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Brindahdevi K, Kim PT, Vignesh Kumar M, Govindasamy C, Anderson A, Gavurová B. Enhancing emission control and analyzing the performance and combustion attributes of vehicular engines with spirulina microalgae diesel Ce 2O 3 nanoparticles blends. Environ Res 2023; 239:117370. [PMID: 37827374 DOI: 10.1016/j.envres.2023.117370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 10/14/2023]
Abstract
The current research investigates the utilization of spirulina microalgae biodiesel blends in a naturally aspirated constant speed compression ignition engine with Ce2O3 nanoparticles at the concentration of 50 ppm under diverse engine loading conditions. Blends of microalgae dispersed with neat diesel at the volume of 20% and 40%. A series of tests were conducted to evaluate the combined effects of microalgae and nanoparticles on engine performance, combustion efficiency, and emission characteristics. The study revealed that increasing the microalgae concentration in the diesel fuel resulted in reduced brake thermal efficiency due to less effective atomization and lower calorific value. Surprisingly, the 20% biodiesel blend with nanoparticles exhibited the highest brake thermal efficiency across various engine loads, while the 40% blend showed higher brake specific fuel consumption compared to both the 20% blend and neat diesel, primarily because of its lower heating value necessitating increased fuel consumption. Furthermore, the biodiesel blends led to lower in-cylinder pressure than pure diesel, mainly attributable to suboptimal atomization. In terms of emissions, the utilization of microalgae-based fuel led to a significant reduction in NOx, CO, and smoke emissions, attributed to the lower cylinder temperatures associated with these blends. In conclusion, this study underscores the potential of spirulina microalgae, particularly when combined with nanoparticles at an optimal concentration, as a promising and environmentally friendly alternative for compression ignition engines.
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Affiliation(s)
- Kathirvel Brindahdevi
- Institute of Research and Development, Duy Tan University, Da Nang, Viet Nam; School of Engineering & Technology, Duy Tan University, Da Nang, Viet Nam.
| | - P T Kim
- Institute of Research and Development, Duy Tan University, Da Nang, Viet Nam; School of Engineering & Technology, Duy Tan University, Da Nang, Viet Nam
| | - M Vignesh Kumar
- Department of Aerospace Engineering, SRM Institute of Science and Technology, India.
| | - Chandramohan Govindasamy
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia
| | - A Anderson
- Department of Aeronautical Engineering, Sathyabama Institute of Science and Technology, India
| | - Beata Gavurová
- Technical University of Kosice, Faculty of Mining, Ecology, Process Control and Geotechnologies, Letna 9, Košice, 042 00, Slovakia
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Lewis ME, Wildcat S, Anderson A. Visioning an Effective Health Encounter: Indigenous Healthcare Experiences and Recommendations for Health Professionals. Int J Environ Res Public Health 2023; 20:6917. [PMID: 37887655 PMCID: PMC10606678 DOI: 10.3390/ijerph20206917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 09/05/2023] [Accepted: 09/29/2023] [Indexed: 10/28/2023]
Abstract
PURPOSE Indigenous patients experience challenges while accessing and utilizing healthcare services that relate to worsened health experiences. Bias towards Indigenous patients is prevalent in healthcare settings and leads to poor health outcomes. The purpose of this study was to learn about the healthcare experiences, both positive and negative, of Indigenous patients and solicit subsequent recommendations to improve care delivered to this population. METHODS This study sampled Indigenous patients (n = 20) from an Indigenous-serving health clinic to discuss participants' health experiences and elicit recommendations for improved care. Four focus groups were conducted, and template analysis was employed to analyze the data. RESULTS A total of 15 themes were developed under the category of an effective health encounter. Highlighted themes include healthcare that is free of stigma, quality care, respecting trauma experiences, expanded integrated care and the patient-provider relationship. Based on participant recommendations, a checklist was created for healthcare professionals to improve care delivery to Indigenous patients. Results indicated that bias in healthcare settings may masquerade as poor clinical care but is really founded in biased beliefs and healthcare delivery. Alternatively, when patients received good quality care, their healthcare outcomes improved. Further, effective healthcare incorporates culture, family, tribe, and community and addresses these aspects of health in both clinical and systemic settings. CONCLUSIONS With some of the largest proportions of health disparities and bias experiences in the US, it is critical that healthcare delivered to Indigenous patients incorporate culturally safe care to regain dignity and improve health outcomes for this population.
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Affiliation(s)
- Melissa E. Lewis
- Department of Family and Community Medicine, University of Missouri School of Medicine, Columbia, MO 65201, USA
| | - Sky Wildcat
- Department of Higher Education, College of Education and Health Professions, University of Arkansas, Fayetteville, AR 72701, USA
| | - Amber Anderson
- Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
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Donohue C, Chapin JL, Anderson A, DiBiase L, Gray LT, Wymer JP, Plowman EK. Sensitivity and specificity of the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised to detect dysarthria in individuals with amyotrophic lateral sclerosis. Muscle Nerve 2023; 68:296-302. [PMID: 37345346 PMCID: PMC10529444 DOI: 10.1002/mus.27923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/30/2022] [Accepted: 01/07/2023] [Indexed: 06/23/2023]
Abstract
INTRODUCTION/AIMS Given the widespread use of the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) to measure disease progression in ALS and recent reports demonstrating its poor sensitivity, we aimed to determine the sensitivity and specificity of the ALSFRS-R bulbar subscale and speech item to detect validated clinical ratings of dysarthria in individuals with ALS. METHODS Paired ALSFRS-R and validated Speech Intelligibility Test (SIT) data from individuals with ALS were analyzed. Trained raters completed duplicate, independent, and blinded ratings of audio recordings to obtain speech intelligibility (%) and speaking rate (words per minute, WPM). Binary dysarthria profiles were derived (dysarthria ≤96% intelligible and/or <150 WPM). Data were obtained using the Kruskal-Wallis test, receiver-operating characteristic (ROC) curve, area under the curve (AUC), sensitivity and specificity percentages, and positive/negative predictive values (PPV/NPV). RESULTS A total of 250 paired SIT and ALSFRS-R data points were analyzed. Dysarthria was confirmed in 72.4% (n = 181). Dysarthric speakers demonstrated lower ALSFRS-R bulbar subscale (8.9 vs. 11.2) and speech item (2.7 vs. 3.7) scores (P < .0001). The ALSFRS-R bulbar subscale score had an AUC of 0.81 (95% confidence interval [CI] 0.75 to 0.86). A subscale score of ≤11 yielded a sensitivity of 86%, specificity of 57%, PPV of 84%, and NPV of 60% to correctly identify dysarthria status. The ALSFRS-R speech item score demonstrated an AUC of 0.81 to detect dysarthria (95% CI 0.76 to 0.85), with sensitivity of 79%, specificity of 75%, PPV of 89%, and NPV of 58% for a speech item cutpoint of ≤3. DISCUSSION The ALSFRS-R bulbar and speech item subscale scores may be useful, inexpensive, and quick tools for monitoring dysarthria status in ALS.
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Affiliation(s)
- Cara Donohue
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, FL, USA
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, FL, USA
- Breathing Research and Therapeutics Center, University of Florida, Gainesville, FL, USA
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, USA
| | - Jennifer L. Chapin
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, FL, USA
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, FL, USA
| | - Amber Anderson
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, FL, USA
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, FL, USA
| | - Lauren DiBiase
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, FL, USA
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, FL, USA
| | - Lauren Tabor Gray
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, FL, USA
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, FL, USA
- Breathing Research and Therapeutics Center, University of Florida, Gainesville, FL, USA
- Center of Collaborative Research, NOVA Southeastern University, Fort Lauderdale, FL, USA
| | - James P. Wymer
- Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Emily K. Plowman
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, FL, USA
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, FL, USA
- Breathing Research and Therapeutics Center, University of Florida, Gainesville, FL, USA
- Department of Neurology, University of Florida, Gainesville, FL, USA
- Department of Surgery, University of Florida, Gainesville, FL, USA
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Faro EZ, Sauder KA, Norman GS, Anderson A, Vélez-Vega C, Napp D, Huddleston KC. A mixed-methods analysis to understand the implementation of a multistakeholder research consortium: Environmental influences on child health outcomes (ECHO). J Clin Transl Sci 2023; 7:e198. [PMID: 37830008 PMCID: PMC10565193 DOI: 10.1017/cts.2023.620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 10/14/2023] Open
Abstract
Introduction Large, transdisciplinary research consortia have increasingly been called upon to address complex and challenging health problems. The National Institutes of Health's (NIH) Environmental influences on Child Health Outcomes (ECHO) Program developed multisite collaboration strategies to promote impactful collaborative observational research on child health. Team science and implementation science offer theoretical and methodological structure to answer questions about the strategies that facilitate successful consortia. We sought to characterize the elements and conditions that influence the implementation of a complex, interdisciplinary longitudinal research program, ECHO. Methods Informed by the Practical, Robust, Implementation and Sustainability Model, our ethnographic research included semi-structured interviews with internal stakeholders and program evaluation metrics. We conducted template and matrix analysis and triangulated the qualitative and quantitative data to understand the implementation of ECHO. Results Between February and May 2022, we conducted 24 virtual interviews with representatives from ECHO components. The main cross-cutting topics that emerged from thematic analysis were collaboration and team science; communication and decision-making; data processes and harmonization; and diversity, equity, and inclusion. Both the qualitative and secondary quantitative evaluation data provided insights into the reach, adoption, implementation, and effectiveness of the program. Conclusion A large, multidisciplinary research consortium such as ECHO has produced conceptual, instrumental, capacity building, and connectivity impact for internal and external stakeholders. Facilitators included infrastructure that supported collaboration and learning, alignment of data processes, and harmonization. Opportunities for enhanced impact include multidisciplinary, multimethod communication strategies, and alignment of research priorities.
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Affiliation(s)
- Elissa Z. Faro
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Katherine A. Sauder
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine, Aurora, CO, USA
| | - Gwendolyn S. Norman
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA
| | - Amber Anderson
- Duke Clinical Research Institute, Duke University, Durham, NC, USA
| | - Carmen Vélez-Vega
- Social Sciences Department, Graduate School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
| | - David Napp
- Practical Applications of Public Health, Durham, NC, USA
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Dacres H, Weihs F, Wang J, Anderson A, Trowell SC. Bioluminescence resonance energy transfer biosensor for measuring activity of a protease secreted by Pseudomonas fluorescens growing in milk. Anal Chim Acta 2023; 1270:341401. [PMID: 37311608 DOI: 10.1016/j.aca.2023.341401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 05/18/2023] [Accepted: 05/20/2023] [Indexed: 06/15/2023]
Abstract
Bacterial proteases are sporadic contributors to milk spoilage, reducing the quality of ultra-heat treated (UHT) milk and other dairy products. Current methods for measuring bacterial protease activity in milk are insensitive and too slow to be used in routine testing in dairy processing plants. We have designed a novel bioluminescence resonance energy transfer (BRET)-based biosensor to measure the activity of proteases secreted by bacteria in milk. The BRET-based biosensor is highly selective for bacterial protease activity compared with other proteases tested, notably including plasmin, which is abundant in milk. It incorporates a novel peptide linker that is selectively cleaved by P. fluorescens AprX proteases. The peptide linker is flanked by green fluorescent protein (GFP2) at the N-terminus and a variant Renilla luciferase (RLuc2) at the C-terminus. Complete cleavage of the linker by bacterial proteases from Pseudomonas fluorescens strain 65, leads to a 95% decrease in the BRET ratio. We applied an azocasein-based calibration method to the AprX biosensor using standard international enzyme activity units. In a 10-min assay, the detection limit for AprX protease activity in buffer was equivalent to 40 pg/mL (≈0.8 pM, 22 μU/mL) and 100 pg/mL (≈2pM, 54 μU/mL) in 50% (v/v) full fat milk. The EC50 values were 1.1 ± 0.3 ng/mL (87 μU/mL) and 6.8 ± 0.2 ng/mL (540 μU/mL), respectively. The biosensor was approximately 800x more sensitive than the established FITC-Casein method in a 2-h assay, the shortest feasible time for the latter method. The protease biosensor is sensitive and fast enough to be used in production settings. It is suitable for measuring bacterial protease activity in raw and processed milk, to inform efforts to mitigate the effects of heat-stable bacterial proteases and maximise the shelf-life of dairy products.
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Affiliation(s)
- H Dacres
- CSIRO Health & Biosecurity, Food Innovation Centre, 671 Sneydes Road, Werribee, VIC, 3030, Australia
| | - F Weihs
- PPB Technology Pty Ltd, PO Box 265, Erindale Centre, ACT, 2903, Australia; CSIRO Health & Biosecurity, Canberra, ACT, 2601, Australia.
| | - J Wang
- CSIRO Health & Biosecurity, Canberra, ACT, 2601, Australia
| | - A Anderson
- CSIRO Health & Biosecurity, Canberra, ACT, 2601, Australia
| | - S C Trowell
- PPB Technology Pty Ltd, PO Box 265, Erindale Centre, ACT, 2903, Australia; CSIRO Health & Biosecurity, Canberra, ACT, 2601, Australia
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Lu H, Xie R, S Almoallim H, Alharbi SA, Jhanani GK, Praveenkumar TR, Anderson A, Xia C. Utilization of the Nannochloropsis microalgae biochar prepared via microwave assisted pyrolysis on the mixed biomass fuel pellets. Environ Res 2023; 231:116078. [PMID: 37182832 DOI: 10.1016/j.envres.2023.116078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/03/2023] [Accepted: 05/05/2023] [Indexed: 05/16/2023]
Abstract
Nannochloropsis microalgae biochar has become increasingly attractive due to its potential as a component of microalgae-based biodiesel blends. This biochar is a by-product of the pyrolysis process, but its use in the energy sector has been limited. In this study, pellets were formed using microalgae residues and their physiochemical properties were analyzed to assess the feasibility of using microalgae biochar as a fuel source. Three types of biomasses, namely date seed dust, coconut shell waste, and microalgae biochar, were utilized to produce fuel pellets. These pellets were categorized into three types, B1, B2, and B3, based on the composition of the biomass. The inclusion of microalgae biochar in the pellets resulted in enhanced calorific value, as well as improved heating value and bulk density. Moreover, the mechanical strength of microalgae-based pellets was higher due to their high lignin content compared to another biomass. The moisture absorption test results showed that the use of mixed biomass reduced the moisture content over an extended period. Microalgae pellets exhibited higher young's modulus and greater impact resistance, indicating greater mechanical strength. Furthermore, due to their higher calorific value, the combustion time of microalgae pellets was greater than that of other biomass. In conclusion, the results of this study suggest that microalgae biochar can be a promising alternative fuel source for the energy sector.
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Affiliation(s)
- Haiying Lu
- College of Biology and the Environment, Co-Innovation Center for the Sustainable Forestry in Southern China, Nanjing Forestry University, Nanjing, Jiangsu, 210037, China
| | - Ruiyan Xie
- College of Biology and the Environment, Co-Innovation Center for the Sustainable Forestry in Southern China, Nanjing Forestry University, Nanjing, Jiangsu, 210037, China
| | - Hesham S Almoallim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, PO Box-60169, Riyadh, 11545, Saudi Arabia
| | - Sulaiman Ali Alharbi
- Department of Botany and Microbiology, College of Science, King Saud University, PO Box -2455, Riyadh, 11451, Saudi Arabia
| | - G K Jhanani
- University Centre for Research & Development, Chandigarh University, Mohali, 140103, India
| | - T R Praveenkumar
- Department of Construction Technology and Management, College of Engineering and Technology, Wollega University, Ethiopia.
| | - A Anderson
- Department of Aeronautical Engineering, Sathyabama Institute of Science and Technology, Chennai, Tamil Nadu, India
| | - Changlei Xia
- Jiangsu Co-Innovation Center of Efficient Processing and Utilization of Forest Resources, International Innovation Center for Forest Chemicals and Materials, College of Materials Science and Engineering, Nanjing Forestry University, Nanjing, Jiangsu, 210037, China.
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Croft K, Dallal-York J, Miller S, Anderson A, Donohue C, Jeng E, Plowman EK. Provision of Oral Care in the Cardiothoracic Intensive Care Unit: Survey of Nursing Staff Training, Confidence, Methods, Attitudes, and Perceived Barriers. J Contin Educ Nurs 2023; 54:313-321. [PMID: 37390307 DOI: 10.3928/00220124-20230620-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
BACKGROUND Poor oral health is associated with adverse outcomes in critical care settings. Although provision of oral care is a fundamental aspect of nursing practice, both formal training and practice among nursing staff remain unclear. METHOD Cardiothoracic intensive care unit nurses were recruited to complete a 16-item survey regarding training, confidence, methods, prioritization, and barriers to provision of oral care. RESULTS A total of 108 nurses participated (70% response rate). Formal training in oral care was reported by 38%, most frequently reported as less than 1 hour (53%) in duration. Of the respondents, 70% reported confidence in providing oral care. Nine methods and 16 products were identified, with variability in the frequency of provision. Prioritization of oral care was rated most frequently as moderate (53%), with 28% reporting barriers. CONCLUSION Despite limited formal training, surveyed nurses reported confidence in providing oral care. Methods, frequency, and prioritization were variable. Both development of formal curricula and evaluation of adherence to standardized protocols for oral care are warranted. [J Contin Educ Nurs. 2023;54(7):313-321.].
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Hayden KM, Anderson A, Spira AP, St-Onge MP, Ding J, Culkin M, Molina-Henry D, Sanderlin AH, Reboussin D, Bahnson J, Espeland MA. Daytime Sleepiness Is Associated with Lower Cognitive Scores: The Look AHEAD Study. JAR Life 2023; 12:46-55. [PMID: 37457508 PMCID: PMC10345450 DOI: 10.14283/jarlife.2023.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 07/18/2023]
Abstract
Background Daytime sleepiness is common in older adults and may result from poor nighttime sleep due to sleep disordered breathing, fragmented sleep, or other sleep disorders. Daytime sleepiness may be associated with cognition in older adults. Objectives We investigated the association between self-reported daytime sleepiness and cognitive function in the Look AHEAD clinical trial. Design Observational follow-up of a randomized clinical trial of an intensive lifestyle intervention. Setting Clinic. Participants Participants (n=1,778) aged 45-76 years at baseline with type 2 diabetes and overweight or obesity. Interventions Participants were randomized to an intensive lifestyle intervention for weight loss or a control condition of diabetes support and education. Measurements Participants provided self-reported levels of daytime sleepiness at baseline and years 12-13. Cognitive function was assessed with a neurocognitive battery at years 12-13 and 18-20. Results Participants who reported having frequent daytime sleepiness (often or always) performed significantly worse than others on the cognitive composite (-0.35; p-value=0.014) after controlling for covariates. When stratified by intervention arm, participants assigned to the intensive lifestyle intervention who reported often/always having daytime sleepiness performed worse on Digit Symbol Coding (-0.63; p-value=0.05) and Trail Making Part-B (-0.56; p-value=0.02) after controlling for covariates. Statistical interactions revealed associations between daytime sleepiness and the following covariates: race and ethnicity, APOE ε4 carrier status, baseline history of cardiovascular disease, and depression. Conclusions Daytime sleepiness over ~13 years predicted poorer cognitive performance in older individuals who, by virtue of having diabetes and overweight/obesity, are at high risk for sleep disorders and cognitive impairment.
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Affiliation(s)
- K M Hayden
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - A Anderson
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - A P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
| | - M-P St-Onge
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - J Ding
- Department of Internal Medicine, Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - M Culkin
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - D Molina-Henry
- Winston-Salem State University, Winston-Salem, NC, USA
- University of Southern California, Alzheimer's Therapeutic Research Institute, San Diego, CA, USA
| | - A H Sanderlin
- Department of Internal Medicine, Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Biology, North Carolina Agricultural and Technical State University, Greensboro, NC, USA
| | - D Reboussin
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - J Bahnson
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - M A Espeland
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Internal Medicine, Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Wadaan MA, Baabbad A, Khan MF, Saravanan M, Anderson A. Phytochemical profiling, anti-hyperglycemic, antifungal, and radicals scavenging potential of crude extracts of Athyrium asplenioides- an in-vitro approach. Environ Res 2023; 231:116129. [PMID: 37187305 DOI: 10.1016/j.envres.2023.116129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 05/17/2023]
Abstract
This research was aimed to evaluate the phytochemical profile, antifungal, anti-hyperglycemic, as well as antioxidant activity competence of different extracts of Athyrium asplenioides through in-vitro approach. The A. asplenioides crude methanol extract contained considerable quantity of pharmaceutically precious phytochemicals (saponins, tannins, quinones, flavonoid, phenols, steroid, and terpenoids) than others (acetone, ethyl acetate, and chloroform). Interestingly, the crude methanol extract showed remarkable antifungal activity against Candida species (C. krusei: 19.3 ± 2 mm > C. tropicalis: 18.4 ± 1 mm > C. albicans: 16.5 ± 1 mm > C. parapsilosis: 15.5 ± 2 mm > C. glabrate: 13.5 ± 2 mm > C. auris: 7.6 ± 1 mm) at a concentration of 20 mg mL-1. The crude methanol extract also showed remarkable anti-hyperglycemic activity on concentration basis. Surprisingly, remarkable free radicals scavenging potential against DPPH (76.38%) and ABTS (76.28%) free radicals at a concentration of 20 mg mL-1. According to the findings, the A. asplenioides crude methanol extract contains pharmaceutically valuable phytochemicals and may be useful for drug discovery.
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Affiliation(s)
- Mohammad Ahmad Wadaan
- Bio-Products Research Chair, Department of Zoology, College of Sciences, King Saud University, P.O. Box, 2455, Riyadh, 11451, Saudi Arabia.
| | - Almohannad Baabbad
- Bio-Products Research Chair, Department of Zoology, College of Sciences, King Saud University, P.O. Box, 2455, Riyadh, 11451, Saudi Arabia
| | - Muhammad Farooq Khan
- Bio-Products Research Chair, Department of Zoology, College of Sciences, King Saud University, P.O. Box, 2455, Riyadh, 11451, Saudi Arabia
| | - Mythili Saravanan
- Department of Pharmaceutical Sciences, North Carolina Central University, USA
| | - A Anderson
- Faculty of Science of Engineering, Sathyabama Institute of Science and Technology, Chennai, Tamil Nadu, 600119, India.
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Anderson A, Kumar M V, Gavurová B, Li H, Xia C, Zhang X. Optimizing engine performance and reducing emissions of greenhouse gases through spirulina microalgae and nano-additive blends. Environ Res 2023:115958. [PMID: 37086880 DOI: 10.1016/j.envres.2023.115958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 04/10/2023] [Accepted: 04/19/2023] [Indexed: 05/03/2023]
Abstract
The shift in focus towards biofuels has led to the attention towards fourth-generation fuels, particularly microalgae, due to its high oil productivity and simple cultivation processes. The current study aimed to examine the effects of spirulina microalgae blends in a naturally aspirated diesel engine by testing two blend percentages (15% and 30%) and incorporating Fe2O3 nanoparticles (75 ppm). A series of test conducted in a single-cylinder engine with an optimum compression ratio of 17.5. The fuels tested include 100% diesel (D0), diesel with Fe2O3 nanoparticles (DF), diesel with 15% microalgae blends (B15), diesel with 15% microalgae blends and Fe2O3 nanoparticles (B15F), diesel with 30% microalgae blends (B30), and diesel with 30% microalgae blends and Fe2O3 nanoparticles (B30F). The results showed that the addition of microalgae blends led to a marginal increase in engine performance, while the addition of Fe2O3 nanoparticles led to a significant increase in brake thermal efficiency and decreased fuel consumption. The emissions rate was also lower compared to diesel, but the addition of Fe2O3 nanoparticles increased the oxygen content in the fuel, thereby improving the combustion rates. By ensuring the complete combustion the formation of CO2, HC and smoke intensity was also found to be significantly lower compared to diesel fuel. On the contrary, NOx increased due to the cylinder temperatures. This research highlights the potential of using microalgae as a sustainable source of biofuel, and the positive effects of adding Fe2O3 nanoparticles to enhance the fuel's efficiency.
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Affiliation(s)
- A Anderson
- School of Mechanical Engineering, Sathyabama Institute of Science and Technology, India
| | - Vignesh Kumar M
- Department of Aerospace Engineering, SRM Institute of Science and Technology, India
| | - Beata Gavurová
- Technical University of Košice, Faculty of Mining, Ecology, Process Control and Geotechnologies, Letná 1/9, 042 00, Košice-Sever, Slovak Republic
| | - Hui Li
- College of Electrical and Electronic Engineering, Changchun University of Technology, Changchun, Jilin, 130012, China
| | - Changlei Xia
- College of Materials Science and Engineering, Nanjing Forestry University, Nanjing, Jiangsu, 210037, China
| | - Xiumei Zhang
- College of Materials Science and Engineering, Nanjing Forestry University, Nanjing, Jiangsu, 210037, China.
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Robison RD, DiBiase L, Anderson A, Wymer JP, Plowman EK. Maximum lingual pressure impacts both swallowing safety and efficiency in individuals with amyotrophic lateral sclerosis. Neurogastroenterol Motil 2023; 35:e14521. [PMID: 36573040 PMCID: PMC10033350 DOI: 10.1111/nmo.14521] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 12/05/2022] [Accepted: 12/10/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Although reduced lingual strength is a confirmed early manifestation of amyotrophic lateral sclerosis (ALS), its functional impact on swallowing remains unclear. We therefore sought to examine relationships between maximum anterior isometric lingual pressure (MAIP) with swallowing safety, swallowing efficiency, and swallowing timing metrics in a large cohort of individuals with ALS. METHODS Ninety-seven participants with ALS completed a standardized videofluoroscopic swallowing examination (VF) and lingual pressure testing (Iowa Oral Performance Instrument). Duplicate and blinded ratings of the Penetration-Aspiration Scale (PAS) and Analysis of Swallowing Physiology: Events, Kinematics and Timing (ASPEKT) percent efficiency (%C2-C42 ) and timing (laryngeal vestibule closure (LVC) duration: amount of time (milliseconds, msec) between LVC onset and laryngeal vestibule opening; time-to-LVC: hyoid burst to onset of LVC (msec); and swallow reaction time: interval between bolus passing ramus of mandible and onset of LVC (msec)) were performed across bolus trials. Swallowing safety (safe PAS: 1, 2, 4; unsafe PAS: 3, 5, 6, 7, and 8) and efficiency (inefficient: ≥3% worst total residue) were derived. Statistical analyses including descriptives, binary logistic regressions, and Spearman's rho correlations were performed (α = 0.05). KEY RESULTS Mean MAIP was 36.3 kPa (SD: 18.7). Mean MAIP was higher in those with safe swallowing as compared to those who penetrated (mean difference: 12 kPa) or aspirated (mean difference: 18 kPa). Individuals with efficient swallowing demonstrated higher MAIP than those with inefficient swallowing (mean difference: 11 kPa). Binary logistic regression analyses revealed increasing MAIP was significantly associated with a 1.06 (95% CI: 1.03-1.09) and 1.04 (95% CI: 1.01-1.06) greater odds of safe and efficient swallowing, respectively. No relationships were observed between MAIP and swallow reaction time across all bolus trials. Longer time-to-LVC (5 ml thin liquid: rs = -0.35, p = 0.002; cup sip thin liquid: rs = -0.26, p = 0.02; moderately thick liquid: rs = -0.28, p = 0.01) and prolonged LVC duration (cup sip thin liquid, rs = -0.34, p = 0.003) were associated with lower MAIP. CONCLUSIONS AND INFERENCES Reduced lingual strength was confirmed in this group of 97 individuals with ALS that was associated with a diminished ability to effectively transport boluses and aide in laryngeal vestibule closure to prevent entry of material into the airway.
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Affiliation(s)
- Raele Donetha Robison
- Aerodigestive Research Core, University of Florida, Gainesville, Florida, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Center for Health Disparities Research, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Lauren DiBiase
- Aerodigestive Research Core, University of Florida, Gainesville, Florida, USA
| | - Amber Anderson
- Aerodigestive Research Core, University of Florida, Gainesville, Florida, USA
| | - James P. Wymer
- Department of Neurology, University of Florida, Gainesville, Florida, USA
| | - Emily K. Plowman
- Aerodigestive Research Core, University of Florida, Gainesville, Florida, USA
- Department of Neurology, University of Florida, Gainesville, Florida, USA
- Speech, Language and Hearing Science Department, University of Florida, Gainesville, Florida, USA
- Department of Surgery, University of Florida, Gainesville, Florida, USA
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12
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Dallal-York J, Croft K, Anderson A, DiBiase L, Donohue C, Vasilopoulos T, Shahmohammadi A, Pelaez A, Pipkin M, Hegland KW, Machuca TN, Plowman EK. A prospective examination of swallow and cough dysfunction after lung transplantation. Neurogastroenterol Motil 2023; 35:e14458. [PMID: 36168190 DOI: 10.1111/nmo.14458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/08/2022] [Accepted: 08/23/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Swallow and cough dysfunction are possible surgical complications of lung transplantation (LT). We examined voluntary cough strength, sensorimotor reflexive cough integrity, and swallow-related respiratory rate (RR) across swallowing safety and aspiration response groups in recovering LT recipients. METHODS Forty-five LT recipients underwent flexible endoscopic evaluation of swallowing indexed by the validated Penetration Aspiration Scale. RR before and after a 3-ounce water drinking task was measured. Voluntary and reflexive cough screening were performed to index motor and sensory outcomes. T-tests, one-way ANOVAs, and chi-square (odds ratios) were used. RESULTS 60% of patients exhibited laryngeal penetration (n = 27) and 40% demonstrated tracheal aspiration (n = 18); 72% (n = 13) demonstrated silent aspiration. Baseline RR was higher in aspirators versus non-aspirators (26.5 vs. 22.6, p = 0.04) and in silent aspirators compared to non-silent aspirators (27.9 vs. 20.7, p = 0.01). RR change post-swallowing did not differ between aspiration response groups; however, it was significantly higher in aspirators compared to non-aspirators (3 vs. -2, p = 0.02). Compared to non-silent aspirators, silent aspirators demonstrated reduced voluntary cough peak expiratory flow (PEF; 166 vs. 324 L/min, p = 0.01). PEF, motor and urge to cough reflex cough ratings did not differ between aspirators and non-aspirators. Silent aspirators demonstrated a 7.5 times higher odds of failing reflex cough screening compared to non-silent aspirators (p = 0.07). CONCLUSIONS During the acute recovery period, all LT participants demonstrated some degree of unsafe swallowing and reduced voluntary cough strength. Silent aspirators exhibited elevated RR, reduced voluntary cough physiologic capacity to defend the airway, and a clinically distinguishable blunted motor response to reflex cough screening.
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Affiliation(s)
- Justine Dallal-York
- Aerodigestive Research Core, University of Florida, Gainesville, Florida, USA
- Department of Speech, Language and Hearing Sciences, University of Florida, Gainesville, Florida, USA
| | - Kayla Croft
- Aerodigestive Research Core, University of Florida, Gainesville, Florida, USA
- Department of Speech, Language and Hearing Sciences, University of Florida, Gainesville, Florida, USA
| | - Amber Anderson
- Aerodigestive Research Core, University of Florida, Gainesville, Florida, USA
- Department of Speech, Language and Hearing Sciences, University of Florida, Gainesville, Florida, USA
| | - Lauren DiBiase
- Aerodigestive Research Core, University of Florida, Gainesville, Florida, USA
- Department of Speech, Language and Hearing Sciences, University of Florida, Gainesville, Florida, USA
| | - Cara Donohue
- Aerodigestive Research Core, University of Florida, Gainesville, Florida, USA
- Department of Speech, Language and Hearing Sciences, University of Florida, Gainesville, Florida, USA
- Department of Surgery, Division of Cardiothoracic Surgery, University of Florida, Gainesville, Florida, USA
| | - Terrie Vasilopoulos
- Aerodigestive Research Core, University of Florida, Gainesville, Florida, USA
- Departments of Anesthesiology and Orthopedics and Rehabilitation, University of Florida, Gainesville, Florida, USA
| | | | - Andres Pelaez
- Department of Neurology, University of Florida, Gainesville, Florida, USA
| | - Mauricio Pipkin
- Department of Neurology, University of Florida, Gainesville, Florida, USA
| | - Karen W Hegland
- Department of Speech, Language and Hearing Sciences, University of Florida, Gainesville, Florida, USA
- Breathing Research and Therapeutics Center, University of Florida, Gainesville, Florida, USA
| | - Tiago N Machuca
- Department of Neurology, University of Florida, Gainesville, Florida, USA
| | - Emily K Plowman
- Aerodigestive Research Core, University of Florida, Gainesville, Florida, USA
- Department of Speech, Language and Hearing Sciences, University of Florida, Gainesville, Florida, USA
- Department of Surgery, Division of Cardiothoracic Surgery, University of Florida, Gainesville, Florida, USA
- Departments of Anesthesiology and Orthopedics and Rehabilitation, University of Florida, Gainesville, Florida, USA
- Department of Neurology, University of Florida, Gainesville, Florida, USA
- Breathing Research and Therapeutics Center, University of Florida, Gainesville, Florida, USA
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13
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Plowman EK, Gray LT, Chapin J, Anderson A, Vasilopoulos T, Gooch C, Vu T, Wymer JP. Respiratory Strength Training in Amyotrophic Lateral Sclerosis: A Double-Blind, Randomized, Multicenter, Sham-Controlled Trial. Neurology 2023; 100:e1634-e1642. [PMID: 36805435 PMCID: PMC10103108 DOI: 10.1212/wnl.0000000000206830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 12/05/2022] [Indexed: 02/22/2023] Open
Abstract
OBJECTIVE Evaluate the short-term physiologic and one-year functional impact of a 12-week inspiratory and expiratory respiratory strength training (RST) program in individuals with amyotrophic lateral sclerosis (ALS). METHODS A double-blind, randomized, sham-controlled trial was conducted in 45individuals with early-stage ALS. Participants were randomized into 12-weeks of active-RST (30% load, n=23) or sham-RST (0% load, n=22). An intent-to-treat analysis was conducted. Linear regression of pre-post change with group status and pre-test scores as predictors was conducted. Primary outcomes included maximum expiratory and inspiratory pressure (MEP, MIP) and secondary outcomes were cough spirometry and forced vital capacity. Exploratory follow-up outcomes included one-year global and bulbar decline (ALS Functional Rating Scale-Revised- ALSFRS-R total and Bulbar subscale slope), oral-intake status, and time to noninvasive ventilation (NIV). RESULTS RST completion rate was 91% with no RST-related adverse events. A 12-week RST program led to increases in MEP (p=0.004) but not MIP (p=0.33). On average, MEP increased by 20.8 cmH20 following active-RST (95% CI: +7.6, +33.9) and decreased by 1.0 cmH20 (95% CI: -9.1, +7.2) following sham-RST. Mean MIP increased by 8.9 cmH20 (95% CI: +1.5, +16.3) and 4.8 cmH20 (95% CI: -0.6, +10.2) for the active and sham groups respectively. Secondary Outcomes: RST led to significant increases in cough peak inspiratory flow (p=0.02), however, did not impact cough expiratory flow (p = 0.06) or FVC (p=0.60). Twelve-Month Outcomes: A significant difference in ALSFRS-R Bulbar subscale slope was observed across treatment groups, with a more than two-fold faster rate of bulbar decline in the sham versus active-RST groups observed (-0.29 vs. -0.12 points/month, p=0.02). Total ALSFRS-R slope, feeding status, and time to NIV did not differ across treatment groups (p >0.05). CONCLUSIONS RST was well tolerated and led to improvements in some, but not all, short- and long-term outcomes. RST represents a proactive rehabilitative intervention that could increase physiologic capacity of specific breathing and airway clearance functions during the early stages of ALS. Further work is needed to determine optimal training intensity, resistance load specifications, and potential long-term functional outcomes.
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Affiliation(s)
| | - Lauren Tabor Gray
- Aerodigestive Research Core, University of Florida, Gainesville, FL.,Center for Collaborative Research, NOVA Southeastern University, Fort Lauderdale, FL
| | - Jennifer Chapin
- Aerodigestive Research Core, University of Florida, Gainesville, FL
| | - Amber Anderson
- Aerodigestive Research Core, University of Florida, Gainesville, FL
| | | | - Clifton Gooch
- Department of Neurology, University of South Florida, Tampa, FL
| | - Tuan Vu
- Department of Neurology, University of South Florida, Tampa, FL
| | - James P Wymer
- Department of Neurology, University of Florida, Gainesville, FL
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14
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Plowman EK, Anderson A, York JD, DiBiase L, Vasilopoulos T, Arnaoutakis G, Beaver T, Martin T, Jeng EI. Dysphagia after cardiac surgery: Prevalence, risk factors, and associated outcomes. J Thorac Cardiovasc Surg 2023; 165:737-746.e3. [PMID: 33814177 DOI: 10.1016/j.jtcvs.2021.02.087] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 02/17/2021] [Accepted: 02/17/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVES The study objectives were to determine the prevalence of swallowing impairment in adults after cardiac surgery and examine associated risk factors and health-related outcomes. METHODS A prospective single-center study was conducted in postoperative adult cardiac surgery patients with no history of dysphagia. A standardized fiberoptic endoscopic evaluation of swallowing was performed within 72 hours of extubation. Blinded raters completed validated outcomes of swallowing safety and efficiency. Demographic, surgical, and postoperative health-related outcomes were collected. Univariate and multivariable regression analyses were performed with odds ratios (OR) and 95% confidence intervals (CIs). RESULTS In 182 patients examined, imaging confirmed inefficient swallowing (residue) in 52% of patients and unsafe swallowing in 94% (65% penetrators, 29% aspirators). Silent aspiration was observed in 53% of aspirators, and 32% did not clear aspirate material. Independent risk factors for aspiration included New York Heart Association III and IV (OR, 2.9; CI, 1.2-7.0); reoperation (OR, 2.0; CI, 0.7-5.5); transesophageal echocardiogram images greater than 110 (OR, 2.6; CI, 1.1-6.3); intubation greater than 27 hours (OR, 2.1; CI, 0.8-5.3); and endotracheal tube size 8.0 or greater (OR, 3.1; CI, 1.1-8.6). Patients with 3 or 4 identified risk factors had a 16.4 (CI, 3.2-148.4) and 22.4 (CI, 3.7-244.7) increased odds of aspiration, respectively. Compared with nonaspirators, aspirators waited an additional 85 hours to resume oral intake, incurred $49,372 increased costs, and experienced a 43% longer hospital stay (P < .05). Aspiration was associated with pneumonia (OR, 2.6; CI, 1.1-6.5), reintubation (OR, 5.7; CI, 2.1-14.0), and death (OR, 2.8; CI, 1.2-9.0). CONCLUSIONS Tracheal aspiration was prevalent, covert, and associated with increased morbidity and mortality.
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Affiliation(s)
- Emily K Plowman
- Aerodigestive Research Core, University of Florida, Gainesville, Fla; Department of Speech, Language and Hearing Sciences, University of Florida, Gainesville, Fla; Division of Cardiothoracic Surgery, Department of Surgery, University of Florida, Gainesville, Fla.
| | - Amber Anderson
- Aerodigestive Research Core, University of Florida, Gainesville, Fla; Department of Speech, Language and Hearing Sciences, University of Florida, Gainesville, Fla
| | - Justine Dallal York
- Aerodigestive Research Core, University of Florida, Gainesville, Fla; Department of Speech, Language and Hearing Sciences, University of Florida, Gainesville, Fla
| | - Lauren DiBiase
- Aerodigestive Research Core, University of Florida, Gainesville, Fla; Department of Speech, Language and Hearing Sciences, University of Florida, Gainesville, Fla
| | - Terrie Vasilopoulos
- Aerodigestive Research Core, University of Florida, Gainesville, Fla; Departments of Anesthesiology and Orthopedics and Rehabilitation, University of Florida, Gainesville, Fla
| | - George Arnaoutakis
- Division of Cardiothoracic Surgery, Department of Surgery, University of Florida, Gainesville, Fla
| | - Thomas Beaver
- Division of Cardiothoracic Surgery, Department of Surgery, University of Florida, Gainesville, Fla
| | - Tomas Martin
- Division of Cardiothoracic Surgery, Department of Surgery, University of Florida, Gainesville, Fla
| | - Eric I Jeng
- Division of Cardiothoracic Surgery, Department of Surgery, University of Florida, Gainesville, Fla
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15
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Donohue C, Gray LT, Anderson A, DiBiase L, Wymer JP, Plowman EK. Profiles of Dysarthria and Dysphagia in Individuals With Amyotrophic Lateral Sclerosis. J Speech Lang Hear Res 2023; 66:154-162. [PMID: 36525626 PMCID: PMC10023186 DOI: 10.1044/2022_jslhr-22-00312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 07/22/2022] [Accepted: 09/21/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE While dysarthria and dysphagia are known bulbar manifestations of amyotrophic lateral sclerosis (ALS), the relative prevalence of speech and swallowing impairments and whether these bulbar symptoms emerge at the same time point or progress at similar rates is not yet clear. We, therefore, sought to determine the relative prevalence of speech and swallowing impairments in a cohort of individuals with ALS and to determine the impact of disease duration, severity, and onset type on bulbar impairments. METHOD Eighty-eight individuals with a confirmed diagnosis of ALS completed the ALS Functional Rating Scale-Revised (ALSFRS-R), underwent videofluoroscopy (VF), and completed the Sentence Intelligibility Test (SIT) during a single visit. Demographic variables including disease duration and onset type were also obtained from participants. Duplicate, independent, and blinded ratings were completed using the Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) scale and SIT to index dysphagia (DIGEST ≥ 1) and dysarthria (< 96% intelligible and/or < 150 words per minute) status. Descriptive statistics, Pearson chi-squared tests, independent-samples t tests, and odds ratios were performed. RESULTS Dysphagia and dysarthria were instrumentally confirmed in 68% and 78% of individuals with ALS, respectively. Dysarthria and dysphagia were associated (p = .01), and bulbar impairment profile distributions in rank order included (a) dysphagia - dysarthria (59%, n = 52), (b) no dysphagia - dysarthria (19%, n = 17), (c) no dysphagia - no dysarthria (13%, n = 11), and (d) dysphagia - no dysarthria (9%, n = 8). Participants with dysphagia or dysarthria demonstrated 4.2 higher odds of exhibiting a bulbar impairment in the other domain than participants with normal speech and swallowing (95% CI [1.5, 12.2]). There were no differences in ALSFRS-R total scores or disease duration across bulbar impairment profiles (p > .05). ALSFRS-R bulbar subscale scores were significantly lower in individuals with dysphagia versus no dysphagia (8.4 vs. 10.4, p < .0001) and dysarthria versus no dysarthria (8.5 vs. 10.9, p < .0001). Dysphagia and onset type (p = .003) and dysarthria and onset type were associated (p < .0001). CONCLUSIONS Over half of the individuals with ALS in this study demonstrated both dysphagia and dysarthria. Of those with only one bulbar impairment, speech was twice as likely to be the first bulbar symptom to degrade. Future studies are needed to confirm these findings and determine the longitudinal progression of bulbar impairments in this patient population.
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Affiliation(s)
- Cara Donohue
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
- Breathing Research and Therapeutics Center, University of Florida, Gainesville
| | - Lauren Tabor Gray
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
- Breathing Research and Therapeutics Center, University of Florida, Gainesville
- Center of Collaborative Research, NOVA Southeastern University, Fort Lauderdale, FL
| | - Amber Anderson
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
| | - Lauren DiBiase
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
| | - James P. Wymer
- Department of Neurology, University of Florida, Gainesville
| | - Emily K. Plowman
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
- Breathing Research and Therapeutics Center, University of Florida, Gainesville
- Department of Neurology, University of Florida, Gainesville
- Department of Surgery, University of Florida, Gainesville
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16
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Stahelski A, Anderson A, Browitt N, Radeke M. Corrigendum: Facial expressions and emotion labels are separate initiators of trait inferences from the face. Front Psychol 2022; 13:1095086. [PMID: 36570998 PMCID: PMC9770008 DOI: 10.3389/fpsyg.2022.1095086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022] Open
Abstract
[This corrects the article DOI: 10.3389/fpsyg.2021.749933.].
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Affiliation(s)
- Anthony Stahelski
- Department of Psychology, Central Washington University, Ellensburg, WA, United States
| | - Amber Anderson
- Department of Psychology, Central Washington University, Ellensburg, WA, United States
| | | | - Mary Radeke
- Department of Psychology, Central Washington University, Ellensburg, WA, United States,*Correspondence: Mary Radeke
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17
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Donohue C, Tabor Gray L, Anderson A, DiBiase L, Chapin J, Wymer JP, Plowman EK. Discriminant Ability of the Eating Assessment Tool-10 to Detect Swallowing Safety and Efficiency Impairments. Laryngoscope 2022; 132:2319-2326. [PMID: 35137963 DOI: 10.1002/lary.30043] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/07/2022] [Accepted: 01/21/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVES/HYPOTHESIS Quick, sensitive dysphagia screening tools are necessary to identify high-risk patients for further evaluation in busy multidisciplinary amyotrophic lateral sclerosis (ALS) clinics. We examined the relationship between self-perceived dysphagia using the validated Eating Assessment Tool-10 (EAT-10) and videofluoroscopic analysis of swallowing safety and efficiency. STUDY DESIGN Prospective, observational, longitudinal study. METHODS Individuals with ALS completed the EAT-10 and a videofluoroscopic swallowing study. Duplicate, independent, blinded analyses of the validated Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) scale were performed to index swallowing safety and efficiency (mild dysphagia: DIGEST ≥ 1, moderate dysphagia: DIGEST ≥ 2). A between-groups analysis of variance with Games-Howell test for post-hoc pairwise comparisons was performed to examine EAT-10 scores across dysphagia severity levels. Receiver operator characteristic curve analysis, area under the curve (AUC), sensitivity, specificity, positive-negative predictive values (PPV, NPV), and odds ratios (OR) were derived. RESULTS Four hundred and thirty five paired EAT-10 and DIGEST scores were analyzed. Mean EAT-10 score was 8.48 (95% confidence interval [CI]: 7.63-9.33). Individuals with dysphagia demonstrated higher EAT-10 scores (mild: 4.1 vs. 11.3, moderate: 6.0 vs. 17.5, P < .001). Mean EAT-10 scores increased across DIGEST levels (D0: 4.1, D1: 7.9, D2: 15.1, D3: 20.4, D4: 39.0). For mild dysphagia, an EAT-10 cut score of 3 was optimal: AUC 0.74 (95% CI: 0.69-0.78; sensitivity: 77%; specificity: 53%; PPV: 71%; NPV: 60%; OR: 3.5). An EAT-10 cut score of 7 optimized detection of moderate dysphagia: AUC 0.83 (95% CI: 0.78-0.87; sensitivity: 81%; specificity: 66%; PPV: 39%; NPV: 93%; OR: 8.1). CONCLUSION The EAT-10 is an easy-to-administer dysphagia screening tool with good discriminant ability for use in ALS clinics. LEVEL OF EVIDENCE 2 Laryngoscope, 132:2319-2326, 2022.
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Affiliation(s)
- Cara Donohue
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, Florida, U.S.A.,Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Florida, U.S.A.,Breathing Research and Therapeutics Center, University of Florida, Gainesville, Florida, U.S.A
| | - Lauren Tabor Gray
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, Florida, U.S.A.,Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Florida, U.S.A.,Breathing Research and Therapeutics Center, University of Florida, Gainesville, Florida, U.S.A
| | - Amber Anderson
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, Florida, U.S.A.,Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Florida, U.S.A
| | - Lauren DiBiase
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, Florida, U.S.A.,Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Florida, U.S.A
| | - Jennifer Chapin
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, Florida, U.S.A.,Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Florida, U.S.A
| | - James P Wymer
- Department of Neurology, University of Florida, Gainesville, Florida, U.S.A
| | - Emily K Plowman
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, Florida, U.S.A.,Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Florida, U.S.A.,Breathing Research and Therapeutics Center, University of Florida, Gainesville, Florida, U.S.A.,Department of Neurology, University of Florida, Gainesville, Florida, U.S.A.,Department of Surgery, University of Florida, Gainesville, Florida, U.S.A
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18
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De Montalembert M, Anderson A, Costa F, Jastaniah W, Kuntz J, Odame I, Alfa Cissé O, Beaubrun A, Lartey B, Inusa B. Étude SHAPE (Sickle cell Health Awareness, Perspectives and Experience) : résultats de l’enquête sur le fardeau de la drépanocytose pour les patients et leurs besoins non satisfaits, rapportés par les professionnels de santé. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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19
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Odame I, Anderson A, Costa F, Inusa B, Jastaniah W, Kuntz J, Alkhadem Z, Tinga B, Ba D, Ingoli E, James J, Clark A, Alfa Cissé O, Beaubrun A, Lartey B, De Montalembert M. Étude SHAPE (Sickle Cell Health Awareness, Perspectives and Experiences) : enquête sur le fardeau de la drépanocytose et les besoins non satisfaits rapportés par les patients et les aidants. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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20
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Nguyen M, Beidler P, Lybarger K, Anderson A, Holmberg O, Kang J, Ford E. Automatic Prediction of Severity Score of Incident Learning Reports in Radiation Oncology Using Natural Language Processing. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Costa FF, Montalembert M, Anderson A, Jastaniah W, Kunz JB, Odame I, Beaubrun A, Montealegre-Golcher F, Lartey B, Inusa BPD. PERSPECTIVAS DOS MÉDICOS BRASILEIROS SOBRE A DOENÇA FALCIFORME E SEU TRATAMENTO: RESULTADOS DA PESQUISA DE CONHECIMENTO, PERSPECTIVAS E EXPERIÊNCIAS EM SAÚDE DA DOENÇA FALCIFORME (SICKLE CELL HEALTH AWARENESS, PERSPECTIVES AND EXPERIENCES, SHAPE). Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Costa FF, Odame I, Anderson A, Inusa BPD, Jastaniah W, Kunz JB, Soares MZ, Montealegre-Golcher F, Lartey B, Montalembert M. IMPACTO DA DOENÇA FALCIFORME NA QUALIDADE DE VIDA DE PACIENTES BRASILEIROS E SEUS CUIDADORES: ACHADOS DA PESQUISA DE PERCEPÇÃO, PERSPECTIVAS E EXPERIÊNCIAS EM SAÚDE FALCIFORME. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Pacella G, Anderson A, Ko E, Capell B. 510 The role of histone demethylase UTX on epidermal homeostasis and carcinogenesis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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López AMM, Huang S, Anderson A, Capell B. 506 Epidermal epitranscriptomics: METTL3 dependent m6A maintains the epidermal stem cell state through regulation of chromatin-modifying enzymes. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Donohue C, Robison R, DiBiase L, Anderson A, Vasilopoulos T, Plowman EK. Comparison of Validated Videofluoroscopic Outcomes of Pharyngeal Residue: Concordance Between a Perceptual, Ordinal, and Bolus-Based Rating Scale and a Normalized Pixel-Based Quantitative Outcome. J Speech Lang Hear Res 2022; 65:2510-2517. [PMID: 35749660 PMCID: PMC9584126 DOI: 10.1044/2022_jslhr-21-00659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/09/2022] [Accepted: 04/11/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE This study compared the concordance between two validated videofluoroscopic pharyngeal residue outcome scales used in clinical and research settings: the Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) and the Analysis of Swallowing Physiology: Events, Kinematics and Timing (ASPEKT) percent residue metric. METHOD Two trained raters completed independent and blinded videofluoroscopic ratings of both DIGEST efficiency and ASPEKT percent pharyngeal residue outcomes for bolus trials of 5 cc Varibar thin liquid (n = 223), thin liquid comfortable cup sips (n = 223), and 5 cc Varibar thin honey (n = 223). Spearman's rho and Kruskal-Wallis analyses were performed for each bolus type. RESULTS Significant associations between DIGEST and ASPEKT pharyngeal residue outcomes were noted for 5 cc thin (r = .54, p < .001), cup sip thin (r = .41, p < .001), and 5 cc thin honey (r = .60, p < .001) bolus trials. ASPEKT percent residue increased across worsening DIGEST efficiency ordinal scale levels, with a main effect for each bolus type. Post hoc analysis revealed significant differences in the ASPEKT percent residue values between each DIGEST pairwise comparison for the thin cup sip bolus trial and for each pairwise comparison except between the moderate-to-severe (less than half vs. majority) ordinal levels for the 5 cc thin and 5 cc honey bolus trials, p < .05. CONCLUSIONS Perceptual, ordinal (DIGEST) and quantitative, pixel-based (ASPEKT) videofluoroscopic pharyngeal residue outcomes were associated in this data set of 669 bolus trials. Future research is warranted to confirm these results.
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Affiliation(s)
- Cara Donohue
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
- Breathing Research and Therapeutics Center, University of Florida, Gainesville
| | - Raele Robison
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
- Department of Medicine, University of Wisconsin–Madison
| | - Lauren DiBiase
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
| | - Amber Anderson
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
| | | | - Emily K. Plowman
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
- Breathing Research and Therapeutics Center, University of Florida, Gainesville
- Department of Neurology, University of Florida, Gainesville
- Department of Surgery, University of Florida, Gainesville
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Donohue C, Tabor Gray L, Chapin J, Anderson A, DiBiase L, Wymer JP, Plowman EK. Discriminant ability of the 3-ounce water swallow test to detect aspiration in amyotrophic lateral sclerosis. Neurogastroenterol Motil 2022; 34:e14310. [PMID: 34936158 DOI: 10.1111/nmo.14310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/18/2021] [Accepted: 12/10/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Given the need for quick and accurate dysphagia screening tools to optimize referral workflows and resource utilization in fast-paced multidisciplinary amyotrophic lateral sclerosis (ALS) clinics, we evaluated the discriminant ability of the 3 oz. water swallow test (WST) to detect aspiration in individuals with ALS. METHODS A total of 212 paired 3 oz. WST (index test) and standardized videofluoroscopic swallow studies (reference test) were completed in individuals with a confirmed diagnosis of ALS. Blinded raters analyzed swallowing safety using the validated penetration-aspiration scale (PAS; non-aspirator: PAS < 6; aspirator: PAS ≥ 6). Receiver operating characteristic curve analysis, area under the curve (AUC), sensitivity, specificity, and positive and negative predictive values (PPV, NPV) were calculated. KEY RESULTS Index test: 78 (36.8%) WSTs were scored as a fail and 134 (63.2%) as a pass. REFERENCE TEST Aspiration was confirmed in 67 (31.6%) reference tests with 145 (68.4%) reference tests verified as having no aspiration. Sensitivity and specificity of the 3 oz. WST to detect radiographically confirmed aspiration was 55.2% and 71.7%, respectively (AUC: 0.635, PPV: 47.4%, NPV: 77.6%). CONCLUSIONS & INFERENCES In this dataset, the 3 oz. WST did not demonstrate adequate sensitivity or specificity to detect aspiration in people with ALS as a stand-alone dysphagia screening tool.
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Affiliation(s)
- Cara Donohue
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, Florida, USA.,Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Florida, USA.,Breathing Research and Therapeutics Center, University of Florida, Gainesville, Florida, USA
| | - Lauren Tabor Gray
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, Florida, USA.,Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Florida, USA.,Breathing Research and Therapeutics Center, University of Florida, Gainesville, Florida, USA
| | - Jennifer Chapin
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, Florida, USA.,Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Florida, USA
| | - Amber Anderson
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, Florida, USA.,Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Florida, USA
| | - Lauren DiBiase
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, Florida, USA.,Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Florida, USA
| | - James P Wymer
- Department of Neurology, University of Florida, Gainesville, Florida, USA
| | - Emily K Plowman
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, Florida, USA.,Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Florida, USA.,Breathing Research and Therapeutics Center, University of Florida, Gainesville, Florida, USA.,Department of Neurology, University of Florida, Gainesville, Florida, USA.,Department of Surgery, University of Florida, Gainesville, Florida, USA
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Lewis ME, Smith J, Wildcat S, Anderson A, Walls ML. The Health Effects of a Cherokee Grounded Culture and Leadership Program. IJERPH 2022; 19:ijerph19138018. [PMID: 35805678 PMCID: PMC9266134 DOI: 10.3390/ijerph19138018] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 11/16/2022]
Abstract
Introduction: Indigenous youth and young adults endure some of the highest rates of physical and mental health problems in the United States compared to their non-Indigenous counterparts. Colonization, oppression, and discrimination play a substantial role in these inequitable disease rates. However, culture (e.g., identity, participation, and connection) relates to the prevention of and recovery from illness in Indigenous populations. The Remember the Removal program aims to teach Indigenous youth and young adults tribally specific culture, history, and language to put them on a trajectory to become informed and culturally connected community leaders. We examined the program’s effects on health. Method: Thirty Remember the Removal program participants, mainly young adults, completed surveys four times: before the program’s start, at the end of the training period, at the program’s end, and at a six-month follow-up. Various indicators of physical, mental, spiritual, and cultural health and well-being were measured at each time period. Paired t-tests were completed to compare baseline scores to each subsequent time interval. Results: At program completion, and as indicated with an asterisk at the six month follow-up, participants had statistically significantly improved diet and exercise measures (e.g., reduced sugary, salty, and fatty foods, reduced soda consumption, increased fruit consumption, and improved self-efficacy for exercise), improved mental health indicators (e.g., reduced stress, anxiety, depression*, anger*, post-traumatic stress disorder, and microaggressions*, and improved positive mental health) and improved social and cultural connection (e.g., social support, Cherokee identity*, Cherokee values). Discussion: This is one of the first quantitative studies to demonstrate the profound effects that cultural learning and connection have on the health and well-being of Indigenous people and practices. It also demonstrates the specificity and effectiveness of a program created by and for tribal citizens. Future programs with Indigenous populations should work to center cultural connection and ensure that programs are created and directed by tribal community members.
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Affiliation(s)
- Melissa E. Lewis
- Department of Family and Community Medicine, School of Medicine, University of Missouri, Columbia, MO 65212, USA;
- Correspondence:
| | - Jamie Smith
- Department of Family and Community Medicine, School of Medicine, University of Missouri, Columbia, MO 65212, USA;
| | - Sky Wildcat
- Department of Rehabilitation, Human Resources, & Communication Disorders, University of Arkansas, Fayetteville, AR 72701, USA;
| | - Amber Anderson
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA;
| | - Melissa L. Walls
- Center for American Indian Health, Bloomberg School of Public Health, Johns Hopkins University, Duluth, MN 55812, USA;
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Bourke S, Palmer E, Echevarria C, Anderson A, Doe S, Brodlie M, Ward C. P200 The prevalence of laryngopharyngeal reflux and sino-nasal symptoms in adults with cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00529-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Dallal-York J, Segalewitz T, Croft K, Colsky J, DiBiase L, Anderson A, Vasilopoulos T, Pelaez A, Shahmohammadi A, Pipkin M, Machuca TN, Plowman EK. Incidence, Risk Factors and Sequelae of Dysphagia Mediated Aspiration Following Lung Transplantation. J Heart Lung Transplant 2022; 41:1095-1103. [DOI: 10.1016/j.healun.2022.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 04/11/2022] [Accepted: 05/02/2022] [Indexed: 10/18/2022] Open
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Anderson A, Anbarasu A, Pasupuleti RR, Manigandan S, Praveenkumar TR, Aravind Kumar J. Treatment of heavy metals containing wastewater using biodegradable adsorbents: A review of mechanism and future trends. Chemosphere 2022; 295:133724. [PMID: 35101432 DOI: 10.1016/j.chemosphere.2022.133724] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/16/2022] [Accepted: 01/20/2022] [Indexed: 05/27/2023]
Abstract
The direct disposal of industrial effluents into the aquatic system is considered as a significant environmental hazard in many countries. Because of poisonous chemicals, substantial volumes of effluent release, as well as the lack of adequate of conventional treatment methodologies, industrial effluent treatment is extremely difficult. Numerous researchers have been interested in adsorption technology for its high efficiency of pollutant removal, low cost, and abundantly available adsorbent. Various adsorbent materials, both natural and modified form, have been widely used for the removal of toxic contaminants from industrial effluent. This paper highlights recent advancements in multiple modification types to functionalize the adsorbent material, resulting in higher adsorption capacity on various toxic pollutants. This review provides an overview of the adsorption mechanism and parameters (pH, adsorbent dosage, initial concentration, temperature and interaction time), which influencing the removal efficiency of adsorbents. Furthermore, this review compiles the desorption study to recover the adsorbent and improve the cycle's financial viability. This review provides a concise overview of the future directions and outlook in the framework of adsorbent application for industrial wastewater treatment.
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Affiliation(s)
- A Anderson
- Department of Aeronautical Engineering, Sathyabama Institute of Science and Technology, Chennai, 119, India
| | - A Anbarasu
- Department of Mechanical Engineering, Panimalar Engineering College, 600123, India
| | - Raghavendra Rao Pasupuleti
- Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Sekar Manigandan
- Department of Aeronautical Engineering, Sathyabama Institute of Science and Technology, Chennai, 119, India.
| | - T R Praveenkumar
- Department of Construction Technology and Management, Wollega University, Nekemte, Ethiopia.
| | - J Aravind Kumar
- Department of Energy and Environmental Engineering, Saveetha School of Engineering, SIMATS, Chennai, 602105, Tamilnadu, India
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Hariharan MK, Anderson A, Raghavan K, Nithya S. Hot corrosion behaviour of Hastelloy X and Inconel 625 in an aggressive environment for superalloys for high-temperature energy applications. Appl Nanosci 2022. [DOI: 10.1007/s13204-021-02077-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Smith S, Godley S, Miller P, Anderson A, Heap S. Expanding physiotherapy placement capacity: Clinical educators’ experiences of implementing a coaching approach to supervision. Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dwyer K, Anderson A, Doescher M, Campbell J, Wharton B, Nagykaldi Z. Provider Communication: The Key to Care Coordination Between Tribal Primary Care and Community Oncology Providers. Oncol Nurs Forum 2022; 49:21-35. [PMID: 34914677 PMCID: PMC10428662 DOI: 10.1188/22.onf.21-35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To explore tribal primary care providers' and community oncology providers' experiences of caring for individuals with cancer to inform intervention development and improve cancer care coordination in this high-need population. PARTICIPANTS & SETTING 33 tribal primary care providers and 22 nontribal, community-based oncology providers. METHODOLOGIC APPROACH A qualitative, descriptive design was used, and 55 semistructured individual interviews were completed. Data were analyzed using conventional inductive content analysis to identify major themes. FINDINGS Effective care coordination for individuals with cancer was characterized by timely communication. Providers in both settings identified unhindered communication between providers as a key element of care coordination. Identification of points of contact in each setting enhanced information exchange. As patient needs related to cancer care intensified, care coordination increased in complexity. IMPLICATIONS FOR NURSING Evaluating strategies to enhance communication between tribal primary care providers and community oncology providers is an important next step in enhancing the coordination of care for tribal individuals with cancer.
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Tilton E, Mitchelson B, Anderson A, Peat B, Jack S, Lund M, Webb R, Wilson N. New Zealand Rheumatic Heart Disease Registry. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kado J, Salman S, Hla T, Enkel S, Henderson R, Hand R, Hort A, Bennett J, Anderson A, Page-Sharp M, Batty K, Carapetis J, Manning L. Subcutaneous Infusions of High-Dose Benzathine Penicillin G (SCIP) is Safe, Tolerable and Potentially Suitable for Less Frequent Dosing for Rheumatic Heart Disease Secondary Prophylaxis. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Stahelski A, Anderson A, Browitt N, Radeke M. Facial Expressions and Emotion Labels Are Separate Initiators of Trait Inferences From the Face. Front Psychol 2021; 12:749933. [PMID: 34955967 PMCID: PMC8696589 DOI: 10.3389/fpsyg.2021.749933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/10/2021] [Indexed: 12/27/2022] Open
Abstract
Facial inferencing research began with an inadvertent confound. The initial work by Paul Ekman and Wallace Friesen identified the six now-classic facial expressions by the emotion labels chosen by most participants: anger, disgust, fear, happiness, sadness, and surprise. These labels have been used by most of the published facial inference research studies over the last 50 years. However, not all participants in these studies labeled the expressions with the same emotions. For example, that some participants labeled scowling faces as disgusted rather than angry was seen in very early research by Silvan Tomkins and Robert McCarty. Given that the same facial expressions can be paired with different emotions, our research focused on the following questions: Do participants make different personality, temperament, and social trait inferences when assigning different emotion labels to the same facial expression? And what is the stronger cause of trait inferences, the facial expressions themselves, or the emotion labels given to the expressions? Using an online survey format participants were presented with older and younger female and male smiling or scowling faces selected from a validated facial database. Participants responded to questions regarding the social traits of attractiveness, facial maturity, honesty, and threat potential, the temperament traits of positiveness, dominance, excitability, and the Saucier Mini-marker Big Five personality trait adjective scale, while viewing each face. Participants made positive inferences to smiling faces and negative inferences to scowling faces on all dependent variables. Data from participants labeling the scowling faces as angry were compared to those who labeled the faces as disgusted. Results indicate that those labeling the scowling faces as angry perceived the faces significantly more negatively on 11 of the 12 dependent variables than those who labeled the same faces as disgusted. The inferences made by the "disgust" labelers were not positive; just less negative. The results indicate that different emotion labels made to scowling faces can either intensify or reduce negativity in inferences, but the facial expressions themselves determine negativity or positivity.
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Affiliation(s)
- Anthony Stahelski
- Department of Psychology, Central Washington University, Ellensburg, WA, United States
| | - Amber Anderson
- Department of Psychology, Central Washington University, Ellensburg, WA, United States
| | | | - Mary Radeke
- Department of Psychology, Central Washington University, Ellensburg, WA, United States,*Correspondence: Mary Radeke,
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Skoulidis F, Schuler M, Wolf J, Barlesi F, Price T, Dy G, Govindan R, Borghaei H, Falchook G, Li B, Ramalingam S, Sacher A, Spira A, Takahashi T, Anderson A, Ang A, Dai T, Flesher D, Cifuentes P, Velcheti V. MA14.03 Genomic Profiles and Potential Determinants of Response and Resistance in KRAS p.G12C-mutated NSCLC Treated With Sotorasib. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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O'Gorman C, Khoury R, Anderson A, Carter M, DiCesare F, Dubé S, Ereshefsky L, Grossberg G, Hefting N, Khan S, Lind S, Moebius H, Shiovitz T, Rosenberg P. A Framework for Developing Pharmacotherapy for Agitation in Alzheimer's Disease: Recommendations of the ISCTM* Working Group. J Prev Alzheimers Dis 2021; 7:274-282. [PMID: 32920630 DOI: 10.14283/jpad.2020.37] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Dementia is characterized by a significant decline in one of several cognitive domains such as memory, language and executive function, affecting independence and representing a significant deterioration from a previous level of functioning (1). Alzheimer’s Disease (AD) represents the most common form of dementia and contributes up to 70% of the almost 50 million dementia cases worldwide, a number that is projected to double in 20 years (2).
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Affiliation(s)
- C O'Gorman
- Cedric O'Gorman MD, 200 Broadway (3rd Floor), New York, NY 10038, USA,
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Keegan N, Schonhoft J, Barnett E, Cohn E, Zhao J, Carbone E, Zanone M, Anderson A, Wenstrup R, Scher H. 613P Chromosomal instability (CIN) biomarker in circulating tumor cells (CTC) may predict for therapy resistance in metastatic castration-resistant prostate cancer (mCRPC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Gomes VCL, Del Piero F, Langohr IM, Aguiar LH, Anderson A, Sones JL, Pinto CR. Equine focal mucopurulent placentitis associated with
Stenotrophomonas maltophilia. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- V. C. L. Gomes
- Department of Veterinary Clinical Sciences Louisiana State University Baton Rouge LouisianaUSA
| | - F. Del Piero
- Department of Pathobiological Sciences School of Veterinary Medicine Louisiana State University Baton Rouge Louisiana USA
| | - I. M. Langohr
- Department of Pathobiological Sciences School of Veterinary Medicine Louisiana State University Baton Rouge Louisiana USA
| | - L. H. Aguiar
- Department of Veterinary Clinical Sciences Louisiana State University Baton Rouge LouisianaUSA
| | - A. Anderson
- Department of Pathobiological Sciences School of Veterinary Medicine Louisiana State University Baton Rouge Louisiana USA
| | - J. L. Sones
- Department of Veterinary Clinical Sciences Louisiana State University Baton Rouge LouisianaUSA
| | - C. R. Pinto
- Department of Veterinary Clinical Sciences Louisiana State University Baton Rouge LouisianaUSA
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Zhao J, Antonarakis E, Cheng H, George D, Aggarwal R, Abida W, Decker B, Smart-Curley T, Schonhoft J, Anderson A, Haywood S, Riedel E, Carver B, Wyatt A, Feng F, Knudsen K, Rathkopf D. 598P A phase Ib study of enzalutamide (Enza) plus CC-115 in men with metastatic castration-resistant prostate cancer (mCRPC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Dallal York J, Leonard K, Anderson A, DiBiase L, Jeng EI, Plowman EK. Discriminant Ability of the 3-Ounce Water Swallow Test to Detect Aspiration in Acute Postoperative Cardiac Surgical Patients. Dysphagia 2021; 37:831-838. [PMID: 34268585 DOI: 10.1007/s00455-021-10333-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 06/22/2021] [Indexed: 01/22/2023]
Abstract
Dysphagia is a common complication of cardiac surgery (CS) contributing to morbidity and mortality. Although early dysphagia detection is important, no current screening guidelines or validated tools exist in the cardiac intensive care setting. We therefore aimed to examine the discriminant ability of the 3-ounce water swallow test (3 oz. WST) to detect aspiration in acute postoperative CS patients. 196 postoperative CS patients were enrolled in this prospective single-center study. Participants completed the 3 oz. WST and a standardized Flexible Endoscopic Evaluation of Swallowing. Independent duplicate ratings of the penetration aspiration scale (PAS) were performed in a blinded fashion (100% agreement criteria). Receiver operating characteristic curve and area under the curve (AUC) analyses were performed with sensitivity, specificity, positive, and negative predictive values (PPV, NPV) derived. Fifty-four CS patients (28%) were confirmed aspirators (PAS ≥ 6), of whom 48% (n = 26) were silent aspirators (PAS = 8). Both the sensitivity and specificity of the 3 oz. WST to identify instrumentally confirmed aspiration was 63% (AUC: 0.63, 95% CI: 0.54, 0.72), and PPV was 39% and NPV 82%. The 3 oz. WST demonstrated fair discriminant ability to detect aspiration in acute postoperative CS patients. The high rate of silent aspiration may explain, in part, these findings given that the screening fail criteria include an overt cough response. In isolation, the 3 oz. WST does not represent a sensitive screen of aspiration in postoperative CS patients with a need to identify alternative screening tools for this setting.
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Affiliation(s)
- Justine Dallal York
- Aerodigestive Research Core, University of Florida, Gainesville, FL, USA.,Department of Speech, Language & Hearing Science, College of Public Health, Health Professions, University of Florida, 1225 Center Drive, PO Box 100174, Gainesville, FL, USA
| | - Kelly Leonard
- Department of Speech, Language & Hearing Science, College of Public Health, Health Professions, University of Florida, 1225 Center Drive, PO Box 100174, Gainesville, FL, USA
| | - Amber Anderson
- Aerodigestive Research Core, University of Florida, Gainesville, FL, USA
| | - Lauren DiBiase
- Aerodigestive Research Core, University of Florida, Gainesville, FL, USA
| | - Eric I Jeng
- Department of Surgery, Division of Cardiothoracic Surgery, University of Florida, Gainesville, FL, USA
| | - Emily K Plowman
- Aerodigestive Research Core, University of Florida, Gainesville, FL, USA. .,Department of Speech, Language & Hearing Science, College of Public Health, Health Professions, University of Florida, 1225 Center Drive, PO Box 100174, Gainesville, FL, USA. .,Department of Surgery, Division of Cardiothoracic Surgery, University of Florida, Gainesville, FL, USA. .,Department of Neurology, University of Florida, Gainesville, FL, USA.
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Senthilkumar A, Anderson A, Sekar M. Performance analysis of R600a vapour compression refrigeration system using CuO/Al2O3 hybrid nanolubricants. Appl Nanosci 2021. [DOI: 10.1007/s13204-021-01936-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Brown P, Anderson A, Hargreaves B, Morgan A, Isaacs JD, Pratt A. OP0033 REGULATORY T CELL CD39 EXPRESSION AS A PREDICTOR OF EARLY REMISSION-INDUCTION WITH METHOTREXATE IN NEW-ONSET RHEUMATOID ARTHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The long term outcomes for patients with rheumatoid arthritis (RA) depend on early and effective disease control. Methotrexate remains the key first line disease modifying therapy for the majority of patients, with 40% achieving an ACR50 on monotherapy(1). There are at present no effective biomarkers to predict treatment response, preventing effective personalisation of therapy. A putative mechanism of action of methotrexate, the potentiation of anti-inflammatory adenosine signalling, may inform biomarker discovery. By antagonism of the ATIC enzyme in the purine synthesis pathway, methotrexate has been proposed to increase the release of adenosine moieties from cells, which exert an anti-inflammatory effect through interaction with ADORA2 receptors(2). Lower expression of CD39 (a cell surface 5-’ectonucleotidase required for the first step in the conversion of ATP to adenosine) on circulating regulatory T-Lymphocytes (Tregs) was previously identified in patients already established on methotrexate who were not responding (DAS28 >4.0 vs <3.0)(3). We therefore hypothesised that pre-treatment CD39 expression on these cells may have clinical utility as a predictor of early methotrexate efficacy.Objectives:To characterise CD39 expression in peripheral blood mononuclear cells in RA patients naïve to disease modifying therapy commencing methotrexate, and relate this expression to 4 variable DAS28CRP remission (<2.6) at 6 months.Methods:68 treatment naïve early RA patients starting methotrexate were recruited from the Newcastle Early Arthritis Clinic and followed up for 6 months. Serial blood samples were taken before and during methotrexate therapy with peripheral blood mononuclear cells isolated by density centrifugation. Expression of CD39 by major immune subsets (CD4+ and CD8+ T-cells, B-lymphocytes, natural killer cells and monocytes) was determined by flow cytometry. The statistical analysis used was binomial logistic regression with baseline DAS28CRP used as a covariate due to the significant association of baseline disease activity with treatment response.Results:Higher pre-treatment CD39 expression was observed in circulating CD4+ T-cells of patients who subsequently achieved clinical remission at 6 months versus those who did not (median fluorescence 4854.0 vs 3324.2; p = 0.0108; Figure 1-A). This CD39 expression pattern was primarily accounted for by the CD4+CD25 high sub-population (median fluorescence 9804.7 vs 6455.5; p = 0.0065; Figure 1-B). These CD25 high cells were observed to have higher FoxP3 and lower CD127 expression than their CD39 negative counterparts, indicating a Treg phenotype. No significant associations were observed with any other circulating subset. A ROC curve demonstrates the discriminative utility of differential CD39 expression in the CD4+CD25 high population for the prediction of DAS28CRP remission in this cohort, showing greater specificity than sensitivity for remission prediction(AUC: 0.725; 95% CI: 0.53 - 0.92; Figure 1-C). Longitudinally, no significant induction or suppression of the CD39 marker was observed amongst patients who did or did not achieve remission over the 6 months follow-up period.Figure 1.Six month DAS28CRP remission versus pre-treatment median fluorescence of CD39 expression on CD4+ T-cells (A); CD25 High expressing CD4+ T-cells (B); and ROC curve of predictive utility of pre-treatment CD39 expression on CD25 High CD4+ T-cells (C).Conclusion:These findings support the potential role of CD39 in the mechanism of methotrexate response. Expression of CD39 on circulating Tregs in treatment-naïve RA patients may have particular value in identifying early RA patients likely to respond to methotrexate, and hence add value to evolving multi-parameter discriminatory algorithms.References:[1]Hazlewood GS, et al. BMJ. 2016 21;353:i1777[2]Brown PM, et al. Nat Rev Rheumatol. 2016;12(12):731-742[3]Peres RS, et al. Proc Natl Acad Sci U S A. 2015;112(8):2509-2514Disclosure of Interests:None declared
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Swift J, Stanway J, Nicorescu I, Hilkens C, Stevenaert F, Anderson A, Pratt A, Isaacs JD. AB0025 CITRULLINATED-PEPTIDE SPECIFIC CD4+ T CELL RESPONSES IN RHEUMATOID ARHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:CD4+ T cells reacting to post-translationally modified, citrullinated self-antigens are thought to play a central role in the pathogenesis of rheumatoid arthritis (RA)1. This is evidenced by a strong HLA class II association, the success of therapeutic co-stimulation blockade and the detection of autoantigen specific T-cells using HLA class II multimers2. These cells may represent a target for antigen-specific, tolerogenic therapies and their in-depth phenotyping may provide the means by which to monitor such treatment.Objectives:To identify the citrullinated-peptide (cit-peptide) induced cytokine repertoire of antigen-specific memory CD4+ T cells in both healthy controls (HCs) and ACPA positive RA patients using intracellular cytokine staining and flow cytometry. Of note, the HLA-types of both HCs and RA patients were not known.Methods:Cryopreserved peripheral blood mononuclear cells (PBMC) from both HCs (n = 8) and RA patients (n = 13) with both early (untreated) and established disease were thawed and labelled with a proliferation tracking dye (PTD). Labelled PBMC were then either incubated alone or with a pool of cit-peptides for 9-days, followed by a 5-hour restimulation with PMA and ionomycin, where cytokine secretion was blocked for the final 4-hours using brefeldin-A. Cells were then harvested, permeabilised and stained for T cell surface markers and intracellular cytokines including IFN-γ, IL-4, IL-21 and IL-17. Stained cells were immediately acquired using a BD Fortessa X20, where antigen-specific CD4+ T cells were identified as the viable CD45RO+ (memory) CD4+ T cell population that had proliferated (PTDlow) in response to the cit-peptides. Stimulation indices (SI) were calculated as the percentage of proliferated memory CD4+ T cells in the stimulated wells divided by the percentage in the unstimulated conditions, and cit-peptide responders were defined as those with an SI > 2.0. Net cytokine production was measured by subtracting the percentage cytokine production from unstimulated CD4+ CD45RO+ PTDlow cells, from those stimulated with the cit-peptides.Results:Comparable proliferative responses were observed in both donor groups in response to stimulation with the cit-peptide pool, where 37 % of HCs and 31 % of RA patients responded with an SI > 2.0 (Fig. 1A). While little cytokine production was observed in the cit-peptide responding HC T cells, for responding RA donors, cit-peptide responsive CD4+ memory T cells were predominantly IFN-γ and IL-21 producing (Fig. 1B and 1C). In contrast, these donors did not produce significant levels of either IL-17 or IL-4 (Fig. 1D and 1E).Conclusion:Cit-peptides were able to induce proliferation in both HCs and RA memory CD4+ T cells which, amongst the RA donors only, were of a Th1/Tfh subtype. In contrast, and while based only on a small sample, cit-peptides did not induce either IL-17 or IL-4 production in either donor group, suggesting a lack of Th17/Th2 responses. Not all donors responded to the peptide pool, possibly reflecting the limited number of pooled cit-peptides or to a lack of confirmed HLA-DRB1*04:01 positive donors, as peptides were selected for their specificity on this basis. Future work will therefore include HLA-typing, as well as the inclusion of additional citrullinated-epitopes to demonstrate autoreactivity in a wider cross-section of patients. Further phenotyping of the cit-peptide specific T cells will be performed, and future plans will be to study the assay data alongside clinical outcomes to assess its value for immune monitoring.References:[1]Malmström, V et al Nat Rev Immunol. 2017; 17(1):60-75.[2]Gerstner, C et al BMC Immunol. 2020; 21(27):1-14.Disclosure of Interests:Jessica Swift: None declared, James Stanway: None declared, Ioana Nicorescu: None declared, Catharien Hilkens: None declared, Frederik Stevenaert Employee of: Janssen, Amy Anderson Grant/research support from: Pfizer, GSK and Janssen, Arthur Pratt Grant/research support from: Pfizer, GSK and Janssen, John D Isaacs Speakers bureau: Abbvie, Gilead, Roche, UC, Consultant of: Abbvie, Gilead, Roche, UC, Grant/research support from: Pfizer, GSK and JanssenFigure 1.Citrullinated-peptide specific memory CD4+ T cell proliferation (A) and net % cytokine production of IFN-γ (B), IL-21 (C), IL-17 (D) and IL-4 (E) positive cells.
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Robison R, DiBiase L, Ashley A, McElheny K, Anderson A, Wymer JP, Plowman EK. Swallowing Safety and Efficiency Impairment Profiles in Individuals with Amyotrophic Lateral Sclerosis. Dysphagia 2021; 37:644-654. [PMID: 34037850 DOI: 10.1007/s00455-021-10315-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 05/13/2021] [Indexed: 12/01/2022]
Abstract
Dysphagia is common in individuals with amyotrophic lateral sclerosis (ALS) and associated with reductions in quality of life and health-related outcomes. Despite the high prevalence of dysphagia in ALS, functional impairment profiles of swallowing safety and efficiency have not been comprehensively examined. We therefore aimed to determine the relative prevalence of unsafe and inefficient swallowing in a large cohort of individuals with ALS. We further sought to examine the impact of global and bulbar disease progression (Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised "ALSFRS-R" total and bulbar scores, respectively), disease duration, and onset type on swallowing impairment profiles. One hundred individuals with ALS completed a standardized videofluoroscopic swallowing examination Two independent and blinded raters performed validated ratings of safety (Penetration-Aspiration Scale, PAS) and efficiency (Analysis of Swallowing Physiology: Events, Kinematics, and Timing, ASPEKT % residue). Binary classifications of safety (unsafe: PAS ≥ 3), efficiency (inefficient: total residue ≥ 3% of C2-42) and global swallowing status were derived. The ALSFRS-R was completed to derive ALSFRS-R total and bulbar subscale scores. Demographic data (disease duration and onset type) for each participant was also recorded. Descriptives, 2 × 2 contingency tables with Fishers exact test, and independent samples t-tests were performed (α = 0.05). Prevalence of unsafe and inefficient swallowing was 48% and 73%, respectively. Global swallowing profiles were, in rank order: unsafe and inefficient (39%), inefficient but safe (34%), safe and efficient (18%), and unsafe but efficient (9%). There were no differences in global disease progression or disease duration across swallowing impairment profiles. ALSFRS-R bulbar subscale scores were significantly lower in unsafe versus safe swallowers, p < 0.05. Spinal onset patients had a greater proportion of safe swallowers as compared to bulbar onset patients (p = 0.000, Fisher's exact test). Both spinal and bulbar onset patients demonstrated a higher prevalence of inefficient swallowers as compared to efficient swallowers (p = 0.04, Fisher's exact test). Dysphagia was prevalent in this group of individuals with ALS. Approximately half demonstrated safety impairments and two-thirds had impairments in swallowing efficiency. Inefficient swallowing was approximately four times more likely to be the initial functional impairment in patients with one pathophysiologic functional impairment. A longitudinal study is needed to examine the temporal evolution of dysphagia in ALS.
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Affiliation(s)
- Raele Robison
- Aerodigestive Research Core, University of Florida, Gainesville, FL, USA. .,Speech, Language and Hearing Science Department, University of Florida, Gainesville, FL, USA. .,William S. Middleton Memorial Veteran's Hospital, Madison, WI, USA.
| | - Lauren DiBiase
- Aerodigestive Research Core, University of Florida, Gainesville, FL, USA
| | - Amy Ashley
- Aerodigestive Research Core, University of Florida, Gainesville, FL, USA.,Speech, Language and Hearing Science Department, University of Florida, Gainesville, FL, USA
| | - Kasey McElheny
- Aerodigestive Research Core, University of Florida, Gainesville, FL, USA.,Speech, Language and Hearing Science Department, University of Florida, Gainesville, FL, USA
| | - Amber Anderson
- Aerodigestive Research Core, University of Florida, Gainesville, FL, USA
| | - James P Wymer
- Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Emily K Plowman
- Aerodigestive Research Core, University of Florida, Gainesville, FL, USA.,Speech, Language and Hearing Science Department, University of Florida, Gainesville, FL, USA.,Department of Neurology, University of Florida, Gainesville, FL, USA.,Department of Surgery, University of Florida, Gainesville, FL, USA
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Maldonado López A, Aubert Y, Anderson A, Ko E, Liu F, Capell B. 165 Elucidating the METTL3-m6A epitranscriptome in epidermal development and carcinogenesis. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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York JD, Colsky J, Croft K, Segalewitz T, DiBiase L, Anderson A, Palaez A, Shahmohammadi A, Pipkin M, Machuca T, Plowman E. Dysphagia in Lung Transplant Recipients: Prevalence, Risk Factors and Health-Related Outcomes. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Segalewitz T, Colsky J, York JD, Croft K, DiBiase L, Anderson A, Pelaez A, Shahmohammadi A, Pipkin M, Machuca T, Plowman E. Is Dysphagia a Pre-Existing Condition in Individuals Undergoing Lung Transplantation? Radiographic Swallowing Safety Profiles before and after Lung Transplantation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Dawson S, Carolan C, Daniels T, Lee K, Anderson A, Choyce J, Gledhill H, Warnock L, Moran P, Wildman M. P235 Using a 1,500-patient learning health system (LHS) to support virtual clinics and medicines optimisation: a UK seven-centre Patient and Public Involvement (PPI) project to understand user experience. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01260-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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