Publications by authors named "Falvo M"

Background: Veterans have unique military risk factors and exposures during deployment that may augment their risk of post-acute sequelae of SARS-CoV-2 (PASC). The purpose of this study is to identify potential risk factors for PASC among Veterans in the national Airborne Hazards and Open Burn Pit Registry (AHOBPR).

Methods: This prospective observational study consisted of a semi-structured interview conducted via phone or videoconference from November 2021 to December 2022 among a stratified random sample of deployed Veterans nested within the national AHOBPR with laboratory-confirmed SARS-CoV-2 infection.

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Unlabelled: Chronic multisymptom illnesses (CMI) such as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, Long-COVID, and Gulf War Illness (GWI) are associated with an elevated risk of post-exertional malaise (PEM), an acute exacerbation of symptoms and other related outcomes following exercise. These individuals may benefit from personalized exercise prescriptions which prioritize risk minimization, necessitating a better understanding of dose-response effects of exercise intensity on PEM.

Methods: Veterans with GWI (n = 40) completed a randomized controlled crossover experiment comparing 20 min of seated rest to light-, moderate-, and vigorous-intensity cycling conditions over four separate study visits.

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Aedes aegypti is a vector of various disease-causing arboviruses. Chemical insecticide-based methods for mosquito control have increased resistance in different parts of the world. Thus, alternative control agents such as the entomopathogenic fungi are excellent candidates to control mosquitoes as part of an ecofriendly strategy.

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Gulf War Illness (GWI) is a major health problem for approximately 250,000 Gulf War (GW) veterans, but the etiology of GWI is unclear. We hypothesized that mitochondrial dysfunction is an important contributor to GWI, based on the similarity of some GWI symptoms to those occurring in some mitochondrial diseases; the plausibility that certain pollutants to which GW veterans were exposed affect mitochondria; mitochondrial effects observed in studies in laboratory models of GWI; and previous evidence of mitochondrial outcomes in studies in GW veterans. A primary role of mitochondria is generation of energy via oxidative phosphorylation.

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Background: Exertional dyspnea and exercise intolerance are frequently endorsed in Veterans of post 9/11 conflicts in Southwest Asia (SWA). Studying the dynamic behavior of ventilation during exercise may provide mechanistic insight into these symptoms. Using maximal cardiopulmonary exercise testing (CPET) to experimentally induce exertional symptoms, we aimed to identify potential physiological differences between deployed Veterans and non-deployed controls.

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Methods: Symptoms were assessed immediately following completion of a rugby match (median 60 minutes). Players removed from the match for assessment due to a head hit were classified as head injured. Controls completed match without head hit.

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Background: Post-exertional malaise (PEM) is considered a characteristic feature of chronic multi-symptom illnesses (CMI) like Gulf War illness (GWI); however, its pathophysiology remains understudied. Previous investigations in other CMI populations (i.e.

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Corn cobs (CCs) are abundant xylan-rich agricultural wastes. Here, we compared CCs XOS yields obtained via two different pretreatment routs, alkali and hydrothermal, using a set of recombinant endo- and exo-acting enzymes from GH10 and GH11 families, which have different restrictions for xylan substitutions. Furthermore, impacts of the pretreatments on chemical composition and physical structure of the CCs samples were evaluated.

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  • - This study investigated the risk factors for sarcoidosis in veterans who participated in the Airborne Hazards and Open Burn Pit Registry after serving in Afghanistan or Southwest Asia.
  • - A total of 661 veterans (0.37%) were diagnosed with sarcoidosis, with Hispanic veterans and Navy service members showing lower odds of the condition, while African American veterans and former smokers had increased risk.
  • - The study found that sarcoidosis was rare among participants, linked primarily to convoy activities, and was only associated with one out of eight deployment-related exposure factors assessed.
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  • - Many service members and veterans who served in Southwest Asia report respiratory issues potentially linked to environmental exposures, prompting the VA to create the Airborne Hazards and Open Burn Pit Registry (AHOBPR) in 2014 for better health understanding.
  • - The AHOBPR allows veterans to complete an online questionnaire and receive evaluations from healthcare professionals, enabling discussions about their symptoms and potential treatments while contributing to medical research.
  • - The Post-Deployment Cardiopulmonary Evaluation Network (PDCEN) identifies veterans with specific respiratory issues to provide specialized evaluations and ongoing care, building on the initial assessments from the AHOBPR to enhance understanding of deployment-related health consequences.
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Background: The diagnosis of constrictive bronchiolitis (CB) in previously deployed individuals, and evaluation of respiratory symptoms more broadly, presents considerable challenges, including using consistent histopathologic criteria and clinical assessments.

Research Question: What are the recommended diagnostic workup and associated terminology of respiratory symptoms in previously deployed individuals?

Study Design And Methods: Nineteen experts participated in a three-round modified Delphi study, ranking their level of agreement for each statement with an a priori definition of consensus. Additionally, rank-order voting on the recommended diagnostic approach and terminology was performed.

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  • * A study on mice showed that exposure to PM alone or alongside psychological stress resulted in decreased pulmonary function and increased airway hyperreactivity, as well as impaired cardiac function.
  • * The findings suggest that short-term exposure to PM and stress negatively impacts respiratory and heart health, highlighting the need for further research on the mechanisms involved, especially for military and occupational settings.
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  • - The Forced Oscillation Technique (FOT) helps gather valuable data about respiratory system mechanics, but its clinical use is limited due to unclear guidelines for obtaining and reporting data.
  • - Current European guidelines suggest conducting 3-5 trials in each session, ensuring that certain variability thresholds are met to enhance the validity of results.
  • - An analysis of trial combinations indicated that using either R5 or R19 as criteria allows for a high proportion of subjects to achieve valid data, while also confirming the appropriateness of existing ERS recommendations for reporting FOT results in healthy adults.
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Chronic musculoskeletal pain (CMP) is a significant burden for Persian Gulf War Veterans (GWVs), yet the causes are poorly understood. Brain structure abnormalities are observed in GWVs, however relationships with modifiable lifestyle factors such as physical activity (PA) are unknown. We evaluated gray matter volumes and associations with symptoms, PA, and sedentary time in GWVs with and without CMP.

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  • The study examines the long-term respiratory effects of explosive blast overpressure waves on Veterans, expanding the focus beyond the well-documented traumatic brain injury (TBI) to understand pulmonary function.
  • Researchers evaluated 307 Veterans with post-deployment health issues, classifying them based on blast exposure severity and conducting comprehensive pulmonary function tests (PFTs).
  • Findings showed that despite varying levels of blast exposure, objective measures of pulmonary function were similar across all groups, indicating that blast exposure may not significantly impact respiratory health in the sample studied.
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Background: Cardiopulmonary exercise testing has demonstrated clinical utility in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). However, to what extent exercise responses are independent of, or confounded by, aerobic fitness remains unclear.

Purpose: To characterize and compare exercise responses in ME/CFS and controls with and without matching for aerobic fitness.

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  • - Interest in the forced oscillation technique (FOT) is growing for assessing respiratory mechanics in both healthy and diseased individuals, complementing traditional lung function tests.
  • - FOT measures key respiratory metrics such as resistance and reactance through passive assessments during natural breathing, but its clinical use is limited due to inconsistent data reporting standards.
  • - The article aims to standardize FOT practices by presenting a detailed protocol and instructional video, demonstrating the method with different devices, and addressing future questions in the field.
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It is increasingly appreciated that the cell nucleus is not only a home for DNA but also a complex material that resists physical deformations and dynamically responds to external mechanical cues. The molecules that confer mechanical properties to nuclei certainly contribute to laminopathies and possibly contribute to cellular mechanotransduction and physical processes in cancer such as metastasis. Studying nuclear mechanics and the downstream biochemical consequences or their modulation requires a suite of complex assays for applying, measuring, and visualizing mechanical forces across diverse length, time, and force scales.

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Alternative methods have been proposed to report spirometry indices from test sessions (forced expiratory volume 1 s, FEV; forced vital capacity, FVC). However, most use the American and European Societies' standard (ATS/ERS) which stops sessions once a repeatability threshold is met which may not accurately represent intra-session variability. Our goal was to repeat trials beyond the repeatability threshold and evaluate alternative reporting methods.

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  • Veterans with Gulf War Illness (GWI) showed altered red blood cell (RBC) deformability, which relates to fatigue and worsened symptoms during exercise.
  • The study measured RBC deformability before, immediately after, and 60 minutes post-maximal exercise in 17 Veterans with GWI and 11 controls.
  • Results indicated that Veterans with GWI had more deformable RBCs than controls, and this deformability did not change significantly with exercise, highlighting the need for further research to understand the underlying mechanisms.
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