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Drawing from a large dataset of over 13,000 college students, this research compared 75 self-identified asexual individuals with heterosexual, bisexual, and gay/lesbian undergraduates. The results revealed that asexual individuals were less likely to have engaged in sexual behaviors (oral sex, anal sex, friends with benefits, sexual intercourse, hooking up) than heterosexual, bisexual, and gay or lesbian individuals. Asexual and heterosexual individuals were similar in endorsing absolutist sexual values, having a lower willingness to cohabit, and reporting less likelihood of having masturbated. Asexual individuals were similar to other sexual minorities in being less religious and having more positive attitudes toward LGB issues. A multinomial logistic regression analysis using all the variables with significant differences at the bivariate level revealed similar findings, though asexual individuals differed most dramatically in their lower levels of sexual experience when compared to gay/lesbian individuals. Future researchers are encouraged to consider reframing asexuality as more sex positive so as to recognize diversity and empower asexual individuals.

This research investigated the interpersonal impact of self-reported mental health diagnoses and/or perceptions on undergraduate students’ current or most recent romantic relationship. Analysis of data from a 43-item online questionnaire completed by 267 undergraduates revealed that 68.3% of women and 52.5% of men reported having either been professionally diagnosed with a mental illness or perceive themselves to be mentally ill based on DSM criteria, with women and white students reporting significantly higher levels. Sociologically speaking, mental illness was found to influence relationship initiation, maintenance, and dissolution in this study. The mental health of the respondents’ potential partners was an important consideration in deciding to form a relationship, particularly for male, white, heterosexuals. When the respondents reported relationship problems, men were more likely to blame such problems on mental health issues than women. Finally, though more respondents reported having broken up with a romantic partner who had mental health issues than had romantic partners break up with them, there were no significant gender, race, or sexual orientation differences in the termination of these romantic relationships. Study findings emphasize the importance of acknowledging and providing mental health resources—particularly interpersonal options—for emerging adults in the college setting.

In January 2021, a new academic unit (School of Engineering Design and Teaching Innovation) was created in the Faculty of Engineering for the first time in over 20 years. After identifying needs in the job market for programs with a focus on multidisciplinary skills, the academic unit’s first task was to develop a three-year nonaccredited program, titled “Bachelor’s of Multidisciplinary Design (Internship)”. Fundamentally, the program will include core technical expertise expected from an engineering faculty but will also offer flexibility for students to explore other interests. This type of flexibility and openness may seem daunting for first year students. Therefore, example learning paths were created based on current job market trends, with more learning paths in development. This paper focuses not only on the development of such a unique program in Canada, considering insight provided through stakeholder and focus group meetings, but also the challenges associated with submitting this program proposal through all levels of university bureaucracy, from the faculty committees through to provincial review. While there have been questions, and sometimes doubts, that such a program could be fully developed, the program is on track to pass all levels of approval and welcome its first cohort of students for the Fall 2023 term.

This research investigated whether there are gender differences in revealing sex secrets to a romantic partner, including the number and type of secrets kept; method of disclosure; and outcome of that disclosure. Analysis of data from a 39-item Internet questionnaire completed by 195 undergraduate students revealed that over a third (36%) of respondents reported having one or more sex secrets, with gendered differences in the type of sex secrets being kept. Analyses revealed that women hid being the victim of sexual assault and/or that they had practiced or were interested in BDSM/kink play significantly more often than men. Men, by contrast, kept secret that they had engaged in sex with multiple partners at the same time (i.e., a ‘threesome’) significantly more often than women. Women hid their sex secrets because they feared their partners would not understand their past actions; men worried that their romantic partner would disapprove of their secret behaviors, whether understanding such experiences or not. Overall, both genders reported that disclosing sex secrets to their romantic partners had a positive outcome, individually and interpersonally.

For many years, the oil and gas industry has deployed techniques which enhance formation strength via the successful propping and plugging of induced fractures. Induced fracture sizes have been successfully treated using this method up to the 600 – 1,100-micron range. Static wellbore strengthening techniques are commonly deployed to cover 1,000 micron and all fracture size risks underneath. The deployment of wellbore strengthening techniques has historically been confined to permeable formations. In most cases, wellbore strengthening has been deployed to operationally challenging sand fracture gradients or, where boundaries are pushed, lower ranges of permeability, such as silts. The subject of wellbore strengthening in shales or carbonates to this day, remains a challenge for the industry, with very few documented success stories or evidence of sustained ability to enhance fracture gradient across a drilling campaign. This paper covers the history of lost circulation events which have been reported in the Khazzan/Ghazeer field in the carbonate Habshan formation. It also describes the design changes which were introduced to strengthen the rock and enable circulation/returns, during liner cementation. The design work built on experience applying wellbore strengthening techniques in carbonates in the Norwegian sector of the North Sea. This work is also summarized in this paper. The Habshan carbonate formation in Oman presents a lost circulation challenge through an ‘induced’ fracture risk. Since the beginning of the drilling campaign in the Khazzan/Ghazeer field, the Habshan formation has repeatedly experienced induced mud losses during well activities such as liner running, mud conditioning with liner on bottom and cementing, when the formation is exposed to higher pressures, less so during drilling. The Habshan challenge in Oman has led to regular, significant lost circulation events during cement placement, adding operational cost and more importantly, presenting difficulties around meeting zonal isolation objectives. Through previous field experience in Norway, a set of criteria was developed to qualify a standard pill approach to carbonate strengthening. The currently deployed strategy is designed to address both the risk of induced fracture by propping and plugging (wellbore strengthening) and provide some ability to seal natural fractures which are often encountered with carbonates, or similarly flawed rocks. The strategy deployed aims to cover these two risks with a blanket approach to lost circulation risk in carbonates. The success of this approach is demonstrated using well performance data from a total of 43 wells drilled before and after the introduction of the wellbore strengthening strategy. As it was initially assumed that wellbore strengthening could not be applied to carbonate formations, other techniques had been tried to prevent lost circulation. Those techniques provided mixed results. Since the implementation of wellbore strengthening significant improvements in achieving zonal isolation requirements and reducing fluid losses have been documented.

Common associations between religiosity and beliefs or behaviors related to love and sexuality could differ by race and sexual identity. Data from 6068 undergraduates who completed a 100-item survey revealed that students scoring high on religiosity were more likely to believe in one true love and were more committed to staying married if they had fallen out of love or if their partner cheated on them. High religiosity was also associated with disapproval of being gay, not being involved in a “friends with benefits” relationship, not intending to cohabit, avoiding hooking up, not having cheated on a partner, being against abortion, and not having used the Internet to find a partner. However, regression analyses suggested a differential influence of religion based on race and sexual identity on some associations, suggesting potentially distinct associations of religion based on identify influences.

It is important to understand how people experience pleasure and sexual satisfaction with a partner, as these phenomena can impact how they view their relationships, themselves, as well as the role...

Information on the virologic durability of modern antiretroviral regimens is important to clinicians. We aimed to describe virologic durability of first-line integrase strand transfer inhibitor (INSTI)-, nonnucleoside reverse transcriptase inhibitor (NNRTI)-, or protease inhibitor (PI)-based antiretroviral regimens. This was a retrospective study of antiretroviral-naïve patients that initiated first-line antiretroviral regimens with two nucleoside reverse transcriptase inhibitors and an INSTI, NNRTI, or PI between January 2006 and June 2016. The outcome was time to virologic failure, which was assessed by Kaplan–Meier survival analysis and Cox regression models. There were 780 patients (median age = 37 years [interquartile range (IQR) = 30–45], 93.3% male, 56.2% Caucasian, median HIV duration = 1.8 years [IQR = 0.4–5.4], baseline log10viral load [VL]=4.6 [IQR = 4.1–5.1], and baseline CD4+ cell count = 320 cells/µl [IQR = 217–440]). In total, 189/780 were on a third agent INSTI, 339/780 on a third agent NNRTI, and 252/780 on a third agent PI. Kaplan–Meier survival probability revealed longer time to virologic failure for INSTI, followed by NNRTI then PI (p 10of baseline VL (aHR = 1.94; 95%CI = 1.58–2.39 per log10) increased risk. Virologic failure was delayed and virologic durability prolonged for INSTI- compared to NNRTI- and PI-based regimens, supporting current antiretroviral therapy guidelines.

Creutzfeldt-Jakob disease (CJD) is a rapidly progressive, fatal degenerative encephalopathy caused by a pathologically altered form of the prion protein (PrP). CJD is rare, with 1 and 2 cases per million per year reported in the general population, mostly in individuals over 50 years of age. It is almost unknown in the pediatric population. Sporadic CJD with unusually long survival (sCJD-LS), an unusual clinicopathological variant of CJD, has been described mostly in Japanese patients. We present here the first case report of pediatric CJD-LS occurring sporadically in a teenage girl of European descent, with initially rapid neurocognitive decline followed by a prolonged (∼10 years) clinical course. Neuropathological findings at autopsy included generalized cerebral and cerebellar atrophy with relative sparing of the hippocampi, cerebral and cerebellar white and gray matter involvement, minimal spongiform change, PrP deposits in the neocortex, striatum and cerebellum by immunohistochemistry, and protease-resistant PrP by Western immunoblot. With its longer disease duration and atypical manifestations of white matter loss, CJD-LS can be clinically mistaken for other neurodegenerative diseases, or in the pediatric setting for metabolic/genetic conditions. This case clearly demonstrates that with rapid-onset encephalopathy, prion disease should be carefully considered, even in younger patients with slower disease progression.

We assessed renal and metabolic changes associated with switching from tenofovir disoproxil fumarate (TDF)– to tenofovir alafenamide (TAF)–containing regimens among patients with HIV at the Maple Leaf Medical Clinic, Toronto, Canada. Using an electronic medical records retrospective chart review from July 2005 to December 2019, 651 patients aged ≥16 years taking TDF-containing regimens for ≥6 months who switched to TAF-containing regimens for ≥6 months were included. Change in estimated glomerular filtration rate (eGFR) was examined at 12-month follow-up. Secondary outcomes included change in urine albumin-to-creatinine ratio, serum phosphate, alkaline phosphatase (ALP), cholesterol markers, HbA1C, and weight. After 12 months, eGFR increased in 63% of the baseline eGFR 2 group (mean change [SD] = +5.1 [10.8], p = 0.002), 52% for the baseline eGFR = 60–90 mL/min/1.73 m2 group (+0.5 [10.4], p = 0.490), and 26% for baseline eGFR >90 mL/min/1.73 m2 group (−7.2 [11.2], p 2).

This research investigated the relationship consequences of disclosing sexual secrets to a romantic partner. Analyses of data from a 39-item Internet questionnaire completed by 195 undergraduate students showed that revealing sex secrets to a romantic partner was associated with either neutral or positive relationship outcomes. Disclosure of sexual secrets almost never (

Background Although HIV pre-exposure prophylaxis (PrEP) substantially diminishes the likelihood of HIV acquisition, poor adherence can decrease the HIV-protective benefits of PrEP. The present investigation sought to identify the extent to which alcohol consumption, substance use, and depression were linked to PrEP nonadherence among gay, bisexual, and other men-who-have-sex-with-men (gbMSM). Methods gbMSM (age ≥ 18, prescribed PrEP for ≥3 months) were recruited from two clinics in Toronto, Canada for an e-survey assessing demographics; PrEP nonadherence (4-day PrEP-focused ACTG assessment); hazardous and harmful alcohol use (AUDIT scores of 8–15 and 16+, respectively); moderate/high risk substance use (NIDA M-ASSIST scores > 4); depression (CESD-10 scores ≥10); and other PrEP-relevant factors. The primary outcome, PrEP nonadherence, entailed missing one or more PrEP doses over the past 4 days. A linear-by-linear test of association assessed whether increasing severity of alcohol use (i.e., based on AUDIT categories) was linked to a greater occurrence of PrEP nonadherence. Univariate logistic regression was employed to determine factors associated with PrEP nonadherence, and factors demonstrating univariate associations at the p Results A total of 141 gbMSM (Mean age = 37.9, white = 63.1%) completed the e-survey. Hazardous/harmful drinking (31.9%), moderate/high risk substance use (43.3%), and depression (23.7%) were common; and one in five participants (19.9%) reported PrEP nonadherence. Increasing alcohol use level was significantly associated with a greater likelihood of nonadherence (i.e., 15.6, 25.0, and 44.4% of low-risk, hazardous, and harmful drinkers reported nonadherence, respectively (χ2(1) = 4.79, p = .029)). Multivariate logistic regression demonstrated that harmful alcohol use (AOR = 6.72, 95%CI = 1.49–30.33, p = .013) and moderate/high risk cocaine use (AOR = 3.11, 95%CI = 1.01–9.59, p = .049) independently predicted nonadherence. Furthermore, an additive association emerged, wherein the likelihood of PrEP nonadherence was highest among those who were hazardous/harmful drinkers and moderate/high risk cocaine users (OR = 2.25, 95%CI = 1.19–4.25, p = .013). Depression was not associated with nonadherence. Conclusions Findings highlight the need to integrate alcohol- and substance-focused initiatives into PrEP care for gbMSM. Such initiatives, in turn, may help improve PrEP adherence and reduce the potential for HIV acquisition among this group.

Following cardiovascular events (CVE) among people living with HIV (PLWH) is essential. Abacavir (ABC)'s impact on CVE challenges clinicians. We characterized CVE at our HIV clinic associated with ABC versus tenofovir disoproxil fumarate (TDF). This was a retrospective study of PLWH who started combination antiretroviral therapy with no prior CVE. Patients were evaluated as antiretroviral naive or antiretroviral experienced. Regimens included the following: always-ABC, always-TDF, first-ABC-switched-to-TDF, and first-TDF-switched-to-ABC regimens. Frequencies, rates, and Poisson regression were used to analyze CVE (cardiovascular/cerebrovascular) and were stratified with an

Pre-exposure prophylaxis (PrEP) is traditionally prescribed by HIV specialist physicians. Given finite specialist resources, there is a need to scale up PrEP delivery by decentralizing services via other healthcare professionals. We aimed to assess the feasibility of delivering PrEP to men who have sex with men (MSM) through primary care physicians and sexual health clinic nurses. We piloted a multi-component, implementation and dissemination research program to increase provision of PrEP through primary care physicians and sexual health clinic nurses in Toronto, Canada. Community-based organizations (CBOs) provided prospective participants with information cards that contained links to an online module on engaging providers in a conversation about PrEP. In our patient-initiated continuing medical education (PICME) strategy, participants saw their family doctors and gave them the card, which also contained a link to a Continuing Medical Education module. In the nurse-led strategy, participants visited one of two participating clinics to obtain PrEP. We administered an optional online questionnaire to patients and providers at baseline and six months. CBOs distributed 3043 cards. At least 339 men accessed the online module and 196 completed baseline questionnaires. Most (55%) intended to visit nurses while 21% intended to consult their physicians. Among 45 men completing follow-up questionnaires at 6 months, 31% reported bringing cards to their physicians and obtaining PrEP through them; sexual health clinics delivered PrEP to 244 patients. Participants who went through the PICME approach reported no changes in relationships with their providers. Nurses showed fidelity to PrEP prescribing guidelines. Nurse-led PrEP and patient-initiated continuing medical education (PICME) for primary care physicians are feasible strategies to increase PrEP uptake. Nurse-led PrEP delivery was preferred by most patients.

Prospectively acquired Canadian cerebrospinal fluid samples were used to assess the performance characteristics of three ante-mortem tests commonly used to support diagnoses of Creutzfeldt–Jakob disease. The utility of the end-point quaking-induced conversion assay as a test for Creutzfeldt–Jakob disease diagnoses was compared to that of immunoassays designed to detect increased amounts of the surrogate markers 14-3-3γ and hTau. The positive predictive values of the end-point quaking-induced conversion, 14-3-3γ, and hTau tests conducted at the Prion Diseases Section of the Public Health Agency of Canada were 96%, 68%, and 66%, respectively.

A 32-item survey (completed by 286 undergraduates) identified factors associated with positive (feeling happy, less anxious, sense of relief, freedom) and negative (sadness, jealousy, loss of self-...

Background Gay, bisexual and other men who have sex with men (gbMSM) in Canada continue to experience high rates of incident HIV. Pre-exposure prophylaxis (PrEP, the regular use of anti-HIV medication) reduces HIV acquisition and could reduce incidence. However, there are too few physicians with expertise in HIV care to meet the projected demand for PrEP. To meet demand and achieve greater public health impact, PrEP delivery could be ‘decentralized’ by incorporating it into front-line prevention services provided by family physicians (FPs) and sexual health clinic nurses. Methods This PrEP decentralization project will use two strategies. The first is an innovative knowledge dissemination approach called ‘Patient-Initiated CME’ (PICME), which aims to empower individuals to connect their family doctors with online, evidence-based, continuing medical education (CME) on PrEP. After learning about the project through community agencies or social/sexual networking applications, gbMSM interested in PrEP will use a uniquely coded card to access an online information module that includes coaching on how to discuss their HIV risk with their FP. They can provide their physician a link to the accredited CME module using the same card. The second strategy involves a pilot implementation program, in which gbMSM who do not have a FP may bring the card to designated sexual health clinics where trained nurses can deliver PrEP under a medical directive. These approaches will be evaluated through quantitative and qualitative methods, including: questionnaires administered to patients and physicians at baseline and at six months; focus groups with patients, FPs, and sexual health clinic staff; and review of sexual health clinic charts. The primary objective is to quantify the uptake of PrEP achieved using each decentralization strategy. Secondary objectives include a) characterizing barriers and facilitators to PrEP uptake for each strategy, b) assessing fidelity to core components of PrEP delivery within each strategy, c) measuring patient-reported outcomes including satisfaction with clinician-patient relationships, and d) conducting a preliminary costing analysis. Discussion This study will assess the feasibility of a novel strategy for disseminating knowledge about evidence-based clinical interventions, and inform future strategies for scale-up of an underutilized HIV prevention tool.

This study examined the difference in sexual satisfaction between sexual minority and heterosexual college students testing the mediation effects of institutional affiliations and interpersonal relationships. A convenience sample of 280 college sociology students completed a 47-item Internet questionnaire, including self-reports on sexual satisfaction and sexual behaviors/activities. Data on 193 heterosexuals and 87 sexual minority respondents were analyzed using regression to test for differences in reported levels of sexual satisfaction by sexual orientation. Results revealed that sexual minority undergraduates reported lower sexual satisfaction than heterosexual undergraduates. This difference persisted when controlling for sex, race, education, and SES. Mediation analyses found support for the hypothesis that institutional affiliations and interpersonal relationships have an effect on this association. Previous researchers have suggested that sexual minority relationships exist in a context of heterosexism, suppression, stigmatization, prejudice, discrimination and violence which results in lower relationship quality. Such an impact on minority couples’ satisfaction may spill over into lower sexual satisfaction.

Background Bacterially-produced recombinant prion protein (rPrP) has traditionally been used for in vitro fibrillation assays and reagent development for prion disease research. In recent years, it has also been used as a substrate for real-time quaking-induced conversion (RT-QuIC), a very sensitive method of detecting the presence of the misfolded, disease-associated isoform of the prion protein (PrP d ). Multi-centre trials have demonstrated that RT-QuIC is a suitably reliable and robust technique for clinical practice; however, in the absence of a commercial supplier of rPrP as a substrate for RT-QuIC, laboratories have been required to independently generate this key component of the assay. No harmonized method for producing the protein has been agreed upon, in part due to the variety of substrates that have been applied in RT-QuIC. Methods This study examines the effects of two different rPrP refolding protocols on the production, QuIC performance, and structure characteristics of two constructs of rPrP commonly used in QuIC: full length hamster and a sheep-hamster chimeric rPrP. Results Under the described conditions, the best performing substrate was the chimeric sheep-hamster rPrP produced by shorter guanidine-HCl exposure and faster gradient elution. Conclusions The observation that different rPrP production protocols influence QuIC performance indicates that caution should be exercised when comparing inter-laboratory QuIC results.

Atlantic salmon (Salmo salar L.) populations from different river origins mix in the North Atlantic during the marine life stage. To facilitate marine stock identification, we developed a genetic baseline covering the European component of the species’ range excluding the Baltic Sea, from the Russian River Megra in the north-east, the Icelandic Ellidaar in the west, and the Spanish Ulla in the south, spanning 3737 km North to South and 2717 km East to West. The baseline encompasses data for 14 microsatellites for 26 822 individual fish from 13 countries, 282 rivers, and 467 sampling sites. A hierarchy of regional genetic assignment units was defined using a combination of distance-based and Bayesian clustering. At the top level, three assignment units were identified comprising northern, southern, and Icelandic regions. A second assignment level was also defined, comprising eighteen and twenty-nine regional units for accurate individual assignment and mixed stock estimates respectively. The baseline provides the most comprehensive geographical coverage for an Atlantic salmon genetic data-set, and a unique resource for the conservation and management of the species in Europe. It is freely available to researchers to facilitate identification of the natal origin of European salmon.

Aim We constructed an independent phylogeographical hypothesis (IPH) for Atlantic salmon (Salmo salar L.) in Scotland and adjacent northern England and tested if the distribution of contemporary microsatellite variation accorded with the IPH. Location NW Europe. Methods Knowledge of post-Last Glacial Maximum (LGM) landscape development and salmon biology were used to define a temporal sequence of late Quaternary ecological niche models and, combined with the central-marginal (CM) model of diversity evolution, to formulate an IPH. Observed microsatellite locus variation for salmon from 102 rivers in Scotland and northern England was tested for agreement with the IPH. Results The IPH postulated (1) initial colonization (c. 17 ka bp) of multiple isolated deglaciating coastal regions by long-distance dispersal, predominantly from SW Europe via the Atlantic, (2) intra-region colonization dominated by local range expansion, (3) differentiation by founder effects/genetic drift, in line with CM, until deglaciation complete and regions merged (c. 10 ka bp). IPH regions were weakly but significantly differentiated, showed broad agreement with genetically defined regions, and genetic diversity within them positively correlated with time post-deglaciation, conforming to the CM model. The greatest differentiation was seen for the most recently diverged populations, with evidence that accumulating homoplastic mutations muted older regional phylogeographical signatures. Main conclusions Microsatellite differentiation in Scottish Atlantic salmon is significantly but weakly conditioned by post-LGM deglaciation, with a mosaic of regional groups and a temporal cascade of within-region CM effects caused by local range expansion as patches became deglaciated. Colonization was predominantly or exclusively from the south-western European LGM refugium. Accumulating homoplastic mutations have increasingly reduced regional differentiation.

Creutzfeldt-Jakob disease (CJD) is a fatal neurological illness for which accurate diagnosis is paramount. Real-time quaking-induced conversion (RT-QuIC) is a prion-specific assay with high sensitivity and specificity for CJD. The Canadian endpoint quaking-induced conversion (EP-QuIC) test is similar, but unlike RT-QuIC there is little data regarding its diagnostic utility in clinical practice. In this exploratory predictive value analysis of EP-QuIC in CJD, the negative predictive value (NPV) and positive predictive value (PPV) was 100% and 83%, respectively, with one false-positive result identified. Re-testing this sample with an optimized EP-QuIC protocol eliminated this false-positive result, leading to a PPV of 100%.La valeur prédictive de la méthode diagnostique dite de conversion provoquée par tremblement au point final dans le cas de la maladie de Creutzfeldt-Jakob. La maladie de Creutzfeldt-Jakob (MCJ) est une maladie neurologique qui entraîne à terme un décès et pour laquelle l’établissement d’un diagnostic précis est primordial. La conversion provoquée par tremblement en temps réel (RT-QuIC en anglais) est une méthode diagnostique qui repose sur la détection de la protéine prion. Dans le cas de la MCJ, cette méthode est réputée posséder une sensibilité et une spécificité élevées. La méthode canadienne dite de conversion provoquée par tremblement au point final (EP-QuIC en anglais) se veut similaire mais, à la différence de la RT-QuIC, il existe peu de données en ce qui concerne son utilité diagnostique dans le cadre d’une pratique clinique. Dans cette analyse prédictive exploratoire de la EP-QuIC en lien avec la MCJ, la valeur prédictive négative (VPN) et la valeur prédictive positive (VPP) ont été respectivement de 100 % et de 83 %, un seul résultat faux-positif ayant été identifié. Le fait de soumettre notre échantillon à un nouveau test effectué à l’aide d’un protocole d’EP-QuIC optimisé a permis d’éliminer ce résultat faux-positif, ce qui a débouché sur une VPP de 100 %.

Background More providers are needed to deliver PrEP at scale. We examined intentions to seek PrEP from family physicians (FPs) and sexual health clinic nurses (RNs) within an implementation science study on decentralizing PrEP delivery to gay, bisexual and other men who have sex with men (gbMSM). Methods Strategy A was a knowledge dissemination intervention in which community organizations distributed info-cards to gbMSM considering PrEP. Men used the cards to view an online module and meet with their FPs, who could use the card to complete an accredited e-module about PrEP. Strategy B was an implementation intervention in which gbMSM could instead access PrEP from sexual health RNs. Participants completed an optional survey at baseline and 6 months. We used descriptive statistics to characterize the sample and logistic regression to identify characteristics associated with intentions to seek PrEP from FPs vs RNs. Results From 3013 cards distributed, 339 men accessed the module; 179 completed the baseline survey and are included in this analysis. Median (IQR) age was 31 (26,40) years, 97.7% were cisgender males and 46.4% had a prior bacterial STI. Most (n=119, 66.5%) had a FP, of which only 59.5% were ‘out’ to them. Of 97 respondents with a FP and wanting to start PrEP, 35.1% vs 65.0% intended to use Strategy A vs B respectively (p=0.003). In univariable analyses, characteristics associated with intent to approach FPs included being ‘out’ to that doctor (OR=10.67, 95%CI=3.35, 33.96), very good/excellent physician skills in general communication (OR=3.42, 95%CI=1.38, 8.48) and participatory decision-making (OR=3.33, 95%CI=1.14, 9.79). In multivariable analysis, being ‘out’ was the only significant predictor (aOR=14.35, 95%CI=1.59, 129.83). Conclusion Among gbMSM with a FP, sexual health clinic RNs were preferred over FPs for PrEP by most. Multiple strategies are needed to increase numbers of PrEP providers, including interventions to help gbMSM feel comfortable disclosing sexual orientation. Disclosure No significant relationships.

Power is an important element in dating relationships. Using the power within relationships theory and equity theory this research examined perceived relationship power in a sample of 1098 ...

Undergraduates (196) at a large southeastern university completed a 59 item Internet survey on threesome attitudes and behaviors. Fifteen percent of the sample reported having engaged in a threesome. Men evidenced more interest in having a threesome than women and persons most likely to report having had a threesome held hedonistic compared to relativistic or absolutist sexual values. The motivation for a threesome was primarily curiosity and the third person invited to join the couple in a threesome was most often a friend/acquaintance of the woman. The outcome of a threesome for the couple was primarily no effect with a about a fifth reporting negative outcomes and a similar percentage reporting positive outcomes. Finally, the event happened only once for 83% of the respondents who had a threesome. Symbolic interaction, operant learning, social learning, affective theory and feminist theory were used to interpret the data. Implications and limitations are identified.

Mass spectrometry-based phenotypic H-antigen typing (MS-H) combined with whole-genome-sequencing-based genetic identification of H antigens, O antigens, and toxins (WGS-HOT) was used to type 60 clinical Escherichia coli isolates, 43 of which were previously identified as nonmotile, H type undetermined, or O rough by serotyping or having shown discordant MS-H and serotyping results. Whole-genome sequencing confirmed that MS-H was able to provide more accurate data regarding H antigen expression than serotyping. Further, enhanced and more confident O antigen identification resulted from gene cluster based typing in combination with conventional typing based on the gene pair comprising wzx and wzy and that comprising wzm and wzt . The O antigen was identified in 94.6% of the isolates when the two genetic O typing approaches (gene pair and gene cluster) were used in conjunction, in comparison to 78.6% when the gene pair database was used alone. In addition, 98.2% of the isolates showed the existence of genes for various toxins and/or virulence factors, among which verotoxins (Shiga toxin 1 and/or Shiga toxin 2) were 100% concordant with conventional PCR based testing results. With more applications of mass spectrometry and whole-genome sequencing in clinical microbiology laboratories, this combined phenotypic and genetic typing platform (MS-H plus WGS-HOT) should be ideal for pathogenic E. coli typing.

BACKGROUND Escherichia coli H antigen typing with antisera, a useful method for flagella clinical identification and classification, is a time-consuming process because of the need to induce flagella growth and the occurrence of undetermined strains. We developed an alternative rapid and analytically sensitive mass spectrometry (MS) method, termed MS-based H antigen typing (MS-H), and applied it at the protein sequence level for H antigen typing. We also performed a comparison with traditional serotyping on reference strains and clinical isolates. METHODS On the basis of international guidelines, the analytical selectivity and sensitivity, imprecision, correlation, repeatability, and reproducibility of the MS-H platform was evaluated using reference strains. Comparison of MS-H typing and serotyping was performed using 302 clinical isolates from 5 Canadian provinces, and discrepant results between the 2 platforms were resolved through whole genome sequencing. RESULTS Repeated tests on reference strain EDL933 demonstrated a lower limit of the measuring interval at the subsingle colony (16.97 μg or 1.465 × 107 cells) level and close correlation (r2 > 0.99) between cell culture biomass and sequence coverage. The CV was CONCLUSIONS MS-H typing of E. coli is useful for fast and accurate flagella typing and could be very useful during E. coli outbreaks.

The Prion Laboratory Section of the Public Health Agency of Canada supports heath care professionals dealing with patients suspected to have Creutzfeldt-Jakob disease (CJD) by testing cerebrospinal fluid (CSF) for protein markers of CJD. To better serve Canadian diagnostic requirements, a quaking-induced conversion (QuIC)-based assay has been added to the test panel. The QuIC tests exploit the ability of disease-associated prion protein, found in the CSF of a majority of CJD patients, to convert a recombinant prion protein (rPrP) into detectable amounts of a misfolded, aggregated form of rPrP. The rPrP aggregates interact with a specific dye, causing a measurable change in the dye's fluorescence emission spectrum. Optimal test and analysis parameters were empirically determined. Taking both practical and performance considerations into account, an endpoint QuIC (EP-QuIC) configuration was chosen. EP-QuIC uses a thermo-mixer to perform the shaking necessary to produce the quaking-induced conversions. Fluorescence readings are obtained from a microwell fluorescence reader only at the beginning and the end of EP-QuIC reactions. Samples for which the relative fluorescence unit ratio between the initial and final readings represent a ≥4 increase in signal intensity in at least two of the three replicates are classified as positive. A retrospective analysis of 91 CSF samples that included 45 confirmed cases of CJD and 46 non-CJD cases was used to estimate the performance characteristics of the EP-QuIC assay. The diagnostic sensitivity and specificity of the EP-QuIC test of this set of samples were 98 and 91%, respectively.