Hope level and associated factors among older people living with HIV/AIDS: a cross-sectional study.

Background: In China, little is known about the hope level of older people living with HIV/AIDS (PLWHA). This study was to examine the hope level of older PLWHA in China and identify related factors. Methods: This cross-sectional study was conducted in Sichuan province in China among older PLWHA. A standardized self-report questionnaire, the Herth Hope Index, was adopted. Multiple linear regression was used to identify factors influencing hope level. p-values <0.05 were considered statistically significant. Results: There were 314 participants with an average age of 64.5 (SD ± 8.7). Most of the participants were males (72.6%), primary school and below (65.9%), rural household registration (58.6%) and married (64.3%). More than half of the older adults had pension insurance, had a monthly income of more than RMB 1,000 and considered themselves to be in good health. About 80% confirmed being diagnosed for more than a year and disclosed their HIV status to family and friends. The majority of the population had low medium social support (79%). More than 80% had moderate and severe HIV stigma. Many older PLWHA had medium and high levels of hope, with an average score of 34.31 (SD ± 4.85). Multiple linear regression showed that having pension insurance (ß = 1.337, p = 0.015), longer diagnosis (ß = 0.497, p = 0.031), better self-reported health (ß = 1.416, p<0.001) and higher levels of social support (ß = 2.222, p < 0.001) were positively associated with higher levels of hope. HIV stigma (ß = -1.265, p < 0.001) was negatively correlated with hope level. Conclusion: The hope level of older PLWHA is good, but there is still room for improvement, and its hope is related to multiple factors. Therefore, the AIDS-related healthcare sector should pay special attention to the hope of older PLWHA, help them to improve their health, provide financial assistance and social aid to those with financial difficulties, and take measures to reduce HIV stigma, improve family support for the older adults, and guide the older adults to adopt a positive approach to life.

Major and Rare Earth Element Characteristics of Late Paleozoic Coal in the Southeastern Qinshui Basin: Implications for Depositional Environments and Provenance.

To understand the geochemical characteristics of late Paleozoic coal in the Changzhi and Jincheng mining areas in the southeastern Qinshui Basin, major and rare earth element analyses were conducted through inductively coupled plasma-mass spectrometry (ICP-MS), X-ray fluorescence spectrometry (XRF), and proximate analysis. The results show that the study coals are bituminous A rank and anthracite C rank (R o,ran: 1.6-3.24%) with low-ash, low-moisture, low-volatile, and low- to medium-sulfur characteristics. The main forms of sulfur in the study coals are organic sulfur, followed by pyritic sulfur, only some coals with high sulfur contents in the Taiyuan Formation (SGJ, WTP, FHS) are mainly pyritic sulfur, and the contents of sulfate sulfur are extremely low. The major elements of the late Paleozoic coal in the southeastern Qinshui Basin are mainly SiO2 (4.77%) and Al2O3 (3.64%), followed by Fe2O3 (1.22%), CaO (1.53%), FeO (0.48%), MgO (0.25%), Na2O (0.21%), P2O5 (0.18%), TiO2 (0.15%), and minor K2O (0.04%) (on a whole-coal basis). Through correlation analysis and cluster analysis, the occurrence states of major elements in the Shanxi and Taiyuan Formations are different. The average rare earth elements and yttrium (REY) value in the study area is 88.68 µg/g (on a whole-coal basis). The mean light REY (LREY)-to-heavy REY (HREY) ratio is 26.33. The mean values of δEu, δCe, Y, and Gd are 0.60, 0.99, 1.07, and 1.02, respectively. The Shanxi Formation is dominated by the L-type REY enrichment, while the Taiyuan Formation is dominated by the M-H-type REY enrichment. The fractionation degree of REY in the Taiyuan Formation is lower than that in the Shanxi Formation. Rare earth elements in Shanxi coal mainly occur in clay minerals, and some rare earth elements are adsorbed and enriched by vitrinite. Rare earth elements in Taiyuan coal mainly occur in clay minerals and pyrite, and some rare earth elements occur in inertinite. A warm, humid, low-salinity, oxidizing, and acidic environment was favorable for REY enrichment. The coal-forming environment was weakly oxidizing and reducing, and the paleosalinity of the water was relatively high during late Paleozoic coal deposition in the southeastern Qinshui Basin. The paleotemperature of the Shanxi Formation is higher than that of the Taiyuan Formation. The provenance is mainly from an upper crustal felsic source region, the source rocks are mainly post-Archean sedimentary and calcareous mudstones mixed with some granite and alkaline basalt from the Yinshan Upland, and the tectonic setting of the source area mainly includes island arcs and active continental margins.

Application of Prescription Reviews for Traditional Chinese Medicine to Improve Medical Disputes and Patient Satisfaction.

Objective: Medical disputes and patient satisfaction are related to inappropriate prescribing practices. We aim to investigate the clinical application of prescription reviews for traditional Chinese medicine (TCM). Method: TCM prescriptions performed prescription reviews in 372 patients from the year 2019 to 2020 were set as the observation group and those from the year 2017 to 2018 without prescription reviews as the control group (n = 341). According to the Criteria for Assessing Prescription Quality in Chinese Hospitals (CAPQCH) items, "Irrational" and "Rational" TCM prescriptions were determined mainly based on the following category: nonstandard prescriptions, inappropriate prescriptions, and hypernormal prescriptions. The incidence of medical disputes and the degree of patient satisfaction were compared between the two groups. Result: No difference was found in age and gender between the control group and the observation group. The number of irrational TCM prescriptions from the year 2017 to 2020 was 6, 8, 2, and 3, respectively, with the percentage of 3.725%, 4.480%, 1.201%, and 1.446%. The irrational rate in the observation group (1.344%) was significantly lower than that in the control group (4.106%). Specifically, a higher rate of nonstandard prescriptions was revealed in the control group as compared with the observation group. Moreover, a reduced incidence of medical disputes was revealed in the observation group relative to the control group accompanying with the increased degree of patient satisfaction. Conclusion: Prescription reviews have high application value in the management of Chinese pharmacies, which can improve the rationality of prescriptions, increase patient satisfaction, and reduce medical disputes.

Geochemistry Characteristics and Paleoenvironmental Significance of Trace Elements in Coal and Coal Gangue in the Yangcheng Mining Area, Qinshui Basin.

The geochemical characteristics of trace elements in Carboniferous-Permian coal and gangue in the Yangcheng mining area in Qinshui Basin, a large Carboniferous-Permian coalfield in China, were studied by inductively coupled plasma mass spectrometry (ICP-MS), and their geological significance was discussed. The results show that the content of trace elements in late Paleozoic coal in the Yangcheng mining area is depleted, except for slight enrichment of Li. Except for Li, Co, and Mo, the content of trace elements in the gangue was higher than that in the coal. The content of rare earth elements in gangue (324.28 µg/g) is much higher than that in coal (66.22 µg/g). The rare earth elements (REY) content in the coal in the Shanxi Formation (93.88 µg/g) is slightly higher than that in the Taiyuan Formation (66.19 µg/g). The mean values of δEu and δCe are 0.71 and 0.94, respectively. Except for the YIC3-1 curve of the Shanxi Formation, which is obviously convex and shows a positive Eu anomaly, the REY distribution patterns of the remaining samples are similar, showing the characteristics of light rare earth elements (LREY) enrichment and heavy rare earth elements (HREY) depletion. The Carboniferous-Permian coal-forming environment in the Yangcheng mining area is in an anoxic-reducing, warm, humid, and brackish water sedimentary environment. The paleosalinity and paleotemperature of the Shanxi coal formation are higher than those of the Taiyuan Formation, which is more inclined to be a reducing environment. The provenance of Carboniferous-Permian coal in the Yangcheng mining area is mainly derived from acidic sedimentary rocks of the upper crust of the post-Archaean, mixed with a small amount of granite, alkaline basalt, and oceanic tholeiite. The tectonic setting of the provenance is mainly an active continental margin related to a continental island arc mixed with an oceanic island arc and a passive continental margin tectonic setting.

Iron overload correlates with serum liver fibrotic markers and liver dysfunction: Potential new methods to predict iron overload-related liver fibrosis in thalassemia patients.

BACKGROUND: Early detection of liver fibrosis in thalassemia patients and rapid initiation of treatment to interfere with its progression are extremely important. OBJECTIVE: This study aimed to find a sensitive, easy-to-detect and noninvasive method other than liver biopsy for early detection of liver fibrosis in thalassemia patients. METHODS: A total of 244 Chinese Thalassemia patients with non-transfusion-dependent thalassemia (NTDT, n = 105) or thalassemia major (TM, n = 139) and 120 healthy individuals were recruited into the present study, and blood collagen type IV (C IV), precollagen type III (PIIINPC) and hyaluronic acid (HA), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and ferritin were measured. Liver iron concentration was determined by MRI. The correlation of serum markers with liver iron load and liver function was evaluated. RESULTS: Serum C IV, PIIINPC and HA were significantly elevated in Chinese patients with NTDT and further elevated in TM patients. Moreover, C IV, PIIINPC and HA were also positively correlated to serum ferritin and liver iron concentration and further elevated during the progression to multi-organ damage in NTDT patients. Finally, serum ferritin and liver iron concentration were significantly correlated with liver dysfunction determined by AST and ALT. CONCLUSION: Taken together, our results indicate that monitoring serum C IV, PIIINPC and HA is a potentially sensitive method to predict the risks for iron overload-related liver fibrosis in Chinese thalassemia patients.