Evaluation of dry eye disease symptomatology and mental health status among patients with different COVID-19 statuses.

AIM: To evaluate dry eye disease (DED) symptomatology and mental health status in different COVID-19 patients. METHODS: A cross-sectional observational design was used. Totally 123 eligible adults (46.34% of men, age range, 18-59y) with COVID-19 included in the study from August to November, 2022. Ocular Surface Disease Index (OSDI), Five-item Dry Eye Questionnaire (DEQ-5), Hospital Anxiety and Depression Scale (HADS), and Pittsburgh Sleep Quality Index (PSQI) were used in this study. RESULTS: OSDI scores were 6.82 (1.25, 15.91) in asymptomatic carriers, 7.35 (2.50, 18.38) in mild cases, and 16.67 (4.43, 28.04) in recurrent cases, with 30.00%, 35.56%, and 57.89%, respectively evaluated as having DED symptoms (χ2=7.049, P=0.029). DEQ-5 score varied from 2.00 (0, 6.00) in asymptomatic carriers, 3.00 (0, 8.00) in mild cases, and 8.00 (5.00, 10.00) in recurrent cases, with 27.50%, 33.33%, and 55.26%, respectively assessed as having DED symptoms (χ2=8.532, P=0.014). The prevalence of clinical anxiety (50.00%) and depression (47.37%) symptoms were also significantly higher in patients with recurrent infection (χ2=24.541, P<0.001; χ2=30.871, P<0.001). Recurrent infection was a risk factor for high OSDI scores [odds ratio, 2.562; 95% confidence interval (CI), 1.631-7.979; P=0.033] and DEQ-5 scores (odds ratio, 3.353; 95%CI, 1.038-8.834; P=0.043), whereas having a fixed occupation was a protective factor for OSDI scores (odds ratio, 0.088; 95%CI, 0.022-0.360; P=0.001) and DEQ-5 scores (odds ratio, 0.126; 95%CI, 0.039-0.405; P=0.001). CONCLUSION: Patients with recurrent COVID-19 have more severe symptoms of DED, anxiety, and depression.

Evaluation of tear film in patients with AIDS without opportunistic ocular infections in the era of COVID-19: A case-control study.

PURPOSE: The assessment of tear film and ocular surface conditions in patients with acquired immunodeficiency syndrome (AIDS) has been poorly studied thus far. We aim to assess tear film parameters, ocular surface characteristics, and dry eye disease (DED) symptoms of patients with AIDS who did not undergo highly active antiretroviral treatment (HAART). METHODS: This case-control study included 154 age-, sex-, and ethnicity-matched healthy controls and patients with AIDS. All participants underwent comprehensive ocular surface assessment and subjective DED symptomology evaluation. Data were collected between March 2022 and July 2022. RESULTS: HAART-naïve patients with AIDS had a shorter noninvasive tear film breakup time (median 3.76 vs. 8.54 s), thinner tear film lipid layer thickness (median 73.00 vs. 91.00 nm), and lower Schirmer I test values (median 5.00 mm/5 min vs. 12.00 mm/5 min) (all P < 0.001). Moreover, higher corneal fluorescein staining scores (median 1.00 vs. 0.00) and higher upper, lower, and total meibomian gland grades were observed in AIDS patients (all P < 0.05). Negative correlations between the blood viral load and the Ocular Surface Disease Index score ( r = -3.50, P = 0.027) and the Schirmer I test score ( r = -0.374, P = 0.017) were detected in patients with AIDS. CONCLUSION: Altered tear film status was observed in individuals with HAART-naïve AIDS, even when there were no other ocular symptoms present. Therefore, patients with AIDS should be encouraged to undergo comprehensive ocular surface examinations to detect any subclinical tear film alterations occurring.

Ecological factors associated with child sexual abuse among 15- to 17-year-old adolescents in mainland China: implications for intervention.

Background: Child sexual abuse is a major public health problem with adverse consequences for victims' physical, mental, and reproductive health. This cross-sectional study aimed to determine the prevalence of child sexual abuse and its associated factors among 15- to 17-year-old adolescents in mainland China. Methods: From September 8, 2019 to January 17, 2020, a total of 48,660 participants were recruited by 58 colleges and universities across the whole country to complete the self-administered, structured, online questionnaire. This analysis was restricted to 3,215 adolescents aged between 15 and 17 years in mainland China. Chi-square tests and multivariate Logistic regression analyses were performed to identify individual, relationship, and community factors associated with child sexual abuse. Results: The overall prevalence of child sexual abuse was 12.0%. More specifically, 13.0% of girls and 10.6% of boys reported that they were sexually abused prior to 18 years of age. At the individual level, being female, sexual minority identity, younger age, and higher levels of knowledge, skills and self-efficacy regarding condom use were significantly related to increased odds of reporting sexual abuse. At the relationship and community level, adolescents from disrupted families and those entering into a marriage, having casual sexual partners, and having first intercourse at a younger age were more likely to report sexual abuse. On the contrary, those who had never discussed sex-related topics with their family members at home and were offered school-based sexuality education later (vs. earlier) were less likely to report sexual abuse. Conclusion: Multilevel prevention programs and strategies, including targeting adolescents with high-risk characteristics, educating young children and their parents about child sexual abuse prevention and optimizing the involvement of parents, school, community, society and government in comprehensive sexuality education, should be taken to reduce child sexual abuse among 15- to 17-year-old adolescents.

Subconjunctival conbercept for the treatment of corneal neovascularization.

AIM: To investigate the effectiveness and safety of subconjunctival injection of conbercept in the treatment of corneal neovascularization (CNV). METHODS: The data on 10 consecutively recruited patients with CNV who received a subconjunctival conbercept (1 mg) once, and measured the area, length, and diameter of neovascularization before and after (1d, 1, 2wk, and 1mo) treatment as well as the occurrence of systemic and ocular complications after treatment were analyzed. RESULTS: There was a statistically significant reduction in the area of CNV one day after treatment (mean±SD: 38.46±11.36 mm2), compared with before treatment (42.46±12.80 mm2, P<0.01). There was also a statistically significant reduction in the length (3.86±1.80 mm vs 4.64±1.77 mm, P<0.01) and diameter (0.044±0.022 vs 0.060±0.026, P<0.05) of CNV, one week after treatment comparing to before treatment. The reduction in all three parameters was maximized at two weeks after treatment (area: 29.49±8.83 mm2, P<0.001; length: 3.50±1.88 mm, P<0.001; and diameter: 0.038±0.017 mm, P<0.01). No severe systemic or ocular complication was observed during the study. CONCLUSION: During the observation period of one-month, subconjunctival injection of conbercept is an effective and safe method for the reduction of CNV. It may be effective as a preoperative drug for neovascular corneal transplantation.

Evaluation of the Clinical Characteristics of Dry Eye Secondary to Different Types of Liver Diseases.

INTRODUCTION: This study compares the clinical characteristics of dry eye secondary to primary biliary cholangitis (PBC), drug-induced liver injury (DILI), and viral hepatitis B(HBV) to evaluate the ocular surface damage caused by different types of liver diseases. METHODS: Thirty healthy people were included as control group. Sixty patients with dry eye secondary to different types of liver disease were included, including 19 cases of PBC, 18 cases of DILI, and 23 cases of HBV. All patients were evaluated by the SPEED questionnaire, corneal fluorescein staining (CFS), noninvasive tear breakup time (NIBUT), Schirmer I test (SIt), tear meniscus height test (TMH), the area of meibomian glands dropout (MG dropout), partial blinking rate (PBR), lipid layer thickness (LLT), meibum expressibility, and meibum quality. RESULTS: There are statistical differences in ophthalmic examination results between different types of liver diseases and normal people (P < 0.05). Compared with DILI and HBV groups, the CFS score of PBC group score was higher (P < 0.05), the PBR was higher (P < 0.05), and the SIt was lower (P < 0.01). The TMH of PBC and DILI groups were significantly lower than the HBV group, and the difference was statistically significant (P < 0.05). Compared with the PBC group, the LLT of the DILI group decreased (P < 0.01). The area of meibomian glands dropout of the three groups had mild-to-moderate defects, but there was no significant statistical difference between groups (P > 0.05).The Meibum quality score in the DILI group was significantly higher than the HBV group (P < 0.05). CONCLUSIONS: The PBC group was more prone to aqueous-deficient dry eye. The DILI group was more prone to obstructive meibomian gland dysfunction (MGD).The HBV group was more prone to nonobstructive MGD. The symptoms of dry eye in the PBC group are mild-to-moderate discomfort, but the degree of corneal damage is higher, indicating that the corneal sensitivity is reduced, which may be related to the high rate of partial blinking.

Validation of Herek's attitudes toward lesbian women and gay men scale among undergraduates in mainland China.

The lack of a standardized reliable and valid instrument makes it difficult to measure attitudes toward lesbian women and gay men (ATLG) consistently and thus poses a challenge to compare and contrast intervention measures. This study aimed to validate Herek's ATLG scale among undergraduates in mainland China and identify factors associated with negative attitudes toward LG. A total of 6,036 eligible undergraduates conveniently drawn from 30 provinces across mainland China were randomly split in half. Item analysis was first used to select unrelated or redundant items for deletion. Exploratory factor analysis (EFA) were then conducted on the first half of the sample (n = 3,001), followed by confirmatory factor analysis (CFA) and reliability analysis in the second half (n = 3035). Logistic regression analyses were finally carried out to identify their determinants. Six items were removed from the item analysis. EFA supported the existence of two factors (ATL and ATG). CFA results indicated that the two-factor model fit the data better than the one-factor model. Logistic regression analyses indicated that being female, majoring in non-health-related disciplines, attributing homosexuality to uncontrollable causes, non-adherence to traditional gender norms and exposure to homosexual content were significantly associated with less negative attitudes toward both L and G. Urban students were marginally less likely to express negative attitudes toward L but not G, while non-heterosexuals and those who had prior personal contact with homosexuals exhibited less negative attitudes toward G but not L. However, grade showed no significant associations with either ATL or ATG. The retained 14-item version of Herek's ATLG scale has been proven to be a reliable and valid tool. Furthermore, ATL and ATG were determined by different factors and thus would be treated separately. In order to reduce negative attitudes toward LG among undergraduates in mainland China, a comprehensive intervention plan such as conducting comprehensive sex education and pushing the process of legalizing same-sex marriage should be designed, implemented and evaluated.

Prevalence of and factors associated with unintended pregnancies among sexually active undergraduates in mainland China.

BACKGROUND: Unintended pregnancies (UIP) among unmarried sexually active college students in mainland China have emerged as a major reproductive health issue with detrimental personal and socioeconomic consequences. This cross-sectional study aimed to determine the prevalence and factors associated with UIP among sexually active undergraduates in mainland China. METHODS: Between September 8, 2019 and January 17, 2020, a total of 48,660 participants were recruited across the Chinese mainland to complete the self-administered, structured, online questionnaire. This analysis was restricted to 6347 sexually experienced, never-married 15-26 year old undergraduates. Pearson's Chi square tests and multivariate Logistic regression analyses were performed to identify sociodemographic, familial and individual variables associated with UIP. RESULTS: The overall prevalence of UIP was 17.7%. More specifically, 19.5% of male college students reported they had unintentionally gotten a partner pregnant, while 14.9% of female college students became unintentionally pregnant. Students who experienced UIP were more likely to belong to the older age group (23-26 years), live with only one parent or live without parents at home, report that their family members approve of premarital sex, initiate sexual activity younger than 14 years old and have casual sex partners. Furthermore, females with multiple partners and males who came from low- income households, experienced sexual abuse, perceived difficulties in acquiring condoms and did not know how to use condoms correctly were also at higher risk of experiencing an unintended pregnancy. CONCLUSION: In order to prevent UIP, a comprehensive intervention measure should be taken to target older students and those engaging in risky sexual behaviors, work with young male students to improve condom use skills, improve the availability of free condoms, optimize the involvement of parents and other family members in their children's sex education.

In this study, we aimed to determine the prevalence and factors associated with UIP among sexually active undergraduates in mainland China. Between September 8, 2019 and January 17, 2020, a total of 48,660 participants were recruited from the Chinese mainland to complete the self-administered, structured, online questionnaire. This analysis was restricted to 6347 sexually experienced, never-married 15­26 year old undergraduates. Based on a social-ecological theoretical framework, we ran separate multivariate Logistic regression models for men and women to identify sociodemographic, familial and individual variables associated with UIP. Our findings indicate that the overall prevalence of UIP was 17.7%. More specifically, 19.5% of male college students reported they had unintentionally gotten a partner pregnant, while 14.9% of female college students became unintentionally pregnant. Students who experienced UIP were more likely to belong to the older age group, live with only one parent or live without parents at home, report that their family members approve of premarital sex, initiate sexual activity younger than 14 years old and have casual sex partners. Furthermore, females with multiple partners and males who came from low-income households, experienced sexual abuse, perceived difficulties in acquiring condoms and did not know how to use condoms correctly were also at higher risk of having an unintended pregnancy. In order to prevent UIP, a comprehensive intervention measure should be taken to target older students and those engaging in risky sexual behaviors, work with young male students to improve condom use skills, improve the availability of free condoms, optimize the involvement of parents and other family members in their children's sex education.

Discordance between perceived risk and actual risky sexual behaviors among undergraduate university students in mainland China: a cross-sectional study.

BACKGROUND: HIV prevention, diagnosis, treatment and care services might be hampered by inaccurate risk assessment. This study aimed to investigate the extent of and factors associated with the discordance between perceived risk and actual risky sexual behaviors among undergraduates in mainland China, guided by the Anderson's behavioral model. METHODS: This study involved a secondary analysis of cross-sectional data collected during the fall semester of 2018-2019 academic year. The present analysis was restricted to 8808 undergraduates with low risk perception. Those who had low perceived risk but actually engaged in risky sexual behaviors were categorized as risk discordance (RD). Univariate and multivariate Logistic regression analyses were conducted to identify factors associated with RD. RESULTS: Overall, the discordance rate between perceived and actual risk was 8.5% (95% CI: 7.9%-9.1%). Multivariate Logistic regression analysis indicated that non-heterosexual women (AOR = 0.41, 95% CI:0.27-0.60), heterosexual men (AOR = 0.45, 95% CI:0.33-0.61) and women (AOR = 0.26, 95% CI:0.19-0.35) were less likely to exhibit RD, when compared with non- heterosexual men. Furthermore, non-freshmen (AOR = 1.57, 95% CI:1.30-1.90), early initiators of sexual intercourse (AOR = 5.82, 95% CI:4.10-8.26), and those who had lower levels of HIV knowledge (AOR = 1.28, 95% CI:1.08-1.51), displayed higher levels of stigma against PLHIV (AOR = 1.50, 95% CI:1.26-1.77) and had ever been tested for HIV (AOR = 1.36, 95% CI:1.04-1.77) were more prone to reporting RD. Those with more enabling resources [i.e., displaying high levels of condom use self-efficacy (AOR = 0.70, 95% CI:0.59-0.84) and being knowledge of local testing center (AOR = 0.71, 95% CI:0.60-0.83)] were less likely to report RD. However, spending more than 2000 Yuan a month on basic needs (AOR = 2.55, 95% CI:2.07-3.14), residing in urban areas (AOR = 1.35, 95% CI:1.15-1.59) and being knowledgeable of the national AIDS policy (AOR = 1.40,95% CI:1.18-1.66) increased the chance of exhibiting RD. CONCLUSIONS: Comprehensive interventions, including targeting students with high-risk characteristics, improving the acceptability of PrEP and PEP, conducting health education, enhancing self-efficacy for using condoms and making opt-out HIV testing routine in college campus, should be taken to reduce the discordance between perceived and actual HIV risk and finally to reach the goal of Zero AIDS.

[Meta-analysis of the Impact of Different Ozone Metrics on Total Mortality in China].

This study explores the effect of different ozone metrics on the total mortality risk in China. Using the CNKI, Wanfang, VIP, Web of Science, and PubMed databases, the time series studies and case crossover studies from the establishment of each database to December 31, 2020 were retrieved, and 22 eligible studies were included in this analysis. A meta-analysis was performed for the ozone metrics of O3-M1h, O3-M8h, and O3-24h. The results indicated that the increase in the total mortality risk is more closely associated with O3-M1h (RR #, 1.0052; 95%CI, 1.0031-1.0073) and is more weakly associated with O3-24h (RR #, 1.0036; 95%CI, 1.0025-1.0048) and O3-M8h (RR #, 1.0031; 95%CI, 1.0022-1.0041). A subgroup analysis of the three metrics revealed that the total mortality risk of ozone is higher in the cold season, the elderly (≥ 65) are more vulnerable to ozone pollution, and the total mortality risk in the north is higher than that in the south.

Inequities in the utilization of HIV counseling and testing services among undergraduates in mainland China.

BACKGROUND: HIV counseling and testing (HCT) is provided free of charge on college campuses, but very few studies have examined whether HCT uptake is equitably distributed. This cross-sectional study aimed to compare the relative importance of various determinants of HCT uptake among undergraduates in mainland China so as to assess and subsequently to suggest ways to eliminate inequities in its use, guided by the Andersen's behavioral model. METHODS: A total of 10,665 eligible undergraduates were conveniently selected to complete an online survey. Hierarchical logistic regression analyses were performed to identify the factors associated with HCT utilization. RESULTS: Only 7.7% of undergraduates had utilized HCT services. HCT uptake was inequitably distributed, since it was mainly determined by predisposing and enabling factors rather than by need factors. Further analysis indicated that HCT uptake was significantly related to two need factors, one enabling factor and six predisposing factors. Those with a higher need [i.e., perceiving themselves to be at higher risk of acquiring HIV infection (AOR = 2.76, 95% CI:2.02-3.78) and engaging in condomless sex (AOR = 1.29, 95% CI:1.00-1.67)] and those with more resources [i.e., being knowledgeable of local AIDS service organization (AOR = 1.59, 95% CI:1.37-1.85)] were more likely to utilize HCT services. Compared to non-heterosexual men, non-heterosexual women (AOR = 0.51, 95% CI:0.37-0.72), heterosexual men (AOR = 0.44, 95% CI:0.33-0.57) and women (AOR = 0.31, 95%CI: 0.24-0.41) were less likely to utilize HCT service. Furthermore, those with more knowledge (AOR = 0.80, 95% CI:0.69-0.94) and taking a positive attitude towards HCT services [i.e, expressing their willingness to utilize HCT services (AOR = 0.68, 95% CI:0.56-0.81) and having recognized the necessity to provide HTC services in the local university (AOR = 0.46, 95% CI:0.36-0.57)] were less likely to utilize HCT services. However, medical students (AOR = 1.34, 95% CI: 1.15-1.56) and non-freshmen (AOR = 1.22, 95% CI:1.03-1.45) were more likely to utilize HCT services. CONCLUSIONS: To increase HCT uptake and simultaneously reduce the remaining inequities, a comprehensive intervention should be continued to target non-heterosexual men and non- freshmen and those with a higher need for HCT services, conduct health education, improve the availability and accessibility of HIV testing services.

Synthesis of a Reactive Template-Induced Core-Shell PZS@ZIF-67 Composite Microspheres and Its Application in Epoxy Composites.

Developing superior properties of epoxy resin composites with high fire resistance, light smoke, and low toxicity has been the focus of the research in the flame-retardant field. In particular, it is essential to decrease the emissions of toxic gases and smoke particles generated during the thermal decomposition of epoxy resin (EP) to satisfy the industrial requirements for environmental protection and safety. Consequently, the PZS@ZIF-67 composite was designed and synthesized by employing the hydroxyl group-containing polyphosphazene (poly(cyclotriphosphazene-co-4,4'-dihydroxydiphenylsulfone), PZS) as both the interfacial compatibility and an in situ template and the ZIF-67 nanocrystal as a nanoscale coating and flame-retardant cooperative. ZIF-67 nanocrystal with multidimensional nanostructures was uniformly wrapped on the surface of PZS microspheres. Subsequently, the acquired PZS@ZIF-67 composite was incorporated into the epoxy resin to prepare composite samples for the study of their fire safety, toxicity suppression, and mechanical performance. Herein, the EP/5% PZS@ZIF-67 passed the V-0 rating in a UL-94 test with a 31.9% limit oxygen index value. More precisely, it is endowed with a decline of 51.08%, 28.26%, and 37.87% of the peak heat release rate, the total heat release, and the total smoke production, respectively. In addition, the unique structure of PZS@ZIF-67 microsphere presented a slight impact on the mechanical properties of EP composites at low loading. The PZS@ZIF-67 possible flame-retardant mechanism was speculated based on the analysis of the condensed phase and the gas phase of EP composites.

B3GNT3 acts as a carcinogenic factor in endometrial cancer via facilitating cell growth, invasion and migration through regulating RhoA/RAC1 pathway-associated markers.

BACKGROUND: Aberrant expression of beta-1,3-N-acetylglucosaminyltransferase-3 (B3GNT3) has been frequently clarified in various cancers, however, its role in endometrial cancer (EC) has not been assessed in detail. PURPOSE: This study aimed to investigate the biological role of B3GNT3 in EC and simply explored the detailed mechanism. METHODS: The EC RNA-Seq dataset from TCGA database was applied to evaluate the expression of B3GNT3 and assess its role on prognostic value. HEC-1-A and KLE cell lines of EC were used to perform loss- and gain-of-function B3GNT3 assays respectively. Quantitative real-time PCR (qRT-PCR) and western blot were used to measure the mRNA and protein levels of indicated molecules respectively. Cell counting kit-8, clone formation tests, and Transwell assay served to determine the changes of proliferative, invasive and migratory abilities of EC cells after altering the expression of B3GNT3. RESULTS: B3GNT3 was found to be highly expressed in EC tissues compared to normal tissues according to the online public databases, which confirmed by the following qRT-PCR in 3 EC cell lines. Besides, high B3GNT3 expression presented a worse overall survival in EC patients as compared with low B3GNT3 expression group. Furthermore, functional experiments in vitro indicated that B3GNT3 could facilitate the cell growth, invasion and migration. Moreover, we found that downregulation of B3GNT3 significantly reduced the expression level of GTP-RhoA and GTP-RAC1, whereas upregulation of B3GNT3 presented the opposite results. CONCLUSION: The results of current study demonstrate that B3GNT3 acts as an oncogene that promotes EC cells growth, invasion and migration possibly through regulating the RhoA/RAC1 signaling pathway-related markers, suggesting that B3GNT3 may be a candidate biomarker for EC therapeutic intervention.

First trimester serum PAPP-A is associated with placenta accreta: a retrospective study.

PURPOSE: Our objective of this study was to investigate whether first trimester serum pregnancy-associated plasma protein-A (PAPP-A) differed amongst pregnancies with placenta previa-accreta and non-adherent placenta previa and healthy pregnancies by a retrospective cohort analysis. METHODS: A total of 177 pregnant females were included in the study, as follows: 35 cases of placenta previa-accreta, 30 cases of non-adherent placenta previa, and 112 cases of BMI and age matched, healthy pregnant controls. PAPP-A multiples of the median (MoM) were acquired from laboratory data files in 1 January 2017-30 September 2019. The probable maternal serum biochemical predictor of placenta accreta was analyzed by using multiple logistic regression analysis. RESULTS: PAPP-A MoM of placenta previa-accreta group was significantly higher than those of the non-adherent placenta previa group and control group (p = 0.009 < 0.05, p < 0.001). Serum PAPP-A was found to be significantly positively associated with placenta accreta after adjusted gestational week at time of blood sampling, BMI, age, smoking, and previous cesarean section history (OR: 3.51; 95% CI: 1.77-6.94; p = 0.0003 < 0.05). In addition, smoking (OR: 9.17; 95% CI: 1.69-49.62; p = 0.010 < 0.05) and previous cesarean section history (OR: 2.75; 95% CI: 1.23-6.17; p = 0.014 < 0.05) were also significantly associated with placenta accreta. CONCLUSION: Increased first trimester serum PAPP-A was significantly positively associated with placenta accreta, suggesting that the potential role of PAPP-A in identifying pregnancies at high risk for placenta accreta. Smoking and previous cesarean section history may be the risk factors for accreta in placenta previa patients.

Synthesis of a Novel Spirocyclic Inflatable Flame Retardant and Its Application in Epoxy Composites.

Derivatives of 3,9-dichloro-2,4,8,10-tetraoxa-3,9-diphosphaspiro-[5,5]undecane-3,9-dioxide (SPDPC) are of increasing interest as flame retardants for polymeric materials. In addition, SPDPC is also an important intermediate for the preparation of intumescent flame retardants (IFRs). However, low efficiency and undesirable dispersion are two major problems that seriously restrain the application of IFRs as appropriate flame retardants for polymer materials. Usually, the functionalization or modification of SPDPC is crucial to acquiring high-performance polymer composites. Here, a small molecule spirocyclic flame retardant diphenylimidazole spirocyclic pentaerythritol bisphosphonate (PIPC) was successfully prepared through the substitution reaction between previously synthesized intermediate SPDPC and 2-phenylimidazole (PIM). Phenyl group and imidazole group were uniformly anchored on the molecular structure of SPDPC. This kind of more uniform distribution of flame retardant groups within the epoxy matrix resulted in a synergistic flame retardant effect and enhanced the strength of char layers to the epoxy composites, when compared to the unmodified epoxy. The sample reached a limiting oxygen index (LOI) of 29.7% and passed with a V-0 rating in the UL 94 test with the incorporation of only 5 wt % of as-prepared flame retardant PIPC. Moreover, its peak of heat release rate (pHRR) and total heat release (THR) decreased by 41.15% and 21.64% in a cone calorimeter test, respectively. Furthermore, the addition of PIPC has only slightly impacted the mechanical properties of epoxy composites with a low loading.

Job Satisfaction and Hospital Performance Rated by Physicians in China: A Moderated Mediation Analysis on the Role of Income and Person-Organization Fit.

This study tested the effect of person-organization fit (P-O fit) in mediating the link between job satisfaction and hospital performance with income as a moderator. A questionnaire survey was conducted on 301 physicians from two public hospitals in Zhejiang province of China. Respondents were asked to rate their job satisfaction, value congruence (P-O fit) with the hospital, and the hospital's performance. The mediating effect of P-O fit on the link between job satisfaction and hospital performance was tested through partial least squares-structural equation modeling (PLS-SEM). Income was introduced to the model as a moderator on the "P-O fit → hospital performance" and "job satisfaction → hospital performance" path, respectively. Higher job satisfaction and P-O fit were associated with higher ratings on hospital performance (p < 0.01). P-O fit had a partial mediating effect on the association between job satisfaction and hospital performance, accounting for 73% of the total effect. The effects of P-O fit and job satisfaction on hospital performance were stronger in the respondents with higher income. Overall, high job satisfaction is associated with high ratings on hospital performance, which is partially mediated through P-O fit. Value congruence is particularly important when financial tools are used to incentivize hospital physicians.

Tacrolimus dye drop treatment for the management of early post-operative intraocular inflammation after therapeutic keratoplasty for severe infectious keratitis.

The current study investigated the anti-inflammatory effect of 0.1% tacrolimus eye drops for the treatment of therapeutic penetrating keratoplasty (TPK) for severe infectious keratitis during early disease stages and reported the long-term clinical outcomes. The present retrospective study included 20 eyes from patients diagnosed with severe keratitis who underwent TPK surgery. Patients were followed-up for up to 12-18 months. Tacrolimus eye drops were administered 4 times/day starting on the first day post-surgery. Glucocorticoid eye drops were subsequently added to treatment plans one-month post-surgery. All patients were followed-up for the first 3 post-operative days, then examined once a week thereafter for the first month. In early post-operative stages, the states of the grafts (ΔS) and the absorption of intraocular inflammation (S) were observed. ΔS was defined as the difference between the states of the grafts on the first post-operative day (SS1d) and those at one month post-surgery (SS1m). S was calculated as the difference between the inflammation score mean one day post-surgery (T1d) and the mean one-month post-surgery (T1m). For long term clinical outcomes, graft failure rates and complications were recorded. Among the 20 eyes analyzed, the mean T1d, T1m and S were 7.4±2.06, 2.0±2.47 and 5.4±2.13 (P<0.01), respectively. The mean SS1d, SS1m and ΔS were 5.3±1.56, 3.8±1.24 and 1.5±1.5 (P<0.01), respectively. During follow-up, there were 6 cases of corneal graft failure, 4 of which were due to immune rejection and 2 of which were due to complications. The current study concluded that tacrolimus eye drops facilitated the absorption of intraocular inflammation in the early post-operative period of TPK and may extend long term survival of grafts in cases of severe infectious keratitis.

Diagnostic Values of miR-21, miR-124, and M-CSF in Patients With Early Cervical Cancer.

OBJECTIVE: This study aimed to investigate the diagnostic values of microRNA-21, microRNA-124, and macrophage colony-stimulating factor in patients with cervical cancer. METHODS: A total of 68 patients with cervical cancer admitted in our hospital (cervical cancer group) and 57 healthy individuals undergoing physical examinations (healthy group, also control group) were enrolled in this study. The expression of serum microRNA-21 and microRNA-124 was detected by quantitative reverse transcription polymerase chain reaction. The expression of serum macrophage colony-stimulating factor was detected by enzyme-linked immunosorbent assay. The diagnostic values of microRNA-21, microRNA-124, and macrophage colony-stimulating factor in cervical cancer were analyzed. The correlations between the expression of microRNA-21 and microRNA-124 with that of macrophage colony-stimulating factor were also analyzed. RESULTS: Compared to those in the healthy group, patients in the cervical cancer group had a higher expression of microRNA-21 and macrophage colony-stimulating factor (P < .05) but lower expression of microRNA-124 (P < .05). The expression of microRNA-21, microRNA-124, and macrophage colony-stimulating factor in the patients correlated with the tumor size, tumor node metastasis (TNM) staging, tumor differentiation, and the presence or absence of lymph node metastasis and human papillomavirus infection (P < .05). According to the receiver operating characteristic curves, the area under the curve of microRNA-21 for diagnosing cervical cancer was 0.723, the specificity was 58.82%, and the sensitivity was 91.23%. The area under the curve of microRNA-124 was 0.766, the specificity was 94.12%, and the sensitivity was 57.89%. The area under the curve of macrophage colony-stimulating factor was 0.754, the specificity was 64.71%, and the sensitivity was 87.72%. Pearson correlation analysis showed that the expression of microRNA-21 positively correlated with that of macrophage colony-stimulating factor (r = 0.6825, P < .001), and the expression of microRNA-124 negatively correlated with that of macrophage colony-stimulating factor (r = -0.6476, P < .001). CONCLUSION: MicroRNA-21, microRNA-124, and macrophage colony-stimulating factor may be involved in the development and progression of cervical cancer. The detection of serum microRNA-21, microRNA-124, and macrophage colony-stimulating factor has good sensitivity and specificity in the diagnosis of cervical cancer.

LncRNA LEF1-AS1 Promotes Ovarian Cancer Development Through Interacting with miR-1285-3p.

BACKGROUND: Growing evidence indicates that long noncoding RNA (lncRNA) is a group of important regulator in cancer development. However, the correlation between lncRNA and ovarian cancer remains elusive. Here, we aimed to investigate the roles of LEF1-AS1 in ovarian cancer progression. METHODS: LEF1-AS1 expression was analyzed by quantitative real-time polymerase chain reaction (qRT-PCR). Survival rate was analyzed by Kaplan-Meier method. Cell Counting Kit-8 (CCK8) and colony formation assays were used for proliferation analysis. Transwell assay was utilized for analyses of migration and invasion. Luciferase reporter assay was performed to test the interaction between LEF1-AS1 and miR-1285-3p. RESULTS: We showed that LEF1-AS1 expression was upregulated in ovarian cancer tissues compared with normal tissues. Besides, LEF1-AS1 level was positively correlated with lymph node metastasis and advanced stage. Enhanced expression of LEF1-AS1 may predict a poor prognosis. Moreover, LEF1-AS1 knockdown suppressed ovarian cancer cell proliferation, migration and invasion. Mechanistically, LEF1-AS1 exerted its oncogenic functions through interacting with miR-1285-3p to inhibit miRNA activity. Rescue assay validated that miR-1285-3p inhibitors abrogated LEF1-AS1-silencer-caused suppression of ovarian cancer progression. CONCLUSION: Our study revealed that LEF1-AS1 acts as a vital regulation in ovarian cancer progression.

Effects of a Macromolecule Spirocyclic Inflatable Flame Retardant on the Thermal and Flame Retardant Properties of Epoxy Resin.

A new strategy for the preparation of an integrated three-source intumescent flame retardant (IFR) has been developed to improve the flame-retardant and smoke suppression performance of epoxy resin (EP) with a synergistic flame retardant effect. Herein, the synthesis of a macromolecular spirocyclic phosphorus/nitrogen-containing IFR poly sulfonamide spirocyclic pentaerythritol bisphosphonate (SAPC) is reported via a two-step method that uses pentaerythritol, phosphorus oxychloride and sulfonamide (SAA) as raw materials. Subsequently, the SAPC was incorporated into EP to prepare the composite to investigate its thermal stability, flame retardancy, and smoke suppression performance. Herein, a differential scanning calorimetry (DSC) analysis showed that the addition of SAPC increased the glass transition temperature (Tg) of the composite. Cone test results indicated that the incorporation of 8 wt % SAPC significantly improved the flame-retardant performance for the composite, with a 43.45% decrease in peak of heat release rate, a 28.55% reduction in total heat release, and a 30.04% decrease in total smoke release. Additionally, the composite received the V-0 rating in a UL-94 vertical burning test, accompanied by the "blowout" phenomenon. After the addition of SAPC, the amount of flammable gas products from the EP composite decomposition was obviously suppressed, and the amount of non-flammable as was increased. All of this suggests a good dilution role of SAPC. There are enough reasons to believe that the enhanced flame-retardant and toxicity suppression performance for the EP composite can be attributed to the good coordination of carbonization agent, acid source, and blowing agent in the SAPC structure.

Synthesis and characterization of SPDSCD and its flame retardant application on epoxy resins.

In this study, a flame retardant agent, 2,4,8,10-tetraoxo-3,9-diphosphospiro[5.5]undecane spirophosphate-4,4-diaminopair benzene disulfone-1,3,5-himetriazine (SPDSCD), is synthesized through a direct polycondensation reaction. SPDSCD is a chemically expanded phosphorus-containing flame retardant in epoxy resins (EP). The molecular structure of SPDSCD and thermal stability are characterized by nuclear magnetic resonance, Fourier transform infrared spectroscopy, and thermogravimetric analysis, and EP/SPDSCD composites were investigated in detail. These properties are associated with the phosphorus-containing spiro structure on the main molecular chain which can promote condensation polymerization into carbon during pyrolysis, the new nitrogen-containing carbon source, and the triazine structure. SPDSCD shows good thermal stability and low flammability, the weight loss from 500 to 800 °C was only 6.1 wt%, and the residual mass at 800 °C was 48.9 wt%. With the addition of SPDSCD, the flame retardant quality of the composites was gradually enhanced, the carbon residue becomes denser, which isolates heat transfer and inhibits the volatilization of flue gas. The addition of 20 wt% SPDSCD in the EP sample was associated with a limited oxygen index (LOI) value of 26% and a vertical burning V-0 rating. Cone calorimeter test shows that the peak heat release rate is reduced by 75%; the heat release rate curve enters the heat release platform area with a value lower than the first peak, TSP is reduced by 24%, the ac-CO2Y value reduced by 25.6%, indicating that SPDSCD/EP produced less CO2, which obviously prevented the combustion of volatile gas. SPDSCD exerted a charring and barrier effect in the condensation phase. Using basic characterization and flame retardancy testing, this work determined that SPDSCD has good flame retardancy when added to EP.