Several studies have investigated the accuracy of cervical auscultation (CA). However, both the sensitivities and the specificities of CA in detecting dysphagic conditions varied widely among these studies. These wide variations of the accuracy of CA might be caused by differences of the targeted sounds, such as the expiratory sound (ES) and/or swallowing sound (SS). Forty‐six dysphagic patients were served as subjects. Patients who had unoccluded tracheostoma and patients who could not follow the instructions were excluded. During the videofluorographic swallowing study (VFSS), the subjects swallowed 3 ml of yogurt containing barium sulfate. The VFSS images were recorded with acoustic signals including both the swallowing and respiratory sounds detected by our method. Classification of the VFSS images was decided by consensus of the three dentists using a penetration‐aspiration scale (PAS). Recorded VFSS images were classified into the following 2 groups based on PAS: “no or minimum risk group”: PAS1–2; and “possible risk group”: PAS3–8. As a result of the classification of VFSS findings, 30 samples were evaluated as no or minimum risk group and 16 as possible risk group. Twelve observers including 10 dentists other than 3 dentists who evaluated VFSS images and 2 speech pathologists auditorily diagnosed “negative” and “positive.” Sensitivity, specificity, and intra‐rater reliability was calculated for the 3 types of acoustic samples. The sensitivity of the intra‐rater reliability was 60.3% for ES, 76.6% for SS, and 89.9% for ES + SS. The sensitivity of intra‐rater reliability of ES + SS samples was significantly higher than that of ES (p < .01) and SS (p < .05). The sensitivity of intra‐rater reliability of SS was significantly higher than that of ES (p < .01). The specificity of the intra‐rater reliability was 53.7% for ES, 50.3% for SS, and 44.5% for ES + SS. ES + SS might be most useful for detecting the presence of material in the airway.

This research was designed to investigate the acoustic characteristics of voluntary expiratory sounds after swallow for detecting dysphagia. Forty-nine patients with complaints of swallow difficulty received a videofluorographic (VF) examination. They were divided into three groups: nine who did not have any apparent disease (Group N), 22 patients with head and neck cancer (Group H&N) and 18 patients with other diseases including cerebrovascular disease (Group OD). After liquid barium swallows, they exhaled voluntarily without voicing. Videofluorographic findings were classified into four groups: normal (Normal), acceptable swallow (Acceptable), swallow with residue (Resid) and swallows with penetration or aspiration (Pen/Asp). The duration of expiratory sounds was measured on the time waveform. Frequency characteristics of expiratory sounds were obtained using one-third octave band analysis ranging from 62·5 to 2000·0 Hz of central frequency. The averaged level of the 1000·0-Hz band was chosen as the reference band level (RB level). The revised averaged level of each band was obtained by subtracting the RB level from the averaged level of each band. Zero decibel of the revised magnitude of the 125·0-Hz band was set as the critical value to differentiate dysphagia (Resid or Pen/Asp) from no dysphagia (Normal or Acceptable). Comparison of this assessment with VF findings showed a significant percentage agreement (85·4%). These results suggest that frequency characteristics of post-swallow expiratory sounds can differentiate dysphagia from no dysphagia among multiple dysphagic patient groups.

In this paper, the authors will propose the active gait generation of a quadruped robot. The theory that quadruped animals unconsciously generate gaits by some system based on neural networks in the spinal cord is widely accepted. However, how biological neurons or neural networks can generate gaits is not clear. To clarify the gait generation method, one of the solutions is using the neuron model similar to the biological neuron. We developed the quadruped robot system using self-inhibited pulse-type hardware neuron models (P-HNMs), which can output the electrical activity similar to those of biological neurons. The P-HNMs consist of the cell body model and the inhibitory synaptic model. The cell body model periodically outputs pulsed voltages; the inhibitory synaptic model inhibits the pulsed voltages. The pulse period can change by varying the synaptic weight control voltage applied to the P-HNMs. We varied the synaptic weight control voltage according to the pressure on the robot’s toes. Also, we changed the angle of the robot’s joints by a constant angle each time the P-HNMs output a pulse. As a result of the walking experiment, we confirmed that the robot generates walk gait and trot gait according to the moving speed. Also, we clarified the process by which the robot actively generates gaits from the upright state. These results show that animals may not use many biological neurons to generate gaits. Furthermore, the results suggest the possibility of realizing simple and bio-inspired robot control.

Fermilab plans to deliver 5-15 fb ,1 of integrated luminosity to the CDF and D0 experiments. The current i n n e r silicon detectors at CDF SVXIIa and L00 will not tolerate the radiation dose associated with high luminosity running and will need to be replaced. A new readout chip SVX4 has been designed in radiation-hard 0.25 m CMOS technology. Single sided sensors are arranged in a compact structure, called a stave, with integrated readout and cooling systems. This paper describes the general design of the Run IIb system, testing results of prototype electrical components staves, and prototype silicon sensor performance before and after irradiation.

Given the growing interest in using proton beam therapy (PBT) for hepatocellular carcinoma (HCC), it is possible that transarterial chemoembolization (TACE) could be used for selected patients who have previously undergone PBT. However, these cases can be technically challenging to treat and require appropriate preparation. Thus, we aimed to identify angiographic findings in this setting. We retrospectively identified 31 patients (28 men and 3 women, mean age: 69 years, range: 43–84 years) who underwent hepatic angiography plus TACE or transarterial infusion chemotherapy (TAI) for HCC that recurred after PBT (July 2007 to June 2018). We discovered four angiographic findings, which we speculate were related to the previous PBT. 18 patients experienced recurrence in the irradiated field, and 13 patients experienced recurrence outside the irradiated field. 29 patients underwent TACE and only 2 patients underwent TAI. The mean number of previous PBT treatments was 1.3 ± 0.6 (range: 1–4). The median interval from the earliest PBT treatment to hepatic angiography was 559 days (range: 34–5,383 days), and the median interval from the latest PBT treatment to hepatic angiography was 464 days (range: 34–5,383 days). Abnormal staining of the irradiated liver parenchyma was observed in 22 patients, which obscured the angiographic tumor staining in 4 patients. Development of a tortuous tumor feeder vessel was observed in 13 patients. Development of an extrahepatic collateral pathway was observed in 7 patients. Development of an arterioportal or arteriovenous shunt was observed in 4 patients. Based on these findings, we conclude that PBT was associated with various angiographic findings during subsequent transarterial chemotherapy for recurrent HCC, and familiarity with these findings will be important in developing appropriate treatment plans.