the MPS method could be used to develop a numerical simulator of the swallowing process.

Development of a numerical simulator of human swallowing using a particle method (Part 2. Evaluation of the accuracy of a swallowing simulation using the 3D MPS method).

The aim of this study was to develop and evaluate the accuracy of a three-dimensional (3D) numerical simulator of the swallowing action using the 3D moving particle simulation (MPS) method, which can simulate splashes and rapid changes in the free surfaces of food materials. The 3D numerical simulator of the swallowing action using the MPS method was developed based on accurate organ models, which contains forced transformation by elapsed time. The validity of the simulation results were evaluated qualitatively based on comparisons with videofluorography (VF) images. To evaluate the validity of the simulation results quantitatively, the normalized brightness around the vallecula was used as the evaluation parameter. The positions and configurations of the food bolus during each time step were compared in the simulated and VF images. The simulation results corresponded to the VF images during each time step in the visual evaluations, which suggested that the simulation was qualitatively correct. The normalized brightness of the simulated and VF images corresponded exactly at all time steps. This showed that the simulation results, which contained information on changes in the organs and the food bolus, were numerically correct. Based on these results, the accuracy of this simulator was high and it could be used to study the mechanism of disorders that cause dysphasia. This simulator also calculated the shear rate at a specific point and the timing with Newtonian and non-Newtonian fluids. We think that the information provided by this simulator could be useful for development of food products, medicines, and in rehabilitation facilities.

Antimicrobial activity of Gel-entrapped catechins toward oral microorganisms.

The oral cavity contains almost half of the commensal bacterial population present in the human body. An increase in the number of these microorganisms may result in systemic diseases such as infective endocarditis and aspiration pneumonia as well as oral infections. It is essential to control the total numbers of these microorganisms in order to suppress disease onset. Thus, we examined the antimicrobial activity of a newly developed gel-entrapped catechin (GEC) preparation against oral microorganisms. The minimum inhibitory concentration (MIC) of GEC was determined based on the relationship between a modified agar diffusion method and a broth microdilution method. GEC inhibited the growth of the Actinomyces, periodontopathic bacteria and Candida strains tested, but did not inhibit the growth of the oral streptococci that are important in the normal oral flora. Commercially available moisture gels containing antimicrobial components showed antimicrobial activity against all of the tested strains. After a series of washes and after a 24-h incubation, GEC retained the antimicrobial activity of the catechins. Catalase prevented GEC-induced growth inhibition of Actinomyces naeslundii and Streptococcus mutans suggesting that hydrogen peroxide may be involved in the antimicrobial activity of catechins. These results suggest that GEC may be useful for controlling oral microorganism populations and reducing the accumulation of dental plaque, thereby helping to prevent periodontal disease and oral candidiasis.