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Although parental HIV disclosure has benefits for parents and children, the disclosure rate among parents remains low. This study aims to qualitatively examine parental concerns regarding disclosure of their HIV status to their children. Eighty parents were enrolled in a randomized controlled trial of a three-session disclosure-support intervention, with forty receiving the intervention and forty receiving treatment as usual. Intervention sessions were audio recorded, and transcriptions were qualitatively coded for content related to concerns of disclosure. Four themes emerged: Intention to disclose, disclosure approach, indicators for disclosure, and fears about disclosure. These themes reveal struggles that parents experience when considering HIV disclosure suggesting that an effective disclosure intervention must help parents assess pros and cons, discuss the emotions of the children after the disclosure, and monitor the impact on children's lives after disclosure over time. Future research is needed to implement interventions supporting HIV-positive parents' disclosure decision-making and actions.

Abstract Background Many randomized controlled trials have investigated the effects of exercise on the rehabilitation of patients with breast cancer. However, the exercise forms used in most previous studies were monotonous. Therefore, we designed a protocol to estimate the effects of combined exercise intervention using Internet and social media software on the rehabilitation of postoperative patients with BC. Methods/Design This study protocol is a randomized control trial with an intervention time of 12 weeks. After completing baseline questionnaire and physical fitness tests, the participants are randomized to the study group or the control group. Procedure contents of exercise intervention in the study group include: via phone step-recording app, ask the individuals to complete the target number of steps within a specified period of exercise, four times per week; face-to-face remote video guidance of individuals on muscle training, three times per week; common knowledge of physical exercise BC rehabilitation will be pushed regularly by social media apps every day. The control group will receive normal treatment and rehabilitation according to daily specifications of the hospital. The primary outcome will be the quality of life. The secondary outcomes are physical fitness and social cognitive indicators. Discussion This study is a clinical trial to estimate the effects of combined exercise intervention based on the Internet and social media software for postoperative patients with breast cancer (BC). If expected results are achieved in this study, measures and methods of BC rehabilitation will be enriched. Trial registration Chinese Clinical Trial Register, ChiCTR-IPR-17012368. Registered on 14 August 2017.

Introduction: The aim of this study was to explore the associations among physical activity (PA), inflammatory markers, and quality of life (QoL) from preradiotherapy to 1‐year postradiotherapy for patients with head and neck cancer (HNC). Methods: This was an observational longitudinal study. Mixed‐effect models incorporating within‐subject correlation were used to examine the relationship among the three key variables. Results: Aerobically active patients had significantly lower levels of sTNFR2 (but not other inflammatory markers) than aerobically inactive patients. Being aerobically active and lower inflammation were independently associated with better total QoL scores after adjusting covariates. The trend was similar for patients engaged in strength exercises. Conclusions: Being aerobically active was associated with lower inflammation as represented by sTNFR2 but not with other inflammatory markers. Higher PA (aerobic and strength) and lower inflammation were linked to better QoL. More research is warranted to validate the association among PA, inflammation, and QoL. [ABSTRACT FROM AUTHOR]

Aflatoxin is a potent mycotoxin and a common source of grain contamination that leads to great economic losses and health problems. Although distilled baijiu cannot be contaminated by aflatoxin, its presence in the brewing process affects the physiological activities of micro-organisms and reduces product quality. Bacillus cereus XSWW9 capable of degrading aflatoxin B1 (AFB1) was isolated from daqu using coumarin as the sole carbon source. XSWW9 degraded 86.7% of 1 mg/L AFB1 after incubation at 37 °C for 72 h and tolerated up to 1 mg/L AFB1 with no inhibitory effects. Enzymes in the cell-free supernatant of XSSW9 played a significant role in AFB1 degradation. The AFB1-degradation activity was sensitive to protease K and SDS treatment, which indicated that extracellular proteins were responsible for the degradation of AFB1. In order to investigate the AFB1-degradation ability of XSSW9 during the baijiu brewing process, AFB1 and XSWW9 were added to grain fermentation (FG-T) and normal grain fermentation without AFB1, while normal grain fermentation without AFB1 and XSWW9 was used as a control (FG-C). At the end of the fermentation, 99% AFB1 was degraded in the residue of fermented grains. The differences of microbial communities in the fermented grains showed that there were no significant differences between FG-T and FG-C in the relative abundance of dominant genera. The analysis of volatile compounds of their distillation showed that the contents of skeleton flavor components was similar between FG-T and FG-C. These results offer a basis for the development of effective strategies to reduce the effect of AFB1 on the brewing process and ensure that the production of baijiu is stable. [ABSTRACT FROM AUTHOR]

Background: Pregnant women with gestational diabetes mellitus (GDM) have a higher risk of developing elevated depressive symptoms than women without GDM. The aim of this study was to investigate the sociodemographic (eg, location), clinical (eg, health care–seeking behaviors), and psychological (eg, active coping skills) factors associated with elevated depressive symptoms in Chinese women with GDM. Methods: This was a secondary data analysis of a cross‐sectional study among Chinese women with GDM. Data (n = 323) were collected in 2018 from two hospitals in Hunan Province in China. The Center for Epidemiological Survey Depression Scale was used, with a criterion score ≥20 indicative of clinically elevated depressive symptoms. Descriptive, bivariate, and multiple logistic regression analyses were completed. Findings: The women had a mean age of 32.71 (SD = 5.17), and the majority were married (84.2%), college‐educated (65.6%), and with Han ethnicity (89.8%). About 68% of women had elevated depressive symptoms. Women with higher active coping scores were less likely (OR = 0.19, 95% CI: 0.10‐0.38) to have elevated depressive symptoms. Women from one geographical location (Changde) who had more emergency room visits had higher odds (OR = 3.10, 95% CI: 1.88‐5.10) of elevated depressive symptoms. Discussion: There was a high co‐occurrence of GDM and elevated depressive symptoms among pregnant women in our sample. Assessment for depressive symptoms in women with GDM is warranted. More research about increasing active coping skills may improve health outcomes in women with GDM. [ABSTRACT FROM AUTHOR]