Social norms related to combining drugs and sex ("chemsex") among gay men in South London.

BACKGROUND: 'Chemsex' refers to the combining of sex and illicit drugs, typically mephedrone, GHB/GBL, and crystal methamphetamine. While numerous studies have examined the role of illicit drugs in sexual risk taking, less attention has been paid to the broader social context and structures of their use among gay men. Given their established role in influencing health related behaviour, this study sought to examine the nature and operation of social norms relating to chemsex among gay men residing in South London. METHODS: In-depth interviews were conducted with thirty self-identifying gay men (age range 21-53) who lived in three South London boroughs, and who had used either crystal methamphetamine, mephedrone or GHB/GBL either immediately before or during sex with another man during the previous 12 months. Data were subjected to a thematic analysis. In addition, two focus groups (n=12) were conducted with gay men from the community to explore group-level perceptions of drug use and chemsex. RESULTS: Chemsex was perceived as ubiquitous amongst gay men by a majority of participants, who additionally described a variety of ways it is arranged (including mobile apps) and a variety of settings in which it occurs (including commercial and private settings). Chemsex was associated with unique sexual permissions and expectations, although participants also described having personal boundaries with respect to certain drug and sex practices, suggesting within-group stigmatisation. CONCLUSION: This study clearly documents exaggerated beliefs about the ubiquity of chemsex, shifts in the perceived normativity of certain settings and means to facilitate chemsex, and attitudes revealing stigma against certain types of chemsex and men who engage in it. There is a need for health promotion interventions to challenge social norms relating to drug use generally, and chemsex specifically, and for such interventions to make use of the online settings in which chemsex is often facilitated

Bridging data gaps in the food industry – sensor-equipped metal food containers as an enabler for sustainability

In recent years, Machine Learning (ML) applications for manufacturing have reached a high degree of maturity and can be considered as a suitable tool for improving production performance. In addition, ML applications can be used in many other production areas to enhance sustainability within the manufacturing process. One area is storing and transporting bulk materials with metal Intermediate Bulk Containers (IBC). These IBCs are currently used solely for their primary purpose of storage and transportation of raw and finished goods. Hence, while in use , IBCs are often a black box that does not provide additional value to manufacturers. Equipping IBCs with sensor technology can provide such value: new data can be generated along the entire supply chain and production processes, taking the sustainability of production to a new level. Within the research project smart.CONSERVE, we use this additional data, for example, to monitor the stored food's critical characteristics or to establish predictive maintenance for IBCs. Thus, storing produced goods in defective IBCs can be avoided and wasting resources can be prevented. This publication describes how smart IBCs in the food industry can increase supply chain visibility and reduce food waste. To illustrate this, we present possible use cases enabled by new data availabilities. Additionally, we provide insights into how these use cases can be transferred to other industries. Besides, we exemplify the many opportunities for manufacturers to develop new smart services and ML applications based on the collected data - and how this can support manufacturers in achieving higher levels of sustainability

Surgical Management of Intracerebral Hemorrhage

Intracerebral hemorrhage (ICH), defined as bleeding within the brain parenchyma, remains a challenging and controversial neurosurgical entity to treat. ICH has a broad range of etiology—stemming from complications associated with traumatic head injury to complications of hemorrhagic stroke. The role of medical management lies in optimizing blood pressure and intracerebral pressure, preventing secondary injury from complications of the hematoma such as seizures, and correcting coagulopathy. Given the mass effect of a hematoma and the possibility of expansion, surgical interventions attempt to evacuate the clot to restore normal intracerebral pressure and prevent worsening neurologic injury. This chapter reviews the recent controversy associated with surgical evacuation of intracerebral hemorrhage placing particular emphasis on the size and location of the hemorrhage and the methods used to evacuate the expanding ICH. Moreover, this chapter reviews considerations and therapeutic goals of the preoperative and postoperative window to minimize complications and optimize patient care

Restore or Redefine:Future Trajectories for Restoration

Global habitat deterioration of marine ecosystems has led to a need for active interventions to halt or reverse the loss of ecological function. Restoration has historically been a key tool to reverse habitat loss and restore functions, but the extent to which this will be sufficient under future climates is uncertain. Emerging genetic technologies now provide the ability for restoration to proactively match adaptability of target species to predicted future environmental conditions, which opens up the possibility of boosting resistance to future stress in degraded and threatened habitats. As such, the choice of whether to restore to historical baselines or anticipate the future remains a key decision that will influence restoration success in the face of environmental and climate change. Here, we present an overview of the different motives for restoration – to recover or revive lost or degraded habitats to extant or historical states, or to reinforce or redefine for future conditions. We focus on the genetic and adaptive choices that underpin each option and subsequent consequences for restoration success. These options span a range of possible trajectories, technological advances and societal acceptability, and represent a framework for progressing restoration of marine habitat forming species into the future

A Note on the Equality of Algebraic and Geometric D-Brane Charges in WZW Models

The algebraic definition of charges for symmetry-preserving D-branes in Wess-Zumino-Witten models is shown to coincide with the geometric definition, for all simple Lie groups. The charge group for such branes is computed from the ambiguities inherent in the geometric definition.Comment: 12 pages, fixed typos, added references and a couple of remark

RAPID RESPONSE TO FLUOXETINE IN WOMEN WITH PREMENSTRUAL DYSPHORIC DISORDER

Selective serotonin reuptake inhibitors (SRIs) relieve irritability within days in women with premenstrual dysphoric disorder (PMDD); however, the effects on other affective symptoms in PMDD remain to be demonstrated

Pharmacologically Induced Hypogonadism and Sexual Function in Healthy Young Women and Men

Studies fail to find uniform effects of age-related or induced hypogonadism on human sexual function. We examined the effects of induced hypogonadism on sexual function in healthy men and women and attempted to identify predictors of the sexual response to induced hypogonadism or hormone addback. The study design used was a double-blind, controlled, crossover (self-as-own control). The study setting was an ambulatory care clinic in a research hospital, and the participants were 20 men (average ± SD age = 28.5 ± 6.2 years) and 20 women (average ± SD age = 33.5 ± 8.7 years), all healthy and with no history of psychiatric illness. A multidimensional scale assessing several domains of sexual function was the main outcome measure. Participants of the study received depot leuprolide acetate (Lupron) every 4 weeks for 3 months (men) or 5 months (women). After the first month of Lupron alone, men received (in addition to Lupron) testosterone enanthate (200 mg intramuscularly) or placebo every 2 weeks for 1 month each. Women received Lupron alone for 2 months, and then, in addition to Lupron, they received estradiol and progesterone for 5 weeks each. The results of the study: in women, hypogonadism resulted in a significant decrease in global measures of sexual functioning, principally reflecting a significant decrease in the reported quality of orgasm. In men, hypogonadism resulted in significant reductions in all measured domains of sexual function. Testosterone restored sexual functioning scores in men to those seen at baseline, whereas neither estradiol nor progesterone significantly improved the reduced sexual functioning associated with hypogonadism in women. Induced hypogonadism decreased sexual function in a similar number of men and women. No predictors of response were identified except for levels of sexual function at baseline. In conclusion, our data do not support a simple deficiency model for the role of gonadal steroids in human sexual function; moreover, while variable, the role of testosterone in sexual function in men is more apparent than that of estradiol or progesterone in women

Inflammatory breast cancer: dynamic contrast-enhanced MR in patients receiving bevacizumab. Initial experience

To retrospectively compare three dynamic contrast material-enhanced magnetic resonance (MR) imaging (dynamic MR imaging) analytic methods to determine the parameter or combination of parameters most strongly associated with changes in tumor microvasculature during treatment with bevacizumab alone and bevacizumab plus chemotherapy in patients with inflammatory or locally advanced breast cancer. MATERIALS AND METHODS: This study was conducted in accordance with the institutional review board of the National Cancer Institute and was compliant with the Privacy Act of 1974. Informed consent was obtained from all patients. Patients with inflammatory or locally advanced breast cancer were treated with one cycle of bevacizumab alone (cycle 1) followed by six cycles of combination bevacizumab and chemotherapy (cycles 2-7). Serial dynamic MR images were obtained, and the kinetic parameters measured by using three dynamic analytic MR methods (heuristic, Brix, and general kinetic models) and two region-of-interest strategies were compared by using two-sided statistical tests. A P value of .01 was required for significance. RESULTS: In 19 patients, with use of a whole-tumor region of interest, the authors observed a significant decrease in the median values of three parameters measured from baseline to cycle 1: forward transfer rate constant (Ktrans) (-34% relative change, P=.003), backflow compartmental rate constant extravascular and extracellular to plasma (Kep) (-15% relative change, P<.001), and integrated area under the gadolinium concentration curve (IAUGC) at 180 seconds (-23% relative change, P=.009). A trend toward differences in the heuristic slope of the washout curve between responders and nonresponders to therapy was observed after cycle 1 (bevacizumab alone, P=.02). The median relative change in slope of the wash-in curve from baseline to cycle 4 was significantly different between responders and nonresponders (P=.009). CONCLUSION: The dynamic contrast-enhanced MR parameters Ktrans, Kep, and IAUGC at 180 seconds appear to have the strongest association with early physiologic response to bevacizumab. Clinical trial registration no. NCT0001654

A Cross-Sectional Evaluation of Perimenopausal Depression

Overall, the clinical spectrum of depression during the perimenopause is not well characterized. This cross-sectional study examined the following: 1) clinical characteristics of women who presented to the NIMH midlife mood disorders clinic (between March 1990 and January 2004) with perimenopausal major and minor depressions; 2) the impact on these measures of either a prior episode of depression or the presence of hot flushes

Modulation of Hepatic Amyloid Precursor Protein and Lipoprotein Receptor-Related Protein 1 by Chronic Alcohol Intake: Potential Link Between Liver Steatosis and Amyloid-β

Heavy alcohol consumption is a known risk factor for various forms of dementia and the development of Alzheimer’s disease (AD). In this work, we investigated how intragastric alcohol feeding may alter the liver-to-brain axis to induce and/or promote AD pathology. Four weeks of intragastric alcohol feeding to mice, which causes significant fatty liver (steatosis) and liver injury, caused no changes in AD pathology markers in the brain [amyloid precursor protein (APP), presenilin], except for a decrease in microglial cell number in the cortex of the brain. Interestingly, the decline in microglial numbers correlated with serum alanine transaminase (ALT) levels, suggesting a potential link between liver injury and microglial loss in the brain. Intragastric alcohol feeding significantly affected two hepatic proteins important in amyloid-beta (Aβ) processing by the liver: 1) alcohol feeding downregulated lipoprotein receptor-related protein 1 (LRP1, ∼46%), the major receptor in the liver that removes Aβ from blood and peripheral organs, and 2) alcohol significantly upregulated APP (∼2-fold), a potentially important source of Aβ in the periphery and brain. The decrease in hepatic LRP1 and increase in hepatic APP likely switches the liver from being a remover or low producer of Aβ to an important source of Aβ in the periphery, which can impact the brain. The downregulation of LRP1 and upregulation of APP in the liver was observed in the first week of intragastric alcohol feeding, and also occurred in other alcohol feeding models (NIAAA binge alcohol model and intragastric alcohol feeding to rats). Modulation of hepatic LRP1 and APP does not seem alcohol-specific, as ob/ob mice with significant steatosis also had declines in LRP1 and increases in APP expression in the liver. These findings suggest that liver steatosis rather than alcohol-induced liver injury is likely responsible for regulation of hepatic LRP1 and APP. Both obesity and alcohol intake have been linked to AD and our data suggests that liver steatosis associated with these two conditions modulates hepatic LRP1 and APP to disrupt Aβ processing by the liver to promote AD