Search

Balo's concentric sclerosis (BCS) is a rare subtype of multiple sclerosis. Advanced MRI metrics, such as magnetization transfer ratio (MTR), fractional anisotropy (FA), mean diffusivity (MD), and the ratio of total N-acetylaspartate concentration/total creatine concentration (tNAA/tCr) using proton magnetic resonance spectroscopy (1H-MRS), are commonly used in research studies to investigate the effect of a disease modifying therapy (DMT). We report a patient diagnosed with BCS, receiving ocrelizumab, and provide a comparison of the lesion volume, T1-gadolinium lesion volume, MTR, FA, MD, and MRS metrics at baseline, 6- and 12-month follow-up. There was a reduction in Balo's lesion volume on fluid-attenuated inversion recovery (FLAIR) imaging observed in our patient from baseline (23.925 mL) to 12-month follow-up (2.391 mL), with the largest decrease from baseline to 6-month follow-up (3.650 mL). There was no T1-gadolinium enhancement seen at month 6 and 12. The MTR of the lesion did not change significantly (baseline = 50.9%, 6-month = 49.9%, 12-month =50.1%) but the FA increased from 0.188 (at baseline) to 0.304 (at 6 months), while the 12-month follow-up FA was 0.297. We also noted a reduction in MD from baseline (1.333 × 10−3 mm2/s) to 6-month follow-up (1.037 × 10−3 mm2/s), while the 12-month follow-up MD was 1.086 × 10−3 mm2/s. There was a 10.3% increase in tNAA/tCr from 1.583 (at month 0) to 1.747 (at month 12). Our results demonstrate for the first time a direct effect of ocrelizumab on BCS lesions. To validate our findings, more observations are needed in a larger group of BCS patients.

Learning the SQL language for working with relational databases is a fundamental subject for future computer engineers. However, in distance learning contexts or unexpected situations like the COVID-19 pandemic, where students had to follow lectures remotely, they may find it hard to learn. Chatbots are software applications that aim to have conversations with people to help them solve problems or provide support in a specific domain. This paper proposes a chatbot-based learning platform to assist students in learning SQL. A case study has been conducted to evaluate the proposal, with undergraduate computer engineering students using the learning platform to perform SQL queries while being assisted by the chatbot. The results show evidence that students who used the chatbot performed better on the final SQL exam than those who did not. In addition, the research shows positive evidence of the benefits of using such learning platforms to support SQL teaching and learning for both students and lecturers: students use a platform that helps them self-regulate their learning process, while lecturers get interesting metrics on student performance.

Abstract Background Drugs with anticholinergic properties are associated with cognitive adverse effects, especially in patients vulnerable to central muscarinic antagonism. A variety of drugs show weak, moderate or strong anticholinergic effects. Therefore, the cumulative anticholinergic burden should be considered in patients with cognitive impairment. This study aimed to develop a Swedish Anticholinergic Burden Scale (Swe-ABS) to be used in health care and research. Methods A systematic literature review was conducted in PubMed and Ovid Embase to identify previously published tools quantifying anticholinergic drug burden (i.e., exposure). Drugs and grading scores (0–3, no to high anticholinergic activity) were extracted from identified lists. Enteral and parenteral drugs authorized in Sweden were included. Drugs with conflicting scores in the existing lists were assessed by an expert group. Two drugs that were not previously assessed were also added to the evaluation process. Results The systematic literature search identified the following nine anticholinergic burden scales: Anticholinergic Activity Scale, Anticholinergic Burden Classification, updated Anticholinergic Cognitive Burden scale, Anticholinergic Drug Scale, Anticholinergic Load Scale, Anticholinergic Risk Scale, updated Clinician-rated Anticholinergic Scale, German Anticholinergic Burden Scale and Korean Anticholinergic Burden Scale. A list of drugs with significant anticholinergic effects provided by The Swedish National Board of Health and Welfare was included in the process. The suggested Swe-ABS consists of 104 drugs scored as having weak, moderate or strong anticholinergic effects. Two hundred and fifty-six drugs were listed as having no anticholinergic effects based on evaluation in previous scales. In total, 62 drugs were assessed by the expert group. Conclusions Swe-ABS is a simplified method to quantify the anticholinergic burden and is easy to use in clinical practice. Publication of this scale might make clinicians more aware of drugs with anticholinergic properties and patients’ total anticholinergic burden. Further research is needed to validate the Swe-ABS and evaluate anticholinergic exposure versus clinically significant outcomes.

This paper presents an extended work on the Finite Element Method (FEM) simulation of Love Wave (LW) sensors in a liquid medium. Two models are proposed to simulate the multiphysical response of the sensor. Both are extensively described in terms of principle, composition and behavior, making their applications easily reproducible by the sensor community. The first model is a Representative Volume Element (RVE) simulating the transducer and the second focuses on the sensor’s longitudinal (OXZ) cut which simulates the multiphysical responses of the device. Sensitivity of the LW device to variations in the rheological and dielectric properties of liquids is estimated and then compared to a large set of measurements issued from LW sensors presenting different technological characteristics. This integral approach allows for a deeper insight into the multiphysical behavior of the LW sensor. This article also explores the advantages and drawbacks of each model. Both are in good accordance with the measurements and could be used for various applications, for which a non-exhaustive list is proposed in the conclusion.

Abstract Background Cas12a (formerly known as Cpf1), the class II type V CRISPR nuclease, has been widely used for genome editing in mammalian cells and plants due to its distinct characteristics from Cas9. Despite being one of the most robust Cas12a nucleases, LbCas12a in general is less efficient than SpCas9 for genome editing in human cells, animals, and plants. Results To improve the editing efficiency of LbCas12a, we conduct saturation mutagenesis in E. coli and identify 1977 positive point mutations of LbCas12a. We selectively assess the editing efficiency of 56 LbCas12a variants in human cells, identifying an optimal LbCas12a variant (RVQ: G146R/R182V/E795Q) with the most robust editing activity. We further test LbCas12a-RV, LbCas12a-RRV, and LbCas12a-RVQ in plants and find LbCas12a-RV has robust editing activity in rice and tomato protoplasts. Interestingly, LbCas12a-RRV, resulting from the stacking of RV and D156R, displays improved editing efficiency in stably transformed rice and poplar plants, leading to up to 100% editing efficiency in T 0 plants of both plant species. Moreover, this high-efficiency editing occurs even at the non-canonical TTV PAM sites. Conclusions Our results demonstrate that LbCas12a-RVQ is a powerful tool for genome editing in human cells while LbCas12a-RRV confers robust genome editing in plants. Our study reveals the tremendous potential of these LbCas12a variants for advancing precision genome editing applications across a wide range of organisms.

Feng et al. compare the genome-wide binding and activity of two Drosophila Hox transcription factors that determine the identities of different fly legs. For binding events that are Hox specific, two cofactors, Exd and Dll, are used to achieve specificity in non-overlapping leg domains.

This paper proposes triangular region representations based on keypoints detected in images with viewpoint changes. The strongest keypoints in the reference and query images are allocated individually using a previously published contourlet-based approach to determine the keypoints. These selected keypoints serve as vertices of the triangular regions to be transformed into rectangular representations as simple numeric matrices. The suggested representation methods used to form rectangular matrices are full triangle representation (FTR) and a lighter representation called triangle medians and sides representation (TMSR). For the former, the intensity values along the lines connecting the anchor keypoint to the points between the other two triangular vertices form the rows of the representation matrix. These two triangle vertices are located in an allotted window around the anchor keypoint from the nearby keypoints. For the latter, the intensity values on the six triangular lines, medians, and sides formed the resulting rectangular matrix. The proposed representations are validated for image-matching applications using a descriptor-less matching method. Moreover, the performances of these algorithms are compared with those of traditional algorithms. The results confirmed the superiority of the proposed method over these algorithms.

Tuberous sclerosis complex (TSC) is a genetic neurocutaneous disorder that presents with multi-organ involvement, including but not limited to hamartomas in the brain, eyes, heart, lung, liver, kidney, and skin. Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory, autoimmune, demyelinating, central nervous system disorder, targeting the optic nerves and spinal cord. We report a 30-year-old woman with TSC who developed tingling in the legs that gradually involved her abdomen. Additional symptoms included severe vomiting that lasted for a week and spasms in her legs. One month later, she was hospitalized due to difficulty ambulating and tingling in her hands. Magnetic resonance imaging (MRI) of her spine showed longitudinally extensive upper cervical and lower thoracic cord signal changes. MRI scan of her brain showed few non-specific T2 signal changes along with cortical and subcortical tubers. Aquaporin (AQP4) IgG antibody was found to be positive in both serum and cerebrospinal fluid. Accordingly, she was diagnosed with NMOSD, treated with a 5-day course of intravenous steroids, followed by 5 sessions of plasma exchange. After her initial improvement, she was started on rituximab as maintenance therapy. Two years later, she is clinically stable, and her follow-up MRI showed marked improvement.

The utility of AsCas12a can be limited to poor editing efficiency. Here the authors identify a variant, “AsCas12a Ultra”, that has high on-target specificity demonstrated through editing of clinically relevant T cell genes.

Purpose: The purpose of this study was to investigate whether there were indications of restrictions to voice function in our group of gender-diverse people assigned female at birth (GD people[superscript AFAB]) and whether the participants would benefit from professional voice support. Method: We conducted a descriptive, cross-sectional, mixed-methods study combining qualitative content analyses of semistructured interviews, phoniatric examinations, and acoustical voice analyses. Fourteen German-speaking GD peopleAFAB participated. The data were examined for indications of restrictions to voice function according to the results of participant self-evaluation, auditory-perceptual analyses, laryngostroboscopic examinations, and acoustical measurements. Results: All participants presented with indications of restrictions to voice function, with vocal power, voice quality, singing voice, laryngeal function, pitch range/variability, and vocal control having found to be most frequently affected (in over 60% of participants). Sixty-four percent of participants expressed an interest in professional voice support, with clinicians and researchers recommending professional voice support for 67% and 71%, respectively. Conclusions: GD people[superscript AFAB] may experience restrictions to a range of domains of voice function and request or be recommended to participate in professional voice support. Research into this area needs to be intensified so that a more in-depth understanding of the potential voice problems GD people[superscript AFAB] might experience can be produced and members of this group can be provided with more comprehensive, evidence-based, and high-quality professional support if and when they need it.

Designing visual models to describe and conceptualize objects and systems requires abstraction skills and a predisposition for visual interactions. Readily available modeling tools rely on the users’ logical-mathematical and visual-spatial abilities to support modeling design. However, they fall short of mechanisms to tap into the users’ bodily-kinesthetic abilities. This research presents a model-driven framework to automatically develop visual editors to work with Domain Specific Languages in tangible interaction environments. The framework is illustrated through the development of an editor of entity-relationship models supported by augmented reality. The editor usability evaluation indicates good acceptance by users as well as potential to support alternative interactions and to learn database concepts.

BackgroundThe digital age has introduced opportunities and challenges for clinical education and practice caused by infinite incoming information and novel technologies for health. In the interdisciplinary field of communication sciences and disorders (CSD), engagement with digital topics has emerged slower than in other health fields, and effective strategies for accessing, managing, and focusing on digital resources are greatly needed. ObjectiveWe aimed to conceptualize and investigate preferences of stakeholders regarding a digital learning toolbox, an app containing a library of current resources for CSD. This cross-sectional survey study conducted in German-speaking countries investigated professional and student perceptions and preferences regarding such an app’s features, functions, content, and associated concerns. MethodsAn open web-based survey was disseminated to professionals and students in the field of CSD, including speech-language pathologists (SLPs; German: Logopäd*innen), speech-language pathology students, phoniatricians, otolaryngologists, and medical students. Insights into preferences and perceptions across professions, generations, and years of experience regarding a proposed app were investigated. ResultsOf the 164 participants, an overwhelming majority (n=162, 98.8%) indicated readiness to use such an app, and most participants (n=159, 96.9%) perceived the proposed app to be helpful. Participants positively rated app functions that would increase utility (eg, tutorial, quality rating function, filters based on content or topic, and digital format); however, they had varied opinions regarding an app community feature. Regarding app settings, most participants rated the option to share digital resources through social media links (144/164, 87.8%), receive and manage push notifications (130/164, 79.3%), and report technical issues (160/164, 97.6%) positively. However, significant variance was noted across professions (H3=8.006; P=.046) and generations (H3=9.309; P=.03) regarding a username-password function, with SLPs indicating greater perceived usefulness in comparison to speech-language pathology students (P=.045), as was demonstrated by Generation X versus Generation Z (P=.04). Participants perceived a range of clinical topics to be important; however, significant variance was observed across professions, between physicians and SLPs regarding the topic of diagnostics (H3=9.098; P=.03) and therapy (H3=21.236; P

Objective: To study the effect of obesity on retinal structures in African Americans (AAs) and Caucasian Americans (CAs) with relapsing-remitting multiple sclerosis (RRMS).Methodology: About 136 patients with RRMS without history of optic neuritis were divided into two groups, based on body mass index (BMI): 67 obese (40 AA, 27 CA, mean BMI ± SD: 36.7 ± 5.8), and 69 non-obese (23 AA, 46 CA, mean BMI ± SD: 24.0 ± 3.1). The peripapillary retinal nerve fiber layer (pRNFL) thickness was quantified by optical coherence tomography (OCT) and was segmented into quadrant thickness: superior (S), inferior (I), temporal (T), and nasal (N). Papillomacular bundle (PMB) thickness, retinal nerve fiber layer (RNFL), ganglion cell + inner plexiform layer (GCIPL), inner nuclear (INL), outer plexiform (OPL), outer nuclear (ONL), and total macular (TMV) volumes were obtained.Results: Obesity was associated with lower T thickness (58.54 ± 15.2 vs. 61.9 12.4, p = 0.044), higher INL (0.98 ± 0.07 vs. 0.96 ± 0.06, p = 0.034), and lower RNFL (0.77 ± 0.14 vs. 0.82 ± 0.12, p = 0.009) volumes. Obese AA had significantly thinner T (58.54 ± 15.19 vs. 61.91 ± 12.39, p = 0.033), N (68.94 ± 2.7 vs. 77.94 ± 3.3, p = 0.044), and TMV (8.15 ± 0.07 vs. 8.52 ± 0.09, p = 0.003), RNFL (0.74 ± 0.02 vs. 0.82 ± 0.02, p = 0.013), OPL (0.76 ± 0.01 vs. 0.79 ± 0.1, p = 0.050), ONL (1.68 ± 0.031 vs. 1.79 ± 0.038, p = 0.026), and GCIPL (1.78 ± 0.04 vs. 1.9 ± 0.05, p = 0.038) compared to obese CA. Among patients with non-obesity, the ONL was significantly lower in AA (1.78 ± 0.04 vs. 1.9 ± 0.05, p < 0.001).Conclusions: Obesity is associated with retinal structure abnormalities in patients with RRMS. Its impact might be more prominent in AA than CA. Large longitudinal studies are needed to validate our findings.

BackgroundAdvances in digital health and digital learning are transforming the lives of patients, health care providers, and health professional students. In the interdisciplinary field of communication sciences and disorders (CSD), digital uptake and incorporation of digital topics and technologies into clinical training programs has lagged behind other medical fields. There is a need to understand professional and student experiences, opinions, and needs regarding digital health and learning topics so that effective strategies for implementation can be optimized. ObjectiveThis cross-sectional survey study aims to interdisciplinarily investigate professional and student knowledge, use, attitudes, and preferences toward digital health and learning in the German-speaking population. MethodsAn open-ended, web-based survey was developed and conducted with professionals and students in CSD including phoniatricians and otolaryngologists, speech-language pathologists (German: Logopäd*innen), medical students, and speech-language pathology students. Differences in knowledge, use, attitudes, and preferences across profession, generation, and years of experience were analyzed. ResultsA total of 170 participants completed the survey. Respondents demonstrated greater familiarity with digital learning as opposed to eHealth concepts. Significant differences were noted across profession (P

The present study aimed to develop and characterize new heavy metal sensors functionalized by extracellular polymeric substances (EPSs) isolated from a Tunisian thermophilic microalga strain Graesiella sp. The elaborated sensor showed a highly homogeneous character and revealed a microstructural lamellar arrangement, high crystalline nature, and several functional groups. Electrochemical impedance spectroscopy (EIS) and acoustic wave sensing were used as sensing techniques to explore the ability of microalgae-EPS-functionalized sensors to detect cadmium and mercury as heavy metals. For impedimetric measurements, a two-dipole circuit was adopted and showed good-fitted results with a low total error. The acoustic sensor platforms showed good compatibility with EPS in adjacent water. For both EPS-functionalized sensors, metal ions (Cd2+, Hg2+) were successfully detected in the concentration range from 10−10 M to 10−4 M. Impedimetric sensor was more sensitive to Cd2+ at low concentrations before saturation at 10−7 M, while the acoustic sensor exhibited more sensitivity to Hg2+ over the full range. The results highlight a new potential alternative to use microalgae EPSs as a sensitive coating material for the detection of heavy metals. However, its use in a real liquid medium requires further investigation of its selectivity in the presence of other compounds.

BackgroundNumerous publications show that electronic medical records (EMRs) may make an important contribution to increasing the quality of care. There are indications that particularly the medical specialist plays an important role in the use of EMRs in hospitals. ObjectiveThe aim of this study was to examine how, and by which aspects, the relationship between EMR use and the quality of care in hospitals is influenced according to medical specialists. MethodsTo answer this question, a qualitative study was conducted in the period of August-October 2018. Semistructured interviews of around 90 min were conducted with 11 medical specialists from 11 different Dutch hospitals. For analysis of the answers, we used a previously published taxonomy of factors that can influence the use of EMRs. ResultsThe professional experience of the participating medical specialists varied between 5 and 27 years. Using the previously published taxonomy, these medical specialists considered technical barriers the most significant for EMR use. The suboptimal change processes surrounding implementation were also perceived as a major barrier. A final major problem is related to the categories “social” (their relationships with the patients and fellow care providers), “psychological” (based on their personal issues, knowledge, and perceptions), and “time” (the time required to select, implement, and learn how to use EMR systems and subsequently enter data into the system). However, the medical specialists also identified potential technical facilitators, particularly in the assured availability of information to all health care professionals involved in the care of a patient. They see promise in using EMRs for medical decision support to improve the quality of care but consider these possibilities currently lacking. ConclusionsThe 11 medical specialists shared positive experiences with EMR use when comparing it to formerly used paper records. The fact that involved health care professionals can access patient data at any time they need is considered important. However, in practice, potential quality improvement lags as long as decision support cannot be applied because of the lack of a fully coded patient record.

This paper evaluates the effects of circuit training (CT) and super circuit training (SCT) on skill-related fitness components in youth athletes. Skill-related fitness encompasses agility, balance, coordination, speed, power, and reaction time, which are crucial for optimal athletic performance. As youth sports participation continues to rise, effective training interventions that enhance these fitness components are essential for fostering athletic development and reducing injury risks. The study reveals that both CT and SCT are effective methods for improving skill-related fitness in youth athletes. CT typically involves performing a series of exercises targeting different muscle groups in succession, while SCT integrates aerobic and anaerobic exercises into a single workout, often incorporating high-intensity intervals. This review synthesizes existing research to compare the efficacy of these training modalities on various skill-related fitness attributes. Findings indicate that SCT may provide superior benefits for improving cardiovascular endurance and power, while CT is particularly effective for enhancing agility and balance. Furthermore, incorporating functional movements in both training formats encourages engagement and motivation among young athletes. Despite promising results, the study highlights the need for further longitudinal studies to assess the long-term impacts of these training modalities on skill retention and athletic performance. Additionally, the influence of individual factors, such as age, sex, and baseline fitness levels, warrants consideration in future research. Ultimately, this study serves as a foundation for coaches, trainers, and sports organizations to implement evidencebased training programs that maximize the skill-related fitness of youth athletes, thereby promoting healthy development and athletic excellence. [ABSTRACT FROM AUTHOR]

This research paper provides a comparative analysis of assisted versus resisted sprint training, focusing on their effects on acceleration, speed, and biomechanical efficiency in athletes. Sprinting performance is critical in various sports, making the optimization of training methods essential for enhancing athletic capabilities. Assisted sprint training, which utilizes methods such as bungee cords or downhill running, aims to improve acceleration and speed by reducing the resistance faced by the athlete during sprints. Conversely, resisted sprint training involves the application of resistance through techniques like weighted sleds or resistance bands to develop strength and power during the sprinting motion. The paper synthesizes findings from multiple studies to examine the physiological and biomechanical effects of these training modalities. Key performance indicators such as acceleration time, maximum speed, and biomechanical efficiency are evaluated to ascertain which method yields superior results. The analysis reveals that while both training types contribute positively to sprint performance, their mechanisms differ significantly. Assisted sprint training primarily enhances acceleration and speed through improved stride length and frequency, while resisted training focuses on developing strength and power, resulting in better biomechanical efficiency. Additionally, the paper highlights practical implications for coaches and athletes in selecting appropriate training methods based on individual needs and performance goals. Understanding the comparative effectiveness of assisted and resisted sprint training is crucial for optimizing training regimens, enhancing athletic performance, and minimizing injury risks. This paper ultimately contributes to the existing literature by providing a comprehensive overview of these training strategies and their implications for sprint performance in athletes. [ABSTRACT FROM AUTHOR]

Learning the SQL language for working with relational databases is a fundamental subject for future computer engineers. However, in distance learning contexts or unexpected situations like the COVID-19 pandemic, where students had to follow lectures remotely, they may find it hard to learn. Chatbots are software applications that aim to have conversations with people to help them solve problems or provide support in a specific domain. This paper proposes a chatbot-based learning platform to assist students in learning SQL. A case study has been conducted to evaluate the proposal, with undergraduate computer engineering students using the learning platform to perform SQL queries while being assisted by the chatbot. The results show evidence that students who used the chatbot performed better on the final SQL exam than those who did not. In addition, the research shows positive evidence of the benefits of using such learning platforms to support SQL teaching and learning for both students and lecturers: students use a platform that helps them self-regulate their learning process, while lecturers get interesting metrics on student performance. [ABSTRACT FROM AUTHOR]

This paper presents an extended work on the Finite Element Method (FEM) simulation of Love Wave (LW) sensors in a liquid medium. Two models are proposed to simulate the multiphysical response of the sensor. Both are extensively described in terms of principle, composition and behavior, making their applications easily reproducible by the sensor community. The first model is a Representative Volume Element (RVE) simulating the transducer and the second focuses on the sensor's longitudinal (OXZ) cut which simulates the multiphysical responses of the device. Sensitivity of the LW device to variations in the rheological and dielectric properties of liquids is estimated and then compared to a large set of measurements issued from LW sensors presenting different technological characteristics. This integral approach allows for a deeper insight into the multiphysical behavior of the LW sensor. This article also explores the advantages and drawbacks of each model. Both are in good accordance with the measurements and could be used for various applications, for which a non-exhaustive list is proposed in the conclusion. [ABSTRACT FROM AUTHOR]

Botulinum neurotoxin (BoNT) is used for the treatment of a number of ailments. The activity of the toxin that is isolated from bacterial cultures is frequently tested in the mouse lethality assay. Apart from the ethical concerns inherent to this assay, species-specific differences in the affinity for different BoNT serotypes give rise to activity results that differ from the activity in humans. Thus, BoNT/B is more active in mice than in humans. The current study shows that the stimulus-dependent release of a luciferase from a differentiated human neuroblastoma–based reporter cell line (SIMA-hPOMC1-26-Gluc) was inhibited by clostridial and recombinant BoNT/A to the same extent, whereas both clostridial and recombinant BoNT/B inhibited the release to a lesser extent and only at much higher concentrations, reflecting the low activity of BoNT/B in humans. By contrast, the genetically modified BoNT/B-MY, which has increased affinity for human synaptotagmin, and the BoNT/B protein receptor inhibited luciferase release effectively and with an EC50 comparable to recombinant BoNT/A. This was due to an enhanced uptake into the reporter cells of BoNT/B-MY in comparison to the recombinant wild-type toxin. Thus, the SIMA-hPOMC1-26-Gluc cell assay is a versatile tool to determine the activity of different BoNT serotypes providing human-relevant dose-response data.

BackgroundThe digital revolution is rapidly transforming health care and clinical teaching and learning. Relative to other medical fields, the interdisciplinary fields of speech-language pathology (SLP), phoniatrics, and otolaryngology have been slower to take up digital tools for therapeutic, teaching, and learning purposes—a process that was recently expedited by the COVID-19 pandemic. Although many current teaching and learning tools have restricted or institution-only access, there are many openly accessible tools that have gone largely unexplored. To find, use, and evaluate such resources, it is important to be familiar with the structures, concepts, and formats of existing digital tools. ObjectiveThis descriptive study aims to investigate digital learning tools and resources in SLP, phoniatrics, and otolaryngology. Differences in content, learning goals, and digital formats between academic-level learners and clinical-professional learners are explored. MethodsA systematic search of generic and academic search engines (eg, Google and PubMed); the App Store; Google Play Store; and websites of established SLP, phoniatrics, and otolaryngology organizations was conducted. By using specific search terms and detailed inclusion and exclusion criteria, relevant digital resources were identified. These were organized and analyzed according to learner groups, content matter, learning goals and architectures, and digital formats. ResultsWithin- and between-learner group differences among 125 identified tools were investigated. In terms of content, the largest proportion of tools for academic-level learners pertained to anatomy and physiology (60/214, 28%), and that for clinical-professional learners pertained to diagnostic evaluation (47/185, 25.4%). Between groups, the largest differences were observed for anatomy and physiology (academic-level learners: 60/86, 70%; clinical-professional learners: 26/86, 30%) and professional issues (8/28, 29% vs 20/28, 71%). With regard to learning goals, most tools for academic-level learners targeted the performance of procedural skills (50/98, 51%), and those for clinical-professional learners targeted receptive information acquisition (44/62, 71%). Academic-level learners had more tools for supporting higher-level learning goals than clinical-professional learners, specifically tools for performing procedural skills (50/66, 76% vs 16/66, 24%) and strategic skills (8/10, 80% vs 2/10, 20%). Visual formats (eg, pictures or diagrams) were dominant across both learner groups. The greatest between-group differences were observed for interactive formats (45/66, 68% vs 21/66, 32%). ConclusionsThis investigation provides initial insights into openly accessible tools across SLP, phoniatrics, and otolaryngology and their organizing structures. Digital tools in these fields addressed diverse content, although the tools for academic-level learners were greater in number, targeted higher-level learning goals, and had more interactive formats than those for clinical-professional learners. The crucial next steps include investigating the actual use of such tools in practice and students’ and professionals’ attitudes to better improve upon such tools and incorporate them into current and future learning milieus.

Purpose: The purpose of this study was to investigate whether there are indications of gender-related voice problems in our transmasculine participants and to analyze how discrepancies between participant self-evaluations and researcher-led examinations can be best negotiated to ensure a participant-centered interpretation. Method: We conducted a participant-centered mixed-methods study combining qualitative content analyses of semistructured interviews, acoustical voice analyses, and an examination of gender attributions to voice. Fourteen German-speaking transmasculine people, 14 cisfemale control persons, and 7 cismale control persons participated. The data were examined for indications of gender-related voice problems pertaining to vocal gender presentation and gender attribution to voice received from others. Results: Eleven participants (79%) presented with indications of gender-related voice problems. Problems included dissatisfaction with gender-related voice features, difficulties with control of vocal gender presentation, and mismatch between desired gender attribution and gender attributions received from others. Discrepancies between participant self-evaluations and researcher-led examinations were observed in a number of cases. Conclusion: Transmasculine speakers may experience a range of gender-related voice problems. Research and clinical practice with transmasculine people need to be adapted to better match the diversity of the population and the complexity of the processes that shape the production of speaker vocal gender in interaction.