Male circumcision and Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis: observations after a randomised controlled trial for HIV prevention

International audienceOBJECTIVE: To assess the association between male circumcision and Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis using data from a male circumcision randomised controlled trial. METHODS: We used data collected during the male circumcision trial conducted in Orange Farm (South Africa) among men aged 18-24 years. Altogether, 1767 urine samples collected during the final follow-up visit were analysed using PCR. Prevalence of N gonorrhoeae, C trachomatis and T vaginalis was assessed as a function of male circumcision using odds ratios (OR) given by univariate and multivariate logistic regression. RESULTS: In an intention-to-treat analysis, prevalence of N gonorrhoeae, C trachomatis and T vaginalis among intervention and control groups were 10.0% versus 10.3% (OR 0.97; p = 0.84), 2.1% versus 3.6% (OR 0.58; p = 0.065) and 1.7% versus 3.1% (OR 0.54; p = 0.062), respectively. The association between T vaginalis and male circumcision remained borderline when controlling for age, ethnic group, number of lifetime partners, marital status, condom use and HIV status (AOR 0.48; p = 0.069). In the as-treated analysis, this association became significant (OR 0.49, p = 0.030; AOR 0.41, p = 0.030). CONCLUSIONS: This study demonstrates for the first time that male circumcision reduces T vaginalis infection among men. This finding explains why women with circumcised partners are less at risk for T vaginalis infection than other women. The protective effect on T vaginalis is an additional argument to recommend male circumcision in Africa where it is acceptable

Prediction of ‘Nules Clementine’ mandarin susceptibility to rind breakdown disorder using Vis/NIR spectroscopy

The use of diffuse reflectance visible and near infrared (Vis/NIR) spectroscopy was explored as a non-destructive technique to predict ‘Nules Clementine’ mandarin fruit susceptibility to rind breakdown (RBD) disorder by detecting rind physico-chemical properties of 80 intact fruit harvested from different canopy positions. Vis/NIR spectra were obtained using a LabSpec® spectrophotometer. Reference physico-chemical data of the fruit were obtained after 8 weeks of storage at 8 °C using conventional methods and included RBD, hue angle, colour index, mass loss, rind dry matter, as well as carbohydrates (sucrose, glucose, fructose, total carbohydrates), and total phenolic acid concentrations. Principal component analysis (PCA) was applied to analyse spectral data to identify clusters in the PCA score plots and outliers. Partial least squares (PLS) regression was applied to spectral data after PCA to develop prediction models for each quality attribute. The spectra were subjected to a test set validation by dividing the data into calibration (n = 48) and test validation (n = 32) sets. An extra set of 40 fruit harvested from a different part of the orchard was used for external validation. PLS-discriminant analysis (PLS-DA) models were developed to sort fruit based on canopy position and RBD susceptibility. Fruit position within the canopy had a significant influence on rind biochemical properties. Outside fruit had higher rind carbohydrates, phenolic acids and dry matter content and lower RBD index than inside fruit. The data distribution in the PCA and PLS-DA models displayed four clusters that could easily be identified. These clusters allowed distinction between fruit from different preharvest treatments. NIR calibration and validation results demonstrated that colour index, dry matter, total carbohydrates and mass loss were predicted with significant accuracy, with residual predictive deviation (RPD) for prediction of 3.83, 3.58, 3.15 and 2.61, respectively. The good correlation between spectral information and carbohydrate content demonstrated the potential of Vis/NIR as a non-destructive tool to predict fruit susceptibility to RBD

Probing structural relaxation in complex fluids by critical fluctuations

Complex fluids, such as polymer solutions and blends, colloids and gels, are of growing interest in fundamental and applied soft-condensed-matter science. A common feature of all such systems is the presence of a mesoscopic structural length scale intermediate between atomic and macroscopic scales. This mesoscopic structure of complex fluids is often fragile and sensitive to external perturbations. Complex fluids are frequently viscoelastic (showing a combination of viscous and elastic behaviour) with their dynamic response depending on the time and length scales. Recently, non-invasive methods to infer the rheological response of complex fluids have gained popularity through the technique of microrheology, where the diffusion of probe spheres in a viscoelastic fluid is monitored with the aid of light scattering or microscopy. Here we propose an alternative to traditional microrheology that does not require doping of probe particles in the fluid (which can sometimes drastically alter the molecular environment). Instead, our proposed method makes use of the phenomenon of "avoided crossing" between modes associated with the structural relaxation and critical fluctuations that are spontaneously generated in the system.Comment: 4 pages, 4 figure

Commentary on muscle dysmorphia as an addiction: A response to Grant (2015) and Nieuwoudt (2015)

Background: Following the publication of our paper ‘Muscle Dysmorphia: Could it be classified as an addiction to body image?’ in the Journal of Behavioral Addictions, two commentaries by Jon Grant and Johanna Nieuwoudt were published in response to our paper. Method: Using the ‘addiction components model’, our main contention is that muscle dysmorphia (MD) actually comprises a number of different actions and behaviors and that the actual addictive activity is the maintaining of body image via a number of different activities such as bodybuilding, exercise, eating certain foods, taking specific drugs (e.g., anabolic steroids), shopping for certain foods, food supplements, and purchase or use of physical exercise accessories. This paper briefly responds to these two commentaries. Results: While our hypothesized specifics relating to each addiction component sometimes lack empirical support (as noted explicitly by both Nieuwoudt and Grant), we still believe that our main thesis (that almost all the thoughts and behaviors of those with MD revolve around the maintenance of body image) is something that could be empirically tested in future research by those who already work in the area. Conclusions: We hope that the ‘Addiction to Body Image’ model we proposed provides a new framework for carrying out work in both empirical and clinical settings. The idea that MD could potentially be classed as an addiction cannot be negated on theoretical grounds as many people in the addiction field are turning their attention to research in new areas of behavioral addiction

Technological pedagogical content knowledge in South African mathematics classrooms: A secondary analysis of SITES 2006 data

This article reports on a secondary data analysis conducted on the South African mathematics teachers’ dataset of the Second Information Technology in Education Study (SITES 2006). The sample consisted of a stratified sample of 640 mathematics teachers from 504 randomly selected computer-using and non–computer-using schools that completed the SITES 2006 teachers’ questionnaire, which investigated their pedagogical use of Information Communication Technology (ICT). The purpose of the current investigation was to investigate the level of Technological Pedagogical Content Knowledge (TPACK) of mathematics teachers, and how TPACK attributes contribute towards more effective Grade 8 mathematics teaching in South African schools, using the TPACK conceptual framework. The findings are presented according to the three clusters identified through the association between the main variables of the TPACK model and other variables on the SITES 2006 teachers’ questionnaire: (1) impact of ICT use, (2) teacher practices and (3) barriers. A Cramér V of between 0.3 and 0.4 was considered to signal a medium effect that tended towards practically significant association, and a Cramér V of 0.4 or larger was considered to signal a large effect with practically significant association. The results indicate that the TPACK of mathematics teachers contributes towards more effective Grade 8 mathematics teaching in South African schools

Endoscopic ultrasound guided fine needle aspiration allows accurate diagnosis of mycobacterial disease in HIV-positive patients with abdominal lymphadenopathy

BACKGROUND : Abdominal lymphadenopathy in HIV remains a challenge due to inaccessibility of lymph nodes and multitude of causes. The diagnostic yield of EUS FNA in HIV-infected patients with abdominal lymphadenopathy in the setting of high tuberculosis (TB) prevalence was assessed. METHODS : Prospective cohort study was conducted in tertiary referral centres recruiting symptomatic HIV+ patients (N=31, mean age 38.5 years, mean CD4 count 124 cells/μl, WHO stage 3-4 with abdominal lymphadenopathy. EUS was performed to assess lymph node characteristics and FNA aspirate subjected to cytological analysis, microbial culture and PCR. RESULTS : EUS appearance of lymph nodes was highly variable. Mycobacterial infections were the most common cause of lymphadenopathy in this cohort. Of the 31 patients 21/31 67.7 % had mycobacterial infections; 17 (80.9 %) of these were tuberculosis. Cytology failed to identify 23.8% and culture 38.1% of cases. PCR identified 16/17 (94.1%) of these cases. EUS-FNA altered the management of more than half of the patients. CONCLUSIONS : Mycobacterial disease was the commonest cause of lymphadenopathy in HIV but a third of patients had reactive lymphadenopathy. By combining the appearance of EUS FNA and cytological aspirate we could develop a diagnostic algorithm with a high PPV and NPV to identify patients in whom further analysis with PCR would be useful. PCR was highly accurate in confirming mycobacterial disease and determining genotypic drug resistance.South African Gastroenterological Society (SAGES)/Astra Zeneca Fellowship in Gastroenterologyhttp://www.journals.elsevier.com/ultrasound-in-medicine-and-biology/hb201

Muscle dysmorphia: Could it be classified as an addiction to body image?

BACKGROUND: Muscle dysmorphia (MD) describes a condition characterised by a misconstrued body image in which individuals who interpret their body size as both small or weak even though they may look normal or highly muscular. MD has been conceptualized as a type of body dysmorphic disorder, an eating disorder, and obsessive–compulsive disorder symptomatology. METHOD AND AIM: Through a review of the most salient literature on MD, this paper proposes an alternative classification of MD – the ‘Addiction to Body Image’ (ABI) model – using Griffiths (2005) addiction components model as the framework in which to define MD as an addiction. RESULTS: It is argued the addictive activity in MD is the maintaining of body image via a number of different activities such as bodybuilding, exercise, eating certain foods, taking specific drugs (e.g., anabolic steroids), shopping for certain foods, food supplements, and the use or purchase of physical exercise accessories). In the ABI model, the perception of the positive effects on the self-body image is accounted for as a critical aspect of the MD condition (rather than addiction to exercise or certain types of eating disorder). CONCLUSIONS: Based on empirical evidence to date, it is proposed that MD could be re-classified as an addiction due to the individual continuing to engage in maintenance behaviours that may cause long-term harm

Fractal fronts of diffusion in microgravity

Spatial scale invariance represents a remarkable feature of natural phenomena. A ubiquitous example is represented by miscible liquid phases undergoing diffusion. Theory and simulations predict that in the absence of gravity diffusion is characterized by long-ranged algebraic correlations. Experimental evidence of scale invariance generated by diffusion has been limited, because on Earth the development of long-range correlations is suppressed by gravity. Here we report experimental results obtained in microgravity during the flight of the FOTON M3 satellite. We find that during a diffusion process a dilute polymer solution exhibits scale-invariant concentration fluctuations with sizes ranging up to millimetres, and relaxation times as large as 1,000 s. The scale invariance is limited only by the finite size of the sample, in agreement with recent theoretical predictions. The presence of such fluctuations could possibly impact the growth of materials in microgravity

HIV drug resistance levels in adults failing first-line antiretroviral therapy in an urban and a rural setting in South Africa

OBJECTIVES : Urban and rural HIV treatment programmes face different challenges in the long-term management of patients. There are few studies comparing drug resistance profiles in patients accessing treatment through these programmes. METHODS : HIV drug resistance data and associated treatment and monitoring information from adult patients failing first-line therapy in an urban and rural programme were collected. Data were curated and managed in SATuRN RegaDB before statistical analysis using Microsoft Excel 2013 and Stata Ver14 where clinical parameters, resistance profiles and predicted treatment responses were compared. RESULTS : Data from 595 patients were analyzed: 492 rural and 103 urban. The urban group had lower CD4 counts at treatment initiation (98 versus 126 cells/μl, p=0.05), had more viral loads done per year (median 3 versus 1.4, p< 0.01) and was more likely to have no drug resistance mutations detected (35.9% versus 11.2%, p<0.01). Patients in the rural group were more likely to have been on first-line treatment for a longer period, failed for longer, and have thymidine analogue mutations. Notwithstanding these differences, both groups had a comparable predicted response to standard second-line regimen, based on the genotypic susceptibility score. Mutations accumulated in a sigmoidal fashion over failure duration. CONCLUSIONS : The frequency and patterns of drug resistance, as well the intensity of virological monitoring, in adults with first-line therapy failure differed between the urban and rural site. Despite these differences, based on the genotypic susceptibility scores, the majority of patients across both sites would be expected to respond well to the standard second-line regimen.This work was supported by the European Union (SANTE 2007 147– 790). The Hlabisa HIV Treatment and Care Programme has received support through the United States Agency for International Development (USAID) and the President’s Emergency Plan (PEPFAR) under the terms of Award No. 674-A-00-08-00001-00. Data analysis and curation were also supported by a Flagship grant from the Medical Research Council (MRC) of the Republic of South Africa (MRC- RFA-UFSP-01-2013/UKZN HIVEPI).http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1468-12932018-02-27hb2017Immunolog

Polymerase chain reaction amplifying mycobacterial DNA from aspirates obtained by endoscopic ultrasound allows accurate diagnosis of mycobacterial disease in HIV-positive patients with abdominal lymphadenopathy

Abdominal lymphadopathy in Human Immunodeficiency Virus (HIV) infection remains a diagnostic challenge. We performed a prospective cohort study recruiting thirty-one symptomatic HIV+ patients with abdominal lymphadenopathy assessing diagnostic yield of endoscopic ultrasound (EUS) fine needle aspiration (FNA). Mean age was 38 years, 52% were female, mean CD4 count and viral load were 124 cells/pl, and 4 log respectively. EUS confirmed additional mediastinal nodes in 26 %. Porta- hepatis was the most common abdominal site. EUS FNA was subjected to cytology, culture and polymerase chain reaction (PCR) analysis. Mycobacterial infections were confirmed in 67.7% and 31% had reactive lymphadenopathy. Cytology and culture had low sensitivity whereas PCR identified 90% of mycobacterial infections. Combining appearance of EUS FNA and cytology a diagnostic algorithm was developed to indicate when analysis with PCR would be useful. PCR performed on an EUS guided aspirate was highly accurate in confirming mycobacterial disease and determining genotypic drug resistance.South African Gastroenterological Society (SAGES)/ Astra Zeneca Fellowship in Gastroenterology awarded to Schalk van der Merwehttp://www.journals.elsevier.com/ultrasound-in-medicine-and-biology/hb201