Miracle-dz/UniFAR-FTUs huggingface dataset:
Motivations and values associated with combining sex and illicit drugs (‘chemsex’) among gay men in South London: findings from a qualitative study

Objectives There is considerable public health concern about the combining of sex and illicit drugs (chemsex) among gay men. With a view to inform supportive therapeutic and clinical interventions, we sought to examine the motivations for engaging in chemsex among gay men living in South London. Methods Community advertising recruited 30 gay men for qualitative semi-structured interview. Aged between 21 and 53 years, all lived in South London in the boroughs of Lambeth, Southwark and Lewisham and all had combined crystal methamphetamine, mephedrone and/or γ-hydroxybutyric acid/γ-butyrolactone with sex in the past 12 months. Transcripts were subjected to a thematic analysis. Results We broadly distinguished two groups of reasons for combining sex and drugs, within which we described eight distinct motivations. The first major group of motivations for combining drugs with sex was that drugs provide the means by which men can have the sex they desire by increasing libido, confidence, disinhibition and stamina. The second major group of motivations for chemsex was that drugs enhance the qualities of the sex that men value. Drugs made other men seem more attractive, increased physical sensations, intensified perceptions of intimacy and facilitated a sense of sexual adventure. Conclusion Analysis revealed that sexualised drug use provides both motivation and capability to engage in the kinds of sex that some gay men value: sex that explores and celebrates adventurism. Those services providing (talking) interventions to men engaging in chemsex should consider these benefits of sexualised drug use alongside the harms arising.
Insulin pump therapy is perceived as liberating, but to many it can imply a sense of the diabetes made visible

AbstractThis study describes how adults with type 1 diabetes experience the transition from multiple daily injections (MDI) to continuous subcutaneous insulin infusion (CSII or ‘insulin pump’). The study is based on interviews in focus groups, with 11 persons with type 1 diabetes who had had CSII for at least one year, which were analysed using qualitative content analysis. The analysis resulted in three categories: life and health; involvement of others; and technology dependence. Participants’ experiences are summarised in the theme ‘CSII is perceived as liberating, but also implies a sense of the diabetes made visible’. The transition resulted in changed life and health with greater freedom and flexibility, particularly in meal situations. The participants felt that their blood glucose was easier to control. Those around them reacted with curiosity, but some participants felt compelled to tell others that they had diabetes since the pump could be seen or heard. The participants found that coping with C.
Relationships between neighbourhood characteristics and current STI status among HIV-infected and HIV-uninfected women living in the Southern USA: a cross-sectional multilevel analysis

Objectives Neighbourhood characteristics (eg, high poverty rates) are associated with STIs among HIV-uninfected women in the USA. However, no multilevel analyses investigating the associations between neighbourhood exposures and STIs have explored these relationships among women living with HIV infection. The objectives of this study were to: (1) examine relationships between neighbourhood characteristics and current STI status and (2) investigate whether the magnitudes and directions of these relationships varied by HIV status in a predominantly HIV-infected cohort of women living in the Southern USA. Methods This cross-sectional multilevel analysis tests relationships between census tract characteristics and current STI status using data from 737 women enrolled at the Women's Interagency HIV Study's southern sites (530 HIV-infected and 207 HIV-uninfected women). Administrative data (eg, US Census) described the census tract-level social disorder (eg, violent crime rate) and social disadvantage (eg, alcohol outlet density) where women lived. Participant-level data were gathered via survey. Testing positive for a current STI was defined as a laboratory-confirmed diagnosis of chlamydia, gonorrhoea, trichomoniasis or syphilis. Hierarchical generalised linear models were used to determine relationships between tract-level characteristics and current STI status, and to test whether these relationships varied by HIV status. Results Eleven per cent of participants tested positive for at least one current STI. Greater tract-level social disorder (OR=1.34, 95% CI 0.99 to 1.87) and social disadvantage (OR=1.34, 95% CI 0.96 to 1.86) were associated with having a current STI. There was no evidence of additive or multiplicative interaction between tract-level characteristics and HIV status. Conclusions Findings suggest that neighbourhood characteristics may be associated with current STIs among women living in the South, and that relationships do not vary by HIV status. Future research should establish the temporality of these relationships and explore pathways through which neighbourhoods create vulnerability to STIs. Trial registration number NCT00000797; results.
Rapid and point-of-care tests for the diagnosis of Trichomonas vaginalis in women and men

Background Trichomonasvaginalis (TV) is a highly prevalent parasitic infection worldwide. It is associated with many adverse reproductive health outcomes. Many infections are asymptomatic and syndromic management leads to underdetection of TV. Traditional methods of TV detection such as wet preparation are insensitive. New rapid, point-of-care (POC) tests can enhance the diagnosis of trichomoniasis. Methods The authors reviewed the literature and discuss older POC tests for TV detection, as well as the OSOM lateral flow test, the AmpliVue test, the Solana test and the GeneXpert test as well as the limitations of wet preparation and culture for detection of TV. Results The OSOM test is easy to perform, compared with other POC tests, and is Clinical Laboratory Improvement Amendments (CLIA)-waived, equipment-free, has sensitivities of 83%–86% compared with nucleic acid amplification tests (NAATs) and can be performed in 15 min. The AmpliVue and the Solana tests are not CLIA waived and require small pieces of equipment. They are molecular amplified assays and can be completed in <1 hour. AmpliVue demonstrated a sensitivity for vaginal swabs of 100% compared with wet preparation/culture and 90.7% compared with NAATs. Solana demonstrated a sensitivity of 98.6%–100% for vaginal swabs and 92.9%–98% for female urines, compared with wet preparation/culture. Compared with other NAATs, the sensitivity for Solana was 89.7% for swabs and 100% for urine. The GeneXpert TV test for women and men is a moderately complex test, requires a small platform and can be performed in <1 hour. The sensitivity compared with wet preparation/culture for self-collected vaginal swabs was 96.4%, 98.9% for endocervical specimens and 98.4% for female urine. For men, sensitivity for urines was excellent (97.2%). The specificity for all assays was excellent. Conclusions Several rapid POC tests have the potential to rapidly diagnose trichomoniasis in women and one is available for detection of TV in men.
Advancing prevention of sexually transmitted infections through point-of-care testing: target product profiles and landscape analysis

Objectives Advancing the field of point-of-care testing (POCT) for STIs can rapidly and substantially improve STI control and prevention by providing targeted, essential STI services (case detection and screening). POCT enables definitive diagnosis and appropriate treatment in a single visit and home and community-based testing. Methods Since 2014, the WHO Department of Reproductive Health and Research, in collaboration with technical partners, has completed four landscape analyses of promising diagnostics for use at or near the point of patient care to detect syphilis, Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis and the human papillomavirus. The analyses comprised a literature review and interviews. Two International Technical Consultations on STI POCTs (2014 and 2015) resulted in the development of target product profiles (TPP). Experts in STI microbiology, laboratory diagnostics, clinical management, public health and epidemiology participated in the consultations with representation from all WHO regions. Results The landscape analysis identified diagnostic tests that are either available on the market, to be released in the near future or in the pipeline. The TPPs specify 28 analytical and operational characteristics of POCTs for use in different populations for surveillance, screening and case management. None of the tests that were identified in the landscape analysis met all of the targets of the TPPs. Conclusion More efforts of the global health community are needed to accelerate access to affordable quality-assured STI POCTs, particularly in low- and middle-income countries, by supporting the development of new diagnostic platforms as well as strengthening the validation and implementation of existing diagnostics according to internationally endorsed standards and the best available evidence.
A 47$\,\times\,$ 10 Gb/s 1.4 mW/Gb/s Parallel Interface in 45 nm CMOS

A 47 × 10 Gb/s chip-to-chip interface consuming 660 mW is demonstrated in 45 nm CMOS. The circuitry and interconnect are co-designed to minimize power and area for a wide parallel interface. Power is reduced by amortizing clocking, minimizing the span of clock signals and pairing a low-swing transmitter driver with a sensitive receiver sampler. The active silicon area is compressed by 64% relative to the C4 bumps using on-chip transmission line routing. A dense, top-side package connector and bridge enable both high off-chip interconnect density and low overall power by reducing equalization and deskew requirements. The interface also demonstrates fast power management for the I/O circuits. The receiver power can be reduced by 93% during standby and an integrated wake-up timer indicates that all lanes return reliably to active mode in <;5 ns. The interface operates at 470 Gb/s with an aggregate bit error ratio better than 2 ×10-18 while consuming 1.4 mW/Gb/s and occupies 3.2 mm2 active silicon area.
Multi-Step Word-Line Control Technology in Hierarchical Cell Architecture for Scaled-Down High-Density SRAMs

A multi-step word-line control technology (MWC), combined with a new hierarchical cell SRAM architecture (HCA), has been developed to overcome rapid increase in random variability with no area penalty. A 40-nm-node 0.248-μm2-cell SRAM using a single power supply has been successfully fabricated, pushing up bit density to 2.98 Mb/mm2. MWC improved VDD_min@-6σ by 0.34 V and 0.22 V for read and write operations, respectively, enabling stable 1.0 V operations. Four nanosecond SRAM access time is achieved by adopting HCA, which cancels out a 1.4 ns increase of access delay caused by MWC.
Array Architecture for a Nonvolatile 3-Dimensional Cross-Point Resistance-Change Memory

This work explores the design and capabilities of a three-dimensional cross-point array structure suitable for use with resistance-change non-volatile memory. The resistance-change cell serves as both the access element and the memory element, eliminating the need for individual selection devices. This work presents novel architecture and circuit techniques that minimize leakage current effects while maintaining a high effective bit density. A test chip fabricated in 0.18 μm CMOS technology verifies the architecture and circuit functionality. The performance of an 8 Gb memory chip built in 65 nm technology has been simulated. A random access time of 104 ns is achieved with a power dissipation of 61.2 mW. This makes the 3D cross-point memory competitive with NOR flash in terms of read time, and competitive with NAND flash in terms of area efficiency.
An 8.5 mW Continuous-Time  $\Delta \Sigma $ Modulator With 25 MHz Bandwidth Using Digital Background DAC Linearization to Achieve 63.5 dB SNDR and 81 dB SFDR

This paper presents a third order, single-loop, continuous-time ΔΣ modulator with an internal 4-bit quantizer. The modulator is sampled at 500 MHz, and features an oversampling ratio of only 10. Therefore, DAC linearization by dynamic element matching is ineffective, and the DAC nonlinearities are not corrected within the ΔΣ modulator loop but in the subsequent digital circuit. The unit element mismatches are digitally estimated based on a correlation, and correction factors are thus derived. Moreover, in order to achieve a low-power operation, all amplifiers are compensated for finite gain-bandwidth related non-idealities. In the presented work, this compensation includes the fast proportional loop, which is used to compensate for excess loop delay. The presented ΔΣ modulator has been realized in a 1.2 V, 90 nm CMOS process and achieves an SNDR of 63.5 dB and an SFDR of 81 dB within a 25 MHz bandwidth. The modulator occupies an active die area of only 0.15 mm2 and has a power consumption of 8 mW, with an additional 0.02 mm2 and 0.42 mW estimated for the digital DAC correction logic. The overall modulator achieves a figure of merit of 138 fJ/conv.
The cost-effectiveness of syndromic management for male sexually transmitted disease patients with urethral discharge symptoms and genital ulcer disease in Taiwan

Objective: To assess the cost-effectiveness of syndromic management for the treatment of sexually transmitted diseases (STD) in comparison with the strategies currently used in STD clinics in Taiwan. Methods: Between July 2004 and June 2005, all male patients with genitourinary symptoms attending two hospitals were included in this study. Current clinical procedures (presumptive treatment and laboratory tests), aetiological diagnosis and syndromic management were compared in terms of diagnostic accuracy, treatment appropriateness, costs and effectiveness. Results: 473 patients met the inclusion criteria and were enrolled in the study. 335 patients (71%) had urethral symptoms (discharge, dysuria or painful urination) and 138 (29%) had genital ulcers, sores and skin rashes. For the current approach, the sensitivity, specificity and positive predictive value (PPV) for the detection of chlamydial, gonococcal and combined forms of infection were 100%, 40.0% and 60.4%, respectively. In contrast, the sensitivity, specificity and PPV for the detection of syphilis were 100%, 86.7% and 70.2%, respectively. For syndromic management, the sensitivity, specificity and PPV detection of chlamydial, gonococcal and combined forms of infection were 85.0%, 40.0% and 56.4%, respectively. In contrast, the sensitivity, specificity and PPV for the detection of syphilis were 78.8%, 18.1% and 23.2%, respectively. The average cost of implementing a correct treatment using the current approach was US$54.27 and US$30.74 for urethritis and syphilis, respectively. For the aetiological approach, the average cost of implementing a correct treatment was US$32.83 and US$21.58 for urethritis and syphilis, respectively. For the syndromic approach, the average cost for a correct treatment was US$3.86 and US$14.30 for urethritis and syphilis, respectively. Conclusions: In this sample of patients attending STD clinics in Taiwan, syndromic management was found to be a more cost-effective protocol in terms of cost per treated STD patient compared with the current and aetiological protocols for STD.
A real-time quadriplex PCR assay for the diagnosis of rectal lymphogranuloma venereum and non-lymphogranuloma venereum Chlamydia trachomatis infections

Objectives: To develop and evaluate a real-time quadriplex PCR for the diagnosis of lymphogranuloma venereum (LGV) and non-LGV chlamydial infections using rectal swab specimens. Methods: The design of the real-time quadriplex PCR assay incorporates an LGV-specific, a non-LGV-specific target sequence, a Chlamydia trachomatis plasmid target, and the human RNase P gene as an internal control. The performance of the quadriplex PCR was compared with a previously reported real-time duplex PCR assay on which LGV diagnosis was based on exclusion. Results: Very good agreement (85 of 89 specimens, 95.5%) was found between the two multiplex PCR assays for the detection of C trachomatis DNA (kappa value 0.93, 95% CI 0.86 to 0.99). Both assays identified 34 LGV, 35 non-LGV C trachomatis and 16 negative specimens. Of two specimens that tested positive for non-LGV by the duplex PCR, one was found to be a mixed infection and the other was positive only for plasmid and RNase P targets by the quadriplex PCR. Two additional specimens that had equivocal results for non-LGV by the duplex PCR also tested positive only for plasmid target and human DNA by the quadriplex PCR. In addition, six specimens that tested negative by the duplex PCR assay were found to be invalid when using the quadriplex PCR. Conclusions: A real-time quadriplex PCR assay has been developed that is capable of detecting LGV, non-LGV, or mixed infections simultaneously in rectal specimens. The assay also contains a supplemental amplification target for the confirmation of C trachomatis infection as well as a human DNA control for monitoring sample adequacy and PCR inhibition.
Exercise Capacity for Mountaineering: How Much Is Necessary?

In Austria alone, more than 10 million hikers and skiers annually visit moderate altitudes. That number may exceed 40 million for the whole Alps, and it is assumed that worldwide there are about 100 million mountain tourists. Many of these tourists are not aware that mountain sport activities demand a relatively high degree of physical fitness and that the risk of injury and death increases when fitness is insufficient. However, little information exists on the requirements of aerobic performance in the mountaineer. Thus, the aims of this study were to evaluate normal times required for ascent to a mountain hut or peak and to measure related energy costs. The analyses of the descriptions of 100 typical paths to mountain huts and peaks in the Alps revealed that, on average, a 317 m gain in altitude is expected to be covered in one hour. Data gathered by documenting the climbing speed of 82 mountaineers showed that this goal is, on average, actually achieved. However, large variations were observed (180—480 mph). Climbing at 300 mph corresponds to an oxygen demand of about 18 ml/min/kg. Because only 62% of the individual maximum oxygen uptake (VO2 max) was used during prolonged hiking, a VO2 max of about 30 ml/min/kg is necessary to perform ascents at normal rates. Considering that VO2 max declines at the rate of 1% per 100 m altitude gain above 1,500 m, these values must be increased by 20% when mountaineering at 3500 m. Thus, endurance capacity may well represent a limiting factor, especially when the aerobic fitness declines with age or due to preexisting diseases.
Bajo nivel de forma física en los adolescentes españoles. Importancia para la salud cardiovascular futura (Estudio AVENA)

Introduccion y objetivos En diversos estudios se ha mostrado la relacion entre el nivel de forma fisica durante la infancia-adolescencia y el riesgo cardiovascular en la edad adulta. Dado que no se dispone de datos relativos al nivel de condicion fisica de los adolescentes espanoles, los objetivos de este estudio son: a) determinar el nivel de condicion fisica de los adolescentes espanoles y establecer valores de referencia que puedan ser utilizados en el medio sanitario y educativo como indicadores de salud cardiovascular, y b) conocer la proporcion de adolescentes espanoles que no alcanza valores de capacidad aerobica indicativos de salud cardiovascular futura. Sujetos y metodo Se ha utilizado la bateria EUROFIT modificada para evaluar la condicion fisica de una muestra representativa de adolescentes espanoles (n = 2.859; 1.357 varones y 1.502 mujeres) procedente del estudio AVENA (Alimentacion y Valoracion del Estado Nutricional de los Adolescentes). Resultados Se han obtenido los valores normativos de condicion fisica de la poblacion adolescente espanola. El rango del percentil 5 respecto a la capacidad aerobica maxima (test de Course Navette) es de 2,0-3,3 y 1,4-1,9 paliers para varones y mujeres, respectivamente. Casi 1 de cada 5 adolescentes presenta riesgo cardiovascular futuro sobre la base de su capacidad aerobica. Este subgrupo de adoles- centes mostro tambien una peor forma fisica que el resto de adolescentes en todas las pruebas fisicas realizadas. Conclusiones Los resultados obtenidos en el presente estudio permiten evaluar e interpretar correctamente el nivel de forma fisica de cualquier adolescente. Los resultados obtenidos indican la necesidad de mejorar el nivel de condicion fisica de los adolescentes espanoles.
Outcome of head injury in a tertiary hospital in Niger Delta, Nigeria: A prospective study

Background: Head injury is the leading cause of death worldwide. Measurement of outcome is essential in determining how the quality of care, the extent of injuries, and other variables affect the quality of lives in these patients. Aims and Objectives: To determine the general outcome of head injury in a young neurosurgical center and the effects of Glasgow Coma Scores at presentation on the outcome. Patients and Methods: It is a prospective descriptive study of patients who presented with head injury in a young neurosurgical center in tertiary hospital with poor infrastructural support from July 2010 to December 2012. Data were collected using structured proforma in accident and emergency, intensive care unit, wards and out-patient clinic. The data was analyzed with Environmental Performance Index (EPI) info 7 Software. Results: One hundred and seventy-seven patients were seen within the period. Males were 136 (76.8%). Those involved in road traffic accident were 130 (73.4%). There were 99 mild, 43 moderate, and 35 severe head injuries. The functional outcome was good in 89.3% (158) and the mortality was 10.1% (18). Glasgow Coma Scores at presentation significantly affected the outcome. Conclusion: The overall functional outcome in this study was good. Glasgow Coma Score at presentation influenced the outcome. Lack of infrastructural support should not discourage Neurosurgeons from starting neurosurgical center.