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Despite extensive studies revealing the potential of cholinium-based ionic liquids (ILs) in protein stabilization, the nature of interaction between ILs' constituents and protein residues is not well understood. In this work, we used a combined computational and experimental approach to investigate the structural stability of a peptide hormone, insulin aspart (IA), in ILs containing a choline cation [Ch]+ and either dihydrogen phosphate ([Dhp]-) or acetate ([Ace]-) as anions. Although IA remained stable in both 1 M [Ch][Dhp] and 1 M [Ch][Ace], [Dhp]- exhibited a much stronger stabilization effect than [Ace]-. Both the hydrophilic ILs intensely hydrated IA and increased the number of water molecules in IA's solvation shell. Undeterred by the increased number of water molecules, the native state of IA's hydrophobic core was maintained in the presence of ILs. Importantly, our results reveal the importance of IL concentration in the medium which was critical to maintain a steady population of ions in the microenvironment of IA and to counteract the denaturing effect of water molecules. Through molecular docking, we confirm that the anions exert the dominant effect on the structure of IA, while [Ch]+ have the secondary influence. The computational results were validated using spectroscopic analyses (ultra-violet, fluorescence, and circular dichroism) along with dynamic light scattering measurements. The extended stability of IA at 30 °C for 28 days in 1 M [Ch][Dhp] and [Ch][Ace] demonstrated in this study reveals the possibility of stabilizing IA using cholinium-based ILs.
Subject(s)
Ionic Liquids , Molecular Docking Simulation , Ionic Liquids/chemistry , Insulin Aspart , Cations , Anions , Water/chemistryABSTRACT
Purpose: The performance ability of position logic circuitry of gamma-camera to superimpose the X-Y gains obtained from different pulse height analyzers is multiple window spatial registration (MWSR). This study was conducted to evaluate the feasibility of dual-tracer method using 99mTc and 131I to assess MWSR. Materials and Methods: The procedure was carried out on a dual-head gamma-camera with rectangular NaI (Tl) crystal using a point source containing 99mTc pertechnetate and 131I-NaI. Pixel coordinates, full width at half-maximum of point spread function at 364 keV and 140 keV, and pixels with maximum count of images for dual detectors were analyzed and compared. Results: The experiment demonstrated an excellent correlation between the X and Y coordinates identified on 364 keV and 140 keV images (Spearman's coefficient of rank correlation: 0.9, P < 0.0001). Intraclass correlation of studies performed on two separate occasions showed a good correlation (k = 0.87) demonstrating the reproducibility of the procedure. Conclusion: Dual-tracer method for evaluation of MWSR is a reproducible, accurate, and logical alternative to the routine National Electrical Manufacturers Association procedure.
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Background: There is a need to monitor the fluoride content of dentifrices used for children in a country like India, where there is prevalence of endemic fluorosis. Aim: To evaluate the fluoride content of dentifrices for children available in India. Settings and Design: In vitro study in a laboratory setting. Methods: About 27 major supermarkets/departmental stores in Chennai city were approached by the investigator. All dentifrices indicated for children, available in these stores were included in the present study. A total of four different dentifrice brands were procured from these outlets. For each brand of dentifrice, three samples were randomly chosen and used for fluoride analysis. The fluoride content was assessed in triplet by using spectrophotometric analysis, by a single blinded examiner. The test sample was compared to a standard solution, in a calibration curve to determine the fluoride concentration. Results: The mean fluoride content of dentifrices, indicated for children was 449.5 ± 26.1 ppm. Conclusions: All brands of commercially available dentifrices indicated for children had optimum amount of fluoride.
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AIM: Evidence-based intervention is an effective method for improving autism spectrum disorder (ASD) in children on socialization, behavior, and communication and may have an impact on brain activity. The aim of this study is to find the effectiveness of picture exchange communication system (PECS) and parent-implemented intervention (PII) among ASD children. MATERIALS AND METHODS: Sixty ASD children who fulfilled the inclusion criteria were selected and assigned into control (n=30) and experimental (n=30) groups. The experimental group received evidence-based intervention with PECS and PII for 6 months, whereas the control group received routine care. The children were assessed for social relationship and reciprocity (SRR) and speech language communication (SLC) before and after the intervention. For the experimental group, a 3-month post-intervention was also assessed. Parametric and nonparametric statistical methods were used. RESULTS: The data showed that male nuclear family and birth order above 1 was more among ASD. Two-way RM ANOVA showed a significant difference among the groups and tests (P < 0.001) and interaction of groups with tests (P < 0.001). Experimental post-test-2, that is, after 6 months, showed significant improvement in SRR and SLC compared with the control group. CONCLUSION: The present study shows that the PECS and PII as a nursing strategy can improve ASD children socialization and communication.
Subject(s)
Autism Spectrum Disorder , Autism Spectrum Disorder/therapy , Child , Communication , Evidence-Based Medicine , Humans , Male , Parents , Social SkillsABSTRACT
Sampling inspection plans for life tests, called reliability sampling plans, are generally employed to determine the acceptance or non-acceptance of the lot(s) of finished products by performing tests on the sampled items, measuring the lifetime of the items and observing the number of failures of items. Lifetime of individual items is a prime quality characteristic that can be treated as a continuous random variable and can be modeled by an appropriate probability distribution. In this article, double sampling plans for life tests under time censoring with a provision to draw two random samples and to admit a maximum of one failure in the combined samples are formulated assuming that the lifetime random variable follows a Pareto type IV distribution. A methodical procedure for the selection of the plan parameters using reliable life criterion with the desired discrimination protecting the interests of the producer and the consumer in terms of the acceptable reliable life and unacceptable reliable life is evolved. The operating ratio is used as a measure of discrimination in designing the proposed reliability sampling plans.
Subject(s)
Research Design , Specimen Handling , Probability , Reproducibility of ResultsABSTRACT
Background and Aim: Tooth-colored restorative materials for the restoration of decayed posterior teeth continue to gain popularity both among dental practitioners and patients. These materials have undergone a number of improvements in recent years to enhance their physical properties and diversify their use as a restorative material relevant to clinical practice. The aim of this study was to evaluate and compare the fracture resistance of two such advanced restorative materials, namely EverX Posterior, a fiber-reinforced composite and Cention N, an alkasite material in a Class I Cavity. Materials and Methods: Forty intact, caries-free human maxillary premolar teeth extracted for orthodontic purposes were divided randomly into four groups of 10 teeth each. Group I were unprepared teeth (intact teeth); Group II were unrestored teeth with class I cavity; Group III were teeth restored with fiber-reinforced composite (EverX Posterior); and Group IV were teeth restored using alkasite material (Cention N). Fracture resistance was recorded for all samples using a universal testing machine. Results: Higher fracture resistance was recorded in intact teeth group followed by EverX Posterior, Cention N and unrestored teeth, respectively. The teeth restored with EverX Posterior showed higher mean fracture resistance to fractures than those restored with Cention N. Teeth restored with EverX Posterior showed no significant difference in mean fracture resistance from Intact teeth while restored teeth with Cention N and unrestored teeth did. Conclusion: Fracture resistance of EverX Posterior was comparable to that of the natural tooth and was higher as compared to Cention N.
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Accurate diagnosis and staging of malignant melanoma remain crucial components in the overall treatment and prognosis of the patient. Advanced imaging modalities as well as laboratory testing continue to constitute an important part of the workup in melanoma and have seen several developments in recent years. The authors discuss imaging techniques and serum biomarkers used in the assessment of the melanoma patient.
Subject(s)
Melanoma , Skin Neoplasms , Humans , Melanoma/diagnostic imaging , Neoplasm Staging , Prognosis , Skin Neoplasms/diagnostic imaging , Skin Neoplasms/pathology , Tomography, X-Ray ComputedABSTRACT
Cholinium aminoates [Ch][AA] have gained tremendous interest as a promising ionic liquid medium for the synthesis and storage of proteins. However, high alkalinity of [Ch][AA] limits its usage with pH-sensitive proteins. Here, we probed the structure, stability, and interactions of a highly unstable therapeutic protein, insulin aspart (IA), in a range of buffered [Ch][AA] (b-[Ch][AA]) using a combination of biophysical tools and in silico pipeline including ultraviolet-visible, fluorescence, and circular dichroism spectroscopies, dynamic light scattering measurements and molecular docking. b-[Ch][AA] used in the study differed in concentrations and their anionic counterparts. We reveal information on ion and residue specific solvent-protein interactions, demonstrating that the structural stability of IA was enhanced by a buffered cholinium prolinate. In comparison to the glycinate and alaninate anions, the hydrophilic prolinate anions established more hydrogen bonds with the residues of IA and provided a less polar environment that favours the preservation of IA in its active monomeric form, opening new opportunities for utilizing [Ch][AA] as storage medium.
Subject(s)
Ionic Liquids , Anions , Hydrogen Bonding , Insulin Aspart , Ionic Liquids/chemistry , Molecular Docking Simulation , ProteinsABSTRACT
AIM: To evaluate the response of locoregional therapy (LRT) on combined hepatocellular-cholangiocarcinoma (cHCC-CC) and intrahepatic cholangiocarcinoma (IHC) and compare their outcomes with propensity matched hepatocellular carcinoma (HCC) patients. MATERIALS AND METHODS: From January 2011 to July 2020, 13 patients with cHCC-CC (11 men, two women, median age 56 years) and 15 IHC patients (10 men, five women, median age 60 years) were compared with 101 HCC patients (79 men, 22 women, median age 60 years) after LRT. All tumours were proven histologically. Among the 13 cHCC-CC patients, 11 received transarterial chemoembolisation (TACE), one received microwave ablation (MWA) and one received TACE with radiofrequency ablation (RFA). Of 15 IHC patients, eight received TACE, five received RFA, and one received MWA, and one received TACE with RFA. Propensity score matching (PSM) was done with conditional logistic regression adjusted for age, type of LRT, tumour specific features and Child-Pugh score. RESULTS: After LRT, on univariate analysis an objective response was seen in 30% of cHCC-CC and 53% of IHC patients. PSM analysis demonstrated shorter progression-free survival (PFS; cHCC-CC versus HCC: 1.5 versus 7.5 months; IHC versus HCC: 6 versus 14 months, p<0.05), overall survival (OS; cHCC-CC versus HCC: 12 versus 28 months; IHC versus HCC: 18 versus 34 months, p<0.005), and poor objective response (cHCC-CC versus HCC: 25% versus 91%; IHC versus HCC: 58% versus 88%, p<0.05) in cHCC-CC and IHC patients versus HCC patients. Hypovascular tumour, macrovascular invasion, and infiltrative appearance were independent prognostic factors for OS in IHC patients. CONCLUSION: cHCC-CC and IHC are aggressive tumours with a poor objective response, greater distant progression of the disease and shorter PFS and OS post LRT as compared to HCC.
Subject(s)
Ablation Techniques/methods , Bile Duct Neoplasms/therapy , Carcinoma, Hepatocellular/therapy , Chemoembolization, Therapeutic/methods , Cholangiocarcinoma/therapy , Liver Neoplasms/therapy , Aged , Bile Duct Neoplasms/complications , Bile Duct Neoplasms/surgery , Bile Ducts, Intrahepatic/surgery , Carcinoma, Hepatocellular/complications , Carcinoma, Hepatocellular/surgery , Cholangiocarcinoma/complications , Cholangiocarcinoma/surgery , Female , Humans , Liver Neoplasms/complications , Liver Neoplasms/surgery , Male , Middle Aged , Propensity Score , Radiofrequency Ablation , Retrospective Studies , Treatment OutcomeABSTRACT
The study highlights the effect of acid- and base-rich conditions on the proton dynamics of diethylmethylammonium poly[4-styrenesulfonyl(trifluoromethylsulfonyl)imide, [DEMA][PSTFSI], a polymerized protic ionic liquid designed as a polymer electrolyte for nonhumidified polymer electrolyte membrane fuel cells. Different proportions of triflic acid (HTf) and diethylmethylamine (DEMA) were added to the pristine polymer. The thermal analysis of the mixtures revealed that the addition of the base increases the glassy/amorphous nature of the polymer; however, HTf plasticizes the polymer and lowers the Tg value, so that it falls outside of the differential scanning calorimetry-studied temperature range. 50 mol % doping of the HTf contents increases the conductivity upto 0.952 mS cm-1, and 50 mol % DEMA mixture has a conductivity of 0.169 mS cm-1 at 100 °C. Vogel-Tamman-Fulcher fitting of the ionic conductivities of the doped systems suggested that the ionic conductivities are completely decoupled from segmental motion of the polymer. A combination of Fourier transform infrared and static NMR studies demonstrated that HTf-added polymer composites show conduction via Grotthuss and vehicular mechanisms, while DEMA-added polymer composites show predominantly a Grotthuss mechanism by developing the aggregates of proton and added base.
Subject(s)
Imides , Ionic Liquids , Diethylamines , Mesylates , ProtonsABSTRACT
A dearth of inexpensive means of energy storage is constraining the expansion of intermittent renewable energy sources such as sun and wind. Thermal energy storage technology utilizing phase-change materials (PCMs) is a promising solution, enabling storage of large quantities of thermal energy at a relatively low cost. Guanidinium mesylate, which melts at 208 °C with latent heat of fusion of ΔHf =190â J g-1 is a promising PCM candidate for these applications.[1] Here, studies on guanidinium organic salts were conducted, including heat capacity, thermal conductivity, advanced thermal stability, long-term cycling, and economic analysis. The data place guanidinium mesylate among the best PCMs operating in the 100-220 °C temperature region in terms of thermal energy storage, with total volumetric energy storage measured as 622â MJ m-3 (173â kWh m-3 ). Additionally, it was shown to be stable during cycling, with over 400â cycles performed. Simple economic analysis indicated a cost of 6 USD per MJ of stored thermal energy. This study proves that guanidinium mesylate and potentially other similar salts can be feasible as PCMs for inexpensive energy storage for renewable energy storage applications.
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PURPOSE: We aimed to evaluate and compare the efficacy of neem leaves extract with normal saline irrigation practice in wound dressing on healing outcome and clinic-physiological parameters among individuals with diabetic foot ulcer (DFU). METHODS: A quasiexperimental with repeated measures design was used on two study groups. One group received neem leaf extract wound irrigation and another group received normal saline wound irrigation. Study participants were randomly assigned to each group from 100 DFU individuals. Demographic and clinical data sheets were used to collect baseline information. Random blood sugar and HbA1C measurement was performed on the initial day of visit for all participants. We used the PUSH tool for wound assessment (wound surface area, exudate amount, and tissue type), and clinic physiological parameters (temperature, pulse rate, respiration, blood pressure, wound pain, wound infection, and local warmth) assessment was performed at baseline and then at the end of each week till four weeks were completed. Participants attended a foot clinic every 3rd or 4th day for wound care. RESULTS: Reduction of wound healing score (PUSH score) and other wound variables improved significantly in the neem leaves extract group (p < 0.001). There were no significant changes in the clinic-physiological parameters. CONCLUSION: Neem leaves extract irrigation for foot ulcers is considered to be very safe as it did not cause any complication systematically during the study. Neem leaf extract solution can be used as an alternative solution for normal saline. Managing DFU requires continuous foot care and early risk identification of ulcer.
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BACKGROUND AND OBJECTIVES: Cisplatin is one of the major drugs that used in the treatment of oral cancer.Excision repair cross-complementation group 1 (ERCC1) is a key DNA repair gene in the nucleotide excision repair pathway which is activated in the repair of intra- and interstrand DNA crosslink caused by platinum-based treatment. The aim of this study was to investigate the association between polymorphisms in ERCC1 (C118T & C8092A) genes and the response to cisplatin-based chemotherapy. METHODS: ERCC1polymorphisms (C118T & C8092A) were studied using PCR-RFLP method from 150 OSCC patients as cases as well as 150 normal tissues from the same patients were collected as controls for this study. Results: Frequencies of ERCC1 C118C, C118T and T118T genotypes were 60%, 28% and 12% in OSCC patients and 78%, 19% and 3% in the controls, respectively. The C118T & T118T genotype had a 1.69 and 4.97 -folds increased risk for OSCC. Frequencies of ERCC1 C8092C, C8092A and A8092A were 78%, 18% and 4% in the OSCC patients and 89%, 10%, amd 1% in the controls, respectively. The C8092A genotype showed a 1.97-fold increased risk for OSCC. INTERPRETATION & CONCLUSIONS: In conclusion, this study highlights the DNA repair gene polymorphisms that might play a role in mediating susceptibility to oral squamous cell carcinoma and cisplatin therapy. Our data suggest that the ERCC1 C118T, T118T and ERCC1 C8092A genotypes are genetic risk factors for Oral squamous cell carcinoma and ERCC1 118 C/T and C8092A polymorphisms have significant influence on clinical outcome.
Subject(s)
Antineoplastic Agents/therapeutic use , Carcinoma, Squamous Cell/drug therapy , Cisplatin/therapeutic use , DNA-Binding Proteins/genetics , Endonucleases/genetics , Mouth Neoplasms/drug therapy , Polymorphism, Genetic , Adult , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/genetics , Disease-Free Survival , Female , Genotype , Humans , Male , Middle Aged , Mouth Neoplasms/geneticsABSTRACT
Accelerated rate calorimetric studies have been employed to study the exothermic and thermal runaway behaviour of some aprotic and protic ionic liquids based on several families of ions including the bis(flurorsulfonyl)imide anion ([FSI]-); it was found that the protic salts are safer than aprotic salts of the [FSI]- anion.
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The present study is first of its kind that focuses upon the extraction of bromelain from pineapple core waste and stabilising it as insoluble cross-linked aggregates. The influence of process variables such as the choice of precipitant, type of cross-linker, concentration of cross-linker and the reaction time for cross-linking step was investigated upon the activity recovery of bromelain cross-linked aggregates. The optimization of this biocatalyst preparation specifically recovered 87% of the enzymatic activity available in pineapple core waste by ammonium sulphate (60%, w/v) precipitation followed by cross-linking for 4 h with 80 mM glutaraldehyde. Cross-linked bromelain aggregates were thermally more stable and exhibited higher pH stability in comparison to free bromelain. The cross-linked bromelain aggregates exhibited higher operational stability in different organic solvents at 4 °C. The highest operational stability (% stability given in parenthesis) was observed in acetone (100%) followed by hexane (53.6%), ethyl acetate (39.6%), ethanol (32.5%) and chloroform (14.9%). The kinetic studies revealed higher Km value (5.45 mM) after the formation of cross-linked bromelain aggregates as compared to free bromelain (5.04 mM) with almost similar Vmax values. Cross-linked bromelain aggregates also showed significant reusability characteristics with an activity retention of >85% after 5-time cycles. Such recyclability of bromelain cross-linked aggregates could lead to potential industrial applications in both food and non-food sector. In addition, the present extraction method avoids costs related to purification and expensive immobilization carriers.
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Polycystic Ovary Syndrome is a multifactorial reproductive problem and a leading cause of female infertility worldwide. Evidences have shown that Oxidative Stress and decreased antioxidant status are often linked with PCOS. Insulin Resistance in PCOS patients ranges from 50% to 70% and may encourage OS by production of reactive oxygen species.Objective: Our study determines serum MDA levels along with plasma glucose, serum insulin, and insulin resistance in obese and nonobese PCOS subjects.Materials and methods: A case control study was conducted on diagnosed 100 PCOS patients and 100 controls. Fasting plasma glucose was measured by enzymatic method. Insulin was estimated by chemiluminescent microparticle immunoassay using Abott Architect i 2000 SR analyser. Insulin resistance was calculated by HOMA-IR. Malonaldehyde is determined as Thiobarbituric acid reactive substances.Results: CRP and serum MDA levels were increased in women with PCOS irrespective of obesity compared to their respective controls with a p value of < .001. However, though fasting glucose, serum insulin, and IR were increased in both obese and nonobese women with PCOS compared to their BMI adjusted controls with p value of < .001, the values were within reference range in nonobese women.Conclusion: Our study suggests that women with PCOS have oxidative stress and elevated CRP irrespective of obesity. However, hyperinsulinemia and Insulin resistance are seen only in obese women with PCOS, indicating that these women are at high risk for developing low grade inflammation and cardiovascular diseases.
Subject(s)
C-Reactive Protein/metabolism , Hyperinsulinism/blood , Insulin Resistance , Malondialdehyde/blood , Obesity/blood , Polycystic Ovary Syndrome/blood , Adolescent , Adult , Biomarkers/blood , Blood Glucose/metabolism , Body Mass Index , Case-Control Studies , Fasting/blood , Female , Humans , Hyperinsulinism/diagnosis , Hyperinsulinism/pathology , Insulin/blood , Obesity/diagnosis , Obesity/pathology , Ovary/metabolism , Ovary/pathology , Oxidative Stress , Polycystic Ovary Syndrome/diagnosis , Polycystic Ovary Syndrome/pathology , Risk FactorsABSTRACT
Thermal energy storage technology utilizing phase-change materials (PCMs) can be a promising solution for the intermittency of renewable energy sources. This work describes a novel family of PCMs based on the pyrazolium cation, that operate in the 100-200 °C temperature range, offering safe, inexpensive capacity and low supercooling. Thermal stability and extensive cycling tests of the most promising PCM candidate, pyrazolium mesylate (Tm =168±1 °C, ΔHf =160â J g-1 ±5 %, ΔHtotal v =495â MJ m-3 ±5 %) show potential for its use in thermal storage applications. Additionally, this work discusses the molecular origins of the high thermal energy storage capacity of these ionic materials based on their crystal structures, revealing the importance of hydrogen bonds in PCM performance.
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Dental forensics for the resolution of unnatural death remains an underdeveloped field. Accordingly, an experimental study was conducted with six to seven months old Wistar rats that were drowned in order to identify key postmortem features and pattern of dental decomposition. The visual, structural and elemental changes were assessed periodically. Based on mode of death, they were designated as SB (euthanized and soil buried), FWD (fresh water drowned) and SWD (sea water drowned). Postmortem features as well as the structural and elemental patterns of decomposition of teeth were analyzed with Field Emission Scanning Electron Microscopy (FE-SEM) and Energy Dispersive Spectroscopy (EDAX) periodically for two months. The periodic observation of elemental changes in the teeth of SB, FWD and SWD rats allowed us to derive an equation using linear regression analysis to relate the degree of dental decomposition with the time since death. The difference in pattern of surface deterioration was also observed. The present findings could provide a better knowledge in resolving unnatural deaths and supporting evidence for legal prosecution.
Subject(s)
Drowning/pathology , Incisor/pathology , Postmortem Changes , Animals , Burial , Forensic Dentistry/methods , Fresh Water , Linear Models , Microscopy, Electron, Scanning , Models, Animal , Pilot Projects , Rats, Wistar , Seawater , Spectrometry, X-Ray EmissionABSTRACT
Protic ionic liquids containing cations with long alkyl chains can form self-assembled micelles, vesicles, microemulsions, and lyotropic liquid crystal structures in water, acid water or tetrahydrofuran, etc. As a result of this unique property, they are regarded as a novel category of amphiphiles, and are gaining importance in the field of colloid and interface chemistry. The critical micelle concentration (CMC) of protic salts, e.g., alkyl-ammonium nitrates in water, was found to increase with decreasing chain length. It is generally believed that a long alkyl chain length is essential for the formation of self-assembled structures. So far, no self-assembled structure has been reported for protic ionic liquids with an alkyl chain length of n < 4. This paper reports on the structure and dynamics of two imidazolium based protic organic salts with no alkyl chain or a methyl group (n = 1) attached to the cation in water solution, determined through a detailed analysis of NMR spectra and pulsed-field gradient NMR data. We demonstrate that these imidazolium cations with no or a short alkyl chain (n = 1) can form a self-assembled clustering structure in water solution, which has a strong influence on the diffusion behavior of imidazolium molecular ions. It is speculated that this self-assembled structure is likely to be present in other similar solutions of ionic liquids with short alkyl chains.
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Background:Swallowing is affected following stroke. Many studies focus on various aspects of swallowing difficulties (dysphagia) following stroke. However, there are not many studies on the determinants of dysphagia following stroke. The aim of the present study is to establish the association between various factors with the severity of dysphagia. Methods: After screening for Mann Assessment of Swallowing Ability (MASA),110 patients, post-stroke were selected using consecutive sampling to assess the common risk factors, namely the presence of diabetes mellitus, dyslipidemia, hypertension, alcohol usage and smoking habits. Additionally, other variables such as age, gender, type of lesion, side of lesion, tobacco chewing, speech disorders, arterial dysfunction, lobe involvement and Brunnstrom's stages, were also evaluated using a structured interview method. ï£2 (chi-squared) analysis was carried outto find out the association between the selected determinants and severity of dysphagia following stroke.Results: It was found that age and Brunnstrom's stages are the determinants of dysphagia, as analysis showed a strong association with a p value < 0.001. A marginal association between post-stroke dysphagia and type of lesion with a p value of 0.056 was also observed.Conclusions: Among15 factors evaluated, age, type of lesion and Brunnstrom's stages showed a significant association with the severity of dysphagia following stroke. This study advocates early dysphagia management for elderly patients with high Brunnstrom's grading, for those who are not expected to spontaneously recover following stroke, and for earlier and better community rehabilitation