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Abstract Background & aims This study aimed to establish multivariate prediction models according to a response-guided therapy (RGT) based strategy at baseline and week 12 and 24 of follow-up to predict the functional cure for HBeAg-negative patients with chronic hepatitis B (CHB) treated with pegylated interferonα (PEG-IFNα). Methods A total of 242 HBeAg-negative patients with CHB were treated with PEG-IFNα for 52 weeks and followed up for 24 weeks. Responses at the end of follow-up (EOF) were defined as hepatitis B surface antigen (HBsAg) loss, and patients were defined as either responders or non-responders. Results The three most meaningful predictors were an age ≤ 40 years, alanine aminotransferase (ALT) levels ≤ 40 U/L, and HBsAg levels ≤ 100 IU/mL at baseline; ALT levels ≥ 80 U/L, anti-HBc levels ≤ 8.42 S/CO, and HBsAg levels ≤ 50 IU/mL at week 12; and ALT levels ≥ 40 U/L, anti-HBc levels ≤ 8.46 S/CO, and HBsAg levels ≤ 0.2 IU/mL at week 24. The response rates of patients with a score of 0–1 and 4–5 at baseline, week 12, and 24 were 13.5%, 7.8%, and 11.7%; and 63.6%, 68.1%, and 98.1%, respectively. At week 12, the cumulative scores were 0–2, 3–4, 5–7, and 8–10 (response rates 5.0%, 18.9%, 41.3%, and 71.4%, respectively). At week 24, the cumulative scores were 0–3, 4–6, 7–10, and 11–15 (response rates: 1.3%, 12.3%, 37.0%, and 92.5%, respectively). At baseline, patients with scores of 0–1 were slightly recommended; at week 12, patients with 0–1 or 0–2 cumulative scores were recommended to stop treatment. At week 24, patients with a score of 0–1 or a cumulative score of 0–6 were recommended to stop treatment. Conclusion We established a multi-parameter prediction model for the functional cure of HBeAg-negative patients with CHB treated with PEG-IFNα.

Abstract Background Recently, with the rapid progress of metagenomic next-generation sequencing (mNGS), inconsistency between mNGS results and clinical diagnoses has become more common. There is currently no reasonable explanation for this, and the interpretation of mNGS reports still needs to be standardised. Methods A retrospective analysis was conducted on 47 inpatients with suspected central nervous system (CNS) infections, and clinical data were recorded. The final diagnosis was determined by an expert group based on the patient’s clinical manifestation, laboratory examination, and response to treatment. mNGS results were compared with the final diagnosis, and any inconsistencies that occurred were investigated. Finally, the credibility of mNGS results was evaluated using the integral approach, which consists of three parts: typical clinical features, positive results with the traditional method, and cerebrospinal fluid cells ≥ 100 (× 106/L) or protein ≥ 500 mg/L, with one point for each item. Results Forty-one patients with suspected CNS infection were assigned to infected (ID, 31/41, 75.61%) and non-infected groups (NID, 10/41, 24.39%) after assessment by a panel of experts according to the composite diagnostic criteria. For mNGS-positive results, 20 of the 24 pathogens were regarded as contaminants when the final score was ≤ 1. The remaining 11 pathogens detected by mNGS were all true positives, which was consistent with the clinical diagnosis when the score was ≥ 2. For mNGS negative results, when the score was ≥ 2, the likelihood of infection may be greater than when the score is ≤ 1. Conclusion The integral method is effective for evaluating mNGS results. Regardless of whether the mNGS result was positive or negative, the possibility of infection was greater when the score was ≥ 2. A negative mNGS result does not necessarily indicate that the patient was not clinically infected, and, therefore, clinical features are more important.

BackgroundThere are a few models for predicting the outcomes of patients with severe fever with thrombocytopenia syndrome (SFTS) based on single-center data, but clinicians need more reliable models based on multicenter data to predict the clinical outcomes and effectiveness of drug therapy.Methodology/principal findingsThis retrospective multicenter study analyzed data from 377 patients with SFTS, including a modeling group and a validation group. In the modeling group, the presence of neurologic symptoms was a strong predictor of mortality (odds ratio: 168). Based on neurologic symptoms and the joint indices score, which included age, gastrointestinal bleeding, and the SFTS virus viral load, patients were divided into double-positive, single-positive, and double-negative groups, which had mortality rates of 79.3%, 6.8%, and 0%, respectively. Validation using data on 216 cases from two other hospitals yielded similar results. A subgroup analysis revealed that ribavirin had a significant effect on mortality in the single-positive group (P = 0.006), but not in the double-positive or double-negative group. In the single-positive group, prompt antibiotic use was associated with reduced mortality (7.2% vs 47.4%, P < 0.001), even in individuals without significant granulocytopenia and infection, and early prophylaxis was associated with reduced mortality (9.0% vs. 22.8%, P = 0.008). The infected group included SFTS patients with pneumonia or sepsis, while the noninfected group included patients with no signs of infection. The white blood cell count and levels of C-reactive protein and procalcitonin differed significantly between the infection and non-infection groups (P = 0.020, P = 0.011, and P = 0.003, respectively), although the absolute difference in the medians were small.Conclusions/significanceWe developed a simple model to predict mortality in patients with SFTS. Our model may help to evaluate the effectiveness of drugs in these patients. In patients with severe SFTS, ribavirin and antibiotics may reduce mortality.

Parking constraints are particularly acute in the urban city center, but the many negative impacts of sharing private parking make owners living in central areas reluctant to share private parking. Hence, we employ the quantum game to analyze the interactions among heterogeneous parking providers. This study explores quantum non-entanglement and entanglement strategies in the context of parking sharing and investigates the impact of heterogeneous and fairness preferences on gaming strategies. The findings indicate that in the absence of quantum entanglement, achieving a Pareto optimal strategy in which both parties share private parking is challenging. However, at the maximum quantum entanglement, the cost incurred by the unwilling side must be borne individually, whereas adopting mutual-sharing quantum strategy leads to a win–win situation. Furthermore, owners’ fairness preferences significantly motivate parties with higher sharing revenues. When the disparity in revenues is too high, leading to distinctly unfair aversion to the side with lower sharing revenues, owners’ willingness to engage in sharing is reduced.

This article examined the differences in causes and health consequences between synthetic drug and heroin abuse in urban China. Two-group comparisons were conducted to quantify differences in individual characteristics, causes of drug use, and HIV/STI risky sexual behavior between synthetic drug and heroin users; logistic regressions were employed to assess the net effect of synthetic drug use on risky sexual behavior. Results revealed that causes of synthetic drug use differed from those of heroin use; a combination of the knowledge gap concerning the harmful impact of synthetic drugs and the lesser punishment for their use appeared a main reason behind the shift from heroin to synthetic drugs; and synthetic drug use was a significant and powerful risk factor for HIV/STI risky sexual behavior. Educational and behavioral interventions are urgently needed to prevent the initiation of synthetic drug use among users to reduce their HIV/STI risky sexual behavior. [ABSTRACT FROM AUTHOR]

The article discusses the study which aims to explore the individual risk factors and social influence of HIV unsafe sex towards female entertainment workers in Shanghai, China. It stresses that most female entertainers in the country has a high sexual risk of developing HIV but still causes of their unprotected sex practice was poorly understood. The study uses the information-motivation-behavioral skills model (IMB) which will be applied on a venue sample of 732 female entertainers in the country. Results suggests that behavioral intervention is needed in promoting a supportive social and working environment to entertainers.

The link between migration and STD/HW risky sexual behavior has been well documented. Research of risky sexual behavior that addresses the issue of gender-migration interaction or employs a multilevel perspective is still limited in China. Using data from a probability survey and applying multilevel modeling, this paper examines gender differences in (1) the link between migration and risky sexual behavior and (2) individual and community correlates of risky sexual behavior. Results suggest significant interaction between gender and migration. Being a temporary migrant is associated with significantly more risky sexual behaviors for females but significantly fewer for males. There are also significant interactions between gender and marriage and living arrangement. Being married and living with others both appear to be more powerful deterrents to risky sexual behavior for females than for males. Single migrant women who live alone have the most risky sexual behaviors while married nonmigrant women who live with others have the least. Risky sexual behavior is further influenced by family and peers and conditioned by community contexts. Prevention programs are urgently needed for female temporary migrants and must address the issue of gender and pay attention to social influences of family and peers and community contexts. [ABSTRACT FROM AUTHOR]

Explores factors associated with unprotected sex and barriers to consistent condom use among female prostitutes in China. Lack of knowledge on HIV transmission; Endorsement of the need for HIV/sexually transmitted disease prevention strategies; Expression of suspicion toward government programs; Need of promoting a social environment supportive of total condom use in commercial sex.

This article is inspired by an accident in a hospital where a pregnant woman died on the operating table because her husband was unwilling to sign the operation consent form. What's lurking behind this tragedy is the crisis of faith between doctors and patients in China. The crisis is a product of the Marketization of the health care system, which generates an unequal relationship between doctors and patients. Such a relationship makes patients unable to actively protect their rights. From a bioethical perspective, health is a basic right for everyone. In order to improve the physician-patient relationship, health rights must be considered as a priority in policy making. Although the Chinese government has been trying to implement universal health coverage, a progress indeed, problems and difficulties still exist in equalizing status between patients and doctors and in rebuilding a benign physician-patient relationship.