IMPORTANCE People exposed to coronavirus disease 2019 (COVID-19) and a series of imperative containment measures could be psychologically stressed, yet the burden of and factors associated with mental health symptoms remain unclear. OBJECTIVE To investigate the prevalence of and risk factors associated with mental health symptoms in the general population in China during the COVID-19 pandemic. DESIGN, SETTING, AND PARTICIPANTS This large-sample, cross-sectional, population-based, online survey study was conducted from February 28, 2020, to March 11, 2020. It involved all 34 province-level regions in China and included participants aged 18 years and older. Data analysis was performed from March to May 2020. MAIN OUTCOMES AND MEASURES The prevalence of symptoms of depression, anxiety, insomnia, and acute stress among the general population in China during the COVID-19 pandemic was evaluated using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Insomnia Severity Index, and Acute Stress Disorder Scale. Logistic regression analyses were used to explore demographic and COVID-19-related risk factors. RESULTS Of 71 227 individuals who clicked on the survey link, 56 932 submitted the questionnaires, for a participation rate of 79.9%. After excluding the invalid questionnaires, 56 679 participants (mean [SD] age, 35.97 [8.22] years; 27 149 men [47.9%]) were included in the study; 39 468 respondents (69.6%) were aged 18 to 39 years. During the COVID-19 pandemic, the rates of mental Author affiliations and article information are listed at the end of this article.

The intrauterine environment is a major contributor to increased rates of metabolic disease in adults. Intrahepatic cholestasis of pregnancy (ICP) is a liver disease of pregnancy that affects 0.5%-2% of pregnant women and is characterized by increased bile acid levels in the maternal serum. The influence of ICP on the metabolic health of offspring is unknown. We analyzed the Northern Finland birth cohort 1985-1986 database and found that 16-year-old children of mothers with ICP had altered lipid profiles. Males had increased BMI, and females exhibited increased waist and hip girth compared with the offspring of uncomplicated pregnancies. We further investigated the effect of maternal cholestasis on the metabolism of adult offspring in the mouse. Females from cholestatic mothers developed a severe obese, diabetic phenotype with hepatosteatosis following a Western diet, whereas matched mice not exposed to cholestasis in utero did not. Female littermates were susceptible to metabolic disease before dietary challenge. Human and mouse studies showed an accumulation of lipids in the fetoplacental unit and increased transplacental cholesterol transport in cholestatic pregnancy. We believe this is the first report showing that cholestatic pregnancy in the absence of altered maternal BMI or diabetes can program metabolic disease in the offspring.

Lymphocyte activation gene 3 (LAG-3) is expressed on activated T cells, natural killer cells or B cells, and functions to negatively regulate homeostasis of these cells. Anti-LAG-3 antibodies might be useful for antitumor immunotherapy. In this study, we characterized a novel anti-LAG-3 antibody, LBL-007, which was isolated from a human antibody phage display library. LBL-007 was found to specifically bind to human LAG-3 antigen, but not to human CD4 or mouse LAG-3. LBL-007 bound activated T cells and promoted interleukin-2 secretion. LBL-007 internalization efficacy by endocytosis into different cells was better than that of another anti-LAG-3 antibody, relatlimab analog. Moreover, LBL-007 was able to block LAG-3 binding to MHC class II molecules and liver sinusoidal endothelial cell lectin, and block LAG-3-induced downstream signaling. In mice transplanted with colorectal cancer cells, treatment with either anti-PD-1 antibody or LBL-007 (10 mg/kg per mouse twice a week for three weeks) resulted in a significant delay in tumor growth compared with control IgG treatment, and their combination was even more effective. Serum LBL-007 levels were highly stable in monkeys after a single intravenous injection of LBL-007 at 3, 10, or 30 mg/kg. This study demonstrated that the combination of LBL-007 with an anti-PD-1 antibody is a promising antitumor regimen for immunotherapy of solid tumors in future that deserves further study.

Infectious diseases, including COVID-19, are crucial public health issues and may lead to considerable fear among the general public and stigmatization of, and discrimination against, specific populations. This meta-analysis aimed to estimate the pooled prevalence of stigma in infectious disease epidemics. We systematically searched PubMed, PsycINFO, Embase, MEDLINE, Web of Science, and Cochrane databases since inception to June 08, 2021, and reported the prevalence of stigma towards people with infectious diseases including SARS, H1N1, MERS, Zika, Ebola, and COVID-19. A total of 50 eligible articles were included that contributed 51 estimates of prevalence in 92722 participants. The overall pooled prevalence of stigma across all populations was 34% [95% CI: 28−40%], including enacted stigma (36% [95% CI: 28−44%]) and perceived stigma (31% [95% CI: 22−40%]). The prevalence of stigma in patients, community population, and health care workers, was 38% [95% CI: 12− 65%], 36% [95% CI: 28−45%], and 30% [95% CI: 20−40%], respectively. The prevalence of stigma in participants from low- and middle-income countries was 37% [95% CI: 29−45%], which is higher than that from high-income countries (27% [95% CI: 18−36%]) though this difference was not statistically significant. A similar trend of prevalence of stigma was also observed in individuals with lower education (47% [95% CI: 23−71%]) compared to higher education level (33% [95% CI: 23−4%]). These findings indicate that stigma is a significant public health concern, and effective and comprehensive interventions are needed to counteract the damaging effects of the infodemics during infectious disease epidemics, including COVID-19, and reduce infectious disease-related stigma.

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Indoor physical environments appear to influence learning efficiency nowadays. For improvement in learning efficiency, environmental scenarios need to be designed when occupants engage in different learning tasks. However, how learning efficiency is affected by indoor physical environment based on task types are still not well understood. The present study aims to explore the impacts of three physical environmental factors (i.e., temperature, noise, and illuminance) on learning efficiency according to different types of tasks, including perception, memory, problem-solving, and attention-oriented tasks. A 3 × 4 × 3 full factorial design experiment was employed in a university classroom with 10 subjects recruited. Environmental scenarios were generated based on different levels of temperature (17 °C, 22 °C, and 27 °C), noise (40 dB(A), 50 dB(A), 60 dB(A), and 70 dB(A)) and illuminance (60 lx, 300 lx, and 2200 lx). Accuracy rate (AC), reaction time (RT), and the final performance indicator (PI) were used to quantify learning efficiency. The results showed ambient temperature, noise, and illuminance exerted significant main effect on learning efficiency based on four task types. Significant concurrent effects of the three factors on final learning efficiency was found in all tasks except problem-solving-oriented task. The optimal environmental scenarios for top learning efficiency were further identified under different environmental interactions. The highest learning efficiency came in thermoneutral, relatively quiet, and bright conditions in perception-oriented task. Subjects performed best under warm, relatively quiet, and moderately light exposure when recalling images in the memory-oriented task. Learning efficiency peaked to maxima in thermoneutral, fairly quiet, and moderately light environment in problem-solving process while in cool, fairly quiet and bright environment with regard to attention-oriented task. The study provides guidance for building users to conduct effective environmental intervention with simultaneous controls of ambient temperature, noise, and illuminance. It contributes to creating the most suitable indoor physical environment for improving occupants learning efficiency according to different task types. The findings could further supplement the present indoor environment-related standards or norms with providing empirical reference on environmental interactions.