Degree Of Weakness Research Articles

The kalaemic and neuromuscular effects of succinylcholine in centronuclear myopathy: A pilot investigation in a canine model.

Myopathies are generally considered to increase the risk for succinylcholine-induced hyperkalaemia and may affect the duration of action of neuromuscular blockers. Centronuclear (myotubular) myopathy (CNM) is congenital and produces various degrees of muscular weakness and associated complications such as respiratory failure. The effects of succinylcholine and the potentially lethal consequences of hyperkalaemia on patients with CNM are unknown due to its rarity. One source of information is the dog, as CNM occurs naturally in dogs. Because of its remarkable similarity with the disease in man, canine CNM can serve as a model to further our knowledge of the effects of succinylcholine. We examined the kalaemic and neuromuscular effects of succinylcholine in dogs with and without autosomal-recessive CNM. A prospective, experimental study. Anaesthesiology laboratory, College of Veterinary Medicine, Cornell University, New York, USA. Six dogs with autosomal-recessive CNM and six control dogs. Dogs received succinylcholine 0.3 mg kg during isoflurane anaesthesia. Whole blood potassium concentration was measured 5 min before and after succinylcholine administration. Neuromuscular function was measured with acceleromyography and single twitch stimulation. All dogs recovered uneventfully from anaesthesia. The increase in potassium concentration [mean (SD)] following succinylcholine was similar between groups: CNM 0.5 (0.4) mmol l and control 0.7 (0.4) mmol l (P = 0.47). Recovery of the single twitch to 25, 75 and 90% was longer in the CNM group (all P < 0.001); 90% recovery took 35.5 (1.18) min for the CNM group and 23.3 (1.68) min for the control group. CNM did not exacerbate the increase in blood potassium that is ordinarily seen with succinylcholine. Recovery from succinylcholine was nearly 50% longer in dogs with CNM. Although our sample size is too small to evaluate the incidence of succinylcholine-induced hyperkalaemia, extrapolation of these findings suggests that increased duration of action should be expected if succinylcholine is given to a patient with autosomal-recessive CNM.

The hair structure of the long-eared gymnure (Otohylomys megalotis)

Weak degree of hair differentiation and microstructure of hair and whiskers of Otohylomys megalotis are similar to those in Hylomys suillus and Neotetracus sinensis: there are spear-shaped lead hairs and zigzag guard hairs of three orders, downy hairs are missing. In O. megalotis: 1) hairs are longer than those of other gymnures; 2) thin convoluted hair bases bound up contributing to the formation of the inert layer of air near the surface of the skin, improves the thermal insulation properties of hair in the absence of downy hairs; 3) strength in thinnest areas of the shaft (at its base and excesses) is provided by thickening of its cuticular scales, the special interconnection between cuticle and cortex, and cruciform layout of medulla discs in these places; 4) the pineal cuticular ornament of hair bases is characteristic of all three species of gymnures and resembles that of other insectivores, as well as of some marsupials and carnivores that reflects similar hair adaptations to the habitats; 5) for the first time discovered specialized pyramidal medulla of vibrissae, stiffening a shaft that is necessary for effective transfer of mechanical impulses to nerve cells of vibrissae follicle and functioning of whiskers as a tactile organ; 6) a long proboscis with well-developed nasal vibrissae and also numerous long whiskers on muzzle, neck, wrists and forearms are important and effective for the O. megalotis orientation in complex terrain karst habitats.

Bank Market Structure, Property Rights and Financial Freedom Effects on Capital Structure: Evidence from Asian Developing Countries

The paper considers direct and indirect impacts of bank concentration, property rights and financial freedom on corporate leverage in 12 Asian developing countries from 2000 to 2013. Our result shows that bank concentration has a directly negative relationship with leverage in these countries but this relationship becomes revertible when bank concentration reaches a given point. Highly concentrated banking market structure favors for profitable firms to obtain debts and is considered as a solution against strong private property rights proxy. A strong private property rights decreases amount of debts financed by banking system and leads firms to prefer using internal funds to obtain protection advantages for newly established assets. Our results indicate stronger degree of financial freedom encourages firms borrow more and supports for profitable firms. Strong degree of financial freedom also reduces the importance of collapse coverage in accessing debts whilst weaker degree of financial freedom leads to an increase of using trade credit as a substitute for bank loans.

G.P.30 - A European prospective study of the natural history of patients with type 2 and 3 spinal muscular atrophy

Spinal muscular atrophy (SMA) is the second most frequent autosomal recessive disorder worldwide affecting approximately 1 in 10,000 people. Clinical manifestations include muscle atrophy and varying degrees of weakness. Several therapeutic strategies for treatment of SMA are under investigation including SMN2 splicing modifiers and gene therapy. Recently, Trophos reported positive results in a phase III trial for olesoxime in non-ambulant type 2 and 3 SMA. However no effective treatment has currently received market approval. Due to the variability in SMA phenotypes, it is important to determine the best outcome measures to assess the efficacy of potential therapies and the prognostic factors for the disease. We present here a prospective natural history study of type 2 and 3 SMA patients to characterize the disease course by using standardized evaluations. A total of 70 patients aged 2 to 30 years are planned to be enrolled in Belgium, France and Germany. Visit frequency and assessments are adjusted to age, ambulatory and respiratory status. Evaluations include clinical exam, pulmonary function tests, electrophysiology and NMR measurements, strength and motor function assessments using upper limb-specific devices (MyoSet and Active-Seated), MFM scale and standard timed tests, activity monitoring using the Actimyo device and quality of life assessment. Blood samples are collected to determine the copy number of SMN2 gene, and to analyze SMN mRNA, SMN protein and exploratory biomarkers. Data from the patients' usual follow-up care are collected from their medical files including psychomotor development, respiratory function, feeding and orthopedic status. According to the fatigability of the patient, the assessments can be performed on one or two days. These data will help to characterize the disease course and spectrum of SMA and may help to empower future therapeutic studies as well as to eventually reduce the need for placebo groups.

Global analysis of asymmetric RNA enrichment in oocytes reveals low conservation between closely relatedXenopusspecies

RNAs that localize to the vegetal cortex during Xenopus laevis oogenesis have been reported to function in germ layer patterning, axis determination, and development of the primordial germ cells. Here we report on the genome-wide, comparative analysis of differentially localizing RNAs in Xenopus laevis and Xenopus tropicalis oocytes, revealing a surprisingly weak degree of conservation in respect to the identity of animally as well as vegetally enriched transcripts in these closely related species. Heterologous RNA injections and protein binding studies indicate that the different RNA localization patterns in these two species are due to gain/loss of cis-acting localization signals rather than to differences in the RNA-localizing machinery.

El papel del Estado en el alivio a la pobreza en la era neoliberal Una aproximación teórica

Differing from what has been stated by the Washington Consensus indicating that state intervention to help the poor only exacerbates poverty, this work examines if the degree of institutional weakness of the developing States is what prevents them from reaching a solution. The article is divided into five sections. In the first section, the reforms implemented by the Washington Consensus in Latin America are presented descriptively, as well as the subsequent dismantling of the Welfare State. In the second section, the importance of state intervention in the coordination of the economy to avoid poverty and social violence is exposed. In the third, we explore the role of the State under the current logic of the fundamental paradigm for poverty alleviation. In the fourth, the existing relationship between the institutional capacities of the State and poverty is discussed. Finally, the last section presents conclusions.

Network analysis of eight industrial symbiosis systems

Industrial symbiosis is the quintessential characteristic of an eco-industrial park. To divide parks into different types, previous studies mostly focused on qualitative judgments, and failed to use metrics to conduct quantitative research on the internal structural or functional characteristics of a park. To analyze a park’s structural attributes, a range of metrics from network analysis have been applied, but few researchers have compared two or more symbioses using multiple metrics. In this study, we used two metrics (density and network degree centralization) to compare the degrees of completeness and dependence of eight diverse but representative industrial symbiosis networks. Through the combination of the two metrics, we divided the networks into three types: weak completeness, and two forms of strong completeness, namely “anchor tenant” mutualism and “equality-oriented” mutualism. The results showed that the networks with a weak degree of completeness were sparse and had few connections among nodes; for “anchor tenant” mutualism, the degree of completeness was relatively high, but the affiliated members were too dependent on core members; and the members in “equality-oriented” mutualism had equal roles, with diverse and flexible symbiotic paths. These results revealed some of the systems’ internal structure and how different structures influenced the exchanges of materials, energy, and knowledge among members of a system, thereby providing insights into threats that may destabilize the network. Based on this analysis, we provide examples of the advantages and effectiveness of recent improvement projects in a typical Chinese eco-industrial park (Shandong Lubei).

The Evolution of and Risk Factors for Neck Muscle Atrophy and Weakness in Nasopharyngeal Carcinoma Treated With Intensity-Modulated Radiotherapy: A Retrospective Study in an Endemic Area.

The aim of this study was to investigate the evolution of sternocleidomastoid muscle (SCM) atrophy in nasopharyngeal carcinoma (NPC) patients following intensity-modulated radiotherapy (IMRT), and the relationship between SCM atrophy and neck weakness.Data were retrospectively analyzed from 223 biopsy-proven NPC patients with no distant metastasis who underwent IMRT with or without chemotherapy. The volume of SCM was measured on pretreatment magnetic resonance imaging (MRI), and MRIs were conducted 1, 2, and 3 years after the completion of IMRT. Change in SCM volume was calculated and classified using the late effects of normal tissues–subjective, objective, management, and analytic system. The grade of neck muscle weakness, classified by the Common Terminology Criteria for Adverse Events V 3.0, was measured 3 years after the completion of IMRT.The average SCM atrophy ratio was −10.97%, −18.65%, and −22.25% at 1, 2, and 3 years postirradiation, respectively. Multivariate analysis indicated N stage and the length of time after IMRT were independent prognostic variables. There were significant associations between the degree of SCM atrophy and neck weakness.Radical IMRT can cause significant SCM atrophy in NPC patients. A more advanced N stage was associated with more severe SCM atrophy, but no difference was observed between N2 and N3. SCM atrophy progresses over time during the 3 years following IMRT. Grade of SCM atrophy is significantly associated with neck weakness.

Characterization of patients with advanced pancreatic cancer and high serum interleukin-6 levels.

High serum level of interleukin 6 (IL-6) is associated with high degree of tumor progression and systemic weakness. Anti-IL-6 therapy possibly improves the deterioration of clinical characteristics in patients with high IL-6 level. However, IL-6-related factors in patients with treatment-naive advanced pancreatic cancer (PC) have not been established. The goal of this study was to identify IL-6-related factors in patients with advanced PC who were scheduled to undergo first-line chemotherapy. Patients with treatment-naive advanced PC were eligible for inclusion in this study. Patients who did not receive first-line chemotherapy were excluded. Serum IL-6 levels and clinical parameters were prospectively recorded. Analyses were performed to identify risk factors for high IL-6 levels. Eighty patients were analyzed. IL-6-related factors were advanced age (P < 0.01), the presence of liver metastasis (P < 0.01), the large volume of liver metastasis (P < 0.01), severe fatigue (P = 0.02), high carcinoembryonic antigen levels (P = 0.02), anemia (P < 0.01), and high C-reactive protein levels (P = 0.02) in multivariate analyses. Decreased skeletal muscle mass tended to be associated with high IL-6 levels. High serum IL-6 was related to advanced age, the presence of hepatic metastasis, large tumor burden in liver, severe fatigue, high carcinoembryonic antigen, high C-reactive protein, and anemia in patients with treatment-naive advanced PC.

Phenotypic variability of CMT4C in a French-Canadian kindred.

Charcot-Marie-Tooth type 4C (CMT4C) is an autosomal recessive dysmyelinating neuropathy characterized by precocious and rapidly progressive scoliosis. Patients in a French-Canadian kindred were evaluated with clinical examination, electrophysiologic study, and genomic DNA extraction. Six of 10 siblings were clinically symptomatic with supportive electrophysiologic features. The proband presented with regional side-to-side sensorimotor asymmetry, typical pes cavus without obvious scoliosis, and unremarkable plain films of the spine. Affected siblings all share symptoms of foot deformity but have variable onset of neuropathic symptoms, degree of extremity weakness, progression of symptoms, and, most notably, evidence of scoliosis. DNA sequence analysis revealed a novel combination of 2 known recessive mutations, p.R904X and p.R954X, in the SH3TC2 gene. A broad spectrum of phenotypes should be considered in the possible diagnosis of CMT4C. The absence of scoliosis or late-onset symptoms should not exclude SH3TC2 from the list of candidate genes under consideration. Age of onset and clinical features were variable and suggest that polygenic factors contribute to the final phenotype.

Afro-Cuban Religious Arts: Popular Expressions of Cultural Inheritance in Espiritismo and Santería

Afro-Cuban Religious Arts: Popular Expressions of Cultural Inheritance in Espiritismo and Santería

ClC-1 chloride channels: state-of-the-art research and future challenges.

The voltage-dependent ClC-1 chloride channel belongs to the CLC channel/transporter family. It is a homodimer comprising two individual pores which can operate independently or simultaneously according to two gating modes, the fast and the slow gate of the channel. ClC-1 is preferentially expressed in the skeletal muscle fibers where the presence of an efficient Cl- homeostasis is crucial for the correct membrane repolarization and propagation of action potential. As a consequence, mutations in the CLCN1 gene cause dominant and recessive forms of myotonia congenita (MC), a rare skeletal muscle channelopathy caused by abnormal membrane excitation, and clinically characterized by muscle stiffness and various degrees of transitory weakness. Elucidation of the mechanistic link between the genetic defects and the disease pathogenesis is still incomplete and, at this time, there is no specific treatment for MC. Still controversial is the subcellular localization pattern of ClC-1 channels in skeletal muscle as well as its modulation by some intracellular factors. The expression of ClC-1 in other tissues such as in brain and heart and the possible assembly of ClC-1/ClC-2 heterodimers further expand the physiological properties of ClC-1 and its involvement in diseases. A recent de novo CLCN1 truncation mutation in a patient with generalized epilepsy indeed postulates an unexpected role of this channel in the control of neuronal network excitability. This review summarizes the most relevant and state-of-the-art research on ClC-1 chloride channels physiology and associated diseases.

The results of an Open, Randomized Comparative Clinical Study to Assess the Reactogenicity, Safety and Immunogenicity of the Vaccine EntseVir in Children Aged 3 to 17 Years

In 2011 - 2012 years in the Institute of childhood infections followed by an open comparative randomized study of tick-borne encephalitis vaccine EntseVir («Microgen») at a dose of 0.25 ml of the two schemes, planned and emergency in children aged 3 - 17 years. As a reference drug used vaccine FSME-Immun junior production (Baxter, AG, Austria). The results of clinical studies have shown that Entsevir at a dose of 0.25 ml has a good safety profile, low reactogenicity. Mostly recorded transient local reactions such as pain at the injection site weak degree. Severe reactions and post-vaccination complications were absent. EntseVir has no immunosuppressive, immunopathological action, highly immunogenic and can be recommended for mass prophylaxis tick-borne encephalitis in children 3 - 17 years on two schemes of vaccination (planned with an interval of 60 days and emergency with an interval of 14 days).

'So' as a weak degree expression

This paper aims to answer three questions about the degree expression 'so' in English: (i) what semantics does it contribute? (I.e., in what ways is 'so' different from 'enough'?) (ii) how can we explain its restricted distribution? And (iii) how does the that-clause compose with 'so'? I point out that equating 'enough' and 'so' (as has been done in the literature) is problematic, and I propose that a new approach that establishes an analogy between"so" and weak pronouns can yield satisfactory answers to questions (i)--(iii). In a nutshell, I argue that there are two 'so's: a strong (deictic) one and a weak (anaphoric) one. I concentrate on weak 'so' and show that its limited distribution has to do with the informational properties of weak items more generally. I further claim that its accompanying that-clause is not a complement of 'so', but rather an adjoined sentence that provides a bona fide focus to the sentence.

THE EFFECT OF IRRIGATION ON THE STATUS INDICATORS OF SOUTHERN CHERNOZEMS FERTILITY OF NIZHNEDNESTROVSKAYA IRRIGATION SYSTEM

There were conducted the research to identify the nature and direction of change in the modern processes of southern chernozems under irrigation. The research object is the southern chernozem fo the Nizhnednestrovskaya irrigation system. According to the results of soil monitoring studies presented a comparative analysis of the impact of irrigation on the soil conditions in a systematic and limited-selective watering. Irrigation leads to the eluviation of soluble salts down the soil profile. In reduced-selective irrigation during the last 20 years, chernozems desalinization processes are activated. As a result, irrigation significantly changes the composition of southern chernozems exchange and absorbed bases, cations exchange capacity is reduced, the content of calcium decreases and magnesium, sodium and potassium accumulates. In reduced-selective sprinkling a partial restoration of the cations exchange capacity occurs, but the exchange ratio Ca2+: Mg2+ significantly narrowes, the proportion of sodium and potassium increases, that is the indicating of the development of secondary processes (irrigation) alkalinization of southern chernozems. General tendency to dehumification southern chernozems under the influence-selective sprinkling is traced, that is explained by extensive agriculture during the last years. In accordance to the soils granule analysis the irrigation leads to the increase of maintenance of silty fraction, a tendency is marked to the gleization, that is connected, probably, with dispergation of fine sand and large dust. The factor of dispersion increases only in the years of systematic irrigation to the level of weak degree of degradation. Under the influence of irrigation the soil density increases to 1,4 – 1,5 (1,6) g/sm3, that characterizes these soils as weak and average degraded.

Commentary on: "Evidence of weak conscious experiences in the exclusion task".

Commentary on: "Evidence of weak conscious experiences in the exclusion task".

Woody flora and dynamic of &lt;i&gt;Aucoumea klaineana&lt;/i&gt; forest in the Congolese littoral

The floristic dynamics of the woody facies of the Aucoumea klaineana forest of the Congolese littoral has been done according to a gradient evolving of the pioneer front towards the interior of the ecosystem. This settlement integrates a dynamics going from the youthful stages towards the most stable of this formation. The objective of this study was focused on the dynamics of the woody formation, the monodominant installation of the Aucoumea klaineana facies with d1.30 . 10 cm and highlights the evolution and the correlation between the density, the basal area and the floristic diversity. The phytoecological parameters count 1186 trees of d1.30 . 10 cm (an average 395 arbres.ha-1) for 71 species. The trees number by subplot oscillated between 70 and 159 trees (6 to 13% of listed trees). The species number by subplot varies from 8 to 28 (11 to 39% of inventoried species). Basal area by plot oscillates of 22 and 35 m2.ha-1 (27 m2.ha-1 an average). It varies from 4 to 10 m2 per subplot (7 m2 by . ha an average). The trees number by subplot and diameter classes vary from 3 to 636 trees (1 to 212 trees.ha-1 an average). The trees of 10 &lt; d1.30 . 20 cm are dominating with 54% and this prevalence is regular in all the subplots. As for the indices of diversity, the Green index (GI) decrease from 0.9 to 0.1 as the ecosystem increases in age. This observation is also true for the skewness coefficient which regresses from pioneer front towards the interior of the forest. The values are respectively 2.10-2 in the first plot, 7.10-4 in the second and 4.10-3 for the third. In this inventory where Aucoumea klaineana is dominating, its density by subplot varies from 42 to 384 trees.ha-1 (183 trees.ha-1 an average). Just like the density, basal area is decreasing to pioneer front towards the interior of the forest. The values oscillate from 87 to 32% of basal area of the subplot (19 m2.ha-1 an average). The report basal area by the density of Aucoumea klaineana is lower than 1 for an average of 0.1. The ecological parameters analysis which allowed seizing the floral dynamics of this forest is stressed by a numerical multivariate analysis (grouping and ordination). It highlights the weak resemblance degree between the twelve plots of the inventory and clearly marks the existence of variation characterizing the Congolese coastal forest, notably during the first stages of installation.Keywords: Congo, Aucoumea klaineana, biological diversity indices, Coastal forest, floristic diversity, phytoecological parameters.

Strategies for the Abnormal Co-Contraction of Internal Rotators of the Shoulder in Children with Obstetrical Brachial Plexus Palsy

Dear Editor, Obstetrical brachial plexus palsy (OBPP) is caused by traction of the brachial plexus during delivery. The incidence of OBPP was once reported to be 2.9 per 1000 live births, and the incidence of persisting OBPP was 0.46 per 1000. 1 Although most patients with OBPP recover spontaneously in the first 2 months, up to 35% are left with varying degrees of shoulder weakness, contracture, or joint deformity. 2 Even after neuro-reconstructive surgery, children with incomplete recovery often have abnormal motor performance. 3

Muscle response of anticholinesterase-intoxicated rats to different therapeutic modalities

Background Organophosphorus (OP) compound poisoning is a common, serious health problem that results in more than 250 000 deaths yearly worldwide, according to WHO estimates. Traditional use of atropine and oxime has failed to reduce the attendant morbidity and mortality. Objective The aim of the study was to evaluate the effects of magnesium sulfate and intravenous lipid emulsions versus the traditional standard of care - atropine and oxime - on butyrylcholineesterase enzyme (BuChE) activity and find whether there is a correlation between the enzyme level and muscle activity. Methods Adult female rats were used to study intermediate syndrome and a sublethal toxic dose of dimethoate (60 mg/kg) was used for induction of OP toxicity. Assessment of BuChE level, evaluation of De Bleecker score for muscle activity, and repetitive nerve stimulation test were carried out in all groups. Results The mean BuChE serum level was significantly reduced in the OP-intoxicated group compared with the normal control group. Significant improvement was recorded in the groups treated with oxime and intralipid emulsion. The De Bleecker scale showed elevated scores in all treated groups, and the best result was with oxime and magnesium sulfate. Regarding electrophysiological findings, the most frequently found were repetitive firing after single nerve stimulation and decrement response after repetitive nerve stimulation. Conclusion This study highlighted possible new trends that could prove beneficial in the management of OP poisoning and in improving the degree of muscle weakness and its impact on respiratory muscles.

A New Invention to Transfer the Patients from Ordinary Hospital Beds to Surgical Beds and Vice Versa in Two States of Railing and Transferring, a Pictorial Review

The process of transferring the patients from ordinary hospital beds to surgical beds and vice versa is really a long lasting challenge in medicine and surgery. Every health care center which deals with transferring the patients from one bed to another may be encountering with this major problem. This problem will be most pronounced when we would like to talk about the surgical and neurosurgical patients specifically with various degrees of cord injuries and multiple trauma, burned patients, orthopedic patients with disability and inability in movement, patients suffering from cancer and with various degrees of weakness and disabilities and older patients with various degrees of paralysis and movement disorders. Many patients with various degrees of Spinal cord injury need close care because a very small change in the alignment of the fixed spinal cord can cause a very dangerous consequence for them. Also the patients with various degrees of disabilities by any congenital or acquired movement disorders or the patients who are suffering from any fractures specifically in their big bones and joints, during the process of transferring may encounter other problems which can have so many dangerous consequences for them. So finding a way to give an answer to this important question that “How can we transfer the patients from one bed to another without causing any problem for them?” was the foundation of designing and manufacturing a device that can facilitate this difficult process.