Difference In Time Research Articles

The Effects of Anchoring a Fatiguing Forearm Flexion Task to a High vs. Low Rating of Perceived Exertion on Torque and Neuromuscular Responses.

Ortega, DG, Housh, TJ, Smith, RW, Arnett, JE, Neltner, TJ, Schmidt, RJ, and Johnson, GO. The effects of anchoring a fatiguing forearm flexion task to a high versus low rating of perceived exertion on torque and neuromuscular responses. J Strength Cond Res 38(5): e219-e225, 2024-This study examined the torque and neuromuscular responses following sustained, isometric, forearm flexion tasks anchored to 2 ratings of perceived exertion (RPE). Nine men (mean ± SD: age = 21.0 ± 2.4 years; height = 179.5 ± 5.1 cm; body mass = 79.6 ± 11.4 kg) completed maximal voluntary isometric contractions (MVIC) before and after sustained, isometric, forearm flexion tasks to failure anchored to RPE = 2 and RPE = 8. The amplitude (AMP) and mean power frequency (MPF) of the electromyographic (EMG) signal were recorded from the biceps brachii. Normalized torque was divided by normalized EMG AMP to calculate neuromuscular efficiency (NME). A dependent t-test was used to assess the mean difference for time to task failure (TTF). Repeated-measures analysis of variances was used to compare mean differences for MVIC and normalized neuromuscular parameters. There was no significant difference in TTF between RPE = 2 and RPE = 8 (p = 0.713). The MVIC decreased from pretest to posttest at RPE = 2 (p = 0.009) and RPE = 8 (p = 0.003), and posttest MVIC at RPE = 8 was less than that at RPE = 2 (p < 0.001). In addition, NME decreased from pretest to posttest (p = 0.008). There was no change in normalized EMG AMP or EMG MPF (p > 0.05). The current findings indicated that torque responses were intensity specific, but TTF and neuromuscular responses were not. Furthermore, normalized EMG AMP and EMG MPF remained unchanged but NME decreased, likely due to peripheral fatigue and excitation-contraction coupling failure. Thus, this study provides information regarding the neuromuscular responses and mechanisms of fatigue associated with tasks anchored to RPE, which adds to the foundational understanding of the relationship between resistance exercise and the perception of fatigue.

The neural representation of an auditory spatial cue in the primate cortex

Humans make use of small differences in the timing of sounds at the two ears-interaural time differences (ITDs)-to locate their sources. Despite extensive investigation, however, the neural representation of ITDs in the human brain is contentious, particularly the range of ITDs explicitly represented by dedicated neural detectors. Here, using magneto- and electro-encephalography (MEG and EEG), we demonstrate evidence of a sparse neural representation of ITDs in the human cortex. The magnitude of cortical activity to sounds presented via insert earphones oscillated as a function of increasing ITD-within and beyond auditory cortical regions-and listeners rated the perceptual quality of these sounds according to the same oscillating pattern. This pattern was accurately described by a population of model neurons with preferred ITDs constrained to the narrow, sound-frequency-dependent range evident in other mammalian species. When scaled for head size, the distribution of ITD detectors in the human cortex is remarkably like that recorded invivo from the cortex of rhesus monkeys, another large primate that uses ITDs for source localization. The data solve a long-standing issue concerning the neural representation of ITDs in humans and suggest a representation that scales for head size and sound frequency in an optimal manner.

Temporal multiscale modeling of biochemical regulatory networks: Calcium-regulated hepatocyte lipid and glucose metabolism

Hepatocyte lipid and glucose metabolism is regulated not only by major hormones like insulin and glucagon but also by many other factors, including calcium ions. Recently, mitochondria-associated membrane (MAM) dysfunction combined with incorrect IP3-receptor regulation has been shown to result in abnormal calcium signaling in hepatocytes. This dysfunction could further lead to hepatic metabolism pathology. However, the exact contribution of MAM dysfunction, incorrect IP3-receptor regulation and insulin resistance to the calcium-insulin-glucagon interplay is not understood yet. In this work, we analyze the role of abnormal calcium signaling and insulin dysfunction in hepatocytes by proposing a model of hepatocyte metabolic regulatory network with a detailed focus on the model construction details besides the biological aspect. In this work, we analyze the role of abnormal calcium signaling and insulin dysfunction in hepatocytes by proposing a model of hepatocyte metabolic regulatory network. We focus on the model construction details, model validation, and predictions. We describe the dynamic regulation of signaling processes by sigmoid Hill function. In particular, we study the effect of both the Hill function slope and the distance between Hill function extremes on metabolic processes in hepatocytes as a model of nonspecific insulin dysfunction. We also address the significant time difference between characteristic time of glucose hepatic processing and a typical calcium oscillation period in hepatocytes. Our modeling results show that calcium signaling dysfunction results in an abnormal increase in postprandial glucose levels, an abnormal glucose decrease in fasting, and a decreased amount of stored glycogen. An insulin dysfunction of glucose phosphorylation, glucose dephosphorylation, and glycogen breakdown also cause a noticeable effect. We also get some insight into the so-called hepatic insulin resistance paradox, confirming the hypothesis regarding indirect insulin action on hepatocytes via dysfunctional adipocyte lipolysis.

Pediatric cardiomyopathy illustrates the importance of reinterpreting the significance of genetic variants

BackgroundClinical genetic testing is increasingly being utilized to establish a molecular diagnosis to help manage children with cardiomyopathy and to assess the risk of cardiomyopathy among family members. However, as evidence and guidelines evolve, variant classification can change with the potential to impact counseling and family screening. ObjectivesThe main purpose of this study was to investigate whether variants in cardiomyopathy genes previously interpreted by clinical genetic testing laboratories would be reclassified under current guidelines for the interpretation of sequence variants. MethodsIn 211 children enrolled in the Pediatric Cardiomyopathy Registry, we compared the results of previous clinical genetic testing with the results of research testing in 37 cardiomyopathy genes. ResultsThe mean time difference between initial testing and reinterpretation was 7 years. Using the 2015 American College of Medical Genetics and Genomics guidelines for the interpretation of sequence variants, we found that 18 % of the tested population had a change in variant classification. Ninety-two percent of the initial classifications were performed before the publication of the guidelines with 82 % of reclassifications resulting in a variant downgrade. Most of these were changes from the pathogenic or likely pathogenic category to a variant of uncertain significance. Reclassification frequency was similar across types of cardiomyopathy. ConclusionOur results highlight that a portion of variants get downgraded, and periodic reinterpretation of genetic testing results is necessary for all types of cardiomyopathy—particularly for variant interpretations prior to 2015. Importantly, variant reclassification has potential impact on the clinical management of at-risk patients.

Fast iterative shooter localization in urban terrain using ray casting.

This study presents a method for real-time capable localization of impulsive acoustic events in urban terrain, omitting the need for precomputation phases, such as in time matching or impulse response matching. Using ray casting, solutions of the wave equation are computed using a boundary discretization of intersected objects, forming a weighted graph using line of sight checks, and deploying an A* search graph traversal algorithm for the calculation of the propagation time. Subsequently, the wave amplitude along the identified eigenrays is computed. The study discusses the properties and suitability of cost functions based on time differences of arrival, amplitude differences of arrival, and a combined cost function for iterative ray-based localization. The method is validated using pressure data of the muzzle blasts of various firearms collected via unattended ground sensors during an experimental campaign at the military urban combat facility in Walenstadt, Switzerland.

Instrumental analysis of loss of assimilation of English nasal stops in adult Saudi EFL learners' speech

Assimilation of consonant sounds within words and at word boundaries is a common phenomenon in English. However, EFL (English as a Foreign Language) learners may fail to observe the rule which makes their English sound sub-standard. This paper investigates whether adult Saudi EFL learners follow assimilation rules in English. Selected words and phrases spoken by a group of participants, where assimilated nasal sounds were used, were recorded using Praat software. Drawing spectrograms of the sound signals, time taken by participants to pronounce the assimilated sound segments was calculated. The time taken by native speakers of English to pronounce the same sound segments was also checked. The mean values of time taken by participants and native speakers to pronounce each assimilated sound segment were compared, with the assumption that if the participants took more time to pronounce the sound segments, they missed assimilation. The findings revealed that although in comparison to native speakers, Saudi EFL learners clocked slightly higher time duration, for most sounds the difference in time was not significant from the statistical point of view. The conclusion is that Saudi English learners are making efforts to be as close to native speakers as possible in using assimilated nasal sounds in English.

Reverse total shoulder replacement versus anatomical total shoulder replacement for osteoarthritis: population based cohort study using data from the National Joint Registry and Hospital Episode Statistics for England

ObjectivesTo answer a national research priority by comparing the risk-benefit and costs associated with reverse total shoulder replacement (RTSR) and anatomical total shoulder replacement (TSR) in patients having elective primary...

Effect of tranexamic acid on blood loss reduction in patients undergoing orthognathic surgery under hypotensive anesthesia: a single-center, retrospective, observational study.

Orthognathic surgery is a surgical procedure performed by intraoral approach with established and safe techniques; however, excessive blood loss has been reported in rare cases. In response, investigative efforts to identify methods to reduce the amount of blood loss have been made. Among such methods, the administration of tranexamic acid was reported to reduce the amount of intraoperative blood loss. However, few studies to date have reported the effect of tranexamic acid in orthognathic surgery under hypotensive anesthesia. The present study aimed to investigate the effect of the administration of tranexamic acid on intraoperative blood loss in patients undergoing bimaxillary (maxillary and mandibular) orthognathic surgery under hypotensive anesthesia. A total of 156 patients (mean age, 27.0±10.8 years) who underwent bimaxillary orthognathic surgery under hypotensive anesthesia performed by the same surgeon between June 2013 and February 2022 were included in this study. The following data were collected from the medical records of each patient: background factors (age, sex, and body mass index), use of tranexamic acid, surgical procedures, previous medical history, duration of surgery, American Society of Anesthesiology physical status findings before surgery, intraoperative blood loss as a primary outcome, in-out balance, and blood test results. Descriptive statistics were calculated for statistical analysis, and a t -test and the chi-squared test were used for between-group comparisons. Group comparisons were performed after 1:1 propensity score matching to adjust for confounding factors. Statistical significance was set at P<0.05. Comparison between the groups based on the use of tranexamic acid revealed a significant difference in operation time. Propensity score matching analysis revealed that intraoperative blood loss was significantly lower in the tranexamic acid group. The administration of tranexamic acid was effective in reducing intraoperative blood loss in patients undergoing bimaxillary orthognathic surgery under hypotensive anesthesia.

Oral Hygiene Habits and Knowledge Among Dentistry Students and Patients: A Questionnaire Study

Purpose: This study aimed to the compare oral hygiene habits, awareness, and knowledge dental students and patients. Materials &amp; Methods: This study was conducted at Xxx University, Faculty of Dentistry. The study included 266 participants divided into groups of dental students (n=127) and patients (n=127). A structured questionnaire with 65 multiple-choice questions covering demographic information, oral hygiene habits, awareness, and knowledge about dental care was used. All the statistical analyses, including chi-square tests and independent sample t-tests, were performed using IBM SPSS Statistics (version 26.0). Results: There were significant differences in tooth brushing frequency, time and toothpaste type, tooth brushing technique, product they used for dentures, and frequency of toothbrush replacement between dental students and patients (p

Superficial meningioma with bone involvement: surgical strategies and clinical outcomes.

Meningiomas with bone involvement account for 4.5-17% of all intracranial meningiomas. Little is known about whether these meningiomas (WHO grade I) behave differently than meningiomas without bone involvement. We sought to study the relatively uncommon imaging manifestations of meningioma and to evaluate their clinical significance. A single-institution retrospective cohort study of surgically treated superficial meningioma patients between 2011 and 2022 was conducted. Age, sex, preoperative imaging, operative data, and surgical outcomes were reviewed. Imaging variables and outcomes were reported for patients with bone-invading meningiomas and compared with those with nonbone-invading meningiomas. Univariate analyses were also conducted. Of 577 total superficial meningiomas treated surgically, 47 (8.1%) exhibited bone invasion. Most bone-invading meningiomas were parasagittal (n = 29, 61.7%). A total of 12.7% (n = 6) of patients with bone-invading meningioma had recurrence, whereas 9.1% (n = 48) of patients with non-bone-invading meningioma had recurrence (p = 0.426). No significant difference in the median time to recurrence was observed between patients with bone-invading meningiomas and patients with nonbone-invading meningiomas (69.8 months, Q1:53.1; Q3:81.4 months vs. 69.7 months, Q1:47.5; Q3:96.7; p = 0.638). Superficial meningioma with bone involvement had similar outcomes compared to those of superficial meningioma without bone involvement. Hyperostosis in meningioma (WHO grade I) may not be a surrogate for aggressive meningioma behavior.

High-efficiency fabrication of uniform photonic crystals by a vertical deposition method from multiple glass slides of simple moulds and their application in isomer recognitions

Vertical deposition method is a simple, cheap and common method for fabricating photonic crystals (PCs). However, a majority of PCs are obtained based on the traditional vertical deposition method from one glass slide, the method is low efficiency. Herein, it is proposed to efficiently fabricate uniform PCs by an optimized vertical deposition method from double or multiple glass slides of simple moulds. Amounts of SiO2 spheres, distances of two glass slides of moulds, preparation temperatures and different diameters of SiO2 spheres are investigated for obtaining uniform PCs. And different types of PCs (the bottom-middle-top 3D PCs, bilayer 2D PCs and amorphous PCs) are also fabricated based on the optimized vertical deposition method. The above method is a simple, cheap and high-efficiency way for mass production of uniform PCs. Meanwhile, the chemicals with similar refractive indices (isomers and cis-trans isomers) can be easily distinguished under high humidity based on dynamic reflection spectra of the PCs. For example, the difference in the refractive indices of m-xylene and p-xylene is only 0.002, the difference of desorption balance time of PCs is 263 s. The PCs have potential applications in visual detections, isomer recognitions and monitoring of volatilization rates of trace liquids.

Examining Variability in Intra-Hospital Patient Referrals to Specialized Palliative Care: A Comprehensive Analysis of Disciplines and Mortality.

Background: In Austria, specialized palliative care (SPC) access is limited, with unclear referral criteria, making it challenging to identify hospitalized patients requiring SPC and determine referral timing and mortality at the palliative care unit (PCU). Methods: This retrospective cohort study analyzed patients who underwent a palliative care (PC) needs assessment between March 2016 and November 2021 and were subsequently admitted to the PCU of Austria's largest academic hospital. Demographic, clinical, and standardized referral form data were used for analysis, employing descriptive statistics and logistic regression. Results: Out of the 903 assessed patients, 19% were admitted to the PCU, primarily cancer patients (94.7%), with lung (19%) and breast cancer (13%) being most prevalent. Common referral reasons included pain (61%) and nutritional problems (46%). Despite no significant differences in referral times, most patients (78.4%) died in the PCU, with varying outcomes based on cancer type. Referral reasons like pain (OR = 2.3), nutritional problems (OR = 2.4), and end-of-life care (OR = 6.5) were significantly associated with the outcome PCU mortality. Conclusions: This study underscores Austria's SPC access imbalance and emphasizes timely PC integration across disciplines for effective advance care planning and dignified end-of-life experiences in PCUs.

Analysis of the Effect of Time and Cost Performance Risk of Toll Road Project Based on the Principle of Project Management Body of Knowledge

Toll road facilities are needed by the community to improve economic standards with adequate mobility. Toll Road Projects often have delays in the implementation schedule which results in increased project costs. This study aims to determine the effect of the risk of increasing costs on toll road projects caused by delays in project implementation time based on PMBOK guidelines. This research is based on the object of the Japek II Selatan Package III Toll Road project and studies journal literature, surveys, and questionnaires using the SEM Smart PLS program. The effect of risk on cost performance is variable due to the lack of project land readiness. Based on project data from the contract, it was supposed to be completed in December 2020 but was pushed back to mid-2024 estimates. The effect is due to an increase in costs, with a percentage of 2%; in this study, the factor of implementing K3 Projects is in the form of work accident costs. The analysis of SEM PLS shows the effect of time and cost performance on the Planning and Implementation of land readiness indicators, unit price increase, project K3 implementation, and risk management implementation. The study concludes that the risk of increasing costs includes poor planning, which is hampered by land readiness and results in delays in implementation time and year differences that cause changes in material unit prices, resulting in an increase in project costs. Risk Management, as stated in the PMBOK guidelines on Toll Road Projects, must be implemented to reduce the impact of the risk of increasing project costs.

Investigating “social time” in autism to develop a smartphone app: a co-produced consultation with specialist psychologists and psychotherapists

Purpose Although increased social time is associated with healthier lifestyles, autistic people often present in therapy with social time difficulties. Given the growing interest in digital interventions and their applicability for autistic individuals, a social time app could be beneficial to support autistic people to manage social time, but there is limited research in this field, especially that which involves people with lived experience. The purpose of this study was to use co-production to conduct consultations with expert clinicians about the relationship between autism and social time, and the future development of a smartphone app to monitor and support social time in autistic people. Design/methodology/approach A qualitative methodology investigated clinicians’ views on the relationship between autism and social time and potential development of a social time app. Clinicians (N = 8) participated in semi-structured interviews facilitated by a researcher with lived experience of autism. Findings Participants were psychologists and psychotherapists from a specialist autism service. Thematic analysis identified factors associated with social time, such as differences with neurotypical populations, need for balance with non-social time and gender differences. According to participants, advantages of social time were connecting with people and forming relationships, whereas challenges were limited social skills, anxiety and anger and frustration. Suggested features of an app were a user-friendly design, psychoeducational components and prompts and reminders. Potential advantages of the app were support outside of therapy, support in therapy and monitoring emotional responses, whereas challenges were task completion and personalising content. Originality/value Findings reinforce the importance of a balance between social and non-social time for autistic people, which could be monitored and supported using a social time app. Clinicians could incorporate use of this app within psychological therapies to support emotional regulation and general functioning.

The implicit power of positive thinking: The effect of positive episodic simulation on implicit future expectancies.

Previous research demonstrating that positive episodic simulation enhances future expectancies has relied on explicit expectancy measures. The current study investigated the effects of episodic simulation on implicit expectancies. Using the Future Thinking Implicit Relational Assessment Procedure (FT-IRAP), participants made true/false decisions to indicate whether or not they expected positive/negative outcomes after adopting orientations consistent or inconsistent with an optimistic disposition. The outcome measure, DIRAP, was based on response time differences between consistent and inconsistent blocks. Participants then engaged in either positive simulation training, in which they imagined positive future events, or a neutral visualisation task before repeating the FT-IRAP twice following 10-minute intervals. Positive simulation training increased DIRAP scores for don't-expect-negative trials-boosting participants' readiness to affirm that negative events were unlikely to happen to them. Although findings did not generalise across all trial types, they show potential for positive simulation training to enhance implicit future expectancies.

Fast and Fault-Tolerant Passive Hyperbolic Localization Using Sensor Consensus

The accuracy of passive hyperbolic localization applications using Time Difference of Arrival (TDOA) measurements can be severely compromised in non-line-of-sight (NLOS) situations. Consensus functions have been successfully used to provide robust and accurate location estimates in such challenging situations. In this paper, a fast branch-and-bound computational method for finding the global maximum of consensus functions is proposed and the global convergence property of the algorithm is mathematically proven. The performance of the method is illustrated by simulation experiments and real measurements.

Evaluation of Tacrolimus Concentrations and Clinical Outcomes Between Extended and Immediate Release Formulations in Kidney Transplant.

Objectives: Tacrolimus remains the mainstay of immunosuppression in kidney transplantation. Understanding the relationship between therapeutic tacrolimus levels and outcomes of acute rejection, patient/graft survival, and tolerability are important. The relationship between time to therapeutic tacrolimus levels and outcomes has not been well established, specifically with the use of extended release tacrolimus formulation (LCP-Tac). This study investigated time to therapeutic tacrolimus levels of 2 tacrolimus formulations, LCP-Tac and immediate release tacrolimus (IR-Tac), as a predictor of clinical outcomes. Methods: This was a single-center, retrospective, cohort study of kidney transplant recipients at Duke Hospital between 2013-2021. The primary objective evaluated the difference in time to therapeutic tacrolimus levels with LCP-Tac vs IR-Tac regimens. Secondary endpoints included time within therapeutic range during the first 3months post-transplant, incidence of biopsy-proven rejection, development of de novo donor specific antibodies, and patient and allograft survival at 12months post-transplant. Results: 128 patients were included (63 in LCP-Tac group and 65 in IR-Tac group). The time to therapeutic tacrolimus level was similar between formulations (7.2 days with LCP-Tac compared to 6.7days with IR-Tac, P = .63). The time within therapeutic range during the first 3months post-transplant, via modified Rosendaal, was similar with LCP-Tac and IR-Tac (56.1% vs 64.8%, respectively). Rates of biopsy-proven acute rejection at 12months were similar (7/63 (11.1%) compared to 4/65 (6.2%)). There was no difference in patient/graft survival between groups. Conclusions: The time to therapeutic tacrolimus levels did not differ based on tacrolimus formulation and was not correlated with clinical outcomes.

A Partial Maximum Likelihood Method to Estimate Cox Model for Competing Risk Data with Application

Many Research and clinical studies have addressed the occurrence of failure (death). As a result of other (external) factors, which may introduce additional risks that compete with the event under study. The resulting data refers to the complete data on Competing risks, which are affected by time differences. The exact times of occurrence of these risks are known, meaning the times of failure are observed for all observations with certainty. The impact of these risks on the hazard function is estimated based on the Cox proportional hazards model, which is estimated using the partial maximum likelihood method and numerical algorithms for parameter estimation. This includes the effect of variables on the Cox hazard function and the nonparametric part, estimated by assessing the effect of time on the hazard function using the Kaplan-Meier formula and calculating competing risks through the cumulative hazard function. These methods were applied to experimental data through large-scale simulations of different sizes and parameters and for several arithmetic means and standard deviations models. Moreover, applied to real data from a sample of 80 individuals with breast cancer. Analyzing the simulation results and real data revealed that the Downhill algorithm outperforms the Newton-Raphson algorithm in terms of estimation accuracy and efficiency, based on the statistical criterion for comparison, the root mean square error. In addition, competitive risks explained the effect of common variables in increasing competitive risks beyond the hazard function of the Cox model of the Newton-Raphson estimator. While it is converging to the hazard function of the Cox model for the Downhill estimator . Paper type: Research paper

Determining the value of the abdominal core health quality collaborative to support regulatory decisions.

The study objective is to document value created by real-world evidence from the Abdominal Core Health Quality Collaborative (ACHQC) for regulatory decisions. The ACHQC is a national effort that generates data on hernia repair techniques and devices. Two retrospective cohort evaluations compared cost and time of ACHQC analyses to traditional postmarket studies. The first analysis was based on 25 reports submitted to the European Medicines Agency of 20 mesh products for post-market surveillance. A second analysis supported label expansion submitted tothe Food and Drug Administration, Center for Devices and Radiological Health for a robotic-assisted surgery device to include ventral hernia repair. Estimated costs of counterfactual studies, defined as studies that might have been done if the registry had not been available, were derived from a model described in the literature. Return on investment, percentage of cost savings, and time savings were calculated. 45,010 patients contributed to the two analyses. The cost and time differences between individual 25 ACHQC analyses (41,112 patients) and traditional studies ranged from $1.3 to $2.2 million and from 3 to 4.8years, both favoring use of the ACHQC. In the second label expansion analysis (3,898 patients), the estimated return on investment ranged from 11 to 461% with time savings of 5.1years favoring use of the ACHQC. Compared to traditional postmarket studies, use of ACHQC data can result in cost and time savings when used for appropriate regulatory decisions in light of key assumptions.

Effect of bolus property on swallowing dynamics in patients with dysphagia.

Modification of foods or liquids is commonly administered as part of dysphagia treatment. However, no consensus exists on the parameters for defining texture-modified food for patients with dysphagia. The aim of this study was to evaluate the effect of food/liquid material on swallowing physiology in patients with dysphagia and to discuss the optimal food choice for direct swallowing therapy. A total of 140 patients underwent a videofluoroscopic swallowing study using three test foods/liquids: 3 mL of mildly thick liquid (Thick liquid), jelly made of agar and polysaccharide (Jelly) and jelly made of pectin (Reset gel). Outcome measures of videofluoroscopic images, bolus transit time and hyoid movements were compared. The frequency of chewing movements was highest for Jelly, followed by Reset gel and Thick liquid. While the probability of oral residue was the highest for Reset gel, pharyngeal residue after swallowing was high for Thick liquid as compared to Jelly and Reset gel. Oral transit time and pharyngeal transit time for Thick liquid were significantly smaller than that for Jelly and Reset gel. Pharyngeal delay time was significantly smaller for Thick liquid than that for Jelly and Reset gel. There was no difference in hyoid elevation time and hyoid movement time among the conditions. Mildly thick liquid material may be optimal for patients with primarily oral motor function impairment and jelly, such as Reset gel, may be more suitable for patients with primarily pharyngeal motor function impairment or oral and pharyngeal coordinative motor function decline.