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Artykuły w czasopismach na temat "Vaccins à ARN messager"
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REYNES, Jacques. "Les vaccins à ARN messager : perspectives en infectiologie". Actualités Pharmaceutiques 62, nr 629 (październik 2023): S17—S18. http://dx.doi.org/10.1016/s0515-3700(23)00476-7.
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REYNES, Jacques. "Les vaccins à ARN messager anti-Covid-19". Actualités Pharmaceutiques 62, nr 629 (październik 2023): S11—S16. http://dx.doi.org/10.1016/s0515-3700(23)00475-5.
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Miauton, Alix, Juliette Besson, Yannick Muller i Blaise Genton. "Vaccins à ARN messager contre le Covid-19 : piqûre de rappel". Revue Médicale Suisse 17, nr 758 (2021): 1910–14. http://dx.doi.org/10.53738/revmed.2021.17.758.1910.
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Dieu-Nosjean, Marie-Caroline, i Jean-Luc Teillaud. "Prix Nobel de physiologie ou médecine 2023 : Katalin Karikó et Drew Weissman". médecine/sciences 40, nr 2 (luty 2024): 186–91. http://dx.doi.org/10.1051/medsci/2024002.
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Le 2 octobre 2023, le prix Nobel de physiologie ou médecine a été décerné à Katalin Karikó et Drew Weissman, tous deux professeurs à l’université de Pennsylvanie, pour leur « découverte concernant les modifications des nucléosides qui ont permis le développement de vaccins ARN efficaces contre le COVID-19 ». Le communiqué du comité Nobel indique que « grâce à leurs découvertes exceptionnelles qui ont changé radicalement notre compréhension des mécanismes par lesquels l’ARN messager interagit avec notre système immunitaire, ces deux lauréats ont contribué au développement, avec une rapidité sans précédent, d’un vaccin contre l’une des plus grandes menaces des temps modernes affectant la santé humaine ».
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Marion, O., N. Longlune, M. B. Nogier, C. Gabilan, C. Cartou, B. Seigneuric, A. Del Bello, J. Izopet, S. Faguer i N. Kamar. "Immunogénicité des vaccins à ARN messager chez les dialysés chroniques : une étude monocentrique". Néphrologie & Thérapeutique 17, nr 5 (wrzesień 2021): 297. http://dx.doi.org/10.1016/j.nephro.2021.07.138.
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POUCHAIN, D., R. BOUSSAGEON i E. FERRAT. "DECRYPTER LA NATURE ET LA QUANTITE DES BENEFICES ET DES RISQUES DES VACCINS ARN MESSAGER POUR PREVENIR LA COVID-19". EXERCER 32, nr 170 (1.02.2021): 71–78. http://dx.doi.org/10.56746/exercer.2021.170.71.
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Poussés par la pandémie, les gouvernements et l’anxiété planétaires, les deux premiers vaccins ARN messager contre la Covid-19 ont été développés dans un délai exceptionnellement court. L’information mondialement diffusée sur leur efficacité à 95 % est valide, mais simpliste, ambiguë et prête à des interprétations erronées. Selon les essais publiés, ces vaccins ont montré qu’ils réduisaient de 95 % un risque de base de Covid-19 symptomatique mesuré à environ 1 % dans le groupe placebo au cours d’un suivi médian de 30 à 64 jours après la seconde injection. Les effets indésirables ont été fréquents et précoces, mais majoritairement bénins, disparaissant en deux à trois jours. Les effets des vaccins ARNm sur la propagation du virus, les hospitalisations, les séjours en soins intensifs et les décès n’ont pas été évalués. Globalement, leur rapport efficacité/effets indésirables est favorable pour la population correspondant à celle qui a été incluse. Cet article didactique propose un regard objectif, détaillé, et plus analytique sur les bénéfices et les risques de chacun des deux vaccins. C’est une approche destinée à favoriser une décision partagée rationnelle prise en connaissance de cause, et tenant compte des préférences et valeurs d’une personne loyalement informée.
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Tangy, Frédéric, i Jean-Nicolas Tournier. "Les virus au service de la santé : la vaccination". médecine/sciences 38, nr 12 (grudzień 2022): 1052–60. http://dx.doi.org/10.1051/medsci/2022168.
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Depuis plus de deux siècles, les virus sont utilisés, avec un succès impressionnant, comme outils de prévention des infections virales. Depuis la variole et la rage, l’histoire de la vaccinologie a suivi les pas de l’histoire de la virologie. Après les découvertes empiriques des premiers vaccins, le développement du génie génétique, de la virologie moléculaire, de la génétique inverse, la manipulation des génomes viraux, leur séquençage à haut débit et leur synthèse chimique, la maîtrise de la culture cellulaire et des méthodes de purification, ont considérablement contribué au développement de nouveaux vaccins viraux. Des vaccins à ARN messager ou à vecteur viral ont ainsi vu le jour ces dernières années et, face à la pandémie de Covid-19, ont été développés et distribués à la population en un temps record. Les virus au service de la santé ont un bel avenir devant eux, que cela soit pour prévenir d’autres pandémies, pour traiter le cancer, ou contrôler, enfin, le VIH ou le Plasmodium, l’agent du paludisme.
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Sahnoun, R., M. Ksentini, R. Athymen, I. Bouaziz, K. Ksouda, H. Affes, L. Ben Mahmoud, S. Hammemi i K. Zghal. "Polysérite après vaccin COVID-19 à ARN messager". Revue Française d'Allergologie 63, nr 3 (kwiecień 2023): 103509. http://dx.doi.org/10.1016/j.reval.2023.103509.
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Grunenwald, S., G. Lethellier, P. Imbert, C. Dekeister i P. Caron. "Orbitopathie inflammatoire après vaccin ARN messager anti-SARS-CoV-2". Annales d'Endocrinologie 84, nr 1 (luty 2023): 109. http://dx.doi.org/10.1016/j.ando.2022.12.058.
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Baratali, Laila, i Jean Perdrix. "Vaccin prometteur à ARN messager contre le virus respiratoire syncytial". Revue Médicale Suisse 20, nr 860 (2024): 326. http://dx.doi.org/10.53738/revmed.2024.20.860.326.
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Sebane, Mohammed Karim. "Développement d’une approche vaccinale antitumorale basée sur la délivrance d’ARN messager". Electronic Thesis or Diss., Strasbourg, 2024. http://www.theses.fr/2024STRAJ039.
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L’immunothérapie a récemment pris une place centrale dans le traitement du cancer. Les vaccins antitumoraux s’y distinguent comme l’une des approches les plus ciblées. Récemment, l’ARN messager (ARNm) s’est distingué comme une plateforme vaccinale prometteuse notamment grâce au développement de nanoparticules lipidiques (LNP) capables de l’encapsuler. Cependant, ces dernières peuvent induire l’apparition d’anticorps anti-LNP. Ainsi, notre but était le développement de nouveaux vecteurs pour la délivrance de vaccins ARNm à base de « cell-penetrating peptides » (CPP), de courtes séquences peptidiques capables de traverser les membranes cellulaires pour y délivrer des molécules thérapeutiques. Ces travaux ont permis l’identification de CPP dérivés des séquences du peptide antimicrobien LAH4, de la protéine virale Vpr et de l’hémagglutinine comme potentiels vecteurs pour la délivrance d’ARNm aux cellules dendritiques. Les CPP que nous avons développés pourraient représenter une alternative viable et efficace pour la vectorisation de l’ARNm, ouvrant de nouvelles perspectives dans le domaine des vaccins antitumorauxImmunotherapy has recently taken on a central role in cancer treatment. Antitumor vaccines stand out as one of the most targeted approaches. Recently, messenger RNA (mRNA) has emerged as a promising vaccine platform, thanks in particular to the development of lipid nanoparticles (LNPs) capable of encapsulating it. However, the latter can induce the appearance of anti-LNP antibodies. Our aim was therefore to develop new vectors for the delivery of mRNA vaccines based on cell-penetrating peptides (CPPs), short peptide sequences capable of crossing cell membranes to deliver therapeutic molecules. This work has led to the identification of CPPs derived from sequences of the antimicrobial peptide LAH4, the viral protein Vpr and hemagglutinin as potential vectors for mRNA delivery to dendritic cells.The CPPs we have developed could represent a viable and efficient alternative for mRNA vectorization, opening up new prospects in the field of antitumor vaccines
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Coolen, Anne-Line. "Formulation et vectorisation d’un ARN messager vaccinal codant l’antigène Gag du VIH-1 à l’aide de nanoparticules biodégradables de poly(acide lactique)". Thesis, Lyon, 2018. http://www.theses.fr/2018LYSE1292.
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Le développement de vaccins à ARNm est en plein essor dans le domaine de la vaccinologie. Un des défis majeurs de ces approches est de parvenir à transporter et délivrer les ARNm dans le cytoplasme des cellules dendritiques (DC) pour permettre la production d’antigène et l’activation des réponses immunitaires.L’objectif de ce travail a porté sur la conception et l’évaluation de nouvelles stratégies de vectorisation des ARNm par des nanoparticules de poly(acide lactique) (NP-PLA). Une stratégie basée sur l’adsorption des ARNm à la surface des NP-PLA par l’intermédiaire du LAH4-L1, un peptide cationique amphipathique, a été développée. Des polyplexes formés suite à la condensation de l’ARNm par le LAH4-L1 ont été adsorbés sur les NP-PLA pour former des nanocomplexes. L’intérêt des polyplexes et nanocomplexes pour le ciblage des DC et l’activation des réponses immunitaires in vitro a été évalué. Dans des tests de transfection, ces formulations ont induit une expression efficace d’ARNm modèles dans des DC. La présence des NP-PLA dans les formulations semble favoriser l’expression des ARNm. Le traitement avec des inhibiteurs a révélé que les polyplexes et nanocomplexes semblent internalisés par phagocytose et endocytose clathrine-dépendante, et s’échappent des endosomes par un mécanisme dépendant de la pompe à protons v-ATPase. Suite à la transfection de DC dérivées de monocytes (moDC), nous avons montré que nos formulations stimulent les récepteurs de l’immunité innée et induisent une réponse pro-inflammatoire. Cette activation est associée à la maturation des moDC, à la présentation de peptides antigéniques sur le CMH-I et -II et à la sécrétion de cytokines et chémokines impliquées dans l’immunité adaptative. Ces données soulignent l’intérêt des NP-PLA associées au LAH4-L1 pour vectoriser des ARNm, cibler des DC et activer les réponses immunitaires. Dans le contexte du VIH-1, ce type de réponse pourrait aider le système immunitaire à contrôler la charge viraleMRNA-based vaccines currently raise a growing interest in vaccinology. However, the transport and delivery of mRNAs to DC cytoplasm in order to induce antigen production and immune responses remains challenging. The objective of this thesis concerns the design and evaluation of novel strategies to vectorize vaccine mRNAs by poly(lactic acid) nanoparticles (PLA-NPs). We developed a strategy based on mRNA adsorption onto PLA-NPs using, as intermediate, LAH4-L1, an amphipathic cationic peptide. To do this, mRNAs were condensed by LAH4-L1 to form polyplexes which was then adsorbed onto PLA-NPs in a second step to form nanocomplexes. The LAH4-L1/mRNA polyplexes and PLA-NP/LAH4-L1/mRNA nanocomplexes ability to target DCs and induce immune responses in vitro was evaluated. We showed that formulations induce an efficient transfection of mRNA in DCs in vitro. The addition of PLA-NPs in formulations seems to increase sustained expression of mRNAs. DC treatment by inhibitors revealed that polyplexes and nanocomplexes are taken up by phagocytosis and clathrin-dependent endocytosis, and escape endosomes by a v-ATPase-dependent mechanism. Transfection of monocyte-derived DCs (moDCs) showed that LAH4-L1/mRNA polyplexes and PLA-NP/LAH4-L1/mRNA nanocomplexes trigger innate-sensing activation with pro-inflammatory responses. This activation is associated with moDCs maturation, MHC-I and MHC-II presentation, and the secretion cytokines and chemokines involved in adaptive immunity.These data highlight the interest of these new platform formulations to vectorize mRNAs, target DCs and induce immune responses, which in the context of HIV-1, could help the immune system to control the viral load
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Gaudin, Cyril. "Nouvelles caractérisations structurales de l'ARN transfert-messager". Rennes 1, 2004. http://www.theses.fr/2004REN10023.
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La "trans-traduction" est un mécanisme bactérien qui permet la libération de ribosomes bloqués en cours de synthèse protéique. Ce mécanisme fait intervenir l'ARN transfert-messager (ARNtm), comportant un domaine ARNt et un cadre ouvert de lecture, et la protéine SmpB. Chez certaines espèces, le gène codant pour l'ARNtm a subi une permutation circulaire dont la transcription aboutit à un ARN précurseur maturé sous la forme de deux ARN distincts. Nous avons caractérisé par cartographie chimique et enzymatique la structure secondaire de cet ARNtm en deux parties. D'autre part, nous avons déterminé, par résonance magnétique nucléaire, le degré de similarité structurale entre le domaine assurant la fonction ARNt de la molécule (TLD) et les ARNt standards. Nous avons montré que ce domaine interagit avec SmpB. Afin d'obtenir des informations supplémentaires sur l'initiation de la trans-traduction, nous avons entrepris de résoudre la structure du complexe TLD/SmpB par RMN.
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Alves, Annabelle. "Analyse fonctionnelle du complexe Nup 107-160 des pores nucléaires au cours du cycle cellulaire des vertébrés". Paris 11, 2005. http://www.theses.fr/2005PA112069.
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Dans les cellules eucaryotes, la communication entre les compartiments nucléaire et cytoplasmique est assurée par les pores nucléaires (ou NPCs), assemblages complexes de protéines, ou nucléoporines, ancrés dans l’enveloppe nucléaire. Mes travaux ont consisté en l’analyse de la fonction d’un sous-complexe des NPCs, le complexe Nup107-160. L’étude de ce complexe par ARN interférence dans des cellules humaines m’a permis de confirmer que ce complexe joue un rôle dans l’export des ARN messagers, fonction qui pourrait être liée à sa présence au sein de foyers intranucléaires. En parallèle, j’ai pu observer que la déplétion de certains composants du complexe Nup107-160 induit une réduction du marquage de nombreuses nucléoporines à l’enveloppe nucléaire et une diminution drastique du nombre de NPCs en général. Cette étude a été approfondie par des expériences in vitro, effectuées en collaboration par l’équipe du Dr Mattaj, qui ont montré que le complexe Nup107-160 joue un rôle crucial dans l’assemblage post-mitotique des NPCs. Le complexe Nup107-160 est également localisé aux kinétochores en mitose. Mes travaux ont permis d’identifier un partenaire potentiel du complexe au sein de ces structures. De plus, l’analyse des phénotypes induits par la déplétion du complexe Nup107-160 au niveau des kinétochores montre que ce complexe pourrait jouer un rôle dans la ségrégation des chromosomes. L’ensemble de mes travaux a donc mis en évidence que le complexe Nup107-160 joue un rôle crucial dans la formation des NPCs et a ouvert de nouvelles perspectives relatives à la compréhension des fonctions de ce complexe dans l’export des ARN et la ségrégation des chromosomesIn eucaryotic cell, nuclear pore complexes (NPCs) allow traffic between nuclear and cytoplasmic compartments. NPCs are large assemblies of proteins, named nucleoporins, that are anchored within the nuclear envelope. During my PhD, I have analyzed the function of a NPC sub-complex, the Nup107-160 complex. The study of this complex using an RNA interference approach in human cells confirmed that this complex has an important role in messengers RNA export in interphase, a feature that might be linked to its appearance in intranuclear foci. In parallel, I have studied the function of the Nup107-160 complex during vertebrate mitosis. I observed that depletion of some components of the Nup107-160 complex by RNA interference induces a decreased staining at the nuclear envelope of numerous nucleoporins and a drastic decrease of NPC number. These data together with in vitro experiments done in collaboration with Dr Mattaj’s laboratory have demonstrated that the Nup107-160 complex plays a critical role during NPC post-mitotic reassembly. Furthermore, the Nup107-160 complex also localizes at kinetochores. We found a potential partner of this complex within these structures. In addition, analysis of the phenotypes induced by Nup107-160 complex depletion at kinetochores show that this complex might be important for proper chromosome segregation during mitosis. The data included in this manuscript have therefore demonstrated that the Nup107-160 complex plays an important role in NPC formation and open new perspectives for the understanding of the mechanisms underlying its involvement in RNA export and chromosome segregation
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Hutchison, Stephen. "Caractérisation de deux élements introniques modulant l'épissage alternatif de l'ARN pré-messager du gene de hnRNP A1". Sherbrooke : Université de Sherbrooke, 2001.
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Rouquier, Sylvie. "La protéine des calculs pancréatiques de rat : structure de l'ARN messager et régulation nutritionnelle". Aix-Marseille 3, 1991. http://www.theses.fr/1991AIX30011.
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Le suc pancreatique est naturellement sursature en caco#3. Or in vivo, la precipitation de ce sel n'a lieu que dans certaines conditions pathologiques. La pancreatite chronique calcifiante (pcc) se caracterise par la formation de calculs de caco#3 dans les canaux pancreatiques conduisant progressivement a une insuffisance de la secretion exocrine. La lithostathine s, proteine abondante de la secretion pancreatique, est un regulateur de la croissance de caco#3, necessaire au maintien de la fluidite du suc. Nous avons obtenu la sequence de son arnm chez l'homme et montre que son expression etait en moyenne 3 fois plus faible chez des patients atteints de pcc que chez des individus sains, indiquant ainsi une origine possible de la maladie. Des etudies epidemiologiques avaient montre que des facteurs dietetiques favorisaient l'apparition de la maladie. Nous avons clone et sequence l'adn complementaire a l'arnm de la lithostathine de rat et montre que, bien que n'ayant pas d'activite proteolytique connue, l'expression de la proteine etait tres fortement stimulee par la ration proteique du regime alimentaire. D'autre part, une homologie complete a ete observee entre l'arnm de la lithostathine s de rat et le transcrit du gene reg (terazono et al. J. Biol. Chem. 1988) exprime specifiquement dans les ilots de langerhans en regeneration. Nous avons egalement mis en evidence cette expression pour la lithostathine s. De plus, nous avons montre sa surexpression au cours de la phase initiale du processus de regeneration du tissu exocrine. Cette expression est probablement reliee au phenomene de dedifferenciation cellulaire observe dans les deux types de tissus (exocrine et endocrine) au cours du processus de regeneration. Dans le pancreas mature, la lithostathine est exprimee uniquement dans le tissu exocrine et est impliquee dans l'inhibition de la croissance des cristaux de caco#3
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Legendre, Matthieu. "Recherche de motifs d'ARN non-codants : du messager au microARN". Aix-Marseille 2, 2005. http://theses.univ-amu.fr.lama.univ-amu.fr/2005AIX22066.pdf.
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Azizi, Hiva. "Mechanistic insights of SIDER2 retroposon-mediated mRNA decay in Leishmania". Doctoral thesis, Université Laval, 2017. http://hdl.handle.net/20.500.11794/27725.
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Leishmania est un pathogène important pour la santé humaine avec plus de 350 millions de personnes à risque dans le monde. Leishmania présente des caractéristiques uniques en termes de régulation génique constituant ainsi un excellent modèle pour l’étude des mécanismes de régulation génique. Chez Leishmania ainsi que les autres Trypanosomatidae, il n’y a pas de controle au niveau de l’initiation de la transcriptin et la regulation se fait pas presque exclusivement au niveau post-transcriptionnel. Les éléments régulateurs en cis situés dans les régions 3' non-traduites (3'UTRs) des ARN messagers chez Leishmania (ARNms) sont essentiels pour la régulation de la stabilité ou la traduction des transcrits. Malgré les efforts considérables déployés pour l’identification de ces éléments régulateurs, uniquement quelques centaines ont été caractérisées chez les eucaryotes. Nous avons identifiés une nouvelle classe de rétroéléments agissant en cis, appelés SIDERs (Short Interspersed DEgenerate Retroposons) qui sont largement distribués dans le génome du parasite (>2000 copies de SIDER1 et SIDER2), situés pour la plupart dans la région 3ʹUTR. Les transcrits contenant SIDER2 le région 3ʹUTR sont dégradés par un mécanisme indépendant de la déadénylation initié par un clivage endonucléolytique au sein de la séquence signature II (SII) qui est conservée parmi SIDER2. Mon travail a consisté à déterminer les séquences nécessaires pour le clivage endonucléolytique et à identifier les trans-régulateurs jouant un rôle dans la dégradation des ARNm dépendante de SIDER2. Nous avons adopté une approche de purification d'affinité d'ARN étiquetés MS2 permettant de capturer les facteurs trans-régulateurs. Parmi ces éléments liant spécifiquement SIDER2, la Pumilio protéine PUF6 est responsable de la dégradation du transcrit rapporteur possédant la séquence SIDER2 en 3ʹUTR. De plus, l’inactivation du gène PUF6 se manifeste par une augmentation de stabilité des transcrits, suggérant un rôle de PUF6 dans la dégradation des ARNm médiée par SIDER2. Des études de mutations au sein de la séquence conservée, signature II, responsable de la régulation de la dégradation, ont permis de souligner l’importance de sites de clivages putatifs, précédemment identifiés au niveau de SIDER2. De plus, deux régions additionnelles proches de l’extrémité terminale de la séquence SIDER2 se sont révélées de jouer aussi un rôle au niveau de la déstabilisation de l’ARNm. Enfin, nous avons investigué le rôle de la traduction au niveau de la dégradation des ARNm médiée par SIDER2 et nous avons montré que la dégradation des transcrits SIDER2 est liée à une traduction active, soulignant ainsi l’importance de la machinerie de la traduction au niveau de la régulation globale des transcrits contenants des éléments SIDER2 dans le 3’UTR..Leishmania spp. are important human pathogens which put lives of over 350 million people at risk, worldwide. Apart from being an important human pathogen, Leishmania has unique features in terms of gene regulation, rendering it an excellent model organism to study gene regulation mechanisms. Notably, Leishmania and other trypanosomatids lack control at the level of transcription initiation and therefore most of the regulation of gene expression takes place post-transcriptionally. Cis-acting elements in 3ʹ-untranslated regions (3ʹUTRs) of Leishmania messenger RNAs (mRNAs) are central to the regulation of mRNA decay or translation efficiency. We have identified a novel class of cis-acting retroposons, termed SIDERs (Short Interspersed DEgenerate Retroposons) that are widely distributed in the parasite genome (>2000 copies of SIDER1 and SIDER2), mostly within 3ʹUTRs. Transcripts bearing SIDER2 in their 3ʹUTR are degraded via a deadenylation-independent pathway involving endonucleolytic cleavage within the conserved signature II (SII) sequence of SIDER2 elements. My research project aimed at determining the sequence requirements for endonucleolytic cleavage and identifying the trans-acting factor(s) contributing to SIDER2-mediated mRNA decay. We employed a tethering approach using the MS2 system to capture the trans-acting proteins in vivo. Amongst the proteins specifically tethered to SIDER2, the Pumilio protein PUF6 was shown to downregulate the SIDER2-harboring reporter transcript. Furthermore, inactivation of the PUF6 gene resulted in upregulation and increased transcript stability, indicating that PUF6 contributes to SIDER2-mediated decay. Mutational analysis within the conserved SII region, known to regulate decay, highlighted the importance of the previously mapped putative cleavage sites in mediating degradation of SIDER2-containing transcripts. Furthermore, two additional regions closer to the end of the SIDER2 sequence were found to contribute to mRNA destabilization. Finally, we addressed the requirement of translation for SIDER2 mediated decay and showed that degradation of SIDER2 transcripts is linked to ongoing translation, underscoring significance of the translation apparatus in global regulation of SIDER2-containing transcripts.
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Rochdi, Moulay Driss. "Les régions 3' non-traduites (3'UTRs) de l'ARNm de la calpastatine : leur organisation, structure et implication dans des intéractions de type ARN-protéine". Sherbrooke : Université de Sherbrooke, 2000.
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Herissant, Lucas. "Ubiquitination de l'Histone H2B et Biogenèse des ARN messagers". Paris 7, 2013. http://www.theses.fr/2013PA077222.
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L'ubiquination de l'Histone H2B est une modification cotranscriptionnelle qui contrôle la dynamique des Atcléosomes ainsi que d'autres marques d'histones, en particulier des évènements de méthylation de l'Histone H3. J'ai participé à l'étude de la régulation de l'ubiquitination de H2B. Nous avons montré que l'AAA-ATPase Cdc48 facilite la modification de H2B en influençant sa machinerie d'ubiquitination chez la levure S. Cerevisiae. Ensuite, nous nous sommes interessés aux rôles de l'ubiquitination de H2B dans la biogenèse des ARNm. Nous avons démontré que l'ubiquitination de H2B contrôle l'intégrité et la stabilité du complexe CPF, impliqué dans la maturation des ARNm en 3' via son action sur la protéine Swd2. Cette protéine facilite le recrutement des facteurs d'export nucléaire sur les ARN néotranscrits. Ainsi, l'ubiquitination de H2B permet un transport efficace des ARNm du noyau vers le cytoplasme. Afin de déterminer si l'ubiquitination de H2B participe à d'autres étapes de maturation, j'ai étudié l'épissage de tous les gènes à introns ainsi que la composition globale des particules ribonucléoprotéique (mRNP) par spectrometrie de masse dans un mutant de H2B. Nous avons montré que l'ubiquitination de H2B favorise l'épissage de nombreux gènes en contrôlant le recrutement des facteurs d'épissage précoces, les snRNP UI et U2, sur les pré-ARNm. L'ubiquitination de H2B participe donc au dialogue entre des évènements cotranscriptionnels et l'assemblage des mRNP. Mes études mettent en évidence que l'environnement chromatinien influence différentes étapes essentielles de la biogenèse des mRNP dans le noyauUbiquitination of histone H2B is a cotranscriptionnal modification which controls nucleosome dynamic and other histones modifications, in particular, methylation on Histone H3. First, I contributed to the analyzis of the regulation of H2B ubiquitination. We showed that the AAA-ATPase Cdc48 facilitates H2B modification by influencing its ubiquitination machinery in the yeast S. Cerevisiae. Then, we investigated the roles of H2B ubiquitination in mRNA biogenesis. We showed that the H2B ubiquitination controls the integrity and stability of the CPF complex, which is involved in 3' end maturation of mRNAs, via its action on the Swd2 protein. This protein facilitates recruitment of nuclear export factors on newly synthetised mRNAs. Thus, H2B ubiquitination allows efficient export of mRNAs from the nucleus to the cytoplasm. In order to determine if H2B ubiquitination is involved in other mRNA maturation steps, we analyzed splicing of all intron-containing genes by specific splicing-arrays as well as the global composition of ribonucleoproteic particules (mRNPs) by mass spectrometry in H2B mutant strain. We observed that H2B ubiquitination promotes splicing of some genes by controlling the recruitment of the early splicing machinery, the snRNPs Ul and U2, on pre¬mRNAs. H2B ubiquitination is thus involved in a crosstalk between transcriptionnal events and mRNP maturation. These results show that the chromatin environnement can affect different essential steps of mRNPs biogenesis in the nucleus
Książki na temat "Vaccins à ARN messager"
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D, Richter Joel, red. mRNA formation and function. San Diego: Academic Press, 1997.
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Lamond, Angus I. Pre-mRNA processing. New York: Springer-Verlag, 1995.
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Lamond, Angus I. Pre-mRNA processing. Austin: R.G. Landes Co., 1995.
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Lemonnier, Jérôme, i Chantal Pichon. Marathon du Messager: Histoire des Vaccins à ARN Messager. EDP Sciences, 2022.
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Crisis communication related to vaccine safety: Technical guidance. Pan American Health Organization, 2021. http://dx.doi.org/10.37774/9789275123126.
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Vaccine- and vaccination-related crises require a communication response that is different from the communication strategies used to promote the benefits and importance of vaccines in general. This document presents the technical guidance needed to develop a communication plan that is appropriate for managing crises related to vaccine safety. This guidance will be useful for managers in the areas of immunization and vaccine and vaccination safety. They will also help preparedness and response teams working in safety crises to optimize their communication plans in order to regain, maintain, or strengthen trust in vaccines, vaccination, and immunization programs in general. Each chapter presents a phase (preparation, implementation, and evaluation) with suggested actions and support tools to prepare, implement, and evaluate a communication response in a crisis situation. Also, some sections can also be used to strengthen routine national communication activities such as interaction with media, message generation, spokespeople preparation among others. The current document complements the Manual for the surveillance of events supposedly attributable to vaccination or immunization (ESAVI) in the Region of the Americas. This document is published within the framework of a joint project that aims to promote communication-related to safe vaccination in the Region of the Americas and support health authorities that need to develop a communication plan to manage crises related to vaccine safety. Some of the sections in this publication are based on the guidance documents available in the WHO Regional Office for Europe’s virtual library and can be consulted on their website.
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Eukaryotic mRNA processing. Oxford: New York, 1997.
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Communicating about Vaccine Safety: Guidelines to help health workers communicate with parents, caregivers, and patients. Pan American Health Organization, 2021. http://dx.doi.org/10.37774/9789275122822.
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Vaccines save between 2 million and 3 million lives each year and protect the entire population from more than a dozen life-threatening diseases. Thanks to vaccination, smallpox was eradicated in 1980, and we are on track to eradicate polio. However, despite great strides in the control of measles, one of the most contagious diseases known, the last few years have unfortunately seen an increase in cases. This is why high vaccination coverage—95% or more—is needed, posing a major technical and communication challenge for health workers. Studies show that telling people about the quality, safety, effectiveness and availability of vaccines is not enough to influence behavior change related to immunization, and in general, doesn´t increase coverage. For this reason, it´s necessary to understand the reasons why people choose not to get vaccinated or not get their children vaccinated, in order to begin a two-way respectful dialogue using the best, most effective messages. Given this context, the main objective of these guidelines is to provide tools for staff working in the field of immunization to support effective communication between health personnel and the general population, with the aim of strengthening, maintaining or recovering trust in vaccines and the immunization programs in the Region of the Americas.
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Chu, Carolyn, i Christopher M. Bositis. HIV Transmission Prevention. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190493097.003.0004.
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The prevention of HIV transmission involves a number of behavioral, structural, and biomedical interventions. Behavioral methods include education about sexual health, drug use, and risk reduction, as well as specific messages for at-risk populations who are HIV positive. Needle exchange programs and consistent use of condoms have proven effective for prevention of HIV infection. Post-exposure prophylaxis against HIV with antiviral drugs is often recommended in occupational health care and non-occupational settings. Voluntary male circumcision also reduces the risk of HIV acquisition. The treatment of pregnant women who are HIV infected can effectively eliminate mother-to-child transmission of the virus. Recently, the use of antiretroviral drugs for pre-exposure prophylaxis has proven highly effective in preventing HIV infections in high-risk groups including men who have sex with men. Promising therapies that likely will be available in the future include injectable antiviral drugs, vaginal microbicides, and HIV vaccines.
Części książek na temat "Vaccins à ARN messager"
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"4 2020 : le triomphe des vaccins à ARNm anti-Covid". W Le marathon du messager, 187–206. EDP Sciences, 2022. http://dx.doi.org/10.1051/978-2-7598-2664-3.c025.
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Norshira Wan Mohd Ghazali, Wan, Shafizan Mohamed, Soadah Wok i Mohd Helmi Yusoh. "Vaccine Communication and the Media Credibility in Addressing Vaccine Hesitancy: A Focus on Malaysia". W Journalism: The Ethical Dilemma [Working Title]. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.108353.
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The resurgence of vaccine-preventable diseases such as polio, diphtheria, measles and the like shows that the anti-vaccine movement is gaining popularity and effectiveness in bolstering its views. Multiple studies have shown worrying trends of distrust towards vaccines, medical professionals, vaccine scientists and the government agencies that promote vaccination. It is observed that the current anti-vaccine discourses and misinformation about vaccines on social media are fuelling fear of vaccination among the public. To minimise the spread of vaccine-preventable diseases, the media has considerable potential to influence the public’s understanding of how vaccines function. Therefore, this chapter proposed the adoption of a media guide to assist media practitioners in reporting vaccination stories. It will highlight an influential role that the media can play by enlisting the assistance of experts and health professionals to dispel erroneous beliefs about vaccinations and aggressively promote vaccination among influential persons and the general public. This chapter argued that responsible and ethical reporting will aid in raising awareness of the public health implications of the anti-vaccine sentiment, thereby combating the transmission of messages that drive vaccine fear and rejection. The chapter also addressed how insights provided by Ihlen on rhetorical communication can enhance the effectiveness of delivering vaccine-related messages.
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Tunde Gbonjubola, Yusuff, Daha Garba Muhammad, Nwaezuoke Chisom Anastasia i Tobi Elisha Adekolurejo. "Maximizing COVID-19 Vaccine Acceptance in Developing Countries". W Vaccine Development. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.102369.
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Coronavirus disease 2019 (COVID-19) is still in existence, with the capacity to spread even further. Vaccination could efficiently reduce the burden of the pandemic, but first, people must accept these vaccines. Vaccine acceptance by the population is crucial to control the pandemic and prevent further deaths. Herd Immunity, which is the indirect protection that occurs when a sufficient percentage of a population has become immune to an infection, offers some protection to unvaccinated individuals. However, herd immunity is compromised when widespread vaccine acceptance is not achieved. Some vaccines have been authorized to prevent COVID-19, such as Pfizer-BioNTech, Moderna, Johnson & Johnson\'s Janssen, and Oxford-AstraZeneca COVID-19 Vaccine. While vaccine development has been achieved within a short time, its safety, potency, efficacy, and universal accessibility are of great concern and could influence vaccine acceptance. Conspiracy beliefs rampant in Africa may influence vaccine hesitance; exposure to anti-vaccine theories decreases willingness to accept vaccination. As such, there is a need for the availability of reliable information about vaccines, messages that highlight the vaccines efficacy and safety could be effective for addressing the hesitancy to increase the acceptance level of the COVID-19 Vaccine in Africa.
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Diers-Lawson, Audra, i Nanna Alida Grit Fredheim. "Designing Strategic Communication Messages for Health in a High Trust Society: Analyzing the Factors Behind Vaccine Confidence in Norway". W Strategic Communication – Contemporary Perspectives, 37–64. Cappelen Damm Akademisk/NOASP, 2024. http://dx.doi.org/10.23865/noasp.208.ch3.
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The chapter aimed to identify factors influencing vaccine confidence in Norway. The findings revealed that several key factors explain more than 50% of the variation in vaccine attitudes offering valuable insights for policy and communication strategies to support vaccination programs. The study identified three noteworthy findings: 1. Age and childhood vaccination status were significant demographics affecting vaccine confidence. Younger individuals who did not receive childhood vaccinations expressed lower confidence in vaccines than older individuals who did. 2. Building health efficacy and maintaining the credibility of official sources of health information were found to be crucial for boosting vaccine confidence. 3. Two primary factors were found to be driving vaccine confidence in Norway: appealing to collectivist values and trust in science. The research emphasized that Norway’s institutional trustworthiness remained positive despite the COVID-19 pandemic and it highlighted that there was no significant difference between vaccine confidence and skepticism in the population. This suggests that skepticism should not be equated with vaccine hesitancy. Moreover, the findings suggest that public engagement and credible information are essential – even in high-trust societies like Norway.
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Devereux, Paul G., Sarah Y. T. Hartzell i Molly M. Hagen. "Crafting Effective Messages to Encourage COVID-19 Vaccination". W The Social Science of the COVID-19 Pandemic, 182–94. Oxford University PressNew York, 2024. http://dx.doi.org/10.1093/oso/9780197615133.003.0014.
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Abstract Social science theories can help develop public health messages that encourage people to take action to minimize harm related to COVID-19 and other crises. For the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to be contained, millions worldwide will need to be vaccinated. Achieving this outcome in an era of misinformation and resistance to vaccinations will be difficult. This chapter draws on examples from mass inoculations in history to show how to work with diverse communities to enable and mobilize them to act. Relevant theories are discussed that describe multiple influences on human behavior, such as the health belief model, the social learning theory, social networks, and community engagement approaches like community-based participatory research. By using these theories, researchers can identify and modify factors related to vaccination uptake, help overcome resistance to vaccines, and promote the successful containment of COVID-19. Lessons learned and future research ideas are offered.
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Capraro, Valerio, Paulo S. Boggio, Robert Böhm, Matjaž Perc i Hallgeir Sjåstad. "Cooperation and Acting for the Greater Good During the COVID-19 Pandemic". W The Social Science of the COVID-19 Pandemic, 164–81. Oxford University PressNew York, 2024. http://dx.doi.org/10.1093/oso/9780197615133.003.0013.
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Abstract Cooperation is essential to overcome global pandemics and other health crises, as many preventive measures require people to bear a personal cost to benefit other people or society as a whole. Wearing a face mask, for example, protects other people more than it protects oneself. This chapter first discusses several key mechanisms that are known to promote cooperative behavior in economic games and real-world scenarios. Then a review is given of the experimental research on what type of interventions could support a cooperative response to the COVID-19 pandemic. Specifically, the chapter focuses on message-based interventions that are intended to promote social distancing, physical hygiene, mask wearing, vaccine uptake, and information seeking. The chapter concludes with some suggested interventions, lessons learned, and future research ideas.
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Katika, Afroditi, Emmanouil Zoulias, Vassiliki Koufi i Flora Malamateniou. "Mining Greek Tweets on Long COVID Using Sentiment Analysis and Topic Modeling". W Studies in Health Technology and Informatics. IOS Press, 2023. http://dx.doi.org/10.3233/shti230554.
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Around 10% to 20% of patients experience Long COVID after recovering from COVID-19. Many people are turning to social networks such as Facebook, WhatsApp, Twitter, etc., to express their opinions and feelings regarding Long COVID. In this paper, we analyse text messages in the Greek language posted on the Twitter platform in 2022 to extract popular discussion topics and classify the sentiment of Greek citizens regarding Long COVID. Results highlighted the following discussion topics: Greek-speaking users discuss Long COVID effects and time required to heal, Long COVID effects in specific population groups like children and COVID-19 vaccines. 59% of analysed tweets conveyed a negative sentiment while the rest had positive or neutral sentiment. The analysis shows that public bodies could benefit from systematically mining knowledge from social media to understand public’s perception of a new disease and take action.
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Arulmozhiselvan L, Uma E i Jayasri R. "COVID-19: Role of Deep Learning and Cloud Through Identification of Kidney, Pancreas and Intestine". W Advances in Parallel Computing Technologies and Applications. IOS Press, 2021. http://dx.doi.org/10.3233/apc210128.
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Worldwide human health and economic has been affected due to the ongoing pandemic of corona virus (COVID-19). The major COVID-19 challenges are prevention, monitoring and FDA approved vaccines. IOT and cloud computing play vital role in epidemic prevention and blocking COVID-19 transmission. Mostly lungs and hearts are affected. Other than lungs many parts are affected which are not considered as prominent conversational cue. In this paper, we have proposed smart system that is effective through detection of pancreas, kidney and intestine. It detects acute pancreatitis, protein leak, microscopic blood leak, post infectious dysmotility and gastrointestinal bleeding. The data from the edge devices are collected and mapped into the cloud layer. The cloud consists of COVID-19 patients medical records which compare the user data with the existing patient records. Once the data matches it sends warning message to the user regarding the result of affected parts. Based on the result from KPI system, it analyzes with all data and using deep Convolutional Neural Network (CNN) it classifies whether the pancreas, kidney and intestine are affected or not due to COVID-19.
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H. Samset, Bjørn. "Styrke og veiledning: Forskningsformidling i møte med særinteresser". W Interessekonflikter i forskning, 231–52. Cappelen Damm Akademisk/NOASP, 2019. http://dx.doi.org/10.23865/noasp.63.ch11.
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Why do people increasingly reject science in favor of subjective opinion? This well-known trend, most recently embodied as “fake news”, has both put lives at risk (through the increasing support for the anti-vaccine movement) and delayed the necessary global adoption of green energy (through so-called climate change skepticism). In this article, I show how rejection of science is often linked to a particular type of new knowledge, one where scientific advice does not grant us local, immediate gains. I also investigate societal megatrends that underlie such skepticism: the growth of social media, the rapid pace of headline news, and the enormous expansion of science itself. Finally, I discuss a way to combat “fake news” and its related phenomena, through more dedicated science communication. “Strength and guidance” is a good slogan for the disseminators of today and tomorrow; strength because the core messages from science need to be ever repeated in a world hungry for sensations, and guidance because the world has grown so complex that bare facts are no longer sufficient. Science communicators need to step out of their comfort zone and give actual, science-based advice – and still refrain from crossing the fine line between objectivity and activism.
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Sharif, Salman, i Faridah Amin. "COVID-19 Pandemic; Anxiety and Depression among frontline healthcare workers: Rising from the Ashes". W Anxiety, Uncertainty, and Resilience During the Pandemic Period - Anthropological and Psychological Perspectives [Working Title]. IntechOpen, 2021. http://dx.doi.org/10.5772/intechopen.98274.
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This chapter gives an insight into the psychological journey of the essential healthcare workers (HCWs) during the COVID-19 pandemic. The catastrophe which started off with uncertainty, provoked fear-related behaviors among the frontline doctors, nurses and paramedical staff. With meager resources and lack of a disaster plan, fire-fighting was a reflex response of healthcare institutions. Though the whole world seemed to be unprepared for the calamity, developing countries with fragile healthcare systems were more vulnerable to collapse. The negative aura was complicated by mistrust among the general population, regarding healthcare workers, institutions and government. Furthermore, with economic downfall; balancing work and protecting the family was a challenge for HCWs, especially during the pandemic peak. The psychological distress translated to rising incidence of depression and anxiety among them. As institutions gained insight into psychosocial issues of HCWs; support and therapies were offered to them. Positive messages labelling HCWs as “Heroes of the Pandemic” were circulated and structured programs developed to address their needs. With the advent of COVID-19 vaccine, a ray of hope emerged, although there are still apprehensions about its efficacy and side-effects. The whole world now eagerly awaits the calamity to perish while normality can rise from ashes.
Streszczenia konferencji na temat "Vaccins à ARN messager"
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Broadnax, Pier A. "African American Nurse’s Hesitancy to Obtain COVID-19 Vaccinations". W 2nd Annual Faculty Senate Research Conference: Higher Education During Pandemics. AIJR Publisher, 2022. http://dx.doi.org/10.21467/proceedings.135.7.
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It has been over a year since the first laboratory-confirmed case of the Coronavirus -19 disease (COVID-19) was detected in the United States. Since then, according to the Kaiser Family Foundation, there have been over 31, 023,000 citizens diagnosed with the disease, resulting in over 560,315 deaths. Although the rate of citizens being diagnosed with the virus as well as the number of deaths has slowed down since the use of the vaccine, there are still concerns regarding sections of communities and various minority groups who are resistant to obtaining the vaccines. Vaccines first became available in November 2020 in response to this pandemic, but distribution issues and problems with compliance soon became evident and demonstrated an extreme gap in health disparities. As of March 31, 2021, the Kaiser Family Foundation reported that in the District of Columbia, African Americans (AA) make up 46% of the population but 45% of the infected cases as compared to whites who make up 31% of the population but only 26% of the infected cases. Anecdotally, it has been reported that AA nurses are hesitant to obtain the COVID-19 vaccine for a variety of reasons, including fear and mistrust of the medical community. The purpose of this pilot study was to survey a small group of AA nurses to refine a tool that will be used to obtain information on factors contributing to their hesitancy to obtain the COVID-19 vaccination. A secondary purpose is to create educational tools that would be effective in developing messages targeting the concerns of African American nurses.
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Dacumos, Shielanie Soriano. "Lexical Features of Medicine Product Warnings in the Philippines". W 10th International Conference on Computer Networks & Communications (CCNET 2023). Academy and Industry Research Collaboration Center (AIRCC), 2023. http://dx.doi.org/10.5121/csit.2023.130411.
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Over the stretch of years, the Philippines has been facing numerous medical problems since the public outcry against a ‘dengue’ vaccine. As a result, parents refused their children from having an anti-measles vaccine which created a medical outbreak in the country. Product warnings are found to be in their optimal position in safeguarding the life of consumerpatients. This paper anatomizes the lexical features of medicine product warnings in the Philippines which are crucial in the response discourses. A range of linguistic frameworks were applied and significant findings were drawn. Lapses on the use of noun abstractness, synthetic personalization, field continuum, adjectives, and adverbs were identified. Such an investigation brought up the transparency of communicative features of medicine safety texts. In the end, linguistic components create a vital impact on the legal content adequacy of medicine product warnings, unfolding the vitalities of these messages in facilitating informed decisionmaking among consumer-patients.
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Dumitran, Angela. "TRANSLATION ERROR IN GOOGLE TRANSLATE FROM ENGLISH INTO ROMANIAN IN TEXTS RELATED TO CORONAVIRUS". W eLSE 2021. ADL Romania, 2021. http://dx.doi.org/10.12753/2066-026x-21-078.
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Both the emergence of the pandemic and lack of knowledge and/or time needed to translate texts related to this topic brought about an increased interest in analyzing Neural Machine Translation (NMT) performance. This study aims to identify and analyze lexical and semantic errors of language aspects that appear in medical texts translated by Google Translate from English into Romanian. The data used for investigation comprises official prospects of 5 vaccines that were approved to be used against the current coronavirus. The focus is on the lexical and semantic errors, as researchers state that these errors made by Machine Translation have the highest frequency compared to morphological or syntactic errors. Moreover, the lexical errors may affect the meaning, the message, and may easily lead to mistranslation, misunderstanding and, therefore, misinformation. The texts to be analyzed are collected from official websites and translated using Google Translate and Google Languages Tools. From the data analyzed, there are 22 lexical and semantic errors that are approached through descriptive methodology. By examining types of errors in translation from English into Romanian and analyzing the potential causes of errors, the results will be used to illustrate the quality and accuracy of Google Translate when translating public health information from English into Romanian, to observe how much the message is affected by the error, in order to sharpen up linguistic awareness. The results of the study can ultimately help improve of the quality of NMT in terms of better lexical selection and attempt to give inputs as a contribution for a more adequate translation into Romanian by Google Machine Translation.
Raporty organizacyjne na temat "Vaccins à ARN messager"
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Lopez Boo, Florencia, Giuliana Daga i Sofia Madariaga. Combating COVID-19 Vaccine Hesitancy: Behaviorally Informed Campaigns in the Caribbean. Inter-American Development Bank, grudzień 2022. http://dx.doi.org/10.18235/0004581.
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This note provides insights into understanding and combating vaccine hesitancy in the Caribbean. We draw on both qualitative and quantitative evidence stemming from IDB analytical and operational work. First, a household survey implemented in Belize in 2021 finds that lack of trust in vaccines and fear of side effects are among the main reasons given by the people that had not yet received the COVID-19 vaccine. Second, we evaluate the correlation between five behaviorally informed campaigns and vaccine uptake and digital engagement (clicks, emojis) and the effect of randomizing the framing of messages within one of such campaigns. We find that messages about COVID-19 vaccine safety and positive framing of side effects were associated with better outcomes. Finally, we describe how these insights are used in vaccination campaigns in Barbados.
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Presseau, Justin, Laura Desveaux, Upton Allen, Trevor Arnason, Judy L. Buchan, Kimberly M. Corace, Vinita Dubey i in. Behavioural Science Principles for Supporting COVID-19 Vaccine Confidence and Uptake Among Ontario Health Care Workers. Ontario COVID-19 Science Advisory Table, marzec 2021. http://dx.doi.org/10.47326/ocsat.2021.02.12.1.0.
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Health Care Workers (HCWs) are the backbone of Ontario’s COVID-19 pandemic response and are a key vaccination priority group. About 80% of Ontario HCWs intend to receive COVID-19 vaccine.1 Challenges include the logistics of delivering the vaccine to this mobile and diverse group and improving vaccine confidence in the remaining 20%. These challenges can be overcome by allaying safety concerns and highlighting personal benefits; tailoring messages to factors associated with lower intention (e.g. age, gender, ethnicity and work setting); employing trusted leaders to set the tone and peers to build social norms; and leveraging public health organizations and health institutions as existing channels of influence.
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Lippman, Betsy, Rebecca Sutton, Allyson Doby, Zeynep Ilkkursun, Gulsah Kurt, Shaffa Hameed, Ceren Acarturk i Brigitte Rohwerder. Covid-19: Understanding the Impact of the Pandemic on Forcibly Displaced Persons. Institute of Development Studies (IDS), styczeń 2022. http://dx.doi.org/10.19088/cc.2021.010.
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The Covid-19 pandemic has left no corner of the world untouched. To cite just one figure, 100 million people have been pushed into poverty, according to a recent World Bank study. The two-speed recovery from the pandemic, depending on vaccine availability, is expected to leave lasting imprints on the economic performances of countries, which data suggest will have a disproportionate effect on forcibly displaced persons and their host communities. This summary highlights key messages from research focusing on how people displaced by war and conflict have been affected by Covid 19 and its secondary impacts. Diverse lived experiences are explored, ranging from the erosion of forcibly displaced persons’ rights during the pandemic, to Syrian refugees with disabilities in Turkey, to displaced Rohingya in Bangladesh. This Research for Policy and Practice Paper sets out examples of the multidimensional social and economic challenges displaced people are facing during the pandemic and presents a series of evidence-based recommendations for positive change that could be achieved even in the most challenging contexts.
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Stall, Nathan M., Kevin A. Brown, Antonina Maltsev, Aaron Jones, Andrew P. Costa, Vanessa Allen, Adalsteinn D. Brown i in. COVID-19 and Ontario’s Long-Term Care Homes. Ontario COVID-19 Science Advisory Table, styczeń 2021. http://dx.doi.org/10.47326/ocsat.2021.02.07.1.0.
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Key Message Ontario long-term care (LTC) home residents have experienced disproportionately high morbidity and mortality, both from COVID-19 and from the conditions associated with the COVID-19 pandemic. There are several measures that could be effective in preventing COVID-19 outbreaks, hospitalizations, and deaths in Ontario’s LTC homes, if implemented. First, temporary staffing could be minimized by improving staff working conditions. Second, homes could be further decrowded by a continued disallowance of three- and four-resident rooms and additional temporary housing for the most crowded homes. Third, the risk of SARS-CoV-2 infection in staff could be minimized by approaches that reduce the risk of transmission in communities with a high burden of COVID-19. Summary Background The Province of Ontario has 626 licensed LTC homes and 77,257 long-stay beds; 58% of homes are privately owned, 24% are non-profit/charitable, 16% are municipal. LTC homes were strongly affected during Ontario’s first and second waves of the COVID-19 pandemic. Questions What do we know about the first and second waves of COVID-19 in Ontario LTC homes? Which risk factors are associated with COVID-19 outbreaks in Ontario LTC homes and the extent and death rates associated with outbreaks? What has been the impact of the COVID-19 pandemic on the general health and wellbeing of LTC residents? How has the existing Ontario evidence on COVID-19 in LTC settings been used to support public health interventions and policy changes in these settings? What are the further measures that could be effective in preventing COVID-19 outbreaks, hospitalizations, and deaths in Ontario’s LTC homes? Findings As of January 14, 2021, a total of 3,211 Ontario LTC home residents have died of COVID-19, totaling 60.7% of all 5,289 COVID-19 deaths in Ontario to date. There have now been more cumulative LTC home outbreaks during the second wave as compared with the first wave. The infection and death rates among LTC residents have been lower during the second wave, as compared with the first wave, and a greater number of LTC outbreaks have involved only staff infections. The growth rate of SARS-CoV-2 infections among LTC residents was slower during the first two months of the second wave in September and October 2020, as compared with the first wave. However, the growth rate after the two-month mark is comparatively faster during the second wave. The majority of second wave infections and deaths in LTC homes have occurred between December 1, 2020, and January 14, 2021 (most recent date of data extraction prior to publication). This highlights the recent intensification of the COVID-19 pandemic in LTC homes that has mirrored the recent increase in community transmission of SARS-CoV-2 across Ontario. Evidence from Ontario demonstrates that the risk factors for SARS-CoV-2 outbreaks and subsequent deaths in LTC are distinct from the risk factors for outbreaks and deaths in the community (Figure 1). The most important risk factors for whether a LTC home will experience an outbreak is the daily incidence of SARS-CoV-2 infections in the communities surrounding the home and the occurrence of staff infections. The most important risk factors for the magnitude of an outbreak and the number of resulting resident deaths are older design, chain ownership, and crowding. Figure 1. Anatomy of Outbreaks and Spread of COVID-19 in LTC Homes and Among Residents Figure from Peter Hamilton, personal communication. Many Ontario LTC home residents have experienced severe and potentially irreversible physical, cognitive, psychological, and functional declines as a result of precautionary public health interventions imposed on homes, such as limiting access to general visitors and essential caregivers, resident absences, and group activities. There has also been an increase in the prescribing of psychoactive drugs to Ontario LTC residents. The accumulating evidence on COVID-19 in Ontario’s LTC homes has been leveraged in several ways to support public health interventions and policy during the pandemic. Ontario evidence showed that SARS-CoV-2 infections among LTC staff was associated with subsequent COVID-19 deaths among LTC residents, which motivated a public order to restrict LTC staff from working in more than one LTC home in the first wave. Emerging Ontario evidence on risk factors for LTC home outbreaks and deaths has been incorporated into provincial pandemic surveillance tools. Public health directives now attempt to limit crowding in LTC homes by restricting occupancy to two residents per room. The LTC visitor policy was also revised to designate a maximum of two essential caregivers who can visit residents without time limits, including when a home is experiencing an outbreak. Several further measures could be effective in preventing COVID-19 outbreaks, hospitalizations, and deaths in Ontario’s LTC homes. First, temporary staffing could be minimized by improving staff working conditions. Second, the risk of SARS-CoV-2 infection in staff could be minimized by measures that reduce the risk of transmission in communities with a high burden of COVID-19. Third, LTC homes could be further decrowded by a continued disallowance of three- and four-resident rooms and additional temporary housing for the most crowded homes. Other important issues include improved prevention and detection of SARS-CoV-2 infection in LTC staff, enhanced infection prevention and control (IPAC) capacity within the LTC homes, a more balanced and nuanced approach to public health measures and IPAC strategies in LTC homes, strategies to promote vaccine acceptance amongst residents and staff, and further improving data collection on LTC homes, residents, staff, visitors and essential caregivers for the duration of the COVID-19 pandemic. Interpretation Comparisons of the first and second waves of the COVID-19 pandemic in the LTC setting reveal improvement in some but not all epidemiological indicators. Despite this, the second wave is now intensifying within LTC homes and without action we will likely experience a substantial additional loss of life before the widespread administration and time-dependent maximal effectiveness of COVID-19 vaccines. The predictors of outbreaks, the spread of infection, and deaths in Ontario’s LTC homes are well documented and have remained unchanged between the first and the second wave. Some of the evidence on COVID-19 in Ontario’s LTC homes has been effectively leveraged to support public health interventions and policies. Several further measures, if implemented, have the potential to prevent additional LTC home COVID-19 outbreaks and deaths.