Toward Empowering Conversational Agency in Aphasia: Understanding Mechanisms of Topic Initiation in People With and Without Aphasia

Purpose: This study examined topic initiation (TI) in conversations involving people with aphasia (PWA), matched people without aphasia (M-PWoA), and speech-language pathologists who were their conversation partners (SLP-Ps). For each speaker type, we analyzed patterns of distribution of typical mechanisms of TI and patterns of simultaneous use of multiple TI mechanisms. Lastly, we examined associations between use of simultaneous TI mechanisms and communicative success. Method: Twenty PWA and 20 M-PWoA each participated in two conversations with SLP-Ps. Conversation samples were analyzed for TI locations and mechanisms, with results tallied for each speaker type following a published typology. A measure of communicative success was applied to TI utterances. Rank-order correlations were conducted to evaluate the patterns of distribution of the TI mechanisms between speaker types and the patterns of multiple mechanism usage between speaker types. Descriptive analysis was conducted to provide additional insight to the TI behaviors of each speaker type and to evaluate the relationship between multiple TI mechanisms and communicative success. Results: All speaker types used cohesion most often to achieve TI. PWA used an abrupt method of TI (noncoherent TI) more often than other speaker types. A single mechanism of TI was used most often by all speaker types, except for SLP-Ps when they were in conversations with PWA. In this case, SLP-Ps most often used two or more layered mechanisms of TI. SLP-Ps also used a highly salient TI mechanism with greater frequency when speaking with PWA than observed between other speaker types. When PWA layered mechanisms of TI, they appeared to be more likely to achieve better communicative success. Conclusions: Specific, teachable behaviors such as favoring certain TI mechanisms and using multiple TI mechanisms may improve communicative success during TI for PWA. Furthermore, findings suggest that SLP-Ps modify their TI behaviors when speaking to PWA. Supplemental Material: https://doi.org/10.23641/asha.17699423

Selenosemicarbazone Metal Complexes as Potential Metal-based Drugs

The discovery of the anticancer activity of cisplatin has marked the emergence of modern Inorganic Medicinal Chemistry. This field of research is concerned with the application of inorganic compounds to therapy or diagnosis of disease. In particular, metal coordination of bioactive ligands has gained recognition in drug design. The interaction between transition metal ions and the organic drugs could enhance their diagnostic and therapeutic potentials by improving the stability and/or bioavailability or by achieving a metal-drug synergism through a dual or multiple mechanism of action. The isosteric replacement of sulfur by selenium in thiosemicarbazones leads to selenosemicarbazones. This class of compounds exhibit numerous biological activities like antitumor, antimicrobial, antiviral etc. and, in most cases, they were more pronounced in comparison to the sulfur analogues. On the other hand, while the effect of transition metal complexation on the biological activity of thiosemicarbazones has been widely studied, the pharmacological activity of the corresponding metal-selenosemicarbazone compounds has been less explored. In this work, the most relevant results related to the selenosemicarbazone metal complexes as potential metal-based drugs have been reviewed.

Antiangiogenic Drugs in NASH: Evidence of a Possible New Therapeutic Approach

Non-alcoholic fatty liver disease is the most common liver disorder worldwide, and its progressive form non-alcoholic steatohepatitis (NASH) is a growing cause of liver cirrhosis and hepatocellular carcinoma (HCC). Lifestyle changes, which are capable of improving the prognosis, are hard to achieve, whereas a pharmacologic therapy able to combine efficacy and safety is still lacking. Looking at the pathophysiology of various liver diseases, such as NASH, fibrosis, cirrhosis, and HCC, the process of angiogenesis is a key mechanism influencing the disease progression. The relationship between the worsening of chronic liver disease and angiogenesis may suggest a possible use of drugs with antiangiogenic activity as a tool to stop or slow the progression of the disorder. In this review, we highlight the available preclinical data supporting a role of known antiangiogenic drugs (e.g., sorafenib), or phytotherapeutic compounds with multiple mechanism of actions, including also antiangiogenic activities (e.g., berberine), in the treatment of NASH.

A Review on Therapeutic strategies of Relapsed and Refractory Multiple Myeloma

Improvement in treatment options in multiple myeloma (MM) makes the survival rate intodouble during recent years but most of the patient eventually relapses. The treatment of relapseand refracting MM is still now very complex. At the time of relapse, the use of alternative drugsis the current practice. Using Protease inhibitors like Bortezomib and immune-modulators likethalidomide gives a satisfactory treatment prognosis in MM. Now many new options areavailable like second and third generation protease inhibitor like carfilzomib and ixazomib, theimmune-modulator like lenalidomide, pomalidomide, the monoclonal antibody likedaratumumab, elotuzumab, Histone Deacetylase inhibitor, Kinesin Spindle inhibitor and NF-kB,MAPK, AKT inhibitors. Daratumumab, targeting CD38, has multiple mechanism of action likemodulation immunosuppressive bone marrow micro-environment. Daratuzumab has a goodprogression free survival when it is given with lenalidomide/ dexamethasone orbortezomib/dexamethsone. Autologous stem cell transplantation (ASCT) is important treatmentin relapsing and refracting MM. Donor lymphocytic infusion is a new and effective technique inthe treatment of relapsing and refracting MM. The advancement in the treatment of relapsed andrefractory MM has been discussed in this article. The final goal should be finding a balancebetween efficacy, toxicity and cost.

A systems-based analysis to explore the multiple mechanism of Shan Zha for treating human diseases

Shan Zha has garnered increasing attention in the field of functional foods and medicines due to its widely reported healing effects. However, the potential mechanisms of Shan Zha for human...