Trends in different contraception methods among women attending the Melbourne Sexual Health Centre from 2011 to 2020.

OBJECTIVES: The efficacy and availability of contraception have changed in the last several decades; however, unintended pregnancies continue to be an issue in Australia. This study aimed to describe trends in contraception in women attending a sexual health service over 9 years. STUDY DESIGN: Repeated cross-sectional study. METHODS: Women aged 16-49 years attending Melbourne Sexual Health Centre between 2011 and 2020 were included. Women were asked what methods of contraception they currently use. Contraception were categorised into long-acting reversible contraception (LARC; e.g. intrauterine devices and implants classified as highly effective), moderately effective contraception (e.g. oral contraception pill), less effective contraception (e.g. condom and withdrawal) and no contraception, as defined by US Centers for Disease Control and Prevention guidelines. Multivariable logistic regression was used to examine the factors associated with the use of moderate-high-efficacy contraception. RESULTS: A total of 38,288 women were included with a median age of 25 (interquartile range: 22-29). Between 2011 and 2020, there was a decreasing trend in condom (63.3%-56.1%; Ptrend <0.001) and oral contraception (27.2%-20.5%; Ptrend <0.001) use, whilst there was an increasing trend in the use of LARCs: implant (4.6%-6.0%; Ptrend = 0.002) and intrauterine device (2.8%-11.8%; Ptrend <0.001). Increasing age was associated with decreased odds of using moderate-high-efficacy contraception (Ptrend <0.001). Compared with Oceanian-born women, Asian (adjusted odds ratios [aOR] = 0.63, 95% confidence interval [CI]: 0.56-0.72) and Middle Eastern-born women (aOR = 0.60, 95% CI: 0.48-0.74) had lower odds of using moderate-high-efficacy contraception, whilst European (aOR = 1.23, 95% CI:1.07-1.41) and North American-born women (aOR = 1.51, 95% CI: 1.22-1.87) had higher odds of using moderate-high-efficacy contraception. CONCLUSIONS: Between 2011 and 2020, LARC use has increased, whilst less effective contraceptives, such as condom and oral contraception, have decreased among women at Melbourne Sexual Health Centre. Further research is required to understand age and ethnic disparities in contraception methods for future family planning programmes.

Multi-omics for studying and understanding polar life.

Polar ecosystems are experiencing amongst the most rapid rates of regional warming on Earth. Here, we discuss 'omics' approaches to investigate polar biodiversity, including the current state of the art, future perspectives and recommendations. We propose a community road map to generate and more fully exploit multi-omics data from polar organisms. These data are needed for the comprehensive evaluation of polar biodiversity and to reveal how life evolved and adapted to permanently cold environments with extreme seasonality. We argue that concerted action is required to mitigate the impact of warming on polar ecosystems via conservation efforts, to sustainably manage these unique habitats and their ecosystem services, and for the sustainable bioprospecting of novel genes and compounds for societal gain.

Major haemorrhage after non-surgical management of oropharyngeal squamous cell carcinoma.

OBJECTIVES: Major haemorrhage is a rare complication after chemoradiotherapy for oropharyngeal squamous cell carcinoma. This is managed by interventional neuroradiology with endovascular embolisation of the bleeding vessel. This study aimed to describe radiological and clinical predictors of haemorrhage. METHODS: A retrospective case series was conducted of all patients with oropharyngeal squamous cell carcinomas who suffered a major haemorrhage requiring embolisation during or after treatment with chemoradiotherapy or radiotherapy alone, between 2013 and 2021, in Western Australia. RESULTS: This study included 14 patients, in two groups: haemorrhage group (n = 70) and tumour stage matched non-haemorrhage group (n = 7). Patients who haemorrhaged had a larger average transverse axial tumour size on pre-treatment computed tomography (38 mm vs 22 mm; p = 0.02) and tumours tended to involve the proximal aspect of the offending bleeding vessel. All patients who haemorrhaged developed deep cavitating or ulcerative tumour bed changes on post-treatment imaging (p < 0.0001). CONCLUSION: Tumour bed ulceration or cavitation appears to be highly predictive of haemorrhage in this patient cohort.

Does Group Contact Shape Styles of Pictorial Representation? A Case Study of Australian Rock Art.

Image-making is a nearly universal human behavior, yet the visual strategies and conventions to represent things in pictures vary greatly over time and space. In particular, pictorial styles can differ in their degree of figurativeness, varying from intersubjectively recognizable representations of things to very stylized and abstract forms. Are there any patterns to this variability, and what might its ecological causes be? Experimental studies have shown that demography and the structure of interaction of cultural groups can play a key role: the greater the degree of contact with other groups, the more recognizable and less abstract are the representations. Here we test this hypothesis on a real-world dataset for the first time. We constructed a balanced database of Indigenous Australian rock art motifs from both isolated and contact Aboriginal groups (those often in contact with other groups). We then ran a survey asking participants to judge the recognizability of the motifs and to provide interpretations. Results show that motifs from contact Aboriginal groups were more likely to be judged as inter-subjectively recognizable and also elicited more convergent descriptions than motifs from isolated groups. This is consistent with the idea that intergroup contact is likely to be an important factor in the cultural evolution of pictorial representation. We discuss the implications of these findings for the archaeology and anthropology of art, and the parallels with language evolution.

Peri-adolescent exposure to (meth)amphetamine in animal models.

Experimentation with psychoactive drugs is often initiated in the peri-adolescent period, but knowledge of differences in the outcomes of peri-adolescent- vs adult-initiated exposure is incomplete. We consider the existing animal research in this area for (meth)amphetamines. Established for a number of phenotypes, is lower sensitivity of peri-adolescents than adults to acute effects of (meth)amphetamines, including neurotoxic effects of binge-level exposure. More variable are data for long-term consequences of peri-adolescent exposure on motivational and cognitive traits. Moreover, investigations often exclude an adult-initiated exposure group critical for answering questions about outcomes unique to peri-adolescent initiation. Despite this, it is clear from the animal research that (meth)amphetamine exposure during the peri-adolescent period, whether self- or other-administered, impacts brain motivational circuitry and cognitive function, and alters adult sensitivity to other drugs and natural rewards. Such consequences occurring in humans have the potential to predispose toward unfortunate and potentially disastrous family, social and livelihood outcomes.

Developing a prototype for integrated dental and diabetes care: understanding needs and priorities.

BACKGROUND: Periodontal treatment may be a useful adjunct to medical management of diabetes; however, oral health has not been integrated into multidisciplinary diabetes care in Australia. This study aimed to understand the needs of patients and staff at a diabetes clinic to inform a prototype of integrated dental and diabetes care. METHODS: Quantitative and qualitative data were collected from patients and staff at West Moreton Diabetes Clinic (WMDC) between September-October 2019. Clinical information, survey responses and dental screening results were analysed for 41 patients. Semi-structured interviews were held with six patients and a focus group with seven staff. RESULTS: Most patients (83%) had not seen a dentist in the previous year. Of the 37 patients with remaining natural teeth, 84% required periodontal assessment and 46% had multiple carious lesions. Unmet treatment needs and rates of access were similar for private and public dental patients. Staff and patients reported high levels of support for incorporation of dental care at WMDC. CONCLUSIONS: Integrating oral health into diabetes management is well-supported by patients and staff to address significant unmet dental needs for both public and private dental patients. Incorporating dental screening/services within diabetes clinics may increase uptake and improve awareness of its importance in diabetes management.

Maternal antioxidant treatment prevents the adverse effects of prenatal stress on the offspring's brain and behavior.

Maternal exposure to stress during pregnancy is associated with an increased risk of psychiatric disorders in the offspring in later life. The mechanisms through which the effects of maternal stress are transmitted to the fetus are unclear, however the placenta, as the interface between mother and fetus, is likely to play a key role. Using a rat model, we investigated a role for placental oxidative stress in conveying the effects of maternal social stress to the fetus and the potential for treatment using a nanoparticle-bound antioxidant to prevent adverse outcomes in the offspring. Maternal psychosocial stress increased circulating corticosterone in the mother, but not in the fetuses. Maternal stress also induced oxidative stress in the placenta, but not in the fetal brain. Blocking oxidative stress using an antioxidant prevented the prenatal stress-induced anxiety phenotype in the male offspring, and prevented sex-specific neurobiological changes, specifically a reduction in dendrite lengths in the hippocampus, as well as reductions in the number of parvalbumin-positive neurons and GABA receptor subunits in the hippocampus and basolateral amygdala of the male offspring. Importantly, many of these effects were mimicked in neuronal cultures by application of placental-conditioned medium or fetal plasma from stressed pregnancies, indicating molecules released from the placenta may mediate the effects of prenatal stress on the fetal brain. Indeed, both placenta-conditioned medium and fetal plasma contained differentially abundant microRNAs following maternal stress, and their predicted targets were enriched for genes relevant to nervous system development and psychiatric disorders. The results highlight placental oxidative stress as a key mediator in transmitting the maternal social stress effects on the offspring's brain and behavior, and offer a potential intervention to prevent stress-induced fetal programming of affective disorders.

Neurofibromatosis type 1: More than skin deep.

Dermatologic findings manifest in childhood, but the disease progresses to multiple organ systems. Here's how to proceed if you diagnose this in your patient.

Demonstration of Muon-Beam Transverse Phase-Space Compression.

We demonstrate efficient transverse compression of a 12.5 MeV/c muon beam stopped in a helium gas target featuring a vertical density gradient and crossed electric and magnetic fields. The muon stop distribution extending vertically over 14 mm was reduced to a 0.25 mm size (rms) within 3.5 µs. The simulation including cross sections for low-energy µ^{+}-He elastic and charge exchange (µ^{+}↔ muonium) collisions describes the measurements well. By combining the transverse compression stage with a previously demonstrated longitudinal compression stage, we can improve the phase space density of a µ^{+} beam by a factor of 10^{10} with 10^{-3} efficiency.

Non-genetic factors that influence methamphetamine intake in a genetic model of differential methamphetamine consumption.

RATIONALE: Genetic and non-genetic factors influence substance use disorders. Our previous work in genetic mouse models focused on genetic factors that influence methamphetamine (MA) intake. The current research examined several non-genetic factors for their potential influence on this trait. OBJECTIVES: We examined the impact on MA intake of several non-genetic factors, including MA access schedule, prior forced MA exposure, concomitant ethanol (EtOH) access, and gamma-aminobutyric acid type B (GABAB) receptor activation. Selectively bred MA high drinking (MAHDR) and low drinking (MALDR) mice participated in this research. RESULTS: MAHDR, but not MALDR, mice increased MA intake when given intermittent access, compared with continuous access, with a water choice under both schedules. MA intake was not altered by previous exposure to forced MA consumption. Male MAHDR mice given simultaneous access to MA, EtOH, and an EtOH+MA mixture exhibited a strong preference for MA over EtOH and EtOH+MA; MA intake was not affected by EtOH in female MAHDR mice. When independent MAHDR groups were given access to MA, EtOH, or EtOH+MA vs. water in each case, MA intake was reduced in the water vs. EtOH+MA group, compared with the water vs. MA group. The GABAB receptor agonist R(+)-baclofen (BAC) not only reduced MA intake but also reduced water intake and locomotor activity in MAHDR mice. There was a residual effect of BAC, such that MA intake was increased after termination of BAC treatment. CONCLUSIONS: These findings demonstrate that voluntary MA intake in MAHDR mice is influenced by non-genetic factors related to MA access schedule and co-morbid EtOH exposure.

A high-resolution polarimeter formed from inexpensive optical parts.

We describe a high resolution laser polarimeter built from commodity optical components. The optical rotation angle is determined by measuring the phase difference between two harmonically modulated polarised laser beams - an 'object beam' that passes through the sample under test and a 'reference beam' that bypasses the sample. The complete polarimeter may be assembled from low cost off-the-shelf parts for less than £300 (UK Sterling). Data acquisition and analysis are carried out on a microcontroller running an efficient algorithm based on the sliding Discrete Fourier Transform. Despite its low cost, the polarimeter is a fully automatic, research-grade instrument with an accuracy of ±0.0013° and a precision of ±0.0028° - comparable to far costlier commercial instruments. The polarimeter's ease of use, compact size, fast measurement times and high angular resolution make it a capable and versatile tool for analytical science, while its low cost means it is ideally suited for use in resource-constrained environments and process monitoring. The polarimeter is released here as open hardware, with technical diagrams, a full parts list, and source code for its firmware included as Supplementary Information.

Relationship Type and Use of the Vaginal Ring for HIV-1 Prevention in the MTN 020/ASPIRE Trial.

Gender roles and imbalances in sexual power contribute to the heightened HIV-1 risk faced by women in Sub-Saharan Africa. This has led prevention research to focus on the development of female controlled methods. Despite the design of products such as vaginal rings to be used autonomously by women, male partners and women's perceptions of relationships influence HIV prevention choices. To understand the influences that male partners and dyadic dynamics had on the use of the Dapivirine Vaginal Ring in the ASPIRE trial, this analysis of qualitative data explored the types of intimate partner relationships that women engaged in. This paper describes how partners facilitated or challenged women's ring use and how women dealt with these challenges within six different types of relationships characterized by power dynamics and commitment levels. We offer insights into how future use of female-initiated HIV prevention products can be promoted through recognition of different relationship types.

Chondromalacia of the cranial medial femoral condyle; its occurrence and association with clinical outcome in a population of adult horses with stifle lameness.

BACKGROUND: Chondromalacia of the cranial medial femoral condyle (CMFC) is a potential cause of stifle lameness in adult horses. However, there is scant published evidence of either its occurrence or its clinical significance. OBJECTIVES: To document the occurrence of CMFC seen during diagnostic arthroscopy in adult horses with stifle lameness and to investigate its prognostic significance. STUDY DESIGN: Retrospective cohort study. METHODS: The records were reviewed of all horses with unilateral or bilateral lameness localised to the stifle that underwent diagnostic arthroscopy of the cranial medial femorotibial joint at a UK equine hospital. The surgical findings were noted from each. Case outcomes were determined by unstructured telephone discussions with owners. A satisfactory outcome was defined as a horse that was in ridden work without ongoing anti-inflammatory medication. Multivariable logistic regression was used to create a model with an outcome time point at 12-month post-operatively. RESULTS: One hundred and four horses were included in the study. CMFC was found in 79. In 25 CMFC was the only finding, 54 horses had CMFC plus other pathology and 25 had other pathology, but no CMFC. At 12 months, horses with CMFC were 9.9 (95% CI 2.2-45.0, P<0.01) times more likely to have an unsatisfactory outcome than horses without CMFC. MAIN LIMITATIONS: The study relied on retrospective analysis of clinical notes and archived arthroscopy videos. Assessment of outcome was determined by unstructured telephone interview and therefore there is potential for reporting errors to exist. CONCLUSIONS: CMFC is a common arthroscopic finding in horses with stifle lameness and is significantly associated with an increased likelihood of the horse not being in ridden work at long-term follow-up.

Pathological margins and advanced cutaneous squamous cell carcinoma of the head and neck.

OBJECTIVE: The recommended treatment for cutaneous squamous cell cancer (CuSCC) of the head and neck is Mohs surgical excision or wide local excision. Excision is recommended to a gross surgical margin of 4-6 mm however this is based on limited evidence and specify a goal histologic margin. The objective of this study was therefore to examine the reported histological margin distance following WLE of advanced CuSCC and its association with recurrence and survival. STUDY DESIGN: Retrospective database review. SETTING: All patients included received treatment at UC Davis Department of Otolaryngology-Head and Neck Surgery and/or Radiation Oncology in Sacramento, California. SUBJECTS AND METHODS: The patients included were treated for advanced CuSCC with primary surgery with or without adjuvant therapy. Kaplan Meier survival curves with log rank analysis were then performed to compare 5-year recurrence free survival, and disease-specific survival for patients with different margin distances. RESULTS: Total number of subjects was 92. The overall 5-year DSS and RFS was 68.8 and 51.0% respectively. When the pathological margin distance was ≥5 mm, 5-year disease specific survival was improved when compared to margin distance less than 5 mm (94.7 vs 60.7 p = 0.034). CONCLUSION: The findings of this study suggest that a histologic margin of at least 5 mm may increase survival in advanced head and neck CuSCC patients.

Microbial evaluation of automated sorting systems in stone fruit packinghouses during peach packing.

Automated fruit sorting systems with individual fruit carriers are utilized in modern fruit packing facilities. This study evaluated the levels of naturally occurring microflora on the surfaces of peaches and fruit carriers during automated sorting operations at stone fruit packinghouses in California. The study also assessed the growth potential of Salmonella enterica and Listeria monocytogenes on fruit carriers under various environmental conditions. No difference of microbial loads was found on peaches (n = 420) before, during, and after fruit sorting at seven packinghouses. The average surface total microbial, coliform, and yeast and mold levels of peaches during sorting were 3.6, 2.7, and 1.9 log CFU/cm2, respectively. Environmental swab testing indicated routine cleaning of fruit carriers (n = 192) reduced total microbes from 3.9 to 3.2 log CFU/cm2 (P = 0.003) and coliforms from 1.5 to 0.9 log CFU/cm2 (P = 0.001) on carriers' fruit contact surfaces. Laboratory exposures to temperature (22, 28, 34 or 40 °C) and humidity (65, 75, 85 or 95%) conditions significantly reduced inoculated Salmonella and Listeria on clean and commercially used (deposited with wax, fuzz, dirt, etc.) fruit carriers within 24 h (P < 0.001). The observed Salmonella reduction was greater on clean carriers (P < 0.001). On used carriers, Salmonella was persistent at 95% humidity and Listeria was persistent at 22 °C. The results showed the levels of surface microflora on peaches during fruit sorting, the reduction of microbial loads on fruit carriers due to packinghouses' cleaning, and the reduction, rather than growth, of Salmonella and Listeria under tested conditions on fruit carriers.

Burden of tuberculosis in HIV-positive pregnant women in Cape Town, South Africa.

BACKGROUND: The burden of active tuberculosis (TB) in pregnancy compared with preconception and postpartum is unclear, particularly with universal antiretroviral therapy (ART) initiation in pregnancy. METHODS: We retrospectively compared active TB incidence in the 18 months preconception, during pregnancy and up to 6 months postpartum in human immunodeficiency virus (HIV) positive women attending antenatal care at a primary health care facility in Cape Town from 2013 to 2014. RESULTS: Among 1513 women (4116 person-years [py]), 1489 (98.4%) received lifelong ART in pregnancy, and 79 TB episodes were identified. Unadjusted TB incidence rates (IR) preconception, during pregnancy and postpartum were 2466 (95%CI 1863-3202), 1127 (95% CI 600-1928) and 1447 (95% CI 694-2661) per 100 000 py, respectively. Adjusting for age and CD4 count at first antenatal visit and ART status, TB risk was lower during pregnancy (incidence rate ratio [IRR] 0.17 vs. preconception, 95%CI 0.09-0.31) and increased slightly postpartum (IRR 1.31 vs. pregnancy, 95%CI 0.56-3.07). CONCLUSION: Among HIV-positive women in South Africa, the TB burden preconception, during pregnancy and postpartum was substantial. The risk of TB during pregnancy was lower than preconception, but increased slightly postpartum; this represents missed opportunities for diagnosis, prevention and control. Improved TB prevention strategies and integrated care for HIV-positive women and their children are needed.

Evaluation of Pyrethroid Insecticides and Insect Growth Regulators Applied to Different Surfaces for Control of Trogoderma granarium (Coleoptera: Dermestidae) the Khapra Beetle.

The khapra beetle, Trogoderma granarium Everts (Coleoptera: Dermestidae), is a serious pest of stored products and is the only stored product insect pest that triggers a quarantine response when it is found in the United States. The larvae of T. granarium feed on a wide range of dry food products of plant and animal origin, including cereals, dried fish, and museum specimens. In this study, we evaluated the residual efficacy of two pyrethroid insecticides, deltamethrin and cyfluthrin, applied on concrete, wood, painted wood, vinyl flooring tile, and metal surfaces using small and large T. granarium larvae. Residual efficacy of two insect growth regulators (IGRs), methoprene and pyriproxyfen was also evaluated on concrete, metal, and wood surfaces. In both studies, larvae were exposed with provision of a food source on the treated surfaces and residual assays were conducted at 0 months (1 d), 1, 2, and 3 months post treatment. In general, both of the pyrethroids provided a high level of control of T. granarium larvae, though small larvae were much more susceptible than large larvae. The IGRs were comparatively less effective, with more larval survival and adult emergence of exposed larvae compared with the pyrethroids. Residues of the pyrethroids and IGRs were most persistent on the metal surface. Results can be used to help to control and eradicate infestations of T. granarium when they are detected in the United States.

Hair Loss: Common Causes and Treatment.

Hair loss is often distressing and can have a significant effect on the patient's quality of life. Patients may present to their family physician first with diffuse or patchy hair loss. Scarring alopecia is best evaluated by a dermatologist. Nonscarring alopecias can be readily diagnosed and treated in the family physician's office. Androgenetic alopecia can be diagnosed clinically and treated with minoxidil. Alopecia areata is diagnosed by typical patches of hair loss and is self-limited. Tinea capitis causes patches of alopecia that may be erythematous and scaly and must be treated systemically. Telogen effluvium is a nonscarring, noninflammatory alopecia of relatively sudden onset caused by physiologic or emotional stress. Once the precipitating cause is removed, the hair typically will regrow. Trichotillomania is an impulse-control disorder; treatment is aimed at controlling the underlying psychiatric condition. Trichorrhexis nodosa occurs when hairs break secondary to trauma and is often a result of hair styling or overuse of hair products. Anagen effluvium is the abnormal diffuse loss of hair during the growth phase caused by an event that impairs the mitotic activity of the hair follicle, most commonly chemotherapy. Physician support is especially important for patients in this situation.