Purpose: Integrating patient-reported outcomes (PROs) into clinical practice is an increasingly promising strategy for improving patients’ symptoms, communication, and clinical outcomes. The objective of this study was to assess the feasibility, acceptability, and perceived effectiveness of a mobile health intervention designed to collect PROs and activity data as a measure of health status. Patients and Methods: Pilot intervention with 10 patients with gynecologic cancers receiving palliative chemotherapy. The HOPE (Helping Our Patients Excel) study used wearable accelerometers to assess physical activity and the Beiwe research platform to collect PROs, risk stratify patient responses, provide tailored symptom management, and notify patients and clinicians of high-risk symptoms. Feasibility and acceptability were assessed through enrollment and adherence rates; perceived effectiveness was evaluated by patients and oncologists at study completion. Results: The approach-to-consent rate was 100% and participants were 90% and 70% adherent, respectively, to the wearable accelerometers and smartphone surveys. Participants’ mean daily step count was 4,040 (SD=2,270) and increased from week 1 (mean=3,520, SD=1578) to week 3 (mean=4,136, SD=1,578). Active monitoring of participants’ heart rates, daily steps, and PROs throughout the study identified anomalies in participants’ behavior patterns that suggested poor health for 20% (2 patients). Patients and clinicians indicated that the intervention improved physical activity, communication, and symptom management. Conclusion and Relevance: A mobile health intervention that collects PROs and activity data as a measure of health status is feasible, acceptable, and was perceived to be effective in improving symptom management patients with advanced gynecologic cancers. A larger, multisite randomized clinical trial to assess the efficacy of the HOPE intervention on patients’ symptoms, health-related quality of life, clinical outcomes, and health care utilization is warranted.

Math anxiety (MA) is associated with negative thoughts and emotions when encountering mathematics, often resulting in under-performance on math tasks. One hypothesized mechanism by which MA affects performance is through anxiety-related increases in working memory (WM) load, diverting resources away from mathematical computations. Here we examine whether this effect is specific to WM, or whether the impact of MA extends to an overall depletion of executive function (EF) resources. In this fMRI experiment, we manipulated two separate factors known to impact EF demands—task-switching (TS) and increased WM load—in order to evaluate how MA relates to behavioral performance and neural activity related to mathematical calculations. Relative to a difficult non-math task (analogies), we observed MA-related deficits in math performance and reduced neural activity in a network of regions in the brain associated with arithmetic processing. In response to TS demands, higher levels of math anxiety were associated with a pattern of avoidance and disengagement. When switching from the control task, high math anxiety (HMA) was associated with disengagement from math trials, speeding through these trials and exhibiting reduced neural activity in regions associated with arithmetic processing. The effects of math anxiety and WM were most pronounced at the lowest levels of WM load. Overall, the results of this study indicate that the effects of MA are broader than previously demonstrated, and provide further insight into how EF deficits in MA might impact recruitment of neural resources that are important for successful math computations.

Smokeless tobacco (ST) chewing warranties special attention in India because of its popularity and widespread social acceptance. The major factors that persist to encourage people to use smokeless form of tobacco are its low price, ease of purchase, and the widely held misconception of purported medicinal value in curing toothache, headache, and in decreasing hunger. Furthermore, in contrast to smoking, there is no taboo against using ST. The lifestyle, socioeconomic status, and the standards of living of industrial workers are different from the rest of the population. Poverty, language barriers, and poor education contribute different lifestyle that encourages addictive tobacco habits. As there is a ban on smoking tobacco in most of the industrial premises, workers tend to consume more of ST products. Therefore, they form a special group who could be at a higher risk of periodontal breakdown. Hence the present study was planned for study of Prevalence of Oral Submucous Fibrosis and Periodontal Health Status in patients chewing Gutka from Bihar Region. The present study was planned in Department of Dentistry, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar. Total 30 patients were enrolled in the present study. The patients were divided in three groups. The Group A included patients with a healthy periodontium. The Group B included patients with chronic periodontitis without OSMF, and Group C included patients with chronic periodontitis and OSMF. The data generated from the present study concludes that that chewing gutka leads to periodontal destruction in patients with OSMF. The cases illustrate the significant morbidity and mortality associated with OSF and emphasize the importance of close follow-up of such cases. Because of the significant cancer risk among these patients, periodic biopsies of suspicious regions of the oral mucosa are essential for the early detection and management of high-risk oral premalignant lesions and prevention of cancer. Keywords: oral submucous fibrosis, periodontal destruction, gutka, Bihar region, etc.