Gender nonconformity and common mental health problems: A meta-analysis.

We tested the association between gender nonconformity and common mental health outcomes, including generalized anxiety symptoms, depressive symptoms, self-esteem, self-harm attempts, and suicide attempts using an exhaustive meta-analysis. PsycInfo, ProQuest Central, EBSCOhost, and PubMed were searched for eligible articles using either cross-sectional or longitudinal designs on 11th July 2024. A total number of 1975 articles were identified and selected following PRISMA. Twenty-five, 48, 32, seven, and nine studies were included on generalized anxiety symptoms, depressive symptoms, self-esteem, self-harm attempts, and suicide attempts, reaching a total sample size of 142,069, 188,681, 27,488, 47,523, and 25,573, respectively. Meta-analyses were performed using a random-effects model stratified by mental health outcomes. We found that higher levels of gender nonconformity were associated with higher levels of generalized anxiety (r = 0.06) and depressive symptoms (r = 0.11), lower levels of self-esteem (r = 0.18), and increased risk of self-harm (r = 0.17) and suicide attempts (r = 0.14). Gender nonconformity had stronger links to generalized anxiety symptoms, depressive symptoms, and self-esteem in men than in women. Behaviors-based gender nonconformity showed stronger links to depressive symptoms and self-esteem compared to traits-based gender nonconformity. The effect size for the association between gender nonconformity and depressive symptoms was significantly larger in adolescent samples than in childhood samples. There was no significant moderation by sexual orientation. While gender nonconformity is robustly associated with a range of common mental health problems, the magnitude of this association varies depending on the specific mental health outcomes considered and sex. Interventions to mitigate mental health differences and improve overall well-being among individuals who display greater gender nonconformity are needed.

Exploring the Role of Attachment and Coping Strategies in Sexual Orientation Disparities in Depressive Symptoms.

We tested whether sexual orientation disparities in depressive symptoms are partially explained by a path through attachment anxiety or avoidance leading to ineffective coping strategies. A convenience sample of 1290 individuals from two reliable data collection platforms (Credamo and Wenjuanxing) in China were included. Structural equation modeling was performed, with sexual orientation treated as the independent variable, ineffective coping strategies, attachment avoidance and anxiety as mediators, and depressive symptoms as the dependent variable. We found that lesbian, gay and bisexual (LGB) individuals reported higher levels of attachment anxiety and avoidance than heterosexual individuals, regardless of sex, with Cohen's ds ranging from 0.25 to 0.76. For both sexes, LGB individuals reported more depressive symptoms than heterosexual individuals, with total effects (standardized regression coefficients) ranging from 0.22 to 0.26. More depressive symptoms reported by LGB individuals compared to heterosexual individuals were partially explained by a path involving attachment avoidance or anxiety leading to ineffective coping strategies, with indirect effects ranging from 0.04 to 0.09 (small effect sizes). Overall, our results suggest that psychological factors, such as the cognitive or emotional representations of self and others, as well as ineffective coping strategies, may partially explain sexual orientation disparities in depressive symptoms.

Approaches to scarless burn wound healing: application of 3D printed skin substitutes with dual properties of anti-infection and balancing wound hydration levels.

BACKGROUND: Severe burn wounds face two primary challenges: dysregulated cellular impairment functions following infection and an unbalanced wound hydration microenvironment leading to excessive inflammation and collagen deposition. These results in hypertrophic scar contraction, causing significant deformity and disability in survivors. METHODS: A three-dimensional (3D) printed double-layer hydrogel (DLH) was designed and fabricated to address the problem of scar formation after burn injury. DLH was developed using methacrylated silk fibroin (SFMA) and gelatin methacryloyl (GelMA) for the upper layer, and GelMA and hyaluronic acid methacryloyl (HAMA) for the lower layer. To combat infection, copper-epigallocatechin gallate (Cu-EGCG) was incorporated into the lower layer bioink, collectively referred to as DLS. To balance wound hydration levels, HaCaT cells were additionally encapsulated in the upper layer, designed as DLS/c. FINDINGS: DLH demonstrated suitable porosity, appropriate mechanical properties, and excellent biocompatibility. DLS exhibited potent antimicrobial properties, exerted anti-inflammatory effects by regulating macrophage polarisation, and may enhance angiogenesis through the HIF-1α/VEGF pathway. In the DLS/c group, animal studies showed significant improvements in epidermal formation, barrier function, and epidermal hydration, accompanied by reduced inflammation. In addition, Masson's trichrome and Sirius red staining revealed that the structure and ratio of dermal collagen in DLS/c resembled that of normal skin, indicating considerable potential for scarless wound healing. INTERPRETATION: This biomimetic matrix shows promise in addressing the challenges of burn wounds and aiming for scarless repair, with benefits such as anti-infection, epidermal hydration, biological induction, and optimised topological properties. FUNDING: Shown in Acknowledgements.

Application of In Situ Mucoadhesive Hydrogel with Anti-Inflammatory and Pro-Repairing Dual Properties for the Treatment of Chemotherapy-Induced Oral Mucositis.

Chemotherapy-induced oral mucositis (CIOM) is a prevalent complication of chemotherapy and significantly affects the treatment process. However, effective treatment for CIOM is lacking due to the unique environment of the oral cavity and the single effect of current drug delivery systems. In this present study, we propose an innovative approach by combining a methacrylate-modified human recombinant collagen III (rhCol3MA) hydrogel system with hyaluronic acid-epigallocatechin gallate (HA-E) and dopamine-modified methacrylate-alginate (AlgDA-MA). HA-E is used as an antioxidant and anti-inflammatory agent and synergizes with AlgDA-MA to improve the wet adhesion of hydrogel. The results of rhCol3MA/HA-E/AlgDA-MA (Col/HA-E/Alg) hydrogel demonstrate suitable physicochemical properties, excellent wet adhesive capacity, and biocompatibility. Notably, the hydrogel could promote macrophage polarization from M1 to M2 and redress human oral keratinocyte (HOK) inflammation by inhibiting NF-κB activation. Wound healing evaluations in vivo demonstrate that the Col/HA-E/Alg hydrogel exhibits a pro-repair effect by mitigating inflammatory imbalances, fostering early angiogenesis, and facilitating collagen repair. In summary, the Col/HA-E/Alg hydrogel could serve as a promising multifunctional dressing for the treatment of CIOM.

Photocatalytic performance and mechanism insights of a S-scheme g-C3N4/Bi2MoO6 heterostructure in phenol degradation and hydrogen evolution reactions under visible light.

Photocatalysis with potentially low cost and sustainable utilization is a typically environmentally benign method for the degradation of organic pollutants, but the rational design and fabrication of photocatalysts with high catalytic performance is still an enormous challenge. The efficient segregation of photogenerated electron-hole pairs in photocatalysts is a key and essential factor to decide photocatalytic activity. Herein, a novel Step-scheme (S-scheme) heterojunction photocatalyst, a g-C3N4/Bi2MoO6 (g-CN/BMO) composite, was successfully fabricated using g-C3N4 nanosheet-wrapped Bi2MoO6 microspheres. By adjusting the amount of g-C3N4 in BMO, a series of g-CN/BMO composites was prepared while optimizing posttreatment temperature. The resulting g-CN/BMO indicated well the photocatalytic performance for the degradation of phenol and hydrogen evolution reactions, especially, 100 g of g-CN was integrated into 100 g of the pre-calcined BMO at 200 °C to produce 100% g-CN/BMO-200, showing the highest photocatalytic performance compared to single composite BMO, BMO-200, g-CN, and g-CN/BMO-200 with other mass ratios. Combining the results from the density functional theory calculations and the results of X-ray photoelectron spectroscopy, for S-scheme heterojunction-structured g-CN/BMO-200, the internal electric field-, band edge bending- and coulomb interaction-driven efficient segregation of photogenerated electrons and holes at the interface is elucidated to explain the photocatalytic mechanism, and the resulting holes on the VB of BMO and electrons on the CB of g-CN are responsible for the improvement of the photocatalytic performance. This study revealed that for the S-scheme g-CN/BMO composite the internal electric field, band edge bending and coulomb interaction at the interface between g-CN and BMO can not only promote the effective segregation of electrons and holes, but also retain stronger redox ability. Such an investigation provides a facile and simple strategy to fabricate novel S-scheme heterojunction-structured photocatalysts for solar energy conversion.

Selective debridement of burn wounds using hydrosurgery system.

In recent years, hydrosurgery is a technology that has been applied more and more in debridement procedures. However, the selectivity of hydrosurgery to cutaneous necrotic tissues has not been proved. This study was designed to investigate the possible tissue selectivity of hydrosurgery in the debridement in burn wounds. Deep partial-thickness burns were produced on the back of porcine, and 48 hours later, both burn wounds and normal skin were debrided using the hydrosurgery system. Then tissue samples were taken, and histological staining was performed and observed under microscope. Burn wound resection rates and the normal skin damaged rates were measured. Our result indicated that the burn wounds were significantly more sensitive than the normal skin when the water pressure produced by the hydrosurgery system was set between 3000 and 5000 psi (pounds per square inch), that is, the necrotic tissue portions were debrided more easily than the normal skin tissue. Based on these data, we suggest that 3000 to 5000 psi of water pressure in the hydrosurgery system has a skin tissue selectivity in burn wounds.