70 results on '"Hanxi Zhang"'
Search Results
2. Comparing survival outcomes between neoadjuvant and adjuvant chemotherapy within breast cancer subtypes and stages among older women: a SEER-Medicare analysis
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Hanxi Zhang, Jamie C. Barner, Leticia R. Moczygemba, Karen L. Rascati, Chanhyun Park, and Dhatri Kodali
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Oncology ,Pharmacology (medical) ,Radiology, Nuclear Medicine and imaging ,General Medicine - Published
- 2023
3. Bio-inspired Oxidative Stress Amplifier for Suppressing Cancer Metastasis and Imaging-Guided Combination Therapy
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Geng Yang, Qingqing Su, Jiazhen Lv, Yue Zheng, Ting Song, Hanxi Zhang, Mengyue Li, Wanyi Zhou, Tingting Li, Xiang Qin, Shun Li, Chunhui Wu, Xiaoling Liao, Yiyao Liu, and Hong Yang
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General Materials Science - Published
- 2023
4. Homologous Targeting Cascade Nanobioreactor for Autophagy Inhibition Amplified Tumor Catalytic Therapy
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Xiaodan Wei, Ningxi Li, Honglin Huang, Geng Yang, Hanxi Zhang, Tingting Li, Xiang Qin, Shun Li, Lulu Cai, Hong Yang, Chunhui Wu, and Yiyao Liu
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General Chemical Engineering ,Biomedical Engineering ,General Materials Science - Published
- 2023
5. Remodeling tumor immunosuppressive microenvironment via a novel bioactive nanovaccines potentiates the efficacy of cancer immunotherapy
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Xiaoxue, Xie, Yi, Feng, Hanxi, Zhang, Qingqing, Su, Ting, Song, Geng, Yang, Ningxi, Li, Xiaodan, Wei, Tingting, Li, Xiang, Qin, Shun, Li, Chunhui, Wu, Xiaojuan, Zhang, Guixue, Wang, Yiyao, Liu, and Hong, Yang
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Biomaterials ,Biomedical Engineering ,Biotechnology - Abstract
The clinical outcomes of cancer nanovaccine have been largely impeded owing to the low antigen-specific T cell response rate and acquired resistance caused by the immunosuppressive tumor microenvironment (TME). Here, we reported a tumor acidity-responsive nanovaccine to remodel the immunosuppressive TME and expand the recruitment of tumor infiltrating lymphocytes (TILs) using hybrid micelles (HM), which encapsulated colony stimulating factor 1 receptor (CSF1-R) inhibitor BLZ-945 and indoleamine 2,3-dioxygenase (IDO) inhibitor NLG-919 in its core and displayed a model antigen ovalbumin (OVA) on its surface (denoted as BN@HM-OVA). The bioactive nanovaccine is coated with a polyethylene glycol (PEG) shell for extending nanoparticle circulation. The shell can be shed in response to the weakly acidic tumor microenvironment. The decrease in size and the increase in positive charge may cause the deep tumor penetration of drugs. We demonstrated that the bioactive nanovaccine dramatically enhance antigen presentation by dendritic cells (DCs) and drugs transportation into M1-like tumor-associated macrophages (TAMs) and tumor cells via size reduction and increasing positive charge caused by the weakly acidic TME. Such bioactive nanovaccine could remodel the immunosuppressive TME into an effector T cells favorable environment, leading to tumor growth inhibition in prophylactic and therapeutic E.G7-OVA tumor models. Furthermore, combining the bioactive nanovaccine with simultaneous anti-PD-1 antibody treatment leads to a long-term tumor inhibition, based on the optimal timing and sequence of PD-1 blockade against T cell receptor. This research provides a new strategy for the development of efficient cancer immunotherapy.
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- 2022
6. Tumor homing-penetrating and nanoenzyme-augmented 2D phototheranostics against hypoxic solid tumors
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Chunhui, Wu, Yingxue, Zhang, Xiaodan, Wei, Ningxi, Li, Honglin, Huang, Zhengxin, Xie, Hanxi, Zhang, Geng, Yang, Mengyue, Li, Tingting, Li, Hong, Yang, Shun, Li, Xiang, Qin, and Yiyao, Liu
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Photosensitizing Agents ,Biomedical Engineering ,Breast Neoplasms ,Oxides ,Hydrogen Peroxide ,General Medicine ,Biochemistry ,Oxygen ,Biomaterials ,Mice ,Manganese Compounds ,Photochemotherapy ,Cell Line, Tumor ,Tumor Microenvironment ,Animals ,Humans ,Nanoparticles ,Female ,Hypoxia ,Molecular Biology ,Biotechnology - Abstract
Tumor microenvironment (TME)-oriented nanomedicine emerges as an efficient routine to greatly improve the efficiency of cancer treatment. The typical feature of hypoxia in TME remains as the main obstacle of many therapeutics like photodynamic therapy. Herein, a specific two-dimensional (2D) phototheranostics (GO-MnO
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- 2022
7. Stimulus‐Detonated Biomimetic 'Nanobomb' with Controlled Release of HSP90 Inhibitor to Disrupt Mitochondrial Function for Synergistic Gas and Photothermal Therapy
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Geng Yang, Ting Song, Hanxi Zhang, Mengyue Li, Xiaodan Wei, Wanyi Zhou, Chunhui Wu, Yiyao Liu, and Hong Yang
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Biomaterials ,Biomedical Engineering ,Pharmaceutical Science - Published
- 2023
8. Neoadjuvant chemotherapy use trends among older women with breast cancer: 2010–2017
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Hanxi Zhang, Jamie C. Barner, Leticia R. Moczygemba, Karen L. Rascati, Chanhyun Park, and Dhatri Kodali
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Cancer Research ,Oncology - Published
- 2022
9. Effect of wood microstructure and hygroscopicity on the drying characteristics of waterborne wood coating
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Xiaoxue Song, Guangping Han, Kaiwen Jiang, Xiang Chi, Dajun Liu, Hanxi Zhang, Wanli Cheng, and Sheldon Q. Shi
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General Materials Science ,Forestry ,Plant Science ,Industrial and Manufacturing Engineering - Published
- 2022
10. Recent Advancements in Nanosystem-Based Molecular Beacons for RNA Detection and Imaging
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Geng Yang, Ting Song, Meng Wang, Mengyue Li, QingQing Su, Zhengxin Xie, Xiaoxue Xie, Hanxi Zhang, Yi Feng, Chunhui Wu, Yiyao Liu, and Hong Yang
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General Materials Science - Published
- 2022
11. Prevalence of doravirine cross-resistance in HIV-infected adults who failed first-line ART in China, 2014–18
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Zhuoqun Sun, Yun Lan, Shujia Liang, Jing Wang, Mingjian Ni, Xia Zhang, Fengting Yu, Meiling Chen, Hanxi Zhang, Liting Yan, Weiping Cai, Guanghua Lan, Ye Ma, and Fujie Zhang
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Adult ,Pharmacology ,Microbiology (medical) ,China ,Genotype ,Anti-HIV Agents ,Pyridones ,HIV Infections ,Triazoles ,Infectious Diseases ,Drug Resistance, Viral ,Mutation ,HIV-1 ,Prevalence ,Humans ,Reverse Transcriptase Inhibitors ,Pharmacology (medical) - Abstract
Objectives To evaluate the prevalence and characteristics of doravirine resistance and cross-resistance in patients who failed first-line ART in China. Methods From 2014 to 2108, 4132 patients from five provinces were tested for drug resistance by genotypic resistance testing. Drug resistance mutations were assessed using the Stanford HIVdb algorithm Version 9.0. Sequences classified as having low-level, intermediate and high-level resistance were defined as having drug resistance. Results Overall, the prevalence of doravirine and other NNRTIs cross-resistance was 69.5%, with intermediate and high-level resistance accounting for 56.4%. Doravirine resistance highly correlated with efavirenz (r = 0.720) and nevirapine (r = 0.721) resistance and moderately correlated with etravirine (r = 0.637) and rilpivirine (r = 0.692) resistance. The most frequent doravirine-associated resistance mutations were V106M (8.7%), K101E (6.8%) and P225H (5.1%). High-level resistance was mainly due to Y188L (3.2%) and M230L (2.7%). There were significant differences between genotypes and provinces. Compared with CRF01_AE, CRF07_BC (OR = 0.595, 95% CI = 0.546–0.648) and CRF08_BC (OR = 0.467, 95% CI = 0.407–0.536) were associated with lower risks of doravirine resistance. Conversely, genotype A (OR = 3.003, 95% CI = 1.806–4.991) and genotype B (OR = 1.250, 95% CI = 1.021–1.531) were associated with higher risks of doravirine resistance. The risk of doravirine resistance was significantly lower in Xinjiang compared with other provinces. Conclusions In China, the prevalence of doravirine cross-resistance among patients who have failed first-line ART is high. Therefore, doravirine should not be used blindly without genotypic resistance testing and is not recommended for people who have failed first-line NNRTI-based ART.
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- 2022
12. Enhanced Ferroptosis Therapy with a 'Nano-Destructor' by Disrupting Intracellular Redox and Iron Homeostasis
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Ting Song, Geng Yang, Hanxi Zhang, Mengyue Li, Wanyi Zhou, Chuan Zheng, Fengming You, Chunhui Wu, Yiyao Liu, and Hong Yang
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- 2023
13. Prevalence and factors associated with fertility desires among HIV-positive MSM
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Hanxi Zhang, Jing Han, Ye Su, Zhennan Li, and Hongxin Zhao
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Background: Despite the emphasis on the prevention of mother-to-child transmission for people living with HIV/AIDS. Issues of fertility desire have a paucity of data among HIV-positive men who have sex with men (MSM). Methods: We conducted a cross-sectional study to assess fertility attitudes and associated factors, as well as the reproductive knowledge among HIV-positive MSM. Analysis was mainly based on the multivariate regression model. Results: About 35% (46/129) expressed a fertility desire. MSM without siblings tended to have fertility desire. And there was a higher proportion of having fertility intention with a master's degree or above. Surrogacy was the most desired method among the 86 respondents who had the desire or did not make a decision. While the accuracy of the reproductive knowledge was only 69.6%. Conclusion: We recommend that providers offer much more professional information and developing assisted reproductive technology to meet the reproductive aspirations of HIV-positive MSM.
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- 2022
14. Spatial analysis and risk factors of suicide among people living with HIV/AIDS who committed suicide
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Hanxi Zhang, Xiangfei Xiu, Yibing Feng, Lu Wang, and Zheng Li
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Mainland China ,Younger age ,Hiv epidemic ,Human immunodeficiency virus (HIV) ,HIV Infections ,Dermatology ,Health outcomes ,medicine.disease_cause ,Suicidal Ideation ,03 medical and health sciences ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,Risk Factors ,Humans ,Medicine ,Pharmacology (medical) ,030212 general & internal medicine ,Spatial Analysis ,Suicide mortality ,business.industry ,Public Health, Environmental and Occupational Health ,medicine.disease ,Mental health ,030227 psychiatry ,Suicide ,Infectious Diseases ,business ,Demography - Abstract
Poor mental health may confer worse health outcomes among people living with HIV/AIDS (PLWH). Suicidal behaviors are symptoms of a depressive episode. The goal was to explore characteristics for spatial distribution and risk factors for suicide among PLWH. This study was conducted in Mainland China with the annual newly reported data of PLWH from 2013 to 2018. We compared the spatial distribution differences between the HIV epidemic and suicide mortality and analyzed the global and local spatial analysis of suicide. Further, we explored the possible risk factors of suicide in PLWH by multivariate regression and a decision tree model. High suicide mortality regions in PLWH in China were inconsistent with that of the high prevalence of PLWH, which showed that there was distribution discordance between the HIV epidemic and suicide mortality. Multivariate regression showed that the possible risk factors of PLWH who committed suicide were younger age, with Han nationality, single, having a higher educational level, and homosexual infection route. The decision tree model showed that age was the primary factor. In conclusion, there was a discordance between HIV prevalence and suicide mortality; lower HIV prevalence regions might have higher mortality due to suicide. Concern is merited amongst PLWH with poor mental health.
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- 2021
15. Efficacy of Psychological Interventions Towards the Reduction of High-Risk Sexual Behaviors Among People Living with HIV: A Systematic Review and Meta-analysis, 2010–2020
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Lu Wang, Mengjie Han, Hanxi Zhang, Qing Yu, Xiangfei Xiu, Fan Lv, and Zheng Li
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Safe Sex ,Sexual transmission ,Social Psychology ,Psychological interventions ,Sexual Behavior ,Psychological intervention ,HIV Infections ,PsycINFO ,Psychosocial Intervention ,law.invention ,Condoms ,Acquired immunodeficiency syndrome (AIDS) ,Condom ,law ,medicine ,Humans ,Condom use ,Behavior ,PLWH ,Unsafe Sex ,business.industry ,Substantive Review ,Public Health, Environmental and Occupational Health ,HIV ,Mental illness ,medicine.disease ,Meta-analysis ,Health psychology ,Infectious Diseases ,business ,Clinical psychology - Abstract
People living with HIV/AIDS (PLWH) may be vulnerable to mental illness. As sexual transmission is the leading cause of HIV infection, evidence-based study for the effect of psychological interventions on the change of sexual is needed. To estimate the efficacy of psychological interventions towards reducing unprotected sex and increasing condom use among PLWH. We systematically searched PubMed, Web of Science, EMBASE (OVID), and PsycINFO (OVID) for studies reporting psychological intervention effects on the outcomes of condom use and/or unprotected sex from 2010 to 2020. This review is registered with PROSPERO, CRD42020193640. Of 949 studies, 17 studies were included in this systematic review. Overall, participants in the intervention group reduced sexual risk or condomless sex relative to control groups. The effect was higher for people having sex with HIV-positive partners comparing with those who had sex with HIV-negative or unknown status partners. Psychological interventions might positively affect the condom use of PLWH and should be prioritized and regularly.
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- 2021
16. Uptake of Maintenance Immunotherapy and Changes in Upstream Treatment Selection Among Patients With Urothelial Cancer
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Ronac Mamtani, Hanxi Zhang, Ravi B. Parikh, Khilna Patel, Haojie Li, Kentaro Imai, and Rebecca A. Hubbard
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General Medicine - Abstract
This cohort study compares the proportion of patients with urothelual cancer who initiated first-line chemotherapy and immune checkpoint inhibitors during the periods before and after avelumab approval.
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- 2023
17. Uptake of maintenance immunotherapy and changes in upstream treatment selection in patients with advanced urothelial cancer (aUC)
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Ronac Mamtani, Hanxi Zhang, Ravi Bharat Parikh, Aaron B. Cohen, Khilna Patel, Blanca Homet Moreno, Haojie Li, Kentaro Imai, Matt D. Galsky, and Rebecca A. Hubbard
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Cancer Research ,Oncology - Abstract
466 Background: In July 2020, the FDA approved avelumab, an immune checkpoint inhibitor (ICI), for maintenance treatment of aUC that has not progressed with first-line (1L) platinum-containing chemotherapy (chemo). Availability of avelumab may have influenced upstream treatment selection between 1L chemo and 1L ICI (pembrolizumab or atezolizumab). We described avelumab use in real-world practice and determined whether 1L treatment choice changed following its approval. Methods: This cohort study used Flatiron Health’s nationwide de-identified EHR-derived database. Included patients started 1L therapy for aUC in the US before (April 1 2017 to June 30 2020) or after (July 1 2020 to May 31 2022) avelumab approval. We calculated the proportion of patients initiating 1L chemo (carboplatin- or cisplatin-based) or ICI during the pre- and post- avelumab approval periods. Time trends were estimated using multinomial logistic regression for 1L treatment choice regressed on time modeled via a natural cubic spline, allowing for a discontinuity in the time trend at the time of FDA approval. Differences in probabilities of 1L treatment in July 2020 (immediately following approval) compared to June 2020 (immediately prior to approval) were calculated. Maintenance avelumab use was described among patients treated with 1L chemo in the post-approval period, and in a sensitivity analysis, among ‘maintenance eligible’ patients defined as those who were progression-free 28 weeks after 1L chemo start. Results: Among all 1L treatment initiators (n=3,507), the FDA approval of maintenance avelumab was followed by increased use of 1L carboplatin-based chemo (+9.9%; 95% CI 1.1-17.2%) but no significant changes in the use of ICI (-5.8%; 95% CI -15.9-4.4%) or cisplatin-based chemo (-4.2%; 95% CI -12.7-5.2%) (Table). Among patients treated with 1L platinum-chemo (n=485), probability of initiating maintenance avelumab increased over time. In the 22 months after approval, approximately 20.4% (n=99/485) of all 1L chemo-treated patients and 24.3% (n=78/321) of maintenance eligible patients received maintenance avelumab. Conclusions: We found modest uptake of maintenance avelumab for aUC after FDA approval. Potential reasons include limited clinician awareness of maintenance immunotherapy and/or patient preferences against long-term treatment after response to initial chemo. Our finding of higher treatment starts with carboplatin-based chemo in the post-maintenance period suggests increasing preference by clinicians of a strategy that provides patients an opportunity for two effective treatment options. Real-world data can provide important insights on community response to regulatory approvals. [Table: see text]
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- 2023
18. Neonatal Hypoglycemia Related to Glycine Levels in Uncontrolled Gestational Diabetes Mellitus during Mid-Late Pregnancy: Multicenter, Prospective Case-Cohort Observational Study
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Fangfang Jiang, Le Chen, Hanxi Zhang, Wei Liu, Yaochao Yang, WuJuan Chen, Yao Chen, Xin Bao, Meijun Liu, Dan Xie, Ting Hong, Jianying Wang, Zhaojuan Su, Jianyong Cao, and Yuhang Long
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0301 basic medicine ,medicine.medical_specialty ,Article Subject ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,education ,030209 endocrinology & metabolism ,behavioral disciplines and activities ,Umbilical cord ,Diseases of the endocrine glands. Clinical endocrinology ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,medicine ,Carnitine ,Obstetrics ,business.industry ,Neonatal hypoglycemia ,nutritional and metabolic diseases ,RC648-665 ,medicine.disease ,Gestational diabetes ,030104 developmental biology ,medicine.anatomical_structure ,Cord blood ,Cohort ,Gestation ,Observational study ,business ,psychological phenomena and processes ,medicine.drug - Abstract
Aims. To explore the relationship between gestational diabetes mellitus (GDM) and neonatal cord blood amino acid and carnitine levels after GDM was diagnosed among pregnant women monitoring glycosylated haemoglobin levels of 5.5%-6.4% during mid-late gestation. Methods. In all, 7289 qualified participants were recruited and divided into two groups (GDM and control groups) between 1 July 2015 and 1 July 2020, and all maternal-neonatal data were collected and analyzed at three centers. Results. Interestingly, glycine in cord blood was not only significantly different between groups (15.52 vs. 6.67, P < 0.001 ) but also associated with neonatal hypoglycemia ( r = 0.132 , P < 0.001 ). Although glycine was an independent positive factor with neonatal hypoglycemia, it had lacked effective size to predict the risk of neonatal hypoglycemia ( b = 0.002 , P < 0.001 ). Conclusion. The study identifies some differences and relationships in maternal-neonatal data when the GDM group has fluctuating glycosylated haemoglobin levels of 5.5%-6.4% without hypoglycemic drug intervention, compared with the control group. Although umbilical cord blood of glycine levels has a lack of effective power to predict the risk of neonatal hypoglycemia, it is probably an independent factor involved in the maternal-neonatal glucolipid metabolism.
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- 2020
19. Assessment of basal insulin adherence using 2 methodologies among Texas Medicaid enrollees with type 2 diabetes
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Karen L. Rascati, Jamie C. Barner, Leticia R. Moczygemba, and Hanxi Zhang
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Adult ,Blood Glucose ,Male ,medicine.medical_specialty ,Time Factors ,Adolescent ,Databases, Factual ,medicine.medical_treatment ,Pharmaceutical Science ,Pharmacy ,Type 2 diabetes ,Hypoglycemia ,Medication Adherence ,Young Adult ,Pharmacoeconomics ,Bolus (medicine) ,Diabetes management ,Internal medicine ,medicine ,Humans ,Hypoglycemic Agents ,Medical prescription ,Retrospective Studies ,Medicaid ,business.industry ,Health Policy ,Insulin ,Middle Aged ,medicine.disease ,Texas ,United States ,Insulin, Long-Acting ,Treatment Outcome ,Diabetes Mellitus, Type 2 ,Female ,Outcomes research ,business ,Biomarkers - Abstract
BACKGROUND: Basal insulin is often recommended as the initial therapy for patients with type 2 diabetes who require insulin treatment. Adequate adherence is critical to diabetes management, yet suboptimal insulin adherence has been reported. Second-generation long-acting (SGLA) insulin has higher dosing flexibility and lower hypoglycemia risk and may improve adherence. However, little is known regarding adherence to SGLA insulin and how adherence to SGLA insulin compares with intermediate-acting neutral protamine Hagedorn (NPH) and first-generation long-acting (FGLA) insulin. Measurement of insulin adherence is challenging because of the inaccuracies of recorded days supply of insulin, and traditional medication possession ratio (MPR) may be negatively affected. Adjusted MPR (aMPR) has been developed in an effort to address this issue. OBJECTIVE: To examine the unadjusted and adjusted associations between basal insulin type and adherence to basal insulin using MPR and aMPR. METHODS: This retrospective database study used Texas Medicaid prescription claims from January 1, 2014, through June 30, 2017. The index date was the date of the first basal insulin prescription without the same prescription 6 months before (pre-index), and all patients were followed for 12 months (post-index). Patients aged 18-63 years with ≥ 1 pre-index prescription of an oral hypoglycemia agent (OHA) or a glucagon-like peptide-1 receptor agonist (GLP-1 RA), without any post-index prescription of premixed insulin or a basal insulin different from index insulin, and with continuous enrollment throughout the pre- and post-index periods, were included. The dependent variable was basal insulin adherence over 12 months, measured using MPR and aMPR. Unadjusted and adjusted adherence comparisons were conducted by basal (background) insulin type (NPH, FGLA, and SGLA). Covariates included age, gender, baseline use of basal insulins and comorbid medications, total number of medications, OHA adherence, post-index number of OHAs, and use of bolus insulins and GLP-1 RAs. Analysis of variance, chi-square tests, and multiple logistic regression analyses were performed. RESULTS: Of the 5,034 patients included, NPH, FGLA, and SGLA insulin users accounted for 3.7%, 89.8%, and 6.5%, respectively. The overall mean (SD) age was 50.9 (9.9) years, and 65.9% were female. In the unadjusted bivariate analyses, SGLA insulin users had significantly higher adherence, using either MPR (SGLA 0.68 [0.25] vs. FGLA 0.59 [0.27] vs. NPH 0.55 [0.27]; P < 0.0001) or aMPR (0.83 [0.23] vs. 0.78 [0.26] vs. 0.73 [0.28]; P = 0.0001). After controlling for covariates, insulin type was not significantly associated with the likelihood of being adherent (MPR or aMPR ≥ 0.8) using either measure. CONCLUSIONS: Adherence to SGLA insulin was not different from adherence to other basal insulins after controlling for patient characteristics. Yet, MPR and aMPR have limitations and warrant further confirmation of the study findings. Before new adherence measures for insulin therapy are developed, MPR and aMPR should be used with caution. DISCLOSURES: No specific funding was received for this manuscript. The authors report no potential conflicts of interest. Part of the data from this study was presented as posters at the American Pharmacists Association 2020 Annual Meeting & Exposition, March 20-23, 2020, in National Harbor, MD, and at the International Society for Pharmacoeconomics and Outcomes Research 2020 Conference, May 16-20, 2020, in Orlando, FL.
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- 2020
20. HIV/AIDS Among Female Sex Workers in China: Epidemiology and Recent Prevention Strategies
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Hanxi Zhang, Evelyn Hsieh, Susu Liao, and Lu Wang
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Adult ,Male ,Safe Sex ,0301 basic medicine ,China ,medicine.medical_specialty ,Sexual Behavior ,Prevalence ,Human sexuality ,Article ,law.invention ,Condoms ,03 medical and health sciences ,0302 clinical medicine ,Condom ,Acquired immunodeficiency syndrome (AIDS) ,Risk Factors ,law ,Virology ,Environmental health ,Epidemiology ,medicine ,Humans ,030212 general & internal medicine ,Sex work ,Acquired Immunodeficiency Syndrome ,Sex Workers ,business.industry ,HIV ,virus diseases ,Female sex ,medicine.disease ,Sex Work ,030104 developmental biology ,Infectious Diseases ,Female ,Pre-Exposure Prophylaxis ,business - Abstract
PURPOSE OF REVIEW: This review aims to describe the epidemiology of HIV among female sex workers (FSWs) in China over the past decade, to summarize current gaps in knowledge regarding risk factors, and to identify new directions for HIV prevention strategies. RECENT FINDINGS: We summarized national and regional levels of HIV prevalence among FSWs based on reported rates in the literature from 2008 to 2018. Studies identified cases of HIV infection among FSWs in all but one province during this time period, and demonstrated a sporadic pattern in most provinces, with a low overall national HIV prevalence below 1%. However, in Yunnan and Guanxi Zhuang Autonomous Regions, the median-reported prevalence rates were close to or slightly above 1%. National prevention programs have widely promoted male condoms as a primary and practical measure for HIV prevention, but studies evaluating condom use practices among FSWs demonstrated wide variability. A rise in illicit use of synthetic drugs and changing sexual practices in the setting of sex work (e.g., anal sex) may represent newer risk factors for HIV transmission among FSWs; however, more data are needed to better characterize these trends. Limited studies have examined the feasibility and efficacy of innovative prevention tools (e.g., female condoms) or strategies (e.g., pre-exposure prophylaxis, PrEP) to prevent HIV among FSWs. SUMMARY: We call for a more comprehensive understanding of current trends in HIV risk among FSWs, as well as more research focuses on innovative strategies to reduce the spread of HIV in this vulnerable population.
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- 2020
21. Stimulus-Detonated Biomimetic 'Nanobomb' with Controlled Release of HSP90 Inhibitor to Disrupt Mitochondrial Function for Synergistic Gas and Photothermal Therapy
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Geng Yang, Jiazhen Lv, Yue Zheng, Ting Song, Hanxi Zhang, Mengyue Li, Xiaodan Wei, Wanyi Zhou, Tingting Li, Xiang Qin, Shun Li, Chunhui Wu, Yiyao Liu, and Hong Yang
- Subjects
History ,Polymers and Plastics ,Business and International Management ,Industrial and Manufacturing Engineering - Published
- 2022
22. Mesoporous Silica Nanoparticles‐Based Nanoplatforms: Basic Construction, Current State, and Emerging Applications in Anticancer Therapeutics
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Yi Feng, Zhen Liao, Mengyue Li, Hanxi Zhang, Tingting Li, Xiang Qin, Shun Li, Chunhui Wu, Fengming You, Xiaoling Liao, Lulu Cai, Hong Yang, and Yiyao Liu
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Biomaterials ,Biomedical Engineering ,Pharmaceutical Science - Abstract
In recent years, researchers are developing novel nanoparticles for diagnostic applications using imaging techniques and for therapeutic purposes through drug delivery techniques. The unique physical and chemical properties of mesoporous silica nanoparticles (MSNs) make it possible to integrate a variety of commonly used therapeutic and imaging agents to construct a multimodal synergistic anticancer drug delivery system. Here, we review recent advances in MSNs synthesis for drug delivery and smart response applications. First, we outline synthetic strategies for the fabrication of ordered MSNs, hollow MNSs, core-shell structured MSNs, dendritic MSNs, and biodegradable MSNs. Then, the recent research progress in designing functional MSN materials with various controlled release mechanisms in anticancer therapy is discussed, and new properties are introduced to suggest the latest design requirements as drug delivery materials. The review also highlights significant achievements in bioimaging using mesoporous silica nanoparticles and their multifunctional counterparts as delivery vehicles. Finally, we present our personal views on key directions for future work in this area. This article is protected by copyright. All rights reserved.
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- 2023
23. Emerging nanomedicines strategies focused on tumor microenvironment against cancer recurrence and metastasis
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Yi Feng, Zhen Liao, Hanxi Zhang, Xiaoxue Xie, Fengming You, Xiaoling Liao, Chunhui Wu, Wei Zhang, Hong Yang, and Yiyao Liu
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General Chemical Engineering ,Environmental Chemistry ,General Chemistry ,Industrial and Manufacturing Engineering - Published
- 2023
24. Neoadjuvant chemotherapy use trends among older women with breast cancer: 2010-2017
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Hanxi, Zhang, Jamie C, Barner, Leticia R, Moczygemba, Karen L, Rascati, Chanhyun, Park, and Dhatri, Kodali
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Chemotherapy, Adjuvant ,Receptor, ErbB-2 ,Antineoplastic Combined Chemotherapy Protocols ,Humans ,Breast Neoplasms ,Female ,Triple Negative Breast Neoplasms ,Medicare ,Neoadjuvant Therapy ,United States ,Aged - Abstract
This study assessed chemotherapy use trends before (neoadjuvant chemotherapy [NAC]) or after surgery (adjuvant chemotherapy [AdC]) among older women with breast cancer and examined factors related to NAC receipt.Women ( 65 years) diagnosed with stage I-III breast cancer during 2010-2017 who received NAC or AdC were identified from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. All patients were stratified into six strata based on subtype (hormone receptor-positive/human epidermal growth factor receptor 2-negative [HR + /HER2-], HER2 + , and triple-negative breast cancer [TNBC]) and stage (I-II and III). Cochran-Armitage tests were performed to test temporal trends of NAC use in each stratum. Multivariable logistic regression analyses were performed to identify factors (sociodemographic and clinical) related to NAC use.Among included older (mean ± standard deviation: 72.3 ± 5.2 years) women (N = 8,495) with stage I-III breast cancer, NAC use increased from 11.7% (2010) to 32.6% (2017). Significant increases in NAC were found in all strata (p .0001) with more substantial increases in HER2 + disease and TNBC compared to HR + /HER2- disease. Multivariable logistic regressions identified the youngest age category (66-69 years) and later stage as significant (p 0.05) predictors of NAC receipt in most strata, in addition to diagnosis year.Similar to the overall breast cancer population, NAC use increased among a population of older women. NAC was received by most patients with stage III HER2 + disease or TNBC in more recent years and was more common among younger elderly women and those in stage III.
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- 2021
25. Aptamer-Dendrimer Functionalized Magnetic Nano-Octahedrons: Theranostic Drug/Gene Delivery Platform for Near-Infrared/Magnetic Resonance Imaging-Guided Magnetochemotherapy
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Xiaodan Wei, Fengming You, Shun Li, Xiaoxue Xie, Hanxi Zhang, Yiyao Liu, Zhongyuan Chen, Xiang Qin, Yueting Peng, Yichao Li, Tingting Li, Hong Yang, Chunhui Wu, Geng Yang, and Ningxi Li
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Dendrimers ,Chemistry ,Aptamer ,technology, industry, and agriculture ,General Engineering ,General Physics and Astronomy ,Gene delivery ,Magnetic Resonance Imaging ,Theranostic Nanomedicine ,Magnetic hyperthermia ,Drug Delivery Systems ,Pharmaceutical Preparations ,In vivo ,Doxorubicin ,Dendrimer ,Cell Line, Tumor ,medicine ,Biophysics ,Magnetic nanoparticles ,Nanoparticles ,General Materials Science ,Precision Medicine ,medicine.drug ,Superparamagnetism - Abstract
The combination of magnetic hyperthermia and chemotherapy within a nanosystem is thought to be a promising approach for cancer therapies. However, the nonspecific accumulation and fast clearance of magnetic nanoparticles in the physiological environment limited their further biomedical applications. Herein, we report a highly selective theranostic nanocomplex, ZIPP-Apt:DOX/siHSPs, built with superparamagnetic zinc-doped iron oxide nano-octahedral core, cationic PAMAM dendrimer, and functional surface modifications such as PEG, AS1411 aptamer, and fluorescent tags (FITC or Cy5.5), together with the loading of hydrophobic anticancer drug doxorubicin (DOX) and HSP70/HSP90 siRNAs. Our results demonstrate that the cellular uptake and the tumor-specific accumulation of ZIPP-Apt:DOX/siHSPs were significantly increased due to the AS1411-nucleolin affinity and further confirmed that the simultaneous depletion of HSP70 and HSP90 sensitized magnetic hyperthermia and chemotherapy-induced cell death both in vitro and in vivo. Altogether, our study provides a theranostic nanoplatform for aptamer-targeted, NIR/MR dual-modality imaging guided, and HSP70/HSP90 silencing sensitized magnetochemotherapy, which has the potential to advance versatile magnetic nanosystems toward clinical applications.
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- 2021
26. Polydopamine‐Engineered Theranostic Nanoscouts Enabling Intracellular HSP90 mRNAs Fluorescence Detection for Imaging‐Guided Chemo–Photothermal Therapy
- Author
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Geng Yang, Mengyue Li, Ting Song, Xiangyan Chen, Hanxi Zhang, Xiaodan Wei, Ningxi Li, Tingting Li, Xiang Qin, Shun Li, Fengming You, Chunhui Wu, Wei Zhang, Yiyao Liu, and Hong Yang
- Subjects
Biomaterials ,Photothermal Therapy ,Biomedical Engineering ,Pharmaceutical Science ,RNA, Messenger - Abstract
The combination of photothermal therapy (PTT) and chemotherapy is considered a promising tumor treatment modality, nevertheless, cellular resistance induced by heat shock proteins (HSPs) overexpressed in tumor cells will restrict the therapeutic effect. Herein, a multifunctional nanobeacon DOX/HCuS@PDA-MB (D/CP-MB) with a scout function for HSP90 mRNA fluorescence detection and near-infrared (NIR) triggered drug release for sensitizing chemo-photothermal therapy, is proposed. In the theranostic nanobeacons, HSP90MBs not only enable fluorescence detection of intracellular HSP90 mRNAs, but also downregulate the expression of HSP90 to reduce cell resistance. With the assistance of NIR and guidance of fluorescence imaging, spatiotemporal doxorubicin release can be achieved by the trigger of the photothermal effect, allowing for combined chemotherapy and photothermal treatment. Furthermore, the dual photothermal effect of hollow mesoporous CuS (HCuS) and polydopamine will lead to a better photothermal effect. Moreover, compared with other control groups, D/CP-MB nanobeacons exhibit effective boost therapeutic efficacy by inducing significant suppression of tumor proliferation and enhancement of apoptosis both in vitro and in vivo. In summary, this work provides novel theranostic nanobeacons that integrate imaging and therapy in a single nanoparticle, this strategy of imaging-guided therapy can enable precise tumor treatment and effectively improve tumor treatment efficacy.
- Published
- 2022
27. Gender differences in the relationship of sexual partnership characteristics and inconsistent condom use among people living with HIV in China
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Chengbo Zeng, Zhimeng Xu, Hanxi Zhang, Debra Kellstedt, Cong Liu, Yajing Zhu, Yan Guo, Weiping Cai, Jiaying Qiao, Y Alicia Hong, and Linghua Li
- Subjects
Adult ,Male ,Safe Sex ,China ,Health (social science) ,Social Psychology ,Human immunodeficiency virus (HIV) ,HIV Infections ,medicine.disease_cause ,Sexual partnership ,Condoms ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Risk Factors ,Surveys and Questionnaires ,medicine ,Humans ,Interpersonal Relations ,030212 general & internal medicine ,030505 public health ,business.industry ,Public Health, Environmental and Occupational Health ,virus diseases ,Logistic Models ,Sexual Partners ,Female ,Inconsistent condom ,0305 other medical science ,business ,Demography - Abstract
Few studies have examined the relationship between inconsistent condom use and sexual partnership characteristics among people living with HIV (PLWH). The current study focused on such association and its gender differences. The study was conducted in a large hospital in South China in 2013. A total of 320 dyads (PLWH indexes and their sexual partners) were recruited from an outpatient clinic using convenience sampling. The proportion of inconsistent condom use in the last six months among female indexes was higher than that among male indexes (52.4% vs. 43.6%). Of sexual partnership characteristics, HIV seropositive status was a risk factor for inconsistent condom use for both male and female indexes (aOR = 2.32, 95%CI = 1.15∼4.66, aOR = 3.09, 95%CI = 1.10∼8.67, respectively). For male indexes, lower educational level was also a risk factor (aOR = 2.39, 95%CI = 1.23∼4.67); while having had emotionally intimate relationships was a protective factor (aOR = 0.40, 95%CI = 0.21∼0.77). For female indexes, receiving material support was a risk factor (aOR = 10.17, 95%CI = 2.13∼48.61) and receiving health-related advice was a protective factor (aOR = 0.11, 95%CI = 0.02∼0.55). Future HIV interventions for PLWH need to be gender-sensitive and include their sexual partners.
- Published
- 2019
28. Recent advancements in mesoporous silica nanoparticles towards therapeutic applications for cancer
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Yiyao Liu, Shun Li, Xiaoxue Xie, Xiang Qin, Chunhui Wu, Hong Yang, Zhongyuan Chen, Xue Shen, Hanxi Zhang, Shreya Goel, Tingting Li, and Sixiang Shi
- Subjects
Pore size ,Biocompatibility ,0206 medical engineering ,Biomedical Engineering ,Nanoparticle ,Nanotechnology ,02 engineering and technology ,Biochemistry ,Biomaterials ,Drug Delivery Systems ,Neoplasms ,medicine ,Animals ,Humans ,Molecular Biology ,Cancer ,General Medicine ,Mesoporous silica ,Silicon Dioxide ,021001 nanoscience & nanotechnology ,medicine.disease ,020601 biomedical engineering ,Treatment efficacy ,Drug delivery ,Nanoparticles ,Nanomedicine ,0210 nano-technology ,Porosity ,Biotechnology - Abstract
Recently, drug delivery systems based on nanotechnology have received great attention in cancer therapeutics and diagnostics since they can not only improve the treatment efficacy but also reduce the side effects. Among them, mesoporous silica nanoparticles (MSNs) with large surface area, high pore volume, tunable pore size, abundant surface chemistry, and acceptable biocompatibility exhibit unique advantages and are considered as promising candidates for cancer diagnosis and therapy. In this review, we update the recent progress on MSN-based systems for cancer treatment purposes. We also discuss the drug loading mechanism of MSNs, stimuli-responsive drug release, and surface modification strategies for improving biocompatibility, and targeting functionalities. STATEMENT OF SIGNIFICANCE: The development of MSN-based delivery systems that can be used in both diagnosis and treatment of cancer has attracted tremendous interest in the past decade. MSN-based delivery systems can improve therapeutic efficacy and reduce cytotoxicity to normal tissue. To further improve the in vivo properties of MSNs and potential translation to the clinics, it is critical to design MSNs with appropriate surface engineering and desirable cancer targeting. This review is intended to provide the readers a comprehensive background of the vast literature till date on silica-based drug delivery systems, and to inspire further innovations in silica nanomedicine in the future.
- Published
- 2019
29. NIR-Light-Triggered Anticancer Strategy for Dual-Modality Imaging-Guided Combination Therapy via a Bioinspired Hybrid PLGA Nanoplatform
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Chunhui Wu, Shun Li, Fengming You, Xiaoxue Xie, Chuan Zheng, Tingting Li, Yi Feng, Xue Shen, Xiang Qin, Zhongyuan Chen, Hong Yang, Jie Zhu, Yiyao Liu, and Hanxi Zhang
- Subjects
Indocyanine Green ,Hot Temperature ,Combination therapy ,Cell Survival ,Infrared Rays ,Mice, Nude ,Pharmaceutical Science ,Apoptosis ,02 engineering and technology ,030226 pharmacology & pharmacy ,Mice ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Drug Stability ,Polylactic Acid-Polyglycolic Acid Copolymer ,Cell Line, Tumor ,Neoplasms ,Combination cancer therapy ,Drug Discovery ,medicine ,Animals ,Tissue Distribution ,Doxorubicin ,Drug Carriers ,Mice, Inbred BALB C ,Optical Imaging ,Photothermal effect ,Serum Albumin, Bovine ,Phototherapy ,Photothermal therapy ,021001 nanoscience & nanotechnology ,Combined Modality Therapy ,Disease Models, Animal ,Drug Liberation ,PLGA ,Treatment Outcome ,chemistry ,NIH 3T3 Cells ,Biophysics ,Nanoparticles ,Molecular Medicine ,Female ,Nanocarriers ,0210 nano-technology ,Indocyanine green ,medicine.drug - Abstract
A promising approach toward cancer therapy is expected to integrate imaging and therapeutic agents into a versatile nanocarrier for achieving improved antitumor efficacy and reducing the side effects of conventional chemotherapy. Herein, we designed a poly(d,l-lactic- co-glycolic acid) (PLGA)-based theranostic nanoplatform using the double emulsion solvent evaporation method (W/O/W), which is associated with bovine serum albumin (BSA) modifications, to codeliver indocyanine green (ICG), a widely used near-infrared (NIR) dye, and doxorubicin (Dox), a chemotherapeutic drug, for dual-modality imaging-guided chemo-photothermal combination cancer therapy. The resultant ICG/Dox co-loaded hybrid PLGA nanoparticles (denoted as IDPNs) had a diameter of around 200 nm and exhibited excellent monodispersity, fluorescence/size stability, and biocompatibility. It was confirmed that IDPNs displayed a photothermal effect and that the heat induced faster release of Dox, which led to enhanced drug accumulation in cells and was followed by their efficient escape from the lysosomes into the cytoplasm and drug diffusion into the nucleus, resulting in a chemo-photothermal combinatorial therapeutic effect in vitro. Moreover, the IDPNs exhibited a high ability to accumulate in tumor tissue, owing to the enhanced permeability and retention (EPR) effect, and could realize real-time fluorescence/photoacoustic imaging of solid tumors with a high spatial resolution. In addition, the exposure of tumor regions to NIR irradiation could enhance the tumor penetration ability of IDPNs, almost eradicating subcutaneous tumors. In addition, the inhibition rate of IDPNs used in combination with laser irradiation against EMT-6 tumors in tumor-bearing nude mice (chemo-photothermal therapy) was approximately 95.6%, which was much higher than that for chemo- or photothermal treatment alone. Our study validated the fact that the use of well-defined IDPNs with NIR laser treatment could be a promising strategy for the early diagnosis and passive tumor-targeted chemo-photothermal therapy for cancer.
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- 2019
30. Nanotechnology-based multifunctional vaccines for cancer immunotherapy
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Xiaoxue Xie, Ting Song, Yi Feng, Hanxi Zhang, Geng Yang, Chunhui Wu, Fengming You, Yiyao Liu, and Hong Yang
- Subjects
General Chemical Engineering ,Environmental Chemistry ,General Chemistry ,Industrial and Manufacturing Engineering - Published
- 2022
31. Mediating Effects of Stigma and Depressive Symptoms in a Social Media–Based Intervention to Improve Long-term Quality of Life Among People Living With HIV: Secondary Analysis of a Randomized Controlled Trial (Preprint)
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Yiran Li, Yan Guo, Y Alicia Hong, Chengbo Zeng, Yu Zeng, Hanxi Zhang, Mengting Zhu, Jiaying Qiao, Weiping Cai, Linghua Li, and Cong Liu
- Abstract
BACKGROUND Mobile health (mHealth) interventions have been shown to effectively improve the quality of life (QOL) among people living with HIV. However, little is known about the long-term effects of mHealth interventions. OBJECTIVE This study aims to explore the intervention mechanisms of a social media–based intervention, Run4Love, on the QOL of people with HIV over across a 9-month follow-up period. METHODS We recruited people living with HIV who were concurrently experiencing elevated depressive symptoms from an HIV outpatient clinic in South China. A total of 300 eligible participants were randomized either to the intervention group or the control group in a 1:1 ratio after they provided informed consent and completed a baseline survey. The intervention group received a 3-month WeChat-based intervention, comprising cognitive-behavioral stress management (CBSM) courses and physical activity promotion. The control group received a printed brochure on nutrition guidelines in addition to the usual care for HIV treatment. Neither participants nor the research staff were blinded to group assignment. All patients were followed at 3, 6, and 9 months. The primary outcome was depressive symptoms. Structural equation model (SEM) with longitudinal data was conducted to examine the sequential mediating effects of HIV-related stigma and depressive symptoms on the long-term intervention effects on participants’ QOL. RESULTS About 91.3% (274/300), 88.3% (265/300), and 86.7% (260/300) of all participants completed follow-up surveys at 3, 6, and 9 months, respectively. Results showed that the intervention had significantly improved participants' QOL at 9 months, via complete mediating effects of reduced HIV-related stigma at 3 months and decreased depressive symptoms at 6 months. No adverse events were reported. CONCLUSIONS These findings underscore the critical roles of HIV-related stigma and depressive symptoms in an mHealth intervention with long-term effects on QOL improvements. We call for targeted mHealth interventions to improve QOL among people living with HIV, especially social media–based interventions that can address HIV-related stigma and alleviate depressive symptoms. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR-IPR-17012606; https://www.chictr.org.cn/showproj.aspx?proj=21019
- Published
- 2021
32. Positive Coping as a Mediator of Mobile Health Intervention Effects on Quality of Life Among People Living With HIV: Secondary Analysis of the Randomized Controlled Trial Run4Love
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Yu Zeng, Yan Guo, Rainbow Tin Hung Ho, Mengting Zhu, Chengbo Zeng, Aliza Monroe-Wise, Yiran Li, Jiaying Qiao, Hanxi Zhang, Weiping Cai, Linghua Li, and Cong Liu
- Subjects
Depression ,Adaptation, Psychological ,Quality of Life ,Humans ,Health Informatics ,HIV Infections ,Telemedicine - Abstract
Background The effectiveness of psychosocial interventions on quality of life (QOL) among people living with HIV has been validated, including mobile health (mHealth) interventions. However, it is unclear which components of such interventions account for these effects. Objective This study aims to examine positive coping as a potential mediator of the effects of an mHealth intervention on QOL among people living with HIV. Methods For this secondary analysis, we used data from an mHealth-based randomized controlled trial, Run4Love, which was conducted to improve QOL and mental health outcomes of people living with HIV. A total of 300 participants were randomly assigned to the intervention group to receive the adapted cognitive-behavioral stress management courses and regular physical activity promotion or the waitlist control group in a 1:1 ratio. Our analysis focused on positive coping and QOL, which were repeatedly measured at baseline and at 3-, 6-, and 9-month follow-ups. Latent growth curve models were constructed to explore the mediating role of positive coping in the effects of the mHealth intervention on QOL. Results Positive coping served as a mediator in the effect of the mHealth intervention on QOL for up to 9 months. The mHealth intervention had a significant and positive indirect effect on the slope of QOL via the slope of positive coping (b=2.592×1.620=4.198, 95% CI 1.189-7.207, P=.006). The direct effect of the intervention was not significant (b=0.552, 95% CI −2.154 to 3.258, P=.69) when controlling for the mediator. Conclusions The longitudinal findings suggest that positive coping could be a crucial mediator of the mHealth intervention in enhancing QOL among people living with HIV. These findings underscore the importance of improving positive coping skills in mHealth interventions to improve QOL among people living with HIV.
- Published
- 2020
33. Dose-Response Effects of Patient Engagement on Health Outcomes in an mHealth Intervention: Secondary Analysis of a Randomized Controlled Trial
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Yiran Li, Yan Guo, Y Alicia Hong, Yu Zeng, Aliza Monroe-Wise, Chengbo Zeng, Mengting Zhu, Hanxi Zhang, Jiaying Qiao, Zhimeng Xu, Weiping Cai, Linghua Li, and Cong Liu
- Subjects
Original Paper ,mHealth ,patient engagement ,Outcome Assessment, Health Care ,Quality of Life ,dose–response relationship ,Humans ,Health Informatics ,HIV Infections ,Patient Participation ,Telemedicine ,long-term effect ,generalized linear mixed effects model - Abstract
Background The dose–response relationship between patient engagement and long-term intervention effects in mobile health (mHealth) interventions are understudied. Studies exploring long-term and potentially changing relationships between patient engagement and health outcomes in mHealth interventions are needed. Objective This study aims to examine dose–response relationships between patient engagement and 3 psychosocial outcomes in an mHealth intervention, Run4Love, using repeated measurements of outcomes at baseline and 3, 6, and 9 months. Methods This study is a secondary analysis using longitudinal data from the Run4Love trial, a randomized controlled trial with 300 people living with HIV and elevated depressive symptoms to examine the effects of a 3-month mHealth intervention on reducing depressive symptoms and improving quality of life (QOL). We examined the relationships between patient engagement and depressive symptoms, QOL, and perceived stress in the intervention group (N=150) using 4–time-point outcome measurements. Patient engagement was assessed using the completion rate of course assignments and frequency of items completed. Cluster analysis was used to categorize patients into high- and low-engagement groups. Generalized linear mixed effects models were conducted to investigate the dose–response relationships between patient engagement and outcomes. Results The cluster analysis identified 2 clusters that were distinctively different from each other. The first cluster comprised 72 participants with good compliance to the intervention, completing an average of 74% (53/72) of intervention items (IQR 0.22). The second cluster comprised 78 participants with low compliance to the intervention, completing an average of 15% (11/72) of intervention items (IQR 0.23). Results of the generalized linear mixed effects models showed that, compared with the low-engagement group, the high-engagement group had a significant reduction in more depressive symptoms (β=−1.93; P=.008) and perceived stress (β=−1.72; P Conclusions This study revealed a positive long-term dose–response relationship between patient engagement and 3 psychosocial outcomes among people living with HIV and elevated depressive symptoms in an mHealth intervention over 9 months using 4 time-point repeat measurement data. The high- and low-engagement groups showed significant and widening differences in depressive symptoms, QOL, and perceived stress at the 3-, 6-, and 9-month follow-ups. Future mHealth interventions should improve patient engagement to achieve long-term and sustained intervention effects. Trial Registration Chinese Clinical Trial Registry ChiCTR-IPR-17012606; https://www.chictr.org.cn/showproj.aspx?proj=21019
- Published
- 2020
34. Dose–Response Effects of Patient Engagement on Health Outcomes in an mHealth Intervention: Secondary Analysis of a Randomized Controlled Trial (Preprint)
- Author
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Yiran Li, Yan Guo, Y Alicia Hong, Yu Zeng, Aliza Monroe-Wise, Chengbo Zeng, Mengting Zhu, Hanxi Zhang, Jiaying Qiao, Zhimeng Xu, Weiping Cai, Linghua Li, and Cong Liu
- Abstract
BACKGROUND The dose–response relationship between patient engagement and long-term intervention effects in mobile health (mHealth) interventions are understudied. Studies exploring long-term and potentially changing relationships between patient engagement and health outcomes in mHealth interventions are needed. OBJECTIVE This study aims to examine dose–response relationships between patient engagement and 3 psychosocial outcomes in an mHealth intervention, Run4Love, using repeated measurements of outcomes at baseline and 3, 6, and 9 months. METHODS This study is a secondary analysis using longitudinal data from the Run4Love trial, a randomized controlled trial with 300 people living with HIV and elevated depressive symptoms to examine the effects of a 3-month mHealth intervention on reducing depressive symptoms and improving quality of life (QOL). We examined the relationships between patient engagement and depressive symptoms, QOL, and perceived stress in the intervention group (N=150) using 4–time-point outcome measurements. Patient engagement was assessed using the completion rate of course assignments and frequency of items completed. Cluster analysis was used to categorize patients into high- and low-engagement groups. Generalized linear mixed effects models were conducted to investigate the dose–response relationships between patient engagement and outcomes. RESULTS The cluster analysis identified 2 clusters that were distinctively different from each other. The first cluster comprised 72 participants with good compliance to the intervention, completing an average of 74% (53/72) of intervention items (IQR 0.22). The second cluster comprised 78 participants with low compliance to the intervention, completing an average of 15% (11/72) of intervention items (IQR 0.23). Results of the generalized linear mixed effects models showed that, compared with the low-engagement group, the high-engagement group had a significant reduction in more depressive symptoms (β=−1.93; P=.008) and perceived stress (β=−1.72; Pβ=2.41; P=.01) over 9 months. From baseline to 3, 6, and 9 months, the differences in depressive symptoms between the 2 engagement groups were 0.8, 1.6, 2.3, and 3.7 points, respectively, indicating widening between-group differences over time. Similarly, between-group differences in QOL and perceived stress increased over time (group differences in QOL: 0.9, 1.9, 4.7, and 5.1 points, respectively; group differences in the Perceived Stress Scale: 0.9, 1.4, 2.3, and 3.0 points, respectively). CONCLUSIONS This study revealed a positive long-term dose–response relationship between patient engagement and 3 psychosocial outcomes among people living with HIV and elevated depressive symptoms in an mHealth intervention over 9 months using 4 time-point repeat measurement data. The high- and low-engagement groups showed significant and widening differences in depressive symptoms, QOL, and perceived stress at the 3-, 6-, and 9-month follow-ups. Future mHealth interventions should improve patient engagement to achieve long-term and sustained intervention effects. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR-IPR-17012606; https://www.chictr.org.cn/showproj.aspx?proj=21019
- Published
- 2020
35. Cascade-activatable NO release based on GSH-detonated 'nanobomb' for multi-pathways cancer therapy
- Author
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Yi, Feng, Hanxi, Zhang, Xiaoxue, Xie, Yu, Chen, Geng, Yang, Xiaodan, Wei, Ningxi, Li, Mengyue, Li, Tingting, Li, Xiang, Qin, Shun, Li, Fengming, You, Chunhui, Wu, Hong, Yang, and Yiyao, Liu
- Subjects
Biomaterials ,Biomedical Engineering ,Bioengineering ,Cell Biology ,Molecular Biology ,Biotechnology - Abstract
Therapeutic approaches of combining conventional photodynamic therapy (PDT) with other adjuvant treatments to sensitize PDT represent an appealing strategy. Herein, a novel synergetic "nanobomb" strategy based on glutathione (GSH)-responsive biodegradation was proposed to effectively destroy tumors expeditiously and accurately. This "nanobomb" was rationally constructed via the simultaneous encapsulation of methylene blue (MB) and l-arginine (L-Arg) into polyethylene glycol (PEG) modified mesoporous organosilicon nanoparticles (MON). The resulting L-Arg/MB@MP initially exhibited prolonged blood circulation, improved bioavailability, and enhanced tumor accumulation in mice after tail vein injection according to the pharmacokinetic investigations, before the nanoparticles were entirely excreted. Under laser irradiation, L-Arg/MB@MP produced remarkable reactive oxygen species (ROS) directly for PDT therapy, while a portion of ROS may oxidize L-Arg to generate nitric oxide (NO) not only for gas therapy (GT) but also serve as a biological messenger to regulate vasodilation to alleviate the tumor hypoxia. Subsequently, the rapidly released NO was further oxidized to reactive nitrogen species, which together with ROS promote immunogenic cell death by inducing G2/M cell-cycle arrest and apoptosis in cancer cells, and eventually resulting in enhanced anti-tumor immune responses. Moreover, the GSH depletion in tumor tissues induced by L-Arg/MB@MP biodegradation can cooperate with GT to amplify the therapeutic effect of PDT. These results demonstrate that this "nanobomb" provides new ideas for clinical translation to treat tumor patients in terms of synergistic PDT-GT nanotherapy in hypoxic-solid tumors.
- Published
- 2022
36. Relationship Between Patient Engagement and Depressive Symptoms Among People Living With HIV in a Mobile Health Intervention: Secondary Analysis of a Randomized Controlled Trial (Preprint)
- Author
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Yu Zeng, Yan Guo, Linghua Li, Y Alicia Hong, Yiran Li, Mengting Zhu, Chengbo Zeng, Hanxi Zhang, Weiping Cai, Cong Liu, Shaomin Wu, Peilian Chi, Aliza Monroe-Wise, Yuantao Hao, and Rainbow Tin Hung Ho
- Abstract
BACKGROUND Associations between higher levels of patient engagement and better health outcomes have been found in face-to-face interventions; studies on such associations with mobile health (mHealth) interventions have been limited and the results are inconclusive. OBJECTIVE The objective of this study is to investigate the relationship between patient engagement in an mHealth intervention and depressive symptoms using repeated measures of both patient engagement and patient outcomes at 4 time points. METHODS Data were drawn from a randomized controlled trial (RCT) of an mHealth intervention aimed at reducing depressive symptoms among people living with HIV and elevated depressive symptoms. We examined the association between patient engagement and depressive symptoms in the intervention group (n=150) where participants received an adapted cognitive-behavioral stress management (CBSM) course and physical activity promotion on their WeChat social media app. Depressive symptoms were repeatedly measured using the Patient Health Questionnaire (PHQ-9) at baseline and 1 month, 2 months, and 3 months. Patient engagement was correspondingly measured by the completion rate, frequency of items completed, and time spent on the program at 1 month, 2 months, and 3 months. Latent growth curve models (LGCMs) were used to explore the relationship between patient engagement and depressive symptoms at multiple time points in the intervention. RESULTS The mean PHQ-9 scores were 10.2 (SD 4.5), 7.7 (SD 4.8), 6.5 (SD 4.7), and 6.7 (SD 4.1) at baseline, 1 month, 2 months, and 3 months, respectively. The mean completion rates were 50.6% (SD 31.8%), 51.5% (SD 32.2%), and 50.8% (SD 33.7%) at 1, 2, and 3 months, respectively; the average frequencies of items completed were 18.0 (SD 14.6), 32.6 (SD 24.8), and 47.5 (SD 37.2) at 1, 2, and 3 months, respectively, and the mean times spent on the program were 32.7 (SD 66.7), 65.4 (SD 120.8), and 96.4 (SD 180.4) minutes at 1, 2, and 3 months, respectively. LGCMs showed good model fit and indicated that a higher completion rate (β at 3 months=–2.184, P=.048) and a greater frequency of items completed (β at 3 months=–0.018, P=.04) were associated with fewer depressive symptoms at 3 months. Although not significant, similar trends were found in the abovementioned relationships at 1 and 2 months. There was no significant relationship between time spent on the program and depressive symptoms. CONCLUSIONS This study revealed a positive association between patient engagement and health outcomes at 3 months of an mHealth intervention using LGCMs and repeated measures data. The results underscore the importance of improving patient engagement in mHealth interventions to improve patient-centered health outcomes. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR-IPR-17012606; https://tinyurl.com/yxb64mef INTERNATIONAL REGISTERED REPORT RR2-10.1186/s12889-018-5693-1
- Published
- 2020
37. Mid-late pregnancy maternal glycolipids in gestational diabetes mellitus (GDM) fluctuated in glycosylated hemoglobin levels of 5.5%-6.4% associated with umbilical cord blood of amino acid and carnitine profiles: a nested case-cohort observational study
- Author
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WuJuan Chen, Jianyong Cao, Jianying Wang, Ting Hong, Fangfang Jiang, Yaochao Yang, Dan Xie, Le Chen, Yao Chen, long yuhang, Hanxi Zhang, Zhaojuan Su, and Wei Liu
- Subjects
chemistry.chemical_classification ,business.industry ,Physiology ,Hemoglobin levels ,medicine.disease ,Umbilical cord ,Amino acid ,Gestational diabetes ,medicine.anatomical_structure ,Glycolipid ,chemistry ,Cohort ,medicine ,Observational study ,Carnitine ,business ,medicine.drug - Abstract
Background To explore the relationship between maternal-neonatal clinical data and the changes of cord blood amino acid and carnitine levels between pregnant women with gestational diabetes mellitus (GDM) when glycosylated hemoglobin levels of 5.5%-6.4% excluded diabetic medicine as GDMa group and the control group. Methods In all, 312 qualified participants were recruited with permission from the ethical department of the Fifth Affiliated Hospital of Sun Yat-Sen University and divided into two groups (GDMa and non-GDM) after adjusting for maternal age and body mass index (BMI) between the 1 June 2017 and 30 April 2020. All maternal-neonatal data were collected and analysed at the centre. Results Interestingly, glycine in cord blood was not only significantly different between groups(594.19 vs 407.45, P a group, glycosylated hemoglobin levels of 5.5%-6.4% without diabetic medicine, compared with the control group which adjusted by age and BMI. Particularly, umbilical cord blood of glycine levels is related to the diabetic status of glycosylated hemoglobin 5.5%-6.4% in GDM during pregnancy and could be potential diabetic mechanism by maternal-fetal interface.
- Published
- 2020
38. Epidemiological characteristics of COVID-19 clusters in Hainan, China
- Author
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Hanxi Zhang, Sha Xiao, Fang Liu, Fan Zhang, Lu Wang, and Yunru Liu
- Subjects
Adult ,Male ,medicine.medical_specialty ,Disease clusters ,Veterinary medicine ,China ,Coronavirus disease 2019 (COVID-19) ,Adolescent ,Observational Study ,Hainan ,Incubation period ,Young Adult ,coronavirus disease 2019 ,Epidemiology ,medicine ,Cluster (physics) ,Humans ,epidemiological characteristics ,Child ,cluster ,Aged ,Retrospective Studies ,Infectivity ,business.industry ,SARS-CoV-2 ,Significant difference ,COVID-19 ,General Medicine ,Middle Aged ,First generation ,Disease Hotspot ,Child, Preschool ,Female ,business ,Research Article - Abstract
To analyze the epidemiological characteristics of coronavirus disease 2019 (COVID-19) clusters in Hainan, and to provide a basis for the prevention and control of disease clusters.Descriptive epidemiology was used to retrospectively analyze the characteristics of disease clusters in 168 cases of COVID-19.Of the 168 COVID-19 cases, 99 (58.93%) comprised 29 clusters, 22 (75.86%) of which were imported and included 63 cases (63.64%), while 7 clusters (24.14%) were local and included 36 cases (36.36%). Of the cluster cases, 49 were men (49.49%) and 50 were women (50.50%), the median age was 52âyears, and the maximum number of cases from 41 to 60 was at 37âyears (37.37%). There were 67 first generation cases (67.68%), 28 (28.28%) second generation, and 4 (4.04%) third generation. Of the clusters, 68.97% occurred from January 31 to February 7, with the highest peak on February 6. The local disease clusters occurred with a time lag. The 2 cities with the most reported incidents were Sanya (10 cases, 34.48%) and Haikou (5 cases, 17.24%). Family clusters were most frequent, with 18 clusters (62.07%) involving 62 cases (62.63%), followed by social clusters, with 3 clusters (10.34%). The most complex clusters involved 3 cluster types (family, travel, and community). There was a statistically significant difference in the infectivity of the imported clusters versus the local clusters, with imported clusters being lower (Zâ=â-2.851, Pâ=â.004). The infectivity of all cases or family members was highest in Haikou and lowest in Sanya. The infectivity of all cases with an incubation period of ≤7âdays was 1.53â±â1.01, in which the infectivity of family members was 1.29â±â1.10. The infectivity of all cases with an incubation period of ≤14âdays was 1.89â±â1.23, in which the infectivity of family members was 1.43â±â1.37.COVID-19 clusters in Hainan mainly occurred in families, and local clusters had high infectivity. Therefore, key populations and regions should be monitored, and targeted preventive measures should be carried out to provide a reference for the prevention and control of disease clusters.
- Published
- 2020
39. A versatile nanoplatform for synergistic chemo-photothermal therapy and multimodal imaging against breast cancer
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Xiang Qin, Yue Geng, Yi Feng, Zhongyuan Chen, Shun Li, Xiaoxue Xie, Jing Wang, Hong Yang, Yiyao Liu, Hanxi Zhang, Chunhui Wu, and Tingting Li
- Subjects
Indocyanine Green ,Materials science ,Photothermal Therapy ,Pharmaceutical Science ,Mice, Nude ,Nanotechnology ,Breast Neoplasms ,02 engineering and technology ,030226 pharmacology & pharmacy ,Multimodal Imaging ,03 medical and health sciences ,Mice ,0302 clinical medicine ,Breast cancer ,Drug Delivery Systems ,medicine ,Animals ,Humans ,Doxorubicin ,Hyaluronic Acid ,Multimodal imaging ,Mice, Inbred BALB C ,Mesoporous silica ,Photothermal therapy ,Phototherapy ,021001 nanoscience & nanotechnology ,medicine.disease ,Silicon Dioxide ,Nanoparticles ,Female ,0210 nano-technology ,medicine.drug - Abstract
Mesoporous silica nanoparticles (MSNs) with unique advantages can combine multiple functionalities including imaging and therapeutic into one single platform that can provide personalized diagnosis...
- Published
- 2020
40. Mediators of Intervention Effects on Depressive Symptoms Among People Living With HIV: Secondary Analysis of a Mobile Health Randomized Controlled Trial Using Latent Growth Curve Modeling
- Author
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Aliza Monroe-Wise, Mengting Zhu, Yiran Li, Linghua Li, Hanxi Zhang, Chengbo Zeng, Jiaying Qiao, Yan Guo, Zhimeng Xu, Yu Zeng, Cong Liu, and Weiping Cai
- Subjects
Adult ,Male ,China ,Coping (psychology) ,Psychometrics ,Psychological intervention ,Human immunodeficiency virus (HIV) ,HIV Infections ,Health Informatics ,Information technology ,medicine.disease_cause ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Surveys and Questionnaires ,Humans ,longitudinal studies ,Medicine ,030212 general & internal medicine ,mobile health ,mHealth ,Depressive symptoms ,Quality of Health Care ,Original Paper ,Depression ,business.industry ,Latent growth modeling ,HIV ,Middle Aged ,T58.5-58.64 ,Mental health ,Telemedicine ,030227 psychiatry ,randomized controlled trial ,Female ,Public aspects of medicine ,RA1-1270 ,business ,Clinical psychology - Abstract
Background Although several studies have investigated the effects of mobile health (mHealth) interventions on depression among people living with HIV, few studies have explored mediators of mHealth-based interventions to improve mental health in people living with HIV. Identifying influential mediators may enhance and refine effective components of mHealth interventions to improve mental health of people living with HIV. Objective This study aimed to examine mediating factors of the effects of a mHealth intervention, Run4Love, designed to reduce depression among people living with HIV using 4 time-point measurement data. Methods This study used data from a randomized controlled trial of a mHealth intervention among people living with HIV with elevated depressive symptoms in Guangzhou, China. A total of 300 patients were assigned to receive either the mHealth intervention (n=150) or a waitlist control group (n=150) through computer-generated block randomization. Depressive symptoms, coping, and HIV-related stigma were measured at baseline, 3-, 6-, and 9-month follow-ups. The latent growth curve model was used to examine the effects of the intervention on depressive symptoms via potential mediators. Mediating effects were estimated using bias-corrected 95% bootstrapped CIs (BCIs) with resampling of 5000. Results Enhanced positive coping and reduced HIV-related stigma served as effective treatment mediators in the mHealth intervention. Specially, there was a significant indirect effect of the mHealth intervention on the slope of depressive symptoms via the slope of positive coping (beta=–2.86; 95% BCI –4.78 to –0.94). The indirect effect of the mHealth intervention on the slope of depressive symptoms via the slope of HIV-related stigma was also statistically significant (beta=–1.71; 95% BCI –3.03 to –0.40). These findings indicated that enhancement of positive coping and reduction of HIV-related stigma were important mediating factors of the mHealth intervention in reducing depression among people living with HIV. Conclusions This study revealed the underlying mediators of a mHealth intervention to reduce depression among people living with HIV using latent growth curve model and 4 time-point longitudinal measurement data. The study results underscored the importance of improving positive coping skills and mitigating HIV-related stigma in mHealth interventions to reduce depression among people living with HIV.
- Published
- 2019
41. Mechanisms and Effects of a WeChat-Based Intervention on Suicide Among People Living With HIV and Depression: Path Model Analysis of a Randomized Controlled Trial
- Author
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Zhimeng Xu, Yan Guo, Jiaying Qiao, Hanxi Zhang, Cong Liu, Weiping Cai, Y Alicia Hong, Chengbo Zeng, Linghua Li, Mengting Zhu, Yu Zeng, and Yiran Li
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Psychological intervention ,Poison control ,Health Informatics ,HIV Infections ,Suicide prevention ,law.invention ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Randomized controlled trial ,Acquired immunodeficiency syndrome (AIDS) ,law ,Medicine ,Outpatient clinic ,Humans ,030212 general & internal medicine ,Psychiatry ,mHealth ,Original Paper ,business.industry ,Depression ,HIV ,Middle Aged ,medicine.disease ,Mental health ,Telemedicine ,030227 psychiatry ,Suicide ,Mental Health ,Female ,business - Abstract
Background People living with HIV and depression have high rates of suicide. Studies of mobile health (mHealth) interventions have shown feasibility, acceptability, and efficacy in improving mental health in people living with HIV and depression. However, few studies have examined the mechanisms and effects of mHealth interventions on suicide. Objective This study was designed to examine the mechanisms and effects of a WeChat-based intervention, Run4Love, on suicide among people living with HIV and depression in China, while considering perceived stress and depressive symptoms as mediators. Methods A sample of 300 People living with HIV and depression was recruited from the outpatient clinic of a large HIV or AIDS treatment hospital and was randomized to the Run4Love group or a control group. Data were collected at baseline, 3-, 6-, and 9-month follow-ups. Path analysis modeling, with longitudinal data, was used in data analyses. Results The Run4Love mHealth intervention had a direct effect on reducing suicide rate at the 6-month follow-up (beta=−.18, P=.02) and indirect effect through reducing perceived stress and depressive symptoms at the 3-month follow-up (beta=−.09, P=.001). A partial mediating effect between perceived stress and depressive symptoms accounted for 33% (–0.09/–0.27) of the total effect. Conclusions Through path analyses, we understood the mechanisms and effects of an mHealth intervention on suicide prevention. The findings underscored the importance of stress reduction and depression treatment in such a program. We call for more effective suicide prevention, especially mHealth interventions targeting the vulnerable population of people living with HIV and depression. Trial Registration Chinese Clinical Trial Registry ChiCTR-IPR-17012606; http://www.chictr.org.cn/showprojen.aspx?proj=21019
- Published
- 2019
42. Run4Love, a mHealth (WeChat-based) intervention to improve mental health of people living with HIV: a randomized controlled trial protocol
- Author
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Zhimeng Xu, Jiaying Qiao, Cong Liu, Y Alicia Hong, Weiping Cai, Linghua Li, Chengbo Zeng, Nathan Asher Harris, Yiran Li, Cui Yang, Hanxi Zhang, Yan Guo, and Mengting Zhu
- Subjects
Gerontology ,Adult ,Male ,mHealth intervention ,Stress management ,medicine.medical_specialty ,China ,020205 medical informatics ,Social Stigma ,Psychological intervention ,HIV Infections ,02 engineering and technology ,Health Promotion ,People living with HIV (PLWH) ,law.invention ,03 medical and health sciences ,Study Protocol ,0302 clinical medicine ,Patient satisfaction ,Randomized controlled trial ,law ,Adaptation, Psychological ,0202 electrical engineering, electronic engineering, information engineering ,medicine ,Humans ,030212 general & internal medicine ,mHealth ,business.industry ,Depression ,Public health ,lcsh:Public aspects of medicine ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,Mental health ,Telemedicine ,Clinical trial ,Patient Satisfaction ,Quality of Life ,Female ,Smartphone ,business - Abstract
People living with HIV (PLWH) suffer from high rates of mental illness; but targeted effective interventions are limited, especially in developing countries. High penetration of smartphone usage and widespread acceptance of social media applications provide an unprecedented opportunity for mobile-based health interventions (mHealth interventions) in resource-limited settings like China. The current report describes the design and sample characteristics of the Run4Love randomized controlled trial (RCT) aimed at improving mental health in PLWH in China. A total of 300 PLWH with elevated depressive symptoms were recruited and randomized into either the intervention or control group. Participants in the intervention group received an adapted cognitive-behavioral stress management (CBSM) course delivered by the enhanced WeChat platform (for 3 months) and were motivated to engage in physical activities. Progress of the participants was automatically tracked and monitored with timely feedback and rewards. The control group received a brochure on nutrition for PLWH in addition to standard care. The outcome assessments are conducted at baseline, 3, 6, and 9 months using tablets. The primary outcome is depressive symptoms measured by the scale of the Center for Epidemiology Studies Depression (CES-D). Secondary outcomes include quality of life, chronic stress measured with biomarker of hair cortisol, and other measures of stress and depression, self-efficacy, coping, HIV-related stigma, physical activity, and patient satisfaction. Mixed effects model with repeated measures (MMRM) will be used to analyze the intervention effects. The Run4Love study is among the first efforts to develop and evaluate a multicomponent and integrated mHealth intervention to improve the mental health and quality of life of PLWH. Once proven effective, Run4Love could be scaled up and potentially integrated into the routine case management of PLWH and adapted to other populations with chronic diseases. Chinese Clinical Trial Registry - ChiCTR-IPR-17012606 , registered on 07 September 2017.
- Published
- 2018
43. Mediating Effects of Stigma and Depressive Symptoms in a Social Media–Based Intervention to Improve Long-term Quality of Life Among People Living With HIV: Secondary Analysis of a Randomized Controlled Trial
- Author
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Jiaying Qiao, Chengbo Zeng, Y Alicia Hong, Hanxi Zhang, Yu Zeng, Weiping Cai, Yan Guo, Cong Liu, Mengting Zhu, Linghua Li, and Yiran Li
- Subjects
medicine.medical_specialty ,Social Stigma ,Psychological intervention ,Stigma (botany) ,HIV Infections ,Health Informatics ,law.invention ,depressive symptoms ,Quality of life ,Randomized controlled trial ,law ,Intervention (counseling) ,Humans ,Medicine ,Outpatient clinic ,Psychiatry ,mHealth ,Original Paper ,Depression ,business.industry ,structural equation model ,HIV ,Clinical trial ,quality of life ,business ,Social Media - Abstract
Background Mobile health (mHealth) interventions have been shown to effectively improve the quality of life (QOL) among people living with HIV. However, little is known about the long-term effects of mHealth interventions. Objective This study aims to explore the intervention mechanisms of a social media–based intervention, Run4Love, on the QOL of people with HIV over across a 9-month follow-up period. Methods We recruited people living with HIV who were concurrently experiencing elevated depressive symptoms from an HIV outpatient clinic in South China. A total of 300 eligible participants were randomized either to the intervention group or the control group in a 1:1 ratio after they provided informed consent and completed a baseline survey. The intervention group received a 3-month WeChat-based intervention, comprising cognitive-behavioral stress management (CBSM) courses and physical activity promotion. The control group received a printed brochure on nutrition guidelines in addition to the usual care for HIV treatment. Neither participants nor the research staff were blinded to group assignment. All patients were followed at 3, 6, and 9 months. The primary outcome was depressive symptoms. Structural equation model (SEM) with longitudinal data was conducted to examine the sequential mediating effects of HIV-related stigma and depressive symptoms on the long-term intervention effects on participants’ QOL. Results About 91.3% (274/300), 88.3% (265/300), and 86.7% (260/300) of all participants completed follow-up surveys at 3, 6, and 9 months, respectively. Results showed that the intervention had significantly improved participants' QOL at 9 months, via complete mediating effects of reduced HIV-related stigma at 3 months and decreased depressive symptoms at 6 months. No adverse events were reported. Conclusions These findings underscore the critical roles of HIV-related stigma and depressive symptoms in an mHealth intervention with long-term effects on QOL improvements. We call for targeted mHealth interventions to improve QOL among people living with HIV, especially social media–based interventions that can address HIV-related stigma and alleviate depressive symptoms. Trial Registration Chinese Clinical Trial Registry ChiCTR-IPR-17012606; https://www.chictr.org.cn/showproj.aspx?proj=21019
- Published
- 2021
44. Multistage-responsive nanovehicle to improve tumor penetration for dual-modality imaging-guided photodynamic-immunotherapy
- Author
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Fengming You, Chunhui Wu, Tingting Li, Geng Yang, Xiaodan Wei, Shun Li, Xiaoxue Xie, Ningxi Li, Guixue Wang, Qingqing Su, Jie Zhu, Hanxi Zhang, Yiyao Liu, Chuan Zheng, Hong Yang, Yi Feng, and Xiang Qin
- Subjects
medicine.medical_treatment ,Biophysics ,Bioengineering ,Photodynamic therapy ,02 engineering and technology ,Biomaterials ,03 medical and health sciences ,Cancer immunotherapy ,Cell Line, Tumor ,Neoplasms ,Tumor Microenvironment ,medicine ,Humans ,Cytotoxic T cell ,030304 developmental biology ,0303 health sciences ,Tumor microenvironment ,Chemistry ,X-Ray Microtomography ,Immunotherapy ,021001 nanoscience & nanotechnology ,Immune checkpoint ,Photochemotherapy ,Mechanics of Materials ,Drug delivery ,Ceramics and Composites ,Cancer research ,Matrix Metalloproteinase 2 ,Nanoparticles ,Nanocarriers ,0210 nano-technology - Abstract
The exploration of an intelligent multifunctional imaging-guided therapeutic platform is of great significance because of its ideal delivery efficiency and controlled release. In this work, a tumor microenvironment (TME)-responsive nanocarrier (denoted as MB@MSP) is designed for on-demand, sequentially release of a short D-peptide antagonist of programmed cell death-ligand 1 (named as PDPPA-1) and a photosensitizer methylene blue (MB). Fe3O4-Au located in the core of MB@MSP is used as a magnetic resonance imaging and micro-computed tomography imaging contrast agent for noninvasive diagnosis of solid tumors and simultaneous monitoring of drug delivery. The PDPPA-1 coated on MB@MSP can be shed due to the cleavage of the peptide substrate by matrix metalloproteinase-2 (MMP-2) that is highly expressed in the tumor stroma, and disulfide bonding is further broken when it encounters high levels of glutathione (GSH) in TME, which finally leads to significant size reduction and charge-reversal. These transitions facilitate penetration and uptake of nanocarriers against tumors. Noticeably, the released PDPPA-1 can block the immune checkpoint to create an environment that favors the activation of cytotoxic T lymphocytes and augment the antitumor immune response elicited by photodynamic therapy, thus significantly improving therapeutic outcomes. Studies of the underlying mechanisms suggest that the designed MMP-2 and GSH-sensitive delivery system not only induce apoptosis of tumor cells but also modulate the immunosuppressive tumor microenvironment to eventually augment the suppression tumor metastasis effect of CD8+ cytotoxic T cells. Overall, the visualization of the therapeutic processes with comprehensive information renders MB@MSP an intriguing platform to realize the combined treatment of metastatic tumors.
- Published
- 2021
45. Research on cost management of prefabricated construction based on BIM
- Author
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Hanxi Zhang and Zhen Wen
- Subjects
Prefabrication ,Engineering ,Process (engineering) ,business.industry ,Cost accounting ,Theoretical research ,business ,Bottleneck ,Construction engineering - Abstract
In recent years, prefabricated construction has been widely concerned with its significant advantages of high efficiency, environmental protection and energy saving. However, the prefabricated construction in China is in the initial stage, with more theoretical research than practical cases. Even with strong policy support, the development of prefabricated buildings is relatively slow. There are many reasons for this. The main reason is that the cost of prefabricated construction is too high for most developers to bear. This paper attempts to study the effect of BIM Technology on the whole process of cost management, aiming to solve the problem of cost compression in the implementation stage of prefabricated construction project and overcome the bottleneck of prefabricated construction development.
- Published
- 2021
46. Mechanisms and Effects of a WeChat-Based Intervention on Suicide Among People Living With HIV and Depression: Path Model Analysis of a Randomized Controlled Trial (Preprint)
- Author
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Yiran Li, Yan Guo, Y Alicia Hong, Mengting Zhu, Chengbo Zeng, Jiaying Qiao, Zhimeng Xu, Hanxi Zhang, Yu Zeng, Weiping Cai, Linghua Li, and Cong Liu
- Abstract
BACKGROUND People living with HIV and depression have high rates of suicide. Studies of mobile health (mHealth) interventions have shown feasibility, acceptability, and efficacy in improving mental health in people living with HIV and depression. However, few studies have examined the mechanisms and effects of mHealth interventions on suicide. OBJECTIVE This study was designed to examine the mechanisms and effects of a WeChat-based intervention, Run4Love, on suicide among people living with HIV and depression in China, while considering perceived stress and depressive symptoms as mediators. METHODS A sample of 300 People living with HIV and depression was recruited from the outpatient clinic of a large HIV or AIDS treatment hospital and was randomized to the Run4Love group or a control group. Data were collected at baseline, 3-, 6-, and 9-month follow-ups. Path analysis modeling, with longitudinal data, was used in data analyses. RESULTS The Run4Love mHealth intervention had a direct effect on reducing suicide rate at the 6-month follow-up (beta=−.18, P=.02) and indirect effect through reducing perceived stress and depressive symptoms at the 3-month follow-up (beta=−.09, P=.001). A partial mediating effect between perceived stress and depressive symptoms accounted for 33% (–0.09/–0.27) of the total effect. CONCLUSIONS Through path analyses, we understood the mechanisms and effects of an mHealth intervention on suicide prevention. The findings underscored the importance of stress reduction and depression treatment in such a program. We call for more effective suicide prevention, especially mHealth interventions targeting the vulnerable population of people living with HIV and depression. CLINICALTRIAL Chinese Clinical Trial Registry ChiCTR-IPR-17012606; http://www.chictr.org.cn/showprojen.aspx?proj=21019
- Published
- 2019
47. Differential effects of unemployment on depression in people living with HIV/AIDS: a quantile regression approach
- Author
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Zhimeng Xu, Yan Guo, Chengbo Zeng, Weiping Cai, Jinxin Zhang, Hanxi Zhang, Shelene Gentz, Jiaying Qiao, and Y Alicia Hong
- Subjects
Adult ,Male ,Health (social science) ,Social Psychology ,media_common.quotation_subject ,Human immunodeficiency virus (HIV) ,HIV Infections ,medicine.disease_cause ,03 medical and health sciences ,0302 clinical medicine ,Depression (economics) ,Acquired immunodeficiency syndrome (AIDS) ,Surveys and Questionnaires ,medicine ,Humans ,030212 general & internal medicine ,media_common ,030505 public health ,business.industry ,Depression ,Public Health, Environmental and Occupational Health ,Middle Aged ,medicine.disease ,Differential effects ,Quantile regression ,Unemployment ,Regression Analysis ,Female ,0305 other medical science ,business ,Demography - Abstract
Unemployment is associated with depression in people living with HIV (PLWH). However, few studies have examined the effects of unemployment on PLWH with different levels of depression. The current study explores the plausible differential effects of unemployment on the different percentiles of depression in PLWH employing a quantile regression (QR) approach, based on a recent survey of 411 PLWH in China. Among participants, 47.7% had elevated depressive symptoms, and 23.8% were unemployed. The effects of unemployment on depression were statistically significant with a trend of initial increase followed by a decline at the quantile levels of 0.51-0.90 of depression. The maximum effect of unemployment status on depression was statistically significant at the 70th and 75th percentiles of depression (coefficient = 7.0
- Published
- 2019
48. Structural equation modeling test of the pre-intentional phase of the health action process approach (HAPA) model on condom use intention among senior high school students in Tianjin, China
- Author
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Shanshan Jin, Hanxi Zhang, Fangfang Chen, Lu Wang, Mengjie Han, Dong Zhang, Fang Xu, Ning Wang, Kai Bu, and Caixia Sun
- Subjects
Male ,China ,Adolescent ,Cross-sectional study ,Sexual Behavior ,high school students ,education ,Observational Study ,Intention ,acquired immunodeficiency syndromes ,Structural equation modeling ,law.invention ,Condoms ,03 medical and health sciences ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,Condom ,law ,Surveys and Questionnaires ,medicine ,Humans ,030212 general & internal medicine ,Students ,Contraception Behavior ,condom use intention ,Self-efficacy ,Medical education ,business.industry ,Health action process approach ,General Medicine ,medicine.disease ,Self Efficacy ,Latent class model ,Test (assessment) ,Cross-Sectional Studies ,Latent Class Analysis ,health action process approach ,030220 oncology & carcinogenesis ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,Female ,business ,Research Article - Abstract
Supplemental Digital Content is available in the text, Based on the Theory of Health Action Process Approach (HAPA) Model, this study aimed to investigate factors associated with condom use intention in Chinese adolescents. In 2017, we conducted a cross-sectional study using stratified cluster, convenience sampling method to assess condom use intention among senior high school students in Tianjin, China. One thousand eighty two senior high school students were anonymously surveyed through self-administered questionnaires. Structural equation modelling was used to assess the pre-intentional phase of HAPA model. Among the participants, 41.5% (449/1082) were male, 54.1% (585/1082) were female, 4.4% (48/1082) were gender-deficient. The average age was 16.7 years. The final pre-intentional phase of HAPA model was acceptable (CFI = 0.95; GFI = 0.94; RMSEA = 0.06). Action self-efficacy (r = 0.60) had a strong direct effect on condom use intention. The pre-intentional phase of HAPA model is valid to assess condom use intention among Chinese senior high school students. The pre-intention phase of the HAPA model could be applied to guide AIDS health educations of students, and further research is needed to evaluate the effect.
- Published
- 2020
49. Effect of a WeChat-Based Intervention (Run4Love) on Depressive Symptoms Among People Living With HIV in China: A Randomized Controlled Trial
- Author
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Weiping Cai, Yuantao Hao, Yan Guo, Cong Liu, Chengbo Zeng, Mengting Zhu, Linghua Li, Yu Zeng, Jiaying Qiao, Yiran Li, Y Alicia Hong, Zhimeng Xu, Frank J. Penedo, and Hanxi Zhang
- Subjects
Adult ,Male ,China ,medicine.medical_specialty ,020205 medical informatics ,Psychological intervention ,HIV Infections ,Health Informatics ,02 engineering and technology ,lcsh:Computer applications to medicine. Medical informatics ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,WeChat ,Randomized controlled trial ,law ,Informed consent ,Intervention (counseling) ,0202 electrical engineering, electronic engineering, information engineering ,Humans ,Medicine ,Outpatient clinic ,030212 general & internal medicine ,mHealth ,Original Paper ,Depression ,business.industry ,lcsh:Public aspects of medicine ,HIV ,lcsh:RA1-1270 ,Middle Aged ,Mental health ,Telemedicine ,Clinical trial ,Mental Health ,Case-Control Studies ,randomized controlled trial ,Physical therapy ,lcsh:R858-859.7 ,Female ,business - Abstract
Background People living with HIV (PLWH) have high rates of depressive symptoms. However, only a few effective mental health interventions exist for this vulnerable population. Objective The aim of this study was to assess the efficacy of a WeChat-based intervention, Run4Love, with a randomized controlled trial among 300 people living with HIV and depression (PLWHD) in China. Methods We recruited PLWH from the HIV outpatient clinic in South China. Participants were screened based on the Center for Epidemiologic Studies-Depression (CES-D) scale. Those who scored 16 or higher were eligible to participate. A total of 300 eligible patients were enrolled. After obtaining informed consent from the participants, completion of a baseline survey, and collection of participants’ hair samples for measuring cortisol, the participants were randomly assigned to an intervention or a control group in a 1:1 ratio. The intervention group received the Run4Love program, delivered via the popular social media app WeChat. Cognitive behavioral stress management courses and weekly reminders of exercise were delivered in a multimedia format. Participants’ progress was monitored with timely and tailored feedback. The control group received usual care and a brochure on nutrition for PLWH. Data were collected at 3, 6, and 9 months. The primary outcome was depression, which was measured by a validated instrument. Results Participants in the intervention and control groups were comparable at baseline; about 91.3% (139/150), 88.3% (132/150), and 86.7% (130/150) participants completed the 3-, 6-, and 9-month follow-ups, respectively. At the 3-month follow-up, a significant reduction in CES-D score was observed in the intervention group (from 23.9 to 17.7 vs from 24.3 to 23.8; mean difference=−5.77, 95% CI −7.82 to −3.71; P Conclusions The WeChat-based mobile health (mHealth) intervention Run4Love significantly reduced depressive symptoms among PLWHD, and the effect was sustained. An app-based mHealth intervention could provide a feasible therapeutic option for many PLWHD in resource-limited settings. Further research is needed to assess generalizability and cost-effectiveness of this intervention. Trial Registration Chinese Clinical Trial Registry ChiCTR-IPR-17012606; http://www.chictr.org.cn/showproj.aspx?proj=21019 (Archived by WebCite at https://www.webcitation.org/78Bw2vouF)
- Published
- 2020
50. Development and Feasibility Testing of an mHealth (Text Message and WeChat) Intervention to Improve the Medication Adherence and Quality of Life of People Living with HIV in China: Pilot Randomized Controlled Trial
- Author
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Jiaying Qiao, Linghua Li, Cong Liu, Weiping Cai, Chengbo Zeng, Hanxi Zhang, Y Alicia Hong, Zhimeng Xu, and Yan Guo
- Subjects
medicine.medical_specialty ,020205 medical informatics ,social media ,Population ,Psychological intervention ,Health Informatics ,02 engineering and technology ,Information technology ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Randomized controlled trial ,law ,Intervention (counseling) ,0202 electrical engineering, electronic engineering, information engineering ,Outpatient clinic ,Medicine ,030212 general & internal medicine ,people living with HIV ,education ,mHealth ,education.field_of_study ,Original Paper ,business.industry ,T58.5-58.64 ,Clinical trial ,Family medicine ,medication adherence ,randomized controlled trial ,Public aspects of medicine ,RA1-1270 ,business - Abstract
BackgroundMost people living with HIV (PLWH) reside in middle- and low-income countries with limited access to health services. Thus, cost-effective interventions that can reach a large number of PLWH are urgently needed. ObjectiveThe objective of our study was to assess the feasibility and acceptability of an mHealth intervention among PLWH in China. MethodsBased on previous formative research, we designed an mHealth intervention program that included sending weekly reminders to participants via text messages (short message service, SMS) and articles on HIV self-management three times a week via a popular social media app WeChat. A total of 62 PLWH recruited from an HIV outpatient clinic were randomly assigned to intervention or control group. The intervention lasted for 3 months, and all participants were assessed for their medication adherence, presence of depression, quality of life (QoL), and CD4 (cluster of differentiation 4) counts. Upon completing the intervention, we interviewed 31 participants to further assess the feasibility and acceptability of the study. ResultsAt baseline, the intervention and control groups did not differ in terms of demographic characteristics or any of the major outcome measures. About 85% (53/62) of the participants completed the intervention, and they provided valuable feedback on the design and content of the intervention. Participants preferred WeChat as the platform for receiving information and interactive communication for ease of access. Furthermore, they made specific recommendations about building trust, interactive features, and personalized feedback. In the follow-up assessment, the intervention and control groups did not differ in terms of major outcome measures. ConclusionsThis pilot study represents one of the first efforts to develop a text messaging (SMS)- and WeChat-based intervention that focused on improving the medication adherence and QoL of PLWH in China. Our data indicates that an mHealth intervention is feasible and acceptable to this population. The data collected through this pilot study will inform the future designs and implementations of mHealth interventions in this vulnerable population. We recommend more innovative mHealth interventions with rigorous designs for the PLWH in middle- and low-income countries. Trial RegistrationChinese Clinical Trial Registry ChiCTR1800017987; http://www.chictr.org.cn/showprojen.aspx?proj=30448 (Archived by WebCite at http://www.webcitation.org/71zC7Pdzs) Registered Report IentifierRR1-10.2196/
- Published
- 2018
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