Erratum to: Estimation of country-specific and global prevalence of male circumcision.

[This corrects the article DOI: 10.1186/s12963-016-0073-5.]

Estimation of country-specific and global prevalence of male circumcision.

BACKGROUND: Male circumcision (MC) status and genital infection risk are interlinked and MC is now part of HIV prevention programs worldwide. Current MC prevalence is not known for all countries globally. Our aim was to provide estimates for country-specific and global MC prevalence. METHODS: MC prevalence data were obtained by searches in PubMed, Demographic and Health Surveys, AIDS Indicator Surveys, and Behavioural Surveillance Surveys. Male age was ≥15 years in most surveys. Where no data were available, the population proportion whose religious faith or culture requires MC was used. The total number of circumcised males in each country and territory was calculated using figures for total males from (i) 2015 US Central Intelligence Agency (CIA) data for sex ratio and total population in all 237 countries and territories globally and (ii) 2015 United Nations (UN) figures for males aged 15-64 years. RESULTS: The estimated percentage of circumcised males in each country and territory varies considerably. Based on (i) and (ii) above, global MC prevalence was 38.7 % (95 % confidence interval [CI]: 33.4, 43.9) and 36.7 % (95 % CI: 31.4, 42.0). Approximately half of circumcisions were for religious and cultural reasons. For countries lacking data we assumed 99.9 % of Muslims and Jews were circumcised. If actual prevalence in religious groups was lower, then MC prevalence in those countries would be lower. On the other hand, we assumed a minimum prevalence of 0.1 % related to MC for medical reasons. This may be too low, thereby underestimating MC prevalence in some countries. CONCLUSIONS: The present study provides the most accurate estimate to date of MC prevalence in each country and territory in the world. We estimate that 37-39 % of men globally are circumcised. Considering the health benefits of MC, these data may help guide efforts aimed at the use of voluntary, safe medical MC in disease prevention programs in various countries

Male circumcision significantly reduces prevalence and load of genital anaerobic bacteria

Male circumcision reduces female-to-male HIV transmission. Hypothesized mechanisms for this protective effect include decreased HIV target cell recruitment and activation due to changes in the penis microbiome. We compared the coronal sulcus microbiota of men from a group of uncircumcised controls (n = 77) and from a circumcised intervention group (n = 79) at enrollment and year 1 follow-up in a randomized circumcision trial in Rakai, Uganda. We characterized microbiota using16S rRNA gene-based quantitative PCR (qPCR) and pyrosequencing, log response ratio (LRR), Bayesian classification, nonmetric multidimensional scaling (nMDS), and permutational multivariate analysis of variance (PerMANOVA). At baseline, men in both study arms had comparable coronal sulcus microbiota; however, by year 1, circumcision decreased the total bacterial load and reduced microbiota biodiversity. Specifically, the prevalence and absolute abundance of 12 anaerobic bacterial taxa decreased significantly in the circumcised men. While aerobic bacterial taxa also increased postcircumcision, these gains were minor. The reduction in anaerobes may partly account for the effects of circumcision on reduced HIV acquisition. IMPORTANCE The bacterial changes identified in this study may play an important role in the HIV risk reduction conferred by male circumcision. Decreasing the load of specific anaerobes could reduce HIV target cell recruitment to the foreskin. Understanding the mechanisms that underlie the benefits of male circumcision could help to identify new intervention strategies for decreasing HIV transmission, applicable to populations with high HIV prevalence where male circumcision is culturally less acceptable

Den prostituerade missbrukaren: en inblick i kvinnlig missbruksvård i Malmö

The purpose of this paper is to illustrate drug addiction treatment for women and to get an insight if and how they regard the issue of prostitution in women’s rehab. I will do this by reviewing if the context in law SoL 2001:453 kap. 5 § 9 can be applied to women in treatment for drug addiction with prostitution as their main funding source. According to SoL 2001:453 kap.5 § 9 the care that is offered to the addict should be individual and accommodate specific needs. The major question is: do rehab facilities regard the issue of prostitution in women’s rehab? To find my answers I preformed interviews at three drug rehab centers in Malmö and asked if they are implementing prostitution in their rehab plan for women. To insure a deeper understanding for the problems that the prostituted women face I contacted Prostitutionsgruppen in Malmö and Helena Cewers, sexologist and midwife, for guidance to my question formulations. According to background recurs, interviews with key persons and rehab actors, prostitutions is a subject that awakens many feelings and fears due to the stigma that surrounds the topic. The analysis result shows that insecurity, lack of understanding and awareness are the main reasons that prostitution rarely are a part of the rehabilitation plan for women. Still all of the actors regarding this evaluation agreed that there is a need for improvement and changes for women with drug addiction problems and prostitution considering their rehab

Male circumcision and prevalence of genital human papillomavirus infection in men : a multinational study

Background: Accumulated evidence from epidemiological studies and more recently from randomized controlled trials suggests that male circumcision (MC) may substantially protect against genital HPV infection in men. The purpose of this study was to assess the association between MC and genital HPV infection in men in a large multinational study. Methods: A total of 4072 healthy men ages 18-70 years were enrolled in a study conducted in Brazil, Mexico, and the United States. Enrollment samples combining exfoliated cells from the coronal sulcus, glans penis, shaft, and scrotum were analyzed for the presence and genotyping of HPV DNA by PCR and linear array methods. Prevalence ratios (PR) were used to estimate associations between MC and HPV detection adjusting for potential confounders. Results: MC was not associated with overall prevalence of any HPV, oncogenic HPV types or unclassified HPV types. However, MC was negatively associated with non-oncogenic HPV infections (PR 0.85, 95% confident interval: 0.76-0.95), in particular for HPV types 11, 40, 61, 71, and 81. HPV 16, 51, 62, and 84 were the most frequently identified genotypes regardless of MC status. Conclusions: This study shows no overall association between MC and genital HPV infections in men, except for certain non-oncogenic HPV types for which a weak association was found. However, the lack of association with MC might be due to the lack of anatomic site specific HPV data, for example the glans penis, the area expected to be most likely protected by MC

Patterns, receptors and signals:regulation of phagosome maturation

Recognition of microbial pathogens and dead cells and their phagocytic uptake by specialized immune cells are essential to maintain host homeostasis. Phagosomes undergo fusion and fission events with endosomal and lysosomal compartments, a process called 'phagosome maturation', which leads to the degradation of the phagosomal content. However, many phagocytic cells also act as antigen-presenting cells and must balance degradation and peptide preservation. Emerging evidence indicates that receptor engagement by phagosomal cargo, as well as inflammatory mediators and cellular activation affect many aspects of phagosome maturation. Unsurprisingly, pathogens have developed strategies to hijack this machinery, thereby interfering with host immunity. Here, we highlight progress in this field, summarize findings on the impact of immune signals, and discuss consequences for pathogen elimination

Keanekaragaman Makrofauna Tanah di Lahan Karet Bekas Pembakaran dan Tidak Terbakar di Desa Linggang Amer, Kabupaten Kutai Barat, Kalimantan Timur

Makrofauna tanah memainkan peran penting dalam habitat di dalam tanah. Salah satu tugas makrofauna tanah adalah menjaga kesuburan tanah dengan mengembalikan bahan organik, mendistribusikan nutrisi, meningkatkan aerasi tanah, dan lain-lain. Makrofauna berperan sangat penting dalam ekosistem tanah dan masih terbatasnya informasi mengenai keanekaragaman makrofauna tanah yang terdapat pada lahan karet, maka perlu dilakukan penelitian mengenai keanekaragaman makrofauna tanah di lahan karet bekas pembakaran dan tidak terbakar. Waktu pelaksanaan penelitian ini adalah bulan Desember 2023 sampai dengan bulan Mei 2024. Penelitian ini dilaksanakan di Desa Linggang Amer, Kecamatan Linggang Bigung, Kabupaten Kutai Barat dan Laboratorium Fakultas Pertanian Universitas Mulawarman. Metode penelitian yang digunakan yaitu metode eksploratif berupa survei. Pengambilan sampel dilakukan pada lahan karet bekas pembakaran dan tidak terbakar. Metode pengambilan sampel makrofauna tanah menggunakan metode sortir tangan dan metode perangkap jebak (pitfall trap), lalu untuk metode pengambilan sampel karakteristik sifat fisik tanah adalah contoh tanah utuh dan contoh tanah tidak utuh atau terusik.Berdasarkan hasil klasifikasi seluruh pengamatan makrofauna tanah pada lahan karet bekas pembakaran dan lahan karet tidak terbakar, makrofauna tertangkap sebanyak 15 jenis. Lahan karet bekas pembakaran memiliki rata-rata Indeks Keanekaragaman (H’) 1,59925, rata-rata Indeks Kemerataan (E) 0,60676, dan rata-rata Indeks Dominasi (C) 0,23565. Lahan karet tidak terbakar memiliki rata-rata Indeks Keanekaragaman (H’) 1,46309, rata- rata Indeks Kemerataan 0,54028, dan rata-rata Indeks Dominasi (C) 0,2737. Karakteristik sifat fisik tanah di lahan karet bekas pembakaranmaupun lahan karet tidak terbakar memiliki tekstur penyebaran partikel adalah Silty Loam (SiL), rata-rata bobot isi di lahan karet bekas pembakaran 0,81 g cm-3 , rata-rata berat jenis tanah 2,27 g cm-3 , rata-rata porositas 65,45%, serta rata-rata kadar air 41,31%. Lahan karet tidak terbakar mempunyai rata-rata bobot isi 0,79 g cm-3 , rata-rata berat jenis 2,28 g cm-3 , rata-rata porositas 64,78%, dan rata-rata kadar air 40,96%

Prevalence of anogenital HPV infection, related disease and risk factors among HIV-infected men in inner-city Johannesburg, South Africa: baseline findings from a cohort study.

BACKGROUND: Persistent high-risk human papillomavirus (HR-HPV) infection is associated with the development of anogenital cancers, particularly in men living with HIV (MLWH). We describe the prevalence of anogenital HPV infection, abnormal anal cytology and anogenital warts (AGWs) in MLWH in Johannesburg, and explore whether HPV infection and receipt of antiretroviral treatment is associated with detection of abnormal anal cytology and AGWs. METHODS: We enrolled a cohort of 304 sexually-active MLWH ≥18 years, who completed a questionnaire and physical examination. Genital swabs were collected from all men and intra-anal swabs from 250 (82%). Swabs were tested for HPV DNA and genotypes, and anal smears graded using the Bethesda classification. Factors associated with anogenital disease were assessed by logistic regression models. RESULTS: Two thirds were receiving antiretroviral treatment, for a median 33 months (IQR = 15-58) and 54% were HIV-virologically suppressed. Only 5% reported ever having sex with men. Among 283 genital swabs with valid results, 79% had any HPV, 52% had HR-HPV and 27% had >1 HR-HPV infection. By comparison, 39% of the 227 valid intra-anal swabs had detectable HPV, 25% had any HR-HPV and 7% >1 HR infection. While most anal smears were normal (51%), 20% had ASCUS and 29% were LSIL. No cases had HSIL or cancer. Infection with >1 HR type (adjusted OR [aOR] = 2.39; 95%CI = 1.02-5.58) and alpha-9 types (aOR = 3.98; 95%CI = 1.42-11.16) were associated with having abnormal cytology. Prevalence of AGWs was 12%. Infection with any LR type (aOR = 41.28; 95%CI = 13.57-125.62), >1 LR type (aOR = 4.14; 95%CI = 1.60-10.69), being <6 months on antiretroviral treatment (aOR = 6.90; 95%CI = 1.63-29.20) and having a CD4+ count <200 cells/μL (aOR = 5.48; 95%CI: 1.60-18.78) were associated with having AGWs. CONCLUSIONS: In this population, anogenital HR-HPV infection and associated low-grade disease is common, but severe anal dysplasia was not detected. Findings reinforce the need for HPV vaccination in men for preventing both AGWs and HR-HPV infection. Given the absence of anal HSILs, however, the findings do not support the use of anal screening programmes in this population

Potensi Algoritma Berbasis Neural Network dan Turunannya sebagai Prediktor Kadar PM2,5 dan PM10

Pendahuluan: Polusi udara merupakan penyebab utama Penyakit Tidak Menular (PTM) di Asia Tenggara dan telah diidentifikasi sebagai masalah kesehatan global terbesar kedua pada tahun 2016. Strategi prediksi yang efektif sangat penting untuk mengurangi dampak buruknya. Studi ini secara sistematis meninjau penerapan algoritma berbasis Artificial Neural Network (ANN) dalam memprediksi konsentrasi polutan udara, khususnya PM2.5 dan PM10. Metode: Tinjauan sistematis ini mengikuti pedoman PRISMA. Pencarian sistematis dilakukan pada 4 basis data untuk menemukan studi yang menerapkan model ANN dalam prediksi polusi udara dengan menggunakan data meteorologi dan/atau geografis sebagai input. Ekstraksi data difokuskan pada struktur model, akurasi prediksi, serta perbandingan dengan algoritma kecerdasan buatan lainnya. Model ANN dievaluasi berdasarkan kemampuannya menangani interaksi variabel non-linear yang kompleks, fleksibilitas pada berbagai dataset, dan kinerja prediktif dibandingkan metode lain. Hasil: Algoritma berbasis ANN secara konsisten menunjukkan performa lebih baik dibandingkan model alternatif dalam memprediksi kadar PM2.5 dan PM10. Kemampuan ANN dalam pembelajaran adaptif serta integrasi berbagai input meningkatkan akurasi prediksi. Beberapa studi melaporkan adanya peningkatan lebih lanjut ketika ANN dikombinasikan dengan metode turunannya. Simpulan: ANN merupakan alat yang andal dan akurat untuk memprediksi polusi udara serta mendukung kebijakan berbasis bukti dalam pencegahan dan pengelolaan lingkungan. Peran ANN dalam ilmu lingkungan menyoroti inovasi dalam pemodelan prediktif dan membuka peluang integrasi dengan teknologi berkelanjutan.Polusi udara menjadi penyebab terbesar penyakit Non-Communicable Disease (NCD) di Asia Tenggara dan terletak sebagai masalah global terbesar kedua pada tahun 2016. Oleh karena itu, salah satu upaya yang dapat dilakukan pemerintah untuk menangani polusi udara adalah dengan menggunakan algoritma berbasis Artificial Neural Network (ANN) untuk memprediksi kadar polusi udara sehingga mengurangi dampak dan mencegah perburukan dari polusi udara. Penggunaan ANN dengan input parameter meteorologi dan data geografis dapat memberikan hasil yang memuaskan dalam memprediksi kadar polusi udara terutama kadar PM2,5 and PM10. Dari studi perbandingan antara algoritma kecerdasan buatan, algoritma berbasis Neural Network (NN) ini dapat memberikan hasil lebih akurat dibandingkan dengan algoritma lainnya dalam memprediksi PM2,5 and PM10. Kombinasi penggunaan ANN menguntungkan disebabkan karena kelemahan dari algoritma ini dapat diatasi sehingga meningkatnya kapasitas prediksi. Penggunaan ANN dapat mengukur kadar PM2,5 dan PM10 secara akurat, sehingga berpotensi digunakan sebagai salah satu instrumen pertimbangan kebijakan pemerintah dalam pencegahan polusi udara

Penile anaerobic dysbiosis as a risk factor for HIV infection

Sexual transmission of HIV requires exposure to the virus and infection of activated mucosal immune cells, specifically CD4+ T cells or dendritic cells. The foreskin is a major site of viral entry in heterosexual transmission of HIV. Although the probability of acquiring HIV from a sexual encounter is low, the risk varies even after adjusting for known HIV risk factors. The genital microbiome may account for some of the variability in risk by interacting with the host immune system to trigger inflammatory responses that mediate the infection of mucosal immune cells. We conducted a case-control study of uncircumcised participants nested within a randomized-controlled trial of male circumcision in Rakai, Uganda. Using penile (coronal sulcus) swabs collected by study personnel at trial enrollment, we characterized the penile microbiome by sequencing and real-time PCR and cytokine levels by electrochemiluminescence assays. The absolute abundances of penile anaerobes at enrollment were associated with later risk of HIV seroconversion, with a 10-fold increase in Prevotella, Dialister, Finegoldia, and Peptoniphilus increasing the odds of HIV acquisition by 54 to 63%, after controlling for other known HIV risk factors. Increased abundances of anaerobic bacteria were also correlated with increased cytokines, including interleukin-8, which can trigger an inflammatory response that recruits susceptible immune cells, suggesting a mechanism underlying the increased risk. These same anaerobic genera can be shared between heterosexual partners and are associated with increased HIV acquisition in women, pointing to anaerobic dysbiosis in the genital microbiome and an accompanying inflammatory response as a novel, independent, and transmissible risk factor for HIV infection. IMPORTANCE We found that uncircumcised men who became infected by HIV during a 2-year clinical trial had higher levels of penile anaerobes than uncircumcised men who remained HIV negative. We also found that having higher levels of penile anaerobes was also associated with higher production of immune factors that recruit HIV target cells to the foreskin, suggesting that anaerobes may modify HIV risk by triggering inflammation. These anaerobes are known to be shared by heterosexual partners and are associated with HIV risk in women. Therefore, penile anaerobes may be a sexually transmissible risk factor for HIV, and modifying the penile microbiome could potentially reduce HIV acquisition in both men and women