Is Time to Reach EDSS 6.0 Faster in Patients with Late-Onset versus Young-Onset Multiple Sclerosis?

MethodsThis cross-sectional cohort study was conducted to identify LOMS and YOMS patients’ with relapsing remitting course at MS diagnosis. Time (years) to reach sustained EDSS 6.0 was compared between LOMS and AOMS patients. Cox proportional hazards model was used to evaluate the demographic and clinical predictors of time to EDSS 6.0 in these cohorts.ResultsLOMS and YOMS cohorts comprised 99 (10.7%) and 804 (89.3%) patients respectively. Spinal cord presentation at MS onset was more common among LOMS patients (46.5% vs. 32.3%). The proportions of LOMS and YOMS patients reaching EDSS 6.0 during the follow-up period were 19.2% and 15.7% respectively. In multivariable Cox proportional hazards model, older age at MS onset (adjusted hazard ratio (aHR) = 3.96; 95% CI: 2.14–7.32; p < 0.001), male gender (aHR = 1.85; 95% CI: 1.22–2.81; p = 0.004) and spinal cord presentation at onset (aHR = 1.47; 95% CI: 0.98–2.21; p = 0.062) were significantly associated with shorter time to EDSS 6.0.ConclusionsLOMS patients attained EDSS 6.0 in a significantly shorter period that was influenced by male gender and spinal cord presentation at MS onset.     

Why Anthropologists Don’t Reach the Public: A Rumination on Books of Thomas Hylland Eriksen

ABSTRACT

I have been asked in this essay to review two recent books of Thomas Hylland Eriksen and to place them in the context of contemporary debates in anthropology. The first two sections of this review essay discuss the recent Eriksen book Overheating, and the co-edited book Identity Destabilised, outlining the books’ core arguments. Bracketing these reviews, the essay examines the larger issue of anthropologists and the general public. It asks, now that many anthropologists have realised the importance of reaching a larger audience, why are they not being more widely read? It considers various reasons for this, and suggests that since the most fundamental ideas of the discipline have been superseded by more sophisticated and diverse modes of analysis, anthropological explications of the world may no longer have much appeal to a larger audience.     

How Did the TB Patients Reach DOTS Services in Delhi? A Study of Patient Treatment Seeking Behavior

Setting

Revised National Tuberculosis Control Programme (RNTCP), Delhi, India.

Objective

To ascertain the number and sequence of providers visited by TB patients before availing treatment services from DOTS; to describe the duration between onset of symptoms to treatment.

Study design

A cross sectional, qualitative study. Information was gathered through in-depth interviews of TB patients registered during the month of Oct, 2012 for availing TB treatment under the Revised National TB Control Programme from four tuberculosis diagnosis and treatment centers in Delhi.

Results

Out of the 114 patients who registered, 108 participated in the study. The study showed that informal providers and retail chemists were the first point of contact and source of clinical advice for two-third of the patients, while the rest sought medical care from qualified providers directly. Most patients sought medical care from more than two providers, before being diagnosed as TB. Female TB patients and patients with extra-pulmonary TB had long mean duration between onset of symptoms to initiation of treatment (6.3 months and 8.4 months respectively).

Conclusion

The pathways followed by TB patients, illustrated in this study, provide valuable lessons on the importance of different types of providers (both formal and informal) in the health system in a society like India and the delays in the diagnosis and treatment of tuberculosis.     

Phosphatidylinositol 4,5-Bisphosphate Decreases the Concentration of Ca2+, Phosphatidylserine and Diacylglycerol Required for Protein Kinase C α to Reach Maximum Activity

The C2 domain of PKCα possesses two different binding sites, one for Ca²⁺ and phosphatidylserine and a second one that binds PIP₂ with very high affinity. The enzymatic activity of PKCα was studied by activating it with large unilamellar lipid vesicles, varying the concentration of Ca²⁺ and the contents of dioleylglycerol (DOG), phosphatidylinositol 4,5-bisphosphate (PIP₂) and phosphadidylserine (POPS) in these model membranes. The results showed that PIP₂ increased the V_max of PKCα and, when the PIP₂ concentration was 5 mol% of the total lipid in the membrane, the addition of 2 mol% of DOG did not increase the activity. In addition PIP₂ decreases K_0.5 of Ca²⁺ more than 3-fold, that of DOG almost 5-fold and that of POPS by a half. The K_0.5 values of PIP₂ amounted to only 0.11 µM in the presence of DOG and 0.39 in its absence, which is within the expected physiological range for the inner monolayer of a mammalian plasma membrane. As a consequence, PKCα may be expected to operate near its maximum capacity even in the absence of a cell signal producing diacylglycerol. Nevertheless, we have shown that the presence of DOG may also help, since the K_0.5 for PIP₂ notably decreases in its presence. Taken together, these results underline the great importance of PIP₂ in the activation of PKCα and demonstrate that in its presence, the most important cell signal for triggering the activity of this enzyme is the increase in the concentration of cytoplasmic Ca²⁺.     

Does School-Based Health Promotion Affect Physical Activity on Weekends? And,Does It Reach Those Students Most in Need of Health Promotion?

ObjectiveTo determine whether a school-based health promotion program affects children’s weekend physical activity and whether this effect varies according to socioeconomic-status.MethodsThis was a quasi-experimental trial of school-based programs on physical activity levels implemented in disadvantaged neighborhoods in Alberta, Canada. In 2009 and 2011, 7 full days of pedometer data were collected from cross-sectional samples of grade 5 students (age 10–11 years) from 10 intervention schools in low-socioeconomic neighbourhoods and 20 comparison schools in middle-socioeconomic neighbourhoods. Multilevel models assessed differences in step-counts between intervention and comparison groups over-time by weight (objectively measured) and socioeconomic status subgroups.ResultsIn 2009, children from intervention schools were less active on weekends relative to comparison schools (9212 vs. 11186 steps/day p<0.01). Two years later, daily step-counts on weekend days among children in low socioeconomic intervention schools increased such that they approximated those of children from middle socioeconomic comparison schools (12148 vs. 12121 steps/day p = 0.96). The relative difference in steps between intervention and comparison schools on weekends reduced from -21.4% to 0.2% following the intervention. The normalization of weekend step counts was similar for normal weight (–21.4% to +2.0%) and overweight (-19.1 to +3.9%) children, and was balanced across socioeconomic subgroups.ConclusionsThese data suggest that school-based health promotion is effective for reducing inequities in physical activity levels outside school hours. Investments in school-based health promotion lead to behavior modification beyond the school environment.

Trial Registration

ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT01914185","term_id":"NCT01914185"}}NCT01914185     

The Spatial Pattern of the Small Fish Community in the Biandantang Lake – A Small Shallow Lake Along the Middle Reach of the Yangtze River, China

The spatial pattern of the small fish community was studied seasonally in 1996 in the Biandantang Lake. Based on plant cover, the lake was divided into five habitats, arranged in the order by plant structure complexity from complex to simple: Vallisneria spiralis habitat (V habitat), Vallisneria spiralis–Myriophyllum spicatum habitat (V–M habitat), Myriophyllum spicatum habitat (M habitat), Nelunbo nucefera habitat (N habitat), and no vegetation habitat (NV habitat). A modified popnet was used for quantitative sampling of small fishes. A total of 16 fish species were collected; Hypseleotris swinhonis, Ctenogobius giurinus, Pseudorasbora parva, Carassius auratus and Paracheilognathus imberis were the five numerically dominant species. In both summer and autumn, the total density of small fishes was about 10indm^–2. Generally, Ctenogobius giurinus, a sedatory, benthic fish, was distributed more or less evenly among the five habitats, while the other four species had lower densities in the N habitat and NV habitat, which had the simplest structures. The distribution of the small fish species showed seasonal variations. In winter, most species concentrated in the V habitat, which had the most complex structure. In spring, the fish had low densities in the N and NV habitat, and were more or less evenly distributed in the other habitats. In summer, the fish had a low density in the NV habitat, and were evenly distributed in the other habitats. In autumn, the fish had higher densities in the V–M and M habitats than in the others. Generally, spatial overlaps between the dominant species were higher in winter than in the other seasons. It was suggested that the variations in the importance of predation risk and resource competition in habitat choice determined the seasonal changes of spatial patterns in the small fishes in the Biandantang Lake.