text:
Police investigate series of overnight robberies along Fountain Blvd
Crews respond to fire at Fountain Creek riverbed overnight in Pueblo
Inmate death at El Paso County Jail under investigation
Project to improve former 'No Man's Land' in El Paso County officially finished
From "No Man's Land," to the Westside Avenue Action Project, to Adams Crossing has been the evolution of a 1.5-mile stretch along Colorado Avenue between Colorado Springs and Manitou Springs.
On Friday, nearly three years after construction began in January 2017, officials cut a ribbon to symbolize the official end of the improvement project.
The event was held along a redirected section of Fountain Creek, near the new Adams Crossing Bridge at the intersection of Colorado Avenue and Columbia Road.
The project cost nearly $31 million and was a joint effort involving Colorado Springs, Manitou Springs, El Paso County and numerous governmental and community planning groups.
The area was called "No Man's Land" because it was outside city and county boundaries and had deteriorated over the past several decades. It's now within the county's jurisdiction.
Officials say the project will provide a natural and scenic connection between Colorado Springs and Manitou Springs -- a connection that is more import with recent growth in tourism and local population.
The project eliminates a lane of traffic in each direction but adds bike lanes, sidewalks, curbs, gutters, street lights and landscaping.
"It's going to be a safer way to travel for vehicles, bikes and pedestrians," said Stan VanderWerf, an El Paso County Commissioner whose district includes the project. "We think it will eventually bring more economic development."
Many merchants along the stretch said they lost business for three summers and two Christmas holidays but hope the lost business and customers will eventually return.
The bridge was rebuilt for better flood control and overhead power lines were placed underground.
Obstacles such as removing large boulders, old utility lines, a former railroad line and hundreds of old tires caused several delays in the project.
The project manager said work is "98% complete" with some finishing touches to be applied through next spring.
Officials also have given the area its original name of Adams Crossing, in honor of Gen. Charles Adams, a key local figure during the late 1800s who lived there.
Archive / Business / Colorado Springs / Local / Local News / Money / Must See Videos / News / News Videos / Video
Sunshine for Sunday
Yeah more bike lanes no one will use.
new email old me says:
Even when we put them in they won't use them. Drive up and down mark dabling there's some nice bike path off the road. No way will the stupid cyclist use it. When was just hit today. Riding your bike on the road is stupid choice. You put your life in someone else's hands.
mouse says:
That project nearly destroyed Manitou.
RealityCheck says:
Sallie Clark sure loves to see herself in the news… 🤢


Analyzing data for the 100 largest districts in the South and Border states, we ask whether there is evidence of "resegregation" of school districts and whether levels of segregation can be linked to judicial decisions. We distinguish segregation measures based on racial isolation from those based on racial imbalance. Only one measure of racial isolation suggests that districts in these regions experienced resegregation between 1994 and 2004, and changes in this measure appear to be driven largely by the rising nonwhite percentage in the student population rather than by district policies. Although we find no time trend in racial imbalance over this period, we find that variations in racial imbalance across districts are nonetheless associated with judicial declarations of unitary status, suggesting that segregation in schools might have declined had it not been for the actions of federal courts. © 2006 Oxford University Press.


When you think of your favorite brand, what exactly do you think of? What are the exact associations you make with the company? Our subconscious constantly seeks out ways to connect us to a product or service. A first step in creating a brand voice that speaks to those who care to listen starts with positive association and reputation.
Think of these three questions as you start the conversation with your audience. What keywords relate to the core of who you are? What do you offer? And why should people care? Sounds easy, but it's quite complex. When your audience is seeking a new outfit, gadget, movie, or service, they are going to use their senses, past experiences, or guided information to make a justified decision. You want your audience's thoughts to align with your overall mission, as it determines how well your audience will connect to your offerings.
People Buy From People: As you become more familiar with your target market, you can tailor your marketing content to those within your network. Once you solidify words and phrases that matter to your audience, you can communicate that value effortlessly. By creating a persona, you are conditioning yourself to speak with clear intention as a human that cares. Ideally, you are having a conversation with another person that matters to you (i.e., a friend, partner, family member) while triggering language that compels action from your audience.
Become Top Of Mind: Some companies have embedded their branding so deep into the minds of their consumers that people automatically associate certain companies to a specific product. For example, Kleenex is synonymous with tissue, and that association has become a natural link and reflex in people's minds - that is powerful marketing. Becoming synonymous with your product or service is the ultimate goal as you will reside in people's minds a lot longer. You also want to become synonymously associated with positive company values and elements that are important to your audience as you will resonate longer in their subconscious.
Don't Get Lost In Translation: If you are unsure of what your company represents, how will anyone else know? Become familiar with words and phrases that can be misleading to your audience. Reduce any misrepresentation of the brand itself. When the word Dove is mentioned, do you think of a bird, chocolate or the skin care product? Your answer may differ depending on the context, however as mentioned earlier when a company becomes synonymous with a certain product or industry they are not easily confused, no matter the context. This phenomenon becomes apparent when a company practices and maintains a clear and direct message with its audience. Practices makes perfect, this takes a lot of work.
Leave A Lasting Impression: Lastly, establish an emotional connection with your audience. Trigger an emotional response and make them feel something. In the end, people will support a company that aligns with their own morals, values and goals. Establish brand loyalty through positive association. These words will guide your marketing efforts, and connect your products and services to the people and their hearts.


DOWN – "On Game Design"
Pushbutton Engine wasn't working out well for this project. PBE is feature-rich but doesn't have a few things I needed, like tile-maps with good collision detection. It's also much more complicated than I need for this project — I found I was spending more time wrangling my way through PBE than I was making things.
So I switched the project over to flixel, another flash game engine.
It's pretty simple (I had something up and running in a few minutes) and has the bonus of working REALLY well with the dungeon generation code I made.


text:
Paddington: The Movie Storybook (Paddington movie)
By Harper Collins (Author)
List Price: Rs.350
Our Price: Rs.350
Packed with photos from the wonderful Paddington movie.Re-live the story of how Paddington arrives in London, meets the Brown family and gets involved in lots of mayhem and adventure in his new home city! Packed with photos from the wonderful Paddington movie.Re-live the story of how Paddington arrives in London, meets the Brown family and gets involved in lots of mayhem and adventure in his new home city!
Title : Paddington: The Movie Storybook (Paddington movie)
Author : Harper Collins
Publisher : HarperCollins Children's Books
Oh, Baby, The Places You'll Go! (Dr. Seuss) By Harper Collins Children Books Rs.750
{"price":"750.00","category":"Children","name":"Oh, Baby, The Places You'll Go! (Dr. Seuss)","id":"1341200-66464308452"} { "name": "Oh, Baby, The Places You'll Go! (Dr. Seuss)", "id": "200697736", "price": "750.00", "brand": "", "category": "", "variant": "", "list": "", "position": "" } { "name": "Oh, Baby, The Places You'll Go! (Dr. Seuss)", "id": "200697736", "category": "", "brand": "", "variant": "", "position": "", "price": "750.00" }
The Grinch: Movie Colouring Book (Grinch … By Nil Rs.199
{"price":"199.00","category":"Colouring Book","name":"The Grinch: Movie Colouring Book (Grinch Movie Tie In)","id":"1341200-61710331186"} { "name": "The Grinch: Movie Colouring Book (Grinch Movie Tie In)", "id": "200724816", "price": "199.00", "brand": "", "category": "", "variant": "", "list": "", "position": "" } { "name": "The Grinch: Movie Colouring Book (Grinch Movie Tie In)", "id": "200724816", "category": "", "brand": "", "variant": "", "position": "", "price": "199.00" }
The Grinch: Movie Sticker Book (Grinch Movie … By Nil Rs.399
{"price":"399.00","category":"Activity And Puzzles","name":"The Grinch: Movie Sticker Book (Grinch Movie Tie In)","id":"1341200-62768732135"} { "name": "The Grinch: Movie Sticker Book (Grinch Movie Tie In)", "id": "200724817", "price": "399.00", "brand": "", "category": "", "variant": "", "list": "", "position": "" } { "name": "The Grinch: Movie Sticker Book (Grinch Movie Tie In)", "id": "200724817", "category": "", "brand": "", "variant": "", "position": "", "price": "399.00" }
Everything, Eveything(Movie Tie) By Nicola Yoon Rs.399
{"price":"399.00","category":"Young Fiction","name":"Everything, Eveything(Movie- Tie)","id":"1341200-62730920757"} { "name": "Everything, Eveything(Movie- Tie)", "id": "200692543", "price": "399.00", "brand": "", "category": "", "variant": "", "list": "", "position": "" } { "name": "Everything, Eveything(Movie- Tie)", "id": "200692543", "category": "", "brand": "", "variant": "", "position": "", "price": "399.00" }
Goosebum The Movie: Night By Stine R L Rs.195
{"price":"195.00","category":"Young Fiction","name":"Goosebum The Movie: Night","id":"1341200-71417749644"} { "name": "Goosebum The Movie: Night", "id": "200625781", "price": "195.00", "brand": "", "category": "", "variant": "", "list": "", "position": "" } { "name": "Goosebum The Movie: Night", "id": "200625781", "category": "", "brand": "", "variant": "", "position": "", "price": "195.00" }
Wonder (Movie Tie In) By Palacio R J Rs.399
{"price":"399.00","category":"Young Fiction","name":"Wonder (Movie Tie- In)","id":"1341200-44873550786"} { "name": "Wonder (Movie Tie- In)", "id": "200701139", "price": "399.00", "brand": "", "category": "", "variant": "", "list": "", "position": "" } { "name": "Wonder (Movie Tie- In)", "id": "200701139", "category": "", "brand": "", "variant": "", "position": "", "price": "399.00" }
Barbie I Can Be A Movie Reporter By Nil Rs.295
{"price":"295.00","category":" Fairy Tales And Fables","name":"Barbie I Can Be A Movie Reporter","id":"1341200-65787088543"} { "name": "Barbie I Can Be A Movie Reporter", "id": "200691019", "price": "295.00", "brand": "", "category": "", "variant": "", "list": "", "position": "" } { "name": "Barbie I Can Be A Movie Reporter", "id": "200691019", "category": "", "brand": "", "variant": "", "position": "", "price": "295.00" }
American Sniper[ Movie Tie In Edition] By Chris Kyle Author Rs.450
{"price":"450.00","category":"Biography And Autobiographies","name":"American Sniper[ Movie Tie- In Edition]","id":"1341200-37869983886"} { "name": "American Sniper[ Movie Tie- In Edition]", "id": "200593373", "price": "450.00", "brand": "", "category": "", "variant": "", "list": "", "position": "" } { "name": "American Sniper[ Movie Tie- In Edition]", "id": "200593373", "category": "", "brand": "", "variant": "", "position": "", "price": "450.00" }
Discussion:Paddington: The Movie Storybook (Paddington movie)
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redpajama_set_name: RedPajamaCommonCrawl


text:
Federal Court Strikes Down Exxon Valdez Damage Award
By Russell GoldStaff Reporter of The Wall Street Journal
Aug. 24, 2003 11:54 am ET
A federal appeals court again struck down a punitive damages award against Exxon Mobil Corp. for the 1989 Exxon Valdez oil spill, meaning the giant oil company may end up paying only a fraction of the jury's original $5 billion penalty.
On Friday, the Ninth U.S. Circuit Court of Appeals in San Francisco sent the damages award back to a lower court in Anchorage, Alaska, for the second time in two years.
In a significant victory for the Irving, Texas, company in a lengthy legal battle, the appellate court cited a recent U.S. Supreme Court case that severely limits jury awards. It suggested that punitive damages under certain circumstances should be no more than actual damages. In the Exxon Valdez case, the actual damages award was $287 million.
Exxon, using a different method of calculating the damages, says that under its reading of the Supreme Court ruling in the State Farm v. Campbell case, the trial judge should lower the punitive damages to roughly $25 million.
"We will continue to pursue this case until we are satisfied that a fair decision has been made," said Exxon spokesman Tom Cirigliano.
Viator:
Viator 2021 Valentine's Day tours at $32+
Groupon:
Groupon promo code for an additional 20% off your order


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text:
James: Focus on Utah's immigration problem, not everyone else's
Immigration issues have been receiving a lot of media coverage and the chairman of the Cache County Republican Party says the issues have been inflaming a lot of passion. David James says he would like to see some of the rhetoric toned down. James admitted there are issues with immigration that need work. "But, more than anything, I would like to see Utah focus on Utah's problems, not Arizona's problems, not Texas's problems, not anyone else's problems," James says. "I think that we are a unique state. It's why we have 50 individual states." James also expresses a frustration with some people within his own party on this issue. "We have people who cry, 'state's rights,' and then they want to run around copying what other states are doing," he continues. "I'm not sure that's exactly the best approach for things." James says he feels there are some unique situations in Utah that deserve attention within the context of the state of Utah.


Linux & Apache have existed in tandem for some time now and are one of the most well-known server setups. Learn why.
Linux is an Operating System, that is not that widely used for desktop machines, but is among the most commonly used OSs for web servers. It's free of charge, so you shall not need to pay any license charges as part of your hosting payments. Linux is additionally regarded as being the most secure OS these days and because of the permissions that files have as well as the file types that can be run, virus files that can easily infect an average PC will simply not be executed on a Linux-based server. In addition, the Operating System is free, so it could be modified without any limits, so as to match the requirements of the hosting provider and their clients. This means that needless software packages can easily be removed to make the OS lighter and a lot quicker, that may directly lead to a lot better hosting server performance. Many Linux machines have the Apache web server set up on them, since this software is also 100 % free, quick and secure. It's the most commonly used web server out there and is a part of the LAMP bundle that lots of script apps, including WordPress and Joomla™, require. LAMP is an abbreviation for Linux, Apache, MySQL and PHP.
When you get a semi-dedicated server account for your sites, you will be able to take full advantage of a protected and stable hosting service on our groundbreaking hosting platform. Linux-powered clusters of machines will provide you with the system resources and the uptime that you require, as this Operating System satisfies our requirements and allows us to customize the software environment as a way to get the most out of the platform, whose architecture contributes to the speed and reliability of the service even more, since your files, databases, e-mails, statistics, and so forth., will have their own group to deal with them. To enhance the functionality of your Internet sites even further, we use the Apache web server, mainly because our experience reveals that it is the most suitable one for our custom platform because it's potent, yet light and fast.


We'll be teaching our second Creative Compass-themed workshop at Kripalu in Western Massachusetts, and it's not too late to join us.
• Plot a course from inspiration to publication.
Read more on the Kripalu blog.
Back next week with more from our series on writing and publishing The Creative Compass!


The most important thing to remember with this dish is not to add the shallot oil until the end of cooking. Drizzle the shallot oil on just before serving as cooking with it will destroy the aromas. You can also garnish with spring onion but never use ginger and make sure you don't add the garnish to the scallops during cooking as this will change the flavours of the dish.
"Rezept aus Hunan: Scallops in spicy sauce"


with our Yellow Rice (see recipe, right) alongside. If you don't have queso fresco on hand for garnish, feta will work too.
Nutrients per serving (1/2 of recipe): calories: 684, total fat: 25 g, sat. fat: 4 g, monounsaturated fat: 15 g, polyunsaturated fat: 4 g, carbs: 66 g, fiber: 23 g, sugars: 7 g, protein: 52 g, sodium: 535 mg, cholesterol: 103 mg.
Season chicken with oregano, cumin and pepper. In a large sauté pan on high, heat 1 tbsp oil. Add chicken and cook until browned, about 2 minutes per side. Transfer chicken to a plate.
To same pan on medium, heat remaining 1 tbsp oil. Add chiles and toast for 2 minutes, stirring occasionally. Add tomatoes, chopped onion, smashed garlic cloves and tortilla; simmer 3 minutes. Stir in broth, bring to a boil, reduce heat to medium-low, and return chicken to pan. Cover and cook until an instant-read thermometer inserted into thickest part of chicken registers 165°F, about 5 minutes. Remove chicken; purée tomato mixture in a food processor; season with salt.
Meanwhile, prepare beans: In a small saucepan on medium-high, heat 2 tsp oil. Add minced onion and minced garlic and cook until onion is translucent and garlic is fragrant. Stir in beans to heat through; season with salt. If using, garnish servings with cilantro, lime wedges and queso fresco.


text:
Kiss Me Deadly (1955)
TYPE OF FILM: Noir
STUDIO: United Artists
EXECUTIVE PRODUCER: Victor Savile
PRODUCER: Robert Aldrich
DIRECTOR: Robert Aldrich
SCREENWRITER: A.E. Bezzerides
SOURCE: Kiss Me, Deadly, novel by Mickey Spillane
Ralph Meeker … Mike Hammer
Albert Dekker … Dr. Soberin
Paul Stewart … Carl Evello
Cloris Leachman … Christina Bailey
Wesley Addy … Pat Chambers
Marian Carr … Friday
Maxine Cooper … Velda
Gaby Rodgers … Gabrielle/ Lily Carver
When Kiss Me Deadly was filmed, Mickey Spillane, the author of the book on which it was based, was the most successful writer in the world. By the 1960s, his books had sold more than 100,000,000 copies worldwide, and by the 1970s, a survey of the best-selling fiction of the twentieth century showed seven of the top ten sellers of all time were the seven books written by Spillane; The Godfather topped the list.
The liberal media loathed Spillane and his work, and one critic asked him his opinion of a readership that would put him in such a rarefied position. Spillane warned him that, if the critic didn't watch out, he'd write three more books.
The motion pictures made from those books were another matter. United Artists, seeing the record-breaking sales of Spillane's novels, decided to capitalize on this extraordinary popularity and made a four-film contract. I, the Jury (1953), the first book, was also the first film, starring Biff Elliot as Spillane's hero, Mike Hammer. It was made in 3-D but, instead of being a box office smash as anticipated, grossed a respectable but unexciting $1,299,000.
The second and easily the best of the Mike Hammer films was Kiss Me Deadly, which grossed only $726,000—a failure.
The third, My Gun Is Quick (1957) starred Robert Bray as Hammer and had a U.S. gross of only $308,000—a disaster.
Finally, in 1963, Spillane himself played the tough Hammer in The Girl Hunters, doing a better job of it than most would have expected. There was a lot of publicity, but not much box office. The gross of The Girl Hunters was not regarded warmly by United Artists, and they did not sign up any more Spillane films.
Driving along a dark, deserted road, Mike Hammer nearly hits Christina, a terrified woman who is running barefoot down the middle of it. He picks her up, and soon his car is forced off the road and some gangsters knock him out and torture the girl with pliers, eventually killing her. Her body and Hammer are put back in his car and pushed off a cliff. He survives and vows to find out who she was and why she was murdered.
His curiosity becomes inflamed when the FBI warns him to drop his investigations, and Hammer finds a gangster, Carl Evello, who is ostensibly in charge of the operation but who clearly has a powerful boss. In an attempt to get Hammer to lay off, the gangsters kill his mechanic and friend by dropping a car on him, crushing him, and kidnapping his secretary, Velda.
Hammer deduces that the murdered woman had swallowed a key that may be at the center of the case and convinces the morgue attendant to get it for him. Hammer uses the key to open the locker with a box inside, and when he opens the box, a strong, eerie light emanates from it, burning his hand.
Christina's roommate, Lily Carver, manages to get the box and takes it to Dr. Soberin, the brains behind the operation. Hammer traces them to a beach house where Velda has been held hostage and where Lily insists they open the box. Soberin explains that the nuclear material, recently stolen from Los Alamos to be sold to a foreign power, is too dangerous, so she shoots him dead and wounds Hammer. Just as Mike and Velda flee from the little cottage, Lily opens the box, the intense heat causing her to burst into flames and the house to explode.
A violent and exciting film, Kiss Me Deadly became a major influence on French New Wave directors, fond as they are of the darkest side of mankind and relentlessly attracted to nihilism. Although it was not a box office success and was largely unloved by movie reviewers of the day, it has grown in stature over the years and is today a big cult favorite.
Cloris Leachman made her film debut in Kiss Me Deadly as Christian Bailey, the escapée from an insane asylum.
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Detection of ureaplasmas and bacterial vaginosis associated bacteria and their association with non-gonococcal urethritis in men
Maria Frølund ,
Contributed equally to this work with: Maria Frølund, Lars Falk
Roles Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Resources, Visualization, Writing – original draft, Writing – review & editing
Affiliation Research Unit for Reproductive Microbiology, Statens Serum Institut, Copenhagen S, Denmark
Lars Falk ,
Roles Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Resources, Writing – original draft, Writing – review & editing
Affiliation Department of Dermatovenereology, Linköping University Hospital and Linköping University, Linköping, Sweden
Peter Ahrens,
Roles Conceptualization, Methodology, Resources, Writing – review & editing
Jørgen Skov Jensen
Roles Conceptualization, Formal analysis, Funding acquisition, Methodology, Project administration, Resources, Supervision, Validation, Visualization, Writing – review & editing
* E-mail: jsj@ssi.dk
Maria Frølund,
Lars Falk,
Maria Frølund Lars Falk Peter Ahrens Jørgen Skov Jensen
No aetiology is found in up to 40% of men with symptomatic urethritis. Male partners of women with bacterial vaginosis (BV) may be at higher risk of non-gonococcal urethritis (NGU). The aim of this study was to examine the role of BV associated bacteria in first-void urine (FVU) in 97 asymptomatic men without urethritis (controls) and 44 men (cases) with NGU including 20 men with idiopathic urethritis (IU) attending a Swedish STD-clinic between January and October 2010. BV-associated bacteria and ureaplasmas were detected by quantitative PCR assays. All BV associated bacteria, except Megasphaera-like type 1, were strongly positively correlated with U. urealyticum p<0.005 and even stronger with the combined U. urealyticum and U. parvum load (p<0.0005) suggesting that ureaplasma induced elevated pH may stimulate the growth of BV associated bacteria. No statistically significant differences were found between IU cases and controls in the prevalence or load of BV associated bacteria or ureaplasmas. In multiple logistic regression, Megasphaera-like type 1 was associated with IU (p = 0.03), but most positive FVU samples contained very few bacteria and the finding may not be clinically relevant.
Citation: Frølund M, Falk L, Ahrens P, Jensen JS (2019) Detection of ureaplasmas and bacterial vaginosis associated bacteria and their association with non-gonococcal urethritis in men. PLoS ONE 14(4): e0214425. https://doi.org/10.1371/journal.pone.0214425
Editor: David N. Fredricks, Fred Hutchinson Cancer Research Center, UNITED STATES
Received: January 15, 2019; Accepted: March 12, 2019; Published: April 4, 2019
Copyright: © 2019 Frølund et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are within the manuscript and its Supporting Information files.
Funding: This study was supported by ALF-Grant LIO-60221; ALF-Grant LIO-60311; ALF-Grant LIO-205751, to LF, all from County Council of Östergötland, Sweden, https://www.researchweb.org/is/lio/. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: MF, LF, and PA have no conflicts; JSJ has received speaker's fee from Hologic, BD and Cepheid and serves scientific advisory boards of Roche Molecular Systems, Abbott Molecular, and Cepheid. SSI has received remuneration for contract work from SpeeDx, Hologic, NYTor, Diagenode, Abbott, Nabriva, GSK, and Angelini. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
Symptoms of urethritis is a common reason for attendance at sexually transmitted diseases (STD) clinics and in most cases, urethritis is caused by sexually transmitted pathogens [1]. In Scandinavia, non-gonococcal urethritis (NGU) is much more common than urethritis caused by Neisseria gonorrhoeae, although there has been a steady increase of reported cases of N. gonorrhoeae in the last decade from 7 to 25 cases per 100,000 inhabitants in Sweden [2, 3]. NGU is characterised by inflammation of the male urethra and symptoms such as urethral discharge and dysuria are common. However, asymptomatic urethritis with microscopically documented inflammation on stained urethral smears is frequent and well documented for Chlamydia trachomatis, Mycoplasma genitalium and Ureaplasma urealyticum [4–6]. If left untreated, C. trachomatis infection and probably M. genitalium infection may be transmitted to female partners and cause pelvic inflammatory disease and infertility. No aetiology is found in the up to 40% of male urethritis cases where known pathogens such as C. trachomatis, M. genitalium, N. gonorrhoeae, Trichomonas vaginalis, U. urealyticum, herpes simplex virus type 1 and 2, and adenovirus have been excluded [7, 8].
It has been suggested that male partners to women with bacterial vaginosis (BV) are at a higher risk of NGU [1, 9, 10], but this has not been widely studied. BV, present in 10–20% of Scandinavian women [11, 12], is the most common vaginal infection in women with symptoms such as abnormal vaginal discharge, foul odour, itching and burning, although many women have no symptoms or have been accustomed to the condition [13]. It has been associated with a higher risk of preterm birth, HIV transmission, acquisition of other STDs and pelvic inflammatory disease [14, 15]. BV is characterized as an imbalance of the normal bacterial microbiota in the vagina where lactobacilli are reduced and replaced by anaerobic bacteria, the most frequently Gardnerella vaginalis, Atopobium vaginae, Prevotella spp., Eggerthella-like uncultured bacteria, Megasphaera-like type 1, Sneathia spp. and Bacterial Vaginosis Associated Bacterium– 2 (BVAB-2) [16].
However, little is known about the presence of BV associated bacteria in men and their association with NGU. One study found that male partners to women with BV were more likely to suffer from NGU [17] and a more recent study showed one of the key BV associated species Sneathia amnii (previously Leptotrichia amnionii) or S. sanguinegens to be associated with male NGU [10]. In men, first void urine has been shown to be an excellent proxy for the urethral microbiota [18] and since this sample type is non-invasive, this is the preferred sample for studies of the urethral microbiota. Next generation sequencing methods and sequencing the 16S rRNA gene in urine have shown that BV associated bacteria such as Prevotella spp., Gardnerella spp., Mobiluncus spp, Veillonella spp., Atopobium spp. and Megaspherea spp. are found in both sexually experienced and inexperienced men [19, 20].
The aim of this study was to examine the role of selected BV associated bacteria: G. vaginalis, BVAB-2, Eggerthella-like uncultured bacteria, Megasphaera-like type 1, S. amnii, A. vaginae, S. sanguinegens and Prevotella spp as well as U. parvum in urine specimens from men with and without NGU attending an STD clinic. These species were selected based on their strong association with BV in a previous study [21, 22] and because U. parvum is found very frequently in the female lower genital tract; however, the role of this species is still disputed [23].
The study was a cross-sectional case-control study in men attending a Swedish STD-clinic.
Patients and specimens
Men attending the STD clinic in Norrköping, Sweden were included in this study as they took part in a cross-sectional study of prevalence, signs and symptoms of various bacterial STIs among 614 men. Patients selected for the present study were enrolled between January 2010 and October 2010. Men without symptoms and signs of urethritis by microscopy serving as controls in this study, attended the clinic for a check-up for STIs (42%) or as part of contact tracing of patients with STIs (55%); 2% attended for erectile dysfunction. Cases and controls negative for C. trachomatis and M. genitalium were consecutively selected for the present study. In addition, the first nine C. trachomatis positive and the first nine M. genitalium cases, all negative for U. urealyticum and U. parvum and still fulfilling the inclusion criteria were selected aiming to control for associations with BV associated bacteria in men with known causes of urethritis. All selected samples were analysed by polymerase chain reaction (PCR) for adenovirus [6, 24], HSV 1 and 2 and selected BV associated bacteria [22].
Data were collected on a standard questionnaire regarding the reasons for attendance, age, symptoms of urethritis (dysuria and discharge), number of sexual partners within the last year and life-time sexual partners, condom use at the first sexual intercourse with a new partner, sexual intercourse with men (MSM), previous STIs, antibiotic treatment within the last month, current partner (yes or no), whether the partner had a current STI and if so which STI. The patients' identity was coded and the variables noted in a database.
Urethral smears were obtained from all patients with a blunt curette and stained with methylene blue. All smears were examined with a Zeiss (standard 14) light microscope by the physician. Patients with dysuria and/or discharge and smears showing ≥5 polymorphonuclear leukocytes (PMNL) per high-power (×1,000) microscopic field (hpf) in more than 4 hpfs were defined as having urethritis. Low grade urethritis was defined as 5–9 PMNL/hpf, Medium grade as 10–30 PMNL/hpf, and high grade as >30 PMNL/hpf. The controls had no symptoms of urethritis and had urethral smears with <5 PMNL/hpf. They had no other symptoms or signs of genital disease such as ulcers, itching, warts or rash. Neither cases nor controls had received antibiotics within the previous month prior to enrolment.
When N. gonorrhoeae was suspected by microscopy (intracellular diplococci) or due to high-risk behaviour, culture was performed, and if positive, the patient was excluded. The patients had not voided within at least one hour before sampling. After the clinical examination, the patient was asked to collect approximately 20 mL of first void urine; 7–13 mL was immediately decanted into 1.1 mL Genelock transport medium (Sierra Molecular Corp., Sonoma, CA, USA) and sent the same day by mail to Statens Serum Institut (SSI), Copenhagen, Denmark. Specimens were received and DNA extracted in the laboratory within a median of 5 days (mean 4.5 days; range 2–22 days) after they had been collected. From the remaining urine, 3 mL was collected in a Multi-collect tube (Abbott, IL, USA) and analysed at the Linköping University Hospital laboratory within two days for C. trachomatis using the Abbott m2000 system. DNA was extracted from 400 μL according to the manufacturer's protocol. This assay employs two separate targets of the cryptic plasmid detecting also the new variant C. trachomatis, which is common in Sweden and described initially in 2007 [25]. Trichomonas vaginalis was not included in the screening panel as this organism is extremely rare in the population under study.
PCR assays
All other PCR assays were performed at SSI, Copenhagen. Urine samples in Genelock medium were concentrated by centrifugation of 1,900 μL at 30,000×g for 15 min. The pellet was resuspended in 300 μL of a 20% Chelex-100 slurry (BioRad, Hercules, CA) in TE-buffer (10 mM Tris-HCL [pH 8.0], 1 mM EDTA) and incubated at 95° for 10 minutes as previously described [26].The prepared samples were stored at –20°C until PCR was performed.
M. genitalium was detected by real-time PCR targeting the MgPa-gene [26] and confirmed by conventional PCR targeting the 16S rRNA gene [27]. Macrolide resistance-mediating mutations were demonstrated by sequencing region V of the 23S rRNA gene in M. genitalium positive samples [28]. For detection of U. urealyticum and U. parvum, a multiplex PCR targeting the urease gene was used [29].
HSV 1 and 2 were detected with a multiplex real-time Taqman based PCR assay [6]. The primers produced a <100-basepair fragment of the Envelope Glycoprotein G and D in HSV 1 and 2, respectively. Target specific HSV 1 and 2 probes were labelled with FAM and VIC, respectively. Adenovirus was detected with real-time PCR amplifying the hexon gene using the primerset AdF1 and AdR1 [24].
Detection of the BV associated bacteria G. vaginalis, BVAB-2, Eggerthella-like uncultured bacteria, Megasphaera-like type 1, S. amnii, A. vaginae, S. sanguinegens and Prevotella sp. was performed by qPCR as previously described [6, 22]. These species were selected based on their strong association with BV [21, 22]. All qPCR results were expressed as DNA copies per mL of the original urine sample.
Men attending the STD clinic in Norrköping, Sweden were included in this study as they took part in a cross-sectional study of prevalence, signs and symptoms of various bacterial STIs among 614 men. Patients selected for the present study were enrolled between January 2010 and October 2010. The study was approved by the regional research ethical committee of Linköping (protocol # M 134–09). All men received written and oral information about the study and all provided written informed consent.
All samples were coded and analysed anonymously in the SSI research laboratory. Routine testing for STIs at Linköping University Hospital laboratory was performed without anonymization according to standard procedures.
Fisher´s exact test and odds-ratios with confidence intervals were used for dichotomous variables, the Mann-Whitney test for continuous variables, Spearman's correlation coefficients and multiple logistic regression and other statistical analyses were calculated in StatsDirect (StatsDirect Ltd., Cheshire, UK).
Graphs were produced in GraphPad Prism (GraphPad Software, Inc., La Jolla, CA, USA).
Significance level was 5%, and two-sided results were used throughout.
Characteristics of included patients
A total of 141 patients were included of which 97 men were asymptomatic controls and 44 were symptomatic cases. In the latter group, 20 men were negative for C. trachomatis, M. genitalium, HSV, adenovirus and U. urealyticum and defined as having idiopathic urethritis (IU) (Fig 1).
Fig 1. Flowchart showing included male patients (n = 141) and the different subgroups.
C. trachomatis (Ct), M. genitalium (Mg), U. urealyticum (Uu), Idiopatic urethritis (IU).* 26 samples were U. urealyticum positive. †One sample was double-infected with HSV type 1 and M. genitalium.‡ One sample was double-infected with HSV type 1 and U. urealyticum.
Controls (n = 97), patients with IU (n = 20) and NGU patients with known aetiology (n = 24) did not differ with respect to median age, number of life-time sexual partners or partners within the last year, MSM or with respect to habits for condom use at first sexual intercourse with a new partner (Table 1).
Table 1. Characteristics of patients (n = 141) in the groups "Asymptomatic controls", "Symptomatic NGU with known aetiology" and "Symptomatic IU".
The distribution of symptoms in the patients with IU was similar to that of the 24 patients with urethritis with known aetiology for dysuria, discharge and urethral itching 18 (90%) vs. 20 (83%), 10 (50%) vs. 13 (54%) and 3 (15%) vs. 0 (0%), respectively. Neither did the distribution of low, medium, or high-grade urethritis differ between cases with IU and patients with NGU of known aetiology (Table 1).
Distribution of NGU associated organisms
Of the 97 asymptomatic controls, 26 men (27%) were U. urealyticum positive. When excluding the nine C. trachomatis and nine M. genitalium positives, the remaining non-M. genitalium, non-C. trachomatis symptomatic NGU (NMGNCNGU) cases comprised 26 patients (cases) (Fig 1). In this group, four men (15%) were U. urealyticum positive. No difference in U. urealyticum prevalence (positive rate) between controls and cases (p = 0.31) or in bacterial load could be demonstrated (p = 0.31). Twenty-five (26%) controls were U. parvum positive compared with six men in the NMGNCNGU group (23%) (NS). No difference in bacterial load could be demonstrated for U. parvum.
None of the controls were HSV or adenovirus positive. One control was co-infected with U. urealyticum and U. parvum. Among 26 NMGNCNGU cases, one man (4%) was HSV-type 1 positive (1,250 copies/mL and co-infected with U. urealyticum) and two men were adenovirus positive (type D and type F, respectively). Adenovirus was found significantly more frequently among the NMGNCNGU cases (p = 0.04).
Association between U. parvum and BV associated bacteria in IU compared with controls
U. parvum was analysed together with the BV associated bacteria as it was not considered a cause of NMGNCNGU whereas U. urealyticum was excluded from the IU group. None of the BV associated bacteria or U. parvum were found more frequently in the group of symptomatic IU cases (n = 20) than in controls (n = 97) in univariate analysis. The median DNA load for BV associated bacteria and U. parvum did not differ between the controls and the patients with IU (Table 2). There was a trend towards Megasphaera-like type 1 being present more often and in higher loads among men with IU than in controls (p = 0.09 and p = 0.1, respectively).
Table 2. Bacterial vaginosis associated bacteria and Ureaplasma parvum in asymptomatic male controls (n = 97) and in men with symptomatic idiopathic urethritis (n = 20).
Symptomatic IU patients are negative for C. trachomatis, M. genitalium, HSV, adenovirus and U. urealyticum.
The presence of U. parvum and BV associated bacteria was analysed in a multivariate model adjusting for all tested pathogens (Table 3). Megasphaera-like type 1 was associated with urethritis with adjusted odds ratios (ORadj) 4.6 (95% CI 1.2–18.6) (p = 0.03).
Table 3. Adjusted odds ratios (ORadj) with 95% confidence intervals (CI) and p-values in asymptomatic male controls (n = 97) and in men with symptomatic idiopathic urethritis (n = 20) after multivariate logistic regression analysis for eight bacterial vaginosis associated bacteria and Ureaplasma parvum.
G. vaginalis and Prevotella spp. were the BV associated bacteria most commonly found, and they were detected in both patient groups. Seventy-one percent of the controls and 55% of the IU cases were G. vaginalis positive, whereas 70% and 80% respectively were Prevotella spp. positive (NS) (Table 2).
Relationship between urethral inflammation and ureaplasmas and BV associated bacteria
The bacterial load of ureaplasmas and BV associated bacteria was analysed according to the stratified urethral inflammatory response (<5; 5–10; >10 PMNL/hpf) for all men included in the study regardless of the cause of urethritis. Only 10 men had low-grade urethritis (5–10 PMNL/hpf) but the combined U. urealyticum and U. parvum load was significantly lower (p = 0.009) in this group than in the asymptomatic controls. The only other significant difference was seen for G. vaginalis which was found to have a higher median load in controls than in men with high grade urethritis (p = 0.03) suggesting a possible suppression of this species by the inflammatory response.
Co-occurence between BV associated bacteria and ureaplasma in all samples
Just from looking at the unanalysed data, it was obvious that BV associated bacteria were present mainly in ureaplasma positive samples, and for both ureaplasma species, the bacterial load of all BV associated bacteria except Megasphaera-like type 1 were found to correlate with the ureaplasma load (data not shown). As it was speculated that the production of ammonia from urea by the ureaplasmas with the associated increase in pH could be the explanation for the increased bacterial load of BV associated bacteria, the combined ureaplasma DNA load (U. urealyticum plus U. parvum) was compared with the DNA load of each of the eight BV associated bacteria in all 141 samples (Fig 2). All BV associated bacteria, except Megasphaera-like type 1 (p = 0.63), were strongly positively correlated with the total ureaplasma load (p<0.0001–p<0.0005) using Spearman's correlation coefficient. The strongest correlation was found for G. vaginalis (Rho = 0.60), the weakest for BVAB2 (Rho = 0.29).
Fig 2. Comparison of the eight BV associated bacteria and total ureaplasma load (U. urealyticum and U. parvum) in all 141 samples.
Regression lines are shown.
The correlation between BV associated bacteria and ureaplasmas was weaker when the two ureaplasma species, U. parvum and U. urealyticum were compared separately.
In this cross-sectional case-control study, the role of eight BV associated bacteria in men with idiopathic urethritis (IU) was examined. G. vaginalis, BVAB-2, Eggerthella-like bacteria, Megasphaera-like type 1, S. amnii, A. vaginae, S. sanguinegens and Prevotella species were found equally often in men with IU and in controls. However, in a multivariate model adjusting for all tested pathogens, Megasphaera-like type 1 was associated with urethritis with an ORadj of 4.6, but the bacterial load of this species was very low and thus, the association is most likely not clinically relevant.
BV-associated species have been detected in penile skin, semen and urine specimens by others [10, 19, 30]. Although there is no strong evidence that male partners to women with BV should be prescribed antibiotics to prevent recurrence, a study by Liu et al. showed that the BV-like microbiota in the coronal sulcus skin specimens had a close match to the vaginal microbiota of their female partners [31]. The role of anaerobic bacteria as a cause of urethritis in men is still unclear. In this study only Megasphaera-like type 1 was associated with IU with an ORadj of 4.6 and there was a trend towards it being detected more often and in higher loads in IU than in controls although this did not reach statistical significance. Megasphaera-like type 1 is a recently discovered vaginal bacterium and has not yet been placed in a taxonomic group. It is susceptible to metronidazole and clindamycin in vitro [32]. Further studies are suggested to confirm the importance of this finding. In the present dataset, Megasphaera-like type 1 was present in a very low abundance in five of the 20 IU patients, thus, a cut-off such as has been suggested to increase the specificity of the detection of U. urealyticum [6] could not be calculated.
Manhart et al. found that S. amnii (previously Leptotrichia amnionii) and/or S. sanguinegens was more common in men with NGU than in controls [10], but this finding was not confirmed in the present study although the assay used in the present study did not cross-react with S. sanguinegens. Even if the sum of S. amnii and S. sanguinegens was used in the analysis, the two Sneathia species were neither more common nor present at higher loads in IU patients than in asymptomatic controls (p = 0.82 and 0.73, respectively). It is unclear, however, how the assay developed by Fredricks et al. [33] differs in the inclusivity of other Sneathia species as compared to the sum of the two species specific assays used in the present study. Similarly, we were not able to replicate our previous finding that U. urealyticum is associated with NMGNCNGU [6]. The reasons for these discrepancies are not clear, but our study was limited by the relatively small number of NMGNCNGU cases (n = 24) enrolled. In the present study, we further eliminated the U. urealyticum and virus positive patients to yield a strictly defined group of symptomatic IU, which limited the number of cases to 20. Actually, in order to obtain a power of 0.8 with a p-value of 0.05, an odds-ratio in univariate analysis should be as high as 10 in order to demonstrate a significant association with this number of cases and controls and this is a significant limitation of the study. On the other hand, none of the studied bacterial species, except for Megaspaera-like type I and Prevotella spp showed OR>1.5 in univariate analysis whereas several of the studied species showed ORs <1. Thus, expanding the study may not have changed the conclusions.
To our surprise, all BV associated bacteria, except Megasphaera-like type 1, were found to have an increasing bacterial load with increasing total ureaplasma load. This correlation existed even after including a subset of patients with urethritis caused by C. trachomatis or M. genitalium. The correlation was present for both ureaplasma species when analysed separately, but increased when the bacterial load from U. parvum and U. urealyticum, was summed. Other studies examining the female vaginal microbiota using sequencing and/or species specific PCRs have not shown this relationship [34]. This could possibly suggest a symbiotic relationship found only in the urethra and possibly just the male urethra. It could be speculated that the presence of ureaplasmas resulted in an elevated pH due to the release of ammonia from urea hydrolysis, the main energy-generating mechanism used in ureaplasmas. Similar to the suggestions that alkalinisation of vaginal fluid by menstruation and semen increases the growth of BV associated microbiota [35], the same pH change elicited by ureaplasmas in the urethra where an abundance of urea is available, could play a role. As the correlation between ureaplasma and BV associated bacteria was found unexpectedly a long time after sample collection, pH measurements of the urethral secretions were not possible. Nothing is known about the pH gradient along the urethra in urethritis patients and in healthy men, but with the development of pH micro-sensors it would be possible to study this in relation to the microbiota composition. The role of U. urealyticum in male NGU is still not settled, as studies have shown diverging results [5, 6, 36, 37] and the present study did not find any correlation.
The strength of the study is the broad testing for suspected NGU pathogens and the use of well-validated quantitative PCR assays for ureaplasmas and BV associated bacteria. A major limitation is the low number of IU cases examined and possibly the inclusion of asymptomatic controls attending for partner tracing. If BV was present in a large proportion of the female partners due to the strong association between chlamydia and BV, a possible difference may have been masked. In Sweden, contact tracing is mandatory according to the legislation. Usually, contact tracing reaches back one year, and thus, many partners had the contact before the index person acquired her chlamydial infection. One Swedish study reported that 35% of notified partners, where the outcome from testing was known were in fact C. trachomatis test negative [38], and all controls in the present study were C. trachomatis negative. That the status of the asymptomatic control may have some influence was suggested by a higher load of G. vaginalis in the 56 asymptomatic men attending for partner tracing as compared to the 41 men attending for an STI check-up (p = 0.02). However, using only the 41 men attending for check-up as controls for the 20 IU cases, did not change the lack of association between BV-associated bacteria and IU. Furthermore, the association between ureaplasma load and the load of BV-associated bacteria was independent of the urethritis status of the study subjects.
The ureaplasmas were not examined to serotype level, as this marker is not stably associated with the genetic relationship [39]
In summary BV associated bacteria were common in both men with and without urethritis and there was a strong correlation between these bacteria and the total ureaplasma load. These correlations are important to control for in studies of idiopathic urethritis. Megasphaera-like type 1 was associated with IU, but further studies are needed to confirm this finding.
S1 Datafile. Complete dataset with qPCR bacterial load and metadata.
We are most grateful to the staff at the STD-clinic in Norrköping. Susanne Cramer Johansson is thanked for excellent technical assistance.
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14. Peipert JF, Montagno AB, Cooper AS, Sung CJ. Bacterial vaginosis as a risk factor for upper genital tract infection. Am J Obstet Gynecol. 1997;177(5):1184–7. pmid:9396917
15. Haggerty CL, Hillier SL, Bass DC, Ness RB. Bacterial vaginosis and anaerobic bacteria are associated with endometritis. Clin Infect Dis. 2004;39(7):990–5. pmid:15472851
16. Fredricks DN, Fiedler TL, Marrazzo JM. Molecular identification of bacteria associated with bacterial vaginosis. N Engl J Med. 2005;353(18):1899–911. pmid:16267321
17. Keane FE, Thomas BJ, Whitaker L, Renton A, Taylor-Robinson D. An association between non-gonococcal urethritis and bacterial vaginosis and the implications for patients and their sexual partners. Genitourin Med. 1997;73(5):373–7. pmid:9534747
18. Dong Q, Nelson DE, Toh E, Diao L, Gao X, Fortenberry JD, et al. The microbial communities in male first catch urine are highly similar to those in paired urethral swab specimens. PLoS One. 2011;6(5):e19709. pmid:21603636
19. Nelson DE, Dong Q, Van der Pol B, Toh E, Fan B, Katz BP, et al. Bacterial communities of the coronal sulcus and distal urethra of adolescent males. PLoS One. 2012;7(5):e36298. pmid:22606251
20. Frølund M, Wikström A, Lidbrink P, Abu Al-Soud W, Larsen N, Harder CB, et al. The bacterial microbiota in first-void urine from men with and without idiopathic urethritis. PLoS One. 2018;13(7):e0201380. pmid:30052651
21. Shipitsyna E, Roos A, Datcu R, Hallen A, Fredlund H, Jensen JS, et al. Composition of the vaginal microbiota in women of reproductive age—sensitive and specific molecular diagnosis of bacterial vaginosis is possible? PLoS ONE. 2013;8(4):e60670. pmid:23585843
22. Datcu R, Gesink D, Mulvad G, Montgomery-Andersen R, Rink E, Koch A, et al. Vaginal microbiome in women from Greenland assessed by microscopy and quantitative PCR. BMC Infect Dis. 2013;13:480. pmid:24131550
23. Horner P, Donders G, Cusini M, Gomberg M, Jensen JS, Unemo M. Should we be testing for urogenital Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum in men and women?—a position statement from the European STI Guidelines Editorial Board. J Eur Acad Dermatol Venereol. 2018;32(11):1845–51. pmid:29924422
24. Tabrizi SN, Ling AE, Bradshaw CS, Fairley CK, Garland SM. Human adenoviruses types associated with non-gonococcal urethritis. Sex Health. 2007;4(1):41–4. pmid:17382037
25. Ripa T, Nilsson PA. A Chlamydia trachomatis strain with a 377-bp deletion in the cryptic plasmid causing false-negative nucleic acid amplification tests. Sex Transm Dis. 2007;34(5):255–6. pmid:17483723
26. Jensen JS, Björnelius E, Dohn B, Lidbrink P. Use of TaqMan 5' nuclease real-time PCR for quantitative detection of Mycoplasma genitalium DNA in males with and without urethritis who were attendees at a sexually transmitted disease clinic. J Clin Microbiol. 2004;42(2):683–92. pmid:14766837
27. Jensen JS, Borre MB, Dohn B. Detection of Mycoplasma genitalium by PCR Amplification of the 16S rRNA Gene. J Clin Microbiol. 2003;41(1):261–6. pmid:12517858
28. Jensen JS, Bradshaw CS, Tabrizi SN, Fairley CK, Hamasuna R. Azithromycin treatment failure in Mycoplasma genitalium-positive patients with nongonococcal urethritis is associated with induced macrolide resistance. Clin Infect Dis. 2008;47(12):1546–53. pmid:18990060
29. Frølund M, Björnelius E, Lidbrink P, Ahrens P, Jensen JS. Comparison between culture and a multiplex quantitative real-time polymerase chain reaction assay detecting Ureaplasma urealyticum and U. parvum. PLoS ONE. 2014;9(7):e102743. pmid:25047036
30. Plummer EL, Vodstrcil LA, Danielewski JA, Murray GL, Fairley CK, Garland SM, et al. Combined oral and topical antimicrobial therapy for male partners of women with bacterial vaginosis: Acceptability, tolerability and impact on the genital microbiota of couples—A pilot study. PLoS One. 2018;13(1):e0190199. pmid:29293559
31. Liu CM, Hungate BA, Tobian AA, Ravel J, Prodger JL, Serwadda D, et al. Penile Microbiota and Female Partner Bacterial Vaginosis in Rakai, Uganda. MBio. 2015;6(3):e00589. pmid:26081632
32. Petrina M, Cosentino L, Rabe L, Hillier S. Susceptibility of bacterial vaginosis (BV)-associated bacteria to secnidazole, metronidazole, tinidazole and clindamycin. American Journal of Obstetrics & Gynecology. 2016;215(6):S833.
33. Fredricks DN, Fiedler TL, Thomas KK, Oakley BB, Marrazzo JM. Targeted PCR for detection of vaginal bacteria associated with bacterial vaginosis. J Clin Microbiol. 2007;45(10):3270–6. pmid:17687006
34. Onderdonk AB, Delaney ML, Fichorova RN. The Human Microbiome during Bacterial Vaginosis. Clin Microbiol Rev. 2016;29(2):223–38. pmid:26864580
35. Norris Turner A, Carr Reese P, Snead MC, Fields K, Ervin M, Kourtis AP, et al. Recent Biomarker-Confirmed Unprotected Vaginal Sex, But Not Self-reported Unprotected Sex, Is Associated With Recurrent Bacterial Vaginosis. Sex Transm Dis. 2016;43(3):172–6. pmid:26859804
36. Zhang N, Wang R, Li X, Liu X, Tang Z, Liu Y. Are Ureaplasma spp. a cause of nongonococcal urethritis? A systematic review and meta-analysis. PLoS One. 2014;9(12):e113771. pmid:25463970
37. Shimada Y, Ito S, Mizutani K, Sugawara T, Seike K, Tsuchiya T, et al. Bacterial loads of Ureaplasma urealyticum contribute to development of urethritis in men. Int J STD AIDS. 2014;25(4):294–8. pmid:24047884
38. Carre H, Boman J, Osterlund A, Garden B, Nylander E. Improved contact tracing for Chlamydia trachomatis with experienced tracers, tracing for one year back in time and interviewing by phone in remote areas. Sex Transm Infect. 2008;84(3):239–42. pmid:18216154
39. Paralanov V, Lu J, Duffy LB, Crabb DM, Shrivastava S, Methe BA, et al. Comparative genome analysis of 19 Ureaplasma urealyticum and Ureaplasma parvum strains. BMC Microbiol. 2012;12:88. pmid:22646228
Is the Subject Area "Bacterial vaginosis" applicable to this article?
Ureaplasma urealyticum
Is the Subject Area "Ureaplasma urealyticum" applicable to this article?
Chlamydia trachomatis
Is the Subject Area "Chlamydia trachomatis" applicable to this article?
Is the Subject Area "Polymerase chain reaction" applicable to this article?
Prevotella
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Adenoviruses
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Is the Subject Area "Microbiome" applicable to this article?


Cycling, undergraduate research, molecular biology, neuroscience, cancer, public health and Kenyon converged on a recent summer afternoon in a lecture hall at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (widely known as the James).
Six Kenyon students gave presentations on their summer projects, all in collaboration with faculty and researchers at the James. Their work has been a part of the partnership between Kenyon and Pelotonia, the nonprofit organization committed to raising money to support cancer-fighting research at the James.
Pelotonia is a three-day celebration that includes a 100-mile bike ride from Columbus to Gambier (and for the particularly hearty, from Gambier back to Columbus). Kenyon has hosted Pelotonia riders for four years, and during that time, many members of the Kenyon community have participated in this event as riders, volunteers and donors. I will be riding again this year; like many, I have family members and friends who have bravely battled cancer or are still in the fight. I ride in Pelotonia not only to support the cause to end cancer but also in tribute to their courage.
Since its founding in 2008, Pelotonia has raised more than $92 million, and each dollar goes to cancer research. Kenyon students have participated directly in these research efforts, working on everything from mathematical modeling of gene expression in tumor cells associated with metastasizing spheroids, to genetically engineering mouse models to be used in identifying molecular targets for cancer therapies, to probing the relationships between socio-economic parameters and cancer frequencies. The fact that Kenyon students are active participants in such transformative research at a leading medical institute like the James fills me with pride.
In this research work, students are given the tremendous opportunity to put concepts learned in their Kenyon classes into direct practice. They integrate ideas across disciplinary boundaries, combining techniques and approaches from biology, mathematics, chemistry, physics and computer science. And they hone their skills in problem solving, collaboration and communication. The presentations were terrific. And, on a personal note, the talks provided a great chance for me to "geek out" over updates on cutting-edge experimental work.
In the Kenyon 2020 vision, we talk about the importance of providing "high-impact experiences" for all Kenyon students and developing partnerships between Kenyon and other institutions to expand the types of opportunities we can offer to students. These research experiences, and our partnership with the James through Pelotonia, are excellent examples of our efforts in these areas, and this program is an excellent model of what Kenyon can — and will — do as we move forward.
For those of you in central Ohio, I hope that you can join us for Pelotonia here in Gambier Aug. 8, in downtown Columbus Aug. 7 at the kick-off or along the road cheering us on. If you're interested, you can volunteer for Pelotonia, and you can make donations recognizing the efforts of Kenyon riders.


Exciting changes are happening at the 900 organizations taking part in the StEPs program (Standards and Excellence Program for History Organizations).
Our "StEPs Spotlight" blog series highlights accomplishments by participating organizations.
Below is another example of how StEPs is helping organizations take a leap forward by improving policies and practices, opening lines of communication, and setting goals for a bright future.
In 1955, the town of Essex, Connecticut was about to announce its intention, according to news reports from the time, to sell Hills Academy. The 1832 historic school building was no longer useful for classroom space and had been rented to various tenants for many years.
A concerned group of citizens sprang into action and the newly formed Essex Historical Society purchased Hills Academy for one dollar. For the next thirty years, Hills Academy served as the society's meeting house, home to its growing collection, and as exhibition space.
Then in 1985, the Society for the Preservation of New England Antiquities (known now as Historic New England) deeded a historic house, the Pratt House, to EHS and the focus of activity shifted to the Pratt family narrative.
Today, Pratt House continues to interpret 18th century farm life in Essex and the nine generations of Pratt smithies, many of whom lived in the house. The barn on the property houses changing exhibits including an early loom that is worked on by an award winning group of weavers. The beautiful meadow to the rear of the property is the site of the Community Garden and often the scene of community events. Hills Academy now serves as EHS's library, offices, and collections storage in addition to offering meeting space.
The Essex Historical Society serves the three villages of Essex: Centerbrook, Essex and Ivoryton. The organization has one part-time paid professional and approximately 60 hard-working volunteers.
How did your organization become involved with the StEPs program?
In 2015, EHS was one of twenty-three organizations accepted into the StEPs-CT program. StEPs-CT is a two-year program created by Connecticut Humanities with the Connecticut League of History Organizations, in partnership with the Connecticut Historical Society.
Using AASLH's nationwide StEPs program as the foundation, the three Connecticut-based organizations guide local historical societies, historic houses and sites―and even a local library― towards excellence. To the StEPs program they have added a series of hands-on workshops, expert mentors who are on call to help with the rough spots, and a competitive granting fund. The StEPs-CT program is the first in the nation to implement the StEPs curriculum on a statewide level.
What would you say is the most significant change or improvement within the Essex Historical Society as a result of taking part in StEPs?
We have a much better understanding of the structure and procedures necessary to run a historical society in today's world and we have, or know where to find, the tools to achieve that success. Our careful rewriting of our mission and vision statements created a significant change in how we do things on a daily and weekly basis. We use them as our measuring stick. Our mission statement has become almost a mantra.
We also used the StEPs process as an organic strategic-plan-in-progress. The StEPs goals helped put all of those niggling to-do objectives into perspective. Earning StEPs certificates was one accomplishment, but it was much more satisfying to see thorny issues dealt with (deferred maintenance, bylaws revision, land-use policy, etc.) in a structured, systematic way. One could parallel the StEPs workbook and our StEPs-CT mentor as being the de-facto facilitators that would keep us on track.
Tell us about some other examples of other positive changes within your organization as a result of StEPs?
We created a governance structure that provides a backbone for how we run our organization in the best way to accomplish our mission and vision statements. In addition, we have totally rewritten our bylaws so they are now guidelines for how we operate. We have also written a strategic plan—something EHS had never done previously—and are beginning to measure board decisions based on what it says. Again, addressing the usage of our historic structures has been paramount.
Guided by its new collections policy, the EHS collections team carefully inventoried Pratt House's upper floor and made difficult decisions about the possible deaccession of some items.
For example, we had an empty first floor and another unused area but we're renting offsite storage (?!). At each Board meeting, we would look around the table and stare at one another about how to address these problematic (and labor-intensive) issues.
Thanks to the in-depth and sometimes awkward discussions we had in our StEPs meetings, we are steadily developing plans to deaccesson some items and move others from offsite storage into the unused sections of our historic house which has better climate control and security. We are moving our library and offices from the second floor to the first floor at Hills Academy to improve visitor and volunteer access. These topics, let alone actions, would have been UNHEARD of before StEPs.
Tell us how your organization is making its way through the program.
As a member of the StEPs-CT group, we addressed the workbook sections one at a time, taking part in the group activities. A very important aspect of our plan was that we purposely involved different people from EHS for each section's activities but always kept our same primary representative. As a result, we had many board members and other volunteers participating directly in the program.
This developed into broad board buy-in and created a deep bench of people who were knowledgeable about the process, often saving valuable time at meetings when we could get to work right away instead of spending time reviewing and explaining the project to those not familiar with StEPs. Moreover, every monthly board meeting included an agenda item of "StEPs next steps" so we could keep the entire board informed about what had and would happen.
After a bit of trial and error, we figured out that our best interaction with our StEPs-CT mentor occurred by holding a workshop for each section. Our director and every EHS volunteer who had attended a StEPs-CT group session was included, so the number of participants grew each time, and so did the ideas and discussion.
The workshops became dynamic, synergistic, and exciting for everyone—far beyond what any of us alone would have thought. Above all, the two years spent as part of the StEPs-CT program became cumulative; we could see solutions arising in 2017 from problems that seemed insurmountable in 2015.
Has your organization been able to use StEPs as leverage in fundraising or in other ways?
We have used StEPs as a springboard to explore how we use our two historic structures. We now see that our Pratt House is stagnant and our archives building is underutilized. StEPs has encouraged us to examine both situations and make changes, beginning with things that can be undone if they don't work.
The Pratt House has undergone a new treatment of deconstruction of several rooms for the purpose of displaying them in a "bare bones" way. This was a direct result of realizing that our exhibits had been in place for years. Making the structure itself the focus of the exhibit has been educational for us and a new and fun way to interpret history to our visitors. We still have many ideas for the future! Although this isn't fundraising, it is interest-raising.
The underuse of the historic structures has been a thorn in our side for years. StEPs gave our organization the opportunity to think creatively and permission to experiment. We've been using the phrase "the politics of care" to address buy-in from our members and the community.
This past spring we were wildly successful with our new StEPs-inspired docent recruitment program. We increased our volunteer base by 50 percent! This will help transition our guide teams and invite a whole new group of people to become excited about the Pratt House.
What advice do you have for organizations just starting in StEPs?
Persevere through the Mission, Vision and Governance (MVG) and Management sections. They're really hard, but they give you a base for everything else.
If you are fortunate enough to take part in a StEPs group, realize the wonderful benefits of working closely with other organizations. The same goes for if you are fortunate to have someone who serves as your mentor like we had in the StEPs-CT group. These relationships are supportive across the board and helpful in many ways. Adjust the ways you try to work with your mentor until you find a way that works for both the organization and the mentor.
Look at StEPs as not another "layer of things to do," but as a system to work through issues that are too easy to ignore. You will need to make challenging decisions about priorities, but tackling those thorny issues is incredibly satisfying and much healthier for your organization in the long run.
Finally, which section of the workbook has been your favorite?
I (Sherry Clark, Immediate Past President) should say MVG because of the results, but it was not during the time I was going through it. I loved the Stewardship of Historic Structures and Landscapes (HSL) section because it made me realize how important it is to celebrate the historic spaces entrusted to our care. We must treat them properly and carefully, but also be willing to look at them from a different angle so we can use and enjoy them rather than worship them.
And I (Melissa Josefiak, EHS Director) would agree that HSL was a favorite as that is where everything came together― all of the units really came "home" to our historic structures and impacted our physical location―and it was where we saw how the other units' work was integral in solving the HSL issues that we had long ignored.
You may be able to tell that there were two voices in this survey. Both our then-president, Sherry Clark, and our current director, Melissa Josefiak, were involved throughout the two-year StEPs-CT program and worked closely together, often sharing (or over-sharing!) the dramas and accomplishments for two and a half years. So for this blog post we each answered the questions separately and then pasted the responses together. We believe working as a team with a number of people who sometimes had different, but complementary visions is truly a hallmark of our StEPs experience.
AASLH congratulates the Essex Historical Society on its accomplishments and thanks Melissa Josefiak, EHS Director, and Sherry Clark, Immediate Past President, for providing information for this blog post.
Since enrolling in StEPs in January 2015, the Essex Historical Society has earned six StEPs certificates.


Merry Christmas, everyone! And welcome back to the farm!
I've always been drawn to simple vintage decor and this year nearly everything I used was handmade or heirloom. It's all very special to us! We made our tree topper out of wood from the original corn crib here on the property. My red wooden bead garland and vintage pie safe belonged to my husband's grandmother (Granny!) and the big, chippy white window is original to our home, as well! I discovered it hiding in our barn a few weeks ago and I'm pretty sure the whole town probably heard me whoopin' and hollerin' in celebration! Aaand I drug it all the way down the barn stairs and up to the farmhouse all by myself. Much to Brett's dismay. #LOLZ. The chicken crate that I used to display our tree was thrifted during our Nashville trip this fall and my sweet hubs gifted me my beautiful German sled for my birthday a few years ago! Just about everything has a story and a memory attached. And although we have about 20 bins of ornaments, we chose a tiny tree and hand picked only our very very favorite handmade ones to hang! I probably only used 1/20th of the stuff I have but less is definitely more and meaningful for us this year!
I scored the most darling 1974 vintage metal fire truck at our local Goodwill! It's perfect for our fire family and one of my favorite finds this year!
Classic whimsical gift wrap for the kiddos this year.. Gift GIVING is one of my love languages! Wrapping them with love is as much a blessing to me as the gift is to them!
And a few Christmas throwbacks because I loved our porch last season!..
DIY cup racks, cookie cutter garland and Longaberger baskets.. These are a few of my favorite things!
Handprint wreaths we made this year! And Brett made this beautiful cabinet for our kitchen a few months ago!
And how cute is this?! My momma made these for her ornament exchange.. It has dip mix inside!
And last but not least.. I can't blog this Christmas without sharing this..
"Baker Ashfurf" has been VERY nice this year!
Merry Christmas, everyone! We love you all!
Christmas should be a time of excitement and wonder. I can remember the thrill of not knowing what I would get o\in Christmas morning.


text:
What's next for women's autonomy? To mark four decades of women exercising the right to abortion, our contributors share ideas & actions in On The Issues Magazine Winter 2012.
BORS ©2012 Matt Bors. Reprinted by permission of Universal Uclick for UFS. All rights reserved.
An embryo is precious;
a woman is a vessel.
A fertilized egg is a person;
a woman is indentured to it.
An embryo is sacred until birth.
After that, he/she is on their own.
Abortion is murder. Rape,
incest are means to an end:
that precious fertilized egg
housed in an expendable body.
Let us make babies and babies
and babies; chlldren are something
else, probably future criminals,
probably welfare cheats whose
education hikes taxes. You
can freely dispose of them.
Marge Piercy's 18th poetry book, "The Hunger Moon: New & selected poems 1980-2010," was released by Knopf last spring and is scheduled for paperback release this spring. Several of her books, including "The Crooked Inheritance," "The Moon Is Always Female," "What Are Big Girls Made Of" and others, are in Knopf paperback. Piercy has published 17 novels, recently "Sex Wars"; two early novels, "Dance The Eagle To Sleep" and "Vida," have just been republished with new introductions by PM Press. Her memoir, "Sleeping With Cats," was published by Harper Perennial. Her work has been translated into 19 languages. She gives numerous readings, workshops and occasional speeches here and abroad. See www.margepiercy.com.
Matt Bors is a nationally syndicated editorial cartoonist based in Portland, Oregon. He collaborated with war correspondent David Axe on the graphic novel War Is Boring and is the comics journalism editor at www.cartoonmovement.com.
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text:
Nominations Committee seeks chapter officers, board of directors
in Latest News, News, Our board
The Nominations Committee of the Connecticut Pro Chapter of the Society of Professional Journalists is seeking members interested in serving as a chapter officer or on the board of directors.
Nominations are sought for one-year terms as president, vice president, vice president/communications, treasurer, secretary. Positions for terms on the board of directors are also open.
To apply send your resume and a note on office or position you are seeking and why you wish to run for office. All nominees must be paid members of both national SPJ and CTSPJ.
Send nomination materials to: Cindy Simoneau, immediate past president and chair of Nominations Committee at: csimoneau@ctspj.org or clsimoneau@aol.com. Cell: 203-400-0454
The deadline to apply is Wednesday, Feb. 27, 2013.
Meet Jerry Dunklee
in Our board
Jerry Dunklee is a member of our board.
You may reach him at jdunklee@ctspj.org.
Meet Vinti Singh
Vinti Singh is a member of our board.
You may reach her at vsingh@ctspj.org.
Meet Tommy Valuckas
Tommy Valuckas is a member of our board.
You may reach him at tvaluckas@ctspj.org.
Meet Don Stacom
Don Stacom is a reporter at the Hartford Courant.
You may reach him at dstacom@ctspj.org.
CTSPJ Board Seeking New Members
The Nominations Committee of CTSPJ is currently seeking nominations for the 2012-13 Officers and Board of Directors. All officer positions are one-year terms and there are three Board of Director positions open for two-year terms.
Vice President/Communications
Three board positions (terms July 1, 2012-June 30, 2014).
All officers and board members must be paid members of CTSPJ and SPJ national.
If you are interested in running, please send President Cindy Simoneau a note at csimoneau@ctspj.org, and attach a recent resume. The committee may ask to meet with you for a follow-up interview.
Nominations close: Tuesday, March 27. Please consider serving your chapter.
Nominations Committee:
Cindy Simoneau, Chairwoman
Liz Glagowski
Cara Baruzzi
Meet Lila Carney
Lila Carney works with aspiring journalists as the assistant director of student media at Quinnipiac University. She is also an adjunct professor of journalism in the School of Communications.
Lila advises students involved with Quinnipiac's multiple media groups, including the university newspaper, "The Chronicle;" the university television station, Q30; the university radio station, WQAQ 98.1-FM; The Summit yearbook; Montage, the university literary and art magazine; and the Quinnipiac Bobcats Sports Network.
Carney holds a master's degree in broadcast journalism from Syracuse University in Syracuse, N.Y., and a bachelor's degree in communication sciences from the University of Connecticut.
Before coming to Quinnipiac, Carney worked for several years as a Multimedia Journalist in central and western New York. Most recently, she worked for the NBC and CBS affiliates in Syracuse, N.Y.
Meet Jamie DeLoma
A recovering journalist with 13 years of professional experience, Jamie DeLoma loves technology as much as he does story-telling.
Jamie, a past president of Connecticut SPJ and current board member, has been unnaturally curious for as long as he can remember. He founded a chapter of SPJ on Quinnipiac University's campus in 2003, and is on the international organization's digital media committee.
Currently the assistant director of public relations and social media at Quinnipiac University in Hamden,Conn., and a part-time A1 page designer and copy editor for the Hearst Connecticut Media Group, Jamie is loving life.
At Quinnipiac, he oversees the university's social media endeavors (where he has helped lead the way to dramatic increases in both interactions and connections on Facebook, Twitter, WordPress and Foursquare,) helps coordinate media relations, coordinates a weekly faculty/staff newsletter and teaches undergraduate and graduate writing and social media courses.
At Hearst Connecticut, Jamie crafts front and inside pages for four daily newspapers (The Connecticut Post, Stamford Advocate, Danbury News-Times and Greenwich Time,) and occasionally the group's six weekly newspapers. Combined, nearly a quarter of a million readers get their news from our products on any given weekday, and substantially more on Sundays.
Jamie has been affiliated with the Connecticut post since 1998, when he began as intern. Since then, he has contributed to the news, features, business and sports sections. He has written regularly printed columns and advised a high school writing section. He also blogs about technology issues for the newspaper group, which has been quoted in national media outlets, including AOL News.
Jamie has also worked full-time at The Stamford Advocate (before it was affiliated with the Connecticut Post,) WNBC-TV and the FOX News Channel. He has a strong understanding of print, broadcast and digital platforms.
Jamie has also mentored young journalists at the Milford (Conn.) Boys and Girls Club and has contributed columns to the Radio Television Digital News Association.
You may connect with him on Twitter at @jdeloma.
Meet Luther Turmelle
Luther Turmelle is North Bureau Chief for the New Haven Register. a position he has held for the past six years. Before that, he served as Milford Bureau Chief and also as the newspaper's business editor. Before coming to Connecticut in 1997, Turmelle spent nearly a decade at the Bridgewater (N.J.) Courier-News in a variety of positions, including working as the paper's business editor.
Turmelle has served on the board of the Connecticut Pro Chapter of Society of Professional Journalist for 10 years and is past past president. For the past three years, he has served as a director on the organization's national board representing Region 1, which covers New England, New York and New Jersey as well as eastern Pennsylvania.
Turmelle is a graduate of Boston University's School of Communications.
Meet Elizabeth Glagowski
Elizabeth Glagowski is the Executive Strategy Editor at Peppers & Rogers Group, developing content for the in the form of white papers, blogs, articles, videos, and more. She also writes for Peppers & Rogers Group's executive journal, Customer Strategist and is a contributing writer to 1to1 Media. She is a board member at Connecticut SPJ.
Elizabeth also teaches multimedia journalism as an adjunct in the journalism department of Southern Connecticut State University and serves on the advisory board for the Three Rivers Community College business department. An avid soccer player, she is a board member and webmaster for the Southern Connecticut Women's Soccer League and Stamford Co-Ed Soccer League. She is also a music fan and plays bass with local bands Done Mama Proud and KC & Anne.
She is a graduate of Southern Connecticut State University's journalism program.
About Connecticut SPJ
Since 1966, the Connecticut Pro Chapter, Society of Professional Journalists has been dedicated to encouraging journalism.
The Society of Professional Journalists works to improve and protect journalism. SPJ promotes the free flow of information vital to a well-informed citizenry and works to inspire and educate the next generation of journalists.
Become an SPJ member
Make a solid investment
in yourself and your profession by joining the Society of Professional Journalists today.
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