Psychosocial Factors Predicting HIV Disclosure Stage Transitions: An Evaluation of A Theory-Based Parental HIV Disclosure Intervention among Parents Living with HIV in China

Appropriate parental HIV disclosures (i.e., parents living with HIV [PLH] tell their HIV diagnosis to their children) benefit parents, children, and family relations. Psychosocial factors could influence the decision-making process of parental HIV disclosure. Using the Health Action Process Approach to frame stages (pre-intention, intention, and action) in the decision-making process, this study aimed to investigate how psychosocial factors predict HIV disclosure stage transitions among PLH in China. Data were collected from a randomized clinical trial of a theory-based parental HIV disclosure intervention among 791 PLH. The predictive effects of psychosocial factors on disclosure stage transitions were examined using a Markov chain model matrix. Results showed that action self-efficacy and action planning were significant predictors of parental HIV disclosure stage transitions. Considering stage-specific psychosocial predictors may contribute to effective interventions to promote appropriate HIV disclosure among PLH in China.

Exogenous melatonin prevents type 1 diabetes mellitus-induced bone loss, probably by inhibiting senescence

Exogenous melatonin inhibited the senescence of preosteoblast cells in type 1 diabetic (T1D) mice and those cultured in high glucose (HG) by multiple regulations. Exogenous melatonin had a protective effect on diabetic osteoporosis, which may depend on the inhibition of senescence.

INTRODUCTION

Senescence is thought to play an important role in the pathophysiological mechanisms underlying diabetic bone loss. Increasing evidence has shown that melatonin exerts anti-senescence effects. In this study, we investigated whether melatonin can inhibit senescence and prevent diabetic bone loss.

METHODS

C57BL/6 mice received a single intraperitoneal injection of 160 mg/kg streptozotocin, followed by the oral administration of melatonin or vehicle for 2 months. Then, tissues were harvested and subsequently examined. MC3T3-E1 cells were cultured under HG conditions for 7 days and then treated with melatonin or not for 24 h. Sirt1-specific siRNAs and MT1- or MT2-specific shRNA plasmids were transfected into MC3T3-E1 cells for mechanistic study.

RESULTS

The total protein extracted from mouse femurs revealed that melatonin prevented senescence in T1D mice. The micro-CT results indicated that melatonin prevented bone loss in T1D mice. Cellular experiments indicated that melatonin administration prevented HG-induced senescence, whereas knockdown of the melatonin receptors MT1 or MT2 abolished these effects. Sirt1 expression was upregulated by melatonin administration but significantly reduced after MT1 or MT2 was knocked down. Knockdown of Sirt1 blocked the anti-senescence effects of melatonin. Additionally, melatonin promoted the expression of CDK2, CDK4, and CyclinD1, while knockdown of MT1 or MT2 abolished these effects. Furthermore, melatonin increased the expression of the polycomb repressive complex (PRC), but knockdown of MT1 or MT2 abolished these effects. Furthermore, melatonin increased the protein levels of Sirt1, PRC1/2 complex-, and cell cycle-related proteins.

CONCLUSION

This work shows that melatonin protects against T1D-induced bone loss, probably by inhibiting senescence. Targeting senescence in the investigation of diabetic osteoporosis may lead to novel discoveries.

Three first records of stick insects attacking plants (Inseect: Phasmida) in Tibet

Except for a few stick insects that are economically valuable, most species be considered to be forest pests, so it is extremely important to obtain plant host-use information of more stick insects. In this paper, the plant hosts of three species of stick insects were recorded for the first time. We also discovered these stick insects can feed upon the flowers or leaves of plants. Lopaphus unidentatus (Chen & He, 1995) (Phasmida: Lonchodidae) attacked Hypericum choisianum Wall. ex N. Robson, 1973 (Hypericaceae), Leurophasma dolichocercum Bi, 1995 (Phasmida: Aschiphasmatidae) attacked Antenoron filiforme (Thunb.) Roberty & Vautier, 1964 (Polygonaceae) and Megalophasma granulatum Bi, 1995 (Phasmida: Lonchodidae) attacked Debregeasia orientalis C. J. Chen, 1991 (Urticaceae). Finally, we were lucky enough to also obtain photographs of them mating and feeding.

Occupational stress, burnout, and organizational readiness for change: A longitudinal study among HIV HCPs in China

Literature suggests that organizational readiness for change (ORC) could facilitate adaptation and implementation of new projects or practices in clinical settings. Limited data are available regarding the longitudinal associations between ORC and psychosocial conditions of HCPs. Using six waves of longitudinal data collected between 2013 and 2016 from 357 HIV HCPs in Guangxi, China, we identify sociodemographic and occupational characteristics that impact ORC and examine how occupational stress and burnout affect ORC adjusting for potential cofounders. A mixed effect model was used to assess the associations of ORC with psychosocial variables controlling for key background variables, and within-cluster and within-subject correlation over time. The ORC level was stable over time. Ethnical minority HCPs reported lower ORC compared with those of Han ethnicity. HCPs with administrative responsibility reported significantly lower ORC compared with the ones without administrative responsibility. HCPs with high school education attainment showed lower ORC compared to those with some college education. The ORC level was negatively associated with occupational stress and burnout controlling all the background variables. It is important to integrate reducing stress and alleviating burnout in the workplace into efforts to promote the acceptance and adaptation of new intervention.

Antiretroviral therapy and mental health among people living with HIV/AIDS in China

Several methodological gaps exist regarding assessing the relationship between antiretroviral therapy (ART) and mental health. Adopting an "HIV care continuum" perspective, cross-sectional data from 2987 people living with HIV (PLHIV) in Guangxi, China were used. ART uptake was retrieved from medical records and ART adherence was self-reported (good vs. poor adherence with a percent adherence cut-off of 90%). Depression, anxiety, and mental-health related quality of life were used as mental health indicators. Separate analysis was conducted for ART uptake and ART adherence. Differences in mental health were investigated using multivariate analysis of variance (MANOVA). Multivariate analysis of covariance (MANCOVA) adjusting for propensity scores was further conducted. MANCOVA results showed statistically significant multivariate effects for ART adherence (Wilk's λ = 0.984, F [3, 1885] =10.26, p<0.001) but not ART uptake (Wilk's λ = 0.998, F [3, 2476] =1.67, p=0.17). Post-hoc comparisons with Bonferroni adjustment (α=0.05/3 = 0.0167) showed that well-adherent ART users had lower scores on anxiety (p=0.006) and higher scores on MHS (p=0.007), but no difference was found for depression (p=0.023). As only ART adherence was associated with better mental health among PLHIV, to maximize the potential mental health benefits of ART, intervention efforts need to emphasize on treatment adherence.

Basal cortisol, cortisol reactivity, and telomere length: A systematic review and meta-analysis

The objective of the present study is to synthesize the existing empirical literature and perform a meta-analysis of published data on the relationship between cortisol and telomere length. We systematically searched studies that examined the relationship between cortisol and telomere length in humans on electronic databases and screened reference sections of included articles. Fourteen studies were included in the meta-analysis, with effect sizes being extracted for two cortisol measures: basal cortisol levels and cortisol reactivity to acute psychological stress. Results from random effects models showed that basal cortisol levels (13 effect sizes from 12 cross-sectional studies, N = 3675 participants) were not significantly correlated with telomere length (r =-0.05, 95% CI [-0.11, 0.02]). Further, results stratified by the specimen type for cortisol measurement (i.e., saliva, urine, blood) showed that none of the three basal cortisol level measures were correlated with telomere length. However, we found a statistically significant correlation between salivary cortisol reactivity to acute psychosocial stress (6 cross-sectional studies, N = 958 participants) and telomere length (r = -0.13, 95% CI [-0.23, -0.03]). Subgroup analyses revealed that correlations between salivary cortisol reactivity and telomere length were more evident in studies conducted among children (vs. adults) and in studies that included female participants only (vs. both genders). However, the small number of available studies limits the conclusions derived from subgroup analyses, and more studies are needed before moderator effects can be properly established. Overall, findings of this study support the existence of a relationship between cortisol reactivity and telomere shortening.

The earliest human occupation of the high-altitude Tibetan Plateau 40 thousand to 30 thousand years ago

The Tibetan Plateau is the highest and one of the most demanding environments ever inhabited by humans. We investigated the timing and mechanisms of its initial colonization at the Nwya Devu site, located nearly 4600 meters above sea level. This site, dating from 40,000 to 30,000 years ago, is the highest Paleolithic archaeological site yet identified globally. Nwya Devu has yielded an abundant blade tool assemblage, indicating hitherto-unknown capacities for the survival of modern humans who camped in this environment. This site deepens the history of the peopling of the "roof of the world" and the antiquity of human high-altitude occupations more generally.

Changes in sexual behaviors following diagnosis with HIV: patterns and correlates among people living with HIV (PLHIV) in China

Effective secondary prevention of HIV infections requires knowledge about changes in sexual behaviors after diagnosis among people living with HIV (PLHIV), yet there is a dearth of literature assessing gender-specific patterns and correlates of such changes among heterosexual PLHIV in China. Data used in the current study were derived from a cross-sectional survey conducted from 2012 to 2013 among 1212 heterosexual sexually active PLHIV in Guangxi, China. Most participants reduced sexual frequency (71.2%), reduced or maintained the same number of sexual partners (96.6%), and increased or maintained same frequencies of condom use (80.6%). Gender difference was found in changes in sexual frequency, but not in the number of sexual partners or condom use. For males, decrease in sexual frequency was associated with having no desire to have children (OR = 2.03, 95% CI 1.20, 3.44), being virally suppressed (OR = 0.27, 95% CI 0.079, 0.94), and social support (OR = 1.44, 95% CI 1.06, 1.96). Health promoting behaviors in condom use (i.e., increased or maintained same frequencies of condom use) for males was associated with being 45 years of age or older (OR = 0.35, 95% CI 0.21, 0.61), having an HIV-negative main partner (OR = 1.80, 95% CI 1.11, 2.92), and physical health-related quality of life (OR = 1.02, 95% CI 1.00, 1.04). For females, decrease in sexual frequency was associated with having no desire to have children (OR = 1.58, 95% CI 1.01, 2.47). Health promoting behaviors in condom use for females was associated with having an HIV-negative main partner (OR = 3.24, 95% CI 1.63, 6.45) and social support (OR = 0.75, 95% CI 0.57, 0.99). Future intervention efforts need to target PLHIV who need extra support in making health-improvement efforts and to facilitate gender-specific behavioral changes in sexual risk reduction after HIV diagnosis.

Evaluation of self-report adherence measures and their associations with detectable viral load among people living with HIV (PLHIV) in China

OBJECTIVES

Self-report antiretroviral therapy (ART) adherence has been consistently associated with clinical outcomes. This study aims to compare the accuracy of self-report ART adherence measures with varying recall timeframes or item contents to predict virological response.

METHODS

Data from a cross-sectional study among 2146 participants on ART in Guangxi, China were used. Detectable viral load was defined as viral load > 50 copies/ml. Adherence was measured using the number of days on which all doses were taken in the past month (i.e., the "one-month days taken" measure), the number of days on which any dose was missed in the past month (i.e., the "one-month days missed" measure), missed doses over the past 3 days, and missed days over the past weekend. Each adherence measure was dichotomized at an empirically determined cut-off to determine poor vs. good adherence. Accuracy of using each dichotomized adherence measure to predict detectable viral load was assessed by sensitivity, specificity, and the area under the receiver-operating characteristic (AUROC) curve. Logistic regressions were used to calculate the association between poor adherence and detectable viral load.

RESULTS

All four measures had sensitivity below 10.0%, specificity above 90.0%, and AUROC slightly above 0.50. In univariate logistic regression, detectable viral load was statistically significantly associated with poor adherence determined by the one-month days taken measure (OR = 1.98, 95% CI 1.15-3.42), the 3-day measure (OR = 2.18, 95% CI 1.10-4.34), and the weekend measure (OR = 2.86, 95% CI 1. 54-5.34). After adjusting for covariates, statistically significant association persisted only for the weekend measure (OR = 2.57, 95% CI 1.33-4.99).

CONCLUSIONS

Adherence measures asking about days on which all doses were taken might work better than items asking about days on which respondents missed their doses, and weekend measures should be included to comprehensively capture adherence behaviors. Further studies looking at intermediate timeframes are also needed to capture patients' dose-missing patterns that may better predict detectable viral load.

Liver injury attenuation by curcumin in a rat NASH model: an Nrf2 activation-mediated effect?

AIM

Nuclear factor-erythroid 2-related factor-2 (Nrf2) acts as a defense system in the development of nonalcoholic steatohepatitis (NASH). Curcumin is a phenolic compound with lipid regulatory, anti-oxidative, anti-inflammatory and anti-tumorigenic properties that is beneficial in defending against NASH and was recently proved to be an Nrf2 activator. The aim of this study was to evaluate whether Nrf2 activation could be involved in NASH mitigation by curcumin.

METHODS

Hepatic, metabolic, and inflammatory parameters, along with hepatic Nrf2 protein expression were explored in adult Sprague-Dawley rats developing high-fat-diet-induced NASH and submitted to curcumin gavage for 6 weeks.

RESULTS

Curcumin administration led to lower degrees of hepatic steatosis and inflammation; lower levels of serum aminotransferases, lipids, and homeostasis model assessment of insulin resistance; and lower serum and hepatic contents of tumor necrosis factor-α (TNF-α), interleukin-6, and malondialdehyde. In contrast, higher hepatic contents of glutathione, heme oxygenase-1 and superoxide dismutase were observed in rats with curcumin. Moreover, Nrf2 expression in liver cell nuclei was significantly higher in rats with curcumin.

CONCLUSIONS

Curcumin can prevent and ameliorate NASH via lipid reduction, improve insulin resistance, improve anti-inflammatory, and have antioxidant effects, possibly related to its activation of Nrf2.

[Experimental study of interleukin-12 gene vaccines in the treatment of low-load malignant lymphoma (EL4)]

OBJECTIVE

Two kinds of murine interleukin-12 (mIL-12) fusion gene vaccines were used to treat the murine low-load malignant T cell lymphoma EL4 as minimal residual disease (MRD) model.

METHODS

C57BL/6 synergistical mice were subcutaneously inoculated with 1 x 10(6) wild-type (wt) EL4 tumor cells as low-load lymphoma model treated with two mIL-12 gene vaccines. Package cell line PA317/12 producing mIL-12 retrovirus (RV) was used as in vivo vaccine and EL4 tumor cells transferred with mIL-12 gene as ex vivo vaccine.

RESULTS

In both mIL-12 gene vaccine-treated groups, there was no tumor growth in 50% mice 60 days after inoculation. Nine of these no tumor growth mice were re-challenged with 5 x 10(5) wt EL4 cells, and 5 of them survived without tumors in another 60 days. All control mice died with tumors within one month after inoculation. Among those developed tumors in both vaccine-treated groups, the development of tumors was delayed, the survival period prolonged (P < 0.01), and the tumors size at death smaller (P < 0.05) as compared with the controls. In the long-survived vaccine-treated mice, no residual tumor cells were found by morphological examination.

CONCLUSION

Both IL-12 gene vaccines can efficiently eliminate wt EL4 MRD in C57BL/6 mice.

[Construction and application of retroviral vector carrying green fluorescent protein]

OBJECTIVE

To construct retroviral vector carrying rapidly selective marker.

METHODS

The recombination retroviral vector GCGFPPXSN was constructed by cloning the green fluorescent protein (GFP) cDNA into the retroviral vector containing putative internal ribosome entry sites GCXPXSN and transferred in ecotropic packaging cell line PE501 by electroporation method. The supernatants of the PE501GCGFPPXSN were used to infect the amphotropic packaging cell line PA317. The G418 resistant clones were selected in 4 weeks and were detectable by fluorescence microscopy or by fluorescence-activated cell sorting(FACS).

RESULTS

A recombination retroviral vector GCGFPPXSN carrying rapidly selective marker GFP was constructed. GFP expression in packaging cell line PA317-GCGFPPXSN transferred by GCGFPPXSN was detected by fluorescence microscopy of FACS. PA317-GCGFPPXSN grew to a titer of 1.2 x 10(5) cpu/ml. By cocultivating retroviral vector producing cells and T lymphocytes, expression of GFP was observed in T lymphocytes 2 days after the end of the cocultivation. T lymphocytes expressing GFP were separated.

CONCLUSION

The mammalian cell can be efficient gene transfected by retroviral vector carrying GFP. The use of GFP for cell marking represents an important advantage over conventional strategies which typically involve the use of neomycin resistance. GFP, in fact, allows a rapid in vitro selection of transduced cell by FACS. The selection requires only two-day culture with this retroviral vector, compared with 10-14 day culture with a classical retroviral vector.

[Hepatic veno-occlusive disease after hemopoetic stem cell transplantation]

The clinical features of 6 cases with severe veno-occlusive disease (SVOD) in 43 patients who received hemopoetic stem cell transplantation (HSCT) in our institute from May 1983 to March 1994 were reported. The incidence of SVOD was 14% of the 43 patients, and 7.9% of those received autologous bone marrow transplantation (ABMT), SVOD occurred within 3 weeks after HSCT in all the 6 cases and was manifested by painful hepatomegaly, jaundice, hyperbilirubinemia, increase of serum liver enzyme level and ascites. Although supportive and symptomatic treatment including steroids were given, all patients died of progressive multiorgan failure within 4 weeks after HSCT. It is suggested that SVOD of the liver is a major and often lethal complication of HSCT and prophylaxis of this disorder with anticoagulant and antiplatelet agents is essential in clinical HSCT.