Positive effect of the combination of multilevel contracture release and glucocorticoid treatment in Duchenne muscular dystrophy

Purpose: In the 1980s the first results of an early multilevel contracture release (MLCR) in patients suffering from progressive Duchenne muscular dystrophy (DMD) showed a positive effect on ambulation. Despite the demonstrated positive effects of prolongation of walking this treatment is not part of current guidelines. The aim of our study was to evaluate the effect of MLCR as well as its combination with glucocorticoid (GC) treatment on ambulation. Methods: Data of all boys (n = 86) with DMD treated in our outpatient department were analyzed regarding the treatment and loss of independent ambulation. In all, 23 were treated with GC only, ten were operated on, 21 received GC and underwent MLCR and 32 received neither of the two treatments. Results: The analysis of the loss of independent ambulation in our cohort showed a comparable extension of the ambulatory period between the GC-treated and MLCR-treated boys (p = 0.008 and p = 0.005, respectively). Furthermore, an additive effect of both therapies was found; patients with DMD who had both treatments were able to walk two years longer than those with only one of the two treatment options (p<0.001). Conclusion: Standard GC treatment and early MLCR in lower limbs have an independent positive effect on prolongation of ambulation in patients with DMD. In our cohort, the combination of both therapies is significantly more effective than each therapy alone. We suggest both should be offered to all DMD patients eligible. Level of evidence: III

Hunting Wildlife in the Tropics and Subtropics

The hunting of wild animals for their meat has been a crucial activity in the evolution of humans. It continues to be an essential source of food and a generator of income for millions of Indigenous and rural communities worldwide. Conservationists rightly fear that excessive hunting of many animal species will cause their demise, as has already happened throughout the Anthropocene. Many species of large mammals and birds have been decimated or annihilated due to overhunting by humans. If such pressures continue, many other species will meet the same fate. Equally, if the use of wildlife resources is to continue by those who depend on it, sustainable practices must be implemented. These communities need to remain or become custodians of the wildlife resources within their lands, for their own well-being as well as for biodiversity in general. This title is also available via Open Access on Cambridge Core

Determining baselines and trends of Eastern chimpanzees and forest elephants in a Central African protected area after civil strife

Protected areas are crucial to safeguard Sub-Saharan Africa’s extraordinary and abundant megafauna. In many of these areas, instability has derailed conservation efforts and impeded adequate wildlife monitoring. Discovered in 2004, Eastern chimpanzees are found in the Central Uele Basin in northern Democratic Republic of Congo (DRC) within the Bili-Uéré Protected Areas Complex (BUPAC), the largest contiguous protected area in the country. BUPAC is threatened by habitat destruction, mining, wild meat trade, and insecurity. BUPAC chimpanzees are part of the largest remaining continuous population of the species in Africa; they are also being behaviourally unique. Forest elephants were frequent in the 1960’s in the BUPAC but have declined significantly up to 2004 - 2007. We used line transects to estimate Eastern chimpanzee and forest elephant density in the BUPAC core area in 2016 and 2019 and compared these with the 2004-2007 surveys. A total of 37 and 137 two km long line transects were systematically placed in 5,841 km2 and 6,176 km2 survey areas in 2016 and 2019, respectively. We found that chimpanzee density did not change during the two survey periods but indicators for forest elephant density decreased eight-fold. Human activities were detected mainly along the core area periphery in both survey years, where they overlapped with centres of animal activity. The stable high density of chimpanzees is a positive outcome for the core BUPAC. However, despite being a conservation priority area that has received relatively intensified protection, declining forest elephant numbers are likely to reflect the high number of human conflict hotspots in vicinity as well as the increasing human population density around the core area. We propose by elevating the core area to National Park whilst strengthening on the ground enforcement and management structures as well as legal measures against poaching might ensure the long-term survival of such an important area in Africa

Assessing disease risk perceptions of wild meat in savanna borderland settlements in Kenya and Tanzania

Wild meat hunting and trade across African savannas is widespread. We interviewed 299 people in rural settlements along the Kenya-Tanzania border to examine impacts of COVID-19 on wild meat consumption and perceptions about wild meat activities associated with zoonotic disease risks. Education level played a key part in understanding COVID-19 transmission. Information about the pandemic was mostly acquired from the media. Nearly all respondents recognized that COVID-19 originated in China. As many as 70% reported no impact of COVID-19 on wild meat consumption; some believed that there was an increase. Over half of the respondents believed that consumption of wild meat leads to food-borne illnesses. Respondents recognized disease risks such as anthrax and brucellosis and accepted that people slaughtering and handling wild meat with open cuts were at greater risk. Ungulates were the most consumed animals, followed by birds, rodents, and shrews. Respondents perceived that hyenas, monkeys, donkeys, and snakes were riskier to eat. More than 90% of the respondents understood that handwashing with soap reduces risks of disease transmission. Country level (11 answers), education and gender (three answers each) and household economy (158 answers) were significant. Country differences were linked to differences in nature legislation; 50% of Kenyan respondents believed that wild meat should not be sold because of conservation concerns. Men were more worried about getting COVID-19 from live animals and perceived that wildlife should not be sold because of conservation reasons. Overall, there was a very strong inclination to stop buying wild meat if other meats were less expensive. Our results allow us to better understand the impact of the COVID-19 pandemic on wild meat-related activities. Differences between countries can frame the attitudes to wild meat since wild meat trade and consumption were found to be country specific

Temporal Changes in Ebola Transmission in Sierra Leone and Implications for Control Requirements: a Real-time Modelling Study.

BACKGROUND: Between August and November 2014, the incidence of Ebola virus disease (EVD) rose dramatically in several districts of Sierra Leone. As a result, the number of cases exceeded the capacity of Ebola holding and treatment centres. During December, additional beds were introduced, and incidence declined in many areas. We aimed to measure patterns of transmission in different regions, and evaluate whether bed capacity is now sufficient to meet future demand. METHODS: We used a mathematical model of EVD infection to estimate how the extent of transmission in the nine worst affected districts of Sierra Leone changed between 10th August 2014 and 18th January 2015. Using the model, we forecast the number of cases that could occur until the end of March 2015, and compared bed requirements with expected future capacity. RESULTS: We found that the reproduction number, R, defined as the average number of secondary cases generated by a typical infectious individual, declined between August and December in all districts. We estimated that R was near the crucial control threshold value of 1 in December. We further estimated that bed capacity has lagged behind demand between August and December for most districts, but as a consequence of the decline in transmission, control measures caught up with the epidemic in early 2015. CONCLUSIONS: EVD incidence has exhibited substantial temporal and geographical variation in Sierra Leone, but our results suggest that the epidemic may have now peaked in Sierra Leone, and that current bed capacity appears to be sufficient to keep the epidemic under-control in most districts

A History of the Book: Disrupting Society from Tablet to Tablet

The written word is arguably one of the most powerful tools available to mankind. This book analyzes the history and social impact of written language from the oldest known writing systems to the rise of electronic media.https://digitalcommons.wou.edu/history_of_book/1015/thumbnail.jp