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Background: Surgical patients often experience intraoperative hypothermia or hyperthermia. However, the relationship of intraoperative hypothermia and hyperthermia with postoperative pulmonary infection (PPI) and surgical site infection (SSI) is unclear. Here, we conducted a retrospective cohort study to address these issues. Methods: Adult patients who underwent major non-cardiac surgery under general anesthesia were eligible for the study and were recruited. Three indices of core body temperature under hypothermia (<36°C) and hyperthermia (>37.3°C) were calculated as mentioned in the following: absolute value (0C), duration of exposure (min), and area under the curve (AUC,°C× min). The outcomes were in-hospital PPI and SSI. The risk-adjusted association of intraoperative hypothermia and hyperthermia with PPI and SSI was determined. Results: The absolute value (the nadir value of hypothermia and the peak value of hyperthermia) was not associated with PPI and SSI. PPI was associated with (1) duration: hypothermia >90 min [adjusted odds ratio (aOR): 1.425, 95% confidence interval (CI): 1.131-1.796] and hyperthermia >75 min (aOR: 1.395, 95%CI: 1.208-1.612) and (2) AUC: hypothermia >3,198 (aOR: 1.390, 95%CI: 1.128-1.731) and hyperthermia >7,945 (aOR: 2.045, 95%CI: 1.138-3.676). SSI was associated with (1) duration: hypothermia > 195 min (aOR: 2.900, 95%CI: 1.703-4.937) and hyperthermia >75 min (aOR: 1.395, 95%CI: 1.208-1.612) and (2) AUC: hypothermia >6,946 (aOR: 2.665, 95%CI: 1.618-4.390), hyperthermia >7,945 (aOR: 2.619, 95%CI: 1.625-4.220). Interactions were not observed between hyperthermia and hypothermia on the outcomes. Conclusions: It was observed that intraoperative hypothermia and hyperthermia are associated with postoperative pulmonary infection and surgical site infection in major non-cardiac surgery.
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Purpose: This study aimed to uncover sexual identity development and investigate the psychiatric risks for bisexual people across mainland China, Hong Kong, and Taiwan by examining ecologically informed factors at the individual, family, and community levels. Methods: An internet-based survey was administered to 685 respondents, from June to August 2021, reached primarily through lesbian, gay, bisexual, transgender, and queer community organizations and professional networks. Participants reported their demographics, identity milestones, and psychiatric symptoms. Results: Significant birth cohort and regional differences were observed regarding bisexual identity milestones. Individuals who were older, transgender and/or nonbinary, and based in Taiwan disclosed their sexual identity more. All respondents reported clinically elevated depression and anxiety symptoms, with a majority experiencing moderately severe depression (60%) and moderate or severe anxiety (80%). Approximately half of respondents contemplated suicide in the past year. Compared with cisgender women, identifying as transgender and nonbinary assigned female at birth was significantly associated with increased depression and higher odds of suicidal ideation in the past year. Enhanced self-esteem was associated with greater well-being and decreased psychiatric symptoms. Experiencing family shame was associated with increased anxiety and depression. At the community level, living in Hong Kong was linked to lower depression and suicidal ideation compared to mainland China. The presence of an LGBT group correlated with improved psychological well-being. Conclusions: Chinese bisexual people face substantial risks for depression, anxiety, and suicidal ideation, influenced by factors including self-esteem, transgender and nonbinary gender identity, family dynamics, and community context. Significant birth cohort and regional differences in bisexual identity development exist.
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OBJECTIVE: LGBTQ-affirmative cognitive-behavioral therapy (CBT) addresses minority stress to improve sexual minority individuals' mental and behavioral health. This treatment has never been tested in high-stigma contexts like China using online delivery. METHOD: Chinese young sexual minority men (n = 120; ages 16-30; HIV-negative; reporting depression and/or anxiety symptoms and past-90-day HIV-transmission-risk behavior), were randomized to receive 10 sessions of culturally adapted asynchronous LGBTQ-affirmative internet-based CBT (ICBT) or weekly assessments only. The primary outcome included HIV-transmission-risk behavior (i.e., past-30-day condomless anal sex). Secondary outcomes included HIV social-cognitive mechanisms (e.g., condom use self-efficacy), mental health (e.g., depression), and behavioral health (e.g., alcohol use), as well as minority stress (e.g., acceptance concerns), and universal (e.g., emotion regulation) mechanisms at baseline and 4- and 8-month follow-up. Moderation analyses examined treatment efficacy as a function of baseline stigma experiences and session completion. RESULTS: Compared to assessment only, LGBTQ-affirmative ICBT did not yield greater reductions in HIV-transmission-risk behavior or social-cognitive mechanisms. However, LGBTQ-affirmative ICBT yielded greater improvements in depression (d = -0.50, d = -0.63) and anxiety (d = -0.51, d = -0.49) at 4- and 8-month follow-up, respectively; alcohol use (d = -0.40) at 8-month follow-up; and certain minority stress (e.g., internalized stigma) and universal (i.e., emotion dysregulation) mechanisms compared to assessment only. LGBTQ-affirmative ICBT was more efficacious for reducing HIV-transmission-risk behavior for participants with lower internalized stigma (d = 0.42). Greater session completion predicted greater reductions in suicidality and rumination. CONCLUSIONS: LGBTQ-affirmative ICBT demonstrates preliminary efficacy for Chinese young sexual minority men. Findings can inform future interventions for young sexual minority men in contexts with limited affirmative supports.
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Brucella BP26 proves to be a highly immunogenic antigen with excellent specificity in brucellosis detection. In China, the authorized use of the Bp26-deleted vaccine M5ΔBP26 for preventing small ruminant brucellosis highlights the importance of developing accurate detection methods targeting BP26, particularly for the diagnosis of differentiation between infected and vaccinated animals (DIVA). Using the traditional mouse hybridoma technique, we successfully obtained 12 monoclonal antibodies (mAbs) targeting BP26. The efficacy of these mAbs in detecting various animal brucellosis cases using the competitive ELISA method was evaluated. Among them, only the E10 mAb exhibited significant efficiency, being inhibited by 100, 97.62, and 100% of brucellosis-positive sera from cattle, small ruminants, and canines, respectively. The E10-based competitive enzyme-linked immunosorbent assay (cELISA) outperformed the BP26-based indirect enzyme-linked immunosorbent assay (iELISA) in accuracy, particularly for cattle and small ruminant brucellosis, with cELISA sensitivity reaching 97.62% compared to 64.29% for iELISA for small ruminants. Although cELISA showed slightly lower specificity than iELISA, it still maintained high accuracy in canine brucellosis detection. The epitope of mAb E10 was identified in the amino acid sequence QPIYVYPDDKNNLKEPTITGY, suggesting its potential as a diagnostic antigen for brucellosis. In conclusion, the E10-based cELISA presents an effective means of detecting animal brucellosis, particularly significant for DIVA diagnosis in China, where the BP26-mutant vaccine is widely used.
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Introduction: Tuberculosis, caused by Mycobacterium tuberculosis complex (MTBC), remains a global health concern in both human and animals. However, the absence of rapid, accurate, and highly sensitive detection methods to differentiate the major pathogens of MTBC, including M. tuberculosis, M. bovis, and BCG, poses a potential challenge. Methods: In this study, we have established a triplex droplet digital polymerase chain reaction (ddPCR) method employing three types of probe fluorophores, with targets M. tuberculosis (targeting CFP-10-ESAT-6 gene of RD1 and Rv0222 genes of RD4), M. bovis (targeting CFP-10-ESATs-6 gene of RD1), and BCG (targeting Rv3871 and Rv3879c genes of ΔRD1), respectively. Results: Based on optimization of annealing temperature, sensitivity and repeatability, this method demonstrates a lower limit of detection (LOD) as 3.08 copies/reaction for M. tuberculosis, 4.47 copies/reaction for M. bovis and 3.59 copies/reaction for BCG, without cross-reaction to Mannheimia haemolytica, Mycoplasma bovis, Haemophilus parasuis, Escherichia coli, Pasteurella multocida, Ochrobactrum anthropi, Salmonella choleraesuis, Brucella melitensis, and Staphylococcus aureus, and showed repeatability with coefficients of variation (CV) lower than 10%. The method exhibits strong milk sample tolerance, the LOD of detecting in spike milk was 5 × 103 CFU/mL, which sensitivity is ten times higher than the triplex qPCR. 60 clinical DNA samples, including 20 milk, 20 tissue and 20 swab samples, were kept in China Animal Health and Epidemiology Center were tested by the triplex ddPCR and triplex qPCR. The triplex ddPCR presented a higher sensitivity (11.67%, 7/60) than that of the triplex qPCR method (8.33%, 5/60). The positive rates of M. tuberculosis, M. bovis, and BCG were 1.67, 10, and 0% by triplex ddPCR, and 1.67, 6.67, and 0% by triplex qPCR, with coincidence rates of 100, 96.7, and 100%, respectively. Discussion: Our data demonstrate that the established triplex ddPCR method is a sensitive, specific and rapid method for differentiation and identification of M. tuberculosis, M. bovis, and BCG.
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BACKGROUND & AIMS: Anxiety and substance use disorders are highly comorbid and represent two of the leading causes of disease burden globally. Psychosocial interventions are important treatment options for people with co-occurring anxiety and substance use (A-SUD). To date, few reviews have assessed the efficacy of psychosocial treatments for patients with A-SUD. This systematic review and meta-analysis aims to synthesize this literature and assess the efficacy of psychosocial interventions among patients with A-SUD. METHODS: We searched all relevant records published until March 2023 in Medline, EMBASE, PsycINFO, CINAHL and Google Scholar. Two authors extracted and reconciled relevant data and assessed risk of bias. Random effects models were used to calculate effect sizes using Hedges' g for post treatment and follow-up time points. Main outcomes of the review were anxiety, alcohol use, and use of other substances. We examined effects on depression as a secondary outcome since it commonly co-occurs with A-SUD. RESULTS: Psychosocial interventions for co-occurring A-SUD showed moderate effects on anxiety (g = 0.44), alcohol (Hedges' g = 0.29), and other substance use (g = 0.38) at post intervention. Large effects were observed on depression (g = 0.88) at post intervention with high heterogeneity. These effects were maintained at follow-up for anxiety (Hedges' g = 0.38), other substances (g = 0.44), and depression (g = 0.50). Moderation analyses for demographic factors, intervention characteristics, community level factors, anxiety reduction, and alcohol use reduction, were non-significant. CONCLUSIONS: The current meta-analysis investigated the effects of psychosocial interventions on patients with anxiety and co-occurring SUD. The analyses indicated promising moderate-sized effects of treatment on anxiety, alcohol, all other drug use, and depression. The findings point to important avenues for psychosocial treatment while highlighting critical gaps in knowledge to be addressed in future research.
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Intervención Psicosocial , Trastornos Relacionados con Sustancias , Humanos , Trastornos Relacionados con Sustancias/psicología , Trastornos Relacionados con Sustancias/terapia , Trastornos Relacionados con Sustancias/epidemiología , Intervención Psicosocial/métodos , Trastornos de Ansiedad/terapia , Trastornos de Ansiedad/epidemiología , Trastornos de Ansiedad/psicología , Comorbilidad , Ansiedad/terapia , Ansiedad/epidemiología , Ansiedad/psicología , Depresión/terapia , Depresión/epidemiología , Depresión/psicologíaRESUMEN
Objectives: Hundreds of trials have evaluated Mindfulness-Based Stress Reduction (MBSR), but in the United States, it is generally not covered by health insurance. Consequently, the aims were to identify the following: (1) key questions to make decisions about if, how, and when MBSR should be covered by health insurance; (2a) barriers and (2b) facilitators to understand and resolve for MBSR to be covered by health insurance; and (3) highest priority evidence needed to inform health insurance coverage decisions. Methods: Key informants (n = 26) included health insurers, healthcare administrators, policymakers, clinicians, MBSR instructors, and MBSR students. An initial pool of items related to the study aims was generated through qualitative interviews. Through the Delphi process, participants rated, discussed, and re-rated each item's relevance. Items were required to reach a consensus of ≥ 80% agreement to be retained for final inclusion. Results: Of the original 149 items, 42 (28.2%) met the ≥ 80% agreement criterion and were retained for final inclusion. The most highly rated items informing whether MBSR should be covered by health insurance included research demonstrating that MBSR works and that it is not harmful. The most highly rated barriers to coverage were that MBSR is not a medical treatment and patient barriers to attendance. Highly rated facilitators included the potential of MBSR to address common mental health and psychosomatic problems. Finally, understanding what conditions are effectively treated with MBSR and the impact of MBSR on stress were rated as the highest priority evidence needed to inform health insurance coverage decisions. Conclusions: Findings highlight priorities for future research and policy efforts to advance health insurance coverage of MBSR in the United States. Supplementary Information: The online version contains supplementary material available at 10.1007/s12671-024-02366-x.
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In Arabidopsis and rice, the glycosyltransferase (GT) 43 family is involved in xylan synthesis. However, there have been limited reports on the study of the TaGT43 family in wheat. In this study, 28 TaGT43 family members were identified in wheat (Triticum aestivum L.) and clustered into three major groups based on the similarity of amino acid sequences. The results of the TaGT43 family's conserved motif and gene structure analyses agree with this result. Collinearity analysis revealed segmental duplications mainly promoted TaGT43 family expansion. cis-Acting element analysis revealed that the TaGT43 genes were involved in the light response, phytohormone response, abiotic/biotic stress response, and growth and development. The TaGT43 family showed a tissue-specific expression pattern, primarily expressed in roots and stems. Besides, the transcriptional and expression levels of multiple TaGT43 genes were upregulated during the infection of F. graminearum. According to metabolomics studies, F. graminearum infection affected the phenylpropanoid biosynthesis pathway in wheat, a critical factor in cell wall construction. Furthermore, GO enrichment analysis indicated that the TaGT43 genes play a significant role in cell wall organization. Based on these results, it may be concluded that the TaGT43 family mediates cell wall organization in response to F. graminearum infection.
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Fusarium , Regulación de la Expresión Génica de las Plantas , Glicosiltransferasas , Triticum , Triticum/genética , Triticum/microbiología , Glicosiltransferasas/genética , Glicosiltransferasas/metabolismo , Familia de Multigenes , Enfermedades de las Plantas/microbiología , Enfermedades de las Plantas/genética , Filogenia , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , Genoma de Planta , Perfilación de la Expresión GénicaRESUMEN
We develop and validate a method for the rapid determination and identification of 20 ß-lactamase antibiotics traces in goat's milk by combining the solid phase extraction technology with ultra-high performance liquid chromatography-tandem mass spectrometry. Goat milk samples were extracted with acetonitrile twice. The supernatant was then extracted and cleaned by solid-phase extraction using divinylbenzene and N-vinylpyrrolidone copolymer. The method was validated, with limits of quantification (LOQs) of 0.3 µg kg-1, specificities of 1/3 LOQ, linearities (R2) > 0.99, recoveries of 80-110%, repeatabilities <10.0%, and intermediate precisions <10.0%. The developed method was suitable for the routine analysis of ß-lactamase antibiotics residues in goat's milk and was used to test 76 goat milk samples produced in China.
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Antibacterianos , Cabras , Leche , Extracción en Fase Sólida , Espectrometría de Masas en Tándem , beta-Lactamasas , Animales , Extracción en Fase Sólida/métodos , Leche/química , Espectrometría de Masas en Tándem/métodos , Antibacterianos/análisis , Cromatografía Líquida de Alta Presión/métodos , Límite de Detección , Reproducibilidad de los Resultados , Residuos de Medicamentos/análisis , Contaminación de Alimentos/análisis , Cromatografía Líquida con Espectrometría de MasasRESUMEN
Background: There is a lack of mindfulness instructors from underserved/underrepresented communities who have completed systematic mindfulness teacher-training programs to meet the growing demand for culturally responsive mindfulness training in those communities. Objectives: To investigate strategies for increasing the representation of Mindfulness-Based Stress Reduction (MBSR) teachers who serve historically underrepresented racial and ethnic groups. Methods: Conducted through 4 one-hour Zoom focus groups (n = 54; women = 74%), this study queried individuals with experience serving underrepresented racial and ethnic communities, and had mindfulness experience, on how to increase participation from underrepresented communities in mindfulness. Thematic analysis of transcripts of participant responses involved double-coding by three team members, supporting rigorous evaluation of the data. All respondents who expressed interest in participating enrolled (no dropout from study enrollment to participation in focus groups). Results: The study identified four key themes that illuminate challenges and essential adaptations for MBSR teacher training aimed at individuals serving historically underrepresented racial and ethnic groups. These themes include: (1) Cost and time commitment; (2) Trauma sensitivity; (3) Cultural Awareness; and (4) Diversity in teachers. Conclusion: Participants provided actionable recommendations poised to facilitate the expansion of MBSR into more diverse communities, emphasizing optimal benefits and effective communication of inherent healing strengths within these communities. The findings underscore the compelling interest among leaders in marginalized communities to extend the reach of MBSR through culturally responsive approaches. This involves guiding pertinent adjustments and encouraging greater involvement of underserved communities in MBSR teacher training programs.
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Meta-analysis was used to investigate the potential benefits of stress management interventions (SMIs) on vagally-mediated heart rate variability (HRV) in adults with cardiovascular disease. Electronic bibliographic databases were searched through August 2022. Randomized controlled trials and quasi-experimental studies assessing effects of SMIs on HRV were included. Methodological quality was assessed with a standardized checklist. A pooled effect size was calculated for vagally-mediated HRV indices (standard deviation of normal-to-normal intervals, root mean square of the successive differences, and high frequency power) using random effects models. Fourteen studies (1202 participants, Mage: 59 ± 6.25 years; 25% ± 16% women; 61% ± 22% White) were included. Ten studies (11 effects) reported short-term HRV assessment; a small between-group difference emerged for vagally-mediated HRV (d+ = .27, 95% confidence interval [CI] 0.01-0.52, k = 11). Most interventions examined biofeedback; these studies yielded a small between-group difference on vagally-mediated HRV (d+ = 0.31, 95% CI 0.09-0.53, k = 7, Q [6] = 3.82, p = .70, I2 = 11%). This is the first systematic examination of the effect of SMIs on HRV in adults with CVD. Findings suggest a small effect of SMIs on vagally-mediated HRV, with biofeedback likely driving the effect. More research is required to fully understand whether this benefit on vagally-mediated HRV applies to other SMIs.
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Enfermedades Cardiovasculares , Frecuencia Cardíaca , Estrés Psicológico , Humanos , Frecuencia Cardíaca/fisiología , Estrés Psicológico/terapia , Estrés Psicológico/fisiopatología , Enfermedades Cardiovasculares/terapia , Enfermedades Cardiovasculares/fisiopatología , Persona de Mediana Edad , Biorretroalimentación Psicológica , Femenino , MasculinoRESUMEN
Fusarium head blight (FHB), caused by Fusarium graminearum, is a predominant disease of wheat. Due to the lack of disease-resistant germplasm, chemical control is an important means to control wheat scab. Volatile substances produced in near-isogenic wheat lines were detected after inoculation with F. graminearum, and 4-propylphenol, which appears in FHB-resistant lines, was identified. In vitro and in vivo antifungal activity tests demonstrate that 4-propylphenol effectively inhibits the mycelial growth of F. graminearum. Metabolomics analysis showed changes in glutathione metabolism, indicating that 4-propylphenol triggered reactive oxygen species (ROS) stress. This was consistent with the increasing ROS levels in Fusarium cells treated with 4-propylphenol. Further results demonstrated that excessive accumulation of ROS induced DNA and cell membrane damage in the mycelium. Moreover, 4-propylphenol showed different degrees of inhibition against other soil-borne pathogens (fungi and oomycetes). These findings illustrated that 4-propylphenol has broad spectrum and high antifungal activity and should be considered for use as an ecological fungicide.
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Antifúngicos , Fusarium , Fenoles , Antifúngicos/farmacología , Triticum/metabolismo , Especies Reactivas de Oxígeno/metabolismo , Enfermedades de las Plantas/microbiologíaRESUMEN
BACKGROUND: Men who have sex with men (MSM) in China have a high risk for HIV infection but experience suboptimal rates of HIV testing and service engagement due to various social and structural barriers. We developed a mobile health (mHealth) intervention entitled "WeTest-Plus" (WeTest+) as a user-centered "one-stop service" approach for delivering access to comprehensive information about HIV risk, HIV self-testing, behavioral and biomedical prevention, confirmatory testing, treatment, and care. OBJECTIVE: The goal of the current study was to investigate the feasibility of WeTest+ to provide continuous HIV services to high-risk MSM. METHODS: Participants completed a 3-week pilot test of WeTest+ to examine acceptability, feasibility, and recommendations for improvement. Participants completed a structured online questionnaire and qualitative exit interviews facilitated by project staff. "Click-through" rates were assessed to examine engagement with online content. RESULTS: 28 participants were included, and the average age was 27.6 years (standard deviation = 6.8). Almost all participants (96.4%) remained engaged with the WeTest+ program over a 3-week observational period. The majority (92.9%) self-administered the HIV self-test and submitted their test results through the online platform. Overall click-through rates were high (average 67.9%). Participants provided favorable comments about the quality and relevance of the WeTest+ information content, the engaging style of information presentation, and the user-centered features. CONCLUSION: This pilot assessment of WeTest+ supports the promise of this program for promoting HIV self-testing and linkage to in-person services for MSM in China. Findings underscore the utility of a user-centered approach to mHealth program design.
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Estudios de Factibilidad , Infecciones por VIH , Homosexualidad Masculina , Telemedicina , Humanos , Masculino , China , Proyectos Piloto , Infecciones por VIH/diagnóstico , Infecciones por VIH/prevención & control , Adulto , Adulto Joven , Encuestas y Cuestionarios , Ciudades , Aceptación de la Atención de Salud/estadística & datos numéricos , Prueba de VIH/métodosRESUMEN
Applying plant-derived fungicides is a safe and sustainable way to control wheat scab. In this study, volatile organic compounds (VOCs) of wheat cultivars with and without the resistance gene Fhb1 were analyzed by GC-MS, and 2-phenylethanol was screened out. The biocontrol function of 2-phenylethanol on Fusarium graminearum was evaluated in vitro and in vivo. Metabolomics analysis indicated that 2-phenylethanol altered the amino acid pathways of F. graminearum, affecting its normal life activities. Under SEM and TEM observation, the mycelial morphology changed, and the integrity of the cell membrane was destroyed. Furthermore, 2-phenylethanol could inhibit the production of mycotoxins (DON, 3-ADON, 15-ADON) by F. graminearum and reduce grain contamination. This research provides new ideas for green prevention and control of wheat FHB in the field.
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Maximizing socioeconomic and environmental benefits with minimal investment in urban land resources is a key concern for sustainable urban development. The emission trading system is an important strategy of the Chinese government to control environmental pollution and promote green development, but whether it improves urban land green use efficiency is still unclear. Combining the concept of green development with urban land use efficiency, this paper uses the super-efficiency slack-based measure (SBM) model with undesirable outputs to measure the land green use efficiency of 261 prefecture-level cities in China from 2003 to 2017. In addition, the propensity score matching difference-in-differences (PSM-DID) method and the mediating effect model were used to test the impact of the China's emission trading system on urban land green use efficiency and behind the mechanism. According to the findings, China's emission trading system has significantly improved urban land green use efficiency, compared with that in nonpilot cities, urban land green use efficiency in pilot cities has increased by 10.40%. Moreover, the policy effect of the emission trading system is more significant in resource-based cities and cities with a high intensity of environmental regulations. Further mechanism analysis reveals that green technology innovation and industrial structure upgrading are effective transmission mechanisms for China's emissions trading policy to improve urban land green use efficiency. The findings provide policy implications for promoting the sustainable use of urban land resources and advancing the coordinated development of urban socioeconomic and ecological environments.
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Ambiente , Carbono , China , Ciudades , Desarrollo Económico , Eficiencia , Contaminación AmbientalRESUMEN
To combat the pressing issue of contemporary suicide rates, an effective Life Gatekeeper training program was developed to educate school teachers in identifying and intervening with at-risk students. Two single-arm sequential studies evaluated the program's effectiveness, spanning implementation science stages from design to refinement. The initial study employed face-to-face training (FTF), followed by a standardized video-based 'Train-the-trainer' (TTT) approach. In Study 1, post-intervention and one-month follow-up results showed improved suicide literacy, reduced stigma, and increased willingness to intervene among gatekeepers. The revised TTT program (study 2) also yielded reduced stigmatization and improved intervention competence. In addition, six out of twenty teachers exhibited gatekeeper behaviors. In conclusion, both delivery methods proved effective, particularly the practical application of the TTT version, although further research is warranted to examine long-term effectiveness of the program.
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Pueblos del Este de Asia , Prevención del Suicidio , Suicidio , Adolescente , Humanos , Maestros , EstudiantesRESUMEN
BACKGROUND: Gestational diabetes mellitus (GDM) has been rising in the United States, and it poses significant health risks to pregnant individuals and their infants. Prior research has shown that individuals with GDM also experience prevalent stress and mental health issues, which can further contribute to glucose regulation difficulties. Stigma associated with GDM may contribute to these mental health challenges, yet there is a lack of focused research on GDM-related stigma, its impact on psychological health, and effective coping mechanisms. Thus, this qualitative study aims to understand individuals' experiences related to GDM stigma, mental health, and facilitative coping. METHODS: In-depth, semi-structured interviews were conducted with 14 individuals with a current or recent (within the last year) diagnosis of GDM. Thematic analysis was employed to guide data analysis. RESULTS: Four themes emerged from data analysis: (1) experience of distal GDM stigma including stigmatizing provider interactions, stigma from non-medical spaces, and intersecting stigma with weight, (2) internalized GDM stigma, such as shame, guilt, and self-blame, (3) psychological distress, which included experiences of stress and overwhelm, excessive worry and fear, and loneliness and isolation, and (4) facilitative coping mechanisms, which included diagnosis acceptance, internet-based GDM community, active participation in GDM management, social and familial support, and time for oneself. CONCLUSIONS: Findings demonstrate the relevance of GDM stigma in mental health among people with GDM and the need for addressing GDM stigma and psychological health in this population. Interventions that can reduce GDM stigma, improve psychological wellness, and enhance positive coping may facilitate successful GDM management and healthy birth outcomes. Future quantitative, theory-driven research is needed to understand the prevalence of GDM stigma experiences and mechanisms identified in the current study, as well as among marginalized populations (e.g., individuals of color, sexual and gender minorities).
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Diabetes Gestacional , Distrés Psicológico , Lactante , Femenino , Embarazo , Humanos , Adaptación Psicológica , Salud Mental , Estigma SocialRESUMEN
Hundreds of randomized controlled trials (RCTs) have tested the efficacy of mobile health (mHealth) tools for a wide range of mental and behavioral health outcomes. These RCTs have used a variety of control condition types which dramatically influence the scientific inferences that can be drawn from a given study. Unfortunately, nomenclature across mHealth RCTs is inconsistent and meta-analyses commonly combine control conditions that differ in potentially important ways. We propose a typology of control condition types in mHealth RCTs. We define 11 control condition types, discuss key dimensions on which they differ, provide a decision tree for selecting and identifying types, and describe the scientific inferences each comparison allows. We propose a five-tier comparison strength gradation along with four simplified categorization schemes. Lastly, we discuss unresolved definitional, ethical, and meta-analytic issues related to the categorization of control conditions in mHealth RCTs.
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BACKGROUND: Sexual minority women (lesbian, gay, bisexual, pansexual, queer, and other nonheterosexual women) remain considerably underrepresented in health research despite being at a higher risk for diabetes and obesity as well as stigma and psychological distress than their heterosexual peers. In addition, early life adversity (ELA) is prevalent among sexual minority women, which further increases risks for obesity, psychological distress, and poor cardiovascular health. App-based mindfulness interventions are potentially promising for this group in mitigating the adverse health effects of ELA, reducing food craving and unhealthy eating, addressing the risks associated with obesity. OBJECTIVE: This mixed methods feasibility trial aimed to test a mindfulness-based mobile health approach for middle-aged sexual minority women (aged 30-55 years) with ELA and overweight or obesity (BMI ≥25 kg/m2) to improve health outcomes. METHODS: The single-arm trial was advertised on social media and various lesbian, gay, bisexual, transgender, and queer web-based groups. At baseline, after the intervention (2 months), and at the 4-month follow-up, participants completed assessments of primary outcomes (food craving, emotional eating, and weight via a mailed scale) and secondary outcomes (depression, anxiety, mindfulness, and emotion dysregulation). A standardized weight measure was mailed to participants for weight reporting. Feasibility and acceptability were assessed after the intervention via surveys and semistructured exit interviews. RESULTS: We screened 442 individuals, among which 30 eligible sexual minority women (mean age 40.20, SD 7.15 years) from various US regions were enrolled in the study. At baseline, 86% (26/30) and 80% (24/30) of participants had elevated depressive and anxiety symptoms, respectively. Among the 30 enrolled participants, 20 (66%) completed all intervention modules, 25 (83%) were retained at the 2-month follow-up, and 20 (66%) were retained at the 4-month follow-up. None reported adverse effects. From baseline to the 4-month follow-up, large effects were found in food craving (Cohen d=1.64) and reward-based eating (Cohen d=1.56), whereas small effects were found with weight (Cohen d=0.20; 4.21 kg on average). Significant improvements were also found in the secondary outcomes (depression, Cohen d=0.98; anxiety, Cohen d=0.50; mindfulness, Cohen d=0.49; and emotion dysregulation, Cohen d=0.44; all P<.05). Participants with higher levels of parental verbal and emotional abuse were particularly responsive to the intervention. Participants reported that the program aligned with their goals and expectations, was easy to use, and facilitated changes in eating behavior and mental health. Barriers to engagement included the need for diverse teachers, individualized support, and body positive language. CONCLUSIONS: This early phase feasibility trial provides proof-of-concept support for a mindfulness mobile health approach to improve obesity-related outcomes among sexual minority women and warrants a larger randomized controlled trial in the future. The findings also suggest the need to address trauma and psychological health when addressing weight-related outcomes among sexual minority women.
Asunto(s)
Experiencias Adversas de la Infancia , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Atención Plena , Minorías Sexuales y de Género , Persona de Mediana Edad , Femenino , Humanos , Adulto , Estudios de Factibilidad , Obesidad/terapiaRESUMEN
To detect the antibody against fowl adenovirus serotype 4 (FAdV-4) in clinical practice, the latex agglutination test (LAT) was developed by using the Fiber-2 protein of FAdV-4 as an antigen bound to sensitized latex microspheres. The concentration, time, and temperature of sensitization latex microspheres by the Fiber-2 protein were studied and optimized; the specificity, sensitivity, and repeatability of LAT were tested; and the method developed in the study was applied. The results showed that the optimum sensitization concentration of Fiber-2 protein was 0.8 mg/mL, the time was 120 min, and the temperature was 37 â. Except for antiserum against FAdV-4 and FAdV-10, LAT developed in the study could not agglutinate antisera against FAdV-1, FAdV-2, FAdV-3, FAdV-4, FAdV-5, FAdV-6, FAdV-8a, FAdV-8b, FAdV-11, Newcastle disease virus, infectious bronchitis virus, egg drop syndrome virus and Clostridium perfringens. Compared with the commercial FAdV-4 ELISA Kit, the titers in 21 clinical samples were low when tested by the developed LAT method, but there was no significant difference. The coefficients of variation among different batches and the same batch of latex-sensitized particles were between 0 % and 13.3 % and 0-8.7 %, respectively. The critical value of immune protective antibody against FAdV-4 was 25, and the titers in 40.9 % of clinical samples were higher than the immune critical point. The results showed that the Fiber-2-based LAT developed in the study has the characteristics of high specificity, sensitivity and repeatability, has the advantages of free equipment, long shelf life, and fast and easy operation, and is an effective and convenient method for serological diagnosis of FAdV-4 infection and evaluating the efficacy of vaccines.