AsianCrit lens on Chinese international student multi-dimensional transitions and experiences in the US

PurposeThe purpose of this study is to examine Chinese international students' narrative stories, experiences and racial dynamics while studying in the United States to argue that Chinese international students navigate multi-dimensional transitions and experiences in different stages. This study uses an AsianCrit lens to address the gap in existing research focusing on Chinese international students' narratives and experiences.Design/methodology/approachNarrative inquiry with a social constructivist paradigm was used to provide an in-depth exploration of Chinese international students' navigation and negotiation in multi-dimensional experiences. Three phases of semi-structured interviews and journal entries were utilized to examine participants' experiences and struggles while studying in the United States. Descriptive coding, deductive coding and restorying were used to analyze and feather narrators' voices and stories for interpretation.FindingsThe findings in this qualitative study demonstrate that Chinese international students have unique backgrounds, and their backgrounds shape their multi-dimensional transitions and experiences in the present and the future. The findings address students' nuanced experiences in academic transitions and non-academic transitions with an AsianCrit lens.Practical implicationsThe study calls for higher education institutions to promote intercultural and international training for faculty and staff to better understand and support the unique needs of international students.Originality/valueUsing Multiple and Multi-dimensional Transitions theory with an AsianCrit lens helps make sense of the intersection of international student status, geopolitical tensions, racial dynamics and international student experiences.

Real world experience of drug-drug interactions for HCV patients receiving pan-genotypic direct-acting antivirals in the era of COVID-19 pandemic

Background and Aims: The treatment of chronic hepatitis C (CHC) has evolved from genotype-specific to pan-genotypic direct acting antivirals (DAAs) with high efficacy and safety. However, drug-drug interactions (DDIs) must be avoided when used in combination with other medications, especially with the possible concomitant use of COVID-19 infection antivirals during the COVID-19 pandemic. This study aimed to access the potential DDIs of concomitant drugs with pan-genotypic DAAs and COVID-19 infection antivirals, and actual incidence of DDIs in real-world experience. Method(s): From January 2022 to October 2022, consecutive 116 HCV patients receiving pan-genotypic DAAs were retrospectively enrolled in Taipei Veterans General Hospital. The number of comedications and their potential DDIs with three pan-genotypic DAA regimens and three COVID-19 infection antivirals were analyzed. The actual incidence of DDIs during DAAs treatment were also investigated. Result(s): The mean age was 60.9 years old, with male predominant (55.2%). Of them, 12 (10.3%) patients had cirrhosis, and 24 (20.7%) patients had diabetes mellitus. Most patients were within Child-Pugh class A (109/116, 94.0%). The distribution of HCV genotypes was 8.6% in GT 1a, 36.2% in GT 1b, 39.7% in GT 2, 6.9% in GT 6, and 8.6% in indeterminate genotype, respectively. Of them, 43 (37.1%) patients received GLE/PIB, 69 (59.5%) received SOF/VEL 7plusmn;RBV, and 4 (3.4%) received SOF/VEL/VOX as DAAs regimen. Noteworthy, four patients had COVID-19 infection during DAAs treatment course. The rates of ETVR and SVR12 were 97.6% and 95.3%. The mean number of concomitant medications was 2.01. The distribution of concomitant drugs was 64.7% with no concomitant drug, 11.2% with 1-3 drugs, 11.2% with 4-6 drugs, 9.5% with 7-9 drugs, and 3.4% had more than 9 drugs, respectively. In potential contraindicated (red) DDI class, GLE/PIB was the most prevalent (7.3%), followed by SOF/VEL/VOX (6.4%), and SOF/VEL (1.8%) for non-cirrhosis and compensated cirrhosis patients;and no red DDI occurred in decompensated cirrhosis patients. In addition, the percentage of patients without potential DDIs was higher with SOF/VEL (79.8%) than with the other regimens. The potential red DDIs were predominantly with lipid-lowering agents for DAAs. For potential red DDI class with COVID-19 infection antivirals, Nirmatrelvir/Ritonavir was the most prevalent (6%), followed by Remdesivir (0.9%), and no potential DDIs with Molnupiravir. For COVID-19 antivirals, the potential red DDIs was mainly with central nervous system drugs. Finally, the actual incidence of DDIs during DAAs treatment showed no red DDI occurred for all patients, and GLE/PIB was the most prevalent (93%) of no potential DDIs. Conclusion(s): The potential DDIs between these comedications differed, with the most potential DDIs occurring with GLE/PIB and Nirmatrelvir/Ritonavir. After careful assessment of comedications and their potential DDIs, the actual incidence of DDIs could be reduced, and optimize safety in real-world practice.

fvWillingness to Vaccinate Children against COVID-19 Declined During the Pandemic

Objectives To document the level of vaccine hesitancy in caregivers' of children younger than 12 years of age over the course of the pandemic in Pediatric Emergency Departments (ED). Study design Ongoing multicenter, cross-sectional survey of caregivers presenting to 19 pediatric EDs in the USA, Canada, Israel, and Switzerland during first months of the pandemic (phase1), when vaccines were approved for adults (phase2) and most recently when vaccines were approved for children (phase3). Results Willingness to vaccinate rate declined over the study period (59.7%, 56.1% and 52.1% in the three phases). Caregivers who are fully vaccinated, who have higher education, and those worried their child had COVID-19 upon arrival to the ED, were more likely to plan to vaccinate in all three phases. Mothers were less likely to vaccinate early in the pandemic, but this hesitancy attenuated in later phases. Older caregivers were more willing to vaccinate, and caregivers of older children were less likely to vaccinate their children in phase 3. During the last phase, willingness to vaccinate was lowest in those who had a primary care provider but did not rely on their advice for medical decisions (34%). Those with no primary care provider and those who do and rely on their medical advice, had similar rates of willingness to vaccinate (55.1% and 52.1%, respectively). Conclusions COVID-19 vaccine hesitancy is widespread and growing over time, and public health measures should further try to leverage identified factors associated with hesitancy in order to enhance vaccination rates among children.

Willingness to vaccinate children against COVID-19 declined during the pandemic.

OBJECTIVES: To document the level of vaccine hesitancy in caregivers' of children younger than 12 years of age over the course of the pandemic in Pediatric Emergency Departments (ED). Study design Ongoing multicenter, cross-sectional survey of caregivers presenting to 19 pediatric EDs in the USA, Canada, Israel, and Switzerland during first months of the pandemic (phase1), when vaccines were approved for adults (phase2) and most recently when vaccines were approved for children (phase3). RESULTS: Willingness to vaccinate rate declined over the study period (59.7%, 56.1% and 52.1% in the three phases). Caregivers who are fully vaccinated, who have higher education, and those worried their child had COVID-19 upon arrival to the ED, were more likely to plan to vaccinate in all three phases. Mothers were less likely to vaccinate early in the pandemic, but this hesitancy attenuated in later phases. Older caregivers were more willing to vaccinate, and caregivers of older children were less likely to vaccinate their children in phase 3. During the last phase, willingness to vaccinate was lowest in those who had a primary care provider but did not rely on their advice for medical decisions (34%). Those with no primary care provider and those who do and rely on their medical advice, had similar rates of willingness to vaccinate (55.1% and 52.1%, respectively). CONCLUSIONS: COVID-19 vaccine hesitancy is widespread and growing over time, and public health measures should further try to leverage identified factors associated with hesitancy in order to enhance vaccination rates among children.

Research Progress and Implication of Wastewater Surveillance of SARS-CoV-2

Since the outbreak of the coronavirus disease 2019 (COVID-19), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been found in wastewater frequently worldwide. Based on the wastewater-based epidemiology (WBE), wastewater surveillance of SARS-CoV-2 can complement population surveillance for COVID-19. Quantification of viral load and genome sequencing of SARS-CoV-2 can help early warning of COVID-19 outbreaks, early identification of asymptomatic cases, assessment of infection scale, prediction of pandemic trend status, and identification of virus sources to provide scientific basis for polices for the prevention and control. Accordingly, here, the sources of SARS-CoV-2 in wastewater at home and abroad and the major factors affecting the survival of virus were reviewed. Common methods to concentrate, detect and quantify SARS-CoV-2 were reviewed, with an overview of global surveillance projects, progresses, and remaining scientific issues. Some shortcomings of the current procedures, including the lack of sufficient information on distribution characteristics and infectivity of SARS-CoV-2 in wastewater and limited development and application of prediction models were also discussed. WBE can provide insight into the scientific prevention and control of COVID-19 in the face of current or future pandemics in China, and enhance China′s ability to deal with the surveillance and early warning, epidemic scale assessment, and accurate policy-making for the infectious and non-infectious diseases. © 2022 Editorial Board, Research of Environmental Sciences. All rights reserved.

Detection of the SARS-CoV-2 Delta Variant in the Transboundary Rivers of Yunnan, China

Ruili and Longchuan, two border counties in southwestern China, are facing epidemic control challenges due to the high rate of COVID-19 infections originating from neighboring Myanmar. Here, we aimed to establish the applicability of wastewater and environmental water surveillance of SARS-CoV-2 and conduct whole-genome sequencing (WGS) to trace the possible infection origin. In August 2021, total 72 wastewater and river water samples were collected from 32 sampling sites. SARS-CoV-2 ORF1ab and N genes were measured by RT-qPCR. We found that 19 samples (26.39%) were positive, and the viral loads of ORF1ab and N genes were 6.62 × 102–2.55×105 and 1.86 × 103–2.32 × 105 copies/L, respectively. WGS further indicated the sequences in two transboundary river samples, and one hospital wastewater sample belonged to the delta variant, suggesting that the infection source might be areas with high COVID-19 delta variant incidence in Southeast Asia (e.g., Myanmar). We reported for the first time the detection and quantification of SARS-CoV-2 RNA in the transboundary rivers of Myanmar–China. Our findings demonstrate that wastewater and environmental water may provide independent and nonintrusive surveillance points to monitor the global spread of emerging COVID-19 variants of concern, particularly in high-risk regions or border areas with considerable epidemic challenges and poor wastewater treatment facilities.

“Why Are They Always Dissatisfied?” the Difference between Teachers and Students in Feeling of Interaction in Online Classroom

The mixed research focused on the interaction in the online classroom and discovered that (1) functional crisis, psychological and motivational crisis, and technical crises affect all aspects of interaction;(2) students pay more attention to the interaction itself of online classroom, while teachers emphasize the influence of interaction on learning effectiveness, which reflects the divergences and conflicts between them. The students’ sensibility and teachers’ rationality may be the root cause of interaction problems. This is a novel discovery, which has not been mentioned in the past and may help to solve many long-standing problems in online classroom. Copyright for this article is retained by the author(s)

A Fuzzy Bayesian Network Based on Fault Tree for Vaccine Safety Risks Analysis

Against the Covid-19 background, vaccine safety has aroused the wild attention of all social areas. However, the factors that cause vaccine safety risks are complicated and meanwhile, data is difficult to obtain, making it a challenge for analyzing vaccine safety risks quantitatively. This paper concretises the issue of vaccine system safety by creatively proposing an analytical framework for the problem of uncertainty. First, the paper focuses on the whole process of vaccine safety, analyses risk factors affecting vaccine safety in development, approval, production, transportation, and supervision of vaccines in order to build a vaccine risk assessment system. The proposed framework is then used to construct a Bayesian network early warning system for vaccine risk. To address the difficulty of obtaining data, the probability of safety risks occurring throughout the process is calculated by combining expert knowledge and fuzzy set theory to obtain uncertainty data. In response to structural complexity, a comprehensive framework is constructed using fault trees and Bayesian networks to capture the correlation between risk factors. This analytical framework can provide guidance to governments and vaccine-related companies in their decision-making to prevent vaccine safety issues. Finally, sensitivity analysis revealed a high probability of vaccine risk in the transport process. © 2021 IEEE.

Joint Transmission Scheme and Coded Content Placement in Cluster-centric UAV-aided Cellular Networks

Recently, as a consequence of the COVID-19 pandemic, dependence on telecommunication for remote learning/working and telemedicine has significantly increased. In this context, preserving high Quality of Service (QoS) and maintaining low latency communication are of paramount importance. In cellular networks, incorporation of Unmanned Aerial Vehicles (UAVs) can result in enhanced connectivity for outdoor users due to the high probability of establishing Line of Sight (LoS) links. The UAV’s limited battery life and its signal attenuation in indoor areas, however, make it inefficient to manage users’requests in indoor environments. Referred to as the Cluster-centric and Coded UAV-aided Femtocaching (CCUF) framework, the network’s coverage in both indoor and outdoor environments increases by considering a two-phase clustering framework for Femto Access Points (FAPs)’formation and UAVs’deployment. Our first objective is to increase the content diversity. In this context, we propose a coded content placement in a cluster-centric cellular network, which is integrated with the Coordinated Multi-Point (CoMP) approach to mitigate the inter-cell interference in edge areas. Then, we compute, experimentally, the number of coded contents to be stored in each caching node to increase the cache-hit-ratio, Signal-to-Interference-plus-Noise Ratio (SINR), and cache diversity and decrease the users’access delay and cache redundancy for different content popularity profiles. Capitalizing on clustering, our second objective is to assign the best caching node to indoor/outdoor users for managing their requests. In this regard, we define the movement speed of ground users as the decision metric of the transmission scheme for serving outdoor users’requests to avoid frequent handovers between FAPs and increase the battery life of UAVs. Simulation results illustrate that the proposed CCUF implementation increases the cache-hit-ratio, SINR, and cache diversity and decrease the users’access delay, cache redundancy and UAVs’energy consumption. Crown

ITP World Impact Survey (I-WISh) 2.0: Further Exploration of the Impact of ITP on Patients

Immune thrombocytopenia (ITP) is an acquired autoimmune disorder defined by a platelet count < 100 × 109/L without explanation, and an increased risk of bleeding. ITP itself as well as its treatments have multifaceted, often poorly understood impacts on patients’ quality of life (QoL). These effects include impact on activities of daily living, emotional health, energy, ability to think well and clearly, and productivity in the workplace. There are limited data on which individual aspects of ITP are perceived both by patients and physicians as having the greatest impact on QoL. Understanding patients’ perspectives is vital to optimize their QoL by specifying particular areas in need of therapy. I-WISh 1.0 was an exploratory, cross-sectional survey in which 1507 patients with ITP and 472 physicians across 13 countries completed separate, but related, online surveys that included assessments of ITP signs and symptoms, impact of symptoms, and patient-physician relationships. These findings have been presented at previous ASH and EHA congresses, and manuscripts are currently in preparation. However, although I-WISh 1.0 provided considerable insights into unexplored facets of the effects of ITP, an all-too-large number of gaps in understanding still remain. In response to this, I-WISh 2.0 is currently being developed. The objectives of the I-WISh 2.0 patient and physician cross-sectional surveys include: (1) to further explore the burden of fatigue and how it affects patients' lives, including what makes it better or worse;(2) to assess the emotional impact of living with chronic ITP, especially in relation to depression;(3) to assess how treatments for ITP can impact activities of daily living (positively and negatively);(4) to further relate effects of treatment to patients' QoL;and (5) to explore how telemedicine affects healthcare delivery for patients with ITP. Furthermore, data from subsets of patients will address (6) the impact of COVID-19 in patients with ITP;and (7) special issues affecting ITP in pregnancy. A steering committee of ITP expert physicians and patient advocacy group representatives are designing and will endorse the patient and physician surveys now nearing readiness after several meetings to determine the areas of greatest need of assessment. In addition, a control group will be included. Survey launch and data collection are scheduled to commence in early Q4 2020. Patients and physicians will complete similar online surveys. Both patient and physician surveys include a screener and sections of questions related to the specific objectives of I-WISh 2.0. The surveys include updates to key topics in I-WISh 1.0 (impact of fatigue, impact on daily life, treatment of ITP, emotional impact of ITP);validated patient-reported outcome tools to measure fatigue (MFIS-5), presence and severity of depression (PHQ-9), work-related burden (WPAI), and impact on quality of life (ILQI) tools;and questions related to COVID-19, telemedicine (remote patient monitoring), and pregnancy and ITP. Patients will be recruited to I-WISh 2.0 via treating physicians and patient advocacy groups, and will be included if they are ≥ 18 years of age, diagnosed with ITP, and agree to participate. Participating physicians will be required to be actively managing patients with ITP and have a minimum caseload of 3 ITP patients currently under their care;physicians must also have a primary specialty of hematology or hematology-oncology. Approval will be sought from an independent centralized Institutional Review Board. Data analysis will be primarily descriptive and correlative in nature. Breakdown by country and geographic areas will be included. A global sample is planned from 21 countries across 6 continents, with the aim of surveying more than 2000 patients and 600 physicians. I-WISh 2.0 will be the largest observational global survey ever conducted in ITP. If accepted, preliminary data are planned to be presented at the ASH meeting. I-WISh 2.0 will build on the strengths of I-WISh 1.0, which highlighted areas requir ng further assessment and will explore aspects of ITP of great interest that were neither conclusively addressed in the first survey nor well-studied in the past. Disclosures: Ghanima:Bristol Myers Squibb:Research Funding;Principia:Honoraria, Speakers Bureau;Pfizer:Honoraria, Research Funding, Speakers Bureau;Amgen:Honoraria, Speakers Bureau;Novartis:Honoraria, Speakers Bureau;Bayer:Research Funding.Provan:ONO Pharmaceutical:Consultancy;MedImmune:Consultancy;UCB:Consultancy;Amgen:Honoraria, Research Funding;Novartis:Honoraria, Research Funding.Cooper:Amgen:Honoraria, Speakers Bureau;Novartis:Honoraria, Speakers Bureau.Matzdorff:Roche Pharma AG:Other: Family stockownership;Amgen GmbH:Consultancy, Other: Honoraria paid to institution;Grifols Deutschland GmbH:Consultancy, Other: Honoraria paid to institution;Swedish Orphan Biovitrium GmbH:Consultancy, Other: Honoraria paid to institution;UCB Biopharma SRL:Consultancy, Other: Honoraria paid to institution;Novartis Oncology:Consultancy, Other: Honoraria paid to institution.Santoro:Novartis:Honoraria, Speakers Bureau;Takeda:Honoraria, Speakers Bureau;Amgen:Honoraria, Speakers Bureau;Novo Nordisk:Honoraria, Speakers Bureau;Bayer:Honoraria, Speakers Bureau;CSL Behring:Honoraria, Speakers Bureau;Roche:Honoraria, Speakers Bureau;Sobi:Honoraria, Speakers Bureau.Morgan:Sobi:Other: Consultancy fees paid to the ITP Support Association;UCB:Other: Consultancy fees paid to the ITP Support Association;Novartis:Other: Consultancy fees paid to the ITP Support Association.Kruse:Principia:Other: Grant paid to PDSA;Pfizer:Other: Grant and consultancy fee, all paid to PDSA;Argenx:Other: Grant paid to PDSA;Novartis:Other: PDSA received payment for recruiting patients to I-WISh and for promoting I-WISh on the globalitp.org website. Grant and consultancy fee, all paid to PDSA outside the submitted work;CSL Behring:Other: Grant paid to PDSA;UCB:Other: Grant and consultancy fee, all paid to PDSA;Rigel:Other: Grant paid to PDSA;Amgen:Other: Grant and honorarium, all paid to PDSA.Zaja:Janssen-Cilag:Honoraria, Speakers Bureau;Takeda:Honoraria, Speakers Bureau;Bristol Myers Squibb:Honoraria, Speakers Bureau;Grifols:Honoraria, Speakers Bureau;Amgen:Honoraria, Speakers Bureau;AbbVie:Honoraria, Speakers Bureau;Kyowa Kirin:Honoraria, Speakers Bureau;Mundipharma:Honoraria, Speakers Bureau;Novartis:Honoraria, Patents & Royalties: Pending patent (No. PAT058521) relating to TAPER trial (NCT03524612), Speakers Bureau;Roche:Honoraria, Speakers Bureau.Lahav:Novartis:Other: Consultancy fees paid to the Israeli ITP Support Association.Tomiyama:Novartis:Consultancy, Honoraria;Kyowa Kirin:Honoraria;Sysmex:Consultancy.Winograd:Novartis:Other: Consultancy fees paid to the Israeli ITP Support Association.Lovrencic:UCB:Other: Consultancy fees paid to AIPIT;Novartis:Other: Honorarium paid to AIPIT.Bailey:Adelphi Real World:Current Employment;Novartis:Other: Employee of Adelphi Real World, which has received consultancy fees from Novartis.Haenig:Novartis:Current Employment.Bussel:Novartis:Consultancy;Argenx:Consultancy;UCB:Consultancy;CSL Behring:Consultancy;Shionogi:Consultancy;Regeneron:Consultancy;3SBios:Consultancy;Dova:Consultancy;Principia:Consultancy;Rigel:Consultancy;Momenta:Consultancy;RallyBio:Consultancy;Amgen:Consultancy.

Sustaining team morale amidst a Pandemic: Lessons from COVID-19

The following sections are included: Introduction Understanding Morale Recommendation #1: Appeal to Core Values and Higher-Order Aspects Recommendation #2: Foster an Unwavering Team Spirit Recommendation #3: Recognise Each Other’s Sacrifice Recommendation #4: Create Psychologically Safe Spaces Recommendation #5: Provide Sufficient Safeguards for Team Members Conclusion References. © 2021 by Editors.