Initial treatment strategy and clinical outcomes in Finnish MS patients : a propensity-matched study

Background The optimal treatment strategy with disease-modifying therapies (DMTs) in relapsing-remitting multiple sclerosis (RRMS) remains uncertain. Objective To compare outcomes of initial treatment with infusion therapies and starting therapy with medium efficacy therapy in a propensity-matched cohort of Finnish RRMS patients. Methods A total of 154 RRMS patients initiating natalizumab, alemtuzumab, ocrelizumab or rituximab as first DMT (high efficacy DMT, heDMT group) and 1771 patients initially treated with injectable therapies, teriflunomide or dimethylfumarate and escalated based on disease activity (moderate efficacy DMT, meDMT group) were identified from the Finnish MS registry. Nearest neighbor propensity matching (1:1, caliper 0.1) was performed for age, sex, baseline Expanded Disability Status Scale (EDSS), annual relapse rate (ARR) one year prior DMT and time since MS symptom onset. Primary outcome was time to 6-month confirmed EDSS progression and the secondary outcome time to first relapse. Results In the propensity-matched group comparisons, the probability of 6-month confirmed disability progression (CDP) at 5 years after DMT start was 28.4% (95% CI 15.7-39.3) in the heDMT group (n = 66) and 47.0% (95% CI 33.1-58.1) in meDMT group (n = 66), p = 0.013. Probability of relapse at 5 years was 34.6% (95% CI 24.1-43.6) for heDMT (n = 105) and 47.2% (95% CI 36.6-56.1) for meDMT (n = 105), p = 0.019. Conclusions Initiating MS-therapy with heDMT significantly reduced the risk of 5-year disability progression and relapse compared to using meDMT as first DMT choice in propensity-matched groups of Finnish MS-patients.Peer reviewe

Boojums in Rotating Two-Component Bose-Einstein Condensates

A boojum is a topological defect that can form only on the surface of an ordered medium such as superfluid $^3$He and liquid crystals. We study theoretically boojums appearing between two phases with different vortex structures in two-component BECs where the intracomponent interaction is repulsive in one phase and attractive in the other. The detailed structure of the boojums is revealed by investigating its density distribution, effective superflow vorticity and pseudospin texture.Comment: 4 pages, 4 figure

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Spin susceptibility of the superfluid 3^{3}He-B in aerogel

The temperature dependence of paramagnetic susceptibility of the superfluid ^{3}He-B in aerogel is found. Calculations have been performed for an arbitrary phase shift of s-wave scattering in the framework of BCS weak coupling theory and the simplest model of aerogel as an aggregate of homogeneously distributed ordinary impurities. Both limiting cases of the Born and unitary scattering can be easily obtained from the general result. The existence of gapless superfluidity starting at the critical impurity concentration depending on the value of the scattering phase has been demonstrated. While larger than in the bulk liquid the calculated susceptibility of the B-phase in aerogel proves to be conspicuously smaller than that determined experimentally in the high pressure region.Comment: 10 pages, 4 figures, REVTe

Initial treatment strategy and clinical outcomes in Finnish MS patients: a propensity-matched study

BackgroundThe optimal treatment strategy with disease-modifying therapies (DMTs) in relapsing–remitting multiple sclerosis (RRMS) remains uncertain.ObjectiveTo compare outcomes of initial treatment with infusion therapies and starting therapy with medium efficacy therapy in a propensity-matched cohort of Finnish RRMS patients.MethodsA total of 154 RRMS patients initiating natalizumab, alemtuzumab, ocrelizumab or rituximab as first DMT (high efficacy DMT, heDMT group) and 1771 patients initially treated with injectable therapies, teriflunomide or dimethylfumarate and escalated based on disease activity (moderate efficacy DMT, meDMT group) were identified from the Finnish MS registry. Nearest neighbor propensity matching (1:1, caliper 0.1) was performed for age, sex, baseline Expanded Disability Status Scale (EDSS), annual relapse rate (ARR) one year prior DMT and time since MS symptom onset. Primary outcome was time to 6-month confirmed EDSS progression and the secondary outcome time to first relapse.ResultsIn the propensity-matched group comparisons, the probability of 6-month confirmed disability progression (CDP) at 5 years after DMT start was 28.4% (95% CI 15.7–39.3) in the heDMT group (n = 66) and 47.0% (95% CI 33.1–58.1) in meDMT group (n = 66), p = 0.013. Probability of relapse at 5 years was 34.6% (95% CI 24.1–43.6) for heDMT (n = 105) and 47.2% (95% CI 36.6–56.1) for meDMT (n = 105), p = 0.019.ConclusionsInitiating MS-therapy with heDMT significantly reduced the risk of 5-year disability progression and relapse compared to using meDMT as first DMT choice in propensity-matched groups of Finnish MS-patients.</p

Climate-induced hydrography change favours small-bodied zooplankton in a coastal ecosystem

In the Baltic Sea, the climate change is expected to reduce salinity and increase temperature, and shift mesozooplankton communities towards dominance of small-bodied brackish-water taxa and cause a decline in large-bodied marine taxa. Here, we analyse environmental monitoring data, collected in a coastal area in the northern Baltic Archipelago Sea during May–September, 1967––2013, for trends and relationship between mesozooplankton biomass anomalies, salinity and temperature. During the study period, the surface water temperature increased and salinity decreased. Since the mid-1980s, the community was dominated by small-bodied brackish-water taxa whereas large-bodied calanoid copepods and marine taxa were mostly scarce or absent from the samples. The observed decline of marine taxa was related to the decline in salinity and, to some extent, to the increase of temperature. The brackish-water taxa were, for the most part, positively influenced by the temperature increase, although possibly other direct or indirect factors, not considered in this study, were also influencing the dynamics. This study adds to the knowledge of a possible on-going shift in the food web structure towards smaller-sized species and emphasizes the significance of long-term environmental monitoring in understanding the dynamics in plankton communities</p

Model of Inhomogeneous Impurity Distribution in Fermi Superfluids

The standard treatment of impurities in metals assumes a homogeneous distribution of impurities. In this paper we study distributions that are inhomogeneous. We discuss in detail the "isotropic inhomogeneous scattering model" which takes into account the spatially varying scattering on the scale of the superfluid coherence length. On a large scale the model reduces to a homogeneous medium with renormalized parameter values. We apply the model to superfluid 3He, where porous aerogel acts as the impurity. We calculate the transition temperature Tc, the order parameter, and the superfluid density. Both A- and B-like phases are considered. Two different types of behavior are identified for the temperature dependence of the order parameter. We compare the calculations with experiments on 3He in aerogel. We find that most of the differences between experiments and the homogeneous theory can be explained by the inhomogeneous model. All our calculations are based on the quasiclassical theory of Fermi liquids. The parameters of this theory for superfluid 3He in aerogel are discussed.Comment: 14 pages, 9 figures, minor change

A cultured strain of "Helicobacter heilmannii," a human gastric pathogen, identified as H. bizzozeronii: evidence for zoonotic potential of Helicobacter.

We compared the characteristics of a cultured human "Helicobacter heilmannii" isolate with those of other helicobacters found in animals. Phenotypic, protein profile, 16S rDNA sequence, and DNA-DNA hybridization analyses identified the human strain as H. bizzozeronii, a species frequently found in dogs. Thus, H. bizzozeronii may have zoonotic potential

Multi-Sided Marketplaces and the Transformation of Retail: A Service Systems Perspective

Retail is undergoing a series of major transformations as platform-based multi-sided marketplaces, like Amazon, Alibaba, eBay, JD.com and Rakuten, are challenging incumbent retailers. From the thriving brick and mortar stores and the development of shopping centers, malls and retail chains throughout the 1900's, retail has become increasingly digital as multi-sided marketplaces are uniting the online and offline to create more sophisticated and personalized customer experiences. We assimilate these ongoing changes with a service systems perspective into a conceptual framework of how multi-sided marketplaces are integrating their front and back stage processes to create more personalized, convenient, and speedy shopping experiences