The SPORTSMART study: a pilot randomised controlled trial of sexually transmitted infection screening interventions targeting men in football club settings

Background: Uptake of chlamydia screening by men in England has been substantially lower than by women. Non-traditional settings such as sports clubs offer opportunities to widen access. Involving people who are not medically trained to promote screening could optimise acceptability. Methods: We developed two interventions to explore the acceptability and feasibility of urine-based sexually transmitted infection (STI) screening interventions targeting men in football clubs. We tested these interventions in a pilot cluster randomised control trial. Six clubs were randomly allocated, two to each of three trial arms: team captain-led and poster STI screening promotion; sexual health adviser-led and poster STI screening promotion; and poster-only STI screening promotion (control/comparator). Primary outcome was test uptake. Results: Across the three arms, 153 men participated in the trial and 90 accepted the offer of screening (59%, 95% CI 35% to 79%). Acceptance rates were broadly comparable across the arms: captain-led: 28/56 (50%); health professional-led: 31/46 (67%); and control: 31/51 (61%). However, rates varied appreciably by club, precluding formal comparison of arms. No infections were identified. Process evaluation confirmed that interventions were delivered in a standardised way but the control arm was unintentionally ‘enhanced’ by some team captains actively publicising screening events. Conclusions: Compared with other UK-based community screening models, uptake was high but gaining access to clubs was not always easy. Use of sexual health advisers and team captains to promote screening did not appear to confer additional benefit over a poster-promoted approach. Although the interventions show potential, the broader implications of this strategy for UK male STI screening policy require further investigation

Adding cetuximab to capecitabine plus oxaliplatin (XELOX) in first-line treatment of metastatic colorectal cancer: a randomized phase II trial of the Swiss Group for Clinical Cancer Research SAKK

Background: To determine the activity and tolerability of adding cetuximab to the oxaliplatin and capecitabine (XELOX) combination in first-line treatment of metastatic colorectal cancer (MCC). Patients and methods: In a multicenter two-arm phase II trial, patients were randomized to receive oxaliplatin 130 mg/m2 on day 1 and capecitabine 1000 mg/m2 twice daily on days 1-14 every 3 weeks alone or in combination with standard dose cetuximab. Treatment was limited to a maximum of six cycles. Results: Seventy-four patients with good performance status entered the trial. Objective partial response rates after external review and radiological confirmation were 14% and 41% in the XELOX and in the XELOX + Cetuximab arm, respectively. Stable disease has been observed in 62% and 35% of the patients, with 76% disease control in both arms. Cetuximab led to skin rash in 65% of the patients. The median overall survival was 16.5 months for arm A and 20.5 months for arm B. The median time to progression was 5.8 months for arm A and 7.2 months for arm B. Conclusion: Differences in response rates between the treatment arms indicate that cetuximab may improve outcome with XELOX. The correct place of the cetuximab, oxaliplatin and fluoropyrimidine combinations in first-line treatment of MCC has to be assessed in phase III trial

Speed control device for a heavy duty shaft

A speed control device is characterized by a reference speed shaft spatially related to a heavy duty shaft, a drive train for driving the reference speed shaft at a constant angular velocity, a drive train for driving the heavy duty shaft at a variable angular velocity and a speed control assembly for continuously comparing the angular velocity of the heavy duty shaft with the angular velocity of the reference speed shaft. A brake assembly is connected to the heavy duty shaft and is adapted to respond to errors in the angular velocity of the heavy duty shaft in order to reduce the angular velocity of the heavy duty shaft to that of the reference speed shaft

Collapsible loop antenna for space vehicle Patent

Collapsible, space erectable loop antenna system for space vehicl

Constant lift rotor for a heavier than air craft

A rotor blade extended radially from a hub, characterized by an elongated spar and a plurality of axially aligned shells pivotally mounted on the spar is presented. Each has an aerodynamic center located in trailing relation with the spar and supported thereby for simultaneous axial and angular displacement as centrifugal forces are applied, a pitch controller plus a plurality of pivotal pitch limiting arms transversely related to the spar. A push-pull link interconnecting the arms is used for imparting simultaneous pivotal motion, whereby the angular relationship of the arms to the spar is varied for varying the motion of the trucks along the arms for thus limiting the pitch of the segments about the spar

DAX-1 Expression in Pediatric Rhabdomyosarcomas: Another Immunohistochemical Marker Useful in the Diagnosis of Translocation Positive Alveolar Rhabdomyosarcoma

OBJECTIVES: The aim of this study was to investigate the expression of DAX-1 in a series of pediatric rhabdomyosarcomas (RMS) with known translocation and compare it to Ap2\u3b2, known to be selectively expressed in ARMS. DESIGN: We revised a series of 71 alveolar rhabdomyosarcomas (ARMS), enrolled in the Italian Protocols RMS 79 and 96, and 23 embryonal rhabdomyosarcomas (ERMS) as controls. Before investigating Ap2\u3b2 and DAX-1, ARMS were reviewed and reclassified as 48 ARMS and 23 non-ARMS. RESULTS: Translocation positive ARMS showed a characteristic Ap2\u3b2/DAX-1+ staining pattern in 78% of cases, while 76% of classic ERMS were negative for both. Ap2\u3b2 alone was positive in 3.9% of RMS lacking translocation, whereas DAX-1 alone was positive in 25.4%. Conversely, 9% and 6% of translocation positive ARMS were positive only for DAX-1 or Ap2\u3b2, respectively. The 23 non-ARMS shared the same phenotype as ERMS but had a higher frequency of DAX-1 expression. CONCLUSIONS: DAX-1 is less specific than Ap2\u3b2, however it is a sensitive marker for translocation positive ARMS and can be helpful in their diagnosis if used in combination with Ap2\u3b2

Rush to Judgment: The STI-Treatment Trials and HIV in Sub-Saharan Africa

Introduction: The extraordinarily high incidence of HIV in sub-Saharan Africa led to the search for cofactor infections that could explain the high rates of transmission in the region. Genital inflammation and lesions caused by sexually transmitted infections (STIs) were a probable mechanism, and numerous observational studies indicated several STI cofactors. Nine out of the ten randomized controlled trials (RCTs), however, failed to demonstrate that treating STIs could lower HIV incidence. We evaluate all 10 trials to determine if their design permits the conclusion, widely believed, that STI treatment is ineffective in reducing HIV incidence. Discussion: Examination of the trials reveals critical methodological problems sufficient to account for statistically insignificant outcomes in nine of the ten trials. Shortcomings of the trials include weak exposure contrast, confounding, non-differential misclassification, contamination and effect modification, all of which consistently bias the results toward the null. In any future STI-HIV trial, ethical considerations will again require weak exposure contrast. The complexity posed by HIV transmission in the genital microbial environment means that any future STI-HIV trial will face confounding, non-differential misclassification and effect modification. As a result, it is unlikely that additional trials would be able to answer the question of whether STI control reduces HIV incidence. Conclusions: Shortcomings in published RCTs render invalid the conclusion that treating STIs and other cofactor infections is ineffective in HIV prevention. Meta-analyses of observational studies conclude that STIs can raise HIV transmission efficiency two- to fourfold. Health policy is always implemented under uncertainty. Given the known benefits of STI control, the irreparable harm from not treating STIs and the likely decline in HIV incidence resulting from STI control, it is appropriate to expand STI control programmes and to use funds earmarked for HIV prevention to finance those programmes

Rethinking militarism in post-apartheid South Africa

This paper argues that contemporary South Africa is marked by a co-existence of both old and new forms of militarism. It tries to move beyond the statist conception of militarism in much of the scholarly literature in order to examine social relations more broadly, and the appropriation of the means and instruments of violence by non-state groups. The paper argues that a shallow and uneven process of state demilitarisation was underway in South Africa from 1990 in the form of reductions in military expenditure, weapons holdings, force levels, demobilisation, employment in arms production and base closures. However, this has had contradictory consequences. The failure to provide for the effective social integration of ex-combatants throughout the Southern African region, as well as ineffective disarmament in post-conflict peace building, has provided an impetus to a 'privatised militarism'. This is evident in three related processes: new forms of violence, the commoditisation of security, through the growth of private security firms and, most importantly, the proliferation of small arms. It is argued that small arms are highly racialised and linked to a militarised conception of citizenship. This feeds into a militarist nationalism, which claims a powerful army as an indicator of state power, which helps to explain a process of re-militarisation - evident in the R60 billion re-armament programme and increasing reliance on the military as an instrument of foreign policy since 1998. The paper concludes by emphasizing the need for a regional approach to security as a further corrective to a narrow, statist focus on the South African National Defence Force