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Parys A, Klinge S, Doenmez A, Rammos C, Rassaf T, Janosi A, Lortz J. Changes in health perception of COVID-19 among patients with aortic diseases: a longitudinal study between the first and second wave of the COVID-19 pandemic. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The rapidly spread of the novel coronavirus disease (COVID-19) worldwide has become the most challenging global health pandemic since the 1918 flu. In Germany, more than 2.5 million cases are confirmed so far, with more than 70,000 deaths. An increased fatality rate was seen among patients with preexisting comorbid conditions, especially with cardiovascular diseases, representing this group at particular risk.
Purpose
Risk perceptions of public health crises like the COVID-19 pandemic can affect people's mental health, reveal gaps in support, and influences the adherence to regulatory requirements. The aim of this study was to evaluate changes in health perception among patients with aortic diseases during the first and second wave of the COVID-19 pandemic in Germany.
Methods
Patients (n=262) diagnosed with aortic disease participated in telephone interviews during the first (w1, April 6–April 29, 2020) and second wave (w2, January 11–January 29, 2021) of the pandemic in Germany. The perception of COVID-19 as a threat was examined using relevant items of the Brief Illness Perception (BIP) questionnaire to address four dimensions (consequences, control, personal control, and understanding). Relevant data focusing on different aortic diseases and cardiovascular risk factors were taken from patient records.
Results
Aortic diseases included mainly aortic aneurysm of the ascending (n=164, 62.6%) and the descending aorta (n=37, 14.1%). Patients with acute or chronic aortic dissection made up a third (n=41, 15.6%, and n=48, 18.3%, respectively). At baseline (w1), none of the participants had neither been quarantined nor were taken ill with COVID-19. At the second survey (w2), 24 participants (n=252, 9.5%) had already been quarantined and five (n=252, 2%) were diagnosed with COVID-19. The BIP score increased 9.18 (SD=7.132) to 14.58 (SD = 6.956) between w1 and w2 (p<.001). At the level of dimensions, that meant a significant difference between w1 and w2 regarding “consequences” (M=−2.821, SD=3.049, 95% CI [−3.200, −2.443], t(251)=−14.691, p<.001, d=0.92), “control” (M=0.908, SD=2.492, 95% CI [0.589, 1.218], t(249)=5.760, p<.001, d=0.36), and “concern” (M=−1.669, SD=3.349, 95% CI [−2.086, −1.253], t(250)=−7.898, p<0.001, d=0.50). Only “understanding” showed no significant difference (M=−0.032, SD=1.520, 95% CI [−0.220, 0.157], t(251)=−0.332, p=0.740).
Conclusion
Although patients with aortic diseases are highly at risk of having worse outcomes from COVID-19, their overall perception of COVID-19 as a threat was low in the beginning, but rising during the second wave. The main reasons were the increased effects on personal life and elevated concerns about the COVID-19 pandemic, but concerns did not include the educational aspect of COVID-19. Tailored risk communication strengthens the mental health of people in a public health crisis and ensures the success of governmental guidelines and policies.
Funding Acknowledgement
Type of funding sources: None. Course of COVID-19 pandemic in Germany
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Affiliation(s)
- A Parys
- University of Duisburg-Essen - West-German Heart and Vascular Center, Department of Cardiology and Vascular Medicine, Essen, Germany
| | - S Klinge
- University of Duisburg-Essen - West-German Heart and Vascular Center, Department of Cardiology and Vascular Medicine, Essen, Germany
| | - A Doenmez
- University of Duisburg-Essen - West-German Heart and Vascular Center, Department of Cardiology and Vascular Medicine, Essen, Germany
| | - C Rammos
- University of Duisburg-Essen - West-German Heart and Vascular Center, Department of Cardiology and Vascular Medicine, Essen, Germany
| | - T Rassaf
- University of Duisburg-Essen - West-German Heart and Vascular Center, Department of Cardiology and Vascular Medicine, Essen, Germany
| | - A Janosi
- University of Duisburg-Essen - West-German Heart and Vascular Center, Department of Cardiology and Vascular Medicine, Essen, Germany
| | - J Lortz
- University of Duisburg-Essen - West-German Heart and Vascular Center, Department of Cardiology and Vascular Medicine, Essen, Germany
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Klinge S, Aygün S, Gilbert RP, Holzapfel GA. Multiscale FEM simulations of cross-linked actin network embedded in cytosol with the focus on the filament orientation. Int J Numer Method Biomed Eng 2018; 34:e2993. [PMID: 29633544 DOI: 10.1002/cnm.2993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 03/22/2018] [Accepted: 03/22/2018] [Indexed: 06/08/2023]
Abstract
The present contribution focuses on the application of the multiscale finite element method to the modeling of actin networks that are embedded in the cytosol. These cell components are of particular importance with regard to the cell response to external stimuli. The homogenization strategy chosen uses the Hill-Mandel macrohomogeneity condition for bridging 2 scales: the macroscopic scale that is related to the cell level and the microscopic scale related to the representative volume element. For the modeling of filaments, the Holzapfel-Ogden β-model is applied. It provides a relationship between the tensile force and the caused stretches, serves as the basis for the derivation of the stress and elasticity tensors, and enables a novel finite element implementation. The elements with the neo-Hookean constitutive law are applied for the simulation of the cytosol. The results presented corroborate the main advantage of the concept, namely, its flexibility with regard to the choice of the representative volume element as well as of macroscopic tests. The focus is particularly placed on the study of the filament orientation and of its influence on the effective behavior.
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Affiliation(s)
- S Klinge
- Institute of Mechanics, TU Dortmund University, Dortmund, 44227, Germany
| | - S Aygün
- Institute of Mechanics, TU Dortmund University, Dortmund, 44227, Germany
| | - R P Gilbert
- Department of Mathematical Sciences, University of Delaware, Newark, Delaware, 19716, USA
| | - G A Holzapfel
- Institute of Biomechanics, Graz University of Technology, Stremayrgasse 16-II, Graz, 8010, Austria
- Faculty of Engineering Science and Technology, Norwegian University of Science and Technology, Trondheim, 7491, Norway
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Klinge S, Hackl K, Renner J. A mechanical model for dissolution–precipitation creep based on the minimum principle of the dissipation potential. Proc Math Phys Eng Sci 2015. [DOI: 10.1098/rspa.2014.0994] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In contrast to previous approaches that consider dissolution–precipitation creep as a multi-stage process and only simulate its governing subprocess, the present model treats this phenomenon as a single continuous process. The applied strategy uses the minimum principle of the dissipation potential according to which a Lagrangian consisting of elastic power and dissipation is minimized. Here, the elastic part has a standard form while the assumption for dissipation stipulates the driving forces to be proportional to two kinds of velocities: the material-transport velocity and the boundary-motion velocity. A Lagrange term is included to impose mass conservation. Two ways of solution are proposed. The strong form of the problem is solved analytically for a simple case. The weak form of the problem is used for a finite-element implementation and for simulating more complex cases.
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Affiliation(s)
- S. Klinge
- Institute of Mechanics, TU Dortmund University, Dortmund 44227, Germany
| | - K. Hackl
- Institute of Mechanics, Ruhr-University Bochum, Bochum 44780, Germany
| | - J. Renner
- Institute for Geology, Mineralogy and Geophysics, Ruhr-University Bochum, Bochum 44780, Germany
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