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      Assessing the risk and outcome of COVID-19 in patients with psoriasis or psoriatic arthritis on biologic treatment: a critical appraisal of the quality of the published evidence


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          The need to rapidly spread information about the risk of COVID-19 in patients with psoriasis (Pso) and psoriatic arthritis (PsA) on biologics may have hampered the methodological rigor in published literature. We analysed the quality of papers dealing with the risk and outcomes of COVID-19 in patients with Pso and PsA receiving biologic therapies. The Newcastle-Ottawa Scale (NOS) was used to estimate the quality of the published studies. Moreover, to better contextualize results, specific internal and external validity items were further considered, i.e. case definition, modality of COVID-19 assessment, evidence for self-selection of participants, percentage of dropout/nonparticipants, and sample size calculation. Twenty-five out of 141 papers were selected. The median NOS score was 47% for Pso and 44% for PsA, indicating an overall high risk of bias. 37% of Pso and 44% of PsA studies included patients with suspected COVID-19 without a positive swab. No studies provided a formal sample size calculation.

          A significant risk of bias in all the published papers was found. Major issues to be considered in future studies are: reduction of ascertainment bias, better consideration of non-response or participation bias, and provision of formal statistical power calculation .

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          Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses.

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            Is Open Access

            Are healthcare workers’ intentions to vaccinate related to their knowledge, beliefs and attitudes? a systematic review

            Background The Summit of Independent European Vaccination Experts (SIEVE) recommended in 2007 that efforts be made to improve healthcare workers’ knowledge and beliefs about vaccines, and their attitudes towards them, to increase vaccination coverage. The aim of the study was to compile and analyze the areas of disagreement in the existing evidence about the relationship between healthcare workers’ knowledge, beliefs and attitudes about vaccines and their intentions to vaccinate the populations they serve. Methods We conducted a systematic search in four electronic databases for studies published in any of seven different languages between February 1998 and June 2009. We included studies conducted in developed countries that used statistical methods to relate or associate the variables included in our research question. Two independent reviewers verified that the studies met the inclusion criteria, assessed the quality of the studies and extracted their relevant characteristics. The data were descriptively analyzed. Results Of the 2354 references identified in the initial search, 15 studies met the inclusion criteria. The diversity in the study designs and in the methods used to measure the variables made it impossible to integrate the results, and each study had to be assessed individually. All the studies found an association in the direction postulated by the SIEVE experts: among healthcare workers, higher awareness, beliefs that are more aligned with scientific evidence and more favorable attitudes toward vaccination were associated with greater intentions to vaccinate. All the studies included were cross-sectional; thus, no causal relationship between the variables was established. Conclusion The results suggest that interventions aimed at improving healthcare workers’ knowledge, beliefs and attitudes about vaccines should be encouraged, and their impact on vaccination coverage should be assessed.
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              RIG-I-like receptors: their regulation and roles in RNA sensing

              Retinoic acid-inducible gene I (RIG-I)-like receptors (RLRs) are key sensors of virus infection, mediating the transcriptional induction of type I interferons and other genes that collectively establish an antiviral host response. Recent studies have revealed that both viral and host-derived RNAs can trigger RLR activation; this can lead to an effective antiviral response but also immunopathology if RLR activities are uncontrolled. In this Review, we discuss recent advances in our understanding of the types of RNA sensed by RLRs in the contexts of viral infection, malignancies and autoimmune diseases. We further describe how the activity of RLRs is controlled by host regulatory mechanisms, including RLR-interacting proteins, post-translational modifications and non-coding RNAs. Finally, we discuss key outstanding questions in the RLR field, including how our knowledge of RLR biology could be translated into new therapeutics.

                Author and article information

                J Invest Dermatol
                J Invest Dermatol
                The Journal of Investigative Dermatology
                The Authors. Published by Elsevier, Inc. on behalf of the Society for Investigative Dermatology.
                4 August 2021
                4 August 2021
                [1 ]Department of Medicine, Dermatology Unit, University of Padua, Padua, Italy
                [2 ]Department of Medicine, Section of Dermatology and Venereology, University of Verona, Italy
                [3 ]Centro Studi GISED, Bergamo, Italy
                [4 ]Department of Dermatology, Inselspital University Hospital of Bern, Bern, Switzerland
                [5 ]Division of Dermatology, San Bortolo Hospital, Vicenza, Italy
                Author notes
                []Corresponding Author: Stefano Piaserico, MD PhD Unit of Dermatology, University of Padua, via V. Gallucci 4, 35128 Padua, Italy Tel: +39 049 8212914 Fax: +39 049 8212502 .
                © 2021 The Authors

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                : 2 February 2021
                : 12 April 2021
                : 18 April 2021
                Original Article

                psoriasis,biologics,covid-19,quality,external validity,review
                psoriasis, biologics, covid-19, quality, external validity, review


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