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Article ; Online: Chemoradiation to the Submental Muscles Alters Hyoid Movement During Swallowing in a Rat Model.

King, Suzanne N / Kuntz, Abigail / Scott, Nathan / Smiley, Brittany / Portocarrero Bonifaz, Andres / Blackburn, Megan

Journal of applied physiology (Bethesda, Md. : 1985)

2024

Abstract: Hyolaryngeal dysfunction is a commonly reported swallowing problem after chemoradiation treatment for head and neck cancer. The displacement of the hyolaryngeal complex during swallowing protects the airway and assists in opening the upper esophageal ... ...

Abstract	Hyolaryngeal dysfunction is a commonly reported swallowing problem after chemoradiation treatment for head and neck cancer. The displacement of the hyolaryngeal complex during swallowing protects the airway and assists in opening the upper esophageal sphincter. Activation of the submental muscles, specifically the mylohyoid and geniohyoid muscles, are thought to facilitate movement of the hyoid. The purpose of this study was to determine if targeted radiation to the submental muscles given concurrently with chemotherapy alters hyolaryngeal displacement one-month after treatment. We hypothesized that chemoradiation treatment will result in abnormal patterns of hyoid movement compared to controls. Furthermore, we propose that these changes are associated with alterations in bolus size and discoordination of the jaw during drinking. Eighteen rats underwent either chemoradiation, radiation, or no treatment. Radiation treatment was targeted to submental muscles using a clinical linear accelerator given in 12 fractions of 4Gy (3 days per week). Cycles of 1mg/kg of cisplatin were administered concurrently each week of radiation. One-month post-treatment, videofluoroscopy swallow studies (VFSS) were performed in self-drinking rats using a fluoroscope customized with a high speed camera. The hyoid, jaw, and hard palate were tracked during swallowing from VFSS. Hyoid kinematics were analyzed from the start to the end of hyoid movement, and parameters were compared to bolus size and jaw movement. Significant differences in hyoid retraction parameters were found post chemoradiation. Alterations in the trajectory of hyoid motion during swallowing were observed. Findings demonstrate early changes in hyoid motion during swallowing associated with chemoradiation treatment.
Language	English
Publishing date	2024-03-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	219139-8
ISSN	1522-1601 ; 0021-8987 ; 0161-7567 ; 8750-7587
ISSN (online)	1522-1601
ISSN	0021-8987 ; 0161-7567 ; 8750-7587
DOI	10.1152/japplphysiol.00538.2023
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Article ; Online: Conditional associations between childhood cat ownership and psychotic experiences in adulthood: A retrospective study.

Paquin, Vincent / Elgbeili, Guillaume / Munden, Julia / Schmitz, Norbert / Joober, Ridha / Ciampi, Antonio / King, Suzanne

Journal of psychiatric research

2022 Volume 148, Page(s) 197–203

Abstract: ... in adulthood. Adults (n = 2206) were recruited in downtown Montreal to complete a survey about childhood cat ... history, and rodent-hunting cat ownership (n = 22; mean standard score = 0.96). The interaction between ...

Abstract	Ownership of cats in childhood has been inconsistently associated with psychosis in adulthood. Parasitic exposure, the putative mechanism of this association, may be more common with rodent-hunting cats, and its association with psychosis may depend on other environmental exposures. We examined the conditional associations between childhood cat ownership and the frequency of psychotic experiences in adulthood. Adults (n = 2206) were recruited in downtown Montreal to complete a survey about childhood cat ownership (non-hunting or rodent-hunting), winter birth, residential moves in childhood, head trauma history, and tobacco smoking. The frequency of psychotic experiences (PE) was measured with the 15-item positive subscale of the Community Assessment of Psychic Experiences. Associations between exposures and PE were examined in linear regressions adjusted for age and sex. Interactions among variables were explored using a conditional inference tree. Rodent-hunting cat ownership was associated with higher PE scores in male participants (vs. non-hunting or no cat ownership: SMD = 0.57; 95% CI: 0.27, 0.86), but not in female participants (SMD = 0.10; 95% CI: -0.18, 0.38). In the conditional inference tree, the highest mean PE score was in the class comprised of non-smokers with >1 residential move, head trauma history, and rodent-hunting cat ownership (n = 22; mean standard score = 0.96). The interaction between rodent-hunting cat ownership and head trauma history was supported by a post-hoc linear regression model. Our findings suggest childhood cat ownership has conditional associations with psychotic experiences in adulthood.
MeSH term(s)	Adult ; Craniocerebral Trauma ; Female ; Humans ; Male ; Ownership ; Psychotic Disorders/epidemiology ; Retrospective Studies
Language	English
Publishing date	2022-01-30
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	3148-3
ISSN	1879-1379 ; 0022-3956
ISSN (online)	1879-1379
ISSN	0022-3956
DOI	10.1016/j.jpsychires.2022.01.058
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Article: Sheath-tailed bats (Chiroptera: Emballonuridae) from the early Pleistocene Rackham's Roost Site, Riversleigh World Heritage Area, and the distribution of northern Australian emballonurid species.

King, Tyler R / Myers, Troy J / Armstrong, Kyle N / Archer, Michael / Hand, Suzanne J

PeerJ

2021 Volume 9, Page(s) e10857

Abstract: Sheath-tailed bats (Family Emballonuridae) from the early Pleistocene Rackham's Roost Site cave deposit in the Riversleigh World Heritage Area, north-western Queensland are the oldest recorded occurrence for the family in Australia. The fossil remains ... ...

Abstract	Sheath-tailed bats (Family Emballonuridae) from the early Pleistocene Rackham's Roost Site cave deposit in the Riversleigh World Heritage Area, north-western Queensland are the oldest recorded occurrence for the family in Australia. The fossil remains consist of maxillary and dentary fragments, as well as isolated teeth, but until now their precise identity has not been assessed. Our study indicates that at least three taxa are represented, and these are distinguished from other Australian emballonurids based on morphometric analysis of craniodental features. Most of the Rackham's Roost Site emballonurid remains are referrable to the modern species
Language	English
Publishing date	2021-02-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	2703241-3
ISSN	2167-8359
ISSN	2167-8359
DOI	10.7717/peerj.10857
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Article ; Online: Swallowing dysfunction following radiation to the rat mylohyoid muscle is associated with sensory neuron injury.

King, Suzanne N / Hurley, Justin / Carter, Zachary / Bonomo, Nicholas / Wang, Brian / Dunlap, Neal / Petruska, Jeffrey

Journal of applied physiology (Bethesda, Md. : 1985)

2021 Volume 130, Issue 4, Page(s) 1274–1285

Abstract: Radiation-based treatments for oropharyngeal and hypopharyngeal cancers result in impairments in swallowing mobility, but the mechanisms behind the dysfunction are not clear. The purpose of this study was to determine if we could establish an animal ... ...

Abstract	Radiation-based treatments for oropharyngeal and hypopharyngeal cancers result in impairments in swallowing mobility, but the mechanisms behind the dysfunction are not clear. The purpose of this study was to determine if we could establish an animal model of radiation-induced dysphagia in which mechanisms could be examined. We hypothesized that
MeSH term(s)	Animals ; Deglutition ; Deglutition Disorders/etiology ; Neck Muscles ; Pharynx ; Rats ; Sensory Receptor Cells
Language	English
Publishing date	2021-02-18
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	219139-8
ISSN	1522-1601 ; 0021-8987 ; 0161-7567 ; 8750-7587
ISSN (online)	1522-1601
ISSN	0021-8987 ; 0161-7567 ; 8750-7587
DOI	10.1152/japplphysiol.00664.2020
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Article ; Online: Acute effects of radiation treatment to submental muscles on burrowing and swallowing behaviors in a rat model.

King, Suzanne N / Greenwell, Evan / Kaissieh, Nada / Devara, Lekha / Carter, Zachary / Fox, James / Blackburn, Megan

PloS one

2022 Volume 17, Issue 5, Page(s) e0268457

Abstract: Swallowing impairments are a major complication of radiation treatment for oropharyngeal cancers, influencing oral intake and quality of life. The timing and functional consequences of radiation treatment on the swallowing process is not clearly ... ...

Abstract	Swallowing impairments are a major complication of radiation treatment for oropharyngeal cancers, influencing oral intake and quality of life. The timing and functional consequences of radiation treatment on the swallowing process is not clearly understood. A rodent radiation injury model was used to investigate the onset of oral and pharyngeal dysfunctions in deglutition related to radiation treatment. This study tested the hypothesis that (Wall et al., 2013) alterations in normal biting, licking, and swallowing performance would be measurable following 64Gy of fractionated radiation to the submental muscles; and (Kotz et al., 2004) radiation will affect the animal's general well-being as measured via burrowing activity. Seven rats received radiation using a clinical linear accelerator given in 8 fractions of 8Gy and another seven animals received sham anesthesia only treatment. Swallowing bolus transit/size was assessed via videofluoroscopy, tongue movement during drinking was measured via an electrical lick sensor, and biting was analyzed from acoustic recordings of a vermicelli pasta test. Burrowing activity was measured by the amount of gravel substrate displaced within a container. Measurements were taken at baseline, during treatment (1-4 weeks), and after completion of treatment (weeks 5 & 6). Decreases in licking frequency and increases in inter-lick interval were observed 5- and 6-weeks post-treatment. Significant decreases in burrowing performance, swallowing frequency, and inter-swallow interval were observed starting the last week of treatment and continuing up to 2-weeks after completion. Results suggest that tongue dysfunction is one of the first treatment related feeding problems to present immediately after the completion of radiation to the submental muscles.
MeSH term(s)	Animals ; Deglutition/physiology ; Deglutition Disorders ; Muscles ; Quality of Life ; Rats ; Tongue/physiology
Language	English
Publishing date	2022-05-13
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0268457
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Article ; Online: "The Actor Is Policy": Application of Elite Theory to Explore Actors' Interests and Power Underlying Maternal Health Policies in Uganda, 2000-2015.

Mukuru, Moses / Kiwanuka, Suzanne N / Gilson, Lucy / Shung-King, Maylene / Ssengooba, Freddie

International journal of health policy and management

2021 Volume 10, Issue 7, Page(s) 388–401

Abstract: Background: The persistence of high maternal mortality and consistent failure in low- and middle-income countries to achieve global targets such as Millennium Development Goal five (MDG 5) is usually explained from epidemiological, interventional and ... ...

Abstract	Background: The persistence of high maternal mortality and consistent failure in low- and middle-income countries to achieve global targets such as Millennium Development Goal five (MDG 5) is usually explained from epidemiological, interventional and health systems perspectives. The role of policy elites and their interests remains inadequately explored in this debate. This study examined elites and how their interests drove maternal health policies and actions in ways that could explain policy failure for MDG 5 in Uganda. Methods: We conducted a retrospective qualitative study of Uganda's maternal health policies from 2000 to 2015 (MDG period). Thirty key informant interviews and 2 focus group discussions (FGDs) were conducted with national policy-makers, who directly participated in the formulation of Uganda's maternal health policies during the MDG period. We reviewed 9 National Maternal Health Policy documents. Data were analysed inductively using elite theory. Results: Maternal health policies were mainly driven by a small elite group comprised of Senior Ministry of Health (MoH) officials, some members of cabinet and health development partners (HDPs) who wielded more power than other actors. The resulting policies often appeared to be skewed towards elites' personal political and economic interests, rather than maternal mortality reduction. For a few, however, interests aligned with reducing maternal mortality. Since complying with the government policy-making processes would have exposed elites' personal interests, they mainly drafted policies as service standards and programme documents to bypass the formal policy process. Conclusion: Uganda's maternal health policies were mainly influenced by the elites' personal interests rather than by the goal of reducing maternal mortality. This was enabled by the formal guidance for policy-making which gives elites control over the policy process. Accelerating maternal mortality reduction will require re-engineering the policy process to prevent public officials from infusing policies with their interests, and enable percolation of ideas from the public and frontline.
MeSH term(s)	Female ; Health Policy ; Humans ; Maternal Health ; Policy Making ; Retrospective Studies ; Uganda
Language	English
Publishing date	2021-07-01
Publishing country	Iran
Document type	Journal Article ; Review
ZDB-ID	2724317-5
ISSN	2322-5939 ; 2322-5939
ISSN (online)	2322-5939
ISSN	2322-5939
DOI	10.34172/ijhpm.2020.230
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Article ; Online: Sheath-tailed bats (Chiroptera

Tyler R. King / Troy J. Myers / Kyle N. Armstrong / Michael Archer / Suzanne J. Hand

PeerJ, Vol 9, p e

Emballonuridae) from the early Pleistocene Rackham’s Roost Site, Riversleigh World Heritage Area, and the distribution of northern Australian emballonurid species

2021 Volume 10857

Abstract: Sheath-tailed bats (Family Emballonuridae) from the early Pleistocene Rackham’s Roost Site cave deposit in the Riversleigh World Heritage Area, north-western Queensland are the oldest recorded occurrence for the family in Australia. The fossil remains ... ...

Abstract	Sheath-tailed bats (Family Emballonuridae) from the early Pleistocene Rackham’s Roost Site cave deposit in the Riversleigh World Heritage Area, north-western Queensland are the oldest recorded occurrence for the family in Australia. The fossil remains consist of maxillary and dentary fragments, as well as isolated teeth, but until now their precise identity has not been assessed. Our study indicates that at least three taxa are represented, and these are distinguished from other Australian emballonurids based on morphometric analysis of craniodental features. Most of the Rackham’s Roost Site emballonurid remains are referrable to the modern species Taphozous georgianus Thomas, 1915, but the extant species T. troughtoni Tate, 1952 also appears to be present, as well as a very large, as-yet undetermined species of Saccolaimus Temminck, 1838. We identify craniodental features that clearly distinguish T. georgianus from the externally very similar T. troughtoni. Results suggest that the distributions of T. georgianus and T. troughtoni may have overlapped in north-western Queensland since at least the early Pleistocene.
Keywords	Sheath-tailed bats ; Emballonuridae ; Pleistocene ; Riversleigh World Heritage Area ; Australian distribution ; Medicine ; R ; Biology (General) ; QH301-705.5
Subject code	590
Language	English
Publishing date	2021-02-01T00:00:00Z
Publisher	PeerJ Inc.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Radiation induced changes in profibrotic markers in the submental muscles and their correlation with tongue movement.

King, Suzanne N / Kaissieh, Nada / Haxton, Chandler / Shojaei, Marjan / Malott, Luke / Devara, Lekha / Thompson, Rebecca / Osman, Kate L / Millward, Jessica / Blackburn, Megan / Lever, Teresa E

PloS one

2023 Volume 18, Issue 6, Page(s) e0287044

Abstract: Swallowing impairment is a major complication of radiation treatment for oropharyngeal cancers. Developing targeted therapies that improve swallowing outcomes relies on an understanding of the mechanisms that influence motor function after radiation ... ...

Abstract	Swallowing impairment is a major complication of radiation treatment for oropharyngeal cancers. Developing targeted therapies that improve swallowing outcomes relies on an understanding of the mechanisms that influence motor function after radiation treatment. The purpose of this study was to determine whether there is a correlation between radiation induced changes in tongue movement and structural changes in irradiated submental muscles, as well as assess other possible causes for dysfunction. We hypothesized that a clinically relevant total radiation dose to the submental muscles would result in: a) quantifiable changes in tongue strength and displacement during drinking two months post treatment; and b) a profibrotic response and/or fiber type transition in the irradiated tissue. Sprague-Dawley adult male rats received radiation to the submental muscles at total dose-volumes known to provoke dysphagia in humans. A clinical linear accelerator administered 8 fractions of 8Gy for a total of 64Gy. Comparisons were made to sham-treated rats that received anesthesia only. Swallowing function was assessed using videofluoroscopy and tongue strength was analyzed via force lickometer. TGFβ1 expression was analyzed via ELISA. The amount of total collagen was analyzed by picrosirius red staining. Immunofluorescence was used to assess fiber type composition and size. Significant changes in licking function during drinking were observed at two months post treatment, including a slower lick rate and reduced tongue protrusion during licking. In the mylohyoid muscle, significant increases in TGFβ1 protein expression were found post radiation. Significant increases in the percentage of collagen content were observed in the irradiated geniohyoid muscle. No changes in fiber type expression were observed. Results indicate a profibrotic transition within the irradiated swallowing muscles that contributes to tongue dysfunction post-radiation treatment.
MeSH term(s)	Humans ; Adult ; Male ; Rats ; Animals ; Rats, Sprague-Dawley ; Deglutition Disorders ; Deglutition/physiology ; Tongue/physiology ; Neck Muscles ; Nervous System Diseases/complications
Language	English
Publishing date	2023-06-23
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0287044
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Article ; Online: “The Actor Is Policy”

Moses Mukuru / Suzanne N. Kiwanuka / Lucy Gilson / Maylene Shung-King / Freddie Ssengooba

International Journal of Health Policy and Management, Vol 10, Iss Special Issue on Analysing the Politics of Health Policy Change in LMICs, Pp 388-

Application of Elite Theory to Explore Actors’ Interests and Power Underlying Maternal Health Policies in Uganda, 2000-2015

2021 Volume 401

Abstract: BackgroundThe persistence of high maternal mortality and consistent failure in low- and middle-income countries to achieve global targets such as Millennium Development Goal five (MDG 5) is usually explained from epidemiological, interventional and ... ...

Abstract	BackgroundThe persistence of high maternal mortality and consistent failure in low- and middle-income countries to achieve global targets such as Millennium Development Goal five (MDG 5) is usually explained from epidemiological, interventional and health systems perspectives. The role of policy elites and their interests remains inadequately explored in this debate. This study examined elites and how their interests drove maternal health policies and actions in ways that could explain policy failure for MDG 5 in Uganda. MethodsWe conducted a retrospective qualitative study of Uganda’s maternal health policies from 2000 to 2015 (MDG period). Thirty key informant interviews and 2 focus group discussions (FGDs) were conducted with national policy-makers, who directly participated in the formulation of Uganda’s maternal health policies during the MDG period. We reviewed 9 National Maternal Health Policy documents. Data were analysed inductively using elite theory. ResultsMaternal health policies were mainly driven by a small elite group comprised of Senior Ministry of Health (MoH) officials, some members of cabinet and health development partners (HDPs) who wielded more power than other actors. The resulting policies often appeared to be skewed towards elites’ personal political and economic interests, rather than maternal mortality reduction. For a few, however, interests aligned with reducing maternal mortality. Since complying with the government policy-making processes would have exposed elites’ personal interests, they mainly drafted policies as service standards and programme documents to bypass the formal policy process. ConclusionUganda’s maternal health policies were mainly influenced by the elites’ personal interests rather than by the goal of reducing maternal mortality. This was enabled by the formal guidance for policy-making which gives elites control over the policy process. Accelerating maternal mortality reduction will require re-engineering the policy process to prevent public officials from ...
Keywords	policy elites ; millennium development goals ; maternal health ; uganda ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2021-07-01T00:00:00Z
Publisher	Kerman University of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Acute effects of radiation treatment to submental muscles on burrowing and swallowing behaviors in a rat model.

Suzanne N King / Evan Greenwell / Nada Kaissieh / Lekha Devara / Zachary Carter / James Fox / Megan Blackburn

PLoS ONE, Vol 17, Iss 5, p e

2022 Volume 0268457

Abstract	Swallowing impairments are a major complication of radiation treatment for oropharyngeal cancers, influencing oral intake and quality of life. The timing and functional consequences of radiation treatment on the swallowing process is not clearly understood. A rodent radiation injury model was used to investigate the onset of oral and pharyngeal dysfunctions in deglutition related to radiation treatment. This study tested the hypothesis that (Wall et al., 2013) alterations in normal biting, licking, and swallowing performance would be measurable following 64Gy of fractionated radiation to the submental muscles; and (Kotz et al., 2004) radiation will affect the animal's general well-being as measured via burrowing activity. Seven rats received radiation using a clinical linear accelerator given in 8 fractions of 8Gy and another seven animals received sham anesthesia only treatment. Swallowing bolus transit/size was assessed via videofluoroscopy, tongue movement during drinking was measured via an electrical lick sensor, and biting was analyzed from acoustic recordings of a vermicelli pasta test. Burrowing activity was measured by the amount of gravel substrate displaced within a container. Measurements were taken at baseline, during treatment (1-4 weeks), and after completion of treatment (weeks 5 & 6). Decreases in licking frequency and increases in inter-lick interval were observed 5- and 6-weeks post-treatment. Significant decreases in burrowing performance, swallowing frequency, and inter-swallow interval were observed starting the last week of treatment and continuing up to 2-weeks after completion. Results suggest that tongue dysfunction is one of the first treatment related feeding problems to present immediately after the completion of radiation to the submental muscles.
Keywords	Medicine ; R ; Science ; Q
Subject code	616
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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