bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring Social Support Networks and Interactions of Young Adult and LGBTQIA+ Cancer Survivors and Care Partners
Authors: Cloyes Kristin G. , Guo Jia-Wen , Tennant Karrin E. , McCormick Rachael , Mansfield Kelly J. , Wawrzynski Sarah E. , Classen Sarah C. , Jones Eric C. , Reblin Maija
Published: April 2022

Purpose

The purpose of this study was to describe the social support networks and daily support interactions of cancer-affected individuals, including young adult (YA) and LGBTQIA+ survivors and care partners.

Methods

Participants were recruited at two United States cancer centers and via social media for a pilot study testing a novel online method for collecting prospective, daily social support interaction data (N=28). All participants were aged 18+; survivors had a current or recent cancer diagnosis and were engaged in treatment and/or services; care partners were identified by the survivors. Enrollment also purposefully targeted YA and LGBTQIA+ survivors. Social network data (up to 10 members) were assessed at baseline. Daily online surveys assessed support interactions between participants and specific network members over 14 days. Descriptive statistics summarized data and explored between-group (YA/non-YA, LGBTQIA+/non-LGBTQIA+) differences in social network characteristics (size, heterogeneity, density, centralization, cohesion) and support interactions (support source and type).

Results

There were no significant differences between YA and non-YA participants on any measures. LGBTQIA+ participants’ support networks were less dense (Mdn=0.69 vs. 0.82, p=.02), less cohesive (Mdn=0.85 vs. 0.91,.02), more centered on the participant (Mdn=0.40 vs. 0.24, p=.047), and included more LGBTQIA+ members (Mdn=0.35 vs. 0.00, p<.001). LGBTQIA+ participants reported having more interactions with LGBTQIA+ network members (Mdn=14.0 vs. Mdn=0.00, p<.001) and received significantly more of all types of support from LGBTQIA+ vs. non-LGBTQIA+ members. LGBTQIA+ participants also reported receiving more appraisal support than non-LGBTQIA+ (Mdn 21.64 vs. 9.12, p=.008) including more appraisal support from relatives (Mdn=11.73 vs 6.0, p+.037).

Conclusions

Important information related to support access, engagement, and needs is embedded within the everyday contexts of the social networks of cancer-affected people. Individualized, accessible, and prospective assessment could help illuminate how their “real world” support systems are working and identify specific strengths and unmet needs. These insights would inform the development of more culturally competent and tailored interventions to help people understand and leverage their unique support systems. This is particularly critical for groups like YA and LGBTQIA+ survivors and care partners that are underserved by formal support services and underrepresented in cancer, caregiving, and social support research.
PI-RADS v2.1 Combined With Prostate-Specific Antigen Density for Detection of Prostate Cancer in Peripheral Zone
Authors: Wen Jing , Tang Tingting , Ji Yugang , Zhang Yilan
Published: April 2022

Purpose

To evaluate the diagnostic performance of combining the Prostate Imaging Reporting and Data System (PI-RADS) scoring system v2.1 with prostate-specific antigen density (PSAD) to detect prostate cancer (PCa).

Methods

A total of 266 participants with suspicion of PCa underwent multiparametric magnetic resonance imaging (mpMRI) in our hospital, after at least 4 weeks all patients underwent subsequent systematic transrectal ultrasound (TRUS)-guided biopsy or MRI-TRUS fusion targeted biopsy. All mpMRI images were scored in accordance with the PI-RADS v2.1, and univariate and multivariate logistic regression analyses were performed to determine significant predictors of PCa.

Results

A total of 119 patients were diagnosed with PCa in the biopsy, of them 101 patients were diagnosed with clinically significant PCa. The multivariate analysis revealed that PI-RADS v2.1 and PSAD were independent predictors for PCa. For peripheral zone (PZ), the area under the ROC curve (AUC) for the combination of PI-RADS score and PSAD was 0.90 (95% CI 0.83-0.96), which is significantly superior to using PI-RADS score (0.85, 95% CI 0.78-0.93, P=0.031) and PSAD alone (0.83, 95% CI 0.75-0.90, P=0.037). For transition zone (TZ), however, the combination model was not significantly superior to PI-RADS alone, with AUC of 0.94 (95% CI 0.89-0.99) vs. 0.93 (95% CI 0.88-0.97, P=0.186).

Conclusion

The combination of PI-RADS v2.1 with PSAD could significantly improve the diagnostic performance of PCa in PZ. Nevertheless, no significant improvement was observed regarding PCa in TZ.
On the Relationship Between Pain Variability and Relief in Randomized Clinical Trials
Authors: Tiwari Siddharth R. , Vigotsky Andrew D. , Apkarian A. Vania
Published: April 2022

Previous research reports suggest greater baseline variability is associated with greater pain relief in those who receive a placebo. However, studies that evidence this association do not control for confounding effects from regression to the mean and natural history. In this report, we analyzed data from two randomized clinical trials (Placebo I and Placebo II, total N = 139) while adjusting for the effects of natural history and regression to the mean via a no treatment group. Results agree between the two placebo groups in each study: both placebo groups showed negligible semi-partial correlations between baseline variability and adjusted response [rsp (CI95%) = 0.22 (0.03, 0.42) and 0 (−0.07, 0.07) for Placebo I and II, respectively]. The no treatment group in Placebo I showed a negative correlation [−0.22 (−0.43, −0.02)], but the no treatment and drug groups in Placebo II's correlations were negligible [−0.02 (−0.08, 0.02) and 0.00 (−0.10, 0.12) for the no treatment and drug groups, respectively]. When modeled as a linear covariate, baseline pain variability accounted for <1% of the variance in post-intervention pain across both studies. Even after adjusting for baseline pain and natural history, the inability of baseline pain variability to account for substantial variance in pain response highlights that previous results concerning pain variability and treatment response may be inconsistent. Indeed, the relationship appears to be neither consistently specific nor sensitive to improvements in the placebo group. More work is needed to understand and establish the prognostic value of baseline pain variability—especially its placebo specificity and generalizability across patient populations.
Pearls and Pitfalls in Pediatric Kidney Transplantation After 5 Decades
Authors: Oomen Loes , Bootsma-Robroeks Charlotte , Cornelissen Elisabeth , Wall Liesbeth de , Feitz Wout
Published: April 2022

Worldwide, over 1,300 pediatric kidney transplantations are performed every year. Since the first transplantation in 1959, healthcare has evolved dramatically. Pre-emptive transplantations with grafts from living donors have become more common. Despite a subsequent improvement in graft survival, there are still challenges to face. This study attempts to summarize how our understanding of pediatric kidney transplantation has developed and improved since its beginnings, whilst also highlighting those areas where future research should concentrate in order to help resolve as yet unanswered questions. Existing literature was compared to our own data of 411 single-center pediatric kidney transplantations between 1968 and 2020, in order to find discrepancies and allow identification of future challenges. Important issues for future care are innovations in immunosuppressive medication, improving medication adherence, careful donor selection with regard to characteristics of both donor and recipient, improvement of surgical techniques and increased attention for lower urinary tract dysfunction and voiding behavior in all patients.
Lung Ultrasound Characteristics in Neonates With Positive Real Time Polymerase Chain Reaction for SARS-CoV-2 on a Tertiary Level Referral Hospital in Mexico City
Authors: Ibarra-Ríos Daniel , Enríquez-Estrada Andrea Constanza , Serpa-Maldonado Eunice Valeria , Miranda-Vega Ana Luisa , Villanueva-García Dina , Vázquez-Solano Edna Patricia , Márquez-González Horacio
Published: April 2022

Introduction

Acute respiratory syndrome secondary to SARS-CoV-2 virus infection has been declared a pandemic since December 2019. On neonates, severe presentations are infrequent but possible. Lung ultrasound (LUS) has been shown to be useful in diagnosing lung involvement and following up patients, giving more information, and reducing exposure compared to traditional examination.

Methods

LUS was performed after the diagnosis of SARS-CoV-2 infection with respiratory Real Time Polymerase Chain Reaction RT-PCR with portable equipment protected with a silicone sleeve. If hemodynamic or cardiology consultation was necessary, a prepared complete ultrasound machine was used. Ten regions were explored (anterior superior and inferior, lateral, and posterior superior and inferior, right and left), and a semiquantitative score (LUSS) was calculated. Disease severity was determined with a pediatric modified score.

Results

Thirty-eight patients with positive RT-PCR were admitted, 32 (81%) of which underwent LUS. Included patients had heterogenous diagnosis and gestational ages as expected on a referral neonatal intensive care unit (NICU) (median, ICR: 36, 30–38). LUS abnormalities found were B-line interstitial pattern 90%, irregular/interrupted/thick pleural line 88%, compact B-lines 65%, small consolidations (≤5 mm) 34%, and extensive consolidations (≥5 mm) 37%. Consolidations showed posterior predominance (70%). LUSS showed a median difference between levels of disease severity and ventilatory support (Kruskal–Wallis, p = 0.001) and decreased with patient improvement (Wilcoxon signed-rank test p = 0.005). There was a positive correlation between LUSS and FiO2 needed (Spearman r = 0.72, p = 0.01). The most common recommendation to the attending team was pronation (41%) and increase in positive end expiratory pressure (34%). Five patients with comorbidities died. A significant rank difference of LUSS and FiO2 needed between survivors and non-survivors was found (Mann–Whitney U-test, p = 0.005).

Conclusion

LUS patterns found were like the ones described in other series (neonatal and pediatrics). Eighty-eight percent of the studies were performed with handheld affordable equipment. While there is no specific pattern, it varies according to gestational age and baseline diagnosis LUS, which were shown to be useful in assessing lung involvement that correlated with the degree of disease severity and respiratory support.
Antidepressant Potential of Quercetin and its Glycoside Derivatives: A Comprehensive Review and Update
Authors: Chen Shen , Tang Yueheng , Gao Yang , Nie Kexin , Wang Hongzhan , Su Hao , Wang Zhi , Lu Fuer , Huang Wenya , Dong Hui
Published: April 2022

Depression is a global health problem with growing prevalence rates and serious impacts on the daily life of patients. However, the side effects of currently used antidepressants greatly reduce the compliance of patients. Quercetin is a flavonol present in fruits, vegetables, and Traditional Chinese medicine (TCM) that has been proved to have various pharmacological effects such as anti-depressant, anti-cancer, antibacterial, antioxidant, anti-inflammatory, and neuroprotective. This review summarizes the evidence for the pharmacological application of quercetin to treat depression. We clarified the mechanisms of quercetin regulating the levels of neurotransmitters, promoting the regeneration of hippocampal neurons, improving hypothalamic-pituitary-adrenal (HPA) axis dysfunction, and reducing inflammatory states and anti-oxidative stress. We also summarized the antidepressant effects of some quercetin glycoside derivatives to provide a reference for further research and clinical application.
Co-Expression Networks Unveiled Long Non-Coding RNAs as Molecular Targets of Drugs Used to Treat Bipolar Disorder
Authors: Truong Trang TT. , Bortolasci Chiara C. , Spolding Briana , Panizzutti Bruna , Liu Zoe SJ. , Kidnapillai Srisaiyini , Richardson Mark , Gray Laura , Smith Craig M. , Dean Olivia M. , Kim Jee Hyun , Berk Michael , Walder Ken
Published: April 2022

Long non-coding RNAs (lncRNAs) may play a role in psychiatric diseases including bipolar disorder (BD). We investigated mRNA-lncRNA co-expression patterns in neuronal-like cells treated with widely prescribed BD medications. The aim was to unveil insights into the complex mechanisms of BD medications and highlight potential targets for new drug development. Human neuronal-like (NT2-N) cells were treated with either lamotrigine, lithium, quetiapine, valproate or vehicle for 24 h. Genome-wide mRNA expression was quantified for weighted gene co-expression network analysis (WGCNA) to correlate the expression levels of mRNAs with lncRNAs. Functional enrichment analysis and hub lncRNA identification was conducted on key co-expressed modules associated with the drug response. We constructed lncRNA-mRNA co-expression networks and identified key modules underlying these treatments, as well as their enriched biological functions. Processes enriched in key modules included synaptic vesicle cycle, endoplasmic reticulum-related functions and neurodevelopment. Several lncRNAs such as GAS6-AS1 and MIR100HG were highlighted as driver genes of key modules. Our study demonstrates the key role of lncRNAs in the mechanism(s) of action of BD drugs. Several lncRNAs have been suggested as major regulators of medication effects and are worthy of further investigation as novel drug targets to treat BD.
Non-Coding RNAs in Sepsis-Associated Acute Kidney Injury
Authors: Chen Yanna , Jing Huan , Tang Simin , Liu Pei , Cheng Ye , Fan Youling , Chen Hongtao , Zhou Jun
Published: April 2022

Sepsis is a systemic inflammatory response caused by a severe infection that leads to multiple organ damage, including acute kidney injury (AKI). In intensive care units (ICU), the morbidity and mortality associated with sepsis-associated AKI (SA-AKI) are gradually increasing due to lack of effective and early detection, as well as proper treatment. Non-coding RNAs (ncRNAs) exert a regulatory function in gene transcription, RNA processing, post-transcriptional translation, and epigenetic regulation of gene expression. Evidence indicated that miRNAs are involved in inflammation and programmed cell death during the development of sepsis-associated AKI (SA-AKI). Moreover, lncRNAs and circRNAs appear to be an essential regulatory mechanism in SA-AKI. In this review, we summarized the molecular mechanism of ncRNAs in SA-AKI and discussed their potential in clinical diagnosis and treatment.
Estimations of Critical Clear Corneal Incisions Required for Lens Insertion in Cataract Surgery: A Mathematical Aspect
Authors: Qi Nan , Lockington David , Wang Lei , Ramaesh Kanna , Luo Xiaoyu
Published: April 2022

In a routine cataract operation cornea tissue may be damaged when an intra-ocular lens (IOL) injector of diameter between 1.467 and 2.011 mm is inserted through an empirically designed 2.2 mm corneal incision. We aimed to model and estimate the minimal length of the incision required to avoid wound tear. It was assumed that the damage was caused by tissue fracture at the tips of the incision, and this fracture could be studied using damage and fracture mechanics. The criterion of the damage was caused by a tear governed by the critical energy release rate (ERR) Gc, which is tissue dependent. Analytical and numerical studies were both conducted indicating the possibility of a safe and effective incision in cataract surgery. Six commonly used IOL injection systems were examined. Our results suggested that the recommended 2.2 mm incision cannot be treated as a universal threshold. Quicker IOL insertion may reduce wound damage. It was also recommended to advance IOL injector via its minor axis, and to cut the tear preferably along the circumferential direction due to tissue orthotropy. This study provides useful information and a deeper insight into the potential for mechanical damage to the corneal wound in cataract surgery.
Influence of Leaf Age on the Scaling Relationships of Lamina Mass vs. Area
Authors: Jiao Yabing , Niklas Karl J. , Wang Lin , Yu Kexin , Li Yirong , Shi Peijian
Published: April 2022

Leaf lamina mass and area are closely correlated with the photosynthetic capacity and competitive ability of plants, whereas leaf age has been demonstrated to affect physiological processes such as photosynthesis. However, it remains unknown whether the lamina mass vs. area scaling relationship is influenced by leaf age, which is important for understanding plant adaptive strategies and, more broadly, resource utilization and growth. We measured the leaf functional traits of five leaf-age groups of Photinia × fraseri for a total of 1,736 leaves. ANOVA followed by Tukey’s honestly significant difference test was used to compare the functional traits among the five leaf-age groups. Reduced major axis regression protocols were used to fit the scaling relationship between lamina mass and area, and the bootstrap percentile method was used to compare the lamina mass vs. area scaling relationships among the leaf-age groups. Lamina area, and the ratio of lamina dry mass to lamina fresh mass increased with increasing leaf age. Lamina fresh mass per unit area, and lamina dry mass per unit area both exhibited a parabolic-like trend as leaf age increased, i.e., at the leaf maturation stage, it showed a slight but significant decline. The phenomenon called diminishing returns were confirmed by each of the five leaf-age groups, i.e., all of the numerical values of the scaling exponents of lamina mass vs. area were significantly greater than 1. There were significant differences in the scaling exponents of lamina mass vs. area for the leaves across different sampling times. The scaling exponents were lower at the early rapid growth stage, indicating a lower cost for increasing leaf area compared to the leaf maturation stage. These data are consistent with leaves undergoing a transition from resource acquisition to resource conservation in the process of their development and growth.
Multi-Omics Analysis Reveals That SlERF.D6 Synergistically Regulates SGAs and Fruit Development
Authors: Guo Hao , Mao Mengdi , Deng Yuan , Sun Lisong , Chen Ridong , Cao Peng , Lai Jun , Zhang Yueran , Wang Chao , Li Chun , Li Yiran , Bai Qunhang , Tan Tingting , Yang Jun , Wang Shouchuang
Published: April 2022

Steroidal glycoalkaloids (SGAs) are cholesterol-derived molecules that contribute to the pathogen defense in tomato but are toxic and considered to be antinutritional compounds to humans. APETALA2/Ethylene Responsive Factor (AP2/ERF) family transcription factors (TFs) play an indispensable role in various biological processes, such as plant growth and development, fruit ripening, biotic and abiotic stresses responses, and SGA biosynthesis. In this study, we identified 176 AP2/ERF genes that were domesticated or improved SlAP2/ERF in the tomato variome (Solanum lycopersicum) within either domestication or improvement sweeps, respectively. According to the RNA-sequencing data, 93 of the ERF genes with high transcriptional level (Transcripts Per Million, TPM > 1) belong to six clusters. Weighted gene co-expression network analysis (WGCNA) and metabolite-based genome-wide association study (mGWAS) analyses revealed that the expression level of the Solyc04g071770 (SlERF.D6) gene in the cluster six gradually increased as the fruit matured. Transient transformation verified that the overexpression of SlERF.D6 significantly promoted fruit ripening and regulated the expression of multiple genes in the SGA synthesis pathway, thereby affecting the SGA content of the fruit. Virus-induced gene silencing (VIGS) showed that the silencing of SlERF.D6 delayed fruit ripening and influenced the content of SGAs. Our data provide new insights into AP2/ERF TFs in tomato, offer a candidate TF for fruit development and steroidal glycoalkaloids, and provide new resources for tomato breeding and improvement.
Alpine Treeline Dynamics and the Special Exposure Effect in the Hengduan Mountains
Authors: Zou Fuyan , Tu Chengyi , Liu Dongmei , Yang Chaoying , Wang Wenli , Zhang Zhiming
Published: April 2022

Alpine treeline is highly sensitive to climate change, but there remains a lack of research on the spatiotemporal heterogeneity of treeline and their relationships with climate change at the landscape scale. We extracted positions of alpine treeline from high-resolution Google Earth images from three periods (2000, 2010, and 2020) and analyzed the elevation patterns and dynamics of treeline positions in the Hengduan Mountains. Based on the treeline positions in 2020, a buffer zone of 300 m is established as the treeline transition zone, and the changing trend of the fraction vegetation cover (FVC) from 2000 to 2020 and its relationship with climate are also analyzed. Due to the special geographical and climatic environment, the treeline in the Hengduan Mountains area is high in the middle but lower in the surrounding areas. We found that over the past 20 years, the treeline position did not change significantly but that the FVC increased in 80.3% of the treeline areas. The increase in FVC was related to the decrease in precipitation in the growing season. The results also revealed a special exposure effect on the alpine treeline in the Hengduan Mountains. Because of the lower treeline, isotherm position caused by the monsoon climate, the treeline position on south-facing slopes is lower than that on slopes with other exposures. Our results confirmed that the pattern and dynamics of the alpine treeline are driven by the regional monsoon climate regime.
Estimating the Impacts of Plant Internal Nitrogen Deficit at Key Top Dressing Stages on Corn Productivity and Intercepted Photosynthetic Active Radiation
Authors: Zhao Ben , Ata-Ul-Karim Syed Tahir , Duan Aiwang , Gao Yang , Lou He , Liu Zugui , Qin Anzhen , Ning Dongfeng , Ma Shoutian , Liu Zhandong
Published: April 2022

Accurate and timely appraisal of plant nitrogen (N) demand is imperative to regulate the canopy structure and corn production. The strength and time of plant N deficit can be quantified by critical N concentration. The study was aimed to analyze nitrogen nutrition index (NNI), nitrogen deficit content (NDC), plant nitrogen productivity (PNP), and a fraction of intercepted photosynthetic active radiation (FIPAR) across different N treatments and to develop NNI-NDC, NNI-PNP, NNI-FIPAR, NDC-PNP, and NDC-FIPAR relationships from V6 to V12 stages of corn to quantify the suitable PNP and FIPAR values under the optimal plant N condition. Four multi-N rates (0, 75, 90, 150, 180, 225, 270, and 300 kg N ha−1) field experiments were conducted with two cultivars of corn in Henan province of China. Results indicated that N fertilization affected yield, plant biomass, plant N content, and leaf area index. The values of NNI and NDC were from 0.54 to 1.28 kg ha−1and from −28.13 to 21.99 kg ha−1under the different treatments of N rate, respectively. The NDC and NNI showed significantly negative relationships from V6 to V12 stages. The values of PNP and FIPAR increased gradually with the crop growth process. The PNP values gradually declined while the FIPAR values of every leaf layer increased with the increase of N supply. The NDC-PNP and NNI-FIPAR relationships were significantly positive; however, the relationships between NNI-PNP and NDC-FIPAR were significantly negative during the vegetative period of corn. The coefficient of determination (R2) based on NNI was better than that on NDC. The FIPAR values were ~0.35, 0.67, and 0.76% at the upper, middle, and bottom of leaf layers, respectively, and PNP values were ~39, 44, and 51 kg kg−1at V6, V9, and V12 stages, respectively, when NNI and NDC values were equal to 1 and 0 kg ha−1, respectively. This study described the quantitative information about the effect of a plant's internal N deficit on plant N productivity and canopy light intercept. The projected results would assist in predicting the appropriate plant growth status during key N top-dressing stages of corn, which can optimize N application and improve N use efficiency.
Study on the Influence of Low-Price Bid Winning and General Subcontracting Management on the Unsafe Behavior Intention of Construction Workers
Authors: Yao Jinbao , Wu Zhaozhi , Wen Yanan , Peng Zixuan
Published: April 2022

In recent years, there are many reasons for the frequent safety accidents in the construction field. The most controversial and typical one that firmly correlated with China’s national condition is the low-price bid winning and the general subcontracting management, which probably have a great impact on the unsafe behavior intention of workers on the construction site. In order to figure out their internal relation, a quantitative statistical analysis of the unsafe behavior intentions of construction workers in the Beijing area was conducted through the on-site questionnaire considering three main variables, namely, general subcontract management, reasonable low-cost bid winning, and construction experiences. Meanwhile, the correlation, regression, and mediating effects of different influencing factors were analyzed through a regressive model to quantify the impact of each variable on the unsafe behavior intention of construction workers. The results showed that the influence of low-price bid winning on the unsafe behavior intention of on-site workers is faint. This is mainly because, in the case of labor buyer’s market, the actual salary of workers is not relevant to whether the project is awarded at a low price. However, the general subcontracting management has a great impact on the unsafe behavior intention of on-site workers. At the same time, low-price bid winning also indirectly affects the strength of general subcontracting safety management, which has an indirect impact on the unsafe behavior intention of on-site workers. Generally, it is of greater significance to enhance the strength of the general subcontracting management and to formulate relevant regulations to guarantee the safety of construction workers.
Effects of Stress in Adaptation to Undergraduate Life on Psychiatric Morbidity: Mediating Effects of Early Trauma and Adverse Family Factors
Authors: Zhang Yingzhe , Coid Jeremy , Liu Xiang , Zhang Yamin , Sun Huan , Li Xiaojing , Tang Wanjie , Wang Qiang , Deng Wei , Zhao Liansheng , Ma Xiaohong , Meng Yajing , Li Mingli , Wang Huiyao , Chen Ting , Lv Qiuyue , Guo Wanjun , Li Tao
Published: April 2022

Purpose

University students experience high levels of stress, and the prevalence of depression is higher than in the general population. The reason is not clear. More effective interventions and better prevention are needed.

Methods

We did annual cross-sectional surveys of Chinese undergraduates 2014–2018 (mean age 18.7 [SD 2.1], N = 39,573). We measured adaptation to university life using the Adolescent Self-rating Life Events Checklist (ASLEC) and common mental disorders using standardized self-report instruments. Regression analyses identified associations between childhood maltreatment, current family problems, stress in adaptation to undergraduate life, and psychiatric morbidity. Mediation analyses further tested relationships between these factors.

Results

Childhood maltreatment, current family problems, stress in adaptation, and psychiatric morbidity were all significantly associated with each other. The strongest association between childhood experiences and psychiatric morbidity was for sexual abuse and depression (OR = 3.39, 95%CI: 2.38–4.83, p < 0.001) and between stress from adaptation and somatic disorder (OR = 4.54, 95%CI: 3.62–5.68, p < 0.001). Associations between childhood maltreatment and stress from university life were partly mediated by psychiatric morbidity. Associations between family problems and psychiatric morbidity were mediated by stress from university life.

Conclusions

Stress from adaptation to university life and pressures from academic study exert stronger effects on psychiatric morbidity among students than childhood traumatic experiences and current family problems, although these factors are closely interrelated. Mental health services for students should focus on adaptation to university life and pressures from academic study as well as external factors of childhood trauma and family problems.
The Moderating Effect of Age on Low-Income Students' Relationships With Mentors and Their Self-Efficacy Since COVID-19
Authors: Lee Jaewon , Allen Jennifer , Lim Hyejung , Choi Gyuhyun , Jung Jiyu
Published: April 2022

Purposes

This study investigates the moderating effect of age on the association between relationship with mentors and self-efficacy among low-income students.

Methods

A total of 255 low-income middle and high school students participated. The PROCESS macro 3.4 for Statistical Product and Service Solutions was employed to test the moderating effect.

Results

Quality of relationship between mentors and mentees was positively associated with mentees' self-efficacy. Students' age significantly moderated the association between quality of the relationship with mentors and self-efficacy.

Discussion

It is important to expand mentorship programs for low-income students during the COVID-19 pandemic in order to foster high self-efficacy among adolescents. Recruitment of high quality mentors and additional factors that may be helpful to a good relationship between mentees and mentors, such as mentor training, mentor screening, and mentor-mentee matching, should be prioritized to improve self-efficacy among low-income students since COVID-19. Early opportunities for mentoring from high quality mentors is particularly important to increase self-efficacy among younger students such as middle school students.
Relationships Between Cardinal Features of Obstructive Sleep Apnea and Blood Pressure: A Retrospective Study
Authors: Xia Yunyan , You Kai , Xiong Yuanping
Published: April 2022

Background

Obstructive sleep apnea (OSA) is associated with hypertension; however, the associations between cardinal features of OSA, such as intermittent hypoxia (IH) and sleep fragmentation (SF), and blood pressure remain unclear. We performed this study to address this issue.

Method

We investigated 335 subjects with the polysomnography (PSG) tests. Data, including basic characteristics, PSG parameters, and blood pressure, were collected. We calculated p-values for linear trends of blood pressure across oxygen-desaturation index (ODI)/microarousal index (MAI) quartiles. Logistic regressions were used to determine the risk factors for abnormal blood pressure and to detect the multiplicative interaction between ODI and MAI with blood pressure.

Results

After adjusting for multiple variables, compared with subjects with lower ODI quartiles, those with higher ODI quartiles had significant higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) (p for trend = 0.010 and 0.018, respectively). And compared with subjects with lower ODI quartiles, those with higher ODI quartiles were also more likely to have abnormal DBP and hypertension after adjusting for multiple variables. Similarly, compared with subjects with lower MAI quartiles, those with higher MAI quartiles had significant higher SBP and DBP, and were more likely to have abnormal DBP and hypertension. No significant multiplicative interactions between ODI and MAI with blood pressure were detected.

Conclusion

Subjects with more severe IH/SF had significant higher blood pressure and were more likely to have abnormal DBP and hypertension than those with less severe IH/SF. No interaction between IH and SF on the relationship with blood pressure was shown.
Certified Nursing Aides' Training Hours and COVID Case and Mortality Rates Across States in the U.S.: Implications for Infection Prevention and Control and Relationships With Nursing Home Residents
Authors: Levy-Storms Lené , Mueller-Williams Amelia
Published: April 2022

Disproportionately high COVID case and mortality rates in skilled nursing facilities (SNFs) have heightened interest in the role of Certified Nursing Aides (CNAs) in the care of residents living in SNFs. This policy brief will make recommendations for CNA training based on an examination of two sources of secondary data using descriptive statistics. From the first source of secondary data, 34% of CNAs report feeling inadequately trained. The second source, U.S. government data, revealed statistically significant negative correlations between the amount of CNA training required across states and COVID mortality rates (Kendall's τb = −0.32; p = 0.002) but not case rates (Kendall's τb = −0.18; p = 0.09). More training for CNAs may not only reduce health risks from infectious diseases but also improve how they relate to SNF residents during care.
Determining the Predictors of Self-Management Behaviors in Patients With Type 2 Diabetes: An Application of Socio-Ecological Approach
Authors: Habibi Soola Aghil , Davari Mahnaz , Rezakhani Moghaddam Hamed
Published: April 2022

Background

Type 2 diabetes complications are responsible for 2% of hospital emergency visits. Self-management practices are one of the most essential approaches to control type 2 diabetes. The goal of this study was to use an ecological approach to investigate the predictors of self-management behaviors in diabetes patients referred to the emergency department in Ardabil in 2020.

Methods

In this cross-sectional study, 273 individuals with type 2 diabetes who were sent to the emergency department of Imam Khomeini Educational and Medical Center in Ardabil were included using the available sample method. Demographic information questionnaires, including the Diabetes Distress Screening Tool (DDS2), General Diabetes Knowledge (DKT2), Diabetes Empowerment Questionnaire (DES-SF), Patient Health Questionnaire 9 (PHQ 9), Beliefs to Treatment Effectiveness Scale (BTES), Diabetes Self-Efficacy Scale (DSES), Chronic Illness Resources Survey (CIRS), Situational Effects Questionnaire, and Diabetes self-management support (DSMS), were all used to collect data. The independent t-test, one-way ANOVA, Pearson correlation coefficient, and multiple regression were used to analyze the data.

Results

The results of the study showed that in the framework of ecological approach, predictors of self-management behaviors at the four levels are as follows: at the individual level—gender (p = 0.025), education (p = 0.002), duration of diabetes (p = 0.38), having a glucometer at home (p < 0.001), diabetes empowerment (p < 0.001), personal support (p = 0.002), and self-efficacy (p = 0.047); at the interpersonal level—the main health support (p < 0.001), membership in social networks (p < 0.005), family/friends support (p < 0.001), and neighborhoods support (p < 0.001); at the group and organizational level—organizational support (p = 0.013); at the community and policy level—the impact of mass media in health (p < 0.001) and situational influence (p < 0.001).

Conclusion

The impact of non-individual levels, such as the environment, on a person's decision to manage diabetes is crucial. Diabetes management necessitates a significant amount of effort, which involves maintaining the health of diabetes patients and the community while also minimizing emergency department workload.
Economic Growth, People's Livelihood Preferences of Local Governments and Residents' Health
Authors: Cen Shu-tian , Yan Wei-hai
Published: April 2022

This article is aimed to examine the effect of economic growth on the health of residents from the perspective of local government behavior. First of all, it is theoretically proved that in an economy with economic decentralization and political centralization, because the local government implements the central planner's “people-oriented” and “people-centered” requirements, the local government pays attention to both its own consumption and the health of residents. For this reason, he prefers public health investment, and the conclusion is that there is a stable and balanced relationship between residents' health and economic growth. When the local government's relative importance to people's livelihood is greater than its own consumption, the economic growth will have a significant and positive impact on residents' health. And the internal mechanism of economic growth affecting residents' health is combed mathematically. Secondly, using panel data from China's 31 inland provinces from 2003 to 2019, empirical tests show that the hypothesis that China's economic growth promotes residents' health is established. The work of this article means that the improvement of residents' health depends not only on the total amount of available resources brought about by economic growth, but also on the government's livelihood preferences. The public health investment behavior of local governments in China is an important clue to explains that China's economic growth can promote residents' health.
Regional Internet Access and Mental Stress Among University Students: A Representative Nationwide Study of China
Authors: Jiang Shuhan , Zhang Weifang , Yang Tingzhong , Wu Dan , Yu Lingwei , Cottrell Randall R.
Published: April 2022

Background

The Internet changed the lives of average citizens in the early part of the twenty-first century, and it has now become an essential part of daily life. Many studies reported that accessibility of Internet use is associated with mental health. However, previous studies examining this association were confined to local and community subpopulations and limited at the individual level, which increases the potential bias from the selection effect at a different level. Regional variables would be a stable estimate of people's socioeconomic and cultural environments and how these variables affect mental health needed to be studied. The objective of this study was to evaluate the association between regional Internet access, and mental stress among university students.

Methods

Participants were 11,954 students, who were identified through a multistage survey sampling process conducted in 50 Chinese universities. Regional Internet access was retrieved from a national database, and mental stress was measured using the Perceived Stress Scale (Chinese Version) (CPSS). Both unadjusted and adjusted methods were considered in the analyses.

Results

More than one-third 36.9% (95% CI: 24.4–49.5%) of university students in this study suffered from severe mental stress (SMR). The multilevel logistic regression model found that university students studied in low-level universities had 2.52 (95% C.I. 1.17 to 6.37) times the prevalence of SMR than those in high-level universities. Compared with small cities, students in a large city had a lower prevalence of SMR (OR 0.25; 95%C.I. 0.06 to 0.77). Most importantly, regional Internet access was negatively associated with students' SMR (OR 0.25; 95%C.I. 0.08 to 0.76).

Conclusions

This study indicated that regional Internet access and other environmental factors including city size and type of universities contribute to students' mental health. The findings underscore that efforts to control excessive mental stress among students in China should pay greater attention to environmental determinants of stress and particularly to improve internet access.
An End-to-End Integrated Clinical and CT-Based Radiomics Nomogram for Predicting Disease Severity and Need for Ventilator Support in COVID-19 Patients: A Large Multisite Retrospective Study
Authors: Vaidya Pranjal , Alilou Mehdi , Hiremath Amogh , Gupta Amit , Bera Kaustav , Furin Jennifer , Armitage Keith , Gilkeson Robert , Yuan Lei , Fu Pingfu , Lu Cheng , Ji Mengyao , Madabhushi Anant
Published: April 2022

Objective

The disease COVID-19 has caused a widespread global pandemic with ~3. 93 million deaths worldwide. In this work, we present three models—radiomics (MRM), clinical (MCM), and combined clinical–radiomics (MRCM) nomogram to predict COVID-19-positive patients who will end up needing invasive mechanical ventilation from the baseline CT scans.

Methods

We performed a retrospective multicohort study of individuals with COVID-19-positive findings for a total of 897 patients from two different institutions (Renmin Hospital of Wuhan University, D1 = 787, and University Hospitals, US D2 = 110). The patients from institution-1 were divided into 60% training, D1T (N = 473), and 40% test set D1V (N = 314). The patients from institution-2 were used for an independent validation test set D2V (N = 110). A U-Net-based neural network (CNN) was trained to automatically segment out the COVID consolidation regions on the CT scans. The segmented regions from the CT scans were used for extracting first- and higher-order radiomic textural features. The top radiomic and clinical features were selected using the least absolute shrinkage and selection operator (LASSO) with an optimal binomial regression model within D1T.

Results

The three out of the top five features identified using D1T were higher-order textural features (GLCM, GLRLM, GLSZM), whereas the last two features included the total absolute infection size on the CT scan and the total intensity of the COVID consolidations. The radiomics model (MRM) was constructed using the radiomic score built using the coefficients obtained from the LASSO logistic model used within the linear regression (LR) classifier. The MRM yielded an area under the receiver operating characteristic curve (AUC) of 0.754 (0.709–0.799) on D1T, 0.836 on D1V, and 0.748 D2V. The top prognostic clinical factors identified in the analysis were dehydrogenase (LDH), age, and albumin (ALB). The clinical model had an AUC of 0.784 (0.743–0.825) on D1T, 0.813 on D1V, and 0.688 on D2V. Finally, the combined model, MRCM integrating radiomic score, age, LDH and ALB, yielded an AUC of 0.814 (0.774–0.853) on D1T, 0.847 on D1V, and 0.771 on D2V. The MRCM had an overall improvement in the performance of ~5.85% (D1T: p = 0.0031; D1Vp = 0.0165; D2V: p = 0.0369) over MCM.

Conclusion

The novel integrated imaging and clinical model (MRCM) outperformed both models (MRM) and (MCM). Our results across multiple sites suggest that the integrated nomogram could help identify COVID-19 patients with more severe disease phenotype and potentially require mechanical ventilation.
The Effectiveness of Proprioceptive Training for Improving Motor Performance and Motor Dysfunction: A Systematic Review
Authors: Winter Leoni , Huang Qiyin , Sertic Jacquelyn V. L. , Konczak Jürgen
Published: April 2022

Objective

Proprioceptive training is any intervention aiming to improve proprioceptive function with the ultimate goal to enhance motor function and performance. It has been promoted as an approach to enhance athletic performance and as a tool for sensorimotor rehabilitation. Numerous studies sought to provide evidence on the effectiveness of the approach. However, many different training regimes claiming to train proprioception report a variety of sensorimotor measures that are not directly comparable. This, in turn, makes it difficult to assess effectiveness across approaches. It is the objective of this study to systematically review recent empirical evidence to gain an understanding of which outcome measures are most sensitive, which populations may benefit most from proprioceptive training, and what are the effects on proprioceptive and motor systems.

Methods

Four major databases were searched. The following inclusion criteria were applied: (1) A quantified pre- and post-treatment measure of proprioceptive function. (2) An intervention or training program believed to influence or enhance proprioceptive function. (3) Contained at least one form of treatment or outcome measure that is indicative of somatosensory function and not confounded by information from other sensory modalities. 4) The study reported of at least one quantified measure of motor performance.

Results

Of the 3,297 articles identified by the database search, 70 studies met the inclusion criteria and were included for further review. Across studies, proprioceptive training led to comparable gains in both proprioceptive (+46%) and motor performance (+45%). The majority of studies (50/70) applied active movement interventions. Interventions applying somatosensory stimulation were most successful in clinical populations. Joint position sense error (JPSE) was the most commonly used proprioceptive measure and presents a reliable and feasible measure for clinical use.

Conclusion

Proprioceptive training can lead to significant improvements in proprioceptive and motor function across a range healthy and clinical populations. Regimens requiring active movement of the trainee tended to be most successful in improving sensorimotor performance. Conclusive evidence on how long training gains are retained is still lacking. There is no solid evidence about the underlying long-term neuroplastic changes associated proprioceptive training.
Exploring the Effect of a Nature-based Virtual Reality Environment on Stress in Adolescents
Authors: Björling Elin A. , Sonney Jennifer , Rodriguez Sofia , Carr Nora , Zade Himanshu , Moon Soo Hyun
Published: April 2022

Adolescent mental health is a growing public health issue, with 30% of teens reporting increased stress and 20% of adolescents suffering from depression. Given the scarcity and lack of scalability of mental health services available, the use of self-administered, evidence-based technologies to support adolescent mental health is both timely and imperative. We conducted a mixed-methods pilot study with 31 adolescents ages 14–19 (m = 17.97) to explore the self-administration of a nature-based virtual reality tool. Participant use of the VR environment ranged from 1 to 10 sessions (m = 6.6) at home over a 2-week period while reporting their daily stress and mood levels. All participants completed all of the study protocols, indicating our protocol was feasible and the VR environment engaging. Post-study interviews indicated that most participants found the VR tool to be relaxing and helpful with stress. The themes of Calm Down, Relaxation, and Escape emerged to articulate the participants’ experiences using the VR environment. Additionally, participants provided rich data regarding their preferences and activity in the VR environment as well as its effect on their emotional states. Although the sample size was insufficient to determine the impact on depression, we found a significant reduction in momentary stress as a result of using the VR tool. These preliminary data inform our own virtual reality environment design, but also provide evidence of the potential for self-administered virtual reality as a promising tool to support adolescent mental health.