Objectives
The incidence of sexually transmitted infections (STIs) and HIV infection remains high in gay, bisexual, and other men who have sex with men (MSM) in the UK, and sexualized drug use ...(“chemsex”) and injecting drug use (“slamsex”) may play a part in this. We aimed to characterize HIV‐positive MSM engaging in chemsex/slamsex and to assess the associations with self‐reported STI diagnoses and sexual behaviours.
Methods
Data from a 2014 survey of people attending HIV clinics in England and Wales were linked to clinical data from national HIV surveillance records and weighted to be nationally representative. Multivariable logistic regression assessed the associations of chemsex and slamsex with self‐reported unprotected anal intercourse (UAI), serodiscordant UAI (sdUAI) (i.e. UAI with an HIV‐negative or unknown HIV status partner), sdUAI with a detectable viral load (>50 HIV‐1 RNA copies/mL), hepatitis C, and bacterial STIs.
Results
In the previous year, 29.5% of 392 sexually active participants engaged in chemsex, and 10.1% in slamsex. Chemsex was significantly associated with increased odds of UAI adjusted odds ratio (AOR) 5.73; P < 0.001, sdUAI (AOR 2.34; P < 0.05), sdUAI with a detectable viral load (AOR 3.86; P < 0.01), hepatitis C (AOR 6.58; P < 0.01), and bacterial STI diagnosis (AOR 2.65; P < 0.01). Slamsex was associated with increased odds of UAI (AOR 6.11; P < 0.05), hepatitis C (AOR 9.39; P < 0.001), and bacterial STI diagnosis (AOR 6.11; P < 0.001).
Conclusions
Three in ten sexually active HIV‐positive MSM engaged in chemsex in the past year, which was positively associated with self‐reported depression/anxiety, smoking, nonsexual drug use, risky sexual behaviours, STIs, and hepatitis C. Chemsex may therefore play a role in the ongoing HIV and STI epidemics in the UK.
Abstract Background It is not known whether the addition of general educational comments to virology laboratory reports can influence the requesting behaviour of practitioners. Objectives To ...establish if there is any change in requesting behaviour after the addition of a standard comment to virology laboratory reports highlighting the need to include HIV testing when investigating patients presenting with a glandular fever (GF)-like illness. Study design A standard comment to encourage inclusion of HIV testing was added to all GF screening reports from April 2010. The proportion of GF screening samples with concomitant HIV test requests before and after the introduction of the standard comment were compared over a 1 year period. Results A significant increase in concomitant HIV requests from 9.5% to 19.6% on GF screening samples from primary care practitioners was observed after the addition of the standard comment ( p < 0.0000001). This effect peaked at 5 months and although it waned, requests at one year were still higher than at baseline. Conclusions Addition of a general HIV educational comment to virology laboratory reports is effective in changing requesting behaviour.
The thermal reaction norms of 4 closely related intertidal Nacellid limpets, Antarctic (Nacella concinna), New Zealand (Cellana ornata), Australia (C. tramoserica) and Singapore (C. radiata), were ...compared across environments with different temperature magnitude, variability and predictability, to test their relative vulnerability to different scales of climate warming. Lethal limits were measured alongside a newly developed metric of "duration tenacity", which was tested at different temperatures to calculate the thermal reaction norm of limpet adductor muscle fatigue. Except in C. tramoserica which had a wide optimum range with two break points, duration tenacity did not follow a typical aerobic capacity curve but was best described by a single break point at an optimum temperature. Thermal reaction norms were shifted to warmer temperatures in warmer environments; the optimum temperature for tenacity (T(opt)) increased from 1.0°C (N. concinna) to 14.3°C (C. ornata) to 18.0°C (an average for the optimum range of C. tramoserica) to 27.6°C (C. radiata). The temperature limits for duration tenacity of the 4 species were most consistently correlated with both maximum sea surface temperature and summer maximum in situ habitat logger temperature. Tropical C. radiata, which lives in the least variable and most predictable environment, generally had the lowest warming tolerance and thermal safety margin (WT and TSM; respectively the thermal buffer of CT(max) and T(opt) over habitat temperature). However, the two temperate species, C. ornata and C. tramoserica, which live in a variable and seasonally unpredictable microhabitat, had the lowest TSM relative to in situ logger temperature. N. concinna which lives in the most variable, but seasonally predictable microhabitat, generally had the highest TSMs. Intertidal animals live at the highly variable interface between terrestrial and marine biomes and even small changes in the magnitude and predictability of their environment could markedly influence their future distributions.
Ewing sarcoma is a bone and soft-tissue tumor that depends on the activity of the EWS-FLI1 transcription factor for cell survival. Although a number of compounds have been shown to inhibit EWS-FLI1 ...in vitro, a clinical EWS-FLI1-directed therapy has not been achieved. One problem plaguing drug development efforts is the lack of a suitable, non-invasive, pharmacodynamic marker of EWS-FLI1 activity. Here we show that 18 F-FLT PET (18 F- 3'-deoxy-3'-fluorothymidine positron emission tomography) reflects EWS-FLI1 activity in Ewing sarcoma cells both in vitro and in vivo. 18 F-FLT is transported into the cell by ENT1 and ENT2, where it is phosphorylated by TK1 and trapped intracellularly. In this report, we show that silencing of EWS-FLI1 with either siRNA or small-molecule EWS-FLI1 inhibitors suppressed the expression of ENT1, ENT2, and TK1 and thus decreased 18 F-FLT PET activity. This effect was not through a generalized loss in viability or metabolic suppression, as there was no suppression of 18 F-FDG PET activity and no suppression with chemotherapy. These results provide the basis for the clinical translation of 18 F-FLT as a companion biomarker of EWS-FLI1 activity and a novel diagnostic imaging approach for Ewing sarcoma.
Ewing sarcoma is a bone and soft-tissue tumor that depends on the activity of the EWS-FLI1 transcription factor for cell survival. Although a number of compounds have been shown to inhibit EWS-FLI1 ...in vitro, a clinical EWS-FLI1-directed therapy has not been achieved. One problem plaguing drug development efforts is the lack of a suitable, non-invasive, pharmacodynamic marker of EWS-FLI1 activity. Here we show that
F-FLT PET (
F- 3'-deoxy-3'-fluorothymidine positron emission tomography) reflects EWS-FLI1 activity in Ewing sarcoma cells both in vitro and in vivo.
F-FLT is transported into the cell by ENT1 and ENT2, where it is phosphorylated by TK1 and trapped intracellularly. In this report, we show that silencing of EWS-FLI1 with either siRNA or small-molecule EWS-FLI1 inhibitors suppressed the expression of ENT1, ENT2, and TK1 and thus decreased
F-FLT PET activity. This effect was not through a generalized loss in viability or metabolic suppression, as there was no suppression of
F-FDG PET activity and no suppression with chemotherapy. These results provide the basis for the clinical translation of
F-FLT as a companion biomarker of EWS-FLI1 activity and a novel diagnostic imaging approach for Ewing sarcoma.
Plasma DEHP concentrations were measured weekly in whole blood and red cell concentrates (RCC) during 21 days of storage in standard CPD within PL-130 blood bags. In addition, DEHP and MEHP ...accumulation patterns were investigated in blood stored for 42 days in modified CPD with adenine within PL-146 and BB-69 storage containers. Total per-unit plasma DEHP of RCC units was 49 to 71 per cent of the total in plasma of whole blood units (PL-130). From 28 to 42 days, mean DEHP levels were 12 to 19 per cent higher in whole blood stored in PL-146 than in BB-69. Although MEHP was not found in any blood bag plastic, MEHP accumulated in plasma during whole blood storage. MEHP concentrations were 2.8 to 3.8 times higher in plasma stored in BB-69 than in PL-146. It is postulated that MEHP arises from hydrolysis of DEHP by plasma lipase, even in frozen plasma sample, and that the rate of this reaction is influenced by blood bag plastic surface characteristics.
Plasma di-2-ethylhexyl phthalate (DEHP), which accumulates during blood storage in plastic bags, gives rise to plasma mono-2-ethylhexyl phthalate (MEHP). This also in plasma samples awaiting ...analysis, which are no longer stored in plastic bags. Heating plasma samples at 60 C for 25 to 30 minutes in a water bath effectively halts conversion of DEHP to MEHP during subsequent room temperature storage for at least 100 hours. This result is consistent with the view that MEHP accumulation in plasma is due to enzymatic hydrolysis of DEHP by esterase (s) which can be heat-inactivated.
Lower extremity injuries are among the most common injuries sustained by motorcycle riders in crashes and often lead to extended and costly medical treatment and permanent disability. This study ...characterizes lower extremity injuries in a group of 700 motorcycle riders in crashes in Los Angeles County from July 1, 1988, through October 31, 1989. Motorcycle crash fatalities (n = 163) were identified through the Los Angeles County Coroner's office, and nonfatally injured riders (n = 537) were identified at four of the ten level I and level II trauma centers in the county. Lower extremity injuries were diagnosed in 301 (56%) of nonfatally injured and in 75 (46%) of fatally injured riders. Fractures were the most common lower extremity injury and were diagnosed in 52% and 42% of riders with nonfatal and fatal injuries, respectively. Over a third of all fractures were to the tibia or fibula. Drivers and passengers did not differ in their risk for lower extremity injuries. Multiple-vehicle collisions resulted in a higher risk of lower extremity injuries than did single-vehicle collisions. The highest risk for lower extremity fractures was observed among riders in broadside collisions in which another vehicle struck the motorcycle (risk ratio = 2.7). Modifications in vehicle design and rider apparel may prevent some lower extremity injuries in motorcycle crashes.
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