Medical Physiology Commons^™

Single-Cell Analysis Of Aneurysmal Aortic Tissue In Patients With Marfan Syndrome Reveals Dysfunctional Tgf-Β Signaling, Ashley Dawson, Yanming Li, Yang Li, Pingping Ren, Hernan G. Vasquez, Chen Zhang, Kimberly R. Rebello, Waleed Ageedi, Alon R. Azares, Aladdein Burchett Mattar, Mary Burchett Sheppard, Hong S. Lu, Joseph S. Coselli, Lisa A. Cassis, Alan Daugherty, Ying H. Shen, Scott A. Lemaire

Saha Cardiovascular Research Center Faculty Publications

The molecular and cellular processes leading to aortic aneurysm development in Marfan syndrome (MFS) remain poorly understood. In this study, we examined the changes of aortic cell populations and gene expression in MFS by performing single-cell RNA sequencing (scRNA seq) on ascending aortic aneurysm tissues from patients with MFS (n = 3) and age-matched non-aneurysmal control tissues from cardiac donors and recipients (n = 4). The expression of key molecules was confirmed by immunostaining. We detected diverse populations of smooth muscle cells (SMCs), fibroblasts, and endothelial cells (ECs) in the aortic wall. Aortic tissues from MFS showed alterations …

The Effect Of Cancer Cachexia Progression On The Feeding Regulation Of Skeletal Muscle Protein Turnover, Brittany R. Franch

Theses and Dissertations (ETD)

Cancer cachexia is defined as the unintentional loss of skeletal muscle mass with or without fat loss that cannot be reversed by conventional nutritional support. Cachexia occurs in ~20% of cancer patients. More specifically, 50% of lung cancer patients, the most common cancer worldwide, develop cachexia. Cachexia occurs most often in lung and gastrointestinal cancers, whereas breast and prostate have the lowest rate of cachexia. Cancer-induced cachexia disrupts skeletal muscle protein turnover (decreasing protein synthesis and increasing protein degradation). Skeletal muscle’s capacity for protein synthesis is highly sensitive to local and systemic stimuli that are controlled by mTORC1 and AMPK …

Role Of Meibum And Tear Phospholipids In The Evaporative Water Loss Associated With Dry Eye., Samiyyah M. Sledge

Electronic Theses and Dissertations

It is generally believed that the tear film lipid surface film inhibits the rate of evaporation (Revap) of the underlying tear aqueous. It is also generally believed that changes in the composition of the tear film lipid layer is responsible for an increase in Revap in patients with dry eye. Both of these ideas have never been proven. The purpose of the current studies was to test these ideas. Revap was measured in vitro gravimetrically. Lipid spreading was measured using Raman spectroscopy and microscopy. The influence of the following surface films on the Revap of the sub phase of physiologically …

Airway Epithelial Innate Immunity, Sebastian L. Johnston, David L. Goldblatt, Scott E. Evans, Michael J. Tuvim, Burton F. Dickey

School of Medicine Publications and Presentations

Besides providing an essential protective barrier, airway epithelial cells directly sense pathogens and respond defensively. This is a frontline component of the innate immune system with specificity for different pathogen classes. It occurs in the context of numerous interactions with leukocytes, but here we focus on intrinsic epithelial mechanisms. Type 1 immune responses are directed primarily at intracellular pathogens, particularly viruses. Prominent stimuli include microbial nucleic acids and interferons released from neighboring epithelial cells. Epithelial responses revolve around changes in the expression of interferon-sensitive genes (ISGs) that interfere with viral replication, as well as the further induction of interferons that …

Race And Drug Toxicity: A Study Of Three Cardiovascular Drugs With Strong Pharmacogenetic Recommendations., Travis J. O'Brien, Kevin Fenton, Alfateh Sidahmed, April Barbour, Arthur F Harralson

Pharmacology and Physiology Faculty Publications

No abstract provided.

Ethanol And Opioids Do Not Act Synergistically To Depress Excitation In Carotid Body Type I Cells, Ryan J. Rakoczy, Kajal Kamra, Yoon-Jae Yi, Christopher N. Wyatt

Neuroscience, Cell Biology & Physiology Faculty Publications

The combination of opioids and ethanol can synergistically depress breathing and the acute ventilatory response to hypoxia. Multiple studies have shown that the underlying mechanisms for this may involve calcium channel inhibition in central neurons. But we have previously identified opioid receptors in the carotid bodies and shown that their activation inhibits calcium influx into the chemosensitive cells. Given that the carotid bodies contribute to the drive to breathe and underpin the acute hypoxic ventilatory response, we hypothesized that ethanol and opioids may act synergistically in these peripheral sensory organs to further inhibit calcium influx and therefore inhibit ventilation.

Methods …

Physiological Roles Of Mammalian Transmembrane Adenylyl Cyclase Isoforms, Katrina F. Ostrom, Justin E. Lavigne, Tarsis F. Brust, Roland Seifert, Carmen Dessauer, Val J. Watts, Rennolds S. Ostrom

Pharmacy Faculty Articles and Research

Adenylyl cyclases (ACs) catalyze the conversion of ATP to the ubiquitous second messenger cAMP. Mammals possess nine isoforms of transmembrane ACs, dubbed AC1-9, that serve as major effector enzymes of G protein-coupled receptors. The transmembrane ACs display varying expression patterns across tissues, giving potential for them having a wide array of physiologic roles. Cells express multiple AC isoforms, implying that ACs have redundant functions. Furthermore, all transmembrane ACs are activated by Gα_s so it was long assumed that all ACs are activated by Gα_s-coupled GPCRs. AC isoforms partition to different microdomains of the plasma membrane and form …

Genetic Targeting Of Adult Renshaw Cells Using A Calbindin 1 Destabilized Cre Allele For Intersection With Parvalbumin Or Engrailed1, Alicia R. Lane, Indeara C. Cogdell, Thomas M. Jessell, Jay B. Bikoff, Francisco J. Alvarez

Neuroscience, Cell Biology & Physiology Faculty Publications

Renshaw cells (RCs) are one of the most studied spinal interneurons; however, their roles in motor control remain enigmatic in part due to the lack of experimental models to interfere with RC function, specifically in adults. To overcome this limitation, we leveraged the distinct temporal regulation of Calbindin (Calb1) expression in RCs to create genetic models for timed RC manipulation. We used a Calb1 allele expressing a destabilized Cre (dgCre) theoretically active only upon trimethoprim (TMP) administration. TMP timing and dose influenced RC targeting efficiency, which was highest within the first three postnatal weeks, but specificity was low with …

Short-Term High Fat, High Sucrose Diet Increases Markers Associated With Hepaticlipid Accumulation In Rhesus Macaques, Eden Gallegos, Liz Simon, Patricia Molina

Medical Research Day

Self-reported data collected from our clinical cohort, the New Orleans Alcohol Use in HIV (NOAH), shows that a significant number of people living with HIV (PLWH) consume a suboptimal diet as determined by the Dietary Guidelines for Americans. Consumption of a high fat, high sucrose diet (HFSD), known as a Western Diet contributes to metabolic dyshomeostasis and development of metabolic syndrome and non-alcoholic fatty liver disease. At-risk alcohol consumption, HIV-infection, and consumption of a HFSD independently can lead to liver disease. Thus, PLWH with at risk alcohol consumption and consuming a HFSD may have increased risk for liver pathology. Alcoholic …

Peripheral Immune Cell Pro- And Anti-Nociceptive Gene Expression In Chronicbinge Alcohol Administered Siv-Infected Rhesus Macaques, Michael Dubic, Liz Simon, Patricia Molina

Medical Research Day

People living with HIV (PLWH) have a 2-fold higher prevalence of chronic pain compared to the general population. Reports in the literature indicate that alcohol consumption to self-medicate pain may increase the incidence of at-risk alcohol use. Chronic alcohol use, HIV infection, and anti-retroviral therapy (ART) all independently lead to altered pain states, yet the underlying pathophysiology is poorly understood. The aim of this study was to explore the utility of peripheral blood mono nuclear cells (PBMCs) as indicators of alcohol-, ART-, and HIV- associated alterations in pro and anti- nociceptive pathways in a relevant preclinical model of HIV-infection. Four- …

Impaired Aicd In Senescent Cd8 T-Cells: Cell Death Pathwayselectivity & The Effects Of Alcohol, Nabil Essajee, I Welsh, Pm Mcternan, David A. Welsh, Robert W. Siggins

Medical Research Day

Background: Alcohol Use Disorder (AUD) is prevalent in People Living with HIV (PLWH). Chronic alcohol use and HIV infections are both stressors that can accelerate the onset of cellular senescence, a pro-inflammatory phenotype associated with unhealthy ageing and contributor to the phenomenon known as “inflamm-aging.” Furthermore, it has been observed that in senescent cells, there is an impairment of Activation-Induced Cell Death (AICD). The mechanism of impairment of AICD in senescent cells remains unknown. The goal of our research is to investigate by which pathway of cell death (apoptosis, pyroptosis, necroptosis) senescent cells are susceptible by analyzing markers of senescence …

Floppy Eyelid Syndrome And Obesity (Flo) Study, Bethany S. Acosta, Kyle V. Acosta, Stefany D. Primeaux

Medical Research Day

Floppy Eyelid Syndrome (FES) was first described in 1981 by Culbertson and Ostler. Often under-diagnosed, the reported incidence ranges from 0.5-31.5% with an average age of 51 years. A patient will typically present with a soft, rubbery tarsus that folds in on itself, a loose upper eyelid that everts easily with manual manipulation, and papillary conjunctivitis. Studies indicate that patients with FES are often diagnosed with obstructive sleep apnea (OSA) and have high rates of obesity (Body Mass Index (BMI) > 30). Patients with FES exhibit a diminished quantity of elastin fibers throughout the pretarsal orbicularis oculi muscle and tarsus. Interestingly, …

Female Mice Are Protected From Chronic Inhaled Nicotine-Induced Pulmonaryhypertension Via A Sex Hormone-Independent Mechanism, Idanis Z. Garcia, Nicholas D. Fried, Anna K. Whitehead, Eric Lazartigues, Xinping Yue, Jason D. Gardner

Medical Research Day

Introduction: Cigarette smoking has declined in the United States, but e-cigarettes use increased by 46.2% in young adults and 77.8% in high school students between 2017-2018. Little is known about the long-term health implications of these nicotine-containing devices, but cigarette smoking is a major risk factor for cardiovascular and pulmonary diseases, which are the primary cause of death in industrialized countries. Our group previously demonstrated that chronic inhaled nicotine induces pulmonary hypertension (PH) and right ventricular (RV) remodeling in male mice, but female mice exposed to nicotine failed to develop PH, suggesting a sex difference. This led us to hypothesize …

Role Of Lymph From Alcohol-Treated Animals On Naïve Perilymphaticadipose Tissue Immunomodulation, Kourtney Weaver, Flavia Souza-Smith

Medical Research Day

Alcohol impairs innate and adaptive immune responses, harming host defense against infections. Chronic alcohol administration has also been shown to impact early manifestations of metabolic dysfunction such as insulin resistance in rodent models. In our previous studies, we found that alcohol induces mesenteric lymphatic leakage and perilymphatic adipose tissue (PLAT) immunometabolic dysregulation. Whether the lymph from alcohol-treated animals is directly causing PLAT immunometabolic dysregulation is still to be determined. We hypothesize that lymph contents from alcohol-treated animals will immunomodulate naïve PLAT explants. To test this hypothesis, male Fischer 344 rats received Lieber-DeCarli liquid diet containing 36% of calories from alcohol …

Neurobiological Consequences Of Chronic Binge Alcohol Exposure And Ovariectomy On Markers Of Hippocampal Plasticity In Siv-Infected Rhesus Macaques, Taylor Fitzpatrick-Schmidt, Larry B. Coleman, Kimberly N. Edwards, Liz Simon, Patricia E. Molina, Scott Edwards

Medical Research Day

Human immunodeficiency virus (HIV) infection has profound impacts on the central nervous system, including HIV-associated neurocognitive disorder (HAND). HIV-associated cognitive deficits can be further exacerbated by alcohol consumption1 . With the rising prevalence of alcohol use disorder (AUD) in females, understanding the neurobiological impact of AUD and HIV infection in this population is increasingly important 2 . The hippocampus is part of the brain’s limbic system and plays prominent roles in both cognition and affective regulation. Thus, investigating hippocampal neuroadaptations in the context of comorbid HIV infection and AUD is critical for understanding the mechanisms of neurocognitive and affective impairment …

Nsaids Naproxen, Ibuprofen, Salicylate, And Aspirin Inhibit Trpm7 Channels By Cytosolic Acidification, Rikki Chokshi, Orville Bennett, Tetyana Zhelay, J. Ashot Kozak

Neuroscience, Cell Biology & Physiology Faculty Publications

Non-steroidal anti-inflammatory drugs (NSAIDs) are used for relieving pain and inflammation accompanying numerous disease states. The primary therapeutic mechanism of these widely used drugs is the inhibition of cyclooxygenase 1 and 2 (COX1, 2) enzymes that catalyze the conversion of arachidonic acid into prostaglandins. At higher doses, NSAIDs are used for prevention of certain types of cancer and as experimental treatments for Alzheimer’s disease. In the immune system, various NSAIDs have been reported to influence neutrophil function and lymphocyte proliferation, and affect ion channels and cellular calcium homeostasis. Transient receptor potential melastatin 7 (TRPM7) cation channels are highly expressed in …

Identification And Characterization Of Cyps Induced In The Drosophila Antenna By Exposure To A Plant Odorant, Shane R Baldwin, Pratyajit Mohapatra, Monica Nagalla, Rhea Sindvani, Desiree Amaya, Hope A Dickson, Karen Menuz

Department of Medicine Faculty Papers

Degrading Enzymes (ODEs). However, their contribution to olfactory signaling in vivo is poorly understood. This is due in part to the challenge of identifying which of the dozens of antennal-expressed CYPs might inactivate a given odorant. Here, we tested a high-throughput deorphanization strategy in Drosophila to identify CYPs that are transcriptionally induced by exposure to odorants. We discovered three CYPs selectively upregulated by geranyl acetate using transcriptional profiling. Although these CYPs are broadly expressed in the antenna in non-neuronal cells, electrophysiological recordings from CYP mutants did not reveal any changes in olfactory neuron responses to this odorant. Neurons were desensitized …

Role Of Emotional Intelligence In Job Performance Of Healthcare Providers Working In Public Sector Hospitals Of Pakistan, Nimra Zaman, Khalida Naz Memon, Faryal Zaman, Komal Zaman Khan, Shazia Rahman Shaikh

Journal of Mind and Medical Sciences

Objective. To determine the association between emotional intelligence (EI) and job performance (JP) of health care providers (HCPs). Methods. Healthcare professionals from various hospitals were chosen for a cross-sectional study. The survey was conducted using a three-part questionnaire including the demographic profile, Wong and Law Emotional Intelligence (EI) Scale, and an individual work performance (JP) questionnaire. The relationship of predictor variables on JP was sought by applying Chi-square test and multiple regression analysis. Results. About 43.3% of the 50.8% of participants who scored well on the EI scale also scored high on the JP scales. The remaining …

Placenta-Specific Slc38a2/Snat2 Knockdown Causes Fetal Growth Restriction In Mice, Owen R. Vaughan, Katarzyna Maksym, Elena Silva, Kenneth Barentsen, Russel V. Anthony, Sara L. Hillman, Thomas L. Brown, Rebecca Spencer, Anna L. David, Fredrick J. Rosario, Theresa L. Powell, Thomas Jansson

Neuroscience, Cell Biology & Physiology Faculty Publications

Fetal growth restriction (FGR) is a complication of pregnancy that reduces birth weight, markedly increases infant mortality and morbidity and is associated with later-life cardiometabolic disease. No specific treatment is available for FGR. Placentas of human FGR infants have low abundance of sodium-coupled neutral amino acid transporter 2 (Slc38a2/SNAT2), which supplies the fetus with amino acids required for growth. We determined the mechanistic role of placental Slc38a2/SNAT2 deficiency in the development of restricted fetal growth, hypothesizing that placenta-specific Slc38a2 knockdown causes FGR in mice. Using lentiviral transduction of blastocysts with a small hairpin RNA (shRNA), we achieved 59% knockdown of …

Coronavirus Disease 2019 (Covid-19): Multisystem Review Of Pathophysiology, Tanveer Mir, Talal Almas, Jasmeet Kaur, Mohammed Faisaluddin, David Song, Waqas Ullah, Sahil Mamtani, Hiba Rauf, Sunita Yadav, Sharaad Latchana, Nara Miriam Michaelson, Michael Connerney, Yasar Sattar

Division of Internal Medicine Faculty Papers & Presentations

Abstract Coronavirus disease-19 (COVID-19) pandemic is associated with high morbidity and mortality. COVID-19, which is caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS CoV-2), affects multiple organ systems through a myriad of mechanisms. Afflicted patients present with a vast constellation of symptoms, from asymptomatic disease to life-threatening complications. The most common manifestations pertain to mild pulmonary symptoms, which can progress to respiratory distress syndrome and venous thromboembolism. However, in patients with renal failure, life-threatening cardiac abnormalities can ensue. Various mechanisms such as viral entry through Angiotensin receptor (ACE) affecting multiple organs and thus releasing pro-inflammatory markers have been postulated. …

The Effects Of Estrogen In The Glucoregulatory Response To Exercise In Type 1 Diabetes, Mitchell James Sammut

Undergraduate Student Research Internships Conference

Regular exercise has shown to benefit the health of individuals with type 1 diabetes mellitus (T1DM). However, a barrier to regular exercise for this population is the fear of low blood glucose (BG) levels, also known as hypoglycemia. Hypoglycemia can result in short and long-term side-effects, such as recurring loss of consciousness or in severe cases death.

In non-diabetics, sex-related differences in fuel selection during exercise are well established. Women shift towards using fats as fuel whereas men rely mostly on sugars (i.e., carbohydrates) for energy production. Exercise during the luteal phase of the female menstrual cycle, where estrogen levels …

Point Substitutions In G Protein-Coupled Receptors, Jessica Brown

Undergraduate Student Research Internships Conference

G protein-coupled receptors (GPCRs) are proteins that are important in physiological regulatory processes within the body, and for this reason are important drug targets. When bound to an agonist, such as neurotransmitters or hormones, the receptor adopts an active state to allow these biochemical pathways to occur. However, mutations can arise within the receptor that affect its ability to bind its agonist. This natural variation found within the genome can make it difficult to design pharmaceuticals to target the receptors.

To see the effects of these point substitutions on agonist-induced receptor activation, mutations were made within a negative allosteric site …

A Distinct Difference Between Air And Mucosal Temperatures In Human Respiratory Tract, Mehdi Khosravi, Ruei-Lung Lin, Ashish P. Maskey, Subodh Pandey, An-Hsuan Lin, Lu-Yuan Lee

Internal Medicine Faculty Publications

xtensive evidence indicates that several types of temperature-sensitive ion channels are abundantly expressed in the sensory nerves innervating airway mucosa. Indeed, airway temperature is known to play an important role in regulating respiratory functions. However, the actual airway mucosal temperature and its dynamic changes during the respiratory cycle have not been directly measured. In previous studies, airway tissue temperature was often estimated by indirect measurement of the peak exhaled breath temperature (PEBT). In view of the poor thermal conductivity of air, we believe that the airway tissue temperature cannot be accurately determined by the exhaled air temperature, and this study …

Maternal Lifelong Western Diet Consumption Impacts Placental And Brain Development In The Term Guinea Pig Fetus, Carlene H. Cihosky

Electronic Thesis and Dissertation Repository

Both metabolic and cognitive dysfunction can originate from fetal reprogramming precipitating from adverse conditions experienced in utero. Of note is the western diet (WD), which is associated with maternal energy imbalances that may hinder fetal development through altered placental function. Brain-derived neurotrophic factor (BDNF), a growth factor that supports the placenta and developing brain, is responsive to such energy imbalances. This study sought to investigate the impact of lifelong maternal WD consumption on fetoplacental development, focusing on relations between placental changes, and fetal growth and neurodevelopment in a guinea pig model. Maternal WD consumption resulting in a lean metabolically …

Myonuclear Transcriptional Dynamics In Response To Exercise Following Satellite Cell Depletion, Yuan Wen, Davis A. Englund, Bailey D. Peck, Kevin A. Murach, John J. Mccarthy, Charlotte A. Peterson

Physical Therapy Faculty Publications

Skeletal muscle is composed of post-mitotic myofibers that form a syncytium containing hundreds of myonuclei. Using a progressive exercise training model in the mouse and single nucleus RNA-sequencing (snRNA-seq) for high-resolution characterization of myonuclear transcription, we show myonuclear functional specialization in muscle. After 4 weeks of exercise training, snRNA-seq reveals that resident muscle stem cells, or satellite cells, are activated with acute exercise but demonstrate limited lineage progression while contributing to muscle adaptation. In the absence of satellite cells, a portion of nuclei demonstrates divergent transcriptional dynamics associated with mixed-fate identities compared with satellite cell replete muscles. These data provide …

Current State Of Preeclampsia Mouse Models: Approaches, Relevance, And Standardization, Christopher A. Waker, Melissa R. Kaufman, Thomas L. Brown

Neuroscience, Cell Biology & Physiology Faculty Publications

Preeclampsia (PE) is a multisystemic, pregnancy-specific disorder and a leading cause of maternal and fetal death. PE is also associated with an increased risk for chronic morbidities later in life for mother and offspring. Abnormal placentation or placental function has been well-established as central to the genesis of PE; yet much remains to be determined about the factors involved in the development of this condition. Despite decades of investigation and many clinical trials, the only definitive treatment is parturition. To better understand the condition and identify potential targets preclinically, many approaches to simulate PE in mice have been developed and …

Effect Of Metformin On The High-Density Lipoprotein Proteome In Youth With Type 1 Diabetes, Evgenia Gourgari, Kristen J. Nadeau, Laura Pyle, Martin P. Playford, Junfeng Ma, Nehal N. Mehta, Alan T. Remaley, Scott M. Gordon

Saha Cardiovascular Research Center Faculty Publications

Background: Youth with type 1 diabetes (T1D) have normal or elevated High-Density Lipoprotein Cholesterol (HDL-C), however, the function of HDL, partly mediated by the HDL proteome, may be impaired. Metformin can be used as an adjunct therapy in youth with T1D, but its effects on the HDL proteome are unknown.

Objective: To determine the effect of metformin on the HDL proteome.

Subjects: Youth (12-20 years old) with T1D who had a BMI > 90th percentile, HbA1c > 8.0% and Tanner stage 5.

Methods: Double-blinded, placebo-controlled randomized sub-study. We examined the effects of metformin (n = 25) or placebo (n = …

Analysis Of Genetic Variants Associated With Levels Of Immune Modulating Proteins For Impact On Alzheimer’S Disease Risk Reveal A Potential Role For Siglec14, Benjamin C. Shaw, Yuriko Katsumata, James F. Simpson, David W. Fardo, Steven Estus

Biostatistics Faculty Publications

Genome-wide association studies (GWAS) have identified immune-related genes as risk factors for Alzheimer’s disease (AD), including TREM2 and CD33, frequently passing a stringent false-discovery rate. These genes either encode or signal through immunomodulatory tyrosine-phosphorylated inhibitory motifs (ITIMs) or activation motifs (ITAMs) and govern processes critical to AD pathology, such as inflammation and amyloid phagocytosis. To investigate whether additional ITIM and ITAM-containing family members may contribute to AD risk and be overlooked due to the stringent multiple testing in GWAS, we combined protein quantitative trait loci (pQTL) data from a recent plasma proteomics study with AD associations in a recent …

The Role Of Action Potential Waveform In Failure Of Excitation Contraction Coupling, Xueyong Wang, Murad Nawaz, Steve R.A. Burke, Roger Bannister, Brent D. Foy, Andrew A. Voss, Mark M. Rich

Neuroscience, Cell Biology & Physiology Faculty Publications

Excitation contraction coupling (ECC) is the process by which electrical excitation of muscle is converted into force generation. Depolarization of skeletal muscle resting potential contributes to failure of ECC in diseases such as periodic paralysis, ICU acquired weakness and possibly fatigue of muscle during vigorous exercise. When extracellular K+ is raised to depolarize the resting potential, failure of ECC occurs suddenly, over a range of several mV of resting potential. While some studies have hypothesized the sudden failure of ECC is due to all-or-none failure of excitation, other studies suggest failure of excitation is graded. Intracellular recordings of action potentials …

Weak Evidence, Supplemented With Common Sense For Reduction In Postoperative Pulmonary Complications, Natalie M. Wiseman

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising:

Kaminski PN, Forgiarini LA, Jr., Andrade CF. Early respiratory therapy reduces postoperative atelectasis in children undergoing lung resection. Respir Care. 2013;58(5):805-809. https://doi.org/10.4187/respcare.01870

for prevention of postoperative pulmonary complications following thoracic surgery for a patient who is not able to participate in incentive spirometry.