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Bush A, Floto RA. Pathophysiology, causes and genetics of paediatric and adult bronchiectasis. Respirology 2019; 24:1053-1062. [PMID: 30801930 DOI: 10.1111/resp.13509] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 01/16/2019] [Indexed: 02/06/2023]
Abstract
Bronchiectasis has historically been considered to be irreversible dilatation of the airways, but with modern imaging techniques it has been proposed that 'irreversible' be dropped from the definition. The upper limit of normal for the ratio of airway to arterial development increases with age, and a developmental perspective is essential. Bronchiectasis (and persistent bacterial bronchitis, PBB) is a descriptive term and not a diagnosis, and should be the start not the end of the patient's diagnostic journey. PBB, characterized by airway infection and neutrophilic inflammation but without significant airway dilatation may be a precursor of bronchiectasis, and there are many commonalities in the microbiology and the pathology, which are reviewed in this article. A high index of suspicion is essential, and a history of chronic wet or productive cough for more than 4-8 weeks should prompt investigation. There are numerous underlying causes of bronchiectasis, although in many cases no cause is found. Causes include post-infectious, especially after tuberculosis, adenoviral or pertussis infection; aspiration syndromes; defects in host defence, which may solely affect the airways (cystic fibrosis, not considered in this review, and primary ciliary dyskinesia); and primary ciliary dyskinesia or be systemic, such as common variable immunodeficiency; genetic syndromes; and anatomical defects such as intraluminal airway obstruction (e.g. foreign body), intramural obstruction (e.g. complete cartilage rings) and external airway compression (e.g. by tuberculous lymph nodes). Identification of the underlying cause is important, because some of these conditions have specific treatments and others genetic implications for the family.
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Affiliation(s)
- Andrew Bush
- Department of Paediatrics, Imperial College, London, UK.,Department of Paediatric Respirology, National Heart and Lung Institute, London, UK.,Royal Brompton Harefield NHS Foundation Trust, London, UK
| | - R Andres Floto
- Department of Respiratory Biology, University of Cambridge, Cambridge, UK.,Cambridge Centre for Lung Infection, Royal Papworth Hospital, Cambridge, UK
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Lei H, Yan Z, Sun X, Zhang Y, Wang J, Ma C, Xu Q, Wang R, Jarvis ED, Sun Z. Axon guidance pathways served as common targets for human speech/language evolution and related disorders. BRAIN AND LANGUAGE 2017; 174:1-8. [PMID: 28692932 DOI: 10.1016/j.bandl.2017.06.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 05/17/2017] [Accepted: 06/29/2017] [Indexed: 06/07/2023]
Abstract
Human and several nonhuman species share the rare ability of modifying acoustic and/or syntactic features of sounds produced, i.e. vocal learning, which is the important neurobiological and behavioral substrate of human speech/language. This convergent trait was suggested to be associated with significant genomic convergence and best manifested at the ROBO-SLIT axon guidance pathway. Here we verified the significance of such genomic convergence and assessed its functional relevance to human speech/language using human genetic variation data. In normal human populations, we found the affected amino acid sites were well fixed and accompanied with significantly more associated protein-coding SNPs in the same genes than the rest genes. Diseased individuals with speech/language disorders have significant more low frequency protein coding SNPs but they preferentially occurred outside the affected genes. Such patients' SNPs were enriched in several functional categories including two axon guidance pathways (mediated by netrin and semaphorin) that interact with ROBO-SLITs. Four of the six patients have homozygous missense SNPs on PRAME gene family, one youngest gene family in human lineage, which possibly acts upon retinoic acid receptor signaling, similarly as FOXP2, to modulate axon guidance. Taken together, we suggest the axon guidance pathways (e.g. ROBO-SLIT, PRAME gene family) served as common targets for human speech/language evolution and related disorders.
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Affiliation(s)
- Huimeng Lei
- Department of Neurobiology, Beijing Institute for Brain Disorders, Beijing Center of Neural Regeneration and Repair, Key Laboratory for Neurodegenerative Diseases of the Ministry of Education, Capital Medical University, Beijing 100069, China.
| | - Zhangming Yan
- MOE Key Laboratory of Bioinformatics, School of Life Sciences, Tsinghua University, Beijing 100084, China
| | - Xiaohong Sun
- Department of Neurobiology, Beijing Institute for Brain Disorders, Beijing Center of Neural Regeneration and Repair, Key Laboratory for Neurodegenerative Diseases of the Ministry of Education, Capital Medical University, Beijing 100069, China
| | - Yue Zhang
- Department of Children Healthcare, Capital Institute of Pediatrics, Beijing, 100020, China
| | - Jianhong Wang
- Department of Children Healthcare, Capital Institute of Pediatrics, Beijing, 100020, China
| | - Caihong Ma
- Reproductive Medicine Center of Peking University Third Hospital, Beijing, 100191, China
| | - Qunyuan Xu
- Department of Neurobiology, Beijing Institute for Brain Disorders, Beijing Center of Neural Regeneration and Repair, Key Laboratory for Neurodegenerative Diseases of the Ministry of Education, Capital Medical University, Beijing 100069, China
| | - Rui Wang
- Hengkuan Telegenomics Co., Ltd., 36/F, 5 Meiyuan Rd., Tianjin 300384, China
| | - Erich D Jarvis
- Department of Neurobiology, Duke University Medical Center, Durham, NC 27710, USA; Howard Hughes Medical Institute, Chevy Chase, MD, 20815-6789, USA
| | - Zhirong Sun
- MOE Key Laboratory of Bioinformatics, School of Life Sciences, Tsinghua University, Beijing 100084, China.
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Magliulo G, Iannella G, Gagliardi S, Iozzo N, Plateroti R, Mariottini A, Torricelli F. Usher's Syndrome Type II: A Comparative Study of Genetic Mutations and Vestibular System Evaluation. Otolaryngol Head Neck Surg 2017; 157:853-860. [PMID: 28653555 DOI: 10.1177/0194599817715235] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Objective Usher's syndrome type II (USH2) is characterized by moderate to profound congenital hearing loss, later onset of retinitis pigmentosa, and normal vestibular function. Recently, a study investigating the vestibular function of USH2 patients demonstrated a pathologic response to vestibular tests. In this cross-sectional study we performed vestibular tests of a group patients with genetic diagnosis of USH2 syndrome to demonstrate if vestibular damage is present in USH2 patients. Study Design Cross-sectional study. Setting Tertiary referral center. Subjects and Methods Mutated genes of 7 patients with a clinical diagnosis of USH2 were evaluated. Vestibular function was investigated by audiometry, Fitzgerald-Hallpike caloric vestibular testing, cervical vestibular evoked myogenic potentials (C-VEMPs), ocular vestibular evoked myogenic potentials (O-VEMPs), and video head impulse test (v-HIT). Results Genetic tests confirmed the USH2 diagnosis in 5 of 7 patients examined, with 1 patient reporting a unique mutation on genetic tests. Four (80%) of the 5 patients with a genetic diagnosis of USH2 showed pathological O-VEMPs. Two patients (40%) reported bilateral absent or abnormal values of C-VEMPs. The superior semicircular canal presented a significant deficit in 2 (40%) patients. The same 2 cases showed a pathologic response of the v-HIT of the horizontal semicircular canal. Finally, the posterior semicircular canal presented a significant deficit in 4 (40.0%) patients. Conclusion A vestibular evaluation with vestibular evoked myogenic potentials and v-HIT seems to identify latent damage to the vestibular receptors of USH2 patients.
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Affiliation(s)
| | | | - Silvia Gagliardi
- 1 Organi di Senso Department, University "la Sapienza," Rome, Italy
| | - Nicola Iozzo
- 1 Organi di Senso Department, University "la Sapienza," Rome, Italy
| | - Rocco Plateroti
- 1 Organi di Senso Department, University "la Sapienza," Rome, Italy
| | - Alessandro Mariottini
- 2 Department of Genetic Diagnosis, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Francesca Torricelli
- 2 Department of Genetic Diagnosis, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
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Ribeiro JC, Oliveiros B, Pereira P, António N, Hummel T, Paiva A, Silva ED. Accelerated age-related olfactory decline among type 1 Usher patients. Sci Rep 2016; 6:28309. [PMID: 27329700 PMCID: PMC4916436 DOI: 10.1038/srep28309] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 06/02/2016] [Indexed: 12/22/2022] Open
Abstract
Usher Syndrome (USH) is a rare disease with hearing loss, retinitis pigmentosa and, sometimes, vestibular dysfunction. A phenotype heterogeneity is reported. Recent evidence indicates that USH is likely to belong to an emerging class of sensory ciliopathies. Olfaction has recently been implicated in ciliopathies, but the scarce literature about olfaction in USH show conflicting results. We aim to evaluate olfactory impairment as a possible clinical manifestation of USH. Prospective clinical study that included 65 patients with USH and 65 normal age-gender-smoking-habits pair matched subjects. A cross culturally validated version of the Sniffin’ Sticks olfaction test was used. Young patients with USH have significantly better olfactory scores than healthy controls. We observe that USH type 1 have a faster ageing olfactory decrease than what happens in healthy subjects, leading to significantly lower olfactory scores in older USH1 patients. Moreover, USH type 1 patients showed significantly higher olfactory scores than USH type 2, what can help distinguishing them. Olfaction represents an attractive tool for USH type classification and pre diagnostic screening due to the low cost and non-invasive nature of the testing. Olfactory dysfunction should be considered among the spectrum of clinical manifestations of Usher syndrome.
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Affiliation(s)
- João Carlos Ribeiro
- Department of Otorhinolaryngology, Coimbra University Hospitals, Portugal.,Faculty of Medicine, University of Coimbra, Portugal.,Centre of Ophthalmology and Vision Sciences, IBILI, Faculty of Medicine, University of Coimbra, Portugal
| | - Bárbara Oliveiros
- Faculty of Medicine, University of Coimbra, Portugal.,Centre of Ophthalmology and Vision Sciences, IBILI, Faculty of Medicine, University of Coimbra, Portugal
| | - Paulo Pereira
- Faculty of Medicine, University of Coimbra, Portugal.,Centre of Ophthalmology and Vision Sciences, IBILI, Faculty of Medicine, University of Coimbra, Portugal
| | | | - Thomas Hummel
- Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - António Paiva
- Department of Otorhinolaryngology, Coimbra University Hospitals, Portugal.,Faculty of Medicine, University of Coimbra, Portugal
| | - Eduardo D Silva
- Faculty of Medicine, University of Coimbra, Portugal.,Centre of Ophthalmology and Vision Sciences, IBILI, Faculty of Medicine, University of Coimbra, Portugal
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Goyal V, Grimwood K, Marchant J, Masters IB, Chang AB. Pediatric bronchiectasis: No longer an orphan disease. Pediatr Pulmonol 2016; 51:450-69. [PMID: 26840008 DOI: 10.1002/ppul.23380] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 12/15/2015] [Accepted: 01/04/2016] [Indexed: 12/31/2022]
Abstract
Bronchiectasis is described classically as a chronic pulmonary disorder characterized by a persistent productive cough and irreversible dilatation of one or more bronchi. However, in children unable to expectorate, cough may instead be wet and intermittent and bronchial dilatation reversible in the early stages. Although still considered an orphan disease, it is being recognized increasingly as causing significant morbidity and mortality in children and adults in both affluent and developing countries. While bronchiectasis has multiple etiologies, the final common pathway involves a complex interplay between the host, respiratory pathogens and environmental factors. These interactions lead to a vicious cycle of repeated infections, airway inflammation and tissue remodelling resulting in impaired airway clearance, destruction of structural elements within the bronchial wall causing them to become dilated and small airway obstruction. In this review, the current knowledge of the epidemiology, pathobiology, clinical features, and management of bronchiectasis in children are summarized. Recent evidence has emerged to improve our understanding of this heterogeneous disease including the role of viruses, and how antibiotics, novel drugs, antiviral agents, and vaccines might be used. Importantly, the management is no longer dependent upon extrapolating from the cystic fibrosis experience. Nevertheless, substantial information gaps remain in determining the underlying disease mechanisms that initiate and sustain the pathophysiological pathways leading to bronchiectasis. National and international collaborations, standardizing definitions of clinical and research end points, and exploring novel primary prevention strategies are needed if further progress is to be made in understanding, treating and even preventing this often life-limiting disease.
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Affiliation(s)
- Vikas Goyal
- Queensland Children's Medical Research Institute, Children's Health Queensland, Brisbane, Queensland, 4101, Australia.,Department of Respiratory Medicine, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - Keith Grimwood
- Queensland Children's Medical Research Institute, Children's Health Queensland, Brisbane, Queensland, 4101, Australia.,Menzies Health Institute Queensland, Griffith University and Gold Coast Health, Southport, Australia
| | - Julie Marchant
- Queensland Children's Medical Research Institute, Children's Health Queensland, Brisbane, Queensland, 4101, Australia.,Department of Respiratory Medicine, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - I Brent Masters
- Queensland Children's Medical Research Institute, Children's Health Queensland, Brisbane, Queensland, 4101, Australia.,Department of Respiratory Medicine, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - Anne B Chang
- Queensland Children's Medical Research Institute, Children's Health Queensland, Brisbane, Queensland, 4101, Australia.,Child Health Division, Menzies School of Health Research, Darwin, Australia.,Queensland Children's Medical Research Institute, Queensland University of Technology, Brisbane, Queensland, Australia
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Abstract
Primary ciliary dyskinesia (PCD) is a genetic disease of motile cilia, which belongs to a group of disorders resulting from dysfunction of cilia, collectively known as ciliopathies. Insights into the genetics and phenotypes of PCD have grown over the last decade, in part propagated by the discovery of a number of novel cilia-related genes. These genes encode proteins that segregate into structural axonemal, regulatory, as well as cytoplasmic assembly proteins. Our understanding of primary (sensory) cilia has also expanded, and an ever-growing list of diverse conditions has been linked to defective function and signaling of the sensory cilium. Recent multicenter clinical and genetic studies have uncovered the heterogeneity of motile and sensory ciliopathies, and in some cases, the overlap between these conditions. Here, we will describe the genetics and pathophysiology of ciliopathies in children, focusing on PCD, review emerging genotype-phenotype relationships, and diagnostic tools available for the clinician.
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Affiliation(s)
- Amjad Horani
- a Department of Pediatrics , Washington University School of Medicine , St. Louis , MO , USA
| | - Thomas W Ferkol
- a Department of Pediatrics , Washington University School of Medicine , St. Louis , MO , USA.,b Department of Cell Biology and Physiology , Washington University School of Medicine , St. Louis , MO , USA
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Ciancio N, de Santi MM, Campisi R, Amato L, Di Martino G, Di Maria G. Kartagener's syndrome: review of a case series. Multidiscip Respir Med 2015; 10:18. [PMID: 26075070 PMCID: PMC4465165 DOI: 10.1186/s40248-015-0015-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/27/2015] [Indexed: 11/17/2022] Open
Abstract
Background Kartagener Syndrome (KS) is a rare autosomal recessive genetic disorder, resulting in a group of clinical manifestations, including bronchiectasis, chronic pansinusitis and situs inversus. Methods We hereby reviewed eight cases of this rare entity selected from patients attending our outpatients Respiratory Unit since 2006. Samples of respiratory epithelium were obtained with the method of nasal brushing and sent to a specialized center in order to be studied with electron microscopy. At least 50 cross sections of different cilia from different cells were observed in each specimen to study the axonemal structure. Electron micrographs were taken at a magnification of X 50,000 to determine the orientation of the cilia and at a magnification of X 110,000 to study the axonemal pattern. The incidence of abnormal cilia was expressed as a percentage. Results We observed different ultrastructural defects in our KS patients, including absence of outer dynein arms, absence of outer and inner dynein arms, and absence of the central pair with transposition of a peripheral doublet into the central position. Patient’s follow up lasted till 2014, however two patients with more severe clinical behavior died before. Conclusions This is a review of a case series, yet our data has shown that nasal brushing with ultrastructural pathological differentiation may be useful to identify patients with high risk and to develop more complex clinical presentations.
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Affiliation(s)
- Nicola Ciancio
- Pulmonology Unit, A.O.U. Policlinico-Vittorio Emanuele, Catania, Italy
| | - Maria Margherita de Santi
- Department of Human Pathology and Oncology (Division of Pathology), University of Siena, Siena, Italy
| | - Raffaele Campisi
- Pulmonology Unit, A.O.U. Policlinico-Vittorio Emanuele, Catania, Italy
| | - Laura Amato
- Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy
| | - Giuseppina Di Martino
- Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy
| | - Giuseppe Di Maria
- Department of Clinical and Molecular Biomedicine, University of Catania, Catania, Italy
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Yang F, Pavlik J, Fox L, Scarbrough C, Sale WS, Sisson JH, Wirschell M. Alcohol-induced ciliary dysfunction targets the outer dynein arm. Am J Physiol Lung Cell Mol Physiol 2015; 308:L569-76. [PMID: 25595647 DOI: 10.1152/ajplung.00257.2014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Alcohol abuse results in an increased incidence of pulmonary infection, in part attributable to impaired mucociliary clearance. Analysis of motility in mammalian airway cilia has revealed that alcohol impacts the ciliary dynein motors by a mechanism involving altered axonemal protein phosphorylation. Given the highly conserved nature of cilia, it is likely that the mechanisms for alcohol-induced ciliary dysfunction (AICD) are conserved. Thus we utilized the experimental advantages offered by the model organism, Chlamydomonas, to determine the precise effects of alcohol on ciliary dynein activity and identify axonemal phosphoproteins that are altered by alcohol exposure. Analysis of live cells or reactivated cell models showed that alcohol significantly inhibits ciliary motility in Chlamydomonas via a mechanism that is part of the axonemal structure. Taking advantage of informative mutant cells, we found that alcohol impacts the activity of the outer dynein arm. Consistent with this finding, alcohol exposure results in a significant reduction in ciliary beat frequency, a parameter of ciliary movement that requires normal outer dynein arm function. Using mutants that lack specific heavy-chain motor domains, we have determined that alcohol impacts the β- and γ-heavy chains of the outer dynein arm. Furthermore, using a phospho-threonine-specific antibody, we determined that the phosphorylation state of DCC1 of the outer dynein arm-docking complex is altered in the presence of alcohol, and its phosphorylation correlates with AICD. These results demonstrate that alcohol targets specific outer dynein arm components and suggest that DCC1 is part of an alcohol-sensitive mechanism that controls outer dynein arm activity.
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Affiliation(s)
- Fan Yang
- University of Mississippi Medical Center, Department of Biochemistry, Jackson, Mississippi
| | - Jacqueline Pavlik
- University of Nebraska Medical Center, Department of Internal Medicine, Division of Pulmonary, Critical Care, Sleep and Allergy, Omaha, Nebraska; and
| | - Laura Fox
- Emory University School of Medicine, Department of Cell Biology, Atlanta, Georgia
| | - Chasity Scarbrough
- University of Mississippi Medical Center, Department of Biochemistry, Jackson, Mississippi
| | - Winfield S Sale
- Emory University School of Medicine, Department of Cell Biology, Atlanta, Georgia
| | - Joseph H Sisson
- University of Nebraska Medical Center, Department of Internal Medicine, Division of Pulmonary, Critical Care, Sleep and Allergy, Omaha, Nebraska; and
| | - Maureen Wirschell
- University of Mississippi Medical Center, Department of Biochemistry, Jackson, Mississippi;
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Ogun O, Zallocchi M. Clarin-1 acts as a modulator of mechanotransduction activity and presynaptic ribbon assembly. ACTA ACUST UNITED AC 2014; 207:375-91. [PMID: 25365995 PMCID: PMC4226736 DOI: 10.1083/jcb.201404016] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Clarin-1 is a four-transmembrane protein expressed by hair cells and photoreceptors. Mutations in its corresponding gene are associated with Usher syndrome type 3, characterized by late-onset and progressive hearing and vision loss in humans. Mice carrying mutations in the clarin-1 gene have hair bundle dysmorphology and a delay in synapse maturation. In this paper, we examined the expression and function of clarin-1 in zebrafish hair cells. We observed protein expression as early as 1 d postfertilization. Knockdown of clarin-1 resulted in inhibition of FM1-43 incorporation, shortening of the kinocilia, and mislocalization of ribeye b clusters. These phenotypes were fully prevented by co-injection with clarin-1 transcript, requiring its C-terminal tail. We also observed an in vivo interaction between clarin-1 and Pcdh15a. Altogether, our results suggest that clarin-1 is functionally important for mechanotransduction channel activity and for proper localization of synaptic components, establishing a critical role for clarin-1 at the apical and basal poles of hair cells.
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Affiliation(s)
- Oluwatobi Ogun
- Sensory Neuroscience Department, Boys Town National Research Hospital, Omaha, NE 68131
| | - Marisa Zallocchi
- Sensory Neuroscience Department, Boys Town National Research Hospital, Omaha, NE 68131
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