•The prevalence of posttraumatic stress symptoms (PTSS) in China hardest-hit areas a month after the COVID-19 outbreak was 7%.•Hierarchical regression analysis and non-parametric test suggested that ...women reported significant higher PTSS in the domains of re-experiencing, negative alterations in cognition or mood, and hyper-arousal.•Participants with better sleep quality or less frequency of early awakenings reported lower PTSS.
The outbreak of COVID-19 in China in December 2019 has been identified as a pandemic and a health emergency of global concern. Our objective was to investigate the prevalence and predictors of posttraumatic stress symptoms (PTSS) in China hardest-hit areas during COVID-19 outbreak, especially exploring the gender difference existing in PTSS. One month after the December 2019 COVID-19 outbreak in Wuhan China, we surveyed PTSS and sleep qualities among 285 residents in Wuhan and surrounding cities using the PTSD Checklist for DSM-5 (PCL-5) and 4 items from the Pittsburgh Sleep Quality Index (PSQI). Hierarchical regression analysis and non-parametric test were used to analyze the data. Results indicated that the prevalence of PTSS in China hardest-hit areas a month after the COVID-19 outbreak was 7%. Women reported significant higher PTSS in the domains of re-experiencing, negative alterations in cognition or mood, and hyper-arousal. Participants with better sleep quality or less frequency of early awakenings reported lower PTSS. Professional and effective mental health services should be designed in order to aid the psychological wellbeing of the population in affected areas, especially those living in hardest-hit areas, females and people with poor sleep quality.
•The prevalence of PTSD among the Chinese public one month after the COVID-19 outbreak was 4.6%.•Female, having recent epidemic area contact history, population at high risk of infection, and poor ...sleep quality were identified as risk factors for PTSD.•With regard to psychological intervention during the COVID-19 outbreak, females, people with poor sleep quality, and those who are at high risk of infection, such as people residing in high disease-prevalent regions and having had close contact with patients deserve special attention.
To examine the prevalence of and risk factors for acute posttraumatic stress disorder (PTSD) shortly after the massive outbreak of COVID-19 in China.
An online anonymous survey was conducted between 30 January and 3 February, 2020. The survey included two self-administered questionnaires: one collected personal information (gender, age, education background), current location, recent epidemic area contact history, the classification of population, and subjective sleep quality; the other was the PTSD Checklist for DSM-5 (PCL-5).
A total of 2091 Chinese participated in the current study. The prevalence of PTSD among the Chinese public one month after the COVID-19 outbreak was 4.6%. Multiple linear regression analysis revealed that gender (p < 0.001), epidemic area contact history (p = 0.047), classification of population (p < 0.001), and subjective sleep quality (p < 0.001) could be regarded as predictors for PTSD.
First, the majority of participants in this study were the general public, with confirmed or suspected patients being a small part. Second, the measurement of PTSD in this study might be vulnerable to selection bias because of an online self-report study, such as participants’ recruitment. Third, the prevalence of PTSD in this study was estimated by an online questionnaire rather than a clinical interview.
The results suggested that some Chinese showed acute PTSD during the COVID-19 outbreak. Therefore, comprehensive psychological intervention needs further implementation. Furthermore, females, people who had recent epidemic area contact history, those at high risk of infection or with poor sleep quality deserve special attention.
An Investigator Global Assessment (IGA) is recommended by health agencies for drug registration in atopic dermatitis (AD). Current IGA scales lack standardization.
To develop an IGA scale, training ...module, and clinical certification examination for use in AD trials; establish content validity; and assess reliability.
Expert dermatologists participated in the development of the validated IGA for AD (vIGA-ADTM). Reliability (interrater and intrarater) was assessed by 2 web-based surveys. Clinical certification for investigators consisted of a training module and examination.
Expert consensus was achieved around a 5-point IGA scale including morphologic descriptions, and content validity was established. Survey 1 showed strong interrater reliability (Kendall's coefficient of concordance W Kendall's W, 0.809; intraclass correlation ICC, 0.817) and excellent agreement (weighted kappa, 0.857). Survey 2, completed 5 months after training of dermatologists, showed improvements in scale reliability (Kendall's W, 0.819; ICC, 0.852; weighted kappa, 0.889). In this study, 627 investigators completed vIGA-AD training and certification.
Ratings were assessed on photographs.
A validated IGA scale and training module were developed with the intent of harmonizing assessment of disease severity in AD trials. Strong reliability and excellent agreement between assessments were observed.
Training individuals to interpret ambiguous information in positive ways might be an effective method of reducing social anxiety. However, little research had been carried out in Chinese samples, and ...the effect of interpretation training on other processes such as attentional bias also remained unclear. This study examined the effect of interpretation bias modification program (IMP) on interpretation bias, social anxiety and attentional bias, and the possible mediation effects. 51 healthy adults were randomly assigned to either a 5-session IMP training that guided them to endorse benign interpretation in ambiguous scenarios or an interpretation control condition (ICC). Self-reported measures of social anxiety symptoms, attentional bias and interpretation bias were evaluated before and after training. Results showed that compared to control group, IMP group generated more positive interpretations and less negative interpretations after training (F(1,49) = 7.65, p<0.01, eta.sub.p .sup.2 = 0.14; F(1,49) = 14.60, p<0.01, eta.sub.p .sup.2 = 0.23respectively). IMP yielded greater interpretation bias reduction (F(1,49) = 12.84, p<0.01, eta.sub.p .sup.2 = 0.21) and social anxiety reduction (F(1,49) = 21.39, p<0.01, eta.sub.p .sup.2 = 0.30) than ICC, but change in attentional bias was not significant between IMP and the control group. Change in interpretation bias did not show a significant mediation effect in the relationship between training condition and social anxiety reduction. This study provided preliminary evidence for the efficacy of the Chinese version of IMP training. Possible methodological issues and interpretations underlying the findings were discussed. This study was registered in Chinese Clinical Trial Registry (www.chitr.org.cn), a WHO approved registry. The title of registration trial was "A Study on the efficiency of cognitive bias and attentional bias training on fear and phobia" and the registration number was ChiCTR2100045670.
Selenium (Se) as an essential nutrient for human beings at trace concentrations, the allowable concentration for the human is only 40 μg/L. Iron sulfide (FeS) nanoparticles have been applied for ...excessive of selenium (Se) remediation in surface water and groundwater. In this study, FeS nanoparticles were anchored onto biochar (BC) to reduce agglomeration of FeS and prepared into the composite of FeS-BC by pyrolysis to economically and efficiently remove Se(IV) from simulated wastewater based on the excellent performance of FeS and the low cost of BC. Characterizations presented the uniform anchorage of FeS on the BC surface to prevent agglomeration. The results of batch experiments revealed that the removal of Se(IV) by FeS-BC nanomaterials significantly depended on the pH value, with the maximum removal of ∼174.96 mg/g at pH 3.0. A pseudo-second-order kinetic model well reflected the kinetic removal of Se(IV) in pure Se(IV) solution with different concentration, as well as the coexistence of K+, Ca2+, Cl-, and SO42- ions. The presence of K+ ions significantly inhibited the removal of Se(IV) with the increase of K+ ion concentration compared with the effect of the other three ions. SEM-EDS and XPS analyses indicated that the removal process was achieved through adsorption by surface complexation, and reductive precipitation of Se(IV) into Se0 with the electron donor of Fe(II) and S(-II) ions. The FeS-BC nanomaterial exhibited an excellent application prospect in the remediation of Se(IV).
•The aggregation issue of FeS nanoparticles was addressed by BC loading.•FeS-BC can effectively remove Se(IV) through surface complexation, ion exchange, and chemical precipitation.•Fe2 + and S2- species simultaneously acted as electron donors to reduce Se(IV) to Se0.•The removal efficiency was affected by K+ ions significantly rather than other ions.
The impact of 2019 coronavirus disease (COVID-19) outbreak on mental health was of widespread concern recently. The present study aimed to exam sleep quality and posttraumatic stress symptoms (PTSS) ...and potential influence factors in the first phases of COVID-19 massive outbreak in China. A snowball sampling technique was used and a total of 2027 Chinese participated in the present study. Demographic information, epidemic area contact history, sleep quality and PTSS data were collected with an internet-based cross-sectional survey. Results suggested that 59.7% participants were not fully satisfied with their sleep quality, and 50.9% participants had various degrees of short sleep duration problems. 44.1% and 33.0% participants had sleep disturbance and sleep onset latency problems. Also, the prevalence of PTSS reached 4.7% in the self-rating survey. Epidemic area contact history affected PTSS and latency onset of sleep under the influence of COVID-19. Epidemic area contact history and sleep quality had interaction effects on PTSS. The present study was one of the first to evaluate acute psychological responses and possible risk factors during the peak of COVID-19 in China and results indicate that keeping good sleep quality in individuals with pandemic exposure experiences is a way to prevent PTSS.
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•Four different municipal solid wastes were used to produce solid fuel pellets.•NovoGro was used as the binder in the pelletization process for the first time.•Apple pomace waste is ...not suitable for use as a fuel.•Tea waste pellets exhibited the best combustion performance.•It showed the potential of dog manure, horse manure and tea waste pellets to substitute fossil fuels.
Four different municipal solid wastes (dog manure, horse manure, apple pomace waste and tea waste) and an industrial by-product (NovoGro) were used to produce solid fuel pellets. The mixtures followed a raw material to NovoGro ratio of 50:1. The pellets diameters varied between 4 and 5 mm, and the average length was 20 mm. The dog manure, horse manure, apple pomace waste and tea waste pellets were denoted as DN, HN, AN and TN, respectively. The combustion characteristics of the pelletized fuels were investigated, such as total moisture, ash content, calorific value and ash fusion point, etc. The physicochemical properties were analyzed by using a number of analytical techniques including X-ray fluorescence spectrometry (XRF), X-ray diffraction spectrometry (XRD), scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR). The results of the mechanical, thermal and morphological properties show that the raw materials were effectively combined with the NovoGro binder; furthermore, the DN, HN and TN pellets exhibited excellent mechanical and thermal properties, including high calorific values (>16.30 MJ/kg), high resistance to mechanical shock (>99%), high volatile matter contents, optimal softening temperatures and optimal ash contents. However, the high K, Ca, and Si contents of the AN can form low-melting-point eutectics, which can cause slagging. Moreover, the AN materials had large particle sizes, and high cellulose and hemicellulose contents led to high total moistures, low softening temperatures and low calorific values. The AN was not suitable for use as a fuel. The results suggested that NG is an effective binder for pelletization of biomass and showed the feasibility of using municipal solid wastes for energy production.
Abstract
Background
The Itch Numeric Rating Scale (NRS), Skin Pain NRS, and Atopic Dermatitis Sleep Scale (ADSS) are self-administered patient-reported outcome (PRO) instruments developed to assess ...symptoms in patients with atopic dermatitis (AD). The objective of this study was to evaluate the psychometric properties (reliability, validity, and responsiveness) and interpretability thresholds of these PROs using data from three pivotal Phase 3 studies in adults.
Methods
BREEZE-AD1, BREEZE-AD2, and BREEZE-AD5 evaluated the safety and efficacy of baricitinib in adults with moderate-to-severe AD. Clinician-reported outcomes and other PROs commonly assessed in patients with AD were used to estimate meaningful changes and evaluate test–retest reliability, convergent and divergent validity, known-groups validity, responsiveness, and meaningful change thresholds (MCTs) of the Itch NRS, Skin Pain NRS, and ADSS.
Results
The test–retest reliability of the Itch NRS, Skin Pain NRS, and ADSS was evidenced by generally large intraclass correlation coefficients (> 0.7) in stable groups of patients between baseline and Week 1 and Weeks 4 and 8. Moderate-to-large correlations (
r
> 0.4) at baseline and Week 16 were generally observed between each measure and other PROs measuring the same concept, supporting convergent validity. Small-to-moderate correlations with clinician-reported outcomes demonstrated divergent validity. Each instrument was able to distinguish between known groups of disease severity as assessed using other indicators of AD severity. The responsiveness of the Itch NRS, Skin Pain NRS, and ADSS scales was demonstrated through significant differences in their change scores from baseline to Week 16 between categories of change in another PRO also from baseline to Week 16. Thresholds for interpreting meaningful change were estimated as − 4.0 for the 0–10 Itch and Skin Pain NRS items; − 1.25 for the 0–4 ADSS Items 1 and 3 and; − 1.50 for the 0–29 ADSS Item 2, these equivalent to moderate degrees of change.
Conclusions
Results of this study demonstrate that the psychometric properties of the Itch NRS, Skin Pain NRS, and ADSS are good to excellent. These findings support the use of these instruments in daily assessment of AD symptoms in adults with moderate-to-severe AD.
Trial registration
ClinicalTrials.gov numbers: NCT03334396, NCT03334422, and NCT03435081.
In early March 2022, the highly contagious Omicron variant rapidly emerged in Shanghai. This study aimed to explore the prevalence and associated factors of depression and anxiety in isolated or ...quarantined populations under lockdown.
A cross-sectional study was conducted between May 12 and 25, 2022. The depressive and anxiety symptoms, perceived stress, self-efficacy and perceived social support in the 167 participants under isolated or quarantined were examined using the Patient Health Questionnaires-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), the Perceived Stress Scale-10 (PSS-10), the General Self-Efficacy Scale (GSES) and the Perceived Social Support Scale (PSSS). Data on demographic information were also collected.
The prevalence of depression and anxiety in isolated or quarantined populations was estimated to be 12 and 10.8%, respectively. Higher education level, being healthcare workers, being infected, longer duration of segregation and higher perceived stress level were identified as risk factors for depression and anxiety. Furthermore, the relationship between perceived social support and depression (anxiety) was mediated not only by perceived stress but also the chain of self-efficacy and perceived stress.
Being infected, higher education level, longer duration of segregation and higher perceived stress were associated with higher levels of depression and anxiety among isolated or quarantined populations under lockdown. The formulation of psychological strategies that promote one's perceived social support and self-efficacy as well as reduce perceived stress is supposed to be drawn.
Patients who completed the originating studies, BREEZE-AD1 (NCT03334396), BREEZE-AD2(NCT03334422), and BREEZE-AD7 (NCT03733301), were eligible for enrollment in the multicenter,phase-3, long-term ...extension study BREEZE-AD3 (NCT03334435).
At week 52, responders and partial responders to baricitinib 4 mg were re-randomized (1:1) into the sub-study to dose continuation (4 mg, N = 84), or dose down-titration (2 mg, N = 84). Maintenance of response was assessed from week 52 to 104 of BREEZE-AD3. Physician-rated outcomes included vIGA-AD (0,1), EASI75, and mean change from baseline in EASI. Patient-reported outcomes included DLQI, P OEM total score, HADS, and from baseline: WPAI (presenteeism, absenteeism, overall work impairment, daily activity impairment) and change from baseline in SCORAD itch and sleep loss.
With continuous treatment with baricitinib 4 mg, efficacy was maintained up to week 104 in vIGA-AD (0,1), EASI75, EASI mean change from baseline, SCORAD itch, SCORAD sleep loss, DLQI, P OEM, HADS, and WPAI (all scores). Patients down-titrated to 2 mg maintained most of their improvements in each of these measures.
The sub-study of BREEZE AD3 supports flexibility in baricitinib dosing regimens. Patients who continued treatment with baricitinib 4 mg and down-titrated to 2 mg maintained improvements in skin, itch, sleep, and quality of life for up to 104 weeks.
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