A survey on worries of pregnant women - testing the German version of the Cambridge Worry Scale

Background: Pregnancy is a transition period in a woman's life characterized by increased worries and anxiety. The Cambridge Worry Scale (CWS) was developed to assess the content and extent of maternal worries in pregnancy. It has been increasingly used in studies over recent years. However, a German version has not yet been developed and validated. The aim of this study was (1) to assess the extent and content of worries in pregnancy on a sample of women in Germany using a translated and adapted version of the Cambridge Worry Scale, and (2) to evaluate the psychometric properties of the German version. Methods: We conducted a cross-sectional study and enrolled 344 pregnant women in the federal state of Baden-Wurttemberg, Germany. Women filled out structured questionnaires that contained the CWS, the Spielberger-State-Trait-Anxiety Inventory (STAI), as well as questions on their obstetric history. Antenatal records were also analyzed. Results: The CWS was well understood and easy to fill in. The major worries referred to the process of giving birth (CWS mean value 2.26) and the possibility that something might be wrong with the baby (1.99), followed by coping with the new baby (1.57), going to hospital (1.29) and the possibility of going into labour too early (1.28). The internal consistency of the scale (0.80) was satisfactory, and we found a four-factor structure, similar to previous studies. Tests of convergent validity showed that the German CWS represents a different construct compared with state and trait anxiety but has the desired overlap. Conclusions: The German CWS has satisfactory psychometric properties. It represents a valuable tool for use in scientific studies and is likely to be useful also to clinicians

SARS-CoV-2 mRNA vaccinations fail to elicit humoral and cellular immune responses in patients with multiple sclerosis receiving fingolimod

BACKGROUND: SARS-CoV-2 mRNA vaccination of healthy individuals is highly immunogenic and protective against severe COVID-19. However, there are limited data on how disease-modifying therapies (DMTs) alter SARS-CoV-2 mRNA vaccine immunogenicity in patients with autoimmune diseases. METHODS: As part of a prospective cohort study, we investigated the induction, stability and boosting of vaccine-specific antibodies, B cells and T cells in patients with multiple sclerosis (MS) on different DMTs after homologous primary, secondary and booster SARS-CoV-2 mRNA vaccinations. Of 126 patients with MS analysed, 105 received either anti-CD20-based B cell depletion (aCD20-BCD), fingolimod, interferon-β, dimethyl fumarate, glatiramer acetate, teriflunomide or natalizumab, and 21 were untreated MS patients for comparison. RESULTS: In contrast to all other MS patients, and even after booster, most aCD20-BCD- and fingolimod-treated patients showed no to markedly reduced anti-S1 IgG, serum neutralising activity and a lack of receptor binding domain-specific and S2-specific B cells. Patients receiving fingolimod additionally lacked spike-reactive CD4(+) T cell responses. The duration of fingolimod treatment, rather than peripheral blood B and T cell counts prior to vaccination, determined whether a humoral immune response was elicited. CONCLUSIONS: The lack of immunogenicity under long-term fingolimod treatment demonstrates that functional immune responses require not only immune cells themselves, but also access of these cells to the site of inoculation and their unimpeded movement. The absence of humoral and T cell responses suggests that fingolimod-treated patients with MS are at risk for severe SARS-CoV-2 infections despite booster vaccinations, which is highly relevant for clinical decision-making and adapted protective measures, particularly considering additional recently approved sphingosine-1-phosphate receptor antagonists for MS treatment

Childlessness in France

Even though the average age at first childbirth has been increasing and education and employment options for women have improved immensely in recent decades, in France, unlike in other European countries, these developments have not led to a major increase in childlessness. Birth rates remain high and the share of the population who are childless is among the lowest in western Europe. This article discusses the historical roots as well as the societal conditions, institutional regulations, and political decisions that may explain the low levels of childlessness in France. We also discuss differences in rates of childlessness by education and occupation. Using a large representative survey on family life that was conducted parallel to the French census in 2011, we study the fertility histories of men and women born between the 1920s and late 1970s. We find that while the differences in fertility by level of education seem to have declined, having a higher education is still an obstacle to parenthood for women. For men, having a low educational and occupational status is associated with a greater likelihood of being childless. A large part of the differences in rates of childlessness between social groups can be traced back to the men and women who have never lived in a couple relationship; thus, partnership status can be regarded as a decisive parameter of the extent of childlessness

SARS-CoV-2-reactive T cells in healthy donors and patients with COVID-19

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the rapidly unfolding coronavirus disease 2019 (COVID-19) pandemic1,2. Clinical manifestations of COVID-19 vary, ranging from asymptomatic infection to respiratory failure. The mechanisms that determine such variable outcomes remain unresolved. Here we investigated CD4+ T cells that are reactive against the spike glycoprotein of SARS-CoV-2 in the peripheral blood of patients with COVID-19 and SARS-CoV-2-unexposed healthy donors. We detected spike-reactive CD4+ T cells not only in 83% of patients with COVID-19 but also in 35% of healthy donors. Spike-reactive CD4+ T cells in healthy donors were primarily active against C-terminal epitopes in the spike protein, which show a higher homology to spike glycoproteins of human endemic coronaviruses, compared with N-terminal epitopes. Spike-protein-reactive T cell lines generated from SARS-CoV-2-naive healthy donors responded similarly to the C-terminal region of the spike proteins of the human endemic coronaviruses 229E and OC43, as well as that of SARS-CoV-2. This results indicate that spike-protein cross-reactive T cells are present, which were probably generated during previous encounters with endemic coronaviruses. The effect of pre-existing SARS-CoV-2 cross-reactive T cells on clinical outcomes remains to be determined in larger cohorts. However, the presence of spike-protein cross-reactive T cells in a considerable fraction of the general population may affect the dynamics of the current pandemic, and has important implications for the design and analysis of upcoming trials investigating COVID-19 vaccines

Cross-reactive CD4+ T cells enhance SARS-CoV-2 immune responses upon infection and vaccination

The functional relevance of pre-existing cross-immunity to SARS-CoV-2 is a subject of intense debate. Here, we show that human endemic coronavirus (HCoV)-reactive and SARS-CoV-2-cross-reactive CD4+ T cells are ubiquitous but decrease with age. We identified a universal immunodominant coronavirus-specific spike peptide (S816-830) and demonstrate that pre-existing spike- and S816-830-reactive T cells were recruited into immune responses to SARS-CoV-2 infection and their frequency correlated with anti-SARS-CoV-2-S1-IgG antibodies. Spike-cross-reactive T cells were also activated after primary BNT162b2 COVID-19 mRNA vaccination displaying kinetics similar to secondary immune responses. Our results highlight the functional contribution of pre-existing spike-cross-reactive T cells in SARS-CoV-2 infection and vaccination. Cross-reactive immunity may account for the unexpectedly rapid induction of immunity following primary SARS-CoV-2 immunization and the high rate of asymptomatic/mild COVID-19 disease courses

Niedriglohnentwicklung und Lohnungleichheit im Vergleich:Der Einfluss kollektiver Akteure

Looking at the Netherlands, Austria and Germany, this article shows that the differing development of tariff systems in Europe is accompanied by different dynamics of low-wage employment and wage inequality. In doing so, the authors complement institutional explanations as emphasised in the literature with an analysis of the strategies of the social partners and the state. The results can be summarised as follows: In Austria with its stable and comprehensive tariff system, employers have only partly been able to enforce their aim of increased flexibility. However, in conjunction with a strategy of safeguarding jobs, unions have accepted moderate wage inequality and a moderate share of low-wage work. In the Netherlands, despite institutional stability unions have not been successful with their solidaristic wage policy because the government pushed ahead the relative lowering of lower wages. In Germany, unions have successfully fought for a statutory minimum wage, thus reducing wage inequality. However, in order to reduce the high share of low-wage earners, further measures to stabilise the tariff system seem to be necessary

Strong-field-induced single and double ionization dynamics from single and double excitations in a two-electron atom

Two-electron dynamics of an excited model atom interacting with moderately strong laser fields is analyzed in the time domain. We solve the time-dependent Schrödinger equation (TDSE) for two electrons confined to the same one-dimensional configuration space, accounting also for the electron-electron interaction. The computational method allows direct access to the time-dependent population of the relevant atomic states during and right after the interaction with a near-infrared (NIR) laser pulse. We compare the ionization dynamics of singly excited states and doubly excited states. We find that doubly-excited initial states exhibit enhanced double ionization yield, with non-trivial dynamics including contributions from direct and sequential processes, while the electrons leave the atom either back-to-back or in the same direction