Safety,Effectiveness and Acceptability of the PrePex Device for Adult Male Circumcision in Kenya

Objective

To assess the safety, effectiveness and acceptability of the PrePex device for adult medical male circumcision (MMC) in routine service delivery in Kenya.

Methods

We enrolled 427 men ages 18–49 at one fixed and two outreach clinics. Procedures were performed by trained clinical officers and nurses. The first 50 enrollees were scheduled for six follow-up visits, and remaining men were followed at Days 7 and 42. We recorded adverse events (AEs) and time to complete healing, and interviewed men about acceptability and pain.

Results

Placement and removal procedures each averaged between 3 and 4 minutes. Self-reported pain was minimal during placement but was fleetingly intense during removal. The rate of moderate/severe AEs was 5.9% overall (95% confidence interval [CI] 3.8%–8.5%), all of which resolved without sequelae. AEs included 5 device displacements, 2 spontaneous foreskin detachments, and 9 cases of insufficient foreskin removal. Surgical completion of MMC was required for 9 men (2.1%). Among the closely monitored first 50 participants, the probability of complete healing by Day 42 was 0.44 (95% CI 0.30–0.58), and 0.90 by Day 56. A large majority of men was favorable about their MMC procedure and would recommend PrePex to friends and family.

Conclusions

The PrePex device was effective for MMC in Kenya, and well-accepted. The AE rate was higher than reported for surgical procedures there, or in previous PrePex studies. Healing time is longer than following surgical circumcision. Provider experience and clearer counseling on post-placement and post-removal care should lead to lower AE rates.

Trial Registration

ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT01711411","term_id":"NCT01711411"}}NCT01711411     

A Multi-Year Longitudinal Study of Water Quality Parameters in Four Salmon-Bearing and Recreational Streams on Mount Hood,Oregon

Four streams–Clear Fork, Lost Creek, Camp Creek and Still Creek–in northwestern Oregon’s Sandy River Basin were monitored for temperature, dissolved oxygen levels, and fecal bacterial concentrations in a multi-year analysis examining stream health for recreational users and anchor habitat for Pacific Salmon. Temperatures were recorded using micro –T temperature loggers at 15 locations, during 22 July - 5 September 2006, 2 July - 4 September 2007, 20 June - 7 September 2008, 23 June - 9 September 2009, and 2 July –9 September 2010. The Seven-Day Average Maximum water temperature (7-DAM) of 13°C was used as a reference value for the biological limit governing suitable salmonid spawning and egg incubation conditions. The maximum 7-DAM temperatures occurred on different dates and all streams neared or exceeded the 13°C standard at least once each summer. Dissolved oxygen levels were measured at weekly or longer intervals in 2006, 2007, 2008, and 2009. Dissolved oxygen levels fell below the 9.0 ppm standard for Clear Fork on almost half the sampling dates in 2006, 2007, and 2009. Concentrations of the bacterial genus Enterococcus were measured as an indicator of fecal contamination. Samples were collected at 15 sites along the four streams. Weekly samples were collected during a 9 week period from July - September 2007, an 11 week period from June - September 2008, and an 11 week period from June - September 2009. Enterococcus counts exceeded the federal recommended national criterion value of 61 colony forming units (CFU) per 100 mL every year in Camp Creek and occasionally elsewhere, with exceedances trending towards late summer.     

Heavy Metal Contamination in the Brownfield Soils of Cleveland

The results esults of a survey of heavy metal contamination at Cleveland area brownfields and public spaces are presented. Soils were analyzed using a 24?h, 1N HCl extraction procedure. The study was conducted to seek brownfield soils that manifest properties of “old” sequestered contamination and to develop a better understanding of the nature and extent of heavy metal burdens at brownfield sites in the Greater Cleveland area. The results indicated that Cleveland brownfields commonly yield soil burdens well above remediation triggers for residential soils and often yield values above industrial remediation triggers. It was also discovered that public areas in the vicinity of brownfields commonly have heavy metal contamination significantly above background levels and occasionally above residential remediation triggers. These results indicate that brownfields redevelopment initiatives should proceed with caution. The appropriate remediation goals or restrictions must be imposed to control urban exposure to heavy metal contamination.     

EFFECTS OF LIGHT INTENSITY ON DIVISION RATE,STIMULABLE BIOLUMINESCENCE AND CELL SIZE OF THE OCEANIC DINOFLAGELLATES DISSODINIUM LUNULA,PYROCYSTIS FUSIFORMIS AND P. NOCTILUCA12

Preadapted cultures were grown in a 12:12 LD cycle at a series of light intensities under cool-white, fluorescent lamps. Pyrocystis fusiformis Murray maintained high division rates at low light intensities at the expense of cell size. In contrast, Dissodinium lunula (Schuett) Taylor had relatively lower division rates at low light intensities with little concomitant decrease in size. The response of P. noctiluca Murray was intermediate between these two species. For all three, cell numbers did not increase above an intensity of 5–10 μEin·m^?2·sec^?1 and division rate was saturated at ca. 30, 60, and 60μEin·m^?2·sec^?1 for P. fusiformis, P. noctiluca, and D. lunula, respectively. The capacity for stimulable bioluminescence was saturated at light intensities of 0.15 μEin·m^?2·day in short-term (2-day) experiments. In cultures of P. fusiformis and P. noctiluca, maintained for at least one month at lower intensities than needed to saturate division rate, a decrease in the capacity for stimulable bioluminescence was accompanied by a reduction in cell size. Our results suggest that cell size and bioluminescent capacity may prove to be a potentially useful indication of the history of exposure of natural populations of Pyrocystis spp. to ambient intensities.     

Global diversity and balancing selection of 23 leading Plasmodium falciparum candidate vaccine antigens

Investigation of the diversity of malaria parasite antigens can help prioritize and validate them as vaccine candidates and identify the most common variants for inclusion in vaccine formulations. Studies of vaccine candidates of the most virulent human malaria parasite, Plasmodium falciparum, have focused on a handful of well-known antigens, while several others have never been studied. Here we examine the global diversity and population structure of leading vaccine candidate antigens of P. falciparum using the MalariaGEN Pf3K (version 5.1) resource, comprising more than 2600 genomes from 15 malaria endemic countries. A stringent variant calling pipeline was used to extract high quality antigen gene ‘haplotypes’ from the global dataset and a new R-package named VaxPack was used to streamline population genetic analyses. In addition, a newly developed algorithm that enables spatial averaging of selection pressure on 3D protein structures was applied to the dataset. We analysed the genes encoding 23 leading and novel candidate malaria vaccine antigens including csp, trap, eba175, ama1, rh5, and CelTOS. Our analysis shows that current malaria vaccine formulations are based on rare haplotypes and thus may have limited efficacy against natural parasite populations. High levels of diversity with evidence of balancing selection was detected for most of the erythrocytic and pre-erythrocytic antigens. Measures of natural selection were then mapped to 3D protein structures to predict targets of functional antibodies. For some antigens, geographical variation in the intensity and distribution of these signals on the 3D structure suggests adaptation to different human host or mosquito vector populations. This study provides an essential framework for the diversity of P. falciparum antigens to be considered in the design of the next generation of malaria vaccines.     

Coliform Behavior in Frozen Foods: I. Rapid Test for the Recovery of Escherichia coli from Frozen Foods

An assortment of 496 samples of frozen foods consisting of fish or marine products, variety types, and cream pie desserts were subjected to four parallel examinations for the recovery of Escherichia coli. The test procedures consisted of two low-temperature (35 C) and two high-temperature (44 C) presumptive tests, followed by an E C confirmatory test at 45.5 C. Of all the test methods examined, a single Lauryl Sulfate Tryptose (LST) presumptive test at 44 C gave best E. coli recovery (425). This recovery compared favorably with the lengthier Association of Official Analytical Chemists test with which only 420 E. coli cells were recovered. The LST (44 C) test saves much time, since it renders a follow-up 48-hr confirmatory test unnecessary. Moreover, since 96% of all the E. coli are recovered within 24 hr by LST (44 C), it is essentially a 24-hr test. The results of this study also confirmed earlier findings, in that it is possible to describe a specific coliform bacteriological test method by simple reproducible productivity ratios. E. coli recovery dilution data and coliform group behavior were also examined.     

Population-Level Density Dependence Influences the Origin and Maintenance of Parental Care

Parental care is a defining feature of animal breeding systems. We now know that both basic life-history characteristics and ecological factors influence the evolution of care. However, relatively little is known about how these factors interact to influence the origin and maintenance of care. Here, we expand upon previous work and explore the relationship between basic life-history characteristics (stage-specific rates of mortality and maturation) and the fitness benefits associated with the origin and the maintenance of parental care for two broad ecological scenarios: the scenario in which egg survival is density dependent and the case in which adult survival is density dependent. Our findings suggest that high offspring need is likely critical in driving the origin, but not the maintenance, of parental care regardless of whether density dependence acts on egg or adult survival. In general, parental care is more likely to result in greater fitness benefits when baseline adult mortality is low if 1) egg survival is density dependent or 2) adult mortality is density dependent and mutant density is relatively high. When density dependence acts on egg mortality, low rates of egg maturation and high egg densities are less likely to lead to strong fitness benefits of care. However, when density dependence acts on adult mortality, high levels of egg maturation and increasing adult densities are less likely to maintain care. Juvenile survival has relatively little, if any, effect on the origin and maintenance of egg-only care. More generally, our results suggest that the evolution of parental care will be influenced by an organism’s entire life history characteristics, the stage at which density dependence acts, and whether care is originating or being maintained.     

THE EFFECT OF pH ON THE DIVISION RATE OF THE COCCOLITHOPHORID CRICOSPHAERA ELONGATA1

The division rate of Cricosphaera elongata was measured as a function of pH in a medium buffered with the CO₂-bicarbonate-carbonate system. The optimum pH for cell division of the coccolithophorid was 7.8. A change of the partial pressure of CO₂ in the medium from 0.03 to 5% did not affect the division rate. Between pH 6.4 and 7.8 changes in the bicarbonate concentration from 0.1 to 6.0 mm and carbonate concentration from 0.007 to 0.1 mm did not affect the rate of division. At loiv experimental pH, C. elongata was nonmotile and grew in clumps; at higher pH values, it was motile and solitary. Coccoliths were not found covering C. elongata if calcite was soluble in the medium.     

Variation in gut microbial communities and its association with pathogen infection in wild bumble bees (Bombus)

Bacterial gut symbiont communities are critical for the health of many insect species. However, little is known about how microbial communities vary among host species or how they respond to anthropogenic disturbances. Bacterial communities that differ in richness or composition may vary in their ability to provide nutrients or defenses. We used deep sequencing to investigate gut microbiota of three species in the genus Bombus (bumble bees). Bombus are among the most economically and ecologically important non-managed pollinators. Some species have experienced dramatic declines, probably due to pathogens and land-use change. We examined variation within and across bee species and between semi-natural and conventional agricultural habitats. We categorized as ‘core bacteria'' any operational taxonomic units (OTUs) with closest hits to sequences previously found exclusively or primarily in the guts of honey bees and bumble bees (genera Apis and Bombus). Microbial community composition differed among bee species. Richness, defined as number of bacterial OTUs, was highest for B. bimaculatus and B. impatiens. For B. bimaculatus, this was due to high richness of non-core bacteria. We found little effect of habitat on microbial communities. Richness of non-core bacteria was negatively associated with bacterial abundance in individual bees, possibly due to deeper sampling of non-core bacteria in bees with low populations of core bacteria. Infection by the gut parasite Crithidia was negatively associated with abundance of the core bacterium Gilliamella and positively associated with richness of non-core bacteria. Our results indicate that Bombus species have distinctive gut communities, and community-level variation is associated with pathogen infection.     

Indiscelio: A new genus of Scelionidae (Platygastroidea) from India

A new scelionine genus Indiscelio Veenakumari, Popovici and Talamas is described from India with type species Indiscelio aulon Veenakumari, Popovici and Talamas. Both sexes are described and imaged. Affinities with morphologically similar genera are discussed.