bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Tongue Strength Training on Quality of Life in Head and Neck Cancer Patients: Results From a Pilot Interventional Clinical Trial
Authors: Culbert August , Fullerton Amy , Edwards Kaitlyn , Hitchcock Kathryn , Davenport Paul , Ku Jamie , Silver Natalie L 
Published: August 2024

Background: Head and neck cancer (HNC) patients often have dysphagia following surgical and/or chemoradiation treatment, which can lead to reduced quality of life. Some patients suffer from decreased tongue strength and mobility that may cause discomfort and difficulty with swallowing. Our group has developed a patented genioglossus muscle strength trainer (GMST) to increase tongue protrusive force that has been used in patients with sleep apnea. We hypothesized that the GMST device would increase tongue strength in the HNC population. Methods: We conducted an IRB approved, non-randomized, interventional clinical trial of HNC patients with dysphagia to determine the effect of GMST on tongue strength. Our secondary objective was to assess dysphagia quality of life, as determined by questionnaires. Genioglossus muscle strength measurements (measured in Newtons, N) and dysphagia quality of life scores (SWAL-QoL questionnaire) were obtained from enrolled patients at baseline and following 4 weeks of intervention. Treatment was at-home GMST exercise regimen 3 times daily, 5 days per week. Compliance was assessed via review of training logs. Two-sided paired t-tests at significance level α = .05 were performed to assess difference in mean GG muscle strength pre- and post-treatment. Results: Out of 10 patients initially enrolled, 7 patients completed the trial. Eighty-six percent were male and the average age was 60. About 5 patients had surgery plus adjuvant radiation and 2 patients had primary radiation. All patients had baseline dysphagia as determined by patient complaint and/or objective measurement (prior modified barium swallow). No adverse events were reported. We observed a statistically significant increase in genioglossus muscle strength (mean change: 4.0 N, 95% CI 1.1-6.9, P = .015) after 4 weeks of treatment. Patients reported reduced swallowing burden and feeling of stigma around eating based on SWAL-QoL results. Conclusions: Our data suggest that protrusive tongue-training exercises utilizing a novel tongue trainer device is well-tolerated and increases genioglossus muscle strength in treated HNC patients complaining of dysphagia. Patient-reported outcomes based on the SWAL-QoL survey indicate improvements in quality-of-life post-treatment, although our results are limited by small sample size. Larger studies are needed to see if this device could have clinically meaningful results for this difficult-to-treat patient population.
Gaze Sharing, a Double-Edged Sword: Examining the Effect of Real-Time Gaze Sharing Visualizations on Team Performance and Situation Awareness
Authors: Atweh Jad A. , Riggs Sara L. 
Published: August 2024

Objective The goal of this study was to assess how different real-time gaze sharing visualization techniques affect eye tracking metrics, workload, team situation awareness (TSA), and team performance. Background Gaze sharing is a real-time visualization technique that allows teams to know where their team members are looking on a shared display. Gaze sharing visualization techniques are a promising means to improve collaborative performance on simple tasks; however, there needs to be validation of gaze sharing with more complex and dynamic tasks. Methods This study evaluated the effect of gaze sharing on eye tracking metrics, workload, team SA, and team performance in a simulated unmanned aerial vehicle (UAV) command-and-control task. Thirty-five teams of two performed UAV tasks under three conditions: one with no gaze sharing and two with gaze sharing. Gaze sharing was presented using a fixation dot (i.e., a translucent colored dot) and a fixation trail (i.e., a trail of the most recent fixations). Results The results showed that the fixation trail significantly reduced saccadic activity, lowered workload, supported team SA at all levels, and improved performance compared to no gaze sharing; however, the fixation dot had the opposite effect on performance and SA. In fact, having no gaze sharing outperformed the fixation dot. Participants also preferred the fixation trail for its visibility and ability to track and monitor the history of their partner’s gaze. Conclusion The results showed that gaze sharing has the potential to support collaboration, but its effectiveness depends highly on the design and context of use. Application The findings suggest that gaze sharing visualization techniques, like the fixation trail, have the potential to improve teamwork in complex UAV tasks and could have broader applicability in a variety of collaborative settings.
Occupational therapist’s involvement in social prescribing: A qualitative interview study
Authors: Bradley Gemma , Atkin Beth , Atkin Helen , Scott Jason 
Published: August 2024

Introduction: Social prescribing is a process of helping people to access non-medical activities to promote well-being. For occupational therapists, this is not new, although the social prescribing agenda is creating new roles around these approaches. This study aimed to explore how occupational therapists were involved in social prescribing in the United Kingdom and how they would like to contribute to future developments. Method: Semistructured interviews were carried out with 19 occupational therapists who identified they were involved in social prescribing activities. Findings: Thematic analysis led to two over-arching themes: (1) position and identity; and (2) making it work. Conclusion: Participants perceived similarity with social prescribing, leading to difficulty in positioning occupational therapy alongside this role, emotional responses and identity challenge. Points of distinction between the roles were articulated, including occupational therapy being more medical, having oversight of more complex needs and having more senior roles within teams. To manage workflow, occupational therapists delegate to social prescribing workers, although there is a lack of clarity about competence and varying involvement in supervision. Part of desired future involvement included clearer workflow, occupational therapy involvement in supervision and service development and creating legitimacy for both roles to address social determinants of health.
Developing Infectious Disease Outbreak Emergency Communications for Populations With Limited English Proficiency: Insights to Sustain Collaborations Between Local Health Departments and Community-Based Organizations
Authors: SteelFisher Gillian K. , Caporello Hannah L. , Stein Rebekah I. , Lubell Keri M. , Lane Lindsay , Moharam Ali Shakila , Briseño Lisa , Dicent Taillepierre Julio , Rodriguez-Lainz Alfonso , Boyea Alyssa , Espino Laura , Aveling Emma-Louise 
Published: August 2024

Purpose State and local public health departments (LHDs) are encouraged to collaborate with community-based organizations (CBOs) to enhance communication and promote protective practices with communities made vulnerable during emergencies, but there is little evidence-based understanding of practical approaches to fostering collaboration in this context. This research focuses on how collaboration enhances LHD capacity for effective communication for people with limited English proficiency (LEP) during infectious disease outbreaks specifically and strategies to facilitate productive LHD-CBO collaboration. Design Qualitative, telephone interviews, conducted March-October 2021. Setting Rural and urban jurisdictions with Chinese-speaking or Spanish-speaking populations across the United States. Participants 36 LHD and 31 CBO staff working on outreach to Chinese and Spanish speakers during COVID-19. Method Interviews were audio-recorded, transcribed verbatim, and analyzed using a team-based, codebook approach to thematic analysis. Results During COVID-19, CBOs extended LHD capacity to develop and disseminate effective communication, meaning communication that is rapidly in-language, culturally resonant, locally relevant, and trusted. Practical strategies to enable and sustain effective collaboration were needed to address operational dimensions (eg, material and administrative) and relational dimensions (eg, promoting trust and respect). Conclusion Policies and financing to support LHD-CBO collaborations are critical to improving communication with people with LEP and addressing long-standing inequities in outcomes during outbreaks.
Pacritinib and concurrent azole antifungal therapy is deliverable in patients with hematologic malignancies
Authors: Trang Dina , Ngo Dat , Ali Haris , Tinajero Jose 
Published: August 2024

Objective Pacritinib is a novel kinase inhibitor approved for the treatment of adults with intermediate or high-risk primary or secondary myelofibrosis. Strong and moderate CYP3A4 inhibitors, such as some azole antifungals, are contraindicated or recommended to be avoided in combination with pacritinib, respectively. We aim to report our experience in patients who received pacritinib with concurrent azole antifungal therapy. Data Sources We queried for patients with hematologic malignancies in the electronic medical record who received concurrent pacritinib and azole antifungal therapy. Data Summary There were five cases of concurrent pacritinib and azole antifungal therapy in which none of the patients experienced grade 3 or higher non-hematologic toxicities. Some patients required dose modifications and/or interruptions in pacritinib therapy. Conclusion This is the first clinical experience describing concurrent pacritinib and azole antifungals. Our experience shows that in the setting where this interaction cannot be avoided, concurrent administration is feasible with close monitoring and possible empiric dose reductions in select patients.
Predictors of fluid overload in allogeneic hematopoietic cell transplant patients receiving post-transplant cyclophosphamide
Authors: Tsao Megan , Hoeg Rasmus , Pecoraro Joshua , Kuehner Megan , Deen Brittany , Guglielmo Julie 
Published: August 2024

Background Fluid overload (FO) commonly occurs during hospitalization for allogeneic hematopoietic cell transplantation (HCT). Grade 2–4 FO is associated with day +100 non-relapse mortality.1 Post-transplant cyclophosphamide (PTCY) for graft-versus-host disease prevention requires aggressive IV hydration to prevent hemorrhagic cystitis. Materials and Methods This is a single-center, retrospective, observational study conducted at an academic medical center via electronic chart review. Included patients received allogeneic HCT followed by PTCY on days +3 and +4. Patients were excluded for age < 18 years or incarceration. Primary endpoints are incidence of Grade 2–4 FO and associated risk factors. Descriptive and inferential statistics (i.e., Fisher's exact test, multivariable regression analysis) were used. Results Of 97 patients screened, 95 were included and 2 were excluded due to absence of weight measurements needed to grade FO. Median age was 60 years, 66.3% were male, 91.6% received reduced-intensity conditioning, 72.6% received haploidentical HCT, 44.2% were ECOG 0, and 11.6% had diastolic dysfunction. Incidence of grade 2–4 FO was 33.7% (n = 32). Univariate analyses found age (continuous; p = 0.04) and BSA < 1.7 m2 (p = 0.006) as independent factors associated with grade 2–4 FO. Multivariable regression analysis found 3.3% higher risk with every 1-year increase in age ranging from f 20 to 78 years (OR 1.033, 95% CI 1.001, 1.006; p = 0.0453) and 82.8% lower risk with BSA ≥ 1.7 m2 (OR 0.172, 95% CI 0.051, 0.588; p = 0.005) after adjusting for co-variates. Conclusion(s) Increasing age and BSA < 1.7 m2 are risk factors associated with grade 2–4 FO during hospitalization for allogeneic HCT with PTCY.
Dysregulation of tetrahydrobiopterin metabolism in myalgic encephalomyelitis/chronic fatigue syndrome by pentose phosphate pathway
Authors: Bulbule Sarojini , Gottschalk Carl Gunnar , Drosen Molly E. , Peterson Daniel , Arnold Leggy A. , Roy Avik 
Published: August 2024

Background Tetrahydrobiopterin (BH4) and its oxidized derivative dihydrobiopterin (BH2) were found to be strongly elevated in ME/CFS patients with orthostatic intolerance (ME + OI). Objective However, the molecular mechanism of biopterin biogenesis is poorly understood in ME + OI subjects. Here, we report that the activation of the non-oxidative pentose phosphate pathway (PPP) plays a critical role in the biogenesis of biopterins (BH4 and BH2) in ME + OI subjects. Research Design and Results Microarray-based gene screening followed by real-time PCR-based validation, ELISA assay, and finally enzyme kinetic studies of glucose-6-phosphate dehydrogenase (G6PDH), transaldolase (TALDO1), and transketolase (TK) enzymes revealed that the augmentation of anaerobic PPP is critical in the regulations of biopterins. To further investigate, we devised a novel cell culture strategy to induce non-oxidative PPP by treating human microglial cells with ribose-5-phosphate (R5P) under a hypoxic condition of 85%N2/10%CO2/5%O2 followed by the analysis of biopterin metabolism via ELISA, immunoblot, and dual immunocytochemical analyses. Moreover, the siRNA knocking down of the taldo1 gene strongly inhibited the bioavailability of phosphoribosyl pyrophosphate (PRPP), reduced the expressions of purine biosynthetic enzymes, attenuated GTP cyclohydrolase 1 (GTPCH1), and suppressed subsequent production of BH4 and its metabolic conversion to BH2 in R5P-treated and hypoxia-induced C20 human microglia cells. These results confirmed that the activation of non-oxidative PPP is indeed required for the upregulation of both BH4 and BH2 via the purine biosynthetic pathway. To test the functional role of ME + OI plasma-derived biopterins, exogenously added plasma samples of ME + OI plasma with high BH4 upregulated inducible nitric oxide synthase (iNOS) and nitric oxide (NO) in human microglial cells indicating that the non-oxidative PPP-induced-biopterins could stimulate inflammatory response in ME + OI patients. Conclusion Taken together, our current research highlights that the induction of non-oxidative PPP regulates the biogenesis of biopterins contributing to ME/CFS pathogenesis.
Evaluation of the impact of neurology electronic consults (e-consults): Experiences of a neurology resident clinic in a safety-net hospital
Authors: Tardo Lauren , Hirczy Siegfried , Blackburn Kyle , Mejia Maria , Salter Amber , Huynh Melissa , Khan Shaida 
Published: August 2024

Background and Objectives Electronic consults (e-consults) are asynchronous, formalized requests by a provider to involve a specialist to assist with decision making. E-consults are an alternative to face-to-face consultation and are a promising strategy to efficiently address certain requests for advice. The objective of this project was to examine the utility and characteristics of electronic consults utilized in a safety-net hospital outpatient neurology clinic. Methods We retrospectively reviewed e-consults to the neurology clinic from1 January 2021 to 31 September 2021. The reasons for requests and any diagnostic or treatment recommendations were collected. The time to completion of the e-consults and the percentage of e-consult referred for an in-person clinic evaluation were determined as outcome measures. Following each e-consult, the consulting provider completed a survey to gather their assessment on the appropriateness of the consult, time spent answering the consult, and if unnecessary testing or clinic visits were avoided. Results A total of 528 e-consults were completed during the study period. The most frequent e-consult referrals were for headache (22%), stroke/neurovascular (21%), neuropathy/neuritis/disturbance of skin sensation (11%), and seizures/spells (11%). The majority of e-consults (94%) were answered in one business day (defined as occurring within 24 h) with 67% of consults answered the same day (defined as occurring within the same calendar day). The consulting providers reported that more than 90% of e-consults took <15 min to answer, and 84% of e-consult requests were felt to be appropriate. A total 156 (41.4%) patients initially seen as an e-consult were referred for a face-to-face visit within 90 days of the e-consult. Discussion E-consults provided expedited input from neurologists, which is vital in health systems that provide care to vulnerable populations. The majority of e-consults were answered within 1 day of referral, offering rapid access to neurological expertise in comparison to wait times currently encountered for face-to-face visits. Accordingly, e-consults have the potential to expedite treatment for patients, empower primary care providers, and reduce demand for in-person consultations, particularly in large health systems caring for vulnerable populations.
Poor face recognition predicts social anxiety in autism: A short report
Authors: Gehdu Bayparvah Kaur , Gray Katie LH , Cook Richard 
Published: August 2024

In the present study, we sought to examine whether face recognition problems impact the social anxiety experienced by autistic people. Many autistic people – perhaps between 15% and 30% – exhibit severe face recognition problems that closely resemble developmental prosopagnosia. At present, however, little is known about the psychosocial consequences of these difficulties. Autistic participants ( N = 60) with varying degrees of face recognition ability completed two measures of face recognition (the original and Australian variants of the Cambridge Face Memory test), a measure of social anxiety (the Social Interaction Anxiety Scale) and a bespoke survey that enquired about individuals’ experiences of face recognition and social interaction. Relative to autistic individuals with average or above-average face recognition, autistic individuals with poor face recognition described significantly higher levels of social anxiety. Moreover, more than half our participants felt that poor face recognition hampered their social interaction, while more than a third thought that poor face recognition had undermined their efforts to make friends. These initial results suggest that poor face recognition may be an important determinant of social anxiety in autism. Lay abstract Research has shown that some autistic people have severe difficulties in recognising other people’s faces. However, little is understood about how these difficulties impact the daily life and the mental well-being of autistic people. In this study, we asked 60 autistic adults with varying degrees of face recognition ability to complete two tests of face recognition, a questionnaire about social anxiety and a bespoke survey which asked participants about their experiences of face recognition and social interaction. We found that participants who had poor face recognition reported experiencing higher levels of social anxiety compared to those with average or better face recognition skills. More than half felt that their face recognition difficulties affected their social interactions, and over a third believed it hindered their ability to make friends. These findings suggest that face recognition difficulties may contribute to social anxiety among autistic individuals.
Academic achievement in English: Minority home language students in early French immersion
Authors: Sorenson Duncan Tamara , Sutton Ann , Genesee Fred , Chen Xi , Kay-Raining Bird Elizabeth , Pagan Stephanie , Oracheski Joan 
Published: August 2024

Aims and Objectives: Increasingly, students who speak a minority language at home (minority-L1) enroll in Early French Immersion in Canada. A frequent question is the extent to which they develop academic abilities in English. Accordingly, this study asks: (a) Do a similar percentage of minority-L1 students meet provincial standards for academic achievement when tested in English when they attend French immersion compared to English language of instruction? (b) What are the outcomes for minority-L1 students with relatively low English proficiency? and (c) What factors contribute to minority L1-students’ academic achievement when evaluated through English? Methods: We compared performance on province-wide assessments of English reading, writing, and mathematics for Grade 3, minority-L1 students enrolled in French immersion ( n = 196) and in English ( n = 169). Data and Analysis: Chi-square analyses compared the percentage of participants meeting the provincial standard in each academic domain in French immersion and English programs. Predictors of performance within two English proficiency groups ( low and not low) were investigated using binary logistic regression analyses. Findings and Conclusions: In each domain, a similar percentage of minority-L1 students in French immersion and in English met the provincial standard, illustrating that immersion programs are suitable for minority-L1 students. Logistic regression revealed some overlap in individual difference factors, but the constellation of significant predictors differed for students with low English proficiency and those with relatively higher levels of proficiency. Individual learner profiles need to be considered when determining how to support these students. Originality: This study specifically considered performance of minority-L1 students across programs and examined if predictors of achievement in English are comparable for students with different levels of English proficiency. Significance: As school boards work to improve inclusivity within their programs, this study offers much needed evidence concerning the performance of minority-L1 students in dual language programs.
Effect of Chronic Kidney Disease on 30-Day Outcomes in Endovascular Repair of Complex Abdominal Aortic Aneurysm
Authors: Li Renxi , Sidawy Anton , Nguyen Bao-Ngoc 
Published: August 2024

Background Chronic kidney disease (CKD) has been identified as an independent predictor of poorer long-term prognosis after endovascular aneurysm repair (EVAR) for complex abdominal aortic aneurysm (AAA). However, its impact on short-term perioperative outcomes is conflicting, which can be important for preoperative risk stratification. This study aimed to evaluate the 30-day outcomes of patients with CKD following non-ruptured complex EVAR in a national registry. Methods Patients who had EVAR for complex AAA were identified in ACS-NSQIP targeted database from 2012-2022. Complex AAA included juxtarenal, suprarenal, or pararenal proximal extent, Type IV thoracoabdominal aneurysm, and/or aneurysms treated with Zenith Fenestrated endograft. Exclusion criteria included age<18 years, ruptured AAA, acute intraoperative conversion to open, emergency presentation, and dialysis. Multivariable logistic regression was used to compare 30-day postoperative outcomes of CKD and non-CKD patients, where demographics, baseline characteristics, aneurysm diameter, distant aneurysm extent, anesthesia, and concomitant procedures were adjusted. Results There were 695 (39.33%) and 1072 (60.67%) patients with and without CKD, respectively, who underwent EVAR for complex AAA. Patients with and without CKD have comparable 30-day mortality (aOR = 1.165, 95 CI = 0.646-2.099, P = 0.61). However, CKD patients had a higher risk of renal complications (aOR = 2.647, 95 CI = 1.399-5.009, P < 0.01) including higher progressive renal insufficiency (aOR = 3.707, 95 CI = 1.329-10.338, P = 0.01) and acute renal failure requiring renal replacement therapy (aOR = 2.533, 95 CI = 1.139-5.633, P = 0.02). All other 30-day outcomes were comparable between CKD and non-CKD patients. Conclusion Patients with CKD had similar 30-day mortality and morbidity rates but a higher risk of postoperative renal complications. Therefore, meticulous preoperative planning and postoperative management, which may include optimal hydration, appropriate contrast use, and close renal function monitoring, are essential for patients with CKD after complex EVAR.