RBM7 deficiency promotes breast cancer metastasis by coordinating MFGE8 splicing switch and NF-kB pathway.

Aberrant alternative splicing is well-known to be closely associated with tumorigenesis of various cancers. However, the intricate mechanisms underlying breast cancer metastasis driven by deregulated splicing events remain largely unexplored. Here, we unveiled that RBM7 is decreased in lymph node and distant organ metastases of breast cancer as compared to primary lesions and low expression of RBM7 is correlated with the reduced disease-free survival of breast cancer patients. Breast cancer cells with RBM7 depletion exhibited an increased potential for lung metastasis compared to scramble control cells. The absence of RBM7 stimulated breast cancer cell migration, invasion, and angiogenesis. Mechanistically, RBM7 controlled the splicing switch of MFGE8, favoring the production of the predominant isoform of MFGE8, MFGE8-L. This resulted in the attenuation of STAT1 phosphorylation and alterations in cell adhesion molecules. MFGE8-L exerted an inhibitory effect on the migratory and invasive capability of breast cancer cells, while the truncated isoform MFGE8-S, which lack the second F5/8 type C domain had the opposite effect. In addition, RBM7 negatively regulates the NF-κB cascade and an NF-κB inhibitor could obstruct the increase in HUVEC tube formation caused by RBM7 silencing. Clinically, we noticed a positive correlation between RBM7 expression and MFGE8 exon7 inclusion in breast cancer tissues, providing new mechanistic insights for molecular-targeted therapy in combating breast cancer.

Experimental test and mechanism analysis of soil crust erosion resistance of rammed earth Great Wall in rainy season.

Rammed earth is a kind of cleaning material, widely used in all kinds of buildings in the world. The Great Wall of ancient China is a typical world cultural site built from rammed earth. The rammed earth Great Wall of Shanhaiguan is close to Bohai Bay, which has suffered from long-term erosion by rain, causing a series of problems such as soil loss, collapse and gully flushing. The protection materials of the rammed earth site have always puzzled scholars. However, during the rainy season, it was found that some of the walls at Xiaowan Gouge and Nantuzhuang Gouge in the Shanhaiguan Great Wall had unwashed traces, the soil surface of the walls was intact, and the anti-erosion ability of the walls was significantly higher than that of other places. In order to explore the reasons for its strong anti-erosion ability in the natural state of rammed earth wall, guide the protection of rammed earth Great Wall, and carry out different experimental tests to explore its anti-erosion reasons and internal mechanisms. Firstly, the characteristics of rammed soil were understood through the composition test of rammed soil, and the indoor and outdoor erosion test was carried out to determine that the anti-erosion reason was the protection of gray-green soil crust. The property and composition of soil crust were determined through the immersion test and genome sequencing. Finally, the protection mechanism of soil crust was analyzed by scanning electron microscopy.

COVID-19 Vaccine Hesitancy Among People Living with HIV: A Systematic Review and Meta-Analysis.

Vaccine hesitancy is one of the top 10 threats to global health, which affects the prevalence and fatality of vaccine-preventable diseases over the world. During the COVID-19 pandemic, people living with HIV (PLWH) may have higher risks of infection, more serious complications, and worse prognosis without the protection of the COVID-19 vaccine. A systematic review and meta-analysis aiming to evaluate the prevalence of COVID-19 vaccine hesitancy among PLWH was conducted using PubMed, Embase, and Web of Science databases for studies published between January 1, 2020, and August 31, 2022. The pooled prevalence with a corresponding 95%CI of COVID-19 vaccine hesitancy among PLWH was reported. Subgroup analysis was conducted to explore variation in prevalence across different categories. 23 studies with a total of 19,922 PLWH were included in this study. The prevalence of COVID-19 vaccine hesitancy among PLWH was 34.0%, and the influencing factors included male, influenza vaccination experience, and a CD4 count of more than 200 cells/mm3. Subgroup analysis did not identify significant causes of heterogeneity but showed that the prevalence of COVID-19 vaccine hesitancy among PLWH varies by study period, region, and race. Although all PLWH are recommended to receive the COVID-19 vaccine, a large proportion of them remain hesitant to be vaccinated. Therefore, governments and relevant institutions should take specific measures to encourage and promote vaccination to improve the coverage of the COVID-19 vaccine among PLWH.

Characteristics and influencing factors of anticipated HIV stigma among HIV-negative/unknown MSM in China: A regression mixture model.

BACKGROUND: Anticipated HIV stigma among men who have sex with men's (MSM) has a severe negative effect on their physical and mental health wellbeing and hence requires specific attention. The current study aims to identify the characteristics and the psychosocial influencing factors of anticipated HIV stigma in MSM using regression mixture model (RMM) and to determine the cut-off point of the seven-item Anticipated HIV Stigma Questionnaire (AHSQ) using the receiver operating characteristic (ROC) analysis. METHODS: A cross-sectional study was conducted among HIV-negative/unknown MSM from Blued online platform in China from December 16th, 2020 to March 1st, 2021, enrolling 1394 participants. Data were collected on demographic characteristics, perceived social support, anticipated HIV stigma, depressive symptoms, and HIV knowledge. Latent profile analysis was performed to identify different profiles of anticipated HIV stigma level. Chi-square test, analysis of variance, and RMM analysis were conducted to explore the influencing factors in different profiles. ROC analyses were carried out to identify the cut-off value of anticipated stigma. RESULTS: Among the participants, three profiles of anticipated stigma were identified: "low anticipated HIV stigma" (12.0%), "moderate anticipated HIV stigma" (52.1%), and "severe anticipated HIV stigma" (35.9%). RMM analysis showed that higher income and higher levels of knowledge were positively associated with moderate anticipated HIV stigma, whereas full-time job and social support were negatively associated with moderate anticipated HIV stigma; higher income, depressive symptoms, and knowledge were positively associated with severe anticipated HIV stigma, whereas minor ethnicity and social support were negatively associated with severe anticipated HIV stigma. ROC curve of the AHSQ showed that the optimal cut-off value of ≥16 could indicate positive anticipated HIV stigma. CONCLUSION: The study focuses on the level of anticipated HIV stigma and its psycho-socio influencing factors among HIV-negative/unknown MSM. It provides evidence for implementing relevant psychological interventions to HIV-negative/unknown MSM.

The transition issue among new nurses in China: A mediation model analysis.

AIM: To explore the impact and interrelated pathway of work environment, career adaptability, and social support on the transition process and outcomes among new nurses. BACKGROUND: The transition issue affecting new nurses has been discussed for many decades. However, the exact interplay of various factors influencing the transition process and outcomes needs further exploration. METHODS: A cross-sectional, descriptive survey design was employed, and a convenient sample of 1628 new nurses from 22 tertiary hospitals in China was surveyed between November 2018 and October 2019. Mediation model analysis was used to analyze the data, and the STROBE checklist was used to report the study. FINDINGS: The transition status mediated the effects of work environment, career adaptability and social support, and had a significantly positive influence on their intention to remain and job satisfaction. Among the influencing factors, the work environment had the most significant positive impact on both the intention to remain and job satisfaction. CONCLUSION: Work environment was found to be the most significant factor affecting both the transition status and outcomes of new nurses. The transition status played an important mediating role between the influencing factors and the transition outcomes, whereas career adaptability was found to mediate the impact of social support and work environment in the transition process. IMPLICATIONS FOR NURSING AND NURSING POLICIES: The results underscore the critical role of the work environment and demonstrate the mediating effects of transition status and career adaptability in the transition process of new nurses. Therefore, dynamic evaluation of the transition status should serve as the foundation for developing targeted supportive interventions. Such interventions should also focus on enhancing career adaptability and fostering a supportive work environment to facilitate the transition of new nurses.

Prevalence and influencing factors of PTSD symptoms among healthcare workers: A multicenter cross-sectional study during the surge period of the COVID-19 pandemic since December 2022 in the Chinese mainland.

BACKGROUND: China has experienced a surge period of COVID-19 pandemic since December 2022. Healthcare workers (HCWs) were exposed to huge workload under high risk of being infected, and significant levels of trauma, which might cause Post-traumatic Stress Disorders (PTSD) symptoms in HCWs. OBJECTIVES: To identify the prevalence of PTSD symptoms among HCWs in the Chinese mainland during the surge period of the COVID-19 pandemic; to explore their psycho-social factors of PTSD symptoms. METHODS: A multicenter cross-sectional study was conducted among HCWs in Chinese mainland from January 5 to February 9, 2023, covering seven geographical regions. 6552 participants were recruited by convenience sampling. Data were collected on demographic characteristics, work-related factors, and psychological factors by online questionnaires. Univariate analysis and binary logistic regression were used to determine the influencing factors of PTSD symptoms. RESULTS: The prevalence of PTSD symptoms among HCWs was 37.49 %. A higher level of mindfulness, resilience, and perceived social support were protective factors. Female gender, nurses, higher educational attainment, married status, more working years, higher perceived risk of contracting COVID-19 due to work, and higher perceived work intensity were risk factors. CONCLUSION: High prevalence of PTSD symptoms among HCWs necessitates psychological interventions. Tailored interventions, designed by professional psychiatrists, should be tailored to address the stressors. A comprehensive approach, incorporating mindfulness, resilience-building, and perceived social support enhancement, is vital to bolster the mental well-being of HCWs exposed to traumatic events, thus mitigating the impact of PTSD effectively. Additionally, it is essential to provide support to HCWs with other potential risk factors.

The second dose of COVID-19 vaccine booster hesitancy among health care workers in China: A multicenter cross-sectional study.

BACKGROUND: The COVID-19 outbreak in China exposed health care workers (HCWs) to an increased risk of infection. The acquired immunity rapidly diminishes after the previous COVID-19 vaccination and the second booster vaccination has been recommended in several countries. HCWs are a priority group for vaccination because they are at increased risk of being infected, however, a certain amount of HCWs were hesitant. METHODS: The survey was conducted among 5805 HCWs in China from January 5 to February 9, 2023. Questionnaire included sociodemographic information, COVID-19-related variables, psychological factors, and the COVID-19 vaccine hesitancy scale. Multiple logistic regression analysis was used to assess the influencing factors of the second dose of COVID-19 vaccine booster hesitancy. RESULTS: 42.2% of HCWs self-reported having the second dose of COVID-19 vaccine booster hesitancy. Occupations, years of working, COVID-19 infection status were associated with less vaccine hesitancy. HCWs who had received 3 doses of COVID-19 vaccine were less likely to be hesitant compared to those had not received. HCWs with PTSD symptoms and anxiety symptoms were more likely to be hesitant. No relation was observed between COVID-19 vaccine booster hesitancy and age, marriage, salary, and perceived an increased risk of COVID-19 infection due to work (all P > 0.05). CONCLUSIONS: A considerable proportion of HCWs were hesitant to accept the second dose of the COVID-19 booster vaccine. Incorporating vaccine knowledge and new evidence into routine health educations and procedures to raise confidence and reduce complacency may be effective and feasible in promoting the vaccination and implementing future vaccination programs.

HIV-related stigma, depression and suicidal ideation among HIV-positive MSM in China: a moderated mediation model.

BACKGROUND: As the HIV epidemic among MSM in China continues, Chinese men who have sex with men (MSM) face various mental health difficulties, including suicide ideation, depression, and stigma. The current study aims to assess the mechanisms between HIV-related stigma, depression, and suicidal ideation among MSM in China. METHODS: This national cross-sectional study was completed on the geosocial networking application (GSN) app, Blued, from December 2020 to March 2021. We used the HIV Stigma Scale and the Center for Epidemiologic Studies Depression Scale (CES-D10) to measure HIV stigma and depression, respectively. Suicidal ideation was measured by the suicidal ideation-related item. Descriptive analyses, logistic regression, and structural equation modeling (SEM) were used for data analysis. RESULTS: A total of 244 HIV-positive MSM were included in the analysis. The mediation model revealed that the direct pathway of perceived HIV-related stigma on suicidal ideation was significant (standardized pathway coefficient = 0.07), and the indirect pathway of perceived HIV-related stigma on suicidal ideation via depression was also significant (standardized pathway coefficient = 0.04). There was a partial mediating effect of depression in the association between perceived HIV-related stigma and suicidal ideation. CONCLUSIONS: Our study found that both perceived HIV-related stigma and depression were associated with suicidal ideation among HIV-positive MSM in China, and that depression could serve as a mediator between HIV-related stigma and suicidal ideation. Targeted interventions regarding HIV-related stigma and depression should be taken into account to reduce suicidal ideation among HIV-positive MSM in China.

Willingness to use long-acting injectable PrEP among HIV-negative/unknown men who have sex with men in mainland China: A cross-sectional online survey.

BACKGROUND: Men who have sex with men (MSM) are at high risk of HIV acquisition. Long-acting injectable-pre-exposure prophylaxis (LAI-PrEP), requiring less frequent dosing, is being studied as an alternative method to daily oral HIV PrEP. With the addition of this potential new prevention method, it expands the scope for a wider user choice and is expected to increase the acceptability and uptake of HIV prevention measures. The aim of our study was to explore the willingness to use LAI-PrEP and associated influential factors. METHODS: Participants were recruited from December 2020 to March 2021 through banner advertisements on web- and mobile app-based platforms on Blued, a large gay Chinese social media platform. MSM in our cross-sectional study was HIV-negative and currently lived in mainland China. Participants were asked about their willingness to use LAI-PrEP and reasons why they might be or not be willing to use LAI-PrEP. Multivariable logistic regression was used to analyze the factors associated with the willingness to use LAI-PrEP. RESULTS: In total, 969 participants met the inclusion criteria and finished the survey. Nearly twenty percent (19.5%) of participants had never tested for HIV; 66.8% of MSM had multiple male partners; and 51.6% of MSM engaged in condomless sex with their partner. About three-fifths (66.3%) of MSM were aware of PrEP, and only 3.9% of MSM had used PrEP before. The willingness to use LAI-PrEP among MSM was 74.0% (95% CI: 71.4%-76.6%). MSM with higher education levels were less likely to show a willingness to use LAI-PrEP (AOR = 0.56, 95%CI: 0.38-0.84). Participants who had a history of HIV test (AOR = 1.68, 95%CI: 1.11-2.55), were willing to use daily oral PrEP (AOR = 10.64, 95%CI:7.43-15.21), had multiple male sexual partners (AOR = 1.33, 95%CI:0.93-1.90), who used rush popper(AOR = 1.49, 95%CI:1.05-2.13), and who were aware of PEP (AOR = 1.66, 95%CI: 1.02-2.70) were more likely to show willingness to use LAI-PrEP. CONCLUSIONS: In our study, MSM had quite high awareness but low uptake of PrEP. As LAI-PrEP is expected to be approved for use in China in the future, our study of MSM highlights the need for key population-focused education programs about PrEP and healthy sexual behavior. This study also provides some evidence for LAI-PrEP use among the Chinese MSM population in the future.

Prevalence and risk for symptoms of PTSD among survivors of a COVID-19 infection.

COVID-19 pandemic has profound psychological effects worldwide and the psychological sequelae will persist for a long time among COVID-19 survivors. This cross-sectional study aimed to explore the prevalence of PTSD and its associated risk factors in COVID-19 survivors of the first wave pandemic. Demographics questionnaire, the Impact of Events Scale-Revised, the Pittsburgh Sleep Quality Index, the Fatigue Scale-14, the Resilience Style Questionnaire, the Short Version of COVID-19 Stigma Scale, the Peace of Mind Scale, and the Perceived Social Support Questionnaire were used to collect relevant information of the participants. The propensity score-matching (PSM) method was employed to adjust covariate or confounding variables in order to derive more accurate conclusions. After PSM, adjusted odds ratios and 95% confidence intervals were determined by binary conditional logistic regression. A total of 1541 COVID-19 survivors were included firstly and 15.2% reported PTSD symptoms, 1108 participants left after PSM. Four risk factors were identified: higher severity of COVID-19 infection, fatigue, COVID-19 related stigma and poor sleep quality. When designing psychological interventions to alleviate PTSD symptoms of COVID-19 survivors, reducing stigma and fatigue, and improve their sleep quality are suggested.

COVID-19 Vaccine Hesitancy Among Patients Recovered From COVID-19 Infection in Wuhan, China: Cross-Sectional Questionnaire Study.

BACKGROUND: Although patients recovered from COVID-19 already have immunity gained from natural infection, they are still at risk of reinfection due to the emergence of new variants of COVID-19 and the diminishing of naturally acquired immunity over time. Vaccination is associated with efficacious protection against COVID-19 infection and could boost infection-acquired immunity; however, various COVID-19 survivors have not been vaccinated due to vaccine hesitancy. OBJECTIVE: The aim of this study was to investigate COVID-19 vaccine hesitancy and related factors among COVID-19 survivors. METHODS: A cross-sectional questionnaire survey was conducted among patients who recovered from COVID-19 infection in Wuhan, China, between June 10 and July 25, 2021. The questionnaire included sociodemographic information, items on COVID-19 infection, the COVID-19 vaccine hesitancy scale based on the 3Cs (complacency, convenience, and confidence) model, trust in vaccine manufacturers and health facilities, and reasons for the decision to accept COVID-19 vaccination. Multivariate logistic regression analysis was used to assess the factors influencing COVID-19 vaccine hesitancy. RESULTS: Among the 1422 participants, 538 (37.8%) were not vaccinated against COVID-19. The COVID-19-recovered patients who self-reported having a current unhealthy status expressed more hesitancy about the COVID-19 vaccine than those who perceived themselves to be healthy (odds ratio [OR] 0.45, 95% CI 0.28-0.71). Compared to the asymptomatic patients, patients with mild symptoms were more likely to receive a COVID-19 vaccine (OR 1.67, 95% CI 1.02-2.82). Regarding the 3Cs model, high complacency (P=.005) and low convenience (P=.004) were significant negative factors for COVID-19 vaccination. Trust in vaccine manufacturers and health facilities was a significant positive factor for COVID-19 vaccination (OR 1.14, 95% CI 1.09-1.19). "Self-needs" was the main reason for patients to receive the COVID-19 vaccine, whereas "already have antibodies and do not need vaccination" was the main reason for patients to not receive the COVID-19 vaccine. CONCLUSIONS: Among the three major factors of vaccine hesitancy, complacency proved to be the most notable among COVID-19-recovered patients. Therefore, educational campaigns can focus on raising the awareness of risk of infection and the benefits of vaccination to reduce complacency toward vaccination among this population. In particular, for individuals who have recovered from COVID-19, improving factors related to convenience such as transportation, the environment of vaccination, and providing door-to-door service was also deemed necessary to facilitate their vaccination. In addition, addressing the concerns about vaccination of COVID-19-recovered patients could foster trust and promote their uptake of vaccination.

Suicidal ideation and associated risk factors among COVID-19 patients who recovered from the first wave of the pandemic in Wuhan, China.

BACKGROUND: Symptoms of psychiatric, neurological, and physical illnesses with post-COVID syndrome could increase suicidal ideation (SI) and behavior in Corona Virus Disease 2019 (COVID-19) survivors. However, information on the level of SI among COVID-19 survivors in China is still limited. AIM: To assess the prevalence and risk factors of SI among COVID-19 survivors in Wuhan, China. DESIGN: The cross-sectional study was carried out among former COVID-19 patients in Jianghan District (Wuhan, China) from June 10 to July 25, 2021. METHODS: SI, fatigue, stigma, sleep disorder, resilience, peace of mind, and social support of the participants were measured by the SI-related item, Fatigue Scale (FS-14), short version of COVID-19 Stigma Scale, Pittsburgh Sleep Quality Index (PSQI), The Peace of Mind Scale (PoM), The Resilience Style Questionnaire (RSQ) and two single separate items for measuring social support. Logistic regression was utilized to identify associated factors of SI. Mediation analysis was performed to assess the potential mechanisms between psychological factors and SI. RESULTS: A total of 1,297 participants were included in this study. 6.7% of them reported SI. Marriage (AOR = 0.389, P = 0.003) and peace of mind (AOR = 0.854, P < 0.001) were negatively associated with SI. History of psychological or emotional counseling before COVID-19 infection (AOR = 1.889, P = 0.049), fatigue (AOR = 1.110, P = 0.007), higher self-reported COVID-19 related stigma (AOR = 1.054, P = 0.003) and sleep disorder (AOR = 1.112, P = 0.001) were positively associated with SI. CONCLUSIONS: Consideration should be taken into account to develop appropriate alleviating measures such as mindfulness-based cognitive therapy to reduce the rates of SI among COVID-19 survivors and improve their resilience to cope with the personal impact of the COVID-19 pandemic.

RBM4 dictates ESCC cell fate switch from cellular senescence to glutamine-addiction survival through inhibiting LKB1-AMPK-axis.

Cellular senescence provides a protective barrier against tumorigenesis in precancerous or normal tissues upon distinct stressors. However, the detailed mechanisms by which tumor cells evade premature senescence to malignant progression remain largely elusive. Here we reported that RBM4 adversely impacted cellular senescence to favor glutamine-dependent survival of esophageal squamous cell carcinoma (ESCC) cells by dictating the activity of LKB1, a critical governor of cancer metabolism. The level of RBM4 was specifically elevated in ESCC compared to normal tissues, and RBM4 overexpression promoted the malignant phenotype. RBM4 contributed to overcome H-RAS- or doxorubicin-induced senescence, while its depletion caused P27-dependent senescence and proliferation arrest by activating LKB1-AMPK-mTOR cascade. Mechanistically, RBM4 competitively bound LKB1 to disrupt the LKB1/STRAD/MO25 heterotrimeric complex, subsequently recruiting the E3 ligase TRIM26 to LKB1, promoting LKB1 ubiquitination and degradation in nucleus. Therefore, such molecular process leads to bypassing senescence and sustaining cell proliferation through the activation of glutamine metabolism. Clinically, the ESCC patients with high RBM4 and low LKB1 have significantly worse overall survival than those with low RBM4 and high LKB1. The RBM4 high/LKB1 low expression confers increased sensitivity of ESCC cells to glutaminase inhibitor CB-839, providing a novel insight into mechanisms underlying the glutamine-dependency to improve the efficacy of glutamine inhibitors in ESCC therapeutics.

Perceived stigma among discharged patients of COVID-19 in Wuhan, China: A latent profile analysis.

Background: Perceived stigma has greatly influenced the life quality of the COVID-19 patients who recovered and were discharged (RD hereafter). It is essential to understand COVID-19 stigma of RD and its related risk factors. The current study aims to identify the characteristics of perceived COVID-19 stigma in RD using latent profile analysis (LPA), to explore its psycho-social influencing factors, and to determine the cut-off point of the stigma scale using receiver operating characteristic (ROC) analysis. Methods: A cross-sectional study was conducted among COVID-19 RD in 13 communities in Jianghan District, Wuhan City, Hubei Province, China from June 10 to July 25, 2021, enrolling total 1,297 participants. Data were collected on demographic characteristics, COVID-19 perceived stigma, post-traumatic stress disorder (PTSD), anxiety, depression, sleep disorder, fatigue, resilience, social support, and peace of mind. LPA was performed to identify different profiles of perceived COVID-19 stigma level. Univariate analysis and multinominal logistic regression analysis were conducted to explore the influencing factors in different profiles. ROC analyses was carried out to identify the cut-off value of perceived stigma. Results: Among the participants, three profiles of perceived stigma were identified: "low perceived COVID-19 stigma" (12.8%), "moderate perceived COVID-19 stigma" (51.1%), and "severe perceived COVID-19 stigma" (36.1%). Multinominal logistic regression analysis revealed that older age, living with other people, anxiety, and sleep disorder were positively associated with moderate perceived COVID-19 stigma, while higher educational level was negatively associated with moderate perceived COVID-19 stigma. Female, older age, living with other people, anxiety, and sleep disorder were positively associated with severe perceived COVID-19 stigma, while higher educational level, social support, and peace of mind were negatively associated with severe perceived COVID-19 stigma. ROC curve of the Short Version of COVID-19 Stigma Scale (CSS-S) for screening perceived COVID-19 stigma showed that the optimal cut-off value was ≥ 20. Conclusion: The study focuses on the issue of perceived COVID-19 stigma and its psycho-socio influencing factors. It provides evidence for implementing relevant psychological interventions to COVID-19 RD.

Development and validation of the diabetic self-management scale based on information-motivation-behavioral skills theory.

Background: Self-management is important for the blood sugar control of middle-aged and elderly Type 2 diabetes mellitus (T2DM) patients, of which diet, exercise, and drug compliance are the most common components. The Information-Motivation-Behavioral Skills Model (IMB) has been widely used in health behavior management and intervention. Objective: The purpose of this study is to develop and validate the Diabetic Self-Management Scale (DSMS) based on the IMB model. Methods: Self-report survey data was collected from middle-aged and elderly T2DM patients in Zhongmu City, Henan Province, China in November 2021 using convenience sampling. The original DSMS was developed through a literature review and summary of previous similar scales using an inductive approach. Item modification was finished by a panel of specialists. Exploratory factor analysis and confirmatory factor analysis were used to evaluate the reliability, convergent validity, discriminant validity, and criterion validity of DSMS. Results: Four hundred and sixty nine T2DM patients completed the questionnaire survey. The final DSMS consists of 22 items with three dimensions, including information (five items), motivation (eight items), and behavior skills (nine items). The results of simple factor analysis showed that the KMO value was 0.839, Bartlett spherical test 2 = 3254.872, P < 0.001. The results of confirmatory factor analysis showed that 2/df = 2.261, RMSEA = 0.073, CFI = 0.937, TLI = 0.930, and SRMR = 0.096. The standardized factor loadings of 22 DSMS items were all above 0.6, and the CR values of 3 dimensions were all higher than 0.9. In addition, DSMS also showed good discriminant and criterion validity. Conclusion: The 22-item DSMS has good reliability and validity, and can be used to make diabetic self-management assessment regarding diet, physical activity, and medication among middle-aged and elderly Chinese T2DM patients. DSMS is of moderate length and easy to understand. It can be promoted in China in the future to understand the self-management status of middle-aged and elderly T2DM patients in China.

Mediating role of resilience in the relationship between COVID-19 related stigma and mental health among COVID-19 survivors: a cross-sectional study.

BACKGROUND: The global coronavirus disease 2019 (COVID-19) has caused many negative effects on physical and mental health of patients who have survived COVID-19. Apart from some long-lasting physical sequelae, those COVID-19 survivors are also suffering stigma and discrimination at different levels around the world. The current study aims to assess the role resilience played in stigma and mental disorders among COVID-19 survivors. METHODS: The cross-sectional study was carried out among former COVID-19 patients in Jianghan District (Wuhan, China) from June 10 to July 25, 2021. The demographic questions, the Impact of Events Scale-Revised, the Generalized Anxiety Disorder Questionnaire, the Patient Health Questionnaire, the Resilience Style Questionnaire and the Short Version of COVID-19 Stigma Scale of 12 items were used to collect relevant information of the participants. Descriptive analyses, Pearson correlation analysis and Structural Equation Modeling were used to make data description and analysis. RESULTS: A total of 1541 out of 1601 COVID-19 survivors (887 females and 654 males) were included in the analysis. Perceived stigma of those COVID-19 survivors correlates significantly with anxiety (r = 0.335, P < 0.001), depression (r = 0.325, P < 0.001) and post-traumatic stress disorder (PTSD) (r = 0.384, P < 0.001). It has a direct effect on COVID-19 survivors' anxiety (ß = 0.326, P < 0.001), depression (ß = 0.314, P < 0.001), PTSD (ß = 0.385, P < 0.001) and their resilience (ß = - 0.114, P < 0.01). Resilience partially mediated the association between perceived stigma and anxiety (ß = 0.020, P < 0.01), depression (ß = 0.020, P < 0.01), and PTSD (ß = 0.014, P < 0.01) among COVID-19 survivors. CONCLUSION: Stigma has a significant negative impact on mental health, while resilience plays a mediator role in the relationship between stigma and mental health among COVID-19 survivors. Based on our study, we suggested that when designing psychological interventions for COVID-19 survivors, consideration should be taken into account to reduce stigma and improve resilience.

Depressive symptoms, perceived social support, and anticipated HIV stigma among HIV-negative/unknown men who have sex with men in China during the COVID-19 pandemic: A multicenter online cross-sectional study.

OBJECTIVE: To investigate the prevalence of depressive symptoms among human immunodeficiency virus (HIV)-negative/unknown men who have sex with men (MSM) in China and explore the relationship between perceived social support, anticipated HIV stigma, and depressive symptoms. METHODS: Participants in this study were recruited from a gay social networking app (Blued) in China by convenience sampling from December 16, 2020 to March 1, 2021. Perceived Social Support Questionnaire, Anticipated HIV Stigma Questionnaire, and Center for Epidemiologic Studies Depression Scale were used to measure the social support, anticipated HIV stigma, and depressive symptoms of participants. Confirmatory factor analysis was performed to assess the reliability and validity of the measurement model. Structural equation modeling was employed to evaluate the association of perceived social support, anticipated HIV stigma, and depressive symptoms, as well as the mediation effects. RESULTS: Overall, 47.70% (665/1394) of the participants had depressive symptoms. Perceived social support could have both direct and indirect effects on depressive symptoms with the mediating role of anticipated HIV stigma among HIV-negative/unknown MSM. CONCLUSION: Tailored interventions regarding perceived social support and anticipated HIV stigma, such as group therapy, mutual support groups and mindfulness training, with the involvement of non-governmental or governmental organizations, should be taken into account to reduce depressive symptoms and stigma among HIV-negative/unknown MSM in China.

Degradation of Typical Reverse Sand-Mudstone Interbedded Bank Slope Based on Multi-Source Field Experiments.

The bank slopes in the Three Gorges Reservoir area (TGRA) have experienced obvious deterioration under the action of the periodic fluctuations in the reservoir water level. Generally, laboratory tests have been used to reveal the evolution trend of the slope banks. However, this method has a certain degree of cross-scale problem, especially for the mechanical state in a complex environment. Therefore, in this study, we took the Yangjiaping bank slope in the TGRA as an example and proposed a comprehensive on-site detection method to further reveal the rock mass degradation phenomenon of this typical reverse sand-mudstone interbedded bank slope. Specifically, multi-scale laser scanning, cross-hole acoustic wave detection, and inclination measurements were performed to analyze the fractures, quality, and deformation of rocky banks. The results showed that the deterioration of the bank slope manifested as the expansion, deepening, and widening of the cracks, as well as the peeling off and loosening of rocky banks. Large-scale laser scanning revealed that the deterioration zone was deformed along large fracture zones and layers. Unlike limestone slopes, the intact sandstone underground might be degraded by changes in water. There are few inclinometers and no deformation or weak deformation, which requires long-term monitoring. The relevant research methods provide an important reference for determining the instability and failure trend of the reservoir bank slopes.

HIV testing and related factors among 50 years and older MSM in China: results from a cross-sectional study.

ABSTRACTHIV prevalence has increased continuously, and the age groups most afflicted by the epidemic have also shifted to people aged above 50 years. Informed by the theory of HBM, we aimed to investigate related factors associated with regular HIV testing behavior. Cross-sectional data were collected using online questionnaire from geosocial networking (GSN) mobile application (apps) for MSM during May 2020 (N = 1259). Data were analyzed by univariate and multivariate logistic regression. Around 62.0% (n = 781) had received HIV testing before. Participants being divorced/widowed (AOR = 1.5,95%CI:1.1-2.0), being aware of HIV/AIDS-related knowledge (AOR = 1.8,95%CI:1.4-2.3), having disclosed sexual orientation (AOR = 1.9,95%CI:1.5-2.5), ever had sexually transmitted infections symptoms (STIs)before (AOR = 2.4,95%CI:1.8-3.2), having had≥2 sexual partners (AOR = 1.8,95%CI:1.4-2.3) and with high self-efficacy (AOR = 1.1,95%CI:1.0-1.1) were more likely to receive HIV testing. Findings suggest that many Chinses MSM aged 50 and above have not been tested for HIV. Interventions for promoting HIV testing should focus on expanding scales of HIV/STIs screening, providing HIV/AIDS-related knowledge, creating a more supportive social environment and improving self-efficacy of HIV testing.