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Purpose: The primary aim of this study was to examine the criterion-referenced validity of the Visual Analysis of Swallowing Efficiency and Safety (VASES). As a secondary aim, we examined the concurrent validity of using verbal numerical ratings for VASES as a potential substitute for visual analog scale ratings. Method: Fifty-seven novice raters were prospectively recruited to rate 26 flexible endoscopic evaluations of swallowing (FEES) images (2 times each, randomized)—once using VASES and once using a criterion-referenced scale. Ratings were made for the valleculae, piriforms, epiglottis, laryngeal vestibule, vocal folds, and subglottis. Criterion validity was determined by examining the correlation between VASES and the criterion-referenced scales. The novice raters also provided visual analog scale ratings following verbal numerical ratings. Concurrent validity of using verbal numerical ratings as a potential substitute for visual analog scale ratings was determined by examining the correlation and absolute agreement between both rating methods. Results: Three thousand five hundred eighty-seven ratings were analyzed. Spearman's correlation revealed strong correlations between VASES ratings and criterion-referenced ratings across all anatomic landmarks (ρ = .882–.915). Lin's concordance revealed substantial agreement between numerical ratings and visual analog scale ratings (ρ c = .986). Conclusions: The strong correlations between VASES and the criterion-referenced scales suggest that VASES is a valid method for interpreting pharyngeal residue, penetration, and aspiration during FEES. Furthermore, numerical ratings exhibited substantial agreement with visual analog scales. This suggests that clinicians could provide verbal numerical ratings in lieu of visual analog scale ratings as a potential way to enhance the ease and feasibility of implementing VASES into clinical practice. Supplemental Material: https://doi.org/10.23641/asha.18737072

Medieval music generally refers to western European music between the late 8th and early 15th centuries, although topics concerning Christian liturgy and plainchant reach further back into history. The Latin-Christian realms considered here include Britain ranging from England to St. Andrews, Scotland, the Frankish Empire from France to central Europe, the Spanish territories of Galicia, León, Castile, and Catalonia, the Mediterranean region, Sicily, and the Italian peninsula. Questions of how the music of these peoples was composed, conceived, performed, and preserved during this lengthy period are as many and diverse as the backgrounds and interests of those seeking answers. During the early Middle Ages, music was transmitted orally and the churches of different regions had distinctive liturgies and chants. With the unification of the Christian Church under the Carolingians around the turn of the 9th century, chant came to be written down, early musical notation serving as a memory aid. The relationship of Frankish and other regional chant repertories to that of the papal city of Rome, various attempts to regularize Western plainchant, and the music theory that developed to comprehend it are among the most extensively studied topics of chant scholarship. Religious songs other than chant were also sung, often outside of Church services, in Latin or such vernacular languages as Galician, German, Czech, English, Italian, and Hebrew. Numerous love songs were written in Old Occitan, French, and German. Starting in the 9th century, polyphonic arrangements of chants called organum emerged. In the 12th century, one encounters polyphonic settings of strophic Latin poems called versus and conductus. Sacred polyphony was by then performed at a number of centers, although the organum and conductus composed for Notre Dame Cathedral in Paris in the late 12th and early 13th centuries were the most widely disseminated and stylistically influential genres of their time. Toward the end of the Middle Ages, new genres of polyphonic composition emerged, notably the motet, various French and Italian secular songs, and Mass Ordinary movements. Instrumental music had existed since earliest times but it came to be notated only in the late 13th century in the form of monophonic dance tunes. Most composers of medieval sacred monophony are unknown except for certain authors of hymns, sequences, and chants. The courtly troubadours, trouvères, and Minnesänger are however often identified in manuscript song collections. By the 12th century, composers of polyphony like Leonin and Perotin were known and praised.

Pilot study results suggested that a new form of nicotine oral soluble film relieved smoking cue-provoked acute craving faster than nicotine lozenge or gum. The new nicotine film may provide smokers another choice to relieve acute craving.This study compared the efficacy of the 2.5 mg nicotine oral soluble film to 2 mg nicotine lozenge for acute relief of smoking cue-provoked craving.A randomized, open label, active comparator controlled, parallel group study was conducted with 322 smokers enrolled. After 4 h of abstinence from smoking, eligible subjects were exposed to smoking cues as provocation. Immediately after the post-provocation baseline craving assessment using a 0-100 mm visual analogue scale (VAS), subjects took a randomized single dose of either the 2.5 mg nicotine film or the 2 mg nicotine lozenge. Craving assessments were completed at 50 s, 3 min, 5 min, 7 min, 15 min, 20 min, 25 min and 30 min after drug administration.Both treatments reduced cue-induced craving and had similar maximum effects on craving relief. However, the 2.5 mg nicotine film relieved cue-induced craving to a greater degree than the 2 mg nicotine lozenge at 50 s (mean difference: -4.9, p = 0.014), 3 min (mean difference: -6.7, p = 0.011), and 5 min (mean difference: -5.6, p = 0.049) post-treatment.The study confirmed the results from the pilot study. The 2.5 mg nicotine film relieved cue-provoked craving much quicker than the 2 mg nicotine lozenge while both having similar maximum effects. Nicotine film could be useful to provide quick craving relief for low dependence smokers.

Introduction: A new nicotine film that releases nicotine quickly may lead to faster craving relief.Aims: This study compares the efficacy of 2.5 mg nicotine film with 2 mg nicotine lozenge and 2 mg nicotine gum on relieving provoked craving in low dependence smokers.Methods: A randomised, open-label, active comparators controlled study was conducted in 120 subjects. Subjects were abstinent from smoking for 4 hours prior to being provoked with smoking cues. After post-provocation craving assessment, subjects were administered one dose of the 3 treatments: nicotine film, lozenge, or gum. Craving intensity was then assessed at 50 seconds, 3, 5, 7, 15, 20, 25 and 30 minutes after administration.Results/Findings: Three treatments reduced craving with similar maximum effects. The effect was maintained up to 30 minutes. Nicotine film significantly reduced more craving than lozenge at 50 seconds, 3 and 5 minutes. It also significantly reduced more craving than gum at 50 seconds and 3 minutes. There was no significant difference between lozenge and gum.Conclusions: Nicotine film, lozenge and gum have similar maximum craving relief. Nicotine film significantly reduced more craving than lozenge and gum at early time points. Nicotine film may be particularly useful to provide acute craving relief.

This article takes a look at tenth- and eleventh-century rituals for the consecration of virgins. These rituals are described in detail in liturgical books with prayers, pontificals, chants, and rubrics for services that were presided over by a bishop or sometimes an abbot. The pontificals also contained accounts of monastic profession, church dedication, the consecration of a cemetery, the blessing of altars and other cult objects, and clerical ordination. The article notes that the services for the consecration of virgins were more erratic than comparable ones for clerical ordination. It also discusses ritual studies, which tries to explain the meaning of cultural phenomena through interpretation.

In order to validate the sorption cooler flight design, an Engineering Breadboard (EBB) cooler was developed. Testing of the EBB cooler began in January, 2002, and ended in May, 2003. Throughout this period, the cooler was operated for a total of 4300 hours, during which its performance was verified with respect to the flight requirements. Prior to its construction, all of its components and sub-assemblies were tested individually. Interaction among these subsystems was yet to be validated. The EBB provided this system test prior to the construction of the flight models. In addition, operation of the EBB was used to develop robust operational algorithms, which were implemented in the flight prototype electronics. The prototype electronics were validated by testing with the EBB cooler. All the components for the flight cooler have been built to be functionally equivalent to those of the EBB, with a few exceptions. For this reason, the subassembly interactions and performance in the EBB are considered to be representative of those expected of the flight models. The impact of the differences between the EBB and flight models will be assessed in the following sections. All lessons learned from the EBB tests were implemented in the design and operation of the flight cooler.