Self-Assembled Microfiber-Like Biohydrogel for Ultrasensitive Whole-Cell Electrochemical Biosensing in Microdroplets.

A novel microfiber-like biohydrogel was fabricated by a facile approach relying on electroactive bacteria-induced graphene oxide reduction and confined self-assembly in a capillary tube. The microfiber-like biohydrogel (d = ∼1 mm) embedded high-density living cells and activated efficient electron exchange between cells and the conductive graphene network. Further, a miniature whole-cell electrochemical biosensing system was developed and applied for fumarate detection under -0.6 V (vs Ag/AgCl) applied potential. Taking advantage of its small size, high local cell density, and excellent electron exchange, this microfiber-like biohydrogel-based sensing system reached a linear calibration curve (R2 = 0.999) ranging from 1 nM to 10 mM. The limit of detection obtained was 0.60 nM, which was over 1300 times lower than a traditional biosensor for fumarate detection in 0.2 µL microdroplets. This work opened a new dimension for miniature whole-cell electrochemical sensing system design, which provided the possibility for bioelectrochemical detection in small volumes or three-dimensional local detection at high spatial resolutions.

Medication clusters at hospital discharge and risk of adverse drug events at 30 days postdischarge: A population-based cohort study of older adults.

AIMS: Certain combinations of medications can be harmful and may lead to serious adverse drug events (ADEs). Identifying potentially problematic medication clusters could help guide prescribing and/or deprescribing decisions in hospital. The aim of this study is to characterize medication prescribing patterns at hospital discharge and determine which medication clusters were associated with an increased risk of ADEs in the 30-day posthospital discharge. METHODS: All residents of the province of Ontario in Canada aged 66 years or older admitted to hospital between March 2016 and February 2017 were included. Identification of medication clusters prescribed at hospital discharge was conducted using latent class analysis. Cluster identification and categorization were based on medications dispensed up to 30-day posthospitalization. Multivariable logistic regression was used to assess the potential association between membership to a particular medication cluster and ADEs postdischarge, while also evaluating other patient characteristics. RESULTS: In total, 188 354 patients were included in the study cohort. Median age (interquartile range) was 77 (71-84) years, and patients had a median (IQR) (interquartile range [IQR]) of 9 (6-13) medications dispensed prior to admission. Within the study population, 6 separate clusters of dispensing patterns were identified: cardiovascular (14%), respiratory (26%), complex care needs (12%), cardiovascular and metabolic (15%), infection (10%), and surgical (24%). Overall, 12 680 (7%) patients had an ADE in the 30 days following discharge. After considering other patient characteristics, those belonging to the respiratory cluster had the highest risk of ADEs (adjusted odds ratio: 1.12, 95% confidence interval: 1.08-1.17) compared with all the other clusters, while those in the complex care needs cluster had the lowest risk (adjusted odds ratio: 0.82, 95% confidence interval: 0.77-0.87). CONCLUSION: This study suggests that ADEs post hospital discharge can be linked with identifiable medication clusters. This information may help clinicians and researchers better understand patient populations that are more or less likely to benefit from peri-hospital discharge interventions aimed at reducing ADEs.

Global SARS-CoV-2 seroprevalence from January 2020 to April 2022: A systematic review and meta-analysis of standardized population-based studies.

BACKGROUND: Our understanding of the global scale of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection remains incomplete: Routine surveillance data underestimate infection and cannot infer on population immunity; there is a predominance of asymptomatic infections, and uneven access to diagnostics. We meta-analyzed SARS-CoV-2 seroprevalence studies, standardized to those described in the World Health Organization's Unity protocol (WHO Unity) for general population seroepidemiological studies, to estimate the extent of population infection and seropositivity to the virus 2 years into the pandemic. METHODS AND FINDINGS: We conducted a systematic review and meta-analysis, searching MEDLINE, Embase, Web of Science, preprints, and grey literature for SARS-CoV-2 seroprevalence published between January 1, 2020 and May 20, 2022. The review protocol is registered with PROSPERO (CRD42020183634). We included general population cross-sectional and cohort studies meeting an assay quality threshold (90% sensitivity, 97% specificity; exceptions for humanitarian settings). We excluded studies with an unclear or closed population sample frame. Eligible studies-those aligned with the WHO Unity protocol-were extracted and critically appraised in duplicate, with risk of bias evaluated using a modified Joanna Briggs Institute checklist. We meta-analyzed seroprevalence by country and month, pooling to estimate regional and global seroprevalence over time; compared seroprevalence from infection to confirmed cases to estimate underascertainment; meta-analyzed differences in seroprevalence between demographic subgroups such as age and sex; and identified national factors associated with seroprevalence using meta-regression. We identified 513 full texts reporting 965 distinct seroprevalence studies (41% low- and middle-income countries [LMICs]) sampling 5,346,069 participants between January 2020 and April 2022, including 459 low/moderate risk of bias studies with national/subnational scope in further analysis. By September 2021, global SARS-CoV-2 seroprevalence from infection or vaccination was 59.2%, 95% CI [56.1% to 62.2%]. Overall seroprevalence rose steeply in 2021 due to infection in some regions (e.g., 26.6% [24.6 to 28.8] to 86.7% [84.6% to 88.5%] in Africa in December 2021) and vaccination and infection in others (e.g., 9.6% [8.3% to 11.0%] in June 2020 to 95.9% [92.6% to 97.8%] in December 2021, in European high-income countries [HICs]). After the emergence of Omicron in March 2022, infection-induced seroprevalence rose to 47.9% [41.0% to 54.9%] in Europe HIC and 33.7% [31.6% to 36.0%] in Americas HIC. In 2021 Quarter Three (July to September), median seroprevalence to cumulative incidence ratios ranged from around 2:1 in the Americas and Europe HICs to over 100:1 in Africa (LMICs). Children 0 to 9 years and adults 60+ were at lower risk of seropositivity than adults 20 to 29 (p < 0.001 and p = 0.005, respectively). In a multivariable model using prevaccination data, stringent public health and social measures were associated with lower seroprevalence (p = 0.02). The main limitations of our methodology include that some estimates were driven by certain countries or populations being overrepresented. CONCLUSIONS: In this study, we observed that global seroprevalence has risen considerably over time and with regional variation; however, over one-third of the global population are seronegative to the SARS-CoV-2 virus. Our estimates of infections based on seroprevalence far exceed reported Coronavirus Disease 2019 (COVID-19) cases. Quality and standardized seroprevalence studies are essential to inform COVID-19 response, particularly in resource-limited regions.

Chinese mothers' intent to disclose the HIV status to their children: the role of outcome expectations and self-efficacy.

The present study examined the association between outcome expectations, self-efficacy, and intention to disclose HIV status to children among HIV-positive women in China, and the moderating and mediating role of self-efficacy on the association between outcome expectations and intention to disclose. A cross-sectional survey was conducted among 179 HIV-positive mothers who had at least one living child aged >5 years and had not yet disclosed their HIV status to her oldest child. Results from hierarchical regressions revealed that after adjusting for socio-demographic and medical variables, negative outcome expectations had a negative association (ß = -0.22), while disclosure self-efficacy had a positive association (ß = 0.43) with an intention to disclose HIV. The moderation effect of self-efficacy on the association between outcome expectations and intention to disclose HIV was not significant. Results from structural equation modeling showed that self-efficacy mediated the association between negative/positive outcome expectations and intention to disclose HIV. Findings support the importance of outcome expectations and self-efficacy and also the mediating role of self-efficacy in HIV disclosure among HIV-positive mothers in the Chinese context.

Simple and effective serum biomarkers potential for predicting status epilepticus in anti-N-methyl-D-aspartate receptor encephalitis.

BACKGROUND: Patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis who also present with status epilepticus (SE) often have a poor prognosis. The aim of this study is to explore simple and effective predictors for anti-NMDAR encephalitis accompanied with SE. METHODS: We retrospectively analyzed 65 anti-NMDAR encephalitis patients from January 2015 to December 2018 who admitted to the Third Affiliated Hospital of Sun Yat-sen University. Patients were divided into SE group and non-SE groups. Their pre-treatment data and 3-month follow-up data were retrospectively analyzed. RESULTS: The results showed that compared with the non-SE group, the levels of serum uric acid (UA) and high-density lipoprotein cholesterol (HDL-C) in anti-NMDAR encephalitis patients with SE decreased significantly before treatment. Additionally, the levels of serum UA and HDL-C increased while the level of C-reactive protein (CRP) decreased 3 months after treatment in the SE group. Compared with the non-SE group, the SE patients had higher modified Rankin scale (mRS) scores before (mRS1) and after treatment (mRS2). Serum UA concentrations before treatment showed significantly negative correlations with mRS1 (r = - 0.407, p < 0.01) and mRS2 (r = - 0.458, p < 0.001), while the level of serum CRP before treatment had strong positive correlations with mRS1 (r = 0.304, p < 0.05) and mRS2 (r = 0.301, p < 0.05) in anti-NMDAR encephalitis patients. The receiver operating characteristic curve demonstrated that the combined detection of UA, HDL-C and CRP before treatment had a significantly higher value (the area under the curve = 0.848; 95% confidence interval [CI], 0.74-0.957; p < 0.001) to predict anti-NMDAR encephalitis accompanied with SE than that of single detection. CONCLUSIONS: Hence, the combined detection of serum UA, HDL-C and CRP before treatment may be simple and effective indicators for predicting SE in anti-NMDAR encephalitis, which may be helpful in early stages to remind clinicians to be alert to the emergence of SE.

Classification of type 2 diabetes mellitus with or without cognitive impairment from healthy controls using high-order functional connectivity.

Type 2 diabetes mellitus (T2DM) is associated with cognitive impairment and may progress to dementia. However, the brain functional mechanism of T2DM-related dementia is still less understood. Recent resting-state functional magnetic resonance imaging functional connectivity (FC) studies have proved its potential value in the study of T2DM with cognitive impairment (T2DM-CI). However, they mainly used a mass-univariate statistical analysis that was not suitable to reveal the altered FC "pattern" in T2DM-CI, due to lower sensitivity. In this study, we proposed to use high-order FC to reveal the abnormal connectomics pattern in T2DM-CI with a multivariate, machine learning-based strategy. We also investigated whether such patterns were different between T2DM-CI and T2DM without cognitive impairment (T2DM-noCI) to better understand T2DM-induced cognitive impairment, on 23 T2DM-CI and 27 T2DM-noCI patients, as well as 50 healthy controls (HCs). We first built the large-scale high-order brain networks based on temporal synchronization of the dynamic FC time series among multiple brain region pairs and then used this information to classify the T2DM-CI (as well as T2DM-noCI) from the matched HC based on support vector machine. Our model achieved an accuracy of 79.17% in T2DM-CI versus HC differentiation, but only 59.62% in T2DM-noCI versus HC classification. We found abnormal high-order FC patterns in T2DM-CI compared to HC, which was different from that in T2DM-noCI. Our study indicates that there could be widespread connectivity alterations underlying the T2DM-induced cognitive impairment. The results help to better understand the changes in the central neural system due to T2DM.

Constipation induced gut microbiota dysbiosis exacerbates experimental autoimmune encephalomyelitis in C57BL/6 mice.

BACKGROUND: Constipation is a common gastrointestinal dysfunction which has a potential impact on people's immune state and their quality of life. Here we investigated the effects of constipation on experimental autoimmune encephalomyelitis (EAE), an animal model of multiple sclerosis (MS). METHODS: Constipation was induced by loperamide in female C57BL/6 mice. The alternations of gut microbiota, permeability of intestinal barrier and blood-brain barrier, and histopathology of colon were assessed after constipation induction. EAE was induced in the constipation mice. Fecal microbiota transplantation (FMT) was performed from constipation mice into microbiota-depleted mice. Clinical scores, histopathology of inflammation and demyelination, Treg/Th17 and Treg17/Teff17 imbalance both in the peripheral lymphatic organs and central nervous system, cytokines include TGF-ß, GM-CSF, IL-10, IL-17A, IL-17F, IL-21, IL-22, and IL-23 in serum were assessed in different groups. RESULTS: Compared with the vehicle group, the constipation mice showed gut microbiota dysbiosis, colon inflammation and injury, and increased permeability of intestinal barrier and blood-brain barrier. We found that the clinical and pathological scores of the constipation EAE mice were severer than that of the EAE mice. Compared with the EAE mice, the constipation EAE mice showed reduced percentage of Treg and Treg17 cells, increased percentage of Th17 and Teff17 cells, and decreased ratio of Treg/Th17 and Treg17/Teff17 in the spleen, inguinal lymph nodes, brain, and spinal cord. Moreover, the serum levels of TGF-ß, IL-10, and IL-21 were decreased while the GM-CSF, IL-17A, IL-17F, IL-22, and IL-23 were increased in the constipation EAE mice. In addition, these pathological processes could be transferred via their gut microbiota. CONCLUSIONS: Our results verified that constipation induced gut microbiota dysbiosis exacerbated EAE via aggravating Treg/Th17 and Treg17/Teff17 imbalance and cytokines disturbance in C57BL/6 mice.

Analyzing the electron trajectories in strong-field tunneling ionization with the phase-of-the-phase spectroscopy.

By numerically solving the time-dependent Schrödinger equation, we theoretically study strong-field tunneling ionization of Ar atom in the parallel two-color field which consists of a strong fundamental pulse and a much weaker second harmonic component. Based on the quantum orbits concept, we analyzed the photoelectron momentum distributions with the phase-of-the-phase spectroscopy, and the relative contributions of the two parts of the photoelectrons produced during the rising and falling edges of the adjacent quarters of the laser cycle are identified successfully. Our results show that the relative contributions of these two parts depend on both of the transverse and longitude momenta. By comparing the results from model atoms with Coulomb potential and short-range potential, the role of the long-range Coulomb interaction on the relative contributions of these two parts of electrons is revealed. Additionally, we show that the effects of Coulomb interaction on ionization time are vital for identifying their relative contributions.

Did the universal zero-markup drug policy lower healthcare expenditures? Evidence from Changde, China.

BACKGROUND: The zero-markup drug policy (also known as the universal zero-markup drug policy (UZMDP)) was implemented in stages beginning with primary healthcare facilities in 2009 and eventually encompassing city public hospitals in 2016. This policy has been a central pillar of Chinese health reforms. While the literature has examined the impacts of this policy on healthcare utilization and expenditures, a more comprehensive and detailed assessment is warranted. The purpose of this paper is to explore the impacts of the UZMDP on inpatient and outpatient visits as well as on both aggregate healthcare expenditures and its various components (including drug, diagnosis, laboratory, and medical consumables expenditures). METHODS: A pre-post design was applied to a dataset extracted from the Changde Municipal Human Resource and Social Security Bureau comprising discharge data on 27,246 inpatients and encounter data on 48,282 outpatients in Changde city, Hunan province, China. The pre-UZMDP period for the city public hospitals was defined as the period from October 2015 to September 2016, while the post-UZMDP period was defined as the period from October 2016 to September 2017. Difference-in-Difference negative binomial and Tobit regression models were employed to evaluate the impacts of the UZMDP on healthcare utilization and expenditures, respectively. RESULTS: Four key findings flow from our assessment of the impacts of the UZMDP: first, outpatient and inpatient visits increased by 8.89 % and 9.39 %, respectively; second, average annual inpatient and outpatient drug expenditures fell by 4,349.00 CNY and 1,262.00 CNY, respectively; third, average annual expenditures on other categories of healthcare expenditures increased by 2,500.83 CNY, 417.10 CNY, 122.98 CNY, and 143.50 CNY for aggregate inpatient, inpatient diagnosis, inpatient laboratory, and outpatient medical consumables expenditures, respectively; and fourth, men and older individuals tended to have more inpatient and outpatient visits than their counterparts. CONCLUSIONS: Although the UZMDP was effective in reducing both inpatient and outpatient drug expenditures, it led to a sharp rise in other expenditure categories. Policy decision makers are advised to undertake efforts to contain the growth in total healthcare expenditures, in general, as well as to evaluate the offsetting effects of the policy on non-drug components of care.

Internet Access, Social Risk Factors, and Web-Based Social Support Seeking Behavior: Assessing Correlates of the "Digital Divide" Across Neighborhoods in The State of Maryland.

We aimed to empirically measure the degree to which there is a "digital divide" in terms of access to the internet at the small-area community level within the State of Maryland and the City of Baltimore and to assess the relationship and association of this divide with community-level SDOH risk factors, community-based social service agency location, and web-mediated support service seeking behavior. To assess the socio-economic characteristics of the neighborhoods across the state, we calculated the Area Deprivation Index (ADI) using the U.S. Census, American Community Survey (5-year estimates) of 2017. To assess the digital divide, at the community level, we used the Federal Communications Commission (FCC) data on the number of residential fixed Internet access service connections. We assessed the availability of and web-based access to community-based social service agencies using data provided by the "Aunt Bertha" information platform. We performed community and regional level descriptive and special analyses for ADI social risk factors, connectivity, and both the availability of and web-based searches for community-based social services. To help assess potential neighborhood linked factors associated with the rates of web-based social services searches by individuals in need, we applied logistic regression using generalized estimating equation modeling. Baltimore City contained more disadvantaged neighborhoods compared to other areas in Maryland. In Baltimore City, 20.3% of neighborhoods (defined by census block groups) were disadvantaged with ADI at the 90th percentile while only 6.6% of block groups across Maryland were in this disadvantaged category. Across the State, more than half of all census tracts had 801-1000 households (per 1000 households) with internet subscription. In contrast, in Baltimore City about half of all census tracts had only 401-600 of the households (per 1000 households) with internet subscriptions. Most block groups in Maryland and Baltimore City lacked access to social services facilities (61% of block groups at the 90th percentile of disadvantage in Maryland and 61.3% of block groups at the 90th percentile of disadvantage in Baltimore City). After adjusting for other variables, a 1% increase in the ADI measure of social disadvantage, resulting in a 1.7% increase in the number of individuals seeking social services. While more work is needed, our findings support the premise that the digital divide is closely associated with other SDOH factors. The policymakers must propose policies to address the digital divide on a national level and also in disadvantaged communities experiencing the digital divide in addition to other SDOH challenges.

Healthcare Costs and Utilization among Patients Hospitalized for Malignant Pleural Effusion.

BACKGROUND: Malignant pleural effusion (MPE) poses a considerable healthcare burden, but little is known about trends in directly attributable hospital utilization. OBJECTIVE: We aimed to study national trends in healthcare utilization and outcomes among hospitalized MPE patients. METHODS: We analyzed adult hospitalizations attributable to MPE using the Healthcare Cost and Utilization Project - National Inpatient Sample (HCUP-NIS) databases from 2004, 2009, and 2014. Cases were included if MPE was coded as the principal admission diagnosis or if unspecified pleural effusion was coded as the principal admission diagnosis in the setting of metastatic cancer. Annual hospitalizations were estimated for the entire US hospital population using discharge weights. Length of stay (LOS), hospital charges, and hospital mortality were also estimated. RESULTS: We analyzed 92,034 hospital discharges spanning a decade (2004-2014). Yearly hospitalizations steadily decreased from 38,865 to 23,965 during this time frame, the mean LOS decreased from 7.7 to 6.3 days, and the adjusted hospital mortality decreased from 7.9 to 4.5% (p = 0.00 for all trend analyses). The number of pleurodesis procedures also decreased over time (p = 0.00). The mean inflation-adjusted charge per hospitalization rose from USD 41,252 to USD 56,951, but fewer hospitalizations drove the total annual charges down from USD 1.51 billion to USD 1.37 billion (p = 0.00 for both analyses). CONCLUSIONS: The burden of hospital-based resource utilization associated with MPE has decreased over time, with a reduction in attributable hospitalizations by one third in the span of 1 decade. Correspondingly, the number of inpatient pleurodesis procedures has decreased during this time frame.

Acetylcholine regulates the development of experimental autoimmune encephalomyelitis via the CD4+ cells proliferation and differentiation.

Purpose of the study: Multiple sclerosis is a CD4+ T cell mediated autoimmune disease characterized by inflammatory demyelination in the central nervous system. Acetylcholine (ACh) has been reported to be released by T lymphocytes and plays as an inflammation and immune regulator through the participation of T cells. However, both attenuated and aggravated effects of ACh in inflammation were found. The aim of this study is to further investigate the role of ACh in experimental autoimmune encephalomyelitis (EAE).Materials and methods: The left cervical vagotomy was performed to inhibit ACh release with the sham-operation as control. ACh in cerebral cortex and splenocytes culture supernatants of EAE mice were determined. Interleukin-6, interferon-γ, interleukin-4 and interleukin-17A in brain and splenocytes culture supernatants were evaluated by enzyme-linked immunosorbent assay. The proportion of CD4+ T cells and subsets were assessed by flow cytometry.Results: Compared with the sham-operation group, improved clinical and pathological parameters as well as decreased interleukin-6, interferon-γ, interleukin-4 and interleukin-17A were found in EAE mice with vagotomy suppressing the ACh. Marked reductions of CD4+ and CD4+ChAT+ cells, as well as significant decrease in Th1 with a bias to Th2 in Th1/Th2 balance and increased ChAT+Th2 proportion in the spleen were also observed in vagotomized mice.Conclusions: These findings emphasize that inhibiting ACh release by vagotomy can ameliorate the exacerbation of EAE through suppressing CD4+ T cells proliferation and regulating the differentiation of Th1, Th2 and Th17.

Internal collision induced strong-field nonsequential double ionization in molecules.

Using the classical ensemble method, we have investigated the alignment dependence of the correlated electron dynamics in strong-field nonsequential double ionization (NSDI) of diatomic molecules driven by linearly polarized laser pulses. Our numerical results show that the correlated electron pairs are more likely to emit into the same hemisphere (side-by-side emission) for the parallel aligned molecules at the small internuclear distance, in agreement with previous experimental results. Surprisingly, as the internuclear distance increases, this side-by-side emission is more prevalent for the perpendicularly aligned molecules. Back analyzing of the classical trajectories shows that a considerable part of the NSDI events for the parallel aligned molecules at the large internuclear distances occur through an internal collision, not the well-known recollision. In the internal collision induced NSDI, the first electron tunnels through the inner barrier from the up-field core, moves directly towards the other core, and kicks out the second electron. For this type of NSDI events, the electron pairs are more likely to emit into the opposite hemispheres and thus the correlated electron momentum spectrum exhibits a more dominant back-to-back behavior in the parallel aligned molecules.

Timing the release of the correlated electrons in strong-field nonsequential double ionization by circularly polarized two-color laser fields.

With the semiclassical ensemble model, we systematically investigate the correlated electron dynamics in strong-field nonsequential double ionization (NSDI) by the counter-rotating circularly polarized two-color (CPTC) laser pulses. Our results show that the angular distributions of the electrons in NSDI sensitively depend on the intensity ratio of the CPTC laser fields. At the small ratio, the electron pairs emit with a relative angle of about 120°, and this angle shifts to 40° as the ratio increases and finally it exhibits a wide range distribution as the intensity ratio further increases. Back analysis of the NSDI trajectories shows that this behavior results from the relative-intensity-dependence of the release time of the electron pairs in the CPTC laser fields. The release times of the electron pairs are directly mapped to the angular distribution. Our results indicate that the emission times of the correlated electrons in NSDI can be controlled with the CPTC laser fields.

Human papillomavirus infection and associated factors for cervical intraepithelial neoplasia in women living with HIV in China: a cross-sectional study.

OBJECTIVE: Women living with HIV (WLHIV) face disproportionately higher risks of acquiring human papillomavirus (HPV) compared with HIV negative counterparts. We aimed to investigate the prevalence of HPV in WLHIV in Chinese hospital setting and identify associated factors to the progression of late-stage cervical intraepithelial neoplasia (CIN2+) in this population. METHOD: This retrospective study collected data from 183 WLHIV on antiretroviral treatment (ART), based on reproductive health questionnaires. Gynaecological examination results including serum (for HIV viral load, CD4 T-cell count, hepatitis B infections, syphilis) and vaginal swabs for common bacterial sexually transmitted infections (STIs). Multivariate-logistic regression was applied to analyze the contributing factors to CIN2+. RESULTS: HIV coinfection with other Sexually Transmitted Infections (STIs) were observed in 99 participants (54.1%, (99/183)). HPV (43.7% (80/183)) was the most prevalent STI. The three most prevalent HPV subtypes were all high-risk HPV (HR-HPV), including HPV52 (33.8% (27/80)), HPV58 (21.3% (17/80)) and HPV33 (13.75% (11/80)). About a third (37.5%, 30/80) of women with HPV had HR-HPV. Multiple HPV coinfections were common in HIV-HPV coinfected women (41.3%, 33/80). Cytological examinations revealed that 77.5% (62/80) HPV+ women had detectable cervical lesions. In comparison, only 4.9% (5/103) HPV negative womenwith Atypia and 1.0% (1/103) with CIN1 were diagnosed. Multivariate logistic regression revealed that HPV16 (OR=19.04, 2.53 to 122.92; p=0.004) and HPV18 (OR=11.54, 1.45 to 91.64; p=0.021) infections were significantly associated with CIN2+ in HIV-HPV coinfected women. CONCLUSION: A high prevalence of HPV was found in women on ART. HPV16/18 infection are strong associated factors to CIN2+ in HIV-HPV coinfected women.

Modelling the Epidemiological Impact and Cost-Effectiveness of PrEP for HIV Transmission in MSM in China.

Risk of HIV infection is high in Chinese MSM, with an annual HIV incidence ranging from 3.41 to 13.7/100 person-years. Tenofovir-based PrEP is effective in preventing HIV transmission in MSM. This study evaluates the epidemiological impact and cost-effectiveness of implementing PrEP in Chinese MSM over the next two decades. A compartmental model for HIV was used to forecast the impact of PrEP on number of infections, deaths, and disability-adjusted life years (DALY) averted. We also provide an estimate of the incremental cost-effectiveness ratio (ICER) and the cost per DALY averted of the intervention. Without PrEP, there will be 1.1-3.0 million new infections and 0.7-2.3 million HIV-related deaths in the next two decades. Moderate PrEP coverage (50%) would prevent 0.17-0.32 million new HIV infections. At Truvada's current price in China, daily oral PrEP costs $46,813-52,008 per DALY averted and is not cost-effective; on-demand Truvada reduces ICER to $25,057-27,838 per DALY averted, marginally cost-effective; daily generic tenofovir-based regimens further reduce ICER to $3675-8963, wholly cost-effective. The cost of daily oral Truvada PrEP regimen would need to be reduced by half to achieve cost-effectiveness and realize the public health good of preventing hundreds of thousands of HIV infections among MSM in China.

Important Roles of Health Professionals in Maternal HIV Disclosure Among HIV-Infected Women in China.

Maternal HIV disclosure to children is beneficial for both mothers and children. A cross-sectional survey was conducted to investigate the prevalence of maternal HIV disclosure to at least one living child aged > 5 years among 292 HIV-infected mothers in Guangxi Province, China. Among all participants, 45.2% had self-disclosed their HIV positive sero-status to at least one living child aged > 5 years. After adjusting for the significant background variables, participants self-reported health professionals in governmental antenatal care clinics had discussed with them about maternal HIV disclosure (adjusted odds ratios, aOR: 5.85), had received counseling services (aOR: 7.84) or support (aOR: 8.75) from these health professionals when making decision on maternal HIV, and perceived higher empathy of these health professionals (aOR: 1.09) were more likely to have reported maternal HIV disclosure. Instrumental and affective interactions between health professionals and HIV-infected mothers were important facilitators of maternal HIV disclosure.

SpBAG1 promotes the WSSV infection by inhibiting apoptosis in mud crab (Scylla paramamosain).

Bcl-2 associated athanogene-1 (BAG1) is involved in various signalling pathways including apoptosis, cell proliferation, gene transcriptional regulation and signal transduction in animals. However the functions of BAG1 during the antiviral response of mud crab Scylla paramamosain is still unclear. In this study, the mud crab BAG1 (SpBAG1) was characterized to consist of 1761 nucleotides, containing an opening frame of 630bp encoding 209 amino acids with an ubiquitin domain and a BAG1 domain. SpBAG1 was found to be significantly up-regulated at 6 h-24 h, but down-regulated from 48 h-72 h in the hemocytes of mud crab after challenge with white spot syndrome virus (WSSV). RNAi knock-down of SpBAG1 significantly reduced the copies of WSSV and increased the apoptotic rate in mud crabs. The finding from this study suggested that SpBAG1 could promote the WSSV infection by inhibiting apoptosis in mud crab. Therefore, to the best of our knowledge, this is the first study demonstrating the role of SpBAG1 as a novel apoptosis inhibitor to promote virus infection in mud crab.

Controlling nonsequential double ionization of Ne with parallel-polarized two-color laser pulses.

We measure the recoil-ion momentum distributions from nonsequential double ionization of Ne by two-color laser pulses consisting of a strong 800-nm field and a weak 400-nm field with parallel polarizations. The ion momentum spectra show pronounced asymmetries in the emission direction, which depend sensitively on the relative phase of the two-color components. Moreover, the peak of the doubly charged ion momentum distribution shifts gradually with the relative phase. The shifted range is much larger than the maximal vector potential of the 400-nm laser field. Those features are well recaptured by a semiclassical model. Through analyzing the correlated electron dynamics, we found that the energy sharing between the two electrons is extremely unequal at the instant of recollison. We further show that the shift of the ion momentum corresponds to the change of the recollision time in the two-color laser field. By tuning the relative phase of the two-color components, the recollision time is controlled with attosecond precision.

Prevalence of human papillomavirus by geographical regions, sexual orientation and HIV status in China: a systematic review and meta-analysis.

OBJECTIVE: Human papillomavirus (HPV) infection causes multiple cancers in both women and men. In China, both HPV vaccination and cervical cancer screening coverages are low. We aim to investigate the temporal and geographical trends of HPV DNA prevalence in heterosexual men, women, men who have sex with men (MSM) and people living with HIV (PLHIV) in China. METHODS: We conducted a systematic review, collecting publications in PubMed, Web of Science, China National Knowledge Infrastructure (CNKI) and Wanfang Data from January 2000 to May 2017. A total of 247 studies were selected for this meta-analysis to estimate pooled HPV prevalence, incidence of cervical cancer and risk of infection for subgroups. Meta-regression was applied to identify contributing factors to prevalence heterogeneities. RESULTS: The national HPV prevalence was 15.6% (95% CI (14.4% to 16.9%)) in women with normal cervical cytology, and Central China had the highest prevalence (20.5% (15.2% to 25.8%)). HPV prevalence in heterosexual men (14.5% (11.3% to 17.7%)) was comparable with that of women (OR=1.09 (0.98 to 1.17)), but HPV prevalence in MSM (59.9% (52.2% to 67.6%)) was significantly higher than that in heterosexual men (OR=8.81 (8.01 to 9.69)). HIV-positive women (45.0% (38.4% to 51.6%)) and HIV-positive MSM (87.5% (82.3% to 90.9%)) had 4.67 (3.61 to 6.03) and 6.46 (5.20 to 8.02) times higher risk of HPV infection than their HIV negative counterparts. CONCLUSION: HPV infection is prevalent in China, particularly in Central China, in comparison with the global level and neighbouring countries. Targeted HPV vaccination for women, MSM and PLHIV and scale-up of cervical screening for women are priorities in curbing the HPV epidemic in China.