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.
The study was carried out to assess whether hot seasons affect the oxidative status of transition dairy cows. Twenty Holstein cows were utilized. Eleven of those cows gave birth in spring; the ...remaining nine cows gave birth in summer. Oxidative status was evaluated from 21 d before to 35 d after calving, determining oxidative markers in plasma glutathione peroxidase activity, thiol groups, reactive oxygen metabolites, and thiobarbituric acid reactive substances (TBARS) and in erythrocytes glutathione peroxidase activity (GSH-Px-E), intracellular thiols (SH), superoxide dismutase activity (SOD) and TBARS. The season did not modify plasma oxidative markers. In contrast, cows exposed to moderate heat stress (39.5 +/- 0.2 degrees C rectal temperatures) due to summer temperature-humidity index (73.2 +/- 2.5 mean daily THI), showed higher erythrocyte SOD, GSH-PxE, SH, and TBARS compared with spring cows, indicating a condition of oxidative stress in summer transition dairy cows. Some changes (the increase of SOD, for example), represent compensatory changes the cow is undergoing in response to increased oxidative stress. Under the conditions compared, the effect of heat stress on oxidative status in transition dairy cows by use of plasma markers does not give enough information to reach definitive conclusions. Erythrocytes are an appropriate and sensitive model to study the oxidative status of transition dairy cows exposed to hot environments.
The data set consisted of 1,016,856 inseminations of 191,012 first, second, and third parity Holstein cows from 484 farms. Data were collected from year 2001 through 2007 and included meteorological ...data from 35 weather stations. Nonreturn rate at 56 d after first insemination (NR56) was considered. A logit model was used to estimate the effect of temperature-humidity index (THI) on reproduction across parities. Then, least squares means were used to detect the THI breakpoints using a 2-phase linear regression procedure. Finally, a multiple-trait threshold model was used to estimate variance components for NR56 in first and second parity cows. A dummy regression variable (t) was used to estimate NR56 decline due to heat stress. The NR56, both for first and second parity cows, was significantly (unfavorable) affected by THI from 4 d before 5 d after the insemination date. Additive genetic variances for NR56 increased from first to second parity both for general and heat stress effect. Genetic correlations between general and heat stress effects were −0.31 for first parity and −0.45 for second parity cows.
Heat stress represents a key factor that negatively affects the productive and reproductive performance of farm animals. In the present work, a new measure of tolerance to heat stress for dairy ...cattle was developed using principal component analysis. Data were from 590,174 test-day records for milk yield, fat and protein percentages, and somatic cell score of 39,261 Italian Holstein cows. Test-day records adjusted for main systematic factors were grouped into 11 temperature-humidity index (THI) classes. Daughter trait deviations (DTD) were calculated for 1,540 bulls as means of the adjusted test-day records for each THI class. Principal component analysis was performed on the DTD for each bull. The first 2 principal components (PC) explained 42 to 51% of the total variance of the system across the 4 traits. The first PC, a measure of the level at which the curve is located, was interpreted as a measure of the level at which the DTD curve was located. The second PC, which shows the slope of increasing or decreases DTD curves, synthesized the behavior of the DTD pattern. Heritability of the 2 component scores was moderate to high for level across all traits (range = 0.23–0.82) and low to moderate for slope (range = 0.16–0.28). For each trait, phenotypic and genetic correlations between level and slope were equal to zero. A genome-wide association analysis was carried out on a subsample of 423 bulls genotyped with the Illumina 50K bovine bead chip (Illumina, San Diego, CA). Two single nucleotide polymorphisms were significantly associated with slope for milk yield, 4 with level for fat percentage, and 2 with level and slope of protein percentage, respectively. The gene discovery was carried out considering windows of 0.5 Mb surrounding the significant markers and highlighted some interesting candidate genes. Some of them have been already associated with the mechanism of heat tolerance as the heat shock transcription factor (HSF1) and the malonyl-CoA-acyl carrier protein transacylase (MCAT). The 2 PC were able to describe the overall level and the slope of response of milk production traits across increasing levels of THI index. Moreover, they exhibited genetic variability and were genetically uncorrelated. These features suggest their use as measures of thermotolerance in dairy cattle breeding schemes.
This review addresses the issue whether instrumental evaluations of balance may be helpful in orienting the clinical decision regarding balance rehabilitation. The aptitude of instrumental assessment ...of balance in supporting decision making in patients with balance disorders connected with ageing and with neurological diseases is considered. Among instrumental evaluations, recording of body sway during quiet stance and dynamic conditions are described, together with manoeuvres for recording postural reactions to predictable or unpredictable postural perturbations. The posturography patterns encountered in elderly subjects and patients affected by Parkinson's disease, spasticity, peripheral neuropathy, cerebellar diseases, vestibular deficit and neck disorders are presented and discussed. Findings from instrumental assessments of balance are helpful in understanding the pathophysiology of balance disorders, in screening for balance disorders, and in evaluating the natural progression of the disease or the response to therapy, be it physical or pharmacological. Conversely, as far as the prediction of the risk of falling in one individual patient is concerned, the various posturography tests do not produce consistent results.
The study was undertaken to describe the temperature humidity index (THI) dynamics over the Mediterranean basin for the period 1971–2050. The THI combines temperature and humidity into a single ...value, and has been widely used to predict the effects of environmental warmth in farm animals. The analysis was based on daily outputs of the temperature and relative humidity from the Max Planck Institute data using the Intergovernmental Panel on Climate Change Special Report Emission Scenario A1B. Data revealed a gradual increase of both annual and seasonal THI during the period under investigation and a strong heterogeneity of the Mediterranean area. In particular, the analysis indicated that Spain, southern France and Italy should be expected to undergo the highest THI increase, which in the last decade under study (2041–2050) will range between 3 and 4 units. However, only during summer months the area presents characteristics indicating risk of thermal (heat) stress for farm animals. In this regard, scenario maps relative to the summer season suggested an enlargement of the areas in the basin where summer THI values will likely cause thermal discomfort in farm animals. In conclusion, the study indicated that the Mediterranean basin is likely to undergo THI changes, which may aggravate the consequences of hot weather on animal welfare, performances, health and survival and may help farmers, nutritionists, veterinarians, and policy-makers to develop appropriate adaptation strategies to limit consequences of climate change for the livestock sector in the Mediterranean countries.
Objectives
Pre‐exposure prophylaxis (PrEP) has proven biological efficacy in reducing the risk of sexual acquisition of HIV. Healthcare providers' (HCPs) knowledge of and attitudes to PrEP will be ...key to successful implementation. In England, PrEP is only available to men who have sex with men (MSM) through the open‐label randomized PROUD pilot study of immediate or deferred use.
Methods
In September 2013, a cross‐sectional survey of UK HCPs distributed through sexual health clinics (219) and professional societies' email lists (2599) and at a conference (80) asked about knowledge of, attitudes to and practice of PrEP.
Results
Overall, 328 of 2898 (11%) completed the survey, of whom 160 of 328 (49%) were doctors, 51 (16%) sexual health advisers (SHAs), 44 (14%) nurses and 73 (22%) unspecified. Over a quarter (83 of 311; 27%) were involved in PROUD. Most respondents (260 of 326; 80%) rated their knowledge of PrEP as medium or high. Over half of respondents (166 of 307; 54%) thought PrEP should be available outside of a clinical trial. The main barriers to supporting PrEP availability outside a clinical trial were concerns about current evidence (odds ratio OR 0.13), lack of UK‐specific guidance (OR 0.35), concerns about adherence (OR 0.38) and risk of sexual or physical coercion for patients to have condomless or higher risk sex (OR 0.42 in multivariate regression). Just over half (147 of 277; 53%) had been asked about PrEP by patients in the past year, including almost half of those working in a clinic not involved in the PROUD study (86 of 202; 43%).
Conclusions
There is support for PrEP availability outside a clinical trial, but HCPs have residual concerns about its effectiveness and negative consequences, and the absence of UK‐specific implementation guidance.
The study was aimed at assessing heat load–related risk of clinical mastitis (CM) in dairy cows. Records of CM for the years 2014 and 2015 were obtained from a large conventional dairy farm milking ...about 1,200 Holstein cows in central Italy. A case of CM was defined by the presence of clinical signs and veterinary confirmation. Quarter milk samples were collected and bacteriological investigated for each CM. Etiological agents were identified and classified as environmental or contagious pathogens. Hourly weather data from the nearest weather station were used to calculate heat load index (HLI). Upper and lower thresholds of HLI, at which the animal accumulates or dissipates heat, were settled and used to measure heat load balance through the accumulated heat load (AHL) model. Zero and positive values of AHL indicate periods of thermo-neutral and heat accumulation, respectively. Each case of CM was associated with HLI-AHL values recorded 5 d before the event. The risk of CM was evaluated using a case-crossover design. A conditional logistic regression model was used to calculate the odds ratio and 95% confidence intervals of CM recorded in thermo-neutral (AHL = 0) or heat load (AHL > 0) days, pooled or stratified for pathogen type (environmental or contagious). Classes of AHL as low (<6.5), medium (6.6–34.9), and high (>35) were included in the model. Other variables included in the model were milk yield as liters (<20, 20–30, and >30), days in milk (<60, 60–150, and >150), and parity (1, 2–3, and >3). A total of 1,086 CM cases were identified from 677 cows. Escherichia coli, Streptococcus spp., and Streptococcus uberis were the environmental pathogens isolated with the highest frequency; Staphylococcus aureus prevailed within contagious species. The analysis of pooled data indicated a significant effect of heat load on the occurrence of CM in the contagious pathogen stratum. Higher milk yield, middle and late stage of lactation, and older parity increased the risk of CM under heat load conditions. However, the association between pathogen type and these factors was not clear because the model provided significant odds ratios within all pathogen categories. The present study provided the first evidence of an association between HLI and CM in dairy cattle and suggested the ability of the AHL model to assess the risk of mastitis associated with heat load.
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This study investigated the mortality of dairy cows during heat waves. Mortality data (46,610 cases) referred to dairy cows older than 24mo that died on a farm from all causes from May 1 to September ...30 during a 6-yr period (2002–2007). Weather data were obtained from 12 weather stations located in different areas of Italy. Heat waves were defined for each weather station as a period of at least 3 consecutive days, from May 1 to September 30 (2002–2007), when the daily maximum temperature exceeded the 90th percentile of the reference distribution (1971–2000). Summer days were classified as days in heat wave (HW) or not in heat wave (nHW). Days in HW were numbered to evaluate the relationship between mortality and length of the wave. Finally, the first 3 nHW days after the end of a heat wave were also considered to account for potential prolonged effects. The mortality risk was evaluated using a case-crossover design. A conditional logistic regression model was used to calculate odds ratio and 95% confidence interval for mortality recorded in HW compared with that recorded in nHW days pooled and stratified by duration of exposure, age of cows, and month of occurrence. Dairy cows mortality was greater during HW compared with nHW days. Furthermore, compared with nHW days, the risk of mortality continued to be higher during the 3 d after the end of HW. Mortality increased with the length of the HW. Considering deaths stratified by age, cows up to 28mo were not affected by HW, whereas all the other age categories of older cows (29–60, 61–96, and >96mo) showed a greater mortality when exposed to HW. The risk of death during HW was higher in early summer months. In particular, the highest risk of mortality was observed during June HW. Present results strongly support the implementation of adaptation strategies which may limit heat stress-related impairment of animal welfare and economic losses in dairy cow farm during HW.
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