Australian consensus statement on doxycycline post-exposure prophylaxis (doxy-PEP) for the prevention of syphilis, chlamydia and gonorrhoea among gay, bisexual and other men who have sex with men.

INTRODUCTION: Doxycycline post-exposure prophylaxis (doxy-PEP) involves consuming 200 mg of doxycycline up to 72 hours after a condomless sex act to reduce the risk of bacterial sexually transmitted infections (STIs). Recent clinical trials of doxy-PEP have demonstrated significant reductions in syphilis, chlamydia and, to a lesser degree, gonorrhoea among gay, bisexual and other men who have sex with men (GBMSM). There is a high level of interest in doxy-PEP in the GBMSM community and, in response, the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) held a national consensus conference with the aim of creating preliminary guidance for clinicians, community, researchers and policy makers. MAIN RECOMMENDATIONS: There was broad agreement that doxy-PEP should be considered primarily for the prevention of syphilis in GBMSM who are at risk of this STI, with a secondary benefit of reductions in other bacterial STIs. At the end of the consensus process, there remained some disagreement, as some stakeholders felt strongly that doxy-PEP should be considered only for the prevention of syphilis in GBMSM, and that the risk of increasing antimicrobial resistance outweighed any potential benefit from reductions in other bacterial STIs in the target population. The national roundtable made several other recommendations for clinicians, community, researchers and policy makers, as detailed in this article. ASHM will support the development of detailed clinical guidelines and education materials on doxy-PEP (www.ashm.org.au/doxy-pep). CHANGES IN MANAGEMENT AS A RESULT OF THIS CONSENSUS STATEMENT: For GBMSM at high risk of syphilis, and perhaps other bacterial STIs, clinicians may consider prescribing doxy-PEP for a limited period of time, followed by a review of ongoing need. Unlike human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP), doxy-PEP may not be suitable as a population-level intervention and should instead be used more selectively.

A cross-disciplinary view of current and emerging COVID-19 developments.

The emergency phase of the coronavirus disease 2019 (COVID-19) pandemic is over. Still, the work goes on in understanding the SARS-CoV-2 virus and its evolution, infection impacts - acute and long term - as well as therapeutics and the lessons for preventing and responding to future pandemics. Research into the long-term post-infection effects and therapeutic interventions also expands as the post-infection period lengthens. We provide an overview of the leading edge of COVID-19 research across clinical, epidemiological and social domains.

The Legal Needs of People Living with a Sexually Transmissible Infection or Blood-Borne Virus: Perspectives From a Sample of the Australian Sexual Health and Blood Borne Virus Workforce.

Law and the legal environment are important factors in the epidemiology and prevention of sexually transmissible infections (STIs) and blood-borne viruses (BBVs). However, there has been no sustained effort to monitor the legal environment surrounding STIs and BBVs. This article presents the first data on the incidence and impacts of unmet legal needs for those affected by an STI or BBV in Australia using a survey administered to a sample of the Australian sexual health and BBV workforce. Migration, Housing, Money/Debt, Health (including complaints about health services), and Crime (accused/offender) were reported as the five most common legal need areas, with 60% of respondents describing these legal problems as generating a "severe" impact on health. These results indicate that unmet legal needs generate significant negative impacts in terms of individual health, on public health, and the ability to provide sustainable services such as testing and treatment to those facing unmet legal needs.

Myogenic Cell Expression of Intercellular Adhesion Molecule-1 Contributes to Muscle Regeneration after Injury.

This study investigated intercellular adhesion molecule-1 (ICAM-1), a membrane protein that mediates cell-to-cell adhesion and communication, as a mechanism through which the inflammatory response facilitates muscle regeneration after injury. Toxin-induced muscle injury to tibialis anterior muscles of wild-type mice caused ICAM-1 to be expressed by a population of satellite cells/myoblasts and myofibers. Myogenic cell expression of ICAM-1 contributed to the restoration of muscle structure after injury, as regenerating myofibers were more abundant and myofiber size was larger for wild-type compared with Icam1-/- mice during 28 days of recovery. Contrastingly, restoration of muscle function after injury was similar between the genotypes. ICAM-1 facilitated the restoration of muscle structure after injury through mechanisms involving the regulation of myofiber branching, protein synthesis, and the organization of nuclei within myofibers after myogenic cell fusion. These findings provide support for a paradigm in which ICAM-1 expressed by myogenic cells after muscle injury augments their adhesive and fusogenic properties, which, in turn, facilitates regenerative and hypertrophic processes that restore structure to injured muscle.

Living concrete: Democratizing living walls.

Living walls can help bring nature to urban canyons. However, contemporary living walls are cost prohibitive and made of materials with shorter life spans than their buildings. High cost often restricts their use to luxury applications promoting ecological symbolism rather than impactful propagation of urban nature. This study shows an approach to lowering living wall costs and increasing their use by integrating them into the building's structure. Existing living wall systems are hung like curtains from a building's façade; they are made as light as possible to reduce the weight they superimpose. Their lighter materials, e.g., felts and plastics, limit their life cycle. Conversely, combining the living function with the exterior envelope will match a living wall's life cycle to its building, and cost diminishes by eliminating a living wall's secondary support structure. This study focuses on concrete construction, a typology needing ecological evolution. Chosen for its ubiquity, durability, affordability, and plasticity, concrete was tested as a potential growing medium for plants. The result of the study is a new living concrete material and system aimed at advancing biophilic design in cities facing shifting climates and population densification. Presented are a new cast-in-place living wall system, a new concrete and its mechanical properties, verification of constructability, identification of plants suitable to cementitious environments, indoor germination and growth, full-scale tests of a new construction methodology, how concrete's chemical composition affects irrigation water, outdoor germination and perenniality, and a cost analysis showing a 50% reduction to the installed cost of living walls. Cost savings include plants grown from seed-in-situ (eliminating raising plants in a nursery and transplantation), and not using fertilizer (eliminating chemicals and a fertigation system). This study shows how rethinking the current living wall paradigm could shift the industry toward solutions to democratize living walls via lower cost and permanence.

Spectroscopic Compton imaging of prompt gamma emission at the MeV energy range.

This work explores a novel tomographic approach to PGAA that is both quantitative and spatially resolved, adapted from a clinical "proton beam range finder" in which MeV gamma rays are imaged by coincidence measurements of Compton scattered gamma rays with multi-detector arrays. We performed preliminary measurements using a Compton camera made with CdZnTe detector arrays on a series of test samples with high-energy (> 1 MeV) gamma emission lines. 3D image reconstructions were performed on the 2.2 MeV peak from H. The image reconstruction methods were also evaluated using the emission data generated by Monte Carlo simulations under ideal conditions.

Impact of natural organic matter on particle behavior and phototoxicity of titanium dioxide nanoparticles.

Due to their inherent phototoxicity and inevitable environmental release, titanium dioxide nanoparticles (nano-TiO2) are increasingly studied in the field of aquatic toxicology. One of the particular interests is the interactions between nano-TiO2 and natural organic matter (NOM). In this study, a series of experiments was conducted to study the impacts of Suwannee River natural organic matter (SRNOM) on phototoxicity and particle behaviors of nano-TiO2. For Daphnia magna, after the addition of 5mg/L SRNOM, LC50 value decreased significantly from 1.03 (0.89-1.20) mg/L to 0.26 (0.22-0.31) mg/L. For zebrafish larvae, phototoxic LC50 values were 39.9 (95% CI, 25.9-61.2) mg/L and 26.3 (95% CI, 18.3-37.8) mg/L, with or without the presence of 5mg/L SRNOM, respectively. There was no statistically significant change of these LC50 values. The impact of SRNOM on phototoxicity of nano-TiO2 was highly dependent on test species, with D. magna being the more sensitive species. The impact on particle behavior was both qualitatively and quantitatively examined. A global predictive model for particle behavior was developed with a three-way interaction of SRNOM, TiO2 concentration, and time and an additive effect of ionic strength. Based on power analyses, 96-h exposure in bioassays was recommended for nanoparticle-NOM interaction studies. The importance of reactive oxygen species (ROS) quenching of SRNOM was also systematically studied using a novel exposure system that isolates the effects of environmental factors. These experiments were conducted with minimal impacts of other important interaction mechanisms (NOM particle stabilization, NOM UV attenuation, and NOM photosensitization). This study highlighted both the particle stabilization and ROS quenching effects of NOM on nano-TiO2 in an aquatic system. There is an urgent need for representative test materials, together with key environmental factors, for future risk assessment and regulations of nanomaterials.

In vitro antifungal activity of DNA topoisomerase inhibitors.

In this paper we report the results of the study of the in vitro effect of eight anticancer DNA topoisomerase inhibitors on the growth of Aspergillus fumigatus, A. niger, Candida glabrata and Cryptococcus neoformans. Only one compound, idarubicin, displayed promising antifungal activity against A. niger, C. glabrata and C. neoformans with MIC(50) values varying between 3.6 and 14.2 µM (1.8-7.1 µg/ml). Three other compounds, aclarubicin, doxorubicin and mitoxantrone, showed some antifungal activity against C. glabrata and C. neoformans with MIC(50) values in the mid micromolar range. The data of this study indicate that selected DNA topoisomerase inhibitors are a promising class of compounds for the development of new antifungal agents.