Evaluation of the psychometrics of the Social Impact Scale and its association with depression among asymptomatic COVID-19 carriers.

BACKGROUND: COVID-19 carriers experience psychological stresses and mental health issues such as varying degrees of stigma. The Social Impact Scale (SIS) can be used to measure the stigmatisation of COVID-19 carriers who experience such problems. AIMS: To evaluate the reliability and validity of the Chinese version of the SIS, and the association between stigma and depression among asymptomatic COVID-19 carriers in Shanghai, China. METHOD: A total of 1283 asymptomatic COVID-19 carriers from Shanghai Ruijin Jiahe Fangcang Shelter Hospital were recruited, with a mean age of 39.64 ± 11.14 years (59.6% male). Participants completed questionnaires, including baseline information and psychological measurements, the SIS and Self-Rating Depression Scale. The psychometrics of the SIS and its association with depression were examined through exploratory factor analysis, confirmatory factor analysis and receiver operating characteristic analysis. RESULTS: The average participant SIS score was 42.66 ± 14.61 (range: 24-96) years. Analyses suggested the model had four factors: social rejection, financial insecurity, internalised shame and social isolation. The model fit statistics of the four-factor SIS were 0.913 for the comparative fit index, 0.902 for the Tucker-Lewis index and 0.088 for root-mean-square error of approximation. Standard estimated factor loadings ranged from 0.509 to 0.836. After controlling for demographic characteristics, the total score of the 23-item SIS predicted depression (odds ratio: 1.087, 95% CI 1.061-1.115; area under the curve: 0.84, 95% CI 0.788-0.892). CONCLUSIONS: The Chinese version of the SIS showed good psychometric properties and can be used to assess the level of perceived stigma experienced by asymptomatic COVID-19 carriers.

Predicting osteoporosis preventive behaviors in middle-aged and older urban Shanghai residents: a health belief model-based path analysis in a multi-center population study.

Background: Osteoporosis represents a significant health concern as a widespread metabolic bone condition. In this study, we aim to utilize path analysis to examine the intricate relationships among demographic information, Health Belief Model (HBM) constructs and osteoporosis preventive behavior among Shanghai residents over 40 years of age. Methods: A multi-center population study was conducted in 20 volunteer communities in Shanghai, China. Out of the 2,000 participants who volunteered, 1,903 completed the field survey. Results: 56.0% of participants were females. Their mean age was 63.64 ± 10.30 years. The self-efficacy score among females (42.27 ± 15.82) was also significantly higher than that among males (40.68 ± 15.20). in the pathway analysis. In the path analysis preventive behaviors were significantly predicted by education (ß = 0.082, p < 0.001), knowledge (ß = 0.132, p < 0.001) and self-efficacy (ß = 0.392, p < 0.001). Conclusions: This study highlights the importance of gender, education, knowledge and self-efficacy in promoting OP preventive behaviors using the Health Belief Model. The findings emphasize the need for tailored interventions to address the specific needs of different demographic groups.

The Sage of Tea and the Inherited Metabolic Diseases.

Background: Lu Yu (733-804 AD, Tang Dynasty) was an orphan raised and educated in a monastery. His profound knowledge of tea earned him the title "the Sage of Tea." This paper explores the possibility that Lu Yu may have been a patient of inherited metabolic diseases (IMDs), particularly phenylketonuria (PKU), considering historical records and unique aspects of his life. Case Presentation: Examining Lu Yu's orphaned upbringing, clinical manifestations noted in his autobiography, dietary preferences, and the significance of his name, this study postulates that he may have had IMDs, notably PKU. His life choices, such as abstaining from meat and fish and favoring a low-protein diet during his time in a monastery, align with practices recommended for managing IMDs. The linguistic associations of his name further reinforce this hypothesis. Conclusions: This investigation sheds light on the intriguing possibility that Lu Yu may have been affected by IMDs, notably PKU. By considering historical context, clinical correlations, dietary choices, and name symbolism, we offer a unique historical perspective on this celebrated figure's health. Further research could provide valuable insights into both his life and the broader medical practices of the Tang Dynasty.

Validation of the Patient Health Questionnaire-9 for Suicide Screening in Transgender Women.

Purpose: High prevalence of depression in transgender women highlights the importance of validating the measure to assess depression. Moreover, depression is significantly associated with suicide across research studies. The aims of the current study were to validate a Chinese-language version of the Patient Health Questionnaire-9 (PHQ-9) and to assess operating characteristics of the PHQ-9 for suicide screening in transgender women. Methods: With the approval of an Institutional Review Board (IRB), a total of 198 transgender women living in Shenyang, China, were recruited, and asked to complete the PHQ-9, including measures of their suicidal ideation, planning and attempt. Results: A one-factor model of the PHQ-9 was supported in the current sample, showing good reliability and validity. The best cutoff point for the PHQ-9 in suicidal ideation was 17, with a sensitivity/specificity of 77.78%; the best cutoff point for PHQ-9 in suicidal planning was 17, with a sensitivity of 81.82% and a specificity of 73.26%; and the best cutoff point for PHQ-9 in suicidal attempt was 20, with a sensitivity of 75% and a specificity of 90.21%. Conclusion: Findings supported the validity of the PHQ-9. With potential clinical or research application, the PHQ-9 can be an efficient instrument for suicide screening in transgender women.

Prenatal Diagnosis and Molecular Cytogenetic Analyses of a de novo Deletion on Chromosome 4p16.3p15.33.

Wolf-Hirschhorn syndrome (WHS) (OMIM 194190) is a contiguous gene syndrome with an estimated prevalence of around 1 in 50,000 births. The syndrome is caused by the deletion of a critical region (Wolf-Hirschhorn Syndrome Critical region-WHSCR) on chromosome 4p16.3. Its core features are typical facial gestalt, growth retardation, intellectual disability, developmental delay, and seizures. Prenatal diagnosis of WHS helps clinicians and parents make informed decisions about pregnancy management. In this research, a 31-year-old woman (gravida 1, para 0) underwent amniocentesis at 18 weeks gestation because of the short nasal bone of the fetus on prenatal ultrasound. Chromosomal microarray analysis (CMA) on uncultured amniocytes revealed a de novo 11.36-Mb deletion on chromosome 4p16.3p15.33, spanning from position 40 000 to 11 400 000 (hg19). After genetic counselling and being informed of the unfavorable prognosis, the parents decided to terminate the pregnancy. We provide a detailed description of a de novo 11.36-Mb deletion on chromosome 4p16.3p15.33 (Wolf-Hirschhorn syndrome). CMA has more advantages than karyotype analysis in detecting chromosomal microdeletions/microduplications. A combination of karyotype analysis, CMA, prenatal ultrasound, and genetic counseling is helpful for the prenatal diagnosis of chromosomal deletions/duplications.

Association between work stress and mental health in Chinese public health workers during the COVID-19 epidemic: mediating role of social support and self-efficacy.

Background: Little is known about the mediating mechanisms underlying the association between work stress and mental health, especially among primary public health workers (PHWs). We aimed to evaluated the association between work stress and mental health among PHWs, and explore the mediating roles of social support and self-efficacy. Methods: A large-scale cross-sectional survey was conducted among 3,809 PHWs from all 249 community health centers in 16 administrative districts throughout Shanghai, China. Pearson correlation and hierarchical linear regression were used to explore the associations among work stress, social support, self-efficacy and mental health. Structural equation modeling (SEM) was conducted to examine the mediation effects. Results: The prevalence of depression and anxiety symptoms among primary PHWs was 67.3 and 55.5%, respectively. There is a significant positive direct effect of work stress on mental health (ß = 0.325, p < 0.001). Social support and self-efficacy partially mediated the relationship between work stress and mental health, respectively. Meanwhile, the chained mediating effects of social support and self-efficacy also buffered the predictive effects of work stress on anxiety and depression symptoms (ß = 0.372, p < 0.001). Conclusion: Work stress has significant direct and indirect effects on mental health among primary PHWs. Enhancing social support and self-efficacy may be effective psychological interventions to mitigate the effects of work-related stress on mental health. These findings highlight the severity of mental health problems among primary public health workers and provide new evidence for early prevention and effective intervention strategies.

Relationships of work stress and interpersonal needs with industrial workers' mental health: a moderated mediation model.

OBJECTIVES: This study explores whether feelings of defeat (i.e., a sense of failed struggle and losing rank; referred to as defeat for simplicity) mediated the effect of work stress on depression/anxiety, the effect of interpersonal needs on depression/anxiety for Chinese industrial workers, and the possible moderating role of social support. METHOD: A cross-sectional study was conducted in Shenzhen, China in 2019, in total, 2023 industrial workers (of 2700 invited; response rate = 75%) completed a self-administered survey consisted of Job Stress Scale, Interpersonal Needs Questionnaire, Defeat Scale, Centre for Epidemiological Studies Depression Scale, Generalized Anxiety Disorder Scale, two face-valid questions for social support, as well as sociodemographic information. Moderated mediation model was tested and loop plots were applied to probe into the conditional effects of work and interpersonal stress on depression and anxiety symptoms. RESULT: Both the direct and indirect effect of work stress on depression and anxiety through defeat were significant (Work stress→ Depression: B = 0.035, p < .001, Work stress→ Defeat→ Depression: B = 0.034, p < .001; Work stress→ Anxiety: B = 0.038, p < .001, Work stress→ Defeat→ Anxiety: B = 0.045, p < .001). Meanwhile, defeat mediated the relationship of interpersonal needs with depression partially and the relationship of interpersonal needs with anxiety totally (Interpersonal needs→ Anxiety: B = 0.133, p < .001, Interpersonal needs→ Defeat→ Anxiety: B = 0.010, p = .537). Social support moderated the indirect path between interpersonal needs and depression/anxiety and buffered the effect. CONCLUSION: The mediating role of defeat and the moderator role of social support in the relationship between stress and depression/anxiety were confirmed in industrial workers. Workers who reported more work and interpersonal stress would report more defeat feelings, and then exhibited more depression and anxiety symptoms; this mediation effect was stronger for those who had lower social support, respectively.

Exploring the long-term sequelae of childhood sexual abuse on risky sexual behavior among Chinese transgender women.

Introduction: Childhood sexual abuse (CSA) is a hidden but serious public health issue that can lead to a series of behavioral consequences and health problems in adulthood. It has been well documented that transgender women (TGW) have a high prevalence of CSA victimization. Moreover, risky sexual behaviors are also widespread among TGW; nevertheless, research investigating the associations between CSA victimization and risky sexual behaviors in TGW represents a gap in the literature. Methods: Our research was carried out mainly in Shenyang of China from November 2018 to January 2019. Sociodemographic characteristics, as well as information on participants' HIV awareness and sexual behaviors, were collected through face-to-face interviews. The impact of CSA was examined through hierarchical logistic regression, adjusted for sociodemographic factors and HIV awareness. Results: In the sample of 247 adult TGW, 14.2% of them had a CSA history. In the previous 6 months, 30.8% of the participants reported condomless anal intercourse (CAI) and 38.5% of them had multiple sexual partners (MSP). The findings demonstrated that TGW with CSA history were more likely to take part in CAI (p = 0.001, OR = 4.252) or have MSP (p = 0.004, OR = 3.260) in adulthood. Furthermore, HIV knowledge was not a predictor of CAI or MSP, but higher HIV risk perception was associated with a greater probability of CAI. Conclusion: Transgender women with a history of CSA were more prone to engage in CAI and have MSP in China.

Gender-Specific and U-Shaped Relationship Between Serum Uric Acid and All-Cause Mortality Among Chinese Older Adults: A National Population-Based Longitudinal Study.

Objectives: This study aimed to prospectively investigate gender-specific relationship between hyperuricemia and all-cause mortality among Chinese older adults. Methods: The study was based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) 2008-2018, a prospective nationwide cohort of older adults in China. Multivariate Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs for all-cause mortality. Restricted cubic splines (RCS) were conducted to explore the dose-response relationship between SUA levels and all-cause mortality. Results: For older women, compared to the participants in the third quartile of SUA level, those in the highest quartile of SUA was associated with significantly higher risk of all-cause mortality in the fully adjusted model (HR: 1.41, 95% CI: 1.03-1.92). No significant associations between SUA levels and all-cause mortality were observed in older men. The present study further found a U-shaped non-linear relationship between SUA levels and all-cause mortality in both sexes of older population (P for non-linear <0.05). Conclusions: This study provided prospective epidemiological evidence for the predictive role of SUA on all-cause mortality among the Chinese aging population over 10 years of follow-up, while revealing considerable gender-related differences.

The trajectories and associations of insomnia symptoms with addictive behaviours in adolescents: A two-year longitudinal study.

Insomnia displays heterogeneous trajectories across adolescence, which may induce addictive behaviours, including internet gaming disorder and substance use. This study aimed to investigate the latent trajectory classes of insomnia symptoms over 2 years and to examine the associations between insomnia trajectories and these addictive behaviours. Participants were 910 adolescents from six middle schools in Shanghai, China (52.7% males; mean age = 13.17 years). The three-wave survey measured insomnia symptoms, internet gaming disorder, substance use, depressive symptoms, and sociodemographic characteristics from 7th to 9th grade. Latent class growth modelling was performed to identify the latent trajectory classes of insomnia symptoms. Then multivariable logistic regressions were conducted within the best-fitting latent class growth model to examine the associations of insomnia trajectories with internet gaming disorder and substance use. Two latent trajectory classes of insomnia symptoms were recognised: the non-insomnia group (71.8%) and the insomnia group (28.2%). In the multivariable analysis controlling for baseline demographic variables and depressive symptoms, the insomnia group had a higher risk of developing internet gaming disorder (OR = 2.203 [95% CI: 1.258-3.858]) and substance use (OR = 2.215 [95% CI: 1.324-3.705]) compared with the non-insomnia group. These findings add to a growing body of research on heterogeneous trajectories of insomnia symptoms during adolescence, suggesting that intervention strategies are needed to target the characteristics or developmental patterns of different insomnia subgroups. The ultimate goal is to mitigate the impact of insomnia symptoms on adolescent addictive behaviours.

Psychosocial Problems and Condomless Anal Sex among Transgender Women in Two Cities of China: Study Based on the Syndemic Framework.

Studies examining the association between psychosocial problems and condomless anal sex (CAS) among transgender women (TGW) are rare. In this study, close attention was paid to the effect of co-occurring psychosocial problems on sexual risk behaviors. A cross-sectional study, including 247 TGW, was conducted in Kunming and Shenyang, China. The prevalence of condomless anal sex among TGW in the previous 6 months was 30.8%. Most of the psychosocial factors were associated with one another in bivariate logistic regression models. Low self-esteem (ORm = 2.99, 95% CI = 1.25-7.18), sexual compulsivity (ORm = 2.13, 95% CI = 1.13-4.00), and intimate partner violence (ORm = 2.21, 95% CI = 1.19-4.11) were discovered to be related to condomless anal sex in the multivariate regression model. No significant interactive effects of the syndemic factors on condomless anal sex were detected. More programmatic and effective HIV prevention interventions targeting psychosocial problems are required to reduce HIV infection within the population.

Development and Validation of a Prognostic Model to Predict Overall Survival for Lung Adenocarcinoma: A Population-Based Study From the SEER Database and the Chinese Multicenter Lung Cancer Database.

Background: Lung adenocarcinoma (LUAD) is the most common subtype of non-small-cell lung cancer (NSCLC). The aim of our study was to determine prognostic risk factors and establish a novel nomogram for lung adenocarcinoma patients. Methods: This retrospective cohort study is based on the Surveillance, Epidemiology, and End Results (SEER) database and the Chinese multicenter lung cancer database. We selected 22,368 eligible LUAD patients diagnosed between 2010 and 2015 from the SEER database and screened them based on the inclusion and exclusion criteria. Subsequently, the patients were randomly divided into the training cohort (n = 15,657) and the testing cohort (n = 6711), with a ratio of 7:3. Meanwhile, 736 eligible LUAD patients from the Chinese multicenter lung cancer database diagnosed between 2011 and 2021 were considered as the validation cohort. Results: We established a nomogram based on each independent prognostic factor analysis for 1-, 3-, and 5-year overall survival (OS) . For the training cohort, the area under the curves (AUCs) for predicting the 1-, 3-, and 5-year OS were 0.806, 0.856, and 0.886. For the testing cohort, AUCs for predicting the 1-, 3-, and 5-year OS were 0.804, 0.849, and 0.873. For the validation cohort, AUCs for predicting the 1-, 3-, and 5-year OS were 0.86, 0.874, and 0.861. The calibration curves were observed to be closer to the ideal 45° dotted line with regard to 1-, 3-, and 5-year OS in the training cohort, the testing cohort, and the validation cohort. The decision curve analysis (DCA) plots indicated that the established nomogram had greater net benefits in comparison with the Tumor-Node-Metastasis (TNM) staging system for predicting 1-, 3-, and 5-year OS of lung adenocarcinoma patients. The Kaplan-Meier curves indicated that patients' survival in the low-risk group was better than that in the high-risk group (P < .001). Conclusion: The nomogram performed very well with excellent predictive ability in both the US population and the Chinese population.

Predicting the risk of HIV infection among internal migrant MSM in China: An optimal model based on three variable selection methods.

Introduction: Internal migrant Men who have sex with men (IMMSM), which has the dual identity of MSM and floating population, should be more concerned among the vulnerable groups for HIV in society. Establishing appropriate prediction models to assess the risk of HIV infection among IMMSM is of great significance to against HIV infection and transmission. Methods: HIV and syphilis infection were detected using rapid test kits, and other 30 variables were collected among IMMSM through questionnaire. Taking HIV infection status as the dependent variable, three methods were used to screen predictors and three prediction models were developed respectively. The Hosmer-Lemeshow test was performed to verify the fit of the models, and the net classification improvement and integrated discrimination improvement were used to compare these models to determine the optimal model. Based on the optimal model, a prediction nomogram was developed as an instrument to assess the risk of HIV infection among IMMSM. To quantify the predictive ability of the nomogram, the C-index measurement was performed, and internal validation was performed using bootstrap method. The receiver operating characteristic (ROC) curve, calibration plot and dynamic component analysis (DCA) were respectively performed to assess the efficacy, accuracy and clinical utility of the prediction nomogram. Results: In this study, 12.52% IMMSMs were tested HIV-positive and 8.0% IMMSMs were tested syphilis-positive. Model A, model B, and model C fitted well, and model B was the optimal model. A nomogram was developed based on the model B. The C-index of the nomogram was 0.757 (95% CI: 0.701-0.812), and the C-index of internal verification was 0.705. Conclusions: The model established by stepwise selection methods incorporating 11 risk factors (age, education, marriage, monthly income, verbal violence, syphilis, score of CUSS, score of RSES, score of ULS, score of ES and score of DS) was the optimal model that achieved the best predictive power. The risk nomogram based on the optimal model had relatively good efficacy, accuracy and clinical utility in identifying internal migrant MSM at high-risk for HIV infection, which is helpful for developing targeted intervention for them.

Blood lipid levels and all-cause mortality in older adults: the Chinese Longitudinal Healthy Longevity Survey 2008-2018.

OBJECTIVES: Proper blood lipid levels are essential for survival in older adults, but inconsistent relationships have been reported between blood lipids and all-cause mortality in the elderly. METHODS: This retrospective longitudinal study analyzed data from 1,067 Chinese older adults enrolled in the Chinese Longitudinal Healthy Longevity Survey collected in 2008 and followed up until death or December 31, 2018. The outcome was all-cause mortality. Multivariate Cox regression analyses were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) with stratification by age (60-80, 80-100, or ≥100 years) for further analysis. The survival probability according to lipid profile quartiles was calculated using Kaplan-Meier curves and the log-rank test. RESULTS: The participants' mean age was 84.84 years, and 57.0% were female. In total, 578 individuals died, and 277 were lost to follow-up. The mean total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were higher among those who died than among those who survived. Participants in the second HDL-C quartile and the highest LDL-C and triglyceride (TG) quartiles had 28% higher, 23% lower, and 49% lower risks of all-cause mortality, respectively. After further adjustment, the associations remained except for HDL-C, and additional associations were observed between all-cause mortality and the third TC and LDL-C quartiles and the second TG quartile (HR, 1.44; 95% CI, 1.01 to 2.06; HR, 0.68; 95% CI, 0.49 to 0.94; HR, 0.79; 95% CI, 0.62 to 0.99, respectively). CONCLUSIONS: Older adults should maintain an LDL-C level of 1.91-2.47 mmol/L and a TG level of no less than 1.66 mmol/L.

Impact of Intraspinal Nerve Block Anesthesia on Intrapartum Fever and the Neonate.

Objective: To evaluate the impact of intraspinal nerve block anesthesia on intrapartum fever and the neonate. Methods: In this prospective study, between October 2019 and December 2020, 90 eligible primiparous women enrolled in the obstetrics and gynecology department of our hospital for delivery were recruited and assigned via the random number table method at a ratio of 1 : 1 to either an analgesic group given intraspinal nerve block anesthesia for labor or a nonanalgesic group without anesthesia for labor. Outcome measures included intrapartum body temperature, cases of intrapartum fever, Apgar scores of neonates, visual analogue scale (VAS) scores, delivery mode, and indomethacin use. Results: Intraspinal nerve block anesthesia was associated with a higher body temperature at 4 h and 5 h after analgesia and more cases of intrapartum fever versus no anesthesia (P < 0.05). There were no significant differences in the Apgar scores between the two groups (P > 0.05). Participants given intraspinal nerve block anesthesia had lower VAS scores during labor versus those without anesthesia (P < 0.05). The differences in the delivery mode between the two groups were not significant (P > 0.05). Intraspinal nerve block anesthesia resulted in a significantly higher demand for indomethacin versus no anesthesia (P < 0.05). Conclusion: Intraspinal nerve block anesthesia is clinically effective in labor analgesia but may cause increased body temperature or even overt clinical fever, so close clinical observation of maternal temperature changes is required to mitigate the effects of anesthesia on the mothers. No adverse consequences of intraspinal nerve block anesthesia on the newborns were reported in this study.

Perceived Burdensomeness, Thwarted Belongingness, and Social Exclusion in Transgender Women: Psychometric Properties of the Interpersonal Needs Questionnaire.

Transgender women (TGW) experience serious psychiatric problems and high suicide rates. According to the interpersonal theory of suicide, thwarted belongingness and perceived burdensomeness play major roles in suicidality and can be measured by the Interpersonal Needs Questionnaire (INQ). However, no study has validated the use of the INQ in TGW. This study aimed to examine the psychometric properties of the INQ among TGW. We recruited 198 TGW (mean age 38.47 years) from Shenyang, China, using snowball sampling. The construct validity of the INQ was assessed through factor analysis, and convergent and divergent validity were examined through a structural equation model with other psychosocial factors. The construct validation analysis supported a three-factor model (perceived burdensomeness, thwarted belongingness, and social exclusion) with satisfactory fit indices: χ 2/df = 1.54, RMSEA = 0.052, CFI = 0.931, TLI = 0.916, SRMR = 0.053. The thwarted belongingness was significantly associated with self-esteem and social support, and the social exclusion was significantly associated with loneliness, depression, entrapment, and defeat, suggesting satisfactory convergent and divergent validity for the three-factor model. The present findings indicate that for TGW, high social exclusion is important in assessing perceived interpersonal needs, while the notable deviation from previous two-factor model warrants further study.

Social exclusion, thwarted belongingness, and perceived burdensomeness: construct validity and psychometric properties of the Interpersonal Needs Questionnaire among patients with sexually transmitted infections in Shanghai, China.

BACKGROUND: Sexually transmitted infections (STIs) are a serious public health problem worldwide. Patients with STIs have a high rate of psychosocial problems and may perceive unmet interpersonal needs, which is considered a proximal and sufficient cause of suicidal thoughts and behaviors. The present study examined the construct validity and psychometric properties of the 15-item Interpersonal Needs Questionnaire among patients with STIs in Shanghai, China. METHODS: We recruited 910 patients with STIs (438 males and 472 females; mean age = 38.72, standard deviation [SD] = 13.034) from the Shanghai Skin Disease Hospital using accidental sampling. Baseline descriptive statistics were calculated using R 4.0.0, and a latent variable model was developed using Mplus 7.4. RESULTS: The construct validity results supported a latent variable measurement model with three distinct but related constructs (thwarted belongingness, perceived burdensomeness, and social exclusion) (p < 0.001, χ2/df = 2.475, root mean square error of approximation = 0.057, comparative fit index = 0.931, Tucker-Lewis index = 0.916, standardized root mean residual = 0.044). The Cronbach's α and McDonald's ω values were 0.849 and 0.767 for the total scale, 0.888 and 0.889 for perceived burdensomeness, 0.764 and 0.777 for social exclusion, and 0.892 and 0.893 for thwarted belongingness. Interpersonal needs were significantly associated with low self-esteem (r = 0.539), loneliness (r = 0.573), depression (r = 0.338), entrapment (r = 0.420), defeat (r = 0.579), and low perceived social support (r = 0.424). CONCLUSIONS: This was the first study to highlight social exclusion as a distinct but related dimension of interpersonal needs. This finding indicates that patients with STIs perceive high social exclusion. Therefore, health providers should consider the psychological status of these patients and implement strategies to support their integration into society.

A model to predict adherence to antiretroviral therapy among people living with HIV.

OBJECTIVES: Suboptimal adherence to antiretroviral therapy (ART) dramatically hampers the achievement of the UNAIDS HIV treatment targets. This study aimed to develop a theory-informed predictive model for ART adherence based on data from Chinese. METHODS: A cross-sectional study was conducted in Shenzhen, China, in December 2020. Participants were recruited through snowball sampling, completing a survey that included sociodemographic characteristics, HIV clinical information, Information-Motivation-Behavioural Skills (IMB) constructs and adherence to ART. CD4 counts and HIV viral load were extracted from medical records. A model to predict ART adherence was developed from a multivariable logistic regression with significant predictors selected by Least Absolute Shrinkage and Selection Operator (LASSO) regression. To evaluate the performance of the model, we tested the discriminatory capacity using the concordance index (C-index) and calibration accuracy using the Hosmer and Lemeshow test. RESULTS: The average age of the 651 people living with HIV (PLHIV) in the training group was 34.1±8.4 years, with 20.1% reporting suboptimal adherence. The mean age of the 276 PLHIV in the validation group was 33.9±8.2 years, and the prevalence of poor adherence was 22.1%. The suboptimal adherence model incorporates five predictors: education level, alcohol use, side effects, objective abilities and self-efficacy. Constructed by those predictors, the model showed a C-index of 0.739 (95% CI 0.703 to 0.772) in internal validation, which was confirmed be 0.717 via bootstrapping validation and remained modest in temporal validation (C-index 0.676). The calibration capacity was acceptable both in the training and in the validation groups (p>0.05). CONCLUSIONS: Our model accurately estimates ART adherence behaviours. The prediction tool can help identify individuals at greater risk for poor adherence and guide tailored interventions to optimise adherence.

The prevalence of childhood sexual experiences and intimate partner violence among transgender women in China: Risk factors for lifetime suicidal ideation.

Objective: Several studies highlighted childhood sexual experiences (CSEs) and intimate partner violence (IPV) as risk factors that affected lifetime suicidal ideation. TW had higher rates of CSEs and IPV than cisgender people. The aim of this study was to comprehensively assess the prevalence of CSEs and IPV among TW and their association with lifetime suicidal ideation. Methods: A cross-sectional survey was conducted among 247 TW in Shenyang and Kunming, China, from April to September 2018. CSEs, IPV, and lifetime suicidal ideation were assessed. Logistic regression models were used to examine the association between self-reported CSEs under 18 years of age, IPV in adulthood, and lifetime suicidal ideation. Results: In the study, 14.2% (35/247) of the sample participants reported CSEs under 18 years of age; 44.9% (111/247) reported experiencing IPV in adulthood, including 18.6% (44/247) of physical IPV, 27.1% (67/247) of trans-specific identity IPV, 31.6% (78/247) of verbal IPV, and 19.4% (48/247) of sexual IPV; and 26.3% (65/247) had thought about attempting suicide at least one time. CSEs and any form of IPV were significantly associated with suicidal ideation in this sample population. A final stepwise multivariate logistic regression model found that both physical and verbal IPVs were significantly associated with suicidal ideation when controlling for other factors (ORm1 = 2.58, 95% confidence interval (CI) = 1.163-5.724; ORm2 = 2.72, 95% CI = 1.334-5.547). Conclusions: The findings highlight the effects of CSEs and IPV among TW and suggest the need for research on suicide in the future. Suicide prevention efforts for this invisible and vulnerable population should focus on those with physical and verbal IPV.

Pre-Exposure Prophylaxis (PrEP) Adherence Questionnaire: Psychometric Validation among Sexually Transmitted Infection Patients in China.

BACKGROUND: Ensuring adherence guarantees the efficacy of pre-exposure prophylaxis (PrEP). METHODS: We conducted a cross-sectional study among 816 sexually transmitted infection (STI) patients in Shanghai. The questionnaire included self-reported demographic characteristics, self-administered items on adherence to free oral PrEP, and PrEP uptake behavior measurement. We conducted item analysis, reliability analysis, validity analysis and receiver operating characteristic (ROC) curve analysis. RESULTS: Not all items were considered acceptable in the item analysis. The questionnaire had a McDonald's ω coefficient of 0.847. The scale-level content validity index (CVI) was 0.938 and the item-level CVI of each item ranged from 0.750 to 1. In exploratory factor analysis, we introduced a four-factor model accounting for 79.838% of the aggregate variance, which was validated in confirmatory factor analysis. Adding PrEP adherence questionnaire scores contributed to prediction of PrEP uptake behavior (p < 0.001) in regression analysis. The maximum area under the ROC curve was 0.778 (95% IC: 0.739-0.817). CONCLUSION: The PrEP adherence questionnaire presented psychometric validation among STI patients.