Progressive Multifocal Leukoencephalopathy: Current Insights

Cases of PML should be evaluated according to predisposing factors, as these subgroups differ by incidence rate, clinical course, and prognosis. The three most significant groups at risk of PML are patients with hematological malignancies mostly previously treated with immunotherapies but also untreated, patients with HIV infection, and patients using monoclonal antibody (mAb) treatments. Epidemiological data is scarce and partly conflicting, but the distribution of the subgroups appears to have changed. While there is no specific anti-JCPyV treatment, restoration of the immune function is the most effective approach to PML treatment. Research is warranted to determine whether immune checkpoint inhibitors could benefit certain PML subgroups. There are no systematic national or international records of PML diagnoses or a risk stratification algorithm, except for MS patients receiving natalizumab (NTZ). These are needed to improve PML risk assessment and to tailor better prevention strategies.Peer reviewe

Depression-related work disability: socioeconomic inequalities in onset, duration and recurrence

Objective: Depression is a major cause of disability in working populations and the reduction of socioeconomic inequalities in disability is an important public health challenge. We examined work disability due to depression with four indicators of socioeconomic status. Methods: A prospective cohort study of 125 355 Finnish public sector employees was linked to national register data on work disability (>9 days) due to depressive disorders (International Classification of Diseases, codes F32–F34) from January 2005 to December 2011. Primary outcomes were the onset of work disability due to depressive disorders and, among those with such disability, return to work after and recurrent episodes of work disability due to depression. Results: We found a consistent inverse socioeconomic gradient in work disability due to depression. Lower occupational position, lower educational level, smaller residence size, and rented (vs. owner-occupied) residence were all associated with an increased risk of work disability. Return to work was slower for employees with basic education (cumulative odds ratio = 1.21, 95% CI: 1.05–1.39) compared to those with higher education. Recurrent work disability episodes due to depression were less common among upper-grade non-manual workers (the highest occupational group) than among lower-grade non-manual (hazard ratio = 1.16, 95% CI: 1.07–1.25) and manual (hazard ratio = 1.14, 95% CI: 1.02–1.26) workers. Conclusions: These data from Finnish public sector employees show persistent socioeconomic inequalities in work disability due to depression from 2005 to 2011 in terms of onset, recovery and recurrence

Near-infrared evolution of the equatorial ring of SN 1987A

We use adaptive-optics imaging and integral field spectroscopy from the Very Large Telescope, together with images from the \emph{Hubble Space Telescope}, to study the near-infrared (NIR) evolution of the equatorial ring (ER) of SN~1987A. We study the NIR line and continuum flux and morphology over time in order to lay the groundwork for \emph{James Webb Space Telescope} observations of the system. We also study the differences in the interacting ring structure and flux between optical, NIR and other wavelengths, and between line and continuum emission, to constrain the underlying physical processes. Mostly the evolution is similar in the NIR and optical. The morphology of the ER has been skewed toward the west side (with roughly 2/3 of the NIR emission originating there) since around 2010. A steady decline in the ER flux, broadly similar to the MIR and the optical, is ongoing since roughly this time as well. The expansion velocity of the ER hotspots in the NIR is fully consistent with the optical. However, continuum emission forms roughly 70 per cent of the NIR luminosity, and is relatively stronger outside the hotspot-defined extent of the ER than the optical emission or NIR line emission since 2012--2013, suggesting a faster-expanding continuum component. We find that this outer NIR emission can have a significant synchrotron contribution. Even if emission from hot ($\sim$2000~K) dust is dominant within the ER, the mass of this dust must be vanishingly small (a few $\times10^{-12}$~M$_\odot$) compared to the total dust mass in the ER ($\gtrsim10^{-5}$~M$_\odot$) to account for the observed $HKs$ flux. The NIR continuum emission, however, expands slower than the more diffuse 180-K dust emission that dominates in the MIR, indicating a different source, and the same hot dust component cannot account for the $J$-band emission.Comment: 17 pages, 17 figures. Accepted for publication in Astronomy & Astrophysic

Metamorfosa Radikalisme pada Lembaga Pendidikan di Sulawesi Tenggara

Research on the metamorphosis of radicalism in educational institutions in Southeast Sulawesi has been conducted and focused on the segregation potential to be a radical individuals and groups to preach, especially in educational institutions in the Southeast Sulawesi. Data obtained through questionnaires, structured interviews, observation, document tracking and focus group discussion.The results showed that the metamorphosis of radicalism on the knot of educational institutions in Southeast Sulawesi spreading through the penetration movement in educational institutions such as on college campuses and in schools, especially in public campuses with the goal of lecturers and students and public schools targeted teachers and students. The spread on campus through student propaganda agency involving senior students and in the school and through extra-curricular involving senior students with methods of brainwashing. Lecturer plays an important role in the growth of radicalism as teachers and leaders of radical organizations with a method of indoctrination while teachers act through the hidden curriculum. The policy of the state budget subsidies to student organizations affiliated to the radical organization helped sustain the growth of radicalism on campus.The study recommends that efforts to break the chain of radicalism in educational institutions in Southeast Sulawesi can be done by educators either individually or as an educator together with governmen

Do predictors of return to work and recurrence of work disability due to mental disorders vary by age? A cohort study

BACKGROUND: The extent to which predictors of return to work (RTW) and recurrence of work disability episodes vary by age group is not well understood. METHODS: We examined the associations of sociodemographic and clinical factors with RTW and recurrence after mental-disorder-related work disability episodes in a cohort of 10,496 Finnish public sector employees. Disability records were derived from national disability registers between 2005 and 2011. Effect modification by age was examined in age groups of 21-34, 35-50 and >50 years. RESULTS: A total of 16,551 disability episodes from mental disorders were recorded. The likelihood of RTW was elevated in age group 21-34 (hazard ratio (HR) = 1.36, 95% confidence interval (CI) = 1.28-1.46) and 35-50 years (HR = 1.22, 95% CI = 1.18-1.26) compared to age group >50 years. The risk of a recurrent episode of work disability was higher in age groups >50 (HR = 1.29, 95% CI = 1.09-1.52) and 35-50 years (HR = 1.20, 95% CI = 1.03-1.41) compared to the youngest age group. Employees with depressive disorders were less likely to RTW than employees with neurotic, stress-related and somatoform disorders, and this difference increased with age. Low education was associated with increased risk of recurrent work disability episode in age groups of 50 years or younger, while no such association was observed in age group >50 years. CONCLUSIONS: The importance of depressive symptoms over neurotic, stress-related and somatoform disorders as predictors of delayed RTW increases with age, whereas educational differences in the recurrence of an episode diminish by age

First genome-wide association study on rocuronium dose requirements shows association with SLCO1A2

Background: Rocuronium, a common neuromuscular blocking agent, is mainly excreted unchanged in urine (10-25%) and bile ( 70%). Age, sex, liver blood flow, smoking, medical conditions, and ethnic background can affect its pharmacological actions. However, reasons for the wide variation in rocuronium requirements are mostly unknown. We hypothesised that pharmacogenetic factors might explain part of the variation. Methods: One thousand women undergoing surgery for breast cancer were studied. Anaesthesia was maintained with propofol (50-100 mg kg(-1) min(-1)) and remifentanil (0.05-0.25 mg kg(-1) min(-1)). Neuromuscular block was maintained with rocuronium to keep the train-of-four ratio at 0-10%. DNA was extracted from peripheral blood and genotyped with a next-generation genotyping array. The genome-wide association study (GWAS) was conducted using an additive linear regression model with PLINK software. The FINEMAP tool and data from the Genotype-Tissue Expression project v8 were utilised to study the locus further. Results: The final patient population comprised 918 individuals. Of the clinical variables tested, age, BMI, ASA physical status, and total dose of propofol correlated significantly (all P Conclusions: Genetic variation in the gene SLCO1A2, encoding OATP1A2, an uptake transporter, accounted for 4% of the variability in rocuronium consumption. The underlying mechanism remains unknown.Peer reviewe

Suomen metsät 2009–2013 ja niiden kehitys 1921–2013

Tässä julkaisussa esitetään valtakunnan metsien 11. inventoinnin (VMI11) tulokset Suomen metsävaroista ja metsien tilasta. Maastotiedot on kerätty vuosina 2009–2013. Metsien kehitystä tarkastellaan 1920-luvulta lähtien vertailemalla VMI11:n tuloksia aiempien inventointien (VMI1–VMI10) tuloksiin. Julkaisussa esitetään myös VMI11:n menetelmät maastomittausten ja laskentamenetelmien osalta. Puuston määrä on 2,4 miljardia kuutiometriä. Edelliseen inventointiin verrattuna lisäystä on 150 miljoonaa kuutiometriä ja 1920-luvun puumäärään verrattuna noin miljardi kuutiometriä. Puuston määrästä 50 % on mäntyä, 30 % kuusta, 20 % koivua. 1920-lukuun verrattuna kaikkien em. puulajiryhmien kokonaistilavuus on lisääntynyt selvästi, esimerkiksi lehtipuun määrä on lisääntynyt puolitoistakertaiseksi. Puuston vuotuinen kasvu inventoinnin mittausvuosia edeltäneinä 5 vuotena on ollut keskimäärin 105,5 miljoonaa kuutiometriä. Puuntuotannon metsämaan metsistä 36 % on nuoria kasvatusmetsiä, 30 % varttuneita kasvatusmetsiä, 19 % taimikoita ja 13 % uudistuskypsiä metsiä. Puuttomia uudistusaloja sekä siemen- ja suojuspuustoja on yhteensä vajaat 2 % puuntuotannon metsämaan alasta. Mäntyvaltaisia metsiä on 64 % koko Suomen metsämaan alasta, kuusivaltaisia 25 % ja lehtipuuvaltaisia 10 %. Etelä-Suomen nuorissa metsissä kuusivaltaiset metsät ovat yleistymässä, mikä kertoo siitä, että kuusta suositaan metsän uudistamisessa. Metsikön laatua alentavia tuhoja on 25 %:lla puuntuotannon metsämaan alasta. Kuusivaltaisissa metsissä yleisimpiä tuhonaiheuttajia ovat tuuli ja lumi, mäntyvaltaisissa metsissä lumi ja hirvi, lehtipuuvaltaissa metsissä lahottajasienet ja hirvi. Metsien terveydentila on hyvä, sillä vakavia tuhoja esiintyy vain 3 %:lla puuntuotannon metsämaan alasta. Puuntuotannon metsämaan metsistä 28 % on metsänhoidolliselta tilaltaan hyviä ja 44 % tyydyttäviä. Vajaatuottoisia metsiä on 7 %. Vajaatuottoisten metsien määrä on pienentynyt edelliseen inventointiin verrattuna hieman ja aiempiin inventointeihin verrattuna selvästi. Tulevana 10-vuotiskautena metsänhoidollisia ensiharvennustarpeita on 1,9-kertaisesti ja taimikonhoitotarpeita 1,5-kertaisesti menneen 10-vuotiskauden suoritemääriin verrattuna. Metsien monimuotoisuudelle tärkeän lahopuuston määrän lisääntyminen on Etelä-Suomessa jatkunut. Pohjois-Suomessa lahopuuston määrä on vähentynyt. Pohjois-Suomessa lahopuuston keskitilavuus metsämaalla (8,0 m³/ha) on kuitenkin edelleen yli kaksinkertainen Etelä-Suomeen (3,8 m³/ha) verrattuna. Pysyvien koealojen avulla laskettu puuston vuotuinen luonnonpoistuma on 6,5 miljoonaa kuutiometriä. Tästä 0,9 miljoonaa kuutiometriä on korjattu hakkuissa. Puuston rakenteen ja lahopuuston sekä ihmisen vaikutuksen suhteen luonnontilaisen kaltaisia metsiä on 517 000 hehtaaria.201

Modelling mixed-phase clouds with the large-eddy model UCLALES-SALSA

The large-eddy model UCLALES-SALSA, with an exceptionally detailed aerosol description for both aerosol number and chemical composition, has been extended for ice and mixed-phase clouds. Comparison to a previous mixed-phase cloud model intercomparison study confirmed the accuracy of newly implemented ice microphysics. A further simulation with a heterogeneous ice nucleation scheme, in which ice-nucleating particles (INPs) are also a prognostic variable, captured the typical layered structure of Arctic mid-altitude mixed-phase cloud: a liquid layer near cloud top and ice within and below the liquid layer. In addition, the simulation showed a realistic freezing rate of droplets within the vertical cloud structure. The represented detailed sectional ice microphysics with prognostic aerosols is crucially important in reproducing mixed-phase clouds

Psychotherapeutic and vocational interventions among young adults with work disability due to mental disorders in Finland.

BACKROUND: Little is known about treatment and rehabilitation received and planned among young adults with work disability due to a mental disorder. AIMS: To examine the implemented psychotherapeutic and vocational interventions and treatment plans among young adults with work disability due to a mental disorder. MATERIAL AND METHODS: Data were collected from medical records of young Finnish adults aged 18-34 with a long-term work disability history due to a mental disorder (N = 1163). The participant characteristics associated with four types of interventions were analyzed using log-binomial regression analysis. RESULTS: In total, 34% had participated in a psychotherapeutic intervention. Of the non-students, 26% had participated in vocational intervention. For 46% of the non-students, neither type of intervention was planned. Both implemented and planned psychotherapeutic interventions were associated with female sex, high education, attachment to employment, and absence of substance abuse. Low education and childhood adversity were associated with implemented vocational interventions and absence of substance abuse with planned vocational interventions. CONCLUSION AND SIGNIFICANCE: There is an unmet need for psychotherapeutic interventions among men, among those with lower socio-economic status, and among those with poor attachment to labor market. In addition, there is a lack of vocational interventions for those with high education. People with substance abuse are largely excluded from both types of interventions