The spectrum and prognosis of AIDS-defining illnesses in Cape Town

Objectives. To describe the incidence, spectrum and prognosis of AIDS-defining illnesses (ADI) in patients without access to antiretroviral therapy (ART). Design. Prospective cohort study. Subjects. 1 215 HIV-infected patients attending adult HIV clinics affiliated to the University of Cape Town in the New Somerset and Groote Schuur Hospitals from 1992 to 2000. Main outcome measures. Incidence rate (IR) of ADIs and survival after the ..

A L\'evy input fluid queue with input and workload regulation

We consider a queuing model with the workload evolving between consecutive i.i.d.\ exponential timers $\{e_q^{(i)}\}_{i=1,2,...}$ according to a spectrally positive L\'evy process $Y_i(t)$ that is reflected at zero, and where the environment $i$ equals 0 or 1. When the exponential clock $e_q^{(i)}$ ends, the workload, as well as the L\'evy input process, are modified; this modification may depend on the current value of the workload, the maximum and the minimum workload observed during the previous cycle, and the environment $i$ of the L\'evy input process itself during the previous cycle. We analyse the steady-state workload distribution for this model. The main theme of the analysis is the systematic application of non-trivial functionals, derived within the framework of fluctuation theory of L\'evy processes, to workload and queuing models

Soil seed bank and vegetation composition of two fen-meadow stands in The Netherlands

Soil seed bank and aboveground vegetation of Cirsio dissceti-Molinietum, a threatened species-rich fen-meadow community, were studied in two, closely located Dutch stands. In the spring soil cores of 10 cm depth were drilled then subdivided into equal upper and lower segments. After concentration by washing over a fine sieve samples were spread thinly on sterilized soil and germinated in a climate chamber for 14 weeks. In the aboveground vegetation frequency of species was recorded on the same plots in summer. A total of 95% of species germinated in 5 weeks and the same portion of individuals emerged in 10 weeks. Prolonged germination of wetland species possibly due to a limited duirnal fluctuation of temperature was found. Seed densities of the stands did not differ significantly and the seed bank eas similary dominated by a few species. Correlation between dominance ranks of species in vegetation and in seed bank was weak. Seed bank of the smaller stand contained more non fen-meadow species than the other one and dominance ranks of species in different soil depths were also less similar. Most species had transient or short-term persistent seed banks but in Juncaceae and Ericaceae long-term persistent records were typical. The smaller stand had more persistent species but most of the species present at both stands were similary classified. Differences between the stands can be linked to their different distances from external seed sources. A more persistent-dominated seed bank and uneven layer stucture in the smaller stand could reflect the greater effect of environmental fluctuations

P14-07. Offering new prevention modalities in HIV vaccine trials: experience with male circumcision in the Phambili trial

Background: New prevention options will be added to the 'standard of prevention' offered in HIV vaccine efficacy trials as new methods prove effective. The HVTN503/Phambili trial was initiated in January 2007, shortly after results from 3 randomized controlled trials of male circumcision (MC) demonstrated that MC reduces the risk of HIV acquisition. Thus, HVTN503 investigators made plans to offer MC at no cost to enrolled male participants. Methods: All participants were informed of the benefits of MC as a component of HIV risk reduction counseling, including how and where MC could be accessed. One site offered on-site MC and the others provided referral to local services for men who requested MC. We present data on uptake of MC post-enrollment. Results: Prior to discontinuation of enrolment, 441 men joined the trial, of whom 312 (70.7%) were uncircumcised. Of these, 82 (26.3% of uncircumcised men) requested MC after enrolment. Uptake varied by site, being lower (70%) at the eThekwini site, the site with lowest baseline MC prevalence. Among 3 sites with intermediate baseline MC prevalence, uptake varied from 3.3 to 37.6%, being highest at the site providing MC on site. Uptake was similar in vaccine and placebo arms of the trial [42 (26.1%) vs. 40 (26.5%)]. There was no significant difference by arm in the timing of circumcision relative to randomization assignment being provided to participants following release of the STEP trial results [post-unblinding, vaccine 18 (42.9%) vs. placebo 13 (32.5%), p = 0.37]. Conclusion: MC, a new prevention modality, was offered as part of HIV prevention services in HVTN503. Uptake varied by provision of care model and inversely with baseline MC prevalence, but did not differ between treatment arms, and remained similar even after provision of treatment