A Point of Care (POC) test for measurement of salivary antibody or cortisol concentrations, using a Lateral Flow Device (LFD), has given rapid feedback to coaches and support staff in Premier League soccer clubs within a matter of minutes from sample collection. This has been useful in assessing fatigue levels, immune status and readiness to train/compete and offers a considerable time advantage over standard laboratory methods. This current paper assesses a new POC reader, which is smaller, quicker and cheaper than the current model. A total of 48 saliva samples taken during routine monitoring of a cohort of English Premier League soccer players (23.5 ± 6.4 y) using IPRO OFC kits on two separate occasions for the measurement of cortisol on the standard IPRO LFD Reader and the new IPRO Cube reader. The following week 50 samples from the same cohort were measured for sIgA concentration with both IPRO readers. The cortisol LFD showed good agreement on both readers; r = 0.96 (95% CI 0.93–0.98) with typical error of estimate 1.18 nM (95% CI 0.98–1.48) and no difference between the mean values on each reader: LFD Reader 7.5 nM (range 2.73–23.5 nM) v Cube 7.1 nM (range 2.24–25.8). The sIgA LFD measured with the Cube reader showed good agreement with the standard LFD Reader; r = 0.98 (95% CI 0.96–0.99) with typical error of estimate 29.9 (95% CI 24.9–37.4) μg/mL and higher but not significant different mean values on the Cube: mean 215.6 ± 163.8 μg/mL (range 34.7–621.1 μg/mL) v LFD Reader mean 148.3 ± 142.1 (range 20.0–518.8 μg/mL). The new Cube POC device shows suitable validity for use in the sporting environment and represents savings in cost and analysis time in comparison to previous methods.

Background Increasingly, young women living with perinatally acquired HIV (YWLPaHIV) have transitioned from paediatric to adult services. There remains a paucity of data on the sexual and reproductive health (SRH) needs of YWLPaHIV and their access to youth-friendly care. Amidst healthcare changes due to COVID-19 pandemic restrictions, we explored SRH needs of a cohort of YWLPaHIV. Methods Evaluation of SRH needs of YWLPaHIV attending a UK NHS-youth HIV service with data collected from patient records and self-reported questionnaires amongst women attending between July and November 2020 following easing of the first lockdown and reintroduction of in-person appointments. Results 71 of 112 YWLPaHIV registered at the clinic completed questionnaires during the study period and were included in the analysis. Median age was 23 y (IQR 21–27, range 18–36). 51/71(72%) reported coitarche, average age 17.6 y (IQR 16–18, range 14–24). 24 women reported 47 pregnancies resulting in 16 (34%) HIV-negative live-births, 19 (40%) terminations, 9(19%) miscarriages, with 3 pregnancies ongoing. 31/48(65%) sexually active women reported current contraception: 10 (32%) condoms, 19 (62%) long-acting, and 3(10%) oral contraceptive pill. 18/51(35%) reported a previous sexually transmitted infection; human papillomavirus (HPV) (11), Chlamydia trachomatis (9) and herpes simplex (2). 27/71(38%) women had undergone cervical cytology including 20/28(71%) women aged ≥25 y with abnormalities documented in 29%. HPV vaccination was reported in 83%, with protective hepatitis B titres in 71%. Conclusion High rates of unplanned pregnancy, STIs and cervical abnormalities highlight the continuing SRH needs of YWLPaHIV and requirement for open access to integrated HIV/SRH services despite pandemic restrictions.

Injury scoring systems can be used for triaging, predicting morbidity and mortality, and prognosis in mass casualty incidents. Recent conflicts and civilian incidents have highlighted the unique nature of blast injuries, exposing deficiencies in current scoring systems. Here, we classify and describe deficiencies with current systems used for blast injury. Although current scoring systems highlight survival trends for populations, there are several major limitations. The reliable prediction of mortality on an individual basis is inaccurate. Other limitations include the saturation effect (where scoring systems are unable to discriminate between high injury score individuals), the effect of the overall injury burden, lack of precision in discriminating between mechanisms of injury, and a lack of data underpinning scoring system coefficients. Other factors influence outcomes, including the level of healthcare and the delay between injury and presentation. We recommend that a new score incorporates the severity of injuries with the mechanism of blast injury. This may include refined or additional codes, severity scores, or both, being added to the Abbreviated Injury Scale for high-frequency, blastspecific injuries; weighting for body regions associated with a higher risk for death; and blast-specific trauma coefficients. Finally, the saturation effect (maximum value) should be removed, which would enable the classification of more severe constellations of injury. An early accurate assessment of blast injury may improve management of mass casualty incidents.

No abstract

No abstract