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Control of Breathing & Airway Defense Seminar Series - Shared screen with gallery view
Alicia Vose
36:08
Please enter your questions into the chat! Dr. German has 2 fantastic postdocs (Dr. Mayerl and Dr. Adjerid) who will be answering questions… and I will also be selecting some thought provoking questions for our speakers!
Teresa Pitts
48:25
Maybe RLN especially important for feedback and comparison to efferent copy?
Thomas E. Dick
55:15
why no 5s nor 6s what are these deficits and are the unrelated to the RLN
Vivian Biancardi
56:25
Do the infants with RNL lesion have the cough reflex after aspiration?
Jessica Grittner
57:06
My clinical experience has seen both silent aspiration and aspiration with cough.
Melissa Bates
57:12
Whats the timing of RLN development? Is it underdeveloped in these 22 weekers we have here that really have aspiration issues?
Vivian Biancardi
58:21
Thanks Jessica!
Teresa Pitts
59:03
Cough is developmental- not sure when it is first seen in the pig.
Christopher Mayerl
59:09
Great Question Thomas. In the infant pigs, we rarely see any scores of 5 or 6, regardless of if it's an RLN lesion, SLN lesion, or even a preterm infant. One of the issues is that the infant pigs are basically only silently aspirate, and then will cough at the end of their feeding session, rather than stop feeding to cough
Christopher Mayerl
01:00:26
We can see coughing as early as one day after the pigs are born when they're experiencing lots of aspiration (at the conclusion of a feeding bout)
Vivian Biancardi
01:01:13
Interesting!
Thomas E. Dick
01:01:39
It lookedllike the swallow occurred in the postinspiratory period with no diminution of inspiratory duration
Denise Dewald
01:02:29
Have you ever studied piglets that are suckling at the mother’s teat, rather than on an artificial nipple?
Nick Musselwhite
01:02:57
Do you know if when coughing there is an inspiration for every expiration or do they take one inspiration and several expirations as they cough to a lower lung volume?
Christopher Mayerl
01:03:37
Great question Denise, we haven't done that yet, although we do currently have a grant proposal in at NIH to do just that, so stay tuned!
Christopher Mayerl
01:05:19
Really interesting thought Nick! We haven't looked into that explicitly, as it's somewhat hard to do because once the pigs finish eating they start running around so it's hard to measure. From what I recall after just feeding them and watching them afterwards myself, it seems as though they take one inspiration for every expiration, but that's just from us listening to them, not actually measuring breathing with a plethysmograph or thermocouple
Nick Musselwhite
01:06:05
Interesting!
Colin Cleary
01:06:42
Are these results consistent to models of aspiration in the elderly population?
Jessica Grittner
01:06:53
In human infants with RLN injury, we will see vocal cords that are paralyzed in different positions, and there is some thought that aspiration severity is related to that position. Have you seen anything like that with the pigs?
Seva Polotsky
01:07:15
Do pigs swallow during sleep?
Jean-Paul Praud
01:07:39
In newborn lambs, one inspiration for every expiration with a cough
Emily Plowman
01:08:27
We cant!
Jessica Grittner
01:08:33
Have you seen/looked at upper esophageal sphincter opening timing too?
Jean-Paul Praud
01:08:53
Laambs swallow during sleep, and there are bursts of swallows during REM sleep (no burst. During NREM)
Francois Gould
01:09:05
Hi Jessica,
Francois Gould
01:09:19
only a little but we did see difference in UES function in our lesioned pigs
Christopher Mayerl
01:11:32
Jessica, that's an interesting question about vocal cord paralysis in different positions. We haven't looked at it explicitly, but we did see that the individual response to RLN lesion was hugely variable, so that could be part of a mechanism explaining some of those interindividual differences in response!
Christopher Mayerl
01:12:10
Yes, the infant pigs are swallowing during sleep, I imagine that it's probably something similar across mammals
Teresa Pitts
01:13:18
How does the genioglossis EMG activity align with the respiration traces?
Jessica Grittner
01:13:27
Thank you Dr. German, Christopher and Francois - very cool research!
Melissa Bates
01:17:27
Look at those nuggets!!!
Thomas E. Dick
01:17:37
the piglets are not in numerical orde!
Christopher Mayerl
01:18:20
Haha yeah when they're first born we pair strong breathers with weak breathers so they get mixed up quick!
Christopher Mayerl
01:19:03
for people doing human work:7 days ~ 1-2 months postnatal for humans17 days ~ 6-9 months postnatal for humans
Emily Plowman
01:22:40
Yes! I was just thinking about this Vose.
Ralph Fregosi
01:24:11
Rebecca and Francois—I have to join another zoom meeting, but wanted to thank you both for the terrific presentations. I learned a lot!
Denise Dewald
01:29:58
Are there differences in the swallowing if piglets are weaned earlier vs later? Thinking about differences in weaning infants at 4 months in modern infants vs 3-4 years in hunter-gatherer societies.
Christopher Mayerl
01:31:31
Great question Denise - We haven't weaned pigs at too many different ages, they are quite recalcitrant to stop drinking milk any earlier than what Francois presented! That is a really interesting idea though
Jessica Grittner
01:31:57
Can you give us the age comparison again? How “preemie” is 7 days for a pig? :)
Christopher Mayerl
01:32:14
7 days early = 30 - 32 weeks gestation
Christopher Mayerl
01:32:18
for humans
Alicia Vose
01:32:31
Cool! Thanks Chris!
Teresa Pitts
01:33:41
Wow!
Alicia Vose
01:33:50
Woooowwwww fascinating!
Jessica Grittner
01:34:13
This is SO validating to see as a clinician!
Christopher Mayerl
01:35:26
Relevant papers from Francois Presentation:weaning - https://royalsocietypublishing.org/doi/10.1098/rsbl.2019.0942maturation of swallow volume and safety - https://www.nature.com/articles/s41390-019-0624-0Relationship between bolus size and swallow safety - https://doi.org/10.1007/s00455-020-10118-xPreterm resp-swallow coordination - https://journals.physiology.org/doi/full/10.1152/japplphysiol.00101.2019
Luciane Gargaglioni
01:36:49
One of the leading causes of death in Alzheimer's is aspiration pneumonia, do you know what happens with breathing-swallowing coordination?
Seva Polotsky
01:37:22
Wonderful talks! I've learned a lot. Thank you! I have to sign off now
Oriana Brunetti
01:37:24
Hi, everyone! Feel free to turn your cameras back on for the Q&A session. :)
Vivian Biancardi
01:37:25
Is it possible that the swallow movement that happens in utero, could be present for the same function as the in utero respiratory movements, to prepare the infant for breathing the air after they born?
Emily Plowman
01:37:26
AMAZING!
Jean-Paul Praud
01:37:51
It seems to me it is important to realize that the results presented are for nutritive swallowing. For non-nutritive swallowing, at least in lambs, swallowing-breathing coordination is identical in preterm and full-term lambs.
Kingman Strohl
01:38:15
Infant studies....The inspiratory onset is a mechanical one. Any consideration of neural or EMG activity (diaphragm or alae nasi, a muscle that activates before the diaphragm). The negative pressure to suck is created in the oral cavity and then the bolus travels around or through the valeculla to the esophagus. How about negative pressure in the oral cavity and negative pressure in the chest (a sum total of inspiratory activation). no microphone on this computer
Rebecca German
01:38:22
We are collecting comparative data on NNS vs. NS in June.
Bill Milsom
01:41:55
Do you see variation in rhythm - suckle/breath/suckle breath/suckle/breath - versus - suckle/suckle/suckle/breath etc?
Bill Milsom
01:44:09
Owen Bamford once sent me traces of each of these in humans
Jean-Paul Praud
01:44:52
Interestingly, preterms are often swallowing milk during central apnea; I mean several swallows during one several second duration. A different strategy in order not to aspirate
Jean-Paul Praud
01:45:59
Interestingly, preterms are often swallowing milk during central apnea; I mean several swallows during a few second-duration apnea. A different strategy in order not to aspirate in preterms
Jean-Paul Praud
01:49:22
It’s the same in human infants
Jessica Grittner
01:50:46
It would be interesting to know more about how piglet chest wall development correlates with humans. Human babies use that SSB pattern in part because they structurally have shallow diaphragm shapes and lower tidal volumes. They also desaturate more easily, so can’t hold their breath for very long.
Melissa Bates
01:51:08
But their chemoreceptors are less responsive so is that right?
Jessica Grittner
01:52:25
SSB = suck-swallow-breathe
Wendy Olsen
01:53:48
Thank you so much!!!
Emily Plowman
01:53:48
Great stuff guys!
Melissa Bates
01:53:52
Thanks guys!!!
Christopher Mayerl
01:53:59
Rebecca is also hiring a postdoc
Bill Milsom
01:54:03
Great talks
Hardik kalra
01:54:04
Thank you!!
Vivian Biancardi
01:54:05
Great talks Dr. German and Dr. Gould!
Marie-Noëlle Fiamma
01:54:11
Thank you very much
Amber Anderson
01:54:12
Thank you!! This was fantastic!
Thiago Moreira
01:54:19
great talks
Courtney Miller
01:54:21
Thank you for the very interesting talks!
Jessica Grittner
01:54:22
Thank you!!
Maryanne Scott
01:54:25
Thank you for the great talks and discussion
Katrina Rogers
01:54:25
Thank you so much brilliant