Using Stool Antigen to Screen for Helicobacter pylori in Immigrants and Refugees from High Prevalence Countries Is Relatively Cost Effective in Reducing the Burden of Gastric Cancer and Peptic Ulceration

Objectives

Refugees and immigrants from developing countries settling in industrialised countries have a high prevalence of Helicobacter pylori (H. pylori). Screening these groups for H. pylori and use of eradication therapy to reduce the future burden of gastric cancer and peptic ulcer disease is not currently recommended in most countries. We investigated whether a screening and eradication approach would be cost effective in high prevalence populations.

Methods

Nine different screening and follow-up strategies for asymptomatic immigrants from high H. pylori prevalence areas were compared with the current approach of no screening. Cost effectiveness comparisons assumed population prevalence''s of H. pylori of 25%, 50% or 75%. The main outcome measure was the net cost for each cancer prevented for each strategy. Total costs of each strategy and net costs including savings from reductions in ulcers and gastric cancer were also calculated.

Results

Stool antigen testing with repeat testing after treatment was the most cost effective approach relative to others, for each prevalence value. The net cost per cancer prevented with this strategy was US$111,800 (assuming 75% prevalence), $132,300 (50%) and $193,900 (25%). A test and treat strategy using stool antigen remained relatively cost effective, even when the prevalence was 25%.

Conclusions

H. pylori screening and eradication can be an effective strategy for reducing rates of gastric cancer and peptic ulcers in high prevalence populations and our data suggest that use of stool antigen testing is the most cost effective approach.     

Assessment of therapeutic responses to gametocytocidal drugs in Plasmodium falciparum malaria

Background

Effective mating between laboratory-reared males and wild females is paramount to the success of vector control strategies aiming to decrease disease transmission via the release of sterile or genetically modified male mosquitoes. However mosquito colonization and laboratory maintenance have the potential to negatively affect male genotypic and phenotypic quality through inbreeding and selection, which in turn can decrease male mating competitiveness in the field. To date, very little is known about the impact of those evolutionary forces on the reproductive biology of mosquito colonies and how they ultimately affect male reproductive fitness.

Methods

Here several male reproductive physiological traits likely to be affected by inbreeding and selection following colonization and laboratory rearing were examined. Sperm length, and accessory gland and testes size were compared in male progeny from field-collected females and laboratory strains of Anopheles gambiae sensu stricto colonized from one to over 25 years ago. These traits were also compared in the parental and sequentially derived, genetically modified strains produced using a two-phase genetic transformation system. Finally, genetic crosses were performed between strains in order to distinguish the effects of inbreeding and selection on reproductive traits.

Results

Sperm length was found to steadily decrease with the age of mosquito colonies but was recovered in refreshed strains and crosses between inbred strains therefore incriminating inbreeding costs. In contrast, testes size progressively increased with colony age, whilst accessory gland size quickly decreased in males from colonies of all ages. The lack of heterosis in response to crossing and strain refreshing in the latter two reproductive traits suggests selection for insectary conditions.

Conclusions

These results show that inbreeding and selection differentially affect reproductive traits in laboratory strains overtime and that heterotic ‘supermales’ could be used to rescue some male reproductive characteristics. Further experiments are needed to establish the exact relationship between sperm length, accessory gland and testes size, and male reproductive success in the laboratory and field settings.     

Focus on Water: Biodesalination: A Case Study for Applications of Photosynthetic Bacteria in Water Treatment

Shortage of freshwater is a serious problem in many regions worldwide, and is expected to become even more urgent over the next decades as a result of increased demand for food production and adverse effects of climate change. Vast water resources in the oceans can only be tapped into if sustainable, energy-efficient technologies for desalination are developed. Energization of desalination by sunlight through photosynthetic organisms offers a potential opportunity to exploit biological processes for this purpose. Cyanobacterial cultures in particular can generate a large biomass in brackish and seawater, thereby forming a low-salt reservoir within the saline water. The latter could be used as an ion exchanger through manipulation of transport proteins in the cell membrane. In this article, we use the example of biodesalination as a vehicle to review the availability of tools and methods for the exploitation of cyanobacteria in water biotechnology. Issues discussed relate to strain selection, environmental factors, genetic manipulation, ion transport, cell-water separation, process design, safety, and public acceptance.Bacteria are commonly employed for the purification of municipal and industrial wastewater but until now, established water treatment technologies have not taken advantage of photosynthetic bacteria (i.e. cyanobacteria). The ability of cyanobacterial cultures to grow at high cell densities with minimal nutritional requirements (e.g. sunlight, carbon dioxide, and minerals) opens up many future avenues for sustainable water treatment applications.Water security is an urgent global issue, especially because many regions of the world are experiencing, or are predicted to experience, water shortage conditions: More than one in six people globally are water stressed, in that they do not have access to safe drinking water (United Nations, 2006). Ninety-seven percent of the Earth’s water is in the oceans; consequently, there are many efforts to develop efficient methods for converting saltwater into freshwater. Various processes using synthetic membranes, such as reverse osmosis, are successfully used for large-scale desalination. However, the high energy consumption of these technologies has limited their application predominantly to countries with both relatively limited freshwater resources and high availability of energy, for example, in the form of oil reserves.The development of an innovative, low-energy biological desalination process, using biological membranes of cyanobacteria, would thus be both attractive and pertinent. The core of the proposed biodesalination process (Fig. 1) is a low-salt biological reservoir within seawater that can serve as an ion exchanger. Its development can be separated into several complementary steps. The first step comprises the selection of a cyanobacterial strain that can be grown to high cell densities in seawater with minimal requirement for energy sources other than those that are naturally available. The environmental conditions during growth can be manipulated to enhance natural extrusion of sodium (Na⁺) by cyanobacteria. In the second step, cyanobacterial ion transport mechanisms must be manipulated to generate cells in which sodium export is replaced with intracellular sodium accumulation. This will involve inhibition of endogenous Na⁺ export and expression of synthetic molecular units that facilitate light-driven sodium flux into the cells. A robust control system built from biological switches will be required to achieve precisely timed expression of the salt-accumulating molecular units. The third step consists of engineering efficient separation of the cyanobacterial cells from the desalinated water, using knowledge of physicochemical properties of the cell surface and their natural ability to produce extracellular polymeric substances (EPSs), which aid cell separation while preserving cell integrity. The fourth step integrates the first three steps into a manageable and scalable engineering process. The fifth and final step assesses potential risks and public acceptance issues linked to the new technology.Open in a separate windowFigure 1.Proposed usage of cyanobacterial cultures for water treatment. A, Hypothetical water treatment station. Situated in basins next to the water source, sun-powered cell cultures remove unwanted elements from the water. The clean water is separated from the cells for human uses. The produced biomass is available for other industries. The proposed biodesalination process is based on the following steps. B, Photoautotrophic cells divide to generate high-density cultures. C, The combined cell volume is low in salt as a result of transport proteins in the cell membrane that export sodium using photosynthetically generated energy. D, Through environmental and genetic manipulation, salt export is inhibited and replaced with transport modules that accumulate salt inside the cells. This process is again fueled by light energy. E, Manipulation of cell surface properties separates the salt-enriched cells from the desalinated water.In this review, we outline the state of knowledge and available technology for each of the steps, as well as summarize the current knowledge gaps and technical limitations in employing a large-scale water treatment process using cyanobacteria. Before discussing these issues, we provide some background information on the usage of cyanobacteria in biotechnology and the impact of sodium on cellular functions of cyanobacteria. The example of biodesalination provides a good vehicle to discuss the suitability of photosynthetic bacteria for water treatment more generally. The issues addressed in this review are relevant for a wide range of biotechnological applications of cyanobacteria, including bioremediation and biodegradation as well as the generation of biofuels, natural medicines, or cosmetics.     

502. Sinningia Pusilla

Summary. A miniature gesneriad, Sinningia pusilla(C. Mart.) Baill. from Brazil is described and illustrated, and notes are given on the horticultural history of the genus Sinningia     

A second gene at the tomato Cf-4 locus confers resistance to cladosporium fulvum through recognition of a novel avirulence determinant

The tomato Cf-4 and Cf-9 genes confer resistance to the leaf mould pathogen Cladosporium fulvum and map at a complex locus on the short arm of chromosome 1. It was previously shown that the gene encoding Cf-4, which recognizes the Avr4 avirulence determinant, is one of five tandemly duplicated homologous genes (Hcr9-4s) at this locus. Cf-4 was identified by molecular analysis of rare Cf-4/Cf-9 disease-sensitive recombinants and by complementation analysis. The analysis did not exclude the possibility that an additional gene(s) located distal to Cf-4 may also confer resistance to C. fulvum. We demonstrate that a number of Dissociation-tagged Cf-4 mutants, identified on the basis of their insensitivity to Avr4, are still resistant to infection by C. fulvum race 5. Molecular analysis of 16 Cf-4 mutants, most of which have small chromosomal deletions in this region, suggested the additional resistance specificity is encoded by Hcr9-4E. Hcr9-4E recognizes a novel C. fulvum avirulence determinant that we have designated Avr4E.