Using food redistribution to reduce packing in children with severe food refusal

Positive- and negative-reinforcement-based procedures typically have targeted acceptance for children with severe food refusal; however, these procedures do not always result in successful swallowing. Once acceptance is achieved, some children expel the food repeatedly or pack (hold or pocket) it in their mouths for extended periods of time. This study evaluated the effects of using food redistribution with a bristled massaging toothbrush to reduce packing and increase consumption in 4 children with severe feeding disorders. Packing was reduced for all children. In addition, latency to clean mouth (the duration of time from acceptance to food no longer being present in the child's mouth in the absence of expulsion) for 2 children decreased when the food-redistribution procedure was used. Results are discussed in terms of the potential operant functions of the food-redistribution procedure.     

Using a chaser to decrease packing in children with feeding disorders

Packing is a problematic mealtime behavior that is characterized by pocketing or holding solids or liquids in the mouth without swallowing. In the current study, we examined the effects of a chaser, a liquid or solid consistently accepted and swallowed by the child, to decrease packing of solid foods in 3 children with feeding disorders. During the chaser procedure, the therapist presented the chaser immediately for 2 children or 15 s after each bite presentation for 1 child. The chaser was effective in decreasing packing for all 3 children. The results are discussed in terms of the clinical importance of the findings and directions for future research.     

Efficient atomic packing clusters and glass formation in ternary Al-based metallic glasses

In this article, we propose an efficient atomic packing cluster-based composition protocol to help design Al-based metallic glasses. Its validity is verified by some typical experimental data from the literatures. Furthermore, with this understanding, the Al–Ni–Y alloy system is re-evaluated. As a result, the best glass former Al₈₆Ni₉Y₅ in this system, with the critical thickness of about 500 µm, is successfully fabricated by wedge casting.     

A comparison of Nuk presentation and Nuk redistribution to treat packing

Children with feeding disorders may pack food when they lack the oral‐motor skills, the motivation, or both to swallow. Presenting bites on the tongue with a Nuk brush, or redistribution, replacing packed food on the tongue, are two treatments whose relative efficacy is untested. In the current study, we compared the effects of (a) presenting on an upright spoon, (b) presenting on a Nuk, and (c) redistributing with a Nuk on two product measures of swallowing, which we refer to as 15‐s and 30‐s mouth clean, for three children with feeding disorders. Nuk presentation produced the highest levels of 15‐s mouth clean relative to Nuk redistribution and upright‐spoon presentation across participants. Levels of 30‐s mouth clean were higher during Nuk presentation and Nuk redistribution relative to upright‐spoon presentation for two participants. We discuss the oral‐motor skills and motivational deficits that might account for the findings.     

A new counter-example to Kelvin's conjecture on minimal surfaces

A survey of the published literature on undercooled metallic and oxide melts suggests that phase selection during solidification can be categorized as nucleation controlled or growth controlled. Common characteristics governing the phase-selection pathway have been identified for various alloy systems. It is recognized that when competing stable and metastable phases share the same crystalline characteristics and have comparable interface kinetic coefficients, the principle of nucleation control applies for primary phase formation in a deeply undercooled melt. However, there can be a difference of two or three orders of magnitude in the interface kinetic coefficients for competing phases, either between an ordered intermetallic compound and a disordered solid solution, or between a crystalline phase with a high level of complexity and a simple crystal. In such cases, the principle of growth control will apply; more specifically, the phase with the faster growth kinetics should be favoured and the competing counterpart with sluggish interface kinetics should be suppressed at high undercoolings. Some simple predictions are suggested on the basis of this principle when considering stable and metastable phase diagrams. The specific conditions under which the present categorization is applicable are outlined. Future work is required to elucidate phase competition under conditions of very rapid solidification.     

Further evaluation of modified‐bolus‐placement methods during initial treatment of pediatric feeding disorders

Children with feeding disorders might pack or expel food when they lack the oral‐motor skills, the motivation, or both, to swallow. Bolus placement directly on the tongue with a Nuk (e.g., Milnes et al., 2019) or flipped spoon (e.g., Sharp et al., 2010) is a treatment that researchers generally implement after such behavior emerges (e.g., Girolami et al., 2007). However, Wilkins et al. (2014) tested the relative efficacy of Nuk presentation and upright‐spoon presentation during initial treatment of pediatric feeding disorders. In the current study, we compared the effects of (a) upright‐spoon presentation; (b) Nuk presentation; and (c) flipped‐spoon presentation on two product measures of swallowing: 15‐ and 30‐s mouth clean, and expulsion during the initial treatment of feeding disorders with 5 children. We also monitored lip closure during bite presentation and following bolus placement. Nuk presentation produced the highest levels of mouth clean and the lowest rates of expels relative to upright‐spoon presentation and flipped‐spoon presentation. We discuss potential reasons why modified‐bolus‐placement methods improved feeding behavior and how measures of oral‐motor skills might predict its necessity during initial treatment.     

Web模式下三维装箱问题的一种解决方法

为解决Web模式下多约束三维装箱问题对求解时间和效率的要求,针对混合遗传算法中交叉算子的模式干扰带来的求解速度较慢问题,从优化搜索策略方面入手,引入克隆选择算法(SCA),利用克隆扩增、克隆选择算子完成种群进化,并结合六空间启发式策略对SCA算法加以改进,使两者相辅相成、互相受益。实验表明:本算法对提高Web模式下三维装箱的速度成效显著,且算法效率较高。     

Using a flipped spoon to decrease packing in children with feeding disorders

We evaluated the effects of redistribution and swallow facilitation with a flipped spoon on packing in 2 children with a feeding disorder. For both participants, packing decreased when we implemented the flipped spoon treatment package. Mechanisms responsible for behavior change and areas of future research are discussed.     

A systematic evaluation of food textures to decrease packing and increase oral intake in children with pediatric feeding disorders

This study examined packing (pocketing or holding accepted food in the mouth) in 3 children who were failing to thrive or had inadequate weight gain due to insufficient caloric intake. The results of an analysis of texture indicated that total grams consumed were higher when lower textured foods were presented than when higher textured foods were presented. The gram intake was related directly to levels of packing. That is, high levels of packing were associated with higher textured foods and low gram intake, and low levels of packing were associated with lower textured foods and high gram intake. All participants gained weight when texture of foods was decreased. Packing remained low during follow-up for 2 participants even when the texture of food was increased gradually over time. These data are discussed in relation to avoidance, response effort, and skill deficit.