New Daily Persistent Headache and OnabotulinumtoxinA Therapy

OBJECTIVE: The aim of the study was to determine whether onabotulinumtoxinA therapy is effective in the treatment of new daily persistent headache (NDPH). BACKGROUND: New daily persistent headache is a difficult to treat headache syndrome resistant to both conventional and unconventional headache therapies. New daily persistent headache was excluded in the registration trials for onabotunlinumtoxinA (onabot) in chronic migraine. Apart from case reports supporting its benefit, little is known about its therapeutic value in NDPH. DESIGN AND METHODS: We performed a single-center, retrospective chart review of patients with a diagnosis of NDPH who received onabot treatment for a 30-month period at the Cleveland Clinic Headache Center. Measures of interest were headache frequency and headache severity. All patients had received the Food and Drug Administration-approved PREEMPT Protocol. RESULTS: A decrease in headache frequency was noted in 8 (50.0%) of 16 patients at 6 months and 7 (63.6%) of 11 patients at 12 months. Headache severity improved in 5 (50.0%) of 10 patients at 6 months and in 7 (77.8%) of 9 patients at 12 months. CONCLUSIONS: Most therapies are unable to break the unremitting course of NDPH. In our investigation, at 1 year (3-4 cycles of onabot treatment), approximately half of the patients treated showed a reduction in headache frequency and approximately 75% demonstrated some improvement in headache severity. Evidence from this small-scale retrospective study suggests that onabot shows strong promise for the treatment of NDPH, which currently is resistant to most therapies, but a randomized controlled study should be the next step in confirmation of this therapy

New daily persistent headache (NDPH) & onabotulinumtoxina therapy

Objective: To determine whether onabotulinumtoxinA therapy is effective in the treatment of New Daily Persistent Headache (NDPH). Background: New Daily Persistent Headache (NDPH) is a difficult to treat headache syndrome resistant to both conventional and unconventional headache therapies. NDPH was excluded in the registration trials for onabotunlinumtoxinA (onabot) in chronic migraine. Apart from case reports supporting its benefit, little is known about its therapeutic value in NDPH. Design/Methods: We performed a single center, retrospective chart review of patients with a diagnosis of NDPH who received onabot treatment over a 30 month period. Measures of interest were headache frequency and headache severity. After excluding patients seen at the Cleveland Clinic outside of the Headache Center, patients with missing data at baseline, patients that no longer had daily headache, and patients without valid data at any follow-up time point, there were 19 patients for frequency analysis and 14 for severity analysis. All patients had received the FDA-approved PREEMPT Protocol. Results: A decrease in headache frequency was noted in 8/16 (50.0%) patients at 6 months and 7/11 (63.6%) at 12 months. Using mixed effect logistic regression models, which account for loss-to-follow-up, the estimated percentage improving at 6 months was 49.7%, and at 12 months, 58.3%. Headache severity improved in 5/10 (50.0%) of patients at 6 months and in 7/9 (77.8%) at 12 months. Using mixed effect logistic regression models, the estimated percentage improving at 6 months was 50.0%, and at 12 months, 78.1%. Conclusions: Most therapies are unable to break the unremitting course of NDPH. In our investigation, at 1 year (3- 4 cycles of onabot treatment), approximately half of the patients treated showed a reduction in headache frequency and approximately 75% demonstrated some improvement in headache severity. OnabotulinumtoxinA may be a reasonable choice in the treatment of NDPH, but a randomized controlled study should be the next step

Predatory fungi with pest control potential:

Nematoden-fangende Pilze kommen ubiquitär vor allem in Böden vor. Sie leben von abgestorbenem, organischem Material, können aber eine räuberische Lebensweise einschlagen, wenn die Nährstoffe knapp werden. Dann bilden sie je nach Spezies unterschiedliche Fallentypen aus. Arthrobotrys flagrans bildet klebrige Fallennetzwerke. Die Fallenbildung wird durch das Zusammenspiel mehrerer Nematoden-eigener Pheromone und pilzlichen Signalstoffen reguliert. Wenn sich ein Nematode in dem Fallennetzwerk verfangen hat, dringt eine Penetrationshyphe durch die Cuticula und die Epidermis in den Wurmkörper ein. Dort verdickt sich die Hyphe zu einem Bulbus und wächst als Ernährungshyphe durch den Nematodenkörper. Durch lytische Enzyme wird der tierische Körper zersetzt und die Nährstoffe vom Pilz aufgenommen. Im späten Stadium der Attacke wachsen Hyphen aus dem Nematoden in die Umgebung aus. Bei der Penetration und vermutlich auch bei der weiteren Besiedlung des Nematoden spielen kleine, sekretierte pilzliche Proteine eine wichtige Rolle als Virulenzfaktoren. Die Nematoden-Pilz-Interaktion ist nicht nur ein faszinierendes Grundlagenforschungsgebiet, sondern die Pilze können auch zur Bekämpfung schädlicher Nematoden eingesetzt werden.Nematode-trapping fungi are ubiquitous, especially in soil. They live on dead, organic matter, but can adopt a predatory lifestyle when nutrients become scarce. Then they form different types of traps depending on the species. Arthrobotrys flagrans forms sticky trap networks. The formation of traps is regulated by the interaction of several nematode-specific pheromones and fungal signaling molecules. When a nematode becomes entangled in the trap network, a penetrating hypha enters through the cuticle and epidermis into the nematode body. There the hypha thickens into a bulb and grows through the nematode body as a trophic hypha. The animal body is decomposed by lytic enzymes and the nutrients are absorbed by the fungus. In the late stage of the attack, hyphae grow out of the nematode into the environment. Small, secreted fungal proteins play an important role as virulence factors during penetration and presumably also during further colonization of the nematode. Not only is the nematode fungus interaction a fascinating area of basic research, but the fungi can also be used to control harmful nematodes

Integrated assessment model diagnostics: Key indicators and model evolution

Integrated assessment models (IAMs) form a prime tool in informing about climate mitigation strategies. Diagnostic indicators that allow comparison across these models can help describe and explain differences in model projections. This increases transparency and comparability. Earlier, the IAM community has developed an approach to diagnose models (Kriegler (2015 Technol. Forecast. Soc. Change 90 45-61)). Here we build on this, by proposing a selected set of well-defined indicators as a community standard, to systematically and routinely assess IAM behaviour, similar to metrics used for other modeling communities such as climate models. These indicators are the relative abatement index, emission reduction type index, inertia timescale, fossil fuel reduction, transformation index and cost per abatement value. We apply the approach to 17 IAMs, assessing both older as well as their latest versions, as applied in the IPCC 6th Assessment Report. The study shows that the approach can be easily applied and used to indentify key differences between models and model versions. Moreover, we demonstrate that this comparison helps to link model behavior to model characteristics and assumptions. We show that together, the set of six indicators can provide useful indication of the main traits of the model and can roughly indicate the general model behavior. The results also show that there is often a considerable spread across the models. Interestingly, the diagnostic values often change for different model versions, but there does not seem to be a distinct trend