COVID-19 Vaccine Uptake and Its Impacts in a Cohort of Gay and Bisexual Men in Australia.

Successful use of biomedical forms of HIV risk-reduction may have predisposed many gay and bisexual men (GBM) to vaccination against COVID-19, which may, in turn, affect their sexual behavior. A total of 622 Australian GBM provided weekly data on COVID-19 vaccination history and sexual behaviour between 17 January 2021 and 22 June 2021. We identify factors associated with COVID-19 vaccination, and compare sexual behavior before and since vaccination. Mean age was 47.3 years (SD 14.0). At least one-dose vaccination coverage had reached 57.2%, and 61.3% reported that the majority of their friends intended to be vaccinated. Vaccinated men reported a mean of 1.11 (SD 2.10) weekly non-relationship sex partners before vaccination and 1.62 (SD 3.42) partners following vaccination. GBM demonstrated high confidence in COVID-19 vaccines. Their sexual activity increased following vaccination suggesting that greater sexual freedom may be a specific motivation for vaccine uptake among some men.

Multimodal X-ray imaging of grain-level properties and performance in a polycrystalline solar cell.

The factors limiting the performance of alternative polycrystalline solar cells as compared with their single-crystal counterparts are not fully understood, but are thought to originate from structural and chemical heterogeneities at various length scales. Here, it is demonstrated that multimodal focused nanobeam X-ray microscopy can be used to reveal multiple aspects of the problem in a single measurement by mapping chemical makeup, lattice structure and charge collection efficiency simultaneously in a working solar cell. This approach was applied to micrometre-sized individual grains in a Cu(In,Ga)Se2 polycrystalline film packaged in a working device. It was found that, near grain boundaries, collection efficiency is increased, and that in these regions the lattice parameter of the material is expanded. These observations are discussed in terms of possible physical models and future experiments.

Exploring immunomodulation by endocrine changes in Lady Windermere syndrome.

Lung disease due to nontuberculous mycobacteria (NTM) occurs with disproportionate frequency in postmenopausal women with a unique phenotype and without clinically apparent predisposing factors. Dubbed 'Lady Windermere syndrome', the phenotype includes low body mass index (BMI), tall stature and higher than normal prevalence of scoliosis, pectus excavatum and mitral valve prolapse. Although the pathomechanism for susceptibility to NTM lung disease in these patients remains uncertain, it is likely to be multi-factorial. A role for the immunomodulatory consequences of oestrogen deficiency and altered adipokine production has been postulated. Altered levels of adipokines and dehydroepiandrosterone have been demonstrated in patients with NTM lung disease. Case reports of NTM lung disease in patients with hypopituitarism support the possibility that altered endocrine function influences disease susceptibility. This paper catalogues the evidence for immunomodulatory consequences of predicted endocrine changes in Lady Windermere syndrome, with emphasis on the immune response to NTM. Collectively, the data warrant further exploration of an endocrine link to disease susceptibility in Lady Windermere syndrome.

High-resolution three-dimensional structural microscopy by single-angle Bragg ptychography.

Coherent X-ray microscopy by phase retrieval of Bragg diffraction intensities enables lattice distortions within a crystal to be imaged at nanometre-scale spatial resolutions in three dimensions. While this capability can be used to resolve structure-property relationships at the nanoscale under working conditions, strict data measurement requirements can limit the application of current approaches. Here, we introduce an efficient method of imaging three-dimensional (3D) nanoscale lattice behaviour and strain fields in crystalline materials with a methodology that we call 3D Bragg projection ptychography (3DBPP). This method enables 3D image reconstruction of a crystal volume from a series of two-dimensional X-ray Bragg coherent intensity diffraction patterns measured at a single incident beam angle. Structural information about the sample is encoded along two reciprocal-space directions normal to the Bragg diffracted exit beam, and along the third dimension in real space by the scanning beam. We present our approach with an analytical derivation, a numerical demonstration, and an experimental reconstruction of lattice distortions in a component of a nanoelectronic prototype device.

A longitudinal cohort study of HIV 'treatment as prevention' in gay, bisexual and other men who have sex with men: the Treatment with Antiretrovirals and their Impact on Positive And Negative men (TAIPAN) study protocol.

BACKGROUND: Australia has increased coverage of antiretroviral treatment (ART) over the past decade, reaching 73% uptake in 2014. While ART reduces AIDS-related deaths, accumulating evidence suggests that it could also bolster prevention efforts by reducing the risk of HIV transmission ('treatment as prevention'). While promising, evidence of community-level impact of treatment as prevention on reducing HIV incidence among gay and bisexual men is limited. We describe a study protocol that aims to determine if scale up of testing and treatment for HIV leads to a reduction in community viraemia and, in turn, if this reduction is temporally associated with a reduction in HIV incidence among gay and bisexual men in Australia's two most populous states. METHODS: Over the period 2009 to 2017, we will establish two cohorts making use of clinical and laboratory data electronically extracted retrospectively and prospectively from 73 health services and laboratories in the states of New South Wales and Victoria. The 'positive cohort' will consist of approximately 13,000 gay and bisexual men (>90% of all people living with HIV). The 'negative cohort' will consist of at least 40,000 HIV-negative gay and bisexual men (approximately half of the total population). Within the negative cohort we will use standard repeat-testing methods to calculate annual HIV incidence. Community prevalence of viraemia will be defined as the proportion of men with a viral load ≥200RNA copies/mm3, which will combine viral load data from the positive cohort and viraemia estimates among those with an undiagnosed HIV infection. Using regression analyses and adjusting for behavioural and demographic factors associated with infection, we will assess the temporal association between the community prevalence of viraemia and the incidence of HIV infection. Further analyses will make use of these cohorts to assess incidence and predictors of treatment initiation, repeat HIV testing, and viral suppression. DISCUSSION: This study will provide important information on whether 'treatment as prevention' is associated with a reduction in HIV incidence at a community level among gay and bisexual men.

Complete excision of the infrapatellar fat pad is associated with patellar tendon shortening after primary total knee arthroplasty.

BACKGROUND: Patella baja is a potentially disabling and difficult-to-treat complication following total knee arthroplasty (TKA). We investigated whether complete or partial excision of the fat pad has an effect on the length of the patellar tendon following TKA. METHODS: A retrospective review of patient radiographs was performed. One hundred and eleven consecutive patients who underwent primary TKA for osteoarthritis using the same components by two consultants were selected. Seventy-two patients underwent complete excision of the fat pad, whilst 39 had partial excision as per consultant practice. Patellar height was measured using the Caton-Deschamps Index (CDI) on immediate postoperative radiographs and at a minimum follow-up of 1 year. RESULTS: In the complete excision group, the mean CDI changed from 0.54 immediately postoperatively to 0.45 at a minimum follow-up of 1 year (p < 0.0001) indicating shortening of the patellar tendon, and eight patients reported anterior knee pain. The partial excision group's mean CDI changed from 0.76 to 0.75 (p = 0.231). An analysis of variance showed that the effect of complete fat pad excision on patella tendon length was significant, F(1, 109) = 15.273, p < 0.001. CONCLUSION: At a minimum follow-up of 1 year, the patellar tendon length shortened significantly in the group of patients with complete fat pad excision. With partial excision, there was no significant change in tendon length. Complete excision of the fat pad should therefore be avoided wherever possible in an attempt to avoid patella baja. LEVEL OF EVIDENCE: II.

Younger age, recent HIV diagnosis, no welfare support and no annual sexually transmissible infection screening are associated with nonuse of antiretroviral therapy among HIV-positive gay men in Australia.

OBJECTIVES: With the increasing momentum to maximize the benefits of antiretroviral therapy (ART), better understanding of opportunities and challenges in increasing ART coverage and promoting early ART initiation is urgently needed. Key sociodemographic, clinical and behavioural factors associated with Australian HIV-positive gay men's current nonuse of ART were systematically examined. METHODS: Data were based on 1911 responses from HIV-positive men who had participated in the Australian Gay Community Periodic Surveys (GCPS) between 2010 and 2012. Stratified univariate analysis and multivariate logistic regression were used. RESULTS: A majority of the participants were recruited from gay community venues and events and self-identified as gay or homosexual. On average, they were 44 years old and had been living with HIV for at least 10 years. Close to 80% (n=1555) were taking ART, with >90% further reporting an undetectable viral load at the time of the survey. From 2010 to 2012, there had been a moderate increase in ART uptake [adjusted odds ratio (AOR) 1.40; 95% confidence interval (CI) 1.20-1.65]. In addition, younger age (AOR 1.66; 95% CI 1.45-1.92), recent HIV diagnosis (AOR 1.78; 95% CI 1.59-1.98), not receiving any social welfare payments (AOR 2.20; 95% CI 1.05-2.54) and no annual screening for sexually transmissible infections (AOR 1.55; 95% CI 1.03-2.34) were independently associated with ART nonuse. CONCLUSIONS: Current ART coverage among HIV-positive gay men in Australia is reasonably high. To further increase ART coverage and promote early ART initiation in this population, better clinical care and sustained structural support are needed for HIV management throughout their life course.

Effect of testing experience and profession on provider acceptability of rapid HIV testing after implementation in public sexual health clinics in Sydney.

OBJECTIVES: Rapid HIV testing (RHT) is well established in many countries, but it is new in Australia since a policy change in 2011. We assessed service provider acceptability of RHT before and after its implementation in four Sydney public sexual health clinics. METHODS: Service providers were surveyed immediately after training in RHT and again 6-12 months later. Differences in mean scores between survey rounds were assessed via t-tests, with stratification by profession and the number of tests performed. RESULTS: RHT was rated as highly acceptable among staff at baseline and acceptability scores improved between survey rounds. Belief in being sufficiently skilled and experienced to perform RHT (P = 0.004) and confidence in the delivery of nonreactive results increased (P = 0.007), while the belief that RHT was disruptive declined (P = 0.001). Acceptability was higher for staff who had performed a greater number of tests regarding comfort with their role in RHT (P = 0.004) and belief that patients were satisfied with RHT (P = 0.007). Compared with nurses, doctors had a stronger preference for a faster rapid test (P = 0.027) and were more likely to agree that RHT interfered with consultations (P = 0.014). CONCLUSIONS: Differences in responses between professions may reflect differences in staff roles, the type of patients seen by staff and the model of testing used, all of which may affect the number of tests performed by staff. These findings may inform planning for how best to implement RHT in clinical services.

Efficient modeling of Bragg coherent x-ray nanobeam diffraction.

X-ray Bragg diffraction experiments that utilize tightly focused coherent beams produce complicated Bragg diffraction patterns that depend on scattering geometry, characteristics of the sample, and properties of the x-ray focusing optic. Here, we use a Fourier-transform-based method of modeling the 2D intensity distribution of a Bragg peak and apply it to the case of thin films illuminated with a Fresnel zone plate in three different Bragg scattering geometries. The calculations agree well with experimental coherent diffraction patterns, demonstrating that nanodiffraction patterns can be modeled at nonsymmetric Bragg conditions with this approach--a capability critical for advancing nanofocused x-ray diffraction microscopy.

Developing 3D SEM in a broad biological context.

When electron microscopy (EM) was introduced in the 1930s it gave scientists their first look into the nanoworld of cells. Over the last 80 years EM has vastly increased our understanding of the complex cellular structures that underlie the diverse functions that cells need to maintain life. One drawback that has been difficult to overcome was the inherent lack of volume information, mainly due to the limit on the thickness of sections that could be viewed in a transmission electron microscope (TEM). For many years scientists struggled to achieve three-dimensional (3D) EM using serial section reconstructions, TEM tomography, and scanning EM (SEM) techniques such as freeze-fracture. Although each technique yielded some special information, they required a significant amount of time and specialist expertise to obtain even a very small 3D EM dataset. Almost 20 years ago scientists began to exploit SEMs to image blocks of embedded tissues and perform serial sectioning of these tissues inside the SEM chamber. Using first focused ion beams (FIB) and subsequently robotic ultramicrotomes (serial block-face, SBF-SEM) microscopists were able to collect large volumes of 3D EM information at resolutions that could address many important biological questions, and do so in an efficient manner. We present here some examples of 3D EM taken from the many diverse specimens that have been imaged in our core facility. We propose that the next major step forward will be to efficiently correlate functional information obtained using light microscopy (LM) with 3D EM datasets to more completely investigate the important links between cell structures and their functions.

Understanding Concerns About Treatment-as-Prevention Among People with HIV who are not Using Antiretroviral Therapy.

The use of antiretroviral therapy to prevent HIV transmission is now advocated in many settings, yet little research has documented the views of people with HIV. Semi-structured interviews were conducted in Australia between 2012 and 2014 with 27 HIV-positive people not using treatment at the time of interview. Thematic analysis of views on treatment-as-prevention found that while many participants recognised potential prevention benefits, only a minority was in support of initiating treatment solely to achieve those benefits. A range of uncertain or critical views were expressed regarding who would benefit, risk reduction, and changing treatment norms. Participants resisted responsibility narratives that implied treatment should be used for the public good, in favour of making considered decisions about their preferred approach to managing HIV. Engaging communities in dialogue and debate regarding the risks and benefits of treatment will be critical if this new prevention strategy is to engender public trust.

Student perceptions of a healthy university.

UNLABELLED: As complex environments within which individuals and populations operate, universities present important contexts for understanding and addressing health issues. The healthy university is an example of the settings approach, which adopts a whole system perspective, aiming to make places within which people, learn, live, work and play supportive to health and well-being. The UK Healthy Universities Network has formulated an online toolkit, which includes a Self-Review Tool, intended to enable universities to assess what actions they need to take to develop as a healthy university. This paper presents findings from consultative research undertaken with students from universities in England, Scotland and Wales, which explored what they believe, represents a healthy university. METHODS: Student surveys and focus groups were used to collect data across eleven universities in England, Scotland and Wales. A priori themes were used to develop our own model for a healthy university, and for the thematic coding phase of analysis. FINDINGS: A healthy university would promote student health and well-being in every aspect of its business from its facilities and environment through to its curriculum. Access to reasonably priced healthy food and exercise facilities were key features of a healthy university for students in this study. The Self-Review Tool has provided a crucial start for universities undertaking the journey towards becoming a healthy university. In looking to the future both universities and the UK Healthy Universities Network will now need to look at what students want from their whole university experience, and consider how the Self-Review Tool can help universities embrace a more explicit conceptual framework. CONCLUSION: The concept of a healthy university that can tailor its facilities and supportive environments to the needs of its students will go some way to developing students who are active global citizens and who are more likely to value and prioritise health and well-being, in the short and long term through to their adult lives.

Cannabis: a controversial 21st-century drug of antiquity.

Cannabis consumption has been popular for thousands of years and its historical use is noted in many parts of the world including ancient China, India, the Middle East. It is currently the most popular illicit drug in the world, is being utilized as a medicinal plant, and many parts of the world are legalizing this drug. This discussion considers various aspects of cannabis use including its prevalence, history, co-morbid drug abuse, designer cannabinoids, psychiatric adverse effects, medical adverse effects, and management options. The youth of the world should be comprehensively taught that cannabis is neither a safe nor a benign drug. Prevention with comprehensive drug education is the best plan for our youth since management of a chronic or heavy cannabis consummer remains difficult and fraught with failure if cessation is the goal. Caveat emptor!

Traumatic brain injury promotes neurogenesis at the cost of astrogliogenesis in the adult hippocampus of male mice.

Traumatic brain injury (TBI) can result in long-lasting changes in hippocampal function. The changes induced by TBI on the hippocampus contribute to cognitive deficits. The adult hippocampus harbors neural stem cells (NSCs) that generate neurons (neurogenesis), and astrocytes (astrogliogenesis). While deregulation of hippocampal NSCs and neurogenesis have been observed after TBI, it is not known how TBI may affect hippocampal astrogliogenesis. Using a controlled cortical impact model of TBI in male mice, single cell RNA sequencing and spatial transcriptomics, we assessed how TBI affected hippocampal NSCs and the neuronal and astroglial lineages derived from them. We observe an increase in NSC-derived neuronal cells and a concomitant decrease in NSC-derived astrocytic cells, together with changes in gene expression and cell dysplasia within the dentate gyrus. Here, we show that TBI modifies NSC fate to promote neurogenesis at the cost of astrogliogenesis and identify specific cell populations as possible targets to counteract TBI-induced cellular changes in the adult hippocampus.

Imaging local polarization in ferroelectric thin films by coherent x-ray Bragg projection ptychography.

We used x-ray Bragg projection ptychography (BPP) to map spatial variations of ferroelectric polarization in thin film PbTiO3, which exhibited a striped nanoscale domain pattern on a high-miscut (001) SrTiO3 substrate. By converting the reconstructed BPP phase image to picometer-scale ionic displacements in the polar unit cell, a quantitative polarization map was made that was consistent with other characterization. The spatial resolution of 5.7 nm demonstrated here establishes BPP as an important tool for nanoscale ferroelectric domain imaging, especially in complex environments accessible with hard x rays.

Effects of feeding brown midrib corn silage with a high dietary concentration of alfalfa hay on lactational performance of Holstein dairy cows for the first 180 days of lactation.

This experiment was conducted to test a hypothesis that lactating dairy cows fed 35% brown midrib (BMR) corn silage and 25% alfalfa hay (dry matter (DM) basis) would consume more DM around peak lactation compared with those fed conventional corn silage (CS), resulting in longer peak milk production. Twenty-eight multiparous Holstein cows were used starting at the onset of lactation through 180 d in milk (DIM). Treatments were formulated to maintain a forage-to-concentrate ratio of 60:40, differing only in the CS hybrids used. Two dietary treatments were assessed in a completely randomized design: total mixed ration based on conventional CS (CCS) and total mixed ration based on BMR silage. Through peak lactation (1-60 DIM), DM intake was not different between dietary treatments, whereas DM intake post-peak lactation (61-180 DIM) tended to increase by feeding the BMR diet compared with the CCS diet (25.8 vs. 24.7 kg/d). Cows fed the BMR diet tended to lose less body weight through peak lactation compared with those fed the CCS diet (-0.22 vs. -0.52 kg/d). Although milk yield was not different between dietary treatments through peak lactation, milk yield post-peak lactation increased by feeding the BMR diet compared with the CCS diet (41.0 vs. 38.8 kg/d). Yield of 3.5% fat-corrected milk was similar between dietary treatments throughout the experiment (41.4 kg/d, on average), but milk fat concentration decreased by feeding the BMR diet compared with the CCS diet post-peak lactation (3.47 vs. 3.80%). Overall milk protein concentration was similar between dietary treatments throughout the experiment (2.96%, on average), whereas milk protein yield tended to be higher for the BMR diet post-peak lactation compared with the CCS diet (1.19 vs.1.13 kg/d). Feeding BMR silage with a high dietary concentration of alfalfa hay maintained more body weight, but did not affect milk production through peak lactation; however, cows fed the BMR diet post-peak lactation consumed more feed and maintained longer peak milk yield, leading to greater overall milk production and milk protein yield.

Corn silage hybrid type and quality of alfalfa hay affect dietary nitrogen utilization by early lactating dairy cows.

This experiment was conducted to determine the effects of corn silage (CS) hybrids and quality of alfalfa hay (AH) in high-forage dairy diets on N utilization, ruminal fermentation, and lactational performance by early-lactating dairy cows. Eight multiparous Holstein cows were used in a duplicated 4 × 4 Latin square experiment with a 2 × 2 factorial arrangement of dietary treatments. The 8 cows (average days in milk = 23 ± 11.2) were surgically fitted with ruminal cannula, and the 2 squares were conducted simultaneously. Within square, cows were randomly assigned to a sequence of 4 diets: conventional CS (CCS) or brown midrib CS (BMR) was combined with fair-quality AH [FAH: 46.7% neutral detergent fiber (NDF) and 18.4% crude protein (CP)] or high-quality AH (HAH: 39.2% NDF and 20.7% CP) to form 4 treatments: CCS with FAH, CCS with HAH, BMR with FAH, and BMR with HAH. Diets were isonitrogenous across treatments, averaging 15.9% CP. Each period lasted a total of 21 d, with 14 d for treatment adaptation and 7d for data collection and sampling. Intake of DM and milk yield did not differ in response to CS hybrids or AH quality. Although feeding BMR-based diets decreased urinary N output by 24%, it did not affect fecal N output. Feeding HAH decreased urinary N output by 15% but increased fecal N output by 20%. Nitrogen efficiency [milk N (g/d)/intake N (g/d)] tended to increase for BMR treatments. Ruminal ammonia-N concentration was lower for cows fed BMR-based diets than for those fed CCS-based diets but was not affected by quality of AH. Feeding BMR-based diets or HAH decreased milk urea N concentration by 23 or 15%, respectively, compared with CCS-based diets or FAH. Total volatile fatty acid concentration increased with HAH but was not influenced by CS hybrids. Feeding BMR-based diets decreased urinary N-to-fecal N ratio (UN:FN), and it was further reduced by feeding HAH. Although cows fed the BMR-based diets tended to increase milk N-to-manure N ratio, the quality of AH did not affect the ratio. The lower ratio of UN:FN with a higher ratio of milk N-to-manure N ratio for the BMR-based diets indicates that feeding BMR may reduce manure ammonia-N by reducing excretion of urinary N and increasing secretion of milk N per unit of manure N excreted.

Quantitative nanoscale imaging of lattice distortions in epitaxial semiconductor heterostructures using nanofocused X-ray Bragg projection ptychography.

We imaged nanoscale lattice strain in a multilayer semiconductor device prototype with a new X-ray technique, nanofocused Bragg projection ptychography. Applying this technique to the epitaxial stressor layer of a SiGe-on-SOI structure, we measured the internal lattice behavior in a targeted region of a single device and demonstrated that its internal strain profile consisted of two competing lattice distortions. These results provide the strongest nondestructive test to date of continuum modeling predictions of nanoscale strain distributions.

HIV testing, gay community involvement and internet use: social and behavioural correlates of HIV testing among Australian men who have sex with men.

A significant minority of Australian men who have sex with men (MSM) have never been tested for HIV and many men do not test as often as recommended. Using data from 1770 HIV-negative and untested MSM collected in a national, online survey, we compared men who had never tested for HIV with those who had tested over 12 months ago and men who had tested over 12 months ago with those that had tested in the past year. Two multivariate logistic regression models were constructed. Compared with men tested over 12 months ago, untested men were younger, less educated, less likely to have unprotected anal intercourse with a regular male partner, less likely to have sought advice from a doctor, nurse or community organisation, more likely to expect HIV-negative disclosure, had fewer gay friends and spent more time using social networking websites. Compared with men who had tested over 12 months ago, men who had tested within the last year were younger, more likely to expect HIV-negative disclosure and disclose to casual partners, more likely to have sought advice from a doctor or nurse, had attended gay pools, gyms or beaches and had more gay friends and more male sex partners. Our findings suggest that the Internet and sex education in schools are important ways to promote HIV testing to untested MSM. Testing reinforcement messages delivered through gay community outreach and primary care will reach previously tested MSM.

Gay men who are not getting tested for HIV.

Using data from Australian Gay Community Periodic Surveys 1998-2010, we assessed the prevalence, trends and characteristics of gay men not tested for HIV. In 2010, one in eight Australian gay socially-engaged men were never tested for HIV, most of them sexually active and 56.5 % reporting unprotected anal intercourse. The proportion of not tested men was significantly higher in men younger than 30, of non-European origin and living outside of gay metropolitan areas. Although frequency of testing was associated with sexual practices, significant proportions of men with multiple sex partners and reporting unprotected anal intercourse were not tested as recommended. There were issues with using gay-friendly testing services in gay metropolitan areas. Despite Australia's success in HIV testing, improvement is needed for early detection of HIV infections. Interventions should encourage regular testing, engage with young gay men, improve access and convenience of testing, train service providers and expand testing options.