The current study investigates the structural and compositional changes of ocular basement membranes (BMs) during long-term diabetes. By comparing retinal vascular BMs and the inner limiting membrane (ILM) from diabetic and non-diabetic human eyes by light and transmission electron microscopy (TEM), a massive, diabetes-related increase in the thickness of these BMs was detected. The increase in ILM thickness was confirmed by atomic force microscopy (AFM) on native ILM flat-mount preparations. AFM also detected a diabetes-induced increase in ILM stiffness. The changes in BM morphology and biophysical properties were accompanied by partial changes in the biochemical composition as shown by immunocytochemistry and western blots: agrin, fibronectin and tenascin underwent relative increases in concentration in diabetic BMs as compared to non-diabetic BMs. Fibronectin and tenascin were particularly high in the BMs of outlining microvascular aneurisms. The present data showed that retinal vascular BMs and the ILM undergo morphological, biomechanical and compositional changes during long-term diabetes. The increase in BM thickness not only resulted from an up-regulation of the standard BM proteins, but also from the expression of diabetes-specific extracellular matrix proteins that are not normally found in retinal BMs.

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Background: Visual conformity with affirmed gender (VCAG) or "passing" is thought to be an important, but poorly understood, determinant of well-being in transgender people. VCAG is a subjective measure that is different from having an inner sense of being congruent with one's gender identity. Aim:We examined the frequency and determinants of VCAG and explored its association with mental health outcomes in a cohort of transgender adults.

Background Men who have sex with men (MSM) are at a disproportionate risk for HIV infection and common mental disorders worldwide. In the context of HIV, common mental disorders are important and are frequent drivers of suboptimal prevention and treatment outcomes. Mobile ecological momentary assessments (EMAs), or the repeated sampling of people’s behaviors and psychological states in their daily lives using mobile phones, can clarify the triggers and HIV-related sequelae of depressive-anxious symptoms and contribute toward the design of ecological momentary interventions (EMIs) that cater to the contextually varying needs of individuals to optimize prevention and treatment outcomes. Objective This study aims to characterize the feasibility and acceptability of mobile EMA among high-risk MSM in Hanoi, Vietnam. It aims to evaluate the perceived relevance, usability, and concerns of this group with regard to the content and delivery of mobile EMA and the potential of leveraging such platforms in the future to deliver EMIs. Methods Between January and April 2018, a total of 46 participants were recruited. The participants completed 6 to 8 mobile EMA surveys daily for 7 days. Surveys occurred once upon waking, 4 to 6 times throughout the day, and once before sleeping. All surveys queried participants’ perceived safety, social interactions, psychological state, and mental health symptoms. The morning survey further queried on sleep and medication use within the past 24 hours, whereas the night survey queried on sexual activity and substance use and allowed participants to share an audio recording of a stressful experience they had that day. At the end of the week, participants were interviewed about their experiences with using the app. Results Participants completed an average of 21.7 (SD 12.7) prompts over the 7-day period. Excluding nonresponders, the average compliance rate was 61.8% (SD 26.6%). A thematic analysis of qualitative interviews suggested an overall positive reception of the app and 5 recurring themes, which were centered on the relevance of psychological and behavioral items to daily experiences (eg, mental health symptoms and audio recording), benefits of using the app (eg, increased self-understanding), worries and concerns (eg, privacy), usability (eg, confusion about the interface), and recommendations for future design (eg, integrating more open-ended questions). Conclusions Mobile EMA is feasible and acceptable among young MSM in Vietnam; however, more research is needed to adapt EMA protocols to this context and enhance compliance. Most participants eagerly provided information about their mental health status and daily activities. As several participants looked toward the app for further mental health and psychosocial support, EMIs have the potential to reduce HIV and mental health comorbidity among MSM.

BACKGROUND Worldwide men who have sex with men (MSM) are at disproportionate risk for HIV infection and common mental disorders. In the context of HIV, common mental disorders are important and frequent drivers of sub-optimal prevention and treatment outcomes. Mobile ecological momentary assessments (EMA), or the repeated sampling of people’s behaviors and psychological states in daily life using mobile phones, can clarify the triggers and HIV-related sequelae of depressive-anxious symptoms and contribute towards the design of ecological momentary interventions (EMIs) that cater to the contextually varying needs of individuals to optimize prevention and treatment outcomes. OBJECTIVE Our study sought to characterize the feasibility and acceptability of mobile EMA among high-risk MSM in Hanoi, Vietnam. It evaluated the perceived relevance, usability, and concerns of this group with the content and delivery of mobile EMA; and the potential of leveraging such platforms in the future to deliver EMIs. METHODS Between January and April 2018, 46 participants were recruited. Participants completed 6-8 mobile EMA surveys daily for 7 days. Surveys occurred once upon waking, 4-6 times throughout the day, and once before sleep. All surveys queried participants’ perceived safety, social interactions, psychological state, and mental health symptoms. The morning survey further queried on sleep and medication use within the past 24 hours; while the nightly survey queried on sexual activity and substance use and allowed participants to share an audio recording of a stressful experience they had that day. At the end of the week, participants were interviewed about their experiences using the app. RESULTS Participants completed an average of 21.3 prompts over the 7-day period. Compliance averaged 62.2%. Thematic analysis of qualitative interviews suggests positive reception to the app overall, as well as five recurring themes centered on (i) relevance of psychological and behavioral items to daily experiences (e.g., mental health symptoms, audio recording); (ii) benefits to using the app (e.g., increased self-understanding); (iii) worries and concerns (e.g., privacy); (iv) usability (e.g., confusion about the interface); and (v) recommendations for future design (e.g., integrating more open-ended questions). CONCLUSIONS Mobile EMA is a feasible and acceptable among young MSM in Vietnam, but more research is needed to adapt EMA protocols to this context and enhance compliance. Most participants eagerly provided information about their mental health status and daily activities. As several participants looked towards the app for further mental health and psychosocial support, EMIs has the potential to reduce HIV and mental health comorbidity among MSM.