Fatigue-inducing stimulation resolves myotonia in a drug-induced model

<p>Abstract</p> <p>Background</p> <p>Slowed muscle relaxation is the contractile hallmark of myotonia congenita, a disease caused by genetic CLC-1 chloride channel deficiency, which improves with antecedent brief contractions ("warm-up phenomenon"). It is unclear to what extent the myotonia continues to dissipate during continued repetitive contractions and how this relates temporally to muscle fatigue. Diaphragm, EDL, and soleus muscles were examined in vitro during repetitive 20 Hz and 50 Hz train stimulation in a drug-induced (9-AC) rat myotonia model.</p> <p>Results</p> <p>At the onset of stimulation, 9-AC treated diaphragm and EDL muscle had markedly prolonged half relaxation and late relaxation times (range 147 to 884 ms, 894 to 1324 ms). Half relaxation and late relaxation times reached near-normal values over the 5-10 and 10-40 subsequent contractions, respectively. In both muscles myotonia declined faster during repetitive 50 Hz than 20 Hz stimulation, and much faster than the rate of force loss during fatigue at both frequencies. Soleus muscle was resistant to the myotonic effects of 9-AC.</p> <p>Conclusions</p> <p>In a drug-induced model of mechanical myotonia, fatigue-inducing stimulation resolves the myotonia, which furthermore appears to be independent from the development of muscle fatigue.</p

Impaired Wheel Running Exercise in CLC-1 Chloride Channel-Deficient Myotonic Mice

Background: Genetic deficiency of the muscle CLC-1 chloride channel leads to myotonia, which is manifested most prominently by slowing of muscle relaxation. Humans experience this as muscle stiffness upon initiation of contraction, although this can be overcome with repeated efforts (the “warm-up” phenomenon). The extent to which CLC-1 deficiency impairs exercise activity is controversial. We hypothesized that skeletal muscle CLC-1 chloride channel deficiency leads to severe reductions in spontaneous exercise. Methodology/Principal Findings: To examine this quantitatively, myotonic CLC-1 deficient mice were provided access to running wheels, and their spontaneous running activity was quantified subsequently. Differences between myotonic and normal mice in running were not present soon after introduction to the running wheels, but were fully established during week 2. During the eighth week, myotonic mice were running significantly less than normal mice (322 ± 177 vs 5058 ± 1253 m/day, P = 0.025). Furthermore, there were considerable reductions in consecutive running times (18.8 ± 1.5 vs 59.0 ± 3.7 min, P < 0.001) and in the distance per consecutive running period (58 ± 38 vs 601 ± 174 m, P = 0.048) in myotonic compared with normal animals. Conclusion/Significance: These findings indicate that CLC-1 chloride deficient myotonia in mice markedly impairs spontaneous exercise activity, with reductions in both total distance and consecutive running times

Growth Responses of Potted Vitis vinifera Cultivars Differ to a Mycorrhizal Inoculant and Phosphorus Fertilizer

Biological amendments, such as arbuscular mycorrhizal (AM) fungal inoculant products, are increasingly incorporated into agricultural management plans as a way to improve plant productivity. However, the effects of mycorrhizal inoculants on plant growth are context-dependent and can vary with soil fertility and among plant cultivars. To optimize the use of mycorrhizal inoculant products on wine grapes at the nursery stage, we tested the effect of a mycorrhizal inoculant product with and without the addition of phosphorus (P) fertilizer on the growth and tissue nutrients of two popular Vitis vinifera cultivars, Merlot and Chardonnay. We rooted dormant cuttings in the following respective treatments: no AM fungal inocula or P fertilizer; AM fungal inocula; P fertilizer; and co-amendment of AM fungal inocula and P fertilizer. We grew the grapevines in pots for 5 months in a greenhouse. Growth responses to treatments differed between cultivars. ‘Merlot’ vines had a stronger growth response to the mycorrhizal inoculant product than ‘Chardonnay’, especially when no P fertilizer was added. The co-amendment of AM fungi and P fertilizer resulted in larger root biomass for ‘Merlot’, but there was no effect of any treatment on the root biomass of ‘Chardonnay’. ‘Merlot’ vines grown with the AM fungal inoculant product also had higher tissue P than uninoculated vines, but there was no effect of inoculation on tissue nutrients of ‘Chardonnay’. This study provides evidence of grapevine cultivar-specific responses to an AM fungal inoculant product in a greenhouse, which may be useful when planning nursery management strategies for the incorporation of biological amendments into grapevine production

Electra: A Modular-Based Expansion of NASA's Supercomputing Capability

NASA has increasingly relied on high-performance computing (HPC) re- sources for computational modeling, simulation, and data analysis to meet the science and engineering goals of its missions in space exploration, aeronautics, and Earth and space science. The NASA Advanced Supercomputing (NAS) Division at Ames Research Center in Silicon Valley, Calif., hosts NASAs premier supercomputing resources, integral to achieving and enhancing the success of the agencys missions. NAS provides a balanced environment, funded under the High-End Computing Capability (HECC) project, comprised of world-class supercomputers, including its flagship distributed-memory cluster, Pleiades; high-speed networking; and massive data storage facilities, along with multi-disciplinary support teams for user support, code porting and optimization, and large-scale data analysis and scientific visualization. However, as scientists have increased the fidelity of their simulations and engineers are conducting larger parameter-space studies, the requirements for supercomputing resources have been growing by leaps and bounds. With the facility housing the HECC systems reaching its power and cooling capacity, NAS undertook a prototype project to investigate an alternative approach for housing supercomputers. Modular supercomputing, or container-based computing, is an innovative concept for expanding NASAs HPC capabilities. With modular supercomputing, additional containerssimilar to portable storage podscan be connected together as needed to accommodate the agencys ever-increasing demand for computing resources. In addition, taking advantage of the local weather permits the use of cooling technologies that would additionally save energy and reduce annual water usage. The first stage of NASAs Modular Supercomputing Facility (MSF) prototype, which resulted in a 1,000 square-foot module on a concrete pad with room for 16 compute racks, was completed in Fall 2016 and an SGI (now HPE) computer system, named Electra, was deployed there in early 2017. Cooling is performed via an evaporative system built into the module, and preliminary experience shows a Power Usage Effectiveness (PUE) measurement of 1.03. Electra achieved over a petaflop on the LINPACK benchmark, sufficient to rank number 96 on the November 2016 TOP500 list [14]. The system consists of 1,152 InfiniBand-connected Intel Xeon Broadwell-based nodes. Its users access their files on a facility-wide file system shared by all HECC compute assets via Mellanox MetroX InfiniBand extenders, which connect the Electra fabric to Lustre routers in the primary facility over fiber-optic links about 900 feet long. The MSF prototype has exceeded expectations and is serving as a blueprint for future expansions. In the remainder of this chapter, we detail how modular data center technology can be used to expand an existing compute resource. We begin by describing NASAs requirements for supercomputing and how resources were provided prior to the integration of the Electra module-based system

2024 pest management guide for grapes in Washington

The Pest Management Guide for Grapes in Washington presents various chemicals and their uses against pest problems in Washington vineyards. While the recommendations are based on eastern Washington conditions, the information may often be applied to similar pest problems found throughout the state. Specific and more detailed information on pests and diseases can be found in the Field Guide for Integrated Pest Management in Pacific Northwest Vineyards (PNW644). Recommendations are suggested guidelines. They are not intended to represent pest control programs. The use of other materials and varying rates and treatments for control of particular pests depends on individual circumstances

Recommendations for Clinical CYP2C9 Genotyping Allele Selection: A Joint Recommendation of the Association for Molecular Pathology and College of American Pathologists

The goals of the Association for Molecular Pathology Pharmacogenomics (PGx) Working Group of the Association for Molecular Pathology Clinical Practice Committee are to define the key attributes of PGx alleles recommended for clinical testing and a minimum set of variants that should be included in clinical PGx genotyping assays. This document provides recommendations for a minimum panel of variant alleles (Tier 1) and an extended panel of variant alleles (Tier 2) that will aid clinical laboratories when designing assays for CYP2C9 testing. The Working Group considered the functional impact of the variants, allele frequencies in different populations and ethnicities, the availability of reference materials, and other technical considerations for PGx testing when developing these recommendations. Our goal is to promote standardization of testing PGx genes and alleles across clinical laboratories. These recommendations are not to be interpreted as restrictive but to provide a reference guide. The current document will focus on CYP2C9 testing that can be applied to all CYP2C9-related medications. A separate recommendation on warfarin PGx testing is being developed to include recommendations on CYP2C9 alleles and additional warfarin sensitivity–associated genes and alleles

Paired phase II trials evaluating cetuximab and radiotherapy for low risk HPV associated oropharyngeal cancer and locoregionally advanced squamous cell carcinoma of the head and neck in patients not eligible for cisplatin

BackgroundAlternative therapeutic strategies are needed for localized oropharyngeal carcinoma. Cetuximab represents a potential option for those ineligible for cisplatin or, until recently, an agent for de‐escalation in low risk HPV+ oropharyngeal carcinoma (OPSCC). Our objective was to define the toxicity and efficacy of cetuximab‐radiotherapy.MethodsWe conducted paired phase II trials evaluating cetuximab‐radiotherapy in two cohorts (a) low risk HPV+ OPSCC and (b) cisplatin ineligible. The mean follow‐up was 48 months.ResultsForty‐two patients were enrolled in cohort A with a 2‐year disease free survival (DFS) of 81%. Twenty‐one patients were enrolled in cohort B prior to closure due to adverse outcomes with a 2‐year DFS of 37%. Severe toxicities were seen in 60% of patients, 30% required enteral nutrition.ConclusionAmong cisplatin ineligible patients, cetuximab treatment engendered poor outcomes. Rates of severe toxicities were on par with platinum‐based regimens suggesting that cetuximab is not a benign treatment.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156234/2/hed26085.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156234/1/hed26085_am.pd

The flood pulse in a semi-arid riparian forest:metabolic and biogeochemical responses to inter-flood interval

Flood pulse inundation of riparian forests alters rates of nutrient retention and organic matter processing in the aquatic ecosystems formed in the forest interior. Along the Middle Rio Grande (New Mexico, USA), impoundment and levee construction have created riparian forests that differ in their inter-flood intervals (IFIs) because some floodplains are still regularly inundated by the flood pulse (i.e., connected), while other floodplains remain isolated from flooding (i.e., disconnected). This research investigates how ecosystem responses to the flood pulse relate to forest IFI by quantifying nutrient and organic matter dynamics in the Rio Grande floodplain during three years of experimental flooding of the disconnected floodplain and during a single year of natural flooding of the connected floodplain. Surface and subsurface conditions in paired sites (control, flood) established in the two floodplain types were monitored to address metabolic and biogeochemical responses. Compared to dry controls, rates of respiration in the flooded sites increased by up to three orders of magnitude during the flood pulse. In the disconnected forest, month-long experimental floods produced widespread anoxia of four-week duration during each of the three years of flooding. In contrast, water in the connected floodplain remained well oxygenated (3-8 ppm). Material budgets for experimental floods showed the disconnected floodplain to be a sink for inorganic nitrogen and suspended solids, but a potential source of dissolved organic carbon (DOC). Compared to the main stem of the Rio Grande, flood-water on the connected floodplain contained less nitrate, but comparable concentrations of DOC, phosphate-phosphorus, and ammonium-nitrogen. Results suggest that floodplain IFI drives metabolic and biogeochemical responses during the flood pulse. Impoundment and fragmentation have altered floodplains from a mosaic of patches with variable IFI to a bimodal distribution. Relatively predictable flooding occurs in the connected forest, while inundation of the disconnected forest occurs only as the result of managed application of water. In semiarid floodplains, water is scarce except during the flood pulse. Ecosystem responses to the flood pulse are related to the IFI and other measures of flooding history that help describe spatial variation in ecosystem function

Technology-assisted stroke rehabilitation in Mexico: a pilot randomized trial comparing traditional therapy to circuit training in a Robot/technology-assisted therapy gym

Background Stroke rehabilitation in low- and middle-income countries, such as Mexico, is often hampered by lack of clinical resources and funding. To provide a cost-effective solution for comprehensive post-stroke rehabilitation that can alleviate the need for one-on-one physical or occupational therapy, in lower and upper extremities, we proposed and implemented a technology-assisted rehabilitation gymnasium in Chihuahua, Mexico. The Gymnasium for Robotic Rehabilitation (Robot Gym) consisted of low- and high-tech systems for upper and lower limb rehabilitation. Our hypothesis is that the Robot Gym can provide a cost- and labor-efficient alternative for post-stroke rehabilitation, while being more or as effective as traditional physical and occupational therapy approaches. Methods A typical group of stroke patients was randomly allocated to an intervention (n = 10) or a control group (n = 10). The intervention group received rehabilitation using the devices in the Robot Gym, whereas the control group (n = 10) received time-matched standard care. All of the study subjects were subjected to 24 two-hour therapy sessions over a period of 6 to 8 weeks. Several clinical assessments tests for upper and lower extremities were used to evaluate motor function pre- and post-intervention. A cost analysis was done to compare the cost effectiveness for both therapies. Results No significant differences were observed when comparing the results of the pre-intervention Mini-mental, Brunnstrom Test, and Geriatric Depression Scale Test, showing that both groups were functionally similar prior to the intervention. Although, both training groups were functionally equivalent, they had a significant age difference. The results of all of the upper extremity tests showed an improvement in function in both groups with no statistically significant differences between the groups. The Fugl-Meyer and the 10 Meters Walk lower extremity tests showed greater improvement in the intervention group compared to the control group. On the Time Up and Go Test, no statistically significant differences were observed pre- and post-intervention when comparing the control and the intervention groups. For the 6 Minute Walk Test, both groups presented a statistically significant difference pre- and post-intervention, showing progress in their performance. The robot gym therapy was more cost-effective than the traditional one-to-one therapy used during this study in that it enabled therapist to train up to 1.5 to 6 times more patients for the approximately same cost in the long term. Conclusions The results of this study showed that the patients that received therapy using the Robot Gym had enhanced functionality in the upper extremity tests similar to patients in the control group. In the lower extremity tests, the intervention patients showed more improvement than those subjected to traditional therapy. These results support that the Robot Gym can be as effective as traditional therapy for stroke patients, presenting a more cost- and labor-efficient option for countries with scarce clinical resources and funding. Trial registration ISRCTN98578807

Patient Access to U.S. Physicians Who Conduct Internet or E-mail Consults

BACKGROUND: E-mail communication has the potential to improve communication between patients and doctors. OBJECTIVE: The objective of the study is to describe the access of patients to physicians who conduct e-mail consults. METHODS: We analyzed data from the National Ambulatory Medical Care Survey (NAMCS), a nationally representative cross-sectional survey of office-based physician visits, in 2001, 2002, and 2003. The main outcome measure was the percentage of visits to a provider who reported doing internet or e-mail consults. RESULTS: There was fewer than 1 in 10 outpatient visits in 2001 (9.2%) to physicians who reported doing internet or e-mail consults, and this did not increase in 2002 (5.8%) or 2003 (5.5%). Access to these physicians was greater among patients who were male, nonminority, lived in the Western United States, seen for pre-/postoperative care, seen by a primary care provider, and not seen by a nurse during their visit. Access to physicians who conducted internet or e-mail consults was independent of other patient (e.g., chronic conditions), provider (e.g., office setting), and visit (e.g., medications prescribed) characteristics. CONCLUSIONS: Access to physicians who do internet or e-mail consults is generally low and did not increase between 2001 and 2003, despite growth in internet access and in other internet-related activities