Impact of long working hours on depressive symptoms among COVID-19 frontline medical staff: The mediation of job burnout and the moderation of family and organizational support.

Background: During the COVID-19 pandemic, the frontline medical staff faced more workload and heavier physical and mental stress, which increased their job burnout and negative emotions. However, little is known about the potential factors mediating and moderating these relations. This study investigates the association between long working hours and depressive symptoms among frontline medical staff in China, and explores the potential mediating effect of job burnout, and moderating effect of family and organizational support on these associations. Methods: Data of 992 frontline medical staff who participated in the prevention and control of COVID-19 was obtained from the online survey conducted in November to December 2021 in China. Depressive symptoms were evaluated using the Patient Health Questionaire-9 (PHQ-9). Moderated mediating model was employed to understand the relationship between long working hours (X), depressive symptoms (Y) mediated through job burnout (M), moderated by family support (W1) and organizational support (W2), while controlling all possible covariates. Results: 56.96% of participants worked more than 8 h per day. 49.8% of them had depressive symptoms (PHQ-9 ≥ 5) and 65.8% experienced job-related burnout. Long working hours was positively associated with depressive symptoms score (ß = 0.26, 95% CI:0.13 ~ 0.40). Mediation analyses revealed that job burnout significantly mediated this relationship (indirect effect = 0.17, 95% CI: 0.08 ~ 0.26). Moderated mediation further indicated that both two interactions of social support (family support W1, organizational support W2) and job burnout were negatively related to depressive symptoms among frontline medical staff, indicating that higher social support being less job burnout with lower depressive symptoms. Conclusion: Longer working hours and higher job burnout may contribute to worse mental health among frontline medical staff. Social support could buffer the detrimental effects by reducing their job burnout. Contribution: The main contribution of this study was to estimate the negative effect of long working hours on depressive symptoms among frontline medical staff and explore the potential mediating role of job burnout and moderating role of social support on these associations.

Coexistence of Three Different Spin States in a Cyanido-Bridged Trinuclear Iron(III) Complex with an Unusual Fe III to Ligand Charge Transfer.

We report a trinuclear iron(III) cyanido-bridged complex trans-[CpMe3FeIII(dppe)(CN)]2[FeIII(LN4)][PF6]4 (2[PF6]4) as the oxidation product of binuclear complex [CpMe3(dppe)FeIICN-FeIII(LN4)][PF6] (1[PF6]) (CpMe3 = 1, 2, 4-trimethyl-1,3-cyclo-pentadienyl, dppe = 1,2-bis(diphenylphosphino)ethane, LN4 = pentane-2,4-dione-bis(S-methylisothiosemicarbazonato). Complex 1[PF6] possesses an intermediate-spin five-coordinated FeIII (S = 3/2) which couples antiferromagnetically to the π-radical ligand (L•N4)2- and shows a LMCT (ligand to metal charge transfer) transition from (L•N4)2- to FeIII and the FeII → FeIII MMCT transition. Upon oxidation of 1[PF6], (L•N4)2- loses one electron to be the strong electron-attracting ligand (LOxN4)- and the intermediate-spin five-coordinated FeIII (S = 3/2) becomes a low-spin six-coordinated FeIII (S = 1/2) in 2[PF6]4. Also interestingly, 2[PF6]4 presents the coexistence of three different spin states (one S = 3/2 and two S = 1/2) and an uncommon FeIII → (LOxN4)- MLCT transition , confirmed by the experimental results and supported by the TDDFT calculations.

Multicomponent Sulfonylation of Alkenes to Access ß-Substituted Arylsulfones.

A novel multicomponent sulfonylation of alkenes is described for the assembly of various ß-substituted arylsulfones using cheap and easily available K2S2O5 as a sulfur dioxide source. Of note, the procedure does not need any extra oxidants and metal catalysts and exhibits a relatively wide substrate scope and good functional group compatibility. Mechanistically, an initial arylsulfonyl radical is formed involving the insertion of sulfur dioxide with aryl diazonium salt, followed by alkoxyarylsulfonylation or hydroxysulfonylation of alkenes.

The impact of anti-Asian racism on routine activities and mental health among Korean American older adults and their caregivers.

Introduction: Reported anti-Asian discrimination has been on the rise since the COVID-19 pandemic. Nevertheless, limited research addresses the health impact of perceived anti-Asian racism on Asian Americans, especially among older adults, during COVID-19. To address the gap, we examined how the novel coronavirus pandemic affected Korean American older adults, one of the largest Asian subgroups. Specifically, this study addressed the magnitude of racism or discrimination related to the pandemic and impact of anti-Asian racism on negative mental health symptoms among Korean American older adults and their caregivers. Methods: We used survey data collected from 175 Korean American older adults with probable dementia and their primary caregivers (female = 62%, mean age = 71 years) who went through eligibility screening for an ongoing randomized controlled trial involving dyads in the Baltimore-Washington and the New York Metropolitan areas (ClinicalTrials.gov Identifier: NCT03909347). Results: Nearly a quarter of the survey sample reported they were fearful for their safety due to anti-Asian racism related to the pandemic. Additionally, 47% of the respondents indicated changes to routine activities due to anti-Asian racism or discrimination related to COVID-19. The most common changes included avoiding walking alone or physical activities outside, followed by avoiding public transportation or leaving the house to go to any public places such as grocery stores, churches, or schools, not carrying out usual social activities, and avoiding going to health care appointments. Multinomial logistic regression revealed that people who reported changes to routine activities were at least five times more likely (adjusted odds ratio = 5.017, 95% confidence interval = 1.503, 16.748) to report negative mental health symptoms than those who did not. Being fearful for their own safety was not associated with experiencing negative mental health symptoms in the survey sample. Discussion: Study findings indicate that the increased reporting of anti-Asian racism during the COVID-19 pandemic has substantially affected Korean American older adults and their caregivers. The mechanism by which changes to routine activities is related to negative mental health symptoms is unclear, future research is needed to elucidate this pathway. Furthermore, our findings highlight the importance of identifying multi-level strategies to raise awareness of and to mitigate the reported surge of racism.

Characteristics of Cognitive Function Changes and Related Factors in Individuals With Cognitive Impairment During the Pandemic of COVID-19: A Retrospective Chart Review Study.

OBJECTIVE: This study aimed to explore the characteristics and factors related to changes in cognitive function in vulnerable individuals with cognitive impairment during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: Among patients who visited a local university hospital with subjective cognitive complaints, those who had been tested for cognitive function at least once after the onset of COVID-19 and tested regularly at least three times within the last 5 years were included (1st, the initial screening; 2nd, the test immediately before the COVID-19 pandemic; 3rd, the most recent test after the pandemic). Finally, 108 patients were included in this study. They were divided into groups according to whether the Clinical Dementia Rating (CDR) was maintained/improved and deteriorated. We investigated the characteristics of the changes in cognitive function and related factors during COVID-19. RESULTS: When comparing CDR changes before and after COVID-19, there was no significant difference between the two groups (p=0.317). Alternatively, the main effect of the time when the test was conducted was significant (p<0.001). There was also a significant difference in the interaction between the groups and time. When the effect of the interaction was analyzed, the CDR score of the maintained/ improved group significantly decreased before COVID-19 (1st-2nd) (p=0.045). After COVID-19 (2nd-3rd), the CDR score of the deteriorated group was significantly higher than that of the maintained/improved group (p<0.001). Mini-Mental State Examination recall memory and changes in activity during COVID-19 were significantly associated with CDR deterioration. CONCLUSION: Memory dysfunction and decreased activity during the COVID-19 pandemic are strongly related to the deterioration of cognitive impairment.

Multiple genetic mutations increase the risk of thrombosis associated with clopidogrel after percutaneous coronary intervention.

Background: The effect of multiple mutations in CYP2C19, PON1 and ABCB1 genes on the effectiveness and safety of dual antiplatelet therapy after percutaneous coronary intervention remains unclear. Methods: In total, 263 Chinese Han patients were enrolled in this study. Platelet aggregation rates and thrombosis risk were used to compare clopidogrel responses and outcomes in patients with different numbers of genetic mutations. Results: Our study demonstrated that 74% of the patients carried more than two genetic mutations. High platelet aggregation rates were associated with genetic mutations in patients receiving clopidogrel and aspirin after percutaneous coronary intervention. Genetic mutations were closely related to the recurrence of thrombotic events, but not bleeding. The number of genes that become dysfunctional in patients is directly correlated with the risk of recurrent thrombosis. Conclusion: Compared with CYP2C19 alone or the platelet aggregation rate, it is more helpful to predict clinical outcomes by considering the polymorphisms of all three genes.

The effects of different combinations of mutations in the genes CYP2C19, PON1 and ABCB1 on the effectiveness and safety of dual antiplatelet therapy in patients who undergo percutaneous coronary intervention (PCI) are unclear. In total, 263 Chinese Han patients receiving 75 mg clopidogrel and 100 mg aspirin daily for 12 months after PCI were enrolled in this study. ADP-induced platelet aggregation rates, thrombosis and bleeding risk were used to compare clopidogrel responses among the patients. Only 3.4% of patients had no mutations in CYP2C19, PON1 or ABCB1, and 74% of patients who chose to be genetically tested carried more than two mutations in these genes. High ADP-induced platelet aggregation rates in patients receiving clopidogrel and aspirin after PCI were associated with mutations in CYP2C19, PON1 and ABCB1. Patients with double or triple genetic mutations in CYP2C19, PON1 or ABCB1 had a higher risk of thrombosis within 18 months of follow-up. We conclude that multiple genetic polymorphisms influence platelet reactivity, bleeding and thrombosis risk during dual antiplatelet therapy after PCI.

Effects of resourcefulness on internet game addiction among college students: The mediating role of anxiety and the moderating role of gender.

Introduction: The mechanism of internet game addiction is unclear. Whether anxiety mediates between resourcefulness and internet game addiction and whether gender affect its mediation role have not been studied previously. Methods: A total of 4,889 college students from a college in southwest China were included in this study to complete the investigation, in which three questionnaires were used for evaluation. Results: Pearson's correlation analysis indicated a remarkable negative correlation between resourcefulness with internet game addiction and anxiety, as well as a significant positive correlation between anxiety and this addiction. The structural equation model confirmed the mediation role of anxiety. The multi-group analysis confirmed the moderating role of gender in the mediation model. Discussion: These findings have advanced the results of existing studies, indicating the buffering effect of resourcefulness on internet game addiction and revealing the potential mechanism of this relationship.

Assessing vaccine literacy and exploring its association with vaccine hesitancy: A validation of the vaccine literacy scale in China.

BACKGROUND: Assessment of vaccine literacy is essential for understanding people's ability to access various vaccine information to meet health demands. Few studies have examined the role of vaccine literacy in vaccine hesitancy, which is a psychological state. This study aimed to validate the applicability of the HLVa-IT (Vaccine Health Literacy of Adults in Italian) scale in Chinese settings and to explore the association between vaccine literacy and vaccine hesitancy. METHODS: From May to June 2022, we conducted an online cross-sectional survey in mainland China. Potential factor domains were obtained by the exploratory factor analysis. Cronbach's alpha coefficient, composite reliability values, and square root values of average variances extracted were calculated to determine the internal consistency and discriminant validity. The association between vaccine literacy, vaccine acceptance, with vaccine hesitancy was assessed using logistic regression analysis. RESULTS: Totally, 12,586 participants completed the survey. Two potential dimensions, the functional and the interactive/critical, were identified. Cronbach's alpha coefficient and composite reliability values were >0.90. The square root values of average variances extracted exceeded the related correlations. The functional dimension (adjusted odds ratio (aOR): 0579; 95 % Confidence Interval (CI); 0.529, 0.635), interactive (aOR: 0.654; 95%CI: 0.531, 0.806)/critical (aOR: 0.709; 95%CI: 0.575, 0.873) dimension were significantly and negatively associated with vaccine hesitancy. Similar results were also found in different vaccines acceptance subgroups. LIMITATIONS: This report is limited by the convenience sampling method. CONCLUSIONS: The modified HLVa-IT is suitable for use in Chinese settings. Vaccine literacy was negatively associated with vaccine hesitancy.

Willingness to Vaccinate Against Herpes Zoster and Its Associated Factors Across WHO Regions: Global Systematic Review and Meta-Analysis.

BACKGROUND: A life-course immunization approach would enhance the quality of life across all age groups and improve societal well-being. The herpes zoster (HZ) vaccine is highly recommended for older adults to prevent HZ infection and related complications. The proportions of willingness to receive the HZ vaccine varies across countries, and various kinds of factors, including sociodemographics and individual perceptions, influence the willingness to vaccinate. OBJECTIVE: We aim to estimate the HZ vaccination willingness rate and identify factors associated with vaccine uptake willingness across all World Health Organization (WHO) regions. METHODS: A global systematic search was performed on PubMed, Web of Science, and the Cochrane Library for all papers related to the HZ vaccine published until June 20, 2022. Study characteristics were extracted for each included study. Using double arcsine transformation, vaccination willingness rates with 95% CIs were pooled and reported. The willingness rate and associated factors were analyzed by geographical context. Associated factors were also summarized based on Health Belief Model (HBM) constructs. RESULTS: Of the 26,942 identified records, 13 (0.05%) papers were included, covering 14,066 individuals from 8 countries in 4 WHO regions (Eastern Mediterranean Region, European Region, Region of the Americas, and Western Pacific Region). The pooled vaccination willingness rate was 55.74% (95% CI 40.85%-70.13%). Of adults aged ≥50 years, 56.06% were willing to receive the HZ vaccine. After receiving health care workers' (HCWs) recommendations, 75.19% of individuals were willing to get the HZ vaccine; without HCWs' recommendations, the willingness rate was only 49.39%. The willingness rate was more than 70% in the Eastern Mediterranean Region and approximately 55% in the Western Pacific Region. The willingness rate was the highest in the United Arab Emirates and the lowest in China and the United Kingdom. The perception of HZ severity and susceptibility was positively associated with vaccination willingness. The perceived barriers to vaccination willingness (main reasons for unwillingness) included low trust in the effectiveness of the HZ vaccine, concerns about safety, financial concerns, and being unaware of the HZ vaccine's availability. Older individuals, those having lower education, or those having lower income levels were less likely to willing to be vaccinated. CONCLUSIONS: Only 1 in 2 individuals showed a willingness to be vaccinated against HZ. The willingness rate was the highest in the Eastern Mediterranean Region. Our findings show the critical role HCWs play in promoting HZ vaccination. Monitoring HZ vaccination willingness is necessary to inform public health decision-making. These findings provide critical insights for designing future life-course immunization programs.

Mesoporous Pt@Pt-skin Pt3Ni core-shell framework nanowire electrocatalyst for efficient oxygen reduction.

The design of Pt-based nanoarchitectures with controllable compositions and morphologies is necessary to enhance their electrocatalytic activity. Herein, we report a rational design and synthesis of anisotropic mesoporous Pt@Pt-skin Pt3Ni core-shell framework nanowires for high-efficient electrocatalysis. The catalyst has a uniform core-shell structure with an ultrathin atomic-jagged Pt nanowire core and a mesoporous Pt-skin Pt3Ni framework shell, possessing high electrocatalytic activity, stability and Pt utilisation efficiency. For the oxygen reduction reaction, the anisotropic mesoporous Pt@Pt-skin Pt3Ni core-shell framework nanowires demonstrated exceptional mass and specific activities of 6.69 A/mgpt and 8.42 mA/cm2 (at 0.9 V versus reversible hydrogen electrode), and the catalyst exhibited high stability with negligible activity decay after 50,000 cycles. The mesoporous Pt@Pt-skin Pt3Ni core-shell framework nanowire configuration combines the advantages of three-dimensional open mesopore molecular accessibility and compressive Pt-skin surface strains, which results in more catalytically active sites and weakened chemisorption of oxygenated species, thus boosting its catalytic activity and stability towards electrocatalysis.

Panoramic view of clinical features of lupus erythematosus: a cross-sectional multicentre study from China.

OBJECTIVE: Lupus erythematosus (LE) is a complicated disease with highly heterogeneous clinical manifestations. Previous studies have rarely included all subgroups of patients with lupus and have overlooked the importance of the cutaneous manifestations thereof. We aimed to compare the demographic and clinical differences among patients with different subtypes of lupus. METHODS: This is the first real-world study with a relatively large sample size that simultaneously includes patients with isolated cutaneous lupus erythematosus (iCLE) and SLE. All samples were obtained from the Lupus Erythematosus Multicenter Case-control Study in Chinese populations (LEMCSC) (registration number: ChiCTR2100048939). Comparative analyses between different LE subgroups were performed. RESULTS: A total of 2097 patients with lupus were included, with 1865 patients with SLE, 1648 with cutaneous lupus erythematosus (CLE), and 232 with iCLE. Among the patients with CLE, 1330 had acute cutaneous lupus erythematosus (ACLE); 160 had subacute cutaneous lupus erythematosus (SCLE); and 546 had chronic cutaneous lupus erythematosus (CCLE). The study included a relatively large number of patients with CCLE subtypes, including 311 with discoid lupus erythematosus (DLE), 262 with chilblain lupus erythematosus (CHLE) and 45 with lupus erythematosus profundus (LEP). Demographic characteristics, systemic involvement, mucocutaneous manifestations and autoantibodies were significantly different among the groups. CONCLUSIONS: CLE and iCLE are two distinct disease states, and the selection of broad or narrow CLE definitions should be emphasised in scientific reports. LE-non-specific cutaneous lesions imply more severity, while self-reported photosensitivity and LE-specific cutaneous manifestations imply milder severity. Generalised ACLE appears to be a more severe state than localised ACLE, and CHLE appears to be more severe than DLE. Anti-Sjögren's syndrome-related antigen B (SSB) antibodies have higher specific directivity than anti-Sjögren's syndrome-related antigen A (SSA) antibodies for SCLE lesions. Anti-double-stranded DNA antibodies have a higher co-occurrence with ACLE and a lower co-occurrence with SCLE and CCLE. Compared with DLE, CHLE has significantly higher positive rates of anti-SSA/Ro60 (71%) and anti-SSA/Ro52 (42.4%) antibodies, whereas LEP is associated with a higher positive rate of antinucleosome antibodies (31.1%).

Enzymatic Janus Liposome Micromotors.

A liposome-based micromotor system that utilizes regional enzymatic conversion and gas generation to achieve directional motion in water is presented. Constituted mainly of a low-melting lipid and a high-melting lipid together with cholesterol, these liposomes maintain stable Janus configuration at room temperature as a result of lipid liquid-liquid phase separation. Local placement of enzymes such as horseradish peroxidase is realized via affinity binding between avidin and biotin, the latter as a lipid conjugate sorted specifically into one domain of these Janus liposomes as a minor component. In the presence of the substrate, hydrogen peroxide, these enzyme-decorated Janus liposomes undergo directional motion, yielding velocities exceeding thermal diffusion by three folds in some cases. Experimental details on liposome size control, motor assembly, and substrate distribution are presented; effects of key experimental factors on liposome motion, such as substrate concentration and liposome Janus ratio, are also examined. This work thus provides a viable approach to building asymmetrical lipid-assembled, enzyme-attached colloids and, in addition, stresses the importance of asymmetry in achieving particle directional motion.

Emerging Biopharmaceuticals from Pimpinella Genus.

Evolved over eons to encode biological assays, plants-derived natural products are still the first dawn of drugs. Most researchers have focused on natural compounds derived from commonly used Pimpinella species, such as P. anisum, P. thellungiana, P. saxifrage, and P. brachycarpa, to investigate their antioxidant, antibacterial, and anti-inflammatory properties. Ethnopharmacological studies demonstrated that the genus Pimpinella has the homology characteristics of medicine and food and mainly in the therapy of gastrointestinal dysfunction, respiratory diseases, deworming, and diuresis. The natural product investigation of Pimpinella spp. revealed numerous natural products containing phenylpropanoids, terpenoids, flavonoids, coumarins, sterols, and organic acids. These natural products have the potential to provide future drugs against crucial diseases, such as cancer, hypertension, microbial and insectile infections, and severe inflammations. It is an upcoming field of research to probe a novel and pharmaceutically clinical value on compounds from the genus Pimpinella. In this review, we attempt to summarize the present knowledge on the traditional applications, phytochemistry, and pharmacology of more than twenty-five species of the genus Pimpinella.

Access to functionalized 2-pyrones through cascade reactions of α-halothioesters involving DBU-derived ammonium ylides.

Facile access to 4-aryl-6-oxycarbonyl-2-pyrones from α-halothioesters with ß,γ-unsaturated α-keto esters is achieved via a DBU-promoted Michael addition/lactonization/elimination cascade reaction. The reaction mechanism is tentatively elucidated by performing control experiments and high-resolution mass spectrometry analysis, which indicates that the cascade sequence may involve DBU-derived ammonium ylides.

Visual analysis of image-guided radiation therapy based on bibliometrics: A review.

Radiation therapy plays an important role in tumor treatment. The development of image-guided radiation therapy (IGRT) technology provides a strong guarantee for precise radiation therapy of tumors. However, bibliometric studies on IGRT research have rarely been reported. This study uses literature collected from the Web of Science during 1987 to 2021 as a sample and uses the bibliometric method to reveal the current research status, hotspots, and development trends in IGRT. Based on 6407 papers published from the Web of Science during 1987 to 2021, we utilized Microsoft Excel 2007 and cite space software to perform statistical analysis and visualization of IGRT. A total of 6407 articles were included, this area of IGRT has gone through 4 stages: budding period, growth period, outbreak period, and stationary period. The research category is mainly distributed in Radiology Nuclear Medicine Medical Imaging, which intersects with the research categories of Materials, Physics, and Mathematics. Yin FF, Tanderup K, and Sonke JJ are highly productive scholars who are active in IGRT research, while Jaffray DA, van Herk M and Guckenberger M are authors with high impact in this field. The team of scholars has close cooperation within the team and weak cooperation among teams. The League of European Research Universities, University of Texas System, University of Toronto, and Princess Margaret Cancer are the main research institutions in this field. The United States has the most research literature, followed by China and Germany. Six thousand four hundred seven articles are distributed in 712 journals, and the top 3 journals are Med Phys, Int J Radiat Oncol, and Radiather Oncol. Precise registration, intelligence, magnetic resonance guidance, and deep learning are current research hotspots. These results demonstrate that the research in this field is relatively mature and fruitful in the past 35 years, providing a solid theoretical basis and practical experience for precision radiotherapy.

Effects of field soil warming on the growth and physiology of Juglans mandshurica seedlings.

Global climate change will increase surface soil temperature, with consequences on plant seedling growth and population dynamics. In this study, we carried out a field experiment to investigate the effects of 2 ℃ soil warming on the growth and physiological characteristics of 1- and 2-year-old seedlings of a dominant tree species in broadleaved Korean pine forest, Juglans mandshurica. The results showed that soil warming significantly increased basal diameter, root length, total leaf area, leaf dry weight, root dry weight, total biomass, apparent photosynthetic electron transfer rate (ETR), PSⅡ actual photochemical efficiency (ΦPSⅡ), and apparent photosynthetic electrophotochemical quenching coefficient (qP) of 1-year-old seedlings by 18.3%, 66.7%, 94.4%, 105.9%, 95.8%, 37.8%, 89.5%, 100.0%, and 71.4%, respectively. Soil warming significantly increased basal diameter, total leaf area, leaf dry weight, total biomass, leaf superoxide dismutase activity, peroxidase activity, catalase activity and free proline content, ETR, ΦPSⅡ, and qP of 2-year-old seedlings by 12.5%, 180.5%, 97.3%, 42.5%, 23.9%, 20.4%, 14.9%, 20.7%, 66.7%, 283.3% and 284.6%, respectively. There was an interaction between seedling age and soil warming on the root-shoot ratio and the ΦPSⅡ and qP in chlorophyll fluorescence parameters, in that soil warming significantly reduced the root-shoot ratio of 2-year-old seedlings and that the increase of chlorophyll fluorescence parameters of 2-year-old seedlings (4.1-4.6 times) was much higher than that of 1-year-old seedlings (1.5-1.8 times). Soil warming of 2 ℃ was beneficial to the growth of 1- and 2-year-old J. mandshurica seedlings and increased their regeneration potential. In particular, 2-year-old J. mandshurica seedlings responded to soil warming by increasing leaf area, improving leaf photochemical efficiency, and enhancing protective enzyme activity to increase resistance.

Bioelectrical impedance analysis-derived phase angle predicts sarcopenia in patients on maintenance hemodialysis.

BACKGROUND: This study aimed to investigate the association between phase angle (PhA) and sarcopenia and evaluate its performance as a sarcopenia predictor in patients receveing maintenance hemodialysis (MHD). METHODS: All enrolled patients underwent handgrip strength (HGS) and the 6-m walk test, and muscle mass was measured using bioelectrical impedance analysis. Sarcopenia was diagnosed according to the diagnostic criteria of the Asian Sarcopenia Working Group. Logistic regression analysis was used to evaluate the PhA as an independent predictor of sarcopenia after adjusting for confounding factors. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of PhA in sarcopenia. RESULTS: Two hundred forty-one patients receiving hemodialysis were enrolled in this study, and the prevalence of sarcopenia was 28.2%. Patients with sarcopenia presented a lower PhA value (4.7° vs 5.5°; P < 0.001), lower muscle mass index (6.0 vs 7.2 [kg/m2 ]; P < 0.001), lower HGS (19.7 vs 26.0 [kg]; P < 0.001), and lower walk speed (0.83 ± 0.27 vs 0.92 ± 0.23 [m/s]; P = 0.007) than patients without sarcopenia. The odds of patients receiving MHD presenting with sarcopenia increased as PhA decreased, even after adjustment (odds ratio = 0.39; 95% CI, 0.18-0.85; P = 0.019). ROC analysis revealed that the best cutoff value of PhA for sarcopenia was 4.95° in patients receiving MHD. CONCLUSION: PhA may be a useful and simple predictor for predicting patients undergoing hemodialysis who are at risk of sarcopenia. To further facilitate the application of PhA in the diagnosis of sarcopenia, more research need to be conducted.

An immune-related prognostic signature associated with immune landscape and therapeutic responses in gastric cancer.

Immune-related genes (IRGs) have attracted attention in recent years as therapeutic targets in various tumors. However, the role of IRGs in gastric cancer (GC) has not been clearly elucidated. This study presents a comprehensive analysis exploring the clinical, molecular, immune, and drug response features characterizing the IRGs in GC. Data were acquired from the TCGA and GEO databases. The Cox regression analyses were performed to develop a prognostic risk signature. The genetic variants, immune infiltration, and drug responses associated with the risk signature were explored using bioinformatics methods. Lastly, the expression of the IRS was verified by qRT-PCR in cell lines. In this manner, an immune-related signature (IRS) was established based on 8 IRGs. According to the IRS, patients were divided into the low-risk group (LRG) and high-risk group (HRG). Compared with the HRG, the LRG was characterized by a better prognosis, high genomic instability, more CD8+ T cell infiltration, greater sensitivity to chemotherapeutic drugs, and greater likelihood of benefiting from the immunotherapy. Moreover, the expression result showed good consistency between the qRT-PCR and TCGA cohort. Our findings provide insights into the specific clinical and immune features underlying the IRS, which may be important for patient treatment.

Increasing the Repertoire for Depression Care: Methods and Challenges of a Randomized Controlled Trial of Peer Support for Vulnerable Older Adults.

OBJECTIVE: Low-income White and older adults of color face barriers to depression care. Our purpose is to describe the methods and challenges encountered during the implementation of a randomized controlled trial to test the effectiveness of a peer support depression care intervention for low-income White and older adults of color during the COVID-19 pandemic. METHODS: Peer Enhanced Depression Care (Peers) is an 8-week community-based intervention that uses peer mentors who are trained and supervised to provide social support and self-care skills to depressed older adults. The effectiveness of the intervention in reducing depression will be evaluated by following a sample of older adults recruited in the community over a 12-month period. Target enrollment is 160 older adults. We hypothesize that participants randomized to the Peer Enhanced Depression Care intervention will experience greater decrease in depressive symptoms compared to participants randomized to the social interaction control. We provide lessons learned regarding the recruitment of BIPOC and White low-income older adults and peer mentors during the COVID-19 pandemic. RESULTS: Recruitment challenges occurred in primary care clinics that were unable to accommodate recruitment efforts during the pandemic. This led to focused outreach to community-based organizations serving older adults. Challenges to participant recruitment have included barriers related to stigma, distrust, as well as unfamiliarity with research. Peer mentor recruitment was facilitated by existing government-supported resources. CONCLUSIONS: This study will provide knowledge regarding the effectiveness, mechanism, and processes of delivering an informal psychosocial intervention such as peer support to a vulnerable older adult population.