bluuebunny/crossref_metadata_2025 huggingface dataset:
The Innovation Superclusters Initiative in Canada: A new policy strategy?
Authors: Doloreux David , Frigon Anthony
Published: October 2021

The supercluster is a new initiative promoted by the Canadian federal government to strengthen Canada’s most promising clusters and allow innovative firms to operate more productively in sourcing inputs and accessing information, knowledge, and technology. This paper contributes to the scientific research on superclusters and pursues two objectives. First, we discuss the origins of the supercluster initiative and trace its roots back to major research traditions on regional agglomerations and territorial innovation models, in particular the cluster theory, the regional innovation system, and the entrepreneurial ecosystem approaches. Second, we conduct a critical analysis and identify four critical questions (or challenges) that need to be addressed to clarify the scope and objectives of the policy.
How the COVID-19 Pandemic Can and Must Expand Social Worker e-Interventions for Mental Health, Family Wellness, and Beyond
Authors: King Erika L , Spencer Chelsea M , Meeks Colleen A
Published: October 2021

Both media and academic reports have highlighted COVID-19’s negative impacts on mental health and safety in the United States, yet care and service gaps persist. Evidence suggests that a default to in-person service delivery did not meet clients’ needs before the pandemic, and that unmet needs have ballooned since COVID-19 spread throughout the United States due to a combination of increased stress, social isolation, and fewer available services during lockdowns. This article reviews literature on online interventions’ utility and effectiveness in preventing and treating problems likely exacerbated under pandemic conditions, including mental health conditions, anger, couple dynamics, parenting, and alcohol misuse. The article also describes barriers to evidence-based e-interventions’ wider and more consistent use, highlights some vulnerable populations’ unique service needs, outlines service gaps that online programs might effectively mitigate, and offers a path by which social workers can lead an interdisciplinary charge in researching, developing, and implementing e-interventions during the current pandemic and beyond.
Winter Rye Cover Cropping Changes Squash (Cucurbita pepo) Phyllosphere Microbiota and Reduces Pseudomonas syringae Symptoms
Authors: Maglione Rémi , Ciotola Marie , Cadieux Mélanie , Toussaint Vicky , Laforest Martin , Kembel Steven W.
Published: October 2021

Cover cropping is a soil conservation practice that may reduce the impacts of the economically important pathogen Pseudomonas syringae on crops, including squash (Cucurbita pepo). To date, no studies have directly quantified the effect of rye cover crops on P. syringae populations or on the bacterial community of squash leaves. In this work, we tested the hypothesis that the protective effects of cover cropping on squash may be mediated by cover cropping effects on the plant’s microbiota that, in turn, protect against P. syringae. Using combined 16S sequencing and culture-based approaches, we showed that rye cover cropping protects squash against P. syringae, by decreasing pathogen population size on squash leaves and increasing fruit health and marketability at harvest. We also found evidence of a strong effect of rye cover crops on bacterial communities of the squash phyllosphere. Those findings were more striking early in the growing season. Finally, we identified numerous phyllosphere bacteria belonging to the genera Sphingomonas, Methylobacterium, and Pseudomonas that were promoted by rye cover crops. Overall, our findings suggest that cover cropping is effective for the sustainable management of P. syringae on squash and may provide a reservoir of potential microbial biocontrol agents colonizing the phyllosphere.

[Formula: see text] Copyright © 2022 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Design and Validation of Plasmid Vectors for Characterizing Protein–Protein Interactions in Spodoptera frugiperda Insect Cells
Authors: Teh Hao Wei , Martin Kathleen M. , Whitfield Anna E.
Published: October 2021

There are limited molecular biology resources for interrogating protein–protein interactions (PPIs) in insect cells. To address this deficiency, we developed plasmid vectors for localization, bimolecular fluorescence complementation (BiFC), and co-immunoprecipitation (co-IP) assays in Sf9 insect cells. Plasmids were designed to express a protein of interest as a fusion with epitope tags and autofluorescent proteins using the Gateway cloning system. Two robust interactors were utilized to validate this system: the nucleoprotein (N) and the phosphoprotein (P) of maize mosaic virus. The viral N was fused with the carboxy-terminal portion of eYFP and a FLAG epitope tag, and P was fused with the amino-terminal portion of eYFP and a myc epitope tag. The two expression plasmids were cotransfected into Sf9 cells, fluorescence microscopy was used to visualize BiFC, and co-IP was performed to confirm that this system was sensitive enough to detect PPI between the two proteins. BiFC was seen in cells cotransfected with N and P, and co-IP validated the interaction. This plasmid-based system can be used to investigate a variety of PPIs that occur in insects. We validated viral protein interactions that occur in the insect vector, which provides further insights into the biology of rhabdoviruses that are transmitted by insects. The ability to express viral and insect proteins in insect cells for studying PPIs with this streamlined system represents an advancement for protein research in insects. Future work will focus on identifying interacting viral and host proteins and discovery of targets for control of viruses and insect vectors.

[Formula: see text] Copyright © 2022 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Longitudinal Associations Between Use of Tobacco and Cannabis Among People Who Smoke Cigarettes in Real-world Smoking Cessation Treatment
Authors: Nguyen Nhung , Neilands Torsten B. , Lisha Nadra E. , Lyu Joanne Chen , Olson Sarah S. , Ling Pamela M.
Published: October 2021

Objectives

Cannabis use is common among people who use tobacco. However, little is known about the relationship between change in use of tobacco and cannabis over time. We examined the longitudinal associations between use of the two substances in a realworld smoking cessation context.

Methods

This study analyzed data from a 3-month smoking cessation program delivered via Facebook in the San Francisco Bay Area, USA during 2016–2020. The sample included 487 participants who smoked cigarettes (M
age = 25.4 years old, 39.6% Male, 40.3% White). The regressors (ie, frequency or number of days during the past 30 days using cigarettes, e-cigarettes, and cigars) and the outcome (ie, frequency of cannabis use) were measured at both baseline and 3-month follow-up. Random-effects modeling examined the longitudinal associations between the regressors and the outcome controlling for alcohol use and baseline demographics.

Results

Participants who increased (or decreased) their frequency of use of cigarettes (β = 0.17, 95% confidence interval [CI] = 0.10, 0.24), e-cigarettes (β = 0.11, 95% CI = 0.05, 0.17), or cigars (β = 0.19, 95% CI = 0.06, 0.32) also increased (or decreased) their frequency of cannabis use after 3 months. Sexual minority participants (vs heterosexuals) (β = 2.12, 95% CI = 0.01, 4.24) and those whose education attainment being high school or less (vs higher education) (β = 3.89, 95% CI = 1.25, 6.53) were more likely to increase their frequency of cannabis use over time.

Conclusions

The findings indicated positive associations between change in use of tobacco and cannabis use. Promoting cessation among people who use tobacco may help to reduce their cannabis use.
Scoliosis Surgery Normalizes Cardiac Function in Adolescent Idiopathic Scoliosis Patients
Authors: Sarwahi Vishal , Galina Jesse , Atlas Aaron , Gecelter Rachel , Hasan Sayyida , Amaral Terry D. , Maguire Kathleen , Lo Yungtai , Kalantre Sarika
Published: October 2021

Study Design.

Single-center retrospective chart review with minimum 2-year follow up.

Objective.

To determine incidence of pulmonary hypertension in adolescent idiopathic scoliosis patients and to determine the effect of scoliosis surgery on pulmonary hypertension.

Summary of Background Data.

Spinal deformity in adolescent idiopathic scoliosis can increase right atrial and ventricular pressures secondary to restrictive lung disease. Pulmonary hypertension leading to cor pulmonale is the most feared outcome, however mild pulmonary hypertension in adolescent idiopathic scoliosis (AIS) patients has been reported. No study has previously examined changes in the improvement of right heart function following scoliosis surgery.

Methods.

Cobb angle, 2D-echo signs of structural heart disease, aortic root dimensions, tricuspid regurgitant jet velocity (TRV), pulmonary function tests (PFTs), arterial blood gas (ABG), and patient demographics reviewed. Right ventricular systolic pressure (RVSP) estimated using Bernoulli equation (4[TRV]2) and right atrial pressure. RVSP ≥36 mmHg is a surrogate marker for pulmonary hypertension. All echocardiograms were read by board certified Pediatric Cardiologists. Logistic regression used to assess for differences in TRV between groups.

Results.

Mean preoperative RVSP was significantly elevated in AIS patients (26.9 ± 0.49; P < 0.001) compared with controls (17.25 + 0.88). Only 47 (21%) Group 1 patients had elevated preoperative TRV (≥2.8 m/s) versus none in Group 2 (P < 0.001). Additionally, logistic regression showed AIS patients have odds ratio of 3.29 for elevated TRV (P = 0.007)—an indirect measure of pulmonary hypertension. In all Group 3 patients, the cardiac function normalized postoperatively (mean TRV = 2.09 + 0.23; P < 0.001). No association found between Cobb angle, aortic root parameters, or pulmonary function tests.

Conclusion.

This study found 13.9% of patients with adolescent idiopathic scoliosis had elevated TRV while controls had no TRV abnormalities. Additionally, RVSP measurements demonstrated mild pulmonary hypertension in AIS patients. These abnormal values normalized postoperatively, indicating the benefits of scoliosis surgery on cardiac function in adolescent idiopathic scoliosis.

Level of Evidence: 3
The expression of circ_0090049 in hepatocellular carcinoma and the molecular regulation mechanism of other biological functions
Authors: Chen Zongpin , Jin Peisheng , Chen Zhen , Ye Fangpeng , Ren Zonghai , Ji Tingting , Li Rongzhou , Yu Leilei
Published: October 2021

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in liver cancer. Circular RNA_0090049 (circ_0090049) has been shown to be involved in the advance of HCC. However, the interaction between circ_0090049 and microRNA (miRNA) in HCC has not been studied. Quantitative real-time PCR was used to detect the expression of related genes. Through detection of cell proliferation, migration, invasion, and rate of tumor sphere formation, the capping experiment was carried out to verify the regulatory relationship between miRNA and circ_0090049 or circ_0090049 and ubiquitin-conjugating enzyme E2 T (UBE2T). The expression of related proteins was detected by Western blotting. The interaction of miRNA with circ_0090049 or UBE2T was notarized by Dual-luciferase reporter assay. Xenotransplantation experiments confirmed the function of circ_0090049 in vivo. Circ_0090049 and UBE2T were upregulated in liver cancer. Silencing circ_0090049 reduced the proliferation, migration, invasion, and tumor spheroid formation rate of Huh7 and HCCLM3 cells. MiR-605-5p and miR-548c-3p were identified as targets of circ_0090049, and UBE2T was the target of miR-605-5p and miR-548c-3p. Anti-miR-605-5p, anti-miR-548c-3p or UBE2T overexpression restored the inhibitory effect of circ_0090049 knockdown on HCC cells. Animal experiments confirmed the antitumor effect of silence circ_0090049. Circ_0090049 regulates the expression of UBE2T by regulating miR-605-5p or miR-548c-3p, thereby promoting the development of HCC cells.
Biplane Imaging Versus Standard Transverse Single-Plane Imaging for Ultrasound-Guided Peripheral Intravenous Access: A Prospective Controlled Crossover Trial
Authors: Convissar David , Bittner Edward A. , Chang Marvin G.
Published: October 2021

OBJECTIVES:

Obtaining peripheral IV access in critically ill patients is often challenging especially for novice providers. The availability of biplane imaging for ultrasound guided peripheral access has the potential to improve successful venous cannulation compared with standard plane imaging.

DESIGN:

Single-center quasi-randomized (alternate allocation) crossover trial.

SETTING:

Surgical ICU at the Massachusetts General Hospital.

SUBJECTS:

Twenty surgical ICU nurses with no prior experience using ultrasound for peripheral IV were enrolled.

INTERVENTIONS:

All participants viewed instructional videos on single-plane and biplane imaging for peripheral IV insertion. The participants were then quasi-randomly assigned to use either single-plane or biplane imaging for peripheral IV insertion using a phantom model. The time to catheter completion, successful lumen cannulation, and attempts in which the needle was observed to go through the back wall of the vessel were recorded for each of the three attempts. The following day the participants repeated the peripheral IV insertion with the alternate imaging modality.

MEASUREMENTS AND MAIN RESULTS:

Biplane imaging compared with single-plane imaging was associated with a significantly greater overall success rate (78.3% ± 22.4% vs 41.7% ± 26%; p < 0.001), higher first-pass success rate (80% ± 41% vs 45% ± 51%; p = 0.015), faster cannulation times (27.8 ± 14.8 vs 36.6 ± 15.8 s; p = 0.003), and reduced frequency of backwall perforations (0.4 ± 0.7 vs 1.5 ± 0.8; p < 0.001).

CONCLUSIONS:

This proof-of-principle study demonstrates that the biplane ultrasound imaging approach for vessel cannulation resulted in an overall faster, more successful, and safer peripheral IV access than the standard single-plane transverse approach when performed by novice ultrasound users.
A Pilot Double-Blind Placebo-Controlled Randomized Clinical Trial to Investigate the Effects of Early Enteral Nutrients in Sepsis
Authors: Shah Faraaz Ali , Kitsios Georgios D. , Yende Sachin , Dunlap Daniel G. , Scholl Denise , Chuan Byron , Al-Yousif Nameer , Zhang Yingze , Nouraie Seyed Mehdi , Morris Alison , Huang David T. , O’Donnell Christopher P. , McVerry Bryan J.
Published: October 2021

OBJECTIVES:

Preclinical studies from our laboratory demonstrated therapeutic effects of enteral dextrose administration in the acute phase of sepsis, mediated by the intestine-derived incretin hormone glucose-dependent insulinotropic peptide. The current study investigated the effects of an early enteral dextrose infusion on systemic inflammation and glucose metabolism in critically ill septic patients.

DESIGN:

Single-center, double-blind, placebo-controlled randomized pilot clinical trial (NCT03454087).

SETTING:

Tertiary-care medical center in Pittsburgh, PA.

PATIENTS:

Critically ill adult patients within 48 hours of sepsis diagnosis and with established enteral access.

INTERVENTIONS:

Participants were randomized 1:1 to receive a continuous water (placebo) or enteral dextrose infusion (50% dextrose; 0.5 g/mL) at 10 mL per hour for 24 hours.

MEASUREMENTS AND MAIN RESULTS:

We randomized 58 participants between June 2018 and January 2020 (placebo: n = 29, dextrose: n = 29). Protocol adherence was high with similar duration of study infusion in the placebo (median duration, 24 hr [interquartile range, 20.9–24 hr]) and dextrose (23.9 hr [23–24 hr]) groups (p = 0.59). The primary outcome of circulating interleukin-6 at end-infusion did not differ between the dextrose (median, 32 pg/mL [19–79 pg/mL]) and placebo groups (24 pg/mL [9–59 pg/mL]; p = 0.13) with similar results in other measures of the systemic host immune response. Enteral dextrose increased circulating glucose-dependent insulinotropic peptide (76% increase; 95% CI [35–119]; p < 0.01) and insulin (53% [17–88]; p < 0.01) compared with placebo consistent with preclinical studies, but also increased blood glucose during the 24-hour infusion period (153 mg/dL [119–223] vs 116 mg/dL [91–140]; p < 0.01). Occurrence of emesis, ICU and hospital length of stay, and 30-day mortality did not differ between the placebo and enteral dextrose groups.

CONCLUSIONS:

Early infusion of low-level enteral dextrose in critically ill septic patients increased circulating levels of insulin and the incretin hormone glucose-dependent insulinotropic peptide without decreasing systemic inflammation.
Stereotactic Body Radiotherapy for Prostate Cancer
Authors: Viani Gustavo A. , Gouveia Andre G. , Jacinto Alexandre A. , Moraes Fabio Y.
Published: October 2021

Objectives:

To provide an overview of the achievements and future research with stereotactic body radiotherapy (SBRT) in prostate cancer.

Methods:

SBRT publications for prostate cancer were retrieved from the Web of Science and Dimension database. Bibliometric analyses were performed using VOSviewer and Prism graph. Analysis of variance test was used to compare the publication, citation, and the mean citation between specialty journals. Network maps were produced to identify authors’ and countries’ collaboration clusters.

Results:

Between 2006 and 2020, 574 publications fulfilling the inclusion criteria were identified, and a significant growth trend in publication (P<0.0001) and citation (P=0.001) number was recognized over the period. The United States was the most productive country with 253 (44.2%) articles. The RED Journal had the highest number of publications (14%) and citations (19%). Urology journals published (P=0.01) and cited significantly less than radiation oncology journals (P=0.01). All open access and non–open access number of publications increased over time, with a significant difference between non–open access and open access journals (P<0.0001). Two author clusters were identified, in the United States with the collaboration of Canadian and British authors, and in Italy with the participation of European authors.

Conclusion:

The number of publications and citations on SBRT for prostate cancer has grown linearly in the last decades. The United States is the leading country in this research field, and the use of SBRT in oligometastatic disease, reirradiation, and salvage seems to be hot topics in this research field.
EFFICACY AND SAFETY OF AFLIBERCEPT FOR THE TREATMENT OF IDIOPATHIC CHOROIDAL NEOVASCULARIZATION IN YOUNG PATIENTS
Authors: Kodjikian Laurent , Tadayoni Ramin , Souied Eric H. , Baillif Stéphanie , Milazzo Solange , Dumas Stéphane , Uzzan Joël , Bernard Lorraine , Decullier Evelyne , Huot Laure , Mathis Thibaud
Published: October 2021

Purpose:

To evaluate the mean change in visual acuity at 52 weeks in patients with idiopathic choroidal neovascularization treated with aflibercept.

Methods:

We conducted a prospective noncomparative open-label Phase-II trial. The dosage regimen evaluated in this study was structured into two periods: (1) from inclusion to 20 weeks: a treat-and-extend period composed of three mandatory intravitreal injections, and complementary intravitreal injections performed if needed; (2) from 21 weeks to 52 weeks: a pro re nata period composed of intravitreal injections performed only if needed.

Results:

A total of 19 patients were included, and 16 completed the 52-week study. At baseline, the mean best corrected visual acuity was 66.56 (±20.72) letters (≈20/50 Snellen equivalent), and the mean central retinal thickness was 376.74µm (±93.77). At 52 weeks, the mean change in the best-corrected visual acuity was +19.50 (±19.36) letters [95% confidence interval = +9.18 to +29.82]. None of the patients included lost ≥15 letters at 24 weeks or 52 weeks. The mean change in central retinal thickness was −96.78µm (±104.29) at 24 weeks and −86.22µm (±112.27) at 52 weeks. The mean number of intravitreal injections was 5.4 (±3.0) at 52-weeks. No ocular serious adverse events related to the treatment were reported.

Conclusion:

The present analysis shows clinically significant functional and anatomical treatment effect of aflibercept in case of idiopathic choroidal neovascularization. The treat-and-extend regimen proposed after the first injection seems adequate to treat most neovessels.
NONPARANEOPLASTIC AUTOIMMUNE RETINOPATHY VERSUS PERICENTRAL RETINAL DEGENERATION PHENOTYPE: WHICH CAME FIRST? A CASE REPORT
Authors: Garcia Cristina M. , Maleki Arash , Look-Why Sydney , Manhapra Ambika , Durrani Khayyam , Foster Charles S.
Published: October 2021

Purpose:

To report a case of nonparaneoplastic autoimmune retinopathy with phenotypical features of pericentral retinal degeneration (PRD) who responded to IV immunoglobulin therapy.

Methods:

A case report. A 27-year-old man presented with recent subacute progressive nyctalopia and photopsia.

Results:

Dilated fundoscopy demonstrated confluent yellow–white patches along the main temporal vascular arcades with sparing of the central island in the posterior pole. Color vision, fundus autofluorescence, fluorescein angiography, static visual field, and electroretinographic studies were inconclusive for retinal degeneration. Subsequent genetic testing for known mutations was negative. Workup for paraneoplastic autoimmune retinopathy was negative. Antiretinal antibodies were positive. The patient was diagnosed with nonparaneoplastic autoimmune retinopathy and was treated with IV immunoglobulin, which resulted in objective and subjective improvement on electroretinography, visual field, and optical coherence tomography of the retina.

Conclusion:

Nonparaneoplastic autoimmune retinopathy may present in a patient with the clinical phenotype of PRD. It is essential to rule out nonparaneoplastic autoimmune retinopathy in patients with subacute changes in the natural course of pericentral retinal degeneration because treatment with IV immunoglobulin may be helpful.
Adverse Lifelong Experiences in Portuguese People Living With HIV: A Retrospective Study
Authors: Gonçalves Mariana , Maia Ângela
Published: October 2021

This study aimed to analyze the adverse life experiences encountered by people living with HIV in Portugal, analyze differences between men and women, and identify which experiences were related to HIV transmission modes—sexual activity or injection drug use. We used a sample of 328 participants with a mean age of 45.64, mostly men (79.6%), with a known diagnosis of HIV for 10.34 years. Women and persons who inject drugs reported significantly more adverse outcomes throughout life. Physical abuse during childhood was significantly associated with the sexual transmission mode, whereas having a parent sent to prison during childhood, physical violence, experiencing a life-threatening injury/illness (other than HIV) during adulthood, and injuring someone during adulthood were associated with injection drug use. Practical implications are discussed at the prevention and intervention levels.
A Retrospective Cohort Analysis of the Impact of Osteoarthritis on Disability Leave, Workers’ Compensation Claims, and Healthcare Payments
Authors: Thakkar Sheena , Gifford Brian , Sell Heather , Schepman Patricia , Robinson Rebecca , Emir Birol
Published: October 2021

Objectives:

Examine short-term disability (STD) and workers’ compensation (WC) associated leave and wage replacements, and overall direct healthcare payments, among employees with osteoarthritis (OA) versus other chronically painful conditions; quantifying the impact of opioid use.

Methods:

Analysis of employees with more than or equal to two STD or WC claims for OA or pre-specified chronically painful conditions (control) in the IBM MarketScan Research Databases (2014 to 2017).

Results:

The OA cohort (n = 144,355) had an estimated +1.2 STD days, +$152 STD payments, and +$1410 healthcare payments relative to the control cohort (n = 392,639; P < 0.001). WC days/payments were similar. Differences were partially driven by an association between opioid use, increased STD days/payments, and healthcare payments observed in pooled cohorts (P < 0.001).

Conclusions:

OA is associated with high STD days/payments and healthcare payments. Opioid use significantly contributes to these and this should be considered when choosing treatment.
Novel Modification of Impella Sheath to Prevent Limb Ischemia
Authors: Mallikethi-Reddy Sagar , Khan Mahin R. , Khan Hafiz , Munir Ahmad , Moza Ankush
Published: October 2021

Limb ischemia is a dreaded complication of large-bore access during prolonged Impella support. We report a novel technique to modify 14F Impella sheath by creating two perfusion holes in the dorsal sheath surface to enable distal limb perfusion via dead space surrounding 9F Impella catheter in flow-occlusive iliofemoral arteries.
Low attenuation plaque volume on coronary computed tomography angiography is associated with plaque progression
Authors: Wang Guang-xian , Yang Ling , Yang Yan , Zhang Dong , Yu Jie , Wen Li
Published: October 2021

Background

Patient-related clinical factors, laboratory factors, and some imaging factors may lead to statistical bias when investigating coronary plaque progression. In this study, we avoided patient characteristics by comparing morphological characteristics of plaque progression and nonprogression within the same patient with multiple plaques.

Methods

From August 2011 to December 2018, 177 consecutive patients with 424 plaques who were followed with coronary computed tomography angiography (CTA) were reviewed retrospectively. Follow-up images of the plaques were used to determine whether the plaque volume or stenosis grade increased. The plaques were divided into progressive and nonprogressive groups. Logistic regression analysis was used to identify the factors associated with plaque progression. Through clinical follow-up, we analyzed whether the factors associated with plaque progression were related to major adverse cardiac events (MACEs).

Results

There were 223 plaques that progressed during a mean follow-up period of 27.6 ± 15.9 months. The univariate logistic regression model revealed that only low attenuation plaque (LAP) volume (P = 0.02) was associated with plaque progression. After a mean post-CTA follow-up period of 36.7 ± 18.4 months, 37 patients experienced MACEs, and LAP volume was significantly related to future MACEs.

Conclusion

Only a high baseline LAP volume was associated with plaque progression, and patients with progressive plaques and a high LAP volume were more likely to have future MACEs. More attention should be given to plaques with LAP volumes larger than 2.4 mm3.
Factors associated with cyberbullying among vocational students based on the ecological system model in an ethnic minority area
Authors: Zhou Li , Li Chunyu
Published: October 2021

This study aimed to investigate the current situation of youth cyberbullying (CB) in an ethnic minority area in China and the socio-ecological factors influencing it to provide a scientific basis for the development of health education and improved decision-making for youth in these areas.

The cluster sampling method was adopted to conduct a questionnaire survey of 2156 students from 2 vocational high schools in Yanbian Korean Autonomous Prefecture in December 2019. SPSS 22.1 statistical software was used for data analysis.

CB among vocational school students in the Yanbian Korean Autonomous Prefecture is relatively common, with 51.62% of the participants reporting having bullied someone and 68.65% reporting having been bullied online. The rate of CB perpetration and victimization among adolescents in minority areas is affected by individuals, family, peer factors, and school climate.

The phenomenon of vocational high school student CB in ethnic minority areas is affected by personal, familial, interpersonal, and school environments. It is recommended that the individual and social-ecological factors in which adolescent CB interventions are formulated in the future be comprehensively considered.
The mediating role of self-acceptance in the relationship between loneliness and subjective well-being among the elderly in nursing home
Authors: Li Shanshan , Zhang Xing , Luo Caifeng , Chen Moyan , Xie Xin , Gong Fuyu , Lv Fei , Xu Jianou , Han Juan , Fu Lin , Sun Yanpeng
Published: October 2021

The purpose of this study was to investigate the mediating effects of self-acceptance on loneliness and subjective well-being (SWB) among elderly subjects living in Chinese nursing homes.

This cross-sectional study was conducted between October 2019 and March 2020. A total of 415 elderly participants aged 60 to 97 years (mean 81.12 ± 8.90 years) from 3 medical and nursing homes in Fuyang city, Anhui province, were selected using a convenience sampling method. Data were collected using a general information questionnaire, the Memorial University of Newfoundland Scale of Happiness, the self-acceptance scale, and the UCLA Loneliness scale. Correlations, regressions, and structural equation models were used for the analyses. Multiple linear regression analysis was performed to confirm the factors influencing the SWB. Bootstrapping was performed to confirm the mediation effect.

The loneliness of elderly subjects in nursing homes was significantly correlated with self-acceptance and SWB (r = −0.338, P < .01; r = −0.383, P < .01), and self-acceptance was significantly correlated with SWB (r = 0.401, P < .01). Multiple linear regression revealed that the relationship with children, loneliness, residence time in nursing homes, income, marital status, self-acceptance, original residence, and frequency of children's visits were the main factors affecting SWB. Bootstrapping showed that the mediating role of self-acceptance was statistically significant.

The SWB of elderly individuals living in Chinese nursing homes was moderate. Low-income people, subjects from rural areas, and those newly admitted to nursing homes should be emphasized in interventions, and appropriate measures should be taken to harmonize the relationships between elderly residents and their children. Self-acceptance partially mediated the relationship between loneliness and SWB. Consequently, self-acceptance should be the focus of improving the SWB of elderly nursing home residents.
Traditional Chinese medicine as an adjunctive therapy for mild and common COVID-19
Authors: Wu Xiaozheng , Li Wen , Qin Zhong , Xue Lei , Huang Gao , Luo Zhenliang , Chen Yunzhi
Published: October 2021

Background:

Coronavirus disease 2019 (COVID-19) in many countries is still very serious. At present, there is no specific and effective drug for this disease. Traditional Chinese medicine (TCM) has played a great role in fighting against COVID-19. However, their effectiveness and safety are still obscure and deserve further investigation. The aim of the study was to evaluate the efficacy and safety of TCM assisted in conventional treatment in the treatment of mild and common COVID-19.

Methods:

PubMed, EMbase, MEDLINE, China National Knowledge Infrastructure Database, WANFANG DATA, and VIP Chinese Science and Technology Periodical Database were searched for randomized controlled trials (RCTs) and non-randomized controlled trials of TCM assisted in conventional treatment. The RCT research quality was evaluated by Cochrane 5.1.0 bias risk scale and the non-randomized controlled trial research quality was evaluated by Newcastle Ottawa scale, and the statistical analysis was conducted by Revman 5.3 and R software. The bias and sensitivity of the statistical results were analyzed by STATA 14.0. Registration number: CRD42020210619.

Results:

Fifteen studies were included with 7 RCT studies and 8 retrospective cohort studies, involving a total of 1623 patients. Compared with the control group, TCM can improve the main index clinical effective rate (odds ratio [OR] = 2.64, 95% Confidence interval (CI) [1.94,3.59], P < .00001). The results of Begg test (Pr > z = 0.266) and sensitivity analysis showed that the results were relatively stable. Toujie Quwen (OR = 4.9, 95%CI [1.9,14.0]), Shufeng Jiedu (OR = 2.9, 95%CI [1.5,5.7]), and Lianhua Qingwen (OR = 2.4, 95%CI [1.6,3.6]) were with the best. It can also improve the main clinical symptoms (fever, cough, fatigue, and the regression time of the 3 symptoms), severe conversion rate, and computed tomography improvement rate. Its safety was not significantly compared with conventional treatment. However, in terms of safety of a single TCM, Shufeng Jiedu (OR = –0.86, 95%CI [–1.89,0.09]) and Lianhua Qingwen (OR = –0.49, 95%CI[–0.94,–0.05]) were lower than those of conventional treatment.

Conclusion:

TCM as an adjuvant therapy combined with conventional treatment has good curative effect on mild and common type of COVID-19 patients. Its advantages lie in clinical efficacy and improvement of symptom group, and can prevent patients from transforming to severe disease. In terms of clinical efficacy and safety, Shufeng Jiedu and Lianhua Qingwen have obvious advantages, which are worthy of clinical promotion.
A comparative approach to quantifying provision of acute therapy services
Authors: Capo-Lugo Carmen E. , Askew Robert L. , Boebel Matthew , DeLeo Christine , Deutsch Anne , Heinemann Allen
Published: October 2021

This study aims to compare delivery of acute rehabilitation therapy using metrics reflecting distinct aspects of rehabilitation therapy services. Seven general medical-surgical hospitals in Illinois and Indiana prospectively collected rehabilitation therapy data. De-identified data on all patients who received any type of acute rehabilitation therapy (n = 35,449) were extracted and reported as aggregate of minutes of therapy services per discipline. Metrics included therapy types, total minutes, and minutes per day (intensity), as charted by therapists. Extended hospital stay was defined as a length of stay (LOS) longer than Medicare's geometric mean LOS. Discharge destination was coded as postacute care or home discharge. Substantial variability was observed in types, number of minutes, and intensity of therapy services by condition and hospital. The odds of an extended hospital stay increased with increased number of minutes, increased number of therapy types, and decreased with increased rehabilitation intensity. This comparative approach to assessing provision of acute therapy services reflect differential effects of service provision on LOS and discharge destination. Investigators, policymakers, and hospital administrators should examine multiple metrics of rehabilitation therapy provision when evaluating the impact of health care processes on patient outcomes.
Mediating role of instrumental activities of daily living ability on cognitive function of older adults living alone
Authors: Fujii Keisuke , Fujii Yuya , Kitano Naruki , Sato Ayane , Hotta Kazushi , Okura Tomohiro
Published: October 2021

The aim of this study was to clarify the effect of living alone on the cognitive function of older people and the mediating effect of instrumental activities of daily living (IADL) ability.

The data for a final sample of 3276 participants aged 65 years and above who did not require long-term care at the baseline were used from a 4-year prospective cohort study conducted in Kasama City, Japan. Demographic data including age, sex, and depression at baseline were used as covariates. The Kihon checklist evaluated the IADL ability at baseline and cognitive function at follow-up. The characteristics of those living alone and with others were compared using the student t test and χ
2 test. The effect of living alone on cognitive function was analyzed using logistic regression analysis. Mediation analyses determined the mediating effects of IADL.

A total of 325 participants were living alone; they were significantly older than those living with others, more likely to be female, not provide emotional support, and have low physical function, more severe depression, and lower IADL disability. Living alone had a significantly lower risk of cognitive decline at follow-up than living with others. The mediation analysis revealed that IADL disability at follow-up was significantly associated with cognitive decline. Thus, greater IADL ability decreased cognitive decline risk.

Older people living alone had a significantly lower risk of cognitive decline, and cognitive function significantly mediated IADL ability. Health support for enhancing IADL abilities may help older people living alone maintain good cognitive function.
Changes in serum uric acid levels as a predictor of future decline in renal function in older adults with type 2 diabetes
Authors: Shibata Yusuke , Yamazaki Masanori , Kitahara Junichiro , Okubo Yosuke , Oiwa Ako , Sato Ai , Komatsu Mitsuhisa
Published: October 2021

Given that factors affecting renal function remain unknown, this study aimed to identify key predictors of estimated glomerular filtration rate (eGFR) deterioration, which is a representative of renal function decline in older adults with type 2 diabetes (T2DM). In an exploratory prospective observational study, we enrolled 268 Japanese people with T2DM aged ≥20 years who were followed up at Shinshu University Hospital. Among those, 112 eligible individuals aged ≥65 years were included in the present study. Factors associated with 3-year changes in eGFR (ΔeGFR) and eGFR deterioration (ΔeGFR < 0) were identified using bivariate and multivariable analyses. Regarding baseline values of the subjects, the mean age was 73.5 years, mean blood pressure was 131/74 mm Hg, mean hemoglobin A1c was 7.1%, mean eGFR was 62.0 mL/min/1.73 m2, mean urinary albumin excretion was 222.6 mg/gCre, and mean serum uric acid (UA) was 5.5 mg/mL. In bivariate analysis, the 3-year change in UA (ΔUA) levels was significantly correlated with ΔeGFR (r = −0.491, P < .001), but the baseline UA was not (r = 0.073, P = .444). Multiple linear regression analysis revealed that ΔUA was a significant negative predictor of ΔeGFR in the model that included sex, age, body mass index, serum albumin, and ΔUA as explanatory variables. Moreover, multiple logistic regression analysis demonstrated that ΔUA had a positive association with ΔeGFR <0 (odds ratio 2.374; 95% confidence interval 1.294–4.357). Thus, future renal function decline can be predicted by ΔUA but not by baseline UA in older adults with T2DM. Further research is needed to determine whether lowering the serum UA level can prevent eGFR decline.
The impact of COVID-19 on mentoring early-career investigators
Authors: Johnson Mallory O. , Gandhi Monica , Fuchs Jonathan D. , Sterling Lauren , Sauceda John A. , Saag Michael S. , Riley Elise D. , Sevelius Jae M.
Published: October 2021

The COVID-19 pandemic disrupted almost all sectors of academic training and research, but the impact on human immunodeficiency virus (HIV) research mentoring has yet to be documented. We present the perspectives of diverse, experienced mentors in a range of HIV research disciplines on the impact of COVID-19 on mentoring the next generation of HIV researchers.

In November to December, 2020, we used an online data collection platform to cross-sectionally query previously-trained HIV mentors on the challenges related to mentoring during the pandemic, surprising/positive aspects of mentoring in that context, and recommendations for other mentors. Data were coded and analyzed following a thematic analysis approach.

Respondents (180 of 225 mentors invited [80% response]) reported challenges related to relationship building/maintenance, disruptions in mentees’ training and research progress, and mentee and mentor distress, with particular concerns regarding mentees who are parents or from underrepresented minority backgrounds. Positive/surprising aspects included logistical ease of remote mentoring, the relationship-edifying result of the shared pandemic experience, mentee resilience and gratitude, and increased enjoyment of mentoring. Recommendations included practical tips, encouragement for patience and persistence, and prioritizing supporting mentees’ and one's own mental well-being.

Findings revealed gaps in HIV mentors’ competencies, including the effective use of remote mentoring tools, how to work with mentees in times of distress, and the prioritization of mentor well-being. Mentors are in a unique position to identify and potentially address factors that may lead to mentees leaving their fields, especially parents and those from underrepresented backgrounds. We discuss implications beyond the COVID-19 pandemic.
Vasodilator agents improve hemodialysis vascular access patency
Authors: Kim Do Hyoung , Han Donghoon , Kim Jaehwan , Park Hayne Cho , Lee Young-Ki , Shin Dong Geum , Kang Min-Kyung , Cho Jung Rae , Choi Seonghoon , Lee Namho
Published: October 2021

Vascular access (VA) failure is an important problem for patients undergoing hemodialysis, and maintaining VA patency is challenging. In this study, we used a nationwide database to investigate the effects of nitrate, as a vasodilator, on VA failure in hemodialysis patients.

We investigated the Korean insurance claims data of hemodialysis patients who underwent angioplasty for VA failure between January 2012 and December 2017. The patients were divided into 2 groups: those not receiving vasodilator therapy (controls) and those receiving any vasodilator administration (vasodilator treatment, VDT). The primary endpoint was VA primary patency, defined as the time between arteriovenous dialysis access creation and the first percutaneous transluminal angioplasty (PTA).

During the study period, a total of 6350 patients were recruited, 409 (6.4%) patients assigned to the VDT group and 5941 (93.6%) controls. PTA was performed in 998 patients (15.7%), including 8 in the VDT group and 990 controls. The VA site PTA rate was significantly lower in the VDT group (2.0%) than in the control group (16.7%, P < .001). In the subgroup analysis, the patency rates associated with the different vasodilators were similar (P = .736). All vasodilators, except molsidomine, improved the patency rate by approximately 20%.

In this large national database study, vasodilator administration was associated with higher VA primary patency, compared with controls, in hemodialysis patients. VDT may have a beneficial effect on maintaining VA patency in patients undergoing hemodialysis.
Metachronous small bowel adenocarcinoma after rectal adenocarcinoma
Authors: Zhen Ya’nan , Li Jianqi , Wang Ruogu , Lu Shoutang , Zhou Yongshun , Xiao Ruixue
Published: October 2021

Rationale:

Small bowel adenocarcinoma (SBA), an uncommon gastrointestinal malignant tumor, is difficult to diagnose at an early stage because of its non-specific disease presentation. Metachronous SBA is a special type of SBA that is rarely reported. We herein report a case of metachronous primary SBA following resection of rectal adenocarcinoma.

Patient concerns:

A 65-year-old man presented to our hospital after having experienced recurrent bowel obstruction for 6 months. He had undergone a Dixon operation 30 months previously followed by adjuvant chemotherapy with capecitabine plus oxaliplatin.

Diagnosis:

Abdominal computed tomography showed thickened bowel walls in the right lower abdomen, and the patient was initially misdiagnosed with intestinal adhesion. After the operation, he was diagnosed with primary SBA (T3N0M0, stage IIA).

Interventions:

Treatment with a transnasal ileus tube was ineffective. Therefore, we performed small intestinal segmental resection and side-to-side anastomosis through open surgery.

Outcomes:

The patient completed all postoperative adjuvant chemotherapy, and posttreatment surveillance revealed no further abnormalities.

Lessons:

This case suggests that patients with colorectal adenocarcinoma may have an increased risk of metachronous SBA. Corresponding symptoms in high-risk patients should raise clinicians’ suspicion for SBA, and further detailed examinations are imperative. Early screening for SBA may help to improve the patients’ prognosis.
Management of chronic rhinosinusitis with nasal polyps in Samter triad by low-dose ASA desensitization or dupilumab
Authors: Bertlich Mattis , Ihler Friedrich , Bertlich Ines , Weiss Bernhard G. , Gröger Moritz , Haubner Frank
Published: October 2021

Samter triad is a chronic condition where patients suffer from intolerance to aspirin, recurring nasal polyposis and bronchial asthma. Causative treatment is often hard. Potential approaches are the daily intake of acetylsalicylic acid (ASA), shunting arachidonic acid into the lipoxygenase pathway, and a subsequent habituation to this constant inflammatory stimulus. Alternatively, the paramount interleukins 4 and 13 may be antagonized by the monoclonal antibody dupilumab. Hence, we evaluated the daily intake of 100 mg ASA and systemic dupilumab (300 mg s.c. every 2 weeks) therapy in refractory patients for its efficacy and compliance.

We conducted a retrospective chart review for the efficacy and compliance of both continuous ASA desensitization and systemic dupilumab therapy for refractory patients.

Thirty-one patients were included in this retrospective chart review, mean follow-up was 20.4 ± 15.7 months. All patients underwent ASA desensitization. Twenty-one patients had eventually discontinued therapy after 5.8 ± 4.5 months; 11 for its side effects, 12 for its inefficacy. Twenty patients developed sinunasal complaints soon thereafter. Ten patients were still undergoing desensitization (mean duration 15.3 ± 15.7 months). These patients had a higher prevalence of concomitant anti-asthmatic medication. Seventeen refractory patients underwent systemic dupilumab therapy. After 6.4 ± 2.7 months of treatment, sinunasal outcome test (68.1 ± 13.9 vs 20.1 ± 13.9) and visual analogue scales of overall complaints (8.7 ± 0.9 vs 2.2 ± 1.5) as well as endoscopic findings and olfactory function (brief smell identification test; 3.5 ± 2.6 vs 8.6 ± 2.4) all improved significantly.

A considerable number of patients with Samter triad discontinued ASA desensitization, equally for ineffectiveness or side effects. If desensitization is to be effective, special care needs to be taken in respect to concomitant anti-asthmatic medication. Dupilumab is highly effective and safe in treating refractory patients.