Research project EUBeKo: Systematic planning and implementation of decision-making and implementation processes of socioecological-based physical activity promotion in the community to reduce social inequity

Background: Physical activity can be understood in terms of socioecological determinants, which are prerequisites to successfully promote physical activity. Communities play an important role in this context, as they can create health-protective conditions. However, the design, implementation, and evaluation of socioecological approaches often do not follow a systematic and theory-driven approach. Changes in environmental conditions are determined by the behavior and decisions of so-called change agents or local decision-makers, such as mayors. Therefore, it is important to identify the determinants that influence decision-making processes to be able to change the decisional behavior of change agents to promote physical activity in their communities. In addition, there is a need for multipliers (e.g., employees in health offices) to be qualified to systematically implement socioecological-based interventions in communities. Objectives and project process: The research project "Systematic planning and implementation of decision-making and implementation processes of socioecological-based physical activity promotion in the community to reduce social inequity” (with the German acronym EUBeKo) was funded within the framework of the funding scheme "Physical Activity and Physical Activity Promotion” of the German Federal Ministry of Health. It takes both the local change agents and multipliers into account and is inspired by intervention mapping. This article describes the project EUBeKo with its two research questions on the role and competences of multipliers, and on the factors influencing local decision-making processes as well as the planning and implementation of socioecological-based physical activity promotion in two model communities, and the dissemination strategies (e.g., project website). Discussion and conclusions: The strengths of the project include the systematic and theory-based preparation and implementation of a process of socioecological-based physical activity promotion in the community with a special focus on planning and decision-making processes as well as on the target groups of local multipliers and decision-makers. Challenges are found in the theory–practice transfer and the impact of the coronavirus disease 2019 (COVID-19) pandemic on project implementation. © 2023, The Author(s).

Therapeutic Effects of Renin-Angiotensin Systeminhibiting Drugs Losartan and Enalapril on Sars-Cov-2 Infection in Ex Vivo Cultured Human Precisioncut Lung Slices

The role of the renin-angiotensin system (RAS) in coronavirus disease 2019 (COVID-19) has received much attention, because the angiotensin-converting enzyme 2 (ACE2) has been identified as the main receptor for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has been speculated that, in COVID-19, RAS dysregulation in favor of angiotensin II (Ang-II)-mediated signaling might result in severe tissue inflammation and lung injury. Likewise, the role of a pre-existing therapy with angiotensin-converting enzyme 1 inhibitors (ACEi) or Ang- II type 1 receptor blockers (ARBs) in COVID-19 is largely unclear. We evaluated the effects of the ACEi enalapril (ENA) and the ARB losartan (LOS) on SARS-CoV-2 infection in human ex vivo-cultured, precision-cut lung slices (PCLS) obtained from normal human lung tissue. The PCLS were pretreated for 5 days with vehicle, LOS or ENA (300 muM), followed by mock infection or infection with SARS-CoV-2 and (continued) incubation with vehicle, LOS or ENA for 1 or 2 days. Thereafter, PCLS were harvested for analysis of viral replication, inflammatory responses, endoplasmic reticulum (ER) stress and apoptosis pathways. Both LOS and ENA significantly reduced viral replication in PCLS, with ENA being more potent. LOS was more efficient than ENA in reducing the expression of IL1B, CCL2, CXCL2 and TNFA, but not of IL6, whereas ENA preferentially caused a reduction of IL6 and CCL2 in SARS-CoV-2-infected PCLS. Furthermore, ENA, but not LOS, significantly decreased the expression of viral entry factors, ACE2 and transmembrane serine protease 2 (TMPRSS2), in infected PCLS, both of which were found to be robustly induced upon SARS-CoV-2 infection. Importantly, LOS or ENA did not exert apoptosis or other cytotoxic effects. Renin-angiotensin system-antagonizing drugs do not seem to exert detrimental effects during SARS-CoV-2 infection.On the contrary, in an ex vivo model of human PCLS, such treatment was found to dampen SARS-CoV-2 infection and consecutive inflammation.

SARS-CoV-2 Seroprevalence in Germany: results from the second wave of the RKI-SOEP study : Elisabetta Mercuri

Introduction The first wave of the “Corona Monitoring bundesweit” (RKI-SOEP) study showed that shortly before the start of the German vaccination program only about 2% of adults (> 18 years) had already experienced SARS-CoV-2 infection and more than half of these cases had been detected and notified. The objectives of the second wave of this study are to further investigate the spread of SARS-CoV-2 in Germanýs population aged over 14 years. It aims to determine the seroprevalence of infection- and vaccine-induced IgG antibodies against SARS-CoV-2. Finally, it examines health, demographic and socioeconomic risk and protective factors for infection and vaccine acceptance. Methods From November 2021 to February 2022, the second wave of this cross-sectional study collected biospecimens (capillary blood samples) and interview data, including information on infection and vaccination, from a nationwide population sample drawn from the German Socio-Economic Panel (SOEP). The dried self-collected blood samples were then analyzed for the detection of SARS-CoV-2 IgG antibodies by Euroimmun ELISA assay. Results Based on preliminary, unweighted data of around 11,000 participants aged >14 years (52% response rate), we expect the final seroprevalence of SARS-CoV-2 antibodies to be in the range of 80 to 90%. Thus, around 10 to 20% of the German population may still be susceptible to a severe disease progression because they are neither infected nor vaccinated. Final results, weighted for non-response and adjusted for test sensitivity and specificity, will be presented. Conclusions The RKI-SOEP-2 study will be pivotal in both, contributing to an improved understanding of SARS-CoV-2 propagation in different regional and sub-group settings and in identifying vulnerable target groups that need to be protected against future infections. Key messages • Dried blood self-sampling in a nationwide sample is a robust tool to estimate seroprevalence at a population level. • As of February 2022, presumably 80 to 90% of the German population has previously been infected and/or vaccinated against SARS-CoV-2.

TREATMENT OF HYPERGLYCAEMIA IN ACUTE STROKE: RESULTS FROM THE TRIAL OF EXENATIDE IN ACUTE ISCHAEMIC STROKE (TEXAIS)

Background and aims: Hyperglycaemia in acute ischaemic stroke (AIS) is common, reduces the efficacy of stroke thrombolysis and thrombectomy, with worse clinical outcomes. Insulin therapies are difficult to implement and maintain, and may cause symptomatic hypoglycaemia. An alternative treatment is Exenatide, a GLP-1 agonist that lowers blood glucose with a very low risk of hypoglycaemia. Methods: The Trial of Exenatide in Acute Ischaemic Stroke (TEXAIS) enrolled adult patients with AIS ≤9 hours of stroke onset to receive treatment with short-acting Exenatide (5μg bid subcutaneous injection) or Standard care for 5 days, or until hospital discharge (whichever sooner).Primary outcome: proportion of patients with ≥8 point improvement in NIHSS score (or NIHSS 0-1) at 7 days. Results: 350 patients randomised, median age 71 years (IQR 62, 79), and median NIHSS 4 (IQR 2, 8). Planned recruitment (n=528) stopped early due to Covid and time constraints. On Admission the median blood glucose was 6.7 (IQR 5.70, 8.50), and 42% patients had hyperglycaemia (>7.0 mmol/L). Primary outcome occurred in 97/171 (56.7%) in Standard care group vs 104/170 (61.2%) in Exenatide group [aOR: 1.22 (CI 0.79, 1.88) p=0.38]. Mean daily per-patient frequency of hyperglycaemia was significantly less in the Exenatide group (p=0.002). No episodes of hypoglycaemia reported over the treatment period. Nausea/vomiting occurred in 7/174 (4.0%) patients on Exenatide. Conclusions: In this Phase 2 trial Exenatide did not significantly reduce neurological disability at 7 days. Exenatide significantly reduced frequency of hyperglycaemic events, and was safe to use. These results warrant further investigation with larger Phase 3 trials.

Transformation of HCI co-research with older adults: researchers' positionality in the COVID-19 pandemic

In the time of COVID-19, many measurements to contain the pandemic contributed to social isolation and loneliness. Older adults in particular experience various forms of ageism in this regard, for example by being stereotyped as digitally illiterate. Hence, we need to learn more about the aging discourse in the context of participatory approaches, as it is currently lacking. This article presents the results from two participatory research projects that were significantly affected by the 1st COVID-19 lockdown. We specifically focus on the ways the relationships and modes of cooperation with our older research partners, i.e. the positionalities, have been impacted. We draw on the projects' results, reflecting on the possible implications for the involvement of older adults in design and HCI research and specifically, technologies that are supportive and empowering for the individuals against the background of the pandemic situation. © 2021. All Rights Reserved.

Designing for New Forms of Vulnerability: Exploring transformation and empowerment in times of COVID-19

Our workshop will concentrate on vulnerability of specific social groups due to various reasons, including COVID-19, and the potential for technology design to result in empowerment. We want to address issues of what new forms of vulnerabilities emerge and how we can design digital environments in a way that acknowledges vulnerability but also has the potential to empower people in ways that are meaningful for them. When planning the workshop, we will also reflect on social situations that can result in vulnerabilities for participants. Therefore, we will ensure that interested participants will experience low barriers to participation include a variety of people with different backgrounds and ensure that interaction happens based on equality principles and in an atmosphere of solidarity. Participants can exchange ideas and thoughts without worrying about being exposed to biased assumptions. The workshop will allow for non-hierarchical and cooperative discussion and collaboration through interactive online exercises, resulting in a collaboratively developed zine. Finally, the social sustainability of the workshop will be ensured through a website, mailing lists, joint publications and continuous contact. © 2021 Owner/Author.

Qualitative and quantitative detection of SARS-CoV-2 RNA in untreated wastewater in Western Cape Province, South Africa.

Recent studies have shown that the detection of SARS-CoV-2 genetic material in wastewater may provide the basis for a surveillance system to track the environmental dissemination of this virus in communities. An effective wastewater-based epidemiology (WBE) system may prove critical in South Africa (SA), where health systems infrastructure, testing capacity, personal protective equipment and human resource capacity are constrained. In this proof-of-concept study, we investigated the potential of SARS-CoV-2 RNA surveillance in untreated wastewater as the basis for a system to monitor COVID-19 prevalence in the population, an early warning system for increased transmission, and a monitoring system to assess the effectiveness of interventions. The laboratory confirmed the presence (qualitative analysis) and determined the RNA copy number of SARS-CoV-2 viral RNA by reverse transcription polymerase chain reaction (quantitative) analysis from 24-hour composite samples collected on 18 June 2020 from five wastewater treatment plants in Western Cape Province, SA. The study has shown that a WBE system for monitoring the status and trends of COVID-19 mass infection in SA is viable, and its development and implementation may facilitate the rapid identification of hotspots for evidence-informed interventions.

RSNA Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19: Interobserver Agreement Between Chest Radiologists.

PURPOSE: To assess the interobserver variability between chest radiologists in the interpretation of the Radiological Society of North America (RSNA) expert consensus statement reporting guidelines in patients with suspected coronavirus disease 2019 (COVID-19) pneumonia in a setting with limited reverse transcription polymerase chain reaction testing availability. METHODS: Chest computed tomography (CT) studies in 303 consecutive patients with suspected COVID-19 were reviewed by 3 fellowship-trained chest radiologists. Cases were assigned an impression of typical, indeterminate, atypical, or negative for COVID-19 pneumonia according to the RSNA expert consensus statement reporting guidelines, and interobserver analysis was performed. Objective CT features associated with COVID-19 pneumonia and distribution of findings were recorded. RESULTS: The Fleiss kappa for all observers was almost perfect for typical (0.815), atypical (0.806), and negative (0.962) COVID-19 appearances (P < .0001) and substantial (0.636) for indeterminate COVID-19 appearance (P < .0001). Using Cramer V analysis, there were very strong correlations between all radiologists' interpretations, statistically significant for all (typical, indeterminate, atypical, and negative) COVID-19 appearances (P < .001). Objective CT imaging findings were recorded in similar percentages of typical cases by all observers. CONCLUSION: The RSNA expert consensus statement on reporting chest CT findings related to COVID-19 demonstrates substantial to almost perfect interobserver agreement among chest radiologists in a relatively large cohort of patients with clinically suspected COVID-19. It therefore serves as a reliable reference framework for radiologists to accurately communicate their level of suspicion based on the presence of evidence-based objective findings.

Chest CT target sign in a couple with COVID-19 pneumonia

We describe a target sign on chest CT characterized by a combination of peripheral ring-like opacity and a central nodular ground-glass opacity surrounding a vessel in a couple with COVID-19 pneumonia confirmed by real-time reverse transcriptase fluorescence polymerase chain reaction sputum analysis. Resumo Descrevemos o sinal do alvo na TC de tórax representando combinação de opacidade com aspecto de anel periférico e componente central nodular em vidro fosco circundando estrutura vascular em um casal com COVID-19 confirmada por reação em cadeia da polimerase com transcrição reversa.

Chest CT target sign in a couple with COVID-19 pneumonia.

We describe a target sign on chest CT characterized by a combination of peripheral ring-like opacity and a central nodular ground-glass opacity surrounding a vessel in a couple with COVID-19 pneumonia confirmed by real-time reverse transcriptase fluorescence polymerase chain reaction sputum analysis.

Descrevemos o sinal do alvo na TC de tórax representando combinação de opacidade com aspecto de anel periférico e componente central nodular em vidro fosco circundando estrutura vascular em um casal com COVID-19 confirmada por reação em cadeia da polimerase com transcrição reversa.