bluuebunny/crossref_metadata_2025 huggingface dataset:
P229 Hsv management in pregnancy at a joint antenatal-genitourinary clinic in a large maternity hospital in dublin, ireland – a model of care
Authors: Lynn Niamh , Murphy Sinead , Cunningham Orla , Lynam Almida , Lyons Fiona , Mulcahy Fiona
Published: May 2024

Introduction

The ultimate goal of HSV management in pregnancy is to prevent perinatal transmission and, where possible, to facilitate vaginal delivery.

Methods

Data was collected from antenatal charts of 107 women who reported a history of HSV or who had a documented outbreak during that pregnancy. Descriptive column statistics were used in excel for data analysis.

Results

From May 2013 to Feb 2017, 107 Women were seen in the clinic for management of HSV in 108 pregnancies. Median gestation at referral (82/108) was 23/40 (range 2–39/40). Mean age 33yr (range 18–45). 91 (85%) European. 9(8%) HIV+. 82 (76%) reported prior history. 96 (89%) had type-specific serology sent of which 89 (92%) HSV IgG +ve. 28 (31%) HSV 1 & 2 positive, 47 (52%) Type I positive only, 12 (13%) Type 2 positive only, 2 were weak + and not typed. 69 (63%) had STI testing, 100% negative. 4 of the 107 (80%) had primary HSV in that pregnancy. 67 received HSV prophylaxis; 66 valaciclovir; 1 aciclovir. Mean gestation starting prophylaxis was 36/40 (range 20 – 39). Data on mode of delivery on 82 of 107 (76%) pregnancies; 59 (71%) vaginal, 24 (29%) lower segment caesarean sections, none for HSV. Median gestation at delivery of 84 pregnancies 39/40 (range 29 – 41). To date no cases of perinatal HSV transmission have been reported.

Discussion

There is good compliance with Irish guidelines on HSV management in pregnancy. HSV2 remains an issue. This combined clinic facilitates good compliance with standard guidelines for HSV management in pregnancy. This model of care should be available across all antenatal settings.
P235 An audit of the care of msm attending an outer london integrated sexual health service
Authors: Dass Kavita , Fletcher Emma , Quartin Marcia , Kirlew Yasmyn , Thamby Rajah , Browne Rita
Published: May 2024

Introduction

Men who have sex with men (MSM) remain a high risk group for HIV infection, increased rates of syphilis, LGV and gonorrhoea indicating high levels of risky sexual behaviour. The aim of this audit was to measure care against BASHH recommendations for testing for STIs in MSM (2014) and local guidelines to ensure high quality accessible services for MSM.

Methods

Data were collected retrospectively from electronic patient records of all MSM first attendances across all clinics between 1 January 2015 to 30 June 2015 (N=96) and data analysed using SPSS and Excel.

Results

79% (76/96) of MSM were from our local borough; age range was 16–65 with highest attendance in the 25–29 years age group; 43% were from BME communities. 100% were offered STI screening, 91% accepted (87/96) and 47% had a STI diagnosed. 80% of MSM had a comprehensive assessment undertaken while 65% had a record of vaccination status. PEPSE discussion was recorded for 76% of eligible patients. 100% of suitable patients were offered HIV testing (n=88/96), 90% (79/88) tested with a positivity rate of 2.5% (2/79).

Discussion

The service is highly accessible to local MSM, STI testing offer exceeded the BASHH recommendation of 97% and uptake of 91% exceeded the BASHH recommendation of 80%. Uptake of HIV testing met the BASHH recommendation of 90% but improvements are needed in PEPSE and PREP discussions and determining Hepatitis B status in all eligible clients. EPR has been revised and staff training undertaken to address and improve on this.
P238 Working the streets – targetting migrant sex-workers through dedicated outreach
Authors: Braunholtz-Speight Jane , Turner Emily , Wallace Harriet , Schoeman Sarah , Evans Amy
Published: May 2024

Introduction

Sex-workers do not always engage with traditional healthcare settings and migrant sex-workers are a growing vulnerable group. Our city uses a ‘managed approach’ to sex-working, with focus on identifying exploitation and trafficking. This gives a unique opportunity for outreach.

Aim(s)/objectives

Provide accessible sexual healthcare, health promotion and contraception to sex-workers not accessing care. Evaluate this outreach service after one year.

Methods

A partnership was established between the Integrated Sexual Health service and a local Third Sector Sex-work Project. Sex-workers were offered STI testing, treatment, HepB vaccination and contraception in an outreach setting (own homes/workplaces, charity premises, streets).

Results (at one year):

129 sex-workers seen (289 contacts); 70/129 (55%) were migrant (majority Romanian), 113 contacts; 70% previously unknown to sexual health services. Contraception was extended over the first year and provided to 25 sex-workers; Hep B vaccination offered to all. 45 infections identified in 28/70 (40%) migrants (compared with 26 infections in 21/59 (36%) non-migrant sex-workers): 33/45 Chlamydia: 20 extra-genital (5 pharyngeal, 15 rectal); 5/45 Gonorrhoea (all extra-genital); 8/45 Trichomonas Vaginalis. 27/28 successfully treated (1 moved away). 4 women had re-infection on interval rescreening (all Chlamydia). 1 case of chronic HepB, 1 chronic HepC, no cases HIV or syphilis

Discussion

This new outreach service successfully targeted a vulnerable group with a disproportionately high STI burden (40%). Use of a dedicated outreach team achieved trusted relationships with sex-workers. Secondary benefits included a 250% increase in women identifying as sex-workers accessing mainstream clinics.
P245 Monitoring the uptake and early impact of targeted hpv vaccination among men who have sex with men (msm) attending gum and hiv clinics in england
Authors: Checchi Marta , Mesher David , McCall Mark , Chau Cuong , Panwar Kavita , Beddows Simon , Soldan Kate
Published: May 2024

Introduction

MSM are at high risk for HPV infection and associated disease (genital warts and anal, oropharyngeal, and penile cancers). Additionally, MSM will receive little or no herd protection from the existing national vaccination programme for females. Following Joint Committee on Vaccination and Immunisation (JCVI) advice, a targeted HPV MSM vaccination pilot was introduced in GUM and HIV clinics across England from June 2016. We present plans for monitoring vaccination uptake and surveillance of infection and early disease outcomes.

Methods

Uptake (of three doses over a two year period) will be monitored via two existing surveillance and reporting systems: the Genitourinary medicine clinic activity dataset (GUMCADv2) and the HIV and AIDS reporting system (HARS). A seroprevalence study conducted in selected clinics for validation of these data will be considered in due course.

Early impact of targeted HPV vaccination of MSM on the epidemiology of HPV infection will be detected by HPV DNA testing of rectal swabs (residual specimens following chlamydia testing) from MSM attending selected GUM clinics, starting with largely baseline collection in 2017.

Expected early effects on genital warts diagnoses will be monitored (via GUMCADv2). A decline in HPV-associated cancers is not expected to be seen for some years.

Discussion

A comprehensive surveillance strategy has been established to evaluate targeted HPV vaccination of MSM at GUM/HIV clinics. During the pilot, uptake will be the main outcome measure available, and surveillance systems will be established and baseline data collected to evaluate the outcomes of national implementation on infection and disease.
P247 An audit of hepatitis b and c testing in a sexual health service – an opportunity for cost saving
Authors: Bhaduri Sumit , Hanson Lucy , Spice William
Published: May 2024

Introduction

BASHH have recently updated guidelines as regards criteria for hepatitis B and C testing. Are patients accessing the service offered hepatitis B and C testing appropriately? Furthermore can this data be extrapolated to calculate potential cost reductions should audit data suggest overtesting.

Methods

100 case notes SHHAPT coded as T6 from 2 local clinics were scrutinised as to whether testing followed BASHH guidelines. In addition 50 case notes were randomly selected to ascertain whether a T6 code should have been applied.

Results

87/100 (87%) underwent hepatitis B testing of which 10/87(11%) were found to be inappropriate The reasons for testing in this 11% included sexual exposure in a low prevalence (mostly in Europe), saliva exposure, and a history of an ex-partner with multiple contacts – 38/100 underwent hepatitis C testing of which 14/38 (36%) were tested inappropriately—the reasons given included contact with men having sex with men(MSM) with no history of chemsex, contact with a HIV infected patient, sexual assault, sexual contact with an intravenous drug user and sexual exposure in Europe. In the audit of random selection of 50 casenotes- there were no cases of missed opportunities for hepatitis testing. Extrapolation of data showed that £1739 annually could be saved if all testing for hepatitis B and C was based on national guidance.

Discussion

Given the proven overtesting in the audit, guidelines are to be reiterated to clinical staff. It is hoped that this would translate to costs savings on an overstretched service pathology budget.
P248 Genital warts and treatment options: clinical audit
Authors: Patrick Helen , Jayasekara Niroshan , Fitzpatrick Colin , Finnerty Fionnuala , Wijerathna I , Murdock Rebecca , Richardson Daniel
Published: May 2024

Introduction

Genital warts are a common presenting condition in sexual health clinics. There are different treatment options available within BASHH guidelines depending on the size and location of warts. Home treatment reduces follow up clinic attendance.

Method

We randomly selected 30 patients attending our integrated sexual health service with new genital warts and audited their management against local guidance that home treatment with Imiquimod should be used first line for 4 weeks, unless contraindicated.

Results

Of the 30 patients, 18 were male and 12 were female. 14/30 were prescribed Imiquimod only. 7 patients had Cryotherapy only and 9 were also given cryotherapy before Imiquimod. 9/11 who received cryotherapy requested this treatment. 6/11 had documented reasons why it was deemed appropriate to have cryotherapy (unable to apply cream themselves, site of lesion). Interestingly, all 9/9(100%) who had received combination treatment reported clinical resolution within 4 weeks. 6/7(86%) who had cryotherapy only clinically resolved after 3 consecutive applications. 11/14(79%) treated with Imiquimod only resolved within 4 weeks, one deferred. 11/19(58%) treated with Imiquimod experienced side effects and five patients (5/11) sought medical advice. There were no reported complications following cryotherapy application.

Discussion

Despite imiquimod being the recommended first line initial treatment for genital warts in our service, some patients received cryotherapy treatment in isolation or a combination of imiquimod and cryotherapy. The patients receiving cryotherapy were likely to have requested this treatment and had less side effects. All patients who received imiquimod and cryotherapy had resolution of genital warts in four weeks.
O31 Explaining ethnic variations in sti diagnosis: results from britain’s third national survey of sexual attitudes and lifestyles (NATSAL-3)
Authors: Wayal Sonali , Hughes Gwenda , Sonnenberg Pam , Mohammed Hamish , Gerressu Makeda , Furegato Martina , Mercer Catherine
Published: May 2024

Introduction

In Britain, ethnic inequalities in STIs diagnoses persist. We hypothesised that these inequalities are associated with variations in sexual behaviour, which are influenced by differences in socioeconomic deprivation (SED) and mediated by substance use.

Methods

Data from 14,563 participants of Britain’s third National Survey of Sexual Attitudes and Lifestyles, a probability sample survey (N=15,162), were analysed by gender and ethnicity: white British (WB, reference category), black Caribbean (BC), black African (BA), Indian, Pakistani, white other (WO), and mixed ethnicity (ME). Using multivariable regression we examined ethnic variations in reported STI diagnoses adjusted for age, partner numbers (last 5y), recreational drug use (last 1y), and SED, and calculated adjusted odds ratios (AOR).

Results

SED was higher in BC, BA, and Pakistani participants than other ethnicities (50% vs. 16%-38%, p<0.0001). compared with men from other ethnicities, BC and BA men reported higher partner numbers (p<0.0001), and concurrent partnerships (27% and 39% respectively vs. 4%–15%, p=0.001). compared with women from other ethnicities, ME women reported higher partner numbers (p<0.0001) and concurrency (14% vs. 2%–8%, p=0.0005). Recreational drug use was highest among WO and ME participants (26% vs. 4%-15% among other ethnicities; p<0.0001). Reported STI diagnosis was highest among BC men (8.7) and ME women (6.7%), and remained AOR high after adjustment for BC men (2.68, 95%CI: 1.13–6.34) and ME women (2.03, 95%CI: 1.11–3.68).

Discussion

Ethnic variations in sexual behaviours, mediators, and SED partially explain higher STI diagnoses among BC men and ME women highlighting need for holistic interventions addressing these broader determinants.
O37 Genital dermatology is a high proportion of the case load presenting to walk-in sexual health services across the united kingdom
Authors: Hartley Anna , Bates Christine , Fernando Imali , Basavaraj Serish , Pritchard Jillian , Edwards Sarah , Sethi Cindy , Goorney Ben , Vijeratnam Dayan , Parameswaran Sashidharan
Published: May 2024

Introduction

Patients with genital dermatology (GD) conditions frequently present to sexual health services. Following service tendering, there are reports of contracts excluding provision of specialist GD services within sexual health. We aimed to review the case load of GD conditions presenting to walk-in sexual health clinics, to reach an understanding of the demand for these services within our specialty.

Methods

Members of the BASHH GD Specialist Interest Group collected data on the first 30 to 50 new symptomatic patients presenting to their sexual health walk-in service on 5thSeptember.

Results

382 patients presented to 9 services across England and Scotland. Of these, 164 (43%) presented with a GD condition. GD STI diagnoses (e.g. warts, herpes simplex) were excluded. 75 patients (20%) presented with non-STI GD conditions.

Of these, 59% were male, 91% heterosexual. The modal age range and ethnicity were 18–25 year olds (36%) and white British (67%).

GD diagnoses included: candida/tinea 17%, normal variant 11%, eczema 8%, non-specific balanitis 8%, irritant dermatitis 7%, vulvodynia 5%, lichen sclerosus 5%, lichen planus 3%, psoriasis 3%. 17% of cases required senior review. 33% had follow up: 32% by a Genitourinary Medicine consultant; 12% in a Genitourinary Medicine specialist clinic. 4% required skin biopsy.

Discussion

Our study demonstrates that non-STI GD conditions constitute a high proportion of clinical presentations to walk-in sexual health services. Many cases require in-house senior input. Commissioners must recognise the burden of GD on services and the expertise required to ensure optimal management of GD within sexual health.
O04 Findings from the men who have sex with men (MSM) internet survey ireland (MISI): estimated proportion of MISI respondents eligible for pre-exposure prophylaxis (PREP)
Authors: Nic Lochlainn Laura , O’Donnell Kate , Hurley Caroline , Lyons Fiona , Igoe Derval
Published: May 2024

Introduction

In Ireland, HIV infection predominantly occurs among men who have sex with men (MSM). Combination prevention approaches, including pre-exposure prophylaxis (PrEP), are recommended to reduce the risk of acquiring HIV. We used the 2015 MSM Internet Survey Ireland (MISI), a large-scale community survey among adult MSM in Ireland, to estimate the proportion of MISI respondents eligible for PrEP.

Methods

We applied PrEP eligibility criteria from France to MISI variables. Where exact criteria could not be applied, the most similar form was used. French PrEP eligibility criteria include HIV negative MSM or transgender adults who had at least one of the following: condomless anal sex (CAI) with ≥2 different partners in the past six months; episodes of STIs in the past 12 months; used multiple post-exposure prophylaxis (PEP) treatment(s) or used drugs during sex.

Results

MISI included 3,045 MSM aged 18–64 years; 2,870(94%) were HIV negative or never HIV tested. In the past 12 months, 370(12%) reported CAI with ≥2 non-steady partners; 243(8%) reported an STI diagnosis and 181(6%) used drugs associated with chemsex. Four percent (n=119) were treated with PEP. Overall, 23% [95%CI(22–25)] of MISI respondents are eligible for PrEP.

Discussion

An estimated one in four MISI respondents met French PrEP eligibility criteria. Applying this estimate to the MSM population in Ireland, taking study limitations, those engaged in services and assumed PrEP uptake into account, would enable calculation of the number of MSM eligible for PrEP. This estimate will be useful for informing PrEP policy in Ireland.
UG1 Management of symptomatic patients attending open access sexual health walk-in clinics in the UK
Authors: Khatun Azra , Agathangelou Gabriela , Yekini Stephen , Rose Thomas , Foley Elizabeth , Patel Rajul
Published: May 2024

Introduction

Following the NHS Act 2012, Sexual Health services (SHs) have been radically reshaped. Anecdotally many places report problems in maintaining open access services, particularly since local authorities became responsible for commissioning SHs as of 1 April 2013.

Aims

To assess whether SH walk-in clinics can accommodate symptomatic patients and if there is a difference in waiting time between male and female patients. To determine whether the expectations of lead clinicians working in SHs concur with the experience of front line services.

Methods

A postal questionnaire was sent to 262 UK SH clinics to assess lead clinicians’ predicted waiting times. Four researchers; 2 males and 2 females attended clinics as ‘patients’ reporting symptoms suggestive of an acute STI, clinic waiting time was recorded. 50% of clinics in each of the 17 BASHH branches were visited. SPSS v23 was used to analyse the data.

Results

Of the 131 clinics visited, 97.7% could accommodate symptomatic ‘patients’ on the same day. The observed waiting time ranged from 5-285 minutes. The median wait was 54 minutes respectively. There was no significant difference in waiting time between male and female ‘patients’ (p=0.110). 68/262 questionnaires were returned; 31 were from clinics which were visited. 13% of clinics underestimated the walk-in waiting time, while 23% over-estimated the walk-in waiting time, when compared with actual walk-in waiting time established during clinic visits.

Discussion

Despite strains on SHs, most clinics visited could accommodate patients on the same day. However, there is discrepancy between lead clinicians’ expectations and services provided.
UG5 Designing, delivering and evaluating a teaching toolkit for pre-exposure prophylaxis in men who have sex with men
Authors: Langrish Alexander , Pool Erica , Richardson Daniel
Published: May 2024

Introduction

Research on the knowledge of PrEP in healthcare workers including third sector workers is limited, and their knowledge will be vital to future national rollout. The aim of this study was to design and evaluate a teaching toolkit on PrEP to educate healthcare professionals and third-sector workers.

Methods

A 20 minute powerpoint teaching toolkit was designed and delivered to sexual health workers, third sector workers and medical students. A questionnaire was used to evaluate the toolkit, including perceived knowledge pre-toolkit, immediate post-toolkit, and >1-week post-toolkit.

Results

42 participants took part in teaching sessions. There was a 36% increase in mean perceived participant knowledge scores (maximum = 25) immediately after teaching (23.69), and a 26% increase >1-week after teaching (21.93) – when both are compared with a prior mean score of 17.45. This change in perceived knowledge increased significantly both immediately post and >1-week post when compared with pre-toolkit (Z = -5.351, p = <0.001; Z = -3.189, p = 0.001). Immediately after, 42/42 (100%) participants agreed they had some knowledge of the monitoring and tests for PrEP in comparison to 21/42 (50%) pre-teaching (Z = -4.753, p = <0.001). Overall 39/42 (93%) of participants strongly agreed it provided a good overview of PrEP, with 35/42 (84%) thinking it would help them to provide answers to those seeking to use PrEP.

Discussion

Perceived knowledge of PrEP increased following toolkit use and importantly was sustained >1-week post-toolkit when compared with prior knowledge. Toolkits such as this can help educate future PrEP advocates.
P003 Genital c. trachomatisinfections last longer in men than women, but are less likely to become established
Authors: Lewis Joanna , J. Price Malcolm , J. Horner Paddy , J. White Peter
Published: May 2024

Introduction

Rigorous estimates for the duration of untreated chlamydia infection are important for understanding its epidemiology and designing control interventions, but are only available for women. We have estimated the duration of untreated infection in men.

Methods

Data came from published studies in which untreated, chlamydia-infected men were re-tested at a later date. We used analysis methods that had previously been applied to data from women, which allow for a new infection to take one of multiple courses, each clearing at a different rate. We determined the optimal number of possible courses. Parameter estimates were obtained using a Bayesian statistical framework.

Results

The best-fitting model had two different courses of infection: ‘slow-’ and ‘fast-clearing’, as had been the case for women. In men only 68% (57%–78%) (median sample; 95% credible interval) of incident infections were ‘slow-clearing’, compared with 77% (69%–84%) in women. The posterior median estimate for the mean infection duration in men was 2.84 (0.87-18.79) years, compared with 1.35 (1.13–1.63 years) in women.

Discussion

Our estimated infection duration in men is longer than has previously been assumed. Male infections are less likely to become established (slow-clearing) than those in women but once established, tend to last longer. Long-term, asymptomatic infections in men – in whom chlamydia screening rates are lower – could be sustaining chlamydia prevalence in both sexes. This study provides an improved description of chlamydia’s natural history to better inform public health decision-making. We advocate further data collection to reduce uncertainty in estimates.
O05 Evaluation of the implementation of an express ‘test-and-go’ hiv/sti testing service for men who have sex with men in sexual health centre
Authors: Chow Eric , Fortune Ria , Dobinson Sheranne , Read Tim , Chen Marcus , Bradshaw Catriona , Fehler Glenda , Fairley Christopher
Published: May 2024

Introduction

Men who have sex with men (MSM) who are asymptomatic and do not require treatment are eligible to use the new express HIV/STI testing service called ‘Test-And-GO’ (TAG) or the general clinic service for an asymptomatic screen. We aimed to evaluation the utilisation of the TAG service.

Methods

MSM attending the clinic for a TAG service or a general clinic service between 5 August 2015 and 1 June 2016 were analysed. A general estimating equation regression model was constructed to examine the association between the use of TAG service and demographic characteristics, sexual behaviours, and HIV/STI diagnoses.

Results

Of the 4,212 consultations, 750 (17.8%) were TAG consultations and 3,462 (82.2%) were routine consultations for asymptomatic MSM at the general clinic. MSM were more likely to use the TAG service if they were aged >30 years (OR=1.32 [95% CI 1.10–1.58]), were born in Australia (OR=1.40 [95% CI 1.16–1.70]), and had ≤4 male partners in the last 12 months (OR=1.30 [95% CI 1.12–1.52]) but there was no significant difference between condom use in the last 12 months. MSM who used the TAG service had less syphilis but there were no differences in detection of gonorrhoea, chlamydia and HIV diagnoses between the two services.

Discussion

Demographic and some behavioural characteristics differed between the two services but other than syphilis there was no difference in STIs. The TAG service required less clinician time and hence created additional clinical capacity at the general clinic to see patients at higher risk.
P004 Prospective comparison of charcoal swabs versus near-patient direct culture plate inoculation for the culture of gonorrhoea in high-risk patients. a repeat audit
Authors: Parker Luke , Maxwell Helen , McSorley John , Brook Gary
Published: May 2024

Introduction

Gonorrhoea culture is required to monitor antibiotic resistance and is recommended for all patients known or suspected to be infected. In July 2016 a retrospective comparison of near-patient direct plating and transported charcoal swabs found that the culture positive rate was 24% lower for charcoal swabs. Since this audit, the laboratory service implemented an urgent transport system for charcoal swabs, in order to improve the reliability of this method.

Methods

Between July 2016 and January 2017 all patients who had a positive GC NAAT or were otherwise at high risk had two culture swab specimens taken from the infected site (cervical, male urethra, rectum, pharynx): 1. a charcoal swab sent to the laboratory for plating within two hours and 2. specimen directly plated onto VCAT GC selective agar.

Results

Of 139 positive NAATs across all sites, 47 were followed by both direct plating and charcoal swab. Of these 47 pairs of cultures, there were only 2 discrepancies between culture types (one with direct plating positive, charcoal negative, the other vice-versa).

Abstract P004 Table 1

Culture +ve rate by method and site

SiteCervixUrethraPharynxRectumTotalNo. of positive NAATs28503625139No. of patients in whom both methods of culture/transport used5249947No. (%) +ve by direct plate4 (80%)21 (88%)2 (22%)7 (77%)34 (72%)No. (%) +ve charcoal swab4 (80%)21 (88%)2 (22%)7 (77%)34 (72%)

Discussion

With the implementation of the new urgent transport system, there is no difference in the culture positive rates of direct plating versus charcoal swabs for GC culture. Provided the same high standards of transport are maintained, a change in practice, moving to charcoal swabs transported to the lab for GC culture and stopping direct plating, is recommended.
P016 Clinical utility of a mycoplasma genitalium (mg) referral detection assay in selected sexual health clinic attendees
Authors: Bull Lauren , Barber Tristan , Nwokolo Nneka , Jones Rachael , Rayment Michael
Published: May 2024

Introduction

Routine testing for MG in the UK is limited by a lack of assays. New assays are becoming available, with many detecting antimicrobial resistance. We reviewed our use of an MG PCR test, and our treatment of MG, to inform a new, broader testing strategy.

Methods

The clinical database was interrogated for all MG requests from November 2016-February 2017. Data collected: demographics, indication, test result, and treatment.

Results

85 samples were sent from 81 individuals: 79 (93%) were male, [39 (49%) MSM]. Indications for testing were: dysuria +/- discharge in 63 (74%), testicular/pelvic pain in 11 (13%), test of cure in 5 (6%), and contacts of infection in 3 (4%). 88% were tested on the second or greater attendance and 22 (26%) had already had received at least two antimicrobial treatments.

18/85 tests (21%) were positive for MG, of whom 17 (94%) had persistent or recurrent urethral discharge +/- dysuria. The remaining case was a female contact of recurrent NGU. Of the 17, 15 (88%) had previously been treated for NGU with azithromycin 1g (6, 40%) or doxycycline (5, 29%) or both (4, 24%). Eleven (61%) were treated with extended azithromycin (despite 5, (45%) having received azithromycin 1g already) and 4 (22%) with moxifloxacin.

Discussion

Testing for MG in our service is performed mainly in men with persistent/recurrent NGU. Prevalence of MG in this selected group was high. Despite the likelihood of resistance, many patients received repeat courses of macrolides. Earlier testing for MG may reduce time with symptoms and improve antimicrobial prescribing behaviour.
P023 Investigating the clinical value of treponema pallidum PCR within a UK gum clinic
Authors: Parsloe Alice , White David , Smit Erasmus
Published: May 2024

Introduction

Syphilis is a multistage STI caused by Treponema pallidum. The classic lesion of primary syphilis is a chancre – a single, painless, indurated ulcer with a clean base. The number of cases is on the rise, and it has been historically difficult to diagnose due to its variable presentation, requiring clinical correlation and multiple investigations. PCR use has increased recently in investigation of these ulcers. However, how crucial is PCR testing in primary syphilis, when cheaper investigations can lead to a diagnosis?

Methods

Investigation results were collected from 58 patients presenting between January and December 2015 who were treated for primary syphilis, including presentation, serology and PCR status. How they were diagnosed as having primary syphilis was noted and whether this was on presentation, follow up or via PCR.

Results

47 patients had a positive PCR, 11 patients had a negative PCR but were treated for primary syphilis. We found 3 patients would have not been picked up as having primary syphilis if there was no PCR performed. The sensitivity and specificity of Treponema pallidum PCR was 81% and 100% respectively.

Discussion

PCR was essential in diagnosing 3 patients with syphilis who would have been missed, therefore PCR is a crucial tool in contributing to the diagnosis of primary syphilis. The potential implications of missing syphilis diagnosis are serious, as patients can develop progressive disease and unknowingly affect sexual partners.
P027 Re-testing of patients with positive chlamydia results in primary care
Authors: McConnell Sarah , Hutchinson Jane , Symonds Merle
Published: May 2024

Introduction

We aimed to establish how many young people (aged 15–24 years) diagnosed with genital Chlamydia infection in General Practice (GP) in 2015 in an inner city area had Partner Notification (PN) discussed with them and were offered repeat testing three-six months after initial diagnosis in line with BASHH guidelines.

Methods

We identified young people with positive Chlamydia diagnoses made in GP in 2015 by searching the Chlamydia screening dataset from the hospital laboratory. We cross referenced with subsequent data sets for the year 2015 onwards to see if/when the patient was retested and where they were re-tested. For those re-tested in local GU clinics, we checked their records for evidence of PN initiated in primary care.

Results

Preliminary data from January – June 2015 shows that sixty nine 15–24 year olds were diagnosed with Chlamydia in GP; 11 re-tested within six months, seven of these between one and three months post-initial infection of which one was positive. Three of the 11 re-tested in GU clinics; two of these reported PN initiated by GP.

Discussion

Results so far show less than 1 in 5 young people diagnosed with Chlamydia in GP are being re-tested appropriately. It is possible that patients are travelling outside the area for re-testing and are missed by our sampling. Recommendations should include routine recall in GP for re-testing after three months to increase re-test rates.
P036 Improving larc uptake: a retrospective study into the role and impact of enhanced sexual health services in community pharmacies
Authors: Peacham Anthony , Symonds Merle , Sarner Liat
Published: May 2024

Introduction

Unwanted pregnancies and low uptake of LARC continues to be problematic in 15–44 year olds in an East London Borough. Between April 15 and March 16, 45 pharmacies were commissioned, as part of the local enhanced sexual health service (LES) to provide emergency hormonal contraception (EHC) and contraception advice with the aim of increasing LARC uptake in <25s and others at high risk of unwanted pregnancy. Pharmacies taking part in the pilot received PGD and safeguarding training and pathways into LARC were refreshed.

Methods

Analysis of self-sample STI tests via the Doctor’s Laboratory and consultations documented via PharmOutcomes, and corresponding search of PreView for attendances for contraceptive/LARC care during time period.

Results

35/45 pharmacies (77.8%) dispensed 324 Levonorgestrel (1500 microgram) doses to women resident in the borough >13 years (average age 24.9 years; range 14.2-49.6 years). 100% of <16s had Fraser competency assessed (4). 6.2% (20/324) women had >1 attendance for EHC. 16 women (4.9%) subsequently attended local CaSH/GUM services for LARC; 8 (2.5%) for implant; 4 (1.2%) for injectable; 4 (1.2%) for IUD.

Discussion

Pharmacy delivered EHC and signposting to LARC services in primary and secondary care is feasible. There were limitations in the ability to gather data regarding women accessing LARC in primary care following contact with pharmacy so these numbers may under report the actual figures of those accepting LARC following pharmacy contact. Online booking systems should be accessible to pharmacists to facilitate LARC referral. Further work looking at acceptability of this strategy should be conducted.
P042 Emergency, implantable & intrauterine contraception use among under 18s in an integrated sexual health service
Authors: Forbes Kimberley , Cassidy Seán , West Richard
Published: May 2024

Introduction

Teenage pregnancy can be reduced by timely access to emergency contraception (EC), implants, intrauterine (IU) devices and systems and quick-starting. Routine practice is to offer <18s all contraceptive methods, emergency IU contraception and quick-starting where appropriate.

Methods

In the financial year 2015–16 there were 1975 attendances of 998 individuals <18 at a sexual & reproductive health service. Data was analysed using an electronic report.

Results

526 were White British (52.71%). 691 (69.24%) of <18s and 153 (79%) of <16s lived in the local authority area. 824 (82.6%) were female. 86 (10%) of first attendances in those <18 were for EC. 18 (20.1%) were <16, of whom 12 (67%) were quick-started a hormonal method.

15/193 (7.8%) of those 13–15 and 39/805 (4.8%) of those 16–17 years were fitted with an implant. 9/805 (1.1%) of those aged 16-17 were fitted with an IU device, no insertions in 13–15 years.

As a proportion of all ages IU contraception and implant insertions in <18s accounted for 9/1065 (0.85%) and 54/627 (8.6%) respectively.

Discussion

The majority of <18 service users were local residents highlighting the importance of the availability of local services for people. Insertions of IU contraception in those <18 contributed a small proportion of total insertions undertaken. Further exploration of the acceptability and availability of IU contraception including EC for <18s is needed. We also suggest a review of those not quick-started after having EC to identify any barriers to access.
P051 Evaluation of the acceptability and impact of an online booking tool
Authors: Horn Kate , Hawkins Michelle , Kilvington Emily
Published: May 2024

Introduction

Finding smarter ways of working which meet the needs of increasingly IT-savvy clients and support their busy lifestyles is always a priority and provides an opportunity to innovate.

Informed by focus groups, we developed an on-line booking system, designed to be mobile-first, empowering people to book and manage their own appointments through a secure server.

Methods

We monitored use of the online booking system and impact on DNA rates, as well as user acceptability, through online feedback and continued engagement with user focus groups.

Results

In the first 5 months we have seen: Average 11% of all bookable appointments made on-line, with majority completed out of hours. 75+% users accessing from a mobile device. 10% reduction in call volumes to services, saving 213 hours of admin time. Improved patient experience and choice as evidenced through user survey: Very easy or easy to book an appointment online: 84%; Very likely or likely to use the website again: 95%. As yet DNA rates have been unaffected.

Discussion

The ability to book and manage appointments online has been well received by users and has reduced administrative time. Further tweaks have included a ‘text to cancel’ system which we anticipate will have a positive impact on DNA rates.

Investigation of different uptake rates between services has led to shared learning and it is anticipated that the average uptake of bookable appointments made online will reach the target of 20% within the next 3 months.
P052 Using modern technology to improve the management of initial presentation of herpes simplex virus infection – communication with patients and delivering pcr results
Authors: Metcalfe Rebecca , Caulfield Pauline , Fargie Fiona
Published: May 2024

Introduction

The first presentation of Herpes Simplex Virus (HSV) may be distressing, with severe symptoms and associated stigma pertaining to the diagnosis. Initial audit confirmed clinic staff were inconsistent with how the initial clinical diagnosis was relayed to patients, the amount of information given and how follow up and PCR test results would be provided. Best practice dictates that detailed information and uncertainties around diagnosis should be communicated.

Methods

Staff training was delivered using workshop style sessions and local protocol changed to highlight ‘10 key points’ to be communicated. An SMS used to deliver positive HSV PCR results was changed to include a bitlink to clinic website ‘Genital Herpes’ page and link to BASHH patient information leaflet. The automated results line was changed for PCR negative results, providing information for follow up if symptoms remained. A GP letter was created for PCR positives.

Results

Audit cycles were comparable in gender, age distribution, HSV type and PCR negativity rate. There was a significant improvement in the number of patients who received written information (p=0.0043), discussion on PCR sensitivity (p<0.0001), discussion on disclosure (p<0.0001) and significant reduction positive PCR results with no record of result being given (p=0.0091). There number of patients requiring follow up appointment for same episode of HSV did not change.

Discussion

Using modern technology can improve communication of important information to the patient and ensure the patient receives the result appropriately. Altering electronic resources can give more information and provide a back up when the diagnosis is unclear.
Generalized Lomb–Scargle analysis of 22 years of super-Kamiokande solar $$^8$$B neutrino data
Authors: Pasumarti Vibhavasu , Desai Shantanu
Published: May 2024

We apply the generalized Lomb–Scargle periodogram to 22 years data of solar$$^{8}$$8B neutrino fluxes detected by Super-Kamiokande. The primary motivation of this work was to check if the sinusoidal modulation at a frequency of 9.43/year (with a period of 38 days), which we had found to be marginally significant with the first 5 years of Super-K data, persists, with the accumulated data. We use four different metrics for the calculation of significance of any peaks in the Lomb–Scargle periodogram, which could be indicative of periodicities. We do not find any evidence for periodicity at the aforementioned frequency or any other frequency with the updated data. Therefore, the observed peak at 9.43/year with the first 5 years of Super-Kamiokande data was only a statistical fluctuation and its significance is negligible with the updated data.
Exploring Quantum Computing Paradigm: From Conceptualisation, Initial Adoption to Development
Authors: Tripathi Manas , Cherukuri Aswani Kumar , Bhasin Ashish , Jammalamadaka Subramanyam
Published: May 2024

Quantum computing (QC) holds promise for next-generation applications that requires exponential time to solve NP problems. However, even after 25+ years, researchers still struggle with stable error correction solutions for delivering a stable commercialised quantum universal quantum machine. Companies like IBM, Rigetti, and D-Wave have already started offering quantum annealers, intermediate quantum devices based on the qubit. Therefore, researchers believe that QC would be introduced as an extension of classical computers (CC), where CC would offload a specific computational intensive task. Cloud companies, including Amazon, Azure, and IBM, have already begun to provide cloud services where an organisation can use a QC to work on potential applications. This paper systematically analyses the need to provide QC as a service (QCaaS) for potential applications. Furthermore, we discuss the framework on which this service can be offered. Subsequently, we provide a detailed discussion of various toolkits, libraries, and simulators available for QC.
Graphitization of Neoproterozoic sedimentary marbles in The Aird, Scottish Highlands
Authors: Heptinstall Eleanor A. , Parnell John , Schito Andrea , Boyce Adrian J. , Armstrong Joseph G. T. , Muirhead David
Published: May 2024

Graphite occurs in Neoproterozoic (probable Loch Ness Supergroup) marbles of The Aird, in the Northern Highland Terrane, Scotland. The graphite occurs particularly in association with phlogopite mica, and also with other micas and Mg-chlorite. Although the graphite–phlogopite association is recorded widely elsewhere in mantle-derived rocks, our data suggest graphite at The Aird does not have a mantle origin. The carbon isotopic composition of the graphite (

δ

13
C: −1.6 to 0.4‰) indicates that graphitization occurred from a CO
2
-rich fluid associated with decarbonation or devolatilization reactions of a carbonate–silicate protolith. Graphite–phlogopite-bearing marbles in The Aird underwent extensive brecciation and hematite deposition that preceded carbon-rich, mantle-derived (carbonatite) fluids. Pyrite in veins within The Aird marble has a sulfur isotope composition depleted in
34
S (−16.6 to −15.5‰), suggesting a biogenic origin. Elsewhere in The Aird and in surrounding fenitized rocks,
34
S-enriched pyrite has sulfur isotope compositions between 6.1 and 7.7‰, outside the sulfur isotopic composition range of most carbonatite-hosted pyrite, suggesting that pyrite veining is likely to have been influenced by crustal fluid–rock interactions. The observations show that if the protolith has a carbonate–silicate composition, a graphite–phlogopite association can form without the need for mantle-derived fluids.
Efficient Particle-Based Fluid Surface Reconstruction Using Mesh Shaders and Bidirectional Two-Level Grids
Authors: Nishidate Yuki , Fujishiro Issei
Published: May 2024

In this paper, we introduce a novel method for particle-based fluid surface reconstruction that incorporates mesh shaders for the first time. This approach eliminates the need to store triangle meshes in a GPU's global memory, resulting in a significant reduction in the amount of memory needed. Furthermore, our method employs a bidirectional two-level uniform grid, which not only accelerates the computationally expensive stage of surface cell detection but also effectively addresses the issue of vertex overflow among the mesh shaders. Experimental results prove that our method outperforms the state-of-the-art method, achieving both acceleration and memory reductions simultaneously, without sacrificing quality. The method is highly practical, with no major limitations other than requiring a GPU that supports the mesh shaders.
Transforming a Non-Differentiable Rasterizer into a Differentiable One with Stochastic Gradient Estimation
Authors: Deliot Thomas , Heitz Eric , Belcour Laurent
Published: May 2024

We show how to transform a non-differentiable rasterizer into a differentiable one with minimal engineering efforts and no external dependencies (no Pytorch/Tensorflow). We rely on Stochastic Gradient Estimation, a technique that consists of rasterizing after randomly perturbing the scene's parameters such that their gradient can be stochastically estimated and descended. This method is simple and robust but does not scale in dimensionality (number of scene parameters). Our insight is that the number of parameters contributing to a given rasterized pixel is bounded. Estimating and averaging gradients on a per-pixel basis hence bounds the dimensionality of the underlying optimization problem and makes the method scalable. Furthermore, it is simple to track per-pixel contributing parameters by rasterizing ID- and UV-buffers, which are trivial additions to a rasterization engine if not already available. With these minor modifications, we obtain an in-engine optimizer for 3D assets with millions of geometry and texture parameters.
Deblur-GS: 3D Gaussian Splatting from Camera Motion Blurred Images
Authors: Chen Wenbo , Liu Ligang
Published: May 2024

Novel view synthesis has undergone a revolution thanks to the radiance field method. The introduction of 3D Gaussian splatting (3DGS) has successfully addressed the issues of prolonged training times and slow rendering speeds associated with the Neural Radiance Field (NeRF), all while preserving the quality of reconstructions. However, 3DGS remains heavily reliant on the quality of input images and their initial camera pose initialization. In cases where input images are blurred, the reconstruction results suffer from blurriness and artifacts. In this paper, we propose the Deblur-GS method for reconstructing 3D Gaussian points to create a sharp radiance field from a camera motion blurred image set. We model the problem of motion blur as a joint optimization challenge involving camera trajectory estimation and time sampling. We cohesively optimize the parameters of the Gaussian points and the camera trajectory during the shutter time. Deblur-GS consistently achieves superior performance and rendering quality when compared to previous methods, as demonstrated in evaluations conducted on both synthetic and real datasets.
Skill-Based Matchmaking for Competitive Two-Player Games
Authors: Yuksel Cem
Published: May 2024

Skill-based matchmaking is a crucial component of competitive multiplayer games and it is directly tied to how the players would enjoy the game. We present a simple matchmaking algorithm that aims to achieve a target win rate for all players, making long win/loss streaks less probable. It is based on the estimated skill levels of players. Therefore, we also present a rating estimation for players that does not require any game-specific information and purely relies on game outcomes. Our evaluation shows that our methods are effective in estimating a player's rating, responding to changes in rating, and achieving a desirable win rate that avoids long win/loss streaks in competitive two-player games.
FaceFolds: Meshed Radiance Manifolds for Efficient Volumetric Rendering of Dynamic Faces
Authors: Medin Safa C. , Li Gengyan , Du Ruofei , Garbin Stephan , Davidson Philip , Wornell Gregory W. , Beeler Thabo , Meka Abhimitra
Published: May 2024

3D rendering of dynamic face captures is a challenging problem, and it demands improvements on several fronts---photorealism, efficiency, compatibility, and configurability. We present a novel representation that enables high-quality volumetric rendering of an actor's dynamic facial performances with minimal compute and memory footprint. It runs natively on commodity graphics soft- and hardware, and allows for a graceful trade-off between quality and efficiency. Our method utilizes recent advances in neural rendering, particularly learning discrete radiance manifolds to sparsely sample the scene to model volumetric effects. We achieve efficient modeling by learning a single set of manifolds for the entire dynamic sequence, while implicitly modeling appearance changes as temporal canonical texture. We export a single layered mesh and view-independent RGBA texture video that is compatible with legacy graphics renderers without additional ML integration. We demonstrate our method by rendering dynamic face captures of real actors in a game engine, at comparable photorealism to state-of-the-art neural rendering techniques at previously unseen frame rates.