Girl meets girl: sexual sitings in lesbian romantic comedies

Hollywood romantic comedies are, by and large, an ideologically conservative genre. Based around gender stereotypes and the idealised pursuit, however disguised, of heteropatriarchal monogamy, Hollywood romantic comedies offer countless variations of heteronormative ‘intimacy’. How, then, does the shift from ‘boy meets girl’ to ‘girl meets girl’ in lesbian romantic comedies—a genre that emerged in 1994 with the release of films like Bar Girls and Go Fish—effect the representation of intimacy? This chapter focuses on Better than Chocolate to investigate how lesbian intimacies, and lesbian sex in particular, occupy space. Where are lesbian intimacies sited and what, if any, negotiations of space are triggered through the embodiment of those intimacies? Ultimately, this chapter argues that through an unusually explicit emphasis on sex, Better than Chocolate draws attention to the limited public mobility of lesbian intimacies through a consistent siting of lesbian sex as a site of spatial negotiation

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

The Unique Challenges Facing HIV-Positive Patients Who Smoke Cigarettes: HIV Viremia, Art Adherence, Engagement in HIV care, and Concurrent Substance Use

Evidence suggests that smoking may have negative associations with HIV health outcomes. The smoking rate in our sample of people living with HIV (N = 333) was triple that of the general population (57% v. 19%). Regression analyses revealed that smokers (v. non-smokers) reported lower medication adherence (unstandardized beta = 9.01) and were more likely to have a detectable viral load (OR = 2.85, 95%CI [1.53–5.30]). Smokers attended fewer routine medical visits (β = −0.16) and were more likely to report recent hospitalization (OR = 1.89, 95%CI [0.99, 3.57]). Smokers ranked “health” as less important to their quality of life (β = −0.13) and were more likely to report problematic alcohol (OR = 2.40, 95%CI [1.35, 4.30]), cocaine (OR = 2.87, 95%CI [1.48–5.58]), heroin (OR = 4.75, 95%CI [1.01, 22.30]), or marijuana use (OR = 3.08, 95%CI [1.76–5.38]). Findings underscore the need for integrated behavioral smoking cessation interventions and routine tobacco screenings in HIV primary care