Trial of Endovascular Therapy for Acute Ischemic Stroke with Large Infarct.

BACKGROUND: The role of endovascular therapy for acute stroke with a large infarction has not been extensively studied in differing populations. METHODS: We conducted a multicenter, prospective, open-label, randomized trial in China involving patients with acute large-vessel occlusion in the anterior circulation and an Alberta Stroke Program Early Computed Tomography Score of 3 to 5 (range, 0 to 10, with lower values indicating larger infarction) or an infarct-core volume of 70 to 100 ml. Patients were randomly assigned in a 1:1 ratio within 24 hours from the time they were last known to be well to undergo endovascular therapy and receive medical management or to receive medical management alone. The primary outcome was the score on the modified Rankin scale at 90 days (scores range from 0 to 6, with higher scores indicating greater disability), and the primary objective was to determine whether a shift in the distribution of the scores on the modified Rankin scale at 90 days had occurred between the two groups. Secondary outcomes included scores of 0 to 2 and 0 to 3 on the modified Rankin scale. The primary safety outcome was symptomatic intracranial hemorrhage within 48 hours after randomization. RESULTS: A total of 456 patients were enrolled; 231 were assigned to the endovascular-therapy group and 225 to the medical-management group. Approximately 28% of the patients in both groups received intravenous thrombolysis. The trial was stopped early owing to the efficacy of endovascular therapy after the second interim analysis. At 90 days, a shift in the distribution of scores on the modified Rankin scale toward better outcomes was observed in favor of endovascular therapy over medical management alone (generalized odds ratio, 1.37; 95% confidence interval, 1.11 to 1.69; P = 0.004). Symptomatic intracranial hemorrhage occurred in 14 of 230 patients (6.1%) in the endovascular-therapy group and in 6 of 225 patients (2.7%) in the medical-management group; any intracranial hemorrhage occurred in 113 (49.1%) and 39 (17.3%), respectively. Results for the secondary outcomes generally supported those of the primary analysis. CONCLUSIONS: In a trial conducted in China, patients with large cerebral infarctions had better outcomes with endovascular therapy administered within 24 hours than with medical management alone but had more intracranial hemorrhages. (Funded by Covidien Healthcare International Trading [Shanghai] and others; ANGEL-ASPECT ClinicalTrials.gov number, NCT04551664.).

Quantified multidimensional public sentiment characteristics on social media for public opinion management: Evidence from the COVID-19 pandemic.

Background: Public sentiments arising from public opinion communication pose a serious psychological risk to public and interfere the communication of nonpharmacological intervention information during the COVID-19 pandemic. Problems caused by public sentiments need to be timely addressed and resolved to support public opinion management. Objective: This study aims to investigate the quantified multidimensional public sentiments characteristics for helping solve the public sentiments issues and strengthen public opinion management. Methods: This study collected the user interaction data from the Weibo platform, including 73,604 Weibo posts and 1,811,703 Weibo comments. Deep learning based on pretraining model, topics clustering and correlation analysis were used to conduct quantitative analysis on time series characteristics, content-based characteristics and audience response characteristics of public sentiments in public opinion during the pandemic. Results: The research findings were as follows: first, public sentiments erupted after priming, and the time series of public sentiments had window periods. Second, public sentiments were related to public discussion topics. The more negative the audience sentiments were, the more deeply the public participated in public discussions. Third, audience sentiments were independent of Weibo posts and user attributes, the steering role of opinion leaders was invalid in changing audience sentiments. Discussion: Since the COVID-19 pandemic, there has been an increasing demand for public opinion management on social media. Our study on the quantified multidimensional public sentiments characteristics is one of the methodological contributions to reinforce public opinion management from a practical perspective.

Impact of COVID-19 on lifestyle and financial behaviour: The implications to research in financial vulnerability.

The outbreak of coronavirus pandemic in late 2019 posted unprecedented social-economic challenges and disruptions to societies and individuals. The "new-normal" styles of living and working could intertwined with other determinants complicating the investigation of individual's financial vulnerability. The purpose of this paper is to conduct literature survey to review and consolidate the recent scattered literatures to identify some possible factors to be considered in the research related to financial vulnerability, including pandemic's impact of COVID-19 to different aspects of personal finance issues, pandemic-driven digitisation of the economy activities, changes in financial behaviour and addiction to digital technology.

Using Grounded Theory to Identify Online Public Opinion in China to Improve Risk Management-The Case of COVID-19.

BACKGROUND: During the outbreak of COVID-19, online public opinion related to the epidemic was rapidly generated and developed rapidly. If some online public opinions cannot be effectively responded to and guided, it will bring risks to social order. The government should understand how to use information on social media to grasp public demands, provide useful information in a timely manner and take countermeasures. Studying the formation mechanism of online public opinion during the outbreak can help the government make scientific decisions and improve risk management capabilities. METHODS: The research selects the public opinion information of online platforms represented by WeChat, online communities, Sina Weibo and search engines, involving 75 relevant texts (1 January to 31 March 2022). According to the grounded theory method, using the QSR NVivo12 qualitative research software, the collected network texts were successively researched using open coding, axial coding and theoretical coding. RESULTS: The structure of online public opinion during the COVID-19 epidemic was obtained. The operation mechanism of the online public opinion system about COVID-19 was mainly affected by the interaction of online public opinion objects, online public opinion subjects, online public opinion intermediaries and government forces. It was based on social facts and citizens' appeals as the starting point, subject behaviors and prevention and control measures as the focus, government's governance as macro-control and citizens' evaluation as the guide. CONCLUSIONS: Scientific analysis of online public opinion is an important tool to identify and manage risks and improve the quality of government activities. Online public opinion has the function of assisting government decision-making, and the government can identify the important information reflected in it, especially the mainstream public opinion, as a reference for decision-making. By taking effective measures and properly responding to citizens' reasonable demands, the government can prevent social risks and avoid new negative public opinions. Contributions: According to the characteristics of the basic model of online public opinion, this study provides risk mitigation suggestions for Chinese public sectors to use online public opinion, optimize epidemic prevention policies and formulate strategic measures.

The impact of screen time changes on anxiety during the COVID-19 pandemic: sleep and physical activity as mediators.

Under the burden caused by COVID-19 and rapid lifestyle changes, many people increased their screen time due to psychological needs and social requirements. The current study investigated the relationship between screen time changes and anxiety symptoms during the pandemic of COVID-19. Furthermore, we examined whether sleep and physical activity would mediate the association between screen time changes and anxiety. The self-developed questionnaire was delivered online to collect people's changes in anxiety, sleep patterns, and screen time during COVID-19. 970 participants (74.4% female) with an average age of 23 years were involved in this study. After adjusting demographic variables, the ordinal logistic regression analyses revealed that a significant increase in screen time was linked with anxiety. Slightly increased screen time, slightly and significantly decreased screen time did not predict anxiety symptoms during the pandemic. The level of anxiety was significantly higher among respondents who reported decreased sleep quality. Sleep quality directly mediated the association between screen time changes and anxiety, while sleep latency did not. The longer sleep latency caused by increased screen time would amplify anxiety by affecting sleep quality. In addition, the relationship between screen time changes and anxiety was also mediated by physical activity. We concluded that the fluctuation of screen time in a modest range does not affect the anxiety level substantially. The significantly increased screen time would contribute to poor sleep (including longer sleep latency and worse sleep quality) and lack of physical activity, which would lead to higher levels of anxiety.

Training for mental health professionals in responding to experienced and anticipated mental health related discrimination (READ-MH): protocol for an international multisite feasibility study.

Background: Mental health and other health professionals working in mental health care may contribute to the experiences of stigma and discrimination among mental health service users, but can also help reduce the impact of stigma on service users. However the few studies of interventions to equip such professionals to be anti-stigma agents those took place in High-Income Countries. This study assesses the feasibility, potential effectiveness and costs of Responding to Experienced and Anticipated Discrimination training for health professionals working in mental health care (READ-MH) across Low- and Middle-Income Countries (LMICs). Methods: This is an uncontrolled pre-post mixed methods feasibility study of READ-MH training at seven sites across five LMICs (China, Ethiopia, India, Nepal, and Tunisia). Outcome measures: knowledge based on course content; attitudes to working to address the impact of stigma on service users; and skills in responding constructively to service users' reports of discrimination. The training draws upon the evidence bases for stigma reduction, health advocacy and medical education and is tailored to sites through situational analyses. Its content, delivery methods and intensity were agreed through a consensus exercise with site research teams. READ-MH will be delivered to health professionals working in mental health care immediately after baseline data collection; outcome measures will be collected post-training and three months post-baseline, followed by qualitative data collection. Fidelity will be rated during delivery of READ-MH, and data on training costs will be collected. Quantitative data will be assessed using generalised linear mixed models. Qualitative data will be evaluated by thematic analysis to identify feedback about the training methods and content, including the implementability of the knowledge and skills learned. Pooled and site-specific training costs per trainee and per session will be reported. Conclusions: The training development used a participatory and contextualized approach. Evaluation design strengths include the diversity of settings; the use of mixed methods; the use of a skills-based measure; and knowledge and attitude measures aligned to the target population and training. Limitations are the uncertain generalisability of skills performance to routine care, and the impact of COVID-19 restrictions at several sites limiting qualitative data collection for situational analyses.

Measurement of contagion spatial spread probability in public places: A case study on COVID-19.

The scale and scope of the COVID-19 epidemic have highlighted the need for timely control of viral transmission. This paper proposed a new spatial probability model of epidemic infection using an improved Wasserstein distance algorithm and Monte Carlo simulation. This method identifies the public places in which COVID-19 spreads and grows easily. The Wasserstein Distance algorithm is used to calculate the distribution similarity between COVID-19 cases and the public places. Further, we used hypothesis tests and Monte Carlo simulation to estimate the spatial spread probability of COVID-19 in different public places. We used Snow's data to test the stability and accuracy of this measurement. This verification proved that our method is reliable and robust. We applied our method to the detailed geographic data of COVID-19 cases and public places in Wuhan. We found that, rather than financial service institutions and markets, public buildings such as restaurants and hospitals in Wuhan are 95 percent more likely to be the public places of COVID-19 spread.

The Impacts of Globalization on Inequality in the Post-COVID-19 World: Evidence From China.

Empirical studies suggest that globalization (FDI and international trade) has been greatly affected by the COVID-19 and related anti-pandemic measures imposed by governments worldwide. This paper investigates the impact of globalization on intra-provincial income inequality in China and the data is based on the county level. The findings reveal that FDI is negatively associated with intra-provincial inequality, intra-provincial inequality increases as the primary industry sector (agriculture) declines. The result also finds that the increase in inequality stems not from the development in the tertiary or secondary industry sectors per se, but the unevenness in the distribution of these sectors.

Global Industrial Development: Insights From the Distribution Dynamics Approach for the Post Covid Era.

The spread of COVID-19 has significantly dampened global economic activity and has also wreaked havoc on the industrial sector. Understanding the disparity and convergence of global industrial outputs is important in assessing the effectiveness of concurrent development policies. This study investigates the spatial distribution of global industrial output to unveil the disparity in industrial development and the feasibility of achieving convergence over time. Stochastic kernel analyses are carried out for national regimes to study the overall pattern of industrialization for all the countries in the world. Countries are then classified into different groups to further analyse the geographical and income effects on industrial development. The results show that disparity between the Global North and the Global South will enlarge further in the future. Industrial development in the Global North will continue to prosper, while the industrial output in many countries in the Global South just cannot reach the global average.

Global Inequality in Service Sector Development: Trend and Convergence

The COVID-19 pandemic has caused a huge impact on global service sector. In the pandemic background, to understand the disparity in service sector outputs at the global level is crucial for assessing the effectiveness of development policies in different countries. This study investigate the global service sector and it aims to investigate the transitional dynamics of the output from the service sector by adopting stochastic kernel analyses. Distribution dynamics analyses are carried out for all the countries in the world. The data are then divided into different regional and income groups to evaluate the impacts of geographical location and income on the development of the service sector. The results show that the Global North will continue to make greater strides, while the output capacity in many Global South countries struggles to reach the global average. Moreover, it is shown that countries with higher per capita income will perform better in the development of their service sector than those with low per capita income, thereby highlighting the persistence of global inequality. Finally, this study shows that the Sub-Saharan Africa region and the South Asia region both are very important in the alleviation of global inequality.

Integrating basic and applied researches of SARS-CoV-2 into the medical molecular biology teaching.

Molecular biology is an important course for medical postgraduates to understand the practice of modern molecular medicine. At present, molecular biology has been widely used in the prevention, diagnosis, and treatment of clinical medicine. The COVID-19 pandemic forced all universities suspending academic activities and online teaching all over the world, which is a kind of crisis and has become people's memory of the times. The efforts from all sectors of society, include government, research institutions, and enterprises, have gave medical students a profound impact. The integration of memory of the times into molecular biology teaching will enhance students' learning interest and understanding effect.

Logic Analysis of How the Emergency Management Legal System Used to Deal with Public Emerging Infectious Diseases under Balancing of Competing Interests-The Case of COVID-19.

Development of measures for mitigating public emerging infectious diseases is now a focal point for emergency management legal systems. COVID-19 prevention and containment policies can be considered under the core goal of social and individual interests. In this study we analyzed the complexity between individual and public interests as they conflict when implementing disease preventative measures on an epidemic scale. The analysis was used to explore this complex landscape of conflicting social, public, and legal interests to quantify the potential benefits of public acceptance. Here we use the large-scale COVID-19 epidemic backdrop to examine legal norms of the emergency management legal framework. We find that the implementation of emergency management legal system measures involves the resolution of both direct and indirect conflicts of interest among public groups, individual groups, and various subsets of each. When competing interests are not balanced, optimal policies cannot be achieved to serve and safeguard shared social and community stability, whereas effective social outcomes are obtainable through the development of targeted policies as defined within the emergency management legal system. A balanced legal framework in regards to emergency management legal norms can more effectively serve to mitigate and prevent the continued spread of emerging infectious diseases. Further developing innovative procedural mechanisms as a means to ensure emergency response intervention should take into account the weighted interest of the different social parties to determine priorities and aims to protect legitimate public interests.

Influence of coronavirus disease 2019 (COVID-19) on working flow, safety and efficacy outcome of mechanical thrombectomy for acute ischemic stroke with large vessel occlusion.

AIM: The epidemic of COVID-19 has greatly affect the world health care system, particular measures have been taken not only to provide safety for health care providers but also to maintain the treatment quality. We evaluate the effect of COVID-19 epidemic to acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) received endovascular treatment (EVT) in our institution. METHODS: AIS patients with LVO who underwent EVT in the period of January 1st to April 30th between 2015 and 2020 from our stroke center. The baseline characteristics, working flow time, safety and efficacy outcome and the hospitalization status were retrospectively reviewed, compared and analyzed. RESULTS: There is significant decline in the number of AIS patients with LVO treated compared with the previous year (36 Vs 72 patients) during the epidemic period. The door to puncture time was significantly prolong (225 minutes versus 115 minutes) as well as the length of hospital stay with increase of the hospitalization costs (P < 0.05 for all). There is no significant difference on the safety and efficacy outcome, such recanalization rate, incidence of intracranial hemorrhage, functional independence and mortality during the epidemic (P > 0.05 for all). CONCLUSIONS: Prolongation of the working time flow during the COVID-19 epidemic did not influence the safety and efficacy of EVT in AIS patients with LVO. However, special policy and particular measures in this circumstances is still need to evolve to improve the treatment quality.

Safety measures for COVID-19 do not compromise the outcomes of patients undergoing primary percutaneous coronary intervention: a single center retrospective study.

Coronavirus disease 2019 (COVID-19) is a global pandemic impacting nearly 170 countries/regions and millions of patients worldwide. Patients with acute myocardial infarction (AMI) still need to be treated at percutaneous coronary intervention (PCI) centers with relevant safety measures. This retrospective study was conducted to assess the therapeutic outcomes of PCI performed under the safety measures and normal conditions. AMI patients undergoing PCI between January 24 to April 30, 2020 were performed under safety measures for COVID-19. Patients received pulmonary computed tomography (CT) and underwent PCI in negative pressure ICU. Cardiac catheterization laboratory (CCL) staff and physicians worked with level III personal protection. Demographic and clinical data, such as door-to-balloon (DTB) time, operation time, complications for patients in this period (COVID-19 group) and the same period in 2019 (2019 group) were retrieved and analyzed. COVID-19 and 2019 groups had 37 and 96 patients, respectively. There was no significant difference in age, gender, BMI and comorbidity between the two groups. DTB time and operation time were similar between the two groups (60.0 ± 12.39 vs 58.83 ± 12.85 min, p = 0.636; 61.46 ± 9.91 vs 62.55 ± 10.72 min, p = 0.592). Hospital stay time in COVID-19 group was significantly shorter (6.78 ± 2.14 vs 8.85 ± 2.64 days, p < 0.001). The incidences of malignant arrhythmia and Takotsubo Syndrome in COVID-19 group were higher than 2019 group significantly (16.22% vs 5.21%, p = 0.039; 10.81% vs 1.04% p = 0.008). During hospitalization and 3-month follow-up, the incidence of major adverse cardiovascular events and mortality in the two groups were statistically similar (35.13% vs 14.58%, p = 0.094; 16.22% vs 8.33%, p = 0.184). The risk of major adverse cardiac events (MACE) was associated with cardiogenic shock (OR, 11.53; 95% CI, 2.888-46.036; p = 0.001), malignant arrhythmias (OR, 7.176; 95% CI, 1.893-27.203; p = 0.004) and advanced age (≥ 75 years) (OR, 6.718; 95% CI, 1.738-25.964; p = 0.006). Cardiogenic shock (OR, 17.663; 95% CI, 5.5-56.762; p < 0.001) and malignant arrhythmias (OR, 4.659; 95% CI, 1.481-14.653; p = 0.008) were also associated with death of 3 months. Our analysis showed that safety measures undertaken in this hospital, including screening of COVID-19 infection and use of personal protection equipment for conducting PCI did not compromise the surgical outcome as compared with PCI under normal condition, although there were slight increases in incidence of malignant arrhythmia and Takotsubo Syndrome.

Maintaining normal sleep patterns, lifestyles and emotion during the COVID-19 pandemic: The stabilizing effect of daytime napping.

This study aimed to assess changes in sleep pattern and their influence on people's daily life and emotion during the COVID-19 pandemic. Self-developed questionnaires were used to measure changes in nocturnal sleep, daytime napping, lifestyles and negative emotions in individuals before and after the COVID-19 pandemic. Nine hundred and thirty effective questionnaires were collected in this study. Repeated measures analysis of variance and hierarchical regression analysis were applied. We found that individuals' sleep rhythms were delayed, and sleep duration and sleep latency were increased during the stay-at-home orders. Meanwhile, their exercise levels and learning/working efficiency were decreased, and electronic device use time, annoyance levels and anxiety levels were increased. Delayed sleep patterns affected lifestyles and emotions. Moreover, sleep quality positively predicted learning/working efficiency and exercise levels, and negatively predicted use of electronic devices and negative emotions. Sleep patterns became delayed on weekdays during stay-at-home orders in all four daytime napping groups (no daytime napping, daytime napping as before, more daytime napping and less daytime napping), and the group taking daytime naps as before had a minimal variation, and their lifestyles and emotions were significantly better than those of the other groups. This study demonstrated that under the influence of stress caused by the pandemic, maintaining regular daytime napping was an effective way to stabilize sleep patterns and biological rhythms, keep good lifestyles and alleviate the effect of acute psychological stress, and to prevent and control mental disorders during the pandemic.

Efficacy of Traditional Chinese Medicine on COVID-19: Two Case Reports.

Severe acute respiratory syndrome coronavirus 2-infected pneumonia (novel coronavirus-infected pneumonia [NCIP]) is a new viral illness initially identified in the central Chinese city of Wuhan in December 2019. According to the daily report on the epidemic situation of coronavirus disease (COVID-19) issued by the National Health and Family Planning Commission of the People's Republic of China on March 23, 2020: COVID-19 is highly infectious, causing extremely high incidence of NCIP throughout Wuhan and has spread swiftly to 34 provinces within China and >100 other countries around the world between January and March 2020. Up to August 11, 2020, there have been 89,383 cases diagnosed as coronavirus-infected pneumonia; and 4,696 deaths in China (mortality rate of 5.25%) and worldwide reports have confirmed 19,936,210 cases and 732,499 deaths. These figures have been increasing daily. The treatment of viral conditions is well established within the context of Chinese Medicine. We report 2 successful cases in this study showing the patient's chest computed tomography scans and temperature charts made on before, during, and after treatment to demonstrate proof of the positive benefits achieved. Traditional Chinese Medicine (TCM) demonstrates a positive effect in the treatment for COVID-19. It is highly recommended that TCM be incorporated early on in the treatment schedule for COVID-19.