Cholinergic neurons constitutively engage the ISR for dopamine modulation and skill learning in mice

The integrated stress response (ISR) maintains proteostasis by modulating protein synthesis and is important in synaptic plasticity, learning, and memory. We developed a reporter, SPOTlight, for brainwide imaging of ISR state with cellular resolution. Unexpectedly, we found a class of neurons in mouse brain, striatal cholinergic interneurons (CINs), in which the ISR was activated at steady state. Genetic and pharmacological manipulations revealed that ISR signaling was necessary in CINs for normal type 2 dopamine receptor (D2R) modulation. Inhibiting the ISR inverted the sign of D2R modulation of CIN firing and evoked dopamine release and altered skill learning. Thus, a noncanonical, steady-state mode of ISR activation is found in CINs, revealing a neuromodulatory role for the ISR in learning.

Long-term evaluation of AAV-CRISPR genome editing for Duchenne muscular dystrophy

Duchenne muscular dystrophy (DMD) is a monogenic disorder and a candidate for therapeutic genome editing. There have been several recent reports of genome editing in preclinical models of Duchenne muscular dystrophy1-6, however, the long-term persistence and safety of these genome editing approaches have not been addressed. Here we show that genome editing and dystrophin protein restoration is sustained in the mdx mouse model of Duchenne muscular dystrophy for 1 year after a single intravenous administration of an adeno-associated virus that encodes CRISPR (AAV-CRISPR). We also show that AAV-CRISPR is immunogenic when administered to adult mice7; however, humoral and cellular immune responses can be avoided by treating neonatal mice. Additionally, we describe unintended genome and transcript alterations induced by AAV-CRISPR that should be considered for the development of AAV-CRISPR as a therapeutic approach. This study shows the potential of AAV-CRISPR for permanent genome corrections and highlights aspects of host response and alternative genome editing outcomes that require further study.

RNA-guided transcriptional silencing in vivo with S. aureus CRISPR-Cas9 repressors

CRISPR-Cas9 transcriptional repressors have emerged as robust tools for disrupting gene regulation in vitro but have not yet been adapted for systemic delivery in adult animal models. Here we describe a Staphylococcus aureus Cas9-based repressor (dSaCas9KRAB) compatible with adeno-associated viral (AAV) delivery. To evaluate dSaCas9KRAB efficacy for gene silencing in vivo, we silenced transcription of Pcsk9, a regulator of cholesterol levels, in the liver of adult mice. Systemic administration of a dual-vector AAV8 system expressing dSaCas9KRAB and a Pcsk9-targeting guide RNA (gRNA) results in significant reductions of serum Pcsk9 and cholesterol levels. Despite a moderate host response to dSaCas9KRAB expression, Pcsk9 repression is maintained for 24 weeks after a single treatment, demonstrating the potential for long-term gene silencing in post-mitotic tissues with dSaCas9KRAB. In vivo programmable gene silencing enables studies that link gene regulation to complex phenotypes and expands the CRISPR-Cas9 perturbation toolbox for basic research and gene therapy applications.

Tensile mechanical properties of human forearm tendons

Previous studies of the mechanical properties of tendons in the upper limb have used embalmed specimens or sub-optimal methods of measurement. The aim of this study was to determine the biomechanical properties of all tendons from five fresh frozen cadaveric forearms using updated methodology. The cross-sectional area of tendons was accurately measured using a laser reflectance system. Tensile testing was done in a precision servo-hydraulic device with cryo-clamp fixation. We determined that the cross-sectional area of some tendons is variable and directly influences the calculated material properties; visual estimation of this is unreliable. Data trends illustrate that digital extensor tendons possess the greatest tensile strength and a higher Young's modulus than other tendon types.

Evaluation of a dynamic armrest for hydraulic-actuation controller use

The efficacy of a newly designed dynamic armrest was evaluated during joystick operation of a typical North American hydraulic-actuation joystick. The dynamic design was evaluated against a stationary armrest condition as well as no armrest condition. Electromyography (EMG) and subjective measurements were used to make the evaluation. The dynamic armrest, which mimics the natural pendulation of a joystick operator's arm in the forward and backward directions, was shown to significantly decrease the muscular activation in the upper trapezius, posterior deltoid, and anterior deltoid (p ≤ 0.01) over a stationary armrest. A questionnaire revealed that subjects significantly (p = 0.01) preferred the dynamic armrest design over either a standard armrest or no armrest with 17 of 21 operators preferring the dynamic armrest. Ratings from the questionnaire indicated that subjects felt that the dynamic armrest required less effort, was more comfortable, and was more effective than either of the other two armrest conditions.

Development and design of a dynamic armrest for hydraulic-actuation joystick controlled mobile machines

Standard armrests used in conjunction with joysticks of heavy mobile machinery have been proven to inadequately meet operator needs, resulting in excessive static loading of shoulder musculature. During joystick operation, the trajectory of the user's forearm is governed by the motion of the controller, which creates horizontal and vertical movement of the forearm. The vertical motion of the forearm in the forward and backward motion create postures that stationary armrests cannot support thereby generating increased muscle activation and risk of repetitive strain injuries. The current paper describes the design process used in creating a dynamic armrest that replicates the operator's natural motion trajectories. By incorporating the natural motion paths into a dynamic armrest, the postural requirements and muscular activation of the operator's shoulder may be reduced.

Calibration of a Hall effect displacement measurement system for complex motion analysis using a neural network

Biomechanics studies often require the analysis of position and orientation. Although a variety of transducer and camera systems can be utilized, a common inexpensive alternative is the Hall effect sensor. Hall effect sensors have been used extensively for one-dimensional position analysis but their non-linear behavior and cross-talk effects make them difficult to calibrate for effective and accurate two- and three-dimensional position and orientation analysis. The aim of this study was to develop and calibrate a displacement measurement system for a hydraulic-actuation joystick used for repetitive motion analysis of heavy equipment operators. The system utilizes an array of four Hall effect sensors that are all active during any joystick movement. This built-in redundancy allows the calibration to utilize fully connected feed forward neural networks in conjunction with a Microscribe 3D digitizer. A fully connected feed forward neural network with one hidden layer containing five neurons was developed. Results indicate that the ability of the neural network to accurately predict the x, y and z coordinates of the joystick handle was good with r(2) values of 0.98 and higher. The calibration technique was found to be equally as accurate when used on data collected 5 days after the initial calibration, indicating the system is robust and stable enough to not require calibration every time the joystick is used. This calibration system allowed an infinite number of joystick orientations and positions to be found within the range of joystick motion.

Effect of local conjugated estrogens on vaginal pH in elderly women

OBJECTIVE

The decline in estrogens during and after menopause is associated with an increase in vaginal pH and an increased susceptibility to urinary tract infections (UTIs). Decreased vaginal pH following short-term treatment with topical estrogens may reduce the incidence of such infections. This study was undertaken to evaluate the effect of low-dose, topical conjugated estrogens vaginal cream (CEVC) on vaginal pH in older, postmenopausal women.

DESIGN

We conducted a retrospective analysis of initial and follow-up evaluations of older, postmenopausal women residing in 19 long-term care facilities who were referred to Seton Health System's Incontinence Treatment Center between January 2, 1997, and June 13, 1998. Patients were untreated or were administered conjugated estrogens intravaginally (0.5 g/d, 3 days per week).

SETTING

Incontinence Treatment Center, Seton Health System.

PARTICIPANTS

Two hundred fifty-eight postmenopausal women (mean age 83 years), residents of skilled nursing facilities, who were diagnosed with urinary incontinence, were included in the study.

MEASUREMENTS

Measurements included age, CEVC treatment, vaginal pH, and history of UTIs or hysterectomy.

RESULTS

In the CEVC-treated women, vaginal pH was reduced from a mean of 7.41 +/- 0.71 to 6.80 +/- 0.70 after 6 weeks (n = 213; P = 0.0001). No differences in vaginal pH were observed in untreated women (n = 45). Continuation of CEVC treatment for an additional 6 weeks (n = 93) resulted in further decreases in vaginal pH (P = 0.017). Women who discontinued treatment after 6 weeks maintained a lower vaginal pH for 6 weeks (P = 0.0004), and there was no significant difference between groups at Week 12.

CONCLUSIONS

Low-dose CEVC for 6 and 12 weeks reduces vaginal pH in older women residing in long-term care facilities. The decreased vaginal pH following short-term treatment with topical estrogens may reduce the incidence of recurrent UTIs.