In open-loop operation, this finely-tunable bridge circuit [S1] can deeply null the background response arising from parasitic effects and impedance mismatch to yield excellent signal-tobackground ratios (SBR's) of order ~5−10dB, on resonance. Various components for highresolution 180-degree-phase bridging and background nulling are also illustrated in the circuit diagram. Here R B is the resistance of a nanofabricated bridge resistor on chip (as shown in the inset of Fig. 1) -in practice it is often more convenient to employ another metalized nanobeam whose DC resistance is very close to the DC resistance of the resonator device of interest. This As demonstrated in Fig. S2, typical open-loop measurements of the UHF NEMS responses employing the circuit in Fig. S1 can yield SBR's of ~10dB. This represents a significant improvement over the SBR's of ~0.1−0.5dB typically obtained with the previous scheme [S2,S3] .

Bolus manipulation is a primary treatment strategy in the management of oral-pharyngeal dysphagia. The use of thickening agents to alter bolus rheology is particularly commonplace; however, the precise effects of these alterations on swallowing remain uncertain. The purpose of our study, a prospective, double-blind clinical trial (Level 1b), was to investigate the effects of viscosity on aspiration. One hundred patients with dysphagia were prospectively evaluated with fluoroscopic swallow studies performed across three standardized and randomized conditions: thin liquid barium (THIN), liquid barium thickened with a starch-based agent (STARCH), and liquid barium thickened with a gum-based agent (GUM). Outcome measures included the prevalence of aspiration and score on the Penetration-Aspiration Scale. A total of 23 out of 100 patients exhibited 56 episodes of aspiration. Twenty patients aspirated on THIN, 15 on STARCH, and 11 on GUM bolus conditions (P<0.05, thin vs gum). There were 28 instances of aspiration on THIN, 16 on STARCH, and 12 on GUM. Mean Penetration-Aspiration Scale score ± standard deviation was 2.11 ± 2.22 for THIN, 1.76 ± 1.88 for STARCH, and 1.42 ± 1.47 for GUM conditions, respectively (P<0.001, THIN vs GUM). A clinically significant reduction in the incidence of penetration and aspiration was observed for gum-thickened barium compared with thin liquid barium.

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Aspiration on VFSS is not a normal finding. Penetration is present in 11.4 percent of normal adults and is more common with a liquid bolus.

Esophageal screening identified 44/70 (63%) patients with esophageal disease. Esophageal screening is a simple tool that may guide further esophageal investigation. The sensitivity of esophageal screening is limited (63%). If clinical suspicion is high, formal esophagram should be considered.

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