Emotional outcomes in clinically isolated syndrome and early phase multiple sclerosis: a systematic review and meta-analysis.

OBJECTIVE: To study depression, anxiety, suicide risk, and emotional health-related quality of life (HRQoL) in people with clinically isolated syndrome (CIS) and in early phase multiple sclerosis (MS). METHODS: A systematic literature review was conducted with inclusion criteria of observational studies on outcomes of depression, anxiety, suicide risk, and emotional HRQoL in CIS and within five years since diagnosis of MS. Studies were screened using the Preferred Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, and study quality was determined for included studies. Meta-analysis and meta-regression were performed if applicable. RESULTS: Fifty-one studies were included in the systematic review. In early phase MS, meta-analyses of the Hospital Anxiety Depression Scale (HADS) indicated prevalence levels of 17% (95% confidence interval (CI): 9 to 25%; p < .001) for depressive and 35% (95% CI: 28 to 41%; p < .001) for anxiety symptoms. Meta-regression analyses revealed an increase in mean HADS-D and HADS-A associated with larger sample size, and higher HADS-D mean with increased study quality. Similar depressive and anxiety symptoms were observed in CIS, and increased suicide risk and low emotional HRQoL was associated with depressive symptoms in early phase MS. The methodological quality of the studies was considered fair. CONCLUSIONS: Findings suggest that mild-to-moderate symptoms of depression and anxiety might be prevalent in CIS and in early phase MS. Future research on both clinical populations are needed, especially longitudinal monitoring of emotional outcomes.

Inactivation of plant infecting fungal and viral pathogens to achieve biological containment in drainage water using UV treatment.

AIM: To explore whether ultraviolet (UV) light treatment within a closed circulating and filtered water drainage system can kill plant pathogenic species. METHODS AND RESULTS: Ultraviolet experiments at 254 nm were conducted to determine the inactivation coefficients for seven plant pathogenic species. At 200 mJ cm(-2), the individual species log reductions obtained for six Ascomycete fungi and a cereal virus were as follows: Leptosphaeria maculans (9·9-log), Leptosphaeria biglobosa (7·1-log), Barley stripe mosaic virus (BSMV) (4·1-log), Mycosphaerella graminicola (2·9-log), Fusarium culmorum (1·2-log), Fusarium graminearum (0·6-log) and Magnaporthe oryzae (0·3-log). Dilution experiments showed that BSMV was rendered noninfectious when diluted to >1/512. Follow-up large-scale experiments using up to 400 l of microbiologically contaminated waste water revealed that the filtration of drainage water followed by UV treatment could successfully be used to inactivate several plant pathogens. CONCLUSIONS: By combining sedimentation, filtration and UV irradiation within a closed system, plant pathogens can be successfully removed from collected drainage water. SIGNIFICANCE AND IMPACT OF THE STUDY: Ultraviolet irradiation is a relatively low cost, energy efficient and labour nonintensive method to decontaminate water arising from a suite of higher biological containment level laboratories and plant growth rooms where genetically modified and/or quarantine fungal and viral plant pathogenic organisms are being used for research purposes.

First Report of Cassava Common Mosaic Potexvirus Infecting Chaya (Cnidoscolus chayamansa) in Tuvalu.

Chaya (Cnidoscolus chayamansa McVaugh) was introduced into Tu-valu as a leaf vegetable in the early 1990s (1) with the primary objective of alleviating vitamin A and C deficiencies, which at that time were prevalent throughout the population. Although there are no definitive quarantine records, we believe that the crop originated from vegetative cuttings introduced into Funafuti atoll from Kiribati. In the years following its introduction, chaya was distributed as cuttings taken from the original, introduced germplasm, to other islands and atolls of Tuvalu. The occurrence of yellow patches on the mature leaves of chaya cultivated in Funafuti had previously been attributed to iron deficiency, which was the inevitable consequence of growing the crop on coral atoll soils that are well known to be poor sources of metallic ions, notably iron, zinc, and copper. Following heavy cyclonic rains in March 1997, young, emerging chaya leaves were noted to exhibit an angular mosaic of the leaf lamina, characteristic of virus infections. Negatively stained sap from mosaic-affected leaves, when examined in the transmission electron microscope, was found to contain many rod-shaped virus particles similar in morphology to those of the Potexviridae (approximately 510 × 15 nm). The virus was transmitted mechanically to Chenopodium amaranticolor, in which it induced local lesion symptoms. The virus was found to be more closely related serologically to cassava common mosaic potexvirus (CsCMV) from Brazil than to that from Colombia, by immunosorbent electron microscopy with antisera kindly provided by F. Morales. Recently, CsCMV particles have been found in mosaic-affected chaya derived from the original Funafuti mother plants on Vaitupu Island. Similar symptoms have been observed on chaya being cultivated in Nui and Nanumaga islands. We conclude that CsCMV must now have been distributed throughout the atolls and islands of Tuvalu by infected planting material. We believe this to be the first report of the occurrence of CsCMV outside Central America and the first record of a plant virus from Tuvalu. Reference: (1) C. Howells and M. Bainbridge. 1996. South Pacific Commission, Pacific Island Forests and Trees. Page 10.

First Report of Hibiscus Chlorotic Ringspot Carmovirus in Tuvalu.

In September 1997, plants of Hibiscus manihot (locally called nambele) were observed on Vaitupu Island, Tuvalu, exhibiting an angular leaf mosaic and chlorosis that was not always clearly discernible. Electron microscopy of negatively stained sap from affected leaves revealed the presence of numerous isometric virus particles 28 nm in diameter. Poly-acrylamide gel electrophoresis of purified virus gave a single protein band of Mr 38,000 similar to that of the carmoviruses. Immunosorbent electron microscopy tests with antisera kindly provided by N. Spence showed the virus to be hibiscus chlorotic ringspot carmovirus (HCRSV) (1). This virus is also reported from El Salvador, the U.S., Australia, Thailand, Malaysia, Fiji, the Solomon Islands, and Vanuatu. It is not known how the virus reached Tuvalu but we suspect it was via infected cuttings, which were imported for the production of food supplements to combat acute deficiencies of vitamins A and C in the population. The virus is most likely to have been disseminated throughout the islands and atolls of Tuvalu through infected cuttings. Local spread within fields could occur through contaminated hands and cutting implements because of the ease with which the virus is mechanically transmitted. Reference: (1) H. E.Waterworth et al. Phytopathology 66:570, 1976.