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Running Head: CORONAVIRUS 1
CORONA VIRUS 2
Coronavirus
Eqbal Danish
University of Maryland Global Campus
18 April 19, 2020
What is Coronavirus Disease (COVID-19?)
Towards the end of the year 2019, the World Health
Organization (WHO) got was informed of pneumonia cases in
Wuhan City, China, of unknown cause. A novel coronavirus got
was identified as the leading cause by the Chinese government
authorities on 7th January 2020, whereby it got named “2019-
nCoV” (Wu et al. 2020). Coronaviruses (CoV) are a large
viruses’ family causing illness which that ranges from the
common cold to more severe diseases. A novel coronavirus
(nCoV) happens to be a new strain and has not got been
identified previously in humans (Wu et al. 2020). Across the
globe, countries have heightened their surveillance to diagnose
the potential new cases of the novel coronavirus, COVID-19
quickly. OK – here you need a clear thesis that seems to be the
impact of gender and treatment of the corona virus. First, use of
women and their role in this crisis, second, specific policies in
the U.S need amendments to incorporate the gendered impacts
of disease outbreaks, third, risks associated with artificial
intelligence in the study of gendered impacts of COVID-19.
More individuals infected with this novel coronavirus have
since got identified in China, as well as cases imported into
other states, European Region incorporated. European Region
countries get encouraged to continue in the preparation in case
the new virus gets imported (Lu et al. 2020). WHO has to
ensure guidance for all countries gets published, including how
the sick people get to get monitored, samples testing, treatment
of the patients, infection control in health centres, right samples
maintenance, and communication with the public (Lu et al.
2020). The standard recommendation to have the infection
spread prevented for travellers in or from areas affected include
covering nose and mouth when sneezing and coughing, hand
washing, and avoiding close contact with individuals showing
respiratory illness symptoms.
What are the dangers of ignoring the contribution of women in
surveillance, detection, and prevention of diseases?
Throughout history, women’s central role in the society has
ensured progress, stability, and developments which are long-
term of the nations across the globe. Globally, research shows
that 43% of the agricultural labor force of the world get
comprised of women which in some countries it raises to 70%.
It gets accepted that agriculture can be the growth engine in
almost every state (Ma et al. 2020). Therefore, women show
great potential when it comes to the fighting of the global
epidemic currently, coronavirus disease, COVID-2019, and
ignoring the women will lead to failure in some sectors such as
detention, surveillance, and prevention of COVID-2019.
Primarily, women are the elders and children’s caretakers in
every country of the world. The international studies
demonstrate that when the political and economic organization
of a society change, women take the lead in aiding families
adjust to new challenges and realities. At this time, COVID-19
is the new challenge which is faced by every family across the
globe (Ma et al. 2020). And women have to get involved, or else
families will not have their primary caretaker in place, and
families will have a hard time when it comes to adjusting to this
new reality and challenge at the same time. For example, rural
women get considered to play a crucial role when it comes to
supporting their communities and households in improving rural
livelihood and their overall well-being. It is thus evident how it
is a big danger when women get ignored in these times, and
their contribution will matter. A family without its primary
caretaker is prone to ignorance and can lead to severe problems
as women are known to advocate for general cleanliness and
order in families (Ma et al. 2020). The coronavirus disease gets
highly spread if personal hygiene is not maintained, and thus,
women play a vital role in the prevention of the disease. It,
therefore, shows that women can fill the vacuum of health
workers needed in various health institutions across the globe to
provide care services for the rising number of the novel
coronavirus victims.
Women also play the role of an educator. The women’s
contribution to the transition of a society from pre-literature to
literature is undeniable. Primary education is the key to the
ability of a nation to develop and also achieve sustainable
targets. Through research, it shows that knowledge can enhance
the status of the community, environmental protection and raise
widely living standard (Yang et al. 2020). The role of a woman
is at the chain's front end of improvements leading to the
community's, long-term family capacity. It is therefore
dangerous not to incorporate women when it comes to the
surveillance, detection, and prevention of the COVID-2019. The
infection of the novel coronavirus disease can get prevented
through the creation of awareness to the public and women can
be good players of the role of educators. Therefore, ignoring
women in times like this will not do good but great harm to the
larger society.
Also, women play a crucial role when it comes to the
workforce. Today, the global workforce of the median female
share is 45.4%. The formal and informal labour of the women
can get a community transformed from a relatively autonomous
society to a national economy participant. Regardless of the
significant obstacles, small businesses owned by women in rural
developing communities not only can they get an extended
lifeline of a family, but can also have a networked economic
foundation formed for the future generations (Yang et al. 2020).
The role of women in the rural and urban workforce has
expanded exponentially, and the current situation across the
globe needs the input of women in ensuring that the economy
does not stumble. The novel coronavirus has an impact on
almost every aspect of life; political, economic and social
aspects. Women can fit in nearly every profession and make
something good of it.
Regarding the situation at hand, women can fit well as social
health workers to ensure that COVID-19 gets detected surveyed
and most important, more infections prevented (Yang et al.
2020). When a woman receives empowered and can claim her
rights and access to leadership, choices, and opportunities,
economies grow, and prospects get improved for the current and
future generations. Therefore, when it comes to the tackling of
the disease, women can make decisions which that are well
informed, enabling countries to move a step forward in fighting
the pandemic.
Women as global volunteers are yet another unique importance
of women and the critical factor to consider when coming up
with strategies to curb the new coronavirus disease, COVID-19.
Under the local leaders' direction, women volunteers help is
ensuring academic accessibility, offer psycho-social support,
tutor literacy, and numeracy, among many others (Yang et al.
2020). It shows that women are a vital component in the curbing
the spreading and containment of the COVID-19. It is because
at this period many have lost their loved ones, get unemployed,
and some suffer stress due to the disease. And, women get
characterized to be helpful and such support is highly needed
now to ensure panic get not spread across the globe. The
capability of women must get incorporated into the strategies of
curbing the novel COVID-19 as it would be dangerous if they
get not considered. Despite the World Health Organization
Executive Board recognizing the reason to have women
included in making of decision for outbreak response and
preparedness, there still is an inadequate representation of
women in global and national COVID-19 policy spaces.
Therefore, various recommendations need to get issued to
ensure that the needs of women and their leadership get placed
at the heart of the effective and efficient response to COVID-
19. For instance, nations across the globe should ensure that
priority support gets provided to women on the response
frontlines (Ma et al. 2020). Such as, improving access to
personal protective equipment which are women-friendly and
menstrual hygiene products for healthcare caregivers and
workers, and women with care burden, provided with a flexible
working arrangement. Also, it must get ensured that there exists
equal voice for women when it comes to a decision making in
the response and planning whose impact is long-term (Ma et al.
2020). Governments must ensure that there is the developing of
mitigation strategies that target the effects of the economy,
specifically of the outbreak on the women and build the
resilience of women. Lastly, services need to get prioritized for
prevention and response to violence which is gender-based in
nations affected by COVID-19.
What specific policies in the U.S need amendments to
incorporate the gendered impacts of disease outbreaks?
The United States Government priorities in response to the
novel coronavirus disease outbreak include protecting the health
and safety of its global workforce, ensure that it continues its
life-saving mission across the country, and provide support to
other countries in their COVID-19 response (Alon et al. 2020).
The ongoing COVID-19 outbreak has had an enormous impact
on countries around the world, resulting in new travel policies
and restrictions.
However, health efforts and policies by the public have not yet
addressed the disease outbreak gendered impacts appropriately.
The citizens does not understand gender analysis of the given
outbreak by the governments and the health institutions globally
in the countries affected like the U.S or in preparedness phases
(Alon et al. 2020). The understanding of how COVID-19
outbreaks has effect on men and women differently is a crucial
step when it comes to an understanding the secondary and
primary health emergency impacts on different communities and
individuals, and for the creation of equitable and appropriate
interventions and policies.
The experience from the outbreaks in the past shows the gender
analysis incorporation significance into response and
preparedness efforts to have the health interventions
effectiveness improved and health equity and gender goals
promoted. Given women's frontline interaction with the
members of the society, concerns get to develop that they have
not to get incorporated fully in health security detention,
prevention, and surveillance mechanisms globally. The socially
prescribed women’s care role typically gets them placed in a
great position to identify local level trends that might have the
start of the outbreak signaled and thus, health security across
the globe gets improved (Alon et al. 2020). Although the women
need not get burdened further, particularly in consideration of
their labour during health crises goes unpaid or underpaid,
incorporating the women’s voice and knowledge could get
empowering and have outbreak response and preparedness
improved.
If the pandemic outbreaks response like COVID-19 is becoming
active and not perpetuate or reproduce health and inequities in
gender, it is crucial that gender roles, relations, and norms
influencing men’s and women’s differential vulnerability to
infection, get considered and addressed (Alon et al. 2020). It is
a call on the U.S government and global health institutions to
have a consideration that direct and indirect gender and sex
effects of the COVID-19 outbreak, and have analysis conducted
multiple outbreaks regarding gendered outbreaks.
Are there any risks associated with artificial intelligence in the
study of gendered impacts of COVID-19, and how can these
problems be avoided?
Artificial intelligence is entering the field of healthcare
rapidly and serving significant roles. It is from routine tasks
and automating drudgery in medical practice to managing
medical resources and patients. As the developers develop the
artificial intelligence systems to take on various tasks, several
challenges and risks emerge, including injury risks to patients
from the artificial intelligence system errors, the threat to the
privacy of patient data acquisition and artificial intelligence
inference, among others (Pirouz et al. 2020). However, these
problems can get avoided as there exist potential solutions for
the risks.
As stated earlier, among the risks associated with artificial
intelligence in COVID-19’s study of gendered impact is error
and injuries. The risk which is most obvious is that artificial
intelligence will sometimes be not right, and the damage of the
patient or other healthcare-related problems may result (Holmes
et al. 2020). When an AI system has a wrong drug recommended
for a patient, a COVID-19 patient could get injured.
The other risk is that of data availability. The training of
artificial intelligence systems needs large data amounts from
sources like pharmacy records, consumer-generated
information, and electronic health records (Holmes et al. 2020).
But, the data on health are often problematic as data happens to
get fragmented across many various systems which are
different. The fragmentation leads to the increase of error risk,
decreasing datasets comprehensiveness, and thus the entities
types get limited that get involved in the development of useful
healthcare artificial intelligence. The other risk is inequality
and bias. Artificial intelligence systems happen to learn from
data on which they get trained, and it is likely they incorporate
biases from the data.
Among the solutions to the problems associated with
artificial intelligence when it comes to the study of gendered
impacts of COVID-19 include data generation and availability
(Pirouz et al. 2020). Among the risks are as a result of the high-
quality data assembling difficulty in a manner consistent with
patient privacy protection. When adequate privacy safeguards
get ensured for the large-scale datasets will be essential when it
comes to ensuring patient participation and trust (Pirouz et al.
2020). The other solution to the risks is quality oversight as
they aid in addressing the patient injury risk. When oversight
efforts get increased by hospitals and health systems, the
professional organization may be necessary to ensure systems
quality.
References
Alon, T. M., Doepke, M., Olmstead-Rumsey, J., & Tertilt, M.
(2020). The Impact of COVID-19 on Gender Equality (No.
w26947). National Bureau of Economic Research.
Holmes, E. A., O'Connor, R. C., Perry, V. H., Tracey, I.,
Wessely, S., Arseneault, L., ... & Ford, T. (2020).
Multidisciplinary research priorities for the COVID-19
pandemic: a call for action for mental health science. The
Lancet Psychiatry.
Lu, Q., & Shi, Y. (2020). Coronavirus disease (COVID‐19) and
neonate: What neonatologist need to know. Journal of medical
virology.
Ma, X. L., Chen, Z., Zhu, J. J., Shen, X. X., Wu, M. Y., Shi, L.
P., ... & Shu, Q. (2020). Management strategies of neonatal
jaundice during the coronavirus disease 2019 outbreak. World
Journal of Pediatrics, 1-4.
Pirouz, B., Shaffiee Haghshenas, S., Shaffiee Haghshenas, S., &
Piro, P. (2020). Investigating a Serious Challenge in the
Sustainable Development Process: Analysis of Confirmed cases
of COVID-19 (New Type of Coronavirus) Through a Binary
Classification Using Artificial Intelligence and Regression
Analysis. Sustainability, 12(6), 2427.
Wu, Z., & McGoogan, J. M. (2020). Characteristics of and
important lessons from the coronavirus disease 2019 (COVID-
19) outbreak in China: summary of a report of 72 314 cases
from the Chinese Center for Disease Control and
Prevention. Jama.
Yang, Y., Peng, F., Wang, R., Guan, K., Jiang, T., Xu, G., ... &
Chang, C. (2020). The deadly coronaviruses: The 2003 SARS
pandemic and the 2020 novel coronavirus epidemic in
China. Journal of autoimmunity, 102434.

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Gendered Impacts of Disease Outbreaks

  • 1. Running Head: CORONAVIRUS 1 CORONA VIRUS 2 Coronavirus Eqbal Danish University of Maryland Global Campus 18 April 19, 2020 What is Coronavirus Disease (COVID-19?) Towards the end of the year 2019, the World Health Organization (WHO) got was informed of pneumonia cases in Wuhan City, China, of unknown cause. A novel coronavirus got was identified as the leading cause by the Chinese government authorities on 7th January 2020, whereby it got named “2019- nCoV” (Wu et al. 2020). Coronaviruses (CoV) are a large viruses’ family causing illness which that ranges from the common cold to more severe diseases. A novel coronavirus (nCoV) happens to be a new strain and has not got been identified previously in humans (Wu et al. 2020). Across the globe, countries have heightened their surveillance to diagnose the potential new cases of the novel coronavirus, COVID-19 quickly. OK – here you need a clear thesis that seems to be the impact of gender and treatment of the corona virus. First, use of women and their role in this crisis, second, specific policies in the U.S need amendments to incorporate the gendered impacts
  • 2. of disease outbreaks, third, risks associated with artificial intelligence in the study of gendered impacts of COVID-19. More individuals infected with this novel coronavirus have since got identified in China, as well as cases imported into other states, European Region incorporated. European Region countries get encouraged to continue in the preparation in case the new virus gets imported (Lu et al. 2020). WHO has to ensure guidance for all countries gets published, including how the sick people get to get monitored, samples testing, treatment of the patients, infection control in health centres, right samples maintenance, and communication with the public (Lu et al. 2020). The standard recommendation to have the infection spread prevented for travellers in or from areas affected include covering nose and mouth when sneezing and coughing, hand washing, and avoiding close contact with individuals showing respiratory illness symptoms. What are the dangers of ignoring the contribution of women in surveillance, detection, and prevention of diseases? Throughout history, women’s central role in the society has ensured progress, stability, and developments which are long- term of the nations across the globe. Globally, research shows that 43% of the agricultural labor force of the world get comprised of women which in some countries it raises to 70%. It gets accepted that agriculture can be the growth engine in almost every state (Ma et al. 2020). Therefore, women show great potential when it comes to the fighting of the global epidemic currently, coronavirus disease, COVID-2019, and ignoring the women will lead to failure in some sectors such as detention, surveillance, and prevention of COVID-2019. Primarily, women are the elders and children’s caretakers in every country of the world. The international studies demonstrate that when the political and economic organization of a society change, women take the lead in aiding families adjust to new challenges and realities. At this time, COVID-19 is the new challenge which is faced by every family across the globe (Ma et al. 2020). And women have to get involved, or else
  • 3. families will not have their primary caretaker in place, and families will have a hard time when it comes to adjusting to this new reality and challenge at the same time. For example, rural women get considered to play a crucial role when it comes to supporting their communities and households in improving rural livelihood and their overall well-being. It is thus evident how it is a big danger when women get ignored in these times, and their contribution will matter. A family without its primary caretaker is prone to ignorance and can lead to severe problems as women are known to advocate for general cleanliness and order in families (Ma et al. 2020). The coronavirus disease gets highly spread if personal hygiene is not maintained, and thus, women play a vital role in the prevention of the disease. It, therefore, shows that women can fill the vacuum of health workers needed in various health institutions across the globe to provide care services for the rising number of the novel coronavirus victims. Women also play the role of an educator. The women’s contribution to the transition of a society from pre-literature to literature is undeniable. Primary education is the key to the ability of a nation to develop and also achieve sustainable targets. Through research, it shows that knowledge can enhance the status of the community, environmental protection and raise widely living standard (Yang et al. 2020). The role of a woman is at the chain's front end of improvements leading to the community's, long-term family capacity. It is therefore dangerous not to incorporate women when it comes to the surveillance, detection, and prevention of the COVID-2019. The infection of the novel coronavirus disease can get prevented through the creation of awareness to the public and women can be good players of the role of educators. Therefore, ignoring women in times like this will not do good but great harm to the larger society. Also, women play a crucial role when it comes to the workforce. Today, the global workforce of the median female share is 45.4%. The formal and informal labour of the women
  • 4. can get a community transformed from a relatively autonomous society to a national economy participant. Regardless of the significant obstacles, small businesses owned by women in rural developing communities not only can they get an extended lifeline of a family, but can also have a networked economic foundation formed for the future generations (Yang et al. 2020). The role of women in the rural and urban workforce has expanded exponentially, and the current situation across the globe needs the input of women in ensuring that the economy does not stumble. The novel coronavirus has an impact on almost every aspect of life; political, economic and social aspects. Women can fit in nearly every profession and make something good of it. Regarding the situation at hand, women can fit well as social health workers to ensure that COVID-19 gets detected surveyed and most important, more infections prevented (Yang et al. 2020). When a woman receives empowered and can claim her rights and access to leadership, choices, and opportunities, economies grow, and prospects get improved for the current and future generations. Therefore, when it comes to the tackling of the disease, women can make decisions which that are well informed, enabling countries to move a step forward in fighting the pandemic. Women as global volunteers are yet another unique importance of women and the critical factor to consider when coming up with strategies to curb the new coronavirus disease, COVID-19. Under the local leaders' direction, women volunteers help is ensuring academic accessibility, offer psycho-social support, tutor literacy, and numeracy, among many others (Yang et al. 2020). It shows that women are a vital component in the curbing the spreading and containment of the COVID-19. It is because at this period many have lost their loved ones, get unemployed, and some suffer stress due to the disease. And, women get characterized to be helpful and such support is highly needed now to ensure panic get not spread across the globe. The capability of women must get incorporated into the strategies of
  • 5. curbing the novel COVID-19 as it would be dangerous if they get not considered. Despite the World Health Organization Executive Board recognizing the reason to have women included in making of decision for outbreak response and preparedness, there still is an inadequate representation of women in global and national COVID-19 policy spaces. Therefore, various recommendations need to get issued to ensure that the needs of women and their leadership get placed at the heart of the effective and efficient response to COVID- 19. For instance, nations across the globe should ensure that priority support gets provided to women on the response frontlines (Ma et al. 2020). Such as, improving access to personal protective equipment which are women-friendly and menstrual hygiene products for healthcare caregivers and workers, and women with care burden, provided with a flexible working arrangement. Also, it must get ensured that there exists equal voice for women when it comes to a decision making in the response and planning whose impact is long-term (Ma et al. 2020). Governments must ensure that there is the developing of mitigation strategies that target the effects of the economy, specifically of the outbreak on the women and build the resilience of women. Lastly, services need to get prioritized for prevention and response to violence which is gender-based in nations affected by COVID-19. What specific policies in the U.S need amendments to incorporate the gendered impacts of disease outbreaks? The United States Government priorities in response to the novel coronavirus disease outbreak include protecting the health and safety of its global workforce, ensure that it continues its life-saving mission across the country, and provide support to other countries in their COVID-19 response (Alon et al. 2020). The ongoing COVID-19 outbreak has had an enormous impact on countries around the world, resulting in new travel policies and restrictions. However, health efforts and policies by the public have not yet addressed the disease outbreak gendered impacts appropriately.
  • 6. The citizens does not understand gender analysis of the given outbreak by the governments and the health institutions globally in the countries affected like the U.S or in preparedness phases (Alon et al. 2020). The understanding of how COVID-19 outbreaks has effect on men and women differently is a crucial step when it comes to an understanding the secondary and primary health emergency impacts on different communities and individuals, and for the creation of equitable and appropriate interventions and policies. The experience from the outbreaks in the past shows the gender analysis incorporation significance into response and preparedness efforts to have the health interventions effectiveness improved and health equity and gender goals promoted. Given women's frontline interaction with the members of the society, concerns get to develop that they have not to get incorporated fully in health security detention, prevention, and surveillance mechanisms globally. The socially prescribed women’s care role typically gets them placed in a great position to identify local level trends that might have the start of the outbreak signaled and thus, health security across the globe gets improved (Alon et al. 2020). Although the women need not get burdened further, particularly in consideration of their labour during health crises goes unpaid or underpaid, incorporating the women’s voice and knowledge could get empowering and have outbreak response and preparedness improved. If the pandemic outbreaks response like COVID-19 is becoming active and not perpetuate or reproduce health and inequities in gender, it is crucial that gender roles, relations, and norms influencing men’s and women’s differential vulnerability to infection, get considered and addressed (Alon et al. 2020). It is a call on the U.S government and global health institutions to have a consideration that direct and indirect gender and sex effects of the COVID-19 outbreak, and have analysis conducted multiple outbreaks regarding gendered outbreaks. Are there any risks associated with artificial intelligence in the
  • 7. study of gendered impacts of COVID-19, and how can these problems be avoided? Artificial intelligence is entering the field of healthcare rapidly and serving significant roles. It is from routine tasks and automating drudgery in medical practice to managing medical resources and patients. As the developers develop the artificial intelligence systems to take on various tasks, several challenges and risks emerge, including injury risks to patients from the artificial intelligence system errors, the threat to the privacy of patient data acquisition and artificial intelligence inference, among others (Pirouz et al. 2020). However, these problems can get avoided as there exist potential solutions for the risks. As stated earlier, among the risks associated with artificial intelligence in COVID-19’s study of gendered impact is error and injuries. The risk which is most obvious is that artificial intelligence will sometimes be not right, and the damage of the patient or other healthcare-related problems may result (Holmes et al. 2020). When an AI system has a wrong drug recommended for a patient, a COVID-19 patient could get injured. The other risk is that of data availability. The training of artificial intelligence systems needs large data amounts from sources like pharmacy records, consumer-generated information, and electronic health records (Holmes et al. 2020). But, the data on health are often problematic as data happens to get fragmented across many various systems which are different. The fragmentation leads to the increase of error risk, decreasing datasets comprehensiveness, and thus the entities types get limited that get involved in the development of useful healthcare artificial intelligence. The other risk is inequality and bias. Artificial intelligence systems happen to learn from data on which they get trained, and it is likely they incorporate biases from the data. Among the solutions to the problems associated with artificial intelligence when it comes to the study of gendered impacts of COVID-19 include data generation and availability
  • 8. (Pirouz et al. 2020). Among the risks are as a result of the high- quality data assembling difficulty in a manner consistent with patient privacy protection. When adequate privacy safeguards get ensured for the large-scale datasets will be essential when it comes to ensuring patient participation and trust (Pirouz et al. 2020). The other solution to the risks is quality oversight as they aid in addressing the patient injury risk. When oversight efforts get increased by hospitals and health systems, the professional organization may be necessary to ensure systems quality. References Alon, T. M., Doepke, M., Olmstead-Rumsey, J., & Tertilt, M. (2020). The Impact of COVID-19 on Gender Equality (No. w26947). National Bureau of Economic Research. Holmes, E. A., O'Connor, R. C., Perry, V. H., Tracey, I., Wessely, S., Arseneault, L., ... & Ford, T. (2020). Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. The Lancet Psychiatry. Lu, Q., & Shi, Y. (2020). Coronavirus disease (COVID‐19) and neonate: What neonatologist need to know. Journal of medical virology. Ma, X. L., Chen, Z., Zhu, J. J., Shen, X. X., Wu, M. Y., Shi, L. P., ... & Shu, Q. (2020). Management strategies of neonatal jaundice during the coronavirus disease 2019 outbreak. World Journal of Pediatrics, 1-4. Pirouz, B., Shaffiee Haghshenas, S., Shaffiee Haghshenas, S., & Piro, P. (2020). Investigating a Serious Challenge in the Sustainable Development Process: Analysis of Confirmed cases of COVID-19 (New Type of Coronavirus) Through a Binary Classification Using Artificial Intelligence and Regression Analysis. Sustainability, 12(6), 2427. Wu, Z., & McGoogan, J. M. (2020). Characteristics of and important lessons from the coronavirus disease 2019 (COVID-
  • 9. 19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. Jama. Yang, Y., Peng, F., Wang, R., Guan, K., Jiang, T., Xu, G., ... & Chang, C. (2020). The deadly coronaviruses: The 2003 SARS pandemic and the 2020 novel coronavirus epidemic in China. Journal of autoimmunity, 102434.