The impact of alterations in intestinal microbiota on microbial metabolites and on disease processes, such as graft-versus-host disease (GVHD), is not known. Here we performed unbiased analysis to identify novel alterations in gastrointestinal microbiota-derived short chain fatty acids (SCFA) after allogeneic bone marrow transplant (allo-BMT). Alterations in the amounts of only one SCFA, butyrate, were observed only within the intestinal tissue. The reduced butyrate in CD326+ intestinal epithelial cells (IECs) after allo-BMT resulted in decreased histone acetylation, which was restored upon local administration of exogenous butyrate. Butyrate restoration improved IEC junctional integrity, decreased apoptosis, and mitigated GVHD. Furthermore, alteration of the indigenous microbiota with 17 rationally selected strains of high butyrate producing Clostridia also decreased GVHD. These data demonstrate a heretofore unrecognized role of microbial metabolites and suggest that local and specific alteration of microbial metabolites has direct salutary effects on GVHD target tissues and can mitigate its severity.

The intraclass correlation coefficient (ICC) is a fundamental parameter of interest in cluster randomized trials as it can greatly affect statistical power. We compare common methods of estimating the ICC in cluster randomized trials with binary outcomes, with a specific focus on their application to community-based cancer prevention trials with primary outcome of self-reported cancer screening. Using three real data sets from cancer screening intervention trials with different numbers and types of clusters and cluster sizes, we obtained point estimates and 95% confidence intervals for the ICC using five methods: the analysis of variance estimator, the Fleiss-Cuzick estimator, the Pearson estimator, an estimator based on generalized estimating equations and an estimator from a random intercept logistic regression model. We compared estimates of the ICC for the overall sample and by study condition. Our results show that ICC estimates from different methods can be quite different, although confidence intervals generally overlap. The ICC varied substantially by study condition in two studies, suggesting that the common practice of assuming a common ICC across all clusters in the trial is questionable. A simulation study confirmed pitfalls of erroneously assuming a common ICC. Investigators should consider using sample size and analysis methods that allow the ICC to vary by study condition.

We examined how individual and institutional factors in health care settings affected discrimination toward persons with HIV/AIDS. A representative sample of 1101 Chinese service providers was recruited in 2005, including doctors, nurses, and laboratory technicians. Multiple regression models were used to describe associations among identified variables, the relationships with HIV-related personal prejudicial attitudes, and perceived institutional support and discrimination at work. Multivariate analyses revealed that respondents' general view of persons living with HIV/AIDS and their perceived levels of support from their institutions regarding protection procedures were both important predictors for discrimination intent. Perceived institutional support varied according to age, gender, ethnicity, and training background. A better understanding of HIV-related discrimination in health care settings requires consideration of both individual and institutional factors.

This study examines how family support affects people living with HIV/AIDS (PLHA) in China. Indepth, semi-structured interviews (n=30) were conducted with people living with HIV/AIDS who were infected through different routes (e.g., intravenous drug use, sex) and of different age groups. Findings showed that all of the participants were in great need of help and the primary source of support came from their families. Family support included financial assistance, support in the disclosure process, daily routine activities, medical assistance, or psychological support. This study illustrates that the support provided by family makes multiple levels of positive impact on people living with HIV/AIDS, suggesting the importance of including families in HIV/AIDS interventions.

Evaporating seawater and separating salt from water is one of the most promising solutions for global water scarcity. State‐of‐the‐art water desalination devices combining solar harvesting and heat localization for evaporation using nanomaterials still suffer from several issues in energy efficiency, long‐term performance, salt fouling, light blocking, and clean water collection in real‐world applications. To address these issues, this work devises plasma‐enabled multifunctional all‐carbon nanoarchitectures with on‐surface waterways formed by nitrogen‐doped hydrophilic graphene nanopetals (N‐fGPs) seamlessly integrated onto the external surface of hydrophobic self‐assembled graphene foam (sGF). The N‐fGPs simultaneously transport water and salt ions, absorb sunlight, serve as evaporation surfaces, then capture the salts, followed by self‐cleaning. The sGF ensures effective thermal insulation and enhanced heat localization, contributing to high solar‐vapor efficiency of 88.6 ± 2.1%. Seamless connection between N‐fGPs and sGF and self‐cleaning of N‐fGP structures by redissolution of the captured salts in the waterways lead to long‐term stability over 240 h of continuous operation in real seawater without performance degradation, and a high daily evaporation yield of 15.76 kg m−2. By eliminating sunlight blocking and guiding condensed vapor, a high clean water collection ratio of 83.5% is achieved. The multiple functionalities make the current nanoarchitectures promising as multipurpose advanced energy materials.