bluuebunny/crossref_metadata_2025_split huggingface dataset:
Two types of humoral response in acute myocardial infraction
Authors: Konstantinova E , Bogdanova A , Gilyarov M , Sergeev A , Svet A , Konovalova M , Sapozhnikov A , Svirshchevskaya E 
Published: October 2021

Abstract

Background
Atherothrombosis and myocardial infarction are accompanied by the development of an inflammatory reaction. The severity of the immune reaction and its role in the acute myocardial infarction (AMI) remain contradictory to date.

Purpose
The objective of this study was to analyze 39 cytokines and chemokines in the serum of patients hospitalized with AMI compared to the healthy volunteers.

Methods
All patients included in the study were COVID-19 negative. Patients' blood was collected within 1–2 days after hospitalization in the cardiology department. Cytokine and chemokine detection in the serum of patients (n=20) and donors (n=20) was performed using a 39-plex set of cytometric beads.

Results
Among all factors analyzed TGFa, IL-17A, IL-1b, 3, 5, 9 were not detected both in patient and donor sera. Three groups of factors were identified in the normal serum: housekeeping chemokines and vascular factors (F1) ranged from 1000 to 22000 pg/mL (Fig. a); sentinel innate immunity factors F2 (Fig. b), 30–200 pg/mL; and acute phase factors F3 (Fig. c, d), 0–30 pg/mL, detected only in 0–30% of donors but in all AMI patients. Severe imbalance was found in AMI sera at all three levels including chemokine, growth factors, and cytokines. Among AMI patients 65% (Gr1) demonstrated 2–4 times increased level (Fig. a, grey brackets) while 35% (Gr2) had a decreased level of F1 factors in a comparison with donor sera. There was not significant difference between clinical features of the patients in Gr1 and Gr2. GRO, PDGF-AA, and sCD40L levels decreased 35, 15, and 10 times accordingly. Gr1 and Gr2 also differed in F2 and some F3 concentrations: Gr1 had 3–5 times increased level of multiple factors (Fig, b), among them – IL-6, IL-8, and IL-10 were increased 5, 6, and 14 times. At the same time Gr2 had a normal level of these factors (Fig, b, blue brackets). Finally, multiple cytokines and growth factors F3 were significantly increased in both AMI groups (Fig, b, d, red brackets). Of note, IL-12, IFN-g, IL-15, GM-CSF, FLT-3T were increased 8, 6, 5, 5, 5 times accordingly in pooled Gr1+Gr2. There were no correlations found between cytokine profiles in Gr1 and Gr2 and their clinical parameters.

Conclusions
Two types of humoral response in AMI patients were identified which differed in the levels of GRO, PDGF-AA, and sCD40L. IL-6 as well as TNF-a can not serve as master cytokines because their levels were increased only in Gr1 patients. These data show that Th1 cytokine increase is specific for AMI. Further studies are needed to identify groups of patients who may be exposed to new therapeutic targets.

Funding Acknowledgement
Type of funding sources: None.
Asylum seekers’ and refugees’ understanding of government restrictions during the COVID-19 pandemic
Authors: Morisod K , Durand M , Selby K , Le Pogam M , Grazioli V , Sanchis Zozaya J , Bodenmann P , Van Plessen C 
Published: October 2021

Abstract

Background
Asylum seekers and refugees risk poorer public health information and difficulties to follow measures during the COVID-19 pandemic because of language, cultural, administrative barriers and social insecurity. We investigate their attitudes and knowledge about COVID-19 measures.

Methods
A cross-sectional survey conducted between August and October 2020 in the canton of Vaud, Switzerland. The 24 questions covered health literacy, perception of the pandemic, understanding of health measures and adherence to conspiracy theories. The questionnaire was translated into the ten most common languages. It was distributed online through social networks of charitable and public organisations and in paper in asylum centres. Associations between participants responses and their characteristics were studied using multivariable logistic regressions.

Results
The 242 respondents had a mean age of 33 years, 63% were men and 42% had low health literacy. They were 16% asylum seekers, 45% temporarily admitted persons, 12% refugees and 26% rejected asylum seekers. All languages were used.
Self-reported adherence to recommendations was 82%. Respectively, 39% and 31% of participants reported sleep disorders or fear of dying. Adjusted for age, gender, health literacy and French language skills, rejected asylum seekers were less worried about the pandemic (aOR 0.37, p = 0.007) and more sensitive to conspiracy theories (aOR 3.47, p = 0.006) than other respondents. They also reported lower adherence to recommendations (aOR 0.45, p = 0.034).

Conclusions
We contribute new knowledge about a varied group of vulnerable persons under precarious conditions during the COVID-19 pandemic. The network based multi-language survey combining online and center based distribution was useful but also tedious. Our results highlight the low health literacy of asylum seekers and refugees and their deep concerns about the pandemic. Public health messages should be adapted to rejected asylum seekers.

Key messages
Asylum seekers and refugees have deep concerns about the Covid-19 pandemic (including sleep disorders and fear of dying) but a low health literacy. Public health messages should be adapted to socially vulnerable groups, especially rejected asylum seekers.
COVID-19 vaccination readiness: use of digital technologies for data-driven decision making
Authors: Syundyukov E , Mednis M , Zaharenko L , Pildegovica E , Danovska I , Kistkins S , Seidmann A , Bennis A , Pirags V , Tzivian L 
Published: October 2021

Abstract

Background
Digital technology can help scientists and governments to inform large auditoriums about COVID-19 and vaccination. Existing technological solutions for assessment of risk of COVID-19 are foreseen for individual use but not for use in scientific research. We aimed to develop a digital platform for communication between scientists and the general population and to use this digital platform for a pilot study on factors associated with the vaccination readiness.

Methods
We developed a digital platform, ensuring researchers an ability to create and manage study projects and to stratify participant cohorts in real-time. Platform provides an interface for participants to be engaged in the studies and receive personalized reports. We assessed demographic (9 items), COVID-19-related behavioral factors that increase a risk of infection (15 items) and a risk of severe disease (10 items), and a readiness for vaccination (10 items). Multiple logistic regression models adjusted for personal covariates, factors affecting the motivation to vaccinate, and risk of infection/severe disease were built to investigate their association with a vaccination readiness.

Results
The newly developed digital platform was equipped with a dynamic consent management, allowing participants to opt-out or/and receive invitations for follow-up studies. Data collection was performed between 2021.02.01 and 2021.03.10, and 467 participants were enrolled during this period. In fully adjusted multiple logistic regression models, factors associated with the vaccination readiness were anxiety (odds ratio, OR = 3.09 [95% confidence interval 1.88; 5.09]), trust in pharmaceutical companies (OR = 1.53 [1.03; 2.27]), and social responsibility (OR = 1.61 [1.16; 2.22]).

Conclusions
The major factor that affects the vaccination readiness was anxiety. Lack of association with the risk of infection/severe disease indicates that people do not understand how the vaccine can help them to avoid the infection.

Key messages
Assessment of a large number of participants in a short time confirms the fact that people are motivated to collaborate using digital platforms. Applying a digital platform can help to create a data-driven dialogue on vaccination readiness, opening an evidence-based scientific discussion between state authorities and the population.
Meals adequacy during weekdays and weekends in an Italian primary school children sample
Authors: Soldà G , Salussolia A , Zanutto G , Sanmarchi F , Marini S , Dallolio L , Ferretti F , Arrichiello F , Lorenzini A , Masini A 
Published: October 2021

Abstract

Background
Between 15 and 50% of European children aged 6-9 are overweight or obese and this number is rising dramatically over time, making it one of the most important public health challenges. Selection of healthy food and a balanced diet are key when addressing this obesity epidemic. At the same time, it is essential to consider schools' role and parents' influence on children's dietary habits. This study aims to assess the adequacy of meals during the weekdays (WD) and weekends (WE), therefore highlighting the critical moments where schools' and parents' involvement needs to be of greater impact.

Methods
A cross-sectional study was conducted among 428 children aged 6-11 recruited in a primary school of Calderara di Reno (Italy) in 2017. A weekly diary was administered between May and June 2017 to explore the dietary habits of the participants. Every day for each meal (breakfast, morning snack, lunch, dinner) it was required to report what types of food and beverages were consumed, and where (home/school). The adequacy of each meal was determined by using national guidelines. A McNemar test was performed to evaluate the differences in meal adequacy between the WD and WE.

Results
Our analysis showed that meals consumed at school, i.e. morning snacks and lunches, were more adequate during WD than WE (69.6% vs 22.2%, 53.5% vs 32.5%; P-value &lt;0.001), underlying the positive influence of school. On the other hand, breakfasts and dinners were more adequate during WE than WD (64.5% vs 51.4%, 23.8% vs 15.7%; P-value &lt;0.001); this difference might be partially explained by the different amount of time parents have for food preparation during workdays versus weekends.

Conclusions
Further preventive interventions should address childrens' and parents' home dietary routine as a tool to improve meal adequacy at home and therefore reduce childhood obesity. Parental school-based interventions could have a key role in changing childrens' dietary habits.

Key messages
Our study showed a significant difference of healthy dietary habits between meals served at school during weekdays and at home during weekends, highlighting a higher dietary adequacy in the first ones. The results underline the importance of implementing educational programs addressing childrens’ and their parents' home meals routine and dietary habits.
No evidence for an effect of the first COVID-19 lockdown on work stress conditions in office workers
Authors: Aegerter AM , Deforth M , Johnston V , Sjøgaard G , Luomajoki H , Volken T , Distler O , Dressel H , Melloh M , Elfering A 
Published: October 2021

Abstract

Background
The COVID-19 pandemic has forced around 50 % of employees of Switzerland into a working from home setting during March and April 2020. Working from home appears to change the work experience of office workers considerably. The aim of this analysis was to investigate the effect of the first COVID-19 lockdown on work stress conditions.

Methods
We based this longitudinal analysis on control group data from an ongoing stepped-wedge cluster randomized controlled trial. Office workers from two Swiss organizations, aged 18-65 years, were included. Baseline data from January 2020 (before the COVID-19 pandemic) were compared with follow-up data collected during the fourth and fifth week of the first lockdown (April 2020). Work stress conditions were measured using the Job-Stress-Index (JSI). The JSI indicates the ratio of work-related resources (e.g., appreciation at work) and stressors (e.g., work organisation) on a scale from 0 (stressors &lt; resources) to 100 (stressors &gt; resources). Paired sample t-tests were performed for statistical analysis.

Results
Data from 75 participants were analysed. Fifty-three participants were female (70.7 %). The mean age was 42.8 years (range from 21.8 to 62.7) at baseline. At baseline, the mean JSI was 47.6 (SD = 5.0), with 77.7 (SD = 12.4) for resources and 22.3 (SD = 10.1) for stressors. At follow-up, the mean JSI was 47.4 SD = 4.5), with 77.5 (SD = 11.7) for resources and 21.4 (SD = 9.6) for stressors. We found no evidence for a difference in JSI (estimate = 0.67, 95 % CI: -0.33 to 0.66, p-value = 0.50), its index of resources (estimate = 0.23, 95 % CI: -1.32 to 1.69, p-value = 0.82) or the index of work stressors (estimate = 1.4, 95 % CI: -0.32 to 2.02, p-value = 0.15) between measurement time points.

Conclusions
The first COVID-19 lockdown did not result in a difference of work stress conditions among our sample of Swiss office workers. Improved working times and work-life balance may have contributed to this finding.

Key messages
Improved working times and work-life balance may have contributed to stable task-related stressors and resources in the early phase of the lockdown. Other, non-work-related environmental stressors should be investigated to explain COVID-19-related changes in mental and physical health.
Are antigen tests useful as screening for the identification of SARS-CoV-2 in emergency rooms?
Authors: Cigliano F , Boccuzzi A , Basile V , Ferraro A , Macciotta A , Catalano A , Costa G , Vineis P , Sacerdote C , Caramello V 
Published: October 2021

Abstract

Background
A quick and accurate case identification in the Emergency Department (ED) during the SARS-CoV-2 pandemic is crucial for clinical management and to prevent spread of infections. The gold standard for diagnosing SARS-CoV-2 infection is the real-time reverse transcription polymerase chain reaction (RT-PCR) test in upper airways swabs. However, the procedure is available in few specialized laboratories and requires an average sample processing time of about 6 hours from its inception. The development of reliable but cheaper and faster point-of-care tests was expected to be useful either for population-screening or as first aid tests in the ED. Rapid antigenic diagnostic tests (Ag-RDTs), directly detect SARS-CoV-2 proteins produced by the replicating virus in respiratory specimens, were proved to be candidates in both cases. However, data on their effectiveness are still few and controversial. The aim of the study is to establish the accuracy of antigen tests to identify SARS-CoV-2 in a high prevalence setting.

Methods
Results of 324 patients, consecutively admitted to the ED of San Luigi Gonzaga University Hospital in Orbassano (Turin, Italy) between 26 October and 10 November 2020 and subjected to both molecular and antigen tests, were compared.

Results
Using RT-PCR as gold standard, specificity and sensitivity of Ag-RDT were 0.94 (95%CI: 0.90-0.98) and 0.80 (95%CI: 0.75-0.85), respectively. The Ag-RDT positive predictive value was 0.96 (95%CI 0.93- 0.99), and the negative predictive value was 0.72 (95% CI: 0.65-0.79). Patients that tested negative to Ag-RDT but presented with fever and cough or had pneumonia at imaging were more likely to be false negatives. Ag-RDTs best performance occurs in the first days after symptom onset.

Conclusions
These results confirm the limits of antigenic tests as first line screening tests and suggest that the antigenic test should be integrated with clinical judgement, based on physical and instrumental examinations.

Key messages
Antigenic tests have a limited effectiveness as first line screening tests. In a high-prevalence setting these tests incorrectly judge as negative many COVID-19 symptomatic patients, making necessary to integrate their results with clinical judgement.
Factors associated with avoidance of emergency department visits in Portugal during the pandemic
Authors: Lopes S , Soares P , Gama A , Pedro AR , Moniz M , Laires P , Goes AR , Nunes C , Dias S 
Published: October 2021

Abstract

Background
Avoiding an emergency department (ED) visit risks irreversible negative consequences for patients' health. EDs are a frequent access point to the Portuguese health system. Previous studies have shown that patients may avoid visiting ED during the pandemic. This study aims to identify factors associated with avoidance of ED visits in Portugal during the COVID-19 pandemic.

Methods
We used data from a community-based survey, “COVID-19 Barometer: Social Opinion”, which includes healthcare utilisation, health status, and risk perception in Portugal from 11th April 2020 to 16th April 2021. We included respondents that reported having needed ED care. Data were collected on sociodemographics, health status (comorbidities, mental health), risk perception (COVID-19 and complications), level of trust in health services and self-assessment of the severity of the reason for ED visit. The outcome of interest was the decision to avoid ED care. We used logistic regression to identify factors associated with the decision to avoid ED.

Results
Preliminary data showed that 914 respondents reported needing ED care (74.8% female; mean age 43 years). From those, 224 (25%) decided to avoid ED care. ED visits avoidance was higher during lockdowns (28%). People reporting specific comorbidities (cardiac, autoimmune, respiratory) avoided ED more than those without them. Perception of no severe reason for ED visit, poor mental health, perception of higher risk of COVID-19 and complications, and low trust in health services response to the pandemic were associated with higher odds of ED visit avoidance.

Conclusions
People avoiding ED visits represented a considerable share. The decision to avoid ED visit was associated with clinical characteristics, but the perception of risk and assessment of the context and health system response also played a role in decision making.

Key messages
The effect of avoided ED visits on health should be a research and policy concern. People with certain comorbidities or perception of high risk of COVID-19 and complications may be closely monitored.
Social stigma among COVID-19 patients after quarantine in Sousse, Tunisia
Authors: Mlouki I , Zammit N , Ghammem R , Ben Fredj S , Bannour R , El Echi A , Bennasrallah C , Maatoug J , Ghannem H 
Published: October 2021

Abstract

Background
Assessing stigma related to COVID-19 is crucial to better understand the pandemic's impacts and establish effective stigma-reducing interventions. The aim of this study was to screen for stigma and evaluate its associated factors among adults with COVID-19 living in the governorate of Sousse (Tunisia).

Methods
A cross sectional study was conducted among a representative sample of patients with COVID-19 between the 6th of November and the 12th of December 2020 in the governorate of Sousse. The 12-item HIV stigma scale was translated in Arabic and then adapted to the Tunisian context.Three pre-trained medical doctors administrated the pre-tested Arabic questionnaire to each participant by phone calls. Higher scores reflect a higher level of perceived Covid-19-related stigma.

Results
Responses of 346 participants with COVID-19 infection were obtained. The majority of participants were females (60.4%) with a median age of 40 years (interquartile range, 30 to 54.5 years). Among them, 12.7% were health professionals and 12.5% had at least secondary educational level. Because of COVID-19 illness, 17.1% reported financial deterioration. We found mean scores of 14.6 ±4.07, 6.8±2.39 and 6.2±1.95 for social stigma, disclosure concerns and negative self-image dimensions respectively. Social stigma score was significantly higher among adults (14.9±3.9 versus 13.05±4.4 among elderly; p = 0.01) and people with low socioeconomic level (15.8±4.8 versus 14.3±3.8; p = 0.02). Lower scores of social stigma were found among health caregivers (13.3±2.6 versus 14.8±4.2; p = 0.002). Those factors remained as predictors of social stigma after linear regression analysis.

Conclusions
Screening for stigma is required in order to identify the most vulnerable patients and could prevent among them social repercussions. Psychological assistance of patients with social stigma would help them to overcome this crisis.

Key messages
Being adult with low socioeconomic level and not being health worker were determinants of social stigma. Psychological assistance for COVID-19 patients is crucial to prevent social stigma repercussion during this outbreak.
Discriminatory attitudes against people tested for corona virus in the region of Mahdia (Tunisia)
Authors: Omri N , Mlouki I , Sfar H , Ben Youssef F , Jandoubi M , El Mhamdi S 
Published: October 2021

Abstract

Background
Several incidents of stigmatization of healthcare workers, COVID-19 patients and their families have come up during the current pandemic across the world.

Aim
To evaluate discriminative behaviors against people tested for Covid-19 in the governorate of Mahdia in Tunisia.

Methods
We performed a cross sectional study among people tested for Covid-19 from November to December 2020 in the region of Mahdia. Discrimination was assessed using a pretested brief questionnaire inspired from the reliable French version of HIV stigma scale. Trained members of the study team explained the study's purpose and collected data from each participant via phone calls.

Results
A total of 277 participants were recruited with a mean age of 34.32 ±13.7 years. Among them, 60.8% were women and 62.2% were tested positive for Covid-19. Fourty three percent of participants were health professionals with 25.3% of them were directly involved in the care of COVID-19 patients. More than half of respondents (61%) have experienced discrimination. Thus, 40% were subjected to verbal and physical assaults. Concerning stigma among health care workers, 60% were doctors and 67.2% have worked in a covid-19 care service. Our survey shows a higher level of Covid-19 related stigma among married respondents and those living with elderly people (46.8% and 43.8% respectively). Discrimination was associated with being a health care professional (p = 0.05), mainly a doctor (p = 0.03) and having COVID-19 infection (p = 0.02).

Conclusions
The continued discriminatory and stigmatising attitudes towards people tested for Covid-19 negatively impacts their access to health care services. We recognise a pressing need to improve the knowledge of Covid-19 transmission, and implement universal precautions across all health facilities.

Key messages
The high prevalence of discriminatory attitudes against people tested for Covid-19 is alarming. It’s an unpleasant experience causing numerous psychological distresses among those who undergo it. Establishing a positive safety culture and providing appropriate education to reduce the stigma towards infected people offers an effective way to improve the quality of care.