Abstract. The objectives of this study are to (1) characterize the carbon (C) content, leaf area index, and aboveground net primary production (ANPP) for mature aspen, black spruce, and young and mature jack pine stands at the southern and northern Boreal Ecosystem-Atmosphere Study (BOREAS) areas and (2) compare net primary production and carbon allocation coefficients for the major boreal forest types of the world. Direct estimates of leaf area index, defined as one half of the total leaf surface area, range from a minimum of 1.8 for jack pine forests to a maximum of 5.6 for black spruce forests; stems comprise 5 to 15% of the total overstory plant area. In the BOREAS study, total ecosystem (vegetation plus detritus plus soil) carbon content is greatest in the black spruce forests (445,760-479,380 kg C ha-l), with 87 to 88% of the C in the soil, and is lowest in the jack pine stands (68,370-68,980 kg C ha -1) with a similar distribution of carbon in the vegetation and soil. Forest floor carbon content and mean residence time (MRT) also vary more among forest types in a study area than between study areas for a forest type; forest floor MRT range from 16 to 19 years for aspen stands to 28 to 39 years for jack pine stands. ANPP differs significantly among the mature forests at each of the BOREAS study areas, ranging from a maximum of 3490 to 3520 kg C ha -• yr -1 for aspen stands to 1170 to 1220 kg C ha -l yr -• for jack pine stands. Both net primary production (NPP) and carbon allocation differ between boreal evergreen and deciduous forests in the world, suggesting global primary production models should distinguish between these two forest types. On average, 56% of NPP for boreal forests occurs as detritus and illustrates the need to better understand factors controlling aboveground and below-ground detritus production in boreal forests.

Root biomass, net primary production and turnover were studied in aspen, jack pine and black spruce forests in two contrasting climates. The climate of the Southern Study Area (SSA) near Prince Albert, Saskatchewan is warmer and drier in the summer and milder in the winter than the Northern Study Area (NSA) near Thompson, Manitoba, Canada. Ingrowth soil cores and minirhizotrons were used to quantify fine root net primary production (NPPFR). Average daily fine root growth (m m(-2) day(-1)) was positively correlated with soil temperature at 10-cm depth (r(2) = 0.83-0.93) for all three species, with black spruce showing the strongest temperature effect. At both study areas, fine root biomass (measured from soil cores) and fine root length (measured from minirhizotrons) were less for jack pine than for the other two species. Except for the aspen stands, estimates of NPPFR from minirhizotrons were significantly greater than estimates from ingrowth cores. The core method underestimated NPPFR because it does not account for simultaneous fine root growth and mortality. Minirhizotron NPPFR estimates ranged from 59 g m(-2) year(-1) for aspen stands at SSA to 235 g m(-2) year(-1) for black spruce at NSA. The ratio of NPPFR to total detritus production (aboveground litterfall + NPPFR) was greater for evergreen forests than for deciduous forests, suggesting that carbon allocation patterns differ between boreal evergreen and deciduous forests. In all stands, NPPFR consistently exceeded annual fine root turnover and the differences were larger for stands in the NSA than for stands in the SSA, whereas the difference between study areas was only significant for black spruce. The imbalance between NPPFR and fine root turnover is sufficient to explain the net accumulation of carbon in boreal forest soils.

Abstractobjectives To achieve UNAIDS 90-90-90 targets, alternatives to conventional HIV testing models are necessary in South Africa to increase population awareness of their HIV status. One of the alternatives is oral mucosal transudates-based HIV self-testing (OralST). This study describes implementation of counsellor-introduced supervised OralST in a high HIV prevalent rural area. . Inter-rater agreement was 99.8% (Kappa 0.9925). Sensitivity for the OralST was 98.7% (95% CI 96.8-99.6), and specificity was 100% (95% CI 99.8-100).

The introduction of the AIP improved maternal outcomes. There were significant differences related to use of oxytocin and postpartum hemorrhage.

The object of this study was to investigate the ability of a rapid luciferase assay to detect antimycobacterial activity in plant extracts. Recombinant strains of Mycobacterium bovis BCG (rBCG) and Mycobacterium intracellulare expressing firefly luciferase were used as the test organisms. Assays were conducted in a 96-well minitube format under biosafety level 2 conditions. Control and test wells were sampled immediately after inoculation and after 3 (recombinant M. intracellulare) and 5 (rBCG) days of incubation to measure luminescence with a microplate luminometer, and the relative change in luminescence was calculated as a percentage of control values. As an alternative test method, Alamar blue was added after 12 days of incubation, and changes in color were read visually. A total of 480 extracts were tested. Sixteen extracts were active against rBCG, and of those, seven were also active against recombinant M. intracellulare. With activity defined as a relative change in luminescence of <1% (i.e., >99% inhibition) and a persistence of blue color after addition of Alamar blue, there was 99.0% agreement between the two methods. Our results suggest that the luciferase assay is rapid and accurate and has the potential to greatly accelerate the evaluation of antimycobacterial activity in plant extracts in vitro. With this method, it is possible to screen a large number of samples in a short period of time. MATERIALS AND METHODSMycobacterial strains. The strains used in this study were the M. bovis BCG substrain Connaught (ATCC 35745) and M. intracellulare ATCC 35761. The integrating shuttle vector pMV361 was constructed and electroporated into rBCG and M. intracellulare as described previously (10).Culture and growth conditions. Stock strains of mycobacteria were maintained in 7H9 broth with 15% glycerol at Ϫ80ЊC. Subcultures of the microorganisms were made in Middlebrook 7H9 broth (Difco, Detroit, Mich.) containing 10% ADC (albumin-dextrose-catalase) enrichment (BBL, Cockeysville, Md.), 0.05% Tween 80 (BBL), and 20 g of kanamycin (Sigma, St. Louis, Mo.)/ml. Cultures of rBCG and recombinant M. intracellulare were incubated in an ambient atmosphere for 48 and 24 h, respectively. Following incubation, the culture suspension was sonicated for 10 s with a VibraCell Sonicator (Sonics & Materials, Inc., Danbury, Conn.). To prepare the inoculum, the sonicated culture was diluted in Middlebrook 7H9 broth without kanamycin to an optical density at 540 nm of 0.05. This procedure yielded a suspension containing approximately 10 7 CFU/ml, as confirmed by a plate count on 7H11 agar (Remel, Lenexa, Kans.). This diluted suspension was used to inoculate test trays as described below, resulting in a final inoculum of 5 ϫ 10 5 CFU/ml in the reaction tube.

BackgroundHIV and TB programs have rapidly scaled-up over the past decade in Sub-Saharan Africa and uninterrupted supplies of those medicines are critical to their success. However, estimates of stock-outs are largely unknown. This survey aimed to estimate the extent of stock-outs of antiretroviral and TB medicines in public health facilities across South Africa, which has the world’s largest antiretroviral treatment (ART) program and a rising multidrug-resistant TB epidemic.MethodsWe conducted a cross-sectional telephonic survey (October—December 2015) of public health facilities. Facilities were asked about the prevalence of stock-outs on the day of the survey and in the preceding three months, their duration and impact.ResultsNationwide, of 3547 eligible health facilities, 79% (2804) could be reached telephonically. 88% (2463) participated and 4% (93) were excluded as they did not provide ART or TB treatment. Of the 2370 included facilities, 20% (485) reported a stock-out of at least 1 ARV and/or TB-related medicine on the day of contact and 36% (864) during the three months prior to contact, ranging from 74% (163/220) of health facilities in Mpumalanga to 12% (32/261) in the Western Cape province. These 864 facilities reported 1475 individual stock-outs, with one to fourteen different medicines out of stock per facility. Information on impact was provided in 98% (1449/1475) of stock-outs: 25% (366) resulted in a high impact outcome, where patients left the facility without medicine or were provided with an incomplete regimen. Of the 757 stock-outs that were resolved 70% (527) lasted longer than one month.InterpretationThere was a high prevalence of stock-outs nationwide. Large interprovincial differences in stock-out occurrence, duration, and impact suggest differences in provincial ability to prevent, mitigate and cope within the same framework. End-user monitoring of the supply chain by patients and civil society has the potential to increase transparency and complement public sector monitoring systems.

Gambling is a socially acceptable form of recreation for older adults, but excessive gambling can lead to negative financial consequences and mental health problems. The lack of attention given to gambling problems among older adults has been highlighted in the literature for over a decade. The objectives of this review were to examine relevant literature on interventions for prevention and treatment of problem gambling (PG) among older adults and to identify research gaps. To this end, we conducted a scoping review of both quantitative and qualitative research, focusing on adult studies. Because of the lack of PG research specific to older adults, we focused our review on prevention and treatment among adult studies that covered a wide age range. Our literature search, conducted in a range of bibliographic databases, located 7,632 titles. After duplicates were eliminated, 4,268 records remained; 2,321 were excluded based on title and 1,247 remained after abstract review. Three independent assessors reviewed the full text of 700 articles and found 247 that met our inclusion/exclusion criteria. We identified a paucity of research on prevention and treatment of problem gambling specific to older adults, with the gaps in evidence even greater for prevention. We found only six studies specific to adults aged 55 years and older. Studies on older women are severely lacking. We conclude with some suggestions for future research.RésuméLe jeu est une forme de loisir socialement acceptable pour les personnes en âge avancé, mais le jeu excessif peut entraîner des conséquences financières graves et des problèmes de santé mentale. Depuis plus d’une décennie, le manque d’attention accordée aux problèmes de jeu chez les personnes âgées a été souligné dans la littérature. Cette étude avait pour but d’examiner les ouvrages portant sur les interventions de prévention et le traitement du jeu problématique chez les personnes âgées et de cerner les lacunes dans la recherche. À cette fin, on a entrepris un examen de l’étendue de la recherche quantitative et qualitative axée sur les études sur les adultes. En raison de l’absence de recherche sur le jeu compulsif propre aux adultes âgés, nous avons axé notre examen sur la prévention et le traitement dans les études pour adultes couvrant plusieurs tranches d’âge. Notre revue de la littérature, menée dans diverses bases de données bibliographiques, a permis de répertorier 7 632 titres. Après l’élimination des doublons, il est resté 4268 titres; 2321 ont été exclus sur la base du titre et nous en avons conservé 1247 après la lecture des résumés. Trois évaluateurs indépendants ont examiné le texte intégral de 700 articles et ont repéré 247 articles qui répondaient à nos critères d’inclusion/d’exclusion. Nous avons constaté un manque de recherche sur la prévention et le traitement du jeu problématique propre aux personnes âgées, et des lacunes encore plus évidentes au chapitre de la prévention. Nous avons trouvé seulement six études portant spécifiquement sur les adultes âgés de 55 ans et plus. Les études sur les femmes d’âge mûr font cruellement défaut. Nous avons conclu en donnant quelques suggestions pour de futures recherches.

Experience with delamanid (Dlm) is limited, particularly among HIV-positive individuals. We describe early efficacy and safety data from a programmatic setting in South Africa.This was a retrospective cohort study of patients receiving Dlm-containing treatment regimens between November 2015 and August 2017. We report 12-month interim outcomes, sputum culture conversion (SCC) by months 2 and 6, serious adverse events (SAEs) and QT intervals corrected using the Frederica formula (QTcF).Overall, 103 patients were initiated on Dlm; 79 (77%) were HIV positive. The main indication for Dlm was intolerance to second-line anti-tuberculosis (TB) drugs (n=58, 56%). There were 12 months of follow-up for 46 patients; 28 (61%) had a favourable outcome (cure, treatment completion or culture negativity). Positive cultures were found for 57 patients at Dlm initiation; 16 out of 31 (52%) had SCC within 2 months and 25 out of 31 (81%) within 6 months. There were 67 SAEs reported in 29 patients (28%). There were four instances of QTcF prolongation >500 ms in two patients (2%), leading to permanent discontinuation in one case; however, no cardiac arrhythmias occurred.This large cohort of difficult-to-treat patients receiving Dlm for rifampicin-resistant TB treatment in a programmatic setting with high HIV prevalence had favourable early treatment response and tolerated treatment well. Dlm should remain available, particularly for those who cannot be treated with conventional regimens or with limited treatment options.