Public Health Need Research Articles

Caribbean Women's Health and Transnational Ethnobotany.

Caribbean Women’s Health and Transnational Ethnobotany. Immigrants from the Dominican Republic (DR) and Haiti are among the top foreign–born communities in New York City (NYC). As people migrate to new countries, they bring their ethnomedical beliefs and practices, and adapt their plant pharmacopoeias. Haiti and the DR share a flora on the island of Hispaniola. In NYC, the flora is limited to what is available in the city. We selected plants for future laboratory research based on ethnobotanical data from two surveys among Dominicans in the DR and NYC, and a Haitian literature review. In both Dominican datasets, gynecological infections were the top women’s health condition treated with plants. We identified 10 species for this purpose reported by Dominicans that are also known medicines in Haitian culture, although not yet documented for women’s health. Plants for gynecological infections potentially cause dysbiosis of the vaginal microbiota, and may increase rather than prevent disease. There is a public health need to assess traditional medicines for their ability to inhibit pathogenic bacteria, while causing minimal disruption to the vaginal flora. Several species are known antibacterials, but remain to be tested for their efficacy. These results also provide a foundation for a planned ethnobotanical survey among NYC Haitian women.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12231-021-09526-3.

A Comparative Analysis of the Needs of Firefighters and Paramedic Students for Training in Basic Medical Science Disciplines

This study aims to facilitate measures to increase the on-site response capabilities of firefighters by suggesting an appropriate curriculum for the inculcation of basic medical science disciplines through Borich needs assessment and the Locus and Focus model analysis by defining the learning outcomes. A survey was conducted among 188 firefighters and 48 paramedic students the results showed a need for microbiology (2.10) and public health (2.07) for firefighters, pharmacology (4.64) and anatomy and physiology (3.82) for paramedic student. The priority subjects identified in the High-High dimension of the Locus and Focus model for firefighters included public health, microbiology, anatomy and physiology. The learning outcomes, based on the level of present acknowledgment, showed a significant difference between the required and current level in 42 and 37 items of the questionnaires for firefighters and paramedic students respectively (p < .001). The highest discrepancy in priority, based on the level of present acknowledgment between firefighters and paramedic students were in: “sterilization and mechanism of antibiotic action (4th vs. 31st),” “pathogenesis of viral infection (1st vs. 23rd),” and “prevention of diseases and health promotion (14th vs. 36th).” The priority for paramedic students was “receptor-mediated drug response (25th vs. 4th).” Given the difference in the priority level of need of basic medical science disciplines between firefighters and students, an appropriate curriculum for paramedic students that also reflects the needs of firefighters should be developed.

Stigma and Mental Health during COVID-19 New Normal Transition in Indonesia

Background: Social isolation and economic catastrophic became the main characters of the current pandemic.Historically, the strongest stigmas related to diseases were characterized as highly transmittable, potentiallylethal, and without remedy. All represented COVID-19 during the early transition into the new normal. Weaimed to analyzed stigma and economic stressors concerning mental health. Method: We conducted a crosssectionalonline survey of 1375 participants in Java, Indonesia. Mental health status evaluated with DASS-21. The presence of social and self-stigma related to Covid-19 assessed with a questionnaire developed basedon seven domains of public stigma. Demographics and other psychosocial stressors were assessed withan online questionnaire. Descriptive analyses and logistic regression had carried out. Result: A very highpercentage of perceived and anticipated self-stigma and social stigma revealed. Controlling demographicsfactors, clear self-stigma increased the risk for depression (2.323 (1.241-4.346), p<0.05), anxiety (2.134(1.205-3.777), p<0.05) and stress 3.931 (1.779-8.685), P<0.001). Clear social stigma increased the risk foranxiety (2.000 (1.066-3.756), p<0.05) but not on depression and stress.Conclusion: Ensuring basic needsfulfilment and eliminating stigma is critical for supporting mental health in the Covid-19 pandemic. Furtherresearch into the stigma-related risks is necessary because it represents an important need for interventionin public health.

Country-Specific Interests towards Fall Detection from 2004–2021: An Open Access Dataset and Research Questions

Falls, which are increasing at an unprecedented rate in the global elderly population, are associated with a multitude of needs such as healthcare, medical, caregiver, and economic, and they are posing various forms of burden on different countries across the world, specifically in the low- and middle-income countries. For these respective countries to anticipate, respond, address, and remedy these diverse needs either by using their existing resources, or by developing new policies and initiatives, or by seeking support from other countries or international organizations dedicated to global public health, the timely identification of these needs and their associated trends is highly necessary. This paper addresses this challenge by presenting a study that uses the potential of the modern Internet of Everything lifestyle, where relevant Google Search data originating from different geographic regions can be interpreted to understand the underlining region-specific user interests towards a specific topic, which further demonstrates the public health need towards the same. The scientific contributions of this study are two-fold. First, it presents an open-access dataset that consists of the user interests towards fall detection for all the 193 countries of the world studied from 2004–2021. In the dataset, the user interest data is available for each month for all these countries in this time range. Second, based on the analysis of potential and emerging research directions in the interrelated fields of Big Data, Data Mining, Information Retrieval, Natural Language Processing, Data Science, and Pattern Recognition, in the context of fall detection research, this paper presents 22 research questions that may be studied, evaluated, and investigated by researchers using this dataset.

Preventing Adolescent and Young Adult Suicide: Do States With Greater Mental Health Treatment Capacity Have Lower Suicide Rates?

PurposeYouth suicide is increasing at a significant rate and is the second leading cause of death for adolescents. There is an urgent public health need to address the youth suicide. The objective of this study is to determine whether adolescents and young adults residing in states with greater mental health treatment capacity exhibited lower suicide rates than states with less treatment capacity. MethodsWe conducted a state-level analysis of mental health treatment capacity and suicide outcomes for adolescents and young adults aged 10–24 spanning 2002–2017 using data from Centers for Disease Control and Prevention, U.S. Bureau of Labor Statistics, Federal Bureau of Investigation, and other sources. Multivariable linear fixed-effects regression models tested the relationships among mental health treatment capacity and the total suicide, firearm suicide, and nonfirearm suicide rates per 100,000 persons aged 10–24. ResultsWe found a statistically significant inverse relationship between nonfirearm suicide and mental health treatment capacity (p = .015). On average, a 10% increase in a state’s mental health workforce capacity was associated with a 1.35% relative reduction in the nonfirearm suicide rate for persons aged 10–24. There was no significant relationship between mental health treatment capacity and firearm suicide. ConclusionsGreater mental health treatment appears to have a protective effect of modest magnitude against nonfirearm suicide among adolescents and young adults. Our findings underscore the importance of state-level efforts to improve mental health interventions and promote mental health awareness. However, firearm regulations may provide greater protective effects against this most lethal method of firearm suicide.

انتشار خلاصه ایده ها، مقالات علمی پژوهشی چاپ شده در حیطه سلامت عمومی به زبان ساده: یادآوری، تفسیر و توصیه ها

انتشار خلاصه ایده ها، مقالات علمی پژوهشی چاپ شده در حیطه سلامت عمومی به زبان ساده: یادآوری، تفسیر و توصیه ها

Adverse events related to COVID-19 vaccines: the need to strengthen pharmacovigilance monitoring systems.

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a new species of β-coronavirus genus named severe acute respiratory syndrome coronavirus 2. The COVID-19 pandemic, which started in late 2019 and continues as at mid-2021, has caused enormous damage to health and lives globally. The urgent public health need has led to the development of vaccines against COVID-19 in record-breaking time. The COVID-19 vaccines have been widely rolled out for the masses by many countries following approval for emergency use by the World Health Organization and regulatory agencies in many countries. In addition, several COVID-19 vaccine candidates are undergoing clinical trials. However, myths, fears, rumors, and misconceptions persist, particularly in regard to adverse events. In this commentary, we describe the adverse events associated with COVID-19 vaccines and discuss why it is essential to have a functional adverse event monitoring system in this context.

Dynamic Changes of Antibodies to SARS-CoV-2 in Close Contacts.

IntroductionClose contacts of individuals with COVID-19 may directly gain immunity against SARS-CoV-2 despite lacking a detectable infection. This study examined SARS-CoV-2-specific antibodies levels based on gender, age, and exposure source in close contacts of individuals with COVID-19 and compared antibody levels to patients with an asymptomatic or symptomatic COVID-19 infection.MethodsTwo patients had confirmed COVID-19 infections at a community hospital in Qiongzhong, Hainan province. Contact tracing identified all individuals in the community who had been exposed to the two patients during the 14 days before their diagnoses. Close contacts quarantined for 14 days, underwent two SARS-CoV-2 tests, and were screened for SARS-CoV-2-specific antibodies at 7 and 12 weeks after the end of quarantine. SARS-CoV-2-specific antibody levels for the close contacts were compared to those for patients with an asymptomatic or symptomatic COVID-19 infection at 7 and 12 weeks after their diagnoses.ResultsContact tracing identified 10,573 individuals in the community, including 360 (3.4%) close contacts. At 7 weeks, 30 (8.33%) close contacts were positive for SARS-CoV-2-specific antibodies (IgG, n = 26 [7.22%]; IgM, n = 4 [1.11%]), which were lower than the proportion of patients with an asymptomatic (IgG, 100% [12/12]) or symptomatic (IgG, 93.6% [44/47]) COVID-19 infection. SARS-CoV-2-specific IgM antibody levels were significantly higher in close contacts who were exposed through a relative compared to a doctor–patient relationship (P = 0.032). SARS-CoV-2-specific IgG antibody levels were significantly higher in close contacts aged <18 years vs 18–64 years (P = 0.014). At 12 weeks, SARS-CoV-2-specific IgG antibody levels among close contacts were significantly lower than among patients with an asymptomatic (P = 0.004) or symptomatic COVID-19 infection (P < 0.001).ConclusionImmune protection conferred by close contact is short term and unlikely to contribute to herd immunity. There remains an unmet public health need for mass vaccination of populations to increase levels of protective antibodies and achieve and maintain herd immunity.

Managers' Perspectives on the Devolved Health System Response to the Public Health Needs of Internally Displaced Persons in Pakistan: A Qualitative Study.

Population displacement has been embedded in Pakistan's history since its inception in 1947. The displacement of more than 3 million people from the tribal areas of the Khyber Pakhtunkhwa Province of Pakistan and their settlement in recipient areas have posed challenges to governance, service delivery, financial management, and integration of internally displaced persons (IDPs) into existing devolved district health systems. Evidence is lacking on the management of devolved health systems to respond to the public health needs of IDPs. The authors adapted qualitative methods to explore challenges faced by managers of health departments in Khyber Pakhtunkhwa Province in responding to the public health needs of IDPs and to explore policy recommendations for a devolved health system. Study findings revealed that the lack of a skilled workforce, lack of political will, financial limitations, and poor intersectoral collaboration had an impact on the humanitarian crisis response in the province. These findings suggest a dire need for overarching binding international laws and local national policies for complete protection of IDPs, particularly in regard to their health, shelter, and social security.

Assessment of incident frailty hazard associated with depressive symptoms in a Taiwanese longitudinal study.

To estimate the risks of depressive symptoms for developing frailty, accounting for baseline robust or pre-frailty status. An incident cohort study design. Community dwellers aged 55 years and above from urban and rural areas in seven regions in Taiwan. A total of 2,717 participants from the Healthy Aging Longitudinal Study in Taiwan (HALST) were included. Subjects with frailty at baseline were excluded. The average follow-up period was 5.9 years. Depressive symptoms were measured by the 20-item Center for Epidemiological Studies Depression (CES-D) Scale. Frailty was assessed using the Fried frailty measurement. Participants were stratified by baseline robust or pre-frailty status to reduce the confounding effects of the shared criteria between depressive symptoms and frailty. Overall and stratified survival analyses were conducted to assess risks of developing frailty as a result of baseline depressive symptoms. One hundred individuals (3.7%) had depressive symptoms at baseline. Twenty-seven individuals (27.0%) with depressive symptoms developed frailty, whereas only 305 out of the 2,617 participants (11.7%) without depressive symptoms developed frailty during the follow-up period. After adjusting for covariates, depressive symptoms were associated with a 2.6-fold (95% CI 1.6, 4.2) increased hazard of incident frailty. The patterns of increased hazard were also observed when further stratified by baseline robust or pre-frailty status. Depressive symptoms increased the risk of developing frailty among the older Asian population. The impact of late-life depressive symptoms on physical health was notable. These findings also replicated results from Western populations. Future policies on geriatric public health need to focus more on treatment and intervention against geriatric depressive symptoms to prevent incident frailty among older population.

A qualitative evaluation of Southwark Council\u2019s public health response to mitigating the mental health impact of the 2017 London bridge and borough market terror attack

BackgroundOver recent years there have been several major terror attacks in cities across Europe. These attacks result in deaths, physical injuries, and pose long-term threats to mental health and wellbeing of large populations. Although psychologists have completed important work on mental health responses to disaster exposure including terrorist attacks, the mental health impacts of such attacks have been comparatively less examined in academic literature than the acute health response to physical injuries. This paper reflects on Southwark Council’s pioneering public mental health response to the June 2017 terror attack at London Bridge and Borough Market. It aims to explore perceptions of the mental health impact of the incident by those living and working in the borough.MethodsA rapid qualitative evaluation informed by the logic underpinning Southwark Council’s response was conducted. Seven formative interviews were undertaken with individuals involved in the response planning and/or delivery, enabling the evaluation team to establish the response’s theoretical basis. Subsequently, nineteen semi-structured interviews with consenting Council employees, residents, business owners, and workers from the Borough were conducted to understand perceived mental health impacts of the attack and the success of the Council response. Thematic analysis of transcribed interviews was undertaken to evaluate the extent to which the response was implemented successfully.ResultsParticipants reported feeling the attack had a wide-reaching negative impact on the mental health of residents, those working in the borough and visitors who witnessed the attack. Delivering the response was a challenge and response visibility within the community was limited. Participants suggested a comprehensive systematic approach to health needs assessment informed by knowledge and relationships of key Council workers and community stakeholders is imperative when responding to terrorist incidents. Improved communication and working relationships between statutory organisations and community stakeholders would ensure community groups are better supported. Prioritising mental health needs of terror attack responders to mitigate persisting negative impacts was highlighted.ConclusionsThis article highlights a potential public health approach and need for developing robust practical guidance in the aftermath of terror attacks. This approach has already influenced the response to the Christchurch mosque shooting in 2019.

Making patient blood management the new norm(al) as experienced by implementors in diverse countries

BackgroundPatient blood management (PBM) describes a set of evidence-based practices to optimize medical and surgical patient outcomes by clinically managing and preserving a patient’s own blood. This concepts aims to detect and treat anemia, minimize the risk for blood loss and the need for blood replacement for each patient through a coordinated multidisciplinary care process. In combination with blood loss, anemia is the main driver for transfusion and all three are independent risk factors for adverse outcomes including morbidity and mortality. Evidence demonstrates that PBM significantly improves outcomes and safety while reducing cost by macroeconomic magnitudes. Despite its huge potential to improve healthcare systems, PBM is not yet adopted broadly. The aim of this study is to analyze the collective experiences of a diverse group of PBM implementors across countries reflecting different healthcare contexts and to use these experiences to develop a guidance for initiating and orchestrating PBM implementation for stakeholders from diverse professional backgrounds.MethodsSemi-structured interviews were conducted with 1–4 PBM implementors from 12 countries in Asia, Latin America, Australia, Central and Eastern Europe, the Middle East, and Africa. Responses reflecting the drivers, barriers, measures, and stakeholders regarding the implementation of PBM were summarized per country and underwent qualitative content analysis. Clustering the resulting implementation measures by levels of intervention for PBM implementation informed a PBM implementation framework.ResultsA set of PBM implementation measures were extracted from the interviews with the implementors. Most of these measures relate to one of six levels of implementation including government, healthcare providers, funding, research, training/education, and patients/public. Essential cross-level measures are multi-stakeholder communication and collaboration.ConclusionThe implementation matrix resulting from this research helps to decompose the complexity of PBM implementation into concrete measures on each implementation level. It provides guidance for diverse stakeholders to design, initiate and develop strategies and plans to make PBM a national standard of care, thus closing current practice gaps and matching this unmet public health need.

Validation of the attention-related driving errors scale in novice adolescent drivers

IntroductionMotor vehicle collisions (MVCs) are a leading cause of death among adolescents. Identifying factors that contribute to adolescent MVCs is a pressing public health need. Exogenous (cell phones, passengers, music) and endogenous (stress, worry, mind-wandering) forms of driver inattention account for approximately 78% of all MVCs in the United States. Though both exogenous and endogenous distraction contribute to crash risk, prior work investigating adolescent crash risk has largely focused on exogenous distractors. The Attention-Related Driving Errors Scale (ARDES) is a promising measure assessing individual differences in endogenous driver inattention that has been validated in adult drivers. Its validation in an adolescent sample may prove useful in tailoring future interventions to decrease MVC risk in young drivers. MethodsThis study sought to validate the ARDES in novice adolescent drivers by investigating its underlying factor structure and its relations with self-reported measures of daily inattention, performance-based attention assessments, and a self-report measure of driving behavior. ResultsReplicating earlier work in adults, results suggested ARDES items can be classified according to their operational level of the driving. The ARDES had good internal reliability and construct validity, suggesting it is a valid self-report measure of the propensity for adolescents' attentional errors while driving. DiscussionThe ARDES provides a useful tool for researchers to identify adolescents at greater risk of attentional errors while driving. Future research should use the ARDES to better understand the role of driver inattention in adolescent crash risk.

Schizophrenia on Turkish Twitter: an exploratory study investigating misuse, stigmatization and trivialization.

This study aims to investigate use and misuse of the word 'schizophrenia' and its derivatives to assess the prevalence of stigmatizing and trivializing attitudes and the meanings attributed to the condition on Turkish Twitter. Using R programming language, we collected Turkish Twitter posts containing the terms used for schizophrenia in Turkish through Twitter's Search API over a 47-day period between July and June 2019. After removing retweets, we randomly sampled 3000 tweets and manually categorized them in three dimensions: use type (metaphorical/non-metaphorical), topic and attitude. Qualitative analysis on representative tweets were performed and word frequencies were calculated. In total 44,266 tweets were collected and after removing retweets, 24,529 tweets were obtained. Overwhelming majority of the tweets (91.7%) used the terms metaphorically and the majority displayed stigmatizing (68.3%) and trivializing (23%) attitudes. Politics was the most common topic (58.2%) followed by everyday/social chatter (28.5%). Only a small number of tweets were part of awareness campaigns (0.2%) or displayed a supportive attitude (0.8%). Terms were often used metaphorically in a stigmatizing manner as personal or political insults, while in everyday/social contexts, they were used in a trivializing manner to label eccentricity, oddness, overthinking and suspiciousness. Popularity and reach metrics show that these tweets were extensively retweeted, liked and reached millions ofusers. This is the first study investigating attitudes towards schizophrenia on Turkish Twitter. Significantly higher rates of stigmatizing attitudes demonstrate the urgent need for public health and social awareness campaigns targeting stigma surrounding schizophrenia in Turkey.

Clinical laboratory tests and five-year incidence of major depressive disorder: a prospective cohort study of 433,890 participants from the UK Biobank

Prevention of major depressive disorder (MDD) is a public health priority. Identifying biomarkers of underlying biological processes that contribute to MDD onset may help address this public health need. This prospective cohort study encompassed 383,131 white British participants from the UK Biobank with no prior history of MDD, with replication in 50,759 participants of other ancestries. Leveraging linked inpatient and primary care records, we computed adjusted odds ratios for 5-year MDD incidence among individuals with values below or above the 95% confidence interval (<2.5th or >97.5th percentile) on each of 57 laboratory measures. Sensitivity analyses were performed across multiple percentile thresholds and in comparison to established reference ranges. We found that indicators of liver dysfunction were associated with increased 5-year MDD incidence (even after correction for alcohol use and body mass index): elevated alanine aminotransferase (AOR = 1.35, 95% confidence interval [1.16, 1.58]), aspartate aminotransferase (AOR = 1.39 [1.19, 1.62]), and gamma glutamyltransferase (AOR = 1.52 [1.31, 1.76]) as well as low albumin (AOR = 1.28 [1.09, 1.50]). Similar observations were made with respect to endocrine dysregulation, specifically low insulin-like growth factor 1 (AOR = 1.34 [1.16, 1.55]), low testosterone among males (AOR = 1.60 [1.27, 2.00]), and elevated glycated hemoglobin (HbA1C; AOR = 1.23 [1.05, 1.43]). Markers of renal impairment (i.e. elevated cystatin C, phosphate, and urea) and indicators of anemia and macrocytosis (i.e. red blood cell enlargement) were also associated with MDD incidence. While some immune markers, like elevated white blood cell and neutrophil count, were associated with MDD (AOR = 1.23 [1.07, 1.42]), others, like elevated C-reactive protein, were not (AOR = 1.04 [0.89, 1.22]). The 30 significant associations validated as a group in the multi-ancestry replication cohort (Wilcoxon p = 0.0005), with a median AOR of 1.235. Importantly, all 30 significant associations with extreme laboratory test results were directionally consistent with an increased MDD risk. In sum, markers of liver and kidney dysfunction, growth hormone and testosterone deficiency, innate immunity, anemia, macrocytosis, and insulin resistance were associated with MDD incidence in a large community-based cohort. Our results support a contributory role of diverse biological processes to MDD onset.

Faculty perspectives on transitioning public health nursing clinical to virtual in response to COVID-19.

The COVID‐19 pandemic has highlighted the need for public health nursing as an integral part of a strong public health workforce. However, it has also created challenges in preparing future nurses as much of nursing instruction, including clinical experiences, needed to urgently transition learning to a virtual environment. This paper describes the process faculty experienced during spring 2020 to quickly transition public health nursing clinicals from in‐person to virtual learning in response to COVID‐19. Further, faculty lessons learned are shared and include the importance of creating a supportive team dynamic, embracing innovation, continuing to engage with community partners, and adapting to meet emerging student needs during the evolving pandemic. The process and lessons learned may act as a guide for other nursing programs as we continue to navigate nursing education during this and future pandemics.

Structural and Biophysical Characterization of the HCV E1E2 Heterodimer for Vaccine Development.

An effective vaccine for the hepatitis C virus (HCV) is a major unmet medical and public health need, and it requires an antigen that elicits immune responses to multiple key conserved epitopes. Decades of research have generated a number of vaccine candidates; based on these data and research through clinical development, a vaccine antigen based on the E1E2 glycoprotein complex appears to be the best choice. One bottleneck in the development of an E1E2-based vaccine is that the antigen is challenging to produce in large quantities and at high levels of purity and antigenic/functional integrity. This review describes the production and characterization of E1E2-based vaccine antigens, both membrane-associated and a novel secreted form of E1E2, with a particular emphasis on the major challenges facing the field and how those challenges can be addressed.

Planning for the Next Pandemic: Ethics and Innovation Today for Improved Clinical Trials Tomorrow

The coronavirus pandemic has brought public attention to the steps required to produce valid scientific clinical research in drug development. Traditional ethical principles that guide clinical research remain the guiding compass for physicians, patients, public health officials, investigators, drug developers and the public. Accelerating the process of delivering safe and effective treatments and vaccines against COVID-19 is a moral imperative. The apparent clash between the regulated system of phased randomized clinical trials and urgent public health need requires leveraging innovation with ethical scientific rigor. We reflect on the Belmont principles of autonomy, beneficence and justice as the pandemic unfolds, and illustrate the role of innovative clinical trial designs in alleviating pandemic challenges. Our discussion highlights selected types of innovative trial design and correlates them with ethical parameters and public health benefits. Details are provided for platform trials and other innovative designs such as basket and umbrella trials, designs leveraging external data sources, multi-stage seamless trials, preplanned control arm data sharing between larger trials, and higher order systems of linked trials coordinated more broadly between individual trials and phases of development, recently introduced conceptually as “PIPELINEs.”

DNA vaccination induced protective immunity against SARS CoV-2 infection in hamsterss.

The development of efficient vaccines against COVID-19 is an emergent need for global public health. The spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a major target for the COVID-19 vaccine. To quickly respond to the outbreak of the SARS-CoV-2 pandemic, a nucleic acid-based vaccine is a novel option, beyond the traditional inactivated virus vaccine or recombinant protein vaccine. Here, we report a DNA vaccine containing the spike gene for delivery via electroporation. The spike genes of SARS-CoV and SARS-CoV-2 were codon optimized for mammalian cell expression and then cloned into mammalian cell expression vectors, called pSARS-S and pSARS2-S, respectively. Spike protein expression was confirmed by immunoblotting after transient expression in HEK293T cells. After immunization, sera were collected for antigen-specific antibody and neutralizing antibody titer analyses. We found that both pSARS-S and pSARS2-S immunization induced similar levels of antibodies against S2 of SARS-CoV-2. In contrast, only pSARS2-S immunization induced antibodies against the receptor-binding domain of SARS-CoV-2. We further found that pSARS2-S immunization, but not pSARS-S immunization, could induce very high titers of neutralizing antibodies against SARS-CoV-2. We further analyzed SARS-CoV-2 S protein-specific T cell responses and found that the immune responses were biased toward Th1. Importantly, pSARS2-S immunization in hamsters could induce protective immunity against SARS-CoV-2 challenge in vivo. These data suggest that DNA vaccination could be a promising approach for protecting against COVID-19.

Organisation des structures de soins transversales en allergologie en France en 2020

IntroductionAllergies affect 25% of the general population with an increase in severe allergies. The development in France of cross-disciplinary allergology care structures for multidisciplinary management of patients meets a public health need. The aim of our work is to provide an overview of these structures. MethodDescriptive survey by questionnaire sent to the heads of health care facilities either with a main activity in allergology or with a varied activity in allergology. The survey covered the administrative organisation, the medical and paramedical teams, the care offer and the technical means of the facilities. ResultsThirty-seven facilities were analysed, 27 of which had a main activity in allergology and 10 with a varied activity in allergology. For the former, the number of doctors varies from 1 to 16 and the full-time equivalent nurses from 0.8 to 5.9. The numbers of day hospitalisations and annual consultations are respectively 1049 (220 to 3275) and 3561 (609 to 13,674). One third of patient recruitment is outside the department. All the structures with a main activity in allergology carry out investigations on food, drug and pneumallergen allergies but only 81% and 74% respectively provide care for allergies to hymenoptera and contact eczema. ConclusionsThis study constitutes a first inventory of cross-disciplinary hospital structures in allergology in France in order to guide the development of cross-disciplinary allergy units.