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BackgroundSchool closures during the COVID-19 pandemic may have exacerbated students’ loneliness, addictive gaming behaviors, and poor mental health. These mental health issues confronting young people are of public concern. ObjectiveThis study aimed to examine the associations between loneliness and gaming addiction behaviors among young people in Hong Kong and to investigate how familial factors, psychological distress, and gender differences moderate these relationships. MethodsThis cross-sectional study was conducted in June 2020 when schools reopened after 6 months of school closures. Participants included 2863 children and adolescents in primary (Grades 4 to 6) and secondary (Grades 7 and 8) schools (female participants: 1502/2863, 52.5%). Chi-square tests, one-way analyses of variance, and independent-samples t tests were performed to compare the differences of distribution in gaming addiction behaviors across gender, age, and other sociodemographic characteristics. Multinomial logistic regression analyses were conducted to identify factors that relate to excessive or pathological gaming behaviors separately, in comparison with leisure gaming. ResultsA total of 83.0% (2377/2863) of the participants played video games during the COVID-19 pandemic. The prevalence of excessive and pathological game addiction behaviors was 20.9% (597/2863) and 5.3% (153/2863), respectively. More male students had gaming addiction symptoms than female students. The multinomial logistic regressions showed that feeling lonely was associated with more problematic gaming behaviors, and the association was stronger for older female students. Low socioeconomic status, less parental support and less supervision, and poor mental health were risk factors for gaming addiction behaviors, especially among primary school students. ConclusionsLoneliness was associated with gaming addiction behaviors; the findings from this study suggested that this association was similar across gender and age groups among young people. Familial support and supervision during school closures can protect young people from developing problematic gaming behaviors. Results of this study have implications for prevention and early intervention on behalf of policy makers and game developers.

ObjectiveDelayed detection of LN associates with worse outcomes. There are conflicting recommendations regarding a threshold level of proteinuria at which biopsy will likely yield actionable management. This study addressed the association of urine protein:creatinine ratios (UPCR) with clinical characteristics and investigated the incidence of proliferative and membranous histology in patients with a UPCR between 0.5 and 1.MethodsA total of 275 SLE patients (113 first biopsy, 162 repeat) were enrolled in the multicentre multi-ethnic/racial Accelerating Medicines Partnership across 15 US sites at the time of a clinically indicated renal biopsy. Patients were followed for 1 year.ResultsAt biopsy, 54 patients had UPCR

CalFresh benefits can help college students make ends meet while attending college, but not all eligible students apply. One contributing factor may be that students are not aware they are eligible. Therefore, outreach efforts informing them of their eligibility could help increase take-up rates. To test this, we designed and conducted two experiments that leveraged an expansion in CalFresh eligibility for students that went into effect in early 2021. In response to the pandemic, Congress permitted a temporary expansion to college student eligibility for SNAP (Supplemental Nutrition Assistance Program), or CalFresh as it is known in California. The expansion went into effect in January 2021 and will last through the end of the federal public health emergency. The California Department of Social Services (CDSS) and the California Student Aid Commission (CSAC) partnered with The People Lab (TPL) and the California Policy Lab (CPL) on two randomized experiments to evaluate whether outreach about this policy change could increase the number of students who applied for and eventually enrolled in CalFresh. One experiment, conducted in February and March 2021, tested the impact of email outreach. The second, conducted in June 2021, tested the relative effectiveness of different messages and modes of communication on the same group of students who were newly eligible. This brief reports the results of the second experiment. In a randomized experiment with 285,325 Californian college students, we found that the method of communication had a large impact on application rates: 2.9% of students who were only sent an email submitted an application for CalFresh compared to 4.9% of students who were sent an email and a postcard — a 69% increase. Simplifying the content of the communication also yielded a small increase in application rates, but other variations in message content had no meaningful effect. During the six weeks following outreach, 10,000 contacted students applied for CalFresh.This work has been supported, in part, by the University of California Multicampus Research Programs and Initiatives grants MRP-19-600774 and M21PR3278.

The following paper dives into the implications of the growing presence of the Internet and other technologies in our daily lives, especially in relation to handling healthcare data and privacy. In each section, the paper explores the associations of technologies to knowledge, power, and control in the field of healthcare. Ultimately, it warns against the increasingly exploitative nature of today’s technology products which oftentimes trade personal information for usage and convenience. In addition, it discusses the benefits and potential consequences of current healthcare privacy laws. To transition into practical applications and world systems, examples such as the Mexican healthcare system are presented as case studies of how technology companies and producers can adapt their policies and products to best cater to the needs and wants of marginalized communities and populations.

ObjectivesIn lupus nephritis the pathological diagnosis from tissue retrieved during kidney biopsy drives treatment and management. Despite recent approval of new drugs, complete remission rates remain well under aspirational levels, necessitating identification of new therapeutic targets by greater dissection of the pathways to tissue inflammation and injury. This study assessed the safety of kidney biopsies in patients with SLE enrolled in the Accelerating Medicines Partnership, a consortium formed to molecularly deconstruct nephritis.Methods475 patients with SLE across 15 clinical sites in the USA consented to obtain tissue for research purposes during a clinically indicated kidney biopsy. Adverse events (AEs) were documented for 30 days following the procedure and were determined to be related or unrelated by all site investigators. Serious AEs were defined according to the National Institutes of Health reporting guidelines.Results34 patients (7.2%) experienced a procedure-related AE: 30 with haematoma, 2 with jets, 1 with pain and 1 with an arteriovenous fistula. Eighteen (3.8%) experienced a serious AE requiring hospitalisation; four patients (0.8%) required a blood transfusion related to the kidney biopsy. At one site where the number of cores retrieved during the biopsy was recorded, the mean was 3.4 for those who experienced a related AE (n=9) and 3.07 for those who did not experience any AE (n=140). All related AEs resolved.ConclusionsProcurement of research tissue should be considered feasible, accompanied by a complication risk likely no greater than that incurred for standard clinical purposes. In the quest for targeted treatments personalised based on molecular findings, enhanced diagnostics beyond histology will likely be required.

Positive remodelling index and presence of low-attenuation non-calcified plaque (LANCP) are characteristic vessel changes in unstable coronary plaques. We sought to characterise these high-risk plaque features in patients with systemic lupus erythematosus (SLE) and to compare them with controls. A total of 72 patients who satisfied the SLICC classification criteria for SLE had coronary CT angiography (CCTA) studies, 30 of which had follow-up CCTA, as screening for occult coronary atherosclerotic disease in asymptomatic individuals. A total of 100 consecutive controls with no known history of lupus, heart disease or revascularisation who had two coronary CT angiograms at least 1 year apart were included in the study. These were asymptomatic patients referred by their primary physicians for screening of coronary artery disease and the screening interval was decided by the primary physicians. The methodology for image acquisition was identical. LANCP burden at baseline was significantly greater in patients with SLE compared with controls. LANCP volume was significantly greater in patients over 60 years of age (p10 mg/day. LANCP burden remained stable over follow-up. There were no significant differences in remodelling index compared with controls. This is the first study describing high-risk CCTA features of coronary plaque in patients with SLE. Both LANCP and positive remodelling are common in SLE. These characteristic vessel changes may identify patients with SLE at increased risk of cardiovascular events and those in need for more frequent cardiac monitoring.

Adverse birth outcomes remain challenging public health problems in China. Increasing evidence indicated that prenatal depression and anxiety are associated with adverse birth outcomes, highlighting the importance and severity of prenatal depression and anxiety in China. The COVID-19 pandemic is likely to further exacerbate prenatal mental health problems and increase the risk of adverse birth outcomes. The aim of this study is to assess and compare the impacts of prenatal mental health issues on birth outcomes before and during the COVID-19 pandemic in Ma'anshan, Anhui, China. Participants in this study were women who visited local maternal and child health hospitals in Ma'anshan, Anhui, China. Two independent sets of individual maternal data (npre-pamdemic = 1148; npandemic = 2249) were collected. Prenatal depression and anxiety were measured online using the Edinburgh Postnatal Depression Scale (EPDS) and the General Anxiety Disorder-7 (GAD-7). Adverse birth outcomes were determined using hospital-recorded infant birth weight and gestational age at delivery. In this study, we found that the pandemic cohort had lower mean EPDS and GAD-7 scores than the pre-pandemic cohort. The prevalence of prenatal depression (14.5%) and anxiety (26.7%) among the pandemic cohort were lower than the pre-pandemic cohort (18.6% and 36.3%). No significant difference was found in the prevalence of adverse birth outcomes comparing the two cohorts. Prenatal depression was associated with small gestational age only in the pandemic cohort (OR = 1.09, 95% CI 1.00–1.19, p = 0.042). Overall, this study highlighted an association between prenatal depression and small for gestational age in Anhui, China. Addressing prenatal depression may thus be key in improving birth outcomes. Future studies could focus on potential causal relationships. [ABSTRACT FROM AUTHOR]

How should learner analytics and different media be used to optimize feedback to increase students' motivation and sense of learning community in online learning programs? This study was designed to examine the usage of feedback delivery methods (text only, video only, or both) and learner analytics (individual vs. class average) to answer the above question. Two consecutive surveys were administrated to the students of a series of online courses over four semesters which resulted in a sample of 96. Using this quasi-experimental design, we aimed to capture changes in students' perceived feedback quality, motivation, and sense of learning community when different feedback delivery methods and learner analytics were introduced. The findings revealed that students who received both video and text feedback were least motivated and lowest in their sense of online learning community when compared with students who received just video or text feedback. No significant differences were found between students who received video or text feedback regarding motivation and their sense of learning community. The findings also showed that when sharing class average, students' motivation decreased. This study provides insights into how instructors might use media and learner analytics when designing feedback to motivate and promote student learning in online learning programs.