Background We aimed to examine the impact of lockdown on sexually transmitted infection (STI) diagnoses and access to a public sexual health service in the COVID-19 pandemic in Melbourne, Australia. Methods The operating hours of Melbourne Sexual Health Centre (MSHC) remained the same during the lockdown. We examined the number of consultations and STI at MSHC between January and June 2020 and stratified the data into pre-lockdown (3-February to 22-March), lockdown (23-March to 10-May) and post-lockdown (11-May to 28-June) with seven weeks in each period. Incidence rate ratio (IRR) and its 95% confidence intervals (CI) were estimated using Poisson regression models. Results The total number of consultations dropped from 7,818 in pre-lockdown to 4,652 during lockdown (IRR=0.60;95%CI:0.57-0.62) but increased to 5,347 in the post-lockdown period (IRR=1.15;95%CI:1.11-1.20). There was a 68% reduction in asymptomatic screening during lockdown (IRR=0.32; 95%CI:0.30-0.35) but it gradually increased in the post-lockdown period (IRR=1.59;95%CI:1.46-1.74). STI with milder symptoms showed a marked reduction, including non-gonococcal urethritis (IRR=0.60;95%CI:0.51-0.72), and candidiasis (IRR=0.61;95%CI:0.49-0.76) during lockdown compared with pre-lockdown. STI with more marked symptoms did not change significantly, including pelvic inflammatory disease (IRR=0.95;95%CI:0.61-1.47) and infectious syphilis (IRR=1.14;95%CI:0.73-1.77). There was no significant change in STI diagnoses in post-lockdown compared to lockdown. Conclusions The public appeared to be prioritising their attendance for sexual health services based on the urgency of their clinical conditions. This suggests that the effectiveness of clinical services in detecting, treating and preventing onward transmission of important symptomatic conditions is being mainly preserved despite large falls in absolute numbers of attendees.
We studied 15 men (8 treatment, 7 control) before and after 21 days of 6º head-down tilt to determine whether daily, 1-h exposures to 1.0 G(z) (at the heart) artificial gravity (AG) would prevent bed rest-induced cardiovascular deconditioning. Testing included echocardiographic analysis of cardiac function, plasma volume (PV), aerobic power (VO(2)pk) and cardiovascular and neuroendocrine responses to 80º head-up tilt (HUT). Data collected during HUT were ECG, stroke volume (SV), blood pressure (BP) and blood for catecholamines and vasoactive hormones. Heart rate (HR), cardiac output (CO), total peripheral resistance, and spectral power of BP and HR were calculated. Bed rest decreased PV, supine and HUT SV, and indices of cardiac function in both groups. Although PV was decreased in control and AG after bed rest, AG attenuated the decrease in orthostatic tolerance [pre- to post-bed rest change; control: -11.8 ± 2.0, AG: -6.0 ± 2.8 min (p = 0.012)] and VO(2)pk [pre- to post-bed rest change; control: -0.39 ± 0.11, AG: -0.17 ± 0.06 L/min (p = 0.041)]. AG prevented increases in pre-tilt levels of plasma renin activity [pre- to post-bed rest change; control: 1.53 ± 0.23, AG: -0.07 ± 0.34 ng/mL/h (p = 0.001)] and angiotensin II [pre- to post-bed rest change; control: 3.00 ± 1.04, AG: -0.63 ± 0.81 pg/mL (p = 0.009)] and increased HUT aldosterone [post-bed rest; control: 107 ± 30 pg/mL, AG: 229 ± 68 pg/mL (p = 0.045)] and norepinephrine [post-bed rest; control: 453 ± 107, AG: 732 ± 131 pg/mL (p = 0.003)]. We conclude that AG can mitigate some aspects of bed rest-induced cardiovascular deconditioning, including orthostatic intolerance and aerobic power. Mechanisms of improvement were not cardiac-mediated, but likely through improved sympathetic responsiveness to orthostatic stress.
Mice are routinely used to study the development of the external genitalia and, in particular, the process of male urethral closure. This is because misplacement of the male penile urethra, or hypospadias, is amongst the most common birth defects reported in humans. While mice present a tractable model to study penile development, several structures differ between mice and humans, and there is a lack of consensus in the literature on their annotation and developmental origins. Defining the ontology of the mouse prepuce is especially important for the relevance and interpretation of mouse models of hypospadias to human conditions. We have developed a detailed annotation of the adult mouse penis that addresses these differences and enables an accurate comparison of murine and human hypospadias phenotypes. Through MRI data, gross morphology and section histology, we define the origin of the mouse external and internal prepuces, their relationship to the single human foreskin as well as provide a comprehensive view of the various structures of the mouse penis and their associated muscle attachments within the body. These data are combined to annotate structures in a novel 3D adult penis atlas that can be downloaded, viewed at any angle, and manipulated to examine the relationship of various structures.
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