TORO Indexer: a PyTorch-based indexing algorithm for kilohertz serial crystallography.

Serial crystallography (SX) involves combining observations from a very large number of diffraction patterns coming from crystals in random orientations. To compile a complete data set, these patterns must be indexed (i.e. their orientation determined), integrated and merged. Introduced here is TORO (Torch-powered robust optimization) Indexer, a robust and adaptable indexing algorithm developed using the PyTorch framework. TORO is capable of operating on graphics processing units (GPUs), central processing units (CPUs) and other hardware accelerators supported by PyTorch, ensuring compatibility with a wide variety of computational setups. In tests, TORO outpaces existing solutions, indexing thousands of frames per second when running on GPUs, which positions it as an attractive candidate to produce real-time indexing and user feedback. The algorithm streamlines some of the ideas introduced by previous indexers like DIALS real-space grid search [Gildea, Waterman, Parkhurst, Axford, Sutton, Stuart, Sauter, Evans & Winter (2014). Acta Cryst. D70, 2652-2666] and XGandalf [Gevorkov, Yefanov, Barty, White, Mariani, Brehm, Tolstikova, Grigat & Chapman (2019). Acta Cryst. A75, 694-704] and refines them using faster and principled robust optimization techniques which result in a concise code base consisting of less than 500 lines. On the basis of evaluations across four proteins, TORO consistently matches, and in certain instances outperforms, established algorithms such as XGandalf and MOSFLM [Powell (1999). Acta Cryst. D55, 1690-1695], occasionally amplifying the quality of the consolidated data while achieving superior indexing speed. The inherent modularity of TORO and the versatility of PyTorch code bases facilitate its deployment into a wide array of architectures, software platforms and bespoke applications, highlighting its prospective significance in SX.

Which diagnoses and arguments regarding severe mental disorder do forensic psychiatric experts in Sweden consider in different cases? A qualitative vignette study.

The decision-making process of experts in forensic psychiatric investigations (FPI) is complex and reasoning regarding psychiatric diagnosis and severe mental disorder (SMD, the judicial concept central to legal exemption in Swedish law) has severe ramifications. Nevertheless, the qualitative aspects of FPI experts' decision-making process have seldom been studied systematically. METHOD: The participants (N = 41) were FPI experts: forensic psychiatrists (n = 15), forensic psychologists (n = 15) and forensic social workers (n = 11). Using three case vignettes and qualitative content analysis, it was explored how case-specific characteristics could affect which hypotheses FPI experts generated regarding a) psychiatric diagnosis and b) severe mental disorder and c) which information sources they required. Each case vignette described a diagnostically ambiguous case but indicated emphasis on: psychotic symptoms (case 1); personality disorder symptoms (case 2) and neurodevelopmental disorder symptoms (case 3). RESULTS: Experts reasoned in a similar manner regarding generating hypotheses and required information, but also in a case-adapted manner. Experts considered various diagnostic alternatives, and some (e.g. psychosis) were mentioned for all three cases. Other diagnoses were only suggested as hypotheses in certain cases (e.g. case 3: intellectual disability). DISCUSSION: In Sweden, a core basis for SMD is psychotic-like functioning, and psychosis was suggested as a hypothesis for all three cases. Experts reasoned in similar ways regarding SMD in all cases, considering various perspectives for and against SMD. Some case-specific arguments for and against SMD adapted to the psychopathological circumstances were found. These could be related to aspects of the SMD concept that become important to ascertain when the type of psychopathology indicated in the case vignette was present; for example, ascertaining reality monitoring for a person with potential delusions of being followed by a criminal gang requires investigation of criminal history and related conflicts. Taken together, FPI-experts considered a broad range of psychiatric diagnoses in various cases. Their reasoning regarding SMD was both based on general and case-specific (or psychopathology-specific) factors.

Are Queer Men Queering Consent? A Scoping Review of Sexual Consent Literature Among Gay, Bisexual, Trans, and Queer Men.

Objectives: To review the literature on Gay, Bisexual, Trans, and Queer (GBTQ) men and sexual consent. Methods: Eight electronic databases were searched in June 2022, yielding 1924 articles; 30 were included for review after screening. Results: We found a growing body of literature focused on GBTQ men, with an increasingly intersectional lens. Most studies adopted a nuanced definition of sexual consent. Many discussed the unique sexual scripts developed by GBTQ men to communicate consent, especially in sex venues, and how unfamiliarity with these scripts creates vulnerability for newly "out" men. A common theme was the impact of heteromasculine norms on sexual encounters between GBTQ men. Conclusions: The reviewed literature problematizes binary definitions of consent and miscommunication theories of assault. It both celebrates and problematizes GBTQ sexual cultures. We encourage future research to adopt more explicitly anti-carceral approaches to studying sexual consent and violence.

The influence of social knowledge structures on hostile attribution bias in aggressive and nonaggressive individuals: An ERP study.

According to several social-cognitive models, social knowledge structures described as hostile scripts or schemas may explain why aggressive individuals are prone to attribute hostile intention to others' ambiguous behaviors, a cognitive bias called hostile attribution bias (HAB). The aggression-related concepts in aggressive individuals' semantic memory would be highly accessible, notably through the activation of hostile concepts in nonhostile social contexts, and such an activation would result in HAB. The aim of the study was to test this hypothesis using the N400 component with EEG measurements to assess objectively, in real time, the violation of hostile expectations following a nonhostile situation. To this end, scenarios with a clear nonhostile context (mismatch condition) vs. without nonhostile context (match condition) followed by a character's ambiguous provocative behavior were presented to readers, and ERPs to critical words that specified the hostile intent behind the behavior were analysed. Twelve aggressive and twelve nonaggressive individuals participated in the study. The presentation of a critical word (hostile intent) that violated nonhostile expectation caused an N400 response among nonaggressive whereas such an N400 effect was absent in aggressive individuals. The results suggest that, in nonaggressive individuals, a nonhostile social context activates nonhostile concepts, whereas in the same context, aggressive individuals activate nonhostile as well as hostile concepts. Numerous research applications of the Hostile Expectancy Violation paradigm in the field of HAB are discussed.

Clinical reasoning in real-world practice: a primer for medical trainees and practitioners.

Clinical reasoning is a crucial skill and defining characteristic of the medical profession, which relates to intricate cognitive and decision-making processes that are needed to solve real-world clinical problems. However, much of our current competency-based medical education systems have focused on imparting swathes of content knowledge and skills to our medical trainees, without an adequate emphasis on strengthening the cognitive schema and psychological processes that govern actual decision-making in clinical environments. Nonetheless, flawed clinical reasoning has serious repercussions on patient care, as it is associated with diagnostic errors, inappropriate investigations, and incongruent or suboptimal management plans that can result in significant morbidity and even mortality. In this article, we discuss the psychological constructs of clinical reasoning in the form of cognitive 'thought processing' models and real-world contextual or emotional influences on clinical decision-making. In addition, we propose practical strategies, including pedagogical development of a personal cognitive schema, mitigating strategies to combat cognitive bias and flawed reasoning, and emotional regulation and self-care techniques, which can be adopted in medical training to optimize physicians' clinical reasoning in real-world practice that effectively translates learnt knowledge and skill sets into good decisions and outcomes.

Comparative analyses of the information content of letters, characters, and inter-word spaces across writing systems.

One difference among writing systems is how orthographic cues are used to demarcate words; although most alphabetic scripts use inter-word spaces, some Asian scripts do not explicitly mark word boundaries (e.g., Chinese). It is unclear whether these differences are arbitrary or whether they are designed to maximize reading efficiency. Here, we show that spaces inserted between words in non-demarcated scripts provide less information about word boundaries than spaces in demarcated scripts. Furthermore, despite the fact that less information is contained by inter-word spaces than characters/letters of the same size, the information content of inter-word spaces in demarcated scripts is closer to that of characters/letters compared to the information content of inter-word spaces that are inserted in non-demarcated scripts. These results suggest that the conventions used to demarcate word boundaries are sufficient to support efficient reading. Our findings provide new insights into the universals and variation across writing systems and shed light on the mental processes that support skilled reading.

The relationship between caregivers and daughters' food and body shape scripts: A dyadic analysis.

Research indicates a key role for parenting in a daughter's relationship with food and body shape. One possible mechanism for this translational process is through scripts. The present study used a dyadic design to investigate the relationship between caregivers and daughters' scripts regarding food and body shape. Caregivers (n = 40) and their daughters (n = 40) rated word lists of their current and childhood scripts and caregivers completed an additional measure of their parenting scripts. Non-dyadic analysis showed consistent correlations between daughters' current scripts and their recollections of childhood scripts, and several (but less consistent) correlations between caregivers' current scripts, their own childhood scripts and the scripts they had used as a parent. Dyadic analysis showed consistent correlations between the daughter's current scripts relating to negative eating and both positive and negative body scripts and their caregiver's parenting scripts, and between the daughter's current scripts relating to positive and negative eating and body looking positive and their caregiver's current scripts. No associations were found between the daughter's current scripts and the caregiver's childhood scripts. The results indicate that whilst daughters' current scripts relating to food and body shape are often concordant to those reported by their caregivers, they are more closely linked to what they remember from their childhoods. Further, they suggest that those scripts which do transfer between generations may be more related to body size and negative eating than food per se. Finally, the results suggest that scripts do not inevitably pass across the generations possibly due to parents choosing not to repeat the errors of their own parents or due to the role of factors other than just parenting in creating the scripts we hold.

Cultural psychological factors in posttraumatic symptom development and expression: a study protocol.

Introduction: Cultural factors were shown to be particularly relevant for the development and expression of posttraumatic stress. Recently, the concept of cultural scripts of trauma has been introduced, which proposes that trauma sequelae elements may be sequentially linked and specifically associated with cultural factors. Furthermore, a cascade model is proposed, including trauma exposure, demographic characteristics, cultural affiliation, and trauma-related value orientations as influencing factors of posttraumatic development. The purpose of this Network Project is to investigate cultural psychological factors that contribute to the expression of posttraumatic stress.Methods: The present Network Project implements a mixed methods approach and will be conducted in 5 different study sites, including Switzerland, Israel, Georgia, China, and East Africa. In sub-study I, the cultural scripts of traumatic stress inventories (CSTIs) will be developed. These scales provide a pool of trauma sequelae elements for each cultural group. For this purpose, focus groups with trauma survivors and trauma experts will be conducted and analysed using qualitative research methods. Sub-study II implements a validation analysis of the CSTIs and the empirical investigation of a cultural cascade model. This quantitative approach will include a larger sample of individuals who experienced traumatic life events.Discussion: This contribution is timely and enriches the knowledge of trauma and culture. Future publications of this Network Project will address trauma sequelae from a cultural perspective and provide diagnostic and psychotherapeutic implications.

This paper presents a Network Project that investigates cultural factors in posttraumatic sequelae.The Network Project encompasses an innovative research design with both qualitative and quantitative methods.New developments in the field of cultural clinical psychology are introduced, including cultural scripts of trauma and a cascade model of cultural factors in posttraumatic symptom expression.

"It Is A Purposefully Ambiguous Term": Examining Emerging Adults' Definitions of Hooking Up and How They Vary by Sex/Gender and Educational Background.

The majority of past work on hooking up among emerging adults uses a researcher-led definition and often uses college student samples. The purpose of this study was to qualitatively examine participant-led definitions of hooking up using a large sample (N = 701) of college-attending and non-college emerging adults. Most definitions included behaviors (91.7%), a partner type (64.3%), and references to commitment (69.2%). However, considerable variation in definitions within these categories was identified, in particular with reference to commitment. In our sample, definitions attended to what a hook "is" and "is not" as it relates to commitment. Hookup characteristics were also discussed in definitions, including frequency of hooking up, decision making, sexual health and safety, and purposes for hookups. Participants regularly referenced other common terms in relation to hooking up, including one-night stands, casual sex, no strings attached, and friends with benefits. For some, hookups were similar to these other types of casual sex experiences, whereas for others hooking up was distinct. We also quantitatively examined proportional differences in definitional categories and sub-categories based on sex/gender (men vs. women) and educational background (college-attending vs. non-college). Although some proportional differences were found, in general men and women and college-attending and non-college emerging adults defined hookups in similar ways. Programming focused on emerging adult romantic and sexual relationship education would benefit from addressing these subtle, but meaningful variations, as individuals enact hookup scripts based on how they define their encounters. Future opportunities for research to integrate both researcher-led and participant-led definitions of hooking up are discussed.

Evidence that personalized racial stress procedures elicit a stress response and increases alcohol craving among Black adults with alcohol use disorder: A laboratory pilot study.

BACKGROUND: The objective of this study was to pilot test newly developed personalized imagery procedures to investigate the impact of racial stress on alcohol craving and emotional and physiological response in Black adults with alcohol use disorder (AUD). METHODS: Twenty Black adults (45% women, meanage=37.05, SDage=13.19) with AUD participated in two sessions. In the first, participants described a stressful personal event involving their race and a neutral relaxing situation and these descriptions were used to develop scripts for the subsequent laboratory exposure session. The second session was an experimental provocation session in which participants reported on alcohol craving and emotional response before and after imagined exposure to stress and neutral conditions using personalized racial stress and neutral/relaxing scripts. Conditions were randomized and counterbalanced across subjects, and heart rate and blood pressure were assessed before and after each image. RESULTS: Alcohol craving and negative emotions significantly increased, and positive emotions decreased following the racial stress script relative to the neutral/relaxing script. We found no differences in physiological response. Exploratory analyses found that increase in alcohol craving was correlated with racial identity exploration but not racial identity commitment, men reported greater reductions in anger than women in the neutral condition only, and income was correlated with fear in the racial stress condition only. CONCLUSIONS: This study provides evidence that personalized racial stress procedures elicit a stress response and increases alcohol craving and emotional response but not physiological response among Black adults with AUD. These findings warrant replication in a larger study.

The stability of life script and life story events of Nigerian young adults across religion and gender.

The cultural life scripts are shared semantic knowledge of the expected life course in a given culture characterised by a bump for positive events in the second and third life decades, but none for negative events [Berntsen, D., & Rubin, D. C. (2004). Cultural life scripts structure recall from autobiographical memory. Memory & Cognition, 32, 427-442. https://doi.org/10.3758/BF03195836]. We investigated the stability of Nigerian young adults' life scripts and life stories across religion and gender. One-hundred-and-seventy-four participants completed the life script and life story tasks, and the revised religious orientation scale. We found that the life scripts and life stories consisted of mainly positive events with a reminiscence bump located in the 10s and 20s; however, we also found a small bump for negative events. There was a high mention rate of religion-specific events in both the life scripts and life stories of participants across religion and gender. The level of religiosity had effects on the importance ratings of the life scripts and life stories. In sum, despite minor variations, the life scripts and life stories were consistent across religion and gender.

Sex Differences in Sexual Motivation in Humans and Other Mammals: The Role of Conscious and Unconscious Processes.

In self-report questionnaires, men report higher scores than women on variables such as desire for sex, frequency of sexual thoughts, number of sex partners, etc. Based on this, men are considered to have a higher level of sexual motivation than women. However, retrospective self-reports may be unsuitable for estimations of the inherent level of sexual motivation. We review data on automatic (unconsciously controlled) responses and measures of implicit motivation during exposure to sexual stimuli. These responses and measures are inaccessible to willful manipulations and make it possible to determine whether the sex difference in answers to questionnaires is replicated when volitional response manipulations are unlikely. We complement the human data with observations from some rodent and non-human primate species. The attentional resources allotted to stimuli with sexual relevance as well as genital responses to such stimuli are similar in men and women. Measures of implicit motivation also fail to detect any sex difference. Finally, the frequency of masturbation is superior in female infants before the age at which social expectations begin to determine behavior. Neither in rodents nor in non-human primates is there any clear-cut evidence for sex differences in motivation. It seems that males and females are similar with regard to the intensity of sexual motivation. The responses to questionnaires may be affected by social learning of sexual scripts and/or the inferior quality of sexual experiences in women, among other things.

Using ChatGPT in Psychiatry to Design Script Concordance Tests in Undergraduate Medical Education: Mixed Methods Study.

Background: Undergraduate medical studies represent a wide range of learning opportunities served in the form of various teaching-learning modalities for medical learners. A clinical scenario is frequently used as a modality, followed by multiple-choice and open-ended questions among other learning and teaching methods. As such, script concordance tests (SCTs) can be used to promote a higher level of clinical reasoning. Recent technological developments have made generative artificial intelligence (AI)-based systems such as ChatGPT (OpenAI) available to assist clinician-educators in creating instructional materials. Objective: The main objective of this project is to explore how SCTs generated by ChatGPT compared to SCTs produced by clinical experts on 3 major elements: the scenario (stem), clinical questions, and expert opinion. Methods: This mixed method study evaluated 3 ChatGPT-generated SCTs with 3 expert-created SCTs using a predefined framework. Clinician-educators as well as resident doctors in psychiatry involved in undergraduate medical education in Quebec, Canada, evaluated via a web-based survey the 6 SCTs on 3 criteria: the scenario, clinical questions, and expert opinion. They were also asked to describe the strengths and weaknesses of the SCTs. Results: A total of 102 respondents assessed the SCTs. There were no significant distinctions between the 2 types of SCTs concerning the scenario (P=.84), clinical questions (P=.99), and expert opinion (P=.07), as interpretated by the respondents. Indeed, respondents struggled to differentiate between ChatGPT- and expert-generated SCTs. ChatGPT showcased promise in expediting SCT design, aligning well with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria, albeit with a tendency toward caricatured scenarios and simplistic content. Conclusions: This study is the first to concentrate on the design of SCTs supported by AI in a period where medicine is changing swiftly and where technologies generated from AI are expanding much faster. This study suggests that ChatGPT can be a valuable tool in creating educational materials, and further validation is essential to ensure educational efficacy and accuracy.

CRISP: An Inpatient Pediatric Curriculum for Family Medicine Residents Using Clinical Reasoning and Illness Scripts.

Introduction: Clinical reasoning enables safe patient care and is an important competency in medical education but can be challenging to teach. Illness scripts facilitate clinical reasoning but have not been used to create pediatric curricula. Methods: We created CRISP (Clinical Reasoning with Illness Scripts in Pediatrics), a curriculum comprising four 1-hour learning sessions that deliberately incorporated clinical reasoning concepts and illness scripts to organize how four common chief complaints were taught to family medicine residents on inpatient pediatric rotations. We performed a multisite curriculum evaluation project over 6 months with family medicine residents at four institutions to assess whether the use of clinical reasoning concepts to structure CRISP was feasible and acceptable for learners and instructors and whether the use of illness scripts increased knowledge of four common pediatric chief complaints. Results: For all learning sessions, family medicine residents and pediatric hospitalists agreed that CRISP's format was preferable to traditional didactic lectures. Pre-/posttest scores showed statistically significant increases in family medicine resident knowledge (respiratory distress [n = 42]: pretest, 72%, posttest, 92%; abdominal pain [n = 44]: pretest, 82%, posttest, 96%; acute febrile limp [n = 44]: pretest, 68%, posttest, 81%; well-appearing febrile infant [n = 42]: pretest, 58%, posttest, 73%; ps < .05). Discussion: By using clinical reasoning concepts and illness script comparison to structure a pediatric curriculum, CRISP represents a novel instructional approach that can be used by pediatric hospitalists to increase family medicine resident knowledge about diagnoses associated with common pediatric chief complaints.

Offence-specific scripts among juvenile deliberate firesetters: a possible explanation for fire proclivity.

The study employed inductive-thematic analysis to identify dynamic cognitive-emotional processes occurring in proximity to deliberate firesetting among a sample of N = 35 adjudicated juvenile firesetters. Six fire-specific themes were determined. Three of these themes are akin to an implicit theory (i.e. a belief system informed by previous experiences): Fire Interest, Fire is Controllable, and Fire Denial/Accidental. Three of these themes are consistent with a cognitive script (i.e. a behavioural guide for how and when to use fire): (a) fire is destructive; (b) fire conceals evidence; and (c) fire creates calm. When reviewed more closely, the theme 'fire is destructive' is composed of two separate subcategories: 'fire creates destructive fun' and 'fire is a destructive tool for revenge'. The findings have risk assessment and treatment implications for juvenile firesetters.

Cultural pathways to psychosis care: Patient and caregiver narratives from Puebla, Mexico.

The current study used the McGill Illness Narrative Interview (MINI) to explore patients' (n = 6) and caregivers' (n = 3) narratives about how they identified and sought care for psychosis. Participants were recruited from an outpatient clinic at the Hospital Psiquiátrico Dr. Rafael Serrano, a public psychiatric hospital in Puebla, Mexico. All participants consented to complete semi-structured interviews in Spanish. Thematic analyses were used to inductively identify common themes in participants' narratives. The results indicated that during the initial symptom onset, most participants noticed the presence of hallucinations but did not seek help for this hallmark symptom. Participants described seeking care only when they or their ill relative exhibited escalating aggressive behaviors or physical symptoms that were interpreted as common medical problems. As participants became connected to specialty mental health services, they began to develop a conceptualization of psychosis as a disorder of aggression. For some participants, this conceptualization of psychosis as an illness of aggression contributed to their ambivalence about the diagnosis. These results can be understood using a cultural scripts framework, which suggests that cultural norms are influenced by collective understandings of normalcy and valorization of behaviors. Implications for community campaigns are discussed.

If you can make it, you can share it - Perspectives on the first DIY-fair at the European congress of medical physics (ECMP, DUBLIN 2022).

The medical physics and engineering community is known for being active in conjuring do-it-yourself (DIY) -solutions to support their clinical and research work. To facilitate the exchange of solutions and ideas, a DIY-fair was held for the first time at the European Congress of Medical Physics (ECMP) in August 2022 in Dublin, Ireland. Altogether 32 contributions were presented, consisting of software, scripts, 3D-printed customized solutions, devices, gadgets and phantoms. All contributions were published in video format on a dedicated YouTube channel, and most were also presented in person at the conference. The fair demonstrated that there is an unmet need for sharing and distributing information on self-created solutions in the medical physics community. The authors propose the creation of a dedicated platform for sharing such content within our community, as well as a continuity of DIY-fairs at future ECMP meetings.

Responses of Early Childhood Educators to Children's Interpersonal Sexual Behaviors.

There is a considerable amount of evidence in the literature that children engage in a wide range of sexual behaviors before puberty. How early childhood educators (ECEs) respond to children's interpersonal sexual behaviors (ISBs) is especially important during the early childhood stage not only due to their roles as educators, but also protector due to their legal obligation to report suspected cases of child sexual abuse. Considering the pivotal responsibilities ECEs have in addressing ISBs, it becomes imperative to gain a comprehensive understanding of the experiences they encounter in managing such behaviors. Surprisingly, the current body of research provides limited insights into how ECEs respond to children's ISBs. To address this gap, the present study aims to explore these topics by conducting a qualitative investigation to examine the experiences of Taiwanese ECEs who encountered ISBs among children and how they responded to these behaviors. Four themes emerged from an analysis of the stories shared by 36 ECEs: (1) being silent versus supporting children's healthy sexuality development, (2) protect yourself versus respect others, (3) punishments versus exploring strategies to address children's ISBs and (4) insensitivity to boundaries and bodily autonomy. This study provides guidelines for understanding the experiences of Taiwanese ECEs who encounter children's ISBs and contributes to the training needs of ECEs about children's sexuality development.

Men's Narratives of Sexual Intimate Partner Violence in Urban Mwanza, Northwestern Tanzania.

Engaging men has been established as central in addressing intimate partner violence. Yet few studies on intimate partner violence explored men's perspectives on what constitutes sexual violence in relationships only. To explore how men conceptualize sexual violence, we engaged a qualitative approach to unpack men's narratives of sexual IPV. The study was conducted in Mwanza, Tanzania using in-depth interviews with 30 married men. Men shared a broad spectrum of unacceptable behaviors that clearly or potentially connote sexual violence. Some of the acts were deemed to constitute sexual violence when directed to both men and women, while some were perceived as sexual violence when directed to women or men only. Threatened manhood underpinned men's conceptualization of sexual violence against them by their partners. Although a large part of men's narratives of sexual violence towards women seemed to challenge the common sexual scripts existing in patriarchal societies, some of their accounts indicated the persistence of traditional presumptions of masculine sexual entitlement. Our findings uncover additional dimensions of sexual violence that go beyond what is included in the current global frameworks, underscoring the critical need of giving people a voice in their local contexts in defining what sexual intimate partner violence entails for them. This may increase the likelihood of interventions becoming more acceptable and effective when targeting sexual violence, thereby contributing to reduced levels of sexual intimate partner violence.

Pampalibog: chemsex, desire and pleasure in the Philippines.

This article draws from qualitative interviews to provide the first in-depth exploration of reasons for engaging in chemsex in the Philippines. It articulates the many forms that drugs assume as pampalibog, or enhancers of libido, demonstrating the multidimensional pleasures of chemsex along overlapping sensorial and affective planes. By showing the inextricability of the corporeal to the affective, and of the emotional to the erotic, we contend that chemsex also involves the embodied and performed attainment of pleasure. As such, chemsex is both central to modern sexual scripts yet also a negotiable aspect of any sexual encounter. In constructing this rare account of drug use in settings of pleasure in the Philippines, we situate chemsex within a historical pattern of bodily tinkering and, more significantly, demystify people who use drugs by departing not only from global public health's pathologising approach to chemsex, but also from the scholarly tendency to locate drug use in the country within scenes of hardship and marginalisation.