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Aim Transanal total mesorectal excision (TaTME) has been suggested as a potential solution for the resection of challenging mid and low rectal cancer. This relatively complex procedure has been implemented in many centres over the last years, despite the absence of long‐term safety data. Recently, concern has arisen because of an increase in local recurrence in the implementation phase. The aim of this study was to assess the correlation between accumulated experience and local recurrences. Method An independent clinical researcher performed an external audit of consecutive series of all TaTME procedures in six centres in the Netherlands. Kaplan–Meier estimated local recurrence rates were calculated and multivariate Cox proportional hazards regression analysis performed to assess risk factors for local recurrence. Primary outcome was the local recurrence rate in the initial implementation (cases 1–10), continued adoption (cases 11‐40) and prolonged experience (case 41 onward). Results Six hundred and twenty‐four consecutive patients underwent TaTME for rectal cancer with a median follow‐up of 27 months (range 1–82 months). The estimated 2‐ and 3‐year local recurrence rates were 4.6% and 6.6%, respectively. Cox proportional hazards regression revealed procedural experience to be an independent factor in multivariate analysis next to advanced stage (ycMRF+, pT3‐4, pN+) and pelvic sepsis. Corrected analysis projected the 3‐year local recurrence rates to be 9.7%, 3.3% and 3.5% for the implementation, continued adoption and prolonged experience cohorts, respectively. Conclusion This multicentre study shows a high local recurrence rate (12.5%) after implementation of TaTME which lowers to an acceptable rate (3.4%) when experience increases. Therefore, intensified proctoring and further precautions must be implemented to reduce the unacceptably high risk of local recurrence at units starting this technique.

The number of individuals initiating antiretroviral pre-exposure prophylaxis (PrEP) is increasing, but we do not fully understand who is coming forward for PrEP, how they use it and how they are followed-up. The objective of this study was to examine PrEP user profiles, dynamics in PrEP use and follow-up over time.We conducted a cohort analysis of longitudinally collected clinical record and questionnaire data among PrEP users at an HIV centre in Antwerp, Belgium, between June 2017 and March 2020. PrEP follow-up and user profiles were examined using descriptive analyses and bivariate logistic regression. We compared early adopting PrEP users (started before June 2018) with late users. We also calculated the probabilities of switching between daily and on-demand PrEP, and interruption, using a naïve estimator.We included 1347 PrEP users in the analysis. After 12 months, retention in care was 72.3%. Median time between PrEP visits was 98 days (IQR 85-119 days). At screening visit, early adopting PrEP users (starting June 2017-May 2018) were significantly more likely to report one or more sexually transmitted infection in the prior 12 months, having used drugs during sex, a higher number of sexual partners and a history of paid sex and PrEP use prior to initiation, compared with PrEP users who initiated later (starting June 2018-February 2020). When taking PrEP daily, the probability of staying on daily PrEP at the next visit was 76%, while this was 73% when taking PrEP on-demand. Those using on-demand PrEP had a higher probability (13%) of interrupting PrEP care than daily PrEP users (7%), whereas those returning to PrEP care would mostly re-start with on-demand (35% vs. 13% for daily).The majority of PrEP users in this sample remained in care after 12 months. The probability of remaining on the same PrEP regimen at the subsequent visit was high. Though, we observed a diversity of transitions between regimens and interruptions in between visits. Our findings reaffirm the need to provide tailored PrEP services, counselling PrEP users across their life course.

IntroductionDaily and event-driven PrEP are both efficacious in reducing the risk for HIV infection. However, the practice of event-driven PrEP (edPrEP) is less well studied, in particular when provided as an alternative to daily PrEP. We studied regimen preferences and switches, and sexually transmitted infection (STI) incidence.MethodsWe analysed pooled data from two prospective cohort studies among MSM: Be-PrEP-ared, Belgium and AMPrEP, the Netherlands. In both projects, participants could choose between daily and edPrEP at three-monthly study visits, when they were also screened for sexually transmitted infections including hepatitis C (HCV). We assessed the proportion choosing each regimen, and the determinants of choosing edPrEP at baseline. Additionally, we compared the incidence rates (IRs) of HCV, syphilis and chlamydia or gonorrhoea between regimens using Poisson regression. The study period was from 3 August 2015 until 24 September 2018.Results and discussionWe included 571 MSM, of whom 148 (25.9%) chose edPrEP at baseline. 31.7% of participants switched regimen at least once. After 28 months, 23.5% used edPrEP. Older participants (adjusted odds ratio (aOR) = 1.38 per 10 years, 95% confidence interval (CI) = 1.15 to 1.64) and those unemployed (aOR = 1.68, 95% CI = 1.03 to 1.75) were more likely to initially choose edPrEP. IR of HCV and syphilis did not differ between regimens, but the IR of chlamydia/gonorrhoea was higher among daily users (adjusted incidence rate ratio = 1.61, 95% CI = 1.35 to 1.94).ConclusionsA quarter of participants chose edPrEP at baseline and at 28 months this proportion was similar. Although the IR of HCV and syphilis were similar in the two regimens, the lower incidence of chlamydia and gonorrhoea among edPrEP users may suggest that less frequent STI testing of this group could be considered.

Objective: the aim of this study was to investigate the association of obesity with in-hospital coronavirus disease 2019 (COVID-19) outcomes in different ethnic groups.Methods: patients admitted to hospital with COVID-19 in the United Kingdom through the Clinical Characterisation Protocol UK (CCP-UK) developed by the International Severe Acute Respiratory and emerging Infections Consortium (ISARIC) were included from February 6 to October 12, 2020. Ethnicity was classified as White, South Asian, Black, and other minority ethnic groups. Outcomes were admission to critical care, mechanical ventilation, and in-hospital mortality, adjusted for age, sex, and chronic diseases.Results: of the participants included, 54,254 (age = 76 years; 45.0% women) were White, 3,728 (57 years; 41.1% women) were South Asian, 2,523 (58 years; 44.9% women) were Black, and 5,427 (61 years; 40.8% women) were other ethnicities. Obesity was associated with all outcomes in all ethnic groups, with associations strongest for black ethnicities. When stratified by ethnicity and obesity status, the odds ratios for admission to critical care, mechanical ventilation, and mortality in black ethnicities with obesity were 3.91 (3.13-4.88), 5.03 (3.94-6.63), and 1.93 (1.49-2.51), respectively, compared with White ethnicities without obesity.Conclusions: obesity was associated with an elevated risk of in-hospital COVID-19 outcomes in all ethnic groups, with associations strongest in Black ethnicities.

Objective To report on the results of three size estimations of the populations of female sex workers (FSW) in five cities in Cote d'Ivoire and on operational lessons learned, which may be relevant for key populations programs in other parts of the world. Methods We applied three methods: mapping and census, capture-recapture and service multiplier. All were applied between 2008 and 2009 in Abidjan, San Pedro, Bouake, Yamoussoukro and Abengourou. Results Abidjan was the city with the highest number of FSW by far, with estimations between 7880 (census) and 13714 (service multiplier). The estimations in San Pedro, Bouake and Yamoussoukro were very similar, with figures ranging from 1160 (Yamoussoukro, census) to 1916 (San Pedro, capture-recapture). Important operational lessons were learned, including strategies for mapping, the importance of involving peer sex workers for implementing the capture-recapture and the identification of the right question for the multiplier method. Conclusions Successful application of three methods to estimate the population size of FSW in five cities in Cote d'Ivoire enabled us to make recommendations for size estimations of key population in low income countries. This article is protected by copyright. All rights reserved.

Objective The incidence of HIV and sexually transmitted infections is disproportionately high among sex workers (SW). We aimed to update the evidence on the effectiveness of SW interventions in sub-Saharan Africa and to provide more insights into combination prevention. Methods Systematic review following PRISMA guidelines in a search of PUBMED and POPLINE for peer-reviewed literature published between January 1, 2000 and July 22, 2016 (registration number on PROSPERO: CRD42016042529). We considered cohort interventions, randomized controlled trials, and cross-sectional surveys of SW programs. A framework was used in the description and mapping of intervention to desired outcomes. Results 26 papers (reporting on 25 studies) were included. A strategy that empowered peer educator leaders to steer community activities showed a twofold increase in coverage of behaviour change communication and utilization of health facility among SW. Brief alcohol harm reduction effort demonstrated a significant effect on sexual violence and engagement in sex trading. A risk reduction counselling intervention among drug-injecting SW showed an effect on alcohol, substance use and engagement in sex work. No study on a promising intervention like PrEP among SWs was found. We observed that interventions that combined some structural components, biomedical and behavioural strategies tend to accumulate more desired outcomes. Conclusion The evidence base that can be considered in intervention designs to prevent HIV in SW in SSA is vast. The health sector should consider interventions to reduce binge alcohol intake and intravenous drug use among sex workers. Programs should staunchly consider multi-component approaches that explore community-based structural approaches. This article is protected by copyright. All rights reserved.

Introduction Pre‐Exposure Prophylaxis (PrEP) is highly effective in reducing the risk for HIV infection among men who have sex with men (MSM) and may have an important impact in slowing down the HIV epidemic. Concerns remain however about low adherence, increased risk behaviour and reduced condom use when using PrEP. The aim of this study was to assess these factors prospectively among MSM using daily and event‐driven PrEP in Belgium. Methods An open‐label prospective cohort study was conducted from October 2017 to May 2018 at the Institute of Tropical Medicine, in Antwerp, Belgium. At enrolment, MSM at high risk for HIV chose between daily or event‐driven PrEP. They were allowed to switch regimens or stop taking PrEP at each of their tri‐monthly visits. Data were collected on an electronic case report form, web‐based diary and self‐administered questionnaire. Screening for HIV and other Sexually Transmitted Infections (STIs) was also performed. Results Two hundred MSM were followed up for a total duration of 318 person‐years. At month 18, 75.4% of the participants were on daily and 24.6% were on event‐driven PrEP. The mean proportion of covered sex acts by PrEP for the complete follow‐up period was 91.5% for all participants, 96.5% for daily and 67.0% for event‐driven PrEP use. The number of casual and anonymous sex partners was significantly higher for daily users, as compared with event‐driven users, but did not change over time. In contrast, the mean proportion of condomless receptive anal intercourse with casual and anonymous partners increased significantly during follow‐up, for both daily and event‐driven use (p

Cardiovascular disease is the principal complication and the leading cause of death for patients with diabetes (DM). The efficacy of anti-hyperglycemic treatments on cardiovascular disease risk remains uncertain. Cardiovascular risk factors are affected by anti-hyperglycemic medications, as are many intermediate markers of cardiovascular disease. Here we summarize the evidence assessing the cardiovascular effects of anti-hyperglycemic medications with regards to risk factors, intermediate markers of disease, and clinical outcomes.

Because seed yield is the major factor determining the commercial success of grain crop cultivars, there is a large interest to obtain more understanding of the genetic factors underlying this trait. Despite many studies, mainly in the model plant Arabidopsis thaliana, have reported transgenes and mutants with effects on seed number and/or seed size, knowledge about seed yield parameters remains fragmented. This study investigated the effect of 46 genes, either in gain- and/or loss-of-function situations, with a total of 64 Arabidopsis lines being examined for seed phenotypes such as seed size, seed number per silique, number of inflorescences, number of branches on the main inflorescence and number of siliques. Sixteen of the 46 genes, examined in 14 Arabidopsis lines, were reported earlier to directly affect in seed size and/or seed number or to indirectly affect seed yield by their involvement in biomass production. Other genes involved in vegetative growth, flower or inflorescence development or cell division were hypothesized to potentially affect the final seed size and seed number. Analysis of this comprehensive data set shows that of the 14 lines previously described to be affected in seed size or seed number, only nine showed a comparable effect. Overall, this study provides the community with a useful resource for identifying genes with effects on seed yield and candidate genes underlying seed QTL. In addition, this study highlights the need for more thorough analysis of genes affecting seed yield.

CLE peptides are involved in the balance between cell division and differentiation throughout plant development, including nodulation. Previously, two CLE genes of Medicago truncatula, MtCLE12 and MtCLE13, had been identified whose expression correlated with nodule primordium formation and meristem establishment. Gain-of-function analysis indicated that both MtCLE12 and MtCLE13 interact with the SUPER NUMERIC NODULES (SUNN)-dependent auto-regulation of nodulation to control nodule numbers. Here we demonstrate that cytokinin, which is essential for nodule organ formation, regulates MtCLE13 expression. In addition, simultaneous knockdown of MtCLE12 and MtCLE13 resulted in an increase in nodule number, implying that both genes play a role in controlling nodule number. Additionally, a weak link may exist with the ethylene-dependent mechanism that locally controls nodule number.

In multicellular organisms, morphogenesis relies on a strict coordination in time and space of cell proliferation and differentiation. In contrast to animals, plant development displays continuous organ formation and adaptive growth responses during their lifespan relying on a tight coordination of cell proliferation. How developmental signals interact with the plant cell-cycle machinery is largely unknown. Here, we characterize plant A2-type cyclins, a small gene family of mitotic cyclins, and show how they contribute to the fine-tuning of local proliferation during plant development. Moreover, the timely repression of CYCA2;3 expression in newly formed guard cells is shown to require the stomatal transcription factors FOUR LIPS/MYB124 and MYB88, providing a direct link between developmental programming and cell-cycle exit in plants. Thus, transcriptional downregulation of CYCA2s represents a critical mechanism to coordinate proliferation during plant development.

Summary objective To estimate the female sex worker population size in three cities in Cote d'Ivoire and in Kisumu, Kenya. methods Capture-recapture was used, calculating size estimates by first 'tagging' a number of individuals and, through an independent recapture, calculating the proportion of overlap. The same procedures were used in all four cities. In the first phase, members of the target population were 'captured' and 'marked' by giving them a capture card. Six days later, in the same places and at the same time, a second sample was 'captured', which comprised a certain number of people who were captured in the first round. During the exercise, questions were asked to estimate the coverage of the sex worker clinics. results Using capture-recapture, the estimated number of female sex workers was 1160 in Yamoussoukro (95% CI 1053-1287), 1202 in Bouake ´ (95% CI 1128-1279), 1916 in San Pedro (95% CI 1809-2030) and 1350 in Kisumu (95% CI 1261-1443). The proportion of female sex workers in Cote d'Ivoire who had visited the clinic ranged from 15% in Yamoussoukro to 30% in San Pedro and was 34% in Kisumu. conclusions Capture-recapture was successfully applied to estimate the population size of female sex workers. These estimations were urgently needed to help mobilize an increased response to HIV, to assess programme coverage and to estimate potential impact of the targeted intervention.

Our aim was to assess if peri-operative blood transfusion is an independent risk factor for mortality and morbidity in the elderly. We report the results of a cohort study of all patients aged 80 or more on the day of their emergency or elective cardiac surgery (n = 874), using routinely collected data from January 2003 to November 2007. The primary outcome was all-cause mortality in hospital. The secondary outcomes were duration of stay in the intensive care unit (ICU) and overall hospital stay. Confounding variables were used to build up a risk model using a multivariable logistic regression analysis, and blood transfusion was added to assess whether it had additional predictive value for hospital mortality. Patients were divided into three groups: (i) transfusion of 0-2 units of red blood cells; (ii) transfusion of > 2 units of red blood cells and (iii) transfusion of red blood cells plus other clotting products. The strongest independent predictors of hospital death were logistic EuroSCORE and body mass index. After inclusion of these two variables, the odds ratio for transfusion remained significant. Relative to 0-2 units, the odds ratio for > 2 units was 6.80 (95% CI 2.46-18.8), and for other additional blood products was 14.4 (95% CI 5.34-37.3), with a p value of 2 units of red blood cells and 3 (1-76 [0-114]) days if other clotting products were used; p value < 0.001). Hospital stay was also associated with the amount of red cells used (p < 0.001).

A comprehensive transcriptome analysis by means of cDNA-amplified fragment length polymorphism (AFLP) and cDNA-microarray technology was performed in order to gain further understanding of the molecular mechanisms of immediate transcriptional response to ethylene. Col-0 plants were treated with exogenous ethylene and sampled at six different time-points ranging from 10 min until 6 h. In order to isolate truly ethylene-responsive genes, both the ethylene-insensitive mutant ein2-1 and the constitutive mutant (ctr1-1) were analysed in parallel by cDNA-AFLP while ein2-1 was included for the microarray experiment. Out of the cDNA-transcript profiling covering about 5% of the Arabidopsis transcriptome, 46 ethylene-responsive genes were isolated, falling in different classes of expression pattern and including a number of novel genes. Out of the 6008 genes present on the chip, 214 genes were significantly (alpha = 0.001) differentially expressed between Col-0 and ein2-1 over time. Cluster analysis and functional grouping of co-regulated genes allowed to determine the major ethylene-regulated classes of genes. In particular, a large number of genes involved in cell rescue, disease and defence mechanisms were identified as early ethylene-regulated genes. Furthermore, the data provide insight into the role of protein degradation in ethylene signalling and ethylene-regulated transcription and protein fate. Novel interactions between ethylene response and responses to several other signals have been identified by this study. Of particular interest is the overlap between ethylene response and responses to abscisic acid, sugar and auxin. In conclusion, the data provide unique insight into early regulatory steps of ethylene response.

In plants, hydrogen peroxide (H(2)O(2)) plays a major signaling role in triggering both a defense response and cell death. Increased cellular H(2)O(2) levels and subsequent redox imbalances are managed at the production and scavenging levels. Because catalases are the major H(2)O(2) scavengers that remove the bulk of cellular H(2)O(2), altering their levels allows in planta modulation of H(2)O(2) concentrations. Reduced peroxisomal catalase activity increased sensitivity toward both ozone and photorespiratory H(2)O(2)-induced cell death in transgenic catalase-deficient Arabidopsis thaliana. These plants were used as a model system to build a comprehensive inventory of transcriptomic variations, which were triggered by photorespiratory H(2)O(2) induced by high-light (HL) irradiance. In addition to an H(2)O(2)-dependent and -independent type of transcriptional response during light stress, microarray analysis on both control and transgenic catalase-deficient plants, exposed to 0, 3, 8, and 23 h of HL, revealed several specific regulatory patterns of gene expression. Thus, photorespiratory H(2)O(2) has a direct impact on transcriptional programs in plants.

The definitive version is available at www3.interscience.wiley.com, ObjectivesTo evaluate the quality and usefulness of integrated sexually transmitted infection (STI) care at non-governmental family planning (FP) clinics in Côte d'Ivoire. MethodsEvaluation components included: (1) a survey measuring the prevalence of STI and the predictive value of the Ivorian vaginal discharge treatment algorithm, (2) client exit interviews, (3) direct observations of client–provider contacts, (4) the monitoring of the clinics' workload and available equipment and supplies and (5) interviews of programme managers and FP providers. ResultsAmong 368 FP clients surveyed, the prevalence of Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, B. vaginosis and Candida albicans were respectively 1.6, 5.7, 7.1, 44.8 and 5.2%. The positive predictive value of the national algorithm for the detection of cervicitis was only 6.3%, and was 17.9% among a subgroup of young, single women. Of 200 clients interviewed, 96% were satisfied with the services and 95% would return to the FP clinic if they had genital problems. In 215 observed client–provider contacts, 88% of 94 STI cases were correctly managed. Programme managers and providers reported no substantial work overload as a result of the integration of STI services. ConclusionsThe prevalence of cervical infections is relatively low in this population and the Ivorian algorithm that treats all women with vaginal discharge performs poorly. Over-treatment of cervicitis can be reduced by modifying the algorithm, although improved diagnostic tools are urgently needed to detect cervicitis in this population. Continued STI case management at the FP clinics is nevertheless justified because there exists an easily identifiable group of higher risk women who need STI care; and because of the demand by a large proportion of clients, the high prevalence of vaginal pathogens, and the limited costs to the FP programme.

BACKGROUND In a cohort of patients, the authors investigated whether and to what extent the sentinel lymph node (SLN) status contributes to predicting the probability of remaining disease free for at least 3 years. In addition, several traditional prognostic factors were analyzed: Breslow thickness, Clark invasion level, ulceration, lymphatic invasion, location, type of the melanoma, and age and gender of the patient. METHODS In 263 consecutive patients with proven American Joint Committee on Cancer Stages I and II cutaneous melanoma, the triple technique SLN procedure was used, i.e., preoperative visualization of the lymph channels from the initial site of the melanoma toward the SLN by (dynamic) lymphoscintigraphy, intraoperative visualization of those particular lymph channels and lymph nodes with blue dye, and a gamma probe to measure accumulated radioactivity in radiolabeled lymph nodes. Median follow-up time was 48 months (range, 36–84 months). Multivariate logistic regression analysis was performed to examine the influence of the SLN status and several other prognostic factors on a minimum 3-year disease free survival. RESULTS In 20% of patients, the SLN proved to be tumor positive. For SLN negative patients, the 5-year disease free survival rate was 91% (± 2.4%), and for SLN positive patients it was 49% (± 9%). Five variables showed a strong and statistically significant independent prognostic association with outcome, i.e., SLN status (P = 0.0007), thickness of primary melanoma (1.01–2.0 mm; P = 0.04), ulceration (P = 0.05), and lymphatic invasion (P = 0.01) of primary melanoma, and age (40–50 years; P = 0.01). CONCLUSIONS The SLN status—along with Breslow thickness, ulceration, lymphatic invasion, and age—seems to have strong additional value in predicting a minimum 3-year disease free period after the SLN procedure. Patients with a positive SLN have a poorer prognosis than those with a negative SLN. Cancer 2001;91:2401–8. © 2001 American Cancer Society.

The definitive version is available at www3.interscience.wiley.com, Summary objective To recommend a cost-effective approach for the management of acute male urethritis in the developing world, based on the findings of a theoretical study. methods A model was developed to assess the cost-effectiveness of three urethritis management strategies in a theoretical cohort of 1000 men with urethral syndrome. (1) All patients were treated with cefixime and doxycycline for gonococcal urethritis (GU) and nongonococcal urethritis (NGU), respectively, as recommended by WHO. (2) All patients were treated with doxycycline for NGU; treatment with cefixime was based on the result of direct microscopy of a urethral smear. (3) All patients were treated with cotrimoxazole or kanamycin for GU and doxycycline for NGU. Cefixime was kept for patients not responding to the first GU treatment. Strategy costs included consultations, laboratory diagnosis (where applicable) and drugs. The outcome was the rate of patients cured of urethritis. Cost-effectiveness was measured in terms of cost per cured urethritis. results Strategy costs in our model depended largely on drug costs. The first strategy was confirmed as the most effective but also the most expensive approach. Cefixime should cost no more than US$ 1.5 for the strategy to be the most cost-effective. The second strategy saved money and drugs but proved a valuable alternative only when laboratory performance was optimal. The third strategy with cotrimoxazole was the least expensive but a low follow-up visit rate, poor treatment compliance or lower drug efficacy limited effectiveness. Maximizing compliance by replacing cotrimoxazole with single-dose kanamycin had the single greatest impact on the effectiveness of the third strategy. conclusion Our model suggested that a cost-effective approach would be to treat gonorrhoea with a single-dose antibiotic selected from locally available products that cost no more than US$ 1.5.

A set (if 51 elite maize (Zea mays L.) inbred lines representative of the early-maturing European flint and dent heterotic groups were assayed for amplified fragment length polymorphisms (AFLP) markers using eight primer combinations. Our main objectives were to (i) investigate the amount of variation for AFLP markers in these materials, (ii) examine the usefulness of AFLP markers for assigning inbred lines to heterotic groups, and (iii) compare the genetic similarity (GS) based on AFLP markers with Malecot's coancestry coefficient (f) based on pedigree data and with GS estimates based on restriction fragment length polymorphisms (RFLPs) and random amplified polymorphic DNA (RAPD) data. The eight AFLP primer combinations yielded 462 polymorphic bands. GS estimates calculated from AFLP data ranged between 0.38 and 0.77 between unrelated (f=0) pairs of lines. All flint and dent inbreds showed a smaller mean GS to lines from the other heterotic group than to unrelated lines from the same heterotic group. For lines of mixed origin, the difference in mean GS to flint lines and to dent lines was consistent with the expected genomic proportions from each heterolic group determined on the basis of pedigrees. Principle coordinate analysis of GS estimates resulted in a separate grouping of flint and dent lines. Correlations between f and GS estimates were substantially higher for RFLPs and AFLP markers than for RAPDs. Correlations of GS estimates based on different marker systems were closest between RFLP and AFLP markers both for related (J > 0) and unrelated (f=0) pairs of flint and dent lines. Results from this study corroborate the usefulness of AFLP markers for (i) assigning inbreds into heterotic groups and (ii) revealing pedigree relationships among lines.

Micropropagated plants of 36 Musa genotypes with diverse genetic backgrounds, including 14 tetraploid plantain (TMPx) and banana (TMBx) hybrids, were evaluated for their response to banana streak badnavirus (BSV) infection under three environments from 1995 to 1997 in Nigeria. The characteristics evaluated were the natural incidence of BSV based on symptoms and virus indexing, relative concentration of BSV antigens in leaf tissues determined by ELISA, and some growth and yield descriptors. Virus occurrence and symptom expression, as well as the relative concentration of BSV antigens, fluctuated greatly between seasons during the cropping cycle, being high during the rainy season and low or negligible during the hot dry season. The natural incidence of plants with symptoms and BSV-infected plants varied between genotypes. Incidence of BSV on most International Institute of Tropical Agriculture (IITA) TMPx hybrids and three Fundacion Hondureoa de Investigacion Agricola (FHIA) hybrids was high in the three environments, with some variation. Most landraces and some FHIA or Empresa Brasileira de Pesquisa Agropecuaria (EMBRAPA) hybrids were not BSV-infected under either environment at Onne. However, a few expressed some foliar symptoms at Ibadan and indexed BSV positive. The relative concentration of BSV antigens in leaf samples was also high in most TMPx and some FHIA hybrids, but low in most landraces. While BSV infection had no significant effect on most growth characteristics, it had a highly variable effect on bunch weight loss among the genotypes. There was no relationship between the natural incidence of BSV, concentration of viral antigen and bunch weight loss among the 11 TMPx hybrids, three FHIA hybrids and three plantain landraces. Despite the high natural BSV incidence and the high relative antigen concentration in their leaf tissue, TMPx 548-9, TMPx 2637-49, TMPx 7002-1 and FHIA 21 suffered less than 15% bunch weight loss, and TMPx 548-4 and FHIA 22 suffered no loss. These results suggest that under the conditions specified in this study, these hybrids could be tentatively classified as ‘field tolerant’ to BSV.

Prosthetic outcome and patient satisfaction were evaluated in order to investigate whether there is a need or advantage to splint two implants in the mandible retaining a hinging overdenture. This study included 36 fully edentulous patients randomly divided into three groups according to the attachment system they received: magnets, ball attachments or straight bars (reference group). None of the implants failed during the whole observation period in any of the groups. After 5 years of observation, the Bar group presented the highest retention capacity and the least prosthetic complications but revealed more mucositis and gingival hyperplasia. Patient satisfaction rated similar for all groups although the Magnet group showed lower retention forces. All patients would repeat the same treatment even though the majority of the Magnet group would prefer a more retentive solution because of limited denture stability.