Behind the rainbow, "Tongqi" wives of men who have sex with men in China: a systematic review

open access articleBackground: Due to the restrictions and stigmatization of homosexuality in China, there has emerged the “Tongqi,” or the wives of men who have sex with men (MSM). There are around 14 million Tongqi wives whose needs for support are often overshadowed. This phenomenon has been largely under researched, this review is the first to address the current data on the Tongqi. The aim of this systematic review is to begin to provide insight into the pre-existing data and the further support that is needed for the wives of MSM. Methods: The researchers searched PubMed, Web of Science, EMBASE, PsycINFO, CNKI, Sinomed and WangFang databases from their inception date until June 7, 2019. Handsearching was also completed to provide a rich data set. Results: The articles were summarized and analyzed for thematic clusters. From the selected article, five themes emerged, including Sexual Health Issues, Intimate Partner Violence, Mental Health Status, Marriage Dissatisfaction, and Coping Strategies. These themes often intersected to provide a complex understanding of the current gaps in support provided to Tongqi. Conclusion: Tongqi wives remain a hidden population in Chinese mainstream society, who deserves a sensitive approach to support. The study revealed that the MSM wives suffer severe mental, physical, health, and life related harms. However, instead of situating them into the victim roles, many women take on an identity of empowerment and are working together, aiming to make social changes. In order to address the Tongqi phenomenon, it is also essential to reduce the discrimination toward homosexuality. Tongqi are a special group of Chinese women, they require further intensive research attention

Appearance anxiety and social anxiety: A mediated model of self-compassion

BackgroundPrevious studies have focused on the comorbidity of appearance anxiety and social anxiety, but few studies have focused on the protective role of self-compassion as underlying this mechanism, in young people like University students. With the increase of prevalence of appearance anxiety and social anxiety in this age group, it is necessary to explore factors that can buffer against the symptoms of these disorders. Therefore, the aims of this study were to research the effect of appearance anxiety and social anxiety, then to examine whether self-compassion has a protective effect on social anxiety.MethodThe study was cross-sectional and conducted online from October 2021 to November 2021 in Jilin Province, China. A total of 63 Universities in the province participated in this study, totaling 96,218 participants, of which 40,065 were males (41.64%) and 56,153 females (58.36%), the mean age of the sample was 19.59 (±1.74). The Appearance Anxiety Scale-Brief Version was used to measure appearance anxiety. The Social Anxiety subscale of the Self-Consciousness Scale was used to measure social anxiety. The Self-Compassion Scale-Short Form was used to measure self-compassion. A structural equation model (SEM) was run to examine the mediating effect of self-compassion on the relationship between appearance anxiety and social anxiety.ResultOverall, appearance anxiety was positively associated with social anxiety [β = 0.334, 95% CI = (0.328, 0.341), p < 0.001], and self-compassion could mediate the effect of appearance anxiety on social anxiety [β = 0.128, 95% CI = (0.124, 0.132), p < 0.001]. Self-compassion played a partial mediating role between appearance anxiety and social anxiety.ConclusionIndividuals with high appearance anxiety are also at higher risk of social anxiety, but self-compassion can buffer against this relationship. These findings begin to explore novel approaches to treat social anxiety and can provide valuable insights for self-compassion training

Hazardous drinking in young adults with co-occurring PTSD and psychosis symptoms: A network analysis

Background Existing literature suggests the co-occurrence of post-traumatic stress disorder (PTSD) and psychosis among young adults is related to hazardous drinking. However, the influencing mechanisms among these co-occurrences are inconclusive. Thus, this study aimed to investigate the symptomatic associations between PTSD, psychosis, and hazardous drinking. Methods This study included 96,218 young Chinese adults, divided into three groups (PTSD, Psychosis, and co-occurring PTSD-Psychosis). PTSD, psychosis, and hazardous drinking were measured by the ten-item Trauma Screening Questionnaire, the seven-item Psychosis Screener Scale, and the four-item Alcohol Use Disorders Identification Test, respectively. Network analysis was utilized to explore and compare the symptomatic correlation between PTSD, psychosis, and hazardous drinking. Results In this study, the most crucial symptom (both central and bridge) was "delusion of control" among the three networks. Hazardous drinking was another main bridge symptom. Compared to the Psychosis group and the co-occurring PTSD-Psychosis group, “Delusion of reference or persecution” to “Grandiose delusion” was the strongest edge in "the network structure of the PTSD group". Limitations The cross-sectional study cannot determine the causal relationship. Applying self-reporting questionnaires may cause inherent bias. Young adult participants limited the generalization of the results to other groups. Conclusions Among the three network structures, delusion of control was the most crucial symptom, and hazardous drinking was another bridge symptom; the edge of delusion of reference or persecution and grandiose delusion was strongest in the PTSD group's network. Efforts should be taken to develop diverse targeted interventions for these core symptoms to relieve PTSD, psychosis, and hazardous drinking in young adults

Revealing suicide risk of young adults based on comprehensive measurements using decision tree classification

Predicting suicide risk based on risk and protective factors is a critical and complex endeavor. In this study, we combined insights from comprehensive aetiological theories on suicide with the methodological strengths of machine learning techniques. Our primary objectives were twofold: a) to identify hazardous feature combinations that characterize a high risk of suicide, and b) to enhance our understanding of the potential interactions between risk and protective factors related to suicide. We established an interpretable decision tree model to classify young adults at high risk of suicide, utilizing fifty-five variables covering distal, developmental, proximal, and social context factors from a large-scale cross-sectional survey (N = 88,214). The results highlighted the significance of variables such as self-compassion and non-suicidal self-injury (NSSI), and the accumulation of depressive symptoms, medium-to-low self-compassion, and a history of NSSI as substantial indicators of heightened suicide risk. This study serves as a valuable reference for the clinical identification of individuals at risk of suicide

Diet-derived circulating antioxidants and risk of epilepsy: a Mendelian randomization study

BackgroundPrevious studies suggest a link between diet-derived circulating antioxidants and epilepsy, but the causal relationship is unclear. This study aims to investigate the causal effect of these antioxidants on epilepsy.MethodsTo assess the causal link between dietary antioxidants and epilepsy risk, we conducted a two-sample Mendelian randomization (MR) analysis. This involved examining antioxidants such as zinc, selenium, α- and γ-tocopherol, vitamin A (retinol), vitamin C (ascorbate), and vitamin E (α-tocopherol). We utilized instrumental variables (IVs) which were genetic variations highly associated with these commonly used antioxidants. Exposure data were sourced from a comprehensive genome-wide association study (GWAS). We aggregated data from the International League Against Epilepsy (ILAE) Consortium sample, which included various types of epilepsy, as an outcome variable. Finally, we applied the inverse variance weighting method and conducted sensitivity analyses for further validation.ResultsBased on the primary MR estimates and subsequent sensitivity analyses, the inverse variance weighting (IVW) method revealed that a genetically predicted increase in zinc per standard deviation was positively associated with three types of epilepsy. This includes all types of epilepsy (OR = 1.06, 95% CI: 1.02–1.11, p = 0.008), generalized epilepsy (OR = 1.13, 95% CI: 1.01–1.25, p = 0.030), and focal epilepsy (documented hippocampal sclerosis) (OR = 1.01, 95% CI: 1.00–1.02, p = 0.025). However, there is no evidence indicating that other antioxidants obtained from the diet affect the increase of epilepsy either positively or negatively.ConclusionOur research indicates that the risk of developing epilepsy may be directly linked to the genetic prediction of zinc, whereas no such association was found for other antioxidants

Analyzing the causal relationship between lipid-lowering drug target genes and epilepsy: a Mendelian randomization study

BackgroundPrevious research has yielded conflicting results on the link between epilepsy risk and lipid-lowering medications. The aim of this study is to determine whether the risk of epilepsy outcomes is causally related to lipid-lowering medications predicted by genetics.MethodsWe used genetic instruments as proxies to the exposure of lipid-lowering drugs, employing variants within or near genes targeted by these drugs and associated with low-density lipoprotein cholesterol (LDL cholesterol) from a genome-wide association study. These variants served as controlling factors. Through drug target Mendelian randomization, we systematically assessed the impact of lipid-lowering medications, including HMG-CoA reductase (HMGCR) inhibitors, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, and Niemann-Pick C1-like 1 (NPC1L1) inhibitors, on epilepsy.ResultsThe analysis demonstrated that a higher expression of HMGCR was associated with an elevated risk of various types of epilepsy, including all types (OR = 1.17, 95% CI:1.03 to 1.32, p = 0.01), focal epilepsy (OR = 1.24, 95% CI:1.08 to 1.43, p = 0.003), and focal epilepsy documented with lesions other than hippocampal sclerosis (OR = 1.05, 95% CI: 1.01 to 1.10, p = 0.02). The risk of juvenile absence epilepsy (JAE) was also associated with higher expression of PCSK9 (OR = 1.06, 95% CI: 1.02 to 1.09, p = 0.002). For other relationships, there was no reliable supporting data available.ConclusionThe drug target MR investigation suggests a possible link between reduced epilepsy vulnerability and HMGCR and PCSK9 inhibition

Comparative Proteomics Analyses Reveal the virB of B. melitensis Affects Expression of Intracellular Survival Related Proteins

BACKGROUND: Brucella melitensis is a facultative, intracellular, pathogenic bacterium that replicates within macrophages. The type IV secretion system encoded by the virB operon (virB) is involved in Brucella intracellular survival. However, the underlying molecular mechanisms, especially the target proteins affected by the virB, remain largely unclear. METHODOLOGY/PRINCIPAL FINDINGS: In order to define the proteins affected by virB, the proteomes of wild-type and the virB mutant were compared under in vitro conditions where virB was highly activated. The differentially expressed proteins were identified by MALDI-TOF-MS. Forty-four down-regulated and eighteen up-regulated proteins which exhibited a 2-fold or greater change were identified. These proteins included those involved in amino acid transport and metabolism, lipid metabolism, energy production, cell membrane biogenesis, translation, post-translational modifications and protein turnover, as well as unknown proteins. Interestingly, several important virulence related proteins involved in intracellular survival, including VjbR, DnaK, HtrA, Omp25, and GntR, were down-regulated in the virB mutant. Transcription analysis of virB and vjbR at different growth phase showed that virB positively affect transcription of vjbR in a growth phase dependent manner. Quantitative RT-PCR showed that transcription of these genes was also affected by virB during macrophage cell infection, consistent with the observed decreased survival of the virB mutant in macrophage. CONCLUSIONS/SIGNIFICANCE: These data indicated that the virB operon may control the intracellular survival of Brucella by affecting the expression of relevant proteins

On the Connectivity Measurement of the Fractal Julia Sets Generated from Polynomial Maps: A Novel Escape-Time Algorithm

In this paper, a novel escape-time algorithm is proposed to calculate the connectivity’s degree of Julia sets generated from polynomial maps. The proposed algorithm contains both quantitative analysis and visual display to measure the connectivity of Julia sets. For the quantitative part, a connectivity criterion method is designed by exploring the distribution rule of the connected regions, with an output value Co in the range of [0,1]. The smaller the Co value outputs, the better the connectivity is. For the visual part, we modify the classical escape-time algorithm by highlighting and separating the initial point of each connected area. Finally, the Julia set is drawn into different brightnesses according to different Co values. The darker the color, the better the connectivity of the Julia set. Numerical results are included to assess the efficiency of the algorithm

Blind box over-engagement and suicide risk among adolescents and young adults: Results of a large-scale survey

Summary: Background: Gambling appears to be an independent risk factor for suicide among the young population worldwide. Blind boxes are collectable toys packed randomly in the box, which share certain similarities with gambling and are popular among the young population. This is the first study that examined the association between blind box engagement and suicide risk in the young population, the leading consumption group of blind boxes. Methods: This study is part of a large-scale, cross-sectional study using convenience sampling conducted Oct 26 to Nov 18, 2021, which covered all the university and college students in the Jilin province, China. A total of 73,206 participants completed the survey with valid data for the current study (male: N = 28,762; female: N = 44,444; Mean age = 19·59). Participants’ blind box engagement, suicide risk, depression, anxiety, alcohol use, smoking habit, and sociodemographic characteristics were assessed. First, we used univariate and multivariable binary logistic regression models to examine the relationship between blind box engagement and suicide risk in all participants. Second, we tested whether depression and anxiety would mediate the association between blind box engagement and suicide risk. Third, we analysed the association between “Frequency (i.e., frequency of blind box engagement),” “Bet (i.e., expenditure on the blind box that exceeds affordability),” “Tolerance (i.e., level of addiction),” “Borrowed (i.e., the amount of money borrowed for blind box engagement),” and suicide risk in the group with blind box engagement history. Findings: 4,195 participants (5·73%) have engaged in blind boxes, with 3,255 females (77·59%) and 940 males (22·41%). In the univariate models, binary logistic regression showed that blind box engagement was associated with suicide risk in both male and female participants (male: OR = 2·21, 95% CI = 1·86-2·63; female: OR = 1·64, 95% CI = 1·50-1·78). In the multivariable models, after controlling age, subjective socioeconomic status, per capita disposable income, alcohol use, and smoking habit, blind box engagement still was associated with suicide risk across genders (male: OR = 2·25, 95% CI = 1·89-2·68; female: OR = 1·58, 95% CI = 1·45-1·73). Depression (male: indirect effect = 0·31, SE = 0·04, p < 0·001; female: indirect effect = 0·20, SE = 0·02, p < 0·001) and anxiety (male: indirect effect = 0·26, SE = 0·03, p < 0·001; female: indirect effect = 0·13, SE = 0·02, p < 0·001) mediate the association between blind box engagement and suicide risk. Within the blind box engagement group, forward binary logistic regression revealed that “Tolerance” was associated with participants’ suicide risk in both males (p = 0·001) and females (p < 0·001); “Borrowed” (p = 0·019) alone was associated with the male participants’ suicide risk. Interpretation: Our findings showed that blind box over-engagement is positively associated with suicide risk in both young males and females, and this association persisted after adjusting for influencing factors. In spite of the limitations in this study (e.g., cross-sectional, convenience sampling), current findings can assist policymakers in developing regulations for such a prosperous youth-dominant consumption industry while protecting youth's mental health worldwide. Funding: None

Effect of gender identity on the association between gender dysphoria and suicidality via appearance anxiety among transgender and gender-diverse young people: moderated mediation study

Background Gender dysphoria is associated with suicidality among transgender and gender-diverse (TGD) people. Gender dysphoria also results in a stress on appearance. Aims The objectives of this study were to examine: (a) whether appearance anxiety mediates the effect of gender dysphoria on suicidality; and (b) whether gender identity moderates the mediating effect of appearance anxiety. Method A total of 117 769 college and university students were recruited in this cross-sectional study from Jilin Province, China. After screening based on participants’ gender identity, 2352 TGD young people (aged from 15 to 25 years) were divided into three subgroups: female to male (FTM), male to female (MTF) and non-binary. Self-report inventories measured gender dysphoria, suicidality and appearance anxiety. A structural equation model was run to examine the relationships among TGD gender identity, gender dysphoria, appearance anxiety and suicidality. Results Among TGD young people, gender dysphoria was significantly positively associated with suicidality (β = 0.15, 95% CI = 0.11–0.18, P < 0.001). Appearance anxiety partially mediated the association between gender dysphoria and suicidality (β = 0.07, 95% CI = 0.05–0.08, P < 0.001). Gender identity moderated the mediating effects: compared with individuals with FTM identity, among those with MTF and non-binary identities, gender dysphoria showed stronger positive effects on appearance anxiety, and appearance anxiety showed greater effects in mediating the association between gender dysphoria and suicidality. Conclusions Among TGD young people, gender dysphoria is significantly associated with suicidality via appearance anxiety, with gender identity moderating the mediating effects. Diverse treatments should consider the heterogeneity of TGD subgroups, with the aim of limiting the tendency of gender dysphoria to trigger appearance anxiety, thus further buffering against the risk of suicide