Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview

Objective: The aim of this study was to provide an overview of the recommendations regarding the diagnosis and treatment contained in current clinical practice guidelines for patients with non-specific low back pai

Detector Description and Performance for the First Coincidence Observations between LIGO and GEO

For 17 days in August and September 2002, the LIGO and GEO interferometer gravitational wave detectors were operated in coincidence to produce their first data for scientific analysis. Although the detectors were still far from their design sensitivity levels, the data can be used to place better upper limits on the flux of gravitational waves incident on the earth than previous direct measurements. This paper describes the instruments and the data in some detail, as a companion to analysis papers based on the first data.Comment: 41 pages, 9 figures 17 Sept 03: author list amended, minor editorial change

Association of HIV preexposure prophylaxis with incidence of sexually transmitted infections among individuals at high risk of HIV infection

IMPORTANCE, Emerging evidence suggests that risk of bacterial sexually transmitted infections, STIs, increases among gay and bisexual men following initiation of HIV preexposure prophylaxis, PrEP, . OBJECTIVE, To describe STI incidence and behavioral risk factors among a cohort of predominantly gay and bisexual men who use PrEP, and to explore changes in STI incidence following PrEP commencement. DESIGN, SETTING, AND PARTICIPANTS, The Pre-exposure Prophylaxis Expanded, PrEPX, Study, a multisite, open-label intervention study, was nested within the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance, ACCESS, clinic network. A total of, participants were enrolled, July, April, in Victoria, Australia. Of these, enrolled at, ACCESS clinics, primary care, sexual health, and, community-based HIV rapid testing service, had at least, follow-up visit, and were monitored until April, . EXPOSURES, Upon enrollment, participants received daily oral tenofovir disoproxil fumurate and emtricitabine for HIV PrEP, quarterly HIV and STI testing, and clinical monitoring. MAIN OUTCOMES AND MEASURES, The primary outcomewas incidence of chlamydia, gonorrhea, or syphilis. Incidence rates and hazard ratios describing behavioral risk factors of STI diagnosis were calculated. Incidence rate ratios, IRRs, adjusted for change in testing frequency, described changes in STI incidence from, -year preenrollment to study follow-up among participants with preenrollment testing data, n, . RESULTS, Among the, individuals, median age, years, interquartile range, -, ., identified as gay or bisexual males, used PrEP prior to enrollment, withdrew andwere censored at date of withdrawal, leaving, ., enrolled at final follow-up. During a mean follow-up of, ., years, ., person-years, STIswere diagnosed among, participants, chlamydia, gonorrhea, syphilis, . STI incidencewas, ., per, person-years, with, participants, accounting for, of all STIs. Among, participants with complete data for multivariable analysis, younger age, greater partner number, and group sexwere associated with greater STI risk, but condom usewas not. Among, participants with preenrollment testing data, STI incidence increased from, ., per, person-years prior to enrollment to, ., per, person-years during follow-up, IRR, ., CI, ., -, ., . After adjusting for testing frequency, the increase in incidence from, year preenrollment to follow-upwas significant for any STI, adjusted IRR, ., CI, ., -, ., and for chlamydia, adjusted IRR, ., CI, ., -, ., . CONCLUSIONS AND RELEVANCE, Among gay and bisexual men using PrEP, STIs were highly concentrated among a subset, and receipt of PrEP after study enrollment was associated with an increased incidence of STIs compared with preenrollment. These findings highlight the importance of frequent STI testing among gay and bisexual men using PrEP.Michael W. Traeger, Vincent J. Cornelisse, Jason Asselin, Brian Price, Norman J. Roth ... Wesselingh Steve L. ... et al

Probing surfaces with thermal He atoms: scattering and microscopy with a soft touch

Helium atom scattering (HAS) is a well established technique, particularly suited for the investigation of insulating and/or fragile materials and light adsorbates including hydrogen. In contrast to other beam techniques based on Xrays or electrons, low energy (typically less than 100 meV) He atoms are scattered by the tail of the electron density distribution which spill out from a surface, therefore HAS is strictly a nonpenetrating technique without any sample damage. HAS has been used to investigate structural properties of crystalline surfaces, including precise determination of atomic step heights, for monitoring thin film growth, to study surface transitions such as surface melting and roughening and for determining the presence and properties of adsorbates. Energy resolved HAS can provide information about surface vibrations (phonons) in the meV range and surface diffusion. This chapter provides a brief introduction to HAS with an outlook on a new, promising surface science technique: Neutral Helium Microscopy