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Abstract Background Understanding the experiences of doctoral students regarding courses and comprehensive examinations is crucial to enhance the quality of doctoral programs. Scarce information is available on the experiences of nursing doctoral students on the courses and comprehensive examinations in China. The purpose of this study was to understand the nursing doctoral students’ experiences on courses and comprehensive examinations of the doctoral program at Xiangya School of Nursing, Central South University, and propose improvements. Design A convergent parallel mixed methods design adhering to EQUATOR guidelines for Good Reporting of a Mixed Methods Study. Methods A total of 20 doctoral students were recruited through purposive sampling in September 2022 from the Xiangya School of Nursing, Central South University. They completed the self-designed questionnaire on demographic data, course, and comprehensive examination evaluations and participated in focus groups. Quantitative data were analyzed using descriptive statistics. Qualitative data were recorded and transcribed for content analysis. Results Regarding course experience, doctoral students preferred in-person lectures (80%) and group discussions (60%) for specialized compulsory courses. They were satisfied with the course novelty (85%), difficulty (75%), and practicality (85%), and half of the students found the credit allocation reasonable. The qualitative findings revealed their preference for appropriate and blended teaching methods, needs for additional interdisciplinary courses, statistics, and inter-school collaborative courses, accessible Nursing Philosophy and Theory courses, and high proportion of compulsory course credits. Regarding comprehensive examination experience, only 20% considered it necessary, and qualitative data revealed that they prefer more distinctive and effective contents; moreover, students were confused about the purpose of comprehensive examinations. The triangulation of quantitative and qualitative data demonstrated relative convergence. Conclusions These findings illustrated nursing doctoral students' experiences on courses and comprehensive examinations and provide suggestions on improving the courses and comprehensive examinations in China and possibly in the world. This study contributes to improving the quality of nursing doctoral programs in China and can serve as valuable guidance for nursing doctoral programs with similar educational environment around the world that are undergoing course and comprehensive examination reform.

Abstract Background Poor working postures in morning care operations contribute significantly to work-related muscle fatigue and low back pain among ICU (Intensive Care Unit, ICU) nurses. However,there are few field studies on the relationship between Poor working postures and work-related muscle fatigue, low back pain among ICU nurses. Objective This study aims to assess the frequency and degree of posture hazards associated with poor working postures during morning care operations of ICU nurses. Methods Two ICUs in a Grade-A tertiary hospital in Hunan Province were randomly selected for the field study in May–June 2021 research. The image data of the participating nurses’ morning care work postures were collected by observation method and image recording method, and the postural hazard level was assessed by the two-person interpretation method of the work posture analysis system. The mean and standard deviation, frequency and percentage were used for the basic statistical description, and the general linear model multivariate Hotelling’s T 2 test was used to calculate the Hotelling’s T 2 and F statistics to explore the pattern of change in the postural hazard score curves. Results A total of 45 nurses were observed during morning care operations, resulting in 47.8 h of video data and 34,428 effective static operation posture pictures. Among these pictures, 21,166 (61.5%) depicted poor working postures. Nurses spent up to 7 min and 30 s maintaining a challenging posture during oral care, with the highest postural hazard score (M = 2.2, SD = 0.3) observed during defecation care. Each patient requires a total of 25–30 min of oral care per day.The Hotelling’s T 2 test indicated that the change curve of the postural hazard score in each step revealed the largest second-order F value, F = 52.931, P

Abstract This study examined the prevalence of HIV late diagnosis (LD) and identified associated factors with LD among people living with HIV (PLWH). We extracted sociodemographic, epidemiological, and immunological information between 2018 and 2021 in Hunan, China from the HIV/AIDS Comprehensive Response Information Management System of China. The chi-squared test and multivariable logistic regression model were used to identify the factors associated with LD. Among 22,504 PLWH, 14,988 (66.6%) were diagnosed late. PLWH aged 50 and older had a higher proportion of LD (71.2%) than the younger group (60.0%). Older age, being male, Han ethnicity, being registered in Western Hunan, being transferred from health facilities, and being infected through heterosexual intercourse were associated with LD. Among PLWH younger than 50 years, apart from the factors mentioned above, individuals who had primary school or lower education, were non-student, and were divorced or widowed were more likely to be diagnosed late. Unlike younger PLWH, these factors were not associated with LD in the older group. But regional disparities in LD were more significant among them. LD in PLWH remains a severe issue, especially among older people. The study findings provided valuable insights into designing programs targeting groups at higher risk of LD to reduce its prevalence.

Abstract Background Depressive symptoms among nurses have been a significant public health concern. Although many studies have demonstrated the potential relationship between interpersonal conflict at work and depressive symptoms, the mechanisms underlying this relationship among nurses remain unclear. Based on the theoretical and empirical research, this study aimed to investigate the multiple mediating effects of negative emotion at work and meaning in life on the relationship between interpersonal conflict at work and depressive symptoms among nurses. Methods An online multicenter cross-sectional study was conducted in 15 hospitals from different geographical areas of Hunan Province, China, from December 2021 to February 2022. A total of 1754 nurses completed validated self-reported questionnaires, including their sociodemographic information, interpersonal conflict at work, negative emotions at work, meaning in life, and depressive symptoms. Descriptive statistics analysis, Spearman’s correlation analysis, multiple linear regression analysis, and chain mediation analysis were performed using IBM SPSS software (version 29) and Mplus software (version 8). Results There were significant correlations between interpersonal conflict at work, negative emotions at work, meaning in life, and depressive symptoms (r = -0.206 ~ 0.518, all p

Abstract The emergence of novel AI technologies and increasingly portable wearable devices have introduced a wider range of more liberated avenues for communication and interaction between human and virtual environments. In this context, the expression of distinct emotions and movements by users may convey a variety of meanings. Consequently, an emerging challenge is how to automatically enhance the visual representation of such interactions. Here, a novel Generative Adversarial Network (GAN) based model, AACOGAN, is introduced to tackle this challenge effectively. AACOGAN model establishes a relationship between player interactions, object locations, and camera movements, subsequently generating camera shots that augment player immersion. Experimental results demonstrate that AACOGAN enhances the correlation between player interactions and camera trajectories by an average of 73%, and improves multi‐focus scene quality up to 32.9%. Consequently, AACOGAN is established as an efficient and economical solution for generating camera shots appropriate for a wide range of interactive motions. Exemplary video footage can be found at https://youtu.be/Syrwbnpzgx8.

Abstract Background The retention of new nurses has become a major challenge for medical institutions. Job embeddedness has been seen as a valuable lens for examining nurse turnover, but greater details about job embeddedness are rarely disclosed, especially among new nurses. This study aimed to reveal how the nursing work environment, head nurse leadership and presenteeism shape job embeddedness in this population from the perspective of conservation of resources (COR) theory. Method A cross-sectional multicentre study involving 436 participants from 10 cities and 33 hospitals was conducted over 4 months. Samples were selected using a two-stage convenience sampling method. A sequential multiple mediation model performed with SPSS-PROCESS was used to analyse the relationships among the nursing work environment, head nurse leadership, presenteeism and job embeddedness. Results The nursing work environment not only directly affects the job embeddedness of new nurses (β = 0.480, p

Mulberry is a critical economic tree with a high diversity of germplasm resources. However, the lack of primary data on genome size, chromosome number, and ploidy for this species limits the exploitation of mulberry resources. In this study, the genome size of 323 mulberry germplasm resources were examined using flow cytometry and chromosome numbers analyzed. The genome sizes ranged from 0.36 to 3.08 Gb, and seven different ploidies of mulberry germplasm resources were identified, with chromosome numbers ranging from 14 to 308. Correlation analysis indicated that genome size (1C) and chromosome number positively correlated. Here, the genome size, chromosome number, and ploidy database MGCPdb (https://mgcpdb.biodb.org) were constructed for mulberry plants, which contains 323 core mulberry germplasm resources and provides raw data of flow cytometry analysis, genome size, and chromosome count. This database is significant and valuable for mulberry genome evolution, polyploidy breeding, and genetic diversity research.

The association between human immunodeficiency virus (HIV) status and readmissions and death outcomes in patients with established heart failure (HF) remains unclear. We conducted a systematic search of PubMed, EMBASE, Cochrane Library, and Web of Science up to March 1st, 2023, for cohort studies of adult patients (≥18 years) diagnosed with HF and recorded HIV status at baseline. Our analysis included 7 studies with 10,328 HF patients living with HIV and 48,757 HF patients without HIV. Compared to HF patients without HIV, those with HIV had a higher risk of all-cause deaths (HR: 1.20, 95% CI: 1.15–1.25). HIV infection was also associated with increased risks of HF-associated readmission (HR: 1.34, 95% CI: 1.03–1.75) and all-cause readmission (HR: 1.27, 95% CI: 1.10–1.46). Our study highlights the independent association between HIV and poor HF outcomes, emphasizing the need for improved management in individuals living with HIV.

In NIR spectral modeling, the method of screening wavelengths with consistent stable signals (SWCSS) is based on a standard-free algorithm. However, the wavelengths selected by SWCSS may contain invalid information. In this paper, the Competitive Adaptive Reweighted Sampling (CARS) wavelength optimization algorithm was used in conjunction with SWCSS to eliminate the uninformative variables in the wavelengths selected by SWCSS. The SWCSS-CARS method was based on three near-infrared spectrometers (Lengguang 1, Lengguang 2, and Lengguang 3), with Lengguang 1 as the master and the other two instruments as the targets, using a total of 84 sample spectra of five types of pulpwood and their lignin contents as the research objects. Compared with the full spectrum, the number of wavelengths was reduced from 1601 to 24 in the model built using the coupling algorithm. For target 1, the value of RPD was improved from 1.9247 to 3.1880; for target 2, t the value of RPD was improved from 1.7415 to 3.2508. The wavelengths selected by the SWCSS-CARS coupling algorithm were able to build stable, robust models.

Abstract The nature of charge degrees-of-freedom distinguishes scenarios for interpreting the character of a second order magnetic transition at zero temperature, that is, a magnetic quantum critical point (QCP). Heavy-fermion systems are prototypes of this paradigm, and in those, the relevant question is where, relative to a magnetic QCP, does the Kondo effect delocalize their f-electron degrees-of-freedom. Herein, we use pressure-dependent Hall measurements to identify a finite-temperature scale E loc that signals a crossover from f-localized to f-delocalized character. As a function of pressure, E loc(P) extrapolates smoothly to zero temperature at the antiferromagnetic QCP of CeRhIn5 where its Fermi surface reconstructs, hallmarks of Kondo-breakdown criticality that generates critical magnetic and charge fluctuations. In 4.4% Sn-doped CeRhIn5, however, E loc(P) extrapolates into its magnetically ordered phase and is decoupled from the pressure-induced magnetic QCP, which implies a spin-density-wave (SDW) type of criticality that produces only critical fluctuations of the SDW order parameter. Our results demonstrate the importance of experimentally determining E loc to characterize quantum criticality and the associated consequences for understanding the pairing mechanism of superconductivity that reaches a maximum T c in both materials at their respective magnetic QCP.

Objectives: A noticeable increase in HIV-positive cases among women, particularly those of middle and old age, has been observed worldwide. This study aimed to describe women’s perceived HIV risk, HIV/Acquired Immunodeficiency Syndrome (AIDS) knowledge, attitude, and sexual behaviors to determine factors associated with condom use among these women in Hunan, China. Methods: A cross-sectional study was conducted from July 2019 to August 2020 among 958 women aged 40 and older in four regions of Hunan, China. We collected data on sociodemographic characteristics, perceived HIV risk, HIV/AIDS knowledge and attitude, condom use, and sexual behaviors. Univariate and multivariate logistic regression were performed to identify factors related to condom use. Results: Out of 958 participants, 60.6% perceived no risk of HIV infection, and 46.8% reported they had never used a condom during their past sexual life. Those who were older, had lower monthly household income for family, had not received HIV education in the past year, were unwilling to use condoms, could not determine condom use during sexual activity, and had more negative attitudes towards HIV/AIDS and HIV-positive people were less likely to use condoms in their past sexual behaviors. Conclusions: In Hunan Province, most women aged 40 and older perceived themselves as having a low or no risk of HIV infection; their rate of condom use was low, and six factors were associated with condom use. It is imperative to strengthen HIV prevention and control programs among women aged 40 and above, particularly focusing on those who may use condoms infrequently or not at all.

The migratory endoparasitic phytonematodes Bursaphelenchus xylophilus is the causal agent of pine wilt disease and causes significant economic damage to pine forests in China. Effectors play a key role in the successful parasitism of plants by phytonematodes. In this study, 210 genes obtained by transcriptomics analyses were found to be upregulated in B. xylophilus infecting Pinus massoniana that were not functionally annotated nor reported previously in B. xylophilus infecting P. thunbergii. Among these differentially expressed genes, a novel effector, BxICD1, that could induce cell death in the extracellular space of Nicotiana benthamiana was identified. BxICD1 was upregulated in the early stages of infection, as shown by RT-qPCR analyses. In situ hybridization analysis showed that BxICD1 was expressed in the esophageal gland of nematodes. The yeast signal sequence trap system indicated that BxICD1 possessed an N-terminal signal peptide with secretion functionality. Using an Agrobacterium-mediated transient expression system, it was demonstrated that the cell death-inducing activity of BxICD1 was dependent on N. benthamiana brassinosteroid-insensitive 1-associated kinase 1 (NbBAK1). Finally, BxICD1 contributed to B. xylophilus virulence and migration in host pine trees, as demonstrated by RNAi silencing assays. These findings indicate that BxICD1 both induces plant cell death and also contributes to nematode virulence and migration in P. massonian.

Background: Global evidence on the transmission of asymptomatic SARS-CoV-2 infection needs to be synthesized. Methods: A search of 4 electronic databases (PubMed, EMBASE, Cochrane Library, and Web of Science databases) as of January 24, 2021 was performed. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Studies which reported the transmission rate among close contacts with asymptomatic SARS-CoV-2 cases were included, and transmission activities occurred were considered. The transmission rates were pooled by zero-inflated beta distribution. The risk ratios (RRs) were calculated using random-effects models. Results: Of 4923 records retrieved and reviewed, 15 studies including 3917 close contacts with asymptomatic indexes were eligible. The pooled transmission rates were 1.79 per 100 person-days (or 1.79%, 95% confidence interval [CI] 0.41%–3.16%) by asymptomatic index, which is significantly lower than by presymptomatic (5.02%, 95% CI 2.37%–7.66%; p

The microstructure and mechanical properties of the novel cryogenic high-Mn austenitic steel weld metals with different cerium (Ce) contents were investigated via electron back-scattered diffraction, scanning and spherical aberration-corrected transmission electron microscopy, and cryogenic impact and tensile test. The results indicated that the crystallographic grain size was significantly refined, and the relative frequency of high-angle grain boundaries increased with the increase of Ce content. Ce element addition could modify the main inclusions from irregular Al2O3 into regular Ce-containing inclusions. Meanwhile, the inclusions gradually became fine and dispersed, and the volume fraction of inclusions decreased with the increase of Ce content from 0 to 870 ppm. The increase of Ce content continuously improved cryogenic impact toughness from 82 J to 116 J, and yield strength, tensile strength and total elongation all increased to different degrees. We found that in addition to the beneficial changes in inclusion modification, grain refinement and increase in the proportion of high-angle grain boundaries, the solid solution of Ce also played a crucial role in the mechanical properties.

Single-pass-welding thermal cycles with different peak temperatures (Tp) were reproduced by a Gleeble 3800 to simulate the heat-affected zone (HAZ) of a Fe-24Mn-4Cr-0.4C-0.3Cu (wt.%) high manganese austenitic steel. Then, the effect of Tp on the microstructure and mechanical properties of the HAZ were investigated. The results indicate that recrystallization and grain growth play dominant roles. Based on this, the HAZ is proposed to categorize into three zones: the recrystallization heat-affected zone (RHAZ) with a Tp of 700~900 °C, the transition heat-affected zone (THAZ) with a Tp of 900~1000 °C, and the coarse grain heat-affected zone (CGHAZ) with a Tp of 1000~1300 °C. The recrystallization fraction was 29~44% in the RHAZ, rapidly increased to 87% in the THAZ, and exceeded 95% in the CGHAZ. The average grain size was 17~19 μm in the RHAZ, slightly increased to 22 μm in the THAZ, and ultimately increased to 37 μm in the CGHAZ. The yield strength in the RHAZ and THAZ was consistent with the change in recrystallization fraction, while in the CGHAZ, it satisfied the Hall–Petch relationship with grain size. In addition, compared with the base material, the Charpy impact absorbed energy at −196 °C decreased by 22% in the RHAZ, but slightly increased in the CGHAZ. This indicates that the theory of fine grain strengthening and toughening is not entirely applicable to the HAZ of the investigated high-Mn steel.

The significant impact of Nb on ferrite transformation, both in terms of solute drag effect (SDE) and interphase precipitation, was investigated quantitatively. Ferrite transformation kinetics were characterized using thermal expansion experiments and theoretical calculations. The microstructures were characterized using high−temperature confocal laser scanning microscopy (CLSM), a field−emission scanning electron microscope (FESEM), and a transmission electron microscope (TEM). Under a higher driving force, interphase precipitations were observed in the sample with a higher Nb content. A three−dimensional (3D) reconstruction method was used to convert the two−dimensional (2D) image of interphase precipitation into a three−dimensional model for a more typical view. The SDE and interphase precipitation had opposite effects on the kinetics of ferrite transformation. A lower Nb content showed a strong contribution to the SDE, which delayed ferrite transformation. A higher concentration of Nb was expected to enhance the SDE, but the inhibition effect was eliminated by the interphase precipitation of NbC during interfacial migration. Both the experimental results and theoretical calculations confirmed this phenomenon.

BackgroundSleep disturbances are common in people living with Human Immunodeficiency Virus (HIV) and may lead to poor adherence to antiretroviral therapy and worsen HIV symptom severity. Due to the side effects of pharmacotherapy for sleep disturbances, there is more room for non-pharmacological interventions, but knowledge of how these non-pharmacological interventions have been used to improve sleep in people living with HIV (PLWH) is still missing.ObjectiveTo investigate the content of non-pharmacological interventions, sleep measurements, and the impact of these interventions on improving sleep in PLWH.MethodsFollowing PRISMA guidelines, we conducted a systematic search on PubMed, EMBASE, Cochrane Central Registry of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Web of Science, China National Knowledge Infrastructure, Wanfang Data, and China Biology Medicine disc. Non-pharmacological interventions for improving sleep in PLWH were included, and study quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists. We performed a narrative approach to synthesize the data to better understand the details and complexity of the interventions.ResultsFifteen experimental studies in three categories for improving sleep in PLWH were included finally, including psychological interventions (components of cognitive-behavioral therapy for insomnia or mindfulness-based cognitive therapy, n = 6), physical interventions (auricular plaster therapy, acupuncture, and exercise, n = 8), and elemental interventions (speed of processing training with transcranial direct current stimulation, n = 1). Wrist actigraphy, sleep diary, and self-reported scales were used to measure sleep. Psychological interventions and physical interventions were found to have short-term effects on HIV-related sleep disturbances.ConclusionsPsychological and physical interventions of non-pharmacological interventions can potentially improve sleep in PLWH, and the combination of patient-reported outcomes and actigraphy devices can help measure sleep comprehensively. Future non-pharmacological interventions need to follow protocols with evidence-based dosing, contents, and measures to ensure their sustainable and significant effects.

Backgrounds and purpose Childhood cancer survivors (CCSs) who transition through adolescence and enter young adulthood may suffer psychological, cognitive, social, fertility, and sexual issues and concerns. There is an urgent need for comprehensive intervention strategies to improve the transition of CCSs. Web-based technologies are gaining momentum as a new mechanism to provide healthcare and education for adolescents. However, previous frameworks have been limited in their effectiveness in explaining web-based interventions.This realist synthesis aims to synthesise current evidence on transition of CCSs to develop a framework for web-based interventions. The framework can foster understanding of the integrity of web-based intervention implementation chain, examine which mechanistic factors will be triggered by web-based interventions, note and examine the flows, blockages and points of contention in the implementation, to refine web-based interventions.Method and analysis A realist synthesis that adheres to the Realist and Meta-narrative Evidence Syntheses-Evolving Standard will be used. Studies will be identified through PubMed, Web of Science, EMBASE, PsycINFO, CINAHL, Ovid and Cochrane Library from the period of January 2005 to May 2023. We will also search the reference lists provided in relevant studies and reviews. Articles will be screened based on two principles: (1) Relevance: does the research address the initial programme theory? (2) Rigour: whether a particular inference drawn by the original researcher has sufficient weight to make a methodologically credible contribution to the test of the initial programme theory. No restrictions regarding the design or language of publication will be considered.Ethics and dissemination As a review, ethical approval is not required. The results from this study will be presented at international conferences and disseminated through peer-reviewed publications. Patients and the public will be involved in the dissemination plans.

Background: Occupational exposure is of increasing concern, posing a serious threat to nurses, especially in the event of a public health emergency. Bibliometrics sheds novel light on the current state of research and factors influencing nurses' occupational exposures, illuminating hot topics and trends in the literature. Bibliometrics is essential to analyze the potential harm to nurses in Asia. Methods: Data were extracted from the Web of Science Core Collection on August 6, 2022 with the following search terms: TS= (nurses) AND (TS= (occupational exposure OR occupational health)). CiteSpace and VOSviewer were used to analyze national and institutional collaborations, reference clustering, citations and co-citations of journals and keyword bursts, and HistCite was used to analyze the citation historiography map. To analyze the data and generate statistical charts, Origin and Microsoft Excel were utilized. Results: A total of 1448 studies on nurses' occupational exposure in Asia were identified. China Medical University had the most publications among Asian institutions, and China had the largest share among Asian countries. Most articles on nurses' occupational exposure in Asia were in the Journal of Occupational Health, and the journal with the highest impact factor was the Journal of Nursing Management. The COVID-19 outbreak caused a substantial shift in the direction of studies on nurses' occupational exposure in Asia. Mental health is a current hot topic, while sharps injuries and bodily fluid exposure are long-term priorities for attention. Conclusions: The hotspots of research on nurses' occupational exposure in Asia focus on mental health, burnout, blood exposure, infection, and sharps injury. Due to the COVID-19 pandemic, recent research has concentrated on personalized mental health care and the development of protective equipment, and cross-disciplinary collaboration may be a new trend in the future.

Abstract Background Depressive symptoms are highly prevalent among people living with HIV (PLWH). We leveraged Latent Profile Analysis (LPA) to identify profiles of depressive symptoms among PLWHs. We also investigated differences in psychological factors of interest, demographic characteristics, and HIV-related factors across patients’ profiles. Methods A cross-sectional study was conducted at one hospital and two designated prison facilities in Hunan province, China. A total sample of 533 PLWHs (320 recruited from the hospital, 213 recruited from prisons) completed the survey. Depressive symptoms were assessed using the 9-item Patient Health Questionnaire (PHQ-9). Family function, resilience, childhood trauma, demographic characteristics, and HIV-related factors were also evaluated. We conducted LPA and multinomial logistic regression analyses to: 1) identify distinct profiles for depressive symptoms; 2) identify demographic characteristics, and HIV-related, and psychological factors predicting PLWHs’ likelihood to express a specific profile. Results We identified three distinct profiles of depressive symptoms among PLWHs: severe symptoms (11.8%), moderate symptoms (40.5%), and low/no symptoms (47.7%). Moderate/ severe family dysfunction, low resilience, experiencing emotional abuse and neglect were more likely to fall in the “severe symptoms” rather than the “low/no symptoms” profile. In addition, severe family dysfunction, low resilience, and experiencing emotional neglect indicated a higher likelihood of being classified in the “moderate symptoms” profile, compared to the “low/no symptoms” profile. Conclusion Identifying profiles of depressive symptoms among PLWHs using the PHQ-9 items allows for understanding of the distinct paths of development of depressive symptoms and for developing tailored prevention and intervention programs for PLWHs.

Abstract Background G-quadruplexes (G4s) are unique noncanonical nucleic acid secondary structures, which have been proposed to physically interact with transcription factors and chromatin remodelers to regulate cell type-specific transcriptome and shape chromatin landscapes. Results Based on the direct interaction between G4 and natural porphyrins, we establish genome-wide approaches to profile where the iron-liganded porphyrin hemin can bind in the chromatin. Hemin promotes genome-wide G4 formation, impairs transcription initiation, and alters chromatin landscapes, including decreased H3K27ac and H3K4me3 modifications at promoters. Interestingly, G4 status is not involved in the canonical hemin-BACH1-NRF2-mediated enhancer activation process, highlighting an unprecedented G4-dependent mechanism for metabolic regulation of transcription. Furthermore, hemin treatment induces specific gene expression profiles in hepatocytes, underscoring the in vivo potential for metabolic control of gene transcription by porphyrins. Conclusions These studies demonstrate that G4 functions as a sensor for natural porphyrin metabolites in cells, revealing a G4-dependent mechanism for metabolic regulation of gene transcription and chromatin landscapes, which will deepen our knowledge of G4 biology and the contribution of cellular metabolites to gene regulation.

Model transfer techniques in near infrared spectroscopy are important for avoiding duplicate modeling, sharing samples and data resources, and reducing the human and material consumption required for modeling. Use of the slope/bias correction algorithm (S/B) based on screening wavelengths with consistent and stable signals (SWCSS) for model transfer is a new strategy. To enable sharing of near infrared analysis models of pulp holocellulose and lignin content in two different types of spectroscopic instruments, a combined SWCSS-S/B algorithm was proposed. The stable and consistent wavelengths between the spectroscopic instruments screened by the SWCSS method reduced the differences between the instruments, thereby improving the universality and transmission accuracy of the S/B method. The SWCSS-S/B based model transfer method reduced the predicted standard deviation RMSEP of holocellulose and lignin contents of the samples measured on the target spectrometer of the from 5.4686 and 7.6823 to 1.2133 and 1.3494, respectively. This result showed a significant improvement in the transfer effect compared to the SWCSS and S/B correction results alone, and the prediction of holocellulose was better than that of the prediction effect of lignin. The method has fewer wavelength variables involved in model transfer, fast transfer speed, and high prediction accuracy, which provides a new solution for the wide application of NIR analytical models.

We elucidate here the grain orientation/grain boundary dependence on the deformation behavior of high-Mn steel via tensile tests. The ultra-fine grained/fine grained (UFG/FG) specimen was characterized by superior strength-ductility combination as compared to the as-received specimen. In order to establish the relationship between macro and micro/nano, nanoscale deformation experiments and post-mortem microscopy of the deformed region were conducted on near-defect-free (NDF) specimen, avoiding the influence of defects. Weak anisotropy in elastic modulus and hardness was observed for NDF specimen. The modulus and hardness of grain boundary were 163 GPa and 4.32 GPa, respectively, which were relatively greater as compared to the grain interior, revealing significant grain boundary effect. Indentations in the “grain interior” had highest frequency of ratio of c/d (c - the plastic zone radius, d - distance of the indent from the grain boundary) of ∼1.2, irrespective of the orientation the indents located, implying that the ratio is a property related to the grain boundary. The higher strengthening effect at the high angle grain boundary could be attributed to higher strain and geometry necessary dislocation density surrounded the grain boundary. The strain rate sensitivity (m) and activation volume (v) obtained from nanoindentation had weak dependence on grain orientation and v was ∼5–15 b3, indicating that neither diffusional creep processes nor conventional dislocation by-pass governs plastic deformation independently. With the increase of v, the deformation mechanism transfers from dislocation slip dominant to SFs dominant, and finally twining dominant.

IntroductionPatient activation is determined by an individual’s knowledge, skills and confidence in managing his/her health. It is vital for people living with HIV (PLWH) to enhance their self-management skills and health outcomes, especially those from low- and middle-income regions, since they are at higher risk of worse health outcomes. However, literature from those regions is limited, especially in China.ObjectivesThis study aimed to explore the status and factors associated with patient activation among Yi minority PLWH in Liangshan, China and to determine whether patient activation is associated with HIV clinic outcomes.MethodsThis cross-sectional study included 403 Yi minority people living with HIV in Liangshan between September and October 2021. All participants completed an anonymous survey measuring sociodemographic characteristics, HIV-related information, patient activation and illness perception. Multivariate linear regression and multivariate binary logistic regression were used to explore factors associated with patient activation and the association between patient activation and HIV outcomes, respectively.ResultsThe Patient Activation Measure (PAM) score was low (mean = 29.8, standard deviation = 4.1). Participants with negative illness perception, low income, and self-rated antiretroviral therapy (ART) effect based on self-perception were most likely to have a lower PAM score (β = −0.3, −0.2, −0.1, respectively; all p

IntroductionDelayed antiretroviral therapy (ART) initiation is associated with poor HIV outcomes and a higher likelihood of HIV transmission.MethodsThis cross-sectional study assessed the proportion of delayed ART initiation which was defined as initiating ART after 30 days of HIV diagnosis, and evaluated the pathways influencing ART initiation among adult PLWH in Changsha, China who were diagnosed between 2014 and 2022.ResultsOf 518 participants, 37.8% delayed in initiating ART. Based on the theory of reasoned action (TRA), delayed initiation was indirectly associated with perceptions toward ART through the mediating pathway of patients’ treatment willingness, with treatment willingness significantly being the full mediator.DiscussionThe findings may guide the development of interventions to improve timely uptake of ART in people who are newly diagnosed with HIV.

This article explores the challenges of continuum and magnetic soft robotics for medical applications, extending from model development to an interdisciplinary perspective. First, we established a unified model framework based on algebra and geometry. The research progress and challenges in principle models, data-driven, and hybrid modeling were then analyzed in depth. Simultaneously, a numerical analysis framework for the principle model was constructed. Furthermore, we expanded the model framework to encompass interdisciplinary research and conducted a comprehensive analysis, including an in-depth case study. Current challenges and the need to address meta-problems were identified through discussion. Overall, this review provides a novel perspective on understanding the challenges and complexities of continuum and magnetic soft robotics in medical applications, paving the way for interdisciplinary researchers to assimilate knowledge in this domain rapidly.

Objectives: To explore the relationship between acceptance of illness and quality of life (QOL), and factors associated with acceptance of illness among men who have sex with men (MSM) living with human immunodeficiency virus (HIV). Methods: Three hundred and one MSM were recruited from an HIV clinic between August and December 2018. The battery of measurements consisted of the Acceptance of Illness Scale, World Health Organization Quality of Life Questionnaire for HIV brief version, HIV Cognitive Appraisal Scale and a self-designed questionnaire used to collect general information. Pearson correlation test was used to examine the relationship between acceptance of illness and QOL. Univariate and multivariate ordinal logistic regression analyses were used to examine whether the general data (demographic and HIV-related clinical data) and HIV cognitive appraisal were associated with acceptance of illness levels. Results: Descriptive analysis showed the acceptance level among MSM living with HIV was moderate (Mean = 26.29, SD = 5.28). Those with a better acceptance of illness had a better QOL (r = 0.69, P

BackgroundPeople living with HIV frequently report sleep disturbances. The social zeitgeber theory, which proposes that stressful life events can interfere with sleep and even depression by destabilizing daily routines, provides new insights into identifying predictors of sleep disturbances and improving sleep in people living with HIV.ObjectiveTo explain the pathways affecting sleep quality in people living with HIV based on social zeitgeber theory.MethodsA cross-sectional study was conducted to assess sleep quality, social rhythms, depression, social support, and coping styles from December 2020 to February 2021. The hypothetical model was tested and respecified by performing path analysis and a bias-corrected bootstrapping method using IBM AMOS 24 software. The report of this study followed the STROBE checklist.ResultsA total of 737 people living with HIV participated in the study. The final model presented a good fit (goodness of fit = 0.999, adjusted goodness of fit index = 0.984, normed fit index = 0.996, comparative fit index = 0.998, Tucker–Lewis index = 0.988, root mean square error of approximation = 0.030, chi-squared/degree of freedom = 1.646), explaining 32.3% of the variance in sleep quality among people living with HIV. Lower social rhythm stability was directly associated with poorer sleep quality, and depression mediated the relationship between social rhythms and sleep quality. Social support and coping styles affected sleep quality through social rhythms and depression.LimitationThe cross-sectional study design precludes making assumptions about causality among factors.ConclusionThis study validates and extends the applicability of the social zeitgeber theory in the HIV context. Social rhythms have direct and indirect effects on sleep. Social rhythms, sleep, and depression is not simply linked in a cascading sequence but is theoretically linked in a complex way. More studies are needed to explore the predictors of social rhythms, and interventions for stabilizing social rhythms have the potential to alleviate sleep disturbances and depression in people living with HIV.

The running time of pigs in submarine pipelines is an important reference for pig receiving operation. In order to identify the factors that influence the running time of pigs, the correlation degree of pipeline mileage, pipeline inlet/outlet pressure difference, gas transport capacity, pipeline inlet/outlet temperature difference, amount of interference, pig quality, oil transport capacity and water cut was calculated with the grey incidence analysis method. Meanwhile, the incidence between the influencing factors and the running time of pigs was also analyzed, and on this basis, a BP neural network prediction model of pig running time in the network structure of (8, 11, 1) was established. Then, the running time of pig in submarine pipeline was predicted and verified based on the data record of pigging operation in a submarine pipeline of the Bohai Oilfield. It is indicated that the running time of pigs predicted by the BP prediction model has an average error of 8 min and an average relative error of 12.5%. In general, the research results could provide reference for the preparation of a reasonable plan for pig receiving operation in the submarine pipelines.

Objectives: To investigate health literacy profiles using a multidimensional tool in the elderly, analyze the factors related to health literacy, and explore the relationships between health literacy and health-related behaviors. Methods: A cross-sectional survey including 440 participants was conducted at a community health center and a village health center in Changsha, Hunan Province, between June 2020 and August 2020. We used the Health Literacy Questionnaire (HLQ) to assess the elderly’s health literacy. Sociodemographic data and health-related behaviors of them were surveyed with a self-designed questionnaire. Latent profile analysis, Pearson’s chi-squared and ordinal logistic regression were used to analyze the data. Results: The median age of the 440 respondents was 68 years. The participants had the lowest scores in the “appraisal of health information” subscale (2.22 ± 0.52), followed by “navigating the healthcare system” subscale (2.89 ± 0.81) of HLQ. Based on the analysis of three profiles, respondents who were 60–74 years (OR = 2.06, 95% CI: 1.23–3.42, P = 0.006), living in urban areas (OR = 3.28, 95% CI: 2.17–4.94, P

Green plums are a characteristic fruit resource in China, with a long history of cultivation. Many surface defects will appear in the growth, transportation and preservation of green plums which seriously affect the processing quality of by-products. The existing manual sorting method of green plums is limited by the experience of workers. It is difficult to ensure the quality and speed of detection. Therefore, the formation of automatic detection of green plums surface defects is of great significance to the development of green plum industry. According to the surface defects of green plums, this paper divides green plums into five categories: rot, cracks, scars, rain spots and normal. A total of 1235 images of green plums were obtained by self-built image acquisition device. The WideResNet50-AdamW-Wce model based on WideResNet model was built to classify the surface defects of green plums. Accuracy, recall and F1-measure were selected as the indexes to evaluate the accuracy of classification. The accuracy of classification reached 98.95%, and the classification accuracy of rain spots, normal, scars, rot and crack reached 100%, 99.56%, 98.59%, 98.25% and 96.10% respectively. Comparing the performance of ResNet50-SGD, WideResNet50-SGD, WideResNet50-SGD-Wce, and WideResNet50-AdamW network models, the F1-Measure based on WideResNet50-AdamW-Wce is the highest in each defect, and more greengage defect features can be learned. The detection results can meet the production needs of plum deep processing enterprises – evaluating 1800 green plums per hour on the assembly line.

Abstract Background People living with HIV (PLWH) carry a high risk for mental health problems, which has been extensively reported in the literature. However, an understanding of mental health characteristics in different subgroups of PLWH is still limited. In the present study, we conducted a cross-sectional survey to explore mental health characteristics and their associations with childhood trauma in two major subgroups of PLWH in China. Methods A total of 533 PLWH (213 prisoners in the prison system, and 320 outpatients) were assessed using the 8-item Positive Subscale of the Community Assessment of Psychic Experiences (CAPE-P8), Generalized Anxiety Disorder scale (GAD-7), Patient Health Questionnaire (PHQ-9), and Childhood Trauma Questionnaire (CTQ). Results From the total sample, 22.0% PLWH frequently experienced psychotic-like experiences (PLEs), 21.8% had clinically significant anxiety syndrome, 34.0% had clinically significant depressive syndrome, and 63.6% experienced at least one type of traumatic exposure during their childhood, with physical neglect being the most common. Compared to outpatients with HIV, prisoners living with HIV reported more severe mental health problems and a higher frequency of childhood trauma, with childhood trauma in turn predicting higher risk for mental health problems. Similarly, among outpatients living with HIV, both childhood emotional and sexual abuse had predictive effects on all the three mental health problems. Conclusions The study suggests that PLWH have higher risk of anxiety, depression and PLEs, and childhood trauma could serve as predicting factors for such risks. In addition, childhood trauma may play distinct roles in predicting the risk for the mental health problems, depending on different subgroup of PLWH.

While inhibition of the EZH2 methyltransferase activity has been used for targeting EZH2, its role in cancer progression remains unclear. Here, the authors use neuroblastoma and small cell lung carcinoma model systems and reveal the crosstalk between EZH2 and MYC(N) in the regulation of tumour formation.

Background: The association between immune imbalances and adverse pregnancy outcomes has been extensive investigated by observational studies, but remain unclear. Thus, this study aimed to establish the causality of the circulation levels of cytokines on adverse pregnancy outcomes, such as offspring’s birthweight (BW), preterm birth (PTB), spontaneous miscarriage (SM), and stillbirth (SB).Methods: Two-sample Mendelian randomization (MR) analysis was employed to investigate potential causal relations between 41 cytokines and pregnancy outcomes on the basis of previously published GWAS datasets. Multivariable MR (MVMR) analysis was implemented to investigate the effect of the composition of cytokine networks on the pregnancy outcomes. Potential risk factors were further estimated to explore the potential mediators.Results: Genetic correlation analysis based on large GWAS data sources revealed that genetically predicted MIP1b (β = −0.027, S.E. = 0.010, p = 0.009) and MCSF (β = −0.024, S.E. = 0.011, p = 0.029) were associated with reduced offspring’s BW, MCP1 (OR: 0.90, 95% CI: 0.83–0.97, p = 0.007) was associated with reduced SM risk, SCF (β = −0.014, S.E. = 0.005, p = 0.012) associated with decreased number of SB in MVMR. The univariable MR showed that GROa (OR: 0.92, 95% CI: 0.87–0.97, p = 0.004) was associated with decreased PTB risk. Except for the MCSF-BW association, all above associations surpassed the Bonferroni corrected threshold. The MVMR results revealed that MIF, SDF1a, MIP1b, MCSF and IP10 composed cytokine networks, associated with offspring’s BW. Risk factors analysis indicated that the above causal associations might be mediated by smoking behaviors.Conclusion: These findings suggest the causal associations of several cytokines with adverse pregnancy outcomes, which were potentially mediated by smoking and obesity. Some of the results did not been corrected through multiple tests and larger samples verification is required in further studies.

Adenosine receptors play a key role in cancer progression. This study investigated the effect of the adenosine A2B receptor (ADORA2B) on epithelial–mesenchymal transition (EMT) markers and cell metastasis of gastric cancer (GC) cells. Public databases were used to investigate the specificity of ADORA2B expression in GC tissue. We used immunohistochemistry and immunofluorescence to detect ADORA2B expression in GC tissue, paracancerous tissue, and metastatic greater omental tissue. AGS and HGC-27 GC cells were selected. The effect of ADORA2B on the invasion and migration of GC cells was examined using cell scratch and transwell assays. The effect of ADORA2B on the expression of EMT marker proteins (β-catenin, N-cadherin, and vimentin) in GC cells was measured by cellular immunohistochemistry, immunofluorescence, and Western blot. The effects of an ADORA2B inhibitor combined with cisplatin on EMT markers in GC cells were further explored. The expression levels of ADORA2B in GC tissue, metastatic greater omental tissue, and lymphatic metastasis tissue were significantly higher than those in paracancerous tissue, and ADORA2B was associated with lymph node metastasis and invasion. ADORA2B significantly regulated the invasion and migration ability of GC cells and the expression levels of EMT marker proteins. The combination of an ADORA2B antagonist (PSB-603) and cisplatin had a more significant effect on reversing the expression of EMT marker proteins. ADORA2B was overexpressed in GC tissue, metastatic greater omental tissue, and metastatic lymph node tissue. ADORA2B regulated the expression of EMT marker proteins in GC cells and affected GC cell metastasis. Antagonizing ADORA2B expression increased the efficacy of cisplatin treatment.

ObjectiveHIV continues to be a global challenge. Key recommendations for HIV prevention and treatment are presented on rapid antiretroviral therapy (ART) initiation. However, several studies showed a high prevalence of delayed ART initiation. The aim of this systematic review and meta-analysis was to assess the prevalence of delayed ART initiation among HIV-infected patients globally.MethodsThis review summarised eligible studies conducted between January 2015 and August 2022 on the prevalence of delayed ART initiation in HIV-infected adults (age ≥ 15). Relevant studies were systematic searched through PubMed/Medline, EMBASE, Web of Science, China National Knowledge Infrastructure, Wanfang, and Chongqing VIP databases. Random-effects models were used to calculate pooled prevalence estimates. The heterogeneity was evaluated using Cochran's Q test and I2 statistics. Moreover, potential sources of heterogeneity were explored using univariate subgroup analysis.ResultsData on the prevalence of delayed ART initiation was pooled across 29 studies involving 34,937 participants from 15 countries. The overall pooled prevalence of delayed ART initiation was 36.1% [95% confidence interval (CI), 29.7-42.5%]. In subgroup analysis, the estimated pooled prevalence decreased with age. By sex, the prevalence was higher among male patients (39.3%, 95% CI: 32.2-46.4%) than female (36.5%, 95% CI: 26.9-50.7%). Patients with high CD4 cell count were more likely to delay ART initiation than those with low CD4 cell count (>500cells/mm3: 40.3%; 201-500cells/mm3: 33.4%; and ≤200cells/mm3: 25.3%).ConclusionsOur systematic review and meta-analysis identified a high prevalence of delayed ART initiation. The prolonged time interval between diagnosis and treatment is a prevalent and unaddressed problem that should spur initiatives from countries globally. Further research is urgently needed to identify effective strategies for promoting the early ART initiation.

Background Improving depression is critical to the success of HIV treatment. Concerns about the adverse effects of pharmacotherapy have led to non-pharmacological treatments for depression in people living with HIV (PLWH) becoming increasingly popular. However, the most effective and acceptable non-pharmacological treatments for depression in PLWH have not yet been determined. This protocol for a systematic review and network meta-analysis aims to compare and rank all available non-pharmacological treatments for depression in PLWH in the global network of countries as well as in the network of low-income and middle-income countries (LMICs) only. Methods We will include all randomized controlled trials of any non-pharmacological treatments for depression in PLWH. The primary outcomes will consider efficacy (the overall mean change scores in depression) and acceptability (all-cause discontinuation). Published and unpublished studies will be systematically searched through the relevant databases (PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, CINAHL, ProQuest, and OpenGrey), international trial registers, and websites. There is no restriction by language and publication year. All study selection, quality evaluation, and data extraction will be independently conducted by at least two investigators. We will perform a random-effects network meta-analysis to synthesize all available evidence for each outcome and obtain a comprehensive ranking of all treatments for the global network of countries as well as for the network of LMICs only. We will employ validated global and local approaches to evaluate inconsistency. We will use OpenBUGS (version 3.2.3) software to fit our model within a Bayesian framework. We will evaluate the strength of evidence using the Confidence in Network Meta-Analysis (CINeMA) tool, a web application based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Ethics and dissemination This study will use secondary data and therefore does not require ethical approval. The results of this study will be disseminated through peer-reviewed publication. Trial registration PROSPERO registration number: CRD42021244230.

BackgroundMen who have sex with men (MSM) living with HIV suffer from psychosocial pressures and marginalization as a result of being HIV-positive and belonging to a sexual minority group, and self-injury or suicidal ideation are prevalent among this group. Studies have found that both perceived self-stigma and altered executive function is related to self-injury or suicidal ideation. However, the combined contribution of self-stigma and executive function to self-injury or suicidal ideation remains unclear, especially in MSM living with HIV. Therefore, this study is conducted to explore the mechanism of self-injury or suicidal ideation by hypothesizing that executive function plays a mediating role in the relationship between self-stigma and self-injury or suicidal ideation.MethodsWe conducted a cross-sectional survey among 448 MSM living with HIV who were recruited in the HIV clinic of a tertiary general hospital in Changsha, China, from November 2021 to February 2022. A questionnaires survey was adopted to collect sociodemographic and disease-related information and data related to executive function (including working memory, inhibition, and task monitoring), self-stigma, and self-injury or suicidal ideation. Structural equation modeling and bootstrap testing were used to investigate the potential mediating role of executive function in the relationship between self-stigma and suicidal ideation.ResultsThe participants were aged 18–76 years. Those who had ever had self-injury or suicidal ideation accounted for 32.8% of the total. A higher level of self-stigma and poorer executive function were associated with more frequent self-injury or suicidal ideation (p < 0.01). The mediation model analysis showed a good fit (x2/df = 1.07, p = 0.381). The direct effect of self-stigma on self-injury or suicidal ideation (β = 0.346, p < 0.001) and the indirect effect of self-stigma via executive function (β = 0.132, p < 0.001) were significant, with the indirect effect accounting for 27.6% of the total effect.ConclusionsThis study demonstrates that executive function mediates the relationship between self-stigma and self-injury or suicidal ideation among MSM living with HIV. It suggests that future studies targeting enhancing executive function and decreasing self-stigma may reduce self-injury or suicidal ideation among MSM living with HIV.

Abstract Background There are increasing Chinese migrants in sub-Saharan Africa currently. Most of them are engaged in infrastructure construction. Research has shown that they stay at particular risk of HIV and are recommended for HIV testing. However, their HIV testing behavior, and its relevant factors, have not been researched among them by now. This study describes the recent HIV testing behavior and relevant factors among Chinese migrant workers in Kenya. Methods A cross-sectional survey was conducted among 110 male Chinese workers from six different Chinese infrastructure construction enterprises in Kenya. Furthermore, a two-stage cluster random sampling method was used to select participants. We used a questionnaire that included HIV testing history, demographic characteristics, and putative multilevel facilitators of HIV testing. Logistic regression was used to explore the predictors of recent HIV testing behavior among Chinese migrant workers in Kenya. Result Of the 110 participants, 30 (27.27%) were tested for HIV in the recent year. All participants were male, and the majority were married (73.2%). The mean age was 37.49 years (SD = 9.73; range: 23 to 63), and a considerable proportion refused to answer questions about transactional sexual behaviors in the last year. Most were able to obtain HIV-related information (91.8%) and were exposed to HIV-related information in the last year (68.2%), but only 47.6% had sufficient HIV knowledge. Nearly one-fifth of them believed that selling sex and paying for sex is acceptable. Multiple logistic regression analysis indicated that participants who could accept the ‘pay for sex’ (OR: 2.74; 95% CI: 1.02, 7.36) and exposed to HIV related information (OR: 4.75; 95% CI: 1.29, 17.44) were more likely to test for HIV in the recent 1 year. Conclusion Higher current HIV test rates were associated with a more open sexual attitude towards paying for sex and being exposed to HIV-related information in the last year among Chinese workers in Kenya. More specific attention to HIV should be attached to this population to increase the rate of HIV testing among them.

Objectives To explore genetic/genomic nursing competency and associated factors among nurses from tertiary general and specialist cancer hospitals in mainland China and compare the competencies of nurses from the two types of hospitals.Design and setting A cross-sectional survey was conducted from November 2019 to January 2020, wherein 2118 nurses were recruited from 8 tertiary general hospitals and 4 cancer hospitals in mainland China. We distributed electronic questionnaires to collect data on nurses’ demographics, work-related variables and genomic nursing competency.Participants 2118 nurses were recruited via a three-stage stratified cluster sampling method.Results More than half (59.1%, 1252/2118) of the participants reported that their curriculum included genetics/genomics content. The mean nurses’ genomic knowledge score was 8.30/12 (95% CI=8.21 to 8.39). Only 5.4% had always collected a complete family history in the past 3 months. Compared with general hospital nurses, slightly more cancer hospital nurses (75.6% vs 70.6%, p=0.010) recognised the importance of genomics, while there was no significant difference in the knowledge scores (8.38 vs 8.21, p>0.05). Gender (β=0.06, p=0.005), years of clinical nursing (β=−0.07, p=0.002), initial level of nursing education (β=0.10, p

HIV infection becomes a manageable disease, and self-management is one of the key indicators of achieving optimal health outcomes. Men who have sex with men (MSM) living with HIV face many psychosocial challenges when managing HIV infection, such as sexual minority pressure and HIV-related stigma. Higher perceived HIV-related stigma had been related to low self-management. However, the mechanisms underlying the association between HIV-related stigma and HIV self-management are unclear. Two possible mediators include social support and self-efficacy. This study aimed to examine the relationship between HIV-related stigma and HIV self-management among MSM living with HIV and to explore the single mediating effect of social support and self-efficacy and the chain mediating effect of these two variables on this relationship in China. Convenience sampling was used to recruit participants from the Center for Disease Control (CDC) in Changsha City, Hunan province, China. A total of 459 MSM living with HIV completed questionnaires regarding sociodemographic and disease-related information, HIV-related stigma, social support, self-efficacy, and HIV self-management. Descriptive statistics analysis, one-way ANOVA, independent t-tests, Pearson’s bivariate correlation, and multiple regression were conducted using the SPSS v24.0. Process macro in SPSS was used to analyze the single and chain mediating effect among variables. Our findings showed that the indirect and total effect of HIV-related stigma on HIV self-management was significant, while the direct effect was not statistically significant. Social support and self-efficacy mediated the relationship between HIV-related stigma and HIV self-management, respectively. Moreover, the chain mediating model confirmed that the association between HIV-related stigma and HIV self-management was mediated by social support and self-efficacy sequentially. Future interventions focusing on improving HIV self-management among MSM living with HIV should consider a multi-faced approach.

In this paper, sulfur doped g-C3N4 (S-g-C3N4) was successfully prepared at 500 °C for 3 h via a modified molten salt method using dicyandiamide as the main raw material, trithiocyanuric acid as the sulfur source and LiBrKCl as the reaction medium. The as-prepared SCN5.0% sample (the mass ratio of trithiocyanuric acid to dicyandiamide was 5.0%) composed of irregular flakes showed a band gap of 1.83 eV, which was narrower than that (2.55 eV) of pristine g-C3N4. The SCN5.0% sample also exhibited an outstanding absorption capacity of visible light. Moreover, the photodegradation rate toward methylene blue and tetracycline were respectively 10 and 20 times as high as that of bulk g-C3N4 prepared by conventional heating methods, confirming its superior photocatalytic performance. These results can be attributed to that the replacement of lattice nitrogen with sulfur atom tuned the electronic structure of g-C3N4, improved the absorption of visible light, optimized the separation of photogenerated electron-hole pairs, and consequently enhanced the photocatalytic activity of g-C3N4. Moreover, the trapping experiments implied that hole (h+) and superoxide radical (·O2−) were the main active species in the process of photodegradation.

Numerous ethical issues surged the moment acquired immunodeficiency syndrome (AIDS) was discovered. As advocates of people living with HIV/AIDS (PLWHA), health professionals encounter many ethical dilemmas in clinical practice. However, it remains unclear how health professionals solve these issues. The descriptive qualitative research was conducted through semi-structured interviews with 22 health professionals from May to August 2018. Three themes emerged from data analyses of the interviews: (1) real ethical dilemma experienced by health professionals, (2) factors influencing ethical judgment, (3) ethical motivations. About two-thirds of participants failed to recall ethical dilemmas experienced in their clinical practice. Emotions, gender, occupation, and difficulty balancing different roles may influence the ethical judgments of health professionals. In the ethical decision-making (EDM) process, most participants took other people’s interests into consideration and conformed to law and professional codes of conduct. However, the fear of medical disputes (conflicts with families and others) was experienced by many participants, influencing their ethical behaviors.

Introduction Academic-practice partnerships are a promising strategy that could strengthen the promotion and innovation of evidence-based nursing practice (EBNP). However, there is little evidence of how academic and clinical institutions and individuals should collaborate in each process of EBNP and the factors that influence academic-practice partnerships in EBNP. There is a pressing need to explore the extent of the literature on academic-practice partnerships in EBNP, as well as to classify, compare and summarise the results or opinions obtained from various types of literature to identify both existing knowledge and gaps in the research.Methods and analysis The scoping review will be conducted following the methodological guidelines provided by the JBI. The scoping review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Seven databases, including the Cochrane Library, PubMed, Web of Science, CINAHL, EMBASE, SCOPUS, Educational Resource Information Center and two Chinese databases (ie, CNKI and WANFANG DATA), will be searched. The grey literature will also be searched using the American Association of Colleges of Nursing, American Nurses Association, Open Grey, Grey Literature Report and the official website of JBI. The literature screening and data extraction will be conducted independently by two researchers. A third researcher will be involved when a consensus is needed.Ethics and dissemination Ethics approval is not required. The findings of the scoping review will be disseminated in a conference and a peer-reviewed journal.

ObjectiveThis study aims to evaluate the association between polycystic ovary syndrome (PCOS) phenotypes and adverse perinatal outcomes, comparing the characteristics, ovarian response, and assisted reproductive outcomes in patients with various PCOS phenotypes after in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI).MethodsThis study comprised 6,732 patients who underwent the first cycle of IVF/ICSI treatment in our outpatient department from January 2017 to July 2018. Propensity score matching (PSM) was used in PCOS and non-PCOS groups to balance the influence of intergroup confounding factors. After the PSM procedure, 1,186 patients were included in the two groups, and the PCOS patients were further divided into four PCOS phenotype groups based on the Rotterdam criteria.ResultsPatients with various PCOS phenotypes had similar rates of biochemical pregnancy, clinical pregnancy, and live birth (all P-values > 0.05). The overall incidence of adverse pregnancy outcomes (including ectopic pregnancy, miscarriage, preterm birth) was significantly higher in PCOS phenotype A and D groups than in the control group (44% and 46.4% vs. 28.7%, P = 0.027). The rates of hypertensive disorder of pregnancy (HDP) were significantly higher in PCOS phenotype A and C groups than in the control group (9.3% and 12.5% vs. 3.1%, P = 0.037). After adjustment for potential confounders, the differences in adverse pregnancy outcomes persisted (P = 0.025).ConclusionsThe overall incidence of adverse pregnancy outcomes is higher in women with PCOS phenotypes A and D than in women with non-PCOS.

Abstract Background Karyopherin α-2 (KPNA2) is a member of karyopherin family, which is proved to be responsible for the import or export of cargo proteins. Studies have determined that KPNA2 is associated with the development and prognosis of various cancers, yet the role of KPNA2 in ovarian carcinoma and its potential molecular mechanisms remains unclear. Materials and methods The expression and prognosis of KPNA2 in ovarian cancer was investigated using GEPIA and Oncomine analyses. Mutations of KPNA2 in ovarian cancer were analyzed by cBioPortal database. The prognostic value of KPNA2 expression was evaluated by our own ovarian carcinoma samples using RT-qPCR. Subsequently, the cell growth, migration and invasion of ovarian cancer cells were investigated by CCK-8 and transwell assay, respectively. The protein levels of KPNA2 and KIF4A were determined by western blot. Results We obtained the following important results. (1) KPNA2 and KIF4A wereoverexpressed in ovairan cancer tissues and cells. (2) Among patients with ovarian cancer, overexpressed KPNA2 was associated with lower survival rate. (3) Mutations (R197* and S140F) in KPNA2 will have some influences on protein structure, and then may cause protein function abnormal. (4) KPNA2 konckdown inhibited proliferation, migration, invasion, as well as the expression of KIF4A. Conclusion KPNA2, as a tumorigenic gene in ovarian cancer, accelerated tumor progression by up-regulating KIF4A, suggesting that KPNA2 might be a hopeful indicator of treatment and poor prognosis.

The integration of transcriptome and proteome analysis can lead to the discovery of a myriad of biological insights into ovarian cancer. Proteome, clinical, and transcriptome data about ovarian cancer were downloaded from TCGA’s database. A LASSO–Cox regression was used to uncover prognostic-related proteins and develop a new protein prognostic signature for patients with ovarian cancer to predict their prognosis. Patients were brought together in subgroups using a consensus clustering analysis of prognostic-related proteins. To further investigate the role of proteins and protein-coding genes in ovarian cancer, additional analyses were performed using multiple online databases (HPA, Sangerbox, TIMER, cBioPortal, TISCH, and CancerSEA). The final resulting prognosis factors consisted of seven protective factors (P38MAPK, RAB11, FOXO3A, AR, BETACATENIN, Sox2, and IGFRb) and two risk factors (AKT_pS473 and ERCC5), which can be used to construct a prognosis-related protein model. A significant difference in overall survival (OS), disease-free interval (DFI), disease-specific survival (DSS), and progression-free interval (PFI) curves were found in the training, testing, and whole sets when analyzing the protein-based risk score (p < 0.05). We also illustrated a wide range of functions, immune checkpoints, and tumor-infiltrating immune cells in prognosis-related protein signatures. Additionally, the protein-coding genes were significantly correlated with each other. EMTAB8107 and GSE154600 single-cell data revealed that the genes were highly expressed. Furthermore, the genes were related to tumor functional states (angiogenesis, invasion, and quiescence). We reported and validated a survivability prediction model for ovarian cancer based on prognostic-related protein signatures. A strong correlation was found between the signatures, tumor-infiltrating immune cells, and immune checkpoints. The protein-coding genes were highly expressed in single-cell RNA and bulk RNA sequencing, correlating with both each other and tumor functional states.

The novel high-Mn austenitic steel is becoming a promising steel for cryogenic applications of LNG tanks. The welded joints take a critical role in cryogenic service for storage tanks. In this work, we developed well-matched high-Mn welding consumables and prepared the welded joints by shielded metal arc welding (SMAW), submerged arc welding (SAW) and gas tungsten arc welding (GTAW). The detailed welding parameters were proposed first, then the welding quality, mechanical properties, and microstructure were investigated. The results show that good welding quality, excellent mechanical properties, and stable levels of mechanical properties were obtained for high-Mn steel welded joints using similar welding consumables, the solid core of electrodes, and solid welding wires. Notably, the lowest cryogenic absorbed energy was found at 5 mm away from the fusion line rather than at the fusion line. The hardness of the welded joints was detected to be less than 280 HV due to the whole austenitic microstructure.

ObjectivesTo investigate the characteristics of neck–shoulder pain (NSP) and explore the potentional relationship between the NSP and the individual and work organizational variables.MethodsA cross-sectional study was performed in the tertiary general hospitals in Hunan Province, China between May 2019 and July 2019. A total of 2,030 healthcare workers were enrolled randomly in this study based on a three-stage stratified sampling method. The Neck Disability Index (NDI) was used to measure disability in subjects with neck pain. A self-administered questionnaire was used to assess the characteristics of individual and work organizational variables. The Mann–Whitney U test and the Kruskal–Wallis H test were applied to analyze the prevalence of pain intensity among groups. Multivariate linear regression analysis was performed to explore the potentional relationship between NSP and individual and work organizational variables using the NDI score as the dependent variable.Results2,008 of 2,030 healthcare workers filled out the survey questionnaires online. In the past 12 months, 1,489 participants (74.2%) complained of pain in the cervical–shoulder region. NDI score increased by 0.10 for each year of age, with healthcare workers working in Obstetrics and Gynecology, and the Operating Room less likely to have NSP than those working in other departments. In contrast, female healthcare workers with a history of pregnancy were more likely to have NSP. In terms of organizational factors, workers who received concern from their supervisor about their health, who had the choice to change their shift status to off duty when they were not feeling well, or who were informed about WMSDs were less likely to have NSP.ConclusionThe prevalence of NSP within the previous year was high in this population. Individual factors including history of neck–shoulder diseases, age, and history of pregnancy and organizational factors including being adequately informed regarding WMSDs, concern from supervisors about workers' health, and the ability of workers to change their shift status to off duty when they were not feeling well were shown to induce significant effects to NSP.