Promoting HIV self-testing via emotional support messages among men who have sex with men in China.

OBJECTIVE: Since negative emotions were identified as barriers to HIV self-testing (HIVST), offering emotional support may promote this behavior. This study examined whether the socio-affective and reappraisal components of emotional support messages differ in affecting one's attitude towards and intention to conduct HIVST via response efficacy and self-efficacy. METHOD: A between-subject online experiment was conducted with 309 Chinese men who have sex with men. Participants were randomly assigned to one of three conditions: no support, only reappraisal information, socio-affective and reappraisal information both provided. RESULTS: Emotional support only worked for those completing HIVST in recent three months. The reappraisal information enhanced their response efficacy and self-efficacy, but only self-efficacy was positively related to one's attitude towards and intention to conduct HIVST. The message including socio-affective and reappraisal components directly improved their HIVST-related attitudes. CONCLUSION: Emotional support presents an approach to promoting HIVST. The socio-affective and reappraisal information function differently on their response efficacy, self-efficacy, attitude, and intention. PRACTICE IMPLICATIONS: This study provides implications on how to design messages promoting HIVST for health campaigns and AI-based healthcare technologies. Reappraisal information should be offered to enhance one's response efficacy and self-efficacy. Messages should address both socio-affective and reappraisal needs of individuals.

Factors Associated with the First-time HIV Testing Among Chinese men who have sex with men Who Received HIV Self-tests from Partners or Friends.

Secondary distribution of HIV self-testing (HIVST) among individual social networks was an effective approach to expanding HIV testing among men who have sex with men (MSM). However, understanding the factors associated with first-time HIV testing behaviors in the secondary distribution of HIVST programs is limited. Hence, this study aims to identify factors related to first-time testers in the secondary distribution of HIVST. Participants were recruited from five provinces in southern China through Blued, a geo-social gay networking app in China from January 2021 to December 2021. Eligible consented participants (referred to as "seeds") finished a baseline survey and then applied for up to five HIVST kits. They were encouraged to distribute HIVST kits to other MSM (referred to as "alters") and alters were encouraged to scan a QR code to return their photographed testing results. All alters were invited to finish an online survey. In total, 229 seeds reached 292 alters, among whom 126 (43.2%) were first-time testers whereas 166 (56.8%) were non-first-time testers. Importantly, our results demonstrated that the first-time HIV testers were more likely to self-report as heterosexual (aOR = 4.88, 95% CI 1.01-23.61), disclose sexual orientation and/or SSB (aOR = 1.73, 95% CI 1.01-2.96), and receive HIVST knowledge from the seeds (aOR = 3.25, 95% CI 1.02-10.34). However, those who had sex with male partners in the last three months were less likely to be first-time testers (aOR = 0.43, 95% CI 0.23-0.82). Practical implications and limitations were also discussed to improve future HIV prevention programs.

Facile Synthesis of Black Phosphorus Nanosheet@NaReF4 Nanocomposites for Potential Bioimaging.

Black phosphorus nanomaterials (BPN) have been well developed in tumor therapy. However, lack of diagnostic function limits the development of BPN in biomedicine. Lanthanide-doped nanoparticles are considered as versatile materials for fluorescence or magnetic resonance imaging. Integration of BPN with lanthanide-doped nanoparticles was rarely reported owing to the complex synthesis processes and poor modification effect. Herein, we report a simple and general method for synthesizing BPN@NaReF4 (Re: Gd or Y, Yb, Er) nanocomposite. TEM and XRD characterization confirm efficient combination of BPN and NaGdF4 or NaYF4:Yb,Er (18.2 mol %) after one-step mixing. The FTIR and XPS spectra were used to prove the generation of PO43--Gd and P-Gd coordination bonds and clarify ligand exchange mechanism. The anchored nanoparticles on BPN were stable and become hydrophilic. The prepared BPN@NaGdF4 exhibit the signals of photoacoustic and magnetic resonance imaging. The obtained BPN@NaYF4:Yb,Er (18.2 mol %) have the potential in fluorescence bioimaging. We believe that this work will expand the applications of BPN in diagnosis and therapy together.

Urokinase loaded black phosphorus nanosheets for sequential thrombolysis and reactive oxygen species scavenging in ischemic stroke treatment.

Ischemic stroke often causes devastating damage to human life and health. Excess production of reactive oxygen species (ROS) during thrombolysis will paradoxically result in neuronal injury. Neuroprotection from reperfusion injury must overcome the challenge of crossing the blood-brain barrier (BBB). A strategy including thrombolysis and ROS scavenging accompanied by BBB penetration is highly desirable for improving combination therapies in ischemic stroke. Herein, urokinase plasminogen activator (uPA) loaded on black phosphorus nanosheets (BPNs) is tested as a nanodrug for sequential thrombolysis and neuroprotection. The in vitro thrombolysis shows that the uPA-loaded BPNs can efficiently deliver uPA for thrombus dissolution. The residual BPNs after uPA release exhibit ROS scavenging effects, especially for the most common H2O2 and ˙OH species. Moreover, in vivo studies show that the BPNs can cross the BBB with the assistance of laser irradiation, owing to their good photothermal properties. Further experiments show the effectiveness of BPNs for attenuating reperfusion injury and achieving neuroprotection. These results highlight the promising potential of the present BPN-based nanodrugs for the treatment of ROS-related diseases.

Patient Expectation in China: Exploring Patient Satisfaction in Online and Offline Patient-Provider Communication.

Introduction: Online patient-provider communication (OPPC) has become an alternative approach to seek medical advice and contact health professionals. However, its penetration rate remains low, and the underlying mechanisms of patient satisfaction with OPPC are underexamined. This study investigates the role of patient expectancy and the expectancy violation of patient-centered communication (PCC) in patient satisfaction in emerging OPPC scenarios by integrating the concepts of PCC and expectancy violation theory (EVT). Method: An online survey was conducted in October 2019 among Chinese respondents who experienced OPPC and offline medical services. Results: The 471 qualified participants reported high satisfaction with OPPC (mean [M] = 3.63, standard deviation [SD] = 0.81). However, patient satisfaction with OPPC was lower than that in offline medical encounters (M = 3.75, SD = 0.80), and patients suffered a higher expectancy violation of PCC in OPPC scenarios (M = 0.45, SD = 0.76) than in offline medical encounters (M = 0.27, SD = 0.69). Nevertheless, patients' satisfaction with OPPC significantly increased as the frequency of OPPC usage increased (ß = 0.209, p < 0.001). This positive relationship was partially mediated by the decrease in the expectancy violation of PCC in OPPC scenarios. Discussion: The study can contribute to increasing the adoption of OPPC and reducing the burden of offline medical resources.

Rational Construction of a Two-Photon NIR Ratiometric Fluorescent Probe for the Detection of Bisulfite in Live Cells, Tissues, and Foods.

In this study, we report a novel ratiometric fluorescent probe with a blue shift of 180 nm based on a D-π-A-A structure. The probe composed of a hydroxyl moiety as a donor, a naphthyl ring as a π bridge, and benzothiazole/hemicyanine as an acceptor has good selectivity and high sensitivity to bisulfite (HSO3-) in aqueous solution. Besides one-photon fluorescence properties, the probe possesses excellent two-photon fluorescence properties and is successfully utilized for fluorescence imaging of HSO3- in MCF-7 cells and rat liver tissues. More importantly, the probe also has practical application potential for measuring the HSO3- content of real food samples.

Human umbilical cord Wharton's jelly-derived mesenchymal stem cell transplantation could improve diabetic intracavernosal pressure.

Mesenchymal stem cells (MSCs) secrete various cytokines with angiogenic and neuroprotective effects. This study aimed to assess the effects of human umbilical cord Wharton's jelly-derived MSCs (hWJ-MSCs) on diabetes-related intracavernosal pressure (ICP) impairment in rats. hWJ-MSCs were isolated from human umbilical cord Wharton's jelly and transplanted into the corpus cavernosum of streptozotocin (STZ)-induced diabetic rats by unilateral injection. The erectile function was evaluated at 4 weeks, as well as the expression levels of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), endothelial nitric oxide synthase (eNOS), and insulin-like growth factor 1 (IGF1). STZ-induced diabetic rats showed impaired ICP, which was significantly improved by hWJ-MSC treatment. VEGF, eNOS, IGF1, and bFGF expression levels were higher in hWJ-MSC injection sites than those in control ones in STZ-induced diabetic rats. These results suggest that hWJ-MSC transplantation might improve diabetic erectile dysfunction through increased production of paracrine growth factors, highlighting a novel potential therapeutic option for erectile dysfunction.

Risk factors associated with prolonged viral clearance in patients with a refractory course of COVID-19: a retrospective study.

BACKGROUND: This study aimed to characterize a cohort of patients with a refractory course of COVID-19, and to investigate factors associated with the duration of viral clearance (DoVC). MATERIALS & METHODS: A total of 65 patients with refractory COVID-19 were retrospectively enrolled from Huoshenshan Hospital. Univariate analysis and multivariate analysis were performed to examine the potential association between clinicopathologic characteristics and the DoVC. RESULTS: The median DoVC in the overall study cohort was 48 days (ranged from 21 to 104 days). Multivariate analysis indicated that fever at illness onset (Hazard ratio (HR) = 4.897, 95% CI [1.809-13.260], p = 0.002), serum level of aspartate aminotransferase (AST) > 21.8 IU/L (HR = 3.010, 95% CI [1.195-7.578], p = 0.019), and titer of SARS-CoV-2 IgG > 142.09 AU/ml (HR = 3.061, 95% CI [1.263-7.415], p = 0.013) were the three independent risk factors associated with delayed viral clearance. CONCLUSION: The current study suggested that clinical characteristics such as fever at illness onset, a high serum level of AST or SARS-CoV-2 IgG were associated with delayed viral clearance. Patients with these characteristics might need a more individualized treatment strategy to accelerate their recovery from the refractory COVID-19.

Rearrangement of Ion Transport Path on Nano-Cross-linker for All-Solid-State Electrolyte with High Room Temperature Ionic Conductivity.

The low room temperature ionic conductivity (RTσ) of polyethylene oxide (PEO)-based solid-state polymer electrolyte (SPE) severely restricts its application for lithium batteries. Herein, acrylamide (AM) has been introduced into the poly(ethylene glycol) methyl ether methacrylate-poly(ethylene glycol) diacrylate (P-P). The multiple hydrogen bonds of AM expand the original single lithium environment (Li···O-C) to three types (Li···O-C, Li···N-H, and Li···O═C), which accelerates the conduction of lithium ions. In addition, the double bond modification of nanosilica (═SiO2) not only improves the mechanical properties but also brings a high-speed orderly vehicular transport mechanism. The multiple-lithium-ions environment is rearranged on the surface of the ═SiO2 to play a more significant role, making the RTσ of SPE reach 2.6 × 10-4 S cm-1, and the Li-ion transfer number reaches 0.84. The results show that the assembled all-solid-state lithium-sulfur battery has a high initial discharge capacity of 707 mAh g-1 at 30 °C when the sulfur loading is 4.3 mg cm-2, good cycle stability (capacity retention rate of 89% after 100 cycles at 0.1 C), and excellent rate performance. This SPE with high RTσ, stable interface engineering, and broad potential window (5.1 V) is expected to be used in other lithium/lithium-ion batteries that require high-voltage tolerance.

Moderating effect of people-oriented public health services on depression among people under mandatory social isolation during the COVID-19 pandemic: a cross-sectional study in China.

BACKGROUND: Public health measures, such as social isolation, are vital to control the spread of the coronavirus disease 2019 (COVID-19), but such measures may increase the risk of depression. Thus, this study examines the influencing and moderating factors of depressive symptoms among individuals subjected to mandatory social isolation. METHODS: An online cross-sectional survey was conducted to collect data from people under mandatory home or centralized social isolation in Shenzhen, China, from February 28 to March 6, 2020. The perceived risk of infection with COVID-19, perceived tone of media coverage, perceived quality of people-oriented public health services, and their depressive symptoms were assessed. Three rounds of stepwise multiple regression were performed to examine the moderating effects after controlling various variables, such as demographics, duration and venue of mandatory social isolation, infection and isolation status of family, time spent on COVID-related news, and online social support. RESULTS: Among the 340 participants, 57.6% were men, the average age was 35.5 years old (SD = 8.37), and 55.6% held a bachelor's degree or above. Individuals subjected to mandatory social isolation generally reported low levels of depressive symptoms. Perceived susceptibility to infection was relatively low, whereas perceived tone of media coverage was mainly positive. In terms of perceived quality of public health services, 12 (3.5%), 103 (30.3%), and 225 (66.2%) participants reported low, medium, and high quality of people-oriented services, respectively. Perceived susceptibility was positively associated with depression, whereas perceived tone of media coverage was negatively associated. The quality of people-centered public health services moderated the association between perceived risk and depressive symptoms and between perceived tone of media coverage and depressive symptoms. CONCLUSIONS: This study revealed the depressive symptoms among individuals subjected to mandatory social isolation during the COVID-19 pandemic and highlighted that frontline public health workers play a critical role in protecting public mental health.

Persistent Somatic Symptom Burden and Sleep Disturbance in Patients with COVID-19 During Hospitalization and After Discharge: A Prospective Cohort Study.

BACKGROUND The present study was designed to reveal the trajectory of self-reported somatic symptom burden and sleep quality over time in patients with COVID-19 and to identify prognostic factors for greater somatic symptom burden and sleep disturbance. MATERIAL AND METHODS Seventy-four patients with COVID-19 were prospectively followed for longitudinal assessment of somatic symptom burden and sleep quality. We used the 8-item Somatic Symptom Scale (SSS-8) and the modified Medical Research Council (mMRC) scale for somatic symptom burden and the Pittsburgh Sleep Quality Index for sleep quality investigation. Univariate and multivariate analyses were performed to identify independent factors associated with somatic symptom burden and sleep quality. RESULTS Although the degree of physical discomfort and sleep quality issues tended to decline during self-quarantine, patients still experienced these problems to a certain degree. Univariate and multivariate analyses showed that SSS-8 scores at admission (relative risk [RR] 1.234, 95% CI 1.075-1.417, P=0.003) and mMRC scores at discharge (RR 2.420, 95% CI 1.251-4.682, P=0.009) were 2 independent prognostic indicators of somatic symptom burden. In addition, muscle pain as a chief complaint (RR 4.682, 95% CI 1.247-17.580, P<0.022) and history of use of hypnotic drugs (RR 0.148, 95% CI 0.029-0.749, P<0.019) were 2 independent indicators of patient sleep quality during hospitalization. CONCLUSIONS To the best of our knowledge, the present study was the first dynamic assessment of the somatic symptom burden and sleep quality in patients with COVID-19 during hospitalization and quarantine after discharge. Patients with high somatic symptom burden at admission, especially muscle pain as the chief complaint, are prone to having a higher physical burden and more sleep disturbance at discharge.

Modified rehabilitation exercises for mild cases of COVID-19.

BACKGROUND: Coronavirus disease 2019 (COVID-19) caused by a new Betacoronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is currently a global pandemic. Gathered clinicopathological evidence in COVID-19 patients shows that alveoli injuries and interstitial changes are the major mechanisms of impaired O2/CO2 exchange. Few rehabilitation exercises concerning COVID-19 patients were reported. Here, we present a modified version of rehabilitation exercises based on the underlying mechanism of the disease to mild cases of COVID-19. These exercises aimed to improve the pulmonary function of patients and ease the expectoration process. Additionally, an essential branch of Traditional Chinese Medicine (TCM) named acupressure was integrated into the exercises to facilitate the recovery and maintenance of pulmonary function. METHODS: From March 4, 2020 to May 5, 2020, a total of 60 COVID-19 patients who completed the full course of MRE were enrolled in this observational study. The diagnostic and classification criteria were based on the 7th edition of Diagnosis and Treatment Guideline of COVID-19 published by the National Health Commission of the People's Republic of China. We prospectively gathered patients' reported outcomes concerning respiration-related symptoms at four different time points, including: (I) at admission; (II) at the time of hospital discharge; (III) two weeks after discharge; (IV) four weeks after discharge. The reported respiratory symptoms included dry cough, productive cough, difficulty in expectoration, and dyspnea. RESULTS: In total, 60 confirmed mild COVID-19 cases were enrolled with a median age of 54 years old. The baseline prevalence for dry cough, productive cough, difficulty in expectoration, and dyspnea were 41.7%, 43.3%, 35.0%, and 50.0%, respectively. The pronounced decline in symptom prevalence was recorded over time. Interestingly, four weeks after discharge, we noticed a lower remission rate in productive cough and difficulty in expectoration. CONCLUSIONS: The modified rehabilitation exercises were retrieved from the Eight-Section Brocade, and are specifically designed for rehabilitation of COVID-19 patients at home or health facilities. Based on current findings on pronouncedly improved remission rate in respiratory symptoms, we recommend the MRE as suitable rehabilitation exercise to smooth respiration and ease the expectoration process in mild COVID-19 cases.

Sequence-Dependent DNA Functionalization of Upconversion Nanoparticles and Their Programmable Assemblies.

DNA-modified lanthanide-doped upconversion nanoparticles (DNA-UCNPs) that combine the functions of DNA and the optical features of UCNPs have shown great promise in a wide range of fields. However, challenges remain in precisely tethering and orienting the DNA strands on the UCNP surface. Herein, we systematically investigate the sequence dependence of DNAs in their interactions with UCNPs, and reveal that poly-cytosine (poly-C) has high affinity for the UCNP surface. A general approach to synthesize monodispersed DNA-UCNP conjugates is developed using poly-C-containing diblock DNA strands. The poly-C segment of the DNA strand binds to the surfaces of UCNPs and the second segment is oriented perpendicularly on the UCNP surface, making the DNA-UCNPs highly stable and monodispersed in aqueous solution. The dense layer of DNA on the UCNP surface enables the programmable assembly of UCNPs with other DNA-functionalized nanoparticles or DNA origamis through hybridization, resulting in the formation of well-organized complex structures.

Chemical Vapor Transport Reactions for Synthesizing Layered Materials and Their 2D Counterparts.

2D materials, namely thin layers of layered materials, are attracting much attention because of their unique electronic, optical, thermal, and catalytic properties for wide applications. To advance both the fundamental studies and further practical applications, the scalable and controlled synthesis of large-sized 2D materials is desired, while there still lacks ideal approaches. Alternatively, the chemical vapor transport reaction is an old but powerful technique, and is recently adopted for synthesizing 2D materials, producing bulk crystals of layered materials or corresponding 2D films. Herein, recent advancements in synthesizing both bulk layered and 2D materials by chemical vapor transport reactions are summarized. Beginning with a brief introduction of the fundamentals of chemical vapor transport reactions, chemical vapor transport-based syntheses of bulk layered and 2D materials, mainly exampled by transition metal dichalcogenides and black phosphorus, are reviewed. Particular attention is paid to important factors that can influence the reactions and the growth mechanisms of black phosphorus. Finally, perspectives about the chemical vapor transport-based synthesis of 2D materials are discussed, intending to redraw attentions on chemical vapor transport reactions.

Functional black phosphorus nanosheets for mitochondria-targeting photothermal/photodynamic synergistic cancer therapy.

Organelle-targeting nanosystems are envisioned as promising tools for phototherapy, which can generate heat or reactive oxygen species (ROS) induced cytotoxicity in the targeted location but leave the surrounding biological tissues undamaged. In this work, an imaging-guided mitochondria-targeting photothermal/photodynamic nanosystem has been developed on the basis of functionalized black phosphorus (BP) nanosheets (NSs). In the nanosystem, BP NSs are coated with polydopamine (PDA) and then covalently linked with both chlorin e6 (Ce6) and triphenyl phosphonium (TPP) through carbodiimide reaction between the amino group and the carboxyl group, forming BP@PDA-Ce6&TPP NSs. Due to the strong absorbance of BP@PDA in the near-infrared region and the highly efficient ROS generation of Ce6, the as-prepared nanosystem with mitochondria-targeting capacity (TPP moiety) shows remarkably enhanced efficiency in cancer cell killing. Combined photothermal and photodynamic therapy is implemented and monitored by in vivo fluorescence imaging, achieving excellent performance in inhibiting tumor growth. This study presents a novel nanotheranostic agent for mitochondria-targeting phototherapy, which may open new horizons for biomedicine.

Revisiting the Growth of Black Phosphorus in Sn-I Assisted Reactions.

Black phosphorus, an emerging layered material, exhibits promising applications in diverse fields, ranging from electronics to optics. However, controlled synthesis of black phosphorus, particularly its few-layered counterparts, is still challenging, which should be due to the unclear growth mechanism of black phosphorus. Here, taking the most commonly used Sn-I assisted synthesis of black phosphorus as an example, we propose a growth mechanism of black phosphorus crystals by monitoring the reactions and analyzing the as-synthesized products. In the proposed mechanism, Sn24P19.3I8 is the active site for the growth of black phosphorus, and the black phosphorus crystals are formed with the assistance of SnI2, following a polymerization-like process. In addition, we suggest that all Sn-I assisted synthesis of black phosphorus should share the same reaction mechanism despite the differences among Sn-I containing additives. Our results shown here should shed light on the controlled synthesis of black phosphorus and facilitate further applications of black phosphorus.

Expression and prognostic value of cell-cycle-associated genes in gastric adenocarcinoma.

BACKGROUND: Gastric carcinoma is a malignant disease, and gastric adenocarcinoma (GAC) is the most common histological type. Molecular profiling of GAC has been extensively performed, but few have focused on the clinical significance of gene clusters of the cell cycle. METHODS: We investigated the genetic profile of cell-cycle-associated genes in a GAC cohort. The mRNA expression and clinical data were downloaded from TCGA, according to cBioportal. We conducted a series of analyses to detect the relationships between these genes and GAC. RESULTS: From all the patients, 5 clusters were identified based on mRNA expression of 122 cell-cycle-associated genes. Cluster 1 showed the worst prognosis and is characterized by extremely high expression of WEE2 and CCNE1. Comparison of the gene patterns showed that 16 genes expressed were distinctly varied between each cluster. In addition, investigations into the prognostic role of the 16 genes suggested that high expression of ESPL1 and MCM5 were significantly correlated with favorable outcomes. Moreover, we detected that ESPL1 and MCM5 gene expression were negatively correlated with GAC pathologic stage progression. CONCLUSIONS: This study revealed a gene expression pattern of the cell cycle in different GAC subgroups, and suggested individual genes were associated with the clinical outcome and AJCC stages. These results suggest a novel prognostic strategy for GAC and provide information for patient stratification and trials of targeted therapies.

Black Phosphorus Nanosheets Immobilizing Ce6 for Imaging-Guided Photothermal/Photodynamic Cancer Therapy.

In preclinical and clinical research, to destroy cancers, particularly those located in deep tissues, is still a great challenge. Photodynamic therapy and photothermal therapy are promising alternative approaches for tissue cancer curing. Black phosphorus (BP)-based nanomaterials, with broad UV-vis near-infrared absorbance and excellent photothermal effect, have shown great potential in biomedical applications. Herein, a biocompatible therapeutic platform, chlorin e6 (Ce6)-decorated BP nanosheets (NSs), has been developed for fluorescence and thermal imaging-guided photothermal and photodynamic synergistic cancer treatment. Taking advantage of the relatively high surface area of exfoliated BP NSs, the PEG-NH2-modified BP NSs (BP@PEG) are loaded with a Ce6 photosensitizer. The resulted BP@PEG/Ce6 NSs not only have good biocompatibility, physiological stability, and tumor-targeting property but also exhibit enhanced photothermal conversion efficiency (43.6%) compared with BP@PEG NSs (28.7%). In addition, BP@PEG/Ce6 NSs could efficiently generate reactive oxygen species because of the release of the Ce6 photosensitizer, which is also verified by in vitro studies. In vivo fluorescence imaging suggests that BP@PEG/Ce6 NSs can accumulate in the tumor targetedly through the enhanced permeability and retention effect. Both in vitro and in vivo studies suggest that BP@PEG/Ce6 can be a promising nanotheranostic agent for synergetic photothermal/photodynamic cancer therapy.