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Rastogi R, Woolverton GA, Stevens C, Chen JA, Liu CH. Suicidality associated with decreased help-seeking attitudes in college students: Implications for identifying and treating at-risk students. Psychiatry Res 2024; 335:115825. [PMID: 38460350 DOI: 10.1016/j.psychres.2024.115825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 02/23/2024] [Accepted: 02/24/2024] [Indexed: 03/11/2024]
Abstract
Suicide is a leading cause of death in college-aged youth, yet only half of all college students report engaging in professional mental health help-seeking. We examined how the various aspects of young adults' suicidality were associated with their openness to pursue professional mental health care in the future (i.e., "future help-seeking intentions"). Multilevel binary logistic regressions were tested in a sample of 24,446 U.S. college undergraduates with suicidality. The moderating effect of past service utilization on future help-seeking intentions was also tested. Strikingly, young people reporting past-year suicidal ideation, past-year suicidal attempts, and self-reported likelihood of a future suicide attempt demonstrated decreased likelihood of future help-seeking intentions, while those reporting prior diagnosis of a mental health condition and/or past service utilization demonstrated an increased likelihood. Past service utilization also significantly moderated the effect of suicide disclosure, such that youth reporting prior disclosure and prior professional treatment-seeking demonstrated greater odds of future help-seeking intentions relative to those who had disclosed suicidality but never utilized professional services. In order to mitigate the mental health crisis facing youth, further exploration is necessary to understand why students with suicidality do not report openness to seek help. It is also imperative to develop and implement novel strategies to identify at-risk students, understand and alleviate relevant barriers to treatment, and promote positive help-seeking attitudes and behaviors.
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Affiliation(s)
- Ritika Rastogi
- Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Courtney Stevens
- Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA; Department of Psychology, Willamette University, Salem, OR, USA
| | - Justin A Chen
- Department of Psychiatry, Weill Cornell Medicine/NewYork-Presbyterian, New York, NY, USA
| | - Cindy H Liu
- Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.
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Jiang Q, Feldman N, Koire A, Ma C, Mittal L, Lin HC, Erdei C, Roffman JL, Liu CH. Infant neurodevelopment during the COVID-19 pandemic: Associations with maternal pandemic-related experiences, parenting stress, and self-efficacy. Early Hum Dev 2024; 193:106018. [PMID: 38703424 DOI: 10.1016/j.earlhumdev.2024.106018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/27/2024] [Accepted: 04/19/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Although pandemic-related experiences have been linked to the psychological well-being of mothers, the effects of the COVID-19 pandemic on infant neurodevelopmental outcomes have not been sufficiently studied. AIMS To assess whether maternal COVID-19-related experiences (i.e., COVID-19-related health, risk, resource worries, and feelings of grief), parenting stress, and maternal self-efficacy are associated with infant neurodevelopment as measured by the Ages and Stages Questionnaire, Third Edition (ASQ-3) maternal report when infants were between 8 to 10 months of age. Furthermore, this study examined the moderating effect of maternal self-efficacy between maternal COVID-19-related experiences and infant neurodevelopment. METHODS This cross-sectional study included 122 women who were drawn from the Perinatal Experiences and COVID-19 Effects (PEACE) Study, with online surveys administered between November 2020 and August 2022. RESULTS After controlling for maternal anxiety and depression symptoms and demographic factors, hierarchical regression analysis indicated that parenting stress showed no effect on ASQ-3 scores. However, more adverse COVID-19-related experiences and higher levels of maternal self-efficacy were associated with better infant neurodevelopment. Moreover, there was a significant interaction effect between maternal self-efficacy and COVID-19-related experiences on infant neurodevelopment. For mothers with moderate to high levels of self-efficacy, more adverse COVID-19-related experiences were associated with better infant neurodevelopment. For mothers with low levels of self-efficacy, more adverse COVID-19-related experiences were associated with poorer developmental outcomes in infants. CONCLUSIONS Under adverse conditions, confidence in caregiving may afford more optimal infant neurodevelopment. Interventions aimed at fostering maternal self-efficacy and addressing specific stressors can be valuable in promoting positive developmental trajectories for infants born during the pandemic.
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Affiliation(s)
- Qingyu Jiang
- Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA
| | - Natalie Feldman
- Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Amanda Koire
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Candice Ma
- Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA
| | - Leena Mittal
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Hung-Chu Lin
- Department of Psychology, University of Louisiana at Lafayette, Lafayette, LA, USA
| | - Carmina Erdei
- Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Joshua L Roffman
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Cindy H Liu
- Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA; Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
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Chen W, Yang Z, Liu CH, Jia XY, Zhang YT, Song X, Li S. [The cutoff value of small airway dysfunction in children with bronchial asthma]. Zhonghua Er Ke Za Zhi 2024; 62:245-249. [PMID: 38378286 DOI: 10.3760/cma.j.cn112140-20231012-00278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Objective: To explore the cutoff value for assessing small airway dysfunction in children with asthma. Methods: A total of 364 asthmatic children aged 5 to 14 years, with normal ventilatory function, followed up at the Asthma Clinic of the Children's Hospital of Capital Institute of Pediatrics from January 2017 to January 2018, were selected as the case group. Concurrently, 403 healthy children of the same age range and without any symptoms in the community were chosen as the control group, and pulmonary function tests were conducted. The values of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), forced expiratory flow at 50% of FVC (FEF50), forced expiratory flow at 75% of FVC (FEF75) and maximum mid-expiratory flow (MMEF) were compared between case group and control group. Statistical tests such as t-test, χ2 test, or Mann-Whitney U test were used to analyze the differences between the groups. Receiver operating characteristic (ROC) curves were constructed, and the maximum Youden Index was utilized to determine the optimal cutoff values and thresholds for identifying small airway dysfunction in asthmatic children. Results: This study comprised 364 children in the case group (220 boys and 144 girls) and 403 children in the control group (198 boys and 205 girls). The small airway parameters (FEF50%pred, FEF75%pred, MMEF%pred) in the asthmatic group were significantly lower than in the control group (77% (69%, 91%) vs. 95% (83%, 109%), 67% (54%, 82%) vs. 84% (70%, 102%), 76% (66%, 90%) vs. 97% (86%, 113%), Z=12.03, 11.35, 13.66, all P<0.001). The ROC curve area under the curve for FEF50%pred, FEF75%pred, MMEF%pred was 0.75, 0.74, and 0.79, respectively. Using a cutoff value of 80% for FEF50%pred achieved a sensitivity of 56.9% and specificity of 81.4%. A cutoff value of 74% for FEF75%pred resulted in a sensitivity of 67.3% and specificity of 69.2%. Finally, using a cutoff value of 84% for MMEF%pred achieved a sensitivity of 67.9% and specificity of 77.2%. Conclusion: In the presence of normal ventilatory function, utilizing FEF50<80% predicted or MMEF<84% predicted can accurately serve as criteria for identifying small airway dysfunction in children with controlled asthma.
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Affiliation(s)
- W Chen
- Department of Allergy, Children's Hospital of Capital Institute of Pediatrics, Beijing 100020, ChinaChen Wei is studying at Graduate School, School of Clinical Medicine of Shandong Second Medical University, Weifang 261000, China
| | - Z Yang
- Department of Allergy, Children's Hospital of Capital Institute of Pediatrics, Beijing 100020, ChinaChen Wei is studying at Graduate School, School of Clinical Medicine of Shandong Second Medical University, Weifang 261000, China
| | - C H Liu
- Department of Allergy, Children's Hospital of Capital Institute of Pediatrics, Beijing 100020, ChinaChen Wei is studying at Graduate School, School of Clinical Medicine of Shandong Second Medical University, Weifang 261000, China
| | - X Y Jia
- Department of Allergy, Children's Hospital of Capital Institute of Pediatrics, Beijing 100020, ChinaChen Wei is studying at Graduate School, School of Clinical Medicine of Shandong Second Medical University, Weifang 261000, China
| | - Y T Zhang
- Department of Allergy, Children's Hospital of Capital Institute of Pediatrics, Beijing 100020, ChinaChen Wei is studying at Graduate School, School of Clinical Medicine of Shandong Second Medical University, Weifang 261000, China
| | - X Song
- Department of Allergy, Children's Hospital of Capital Institute of Pediatrics, Beijing 100020, ChinaChen Wei is studying at Graduate School, School of Clinical Medicine of Shandong Second Medical University, Weifang 261000, China
| | - S Li
- Department of Allergy, Children's Hospital of Capital Institute of Pediatrics, Beijing 100020, ChinaChen Wei is studying at Graduate School, School of Clinical Medicine of Shandong Second Medical University, Weifang 261000, China
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Liu CH, Koire A, Ma C, Mittal L, Roffman JL, Erdei C. Prenatal mental health and emotional experiences during the pandemic: associations with infant neurodevelopment screening results. Pediatr Res 2024:10.1038/s41390-024-03100-y. [PMID: 38431665 DOI: 10.1038/s41390-024-03100-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/27/2023] [Accepted: 01/17/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND This study determined whether parental mental health and emotional experiences during the prenatal period were linked to infant developmental outcomes through the Ages and Stages Questionnaire (ASQ-3) at 8-10 months. METHODS Participants included 133 individuals who were living in the US and were pregnant or had given birth within 6 months prior to enrollment. Respondents were majority White with high education and income levels. Online surveys were administered from May 2020 to September 2021; follow-up surveys were administered from November 2020 to August 2022. RESULTS Parent generalized anxiety symptoms were positively associated with infant communication (β = 0.34, 95% CI [0.15, 1.76], p < 0.05), while parent-fetal bonding was positively associated with infant communication (β = 0.20, 95% CI [0.05, 0.76], p < 0.05) and personal-social performance (β = 0.20, 95% CI [0.04, 0.74], p < 0.05). COVID-19-related worry was negatively associated with infant communication (β = -0.30, 95% CI [-0.75, -0.12], p < 0.05) and fine motor performance (β = -0.25, 95% CI [-0.66, -0.03], p < 0.05). CONCLUSION Parent mental health and emotional experiences may contribute to infant developmental outcomes in high risk conditions such as a pandemic. IMPACT STATEMENT Maternal SARS-CoV-2 infection has been evaluated in relation to child outcomes, however, parent psychosocial experiences should not be overlooked when considering pandemic risks to child development. Specific prenatal mental health and pandemic-related emotional experiences are associated with infant developmental performance, as assessed by the Ages and Stages. Questionnaire (ASQ-3) at 8 to 10 months old. Findings indicate that parental prenatal anxiety and emotional experiences from the pandemic should be assessed when evaluating child developmental delays.
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Affiliation(s)
- Cindy H Liu
- Brigham and Women's Hospital, 221 Longwood Ave., BLI 341, Boston, MA, 02115, USA.
- Brigham and Women's Hospital, 75 Francis St., Boston, MA, 02115, USA.
- Harvard Medical School, 25 Shattuck St., Boston, MA, 02115, USA.
| | - Amanda Koire
- Brigham and Women's Hospital, 75 Francis St., Boston, MA, 02115, USA
- Harvard Medical School, 25 Shattuck St., Boston, MA, 02115, USA
| | - Candice Ma
- Brigham and Women's Hospital, 221 Longwood Ave., BLI 341, Boston, MA, 02115, USA
| | - Leena Mittal
- Brigham and Women's Hospital, 75 Francis St., Boston, MA, 02115, USA
- Harvard Medical School, 25 Shattuck St., Boston, MA, 02115, USA
| | - Joshua L Roffman
- Harvard Medical School, 25 Shattuck St., Boston, MA, 02115, USA
- Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA
| | - Carmina Erdei
- Brigham and Women's Hospital, 221 Longwood Ave., BLI 341, Boston, MA, 02115, USA
- Harvard Medical School, 25 Shattuck St., Boston, MA, 02115, USA
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Koire A, Erdei C, Mittal L, Wiegartz P, Liu CH. Virtual(ly) no support: Associations between virtual support group participation and peripartum mental health outcomes during the COVID-19 pandemic. Psychiatry Res 2024; 332:115683. [PMID: 38218050 DOI: 10.1016/j.psychres.2023.115683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 12/20/2023] [Accepted: 12/20/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVE This study examined associations between participation in virtual support groups for peripartum women and mental health outcomes at follow-up approximately 8 months later. METHODS This cross-sectional online survey study assessed 383 women from the Perinatal Experiences and COVID-19 Effects (PEACE) study. Initial participants (T1) were re-contacted (T2) and self-reported mental health symptoms of depression (CES-D), anxiety (GAD-7), and COVID-related grief were assessed at both time points. Participants reported involvement in virtual support groups and their perception of the effectiveness of social media in addressing feelings of loneliness. RESULTS The majority (62%) of respondents participated in a virtual support group, 99% of whom used informal social media-based groups (e.g. Facebook groups). At initial evaluation, virtual group participants reported higher levels of depressive symptoms (p=0.008) and COVID grief (p=0.004), but not higher levels of anxiety. Across the cohort, self-reported depressive, anxiety, and grief symptoms did not change significantly at follow-up in paired analysis, and virtual group participants did not demonstrate improvement in mental health symptoms. CONCLUSIONS Participation in virtual support groups did not seem to improve mental health outcomes for peripartum women, and most women found social media engagement minimally effective at addressing loneliness.
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Affiliation(s)
- A Koire
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - C Erdei
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Department of Newborn Medicine, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA 02115, USA
| | - L Mittal
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - P Wiegartz
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - C H Liu
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Department of Newborn Medicine, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA 02115, USA.
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ElTohamy A, Hyun S, Rastogi R, Wong GTF, Kim GS, Chae DH, Hahm H“C, Liu CH. Effect of vicarious discrimination on race-based stress symptoms among Asian American young adults during the COVID-19 pandemic. Psychol Trauma 2024; 16:217-224. [PMID: 37227832 PMCID: PMC10674031 DOI: 10.1037/tra0001480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE The COVID-19 pandemic has led to a rise in anti-Asian hate crimes in the United States. Previous work has established that experiencing racism increases one's dysfunctional anxiety and avoidance actions-key symptoms of race-based stress symptoms. However, the psychological impact of vicarious, or secondhand, discrimination (witnessing racism targeting one's own race group) remains less understood. METHOD We tested the hypothesis that higher reported vicarious discrimination would be associated with higher levels of race-based stress symptoms reported by Asian American young adults (n = 135) during the pandemic using a cross-sectional analysis of the COVID-19 Adult Resilience Experiences Study (CARES). Starting in April 2020, CARES assessed sociodemographic characteristics and key psychometric scales in young adults through three waves of online surveys. RESULTS Our multiple regression analysis showed vicarious discrimination significantly predicted race-based stress symptoms, even after controlling for direct discrimination (p < .01). This association remained significant after controlling for age, gender, subjective childhood family social status, and preexisting psychiatric disorders (p < .01). Our results demonstrate that regardless of the effect that direct discrimination might have on race-based stress symptoms, witnessing discrimination against members of one's own racial group is significantly associated with increased race-based stress symptoms (b = 2.68, p < .01). Social media was the most common source of vicarious discrimination, with one out of three participants in our sample reporting nearly daily exposure. CONCLUSION Providers should intentionally create a space within the therapeutic setting to discuss the effects of vicarious discrimination. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Abdelrahman ElTohamy
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
- Department of Psychiatry, Brigham and Women’s Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA
| | - Sunah Hyun
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
| | - Ritika Rastogi
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
| | - Ga Tin Finneas Wong
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
| | - Grace S. Kim
- Wheelock College of Education & Human Development, Boston University, 2 Silber Way, Boston, MA, 02215, USA
| | - David H. Chae
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Hyeouk “Chris” Hahm
- School of Social Work, Boston University, 264 Bay State Rd, Boston, MA, 02215, USA
| | - Cindy H. Liu
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
- Department of Psychiatry, Brigham and Women’s Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
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Liu CH, Harrison DC, Patel S, Wilen CD, Rafferty O, Shearrow A, Ballard A, Iaia V, Ku J, Plourde BLT, McDermott R. Quasiparticle Poisoning of Superconducting Qubits from Resonant Absorption of Pair-Breaking Photons. Phys Rev Lett 2024; 132:017001. [PMID: 38242669 DOI: 10.1103/physrevlett.132.017001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 11/22/2023] [Accepted: 11/29/2023] [Indexed: 01/21/2024]
Abstract
The ideal superconductor provides a pristine environment for the delicate states of a quantum computer: because there is an energy gap to excitations, there are no spurious modes with which the qubits can interact, causing irreversible decay of the quantum state. As a practical matter, however, there exists a high density of excitations out of the superconducting ground state even at ultralow temperature; these are known as quasiparticles. Observed quasiparticle densities are of order 1 μm^{-3}, tens of orders of magnitude greater than the equilibrium density expected from theory. Nonequilibrium quasiparticles extract energy from the qubit mode and can induce dephasing. Here we show that a dominant mechanism for quasiparticle poisoning is direct absorption of high-energy photons at the qubit junction. We use a Josephson junction-based photon source to controllably dose qubit circuits with millimeter-wave radiation, and we use an interferometric quantum gate sequence to reconstruct the charge parity of the qubit. We find that the structure of the qubit itself acts as a resonant antenna for millimeter-wave radiation, providing an efficient path for photons to generate quasiparticles. A deep understanding of this physics will pave the way to realization of next-generation superconducting qubits that are robust against quasiparticle poisoning.
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Affiliation(s)
- C H Liu
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - D C Harrison
- Intelligence Community Postdoctoral Research Fellowship Program, Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - S Patel
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - C D Wilen
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - O Rafferty
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - A Shearrow
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - A Ballard
- Department of Physics, Syracuse University, Syracuse, New York 13244, USA
| | - V Iaia
- Department of Physics, Syracuse University, Syracuse, New York 13244, USA
| | - J Ku
- Department of Physics, Syracuse University, Syracuse, New York 13244, USA
| | - B L T Plourde
- Department of Physics, Syracuse University, Syracuse, New York 13244, USA
| | - R McDermott
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
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Gao PY, Chen QY, Gong Q, Liu CH. [Pathogenesis of DOCK family protein gene variations in immunodeficiency diseases]. Zhonghua Er Ke Za Zhi 2023; 61:1139-1143. [PMID: 38018054 DOI: 10.3760/cma.j.cn112140-20230828-00141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Affiliation(s)
- P Y Gao
- Department of Immunology, Yangtze University Health Science Center, Yangtze University, Jingzhou 434023, China
| | - Q Y Chen
- Department of Medical Laboratory Technology, Hubei College of Chinese Medicine, Jingzhou 434020, China
| | - Q Gong
- Department of Immunology, Yangtze University Health Science Center, Yangtze University, Jingzhou 434023, China
| | - C H Liu
- Department of Pathogen Biology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Rastogi R, Cerda IH, Ibrahim A, Chen JA, Stevens C, Liu CH. Long COVID and psychological distress in young adults: Potential protective effect of a prior mental health diagnosis. J Affect Disord 2023; 340:639-648. [PMID: 37553019 DOI: 10.1016/j.jad.2023.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/29/2023] [Accepted: 08/04/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Although young adulthood is a period characterized by marked psychological vulnerability, young adults are typically considered to be in good physical health and are therefore understudied with respect to the effects of COVID-19 infection and long COVID. The present study examined associations between post-acute sequelae of COVID-19 (PASC) and serious psychological distress during young adulthood, and tested whether prior mental health diagnosis moderated this association. METHODS Participants were 44,652 young adults who completed the Spring 2022 administration of the American College Health Association-National College Health Assessment III (ACHA-NCHA). Blockwise logistic regressions tested the odds of meeting the clinical threshold for serious psychological distress. RESULTS PASC was associated with 53 % increased likelihood of meeting the clinical threshold for serious psychological distress. Among young adults with a prior mental health diagnosis, PASC predicted 36 % increased odds of serious psychological distress; among those without a diagnosis, PASC predicted 81 % increased odds. LIMITATIONS PASC was assessed using a single self-report item rather than a clinical diagnosis of specific symptomatology. The analyses were cross-sectional and relied on concurrent reports of PASC and psychological distress which precluded us from making claims regarding directionality of the associations. The outcome of generalized psychological distress limited us from generating targeted treatment recommendations. CONCLUSIONS PASC may confer elevated psychological distress among young adults. The association of PASC to serious psychological distress was stronger in young adults without a mental health diagnosis than those with a diagnosis. Prior experience with mental illness may mitigate the psychological burden of long-term symptomatology.
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Affiliation(s)
- Ritika Rastogi
- Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Abdelrahman Ibrahim
- Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
| | - Justin A Chen
- Department of Psychiatry, Weill Cornell Medicine/NewYork-Presbyterian, New York, NY, USA
| | - Courtney Stevens
- Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA; Department of Psychology, Willamette University, Salem, OR, USA
| | - Cindy H Liu
- Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.
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Liu CH, Zhao H, Xia Y, Cao Y, Zhang LY, Zhao Y, Gao LY, Liu RF, Liu YW, Liu HF, Meng ZL, Liu SZ, Lu Y, Palashate Y, Li XY. [A single-center study on the oncological outcomes of active surveillance of thyroid nodules measuring≤1 cm with highly suspicious ultrasound features]. Zhonghua Yi Xue Za Zhi 2023; 103:3186-3192. [PMID: 37879872 DOI: 10.3760/cma.j.cn112137-20230206-00168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Objective: To investigate the oncological outcomes of active surveillance (AS) in patients showing thyroid nodules measuring≤1 cm with highly suspicious ultrasound features. Methods: A prospective single-center cohort study. A total of 534 patients with highly suspicious thyroid nodules (2015 American Thyroid Association Nodule Sonographic Patterns and Risk of Malignancy: High Suspicion) were enrolled in this study, the patients received AS at Peking Union Medical College Hospital between January 2017 and November 2022 to assess oncological outcomes (disease progression, recurrence/metastasis rate, etc). The patients were followed up every 6 months for physical examination and neck ultrasound examination. And the value of tumor volume changes in evaluating tumor enlargement was explored too. Results: There were 413 females and 121 males in this cohort, with a mean age of (42.6±11.8) years. During a median follow-up period of 45.6 months (ranged from 3.5 to 176.0 months), disease progression occurred in 26 patients (4.9%) with highly suspicious thyroid nodules, characterized by a minimum 3-mm increase in tumor diameter in 19 patients (3.6%) and lymph node metastases in 7 patients (1.3%). Forty-seven (8.8%) patients opted for delayed surgery, with 29 patients due to a change in preference. There was no significant differences in pathologic and follow-up outcomes between patients with disease progression and preference change. Patients aged≤40 years had a higher cumulative incidence of 5-year disease progression than those aged>40 years (4.9% vs 1.9%, P=0.060). No patients experienced distant metastases or deaths. Among the 595 high-risk thyroid nodules with continuous volume assessment results and an increase in nodule diameter of less than 3 mm (including all high-risk nodules in patients with single or multiple nodules), 184 (30.9%) and 79 (13.3%) nodules exhibited volume increases of more than 50% and 100%, respectively, in multiple measurements. Among the nodules with volume changes exceeding 50% and 100%, the proportion of nodules with a baseline tumor diameter of≤0.5 cm was significantly higher than those with a diameter of>0.5 cm, at 69.0% vs 31.0% (P<0.001) and 77.2% vs 22.8% (P<0.001), respectively. Conclusions: Active surveillance in patients with highly suspicious subcentimeter thyroid nodules has good short-term oncological outcomes and can be considered a safe alternative to surgery. Due to the large variability in the measurement results of tumor volume, it is not suitable as an indicator for evaluating tumor enlargement.
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Affiliation(s)
- C H Liu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - H Zhao
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Y Xia
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Y Cao
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - L Y Zhang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Y Zhao
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - L Y Gao
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - R F Liu
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Y W Liu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - H F Liu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Z L Meng
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - S Z Liu
- Department of Otolaryngology Head and Neck Surgery, Hainan General Hospital, Haikou 570311, China
| | - Y Lu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Yeerkenbieke Palashate
- Second Department of General Surgery, Xinjiang Yili Kazak Autonomous Prefecture Friendship Hospital, Yili 835800, China
| | - X Y Li
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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11
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Shao MJ, Wang XY, Wang YF, Du YY, Liu CH. [Natural history and risk factors of IgE-mediated cow's milk protein allergy in infants]. Zhonghua Er Ke Za Zhi 2023; 61:917-921. [PMID: 37803859 DOI: 10.3760/cma.j.cn112140-20230423-00294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/08/2023]
Abstract
Objective: To investigate the natural history and risk factors for continued allergy in infants with IgE-mediated cow's milk protein allergy (CMPA). Methods: This was a prospective cohort study that included 72 infants under 24 months of age diagnosed with IgE-mediated CMPA in the allergy clinic of the Children's Hospital, Capital Institute of Pediatrics from October 2019 to November 2020. General information, clinical manifestations, serum total IgE, cow's milk specific IgE, and cow's milk protein component specific IgE were collected. Follow-ups were conducted at 24 and 36 months of age, and the patients were divided into the persistent allergy group and the tolerance group based on whether they developed cow's milk tolerance at 36 months of age. Mann-Whitney U test, chi-square test, and binary Logistic regression were used for intergroup comparison and multivariate analysis. Results: Among the 72 CMPA children, there were 42 boys and 30 girls, with an age of 10 (7, 15) months at enrollment. Cow's milk protein tolerance was observed in 32 cases (44%) and 46 cases (64%) at 24 and 36 months of age, respectively. There were 26 cases in the persistent allergy group and 46 cases in the tolerance group. The proportion of respiratory symptoms, history of wheezing, positive specific IgE for α-lactalbumin and the total IgE level in the persistent allergy group were higher than that in the tolerance group (7 cases (27%) vs. 0, 6 cases (23%) vs. 2 cases (4%), 67% (14/21) vs. 26% (10/39), 225 (151, 616) vs. 48 (21, 185) kU/L, χ2=10.82, 4.16, 9.57, Z=4.07, all P<0.05). Multivariate Logistic regression analysis showed that anaphylaxis (OR=21.14, 95%CI 2.55-175.14, P=0.005), a history of allergic rhinitis (OR=5.94, 95%CI 1.54-22.86, P=0.005), elevated milk specific IgE (OR=1.04, 95%CI 1.01-1.08, P=0.024), and positive casein specific IgE (OR=6.64, 95%CI 1.39-31.69, P=0.018) were risk factors for continuous CMPA. Conclusions: Most infants with IgE-mediated CMPA can achieve tolerance within 3 years. Anaphylaxis, a history of allergic rhinitis, elevated milk specific IgE levels, and casein sensitization are risk factors for continuous allergy.
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Affiliation(s)
- M J Shao
- Department of Allergy, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - X Y Wang
- Department of Allergy, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - Y F Wang
- Department of Allergy, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - Y Y Du
- Department of Allergy, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - C H Liu
- Department of Allergy, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
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12
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Wang ZG, Pei JM, Liu CH, Zhang J, Song BQ. [Clinical effects of free transplanted pre-expanded scapular flap in reconstructing scar contracture deformity of neck]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2023; 39:813-819. [PMID: 37805796 DOI: 10.3760/cma.j.cn501225-20230225-00059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Abstract
Objective: To investigate the clinical effects of free transplanted pre-expanded scapular flap in reconstructing scar contracture deformity of neck. Methods: A retrospective observational study was conducted. From February 2010 to August 2020, 17 cervical scar deformity patients (9 males and 8 females, aged 8-42 years) who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University. The patients underwent skin and soft tissue expander (hereinafter referred to as expander) implantation in scapular region in stage Ⅰ procedures, and the free transplanted pre-expanded flaps were used to resurface the wounds followed by neck scar resection in the stage Ⅱ procedures. The wound size after neck scar release was 12.0 cm×6.0 cm-30.0 cm×24.0 cm, and the size of the flap ranged from 13.0 cm×7.5 cm to 31.5 cm×25.0 cm. The wounds in donor site of 15 patients were sutured directly, and the wounds in donor site of 2 patients were covered with full-thickness skin graft from abdominal area. The survival of flaps was observed after the operation of stage Ⅱ. Six months after stage Ⅱ surgery, Z plasty was performed to treat the incision scar contracture in 2 patients. For the 5 patients of overweight or bloating appearance in the 1/3 proximal flap underwent debulking procedures in 6-9 months after stage Ⅱsurgery. Before the stage Ⅰ surgery and six months after the last procedure (stage Ⅱ or stage Ⅲ), mental cervical angle (MCA) and cervical mandibular angle (CMA) were measured and the improvement of neck scar was evaluated by the angle values. The cervical motor function, skin color and texture in recipient areas, and scar in the donor sites assessed by Vancouver scar scale (VSS) were observed during follow-up. Data were statistically analyzed with paired sample t test. Results: After stage Ⅱ surgery, 15 patients' flaps survived well; venous crisis occurred in 2 flaps within 24 h after operation, and the flaps survived well after emergency exploration and thrombus removal+vascular re-anastomosis. Compared with the angle values of MCA of (126±12)° and CMA of (148±13)° of patients before the stage Ⅰ surgery, the angle values of MCA of (107±12)° and CMA of (123±11)° of patients in six months after the last procedure were significantly decreased (with t values of 10.68 and 6.54, respectively, P<0.05). After 2 years of follow-up, the patient's neck dorsiflexion, lateral bending, or other motor functions were not restricted; the color and texture of the flap in recipient site were close to those of the normal neck skin; the patient cases with VSS scores of scarring of 3, 4, 5, 6, and 7 were 1, 3, 7, 5, and 1 case, respectively. Conclusions: The free transplantation of the pre-expanded scapular flaps can provide sufficient tissue for wound coverage after the release of cervical scar contracture deformity; the expanded skin tissue is featured by thin soft tissue and good pliability, which is conducive to restore the neck appearance; the donor sites are relatively covert with less tension, therefore, the treatment is an effective method for correcting the contracture in the neck.
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Affiliation(s)
- Z G Wang
- Department of Skin Burn and Plastic Surgery, Xijing 986 Department, Fourth Military Medical University, Xi'an 710054, China
| | - J M Pei
- Department of Plastic Surgery, the First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China
| | - C H Liu
- Department of Plastic Surgery, the First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China
| | - J Zhang
- Department of Plastic Surgery, the First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China
| | - B Q Song
- Department of Plastic Surgery, the First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China
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Luan YT, Liu CH, Jiang SL, Gu HT, Lyu J, Xing F, Zhao CQ, Yuan JL, Liu P, Mu YP. [Comparative analysis of intestinal microbiota distribution characteristics based on metagenomics in patients with hepatitis B cirrhosis with or without ascites]. Zhonghua Gan Zang Bing Za Zhi 2023; 31:974-985. [PMID: 37872094 DOI: 10.3760/cma.j.cn501113-20220830-00440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Objective: To use metagenomic sequencing to compare the differences in intestinal microbiota species and metabolic pathways in patients with hepatitis B cirrhosis with or without ascites and further explore the correlation between the differential microbiota and clinical indicators and metabolic pathways. Methods: 20 hepatitis B cirrhosis cases [10 without ascites (HBLC-WOA), 10 with ascites (HBLC-WA), and 5 healthy controls (HC)] were selected from the previously studied 16S rRNA samples. Metagenome sequencing was performed on the intestinal microbiota samples. The Kruskal-Wallis rank sum test and Spearman test were used to identify and analyse differential intestinal microbiota populations, metabolic pathways, and their correlations. Results: (1) The overall structure of the intestinal microbiota differed significantly among the three groups (R = 0.19, P = 0.018). The HC group had the largest abundance of Firmicutes and the lowest abundance of Proteobacteria at the genus level. Firmicutes abundance was significantly decreased (P(fdr) < 0.01), while Proteobacteria abundance was significantly increased (P(fdr) < 0.01) in patients with cirrhosis accompanied by ascites; (2) LEfSe analysis revealed that 29 intestinal microbiota (18 in the HBLC-WA group and 11 in the HBLC-WOA group) played a significant role in the disease group. The unclassified Enterobacteriaceae and Klebsiella species in the HBLC-WA group and Enterobacteriaceae in the HBLC-WOA group were positively correlated with the Child-Turcotte-Pugh (CTP) score, prothrombin time, and international normalized ratio score and negatively correlated with albumin and hemoglobin levels (P < 0.05). Escherichia and Shigella in the HBLC-WA group were positively correlated with CTP scores (P < 0.05); (3) The correlation analysis results between the KEGG pathway and 29 specific intestinal microbiota revealed that Enterobacteriaceae and arachidonic acid, α-linolenic acid, glycerolipid metabolism, and fatty acid degradation were positively correlated in the lipid metabolism pathway, while most Enterobacteriaceae were positively correlated with branched-chain amino acid degradation and negatively correlated with aromatic amino acid biosynthesis in the amino acid metabolic pathway. Conclusion: A significant increment of Enterobacteriaceae in the intestines of HBLC-WA patients influenced hepatic reserve function and was associated with amino acid and lipid metabolic pathways. Therefore, attention should be paid to controlling the intestinal microbiota to prevent complications and improve the prognosis in patients with hepatitis B cirrhosis, especially in those with ascites.
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Affiliation(s)
- Y T Luan
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Institute of Liver Diseases, Shanghai Academy of TCM, Key Laboratory of Liver and Kidney Disease of the Ministry of Education, Clinical Key Laboratory of TCM of Shanghai, Shanghai 201203, China Department of Infectious Diseases, the Seventh People's Hospital Affiliated to Shanghai University of TCM, Shanghai 200137, China
| | - C H Liu
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Institute of Liver Diseases, Shanghai Academy of TCM, Key Laboratory of Liver and Kidney Disease of the Ministry of Education, Clinical Key Laboratory of TCM of Shanghai, Shanghai 201203, China
| | - S L Jiang
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Institute of Liver Diseases, Shanghai Academy of TCM, Key Laboratory of Liver and Kidney Disease of the Ministry of Education, Clinical Key Laboratory of TCM of Shanghai, Shanghai 201203, China
| | - H T Gu
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Institute of Liver Diseases, Shanghai Academy of TCM, Key Laboratory of Liver and Kidney Disease of the Ministry of Education, Clinical Key Laboratory of TCM of Shanghai, Shanghai 201203, China
| | - J Lyu
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Institute of Liver Diseases, Shanghai Academy of TCM, Key Laboratory of Liver and Kidney Disease of the Ministry of Education, Clinical Key Laboratory of TCM of Shanghai, Shanghai 201203, China
| | - F Xing
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Institute of Liver Diseases, Shanghai Academy of TCM, Key Laboratory of Liver and Kidney Disease of the Ministry of Education, Clinical Key Laboratory of TCM of Shanghai, Shanghai 201203, China
| | - C Q Zhao
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Institute of Liver Diseases, Shanghai Academy of TCM, Key Laboratory of Liver and Kidney Disease of the Ministry of Education, Clinical Key Laboratory of TCM of Shanghai, Shanghai 201203, China
| | - J L Yuan
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Institute of Liver Diseases, Shanghai Academy of TCM, Key Laboratory of Liver and Kidney Disease of the Ministry of Education, Clinical Key Laboratory of TCM of Shanghai, Shanghai 201203, China
| | - P Liu
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Institute of Liver Diseases, Shanghai Academy of TCM, Key Laboratory of Liver and Kidney Disease of the Ministry of Education, Clinical Key Laboratory of TCM of Shanghai, Shanghai 201203, China Cross Science Research Institute of Shanghai University of TCM, Shanghai 201203, China
| | - Y P Mu
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine (TCM), Institute of Liver Diseases, Shanghai Academy of TCM, Key Laboratory of Liver and Kidney Disease of the Ministry of Education, Clinical Key Laboratory of TCM of Shanghai, Shanghai 201203, China
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14
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Che LQ, Du XF, Yan FG, Huang HQ, Hua W, Zhang H, Li N, Hu Y, Shao ZH, Shao MJ, Yao C, Huang JQ, Li W, Shen HH, Liu CH. [Review and perspective of clinical research involving chest tightness variant asthma in China]. Zhonghua Yi Xue Za Zhi 2023; 103:2639-2646. [PMID: 37475568 DOI: 10.3760/cma.j.cn112137-20230416-00677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
Chest tightness variant asthma (CTVA) was first reported and named by Chinese scholars in 2013. It is a new clinical type of asthma characterized by chest tightness as the only or primary symptom, without typical asthma manifestations such as recurrent wheezing and shortness of breath, and without wheezing sounds heard during lung auscultation. The overall epidemiological data on CTVA is currently unavailable. Its pathogenesis is similar to that of typical asthma, involving eosinophilic airway inflammation. Due to the lack of typical clinical manifestations, insufficient knowledge of this disease in some clinicians and some other reasons, CTVA is susceptible to misdiagnosis or missed diagnosis. Currently, the diagnostic criteria for CTVA are: chest tightness as the only or primary symptom, without typical asthma symptoms and signs such as wheezing and shortness of breath, and with any one of the objective indicators of variable airflow limitation. Effective anti-asthma treatment is required, and other diseases that cause chest tightness, such as cardiovascular, digestive, nervous, muscular, and mental diseases should be excluded. CTVA treatment follows that of typical asthma, but the specific treatment duration is uncertain and may require long-term management. Traditional Chinese medicine has shown some therapeutic effects on CTVA. Most CTVA patients have a good prognosis after active anti-asthma treatment. This paper analyzes and summarizes the research of CTVA in China from 2013 and provides new perspectives for further exploration of CTVA.
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Affiliation(s)
- L Q Che
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - X F Du
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - F G Yan
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - H Q Huang
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - W Hua
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - H Zhang
- Department of Respiratory Medicine, Zhejiang Provincial Hospital of Chinese Medicine, Hangzhou 310003, China
| | - N Li
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Y Hu
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Z H Shao
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - M J Shao
- Department of Allergy, Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing 100020, China
| | - C Yao
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - J Q Huang
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - W Li
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - H H Shen
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - C H Liu
- Department of Allergy, Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing 100020, China
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15
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Zhang X, Hsu KC, Fleming KE, Liu CH, Hahm HC. Home away from home: international students' experiences during the COVID-19 pandemic and the role of US higher education. Front Psychol 2023; 14:1104200. [PMID: 37771810 PMCID: PMC10523317 DOI: 10.3389/fpsyg.2023.1104200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 08/03/2023] [Indexed: 09/30/2023] Open
Abstract
Introduction This study focuses on the impact of the COVID-19 pandemic on international students' overall experiences. Method We interviewed 22 international students from 11 countries and 17 universities in the US who participated in a large longitudinal study that aims to understand the physical and emotional wellbeing of young adults during the COVID-19 pandemic. Guided by Bronfenbrenner's ecological model, the findings suggested that students were impacted by the COVID-19 pandemic at interpersonal, institutional, political, and personal levels. Results The results showed that the pandemic exacerbated existing stressors such as the lack of social support from family, various visa regulations, competitive and limited job opportunities, discrimination and xenophobia, particularly toward students from Asia, and financial burdens. Additionally, the findings highlighted students' perceived loss of the "American dream" and the uneven return on investment due to the pandemic. Discussion This study reveals the importance of US higher education institutions in supporting international students during the pandemic, particularly in terms of their sense of belonging. Recommendations for institutions drawn from the findings are proposed to better support international students during times of COVID-19 and beyond.
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Affiliation(s)
- Xiaoqiao Zhang
- School of Education, Shanghai Jiao Tong University, Shanghai, China
| | - Kelly C. Hsu
- School of Arts and Sciences, Tufts University, Medford, MA, United States
| | - Kirsten E. Fleming
- College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Cindy H. Liu
- Department of Pediatrics, Brigham and Women's Hospital, Boston, MA, United States
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
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16
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Zhou YY, Xiong SQ, Liu CH. [New progress in the diagnosis and treatment of pet allergens and related allergic diseases]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:1342-1347. [PMID: 37743293 DOI: 10.3760/cma.j.cn112150-20230216-00113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Pet allergies are the type Ⅰ allergic reaction stimulated by allergens in pet dander, hair, and saliva and urine. Atopic individuals with pet allergies have mucosal and respiratory symptoms and casually severe anaphylaxis. Recently, the increasing presence of household pets in China has contributed to an increase in the prevalence of allergies to pets. Moreover, pet allergen sensitization is one of the critical risk factors for developing other allergic diseases, posing a major health problem. This article discussed the epidemiology, allergenic components, clinical features, diagnosis and management, and prevention of pet allergies, providing advice for prevention and treatment.
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Affiliation(s)
- Y Y Zhou
- School of Clinical Medicine, Weifang Medical University, Weifang 261000, China Department of Allergy, Children's Hospital of Capital Institute of Pediatrics, Beijing 100020, China
| | - S Q Xiong
- Department of Allergy, Children's Hospital of Capital Institute of Pediatrics, Beijing 100020, China
| | - C H Liu
- Department of Allergy, Children's Hospital of Capital Institute of Pediatrics, Beijing 100020, China
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17
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Zheng HS, Zhu WJ, Liu CH, Li YX, Song X, Han TT, Wang W, Guan K, Sha L. [Clinical characteristics of children with IgE-mediated cow's milk protein allergy]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:1271-1279. [PMID: 37574323 DOI: 10.3760/cma.j.cn112150-20230514-00370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Objective: To analyze the clinical characteristics of children with IgE-mediated cow's milk protein allergy (CMPA) and provide a basis for disease management and prevention. Methods: A cross-sectional study was conducted to analyze 142 children aged 0-12 years who were diagnosed with IgE-mediated CMPA in Capital Institute of Pediatrics Affiliated Children's Hospital from 2020 to 2022. There were 79 males (55.6%) and 63 females (44.4%), with an average age of 14 (8, 27) months. 61 cases (43.0%) were in the <1-year-old group, 54 cases (38.0%) in the 1-3-year-old group, and 27 cases (19.0%) in the >3-year-old group. Data on demographic data, clinical manifestations, mean wheel diameter of skin prick test and serum specific IgE level were collected. The serum cow's milk protein sIgE and component sIgE were measured by ImmunoCAP fully automated system of fluorescence enzyme-linked immunosorbent assay, and statistically analyzed using chi-square test, nonparametric tests, correlation. Results: Cutaneous symptoms were the first and most frequent in 142 children (97.9%, 139/142 cases), followed by digestive (29.6%, 42/142 cases) and respiratory symptoms (27.5%, 39/142 cases).The proportion of children with respiratory symptoms after consuming cow's milk was significantly higher in the>3 years age group than those in the infant and toddler groups(66.7% vs 19.7%,χ2=18.396,P<0.01;66.7% vs 16.7%,χ2=20.250,P<0.01), and the symptoms involving ≥3 systems were also significantly higher than those in the other two groups(37.0% vs 13.1%,χ2=6.597,P<0.05;37.0% vs 7.4%,χ2=12.120,P<0.01). The average cow's milk SPT diameter and serum sIgE levels in the>3 years age group were significantly higher than those in the infant and toddler groups (Z=-4.682, P<0.01; Z=-3.498, P<0.01); (Z=-4.463, P<0.01; Z=-6.463, P<0.01). The most common cow's milk component protein were β-lactoglobulin(65.1%,56/86 cases) and casein (57.0%, 49/86 cases). Multiple-sensitization rate of the patients were 54.9%. Egg white (43.7%, 62/142 cases) was the most common co-sensitization food allergen while mold (12.7%, 18/142 cases) and weed pollen (12.7%, 18/142 cases) were the main co-sensitization aeroallergens. The proportion of multiple-sensitization to aeroallergens in the children group was the highest (51.9%, 14/27 cases), followed by the toddler group (29.6%, 16/54 cases), and the infant group was the least (3.3%, 2/61 cases). There was a significant difference among these three groups (χ2=7.476, P<0.05). Conclusion: Skin and mucosal symptoms are the most common in CMPA patients. The proportion of respiratory symptoms and multisystem involvement increased with age as well as the wheal diameter in skin test and serum sIgE level elevated. CMPA patients older than 3 years had the highest proportion of aeroallergen sensitization and airway allergic diseases.
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Affiliation(s)
- H S Zheng
- Department of Allergy, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment on Allergic Diseases, Beijing 100730, China
| | - W J Zhu
- Department of Allergy, Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing 100020, China
| | - C H Liu
- Department of Allergy, Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing 100020, China
| | - Y X Li
- Department of Allergy, Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing 100020, China
| | - X Song
- Department of Allergy, Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing 100020, China
| | - T T Han
- Department of Pediatric Respiratory,Department of Binzhou Medical University Hospital, Binzhou 256603, China
| | - W Wang
- Department of Biochemistry and Immunology, Capital Institute of Pediatrics, Beijing 100020, China
| | - K Guan
- Department of Allergy, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment on Allergic Diseases, Beijing 100730, China
| | - L Sha
- Department of Allergy, Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing 100020, China
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18
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Uhlhaas PJ, Davey CG, Mehta UM, Shah J, Torous J, Allen NB, Avenevoli S, Bella-Awusah T, Chanen A, Chen EYH, Correll CU, Do KQ, Fisher HL, Frangou S, Hickie IB, Keshavan MS, Konrad K, Lee FS, Liu CH, Luna B, McGorry PD, Meyer-Lindenberg A, Nordentoft M, Öngür D, Patton GC, Paus T, Reininghaus U, Sawa A, Schoenbaum M, Schumann G, Srihari VH, Susser E, Verma SK, Woo TW, Yang LH, Yung AR, Wood SJ. Towards a youth mental health paradigm: a perspective and roadmap. Mol Psychiatry 2023; 28:3171-3181. [PMID: 37580524 PMCID: PMC10618105 DOI: 10.1038/s41380-023-02202-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 07/04/2023] [Accepted: 07/21/2023] [Indexed: 08/16/2023]
Abstract
Most mental disorders have a typical onset between 12 and 25 years of age, highlighting the importance of this period for the pathogenesis, diagnosis, and treatment of mental ill-health. This perspective addresses interactions between risk and protective factors and brain development as key pillars accounting for the emergence of psychopathology in youth. Moreover, we propose that novel approaches towards early diagnosis and interventions are required that reflect the evolution of emerging psychopathology, the importance of novel service models, and knowledge exchange between science and practitioners. Taken together, we propose a transformative early intervention paradigm for research and clinical care that could significantly enhance mental health in young people and initiate a shift towards the prevention of severe mental disorders.
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Affiliation(s)
- Peter J Uhlhaas
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK.
- Department of Child and Adolescent Psychiatry, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Christopher G Davey
- Department of Psychiatry, The University of Melbourne, Carlton, VIC, Australia
| | - Urvakhsh Meherwan Mehta
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Jai Shah
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - John Torous
- Division of Digital Psychiatry and Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | | | - Shelli Avenevoli
- Office of the Director, National Institute of Mental Health, Bethesda, MD, USA
| | - Tolulope Bella-Awusah
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Andrew Chanen
- Orygen: National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Eric Y H Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong, China
| | - Christoph U Correll
- Department of Child and Adolescent Psychiatry, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Departments of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hostra/Northwell, Hempstead, NY, USA
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
| | - Kim Q Do
- Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Helen L Fisher
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Sophia Frangou
- Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, RWTH, Aachen, Germany
- JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, Research Center Jülich, Jülich, Germany
| | - Francis S Lee
- Department of Psychiatry, Weill Cornell Cornell Medicall College, New York, NY, USA
| | - Cindy H Liu
- Departments of Pediatrics and Psychiatry, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA
| | - Beatriz Luna
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Patrick D McGorry
- Orygen: National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Merete Nordentoft
- CORE-Copenhagen Research Centre for Mental Health, Mental Health Center Copenhagen, University of Copenhagen, Faculty of Health and Medical Sciences, Department of Clinical Medicine, Hellerup, Denmark
| | - Dost Öngür
- McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - George C Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, University of Melbourne, Parkville, VIC, Australia
| | - Tomáš Paus
- Departments of Psychiatry and Neuroscience, Faculty of Medicine and Centre Hospitalier Universitaire Sainte Justine, University of Montreal, Montreal, QC, Canada
- Department of Psychology and Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany
- Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Akira Sawa
- The John Hopkins Schizophrenia Center, Johns Hopkins University, Baltimore, MD, USA
| | - Michael Schoenbaum
- Division of Service and Intervention Research, National Institute of Mental Health, Bethesda, MD, USA
| | - Gunter Schumann
- Centre for Population Neuroscience and Stratified Medicine, ISTBI, Fudan University, Shanghai, China
- Department of Psychiatry and Neuroscience, Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Vinod H Srihari
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Program for Specialized Treatment Early in Psychosis (STEP), New Haven, VIC, USA
| | - Ezra Susser
- Departments of Epidemiology and Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Swapna K Verma
- Department of Psychosis, Institute of Mental Health, Buangkok, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - T Wilson Woo
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Laboratory for Cellular Neuropathology, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Lawrence H Yang
- Department of Social and Behavioral Sciences, New York University, New York, NY, USA
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Alison R Yung
- School of Medicine, Faculty of Health, Deakin University, Melbourne, VIC, Australia
- Department of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Stephen J Wood
- Orygen: National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
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19
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Wang H, Liu CH, Han Z, Li FH, Hao CF. [Establishment of hysteroscopic scoring system of chronic endometritis and correlative analysis with pregnancy outcomes of in vitro fertilization-embryo transfer in infertile patients]. Zhonghua Yi Xue Za Zhi 2023; 103:1842-1848. [PMID: 37357190 DOI: 10.3760/cma.j.cn112137-20221025-02225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Objective: To establish a hysteroscopic chronic endometritis (hCE) scoring system for patients with chronic endometritis, and observe the correlation of hCE score with in vitro fertilization-embryo transfer (IVF-ET) pregnancy outcomes in infertile women. Methods: The study retrospectively investigated the correlation of morphologic features and hCE score with pregnancy outcomes during IVF-ET in infertile women with CE (n=429) at Yantai Yuhuangding Hospital between January 2017 and September 2018. The clinical pregnancy rate and live birth rate with different score levels (1-3,4-7 and 8-14) after IVF-ET treatment were analyzed. Multivariate regression analysis was performed to adjust for confounding factors. The correlation and regression between hCE score and pregnancy outcomes was analyzed by curve fitting. Results: The age of 429 patients [M(Q1, Q3)] was 31 (29, 35) years. There were 50.6% (217 cases), 35.4% (152 cases), and 14.0% (60 cases) of patients with hCE score of 1-3, 4-7, and 8-14, respectively. The pregnancy rates of the three groups were 60.8% (132 cases), 44.7% (68 cases) and 16.7% (10 cases), P<0.001; The live birth rates were 51.2% (111 cases), 36.8% (56 cases) and 13.3% (8 cases), respectively (P<0.001). Compared with patients with hCE of 1-3, pregnancy rates in those with hCE of 4-7 and 8-14 were lower, and the OR values were 0.521 (0.342-0.793) and 0.129 (0.062-0.268). The live birth rates in patients with hCE of 4-7 and 8-14 were lower than that in patients with hCE of 1-3, and the OR values were 0.570 (0.372-0.873) and 0.162 (0.073-0.360), all P<0.05. Quadratic curve fitting results showed that clinical pregnancy rate and live birth rate decreased with the increase of hCE score. Conclusions: With the increase of hCE score, the clinical pregnancy rate and live birth rate of patients gradually decrease. hCE 4 is an important cut-off threshold significantly affecting the pregnancy outcome.
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Affiliation(s)
- H Wang
- Department of Reproduction, Yantaishan Hospital, Yantai 264003, China
| | - C H Liu
- Department of Reproduction, Yantaishan Hospital, Yantai 264003, China
| | - Z Han
- Department of Reproduction, Yantaishan Hospital, Yantai 264003, China
| | - F H Li
- Department of Reproduction, Yantai Yuhuangding Hospital, Yantai 264003, China
| | - C F Hao
- Department of Reproduction, Qingdao Women and Children's Hospital, Qingdao 266605, China
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20
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Doan SN, Burniston AB, Smiley P, Liu CH. COVID-19 Pandemic and Changes in Children's Behavioral Problems: The Mediating Role of Maternal Depressive Symptoms. Children (Basel) 2023; 10:977. [PMID: 37371209 DOI: 10.3390/children10060977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023]
Abstract
The COVID-19 pandemic has been linked to a range of behavioral problems in children. To date, however, longitudinal studies with data prior to the pandemic are rare, and moreover, few studies have examined the family context. This is notable as evidence suggests that mothers were highly vulnerable to the effects of the pandemic, and stress proliferation models would argue that children's wellbeing are undoubtedly affected by maternal wellbeing. In the current investigation, we examine changes in maternal depressive symptoms and children's behavioral problems from prior to the pandemic to the first few months of COVID-19 in the U.S. The results suggest a significant increase in children's internalizing problems and maternal depressive symptoms. Consistent with stress proliferation models, the relationship between COVID-19-related stressors and children's behavioral problems were mediated by maternal mental health.
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Affiliation(s)
- Stacey N Doan
- Department of Psychological Science, Claremont McKenna College, Claremont, CA 91711, USA
- Department of Population Sciences, City of Hope National Medical Center, Claremont, CA 91711, USA
| | - Anna Beth Burniston
- Department of Psychological Science, Claremont McKenna College, Claremont, CA 91711, USA
| | - Patricia Smiley
- Department of Psychological Science, Pomona College, Claremont, CA 91711, USA
| | - Cindy H Liu
- Department of Pediatric Newborn Medicine & Psychiatry, Brigham and Women's Hospital, Boston, MA 02215, USA
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21
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Hyun S, Chen SE, Levy-Carrick NC, Hahm HC, Liu CH. Posttraumatic growth as a moderator between pandemic-related distress and mental health symptoms in U.S. young adults. Psychol Trauma 2023; 15:S120-S124. [PMID: 35925695 DOI: 10.1037/tra0001306] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
OBJECTIVE Compared to other age groups, young adults are at risk of suffering COVID-19 pandemic-related psychological problems. Prior research suggests that such adverse events (like the pandemic) can initiate adaptive psychological changes, referred to as posttraumatic growth (PTG); however, limited studies have examined the moderating role of PTG among young adults in the United States with regard to COVID-19-related distress. Thus, this study examines whether pandemic-related distress has a differential effect on young adults' mental health symptoms based on varying levels of PTG. METHOD Using the data from 661 participants who completed all three waves of the CARES study (T₁: April-August 2020; T₂: September 2020-March 2021; T₃: April-May 2021), a moderator analysis was performed using the PROCESS Macro to determine the moderating effect of PTG. RESULTS In our data, higher levels of PTG buffered the effects of pandemic-related distress from 2020 on depressive symptoms in 2021; PTG did not show a moderating effect with anxiety as an outcome. CONCLUSIONS Understanding the moderating role of PTG would help to further understand the mental health trajectories of young adults in the United States who are particularly distressed by the pandemic. Our findings suggest the importance of further exploring contributors to PTG for young adults, particularly among those who have experienced high levels of pandemic-related distress to date. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Sunah Hyun
- Department of Newborn Medicine, Brigham and Women's Hospital
| | | | | | | | - Cindy H Liu
- Department of Newborn Medicine, Brigham and Women's Hospital
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22
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Li RR, Li M, Luo Q, Sun X, Liu CH. [Comparative analysis of clinical diagnosis and treatment guidelines for drug-induced liver injury at home and abroad]. Zhonghua Gan Zang Bing Za Zhi 2023; 31:433-439. [PMID: 37248984 DOI: 10.3760/cma.j.cn501113-20220810-00415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Drug-induced liver injury influencing factors are complex and have diverse clinical manifestations. Simple and reliable diagnostic methods are still deficient, and further classification of toxicological mechanisms is required. There are numerous pertinent discrepancies between domestic and international guidelines aimed at drug-induced liver injury diagnosis and treatment, with partial to no consensus on the content. The American Gastroenterological Association's 2021 Clinical Guidelines, the Asia-Pacific Association for the Study of the Liver's 2021 Consensus Guidelines, the Council for International Organizations of Medical Sciences' 2020 International Consensus, the European Society's Hepatology Committee's 2019 Clinical Practice Guidelines, and the 2015 Chinese Medical Association Guidelines are five influential clinical guidelines on drug-induced liver injury at home and abroad. The epidemiology, risk factors, diagnosis and evaluation, treatment management, and other contents, particularly traditional Chinese medicine, were compared and analyzed using other relevant consensus opinions or guidelines in order to improve understanding and provide a reference for clinical diagnosis and treatment of drug-induced liver injury.
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Affiliation(s)
- R R Li
- Institute of Liver Diseases, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - M Li
- Institute of Liver Diseases, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Q Luo
- Institute of Liver Diseases, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - X Sun
- Institute of Liver Diseases, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China Shanghai Key Laboratory of Traditional Chinese Clinical Medicine, Shanghai 201203, China
| | - C H Liu
- Institute of Liver Diseases, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China Shanghai Key Laboratory of Traditional Chinese Clinical Medicine, Shanghai 201203, China Key Laboratory of Liver and Kidney Diseases, Ministry of Education, Shanghai 201203, China
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23
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Liu CH, Zhang S, Zhang YX, Dong HB, Wang SY, Ma YM. [Attach great importance to the significance of serum anti-müllerian hormone and androgen in the evaluation of polycystic ovary syndrome]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:577-583. [PMID: 37032168 DOI: 10.3760/cma.j.cn112150-20220928-00935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine disease in women of childbearing age, which seriously affects women's reproductive health. In recent years, more and more studies have found that serum anti-Müllerian hormone (AMH) has certain significance in the diagnosis and treatment evaluation of PCOS. In addition, with the improvement of detection methods, more attention has been paid to the significance of female androgens and AMH in the evaluation of PCOS. This article reviews the recent research progress of serum AMH and androgens in the evaluation of PCOS.
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Affiliation(s)
- C H Liu
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University/Department of Human Reproductive Medicine, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - S Zhang
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University/Department of Human Reproductive Medicine, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Y X Zhang
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University/Department of Human Reproductive Medicine, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - H B Dong
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University/Department of Human Reproductive Medicine, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - S Y Wang
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University/Department of Human Reproductive Medicine, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Y M Ma
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University/Department of Human Reproductive Medicine, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
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24
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Liu CH, Li LJ, Tian M, Cao GH, Zhang SF, Li JT. Two rare copy number variants involving loss of NPHP1, MALL, and MTLN genes contribute to nephronophthisis-induced nephropathy progression in a family: A case report. Niger J Clin Pract 2023; 26:524-527. [PMID: 37203120 DOI: 10.4103/njcp.njcp_775_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Nephronophthisis (NPHP) is a common pediatric cystic kidney disease, accounting for approximately 10% of end-stage renal failure cases in children. NPHP is primarily diagnosed through the identification of indel mutations and copy number variants (CNVs), and patients carrying NPHP1 mutations usually progress to renal failure at a mean age of 13 years old. However, the association between CNVs containing NPHP1 variations and the progression of NPHP-induced disease remains unclear. Here, we report three NPHP patients in a family. The proband had developed stage 4 chronic kidney disease (CKD) at 9 years old, and her younger brother and older sister had developed renal failure at 8 and 10 years old, respectively. A genetic diagnosis showed that they carried two rare CNVs, including homozygous loss of NPHP1, MALL, ACTR1AP1, MTLN, and LOC100507334. Heterozygous deletions mainly consisted of non-coding RNA genes on both sides of the CNVs. The proband was in stage 4 of CKD while her brother had progressed to renal failure, probably due to more extensive heterozygous deletion of a 67.115 kbp fragment, which included LIMS3-LOC440895, LOC440895, GPAA1P1, ZBTB45P1, and LINC0112 genes. This report demonstrates that larger CNV deletions, including homozygous NPHP1, MALL, and MTLN mutations and heterozygous deletions, presumably accelerate disease progression. Therefore, early genetic diagnosis plays a crucial role in the intervention and prognosis of these patients.
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Affiliation(s)
- C H Liu
- Department of Nephrology and Rheumatology, Zhengzhou Key Laboratory of Pediatric Kidney Disease Research; Henan Provincial Key Laboratory of Children's Genetics and Metabolic Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - L J Li
- Department of Nephrology and Rheumatology, Zhengzhou Key Laboratory of Pediatric Kidney Disease Research, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - M Tian
- Department of Nephrology and Rheumatology, Zhengzhou Key Laboratory of Pediatric Kidney Disease Research, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - G H Cao
- Department of Nephrology and Rheumatology, Zhengzhou Key Laboratory of Pediatric Kidney Disease Research, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - S F Zhang
- Department of Nephrology and Rheumatology, Zhengzhou Key Laboratory of Pediatric Kidney Disease Research, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - J T Li
- Department of Nephrology and Rheumatology, Zhengzhou Key Laboratory of Pediatric Kidney Disease Research; Henan Provincial Key Laboratory of Children's Genetics and Metabolic Diseases, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
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25
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Macaranas AR, ElTohamy A, Hyun S, Chae DH, Stevens C, Chen JA, Liu CH. COVID-19-related direct and vicarious racial discrimination: Associations with psychological distress among U.S. college students. J Affect Disord 2023; 325:747-754. [PMID: 36642315 PMCID: PMC9837219 DOI: 10.1016/j.jad.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 12/23/2022] [Accepted: 01/03/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND The COVID-19 pandemic has been accompanied by a myriad of racist incidents targeting minorities in the U.S. Young adults are susceptible to direct and vicarious (indirect) pandemic-related racial discrimination. We sought to examine associations between both types of discrimination experiences and psychological distress among college students across different racial groups. METHODS We analyzed self-reported data from 64,041 undergraduate students from the Spring 2021 American College Health Association-National College Health Assessment. Logistic regression examined odds of severe distress based on self-reported exposure to direct and vicarious racial discrimination. RESULTS Even after controlling for sociodemographic characteristics and prior mental health diagnoses, there was a significant association between direct discrimination and distress among Asian (AOR: 1.3, p < 0.001), Hispanic (AOR: 1.6, p < 0.001), and Multiracial (AOR: 1.4, p < 0.001) students. Vicarious discrimination was significantly associated with distress among White (AOR: 1.4, p < 0.001), Asian (AOR: 1.4, p < 0.001), Hispanic (AOR: 1.5, p < 0.001), and Multiracial (AOR: 1.3, p < 0.001) students. Further analysis considering distress as a continuous measure revealed a significant association between vicarious discrimination and distress for Black participants (β = 0.9, p < 0.001). LIMITATIONS Self-reported variables are susceptible to recall bias. Minority racial group analyses may be underpowered. CONCLUSIONS Our findings reveal an overall link between both direct and vicarious racial discrimination and distress across several racial groups. Further studies should examine effective mental health interventions and anti-racism initiatives to support students who have experienced direct or vicarious discrimination due to COVID-19.
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Affiliation(s)
| | - Abdelrahman ElTohamy
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA,Department of Psychiatry, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA
| | - Sunah Hyun
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - David H. Chae
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Courtney Stevens
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA,Department of Psychology, Willamette University, Salem, OR, USA
| | - Justin A. Chen
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA,Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Cindy H. Liu
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA,Department of Psychiatry, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA,Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA,Corresponding author at: Department of Psychiatry, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA
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26
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Koire A, Feldman N, Erdei C, Mittal L, Liu CH. Postpartum experiences among individuals with suspected and confirmed prenatal generalized anxiety disorder during the COVID-19 pandemic: Implications for help-seeking. Psychiatry Res 2023; 323:115169. [PMID: 36989907 PMCID: PMC10010836 DOI: 10.1016/j.psychres.2023.115169] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 03/09/2023] [Accepted: 03/12/2023] [Indexed: 03/15/2023]
Abstract
Prenatal generalized anxiety disorder (GAD) is a common and underdiagnosed condition with negative health consequences to both the pregnant individual and child. Here we studied the relationship between diagnosis and treatment status of GAD during pregnancy (no GAD diagnosis, suspected but not diagnosed, diagnosed but not treated, diagnosed and treated) during the COVID-19 pandemic and postpartum mental health outcomes, while considering the potential influence of individual psychological factors such as distress tolerance and resilience and the role of COVID-19-related health worries. In this sample of predominantly highly educated and white birthing individuals, one in five respondents experienced GAD during pregnancy and another one in six suspected GAD but was not diagnosed. Amongst those with a GAD diagnosis, 30% did not receive treatment. We found that those with a GAD diagnosis during pregnancy who did not receive treatment showed the highest levels of postpartum anxiety and depressive symptoms in the postpartum, even after controlling for covariates, and experienced the most COVID-19-related health worries. In comparison, individuals with a GAD diagnosis during pregnancy who received treatment experienced significantly lower anxiety symptom burden and depressive symptom burden, with a symptom burden similar to those without a confirmed or suspected diagnosis after controlling for individual psychological factors. We conclude that clinicians should strongly consider screening for and treating prenatal anxiety to prevent suboptimal postpartum mental health outcomes.
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Affiliation(s)
- Amanda Koire
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA 02115,Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115
| | - Natalie Feldman
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA 02115,Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115
| | - Carmina Erdei
- Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115,Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, 221 Longwood Ave. Boston, MA, USA 02115
| | - Leena Mittal
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA 02115,Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115
| | - Cindy H. Liu
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA 02115,Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115,Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, 221 Longwood Ave. Boston, MA, USA 02115,Corresponding Author: Cindy H. Liu, Tel: 617-525-4131, 221 Longwood Ave., BLI 341, Boston, MA 02115
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Chen JL, Sha L, Liu CH. [Research advances in chest tightness variant asthma]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:327-332. [PMID: 36922166 DOI: 10.3760/cma.j.cn112150-20220627-00661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Chest tightness variant asthma (CTVA) is a special type of asthma with chest tightness as the only or main symptom. Due to the lack of typical asthma symptoms such as coughing, wheezing, shortness of breath, and positive signs in chest, it is easy to be missed or misdiagnosed in clinical practice. The onset of chest tightness variant asthma is insidious, and there is few research and attention both domestic and international, so there is no unified diagnosis and treatment standard especially in childhood asthma. This article expounds the related research advances in chest tightness variant asthma, in order to increase clinical attention and provide reference and basis for the prevention of the disease as well as the formulation of diagnosis and treatment strategies.
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Affiliation(s)
- J L Chen
- Department of Allergy, Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing 100020, China
| | - L Sha
- Department of Allergy, Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing 100020, China
| | - C H Liu
- Department of Allergy, Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing 100020, China
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Tu AK, Restivo Haney J, O'Neill K, Swaminathan A, Choi KW, Lee H, Smoller JW, Patel V, Barreira PJ, Liu CH, Naslund JA. Post-traumatic growth in PhD students during the COVID-19 pandemic. Psychiatry Res Commun 2023; 3:100104. [PMID: 36743383 PMCID: PMC9886426 DOI: 10.1016/j.psycom.2023.100104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 01/16/2023] [Accepted: 01/28/2023] [Indexed: 02/01/2023]
Abstract
Throughout the COVID-19 pandemic, graduate students have faced increased risk of mental health challenges. Research suggests that experiencing adversity may induce positive psychological changes, called post-traumatic growth (PTG). These changes can include improved relationships with others, perceptions of oneself, and enjoyment of life. Few existing studies have explored this phenomenon among graduate students. This secondary data analysis of a survey conducted in November 2020 among graduate students at a private R1 University in the northeast United States examined graduate students' levels and correlates of PTG during the COVID-19 pandemic. Students had a low level of PTG, with a mean score of 10.31 out of 50. Linear regression models showed significant positive relationships between anxiety and PTG and between a measure of self-reported impact of the pandemic and PTG. Non-White minorities also had significantly greater PTG than White participants. Experiencing more negative impact due to the pandemic and ruminating about the pandemic were correlated with greater PTG. These findings advance research on the patterns of PTG during the COVID-19 pandemic and can inform future studies of graduate students' coping mechanisms and support efforts to promote pandemic recovery and resilience.
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Affiliation(s)
- Allison K. Tu
- Harvard College, 86 Brattle Street, Cambridge, MA, 02138, USA,Corresponding author
| | - Juliana Restivo Haney
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA,Department of Psychology, West Virginia University, West Virginia University, Morgantown, WV, 26506, USA
| | - Kathryn O'Neill
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA
| | - Akshay Swaminathan
- Stanford University, School of Medicine, 291 Campus Drive, Stanford, CA, 94305, USA
| | - Karmel W. Choi
- Harvard T.H. Chan School of Public Health, Massachusetts General Hospital, 677 Huntington Ave, Boston, MA, 02115, USA
| | - Hyunjoon Lee
- Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
| | - Jordan W. Smoller
- Massachusetts General Hospital, Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA
| | - Paul J. Barreira
- Office of the Provost and Harvard Medical School, Harvard University, Massachusetts Hall, Cambridge, MA, 02138, USA
| | - Cindy H. Liu
- Departments of Pediatric Newborn Medicine and Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA,Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
| | - John A. Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA
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29
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Zhao T, Huang JY, Liu CH, Chen RB, Fan WL, Zheng WL. [Endovascular therapy accompanied by spontaneous portosystemic shunts for overt hepatic encephalopathy]. Zhonghua Gan Zang Bing Za Zhi 2023; 31:181-185. [PMID: 37137834 DOI: 10.3760/cma.j.cn501113-20210705-00315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Objective: To preliminarily evaluate the safety and efficacy of shunt-related interventional therapy accompanied with spontaneous portosystemic shunts (SPSS) in patients with hepatic encephalopathy (HE). Methods: Case data on six patients who underwent interventional therapy accompanied by SPSS for HE from January 2017 to March 2021 were collected to evaluate the efficacy and postoperative complications. Results: All six patients underwent SPSS. Four patients had hepatitis B cirrhosis; one had alcoholic cirrhosis; and one had hepatic arterioportal fistula-induced portal hypertension. Child-Pugh liver function scores were C and B in three and three cases, respectively. The SPSS type was gastrorenal shunt in two cases; portal-thoracic-azygos venous in two cases; portal-umbilical-iliac venous in one case; and portal-splenic venous - inferior vena cava in one case. Two of them had previously had a transjugular intrahepatic portosystemic shunt (TIPS), and there were SPSS prior to TIPS. Five cases (5/6) successfully underwent shunt embolization, and one case (1/6) underwent stent implantation for flow restriction (portal-umbilical-iliac vein). The technical success rate was 100%. HE did not recur during hospitalization or the three-month follow-up period. However, one case had a recurrence of HE within a year after surgery and was treated symptomatically, while another experienced gastrointestinal bleeding a year after surgery.. Conclusion: SPSS embolization or flow restriction is effective and safe for improving HE patients' symptoms.
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Affiliation(s)
- T Zhao
- Department of Radiology, Zhejiang University Medical College Affiliated Sir Run Shaw Hospital, Hangzhou 310000, China
| | - J Y Huang
- Department of Radiology, Zhejiang University Medical College Affiliated Sir Run Shaw Hospital, Hangzhou 310000, China
| | - C H Liu
- Department of Radiology, Zhejiang University Medical College Affiliated Sir Run Shaw Hospital, Hangzhou 310000, China
| | - R B Chen
- Department of Radiology, Zhejiang University Medical College Affiliated Sir Run Shaw Hospital, Hangzhou 310000, China
| | - W L Fan
- Department of Radiology, Zhejiang University Medical College Affiliated Sir Run Shaw Hospital, Hangzhou 310000, China
| | - W L Zheng
- Department of Radiology, Zhejiang University Medical College Affiliated Sir Run Shaw Hospital, Hangzhou 310000, China
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Erdei C, Forde M, Cherkerzian S, Conley MS, Liu CH, Inder TE. "My Brigham Baby" Application: A Pilot Study Using Technology to Enhance Parent's Experience in the Neonatal Intensive Care Unit. Am J Perinatol 2023. [PMID: 36452968 DOI: 10.1055/a-1990-2414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVE This study aimed to describe the family psychosocial experience in a level-III neonatal intensive care unit (NICU), and to assess how it evolved after rollout of an educational smartphone application (App) called "My Brigham Baby." STUDY DESIGN We surveyed 25 NICU parents pre-App rollout (before coronavirus disease 2019 [COVID-19] pandemic) and 25 parents post-App rollout (during pandemic). Collected data included parental self-reported discharge readiness, symptoms of stress and anxiety, and parenting skill confidence. Survey scores were assessed as total or mean scores, and by category of severity. RESULTS Pre-and post-App parents had comparable demographics, and their infants had similar clinical characteristics during their NICU stay. Discharge readiness differed by group status (p = 0.02) and was characterized by a greater frequency in being "very ready" for discharge among the post-App rollout parent group compared with the pre-App group (56 vs. 20%, p = 0.027), and parenting confidence shifted toward more optimal scores post-App rollout. Parental stress and anxiety symptoms did not significantly differ between groups despite possible stress contagion from the COVID-19 pandemic. CONCLUSION This pilot study suggests that technology Apps are feasible interventions within NICU settings and may enhance parental experiences related to NICU hospitalization. KEY POINTS · Parents' experience increased psychological distress during the time their infant is cared for in the NICU, which has downstream consequences for the family unit.. · In our study, surveyed parents reported higher discharge readiness and parenting confidence shifted toward improvement after rollout of a family education and support smartphone application in a level-III NICU.. · This pilot study suggests that technology applications are feasible interventions that might enhance parental experiences during NICU hospitalization..
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Affiliation(s)
- Carmina Erdei
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Madison Forde
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Sara Cherkerzian
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Maria S Conley
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Cindy H Liu
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Terrie E Inder
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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31
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Cerda IH, Macaranas AR, Liu CH, Chen JA. Strategies for Naming and Addressing Structural Racism in Immigrant Mental Health. Am J Public Health 2023; 113:S72-S79. [PMID: 36696610 PMCID: PMC9877373 DOI: 10.2105/ajph.2022.307165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 01/27/2023]
Abstract
Immigrants account for 13.7% of the US population, and the great majority of these individuals originate from Latin America or Asia. Immigrant communities experience striking inequities in mental health care, particularly lower rates of mental health service use despite significant stressors. Structural barriers are a significant deterrent to obtaining needed care and are often rooted in racist policies and assumptions. Here we review and summarize key pathways by which underlying structural racism contributes to disparities in immigrant mental health, including anti-immigration policies, labor and financial exploitation, and culturally insensitive mental health services. Significant accumulated research evidence regarding these barriers has failed to translate into structural reform and financial investment required to address them, resulting in pronounced costs to both immigrant populations and society at large. We propose specific strategies for addressing relevant structural inequities, including reforming economic and financial policies, community education initiatives, and task-sharing and strengths-based interventions developed in partnership with immigrant communities to promote access to mental health care for populations in dire need of culturally appropriate services. (Am J Public Health. 2023;113(S1): S72-S79. https://doi.org/10.2105/AJPH.2022.307165).
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Affiliation(s)
- Ivo H Cerda
- Ivo H. Cerda is with Harvard Medical School, Boston, MA. Anjeli R. Macaranas is a student at Harvard University, Cambridge, MA. Cindy H. Liu is with the Departments of Pediatric Newborn Medicine and Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA. Justin A. Chen is with the Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston
| | - Anjeli R Macaranas
- Ivo H. Cerda is with Harvard Medical School, Boston, MA. Anjeli R. Macaranas is a student at Harvard University, Cambridge, MA. Cindy H. Liu is with the Departments of Pediatric Newborn Medicine and Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA. Justin A. Chen is with the Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston
| | - Cindy H Liu
- Ivo H. Cerda is with Harvard Medical School, Boston, MA. Anjeli R. Macaranas is a student at Harvard University, Cambridge, MA. Cindy H. Liu is with the Departments of Pediatric Newborn Medicine and Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA. Justin A. Chen is with the Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston
| | - Justin A Chen
- Ivo H. Cerda is with Harvard Medical School, Boston, MA. Anjeli R. Macaranas is a student at Harvard University, Cambridge, MA. Cindy H. Liu is with the Departments of Pediatric Newborn Medicine and Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA. Justin A. Chen is with the Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston
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Hahm HC, Hsu KC, Hyun S, Kane K, Liu CH. Psychological Distress and Heavy Alcohol Consumption Among U.S. Young Women During the COVID-19 Pandemic. Womens Health Issues 2023; 33:17-24. [PMID: 36270930 PMCID: PMC9485433 DOI: 10.1016/j.whi.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 08/24/2022] [Accepted: 09/15/2022] [Indexed: 02/01/2023]
Abstract
INTRODUCTION The predictors of heavy drinking among U.S. young women during the COVID-19 pandemic are not well-examined. This study aims to determine the prospective relationship between COVID-19 psychological distress and heavy alcohol use among U.S. young adult women. DESIGN This study used the COVID-19 Adult Resilience Experiences Study (CARES) data collected from April 13, 2020, to August 31, 2020 (T1) and September 21, 2020, to March 15, 2021 (T2). Among the young adults (ages 18-30) who participated in both surveys, a total of 684 identified as women (including transgender women) and were included in the analysis. Three or more drinks as a typical intake were defined as heavy drinking. Psychological distress in T1 was measured using scores for financial stress, COVID-19-related worry, and COVID-19-related grief. A series of logistic regression analyses were performed to identify risk factors associated with young women's heavy drinking during the pandemic. RESULTS Twenty-two and one-half percent of young women reported heavy drinking in a typical intake. After controlling for covariates, women who reported high levels of COVID-19-related grief were more likely to report heavy drinking (odds ratio, 1.06; 95% confidence interval [CI], 1.01-1.13; p < .05). Those with high levels of COVID-19-related worry were less likely to report drinking heavily (odds ratio, 0.90; 95% confidence interval, 0.85-0.97; p < .01). CONCLUSIONS Those who suffer from a deeper sense of COVID-19-related grief are particularly at risk of heavy drinking and should be targeted for outreach and clinical intervention. Further research is necessary to determine the long-term impacts of the pandemic on heavy drinking among young women and should include a more comprehensive assessment of psychological distress.
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Affiliation(s)
- Hyeouk Chris Hahm
- Boston University, School of Social Work, Boston, Massachusetts,Correspondence to: Hyeouk Chris Hahm, PhD, Professor, Boston University, School of Social Work, 264 Bay State Road, #222, Boston, MA 02215. Phone: (617) 353-3925
| | | | - Sunah Hyun
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Kaiden Kane
- Boston Children's Hospital, Boston, Massachusetts
| | - Cindy H. Liu
- Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts
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Wong SHM, Stevens C, Liu CH, Chen JA. Prevalence and Correlates of Prescription Stimulant Misuse Among US College Students: Results From a National Survey. J Clin Psychiatry 2022; 84. [PMID: 36576364 DOI: 10.4088/jcp.22m14420] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective: There is a high prevalence of prescription stimulant misuse (PSM) among college students in the United States (US). Preventing and identifying PSM requires an understanding of risk factors and correlates, but large-scale surveys regarding this issue have been lacking. We present the largest multi-institution study to date on the correlates of PSM among US college students. Methods: We performed a secondary analysis of the 2017 American College Health Association-National College Health Assessment (ACHA-NCHA), an annual national survey on the demographics, health, and academic experiences of US college students. Logistic regression models examined associations between past-year PSM in 40,645 undergraduate college students and hypothesized risk factors. Results: PSM was reported in 8% of college students. PSM was associated with past-year diagnosis or treatment of depression (adjusted odds ratio [AOR] = 1.16; 99% CI, 1.01-1.33), anorexia (AOR = 1.44; 99% CI, 1.02-2.03), attention-deficit/hyperactivity disorder (AOR = 1.66; 99% CI, 1.41-1.95), and substance use disorder/other addiction (AOR = 1.79; 99% CI, 1.30-2.46). The odds of PSM were 5.5 times higher for students who endorsed past-month use of "Legal drugs" and 8 times higher for students who endorsed past-month use of "Illegal drugs" than for those who did not. Other factors associated with PSM included academic difficulty, daytime sleepiness, fraternity or sorority involvement, White race, and cis-male gender. Conclusions: This study identifies many potential risk factors for PSM among US undergraduate college students. Targeted outreach, prevention, and clinical management are discussed. As the COVID-19 pandemic has exacerbated psychiatric distress, sleep difficulties, substance use, and attentional challenges among college students, this study may serve as a baseline for future studies examining the impact of COVID-19 on PSM among college students.
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Affiliation(s)
- Sylvia H M Wong
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, New York
| | | | - Cindy H Liu
- Departments of Pediatric Newborn Medicine and Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Justin A Chen
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Corresponding author: Justin Chen, MD, MPH, MGH WACC 812, 15 Parkman St, Boston, MA 02114
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Ross JM, Sugimoto JD, Timmons A, Moore K, Adams J, Wilson D, Liu CH, Deardoff KV, Korpak A, Chang KM, Cho K, Crothers K, Gaziano M, Holodniy M, Hunt CM, Isaacs SN, Jones BE, Le E, Shah J, Smith NL, Lee JS. 296. SARS-CoV-2 Illness Severity and Early Hospitalization Outcomes in a Multicenter Prospective Cohort Study Among Veterans. Open Forum Infect Dis 2022. [PMCID: PMC9751552 DOI: 10.1093/ofid/ofac492.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Over 600,000 SARS-CoV-2 infections and 20,000 deaths have occurred among users of the Veterans Health Administration, the US’s largest integrated health care system. We explored early outcomes of SARS-COV-2 infection in Veterans. Methods An ongoing, prospective longitudinal cohort study of Veterans ages ≥ 18 enrolled 1,826 participants (29.0% inpatient; 49.1% vaccinated; 68.3% SARS-CoV-2-positive; 85.0% male, mean age = 57.1 years) seeking inpatient or outpatient care after SARS-CoV-2 testing at 15 Department of Veterans Affairs medical centers in July 2020 to February 13, 2022. Using multivariable regression, we estimated relationships of baseline demographic characteristics, COVID-19 vaccination, and clinical history to illness severity and cumulative length of hospital stay within 60 days of study entry. Illness severity was defined by a Veterans Affairs adaptation of the WHO COVID-19 severity scale and included 4 levels (mild, moderate, severe, or death). We derived the Charlson co-morbidity index (CCI) and other baseline characteristics from electronic health data and study questionnaires, and reported qualitative SARS-CoV-2 IgG responses using inpatients’ study-collected blood specimens. Results High CCI scores (≥ 5) occurred in 47 (42.7%) vaccinated SARS-CoV-2-positive inpatients and 47 (21.2%) unvaccinated. Severe illness occurred in 17 (15.5%) vaccinated inpatients, 37 (16.7%) unvaccinated inpatients, 4 (0.9%) vaccinated outpatients, and 3 (0.7%) unvaccinated outpatients. Eleven (10%) of 110 vaccinated SARS-CoV-2-positive inpatients died, as did 15 (6.8%) of the 222 unvaccinated. In SARS-CoV-2-positive inpatients, a one-step higher CCI was associated with more severe illness (aOR 1.10, 95% CI 1.01-1.20) and more hospitalization days (aIRR 1.06, 95% CI 1.03-1.10), adjusting for vaccination status. Respectively, 93% of vaccinated and 63% of unvaccinated SARS-CoV-2 positive inpatients with baseline antibody results had an anti-spike IgG response. Conclusion In an ongoing longitudinal cohort study of COVID-19 in US Veterans, comorbidity burden was higher among vaccinated than unvaccinated inpatients and was associated with more severe illness and hospitalization days, independent of vaccination status. Disclosures Christine M. Hunt, MD, MPH, Adaptive Phage Therapeutics: Advisor/Consultant|Akebia: Advisor/Consultant|Galmed: Advisor/Consultant|Otsuka: Advisor/Consultant|Palladio: Advisor/Consultant.
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Affiliation(s)
| | | | | | - Kathryn Moore
- VA Puget Sound Health Care System, Seattle, Washington
| | | | | | - Cindy H Liu
- VA Puget Sound Healthcare System, Seattle, Washington
| | | | - Anna Korpak
- VA Puget Sound Health Care System, Seattle, WA, USA, Seattle, Washington
| | - Kyong-Mi Chang
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
| | - Kelly Cho
- VA Boston Health Care System, Boston, Massachusetts
| | | | | | - Mark Holodniy
- Department of Veterans Affairs, Palo Alto, California
| | - Christine M Hunt
- Durham Veterans Affairs Health Care System, Durham, North Carolina
| | | | - Barbara E Jones
- University of Utah and Salt Lake City VA Healthcare System, Salt Lake City, Utah
| | - Elizabeth Le
- VA Palo Alto Health Care System, Palo Alto, California
| | - Javeed Shah
- University of Washington, Seattle, Washington
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Liu CH, Koire A, Feldman N, Erdei C, Mittal L. COVID-19-related health worries and generalized anxiety symptoms: Higher risks in perinatal women without a pre-existing generalized anxiety diagnosis. Psychiatry Res 2022; 317:114918. [PMID: 37732861 PMCID: PMC9584754 DOI: 10.1016/j.psychres.2022.114918] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 11/24/2022]
Abstract
The perinatal period has been well-established as a time of vulnerability to anxiety, as has the COVID-19 pandemic. Perinatal women with a prior diagnosis of Generalized Anxiety Disorder (GAD) may be anticipated to be at particular risk for elevated symptom burden when facing the overlay of these stressors. This study examined whether pre-existing anxiety exacerbates COVID-19-related health worries on anxiety symptom severity among a sample of women who entered perinatal status during the COVID-19 pandemic. We assessed COVID-19-related health worries, past diagnosis of GAD, and current generalized anxiety symptoms cross-sectionally in 1,587 perinatal U.S. women during the COVID-19 pandemic (May 21, 2020 to June 24, 2021). Among perinatal women who reported high levels of COVID-19-related health worries, those with a pre-existing GAD diagnosis were 3.56 times more likely to score at clinically significant levels of generalized anxiety, while those without a pre-existing GAD diagnosis were 6.51 times more likely. COVID-19-related health worries posed a larger risk for elevated anxiety symptoms among those without a pre-existing diagnosis of GAD. Greater access to treatment and psychoeducation for such individuals may be warranted for individuals without a pre-existing mental health diagnosis.
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Affiliation(s)
- Cindy H Liu
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, 221 Longwood Ave. Boston, MA, USA 02115; Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA 02115; Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115.
| | - Amanda Koire
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA 02115; Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115
| | - Natalie Feldman
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA 02115; Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115
| | - Carmina Erdei
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, 221 Longwood Ave. Boston, MA, USA 02115; Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115
| | - Leena Mittal
- Department of Psychiatry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA 02115; Harvard Medical School, 25 Shattuck Street, Boston, MA, USA 02115
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Yeung TS, Hyun S, Zhang E, Wong F, Stevens C, Liu CH, Chen JA. Prevalence and correlates of mental health symptoms and disorders among US international college students. J Am Coll Health 2022; 70:2470-2475. [PMID: 33522452 PMCID: PMC8677361 DOI: 10.1080/07448481.2020.1865980] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 10/14/2020] [Accepted: 12/13/2020] [Indexed: 06/12/2023]
Abstract
Objective: This study assessed the prevalence and correlates of mental health (MH) symptoms and diagnoses in international college students in the United States. Participants: The sample included 44,851 degree-seeking undergraduate students (42,428 domestic students and 2,423 international students). Methods: Logistic regression analyses were conducted using international student status to predict MH symptoms and diagnoses from the Spring 2017 administration of the ACHA-National College Health Assessment (ACHA-NCHA). Results: International students were less likely than domestic students to report a diagnosis of anxiety, comorbid depression and anxiety, or other psychiatric diagnoses. International students were more likely to report suicide attempts and feeling overwhelmingly depressed. Conclusions: Among international students studying in the US, lower rates of MH diagnoses despite higher rates of depressive symptoms and suicide attempts mirror similar trends seen in American-born minority students. University campuses should consider culturally sensitive and targeted psychoeducation, mental health services, and outreach programming.
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Affiliation(s)
- Tat Shing Yeung
- Department of Applied Psychology, Northeastern University, Boston, MA
| | - Sunah Hyun
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Emily Zhang
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Fifi Wong
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | | | - Cindy H. Liu
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Justin A. Chen
- Massachusetts General Hospital, Harvard Medical School, Boston, MA
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Lin HC, Zeanah PL, Olivier DF, Bergeron MA, Liu CH. Responding to the pressing yet unrecognized needs of student-parents amid the COVID-19 pandemic. J Am Coll Health 2022; 70:2276-2280. [PMID: 33544047 PMCID: PMC8829875 DOI: 10.1080/07448481.2020.1870474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 12/07/2020] [Accepted: 12/22/2020] [Indexed: 06/12/2023]
Abstract
The urgent closures of campuses nationwide due to the COVID-19 pandemic have presented unforeseen challenges to college students, who already showed concerning rates of mental health conditions and suicidality. Among US college students, more than one in five are parents raising young children. Student-parents are faced with compounding struggles that substantially intersect with those of minority students, students from low-income backgrounds, and first-generation students. However, the challenges and unique needs of student-parents have not been sufficiently recognized by the college administrations. As higher education grapples with supporting students to navigate through the pandemic, reaching out to student-parents and prioritizing their needs is indispensable to assure their continued engagement and completion of studies. The authors offer recommendations for college administrations to help alleviate strains in student-parents amid the crisis and promote strengths and resilience in the short term and beyond.
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Affiliation(s)
- Hung-Chu Lin
- Department of Psychology, University of Louisiana at Lafayette, Lafayette, LA, USA
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Paula L. Zeanah
- Cecil J. Picard Center for Child Development & Lifelong Learning, University of Louisiana at Lafayette, Lafayette, LA, USA
| | - Dianne F. Olivier
- Educational Leadership & Foundations, University of Louisiana at Lafayette, Lafayette, LA; USA
| | - Megan A. Bergeron
- Cecil J. Picard Center for Child Development & Lifelong Learning, University of Louisiana at Lafayette, Lafayette, LA, USA
| | - Cindy H. Liu
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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Zhang E, Hyun S, Yip T, Hahm HC, Liu CH. Learning about discrimination during childhood: Implications for racial trauma among Asians and Asian Americans during the pandemic. Asian J Psychiatr 2022; 77:103250. [PMID: 36116394 DOI: 10.1016/j.ajp.2022.103250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 08/16/2022] [Accepted: 08/29/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Although the COVID-19 pandemic has led to a sharp rise in anti-Asian hate crimes, limited data exist on racial trauma and its effects on Asian Americans. The current study investigated how racial discrimination and parental ethnic-racial socialization (cultural socialization, preparation for bias, and promotion of mistrust) were associated with racial trauma among Asian Americans in young adulthood. Increased cultural socialization and preparation for bias in childhood were hypothesized to be associated with lower levels of racial trauma, whereas increased racial discrimination and promotion of mistrust were hypothesized to predict higher levels of racial trauma. METHODS Based on a retrospective report of young adults during the COVID-19 pandemic, this longitudinal nationwide study within the United States examined 133 Asian and Asian American young adults ages 18-30 who participated in an online survey regarding ethnic identity, childhood ethnic-racial socialization practices, racial discrimination-related experiences, and racial trauma. RESULTS Lifetime discrimination, but not COVID-19-related discrimination, was associated with higher levels of racial trauma. Greater levels of preparation for bias during childhood predicted lower levels of racial trauma in young adulthood. Contrary to the hypothesis, greater levels of cultural socialization predicted higher levels of racial trauma. Promotion of mistrust was not associated with later racial trauma outcomes. CONCLUSION The current study underscores the long-term impacts of parent-child discussions about racism (i.e., preparation for bias) to address racial trauma in young adulthood. Future research should further examine cultural socialization to determine its effects on racial trauma among Asian Americans.
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Affiliation(s)
- Emily Zhang
- Boston College Lynch School of Education and Human Development, United States; Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, United States
| | - Sunah Hyun
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, United States; Jonathan M. Tisch College of Civic Life, Tufts University, United States; Harvard Medical School, United States
| | - Tiffany Yip
- Department of Psychology, Fordham University, United States
| | | | - Cindy H Liu
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, United States; Harvard Medical School, United States; Department of Psychiatry, Brigham and Women's Hospital, United States.
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ElTohamy A, Wang JJ, Chen JA, Stevens C, Liu CH. Association Between College Course Delivery Model and Rates of Psychological Distress During the COVID-19 Pandemic. JAMA Netw Open 2022; 5:e2244270. [PMID: 36449292 PMCID: PMC9713601 DOI: 10.1001/jamanetworkopen.2022.44270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
IMPORTANCE College students in the US have been heavily affected by the COVID-19 pandemic. In addition to increased rates of depression and anxiety, college students have faced unprecedented stressors, such as geographic relocation and abrupt conversion from in-person classes to online classes. OBJECTIVE To study the association between course delivery model and psychological distress among US college students. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional analysis used national data from the American College Health Association-National College Health Assessment III data set. Data were gathered from a web-based survey administered from January to early June 2021 to full-time US college students attending 4-year programs. EXPOSURE Course delivery model was self-reported. MAIN OUTCOMES AND MEASURES Psychological distress was measured using the Kessler Screening Scale for Psychological Distress. RESULTS This study evaluated 59 250 full-time undergraduate students (68.1% women; 51.5% White students; mean [SD] age, 21.2 [4.3] years); 3.5% attended fully in-person classes, 61.2% attended fully online classes, and 35.3% attended a mixed format of in-person and online classes. Students who attended classes fully online reported higher levels of psychological distress than those who attended a mix of online and in-person classes (b = 0.76 [99% CI, 0.64-0.88]; P < .001). This association remained significant after controlling for geographic region, year in school, gender, race and ethnicity, food security, current anxiety and/or depressive disorders, COVID-19 concerns, and residence (living on campus, off campus with family, or other off-campus arrangements) (b = 0.18 [99% CI, 0.04-0.31]; P = .001), as well as time spent socializing with friends (b = 0.13 [99% CI, 0.002-0.26]; P = .009). CONCLUSIONS AND RELEVANCE The findings of this study suggest that mental health professionals may wish to consider the association of course delivery models with mental health outcomes when working with college students. Colleges should be aware of the mental health burden associated with attending fully online classes and consider possible in-person components and supports for students.
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Affiliation(s)
- Abdelrahman ElTohamy
- Harvard Medical School, Boston, Massachusetts
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, Massachusetts
| | | | - Justin A. Chen
- Harvard Medical School, Boston, Massachusetts
- Department of Psychiatry, Massachusetts General Hospital, Boston
| | - Courtney Stevens
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Department of Psychology, Willamette University, Salem, Oregon
| | - Cindy H. Liu
- Harvard Medical School, Boston, Massachusetts
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, Massachusetts
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
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ElTohamy A, Hyun S, Macaranas AR, Chen JA, Stevens C, Liu CH. Testing positive, losing a loved one, and financial hardship: Real-world impacts of COVID-19 on US college student distress. J Affect Disord 2022; 314:357-364. [PMID: 35878829 PMCID: PMC9304338 DOI: 10.1016/j.jad.2022.07.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/30/2022] [Accepted: 07/17/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND The COVID-19 pandemic has taken a particularly heavy toll on U.S. college students. In addition to facing academic-related stress and social pressures, these individuals are now increasingly susceptible to experiences such as contracting the virus, losing loved ones to COVID-19, or facing financial hardship due to the pandemic. The effects of such personal, pandemic-related experiences on young adult mental health - and the inherent racial disparities within these outcomes - remain largely understudied. METHODS We analyzed 65,568 undergraduate students from the Spring 2021 American College Health Association-National College Health Assessment (ACHA-NCHA). RESULTS The rates of the aforementioned COVID-19-related stressors were unevenly distributed across racial groups. A logistic regression analysis to identify predictors of moderate and serious psychological distress revealed that participants who had experienced the death of a loved one had 1.14 times greater odds of developing psychological distress (p < 0.0001). Those who experienced financial hardship had an odds ratio of 1.78 (p < 0.0001). Surprisingly, testing positive for COVID-19 was associated with an odds ratio of 0.82 of psychological distress (p < 0.0001). LIMITATIONS Self-reported measures are susceptible to recall bias and misinterpretation. Exposure and outcome variables were measured simultaneously in this cross-sectional study which limits inference on causality. CONCLUSIONS Financial burdens and bereavement are especially impactful stressors among college students during the pandemic, whereas contracting COVID-19 seemingly exhibits less impact on distress levels. When addressing student wellbeing, institutions should consider prioritizing the implementation of resources to support individuals affected by pandemic-related financial and familial losses.
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Affiliation(s)
- Abdelrahman ElTohamy
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA,Department of Psychiatry, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA
| | - Sunah Hyun
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA
| | | | - Justin A. Chen
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA,Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Courtney Stevens
- Department of Psychology, Willamette University, Salem, OR 97301, USA
| | - Cindy H. Liu
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA,Department of Psychiatry, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA,Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA,Corresponding author at: Departments of Pediatric Newborn Medicine and Psychiatry, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA
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41
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Liu CH, Hyun S, Erdei C, Mittal L. Prenatal distress during the COVID-19 pandemic: clinical and research implications. Arch Gynecol Obstet 2022; 306:397-405. [PMID: 34716818 PMCID: PMC8556835 DOI: 10.1007/s00404-021-06286-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 10/13/2021] [Indexed: 12/03/2022]
Abstract
PURPOSE The objective of this study was to identify risk and protective factors related to general prenatal distress and COVID-19-specific prenatal distress to inform intervention targets among women pregnant during the COVID-19 pandemic. METHODS The study relied on data obtained from U.S. pregnant women (N = 701) who participated in the Perinatal Experiences and COVID-19 Effects (PEACE) Study from May 21 to October 3, 2020. The present cross-sectional study examined the potential risk and protective factors associated with different features of prenatal distress among U.S. pregnant women during the COVID-19 pandemic. RESULTS Approximately two-thirds of expectant mothers indicated being more stressed about going to the hospital because of COVID-19. Generalized anxiety and PTSD were associated with higher levels of general and COVID-19-specific prenatal distress. Depression symptoms were associated with higher general prenatal distress. Higher levels of distress tolerance were associated with lower levels of general prenatal distress (B = - 0.192, p < .001) and COVID-19-specific prenatal distress (B = - 0.089, p < .05). Higher levels of instrumental social support were marginally associated with lower COVID-19-specific prenatal distress (B = - 0.140, p < 0.1). CONCLUSION Findings draw attention to prenatal distress experiences during the COVID-19 pandemic, including new types of distress arising from the pandemic itself. Women might benefit from the introduction of interventions such as mindfulness-based or relaxation therapy. Coverage of responsibilities and financial assistance is particularly needed during the COVID-19 pandemic. Limitations include a majority White and high socioeconomic sample. These findings provide specificity regarding potential targets for addressing prenatal distress.
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Affiliation(s)
- Cindy H Liu
- Department of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA.
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
| | - Sunah Hyun
- Department of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Carmina Erdei
- Department of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Leena Mittal
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Wong YJ, Kumar R, Kumar R, Tan J, Liu CH, Hui VW, Tan SS, Kao JH, Wong GL, Thurairajah PH. Treatment outcomes of sofosbuvir/velpatasvir/voxilaprevir among NS5A inhibitor-experienced patients with hepatitis C: Real-world data from a multicenter Asian registry. J Gastroenterol Hepatol 2022; 37:1642-1644. [PMID: 35723645 PMCID: PMC9543910 DOI: 10.1111/jgh.15918] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 06/16/2022] [Indexed: 12/12/2022]
Affiliation(s)
- YJ Wong
- Changi General HospitalChangiSingapore,Duke‐NUS Medicine Academic Clinical Program, SinghealthSingapore
| | - R Kumar
- Duke‐NUS Medicine Academic Clinical Program, SinghealthSingapore,Singapore General HospitalSingapore
| | - R Kumar
- Changi General HospitalChangiSingapore,Duke‐NUS Medicine Academic Clinical Program, SinghealthSingapore
| | - J Tan
- Changi General HospitalChangiSingapore,Duke‐NUS Medicine Academic Clinical Program, SinghealthSingapore
| | - CH Liu
- National Taiwan University HospitalTaipeiTaiwan
| | - VW‐K Hui
- Medical Data Analytics CentreThe Chinese University of Hong KongHong Kong
| | - SS Tan
- Selayang HospitalBatu CavesSelangorMalaysia
| | - JH Kao
- National Taiwan University HospitalTaipeiTaiwan
| | - GL‐H Wong
- Medical Data Analytics CentreThe Chinese University of Hong KongHong Kong
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Abstract
The COVID-19 pandemic has already produced profound impacts on college students, with unprecedented directives for student relocation from their college campuses and dormitories mid-semester and coursework that took place through virtual learning. The current disruptions and anticipated potential long-term changes call for immediate prioritization regarding next steps for addressing college mental health and well-being. This viewpoint article highlights two urgent priorities for addressing current college mental health needs: the development of strategies for ensuring mental health service access, and intentional outreach to college students with special circumstances. The current crisis also represents an opportunity for campus administrators, mental health professionals, researchers, and policymakers to leverage innovative models of care as well as identity-related student assets, strengths, and resilience-promoting factors to support students' eventual return to campus and to respond more effectively to future massive disruptions.
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Affiliation(s)
- Cindy H Liu
- Departments of Newborn Medicine and Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Stephanie Pinder-Amaker
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Massachusetts, USA
| | - Hyeouk Chris Hahm
- School of Social Work, Boston University, Boston, Massachusetts, USA
| | - Justin A Chen
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Qi JS, Hu XD, Liu CH. [Reversal mechanism of hepatic fibrosis]. Zhonghua Gan Zang Bing Za Zhi 2022; 30:577-582. [PMID: 36038317 DOI: 10.3760/cma.j.cn501113-20220504-00239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
There is an increasing histological clinical evidence that both hepatic fibrosis and some degree of cirrhosis reversal can improve prognosis. Hepatic fibrosis involves a variety of cells and steps, and its reversal mechanism is also very complex, mainly including the reduction of hepatocyte necrosis and regeneration, the apoptosis and inactivation of activated hepatic stellate cells, and the reversal of hepatic sinusoidal endothelial cells and microvessels, restorative hepatic macrophages polarization and cell-to-cell interactions. Furthermore, the biochemical basis for reversal of hepatic fibrosis is decreased expression of matrix metalloproteinase inhibitors, up-regulation of matrix metalloproteinase activity, and increased degradation of extracellular matrix. However, at present, there are few studies on the clinicopathological mechanism of liver fibrosis reversal, and the key target groups of different etiologies with different degrees are still unclear, and the corresponding translational application research is lacking. Therefore, an in-depth and systematic understanding of the characteristics and mechanisms of hepatic fibrosis reversal can not only enrich the understanding of the natural history of hepatic fibrosis and cirrhosis, but also provide reference for the development and clinical application of anti-hepatic fibrotic drugs.
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Affiliation(s)
- J S Qi
- Institute of Liver Diseases, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - X D Hu
- Department of Biology, School of Basic Medical Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - C H Liu
- Institute of Liver Diseases, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
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45
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Song X, Liu CH, Wang W, Huang GM, Zhao J, Sha L. [Characteristics and changes of sensitization patterns of major allergens in children from 2010 to 2020 in a hospital of pediatric in Beijing]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:763-773. [PMID: 35785858 DOI: 10.3760/cma.j.cn112150-20220321-00266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To analyze the sensitization characteristics and change of major allergens in children from 2010 to 2020 in Beijing, so as to provide basis for diagnosis, treatment and prevention of allergic diseases in children. Methods: A retrospective study was conducted to analyze the children who were suspected of allergic diseases and tested for serum immunoglobulin E (total IgE and specific IgE) in the children's Hospital Affiliated to the Capital Institute of Pediatrics from January 2010 to December 2020. A total of 45 746 children aged 0-17 years in Beijing were enrolled with a median (interquartile range) of 3.8 (2.5, 5.3) years. There were 28 918 boys (63.2%) and 16 828 girls (36.8%) and 14 984 cases (32.8%) in the infant group (<3 years old), 22 049 cases (48.2%) in the preschool group (3-6 years old), and 8 713 cases (19.0%) in the school-age group (6 years old and above). Immunocap allergen detection system (fluorescence enzyme-linked immunosorbent assay) was used to detect and the characteristics and change trend of allergens during 11 years were statistically analyzed by Chi square test. Results: The top three positive rates of single food allergens sIgE were egg white 42.6% (2 788/6 577 tests), milk 38.4% (2 606/6 782 tests) and wheat 31.8% (1 417/4 449 tests), and the sequence of single inhaled allergens were Ragweed 42.6% (440/1 034 tests), Artemisia 38.4% (1 045/3 191 tests) and Alternaria alternata 31.3% (3 358/10 725 tests). The positive detection rates of egg white 47.0%(1 904/4 048 tests), milk 41.9%(1 769/4 226 tests) and wheat 33.9%(973/2 870 tests) in the infant group were the highest, and there have statistically significant(χ2=91.495, 73.907, 16.966, P<0.05). The positive rates of fx1 (22.5%, 121/537 tests), peanut (24.9%, 111/446 tests), soybean (20.0%, 74/370 tests) and shrimp (7.48%, 44/588 tests) were the highest in the school-age group(χ²=14.436, 10.751, 11.569, 13.703, P<0.05). The most common inhaled allergens were Alternaria alternata (14.8%, 422/2 859 tests) in the infant group, Ambrosia (34.5%, 143/415 tests) and Alternaria alternata (33.5%, 1 762/5 254 tests) in the preschool group, while in the school-age group were Ambrosia (56.4%, 282/500 tests) and Artemisia (48.2%, 573/1 189 tests). The positive rates of egg white, milk, wheat, sesame seed and peanut varied from 2010 to 2020, showing a trend of falling first and then rising(χ²=10.293,χ²=12.066,χ²=7.402,χ²=32.458,χ2=31.747,P<0.05).The positive detection rates of soybean showed a significant downward trend (21.4%, 173/809 tests in 2010, 15.4%, 70/455 tests in 2020, χ²=6.751,P=0.009), while that of shrimp and crab were at a stable low level(χ²=0.263, 1.346;P>0.05). From 2010 to 2020, mold (26.7%, 1 066/3 998 tests in 2010, 40.2% 1 705/4 243 tests in 2020), grass pollen (19.8%, 259/1 308 tests in 2010, 39.3%, 1 472/3 746 tests in 2020), tree pollen(17%, 180/1 058 tests in 2010, 29.8%, 916/3 075 tests in 2020) and animal dander (18.5%, 111/601 tests in 2010, 26.6%, 672/2 522 tests in 2020) were all showed significant upward trend (χ²=168.600, 163.601, 65.931 and 17.271 respectively, P<0.001) but dust mites (30.7%, 1 270/4 132 tests in 2010, 26.7%, 1 126/4 221 tests in 2020) showed a significant downward trend(χ²=16.822,P<0.001).In 2010, the most common inhaled allergen was dust mite 30.7% (1 270/4 132 tests), followed by mold 26.7% (1 066/3 998 tests), while they were mold 40.2% (1 705/1 243 tests), and grass pollen 39.3% (1 472/3 746 texts) respectively in 2020. Conclusion: In the past 11 years, the main food allergens in children were still egg white and milk, wheat, but the mold and pollen gradually replaced dust mite as the most common inhaled allergen.
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Affiliation(s)
- X Song
- Department of Allergy, Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing 100020, China
| | - C H Liu
- Department of Allergy, Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing 100020, China
| | - W Wang
- Department of Biochemistry and Immunology, Capital Institute of Pediatrics, Beijing 100020, China
| | - G M Huang
- Child Health Big Data Research Center, Capital Institute of Pediatrics, Beijing 100020, China
| | - J Zhao
- Department of Allergy, Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing 100020, China
| | - L Sha
- Department of Allergy, Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing 100020, China
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Zhang X, Wong GTF, Liu CH, Hahm HC, Chen JA. International student stressors and mental health during the COVID-19 pandemic: a qualitative study. J Am Coll Health 2022:1-7. [PMID: 35549622 DOI: 10.1080/07448481.2022.2068015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 02/25/2022] [Accepted: 04/13/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To identify stressors affecting international students' mental health during the COVID-19 pandemic. PARTICIPANTS Twenty-two international students from 10 countries and 17 US institutions participated. METHODS Participants were recruited from a larger study examining the wellbeing of young adults during the pandemic. RESULTS Four main stressors were identified: (1) Uncertainty and anxiety induced by decisions and policies in response to COVID-19; (2) Fears regarding xenophobia; (3) Limited understanding by educators and school staff of international students' unique challenges; (4) Greater awareness of racial and cultural identity. CONCLUSION The pandemic has contributed to additional stressors for international students. Educators and mental health professionals may help support international students' mental health by gaining basic knowledge about common stressors and directly acknowledging the challenges, educating international students on race and racism and supporting anti-racism efforts, and encouraging the creation of shared affinity spaces and increasing psychoeducation to promote resilience.
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Affiliation(s)
- Xiaoqiao Zhang
- School of Education, Shanghai Jiaotong University, Shanghai, China
| | - Ga Tin Finneas Wong
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Cindy H Liu
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Hyeouk Chris Hahm
- School of Social Work, Boston University, Boston, Massachusetts, USA
| | - Justin A Chen
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
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47
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Wang XY, Shao MJ, Wang YF, Du YY, Xiong SQ, Sha L, Liu CH. [Clinical characteristics of IgE-mediated cow's milk protein allergy in children]. Zhonghua Er Ke Za Zhi 2022; 60:447-451. [PMID: 35488639 DOI: 10.3760/cma.j.cn112140-20211108-00933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To analyze the clinical features of IgE-mediated cow's milk protein allergy (CMPA) in children aged 0-5 years. Methods: This cross-sectional study collected the data on children diagnosed with CMPA in the Department of Allergy at the Children's Hospital of the Capital Institute of Pediatrics from October 2019 to November 2020 and improved peripheral blood routine,total IgE defection, milk specific IgE (sIgE) defection,SPT and milk component defection,diagnosis of severe anaphylaxis based on clinical manifestations. Rank-sum test and chi-square test are used for statistical analysis of clinical characteristics between groups. Results: A total of 106 children (67 boys and 39 girls) were enrolled with the age of 15 (8, 34) months, including 42 cases (≤ 1 year of age), 39 cases (>1-<3 years of age) and 25 cases(≥3 years of age), the onset age of 6 (5, 8) months. Among them, 95 cases (89.6%) were reacted after consuming milk or its products, 42 cases (39.6%) had reaction due to skin contact and 11 cases (10.4%) reacted after exclusive breastfeeding. The onset time of milk product consumption was 45 (1, 120) min, skin contact pathway was 10 (5, 30) min and symptoms in breastfeeding pathway was 121 (61, 180) min. There was statistical difference among the time of symptoms (χ2=77.01, P<0.001).The cutaneous reaction was most common (100 cases, 94.3%), followed by digestive (20 cases, 18.9%) and respiratory (16 cases, 15.1%), and the nervous symptoms (1 case, 0.9%) were uncommon and 24 cases (22.6%) had at least one episode of anaphylaxis. There were 87 cases (82.1%) also diagnosed with other food allergies, 94 cases (88.7%) with previous eczema, 57 cases (53.8%) with history of rhinitis, and 23 cases (21.7%) with history of wheezing. The total IgE level was 191.01 (64.71, 506.80) kU/L, and the cow's milk sIgE level was 3.03 (1.11, 15.24) kU/L. The maximum diameter of the wheal in SPT was 8.2 (4.0, 12.0) mm. Component resolved diagnosis showed that 77 cases (81.9%) were sensitized to at least one out of 4 main components, including casein, α lactalbumin, β lactoglobulin and bovine serum albumin.The possibility of anaphylaxis in children with milk sIgE grade Ⅳ-Ⅵ was higher than that in children with grade 0-Ⅲ (57.7% (15/26) vs. 12.5% (10/80), OR=9.545, 95%CI 3.435-26.523). Children with milk SPT ≥+++ had a higher probability of anaphylaxis than those with milk SPT ≤++ (34.4% (11/32) vs. 11.5% (3/26), OR=4.016, 95%CI 0.983-16.400). Anaphylaxis were more common in α lactalbumin positive children than in negative children (34.3% (13/38) vs. 14.2% (8/56), χ2=1.23,P=0.042). Conclusions: CMPA in children has early onset and diversified clinical manifestations, which are mainly cutaneous symptoms. Most children are sensitized to at least one allergen component. Serum sIgE level, SPT reaction and allergen components play important roles in the diagnosis and evaluation of CMPA, and higher milk sIgE level may predict a higher risk of anaphylaxis.
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Affiliation(s)
- X Y Wang
- Department of Allergy, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - M J Shao
- Department of Allergy, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - Y F Wang
- Department of Allergy, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - Y Y Du
- Department of Allergy, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - S Q Xiong
- Department of Allergy, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - L Sha
- Department of Allergy, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - C H Liu
- Department of Allergy, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
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Liu CH, Koire A, Erdei C, Mittal L. Subjective social status, COVID-19 health worries, and mental health symptoms in perinatal women. SSM Popul Health 2022; 18:101116. [PMID: 35582494 PMCID: PMC9098429 DOI: 10.1016/j.ssmph.2022.101116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 11/13/2022] Open
Abstract
Pregnant women and those who have recently given birth are considered an at-risk population during the COVID-19 pandemic with regards to the impact of both general stress and pandemic-related stressors. The extent to which subjective social status (SSS), one's perception of relative standing compared to others in a social hierarchy, might mitigate the effects of COVID-19-related health worries on mental health has not yet been reported, despite SSS often outperforming socioeconomic status as a predictor of various health outcomes including depression. This cross-sectional survey study tested the moderating effect of SSS on association between COVID-19- related health worries and mental health symptoms (depressive and generalized anxiety) among a sample of 1,637 perinatal women from the United States who took part in the Perinatal Experiences and COVID-19 Effects (PEACE) Study between May 2020 and June 2021. We found that high subjective social status was protective against depressive symptoms when self-reported COVID-19-related worry was low. When COVID-19-related worry was high, subjective social status was no longer influential. Higher levels of COVID-19-related health worries were associated with more anxiety symptoms, and higher subjective social status did not moderate anxiety symptomatology at either level of COVID-19-related worry. Although higher SSS has historically been protective against mental health decline, in the context of the COVID-19 pandemic it may not be sufficiently protective against anxiety, or against depression for those who experience high levels of worry regarding the effects of COVID-19 on health. We assessed perinatal women for mental health symptoms and subjective social status. High subjective social status protected against depression when COVID worry was low. When COVID worry was high, subjective social status didn't protect against depression. COVID-19-related health worries were associated with more anxiety symptoms. High subjective social status was not protective against anxiety symptoms.
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Liu J, Geng J, Liu JQ, Xue XJ, Yan JZ, Yuan Y, Zhang XB, Liu CH, Zhang GL. [Analysis of factors associated with the structure of the gut microbial community in HIV/AIDS patients in some areas of Henan province]. Zhonghua Liu Xing Bing Xue Za Zhi 2022; 43:566-571. [PMID: 35443314 DOI: 10.3760/cma.j.cn112338-20211025-00816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To investigate the related factors associated with the structure of the gut microbial community in HIV infection/AIDS cases (HIV/AIDS) in Henan province. Methods: The convenience sampling method was used to select 122 cases who were receiving Antiviral Treatment (ART) or ART-naive in Henan. Whole blood and stool specimens were collected. Genomic DNA of stool samples was extracted, and the V3-V4 hypervariable regions of the 16S rRNA gene were sequenced using Illumina NovaSeq 6000 high-throughput sequencing system. The analysis was performed mainly at the genus level, and the 30 genera with the highest abundance were selected as a measure of the gut microbial community structure. The correlation between community structure and related factors was analyzed using redundancy analysis and Envfit function. Results: 122 cases were finally completed sequencing and analysis, the average BMI was (23.62±2.78) kg/m2 and the average age was (47±13) years. Among them, male accounted for 66.39% (81/122), and heterosexual transmission route constituted the largest ratio, accounting for 51.64% (63/122). 36 cases were treatment naive (29.51%, 36/122). The top five dominant genera of the total population (122 cases) were Prevotella, Roseburia, Megamonas, Bacteroides and Faecalibacterium and the top five dominant genera of the ART population (86 cases) were Prevotella, Megamonas, Bacteroides, Roseburia and Faecalibacterium. The top five dominant genera of the ART-naive population (36 cases) appeared as Prevotella, Faecalibacterium, Roseburia, Bacteroides and Megamonas. In the total population, ART (P<0.001) was the most significant factors of community structure. Other significant factors were: duration of diagnosis (P=0.009), viral load (P=0.022) and anti-HCV (P=0.018). ART was positively correlated with Megamonas and negatively correlated with Prevotella, Roseburia and Faecalibacterium, while the other three factors of duration of diagnosis, viral load and anti-HCV were positively correlated with Prevotella, Roseburia and Faecalibacterium and negatively correlated with Megamonas. In the ART-naive population, duration of diagnosis (P=0.003) were the factors significantly associated with community structure. Duration of diagnosis was positively correlated with Roseburia, Faecalibacterium, Megamonas and Prevotella and negatively correlated with Bacteroides. Conclusion: ART and duration of diagnosis were factors significantly associated with gut microbial community structure and had a significant impact on multiple high-abundance genera.
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Affiliation(s)
- J Liu
- Institute for Prevention and Control of STD and AIDS, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
| | - J Geng
- Institute for Prevention and Control of STD and AIDS, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
| | - J Q Liu
- Institute for Prevention and Control of STD and AIDS, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
| | - X J Xue
- Institute for Prevention and Control of STD and AIDS, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
| | - J Z Yan
- Institute for Prevention and Control of STD and AIDS, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
| | - Y Yuan
- Institute for Prevention and Control of STD and AIDS, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
| | - X B Zhang
- Institute for Prevention and Control of STD and AIDS, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
| | - C H Liu
- Institute for Prevention and Control of STD and AIDS, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
| | - G L Zhang
- Institute for Prevention and Control of STD and AIDS, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China
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50
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Liu HM, Fu Z, Zhang XB, Zhang HL, Bao YX, Wu XD, Shang YX, Zhao DY, Zhao SY, Zhang JH, Chen ZM, Liu EM, Deng L, Liu CH, Xiang L, Cao L, Zou YX, Xu BP, Dong XY, Yin Y, Hao CL, Hong JG. [Expert consensus on rational usage of nebulization treatment on childhood respiratory system diseases]. Zhonghua Er Ke Za Zhi 2022; 60:283-290. [PMID: 35385931 DOI: 10.3760/cma.j.cn112140-20220118-00059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- H M Liu
- Department of Pediatric Pulmonology and Immunology, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - Z Fu
- Department of Respiratory, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - X B Zhang
- Department of Respiratory Disease, Children's Hospital of Fudan University, Shanghai 201102, China
| | - H L Zhang
- Department of Pediatric Respiratory Medicine, the Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Y X Bao
- Tongxing Children's Clinic, Shanghai 200433, China
| | - X D Wu
- Department of Respiratory,Xiamen Children's Hospital (Children's Hospital of Fudan University at Xiamen), Xiamen 361006, China
| | - Y X Shang
- Department of Pediatric Pulmonology, Shengjing Hospital of China Medical University, Shenyang 110136, China
| | - D Y Zhao
- Department of Respiratory Medicine, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
| | - S Y Zhao
- Department No.2 of Respiratory Medicine, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - J H Zhang
- Department of Pediatric Respiratory, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Z M Chen
- Department of Pulmonology, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China
| | - E M Liu
- Department of Respiratory, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - L Deng
- Department of Respiratory,Guangzhou Women and Children's Medical Center, Guangzhou 510623, China
| | - C H Liu
- Department of Allergy,Children's Hospital Capital Institute of Pediatrics, Beijing 100020, China
| | - L Xiang
- Department of Allergic Medicine, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - L Cao
- Department of Allergy,Children's Hospital Capital Institute of Pediatrics, Beijing 100020, China
| | - Y X Zou
- Department of Respiratory, Tianjin Children's Hospital, Tianjin 300134, China
| | - B P Xu
- Department of Respiratory Medicine, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - X Y Dong
- Department of Pulmonology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200062, China
| | - Y Yin
- Department of Respiratory Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200062, China
| | - C L Hao
- Department of Respiratory,Children's Hospital of Soochow University, Suzhou 215002, China
| | - J G Hong
- Department of Pediatrics, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
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