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OBJECTIVE: Social deficits are already exhibited by people at risk for schizophrenia-spectrum disorders. Technological advances have made passive detection of social deficits possible at granular levels. METHOD: In this real-world study, we tested if schizotypy status (high/low) predicted two types of social behavior: (1) being around other people; and (2) actively socializing with others. We also examined if schizotypy influences relationships between social behavior and affect using subjective and objective instruments. RESULTS: Our findings revealed that socializing with others was significantly decreased in the high schizotypy group. Positive affect increased in social situations and predicted later social behavior in those low, but not high, in schizotypy. CONCLUSION: Decreased social behavior in schizotypy may be explained, in part, by these individuals being less incentivized than their peers to pursue social situations. Future studies should test this explanation in larger samples exhibiting elevated positive, negative, and disorganized schizotypy traits.

Parents, teachers, and paraeducators at three inclusive schools were interviewed as part of a qualitative study to investigate perceptions regarding a quality educational program for students with moderate-severe disabilities. Instead of looking at schools engaged in a systematic change process from separate to inclusive education for students with severe disabilities, a major premise of this study was that all students, regardless of ability or disability, were educated together in chronologically age appropriate general education classrooms (preschool through 8th grade). The intent of this study was to determine what key stakeholders (parents, teachers, and paraeducators) felt was a good educational program for students with moderate-severe disabilities after an inclusive placement was a given. Fifty-eight participants were interviewed (18 parents, 23 teachers, and 17 paraeducators) representing four preschool children, nine elementary students, and five middle school students all having moderate-severe and multiple disabilities. A constant comparison methodology was used to analyze the data across both age of target child and role of stakeholder. Findings revealed 12 themes that highlighted the benefits of inclusive education for all students, specific components that needed to be in place to ensure a quality education, and typical goals for the future. Implications for the field were discussed. (Contains 3 tables.)

Purpose: The study purpose was to capture the clinical practice patterns of speech-language pathologists (SLPs) treating mild traumatic brain injury (mTBI; concussion). Study aims were to (a) characterize expert SLP practice patterns for the management of mTBI and (b) use qualitative content analysis to explore areas of quantitative variability within participants' responses. Method: Using a modified Delphi approach, SLPs completed an online survey, with Round 1 responses shaping questions for Round 2. Round 2 results were analyzed using a concurrent partially mixed-methods approach with quantitative and qualitative items. Quantitative consensus agreement levels were set prestudy at 75% agreement or higher. Topic-level items that did not reach consensus were analyzed using qualitative content analysis. Participants: SLPs engaging in a specialty mTBI-SLP networking group were invited to participate. Round 1 had nine participants (United States: 4, Canada: 5). Round 2 had 18 participants (United States: 12, Canada: 6), with a mean of 15.7 years of experience in mTBI (range: 3-33) and a mean of 7.6 clients with mTBI seen weekly (range: 1-25). Results: Nearly all topic-level practice items met quantitative consensus (42/45). Consensus areas included using conceptual frameworks, interprofessional teaming, assessment and intervention practices, goal setting, and outcomes. Functional, collaborative, and client-centered care anchored clinical practice. Areas lacking consensus included SLP roles in mTBI mental and somatic health symptoms, specific measurement tools, and intervention dosages. Qualitative themes that emerged included limited interprofessional awareness for the role of SLPs in mTBI and challenges in measurement selection. Conclusions: Study aims were met with clear consensus on clinical patterns implemented by SLPs specializing in mTBI. Results will inform both current clinical practices and future practice guidelines. High-level guidance and advocacy are needed to clarify SLP practice concerns and advance interprofessional education. Future work should address identified gaps, including targeted assessment tools and consensus on intervention methods. [ABSTRACT FROM AUTHOR]

Introduction: Pulmonary edema with low systemic oxygen (O2) levels is a hallmark of acute decompensated heart failure (HF) related to elevated left heart filling pressures. However, less is known about arterial O2 (PaO2) responses during exercise in patients with heart failure with preserved ejection fraction (HFpEF). Hypothesis: We hypothesized that changes in PaO2 in response to exercise are governed by extra-cardiac organ systems rather than the degree of elevation in pulmonary capillary wedge pressure (PCWP). Methods: We performed maximum incremental cardiopulmonary exercise testing with invasive hemodynamic monitoring in 411 patients (age 58±2.9, 61% female, BMI 29.7±0.7, LVEF 66±2.6 %; mean±SEM) with HFpEF defined by ACC/AHA criteria with exclusion of patients with O2-dependent lung disease. Results: Exercise PaO2 was associated with peak VO2 (r=0.22, p<0.001) but average PaO2 increased only modestly from rest to peak exercise (3.1±0.7mmHg) and overt O2 desaturation was uncommon (1.5% of patients had PaO2<55mmHg and O2sat ≤ 88%). Exercise change in PaO2 was not associated with resting PCWP (r=0.05, p=0.27) or exercise PCWP (r<0.01, P=0.7) (Figure). Change in PaO2was correlated with % predicted diffusion capacity of the lungs (DLCO) (r=0.28, p<0.001) despite relatively normal average spirometry values (FVC 93±1, FEV1 89±5, FVC/FEV 96±5, % predicted mean±SEM). Pulmonary artery pressure (PAP) and transpulmonary pressure gradient (TPG) were also associated with change in PaO2 (r=-0.18 (PAP), r=-0.25 (TPG), p<0.001) in multivariable models adjusting for age, sex, and BMI. Conclusions: Pulmonary and pulmonary vascular function, but not left sided filling pressures, relate to changes in PaO2 during incremental exercise in HFpEF. These findings highlight the important role of extra-cardiac organ systems, specifically the lungs, in mediating systemic O2 bioavailability during exercise in HFpEF. [ABSTRACT FROM AUTHOR]

In recent decades, the scientific community has seen an increased interest in rigor and reproducibility. In 2017, concerns about methodological thoroughness and reporting practices were implicated as significant barriers to reproducibility within the preclinical cardiovascular literature, particularly in studies using animal research. The Langendorff, whole heart technique has proven to be an invaluable research tool, being modified in a myriad of ways to probe questions across the spectrum of physiological and pathophysiological functions of the heart. As a result, significant variability in the application of the Langendorff technique exists. This literature review quantifies the different methods employed in the implementation of the Langendorff technique and provides brief examples of how individual parametric differences can impact the outcomes and interpretation of studies. From 2017 to 2020, significant variability of animal models, anesthesia, cannulation time, perfusate composition, pH, and temperature demonstrate that the technique has diversified to meet new challenges and answer different scientific questions. The review also reveals which individual methods are most frequently reported, even if there is no explicit agreement upon which parameters should be reported. The analysis of methods related to the Langendorff technique suggests a framework for considering methodological approach when interpreting seemingly contradictory results, rather than concluding that results are irreproducible.

The Marcus Institute for Brain Health (MIBH) provides interdisciplinary care for adults struggling with persistent effects of mild traumatic brain injury and accompanying changes in behavioral health, with specific emphases on Veterans and retired elite athletes. The cognitive, physical, and behavioral symptoms associated with mild traumatic brain injury are interrelated, with neurobiopsychosocial modeling encompassing the factors related to recovery from a traumatic brain injury. The diffuse impacts of chronic concussive injuries require multiple clinical providers to address the breadth of symptoms, facilitating both interdisciplinary and transdisciplinary care models. By implementing integrated practice units, patients receive advanced medical care, imaging, speech-language pathology, physical therapy, behavioral health, neuropsychology, and clinical pharmacy for a cohesive diagnostic and intervention plan. Nationally, speech-language pathologists report challenges with best-practice options for concussion, particularly in the domain of assessment practices. At the MIBH, speech-language pathologists begin their assessment with a structured clinical interview that focuses on patients' needs and concerns. Evaluation modalities focus on hearing, communication, and functional cognition to guide therapeutic treatment planning. The intensive outpatient care program at MIBH incorporates both individual sessions targeting patient-centered goals and group care, where speech-language pathologists work transdisciplinarily to generalize care from all disciplines out into the community. Care practices for concussive injuries continue to evolve rapidly; speech-language pathology at the MIBH offers one such vision for excellence in clinical care., Competing Interests: Kathryn Hardin—Financial: Kathryn Hardin is a faculty member at the University of Colorado School of Medicine and receives accompanying salary support. Nonfinancial: Kathryn Hardin has reviewed works for ASHA focused on traumatic brain injury.James Kelly—Financial: Principal/sole proprietor, Kelly Neuroscience Consulting, LLC. Principal/proprietor, KLNP, LLC. Principal/proprietor, Valor Industries, LLC. Medical Advisory Board Member, Prevacus, Inc. Nonfinancial: Fellow, George W. Bush Institute Military Service Initiative., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)