Readability and quality of online patient health information on parotidectomy

OBJECTIVE

Complications of parotidectomy can have a massive impact on patients' quality of life. This study aimed to evaluate the readability and quality of online health information on parotidectomy.

METHOD

The search terms 'parotidectomy', 'parotid surgery', 'parotidectomy patient information' and 'parotid surgery patient information' were parsed through three popular search engines.

RESULTS

The websites were analysed using readability scores of the Flesch Reading Ease test and the Gunning Fog Index. The DISCERN instrument was used to assess quality and reliability. The average Flesch Reading Ease score was 50.2 ± 9.0, indicating that the materials were fairly difficult to read, the Gunning Fog Index score showed that the patient health information was suitable for an individual above 12th grade level, and the DISCERN score indicated that the online patient health information had fair quality. The Kruskal-Wallis test showed a significant difference in Flesch Reading Ease and DISCERN tool scores according to website category (p < 0.05).

CONCLUSION

Current online patient health information on parotidectomy is too difficult for the public to understand, and it exceeds the reading levels recommended by Health Education England and the American Medical Association.

Acceptability of the LetSync App Wireframes for an mHealth Intervention to Improve HIV Care Engagement and Treatment Among Black Partnered Sexual Minority Men: Findings from In-Depth Qualitative Interviews

BACKGROUND

HIV disparities continue to be a significant challenge affecting Black sexual minority men in the United States. Inadequate engagement and retention of patients in HIV care has been associated with poor health outcomes. Interventions to improve sustained commitment to HIV care are needed. Mobile health interventions can help facilitate access to and use of HIV health services, particularly among individuals at risk for disengaging with care.

OBJECTIVE

We designed the LetSync app wireframes for a mobile health intervention using a couple-centered design approach to improve HIV engagement and treatment among Black sexual minority men and their partners. The objective of this study was to gauge future app user interest and elicit feedback to improve the design, development, and usability of the LetSync app.

METHODS

We conducted in-depth interviews with 24 Black sexual minority men to assess the acceptability of the LetSync app wireframes between May 2020 and January 2021. Participants reviewed the LetSync app wireframes and provided feedback regarding perceived usefulness and interest in future app use and suggestions for improvement.

RESULTS

Participants indicated interest in the future LetSync app and noted that the wireframes' features were acceptable and usable. In our study, the future LetSync app was frequently referred to as a potential resource that could help facilitate users' engagement in HIV care through the following mechanisms: enable scheduling of appointments and timely reminders for clinic visits; help improve HIV medication adherence; encourage and motivate participants to ask questions to their health care provider and stay engaged in conversations during clinic visits; facilitate effective communication by assisting couples with planning, coordination, and management of daily routines; help participants understand their partner's health needs, including access to and use of health care services; and facilitate participants' ability to improve their relationship skills, partner support, and self-efficacy in managing conflict. In addition to near-universal interest in potential daily app use, study participants indicted that they would recommend the LetSync app to other family members, friends, and people in their social networks who are living with HIV.

CONCLUSIONS

Our findings revealed considerable interest in future app use for HIV care management, which could possibly increase the chance of the LetSync app being successfully adopted by Black sexual minority men in couples. Owing to its interactive and couple-centered approach, the LetSync app could help improve communication between Black sexual minority men and their partners and health providers. In addition, the LetSync app could provide an acceptable modality for these men to receive support in accessing HIV care services.

[Progress on development and application of the diet-related inflammatory index in cancer epidemiological studies]

Cancer is a major public health problem worldwide, causing an more serious burden of disease. Inflammation is considered a predisposing factor for cancer with close relationship with its incidence. In recent years, the public and epidemiologists has paid more attention to the association between nutrition and cancer and other chronic diseases in the perspective of inflammation. This paper summarizes the development and application of the diet-related inflammatory index in cancer epidemiological studies based on the literature retrieval of common diet-related inflammatory index. Firstly, we highlight the common diet-related inflammatory indices and their construction methods, such as the Dietary Inflammatory Index, a literature-derived diet-related inflammatory index, and the Empirical Dietary Inflammatory Index, an empirically derived diet-related inflammatory index, and so on. Secondly, the epidemiological research progress on the commonly used diet-related inflammatory indices is briefly introduced. Finally, the advantages and disadvantages of the two types of this inflammatory indices are also briefly described for the purpose of providing reference for nutrition epidemiological studies of cancer and other chronic diseases in China.

[Read-through circular RNA rt-circ-HS promotes hypoxia inducible factor 1α expression and renal carcinoma cell proliferation, migration and invasiveness]

OBJECTIVE

To identify and characterize read-through RNAs and read-through circular RNAs (rt-circ-HS) derived from transcriptional read-through hypoxia inducible factor 1α (HIF1α) and small nuclear RNA activating complex polypeptide 1 (SNAPC1) the two adjacent genes located on chromosome 14q23, in renal carcinoma cells and renal carcinoma tissues, and to study the effects of rt-circ-HS on biological behavior of renal carcinoma cells and on regulation of HIF1α.

METHODS

Reverse transcription-polymerase chain reaction (RT-PCR) and Sanger sequencing were used to examine expression of read-through RNAs HIF1α-SNAPC1 and rt-circ-HS in different tumor cells. Tissue microarrays of 437 different types of renal cell carcinoma (RCC) were constructed, and chromogenic in situ hybridization (ISH) was used to investigate expression of rt-circ-HS in different RCC types. Small interference RNA (siRNA) and artificial overexpression plasmids were designed to examine the effects of rt-circ-HS on 786-O and A498 renal carcinoma cell proliferation, migration and invasiveness by cell counting kit 8 (CCK8), EdU incorporation and Transwell cell migration and invasion assays. RT-PCR and Western blot were used to exa-mine expression of HIF1α and SNAPC1 RNA and proteins after interference of rt-circ-HS with siRNA, respectively. The binding of rt-circ-HS with microRNA 539 (miR-539), and miR-539 with HIF1α 3' untranslated region (3' UTR), and the effects of these interactions were investigated by dual luciferase reporter gene assays.

RESULTS

We discovered a novel 1 144 nt rt-circ-HS, which was derived from read-through RNA HIF1α-SNAPC1 and consisted of HIF1α exon 2-6 and SNAPC1 exon 2-4. Expression of rt-circ-HS was significantly upregulated in 786-O renal carcinoma cells. ISH showed that the overall positive expression rate of rt-circ-HS in RCC tissue samples was 67.5% (295/437), and the expression was different in different types of RCCs. Mechanistically, rt-circ-HS promoted renal carcinoma cell proliferation, migration and invasiveness by functioning as a competitive endogenous inhibitor of miR-539, which we found to be a potent post-transcriptional suppressor of HIF1α, thus promoting expression of HIF1α.

CONCLUSION

The novel rt-circ-HS is highly expressed in different types of RCCs and acts as a competitive endogenous inhibitor of miR-539 to promote expression of its parental gene HIF1α and thus the proliferation, migration and invasion of renal cancer cells.

Pathophysiologic mechanism for MYOcarditis in COVID-19 VAccinations ("MYOVAx" Study)

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): NMRC COVID-19 Research Fund

Objective

This is the first prospective cohort study in Singapore to investigate the COVID-19 vaccine-associated myocarditis to understand its pathophysiology.

Introduction

Acute myocarditis and other cardiovascular symptoms have been observed to be associated with the two mRNA-based coronavirus disease 2019 (COVID-19) vaccines—namely Pfizer-BioNTech BNT162b2 and Moderna mRNA-1273)—currently in-use in Singapore. The mechanisms through which myocarditis occurs are unknown, hence our study aims to understand the pathophysiology of myocarditis associated with COVID-19 vaccines.

Methods

Patients with onset of cardiac manifestations were recruited from multiple hospital outpatient clinics between November 2021 and September 2022. Clinical history and physical examination data was collected with blood sample collection, echocardiography, 12-lead electrocardiogram (ECG), coronary angiography and magnetic resonance imaging (MRI) at recruitment and 6-month follow-up. Analysis of biomarkers, genetic, serological and MRI data was conducted.

Results

As of 6 September 2022, a total of 5 patients have been enrolled (4 males, 1 female). The most commonly reported symptoms across all patients were chest pain/discomfort (80%), followed by palpitations (40%). MRI evidence of myocarditis has been detected in 2 (50%) of the male patients, of which both reported two or more symptoms occurring 1-2 days post-vaccination. Both patients have each received at least two doses of either the Pfizer-BioNTech BNT162b2 vaccine or Moderna mRNA-1273 vaccine. Their MRI findings were consistent with myocarditis. On late gadolinium enhancement (LGE) imaging, epicardial enhancement at the basal inferolateral segment and mid-wall enhancement at the apical anterior, lateral and inferior walls were observed in one patient. Patchy, mid-wall LGE in the basal inferior/inferolateral wall was observed in the other patient. No MRI evidence of myocarditis was available for the sole female patient.

Conclusion

While more data is needed to definitively prove the association of the two mRNA-based Pfizer-BioNTech BNT162b2 and Moderna mRNA-1273 COVID-19 vaccines with post-vaccination myocarditis, we believe our findings may support further investigations to enable risk stratification for vaccine-associated myocarditis and identify potential preventative strategies accordingly.

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

BACKGROUND

Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications.

METHODS

We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC).

FINDINGS

In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]).

INTERPRETATION

In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required.

FUNDING

British Journal of Surgery Society.

Examining the Impact of the Golden Compass Clinical Care Program for Older People with HIV: A Qualitative Study

The combined burden of geriatric conditions, comorbidities, and HIV requires a model of HIV care that offers a comprehensive clinical approach with people 50 years or older with HIV. Golden Compass is an outpatient, multidisciplinary HIV-geriatrics program with an onsite HIV geriatrician, cardiologist, pharmacist, and social worker, offering specialist referrals, care navigation, and classes on improving functional status and cognition. Participants (13 patients and 11 primary care providers) were recruited using a non-probability sampling method to participate in semi-structured interviews on the perceived impact of Golden Compass on care delivered to older people with HIV. Interviews were transcribed verbatim and framework analysis used to analyze the transcripts. The perceived impacts of Golden Compass by patients and providers were organized by the Compass points (Northern: Heart and Mind, Eastern: Bones and Strength, Southern: Navigation and Network, Western: Dental, Hearing, and Vision). Overall, patients valued the focus on functional health and whole-person care, leading to greater trust in the ability of providers. Providers gained new skills through the geriatrics, cardiology and/or pharmacist consultations. The HIV-geriatrics specialty approach of Golden Compass improved functional ability and quality of life for older adults with HIV. Few integrated care programs for older people with HIV have been evaluated. This study adds to the limited literature demonstrating high patient and provider satisfaction with a HIV-care model that incorporated principles of geriatric medicine emphasizing a comprehensive approach to sustaining functional ability and improving quality of life.

Recruiting Black Men Who Have Sex With Men (MSM) Couples via Dating Apps: Pilot Study on Challenges and Successes

Background

HIV disproportionately impacts Black men who have sex with men (MSM), and targeting the primary relationship (ie, couples) using mobile technology for health holds promise for HIV prevention. Web-based recruitment of MSM is commonly employed in HIV prevention and intervention research. However, little known about recruiting Black MSM couples on the internet in the United States.

Objective

This study describes the process of recruiting Black MSM couples over social networking and dating apps frequented by MSM. We describe the activities for recruiting, screening, and enrolling participants as part of a randomized trial employing a multipronged recruitment approach.

Methods

Black MSM in couples were recruited via three apps (ie, Jack’d, Adam4Adam, and Growlr) between May 2020 and March 2021 during the COVID-19 pandemic in the United States. Black MSM couples were eligible if one or both partners are Black, MSM, and living with HIV, and if both partners were 18 years or older, and have been together for at least 2 months in what they both consider a primary relationship (ie, one in which both partners reported feeling most committed to over any other partner or relationship).

Results

A total of 10 Black MSM couples (n=20) were enrolled via social networking apps. App recruitment activities were a combination of passive (eg, in-app advertisements) and active (eg, direct messaging of users) engagement. Recruitment approaches varied by the social networking app owing to differences in app features. A full-time recruiter experienced challenges such as bugs (ie, technical errors in computer program or system), navigating technical requirements specific to each app, and web-based harassment.

Conclusions

Despite challenges, it was possible to recruit Black MSM couples virtually into research as part of a multipronged recruitment strategy. We identify tips for using web-based dating and other social networking apps as part of a recruitment strategy in future research with Black MSM couples.

[A Luciferase-EGFP Reporter System for the Evaluation of DNA Methylation in Mammalian Cells]

DNA methylation is an essential epigenetic modification involved in numerous biological processes. Here, we present a cell-based system pLTR-Luc2P-EGFP for evaluation of DNA methylation in mammalian cells. In this system, the expression of reporter gene luciferase2P (Luc2P)-EGFP is under the control of HIV-1 promoter 5' long terminal repeat (LTR), which contains multiple CpG sites. Once these sites are methylated, the expression of Luc2P-EGFP is turned off, which may be visualized under fluorescence microscopy, with quantification performed in luciferase activity assay. As a proof of principle, pLTR-Luc2P-EGFP was methylated in vitro, and transfected into 293T cells, where the reduction of Luc2P-EGFP expression was confirmed. Premixed reporter DNA samples with the methylation levels varying from 0 to 100% were used for quantitative measurements of DNA methylation. The resulting standard curves indicated the accuracy of luciferase activity exceeding that of the Western blotting against EGFP. The Bland-Altman analysis showed that data from luciferase activity assay were in good agreement with the actual DNA methylation levels. In summary, we have established a reporter system coupled with reliable detection technique capable of efficient quantifying the changes in methylation in mammalian cells. This system may be utilized as a high throughput screening tool for identifying molecules that modulate DNA methylation.

727 Robotic Assisted Versus Fluoroscopic Guided Approach in Pedicle Screw Insertion: A Systematic Review and Meta-Analysis

Aim

The robotic assisted surgery has become prevalent in most of the surgical subspecialty. The adaption of such technique in spine surgery has resulted in minimising several issues encountered with fluoroscopic guided approach. The aim of this study is to compare the outcomes of robotic assisted approach and fluoroscopic guided approach in pedicle screw insertion.

Method

PUBMED, EMBASE, MEDLINE and CENTRAL database were systematically searched from its inception until November 2020. All the studies comparing robotic assisted surgery and fluoroscopic guided approach in pedicle screw insertion were included for quantitative and qualitative analysis.

Results

Twenty-eight studies enrolling 2105 patients (robotic group: 1027, fluoroscopic: 1078) and total screws of 8668 screws (robotic group: 4217, fluoroscopic group: 4451) were eligible for inclusion, these studies consisted of 19 observational studies, 7 randomised controlled trials (RCTs) and 2 cadaveric study. Robotic assisted approach was associated with significantly higher accuracy (Grade A+B) (OR = 2.34; P &lt; 0.0001) and distance between pedicle and screw (MD: 1.69; P = 0.001), lower incident of facet joint violation (OR = 0.22; P &lt; 0.00001), screw revision (OR = 0.38; P = 0.009), intraoperative blood loss (MD: -116.95; P = 0.0006), shorter pedicle screw placement time (MD: -4.66; P &lt; 0.00001), radiation exposure time (MD:-5.27; P = 0.0001), radiation dose (MD:-22.30; P = 0.0002) and postoperative hospital stay (MD: -0.79; P = 0.02) compared to fluoroscopic guided approach. There was no significant difference in operative time and wound infection.

Conclusions

In this meta-analysis, robotic assisted approach is more effective in achieving better clinical outcomes compared to fluoroscopic guided technique in pedicle screw insertion. However, future adequately powered RCTs are warranted to generate standardised outcomes.

Development and Validation of the Couple Sexual Satisfaction Scale for HIV and Sexual Health Research

Sexual satisfaction is an important dimension of relationship quality with implications for sexual and reproductive health (SRH), and HIV prevention, care, and treatment. We developed and validated the Couple Sexual Satisfaction Scale (CSSS) with heterosexual couples in sub-Saharan Africa. Using data from qualitative interviews with 94 partnered women and men in Swaziland and Malawi, we generated a 22-item scale and administered it to 211 couples with at least one partner living with HIV in Malawi. We performed an exploratory factor analysis (EFA) to identify and confirmatory factor analysis (CFA) to test the factor structure. To assess validity, we tested for associations between the CSSS and relationship quality, consistent condom use, and intimate partner violence (IPV) using generalized estimating equations. The EFA yielded two factors, general sexual satisfaction (13-item CSSS-Gen subscale, e.g., "I am satisfied with the sweetness of sex in our relationship") and HIV-specific sexual satisfaction (4-item CSSS-HIV subscale, e.g., "My appetite for sex has gone down due to HIV"), accounting for 78% of the shared variance. The CFA supported the two-factor solution: χ²(118) = 203.60; CFI = 0.909; SRMR = 0.057; RMSEA = 0.058. Participants with higher CSSS-Gen scores reported higher coital frequency and relationship quality (intimacy, trust, unity, equality, relationship satisfaction, commitment, partner social support), and less consistent condom use, physical IPV, and emotional IPV. Participants with higher CSSS-HIV scores reported higher coital frequency and relationship quality (trust, partner support), and less consistent condom use, and sexual IPV. The CSSS demonstrated good psychometric properties and provides new opportunities to study sexual reproductive health and HIV-related health behaviors among couples in sub-Saharan Africa.

Study protocol: a pilot randomised waitlist-controlled trial of a dyadic mobile health intervention for black sexual-minority male couples with HIV in the USA

INTRODUCTION

HIV care engagement is lower among black sexual-minority men relative to other racial/ethnic groups of sexual-minority men. Being in a primary relationship is generally associated with more successful HIV care engagement across various populations. However, among black sexual-minority men, the association between primary relationship status and HIV-related outcomes is inconsistent across the HIV care continuum. Given the ubiquity of mobile technology access and use among racial/ethnic minority communities, leveraging mobile technology for HIV care engagement appears a promising intervention strategy. This paper outlines the protocol of the LetSync study, a pilot randomised controlled trial of a mobile health app intervention developed using the Framework of Dyadic HIV Care Engagement to improve care-engagement outcomes among black sexual-minority male couples living with HIV.

METHODS AND ANALYSIS

Eighty black sexual-minority men in couples (n=160) will be enrolled to pilot test the LetSync app. At least one member of each dyad must be both HIV-positive and self-identify as black/African-American. Couples will be randomised to either a waitlist-control arm or an intervention that uses relationship-based approach to improve HIV care engagement. We will assess feasibility and acceptability of trial procedures and intervention protocols based on predefined metrics of feasibility and acceptability. Execution of the study will yield the opportunity to conduct analyses to test the measurement and analysis protocol on antiretroviral therapy adherence by comparing the intervention and waitlist-control arms on self-reported and biological (hair sample) measures of adherence.

ETHICS AND DISSEMINATION

Study staff will obtain electronic consent from all participants. This study has been approved by the University of California (UCSF) Institutional Review Board. Study staff will work with the Community Advisory Board at the UCSF Center for AIDS Prevention Studies Board to disseminate results to participants and the community via open discussions, presentations, journal publications and/or social media.

TRIAL REGISTRATION NUMBER

NCT04951544.

Multiplex sequencing of SARS-Cov-2 genome directly from clinical samples using the Ion Personal Genome Machine (PGM)

Various methods have been developed for rapid and high throughput full genome sequencing of SARS-CoV-2. Here, we described a protocol for targeted multiplex full genome sequencing of SARS-CoV-2 genomic RNA directly extracted from human nasopharyngeal swabs using the Ion Personal Genome Machine (PGM). This protocol involves concomitant amplification of 237 gene fragments encompassing the SARS-CoV-2 genome to increase the abundance and yield of viral specific sequencing reads. Five complete and one near-complete genome sequences of SARS-CoV-2 were generated with a single Ion PGM sequencing run. The sequence coverage analysis revealed two amplicons (positions 13 751-13 965 and 23 941-24 106), which consistently gave low sequencing read coverage in all isolates except 4Apr20-64- Hu. We analyzed the potential primer binding sites within these low covered regions and noted that the 4Apr20-64-Hu possess C at positions 13 730 and 23 929, whereas the other isolates possess T at these positions. The genome nucleotide variations observed suggest that the naturally occurring variations present in the actively circulating SARS-CoV-2 strains affected the performance of the target enrichment panel of the Ion AmpliSeq™ SARS CoV 2 Research Panel. The possible impact of other genome nucleotide variations warrants further investigation, and an improved version of the Ion AmpliSeq™ SARS CoV 2 Research Panel, hence, should be considered.

A Luciferase-EGFP Reporter System for the Evaluation of DNA Methylation in Mammalian Cells

DNA methylation is an essential epigenetic modification involved in numerous biological processes. Here, we present a cell-based system pLTR-Luc2P-EGFP for evaluation of DNA methylation in mammalian cells. In this system, the expression of reporter gene luciferase2P (Luc2P)-EGFP is under the control of HIV-1 promoter 5' long terminal repeat (LTR), which contains multiple CpG sites. Once these sites are methylated, the expression of Luc2P-EGFP is turned off, which may be visualized under fluorescence microscopy, with quantification performed in luciferase activity assay. As a proof of principle, pLTR-Luc2P-EGFP was methylated in vitro, and transfected into 293T cells, where the reduction of Luc2P-EGFP expression was confirmed. Premixed reporter DNA samples with the methylation levels varying from 0 to 100% were used for quantitative measurements of DNA methylation. The resulting standard curves indicated the accuracy of luciferase activity exceeding that of the Western blotting against EGFP. The Bland–Altman analysis showed that data from luciferase activity assay were in good agreement with the actual DNA methylation levels. In summary, we have established a reporter system coupled with reliable detection technique capable of efficient quantifying the changes in methylation in mammalian cells. This system may be utilized as a high throughput screening tool for identifying molecules that modulate DNA methylation.

Food insecurity and frailty among women with and without HIV in the United States: a cross-sectional analysis

INTRODUCTION

Frailty is frequently observed among people with HIV, and food insecurity is associated with frailty in the general population. Evidence is scarce on the associations between food insecurity and frailty among women with HIV who may be particularly vulnerable to the impacts of food insecurity. The goal of this study was to assess associations between food insecurity and frailty among women with and without HIV.

METHODS

There were 1265 participants from the Women's Interagency HIV Study who participated in frailty assessments in 2017. Frailty was measured using the Fried Frailty Phenotype, and women were subsequently categorized as robust, pre-frail or frail. Food insecurity was assessed using the U.S. Household Food Security Survey Module, with women categorized as having high, marginal, low or very low food security. Multinomial logistic regression models were conducted to examine cross-sectional associations between food insecurity and frailty while adjusting for socio-demographic, behavioural and HIV status covariates.

RESULTS AND DISCUSSION

Approximately one-third (31.9%) of the women had marginal, low or very low food security, and the proportions of women who met the criteria for frailty or pre-frailty were 55.6% and 12.4% respectively. In the adjusted model, the relative risk ratio (RRR) of frailty for women with very low food security versus women with high food security was 3.37 (95% CI [1.38 to 8.24], p < 0.01); the corresponding RRR of pre-frailty was 3.63 (95% CI [1.76 to 7.51], p < 0.001). Higher annual household income was associated with lower RRRs of frailty or pre-frailty (p < 0.01). Similarly, older age was associated with more frequent frailty (RRR=1.06, 95% CI [1.03 to 1.09], p < 0.001). HIV serostatus was not significantly associated with either pre-frailty (RRR=0.97, 95% CI [0.71 to 1.31]) or frailty (RRR=0.75, 95% CI [0.48 to 1.16]).

CONCLUSIONS

Very low food security was associated with more frequent frailty and pre-frailty among women with and without for HIV. HIV serostatus was not associated with frailty.

Food insecurity and neurocognitive function among women living with or at risk for HIV in the United States

BACKGROUND

Neurocognitive impairment (NCI) persists among women living with HIV. Food insecurity is also common among women and may be an important modifiable contributor of NCI.

OBJECTIVE

The goal of this study was to determine the association of food insecurity with neurocognitive function among women living with or without HIV.

METHODS

From 2013 to 2015, we analyzed data from a cross-sectional sample from the Women's Interagency HIV Study (WIHS). Measures included food insecurity and a comprehensive neuropsychological test battery assessing executive function, processing speed, attention/working memory, learning, memory, fluency, and motor function. We conducted multivariable linear regressions to examine associations between food insecurity and domain-specific neurocognitive performance, adjusting for relevant sociodemographic, behavioral, and clinical factors.

RESULTS

Participants (n = 1,324) were predominantly HIV seropositive (68%), Black/African-American (68%) or Hispanic (16%), and low income (48% reported <$12,000/y), with a median age of 49.6 y (IQR = 43.1, 55.5). Approximately one-third (36%, n = 479) were food insecure. Food insecurity was associated with poorer executive function (b = -1.45, SE = 0.58, P ≤ 0.01) and processing speed (b = -1.30, SE = 0.59, P ≤ 0.05). HIV serostatus modified the association between food insecurity and learning, memory, and motor function (P values <0.05). Food insecurity was positively associated with learning among women living with HIV (b = 1.58, SE = 0.77, P ≤ 0.05) and negatively associated with motor function among HIV-negative women (b = -3.57, SE = 1.08, P ≤ 0.001).

CONCLUSIONS

Food insecurity was associated with domain-specific neurocognitive function in women, and HIV serostatus modified associations. Food security may be an important point of intervention for ethnically diverse women with low socioeconomic status. Longitudinal studies are warranted to determine potential pathways by which food insecurity is associated with neurocognitive function among women living with or at risk for HIV.

Resilience and Depression in Young Black Men Who Have Sex with Men: A Social-Ecological Model

Although the health of young Black men who have sex with men (YBMSM) is typically discussed in terms of HIV, they are significantly affected by depression. The present study explored protective and risk pathways to depressive symptoms among YBMSM within a social-ecological framework. A cross-sectional sample of 1,817 YBMSM in two large, southern cities in the United States completed a survey of sociodemographic characteristics as well as individual (e.g., resilience, internalized heterosexism) and contextual (e.g., peer social support, experiences of racism) factors. In cross-sectional analyses, structural equation modeling was used to examine whether there were indirect associations between contextual factors and depressive symptomology that were mediated by individual factors. Higher peer social support was associated with lower depressive symptoms via greater resilience; there was no direct association between peer social support and depressive symptoms when controlling for this indirect association. Additionally, there were indirect associations between several contextual risk factors and higher depressive symptoms via perceived HIV-related stigma and internalized heterosexism; some direct associations between contextual risk factors and higher depressive symptoms were significant when controlling for these indirect associations. Despite a number of risk factors for depression for YBMSM, resilience is a key protective factor that may play a critical role in the beneficial effects of peer social support. Broadly, findings suggest that public health efforts must continue to build upon and leverage YBMSM's community-based strengths in the service of improving their mental health and, indirectly, their physical health.

The Unaddressed Needs of Alcohol-Using Couples on Antiretroviral Therapy in Malawi: Formative Research on Multilevel Interventions

Alcohol use among HIV-positive individuals in sub-Saharan Africa directly impacts adherence to antiretroviral therapy and HIV outcomes. Few studies have examined approaches to reduce alcohol use among HIV-affected couples, despite evidence that alcohol use is a couple-level concern. We conducted a qualitative study with 23 alcohol-using couples to identify multilevel barriers and facilitators of alcohol use, and potential intervention options with couples. Data were analyzed at individual and dyadic levels using framework analysis. All couples were married and had at least one partner on ART. Men were the primary alcohol drinkers with few women reporting alcohol use. Most women tried to persuade their partners to reduce their alcohol intake and when unsuccessful, enlisted help from relatives and HIV care providers. Effective couple negotiation around men's alcohol use was constrained by negative peer influence and men's desire for friendship to cope with life stressors. Women were primarily concerned about the expense of alcohol and described how alcohol prevented the family from meeting basic needs and investing in the future. Alcohol use was described as a major barrier to ART adherence, but was also viewed as the cause of couple and family violence, extramarital partnerships, food insecurity, and poverty. We conclude that multilevel interventions based on couples' needs and preferences are urgently needed. Couple-based intervention approaches could include provider-led alcohol counseling with couples, alcohol reduction support groups for couples, couples' counseling to bolster couple communication and problem-solving around alcohol, and economic-strengthening interventions for couples.

Re-conceptualising gender and power relations for sexual and reproductive health: contrasting narratives of tradition, unity, and rights

Sexual and reproductive health interventions in sub-Saharan Africa will be most effective if grounded in emic (insider) perspectives of gender and power in intimate relationships. We conducted eight focus group discussions with 62 young adults in Malawi to explore conceptions of gender and power relations and areas of tension between different perspectives. We framed our enquiry according to the three social structures of the Theory of Gender and Power: the sexual division of labour, the sexual division of power, and social norms and affective attachments around femininity and masculinity. Young adults drew on interrelated and competing narratives to describe the state of gender relations, which we named tradition, unity, and rights. Participants used tradition narratives most frequently to describe patriarchal gender roles, norms and ideals. Some participants challenged this predominant discourse using unity and rights narratives. Unity narratives illustrated how love and couple reciprocity were essential sources of 'power with' as opposed to 'power over'. Rights narratives were more contested than other narratives, with some participants acknowledging that women's rights were important to the family's survival and others viewing women's rights as problematic for gender relations. Gender-responsive interventions should consider the tensions and intersections between multiple narratives on gender and power, including unity as a gender-equitable form of power.

The Golden Compass Program: Overview of the Initial Implementation of a Comprehensive Program for Older Adults Living with HIV

The population with HIV is aging and has unique health needs. We present findings from an evaluation of the geriatric-HIV program, Golden Compass, at San Francisco General Hospital. We used the implementation science framework, RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) to guide the evaluation and used quantitative and qualitative methods to assess RE-AIM dimensions. From January 2017 to June 2018, 198 adults age ≥50 years participated in the program, with an estimated reach of 17%. Providers and patients indicated high acceptability of the program and were satisfied with clinics and classes. Colocation of services, specific pharmacy and geriatric assessments, and social support from classes were valued (effectiveness). Provider adoption was high, and the program was implemented as originally designed. Areas for improvement included challenges of framing aging services to patients. Future efforts will focus on expanding the reach of the program and examining long-term outcomes.

Improving Shared Decision Making For Asian American Pacific Islander Sexual and Gender Minorities

BACKGROUND

Asian American Pacific Islander (AAPI) sexual and gender minorities (SGM) face unique challenges in mental health and accessing high-quality health care.

OBJECTIVE

The objective of this study was to identify barriers and facilitators for shared decision making (SDM) between AAPI SGM and providers, especially surrounding mental health.

RESEARCH DESIGN

Interviews, focus groups, and surveys.

SUBJECTS

AAPI SGM interviewees in Chicago (n=20) and San Francisco (n=20). Two focus groups (n=10) in San Francisco.

MEASURES

Participants were asked open-ended questions about their health care experiences and how their identities impacted these encounters. Follow-up probes explored SDM and mental health. Participants were also surveyed about attitudes towards SGM disclosure and preferences about providers. Transcripts were analyzed for themes and a conceptual model was developed.

RESULTS

Our conceptual model elucidates the patient, provider, and encounter-centered factors that feed into SDM for AAPI SGM. Some participants shared the stigma of SGM identities and mental health in their AAPI families. Their AAPI and SGM identities were intertwined in affecting mental health. Some providers inappropriately controlled the visibility of the patient's identities, ignoring or overemphasizing them. Participants varied on whether they preferred a provider of the same race, and how prominently their AAPI and/or SGM identities affected SDM.

CONCLUSIONS

Providers should understand identity-specific challenges for AAPI SGM to engage in SDM. Providers should self-educate about AAPI and SGM history and intracommunity heterogeneity before the encounter, create a safe environment conducive to patient disclosure of SGM identity, and ask questions about patient priorities for the visit, pronouns, and mental health.

A Person-Centered Approach to HIV-Related Protective and Risk Factors for Young Black Men Who Have Sex with Men: Implications for Pre-exposure Prophylaxis and HIV Treatment as Prevention

Although young Black men who have sex with men (YBMSM) are disproportionately affected by HIV, they may be more heterogeneous as a group than is typically appreciated. Thus, the present study used a person-centered data-analytic approach to determine profiles of HIV-related risk among YBMSM and whether these profiles could be distinguished by age, HIV status, and socioeconomic risk (i.e., socioeconomic distress). YBMSM (N = 1808) aged 18 to 29 years completed a survey of sociodemographic characteristics, HIV status, and HIV-related behavioral and attitudinal factors (i.e., safer-sex self-efficacy, negative condom attitudes, being in difficult sexual situations, being in difficult sexual relationships, HIV treatment optimism, perceived HIV stigma). Latent profile analysis was used to identify HIV risk profiles and whether age, HIV status, and socioeconomic distress were associated with these profiles. Four profiles emerged: low-, medium-, and high-risk profiles, respectively, and a mixed profile characterized by a tendency to be in difficult sexual situations and relationships while also reporting high safer-sex self-efficacy and low negative attitudes toward condom use. Difficult sexual situations emerged as the key defining indicator of whether a profile reflected higher or lower risk. Younger age, being HIV-positive, and socioeconomic distress were associated with having a higher-risk profile. Given that unique risk profiles emerged that were differentially predicted by sociodemographic characteristics and HIV status, these findings have implications for tailoring interventions to the needs of different subgroups of YBMSM. Also, disempowering or risky sexual situations and relationships among YBMSM must be addressed.

Light scattering by densely packed optically soft particle systems, with consideration of the particle agglomeration and dependent scattering

Light scattering and radiative transfer in optically soft particle systems are important problems in many fields of natural sciences and engineering, such as biology, ocean optics, atmospheric science, solar energy utilization, and so on. Due to the effects of particle agglomeration and dependent scattering, the radiative transfer problem will become more complex with the increase of particle volume fraction. In this study, the scattering properties and radiative transfer characteristics of densely packed optically soft particle systems, with consideration of the effects of dependent scattering and particle agglomeration, are investigated. The dependent scattering properties of densely packed silicon-dioxide spherical particles embedded in water are calculated by using the Lorenz-Mie theory and Percus-Yevick sticky hard-sphere model. The directional-hemispherical reflectance of the dispersed plane-parallel layer is obtained by using the Monte Carlo method. The results show that dependent scattering and particle agglomeration have significant influence on the scattering properties of particles. With the increase of particle agglomeration degree, the scattering coefficients and asymmetry factors of the particles increase obviously, which can be even larger than the results for independent scattering under certain circumstances. Due to the combined interaction of multiple scattering, dependent scattering, and particle agglomeration, for different size particles, the variation tendency of the hemispherical reflectance is obviously different with increasing particle agglomeration degree.

[Advances in research of autophagy and its related proteins in periodontal disease]

Periodontal disease is a chronic infectious disease characterized by gingival inflammation and progressive destruction of alveolar bone, and the interaction between plaque microbes and host defense affects the process of the disease. Recent studies have found that autophagy is one of the most primitive host defense responses against pathogenic microbial invasion. Autophagy plays an important role in the development of periodontal disease through such functions as clearing pathogens, regulating inflammatory responses and promoting osteoclast activation to affect bone resorption with inflammatory factors. This review article mainly introduces the research advances on autophagy mechanism and the relationship between autophagy and periodontal disease from the domestic and foreign literatures and expounds the mechanism of autophagy and periodontal pathogens, inflammatory reaction and bone resorption of osteoclasts, so as to enrich the pathogenesis of periodontal disease and provide a new perspective for the treatment of periodontal disease.

Injecting-related trust, cooperation, intimacy, and power as key factors influencing risk perception among drug injecting partnerships

Sharing of injection drug use paraphernalia is a dyadic process linked to the transmission of HIV and hepatitis C virus (HCV). Despite this, limited research exists identifying specific dyadic interpersonal factors driving injecting partners' engagement in needle/syringe and ancillary injecting equipment sharing among young adults. Using semi-structured in-depth interview data collected between 2014 and 2015 from twenty-seven people who inject drugs (PWID), we applied an inductive approach to identify key injection drug-related interpersonal factors and developed a conceptual model integrating the findings based on interdependence theory. Interactions between injecting partners resulted in varying levels of injecting-related trust, cooperation, intimacy, and power. These factors interacted to collectively influence the type and level of risk perceived and enacted by injecting partners. The relationship between these injecting-related interpersonal factors, on the one hand, and risk perception on the other was dynamic and fluctuated between actions that protect the self (person-centered) and those that protect the partnership (partnership-centered). These findings indicate that the interpersonal context exerts substantial influence that shapes risk perception in all types of injecting partnerships. Partnership-focused prevention strategies should consider the dynamics of trust, cooperation, intimacy, and power, in characterizing dyadic risk perceptions and in understanding risky injecting practices among PWID.

[Analysis of genotype and hematological phenotype of 14 patients with coinheritance HKαα and South-East deletion thalassemia]

Objective: To analyze the genotype-phenotype correlations among those thalassemia samples with the presence of -α(3.7,) --(SEA) and normal α(2) alleles on their α-globin gene clusters. Methods: Fourteen patients(including 1fetus, 4 males and 9 females, aged 0- 56 years old)who were suspected diagnosed by hematologic analysis and genetic testing among 16 080 participants in our laboratory since from August 2011 to August 2016, were enrolled. Complete blood cell count was performed on XE4000i automatic hemocyte analyzer. HbA0, HbF and HbA2 were tested by high performance liquid chromatography (HPLC). Gap-PCR was adopted to detect three common deletional thalassemia deletions. Reverse dot-blot (RDB) assay was applied for detecting 17 common β-globin gene mutations and three common non-deletional α(2) gene mutations. Two-round nested PCR assay was established to detect the genotype of HKαα in α-thalassemia. Results: Fourteen cases were identified as HKαα/--(SEA) (14/16 080), including a pedigree and a rare case of HKαα/--(SEA) co-inheritance with IVS-Ⅱ-654(C→T) heterozygote. In HKαα/--(SEA) thalassemia group, mean cell volume(MCV) was (69.54±5.92)fl, and mean cell hemoglobin(MCH) was(22.11±2.22)pg and hemoglobin(Hb) was (117.64±18.14) g/L. Compared with normal group, MCV, MCH and Hb in HKαα/--(SEA) thalassemia group, was significantly decreased(P<0.05). There were no significant differences between α-thalassemia control group(--(SEA) /αα) in most hematological parameters (P>0.05). Conclusion: The two-round nested PCR could effectively detect the HKαα/--(SEA) genotype. The hematologic characteristics changed significantly in HKαα/--(SEA) group compared with HbH thalassemia and normal group. The genotype and phenotype non-correlation in patients with α-thalassemia should especially be causious to avoid a misdiagnosis of genetic tests, especially in prenatal diagnosis.

Patient and provider perceptions of a comprehensive care program for HIV-positive adults over 50 years of age: The formation of the Golden Compass HIV and aging care program in San Francisco

OBJECTIVE

People living with HIV (PLWH) are living longer and developing comorbidities and aging-related syndromes. New care models are needed to address the combined burden and complexity of HIV and its comorbidities in this group. The goal of this study is to describe qualitative data from patients and providers that informed the development of a comprehensive care model for older PLWH.

METHODS

Patient and provider perspectives on the clinical care and service needs of patients living and aging with HIV were explored via surveys and focus groups at a safety net HIV clinic in San Francisco. We surveyed 77 patients and 26 providers and conducted separate focus groups of older patients living with HIV (n = 31) and staff (n = 20). Transcripts were analyzed using thematic analysis. Themes for a care program were additionally explored using findings from the literature on HIV and aging.

FINDINGS

Themes from surveys and focus groups emphasized (a) the need for knowledge expertise in HIV and aging, (b) focus on medical conditions and determinants of health of particular import (e.g. marginal housing) among older PLWH, (c) co-locating specialty services (e.g. cardiology, geriatrics) with primary care, and (d) addressing social isolation. Findings informed the design of a comprehensive, multidisciplinary care model for PLWH called the Golden Compass program composed of four "points": Heart and Mind (North), Bones and Strength (East), Network and Navigation (South), and Dental, Hearing, and Vision (West).

CONCLUSION

Based on patient and clinic staff perspectives from surveys and focus groups, we designed a multidisciplinary program of integrated primary and specialty care, as well as housing and social support, to address the needs of older PLWH within a safety-net infrastructure. Golden Compass launched in 2017 for PLWH older than 50 years. Future research to evaluate the effectiveness of this care program in improving patient outcomes and satisfaction is ongoing.

Couple-Level Dynamics and Multilevel Challenges Among Black Men Who Have Sex with Men: A Framework of Dyadic HIV Care

The primary romantic relationship may offer critical opportunities for improving HIV care among key populations affected by high rates of HIV infection and low rates of care engagement, such as black men who have sex with men. A conceptual framework is needed to identify dyadic processes involved in addressing challenges in retention in care and adherence to antiretroviral therapy. This study conducted dyadic and individual-level qualitative analyses of individual interviews with men living with HIV from 14 black gay couples (n = 28). Interviews explored each partner's perspectives on challenges to and supportive strategies for retention in care and medication adherence. Findings highlighted challenges at various levels of care engagement and patterns of dyadic interactions that impeded or facilitated HIV care. Couple-level processes (i.e., couple's resilience, interdependence) underlined a joint problem-solving approach toward addressing challenges in care engagement. Findings support a conceptual framework of dyadic HIV care that highlights the impacts of dyadic and individual factors on coordination of care and treatment to influence retention and adherence. The generalizability of study findings is limited by the small sample size. Implications for intervention design include leveraging drivers of partner support, including couples' resilience, in enhancing joint problem-solving in HIV care among black gay couples.

A Conceptual Model of Dyadic Coordination in HIV Care Engagement Among Couples of Black Men Who Have Sex with Men: A Qualitative Dyadic Analysis

Among Black men who have sex with men (MSM), HIV incidence is disproportionately high and HIV care engagement is disproportionately low. There may be important opportunities to leverage the primary relationship to improve engagement in HIV care and treatment among Black MSM couples. Using dyadic qualitative analysis of semi-structured, one-on-one interviews, we explored dyadic aspects of HIV care engagement among 14 Black MSM couples in which at least one partner was HIV-positive and identified as a Black cisgender man. Findings showed that men varied in how involved they were in their HIV-positive partner's care and treatment, and in how they reciprocated their partner's involvement. Patterns of dyadic HIV care engagement supported a conceptual model of dyadic coordination that describes Black MSM relationships in terms of two conceptual dimensions of dyadic HIV care engagement, and guides future intervention designs with Black MSM couples.

Whose Responsibility Is It? Beliefs About Preventing HIV Transmission Among Men Who Have Sex With Men

HIV-negative and HIV-positive men believed that they both are responsible for preventing HIV. Responsibility beliefs, however, did not always correspond with discussing HIV status or refraining from serodiscordant condomless anal sex. Discrepancies between individuals' HIV prevention responsibility beliefs and their sexual risk behaviors merit further examination, particularly in the preexposure prophylaxis era.

[Clinical study on serum 25(OH)D level in patients with moderate to severe allergic rhinitis]

Objective:Through the detection of the serum 25 (OH) D level of patients with moderate to severe allergic rhinitis (AR), we preliminarily explored the mechanism of vitamin D on AR and provided evidence for the control of AR. Method:Eighty cases of moderate to severe AR and 65 healthy adults were selected as the subjects. The level of 25 (OH) D was detected by enzyme-linked immunosorbent assay (ELISA), and the serum 25 (OH) D level of eight common serum allergens in patients with moderate to severe AR was analyzed. Result:The level of serum 25 (OH) D of AR group was (29.4±4.7)ng/ml, and the serum level of 25 (OH) D in the control group was (30.9±5.9)ng/ml, no significant difference (P>0.05). The percentage of serum vitamin D deficiency in AR group was 36%, and the control group was 7%, and the difference was statistically significant (P<0.05). Among eight common serum allergens, the AR patients who were allergic to ragweed, household dust mites and shrimps, the percentage of vitamin D deficiency and insufficient was higher than that of the control group, the difference was statistically significant (P<0.05). Conclusion:Vitamin D deficiency may be associated with moderate to severe AR patients, and vitamin D may have potential beneficial effects on the progression of AR.

Temperature-dependent optical constants of liquid isopropanol, n-butanol, and n-decane

Liquid isopropanol, n-butanol, and n-decane are combustible organic compounds that are frequently used in theoretical and experimental researches on fuel combustion. In this work, the temperature-dependent optical constants of liquid isopropanol, n-butanol, and n-decane in the region 500-5500  cm^-1 at ambient pressure are measured using the combined ellipsometry-transmission method. In the combined method, the optical constants are first measured by a modified ellipsometry method, and then the absorption indices for weak absorption regions are obtained by the transmission method using the refractive indices measured by the modified ellipsometry method. The refractive indices of liquid isopropanol, n-butanol, and n-decane are within the range from 1.3 to 1.45 in the studied wavelength and temperature region. The absorption indices of these liquids range from 10^-5 to 10^-1. In the temperature range studied, the refractive indices decrease with increasing temperature in an approximately linear manner, but the effects of the temperature on the absorption indices are much smaller. The characteristic wavenumbers of the main absorption peaks are consistent with the vibrational frequencies of major functional groups.

The Role of the Primary Romantic Relationship in HIV Care Engagement Outcomes Among Young HIV-Positive Black Men Who Have Sex with Men

The primary romantic relationship plays a fundamental role in health maintenance, but little is known about its role in HIV care engagement among young Black men who have sex with men (MSM) living with HIV. We examined how HIV care engagement outcomes (i.e., having a primary healthcare provider, receiving HIV treatment, taking antiretroviral medication, and medication adherence) vary by partnership status (single vs. concordant-positive vs. discordant) in a sample of young Black MSM living with HIV. Results showed mixed findings. Partnership status was significantly associated with HIV care engagement, even after adjusting for individual, social, and structural factors. While partnered men were consistently more likely than their single counterparts to have a regular healthcare provider, to receive recent treatment, and to have ever taken antiretroviral medication, they were less likely to report currently receiving antiretroviral therapy. Moreover, men with a discordant partner reported better adherence compared to men with a concordant or no partner. The association between partnership status and HIV care engagement outcomes was not consistent across the stages of the HIV Care Continuum, highlighting the complexity in how and why young Black men living with HIV engage in HIV healthcare. Given the social context of HIV disease management, more research is needed to explicate underlying mechanisms involved in HIV care and treatment that differ by relational factors for young Black MSM living with HIV.

[Effects of T helper 1 cells and T helper 17 cells secreting cytokines on rat models of experimental periodontitis]

Objectvie: To investigate the effects of secreting cytokines interferon-gamma (IFN-γ) and interleukin-17 (IL-17) of T helper 1 cells (Th1) and T helper 17 cells (Th17) on the peripheral blood and alveolar bone destruction, so as to provide a new explanation for cellular immunity-mediated alveolar bone destruction. Methods: Eighteen eight-week-old male Sprague-Dawley rats were divided, randomly and equally, into 3 groups: lipopolysaccharide (LPS) group, ligation group and normal control group. In the LPS group, Escherichia coli LPS was injected into the alveolar mucosa on the buccalmedian site of the left upper first molar, while the right upper first molar was injected with equal volume of physiological saline as self-controls. The injections were performed every other day for four times totally. In the ligation group, the left upper first molars were ligatured with 0.2 mm orthodontic cords, while the right upper first molars were left untreated as self-controls, and supplemented with high-sugar diet to promote the periodontitis status. The rats in normal control group were fed normally. The concentrations of IFN-γ and IL-17 in peripheral blood were measured using enzyme linked immunosorbent assay (ELISA) method at the fourth week after the start of injection and at the eighth week after ligation. The histological of periodontal tissues were observed after hematoxylin-eosin (HE) staining and osteoclast count was performed under light microscope. The histological of osteoclasts were observed after tartrate-resistant acid phosphatase (TRAP) staining. Expression of IFN-γ and IL-17 were detected by immunohistochemical assay. Results: The concentrations of IFN-γ in peripheral blood of LPS group [(185.0±50.7) ng/L] and ligation group [(202.9±60.4) ng/L] were significantly higher than that of normal control group [(106.3±17.2) ng/L](P<0.05). Meanwhile, histological examination showed inflammatory cells infiltration in the gingival epithelium, the height reduction of alveolar bone accompanied with absorption lacuna. There were significantly higher HE and TRAP stained osteoclasts in LPS group (9.50±1.05) and ligation group (10.83±1.17) than that in controlgroup (0.33±0.52)(P<0.05). Moreover, the expressions of IL-17 in alveolar bone absorption area of LPS group and ligation group were significantly stronger than that in control group (P<0.05). Conclusions: The rat models of experimental periodontitis and alveolar bone resorption could be successfully established by means of ligationand LPS injection, respectively. The periodontal inflammatory responses were related to secreting cytokines IFN-γ and IL-17 of Th1 and Th17 cells, while Th17 cells might exert a positive effect on alveolar bone destruction.

Wavelength and concentration-dependent optical constants of NaCl, KCl, MgCl2, CaCl2, and Na2SO4 multi-component mixed-salt solutions

The optical constants of sodium chloride (NaCl), potassium chloride (KCl), magnesium chloride (MgCl₂), calcium chloride (CaCl₂) and sodium sulfate (Na₂SO₄) solutions at weight fractions ranging from 0 to 16.6667% are measured by the combined ellipsometry-transmission method in the spectral range 0.3-1.0 μm. In the combined method, a modified ellipsometry method is used to measure the refractive indices of liquids, and then the transmission method is conducted to obtain the extinction coefficients using the refractive indices obtained by the ellipsometry method. The experimental refractive indices of these binary solutions are utilized to obtain a mole-fraction weighted mixing rule, which relates the refractive index of multi-component mixed-salt solutions to the wavelength and concentration of each component. The effects of wavelength and concentration are taken into account by empirical expressions of the Lorentz-Lorenz formulized molar refraction. A mole-fraction weighted linear combined mixing rule is proposed to study the wavelength and concentration-dependent extinction coefficients of mixed-salt solutions. The optical constants of NaCl-KCl and NaCl-Na₂SO₄ ternary solutions, NaCl-KCl-CaCl₂ quaternary solutions, and NaCl-KCl-MgCl₂-CaCl₂-Na₂SO₄ multi-component solutions are measured to verify the mixing rules. The results show that the optical constants calculated based on the mixing rules are in good agreement with experimental data, which demonstrate the feasibility of the proposed mixing rules. As the experimental analysis indicates, both the refractive indices and the extinction coefficients of the saline solutions increase with solute concentrations in the spectral range 0.3-1.0 μm.

[The regulatory mechanisms of 1,25(OH)2D3 in allergic rhinitis]

Nearly 30 years at home and abroad, the study found that Vitamin D can adjust congenital and acquired immune at the same time. As a result, Vitamin D is expected to be used for prevention and treatment of allergic rhinitis. But about vitamin D supplement to the mechanism of action of allergic disease such as allergic rhinitis is still not clear, there is no consistent condusion, even some of the result also has certain contradiction, so vitamin D is not routinely used for clinical therapy. This review will help us to understand the mechanism of action of vitamin D for allergic rhinitis in the treatment of thinking in the future.

Infrared optical constants of liquid palm oil and palm oil biodiesel determined by the combined ellipsometry-transmission method

The optical constants of vegetable oils and biodiesels are the basic input parameters in the study of the thermal radiation transfer and monitoring the productivity of vegetable oils converting to biodiesels. In this work, a combined ellipsometry-transmission method is presented to obtain the optical constants of palm oil and palm oil biodiesel between 20°C and 150°C in the spectral range 600-4100  cm^-1 and to study the temperature effect on the optical constants. In the combined method, a modified ellipsometry method is used to measure the optical constants of palm oil and palm oil biodiesel for the whole researched wave bands. For the weak absorption regions in which the ellipsometry method cannot give precise absorption indices, the transmission method is conducted to get the absorption indices using the refractive indices obtained by the proposed ellipsometry method. Deionized water and methanol are taken as examples to verify the combined ellipsometry-transmission method. It is shown that the combined method can overcome the deficiencies of the traditional ellipsometry and transmission method, which can be used for the measurements of both strong and weak absorption wave bands. The experimental analyses indicate that temperature exerts a noticeable influence on the infrared optical constants of palm oil and palm oil biodiesel. With the increase of temperature, the refractive indices at certain wavenumbers decrease nearly linearly, and the amplitudes of dominant absorption peaks show a decreasing trend. The absorption peaks located around 3550  cm^-1 show blueshift trends as temperature increases. Comparing these two kinds of oils, palm oil presents larger values in refractive indices and dominant absorption peaks.

[In vivo and in vitro experimental studies of remote digital control endovascular robotic system in interventional angiography]

Objective: To investigate the feasibility of the remote control endovascular robotic system in interventional angiography. Method: The endovascular robotic system Heifetz™ and the matched steerable catheter Mirage™ were used to cannulate all the target vessels in the vascular model and cerebral arteries originated from the aorta of Bama mini-pigs under fluoroscopic guidance. The technical success rate, cannulation time and exposure dose were all collected and compared with the result of using conventional techniques. Result: All the target vessels were successfully cannulated.The average cannulation time for the steerable catheter into left subclavian artery, left common carotid artery, brachiocephalic artery, right common carotid artery and right subclavian artery in the vascular model was (21.3±2.8)s, (28.8±5.2)s, (17.7±2.6)s, (31.5±5.1)s and (24.2±3.7) s, respectively, while the average exposure dose was (9.3±1.2)mGy, (12.4±2.2)mGy, (7.4±1.2)mGy, (14.2±2.5)mGy and( 10.4±1.9)mGy, respectively. The endovascular robotic system completed the cerebral angiography in Bama mini-pigs successfully. The average cannulation time for left innominate artery, right innominate artery, right subclavian artery, common internal carotid trunk, left internal carotid artery and right internal carotid artery was (41.5±6.8)s, (29.1±3.7)s, (40.7±5.5)s, (40.1±5.8)s, (59.6±9.0)s and( 60.3±10.1)s, respectively, while the average exposure dose was (40.6±6.5)mGy, (36.0±5.2)mGy, (39.8±6.1)mGy, (43.9±6.7)mGy, (51.0±7.4)mGy and( 50.1±7.8)mGy, respectively. There was no significant difference between robotic and conventional group in success rate, cannulation time and exposure dose. Conclusion: The remote digital control endovascular robotic system could cannulate the target vessel in both vascular model and complete the cerebral angiography in Bama mini-pigs, which shows the feasibility of using this robotic system in endovascular intervention procedures under remote control.

Rashba Interaction and Local Magnetic Moments in a Graphene-BN Heterostructure Intercalated with Au

We intercalate a van der Waals heterostructure of graphene and hexagonal boron nitride with Au, by encapsulation, and show that the Au at the interface is two dimensional. Charge transfer upon current annealing indicates the redistribution of the Au and induces splitting of the graphene band structure. The effect of an in-plane magnetic field confirms that the splitting is due to spin splitting and that the spin polarization is in the plane, characteristic of a Rashba interaction with a magnitude of approximately 25 meV. Consistent with the presence of an intrinsic interfacial electric field we show that the splitting can be enhanced by an applied displacement field in dual gated samples. A giant negative magnetoresistance, up to 75%, and a field induced anomalous Hall effect at magnetic fields <1  T are observed. These demonstrate that the hybridized Au has a magnetic moment and suggests the proximity to the formation of a collective magnetic phase. These effects persist close to room temperature.

Shared Decision Making Among Clinicians and Asian American and Pacific Islander Sexual and Gender Minorities: An Intersectional Approach to Address a Critical Care Gap

Shared decision making (SDM) is a model of patient-provider communication. Little is known about the role of SDM in health disparities among Asian American and Pacific Islander (AAPI) sexual and gender minorities (SGM). We illustrate how issues at the intersection of AAPI and SGM identities affect SDM processes and health outcomes. We discuss experiences of AAPI SGM that are affected by AAPI heterogeneity, SGM stigma, multiple minority group identities, and sources of discrimination. Recommendations for clinical practice, research, policy, community development, and education are offered.

Investigation of the spectral reflectance and bidirectional reflectance distribution function of sea foam layer by the Monte Carlo method

Spectral properties of sea foam greatly affect ocean color remote sensing and aerosol optical thickness retrieval from satellite observation. This paper presents a combined Mie theory and Monte Carlo method to investigate visible and near-infrared spectral reflectance and bidirectional reflectance distribution function (BRDF) of sea foam layers. A three-layer model of the sea foam is developed in which each layer is composed of large air bubbles coated with pure water. A pseudo-continuous model and Mie theory for coated spheres is used to determine the effective radiative properties of sea foam. The one-dimensional Cox-Munk surface roughness model is used to calculate the slope density functions of the wind-blown ocean surface. A Monte Carlo method is used to solve the radiative transfer equation. Effects of foam layer thickness, bubble size, wind speed, solar zenith angle, and wavelength on the spectral reflectance and BRDF are investigated. Comparisons between previous theoretical results and experimental data demonstrate the feasibility of our proposed method. Sea foam can significantly increase the spectral reflectance and BRDF of the sea surface. The absorption coefficient of seawater near the surface is not the only parameter that influences the spectral reflectance. Meanwhile, the effects of bubble size, foam layer thickness, and solar zenith angle also cannot be obviously neglected.

Quantum Transport Detected by Strong Proximity Interaction at a Graphene-WS2 van der Waals Interface

Magnetotransport measurements demonstrate that graphene in a van der Waals heterostructure is a sensitive probe of quantum transport in an adjacent WS2 layer via strong Coulomb interactions. We observe a large low-field magnetoresistance (≫ e(2)/h) and a -ln T temperature dependence of the resistance. In-plane magnetic field resistance indicates the origin is orbital and nonclassical. We demonstrate a strong electron-hole asymmetry in the mobility and coherence length of graphene demonstrating the presence of localized Coulomb interactions with ionized donors in the WS2 substrate, which ultimately leads to screening as the Fermi level of graphene is tuned toward the conduction band of WS2. This leads us to conclude that graphene couples to quantum localization processes in WS2 via the Coulomb interaction and results in the observed signatures of quantum transport. Our results show that theoretical descriptions of the van der Waals interface should not ignore localized strong correlations.

Social-structural indices and between-nation differences in HIV prevalence

Research emphasises the role that social structures play in shaping national HIV prevalence. This study examined how social, economic, and political contexts that may represent the confluence of individual capabilities and environmental affordances or constraints are associated with national HIV prevalence. Based on social-ecological perspectives, we examined social-structural dimensions in relation to national HIV prevalence. The study identified six publicly available nation-level social, political, and economic indices and examined their associations with national 2009 HIV prevalence across 225 nations. National indices, (a) education expenditures, (b) unemployment rate, (c) homicide rate, (d) freedom of religion, and (e) women's social rights, altogether explained 43% of the variability in national HIV prevalence. Education expenditures, homicide rate, and freedom of religion were significant predictors of national HIV prevalence in the multivariate analysis. The present study identified nation-level factors that capture social, economic, and political contexts to explain between-nation differences in HIV prevalence. Findings extend current literature on the social-structural foundation of HIV-risk and the relationship between human rights and health. National safeguards that afford individuals the power to promote general quality of life and protection from structural violence may be most important to lowering overall rates of HIV transmission.

A social-ecological perspective on power and HIV/AIDS with a sample of men who have sex with men of colour

This paper applies a social-ecological theory of power to posit that individual HIV-related vulnerability stems from how power is leveraged across situations over time. The current study identified six power domains and explored how the interchangeability of power shapes HIV-related vulnerability among men who have sex with men of colour. Data were collected as part of a mixed-methods study on the social networks and experiences of racial/ethnic and sexual minority status. A total of 35 Asian/Pacific Islander, Black and Latino men who have sex with men were recruited and individual in-depth interviews were conducted. Results showed that men who have sex with men of colour actively traded upon various domains to alter their relative power within a given situation. Results suggest that power interchangeability, or the degree to which power from one domain can be leveraged to gain power in another, may shape HIV-related vulnerability. Findings offer a dynamic understanding of the nature of HIV risk as derived from everyday power exchanges and provide theoretical foundation for future work on individual resilience against HIV-related risks over time.

Sexual positioning and race-based attraction by preferences for social dominance among gay Asian/Pacific Islander men in the United States

For gay men in the United States, race/ethnicity has been demonstrated to factor importantly into sexual preferences, and race-based beliefs regarding certain racial groups are prevalent within the gay male community. For gay men of color, such beliefs may differentially influence their sexual preferences. Yet, little is known about the social-psychological factors underlying differences in sexual preferences among gay men of color. The present study examined how personal preferences for social hierarchy and dominance may explain variations in sexual positioning preferences, and how this relationship may be further qualified by their race-based sexual attraction among gay Asian/Pacific Islander (API) men. A total of 141 API gay men were recruited to participate in an online survey. Measures assessed participants' sexual positioning preferences, race-based sexual attraction, and preferences for social hierarchy or social dominance orientation (SDO). Self-identified tops scored higher on SDO than bottoms or versatiles. Participants attracted to non-API men scored higher on SDO compared to participants attracted to API men and participants who reported no race-based attraction. Finally, a significant two-way interaction indicated that tops attracted to non-API men scored the highest on SDO, and bottoms with no race-based attraction in men scored the lowest. Race/ethnicity is a prominent factor in sexual attraction and sexual positioning preferences among gay men, and one's proclivity for social hierarchy and dominance explains differences in sexual preferences among API gay men. By demonstrating how API gay men negotiate sexual preferences, present findings help elucidate existing race-based sexual dynamics within gay male culture.

Filial ethics and judgments of filial behaviour in Taiwan and the United States

Parent-child relationships are fundamental human relationships in which specific norms govern proper parent-child interactions. Such norms, or filial ethics, have been observed in different cultures, including in the United States and Taiwan, but important differences may exist in how filial practices are viewed across cultures. From a traditional view of power as domination over others, if filial relationships are viewed to reflect power differentials between parents and children, actors who follow filial ethics should be viewed as less powerful than actors who do not follow filial ethics for maintaining or enhancing positive parent-child relationships. Alternatively, power can be conceptualized as the ability to meet one's needs (e.g., for communal care and trust), and actors who follow filial ethics should be viewed as more powerful and trustworthy than actors who do not follow filial ethics because they have the ability to maintain or enhance positive parent-child relationships. Based on a power-trust model, we compared American and Taiwanese perceptions of actors in an experiment using vignettes describing filial behaviours. We conducted a path analysis with a sample of 112 American and 74 Taiwanese participants to test the proposed relations. Results showed that both Taiwanese and Americans rated actors more favourably (i.e., as more powerful and trustworthy) when actors behaved according to filial ethics than when they did not. Some cross-cultural differences were also observed: Taiwanese attributed trust-traits to actors who performed filial practices to a larger degree than did Americans. We discuss implications for the implicit nature of filial relationships and conceptualization of power cross-culturally.

A meta-analysis of the efficacy of HIV/AIDS prevention interventions in Asia, 1995-2009

The HIV/AIDS epidemic continues to grow in pockets across Asia, despite early successes at curtailing its spread in countries like Thailand. Recent evidence documents dramatic increases in incidence among risk groups and, alarmingly, the general population. This meta-analysis summarizes the sexual risk-reduction interventions for the prevention of HIV-infection that have been evaluated in Asia. Sexual risk-reduction outcomes (condom use, number of sexual partners, incident sexually transmitted infections [STI], including HIV) from 46 behavioral intervention studies with a comparison condition and available by August 2010 were included. Overall, behavioral interventions in Asia consistently reduced sexual risk outcomes. Condom use improved when interventions sampled more women, included motivational content, or did not include STI testing and treatment. Incident HIV/STI efficacy improved most when interventions sampled more women, were conducted more recently, or when they included STI counseling and testing. Sexual frequency efficacy improved more in interventions that were conducted in countries with lower human development capacities, when younger individuals were sampled, or when condom skills training was included. Behavioral interventions for reducing sexual risk in Asia are efficacious; yet, the magnitude of the effects co-varies with specific intervention and structural components. The impact of structural factors on HIV intervention efficacy must be considered when implementing and evaluating behavioral interventions. Implications and recommendations for HIV/AIDS interventions are discussed.