{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T23:07:49Z","timestamp":1784675269694,"version":"3.55.0"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T00:00:00Z","timestamp":1765843200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T00:00:00Z","timestamp":1765843200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82272617"],"award-info":[{"award-number":["82272617"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82402972"],"award-info":[{"award-number":["82402972"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004000","name":"Guangzhou Municipal Science and Technology Program key projects","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004000","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Oral Rehabilitation"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Post\u2010stroke dysphagia (PSD) significantly increases the risk of aspiration\u2010related pneumonia. While prior studies have linked abnormal temporal coordination of swallowing motions to aspiration, limited efforts have been made to explore its individualised mechanisms. This study aims to identify the biomechanical mechanisms underlying aspiration in PSD by developing an interpretable machine learning model based on videofluoroscopic swallowing study (VFSS) data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on 135 PSD patients with dysphagia, comprising 547 individual swallowing events. Ten VFSS\u2010based temporal parameters were extracted, with aspiration and non\u2010aspiration used as binary outcome variables. Five machine learning models and the Shapley Additive Explanations (SHAP) method were employed to evaluate variable importance and their non\u2010linear contributions to aspiration risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The support vector machine (SVM) demonstrated the best performance (Accuracy: 92.7%). SHAP analysis identified laryngeal vestibule closure reaction time (LCRT), oral transit time (OTT), laryngeal closure to upper oesophageal sphincter opening interval (LC\u2010UES), upper oesophageal sphincter opening duration (UOD) and stage transition duration (STD) as the most predictive parameters. Further interpretation demonstrated that aspiration results from complex temporal dysregulation rather than delays in isolated actions. Key parameters exhibited nonlinear and interactive effects, highlighting diverse compensatory or maladaptive patterns in impaired swallows.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>By integrating VFSS\u2010derived temporal parameters with interpretable machine learning, this study elucidates aspiration mechanisms in PSD at both the population and individual swallow levels, thereby providing a mechanism\u2010driven basis for precision\u2010guided clinical interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/joor.70124","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:02:18Z","timestamp":1765886538000},"page":"776-785","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Identification of Individualised Aspiration Mechanisms in Post\u2010Stroke Dysphagia: A VFSS\u2010Based Interpretable Machine Learning Approach"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7889-0870","authenticated-orcid":false,"given":"Tingting","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine The Third Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9599-3532","authenticated-orcid":false,"given":"Lian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The Third Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"},{"name":"Department of Rehabilitation Medicine, Union Hospital, Tongji Medical College Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8470-9580","authenticated-orcid":false,"given":"Jia","family":"Qiao","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The Third Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangxiang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Clinical Medical College of Acupuncture Moxibustion and Rehabilitation Guangzhou University of Chinese Medicine  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4322-0690","authenticated-orcid":false,"given":"Zitong","family":"He","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The Third Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunqing","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The Third Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiqiu","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The Third Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The Third Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4137-8053","authenticated-orcid":false,"given":"Zulin","family":"Dou","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The Third Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,16]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000190056.76543.eb"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.5535\/arm.2016.40.1.88"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-023-10575-0"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-013-9506-5"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-024-10707-0"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2021.09.026"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-008-9198-4"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.compbiomed.2022.105458"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12984-024-01329-6"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-019-05687-z"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1109\/TBME.2018.2807487"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/advs.202404211"},{"issue":"12","key":"e_1_2_13_14_1","first-page":"881","article-title":"Chinese Expert Consensus on the Assessment and Treatment of Dysphagia (2017 Edition): Part I\u2014Assessment","volume":"39","author":"Chinese Expert Consensus Group on the Assessment and Treatment of Dysphagia","year":"2017","journal-title":"Chinese Journal of Physical Medicine and Rehabilitation"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-005-0029-6"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-012-9397-x"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-023-10607-9"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2024.107682"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00417897"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1022627411411"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1022643204877"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1010933404324"},{"key":"e_1_2_13_23_1","doi-asserted-by":"crossref","unstructured":"T.ChenandC.Guestrin \u201cXGBoost: A Scalable Tree Boosting System \u201dProceedings of the 22nd ACM SIGKDD International Conference on Knowledge Discovery and Data Mining (2016): 785\u2013794.","DOI":"10.1145\/2939672.2939785"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01483-0"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.102409"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-024-55629-5"},{"key":"e_1_2_13_27_1","unstructured":"S. M.LundbergandS. I.Lee \u201cA Unified Approach to Interpreting Model Predictions \u201dAdvances in Neural Information Processing Systems (2017): 30."},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-6721-5"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10050992"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12975-019-00701-2"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30222"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40141-018-0192-y"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-04939-9"},{"issue":"10","key":"e_1_2_13_34_1","article-title":"Swallowing Therapy for Dysphagia in Acute and Subacute Stroke","volume":"10","author":"Bath P. M.","year":"2018","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2202-10-71"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(24)00053-X"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.4199\/C00027ED1V01Y201103ISP016"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.3233\/NRE-182569"}],"container-title":["Journal of Oral Rehabilitation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/joor.70124","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/joor.70124","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/joor.70124","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T10:38:11Z","timestamp":1773916691000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/joor.70124"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,16]]},"references-count":37,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1111\/joor.70124"],"URL":"https:\/\/doi.org\/10.1111\/joor.70124","archive":["Portico"],"relation":{},"ISSN":["0305-182X","1365-2842"],"issn-type":[{"value":"0305-182X","type":"print"},{"value":"1365-2842","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,16]]},"assertion":[{"value":"2025-06-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}