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BACKGROUND: Observational studies suggest that voluntary medical male circumcision (VMMC) may lower HIV risk among men who have sex with men (MSM). A randomized controlled trial (RCT) is needed to confirm this. OBJECTIVE: To assess the efficacy of VMMC in preventing incident HIV infection among MSM. DESIGN: An RCT with up to 12 months of follow-up. (Chinese Clinical Trial Registry: ChiCTR2000039436). SETTING: 8 cities in China. PARTICIPANTS: Uncircumcised, HIV-seronegative men aged 18 to 49 years who self-reported predominantly practicing insertive anal intercourse and had 2 or more male sex partners in the past 6 months. INTERVENTION: VMMC. MEASUREMENTS: Rapid testing for HIV was done at baseline and at 3, 6, 9, and 12 months. Behavioral questionnaires and other tests for sexually transmitted infections were done at baseline, 6 months, and 12 months. The primary outcome was HIV seroconversion using an intention-to-treat analysis. RESULTS: The study enrolled 124 men in the intervention group and 123 in the control group, who contributed 120.7 and 123.1 person-years of observation, respectively. There were 0 seroconversions in the intervention group (0 infections [95% CI, 0.0 to 3.1 infections] per 100 person-years) and 5 seroconversions in the control group (4.1 infections [CI, 1.3 to 9.5 infections] per 100 person-years). The HIV hazard ratio was 0.09 (CI, 0.00 to 0.81; P = 0.029), and the HIV incidence was lower in the intervention group (log-rank P = 0.025). The incidence rates of syphilis, herpes simplex virus type 2, and penile human papillomavirus were not statistically significantly different between the 2 groups. There was no evidence of HIV risk compensation. LIMITATION: Few HIV seroconversions and limited follow-up period. CONCLUSION: Among MSM who predominantly practice insertive anal intercourse, VMMC is efficacious in preventing incident HIV infection; MSM should be included in VMMC guidelines. PRIMARY FUNDING SOURCE: The National Science and Technology Major Project of China.
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Circuncisión Masculina , Infecciones por VIH , Homosexualidad Masculina , Humanos , Masculino , Adulto , Infecciones por VIH/prevención & control , Infecciones por VIH/epidemiología , Adulto Joven , Adolescente , Persona de Mediana Edad , China/epidemiología , Incidencia , Conducta Sexual , Análisis de Intención de TratarRESUMEN
Men who have sex with men (MSM) have been recommended for targeted monkeypox vaccination. We aimed to investigate monkeypox awareness and explore the correlates of monkeypox vaccination hesitancy among MSM in China. We conducted a cross-sectional survey from August 10 to September 9, 2022. Awareness related to monkeypox and attitude toward monkeypox vaccination among MSM aged ≥18 years were collected. Multivariable logistic regression was applied to evaluate correlates of vaccination hesitancy. The discrepancy in awareness between subgroups regarding HIV status was assessed. A total of 1090 MSM were included (age: median 30 years, interquartile range [IQR], 25-35; HIV-infected: 53.12%). Only 13.85% of respondents expressed high monkeypox vaccination hesitancy. Hesitancy was associated with no fixed income (adjuster odds ratio [aOR], 2.46, 95% confidence interval [CI], 1.48-4.11), infrequent information following (sometimes, 3.01, 1.55-5.83; seldom or never, 5.66, 2.58-12.45), and lack of worries about monkeypox endemic (1.78, 1.11-2.87). Participants who believed that HIV-infected cases accounted for a smaller proportion (1.62, 1.01-2.60), disagreed that monkeypox virus could be detected in semen (2.21, 1.26-3.88), and considered either replication-competent (1.84, 1.14-2.96) or replication-deficient (4.80, 2.26-10.21) monkeypox vaccine unsuitable for HIV-infected people were generally more hesitant. Compared with HIV-uninfected MSM, HIV-infected MSM supported more for vaccination promotion. MSM in China had low hesitancy toward monkeypox vaccination. Safety and affordability of vaccine and availability of information were essential aspects to reduce hesitancy. Education on vaccination benefits should be encouraged to promote future vaccination plans.
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Infecciones por VIH , Mpox , Minorías Sexuales y de Género , Vacuna contra Viruela , Masculino , Humanos , Adolescente , Adulto , Homosexualidad Masculina , Estudios Transversales , Vacilación a la Vacunación , Vacunación , China/epidemiologíaRESUMEN
Obtaining antiretroviral therapy (ART) was a challenge for people living with HIV (PLHIV) in China during the COVID-19 outbreak. On 26 January 2020, the Chinese Center for AIDS/STD Control and Prevention issued a nationwide directive to relax restrictions on where and when PLHIV could refill ART. This qualitative study explored unexpected barriers under this directive and recommendations to improve future ART delivery. Between February 11 and February 15 2020, in-depth interviews of 4 groups of stake holders related to ART refilling (i.e., PLHIV, community-based organization employees, CDC staff, infectious disease physicians and nurses), were conducted via WeChat. Data were managed by NVivo 11.0 and transcripts were coded using thematic analysis. Sixty-two interviews were conducted. The main barriers to refilling ART included: (1) inconsistent documentation requirements to refill ART, (2) lack of specific protocols on ART refilling, (3) insufficient staffing, and (4) regimen verification and drug shortages. The most common recommendations to improve future ART delivery were: (1) to establish a nationwide system to distribute ART and (2) increase the number of pills delivered with each ART refill. Strengthening protocols and systems to refill ART and improving collaboration is key to preventing interruptions in ART among PLHIV during public health emergencies.
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COVID-19 , Infecciones por VIH , Humanos , Infecciones por VIH/tratamiento farmacológico , COVID-19/epidemiología , Pandemias , Investigación Cualitativa , China/epidemiología , Antirretrovirales/uso terapéuticoRESUMEN
With the widespread use of electrical equipment, cognitive functions such as working memory (WM) could be severely affected when people are exposed to 50 Hz electromagnetic fields (EMF) for long term. However, the effects of EMF exposure on WM and its neural mechanism remain unclear. In the present paper, 15 rats were randomly assigned to three groups, and exposed to an EMF environment at 50 Hz and 2 mT for a different duration: 0 days (control group), 24 days (experimental group I), and 48 days (experimental group II). Then, their WM function was assessed by the T-maze task. Besides, their local field potential (LFP) in the media prefrontal cortex (mPFC) was recorded by the in vivo multichannel electrophysiological recording system to study the power spectral density (PSD) of θ and γ oscillations and the phase-amplitude coupling (PAC) intensity of θ-γ oscillations during the T-maze task. The results showed that the PSD of θ and γ oscillations decreased in experimental groups I and II, and the PAC intensity between θ and high-frequency γ (hγ) decreased significantly compared to the control group. The number of days needed to meet the task criterion was more in experimental groups I and II than that of control group. The results indicate that long-term exposure to EMF could impair WM function. The possible reason may be the impaired communication between different rhythmic oscillations caused by a decrease in θ-hγ PAC intensity. This paper demonstrates the negative effects of EMF on WM and reveals the potential neural mechanisms from the changes of PAC intensity, which provides important support for further investigation of the biological effects of EMF and its mechanisms.
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Campos Electromagnéticos , Memoria a Corto Plazo , Humanos , Ratas , Animales , Memoria a Corto Plazo/fisiología , Campos Electromagnéticos/efectos adversos , Corteza Prefrontal , CogniciónRESUMEN
PURPOSE OF REVIEW: Evidence from clinical trials identified the effectiveness of voluntary medical male circumcision (VMMC) as an additional strategy to reduce the risk of HIV transmission from women to men. However, concerns about post-circumcision sexual risk compensation may hinder the scale-up of VMMC programs. We reviewed the evidence of changes in risky sexual behaviors after circumcision, including condomless sex, multiple sex partners, and early resumption of sex after surgery. RECENT FINDINGS: Most clinical trial data indicate that condomless sex and multiple partners did not increase for men after circumcision, and early resumption of sex is rare. Only one post-trial surveillance reports that some circumcised men had more sex partners after surgery, but this did not offset the effect of VMMC. Conversely, qualitative studies report that a small number of circumcised men had increased risky sexual behaviors, and community-based research reports that more men resumed sex early after surgery. With the large-scale promotion and expansion of VMMC services, it may be challenging to maintain effective sexual health educations due to various restrictions. Misunderstandings of the effect of VMMC in preventing HIV infection are the main reason for increasing risky sexual behaviors after surgery. Systematic and practical sexual health counseling services should be in place on an ongoing basis to maximize the effect of VMMC.
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Circuncisión Masculina , Infecciones por VIH , Masculino , Femenino , Humanos , Circuncisión Masculina/psicología , Infecciones por VIH/prevención & control , Infecciones por VIH/epidemiología , Parejas Sexuales , Conducta Sexual/psicología , Sexo InseguroRESUMEN
2D tellurium is a suitable electrocatalyst support that can assist electron transport while hosting active sites, yet its production remains challenging. Herein, a cathodic exfoliation method that can exfoliate Te crystal directly to Te nanosheets at low potential, also enabling simultaneous transition metal doping on Te nanosheet surface is presented. In situ Raman spectra and ex situ characterizations reveal that the cathodic exfoliation relies on the electrostatic repulsion between Te flakes covered with in situ generated ditelluride (Te2 2- ) anions. The Te2 2- anions can anchor metal ions to the surface, and the doping concentration can be tuned by adjusting the concentration of metal ion in the electrolyte. The metal-doped Te nanosheets exhibit highly improved hydrogen evolution activities. In particular, Pt-doped Te outperforms polycrystalline Pt at high overpotential. A collaborative hydrogen production mechanism via Volmer-Heyrovsky pathway is suggested: Te2 2- adsorbs protons and assists the mass transfer to adjacent Pt atoms where the protons are reduced and released as hydrogen.
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2D titanium carbide (Ti3 C2 Tx MXene) is recognized as a promising material for pseudocapacitor electrodes in acidic solutions, while the current studies in neutral electrolytes show much poorer performances. By a simple hydrothermal method, vanadium-doped Ti3 C2 Tx 2D nanosheets are prepared to tune the interaction between MXene and alkali metal adsorbates (Li+ , Na+ , and K+ ) in the neutral electrolyte. Maintaining the 2D morphology of MXene, the coexisting V3+ and V4+ are confirmed to form surface V-C and V-O species. At a medium doping level of V:Ti = 0.17:1, the V-doped MXene exhibits the highest capacitance of 365.9 F g-1 in 2 m KCl (10 mV s-1 ) and excellent stability (5% loss after 5000 cycles), compared to only 115.7 F g-1 of pristine MXene. Density functional theory calculations reveal the stronger alkali metal ion-O interaction on V-doped MXene surface than unmodified MXene and a further capacitance boost to 404.9 F g-1 using Li+ -containing neutral electrolyte is reported, which is comparable to the performance under acidic conditions.
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With excellent performance in the hydrogen evolution reaction (HER), molybdenum disulfide (MoS2 ) is considered a promising nonprecious candidate to substitute Pt-based catalysts. Herein, pulsed laser irradiation in liquid is used to realize one-step exfoliation of bulk 2H-MoS2 to ultrastable few-layer MoS2 nanosheets. Such prepared MoS2 nanosheets are rich in S vacancies and metallic 1T phase, which significantly contribute to the boosted catalytic HER activity. Protic solvents play a pivotal role in the production of S vacancies and 2H-to-1T phase transition under laser irradiation. MoS2 exfoliated in an optimal solvent of formic acid exhibits outstanding HER activity with an overpotential of 180 mV at 10 mA cm-2 and Tafel slope of 54 mV dec-1 .
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Land use/cover change (LUCC), a local environmental issue of global importance, and its driving forces have been crucial issues in geography and environmental research. Previous studies primarily focused on major driving factors in various land use types, with few explorations of differences between driving forces of mutual land use type conversions, especially in fragile eco-environments. In this study, Zhangjiakou City, in a farming-pastoral ecotone in Northern China, was taken as an example to analyze land use change between 1989 and 2015, and explore the driving forces of mutual land use type conversions using canonical correlation analysis. Satellite images and government statistics, including social-economic and natural data, were used as sources. Arable land, forestland, and grassland formed the main land use structure. From 1989 to 2015 forestland, orchard land, and construction land significantly increased, while arable land, grassland, unused land, and water areas decreased. Conversions from grassland to forestland; from arable land to orchard land, forestland and construction land; and from unused land to grassland and forestland were the primary land use changes. Among these, the conversion from grassland to forestland had the highest ranking. Average annual precipitation and per capita net income of rural residents positively affected the conversion of arable land to forestland and unused land to grassland. GDP, total population, and urbanization rate contributed most significantly to converting arable land to construction land; total retail sales of social consumer goods, average annual temperature, and GDP had important positive influences in converting arable land to orchard land.
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Agricultura/tendencias , Conservación de los Recursos Naturales/métodos , Monitoreo del Ambiente/métodos , Bosques , Pradera , Urbanización/tendencias , China , Factores SocioeconómicosRESUMEN
Concentration, composition profile, spatial distribution, sources, and health risk of 16 polycyclic aromatic hydrocarbons (PAHs) were analyzed in 69 surface soil samples collected from Hangzhou urban districts. ∑PAHs ranged from 180.77 to 1,981.45 µg kg(-1) with a mean of 611.28 µg kg(-1). Among different functional areas, a higher level of PAHs was found in the roadsides, followed by commercial districts, residential areas, parks, and greenbelts. The composition of PAHs was characterized by high molecular weight PAHs (4 ~ 6 rings). Principal component analysis (PCA) and PAH isomeric ratios indicated that PAHs mainly originated from combustion, especially vehicle exhaust. The incremental lifetime cancer risks (ILCRs) associated with exposures to PAHs in soil were calculated separately for children and adults under normal and extreme conditions. The results showed that ILCRs for urban soil of Hangzhou were acceptable. However, attentions should be attracted on the sites of high PAH concentrations because the ILCRs were closed to 10(-4) under extreme conditions, especially for children.
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Exposición a Riesgos Ambientales/estadística & datos numéricos , Hidrocarburos Policíclicos Aromáticos/análisis , Contaminantes del Suelo/análisis , Adulto , Niño , China , Ciudades , Exposición a Riesgos Ambientales/análisis , Monitoreo del Ambiente , Humanos , Análisis de Componente Principal , Riesgo , Medición de Riesgo , Suelo/química , Emisiones de Vehículos/análisisRESUMEN
Wencheng waxy yam is famous for its glutinous and resilient taste, similar to waxy rice, but there is currently a lack of systematic research on the quality of this featured product, and little is known about its pesticide residues. We carried out a 2 year investigation of Wencheng waxy yam at seven sites from 2021 to 2022 to determine the oxidase content and phytochemical characteristics, namely, amylose, amylopectin, protein, reducing sugar, and mineral contents, such as K, Fe, and Zn, including the status of pesticide residues. The results showed that the oxidase content was affected by rainfall, and adequate water reduced the production of oxidase, including polyphenol oxidase, peroxidase, and superoxide dismutase, during the late growth stage of waxy yam, which was beneficial for reducing browning in yam processing. Radar map analysis showed that, with comprehensive evaluation, standardized production sites 1 and 2 had a relatively higher quality than 3-7 with small farmers. The results of pesticide multiresidue testing showed that no pesticides were detected in 64.29% of the samples, and the detected residues in the samples were very low, making the consumption of yam safe for consumers. These findings could be beneficial for the exploitation of the health benefits of waxy yam tubers and the innovation of yam-based functional products.
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Seawater electrolysis presents a viable route for sustainable large-scale hydrogen production, yet its practical application is hindered by several technical challenges. These include the sluggish kinetics of hydrogen evolution, poor stability, cation deposition at the cathode, electrode corrosion, and competing chloride oxidation at the anode. To overcome these obstacles, the development of innovative electrocatalysts is crucial. Transition metal phosphides (TMPs) have emerged as promising candidates owing to their superior catalytic performance and tunable structural properties. This review provides a comprehensive analysis of recent progress in the structural engineering of TMPs tailored for efficient seawater electrolysis. We delve into the catalytic mechanisms underpinning hydrogen and oxygen evolution reactions in different pH conditions, along with the detrimental side reactions that impede hydrogen production efficiency. Several methods to prepare TMPs are then introduced. Additionally, detailed discussions on structural modifications and interface engineering tactics are presented, showcasing strategies to enhance the activity and durability of TMP electrocatalysts. By analyzing current research findings, our review aims to inform ongoing research endeavors and foster advancements in seawater electrolysis for practical and ecologically sound hydrogen generation.
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Due to low cost and high energy density, sodium metal batteries (SMBs) have attracted growing interest, with great potential to power future electric vehicles (EVs) and mobile electronics, which require rapid charge/discharge capability. However, the development of high-rate SMBs has been impeded by the sluggish Na+ ion kinetics, particularly at the sodium metal anode (SMA). The high-rate operation severely threatens the SMA stability, due to the unstable solid-electrolyte interface (SEI), the Na dendrite growth, and large volume changes during Na plating-stripping cycles, leading to rapid electrochemical performance degradations. This review surveys key challenges faced by high-rate SMAs, and highlights representative stabilization strategies, including the general modification of SMB components (including the host, Na metal surface, electrolyte, separator, and cathode), and emerging solutions with the development of solid-state SMBs and liquid metal anodes; the working principle, performance, and application of these strategies are elaborated, to reduce the Na nucleation energy barriers and promote Na+ ion transfer kinetics for stable high-rate Na metal anodes. This review will inspire further efforts to stabilize SMAs and other metal (e.g., Li, K, Mg, Zn) anodes, promoting high-rate applications of high-energy metal batteries towards a more sustainable society.
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Fritillaria thunbergii Miq. (Zhe Beimu, F. thunbergii) is widely cultivated in China's Zhejiang province, and pesticides and heavy metals are two major factors affecting its quality and safety. A total of 106 F. thunbergii samples from six main production areas were analyzed for 76 pesticides and four heavy metal content (As, Cd, Hg, and Pb). The pesticide detection rate of the samples was 66.98%; overall, the pesticide residues were very low, and residue levels ranged from 0.010 to 0.231 mg kg-1. The detection rates of As, Cd, Hg, and Pb were 95.3%, 100%, 76.4%, and 100%, respectively. A risk assessment of human exposure to pesticides and heavy metals via intake of F. thunbergii was performed, and the results revealed that the pesticide residues and heavy metal content detected in F. thunbergii does not pose a potential risk to human health, either in the long or short term. The exposure assessment showed that the levels of pesticides and heavy metals in F. thunbergii were safe for human consumption. These results provide useful information on F. thunbergii consumption.
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Fritillaria , Mercurio , Metales Pesados , Residuos de Plaguicidas , Plaguicidas , Humanos , Fritillaria/química , Cadmio , Plomo , Metales Pesados/análisis , Medición de Riesgo , ChinaRESUMEN
Dendrobium officinale Kimura et Migo (D. officinale) is a traditional Chinese medicine homologous to food, and its safety has attracted considerable attention. Pesticide residues are critical indicators for evaluating the safety of D. officinale. This study investigated the levels of 130 pesticides in 137 stem samples and 82 leaf samples from five main production areas of D. officinale in Zhejiang Province, along with the associated risk of dietary exposure for the population between 2019 and 2021. Forty-five pesticides were detected in 171 samples, of which pyraclostrobin had the highest detection frequency. Multiple residues were detected in 52.56% of the stem samples and 54.88% of the leaf samples, and one stem sample contained up to 18 pesticides. Here, the level of difenoconazole in three samples (two stem samples and one leaf sample) was higher than the maximum residue limit (MRL) in China. Considering the possible health risks related to pesticide residues, a risk assessment of human exposure to pesticides via the intake of D. officinale stems and leaves was evaluated, indicating negligible short-term, long-term, and cumulative risks to human health. However, considering the high detection rate of unregistered pesticides, the supplementation of pesticide registration information on D. officinale should be expedited, and MRLs should be established to ensure food and drug safety.
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Dendrobium , Residuos de Plaguicidas , Plaguicidas , Humanos , Residuos de Plaguicidas/análisis , Medicina Tradicional China , Contaminación de Alimentos/análisis , Medición de RiesgoRESUMEN
Objective: This study aims to evaluate the importance of the gestational age at diagnosis and the types of cesarean scar pregnancy (CSP) for treatment outcomes and to identify the optimal treatment based on both the gestational age at diagnosis and the CSP type. Methods: A retrospective cohort study included 223 pregnant women diagnosed with CSP at Peking University First Hospital, Beijing, China, between 2014 and 2018. All CSP cases underwent ultrasound-guided vacuum aspiration followed by supplementary curettage. Adjuvant treatment modalities included intramuscular injection of systemic methotrexate, uterine artery embolization, and hysteroscopy before ultrasound-guided vacuum aspiration. Linear regression was used to determine the relationship between intraoperative blood loss and gestational age at diagnosis, CSP type, highest ß-human chorionic gonadotropin level, and management procedures. Results: None of the patients required blood transfusions or hysterectomies. Patients presenting at <8, 8-10, and >10 weeks had median estimated blood loss of 5, 10, and 35â ml, respectively. Patients with type I CSP, type II CSP, and type III CSP had median blood loss of 5, 5 and 10â ml, respectively. Multivariate linear regression analysis demonstrated that the gestational age at diagnosis (p < 0.001) and type of CSP (p = 0.023) were independent predictors of intraoperative estimated blood loss. For type I CSP patients, ultrasound-guided vacuum aspiration followed by supplementary curettage alone was performed in 15 of 34 (44.1%) patients, including 12/27 (44.4%) diagnosed at <8 weeks, 2/6 (33.3%) at 8-10 weeks, and 1/1 for >10 weeks. In type II CSP patients, fewer cases were managed by ultrasound-guided vacuum aspiration followed by supplementary curettage alone as the gestational age at diagnosis increased [18/96 (18.8%) for <8 weeks, 7/41 (17.1%) for 8-10 weeks, none for >10 weeks]. Most type III CSP patients (41/45, 91.1%) needed treatments in addition to the ultrasound-guided vacuum aspiration regardless of the gestational age at diagnosis. All CSP patients were treated successfully and did not require readmission or further medical interventions. Conclusion: Gestational age at diagnosis of CSP and its type show a strong correlation with estimated blood loss during ultrasound-guided vacuum aspiration. With careful management, CSPs may be treated at any gestational week, regardless of their type, with minimal intraoperative bleeding.
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INTRODUCTION: Existing studies on sexual health generally focus on younger populations, while the sexual well-being of older adults has received insufficient attention. This protocol describes the design of a study on sexual well-being and its correlates among older adults in China. METHODS AND ANALYSIS: We present the protocol for a multicentre observational study to investigate sexual well-being among Chinese older adults (SWELL). Eligible participants are men and women aged 50 years and older from East, West, South and North China, including older adults living in the community and older adults living with HIV. A multistage sampling approach is used in the SWELL Study. We will collect a questionnaire about sexual health (sexual knowledge, sexual attitude, sexual behaviours, sexually transmitted infections, etc). Blood specimens will be tested for sex hormones (estradiol for women, testosterone for men), biochemical items (eg, cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein, urea, creatinine and uric acid) and syphilis (determined by toluidine red unheated serum test and Treponema pallidum particle agglutination test). The primary analysis will elucidate the current status of sexual health among older adults in China and its correlates. Secondary analyses will compare sexual well-being among older adults in four regions across China. Approximately 3540 older adults will be recruited into the SWELL Study. ETHICS AND DISSEMINATION: This study was approved by the Human Research Ethics Committee of the School of Public Health (Shenzhen), Sun Yat-sen University (approval number SYSU-PHS[2019]006). Verbal informed consent will be obtained from all participants before any study procedure. Data will be anonymised, and participants will not be identified through any data, transcripts or publications. Findings from the SWELL Study will be disseminated widely through peer-reviewed scientific journals and at national and international conferences.
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Infecciones por VIH , Enfermedades de Transmisión Sexual , Masculino , Humanos , Femenino , Persona de Mediana Edad , Anciano , Estudios Transversales , Homosexualidad Masculina , Conducta Sexual , China , Estudios Observacionales como Asunto , Estudios Multicéntricos como AsuntoRESUMEN
BACKGROUND: Systematic reviews and meta-analyses based on observational studies have shown voluntary medical male circumcision (VMMC) may reduce HIV risk among men who have sex with men (MSM). There is a lack of randomized controlled trial (RCT) data assessing the efficacy of VMMC. OBJECTIVE: The primary objective of this study was to assess the efficacy of VMMC for preventing HIV acquisition among MSM who primarily engage in insertive anal sex. METHODS: A multicenter RCT will be conducted among MSM in 8 cities in China. Eligible participants are men aged 18-49 years who self-report ≥2 male sex partners in the past 6 months, predominantly practice insertive anal sex, and are willing to undergo circumcision. Interested men who satisfy inclusion criteria will be tested for HIV 1 month before enrollment and at enrollment, and only those who are HIV negative will be enrolled. At baseline, all enrolled participants will be asked to report sociodemographic characteristics and sexual behaviors; provide a blood sample for HIV, syphilis, and herpes simplex virus type 2 testing; and provide a penile swab for human papillomavirus testing. Participants will be randomly assigned to the intervention or control group. Those in the intervention group will receive VMMC and undergo a web-based weekly follow-up assessment of postsurgery healing for 6 consecutive weeks. All participants will be tested for HIV at 3-, 6-, 9-, and 12-month follow-ups. All participants will also be asked to report sexual behaviors and undergo repeat herpes simplex virus type 2 and human papillomavirus testing at 6- and 12-month follow-ups. The primary end point is HIV seroconversion. Secondary end points are the safety and satisfaction with VMMC and the changes in sexual behaviors after VMMC. The grouped censored data will be analyzed by intention-to-treat approach. RESULTS: Recruitment for the RCT began in August 2020 and continued through July 2022. Data collection is expected to be completed by July 2023, and full data analysis is going to be completed by September 2023. CONCLUSIONS: This study will be the first RCT to assess the efficacy of VMMC in preventing HIV infection among MSM. Results from this trial will provide preliminary evidence for the potential efficacy of VMMC to reduce incident HIV infection among MSM. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2000039436; https://www.chictr.org.cn/showproj.html?proj=63369. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/47160.
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Placenta accreta spectrum (PAS) is a series of disorders, which means that the placental trophoblast invades into the myometrium of the uterine wall. It is a serious obstetric complication which could be detected by ultrasound prenatally. In order to compare our placenta accreta scoring system with prenatal ultrasound staging system and International Federation of Gynecology and Obstetrics (FIGO) clinical classification, we did a retrospective study including 105 patients diagnosed with PAS disorders by operation or pathology at Peking University First Hospital, Beijing, China, between January, 2019 and December, 2020. Placenta accreta scoring system, prenatal ultrasound staging system and FIGO clinical classification were used on each patient. Basic information and clinical outcomes including gestational weeks, intraoperative hemorrhage, hysterectomy rate and blood transfusion were also counted. Both of placenta accreta scoring system, prenatal ultrasound staging system can give a rather clear prediction of placenta percreta, with their area under curve were 0.872 (95% confidential interval [CI]: 0.793-0.951) and 0.864 (95%CI: 0.779-0.949), P value were .000 compared with clinical classification. Beside for ultrasound staging system was designed for placenta previa patients, all those 3 criteria showed their relationships with preterm birth, hysterectomy rate and intraoperative bleeding. PAS scoring system also had the ability to predict a gestational week of deliveryâ ≤34 weeks, intraoperative massive bleedingâ ≥2000 mL and hysterectomy at over 12 points. Our placenta accreta scoring system had good accordance with pre-operational ultrasound staging and FIGO clinical classification, with higher universality for patients without placenta previa.
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Placenta Accreta , Placenta Previa , Nacimiento Prematuro , Humanos , Recién Nacido , Femenino , Embarazo , Placenta Accreta/diagnóstico , Placenta Previa/diagnóstico por imagen , Estudios Retrospectivos , Ultrasonografía Prenatal , Placenta/patologíaRESUMEN
Convenient, and sensitive detection of pesticides and their metabolites in environmental or food samples is critical for assessing potential environmental and health risks. Here, a three-dimensional (3D) electrochemical sensing platform is proposed based on the integration of nanochannel array on pre-activated 3D graphene (p-3DG) electrodes with no need of additional adhesive layers, which enables sensitive detection of prochloraz and 2,4,6-trichlorophenol (TCP) in environmental and food samples. Through two-step electrochemical polarization, organic phase anodic oxidation, and aqueous phase cathodic reduction, p-3DG electrodes with high active area and excellent electrocatalytic performance were obtained. Vertically-ordered mesoporous silica-nanochannel film (VMSF) can be rapidly grown on the surface of p-3DG by an electrochemical-assisted self-assembly (EASA) method. Taking advantage of the high electrocatalytic activity of p-3DG and the ability of nanochannels to enrich TCP through hydrogen bonding, the VMSF/p-3DG sensor can sensitively detect TCP in the range of 10 nM to 0.1 µM and 0.1-15 µM with a low limit of detection (LOD) of 2.4 nM. Compared with p-3DG and VMSF-modified 2D electrodes, the fabricated sensor has a wide detection linear range and low LOD. The coexistence of model interferents such as protein, surfactant, and humic acid did not affect the electrochemical response of TCP, confirming the high anti-fouling ability of the VMSF/p-3DG sensor. In addition, prochloraz in vegetable and fruit samples was indirectly determined because TCP was the metabolite of prochloraz.