A Randomized, Double-Blind, Placebo-Controlled Phase II Study to Evaluate the Efficacy and Safety of Ivarmacitinib (SHR0302) in Adult Patients with Moderate to Severe Alopecia Areata.

BACKGROUND: Alopecia areata (AA) is a CD8+ T cell mediated autoimmune disease characterized by non-scarring hair loss. Ivarmacitinib, a selective oral Janus kinase 1 (JAK1) inhibitor, may interrupt certain cytokine signaling implicated in the pathogenesis of AA. OBJECTIVE: To evaluate the efficacy and safety of ivarmacitinib in adult AA patients who have ≥25% scalp hair loss. METHODS: Eligible patients were randomized 1:1:1:1 to receive ivarmacitinib 2 mg, 4 mg, or 8 mg QD or placebo for 24 weeks. The primary endpoint was percentage change from baseline in Severity of Alopecia Tool (SALT) score at week 24. RESULTS: A total of 94 patients were randomized. At week 24, the least squares mean (LSM) difference in percentage change from baseline in SALT score for ivarmacitinib 2 mg,4 mg, 8 mg, and placebo groups were -30.51% (90% confidence interval [CI]: -45.25, -15.76), -56.11% (90% CI: -70.28, -41.95), -51.01% (90% CI: -65.20, -36.82) and -19.87% (90% CI: -33.99, -5.75), respectively. Two SAEs, follicular lymphoma, and COVID-19 pneumonia were reported. LIMITATIONS: Small sample size limits the generalizability of the results. CONCLUSION: Treatment with ivarmacitinib 4 mg and 8 mg doses in moderate and severe AA patients for 24 weeks was efficacious and generally tolerated.

How do online users perceive health risks during public health emergencies? Empirical evidence from China.

Background: The global COVID-19 pandemic has posed a major threat to human life and health, and new media technologies have intensified the spread of risk perception. Purpose: This study aimed to explore the impact of risk information ground on online users' perceived health risks, and further explore the mediating role of psychological distance and the moderating role of self-efficacy. Methods: A total of 25 Internet users from different provinces in China were interviewed in-depth, NVIVO.11 was used to qualitatively analyze the interview text data and construct a theoretical model. A total of 492 interviewees were recruited in order to complete a scenario questionnaire, SPSS-27 was used to perform orthogonal experiments, generate eight combinatorial scenarios, analyze demographic data, and clean and prepare data for testing hypotheses. SmartPLS 3.0 was used to test the conceptual model using the structural equation model (SEM) of the partial least squares (PLS). Results: The analysis of the SEM model shows that all planned hypotheses (Information fluency → Information diagnosability, Information extensibility → Information diagnosability, Information diagnosability → Psychological distance, Platform interactivity → Scenario embeddedness, Network connectivity → Scenario embeddedness, Scenario embeddedness → Psychological distance, Psychological distance → Risk perception, Psychological distance → Self-efficacy → Risk perception, Information fluency → Information diagnosability → Psychological distance → Risk perception, Information extensibility → Information diagnosability → Psychological distance → Risk perception, Platform interactivity → Scenario embeddedness → Psychological distance → Risk perception, Network connectivity → Scenario embeddedness → Psychological distance → Risk perception) are confirmed. Conclusion: This study found that the information ground factors significantly affect online users' perceptions of health risks, psychological distance mediates the effect of information ground factors on risk perception, and self-efficacy negatively moderates the effect of psychological distance on risk perception.

Epidemiological characteristics of community-acquired pneumonia and effects from the COVID-19 pandemic in Shenzhen of China.

OBJECTIVE: This study aimed to observe the impact of the coronavirus disease 2019 (COVID-19) pandemic on the incidence of non-COVID-19 community-acquired pneumonia (CAP) in Shenzhen of China, offering new ideas for evaluating the effects of non-pharmaceutical interventions. METHODS: A retrospective analysis was conducted of inpatients with pneumonia from 2017 to 2021. Epidemiological characteristics of CAP and effects from the COVID-19 pandemic were analyzed by the basic characteristics, time distribution, etiology and disease burden. RESULTS: There were a total of 5746 CAP inpatient cases included from 2017 to 2021. The number of CAP hospitalizations decreased during the pandemic from 2020 to 2021, with seasonal variations of being higher in spring and winter and lower in summer and autumn, whereas it was prevalent throughout the year prior to the pandemic. The children group decreased significantly during the pandemic, with a 15% decrease in the share of CAP inpatients. The detection rates of bacteria and mycoplasma decreased in CAP patients, while the detection rate of the virus increased, and the number of moderate and severe cases reduced more than that of the mild. CONCLUSION: Non-pharmaceutical interventions from COVID-19 have led to a decrease in the number of CAP inpatients, especially for children, with a specific seasonal prevalence in spring and winter, when the prevention interventions should be strengthened further for adults during the pandemic.

Analyzing the Characteristics of Policies and Political Institutions for the Prevention and Control Governance of the COVID-19 Pandemic: Evidence from China.

This study explores the institutional reasons for and logical mechanism of the Chinese government's rapid positive results and major strategic achievements in coronavirus disease 2019 (COVID-19) pandemic prevention and control. Based on the ROST Content Mining System version 6.0 (ROST) and VOSviewer V1.6.1 (VOSviewer), we conduct an econometric visualization analysis of COVID-19 pandemic prevention and control policies to explore which strengths of Chinese political institutions have been brought into play by the Chinese government and how to systematically analyze the approaches by which these strengths support effective public governance. The findings show that: (1) "institutional strength", "medical terminology", "policy content", "policy implementation object", "policy implementation requirement", and "policy-making and implementation actor" are the six groups of high-frequency keywords in prevention and control policies. (2) The occurrences, links, and total link strength of the seven Chinese institutional strength keywords are very high. These results mean that the Chinese government has made full use of its institutional strengths to prevent and control COVID-19. These findings indicate that institutional strengths are critical to public health crisis prevention and control. They also illustrate that institutional strength is the prerequisite and key factor for achieving effective governance in the policy process. Scientific policymaking, efficient policy implementation, and strict oversight are undeniably necessary for effective governance during public health crises.

Impact of information timeliness and richness on public engagement on social media during COVID-19 pandemic: An empirical investigation based on NLP and machine learning.

This paper investigates how information timeliness and richness affect public engagement using text data from China's largest social media platform during times of the COVID-19 pandemic. We utilize a similarity calculation method based on natural language processing (NLP) and text mining to evaluate three dimensions of information timeliness: retrospectiveness, immediateness, and prospectiveness. Public engagement is divided into breadth and depth. The empirical results show that information retrospectiveness is negatively associated with public engagement breadth but positively with depth. Both information immediateness and prospectiveness improved the breadth and depth of public engagement. Interestingly, information richness has a positive moderating effect on the relationships between information retrospectiveness, prospectiveness, and public engagement breadth but no significant effects on immediateness; meanwhile, it has a negative moderating effect on the relationship between retrospectiveness and depth but a positive effect on immediateness, prospectiveness. In the extension analysis, we constructed a supervised NLP model to identify and classify health emergency-related information (epidemic prevention and help-seeking) automatically. We find that public engagement differs in the two emergency-related information categories. The findings can promote a more responsive public health strategy that magnifies the transfer speed for critical information and mitigates the negative impacts of information uncertainty or false information.

The Association of Suicidal Ideation With Family Characteristics and Social Support of the First Batch of Students Returning to a College During the COVID-19 Epidemic Period: A Cross Sectional Study in China.

Objective: To investigate the prevalence of suicidal ideation among the first batch of students returning to a college during the COVID-19 epidemic, and to explore the correlation of suicidal ideation with family characteristics and social support. Methods: A cluster sampling survey with a self-designed questionnaire was conducted among the first batch of students returning to a college in Wuhu, China. The Positive and Negative Suicidal ideation (PANSI) and Social Support Scale (SSRS) were used to define students' suicidal ideation and social support, respectively. The influence of family characteristics and social support on the students' suicidal ideation was investigated using multivariate unconditional logistic regression analysis. Results: Two thousand seven hundred valid questionnaires were collected, including 673 males (24.9%) and 2,027 females (75.1%), in this study. A total of 146 students (5.4%) showed suicidal ideation. Male respondents reported higher rates (7.9%) than females (4.6%). Multivariate logistic regression analysis showed that a higher risk level of residence before returning to school and lower objective support were the risk factors for suicidal ideation in males. In contrast, a higher level of maternal education, a poorer relationship with the mother, and lower scores for subjective support and support availability had significant effects on females' suicidal ideation. Limitations: This is a cross-sectional study, and lacks comparison to the time point unaffected by COVID-19. Moreover, it was limited by COVID-19 epidemic prevention and control restrictions, and the differences in returning to school in different regions. Only one college was investigated in this study, and all of the respondents were sophomores, so there may be some limitations in the representativeness of the sample and extrapolation of the results. Conclusion: Family characteristics and social support have had an important influence on suicidal ideation among students returning to school during the COVID-19 epidemic. Some gender differences were identified. Targeted interventions are needed for early prevention and control.

Risk stratification by long non-coding RNAs profiling in COVID-19 patients.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic worldwide. Long non-coding RNAs (lncRNAs) are a subclass of endogenous, non-protein-coding RNA, which lacks an open reading frame and is more than 200 nucleotides in length. However, the functions for lncRNAs in COVID-19 have not been unravelled. The present study aimed at identifying the related lncRNAs based on RNA sequencing of peripheral blood mononuclear cells from patients with SARS-CoV-2 infection as well as health individuals. Overall, 17 severe, 12 non-severe patients and 10 healthy controls were enrolled in this study. Firstly, we reported some altered lncRNAs between severe, non-severe COVID-19 patients and healthy controls. Next, we developed a 7-lncRNA panel with a good differential ability between severe and non-severe COVID-19 patients using least absolute shrinkage and selection operator regression. Finally, we observed that COVID-19 is a heterogeneous disease among which severe COVID-19 patients have two subtypes with similar risk score and immune score based on lncRNA panel using iCluster algorithm. As the roles of lncRNAs in COVID-19 have not yet been fully identified and understood, our analysis should provide valuable resource and information for the future studies.

Characterizing the dissemination of misinformation on social media in health emergencies: An empirical study based on COVID-19.

The dissemination of misinformation in health emergencies poses serious threats to public health and increases health anxiety. To understand the underlying mechanism of the dissemination of misinformation regarding health emergencies, this study creatively draws on social support theory and text mining. It also explores the roles of different types of misinformation, including health advice and caution misinformation and health help-seeking misinformation, and emotional support in affecting individuals' misinformation dissemination behavior on social media and whether such relationships are contingent on misinformation ambiguity and richness. The theoretical model is tested using 12,101 textual data about COVID-19 collected from Sina Weibo, a leading social media platform in China. The empirical results show that health caution and advice, help seeking misinformation, and emotional support significantly increase the dissemination of misinformation. Furthermore, when the level of ambiguity and richness regarding misinformation is high, the effect of health caution and advice misinformation is strengthened, whereas the effect of health help-seeking misinformation and emotional support is weakened, indicating both dark and bright misinformation ambiguity and richness. This study contributes to the literature on misinformation dissemination behavior on social media during health emergencies and social support theory and provides implications for practice.

Pneumonia scoring systems for severe COVID-19: which one is better.

PURPOSE: To investigate the predictive significance of different pneumonia scoring systems in clinical severity and mortality risk of patients with severe novel coronavirus pneumonia. MATERIALS AND METHODS: A total of 53 cases of severe novel coronavirus pneumonia were confirmed. The APACHE II, MuLBSTA and CURB-65 scores of different treatment methods were calculated, and the predictive power of each score on clinical respiratory support treatment and mortality risk was compared. RESULTS: The APACHE II score showed the largest area under ROC curve in both noninvasive and invasive respiratory support treatment assessments, which is significantly different from that of CURB-65. Further, the MuLBSTA score had the largest area under ROC curve in terms of death risk assessment, which is also significantly different from that of CURB-65; however, no difference was noted with the APACHE II score. CONCLUSION: For patients with COVID, the APACHE II score is an effective predictor of the disease severity and mortality risk. Further, the MuLBSTA score is a good predictor only in terms of mortality risk.

Short-Term Outcomes of Patients With COVID-19 Undergoing Invasive Mechanical Ventilation: A Retrospective Observational Study From Wuhan, China.

Background: COVID-19 has spread rapidly worldwide. Many patients require mechanical ventilation. The goal of this study was to investigate the clinical course and outcomes of patients with COVID-19 undergoing mechanical ventilation and identify factors associated with death. Methods: Eighty-three consecutive critically ill patients with confirmed COVID-19 undergoing invasive mechanical ventilation were included in this retrospective, single-center, observational study from January 31 to March 15, 2020. Demographic, clinical, laboratory, radiological, and mechanical ventilation data were collected and analyzed. The primary outcome was 28-day mortality after endotracheal intubation. The secondary outcomes included the incidences of SARS-CoV-2-related cardiac, liver, and kidney injury. Results: Seventy-four out of 83 (89.2%) patients achieved oxygen saturation above 93% after intubation. Forty-nine out of 83 (59%) patients died and 34 (41%) patients survived after 28 days of observation. Multivariable regression showed increasing odds of death associated with cardiac injury (odds ratio 15.60, 95% CI 4.20-74.43), liver injury (5.40, 1.46-23.56), and kidney injury (8.39, 1.63-61.41), and decreasing odds of death associated with the higher PaO2/FiO2 ratio before intubation (0.97, 0.95-0.99). PaO2/FiO2 ratio before intubation demonstrated a positive linear correlation with platelet count (r = 0.424, P = 0.001), and negative linear correlation with troponin I (r = -0.395, P = 0.008). Conclusions: Cardiac, liver, and kidney injury may be associated with death for critically ill patients with COVID-19 undergoing invasive mechanical ventilation. The severity of pre-intubation hypoxia may be associated with a poorer outcome of patients with COVID-19 undergoing invasive mechanical ventilation. Larger, multi-institutional, prospective studies should be conducted to confirm these preliminary results.

Value of lung ultrasound for the diagnosis of COVID-19 pneumonia: a protocol for a systematic review and meta-analysis.

INTRODUCTION: In the recent COVID-19 pandemic, cases have exceeded over one million, with the number of confirmed cases increasing by 50 000-60 000 per day. The virus has killed nearly 50 000 people all over the world in only 3 months. These reforms bring major challenges to the public health and healthcare system. The pulmonary pathological features during the initial phase of COVID-19 are alveolar oedema, pneumocyte hyperplasia, gravitational consolidations and interstitial thickening. The ability of lung ultrasound (LUS) and its evolving applications in the diagnosis of COVID-19 pneumonia are widespread. This study aims to evaluate the surveillance value of LUS in the diagnosis of COVID-19 pneumonia. METHODS AND ANALYSIS: We will perform a systematic search and meta-analysis on the use of LUS to diagnose and confirm COVID-19 pneumonia. We will search Ovid Medline, Ovid Embase, Web of Science, Cochrane Library, Scopus, Google Scholar, China Biology Medicine disc and WHO Global Health Library for studies on diagnostic accuracy from December 2019 to April 2021. Data collection and screening will be individually accomplished by two reviewers. The assessment of risk of bias for each outcome will be conducted using the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies 2) tool. Data will be synthesised and heterogeneity will be evaluated. Meta-analysis will be conducted when strong homogeneous data are accessible. Grading of Recommendations Assessment, Development and Evaluation(GRADE) will be used to assess quality of evidence. ETHICS AND DISSEMINATION: Approval of ethics committee is not needed for this review. While results will be disseminated electronically, effective dissemination will be done through presentations and peer-reviewed publication. PROSPERO REGISTRATION NUMBER: CRD42020177803; pre-results.