bluuebunny/crossref_metadata_2025_split huggingface dataset:
P174 Clinical outcomes in adolescents with perinatally acquired HIV (PAH) transitioning from paediatric to adult care in a large regional HIV clinic in london
Authors: Hibbard Aime , Flanaghan Kate , Judd Ali , Prime Katia 
Published: May 2024

IntroductionWe assessed outcomes in PaH adolescents transitioning from paediatric to adult care within a regional HIV clinic.MethodsRetrospective case-note review 10/02/04–31/12/15. Data collected: demographics, CDC stage, viral loads (VL), CD4 counts, antiretroviral therapy (ART), resistance and loss to follow up; using a standardised database. Pre- and post-transition outcomes were compared using paired T-tests for means and McNemar’s Exact tests for proportions.Results57 patients; 29(51%) male, 34(60%) born outside UK, 51(89%) black African. Median age at diagnosis 3 years [range 0–18]; at transition 18 years [15–20]. Median time since transition 5 years [1 month–13 years]. At transition CDC B 27/57(47%), CDC C 18/57(32%), post transition 28/57(49%), 20/57(35%), respectively, including one suicide. Of those with ≥2 years data post-transition, 31/48(65%) had two consecutive VL>40c/mL or one VL>10,000c/mL in the 2 years pre-transition, compared with 22/48(46%) post-transition (p=0.035). Mean CD4 count 12 months pre/post-transition 520 c/mm3, 500 c/mm3, respectively (p=0.4). At transition 52/57(91%) on ART (vs. 55(96%) at last visit, p=0.1), 10/46(22%) 1st line (5/55(9%) last visit), median duration of ART 7 years [0–18]. Resistance: 18/46(39%) nil, 13/46(28%) ≥1, 13/46(28%) ≥2, 1/46(2%) ≥3 drug classes. 4 patients were lost to follow-up (LTFU), all returning within 5 years [1-5].DiscussionThere was no difference in mean CD4 pre or post-transition, but the proportion who were suppressed improved post-transition. CDC stage progressed in 3 adolescents. All patients had options for suppressive ART although few were on 1stline. There was no long-term LTFU.
P212 The clap trap: the effectiveness of partner notification for gonorrhoea in MSM in an lgbt community sexual health clinic
Authors: Turner Kevin , King Miranda , Priestley Cecilia 
Published: May 2024

IntroductionHigh rates of partner change, multiple casual partners, and complex sexual networks are thought to contribute to outbreaks of Neisseria gonorrhoea (GC) in men who have sex with men (MSM), who account for 42% of diagnoses in the UK. Prompt, appropriate treatment and effective partner notification are key to reducing transmission. We audited partner notification for GC in MSM attending an LGBT community sexual health clinic.MethodsA retrospective audit over 12 months (2015–16). A total of 33 episodes of GC were diagnosed in 31 patients. Data was recorded on a spreadsheet for analysis.Results25(76%) were asymptomatic. 29(88%) underwent triple site testing and 4(12%) dual site. Gonorrhoea was detected in the pharynx in 23(70%), urethra in 7(21%), and rectum in 14(42%). 7(21%) had dual and 2(6%) triple site infection. 29/33(88)% were informed of the diagnosis within 10 days (target 95%). 28/33(85%) were treated within 2 weeks. 6 attended as contacts of GC and were treated on the day they attended. A total of 109 contacts were given. 50(46%) were untraceable. Of the traceable contacts, 31/59(53%) were confirmed as treated, 23 at the same clinic. A total of 0.9 contacts were treated per index case (target 0.6).DiscussionThe high frequency of unknown casual partners in MSM with GC means there is often inadequate information to trace partners. Nevertheless, this audit has shown good outcomes for partner notification in a community LGBT sexual health clinic. This should contribute to reducing onward transmission in a high risk MSM population.
P215 Sharing the journey; public and commissioner experiences in developing e-service pathways in sexual health
Authors: Reid Simon , Clarke Jan , Mezzone Jane , O’Sullivan Jonathan , Murchie Martin 
Published: May 2024

IntroductionThe London e-service is an innovative online digital health solution including: Health promotion and education; risk assessment and triage process to access self-sampling kits; provision of self-sampling kits in clinic and online; diagnostics; remote treatment for uncomplicated chlamydia; results management and partner notification.MethodsOver 5000 service users were engaged through waiting room and online surveys, interviews and public groups. There was an appetite for an online service in some segments of the population. Clinicians and commissioners worked collaboratively to develop the e-service pathway. The vision was for a high quality health pathway where the service user seamlessly travels between appropriate providers. The pathway development factored in: service user choice; clear referral pathways; protocols for safeguarding; enhanced results management and partner notification; appropriate treatment.Results27 boroughs participated in the collaborative procurement of the London e-service. The integration of the e-service and sexual health clinics remains a critical success factor. The pathway focuses on 2 main areas of interaction between providers: 1) The e-service ‘offer’ in a clinical environment; a specialist behaviour change company is working with the e-service and providers to develop channel shift resources. This is backed by a clinical service specification with associated KPIs. 2) Ensuring appropriate access to service user results and case history. This requires data sharing agreements and innovative technology solutions. The pathway was further finessed through the negotiation phase, with e-service bidders suggesting additional commercial solutions.DiscussionCan an e-service help improve access, user experience, outcomes and manage resources?
O28 Experience of female genital mutilation (FGM) in a sexual health clinic
Authors: Neill Lorna , Dolan Zac , Murphy Siobhan , McSorley John , Brook Gary 
Published: May 2024

IntroductionAfter recommendations from the Intercollegiate Guidelines in 2013, our sexual health clinic introduced a diagnostic code and mandatory proforma to identify, record and report FGM.MethodsRetrospective case note review of all patients coded FGM.ResultsAll patients presenting were over 18. There were 210 FGM patients; 30/210 Type 1 (clitoridectomy); 40/210 Type 2 (excision); 35/210 Type 3 (infibulation); 79/210 Type 4; 26/210 unclassified. 71 had consensual FGM as adults; of whom 69 were Type 4 (typically genital piercing), 2 were Type 1.In FGM performed under 18 years old (139); average age of cutting was 6 years. Countries involved; Somalia 67% (93/139), Sierra Leone 7% (9/139), Eritrea, Nigeria and Ethiopia 4% (6/139) respectively. 14% (19/139) reported complications.12% (17/139) had prior reversal. 4% (6/139) expressed interest in reversal. 98% (136/139) knew FGM is illegal in the UK.Abstract O28 Table 1Associations if FGM performed under 18 years old or over 18 years old.AssociationFGM types 1–4 <18yrsFGM type 1–4 >18yrsP valuePelvic pain/PID17% (23/139)6% (4/71)0.0289HIV/Hepatitis B/C11% (15/139)3% (2/71)0.0596There was no significant difference in the rates of bacterial STI’s between both groups.DiscussionOur proforma assists in identifying and accurately recording information regarding FGM. No women required referral to police or social services. Some were signposted for surgical intervention. An increased incidence of pelvic pain was noted in those whose FGM was performed as children, with no reflected increase in bacterial STI’s. An increased prevalence of blood borne viruses was also noted. Most women reported negative attitudes to FGM. Sexual health clinics are well placed to assist in awareness, risk assessment and education surrounding FGM.
P240 What are the vaccination needs of msm in the current hepatitis a virus (hav) outbreak? a retrospective study of the hav immune status in first-attendance msm in a london gum clinic
Authors: Brook Gary , McSorley John 
Published: May 2024

IntroductionHepatitis A infection in MSM increased in incidence from late 2016 in the UK and has reached outbreak status. By February 2017, 42 confirmed or suspected cases had been reported in London. BASHH hepatitis guidelines recommend HAV vaccination of MSM in outbreak situations.MethodsWe looked at 100 consecutive MSM who attended our service for the first time in early 2016 to assess what the vaccination needs of MSM would be.ResultsSixty seven of these MSM had a baseline HAV total antibody test of which 33 (49%) were HAV-Ab positive. A further 5/66 (8%) MSM gave a history of HAV vaccination but were antibody negative. 16/33 (48%) HAV-immune MSM gave a history of previous vaccination. 7/66 (11%) of the MSM who were immune, but non-vaccinated, came from HAV-endemic countries and presumed naturally immune.49/98 (50%) who had baseline HBV antibody levels were HBV-immune of whom 14/49 (29%) were also HAV immune.Extrapolating from these data, our estimates for baseline vaccination requirements in new MSM were: 28% require monovalent HAV vaccine, 24% require monovalent HBV vaccine, 21% require bivalent HAV/HBV vaccine and 27% require no vaccine.DiscussionIf these data are representative of MSM in London, 49% (57% including those vaccinated but HAV-Ab –ve) are already HAV-immune. This has implications with regards to estimating the pool of non-immune MSM at-risk. It also enables us to estimate the types of vaccine required to meet the MSM’s needs in relation to HAV as well as HBV in the current outbreak
P001 What is the evidence that previous azithromycin treatment for chlamydia or gonorrhoea is associated with neisseria gonorrhoeae azithromycin resistance?
Authors: Clifton Soazig , Town Katy , Furegato Martina , Cole Michelle , Mohammed Hamish , Woodhall Sarah , Dunbar Kevin , Fifer Helen , Hughes Gwenda 
Published: May 2024

IntroductionThe prevalence of azithromycin resistance inNeisseria gonorrhoeae(NG) including high-level resistance (HL-AziR NG) is increasing in England. It has been suggested that exposure to azithromycin at sub-optimal doses may facilitate development of azithromycin resistance in NG. We investigated whether treatment history for non-rectal chlamydia (CT) or NG (as proxies for azithromycin exposure) in GUM services was associated with susceptibility of NG to azithromycin.MethodsDescriptive and negative binomial regression analyses of azithromycin Minimum Inhibitory Concentration (MIC) data from 4608 NG isolates collected by the Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) 2013–2015 (matched to GUMCADv2 data on CT/NG diagnoses) were performed. Descriptive analyses of previous CT/NG among 56 HL-AziR NG isolates (MIC>256 mg/L) were also performed (2013–2016).ResultsModal azithromycin MIC was 0.25mg/L (1 dilution below the resistance breakpoint) in those with and without history of CT or GC. There were no differences in MIC distribution by previous CT/NG, nor by time since most recent infection (CT: p=0.97; NG: p>0.99). Among patients with HL-AziR NG, 4 (8%) were treated for CT and 4 (8%) for NG in the previous year, compared with 9% and 13% respectively for all GRASP patients.DiscussionThere was no evidence of an association between previous CT/NG treatment in GUM services and subsequent presentation with an azithromycin-resistant strain. However, 46% of CT diagnoses occur in non-GUM settings therefore further research is needed to explore whether an association with azithromycin exposure in other settings and for other conditions exists.
P029 Auditing gonorrhoea treatment and antibiotic sensitivity
Authors: Wilson Yvonne , Johnson Cathy , Murtagh Una , McCartney Joanne , McRoberts Sandra , Perry Fionnuala 
Published: May 2024

IntroductionWith diagnoses of Gonorrhoea on the rise and increased rates of resistance being reported, nurses carried out and audit to establish the level of compliance with current British Association of Sexual Health and HIV guidelines in relation to the treatment of patients diagnosed with GC and to analyse antibiotic sensitivity.MethodsRetrospective case note review of episodes coded B was carried out looking at age, ethnicity, sexual orientation, co-infections, treatment, resistance, number of partners in past 3 months, test of cures and follow up serology.Results69 cases reviewed, 33 MSM, 32 heterosexual, 4 bisexual. 10 patients were known HIV positive, 12 patients had 1 other co-infection, 4 had 2 other co-infections.66 (96%) treated with first therapy of Ceftriaxone 500mg IM/Azithromycin 1G, 19 of these were also given Doxycycline 100mg twice daily for 1 week. 2 (3%) treated with Ceftriaxone 500mg IM/Doxycycline 500mg twice daily for 1 week. 45 (65%) fully sensitive to recommended antibiotics 13 (19%) reduced sensitivity to 1 antibiotic group 8 (11%) reduced sensitivity to 2 antibiotic groups. 4 (5%) reduced sensitivity to 3 antibiotic groups Our 5 cases of high level Azithromycin resistance were included. No cultures were resistant to CeftriaxoneDiscussionTreatment and management was in line with BASHH guidelines, it also highlights the developing problem with resistant infection, the importance of monitoring antibiotic sensitivity and effective partner notification in the effort to treat the infection adequately and reduce risk of transmission.
O08 HPV 16 and 18 seropositivity and dna detection among men who have sex with men: evidence for the potential benefit of vaccination
Authors: Mesher David , King Eleanor , Sonnenberg Pam , Linley Ezra , Beddows Simon , Soldan Kate , Borrow Ray , Gilson Richard 
Published: May 2024

IntroductionTo estimate the prevalence of antibodies to HPV16 and HPV18, and genital HPV DNA among MSM attending a London sexual health clinic, to inform the potential benefit of vaccination in a high risk population.MethodsA cross-sectional study of 18-40 year-old MSM including a computer-assisted self-interview for behavioural data, and collection of extra-genital and intra-anal swabs, and blood. Anogenital samples were tested for 21 genotypes of HPV DNA using an in-house assay. Blood samples were tested for anti-HPV16 and HPV18 IgG by ELISA.Results496 MSM were included: among HIV negative MSM, HPV16 seroprevalence was 27% (95%CI 23–31) and HPV18 was 16% (13–20); HPV16 and 18 DNA prevalence 12.6% (9.8–15.9) and 6.0% (4.0–8.5) respectively. In HIV-positive MSM, seroprevalence was 58% (95% CI 37–77) and 35% (95%CI 17–56), and DNA prevalence 29.6% (13.8–50.2) and 11.1% (2.4–29.2) respectively.After adjusting for age and lifetime partners, seropositivity for anti-HPV–16 and/or HPV–18 was associated with: HIV-positive diagnosis (HPV16-aOR: 3.16 [95%CI 1.37–7.28]), receptive anal sex in the last three months (HPV16-aOR: 3.39 [2.01–5.71]; HPV18-aOR: 2.14 [1.18–3.90]), use of drugs anally (HPV18-aOR: 2.07 [1.05–4.10]) and anogenital same-type DNA detection (HPV16 aOR: 3.58 [2.05–6.23]; HPV18 aOR:2.71 [1.17–6.27]).DiscussionAnogenital HPV DNA detection was less frequent than, but strongly associated with same-type HPV seropositivity. Most MSM attending a sexual health clinic had no serological or DNA evidence of exposure to HPV infection. This supports the case for the potential benefit of targeted HPV vaccination of MSM attending sexual health clinics, as currently being piloted in England.
P037 Why do women discontinue long acting reversible methods of contraception? – findings from an integrated sexual health clinic
Authors: Chikoburo Izu , Dear William , Ohizua Omi , Acharya Sashi , Arumainayagam Joseph 
Published: May 2024

IntroductionLong acting methods of contraception, namely the progestogen only implant and the intra-uterine devices are reliable methods of contraception, favoured by commissioners of integrated sexual health. However in practice, a number of women discontinue these for a variety of reasons thus leading to reduced cost effectiveness. We aimed to determine the number of discontinuations among those who had them fitted in the integrated sexual health clinic and the reasons for doing so.MethodsRetrospective analysis of the case notes on the electronic database for all women who had an implant, copper intra-uterine device or the Mirena intra-uterine device during September 2014 was collected. Reasons noted by the clinician for removing the device and any adjuvant therapy that was prescribed was noted.ResultsA total of 183 women had one of the three methods fitted during this period. Of these 36% had them removed after a median of 2.16 years. Of those who had the implant fitted, 49% had them removed after a median of 1.84 years. Vaginal bleeding was quoted as the reason for removal in 51% of the women. Of the 25% of the women who had the Mirena IUD removed, vaginal bleeding was the reason in 44%. Variety of reasons were noted among the 36% of women who had copper IUD fitted.DiscussionOur findings has shown that vaginal bleeding was the predominant reason for discontinuation for the implant and Mirena IUD. This has shown that appropriate management of irregular vaginal bleeding may lead to longer retention of long acting methods of contraception.
O09 The impact of an HPV vaccination programme in young men who have sex with men (MSM) on clinical presentations with genital warts
Authors: Coleman Harry , O’Farrell Nigel , Kapembwa Moses , Brook Gary , McSorley John 
Published: May 2024

IntroductionWe introduced a quadrivalent HPV (HPV4) vaccination programme in young MSM <27yrs attending our clinical services (Clinic 1 & 2) since 2012. We assess the impact on attendance with genital warts (GW) subsequent to vaccination in this population and an adjoining service (Clinic 3) not then offering vaccination.MethodsWe identified all MSM <27yrs receiving at least one dose HPV4 at Clinics 1 & 2, and all MSM <27yrs attending Clinic 3, between 2012 and 2017. Demographic and clinical data was extracted from electronic patient records. HPV DNA testing was not performed.Abstract O09 Table 1Clinical Outcomes in HPV4 vaccinated and unvaccinated MSM under 27yrsCharacteristicClinic 1& 2 HPV programme No./Total (%)Clinic 3 No HPV programme No./Total (%)Probability value p =History of prior/current GW75/757(9.9%)27/180(9.6%)p = 0.06Ever Re-attended524/757(69%)81/180(45%)p = 0.0001Subsequent episode of GW: Re-attenders11/524(2%)22/81(27%)p = 0.0001Subsequent episode of GW: All11/757(1.5%)22/180(12%)p = 0.0001New cases of GW3/757(0.4%)4/180(2%)p = 0.0285ResultsCurrent or prior history of GW was comparable in the 2 clinic populations. Re-attendance rates were lower in the clinic without active recall. Recurrent episodes of GW was higher 22/180 (12%) in the unvaccinated population than the vaccinated group 11/757 (1.5%). Incidence of new cases of GW, defined as a first clinical episode > 3 months since 1stvaccine, was significantly lower in the vaccinated population.DiscussionWe observed a significant reduction in subsequent episodes and potential new episodes of GW in an unselected population of MSM receiving HPV4 vaccine. Significant clinical benefit and saving can be expected from an HPV4 programme in MSM.
A novel energy-saving method for campus wired and dense WiFi network applying machine learning and idle cycling techniques
Authors: Alvarado Ricardo , Suárez Alvaro 
Published: May 2024

University campus networks need wired (ethernet) and dense wireless fidelity networks that have devices like access points, switches, and routers that are always turned on. Consequently, they generate two important problems: the energy bill and the influence of carbon dioxide into the atmosphere. Energy savings are the solution to those problems. There are several proposals to augment the energy savings separately in ethernet and wireless fidelity, but there is no integrated method to simultaneously reduce them in both parts of the networks. Our novel method combines idle cycling and machine learning techniques to efficiently obtain energy savings in both parts of the network simultaneously. We categorize network devices into two groups: (a) those that are always turned on and (b) those that can be dynamically turned on or off based on network performance. We formulated two algorithms that decide when to turn on and off access points. We use Ward's machine learning hierarchical clustering technique to optimize the energy savings of our model in the network of the Unidades Tecnológicas de Santander (Bucaramanga, Colombia). We showed that energy savings of 21.5 kWh per day are possible. The success of the model in this context highlights its potential to achieve substantial energy savings.
Quasi-spherical gravitational collapse in f(R,T) gravity
Authors: Wang Chuyun , Asghar Hajra , Shah Hasrat Hussain , Shah Hassan 
Published: May 2024

This paper deals with the study of quasi-spherical gravitational collapse in the framework of [Formula: see text] theory. We will divide geometry of the star into two distinct portions i.e. interior portion and exterior portion. In the interior portion, we consider quasi-spherical Szekeres line element and in the exterior portion we take Vaidya line element. The interior and exterior portions will be glued by using Israel’s junction conditions [W. Israel, Il Nuovo Cimento B (1965–1970) 44, 1 (1966); W. Israel, Phys. Lett. A 24, 184 (1967)]. The field equations will be derived in the context of [Formula: see text] theory for a particular model. Apparent horizons and their time configuration for various desirable cases will also be discussed.
Role of Allee and Fear for Controlling Chaos in a Predator–Prey System with Circulation of Disease in Predator
Authors: Das Krishna Pada , Patra Anirban , Mondal Seema Sarkar , Kaur Rajinder Pal , Pal Biswadip , Ali Md Firoj , Ghosh Sayantari , Sikari Somnath 
Published: May 2024

This paper explores a predator–prey system featuring fear and disease within the predator population,utilizing the Rosenzweig–MacArthur model with Holling type-II functional response. The primary focus lies in investigating the impact of a fear factor, wherein the prey’s growth rate is hindered due to predator-induced fear. Additionally, the model accounts for the spread of disease among predators,leading to a division between susceptible and infected predator subpopulations. The inclusion of an Allee effect in the susceptible predator further enriches the model. The study involves a thorough examination, encompassing local and global stability analysis as well as Hopf bifurcation analysis around the interior equilibrium point. Numerical simulations underscore a noteworthy observation: an escalation in interaction force propels the system into chaotic dynamics,marked by stable focus, limit cycles and period-doubling phenomena. A noteworthy finding pertains to the influence of the Allee parameter ([Formula: see text]) on chaotic dynamics. As the Allee parameter values increase, the system tends to stable focus through a sequence of chaotic states, period-doubling and limit cycles. Subsequently, the paper introduces the role of another pivotal parameter, the fear factor, into the chaotic dynamics. Intriguingly, chaos transforms into stable focus through diverse nonlinear phenomena, including period-doubling and limit cycles. This nuanced exploration of parameters sheds light on the intricate dynamics governing the predator–prey system, offering a comprehensive understanding of the interplay between fear, disease and ecological factors. So our observation throughout this paper that how chaos behaves here after one by one injection of our new features: fear factor and Allee parameter?