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Background; Effortful swallowing training (EST) is a remedial method for the training of swallowing-related muscles in the oropharyngeal phase. However, clinical evidence of its effectiveness is insufficient. Aims; To investigate the effects of EST on tongue strength and swallowing function in patients with stroke. Methods & Procedures; Stroke patients with dysphagia were randomly assigned to one of two groups: an experimental group (n = 12) and a control group (n = 12). The experimental group underwent EST, while the control group performed saliva swallowing. Training was conducted 5 days per week for 4 weeks. Both groups underwent conventional dysphagia treatment for 30 min/day, 5 days/week for 4 weeks. Outcomes & Results; Tongue strength was assessed using the Iowa Oral Performance Instrument. The Videofluoroscopic Dysphagia Scale (VDS), based on a videofluoroscopic swallowing study, was used to analyze oropharyngeal swallowing function. The experimental group showed greater improvements in anterior and posterior tongue strength compared with the control group (p = 0.046 and 0.042, respectively), and greater improvement in the oral phases of the VDS (p = 0.017). Conclusions & Implications; We recommend EST as a remedial strategy for improving tongue strength and oral swallowing function in patients with stroke.

One of the greatest strengths of Drosophila genetics is its easily observable and selectable phenotypic markers. The mini-white marker has been widely used as a transgenic marker for Drosophila transgenesis. Flies carrying a mini-white construct can exhibit various eye colors ranging from pale orange to intense red, depending on the insertion site and gene dosage. Because the two copies of the mini-white marker show a stronger orange color, this is often used for selecting progenies carrying two transgenes together in a single chromosome after chromosomal recombination. However, some GAL4 lines available in the fly community originally have very strong red eyes. Without employing another marker, such as GFP, generating a recombinant chromosome with the strong red-eyed GAL4 and a desired UAS-transgene construct may be difficult. Therefore, we decided to change the red eyes of GAL4 lines to orange color. To change the eye color of the fly, we tested the CRISPR/Cas9 method with a guide RNA targeting the white gene with OK371-GAL4 and elav-GAL4. After a simple screening, we have successfully obtained multiple lines of orange-eyed OK371-GAL4 and elav-GAL4 that still maintain their original expression patterns. All of these simple experiments were performed by undergraduate students, allowing them to learn about a variety of different genetic experiments and genome editing while contributing to the fly research community by creating fruit fly lines that will be used in real-world research. [ABSTRACT FROM AUTHOR]

1. Describe the spectrum of provider-reported pediatric palliative care domains discussed and managed during pediatric palliative care - oncology clinic visits and how these differ across initial and follow-up visits. 2. Compare the differences in palliative care domains addressed and managed in visits with pediatric patients with brain tumors versus solid tumors vs leukemia/lymphoma. This retrospective cohort study outlines the content and scope of PPC visits within pediatric oncology. Many domains are addressed in each visit, and significantly more domains were discussed near the end-of-life and in solid tumor visits where symptom management domains predominated compared to other cancer types. Introduction/Context: Pediatric palliative care (PPC) improves end-of-life outcomes for children with cancer. Though PPC visits are the 'intervention' in studies focused on end-of-life care, the content of PPC visits within pediatric oncology is poorly understood. Understand the scope of PPC practice that occurs during PPC outpatient visits for children with cancer. This was a retrospective cohort study of patients 0-27 years with cancer seen in PPC clinic within an academic pediatric oncology center between 2017-2022. During each PPC visit, documenting providers chose the domains discussed or managed (Goals of Care, Symptom Management, and Care Coordination with respective subdomains). Data was abstracted from the electronic health record, PPC clinic database and Cancer Registry. The differences in frequency and type of domains addressed were analyzed by visit type, diagnosis group, proximity to the end-of-life, and year of clinic (2017-2022). There were 1,919 outpatient PPC visits across 351 patients. The median domains discussed per visit (10) did not differ between initial visits (10) and follow-ups (10) or from 2017-2022. Median domains were higher in visits < 90 days compared to visits 91+ days from end-of-life (12 vs. 10, p< 0.0001). Compared to brain tumor or leukemia/lymphoma visits, solid tumor visits addressed more symptom management domains including pain (79.9%), fatigue (33.4%), appetite (28.5%), depression (18.5%, all p< 0.001). Certain Goals of care subdomains were more frequently discussed in follow-ups compared to initial visits, notably around accommodating to the disease (93.2% vs. 86.9; p< 0.0001), advance care planning (16.4% vs. 8.8%; p< 0.0001), and code status (5.8% vs. 2.6%; p=0.01). The scope of PPC practice is broad and each visit encompasses many domains with the most common being care coordination with oncology teams, and helping patients/families cope with the disease. More domains were addressed in solid tumor visits and at the end-of-life. Managing Suffering and Distress / Models of Palliative Care Delivery [ABSTRACT FROM AUTHOR]

Pediatric palliative care (PPC) improves end-of-life (EOL) outcomes for children with cancer. Though PPC visits are the 'intervention' in studies focused on EOL care, the content of PPC visits within pediatric oncology is poorly understood. This study aimed to understand the scope of PPC practice during visits for children with cancer and their families. This was a retrospective cohort study of patients 0–27 years with cancer seen in PPC clinic within an academic pediatric oncology center between 2017 and 2022. During each PPC visit, documenting providers chose the domains discussed or managed (goals of care, symptom management, and care coordination with respective subdomains). Data was abstracted from the electronic health record, PPC clinic database, and Cancer Registry. The differences in frequency and addressed domains were analyzed by demographics, visit type, diagnosis group, and proximity to EOL. Across 351 patients, 1919 outpatient PPC visits occurred. Median domains were higher in visits <90 days vs. 91+ days from EOL (12.0 vs. 10.0; p < 0.0001); pain and hospice collaboration were particularly discussed closer to EOL. Psychological symptoms like anxiety (30.7% vs. 21.1%; p < 0.001) were addressed more in follow-ups than initial visits. Compared to brain tumor or leukemia/lymphoma visits, solid tumor visits addressed more symptom management subdomains, especially pain (79.9%; p < 0.0001). The scope of PPC practice is broad and varied. Each visit encompasses many subdomains, the most common being care coordination with oncology teams and helping patients/families cope with the disease. More domains were addressed in solid tumor visits and near EOL. [ABSTRACT FROM AUTHOR]