1 To date e-cigarettes have been exempt from the advertising bans

1 To date e-cigarettes have been exempt from the advertising bans imposed on tobacco products; moreover, these advertisements are sometimes seen as ‘promoting e-cigarettes as a safe new lifestyle’2. Selleckchem Ganetespib Many smokers interested in quitting are currently and increasingly turning to e-cigarettes. In 2016, the MHRA is planning to regulate e-cigarettes, nevertheless the evidence for using them is still lacking. The aim of the study was to evaluate the views of community pharmacists on the use and safety of e-cigarettes. This was a quantitative study; a questionnaire

was designed to include the following sections: experience with e-cigarettes, safety, perceptions on regulations and training requirements. This was a self-completion Epacadostat datasheet questionnaire where the researchers used the drop off-pick up method which maximises response rate. Pharmacies were selected randomly. Data were entered and analysed using MS Excel. One hundred fifty-four pharmacists were invited to participate, and 92 responded. The highest response rate was obtained

from independent pharmacies (90%). Seventy-three per cent of the participants currently sell e-cigarettes at their pharmacy. Twenty per cent of participants have been presented with e-cigarette adverse effects. These mainly consisted of cough (n = 10) and dry mouth (n = 7). Pharmacists were required to rank five possible reasons for utilisation of e-cigarettes from ‘1’ being most important to ‘5’ least important. ‘Aid in stop smoking’ was ranked as the most important (56%), with ‘cheaper alternative’ (43%)

and ‘social recreational use’ (31%) being ranked the least important. Safety issues were highlighted, where statements such as ‘e-liquid in cartridges may be toxic’ was agreed by 52% (n = 47) Branched chain aminotransferase of respondents. The majority of pharmacists (97%) were supportive of e-cigarettes being regulated, especially regarding excipients (42%) and nicotine content (34%). To be able to advise patients on the use of e-cigarettes, all of the pharmacists indicated that they would require training in the form of information packs (88%), online tutorials (67%), CPD workshops (43%) to cover safety, counselling, dosage instructions, adverse effects and role in smoking cessation care pathway. With the majority of pharmacies already stocking and supplying e-cigarettes but almost unanimously pleading to do this under enforced regulations, it is clear that community pharmacists can see the potential of e-cigarettes to become an official tool for smoking cessation. Forty-three per cent of pharmacists believe that nicotine delivery via e-cigarettes is more efficient than NRTs as smoking cessation tool, despite their efficacy is still unknown. Community pharmacists are concerned about the safety of these devices in light of the adverse effects reported by patients and hope that regulations will strictly impose controls on quality, i.e. excipients and nicotine content.

pylori genes, including peptidyl-prolyl cis–trans isomerase (PPIa

pylori genes, including peptidyl-prolyl cis–trans isomerase (PPIase), which has been characterized as a virulent factor of Legionella pneumophila and Trypanosoma cruzi (Fischer et al., 1992; Pereira et al., 2002) and is implicated in the regulation of gastric epithelial cell growth and apoptosis (Basak et al., 2005). A total of 64 H. pylori strains were

cultured from gastric biopsies from adult patients. These included 22 cases from gastric cancer patients and 42 from superficial gastritis patients. All samples were obtained with informed consent under a protocol approved by the hospital ethical committee at the China Medical University. Helicobacter pylori were cultured at 5% O2/10% CO2/85% N2, 37oC on brain heart infusion agar (Difco) supplemented learn more with 7% sheep blood, 0.4% IsoVitaleX, amphotericin B (8 g mL−1), trimethoprim (5 g mL−1) and vancomycin (6 g mL−1). Helicobacter pylori colonies were identified based on their typical morphology, characteristic appearance on Gram staining, a positive urease test and

gene-specific PCR tests. Bacterial DNA was extracted with phenol–chloroformisoamyl alcohol by standard procedures and precipitated by the addition of 1/10 volume of ammonium acetate and 2.5 volume of cold ethanol. After centrifugation, the DNA pellet was washed with 70% ethanol and dissolved in TE buffer [10 Mm Tris-HCl (pH 8.3), 0.1 mmol L−1 EDTA] as we have described previously (Gong et al., 2005). The differences in gene content between the gastric cancer-associated H. pylori strain and the superficial gastritis-associated strain was determined using this website the PCR-Select™ DNA Substraction Kit (Clontech). To detect gastric cancer-specific Selleckchem Ibrutinib genes, genomic DNA from gastric cancer strain, L301, was used as the tester DNA and genomic DNA from superficial gastritis strain, B975,

was used as the driver DNA. To detect genes that were less abundant or absent in gastric cancer-associated H. pylori strain, genomic DNA from B975 was used as the tester DNA and genomic DNA from L301 was used as the driver DNA. Two micrograms of either tester or driver DNAs were digested to completion with 60 U of AluI (New England Biolabs) for 16 h in 200 μL reaction volumes. The digested products were extracted with phenol, precipitated with ethanol and resuspended in 10 mM Tris-HCl, pH 7.5, at a final concentration of 200 ng μL−1. Two aliquots of the digested tester DNAs were ligated separately to two different adaptors (Adaptor 1, 5′-CTAATACGACTCACTATAGGGCTCGAGCGGCCGCCCGGGCAGGT-3′ and 3′-GGCCCGTCCA-5′; Adaptor 2R, 5′-CTAATACGACTCACTATAGGGCAGCGTGGTCGCGGCCGAGGT-3′ and 3′-GCCGGCTCCA-5′) using T4 DNA ligase (New England Biolabs). Then, 1 μL of each adaptor-ligated tester DNAs was mixed with 2.0 μL of digested driver DNAs and 1.0 μL of 4 × hybridization buffer. The DNA fragments were denatured at 98 °C for 1.5 min, and allowed to anneal at 63 °C for 1.5 h.

Integration occurs via recombination between similar sequences in

Integration occurs via recombination between similar sequences in the chromosome target and episomal circle. This PAI is flanked by direct repeat sequences, suggesting that it may LGK-974 price also adopt a circular intermediate form that is essential for its integration into the chromosome. It has been suggested that this excision is mediated

by a PAI-borne integrase gene (int) related to the integrase gene of P4, a satellite element of phage P2 (Sakellaris et al., 2004). These structures may be involved not only in horizontal transference of the PAI but also in the excision promoted by quinolones as occurs in uropathogenic Escherichia coli (UPEC). In this bacterium, quinolones induce the loss of a PAI by activation of the SOS system, which promotes the excision of phage-related sequences (Soto et al., 2006). Closely related islands that vary in structure can be found CH5424802 datasheet in a wide range of Shigella species and enteroinvasive Escherichia coli (EIEC) (Al-Hasani et al., 2001). These islands are the result of the instability of the she PAI. In our isolates, we found diverse structures of this PAI, similar to the results obtained by Al-Hasani et al. (2001). This variation suggests that the right end of the she PAI may be unstable and undergoes deletions of varying lengths

to yield a variety of structural forms of the PAI. The presence of ShET-2 enterotoxin in E. coli shows that horizontal transference of VFs among bacteria belonging to different species had taken place. The presence of this toxin could increase the Thymidine kinase virulence potential of these strains allowing them to cause more severe infections, although further investigation is needed to prove this hypothesis. Paiva de Sousa & Dubreuil (2001) studied the distribution of the astA gene among 358 strains of Enterobacteriaceae. The gene was found in 32.6% of E. coli. Most E. coli EAST-1-positive strains were found among EHEC (88%), EAEC (86.6%), A-EPEC (58.3%) and EPEC (13.7%). This toxin has also been detected in 15.1% EAEC (Mendez-Arancibia et al., 2008) in which in a plasmid of 60–65 MDa has been located. Analyses have shown that E. coli strains fall into four main phylogenetic groups (A, B1, B2 and D) and that virulent

extraintestinal strains mainly belong to groups B2 and D, whereas most commensal strains belong to groups A and B1 (Clermont et al., 2000). A relationship between the presence of ShET-1 enterotoxin and phylogenetic group B2 has been observed, indicating the higher capacity of these strains to acquire VFs from other bacteria and reinforces the hypothesis that this enterotoxin plays a role as a VF in this phylogenetic group. On the other hand, ShET-2 was related to phylogenetic group B1, suggesting a possible increase in the virulence of these commensal strains. Finally, we found a relationship between the presence of the aggR gene and biofilm formation, with this gene being more frequent among biofilm-producing isolates. This association has also been found in several previous studies.

9%) children Table 2 shows descriptive statistics of the respons

9%) children. Table 2 shows descriptive statistics of the response at the three tests at baseline, and 15 min after the mask had been placed and the inhalation started. No statistically significant difference in reaction time (P = 0.17) was found at baseline between the two sessions (23). N2O/O2 inhalation significantly increased the reaction time with 183 ms (P < 0.001), whereas no effect was found 10 and 30 min after the mask had been

removed. (Table 3) Baseline values for tooth-pulp pain sensitivity were not statistically significantly different between the two sessions (Table 4). At the test 15 min after the mask had been placed and inhalation started, the average value was 92.7 μA during inhalation of N2O/O2 and 54.0 μA during inhalation of atmospheric. This represents a statistically highly significant reduction in tooth-pulp pain sensitivity of 38.7 μA (P < 0.001) (Table 4). learn more After adjustment for increase in reaction time,

however, this effect could not be demonstrated. No effect was found 10 and 30 min after the mask was removed. Baseline pressure pain thresholds of the masseter muscle did also not show any difference between the two sessions. At the test 15 min after the mask had been placed and inhalation started, the average value was 312.5 kPa during inhalation of N2O/O2ir and 231.7 kPa during inhalation of atmospheric air. This represents a statistically DNA Damage inhibitor highly significant increase of 80.8 kPa (P < 0.001)

(Table 4). This effect was reduced to 47.8 kPa, but still statistically significant (P < 0.005) after adjustment for increase in reaction time. In contrast to the findings for tooth-pulp pain sensitivity, an effect on pressure-induced muscle pain could still be seen 10 min after the mask had been removed (P = 0.03), even after adjustment for increase in reaction time (P = 0.04). No effect was found 30 min after the mask Cediranib (AZD2171) had been removed. The VAS score for overall discomfort from the two experimental pain tests was almost identical (N2O/O2 inhalation sessions: average: 1.23; SD: 0.19; atmospheric air sessions: average: 1.18, S.D.: 0.18), and the difference is not statistically significant. This finding was not influenced by adjustment for increase in reaction time. The present study has not been able to show any analgesic effect on tooth-pulp sensitivity, after the increase in reaction time caused by the drug has been taken into account. In contrast, an analgesic effect on pressure-induced muscle pain was found, also after adjustment for the increases in reaction time. We opted to assess both tooth-pulp pain sensitivity and jaw muscle pain sensitivity because different oro-facial tissues may have different sensitivity to painful stimuli and different responses to analgesic interventions. Furthermore, both odontogenic types of pain and musculoskeletal pains are frequently encountered in children.

Giant cells are affected by biphasic postsynaptic currents consis

Giant cells are affected by biphasic postsynaptic currents consisting of an excitatory and a subsequent inhibitory component. Inhibition of Ih reduced the frequency of these biphasic events by 65% and increased the decay time constants of the inhibitory component. We conclude C646 price that Ih adjusts the resting membrane potential, contributes to spontaneous action potential firing, and may participate in the dendritic integration of the synaptic

inputs of the giant neurones. Because its amplitude was higher in young than in adult rats, Ih of the giant cells may be especially important during the postnatal maturation of the auditory system. “
“In contrast to mammals, adult zebrafish have the ability to regrow descending axons and gain locomotor recovery after spinal cord injury (SCI). In zebrafish, a decisive factor for successful spinal cord regeneration buy GDC-0980 is the inherent ability of some neurons to regrow their axons via (re)expressing growth-associated genes during the regeneration period. The nucleus of the medial longitudinal fascicle (NMLF) is one of the nuclei capable of regenerative response after SCI. Using microarray analysis with laser capture microdissected NMLF, we show that cysteine-

and glycine-rich protein (CRP)1a (encoded by the csrp1a gene in zebrafish), the function of which is largely unknown in the nervous system, was upregulated after SCI. In situ hybridization confirmed the upregulation of csrp1a expression in neurons during the axon growth phase after SCI, not only in the NMLF, but also in other nuclei capable of regeneration, such as the intermediate reticular formation and superior reticular formation. The upregulation of csrp1a expression in regenerating nuclei started at 3 days after SCI and continued to 21 days post-injury, the longest time point studied. In vivo knockdown of CRP1a expression using two different antisense morpholino oligonucleotides

impaired axon regeneration and locomotor recovery when compared with a control morpholino, demonstrating that CRP1a upregulation is an important part of the innate regeneration capability in injured neurons of adult zebrafish. This study is the first TCL to demonstrate the requirement of CRP1a for zebrafish spinal cord regeneration. “
“The vascular endothelial growth factor (VEGF) signalling pathway may represent an endogenous anti-convulsant in the rodent hippocampus although its exact contribution requires some clarification. In mouse hippocampal slices, the potassium channel blocker 4-aminopyridine (4-AP) in the absence of external Mg2+(0 Mg2+) produces both ictal and interictal activity followed by a prolonged period of repetitive interictal activity.

, 2010) In

this study, the biofilm bacterins containing

, 2010). In

this study, the biofilm bacterins containing extracellular polysaccharide matrix conferred higher immunoprotection than the free cell bacterins after a challenge infection with the highly virulent SS strain. A major constituent of the biofilm homopolymer matrix has been named polysaccharide intercellular adhesin in S. epidermidis (Mack et al., 1996) and poly-N-acetyl b-1,6 glucosamine in S. aureus (Maira-Litran et al., 2002). Biofilms take advantage of the nutrient concentrating effect and can gain protection against predators and toxic agents I-BET-762 research buy (Beveridge et al., 1997). This protective nature of bacterial biofilms was exploited for the development of an effective vaccine that can facilitate improved antigen delivery. This may explain why the encapsulated glycocalyx biofilm possibly protects antigens and thus provides a large pool of antigens to lymphoid organs compared with free cells, which can facilitate longer retention of antigens in the lymphoid tissue and might http://www.selleckchem.com/products/Gefitinib.html result in an early and heightened primary antibody response. Biofilms and biofilm matrices used as vaccine components have been studied extensively. Some vaccines have been evaluated for efficacy against bacterial pathogens

by involving surface polysaccharides or encompassing inactivated bacteria and toxoids (Opdebeeck & Norcross, 1984). In addition, bacteria surrounded by a mucous substance (likely a biofilm matrix) termed as pseudocapsule (Watson & Davies, 1993) or slime (Ekstedt & Bernhard, 1973), capsular polysaccharides (Lee et al., 2005), and a mixture of slime in liposomes, toxoids, and different inactivated bacteria (Amorena et al., 1994) have been studied, which have been revealed to confer a significant degree of protection. Azad and colleagues have developed and evaluated an Aeromonas hydrophila biofilm for oral vaccination of carp that induced significantly higher antibody titers and protection compared with a free cell vaccine (Azad et al., 1999; Asha et al., 2004; Nayak et al., 2004). Therefore, we can presume that an SS biofilm vaccine could be a potentially

effective vaccine to control this pathogen. This work was supported by the National Natural SPTLC1 Science Foundation of China (U0931002), Youth Foundation of National Natural Science Foundation of China (No. 30800815), Cloning and Identification of the resistance genes of swine against major pathogenic microorganism (2009ZX08009-1546), Special Fund for Public Welfare Industry of Chinese Ministry of Agriculture (200803016). “
“The biofilm phenotype is an increasingly important concept in mycological research. Recently, there has been a developing interest in whether Aspergillus species are truly able to form biofilms or not. Industrial mycologists have long been aware of biofilms and their benefit in fermentation processes, whereas clinically their role is uncertain.

Subthreshold resonance was analysed by sinusoidal current injecti

Subthreshold resonance was analysed by sinusoidal current injection of varying frequency. All Cajal–Retzius cells showed subthreshold resonance, with an average frequency of 2.6 ± 0.1 Hz (n = 60), which was massively reduced by ZD7288, a blocker of hyperpolarization-activated cation currents. Approximately 65.6% (n = 61) of the supragranular pyramidal neurons showed subthreshold resonance, with an average frequency of 1.4 ± 0.1 Hz (n = 40). Application of Ni2+ suppressed subthreshold

resonance, suggesting that low-threshold calcium currents contribute to resonance in these neurons. Approximately 63.6% (n = 77) of the layer V pyramidal neurons showed

subthreshold resonance, with an average frequency of 1.4 ± 0.2 Hz (n = 49), which Anti-infection Compound Library datasheet was abolished by ZD7288. Only Selleck BIBW2992 44.1% (n = 59) of the subplate neurons showed subthreshold resonance, with an average frequency of 1.3 ± 0.2 Hz (n = 26) and a small resonance strength. In summary, these results demonstrate that neurons in all investigated layers show resonance behavior, with either hyperpolarization-activated cation or low-threshold calcium currents contributing to the subthreshold resonance. The observed resonance frequencies are in the range of slow activity patterns observed in the immature neocortex, suggesting that subthreshold resonance may support the generation of this activity. “
“We employed an electroencephalography paradigm manipulating predictive context to dissociate the neural dynamics of anticipatory mechanisms. Subjects either detected random targets or targets preceded by a predictive sequence of three distinct stimuli. The last stimulus in the three-stimulus sequence (decisive stimulus) did not require any motor response but 100%

Leukocyte receptor tyrosine kinase predicted a subsequent target event. We showed that predictive context optimises target processing via the deployment of distinct anticipatory mechanisms at different times of the predictive sequence. Prior to the occurrence of the decisive stimulus, enhanced attentional preparation was manifested by reductions in the alpha oscillatory activities over the visual cortices, resulting in facilitation of processing of the decisive stimulus. Conversely, the subsequent 100% predictable target event did not reveal the deployment of attentional preparation in the visual cortices, but elicited enhanced motor preparation mechanisms, indexed by an increased contingent negative variation and reduced mu oscillatory activities over the motor cortices before movement onset.

ZDV was discontinued because of either anaemia or neutropenia in

ZDV was discontinued because of either anaemia or neutropenia in seven patients. In four subjects with renal toxicity, TDF was substituted with ABC, and in one case of lactic acidosis all NRTIs including TDF were discontinued. LPV/r was not discontinued because of toxicity in any patient. Among patients initiating treatment, 55% reported never missing a dose throughout the study period. Likewise, 55% of patients never missed a clinic visit but 29% of patients missed one visit, 11% missed two visits, and 5% missed three visits. Among survivors, the median increase in CD4 count was 142 cells/μL (IQR 66, 263)

at 12 months and 85% of these patients check details had HIV-1 RNA<400 copies/mL at 12 months (Fig. 3). Overall, 75% of the 101 patients who started second-line therapy survived and were suppressed (Fig. 3). Of the 13 patients who had HIV-1 RNA>400 copies/mL CDK inhibitor at month 12, six were never suppressed and seven had initial suppression but rebounded. On treatment, the HIV-1 RNA suppression rate for patients with wild-type virus was 60% [95% confidence interval (CI) 15–95%]

compared with 94% (95% CI 87–100%) for patients with any TAMs and 95% (95% CI 85–100%) for those with at least three TAMs. HIV-1 RNA suppression rates varied according to the number of active NRTI drugs: at least two active drugs (low), 71% (95% CI 50–93%); one active drug (medium), 92% (95% CI 85–100%); and no active drugs (high), 97% (95% CI 77–100%). Adherence rates (never missed doses) were 48% for those with at least two active

drugs (low), 59% for those with one active drug (medium), and 56% for those with no active drugs (high) (P=0.7), which corresponded to HIV-1 RNA suppression rates of 90% for those with at least two active drugs (low), 96% for those with one active drug (medium), and 89% for those with no active drugs (high) (P=0.6). Among patients who ever missed doses, HIV-1 RNA suppression rates were 55% for those with at least two active drugs (low), 84% for those with one active drug (medium), and 85% for those Etofibrate with no active drugs (high) (P=0.15). Factors associated with HIV-1 RNA>400 copies/mL at 12 months on univariate analysis included having a presenting CD4 count <50 cells/μL and HIV-1 RNA>100 000 copies/mL (Table 3). Paradoxically, having extensive baseline resistance resulted in better virological suppression (Table 3). However, on multivariate analysis, only poor adherence (ever missing a dose) remained statistically significant. Duration on first-line treatment >3 years was not associated with increased risk of failure. In our cohort of ART failure patients identified by clinical and immunological criteria in the public health setting who were confirmed to have virological failure, there is substantial early mortality on second-line ART. Identification of failure by clinical criteria, in particular, was associated with an increased risk of death in the first 6 months as well as new and progressive HIV-associated illnesses.

S2) may influence the packing of active-site residues, probably c

S2) may influence the packing of active-site residues, probably changing the orientation of the lysine residue (Lys 46) and hence modifying the substrate specificities. Based

on the in vitro characterization and in silico predictions concerning DacD function, it can be speculated that three homologous proteins – PBP5, PBP6 and DacD – possibly exert different or partially overlapping cellular activity at different time points of the growth phases. This work is supported in parts by two different grants from the DBT and CSIR, Govt. of India to A.S.G. A.K. is supported by a fellowship from UGC, Govt. of India. There is no conflict of interest to declare. GSK J4 mouse C.C. and D.K. contributed equally to this work. “
“Streptomyces netropsis SD-07, the producer of novel polyene macrolide antifungal antibiotics, was isolated from soil. For the investigation of the functions of its biosynthesis genes and regulation mechanisms, a genetic operating system is necessary. In this study, we successfully transferred the plasmid DNA of pSET152 from the methylation deficient donor, Escherichia coli ET12567/pSET152/pUZ8002, to S. netropsis SD-07 by conjugation and evaluated the crucial factors selleck chemicals llc influencing the conjugation frequency. Ca2+ ions in presence the conjugation media may increase the conjugation frequency by 1000–10 000 times than Ca2+ ions absence in the same conjugation media, and 10–100 time higher than

Mg2+ ions. Similar results (increasing the conjugation frequency by 10–100 times when media containing 60 mM CaCl2) were also obtained from the conjugation between E. coli ET12567 and Streptomyces

coelicolor, S. lavendulae, S. venezuelae, despite their conjugation media were different (MS, CM, GS). So, CaCl2 concentration is a crucial factor for increasing the conjugation frequency, and the suitable concentration may probably be 60 mM. In addition, synthetic medium containing a small amount of organic nitrogen source may benefit increasing the conjugation frequency. These findings could be valuable for the development of a practical Dipeptidyl peptidase method for achieving conjugation in other Streptomyces spp. “
“Biodegradation of polycyclic aromatic hydrocarbons (PAHs) in soils has been linked to history of exposure to PAHs and prevailing environmental conditions. This work assessed the capacity of indigenous microorganisms in soils collected in Livingstone Island (South Shetlands Islands, Antarctica) with no history of pollution (∑PAHs: 0.14–1.47 ng g−1 dw) to degrade 14C-phenanhthrene at 4, 12 and 22 °C. The study provides evidence of the presence of phenanthrene-degrading microorganisms in all studied soils. Generally, the percentage of 14C-phenanhthrene mineralized increased with increasing temperature. The highest extent of 14C-phenanhthrene mineralization (47.93%) was observed in the slurried system at 22 °C.

Before the introduction of the universal offer, all nurses receiv

Before the introduction of the universal offer, all nurses received training on HIV consent and counselling by sexual health advisors. Clinical data was prospectively recorded in an Access database, including patient demographics, travel history and HIV testing outcomes. From May 2009, this included acceptance or decline of the HIV test, reasons for declining and any HIV test result. This database was established for clinical audit and service evaluation on 26 August 2008. HIV tests requested prior to phase 1 were identified using

the Trust’s patient results database. The introduction of universal laboratory and POCT testing in our Trust was approved by the ethics BTK inhibitor committee as being in line with the UK 2008 guidelines, and therefore service development rather than research. Comparisons of testing rates between phases, and between patient groups, were made in Epi-info v 3.5.3 (Centers for Disease Control and Prevention, Atlanta, USA) and Stata v 10.0 (StataCorp LP, Texas, USA) using either Yates-corrected or single table χ2 tests with the appropriate number of degrees of freedom. During phase 0 and phase 1, consenting patients had a venous ethylenediaminetetraacetic acid (EDTA) sample sent to the virology laboratory for initial analysis in a 4th generation HIV test. This was an Abbott HIV Ag/Ab Combo CMEIA performed on the Abbott Architect i2000SR platform (Abbott Diagnostics

Ltd, Maidenhead, England). Samples showing reactivity in the screening test received supplementary testing in a

Bortezomib second 4th generation assay (VIDAS® HIV Duo Ultra, BioMerieux SA, Marcy l’Etoile, France) and an antibody-only immunoassay (Orgenics Immunocomb, 17-DMAG (Alvespimycin) HCl Orgenics Ltd, Yavne, Israel) that permitted identification of the infection as HIV-1 or HIV-2. All patients received information on the time taken to receive a result (average 48–72 h) and how they would be informed of the result. Phase 2 started on introduction of POCT (INSTITM HIV Rapid Antibody Test; Pasante Healthcare, West Sussex, UK). This test is a visually read qualitative immunoassay able to detect antibodies to HIV-1 and HIV-2 in a finger-prick blood sample. Results are read within 60 seconds. All the clinical nurse specialists who provided this test in phase 2 undertook a 1-hour training session on the use of the test. Reactive results were confirmed according to the same laboratory protocol described above using a separate EDTA sample. There were a total of 4965 visits to the emergency open-access clinic between 26 August 2008 and 31 December 2010: 1342 in phase 0 (26 August 2008 to 31 April 2009), 792 in phase 1 (1 May 2009 to 20 September 2009), and 2831 in phase 2 (21 September 2009 to 31 December 2010). The acceptance rates of testing for HIV and the associated prevalence of newly diagnosed HIV infections are shown in Figure 1. Testing rates increased significantly across the three phases (χ2 test for trend 823.