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Viruses regulate host metabolic networks to improve their survival. The molecules that are responsive to viral infection and regulate such metabolic changes are hardly known, but are essential for understanding viral infection. Here we identify a long noncoding RNA (lncRNA) that is induced by multiple viruses, but not by type I interferon (IFN-I), and facilitates viral replication in mouse and human cells. In vivo deficiency of lncRNA-ACOD1 (a lncRNA identified by its nearest coding gene Acod1, aconitate decarboxylase 1) significantly attenuates viral infection through IFN-I–IRF3 (interferon regulatory factor 3)–independent pathways. Cytoplasmic lncRNA-ACOD1 directly binds the metabolic enzyme glutamic-oxaloacetic transaminase (GOT2) near the substrate niche, enhancing its catalytic activity. Recombinant GOT2 protein and its metabolites could rescue viral replication upon lncRNA-ACOD1 deficiency and increase lethality. This work reveals a feedback mechanism of virus-induced lncRNA-mediated metabolic promotion of viral infection and a potential target for developing broad-acting antiviral therapeutics.

Background International migrants are vulnerable to sexually transmitted infections, and their flow may accelerate the related virus (e.g., HIV, HCV, and syphilis) transmission. When international migrants enter a new environment, there will be a process of adaptation in all areas of life, and social integration plays an important role in international migrants’ daily life. Objective This study aimed to explore the influence of social integration on the risky sexual behaviors of international migrants in China and provided evidence both for healthcare intervention and global health development. Methods A cross-sectional survey was conducted between January and September 2021 among international migrants who lived in China by snowball sampling method. Descriptive statistics were used to analyze the basic characteristics and risky sexual behaviors of international migrants. Multivariable logistic regression analyses were used to identify the influencing factors of risky sexual behaviors. Results In total, 1433 international migrants were incorporated into the study. There were 23.10% (331) participants who considered their Chinese fluent, and 34.40% (493) considered it hard. The average number of Chinese friends they frequently interact with was (5.45 ± 2.16), and 77.60% (1112) of international migrants often attend activities held by Chinese people with 84.86% (1216) having a Chinese name. The probability of engaging in risky sexual behaviors was higher among people with lower Chinese or English level. Moreover, participants with fewer Chinese friends frequently interacted with had more unprotected sexual behaviors. People who did not often attend activities held by Chinese people had more multiple sexual partners (AOR 1.441; 95%CI 1.019,2.039) and unprotected sexual behaviors (AOR 1.523; 95%CI 1.006,2.306). Conclusions Social integration was related to the prevalence of risky sexual behaviors among international migrants. Improving Chinese level, increasing social interaction with locals as well as maintaining a healthy lifestyle may help decrease risky sexual behaviors. Therefore, more attention should be paid to social integration among international migrants, helping them integrate into local society, and promote their health condition to effectively address the health challenges faced by them in a globalized world.

Long noncoding RNAs (lncRNAs) are important regulators of gene expression, but whether they are important regulators of the immune system is poorly understood. Wang et al. (p. 310 ) identify a lncRNA expressed exclusively in human dendritic cells (DC), called lnc-DC, that is required for optimal DC differentiation from human monocytes and that regulates DC activation of T cells. Lnc-DC interacts with the transcription factor STAT3, which is also required for DC development and function, to prevent interaction with and to block dephosphorylation by tyrosine phosphatase SHP1. A long noncoding RNA regulates dendritic cell differentiation and function. Long noncoding RNAs (lncRNAs) play important roles in diverse biological processes; however, few have been identified that regulate immune cell differentiation and function. Here, we identified lnc-DC, which was exclusively expressed in human conventional dendritic cells (DCs). Knockdown of lnc-DC impaired DC differentiation from human monocytes in vitro and from mouse bone marrow cells in vivo and reduced capacity of DCs to stimulate T cell activation. lnc-DC mediated these effects by activating the transcription factor STAT3 (signal transducer and activator of transcription 3). lnc-DC bound directly to STAT3 in the cytoplasm, which promoted STAT3 phosphorylation on tyrosine-705 by preventing STAT3 binding to and dephosphorylation by SHP1. Our work identifies a lncRNA that regulates DC differentiation and also broadens the known mechanisms of lncRNA action.

Health communication and promotion on the internet have evolved over time, driven by the development of new technologies, including generative artificial intelligence (GenAI). These technological tools offer new opportunities for both the public and professionals. However, these advancements also pose risks of exacerbating health disparities. Limited research has focused on combining these health communication mediums, particularly those enabled by new technologies like GenAI, and their applications for health promotion and health disparities. Therefore, this viewpoint, adopting a conceptual approach, provides an updated overview of health communication mediums and their role in understanding health promotion and disparities in the GenAI era. Additionally, health promotion and health disparities associated with GenAI are briefly discussed through the lens of the Technology Acceptance Model 2, the uses and gratifications theory, and the knowledge gap hypothesis. This viewpoint discusses the limitations and barriers of previous internet-based communication mediums regarding real-time responses, personalized advice, and follow-up inquiries, highlighting the potential of new technology for public health promotion. It also discusses the health disparities caused by the limitations of GenAI, such as individuals’ inability to evaluate information, restricted access to services, and the lack of skill development. Overall, this study lays the groundwork for future research on how GenAI could be leveraged for public health promotion and how its challenges and barriers may exacerbate health inequities. It underscores the need for more empirical studies, as well as the importance of enhancing digital literacy and increasing access to technology for socially disadvantaged populations.

To quantify and predict the economic burden of dementia in China for the periods 1990-2010 and 2020-2030, respectively, and discuss the potential implications for national public health policy. Using a societal, prevalence-based, gross cost-of-illness approach and data from multiple sources, we estimated or predicted total annual economic costs of dementia in China. We included direct medical costs in outpatient and inpatient settings, direct non-medical costs - e.g. the costs of transportation - and indirect costs due to loss of productivity. We excluded comorbidity-related costs. The estimated total annual costs of dementia in China increased from 0.9 billion United States dollars (US$) in 1990 to US$ 47.2 billion in 2010 and were predicted to reach US$ 69.0 billion in 2020 and US$ 114.2 billion in 2030. The costs of informal care accounted for 94.4%, 92.9% and 81.3% of the total estimated costs in 1990, 2000 and 2010, respectively. In China, population ageing and the increasing prevalence of dementia were the main drivers for the increasing predicted costs of dementia between 2010 and 2020, and population ageing was the major factor contributing to the growth of dementia costs between 2020 and 2030. In China, demographic and epidemiological transitions have driven the growth observed in the economic costs of dementia since the 1990s. If the future costs of dementia are to be reduced, China needs a nationwide dementia action plan to develop an integrated health and social care system and to promote primary and secondary prevention.

As telehealth services have demonstrated significant advantages in providing qualified and accessible care, health insurance payments for telehealth services have been issued by various countries. However, the optimization of health insurance payments for telehealth services remains uncertain. We conducted a scoping review of the current situation regarding health insurance payments for telehealth services, with the aim of providing evidence to enhance policies related to health insurance payments for such services. This scoping review was conducted by comprehensively retrieving data from 6 electronic bibliographic databases from inception to October 2023. The databases included China National Knowledge Infrastructure, Wan Fang, Weipu, Web of Science, PubMed, and Embase, following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Two authors independently assessed search results, extracted data, and evaluated the quality of the included studies using the Critical Appraisal Skills Programme checklist. After the initial screening of titles and abstracts, full texts were obtained and examined. The data regarding the first author, date of publication, country, type of telehealth services introduced in health insurance, health insurance reimbursement providers, reimbursement standards for telehealth (eg, the condition for the reimbursement and reimbursement rate), and key findings of studies were extracted and analyzed. Moreover, we also conducted a narrative synthesis to summarize and report the findings. A total of 7232 papers were retrieved. Following quality assessment, 23 papers were finally included, with the covered countries including China, the United States, Australia, France, Japan, the United Kingdom, and Germany. The forms of the services vary across different regions, mainly including consultation services, medical monitoring services, mental health services, health education services, and other services. Payment standards are generally categorized into fee-for-service and global budget payment, with clear health insurance payment quotas or proportions and certain restrictions (eg, specifying the location of medical visits and setting the limitation on distance from home to hospitals). The paying entities for health insurance payment include national health insurance and commercial health insurance. In addition, there are 2 kinds of reimbursement rates-a comparable rate for both telehealth and in-person health care services, and a lower rate for telehealth services compared to in-person health care services. To enhance the accessibility of telehealth services through health insurance payment, it is crucial to further refine the design of health insurance payment for telehealth and strengthen the supervision of services quality, bridging the gap between telehealth and in-person health care services. Additionally, this review did not include studies from all countries, and we recommend that future reviews should include a broader range of countries to provide a more comprehensive view of global telehealth insurance systems.

Background Female sex workers (FSWs) are high-incidence population of sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). The methods used to find clients for commercial sex have diversified in recent years. As a result, it is crucial to analyze the correlation between methods used to find clients and risky sexual behavior and explore changes in risky sexual behavior among FSWs over time. Methods HIV sentinel surveillance data were collected from Zhejiang Province, China, between 2016 and 2021. In total, 4,798 FSWs were included in our analysis. We collected information related to socio-demographic variables, HIV knowledge, methods used to find clients, and condom use. Descriptive statistics were used to analyze the socio-demographic characteristics of FSWs. Univariate and sequential logistic regression models were employed to determine the influence of methods used to find clients on risky sexual behavior after controlling for other factors. Results The average age of the 4,798 FSWs was 33.0 ± 7.4 years. The majority (70.6%) who find clients online reported always using condoms over the past month. The proportion of FSWs engaging in risky sexual behavior, defined as not using condoms at the last sexual encounter or not using them consistently over the past month, was lowest among those who find clients online, whereas the risk was highest among those who worked at a fixed site ( p  < 0.001). Sequential logistic regression demonstrated that compared to FSWs who find clients at a fixed site, those finding clients online (OR = 0.6, p  < 0.001) were significantly associated with risky sexual behavior. Conclusion FSWs had a high knowledge regarding acquired immunodeficiency syndrome (AIDS), but with greater likelihood of risky sexual behavior, particularly among FSWs who find customers at a fixed site. The risk of engaging in condomless sex among FSWs who find client at fixed sites was higher than those online. Therefore, it is essential to explore health interventions that improve condom use among FSWs.

ObjectivesWhile it is widely accepted that COVID-19 has disrupted routine vaccination globally, the long-term impact of COVID-19 on parental vaccination intentions is uncertain. This study aims to estimate whether COVID-19 impacted parental intentions for self-paid vaccines, and provides suggestions for local vaccination policy and intervention strategies accordingly.MethodsA questionnaire-based cross-sectional survey was conducted among 2212 caregivers in Zhejiang province between 22 March and 30 June 2023. The following information was collected: sociodemographic characteristics, self-paid vaccination related intentions and behaviours, and vaccine hesitancy measured by the Vaccine Hesitancy Scale. Multiple multinomial logistic regression models were used to analyse the factors influencing the change in vaccination intentions.ResultsIn total, 19.32% (n=390) of respondents increased their intention to immunise their children with self-paid vaccines after the COVID-19 epidemic, 9.16% (n=185) decreased their intention, and 71.52% (n=1444) of respondents indicated that the COVID-19 epidemic did not affect their intention. The major reason for increased intentions was ‘Vaccines are effective in preventing diseases’ (83.89%) and for decreased intentions was ‘Worried about the side effects of vaccines’ (65.95%). A higher hesitancy degree (OR=2.208, p=0.0001), reduced trust in vaccines after COVID-19 (OR=16.650, p<0.0001), doctors’ recommendation of Expanded Programme on Immunization vaccines (OR=2.180, p=0.0076), and non-perfect satisfaction with vaccine information (all OR>1, all p<0.05) were considered to be drivers of decreased intention.ConclusionAlthough the intentions of self-paid vaccinations were not largely influenced, nearly 30% of caregivers’ vaccination intentions changed after the COVID-19 pandemic and most of them increased their intentions. In addition, vaccination history of self-paid vaccines, vaccine information, vaccine trust and doctors’ recommendations were the active factors for self-paid vaccination. Therefore, education on the knowledge of self-paid vaccines for caregivers should be implemented to increase their vaccination intentions and decrease the threat of infectious diseases to children’s health.

Background Parent-adolescent reproductive health (RH) communication is one of the potential sources of information for adolescents on the topic. Given that female adolescents in Bangladesh are faced with increasing RH-related risks, it is important to understand how parents communicate about RH to their adolescents from the adolescents’ perspectives. Therefore, the aim of this study is to explore the status of mother-adolescent daughter communication on reproductive health in Bangladesh. Methods A cross-sectional study targeting female students was conducted in five high schools in Chittagong based on a self-administered questionnaire survey. A description method was used to describe the characteristics of mother-adolescent daughters’ communication on RH including the frequency, type and the quantity of topics. Bivariate and multivariate logistic regression analyses were performed to explore the factors influencing mother-adolescent daughter communication. Results In the study, 1174 female students aged from 13 to 19 years old were included. The main source of knowledge on RH was from their mother (62%), and the mother was the person who communicated first on RH with adolescent students. The topics of mother-daughter communication were mainly focused on menstruation issues (> 80%). Multivariate logistic regressions showed that Hindu students, students with good RH knowledge, adolescents’ mothers having good RH knowledge, mothers with high media use, good mother-daughter relationship, daughters’ regular general communication with mothers, and students’ perceiving comfort in RH communication with their mothers were reported as significant predictors for a good RH communication status. On the contrary, students having family members numbering more than four, whose primary source of reproductive health information was friends/classmates as well as media were less likely to have better RH communication with mothers. Conclusions The overall communication on reproductive health between adolescent daughters and their mothers was not good. This study suggests for conducting qualitative research investigating the socio-cultural context within which the RH communications happen. and how to address the obstacles that might hinder this communication.

ObjectiveTo understand the sexual behaviours and HIV testing uptake of sexually experienced male college students in China.DesignA cross-sectional study was conducted between September and November of 2020 among male college students.SettingHangzhou, China.ParticipantsMale students who had sexual experience in the previous year were investigated.Outcome measuresSexual risk behaviour was defined as having multiple sexual partners or having unprotected sex.ResultsMore than half of the sexually experienced male students (556, 53.2%) had their first sexual intercourse under the age of 18 years old. Among participants, 32.82% (343/1045) had causal sex in the last 6 months; 4.21% (44/1045) had paid sex; 37.32% (390/1045) had sex with other men and had two or more sexual partners in last half year; and 33.33% (130/390) used psychoactive drugs during same-sex intercourse. Only 33.5% (350/1045) of male students had undertaken an HIV test before.ConclusionMale college students especially men who have sex with men were at risk because they tended to be sexually adventurous, have sex at an early age, have sex with multiple sexual partners and practice unprotected sex. Furthermore, they had a low HIV testing uptake. This highlights the importance of carrying out targeted and timely HIV risk education towards college students.