Background: Since COVID-19 outbreak, hydroxychloroquine (HCQ) has been tested for effective therapies, and the relevant researches have shown controversial results. Methods: Systematic review and meta-analysis were conducted after a thorough search of relevant studies from databases. Trials that have evaluated HCQ for COVID-19 treatment were recruited for statistical analysis with fixed- and random-effect models. Results: Nine trials involving 4112 patients were included in present meta-analysis. It was seen that HCQ-azithromycin (HCQ-AZI) combination regimen increased the mortality rate in COVID-19 (odds ratio [OR], 2.34; 95% confidence interval [CI], 1.63–3.36) patients; however, it also showed benefits associated with the viral clearance in patients (OR, 27.18; 95% CI, 1.29–574.32). HCQ-alone when used as a therapy in COVID-19 did not reveal significant changes in mortality rate, clinical progression, viral clearance, and cardiac QT prolongation. Subsequent subgroup analysis showed that HCQ treatment could decrease mortality rate and progression to severe illness in severely infected COVID-19 patients (OR, 0.27; 95% CI, 0.13–0.58). A lower risk of mortality rate was also noted in the stratified group of >14 days follow-up period (OR, 0.27; 95% CI, 0.13–0.58) compared to ≤14 days follow-up period group that conversely showed an increased mortality rate (OR, 2.09; 95% CI, 1.41–3.10). Conclusion: Our results indicated that HCQ-AZI combination treatment increased mortality rate in patients with COVID-19, but it also showed benefits associated with viral clearance in patients. HCQ-alone used for treatment has revealed benefits in decreasing the mortality rate among severely infected COVID-19 group and showed potential to be used for COVID-19 treatment in long-term follow-up period group. Accordingly, more rigorous, large-scale, and long follow-up period studies in patients with COVID-19 are needed.

word count: 247 Summary of the article's main point: This study demonstrates that the use of hydroxychloroquine with or without azithromycin might have benefits in viral clearance of SARS-CoV-2 and reduction of progression rate, but was associated with increased mortality in COVID-19.

CsA is an effective and safe treatment for patients with LN. Further randomized controlled trials are needed.
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The objective of this research was to explore the impact factors of sustainable corporate governance for top consulting engineering companies in Taiwan, to facilitate managers in meeting stakeholders’ needs and adapting to the challenges of the global markets. Nine hypotheses derived from a literature review were proposed and used to develop a survey. Based on the concept of structural equation modeling (SEM) and these hypotheses, a questionnaire containing six aspects and comprising 46 stems was developed using the Likert 5-scale format. The survey took around four months to administer with 324 effective returns, with only five hypotheses confirmed. This was followed by factor analysis to determine the weight sequence for the 28 impact factors and four aspects. The contributions of the findings are as follows: (1) the weighted factors provide practitioners with guidelines for the proper order for the implementation of measures to improve corporate governance, and (2) they answer questions about the degree of influence and the relationship among all aspects and factors for sustainable corporate governance.

Background An optimal antithrombotic strategy for patients aged 80 years or older with atrial fibrillation (AF) remains elusive. Objective Using a systematic review with traditional and network meta-analysis, we investigated outcomes in AF patients ≥80 years treated with different antithrombotic strategies. Methods We searched eligible randomised controlled trials (RCTs) and observational studies from MEDLINE, EMBASE, Cochrane Library and Web of Science databases from inception to 16 December 2021. Research comparing treatment outcomes of novel oral anticoagulants (NOACs), aspirin, vitamin K antagonists (VKAs) or no oral anticoagulant/placebo therapy in patients ≥80 years with AF were included. Outcomes were stroke or systemic embolism (SSE), major bleeding, all-cause mortality, intracranial bleeding (ICH) and gastrointestinal bleeding. Traditional and network meta-analyses were performed. Net clinical benefit integrating SSE and major bleeding was calculated. Results Fifty-three studies were identified for analysis. In the meta-analysis of RCTs, risk of SSE (risk ratio [RR]: 0.82; 95% confidence interval [CI]: 0.73–0.99) and ICH (RR: 0.38; 95% CI: 0.28–0.52) was significantly reduced when NOACs were compared with VKAs. Network meta-analysis of RCTs demonstrated that edoxaban (P-score: 0.8976) and apixaban (P-score: 0.8528) outperformed other antithrombotic therapies by showing a lower major bleeding risk and better net clinical benefit. Both traditional and network meta-analyses from RCTs combining with observational studies showed consistent results. Conclusions In patients aged 80 years or older with AF, NOACs have better outcomes than VKAs regarding efficacy and safety profiles. Edoxaban and apixaban may be preferred treatment options since they are safer than other antithrombotic strategies.