Respiratory System Commons^™

Lung Transplant Technology, Lana Tso

Williams Honors College, Honors Research Projects

Lung disease is a significant medical problem. Numerous individuals including infants, children, and adults of all ages can all be affected. Because of this, medical research has been heavily invested in advancing technology and finding solutions for what can be the most effective way to perform lung transplants. This literature review will be focusing on what is currently known about the process of lung transplants as well as future directions for research in this area.

The Impact Of Lung Cancer Screening Education On Knowledge And Screening Rates In A Kentucky Cancer Survivorship Clinic, Alexandra Isler

DNP Projects

Background: Lung cancer is a significant problem in Kentucky, which ranks fourth in the nation in adults who currently smoke. Early detection, through lung cancer screening, can prevent untimely deaths. Several barriers to screening exist including lack of knowledge and awareness among patients regarding lung cancer screening. By increasing knowledge, at risk patients can take the necessary steps to decrease incidence of late stage diagnoses.

Purpose: The purpose of this project was to evaluate patients’ knowledge of lung cancer screening and referral and screening rates before and after one-on-one patient education.

Methods: This was a quality improvement project that used …

Post-Mortem Investigation Of Deaths Due To Pneumonia In Children Aged 1–59 Months In Sub-Saharan Africa And South Asia From 2016 To 2022: An Observational Study., Sana Mahtab, Dianna Blau, Zachary Madewell, Ikechukwu Ogbuanu, Julius Ojulong, Sandra Lako, Hailemariam Legesse, Joseph Bangura, Quique Bassat, Gunturu Revathi

Pathology, East Africa

Background; The Child Health and Mortality Prevention Surveillance (CHAMPS) Network programme undertakes post-mortem minimally invasive tissue sampling (MITS), together with collection of ante-mortem clinical information, to investigate causes of childhood deaths across multiple countries. We aimed to evaluate the overall contribution of pneumonia in the causal pathway to death and the causative pathogens of fatal pneumonia in children aged 1–59 months enrolled in the CHAMPS Network.

Methods; In this observational study we analysed deaths occurring between Dec 16, 2016, and Dec 31, 2022, in the CHAMPS Network across six countries in sub-Saharan Africa (Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and …

Parasympathetic Activity And Bronchial Hyperresponsiveness In Athletes, Audrey Badza

The Downtown Review: An Interdisciplinary Journal Written and Peer-Reviewed by Mandel Honors College Students at Cleveland State University

Bronchial hyperresponsiveness (BHR) is a term used to describe the bronchial constriction response to environmental stimuli. BHR is increasingly common in endurance athletes due to increased exposure to some stimuli. The purpose of this review is to evaluate Stang et al.'s (2016) article, "Parasympathetic Activity and Bronchial Hyperresponsiveness in Athletes" and discuss the significance of their results. The results concluded that BHR is related to the parasympathetic activity of the heart rather than the pupils. The study concluded that there is an association between BHR and parasympathetic activity of the heart, methacholine is associated with BHR and cardiac vagal activity, …

Loss Of Cftr Function In Macrophages Alters The Cell Transcriptional Program And Delays Lung Resolution Of Inflammation, Dianne Wellems, Yawen Hu, Scott Jennings, Guoshun Wang

School of Graduate Studies Faculty Publications

Cystic fibrosis (CF) is an autosomal recessive genetic disorder caused by mutations in the CF Transmembrane-conductance Regulator (CFTR) gene. The most severe pathologies of CF occur in the lung, manifesting as chronic bacterial infection, persistent neutrophilic inflammation, and mucopurulent airway obstruction. Despite increasing knowledge of the CF primary defect and the resulting clinical sequelae, the relationship between the CFTR loss of function and the neutrophilic inflammation remains incompletely understood. Here, we report that loss of CFTR function in macrophages causes extended lung inflammation. After intratracheal inoculation with Pseudomonas aeruginosa, mice with a macrophage-specific Cftr-knockout (Mac-CF) were able to mount an …

Inhaled Epoprostenol Compared With Nitric Oxide For Right Ventricular Support After Major Cardiac Surgery, Kamrouz Ghadimi, Jhaymie L. Cappiello, Mary Cooter Wright, Jerrold H. Levy, Benjamin S. Bryner, Adam D. Devore, Jacob N. Schroder, Chetan B. Patel, Sudarshan Rajagopal, Svati H. Shah, Carmelo A. Milano, Inspire-Flo Investigators

Respiratory Therapy Faculty Publications and Presentations

Background: Right ventricular failure (RVF) is a leading driver of morbidity and death after major cardiac surgery for advanced heart failure, including orthotopic heart transplantation and left ventricular assist device implantation. Inhaled pulmonary-selective vasodilators, such as inhaled epoprostenol (iEPO) and nitric oxide (iNO), are essential therapeutics for the prevention and medical management of postoperative RVF. However, there is limited evidence from clinical trials to guide agent selection despite the significant cost considerations of iNO therapy.

Methods: In this double-blind trial, participants were stratified by assigned surgery and key preoperative prognostic features, then randomized to continuously receive either iEPO or iNO …

Prorelaxant E-Type Prostanoid Receptors Functionally Partition To Different Procontractile Receptors In Airway Smooth Muscle, Ajay P. Nayak, Elham Javed, Dominic R. Villaba, Yinna Wang, Henry P. Morelli, Sushrut D. Shah, Nicholas Kim, Rennolds S. Ostrom, Reynold A. Pannettieri Jr., Steven S. An, Dale D. Tang, Raymond B. Penn

Pharmacy Faculty Articles and Research

Prostaglandin E2 imparts diverse physiological effects on multiple airway cells through its actions on four distinct E-type prostanoid (EP) receptor subtypes (EP1–EP4). Gs-coupled EP2 and EP4 receptors are expressed on airway smooth muscle (ASM), yet their capacity to regulate the ASM contractile state remains subject to debate. We used EP2 and EP4 subtype-specific agonists (ONO-259 and ONO-329, respectively) in cell- and tissue-based models of human ASM contraction—magnetic twisting cytometry (MTC), and precision-cut lung slices (PCLSs), respectively—to study the EP2 and EP4 regulation of ASM contraction and signaling under conditions of histamine or methacholine (MCh) stimulation. ONO-329 was superior (<0.05) to ONO-259 in relaxing MCh-contracted PCLSs (log half maximal effective concentration [logEC50]: 4.9 × 10−7 vs. 2.2 × 10−6; maximal bronchodilation ± SE, 35 ± 2% vs. 15 ± 2%). However, ONO-259 and ONO-329 were similarly efficacious in relaxing histamine-contracted PCLSs. Similar differential effects were observed in MTC studies. Signaling analyses revealed only modest differences in ONO-329– and ONO-259–induced phosphorylation of the protein kinase A substrates VASP and HSP20, with concomitant stimulation with MCh or histamine. Conversely, ONO-259 failed to inhibit MCh-induced phosphorylation of the regulatory myosin light chain (pMLC20) and the F-actin/G-actin ratio (F/G-actin ratio) while effectively inhibiting their induction by histamine. ONO-329 was effective in reversing induced pMLC20 and the F/G-actin ratio with both MCh and histamine. Thus, the contractile-agonist–dependent differential effects are not explained by changes in the global levels of phosphorylated protein kinase A substrates but are reflected in the regulation of pMLC20 (cross-bridge cycling) and F/G-actin ratio (actin cytoskeleton integrity, force transmission), implicating a role for compartmentalized signaling involving muscarinic, histamine, and EP receptor subtypes.

Understanding Our Airways: How Lung Structure And Function Is Impacted By Respiratory Infections And Immune Responses, Katherine Coll

McNair Research Journal SJSU

Understanding the underlying functions and interplaying systems that make up the respiratory system is a crucial step in the research and development of treatments for respiratory illnesses. In this literature review, I explore the complex biochemical processes that occur in the pulmonary epithelium and endothelium. As epithelial and endothelial cells serve a multitude of functions such as host protection and nutrient regulation, discussing the interplay between these cells and intercellular junctions and their immediate impact on the respiratory system is essential to understanding the impact of respiratory dysfunctions and diseases. This review further examines the different types of intercellular junctions …

Preparing For The Unexpected: Recognizing A Tortuous Thoracic Aorta During Ultrasound-Guided Thoracentesis, Michael Choi, Jessica Roettger, Christopher J. Smith

Graduate Medical Education Research Journal

Ultrasound-guidance has become the standard of care for bedside thoracentesis. This manuscript describes the importance of utilizing point-of-care-ultrasound (POCUS) and color Doppler in avoiding an unusual, but potentially catastrophic aortic puncture during thoracentesis. The case describes a 70 year-old man who presented with one week of shortness of breath. He was found to have a large left-sided pleural effusion on imaging studies. During a bedside POCUS examination, he was found to have a hyperechoic linear structure in his posterior left hemithorax. Ultrasound application of color Doppler revealed a pulsatile flow, confirming visualization of the aorta. The site of needle insertion …

Case Report: Cavitary Pneumonia In A 28 Year Old Male, Dan Zaayenga, Katelyn Courtney

Rowan-Virtua Research Day

Cavitary pneumonia can be caused by several different mechanisms. Such causes include suppurative necrosis (pyogenic lung abscess), caseous necrosis (tuberculosis), ischemic necrosis (pulmonary infarction) cystic dilatation of lung structures (ball value obstruction and Pneumocystis pneumonia) as well as malignant processes. Causes are subject to both environmental factors and host susceptibility. The most common cause of infectious process is tuberculosis with its propensity to cause extensive caseous necrosis. The potential for secondary infection after an individual develops a cavitary pneumonia is also great as it provides a shelter for various pathogens the flourish in an environment otherwise usually well-guarded by host …

Uh-02 A Case Report Of The Potential Link Between Pulmonary Fibrosis And Diabetes Mellitus, Bryson T. Rose, Isabella Nielson, Nnenna Igwe

SC Upstate Research Symposium

Pulmonary fibrosis is a chronic lung disease that is characterized by the progressive and irreversible scarring of the lung tissue. This scarring greatly diminishes the efficiency of pulmonary function. After being diagnosed with pulmonary fibrosis, patients live, on average, only three to five years. Diabetes mellitus is known to damage the tissue and blood vessels in organs such as the heart and kidneys due to increased intravascular pressure.

According to recent research, diabetes mellitus has also been linked to similar damage in the lungs. Additionally, a 2021 meta-analysis and systematic review of idiopathic pulmonary fibrosis suggests an association between diabetes …

Comparison Of Dna Extraction Methods For Soft Tissue Samples, Steve Guzman, Nathaniel E. Hill, Mujtaba Shah, Jonathon Reynolds, Cole Farnsworth, Molly Henley, Alfred Amendolara, Laura Minor, John Dougherty Jr., John A. Kriak, Kyle B. Bills, David W. Sant

Annual Research Symposium

No abstract provided.

The Effects Of Vitamin B1 Analog, Benfotiamine, On The Prevention Of Non-Small Cell Lung Cancer, Emely Fernandez, Hannah Christensen, Kota A. Ramana

Annual Research Symposium

No abstract provided.

Assessing Burnout And Well-Being In Higher Education Health Science Faculty, Kristen Mchenry, Megan Koster, Gen Ludwig, Yong Gao, Jennifer Eichmeyer

Respiratory Therapy Faculty Publications and Presentations

This study aimed to examine and compare the extent of burnout among health science faculty at a higher education institution and their self-reported perception of well-being during the COVID-19 pandemic. The design of the study was cross-sectional, descriptive survey research. An electronic questionnaire was developed to measure the constructs of burnout and well-being. Validated instruments used in the survey included the Oldenburg Burnout Inventory (OLBI) and the World Health Organization-5 Well-being Index. The Qualtrics ^® platform was used to distribute the survey to all full-time faculty within the College of Health Sciences. 45 respondents from nursing, community and environmental health, …

Agricultural Dust Derived Bacterial Extracellular Vesicle Mediated Inflammation Is Attenuated By Dha, Art J. Heires, Derrick R. Samuelson, Daniel Villageliu, Tara M. Nordgren, Debra J. Romberger

Journal Articles: Pulmonary & Critical Care Med

Dietary long-chain omega-3 polyunsaturated fatty acids (n-3 PUFA) and their pro-resolving metabolites are protective against atherosclerotic disease, and ameliorate systemic inflammatory conditions including lupus erythematosus, psoriasis, and bronchial asthma. Organic bioaerosol inhalation is a common and injurious hazard associated with agricultural occupations such as work in swine concentrated animal feeding operations (CAFOs) and is known to increase the risk for developing respiratory conditions such as asthma and COPD. Nearly all cells secrete membrane-bound vesicles (extracellular vesicles, EVs) that have the capacity to transmit protein, nucleic acid, and lipid signaling mediators between cells. Using a polymer-based isolation technique (ExoQuick, PEG) followed …

Icenticaftor, Novel Therapy For Copd: This Glass Is Half Full, Stephen I. Rennard

Journal Articles: Pulmonary & Critical Care Med

No abstract provided.

Areas Of Work-Life That Contribute To Burnout Among Higher Education Health Science Faculty And Perception Of Institutional Support, Megan Koster, Kristen Mchenry

Respiratory Therapy Faculty Publications and Presentations

Background: COVID-19 added responsibilities to faculty in health-related fields. Educators in these areas have experienced pandemic-related role strain in both the clinical and academic settings.

Purpose: This investigation sought to identify how health science faculty at one institution perceived challenges related to the COVID-19 pandemic in their role and to glean opportunities for institutions to increase the degree of support for faculty.

Methods: An analysis of narrative comments was conducted on a survey assessing burnout and well-being. The survey was distributed to full-time faculty within the College of Health Sciences at a four-year institution. Using the areas of work-life model …

Longitudinal Assessment Of Multimorbidity Medication Patterns Among Smokers In The Copdgene Cohort, Yisha Li, Sarah J. Schmiege, Heather Anderson, Nicole E. Richmond, Kendra A. Young, John E. Hokanson, Stephen I. Rennard, Tessa L. Crume, Erin Austin, Katherine A. Pratte, Rebecca Conway, Gregory L. Kinney

Journal Articles: Pulmonary & Critical Care Med

Background and objectives: Chronic obstructive pulmonary disease (COPD) is usually comorbid with other chronic diseases. We aimed to assess the multimorbidity medication patterns and explore if the patterns are similar for phase 1 (P1) and 5-year follow-up phase 2 (P2) in the COPDGene cohort. Materials and Methods: A total of 5564 out of 10,198 smokers from the COPDGene cohort who completed 2 visits, P1 and P2 visits, with complete medication use history were included in the study. We conducted latent class analysis (LCA) among the 27 categories of chronic disease medications, excluding COPD treatments and cancer medications at P1 and …

Extracellular Vesticles In Acute Respiratory Distress Syndrome: Understanding Protective And Harmful Signaling For The Development Of New Therapeutics, Matthew Bavuso, Noel Miller, Joshua M. Sill, Anca Dobrian, Ruben M. L. Colunga Biancatelli

Bioelectrics Publications

Acute respiratory distress syndrome (ARDS) is a severe respiratory condition characterized by increased lung permeability, hyper-inflammatory state, and fluid leak into the alveolar spaces. ARDS is a heterogeneous disease, with multiple direct and indirect causes that result in a mortality of up to 40%. Due to the ongoing Covid-19 pandemic, its incidence has increased up to ten-fold. Extracellular vesicles (EVs) are small liposome-like particles that mediate intercellular communication and play a major role in ARDS pathophysiology. Indeed, they participate in endothelial barrier dysfunction and permeability, neutrophil, and macrophage activation, and also in the development of a hypercoagulable state. A more …

The Accuracy Of Recreational Athletes In Self Detecting Ventilation Threshold During A Maximal Exercise Test, Andrew Biegner

Williams Honors College, Honors Research Projects

INTRODUCTION: Ventilatory threshold (VT) is where minute ventilation (VE) increases nonlinearly with increasing exercise intensity. Prior studies have shown that subjects can recognize VT by changes in breathing during exercise. Teaching recreational athletes to use VT as a training method could result in better quality training. PURPOSE: Determine if recreational athletes can accurately perceive changes in ventilation associated with VT during maximal exercise testing. METHODS: Subjects were recruited (n=20, age= 20.5 ± 1.7 yrs.) to participate in the study. Subjects performed a modified maximal treadmill protocol with gas analysis. Subjects indicated when they noticed a considerable change …

The Veins Of Air – Visualization Of The Classical “Ginkgo Leaf” Sign, Steve Chung, Usama Nasir, Adanna C. Akujuo, Michael Macciocca

Tower Health Research Day

No abstract provided.

We’Re In This Together: Student Motivation And Faculty Support In Online Degree Advancement During The Covid-19 Pandemic, Kristen Mchenry, Thomas J. Wing, Jody Lester

Respiratory Therapy Faculty Publications and Presentations

The purpose of this study was to identify the motivation for continued learning and degree attainment in online degree advancement (DA) respiratory care students (those with an associate degree pursuing a bachelor’s degree) during a pandemic and the types of support needed for academic success in the online learning environment. The design of the study was convergent mixed-methods descriptive survey research. Items from the Academic Motivation Scale-College Version (AMS-C) were used to assess the construct. Additionally, open-ended questions allowed for narrative responses related to the pandemic pressures, motivation regulation, and faculty support. One hundred twenty-three students completed various components of …

Community-Based Asthma Assessment In Young Children: Adaptations For A Multicentre Longitudinal Study In South Asia, Mohammad Shahidul Islam, Samin Huq, Steven Cunningham, Jurgen Schwarze, Asmd Ashraful Islam, Mashal Amin, Farrukh Raza, Benazir Baloch, Muhammad Imran Nisar, Sajid Bashir Soofi

Department of Paediatrics and Child Health

Background: Systematic assessment of childhood asthma is challenging in low- and middle-income country (LMIC) settings due to the lack of standardised and validated methodologies. We describe the contextual challenges and adaptation strategies in the implementation of a community-based asthma assessment in four resource-constrained settings in Bangladesh, India, and Pakistan.
Method: We followed a group of children of age 6-8 years for 12 months to record their respiratory health outcomes. The study participants were enrolled at four study sites of the 'Aetiology of Neonatal Infection in South Asia (ANISA)' study. We standardised the research methods for the sites, trained field staff …

Documenting Response To Covid-Individual And Systems Successes And Challenges: A Longitudinal Qualitative Study, Natasha Shaukat, Daniyal Mansoor Ali, Rubina Barolia, Butool Hisam, Sheza Hassan, Badar Afzal Khan, Abdus Salam Khan, Meher Angez, Junaid Razzak

Community Health Sciences

Background: This study aimed to document the evolution of perceptions of frontline healthcare workers (FHCW) regarding their well-being and the quality of health systems' response to the COVID-19 pandemic over four months in Pakistan.
Methods: We conducted this prospective longitudinal qualitative study during the four months (June-September 2020) coinciding with the peak and trough of the first wave of Pakistan's COVID-19 pandemic. We approached frontline healthcare workers (physicians and nurses) working in emergency departments (ED) in two hospitals using the WhatsApp group of the Pakistan Society of Emergency Physicians (PSEM). Participants were asked to self-record their perception of their wellness …

Case Report: How A Vallecular Cyst Could Have Become An Airway Emergency, Adam Kandil, Robin Lahr, Andrew Caravello

Rowan-Virtua Research Day

Vallecular cysts, also known as epiglottic mucous retention cysts are known to be generally self-limiting laryngeal lesion. They can however also be associated with airway obstruction, and dysphagia in infants. In adults, they are usually asymptomatic, and usually incidentally diagnosed. At times they are diagnosed during rapid sequence intubation, as they may contribute to endotracheal intubation difficulty. Moreover, there is question as to the correlation between vallecular cysts and the incidence of acute epiglottitis, as a vallecular cyst may become infected and cause a localized expansion of inflammation and infection. This expansion from the vallecula progresses to epiglottis.

Bodyverse, Colin B. Stilwell

Theses and Dissertations

This paper supports the MFA dance thesis film BodyVerse. Exploring the intertwining relationship of body systems with the natural world, it brings somatic principles such as Body Mind Centering and dance improvisation together with film legacies and digital platforms.

The Utility Of An Inpatient Consult For Paradoxical Vocal Fold Motion, Pankti P. Acharya, Jason Cohn

Rowan-Virtua Research Day

Paradoxical vocal fold motion (PVFM) is vocal fold adduction during inspiration

Patients often present with dyspnea, throat tightness, and cough

Common risk factors that predispose patients to PVFM include gastroesophageal reflux disease, psychiatric disease, chronic cough, airway irritation, and female gender

This study was conducted to identify possible risk factors and associated conditions for PVFM; additionally, a novel scoring system was developed to aid in diagnosis of PVFM

Cpap And Epistaxis: Is There A Connection In Osa Patients?, Aesha Patel

Rowan-Virtua Research Day

Nasal continuous positive airway pressure (CPAP) has become a standard form of therapy for patients with obstructive sleep apnea (OSA). There are reports of patients suffering from episodes of epistaxis within the initial few weeks of starting CPAP therapy, believed to be due to the high flow rate of air during use, nasal CPAP purportedly dries the nasal mucosa, leading to an increased risk of scabbing, ulceration, and ultimately epistaxis. This study seeks to analyze whether epistaxis is common in patients following CPAP initiation and then compare this rate of epistaxis amongst OSA patients that received upper airway stimulation (UAS) …

Arterial Thromboembolism As A Sequela Of Mild Covid-19 Pneumonia With Resultant Gangrene Of The Right Lower Extremity, Sean Coulson, Brian Thomas, Christopher Chhoun

Rowan-Virtua Research Day

Hypercoagulable states leading to stroke, pulmonary embolism, and acute limb ischemia are well documented phenomena secondary to moderate-to-severe COVID-19 infections that produce significant respiratory morbidity.

Incidence is largely unknown with additional emerging clinical manifestations including, but not limited to: Viral and secondary bacterial pneumonia, respiratory failure, sepsis, stroke, acute kidney injury, pulmonary embolism, disseminated intravascular coagulation (DIC), as well as arterial and venous thromboembolism.

Lung Hernia: An Uncommon Cause Of Pleuritic Chest Pain, Brittany Fera

Rowan-Virtua Research Day

Lung hernia is a rare but important consideration in the differential diagnosis of chest pain in patients with recent thoracic trauma or a history of thoracic surgery. Patients who undergo an anterior approach to thoracotomy, as was the case with our patient, are at a higher risk for developing lung herniation as a result of inherent anatomical weakness and wider intercostal spaces anteriorly and inferiorly.