Once Daily Valacyclovir for Reducing Viral Shedding in Subjects Newly Diagnosed with Genital Herpes

Objective. Genital herpes (GH) recurrences and viral shedding are more frequent in the first year after initial HSV-2 infection. The objective of this study was to provide the first evaluation of valacyclovir 1 g once daily compared to placebo in reducing viral shedding in subjects newly diagnosed with GH. Methods. 70 subjects were randomized to receive valacyclovir 1 g daily or placebo in a crossover design for 60 days with a 7-day washout period. A daily swab of the genital/anal-rectal area was self-collected for HSV-2 detection by PCR. Subjects attended the clinic for routine study visits and GH recurrence visits. Treatment differences were assessed using a nonparametric crossover analysis. Results. 52 subjects had at least one PCR measurement in both treatment periods and comprised the primary efficacy population. Valacyclovir significantly reduced HSV-2 shedding during all days compared to placebo (mean 2.9% versus 13.5% of all days (P < .01), a 78% reduction). Valacyclovir significantly reduced subclinical HSV-2 shedding during all days compared to placebo (mean 2.4% versus 11.0% of all days (P < .01), a 78% reduction). However, 79% of subjects had no GH recurrences while receiving valacyclovir compared to 52% of subjects receiving placebo (P < .01). Conclusion. In this study, the frequency of total and subclinical HSV-2 shedding was greater than reported in earlier studies involving subjects with a history of symptomatic genital recurrences. Our study is the first to demonstrate a significant reduction in viral shedding with valacyclovir 1 g daily compared to placebo in a population of subjects newly diagnosed with HSV-2 infection

Direct monitoring of active geohazards: emerging geophysical tools for deep-water assessments

Seafloor networks of cables, pipelines, and other infrastructure underpin our daily lives, providing communication links, information, and energy supplies. Despite their global importance, these networks are vulnerable to damage by a number of natural seafloor hazards, including landslides, turbidity currents, fluid flow, and scour. Conventional geophysical techniques, such as high-resolution reflection seismic and side-scan sonar, are commonly employed in geohazard assessments. These conventional tools provide essential information for route planning and design; however, such surveys provide only indirect evidence of past processes and do not observe or measure the geohazard itself. As such, many numerical-based impact models lack field-scale calibration, and much uncertainty exists about the triggers, nature, and frequency of deep-water geohazards. Recent advances in technology now enable a step change in their understanding through direct monitoring. We outline some emerging monitoring tools and how they can quantify key parameters for deepwater geohazard assessment. Repeat seafloor surveys in dynamic areas show that solely relying on evidence from past deposits can lead to an under-representation of the geohazard events. Acoustic Doppler current profiling provides new insights into the structure of turbidity currents, whereas instrumented mobile sensors record the nature of movement at the base of those flows for the first time. Existing and bespoke cabled networks enable high bandwidth, low power, and distributed measurements of parameters such as strain across large areas of seafloor. These techniques provide valuable new measurements that will improve geohazard assessments and should be deployed in a complementary manner alongside conventional geophysical tools

Clinical Study Once Daily Valacyclovir for Reducing Viral Shedding in Subjects Newly Diagnosed with Genital Herpes

Objective. Genital herpes (GH) recurrences and viral shedding are more frequent in the first year after initial HSV-2 infection. The objective of this study was to provide the first evaluation of valacyclovir 1 g once daily compared to placebo in reducing viral shedding in subjects newly diagnosed with GH. Methods. 70 subjects were randomized to receive valacyclovir 1 g daily or placebo in a crossover design for 60 days with a 7-day washout period. A daily swab of the genital/anal-rectal area was self-collected for HSV-2 detection by PCR. Subjects attended the clinic for routine study visits and GH recurrence visits. Treatment differences were assessed using a nonparametric crossover analysis. Results. 52 subjects had at least one PCR measurement in both treatment periods and comprised the primary efficacy population. Valacyclovir significantly reduced HSV-2 shedding during all days compared to placebo (mean 2.9% versus 13.5% of all days (P &lt; .01), a 78% reduction). Valacyclovir significantly reduced subclinical HSV-2 shedding during all days compared to placebo (mean 2.4% versus 11.0% of all days (P &lt; .01), a 78% reduction). However, 79% of subjects had no GH recurrences while receiving valacyclovir compared to 52% of subjects receiving placebo (P &lt; .01). Conclusion. In this study, the frequency of total and subclinical HSV-2 shedding was greater than reported in earlier studies involving subjects with a history of symptomatic genital recurrences. Our study is the first to demonstrate a significant reduction in viral shedding with valacyclovir 1 g daily compared to placebo in a population of subjects newly diagnosed with HSV-2 infection

Author Correction: Rapidly-migrating and internally-generated knickpoints can control submarine channel evolution (Nature Communications, (2020), 11, 1, (3129), 10.1038/s41467-020-16861-x)

© 2020, The Author(s). The original version of this Article contained an error in the labelling of the cross-section in Fig. 2g and the vertical axis in Fig. 2b. This has been corrected in both the PDF and HTML versions of the Article

Applying the Integrated Sustainability Framework to explore the long-term sustainability of nutrition education programs in schools: A systematic review

Abstract Objective: This review aimed to identify and synthesise the enablers and barriers that influence the long-term (≥2 years) sustainment of school-based nutrition programs. Design: Four databases (PubMed, Cochrane Library, Embase and Scopus) were searched to identify studies reporting on the international literature relating to food and nutrition programs aimed at school aged (5-14 years) children that had been running for ≥2 years (combined intervention and follow-up period). Eligible studies were analysed using the Integrated Sustainability Framework, which involved deductive coding of program enablers and barriers. A quality assessment was completed, using the Mixed-Methods Appraisal Tool and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Setting: International school-based nutrition programs. Subjects: Individuals involved with the implementation of school-based nutrition programs. Results: From the 7366 articles identified, 13 studies (seven qualitative, five mixed methods and one quantitative descriptive) were included, from which the enablers and barriers of 11 different nutrition-related programs were analysed. Thirty-four factors across the five domains of the Integrated Sustainability Framework were identified that influenced the sustained implementation of programs. The most common barrier was a lack of organisational readiness and resources, whereas the most common enabler was having adequate external partnerships and a supportive environment. Conclusions: These findings have application during the initiation and implementation phases of school-based nutrition programs. Paying attention to the ‘outer contextual factors’ of the ISF including the establishment and maintenance of robust relationships across whole of government systems, local institutions and funding bodies which are crucial factors for program sustainment

Breaking the Campus Bubble:Informed, Engaged, Connected

This paper introduces UniVote, a system supporting mobile phone-based interaction with public displays. The case study carried out at Lancaster University indicates that the campus "bubble" in which students live can lead to feelings of isolation within an insular community cut off from the outside world. UniVote makes use of a voting system to help elicit user involvement, keep users informed of campus- and world-wide events and news and create a sense of community. Findings of this preliminary study suggest that the campus "bubble" can indeed be broken, and the voting component of the system particularly fosters interaction and human connectedness

Bioavailability of a novel form of microencapsulated bovine lactoferrin and its effect on inflammatory markers and the gut microbiome: a pilot study

Bovine lactoferrin, extracted from milk or whey, is used in a range of products to enhance immunity and support digestive health, iron absorption, and homeostasis. This study examined the absorption and effect of Progel (Brisbane, Queensland, Australia) microencapsulated bovine lactoferrin (Inferrin™, Bega Bionutrients, Victoria, Australia) on immune markers and the microbiome. A double-blind randomised, cross-over trial was conducted with 12 healthy males randomised to one of two doses, equivalent to 200 mg or 600 mg lactoferrin, for two four-week supplementation arms, with a two-week washout period. Subjects received either standard bovine lactoferrin or Inferrin™ for each arm. Baseline and post each trial arm, CD69+ activation on CD4+ and CD8+ cells was analysed, bovine and human lactoferrin contents of faecal and serum samples were reported, and the gut microbiome was analysed using 16S sequencing and metagenomic sequencing. The mean level of CD69+ activation on the CD4+ cells was lower after supplementation regardless of the form or dose of lactoferrin. This was statistically significant for the 200 mg dose. A higher level of bovine lactoferrin was found post-supplementation in those taking Inferrin™, although this was not statistically significant. Changes in phylum-level microbial community profiling were detected post-supplementation in the second trial arm, particularly in those receiving Inferrin™. Metagenomic sequencing showed changes in the volumes of the top 100 species of bacteria present before and after all treatment arms. Results suggest that lactoferrin supplementation may have beneficial effects on the microbiome and immune system, and that the use of Inferrin™ improves absorption. Larger detailed studies are needed to ascertain the potential positive effects of bovine lactoferrin supplementation