bluuebunny/crossref_metadata_2025_split huggingface dataset:
Objective and Subjective Clinical Swallowing Outcomes via Telehealth: Reliability in Outpatient Clinical Practice
Authors: Borders James C. , Sevitz Jordanna S. , Malandraki Jaime Bauer , Malandraki Georgia A. , Troche Michelle S. 
Published: February 2021

Purpose
The COVID-19 pandemic has drastically increased the use of telehealth. Prior studies of telehealth clinical swallowing evaluations provide positive evidence for telemanagement of swallowing. However, the reliability of these measures in clinical practice, as opposed to well-controlled research conditions, remains unknown. This study aimed to investigate the reliability of outcome measures derived from clinical swallowing tele-evaluations in real-world clinical practice (e.g., variability in devices and Internet connectivity, lack of in-person clinician assistance, or remote patient/caregiver training).

Method
Seven raters asynchronously judged clinical swallowing tele-evaluations of 12 movement disorders patients. Outcomes included the Timed Water Swallow Test (TWST), Test of Masticating and Swallowing Solids (TOMASS), and common observations of oral intake. Statistical analyses were performed to examine inter- and intrarater reliability, as well as qualitative analyses exploring patient and clinician-specific factors impacting reliability.

Results
Forty-four trials were included for reliability analyses. All rater dyads demonstrated “good” to “excellent” interrater reliability for measures of the TWST (intraclass correlation coefficients [ICCs] ≥ .93) and observations of oral intake (≥ 77% agreement). The majority of TOMASS outcomes demonstrated “good” to “excellent” interrater reliability (ICCs ≥ .84), with the exception of the number of bites (ICCs = .43–.99) and swallows (ICCs = .21–.85). Immediate and delayed intrarater reliability were “excellent” for most raters across all tasks, ranging between ICCs of .63 and 1.00. Exploratory factors potentially impacting reliability included infrequent instances of suboptimal video quality, reduced camera stability, camera distance, and obstruction of the patient's mouth during tasks.

Conclusions
Subjective observations of oral intake and objective measures taken from the TWST and the TOMASS can be reliably measured via telehealth in clinical practice. Our results provide support for the feasibility and reliability of telehealth for outpatient clinical swallowing evaluations during COVID-19 and beyond.

Supplemental Material

https://doi.org/10.23641/asha.13661378
Most massive double black hole 3C 454.3 and powerful gravitational wave radiation
Authors: Volvach A. E. , Volvach L. N. , Larionov M. G. 
Published: February 2021

Aims. A new method for determining the parameters of close double systems of supermassive black holes is proposed.
Methods. We used the ground-based radio telescope in Simeiz (RT-22). Observational data were collected and processed automatically. Harmonic and wavelet data analyses were used to find the components of changes in the flux densities of 3C 454.3.
Results. 3C 454.3 may be the most massive double system in the Universe. We show that when the bulk Lorentz (γ-factor) is taken into account, it is possible to obtain the agreed parameters of the 3C 454.3. We present first estimates of the size and thickness of the accretion disk of the 3C 454.3 obtained directly from the observation data. Based on the obtained data, we consider the characteristics of the gravitational radiation of this system, as well as the lifetime before merging, and possible variations in companion orbits.
Ein Leben lang aktiv – sportbezogene Motive und Ziele über die Lebensspanne
Authors: Gut Vanessa , Schmid Julia , Conzelmann Achim 
Published: February 2021

ZusammenfassungMotivationale Aspekte, wie Motive und Ziele, sind für die Aufnahme und die Aufrechterhaltung sportlicher Aktivitäten von zentraler Bedeutung. Motive und Ziele verändern sich im Laufe des Lebens. Daher beschäftigt sich der Beitrag mit der Frage, welche Motive und Ziele in Abhängigkeit vom Lebensalter wichtig sind. Untersucht werden drei Altersgruppen: das Jugend- und frühe Erwachsenenalter (n = 870), das mittlere Erwachsenenalter (n = 448) sowie das höhere Erwachsenenalter (n = 399). Die Daten wurden deskriptiv beschrieben und mittels einfaktorieller Varianzanalysen mit post-hoc Tests ausgewertet. Die Ergebnisse zeigen, dass es sowohl Motive und Ziele gibt, die über die gesamte Lebensspanne im Fokus sind (z. B. Kontakt), als auch Motive, die nur für bestimmte Altersgruppen von Bedeutung sind (z. B. Risiko / Herausforderung im Jugend- und frühen Erwachsenenalter sowie Alltagskompetenz und kognitive Funktionsfähigkeit im höheren Erwachsenenalter). Die Wichtigkeit von einzelnen Motiven und Zielen variiert über die Lebensspanne. Während in der ersten Lebenshälfte der Fokus eher auf Motiven und Zielen im Sinne der Maximierung von Gewinnen liegt, z. B. Wettkampf / Leistung und Figur / Aussehen, verlieren diese Motive und Ziele im höheren Erwachsenenalter an Wichtigkeit.
Motive zum Sporttreiben im Hochschulkontext: Welche Rolle spielen Geschlecht, Alter, BMI und Fitness?
Authors: Walter Jana , Göb Rebecca , Heyer Tobias , Hagemann Norbert 
Published: February 2021

ZusammenfassungIm vorliegenden Beitrag werden der Zusammenhang von Geschlecht, Alter, BMI und Fitness sowie die individuellen Beweggründe von Universitätsangehörigen zur Teilnahme an Sportaktivitäten ermittelt. Die Erfassung der Sportmotive wurde mit dem Berner Motiv- und Zielinventar im Freizeit- und Gesundheitssport durchgeführt. Es nahmen insgesamt N = 1336 Universitätsangehörige an einer Online-Befragung teil. Die Ergebnisse zeigen, dass Universitätsangehörigen der Motivbereich Fitness / Gesundheit am wichtigsten ist, gefolgt von Aktivierung / Freude. Den geringsten Stellenwert hat das Motiv Wettkampf / Leistung.Weiterhin lassen sich signifikante Unterschiede zwischen den Geschlechts-, Alters-, BMI- und Fitnessgruppen in Bezug auf die Bewertung der Motivbereiche erkennen. Bei den Frauen dominieren die Motivbereiche Figur / Aussehen und Aktivierung / Freude, wohingegen sich bei den Männern signifikant höhere Werte bei Kontakt sowie Wettkampf / Leistung zeigen. Der Motivbereich Fitness / Gesundheit gewinnt mit zunehmendem Alter an Bedeutung, wohingegen der Stellenwert der Motive Wettkampf / Leistung sowie Ablenkung / Katharsis abnimmt. Für die BMI-Gruppen gewinnt das Motiv Figur / Aussehen mit steigendem BMI-Wert an Wichtigkeit. Die Fitnessgruppen bemessen Wettkampf / Leistung mit zunehmendem Fitnessstatus einem höheren Stellenwert, wobei Figur / Aussehen an Bedeutung verliert. Insgesamt deuten die Ergebnisse dieser Studie an, dass es sinnvoll erscheint, die unterschiedlichen Motivausprägungen bei der Planung und Durchführung eines Bewegungsangebotes zu berücksichtigen. Es wird vorgeschlagen, Parallelangebote zu erstellen, die sich hinsichtlich der inhaltlichen Schwerpunkte unterscheiden und damit das Spektrum der Motivausprägungen auffangen können.
Study on cervical cancer screening amongst nurses
Authors: Srivastava Astha , Gupta Bindiya , Lakha Vikas , Singh Shilpa 
Published: February 2021

Objective: To study the knowledge, attitude and practice of nurses at tertiary centre regarding cervical cancer screening.
Material and Methods: Validated questionnaire was circulated amongst staff nurses at tertiary care centre after taking informed consent.
Results and Discussion: Cancer of cervix is the most common genital tract malignancy in female and it is ranked second to breast cancer. It has a positive association with HPV infection. Cervical cancer incidence and mortality have declined substantially following introduction of screening programmes. This present study investigated the knowledge, attitude and practice of nurses at GTB Hospital towards cervical cancer risk factors, sign & symptoms and screening as they are important health professionals. In our study, the results showed that 99% of respondents were aware of Pap smear as screening programme and about 60-70% were aware of HPV as positive organism, but most of them never had a Pap smear done before. Majority of them did not know VIA, VILI and colposcopy as screening techniques.
Conclusion: It may thus be recommended that institutions should periodically organize seminars and training for health personnel especially the nurses which form a group of professionals that should give health education to women about cervical cancer.
Female adnexal tumour of probable wolffian origin: A rare case report
Authors: Dhaduk Nehal , Dagar Mamta , Srivastava Mala , Bhardwaj Punita , Verma Tina , Ganguli Indrani ,   Nayak
Published: February 2021

Introduction: Female adnexal tumour of probable wolffian origin (FATWO), is a rare neoplasm arising within the leaves of a broad ligament or hanging from it or a fallopian tube. It is considered a tumour of low malignant potential which shares similar histological and immunochemical features with mesonephric remnants.
Case: Here we present a case repot of a 40 years old, nulliparous female who presented with acute pain abdomen and fever since 2 days. Her LMP was 30.09.2015 and her past menstrual cycles were irregular. She was nulliparous with history of infertility. In past medical history revealed her to be a known diabetic for 5 years, with uncontrolled blood sugars. Patient was hemodynamically stable. On per abdominal examination there was generalized tenderness all over the abdomen with guarding and rigidity. On per speculum examination vaginal discharge was noted with unhealthy cervix. Per vaginal examination revealed a tender mass of approximately 8 cm × 6 cm was felt on left fornix. All her base line investigations were normal. The salient investigations like CA-125 35.60 IU/L, CEA 3.46, Beta-HCG 2.29 were normal. On imaging, MRI showed a well defined solid cum cystic space occupying lesion of 9 cm × 8 cm arising from left adnexa with evidence of right hemorrhagic adnexal cyst 6 cm × 7 cm and hydro/hematosalpinx noted. There was well defined space occupying lesion in the pelvis on the left of the uterus which is likely a broad ligament leiomyoma. Diagnosis of acute abdomen was made with adnexal mass probably infectious in origin. Injectable antibiotics were started. In view of acute pain abdomen decision for surgical intervention was taken. Laparoscopic findings revealed bilateral ovarian abscess with left sided broad ligament mass (solid consistency) probably leiomyoma. Right tube and ovary were normal. Drainage of tuboovarian abscess with left salpingo-oophorectomy with right salpingectomy with adhesiolysis was done and sent for histopathology. HPE reported Female adnexal tumour of probable wolffian origin (FATWO) which was positive for vimentin and CD10, possibly arising from left sided broad ligament. Patient underwent radical hysterectomy with omentectomy with appendicectomy was done.in view of FATWO.
Conclusion: Female adnexal tumour of probable wolffian origin (FATWO), is a rare neoplasm which is usually considered as benign, although in some cases metastasis on recurrences have been reported even after a long interval following the initial diagnosis. Pre-operative diagnosis of FATWO is very difficult because of the rarity of the disease and paucity of the literature available.
Gestational trophoblastic neoplasia: Retrospective analysis of clinical profile, treatment pattern and outcome
Authors: Kaur Paramjeet , Chauhan Ashok K. , Khurana Anil , Verma Yashpal , Bansal Nupur 
Published: February 2021

Background: Gestational trophoblastic disease is a spectrum of cellular proliferation arising from the placental villous trophoblast. Gestational triphoblastic neoplasia (GTN) is a collective term for GTD that invade locally or metastasize. GTD includes hydatidiform mole (complete and partial) and GTN include invasive mole, choricocarcinoma, placental site trophoblastic tumor and epitheliod trophoblastic tumor.
Aim: To evaluate clinicopathological profile, treatment pattern and clinical outcome in patients with gestational trophoblastic neoplasia (GTN).
Materials and Methods: Twelve cases of gestational trophoblastic neoplasia treated between 2012 to November 2015 in Department of Radiotherapy – II, PGIMS, Rohtak were evaluated in this retrospective study. Data was analyzed on the basis of age, histopathology, stage, type of treatment received and treatment related toxicities. Disease free survival was estimated.
Result: Out of 12 women 7 (58 %) had hydatidiform mole, 4 (33%) invasive mole and 1 (8%) had choriocarcinoma. All the cases were given chemotherapy. Two patients had low risk disease. Among high risk group seven patients had score of less than 7 and five patients had risk score of 7 or higher. Five patients were given single agent methotrexate, seven patients received multidrug regimens. All patients are on regular follow up. One patient (high risk group) expired as she did not receive treatment.
Conclusion: GTN are rare and proliferative disorders with proper diagnosis and treatment most of the cases are amenable to treatment with favorable outcome.
Neoadjuvant chemotherapy in epithelial ovarian cancer: Largest single institute experience
Authors: Kumar Siva 
Published: February 2021

Purpose: Neoadjuvant chemotherapy followed by interval debulking surgery (IDS) is an alternative treatment option, compared to the current standard of care primary debulking surgery for treating advanced epithelial ovarian cancer (EOC). We present our institute experience of neoadjuvant chemotherapy strategy in the management of EOC which is one of the largest single institute experience.
Methods: This is a retrospective analysis of patients with epithelial ovarian cancer who were treated in our institute between 2000 and 2006. Patient with advanced disease by clinical and imaging were treated with 3 cycles ofneoadjuvant chemotherapy and then taken up for interval debulking surgery (IDS) who had static or partial or complete response to chemotherapy. The remaining chemotherapy is delivered after the surgery. Patient who had limited disease had primary debulking surgery and then adjuvant chemotherapy according to institute protocol. Outcomes in terms of disease free and overall survival were analysed.
Results: This retrospective analysis included 59 patients with limited disease who had primary debulking surgeryand 283 patients with advanced disease who recievedneoadjuvant chemotherapy. The median age was 50 years and majority are in the 50-59 years age group. Age more than 60 years represent 14.5%. Postmenopausal women were 55.3% and premenopausal women were 44.7 %. Multiparity is higher 70.2% than the uniparity 16.4% ornulliparity 11.7%. Abdomen distension 42% and pain 25% are the most common symptoms. Advanced stage was the most common presentation 71% with stage III-56.1% and stage IV-14.9%. Among the neoadjuvant chemotherapy group 126/283 (44.5%) had optimal cytoreduction, 44/283 (15.5%) had suboptimal cytoreduction and 113/283 (40%) not suitable for IDS. The 5 year disease free and overall survival was 30.8% and 41.5% in the NACT group with advanced disease and 58.5% and 75.8% in the primary cytoreduction group who had limited diseaserespectively. The 5 years overall survival among the IDS group with optimal cytoreduction was 57.1% and 11.7% for the suboptimal cytoreduction group. The 5 years survival was not affected by the number ofneoadjuvant chemotherapycycles delivered before surgery in the IDS group. Patient who received paclitaxol + carboplatin as first line chemotherapy had better survival than carboplatin alone or cyclophosphamide + cisplatin.
Conclusion: NACT as an alternative option to primary debulking surgery in operable EOC is still debatable. But for patient with high disease burden where optimal cytoreduction is not possible NACT strategy is a valid option. Recent randomised controlled trials from Europe had shown the noninferiority of neoadjuvant chemotherapy followed by IDS when compared to the primary debulking surgery in operable advanced EOC.
Role of intraoperative frozen section in the diagnosis of ovarian tumors: Experience at Gujarat Cancer and Research Institute
Authors: Arora Ruchi 
Published: February 2021

Background: The surgical management of ovarian tumors depends on their correct categorization as benign, borderline or malignant. Ovarian neoplasms are an important cause of morbidity and mortality in women. This study was undertaken to evaluate the accuracy of intra-operative frozen section in the diagnosis of various categories of ovarian neoplasms.
Methods: Intraoperative frozen section diagnosis was retrospectively evaluated in 125 patients with suspected ovarian neoplasms who underwent surgery as primary line of therapy at our institution. This was compared with the final histopathologic diagnosis on paraffin sections.
Results: In 125 patients frozen section report had a sensitivity of 100%, 95.55% and 50% for benign, malignant and borderline tumors respectively. The corresponding specificities were 92.45%, 98.75% and 99.14% respectively. The overall accuracy of frozen section diagnosis was 95.2%. The majority of cases of disagreement were in the mucinous and borderline tumors.
Conclusion: Intraoperative frozen section has high accuracy in the diagnosis of suspected ovarian neoplasms. It is a valuable tool to guide the surgical management of these patients and should be routinely used in all major oncology centers.
Pure primary non gestational choriocarcinoma ovary – diagnostic dilemma and treatment intricacy
Authors: Soni Abhishek , Bansal Nupur , Dhull A. K. , Kaushal Vivek , Chauhan A. K. 
Published: February 2021

Introduction: Germ cell tumors of the ovary include all neoplasm derived from primordial germ cells of the embryonal gonad. Five percent of germ cell tumors are malignant, representing three to five per cent of all ovarian carcinomas of which pure primary non-gestational ovarian choriocarcinoma accounts for less than one per cent of ovarian tumors. Primary choriocarcinoma of ovary could be gestational or nongestational in origin. They pose diagnostic challenges in reproductive age group patients because of elevated human chorionic gonadotrophin (hCG). Non-gestational choriocarcinoma (NGCO) is resistant to single agent chemotherapy, requiring more aggressive combination chemotherapy post surgery. Due to the rarity of the disease, this article reviews the treatment protocol for NGCO.
Methods: All the articles related to choriocarcinoma of ovary at Pubmed, Google scholarly article and Scopus were assessed and reviewed and their references were also reviewed and included in this article.
Discussion: Clinical diagnosis of NGCO is often challenging because the clinical symptoms are often nonspecific and can mimic other, more common conditions that occur in young women, such as a hemorrhagic ovarian cyst, tuboovarian abscess, ovarian torsion, and ectopic pregnancy. The symptoms of vaginal bleeding, elevated hCG level, pelvic pain, and an adnexal mass often lead to incorrect diagnosis of ectopic pregnancy, threatened or incomplete abortion, cervical polyp, or other types of malignancy. Non-gestational choriocarcinomas have been found to be resistant to single agent chemotherapy, have a worse prognosis, and therefore require aggressive combination chemotherapy. Adjuvant chemotherapy with the EMA (etoposide 100mg/m2, methotrexate 100mg/m2, actinomycin-D 0.5mg) regimen may be given, for six to nine courses at seven days interval. Studies suggest that the disease responds well to the combination of surgery and postoperative adjuvant chemotherapy. However, long term effects of such therapy should be further studied with more cases.
Conclusion: Because of the small number of patients with pure ovarian choriocarcinoma, a consensus on the treatment regimen including surgery and chemotherapy is lacking. Surgery with adjuvant combination chemotherapy is the standard treatment of choice.
Outcomes of carcinosarcoma of the uterus
Authors: George Anne , Sebastian Ajit , Thomas Vinotha , Thomas Anitha , Chandy Rachel , Peedicayil Abraham 
Published: February 2021

Objectives: To evaluate the outcome of women with uterine carcinosarcoma.
Methods: The medical records of all patients admitted with uterine carcinosarcoma between January 2012 and October 2015 were reviewed. Baseline characteristics were compared and survival was calculated using Kaplan Meier method and compared using log rank test.
Results: The total number of uterine malignancies operated in our centre over this time period was 247 of which 33 were sarcomas (13%). Median age of presentation was 56 years (21-77 years). Most women were postmenopausal (76%) and 46% of them presented with post menopausal bleeding.There were 16 carcinosarcomas of the uterus. Eight presented at Stage 1 (50%) and the remaining 8 in stage III or IV. All patients had TAH/BSO but only 15 had omentectomy and 12 had pelvic and para-aortic lymphadenectomy. Adjuvant treatment was given only to 10 (63%). Seven patients had expired at the time of follow up. The mean survival was 502 days (304-699) with a median of 284 days. Patients who received adjuvant therapy did better compared to those who did not (p=0.05).
Conclusions: Carcinosarcomas are aggressive tumours and the optimal therapy is yet to be determined. Adequate surgical staging followed by adjuvant therapy improves survival.