–1 programmed ribosomal frameshifting (–1PRF) is a fundamental recoding process that makes alternative reading frames accessible during translation. Especially RNA viruses rely on this mechanism to regulate gene expression for example while main- taining the correct stoichiometry of replicative enzymes and structural proteins. –1PRF is at the heart of viral replication and it has been shown that perturbations of –1PRF efficiency can have dramatic effects on viral fitness. In the present work, two viral –1PRF elements were studied: severe acute respi- ratory syndrome coronavirus 2 (SARS-CoV-2) ORF1 a/b and human immunodeficiency virus 1 (HIV-1) gag-pol. In a mutational study of the SARS-CoV-2 –1PRF element it was confirmed that it functions in its pseudoknot conformation. Additionally, through mutagenesis as well as targeting by antisense oligonucleotides, it was shown that the structure of the RNA directly correlates to –1PRF efficiency. Next, protein interactors of both –1PRF elements were captured revealing over 100 interactors for SARS-CoV-2 and almost 50 for HIV-1. Through this, a set of 18 core interactors of the unrelated –1PRF elements of SARS-CoV-2 and HIV-1 was identified. Among those, the two proteins HNRNPH1 and ZNF346 were shown to reduce –1PRF efficiency significantly for both sites. Among the interactors of SARS-CoV or HIV-1 alone, the strongest effect was mediated by ZAP-S for SARS-CoV-2 and SRBD1 for HIV-1. Finally, it was shown that overexpression of ZAP-S reduced the replication of SARS- CoV-2 by 95% in collaboration with the group of Prof. Dr. Čičin-Šain. In addition, using pseudotyped HIV-1 particles, overexpression of SRBD1 reduced RTase levels and by extension viral titers by 90%. / Das –1 programmierte ribosomale Frameshifting (–1PRF) ist ein grundlegender Umkodierungsprozess, der alternative Leseraster während der Translation zugänglich macht. Insbesondere RNA-Viren sind auf diesen Mechanismus angewiesen, um beispielsweise die Genexpression zu regulieren und gleichzeitig die korrekte Stöchiometrie der replizierenden Enzyme und Strukturproteine aufrechtzuerhalten. Das –1PRF ist das Herzstück der viralen Replikation, und es hat sich gezeigt, dass Störungen der –1PRF-Effizienz dramatische Auswirkungen auf die virale Fitness haben können. In der vorliegenden Arbeit wurden zwei virale –1PRF-Elemente untersucht: das Coronavirus 2 des schweren akuten Respirationssyndroms (SARS-CoV-2) ORF1 a/b und das humane Immunschwächevirus 1 (HIV-1) gag-pol. In einer Mutationsstudie des SARS-CoV-2 –1PRF-Elements wurde bestätigt, dass es in seiner Pseudoknotenkonformation funktioniert. Darüber hinaus wurde durch Mutagenese sowie durch Targeting mit Antisense-Oligonukleotiden gezeigt, dass die Struktur der RNA direkt mit der –1PRF-Effizienz korreliert. Als Nächstes wurden die Protein-Interaktoren beider –1PRF-Elemente erfasst, wobei über 100 Interaktoren für SARS-CoV-2 und fast 50 für HIV-1 gefunden wurden. Auf diese Weise wurde eine Gruppe von 18 Kerninteraktoren der nicht miteinander verbundenen –1PRF-Elemente von SARS-CoV-2 und HIV-1 identifiziert. Unter diesen konnten die beiden Proteine HNRNPH1 und ZNF346 die –1PRF-Effizienz an beiden Stellen deutlich verringern. Unter den Interaktoren von SARS-CoV oder HIV-1 allein wurde die stärkste Wirkung durch ZAP-S für SARS-CoV-2 und SRBD1 für HIV-1vermittelt. Schließlich wurde in Zusammenarbeit mit der Gruppe von Prof. Dr. Čičin-Šain gezeigt, dass die Überexpression von ZAP-S die Replikation von SARS-CoV-2 um 95% reduziert. Darüber hinaus reduzierte die Überexpression von SRBD1 unter Verwendung von pseudotypisierten HIV-1-Partikeln die RTase-Werte und damit auch die Virustiter um 90%.

The aim of this diploma thesis was to describe information about SARS-CoV-2 virus and coronavirus disease (COVID-19), to evaluate the course of the disease in the Home with a special regime in Břevnice, in which the epidemic took place at the beginning of the first wave of COVID-19 pandemic in spring 2020. Another goal was to perform an antibody analysis and evaluate the obtained data. I divided the diploma thesis into three main parts: theoretical, experimental and discussion. In the theoretical part, I worked with the literature and described information related not only to COVID-19, but also to other serious infections caused by human coronaviruses. In the experimental part, which I performed in the immunological laboratory of the Department of Joint Laboratories at Havlíčkův Brod Hospital, I dealt with the issue of the clinical course of the disease, the severity of the disease and possible consequences after the infection. I also dealt with methods for the determination of antibodies, the principles of which are described in Chapter 4.5. The diagnostic methods and procedures used are described in Chapter 5.3 Laboratory Assays. From the obtained data, I prepared graphs and tables and processed data on the clinical course of the infection in the Břevnice Home, both for the clients and the...

Se validó y evaluó un método de RT-PCR en tiempo real usando cebadores y sondas específicas para los genes RdRP de SARS-CoV-2 y GAPDH de humanos; este último fue usado como control endógeno. Se evaluó la especificidad y sensibilidad; además, se evaluó otros parámetros como la robustez, la repetibilidad, reproducibilidad, comparabilidad y el límite de detección. La sensibilidad, especificidad, los valores predictivos positivo y negativo, la robustez, comparabilidad y la repetibilidad-reproducibilidad de la prueba de RT-PCR en tiempo real dúplex fue de 100%, con un límite de detección de 100 copias/μL, de acuerdo con los criterios de aceptación establecidos para validación del protocolo. Esta prueba estandarizada es una buena alternativa para el diagnóstico de COVID-19; además, la prueba fue aplicada de manera exitosa en personas sospechosas de la enfermedad permitiendo controlar el número de falsos negativos.

El virus SARS-CoV-2 sigue reproduciéndose velozmente y muestra variantes más infecciosas. La segunda ola de la enfermedad va apaciguándose en Europa y Estados Unidos de América del Norte, menos en América del Sur. En el Perú, las cifras de fallecidos han sido sinceradas a más del doble, encontrándose mayor mortandad en los hombres y en los mayores de 70 años. Se ha corroborado en el mundo que la gestante sufre una enfermedad más severa -a veces con un proceso similar a la preeclampsia-, con más posibilidad de muerte que la mujer no gestante y mayor muerte fetal y prematuridad. Las vacunas iniciales elaboradas en los EE UU y Europa están siendo efectivas en disminuir las infecciones, hospitalizaciones y muertes en los países donde la vacunación ha avanzado más rápido. Está siendo administrada en gestantes sin efectos secundarios mayores, recomendándoseles se vacunen para evitar la infección severa. Mientras tanto, no se conoce la duración de la inmunidad dada por la infección COVID-19 y por la vacuna. Se está considerando una tercera dosis de refuerzo y el cambio de marca en los vacunados. Y se está en espera de una tercera ola de infecciones debido a la aparición de las variantes brasilera e india (delta). / The SARS-CoV-2 virus continues to reproduce rapidly and is showing more infectious variants. The second wave of the pandemic is subsiding in Europe and the United States of North America, but not in South America. In Peru, the number of deaths has more than doubled, with a higher mortality rate in men and in those over 70 years of age. It has been corroborated worldwide that pregnant women suffer a more severe disease -sometimes with a process similar to preeclampsia- with a greater possibility of death than non-pregnant women and greater fetal death and prematurity. Initial vaccines developed in the USA and Europe are proving effective in reducing infections, hospitalizations and deaths in countries where vaccination has advanced more rapidly. It is being administered in pregnant women without major side effects, and they are recommended to be vaccinated to avoid severe infection. As of now, the duration of immunity given by COVID-19 infection and by the vaccine is not known. A third booster dose and rebranding of vaccinees is being considered. And a third wave of infe ergence of the Brazilian and Indian (Delta) variants.

Bakgrund: Den pågående pandemin COVID-19 orsakas av viruset SARS-CoV-2. Sedan december 2020 har nya varianter av viruset med betydande genetiska förändringar upptäckts, gemensamt benämnt varianter av särskild betydelse eller variants of concern (VOC). Just nu är det tre VOC som bevakas särskilt; B.1.1.7 (först upptäckt i Storbritannien), B.1.351 (först upptäckt i Sydafrika) respektive P.1 (först upptäckt i Brasilien). Den tidigaste statistiken från Folkhälsomyndigheten om förekomsten av VOC i Region Dalarna är från februari 2021. Förekomsten av VOC innan dess är fortfarande okänd. I regionen delas analysering av prover vid misstanke om COVID-19 in i de olika kategorierna patienter, vårdpersonal, smittspårning och allmänhet. Befintlig statistik om förekomsten av VOC grundar sig nästan enbart på förekomsten bland allmänhetens prover. Syfte: Syftet med denna studie var att undersöka förekomsten av SARS-CoV-2 varianter av särskild betydelse i prover tagna från patienter, vårdpersonal och smittspårningar under december 2020-januari 2021 i Region Dalarna. Studien syftade också till att undersöka när spridningen av respektive VOC kan ha startat i regionen. Metod: Provmaterialet bestod av SARS-CoV-2 positiva prov tagna inom analyskategorierna under tidsperioden. Prover analyserades med RT-PCR och smältkurvsanalys för detektion av VOC-karaktäristiska mutationer. Resultat: Ett fåtal fall av B.1.1.7 detekterades redan i december och en stigande andel av B.1.1.7 påvisades inom analyskategorierna under januari, som tecken på att en regional spridning kan ha startat vid tidpunkten. Endast ett fåtal fall av B.1.351 och/eller P.1 detekterades inom analyskategorierna under tidsperioden, vilket tyder på att en regional spridning av dessa ännu inte hade startat i januari. / Background: The ongoing pandemic COVID-19 is caused by the virus SARS-CoV-2. Since December 2020 new variants of the virus with significant mutations have been discovered, referred to as variants of concern (VOC). At the point, the occurrence of three VOC is especially monitored; B.1.1.7 (discovered in UK), B.1.351 (discovered in South Africa) and P.1 (discovered in Brazil). The earliest statistics about the occurrence of VOC in Region Dalarna, Sweden, is from February 2021 and the occurrence before that is still unknown. In the region analysis of specimen in case of suspected COVID-19 is divided into the different categories patients, healthcare-staff, infection tracing and public. Existing statistics is based almost exclusively on the occurrence of VOC in specimen from the public. Aim: The aim of this study was to examine the occurrence of SARS-CoV-2 VOC among specimens collected from patients, healthcare staff and infection tracing in Region Dalarna during December 2020-January 2021. The study also aimed to examine when the spread of each VOC started in the region. Method: SARS-CoV-2 positive specimen collected within the categories during the time was analyzed with RT-PCR and melting curve analysis for detection of VOC-characteristic mutations. Results: A few cases of B.1.1.7 was detected already in December and an increased percentage of B.1.1.7 was detected within the categories during January, suggesting that a regional spread started at the time. Only a few cases of B.1.351 and/or P.1 was detected within the categories, suggesting that a regional spread of these had not yet started in January.

I mars 2020 drabbades världen av en pandemi kopplat till viruset Covid-19 (SARS-CoV-2). I Sverige som i resten av världen har sjukvårdspersonalen varit tvungna att jobba under hög belastning i stressiga arbetssituationer som resultat av denna pandemi. Syftet med studien var att undersöka vilka faktorer som spelade roll för att vårdpersonalen skulle orka med det stressiga jobbet under en ovanlig situation som covid-19 pandemin. Till denna studie valdes kvalitativ design med en tematisk induktiv analys. Resultatet visade att kollegornas stöd, tydliga instruktioner från närmaste chefer, känslan av stolthet för att kunna klara av situationen tillsammans med andra samt personliga strategier var positiva faktorer som hjälpte vårdpersonalen att kunna klara av arbetet. Medan sjukvårdspersonalen upplevde att stöd från högre ledningen och samhällets ansvar inte var tillräckligt. / In March 2020, the world was hit by a pandemic linked to the Covid-19 (SARS-CoV-2) virus. In Sweden, as in the rest of the world, healthcare professionals had to work under high load in stressful work situations as a result of this pandemic. The purpose of this study was to investigate what factors played a role in the care staff being able to cope with the stressful job during an unusual situation such as the pandemic. For this study, qualitative design with a thematic inductive analysis was chosen. The results showed that the colleagues' support, clear instructions from immediate managers, the feeling of pride in being able to cope with the situation together with others and personal strategies were positive factors that helped the care staff to cope with the work load. While the health care staff felt that support from senior management and the responsibility of society was not enough.

Inledning: God vårdhygien är ett centralt begrepp inom all hälso- och sjukvård för att förhindra spridning av sjukdomsframkallande mikroorganismer, vilka kan ge upphov till vårdrelaterade infektioner. Tandvården ska därför följa Hälso- och sjukvårdslagen (1982:763) och Socialstyrelsens föreskrifter om basala hygienrutiner. I samband med Covid-19 pandemin aktualiserades vikten av vårdhygien ytterligare för att förhindra smittspridning av Covid-19 inom tandvården. Munhålan utgör en stor potentiell risk för överföring av SARS-CoV-2, men även andra mikroorganismer, särskilt vid aerosolgenererande procedurer.  Ett tidigare mastersarbete vid Odontologiska fakulteten, Malmö Universitet, påvisade brister i följsamheten med basala hygienrutiner bland tandläkarstudenter. En uppföljning har inte genomförts, vilket uppmärksammades i samband med pandemin och frågeställningen om Covid-19 syn på betydelsen av aseptik och vårdhygien väcktes.  Syfte: Undersöka tandläkarstudenters syn på vårdhygien och självbedömd följsamhet med hygienriktlinjer under Covid-19.  Material och metod: En anonym webbenkät skickades till samtliga tandläkarstudenter på kurs 4–10 vid Odontologiska fakulteten, Malmö Universitet.  Resultat: Den totala svarsfrekvensen var 54%. Resultat visade att samtliga studenter ansåg sig ha tillräckliga kunskaper om hygienrutinerna, men trots detta bröt 20% medvetet mot hygienrutinerna och 4% uppgav att de aldrig följde hygienrutinerna.  Slutsats: Den självbedömda kunskapen om hygienriktlinjer är hög, trots det är inte följsamheten med hygienriktlinjerna optimal, vilket innebär att det finns risk för spridning av vårdrelaterade infektioner. / Introduction: Good hygiene is imperative to prevent the spread of health care associated infections. Dental care must therefore comply with the Health and Medical Services Act (1982: 763) and the National Board of Health and Welfare's regulations on basic hygiene guidelines. In conjunction with the Covid-19 pandemic, the importance of hygiene measures was further emphasized to prevent the spread of Covid-19 in dentistry. The oral cavity poses a high potential risk for transmission of SARS-CoV-2, in addition to other microorganisms, especially in aerosol-generating procedures.  A previous master's thesis at the Faculty of Odontology, Malmö University, showed a deficiency in compliance with hygiene guidelines among dental students. The question if Covid-19 view of the importance of aseptic techniques and hygiene measures in dentistry was therefore raised.  Aim: Investigate dental students' views of healthcare hygiene and self-assessed aseptic measures during Covid-19.  Materials and method: An anonymous web survey was sent to all dental students in courses 4–10 at the Faculty of Odontology, Malmö University.  Results: The overall response rate was 54%. Results showed that all students considered themselves to have sufficient knowledge of the hygiene routines, but despite this, 20% of students deliberately broke the hygiene routines and 4% stated that they never followed the hygiene routines.  Conclusion: The self-assessed awareness of hygiene guidelines and aseptic techniques is high among the students, still the compliance with hygiene protocols is not optimal, meaning there is a risk of spread of healthcare associated infections.

Objetivo: Identificar los factores influyentes en la postura ante la inmunización SARSCoV-2 en estudiantes de medicina de una universidad de Lambayeque en el año 2021. Materiales y métodos: Se realizó un estudio tipo observacional transversal analítico. Se tomó a toda la población elegible,que constó de aproximadamente 160 estudiantes y se distribuyó con un muestreo probabilístico tipo estratificado. El cuestionario elaborado se basó en la encuesta online de la Organización de Consumidores y Usuarios (OCU) titulada “Encuesta OCU: los españoles y la vacuna” que fue realizada en España. Para el análisis estadístico se empleó la herramienta estadística IBM SPSS Statistics 25.0.0.0. Se tabularon las variables categóricas para la distribución de frecuencia y porcentajes, y se realizó un análisis bivariado entre las variables de interés y las variables de desenlace, mediante la prueba exacta de Fisher. Resultados: Se encuestó a 155 de 160 universitarios, el 94,8% fueron jóvenes (18-25 años). El semestre académico que representó mayor porcentaje fue octavo ciclo. La mayoría de los ítems del cuestionario obtuvieron el puntaje de 3 puntos según la escala de Likert. El 96,8% de universitarios manifestaron que sí se vacunarían tan pronto como pudieran. Se obtuvo que el factor influyente en la postura ante la inmunización SARS-CoV-2 fue el de la efectividad de la vacuna reduciendo la mortalidad por COVID – 19. Conclusiones: Se concluye que la mayoría de los estudiantes se encontraron a favor de la vacunación. Además, la efectividad de la vacuna reduciendo la mortalidad por COVID-19, fue el único factor influyente. / Objective: To identify the influential factors in the posture before SARS-CoV-2 immunization in medical students of a Lambayeque university in the year 2021. Materials and methods: An analytical cross-sectional observational study was carried out. The entire eligible population was taken, which consisted of approximately 160 college students and was distributed with a stratified probabilistic sampling. The questionnaire prepared was based on the online survey of the Organization of Consumers and Users (OCU) entitled "OCU Survey: Spaniards and the vaccine" that was carried out in Spain. For the statistical analysis, the statistical tool IBM SPSS Statistics 25.0.0.0 was used. Categorical variables were tabulated for frequency distribution and percentages, and a bivariate analysis was performed between the variables of interest and the outcome variables, using Fisher's exact test. Results: 155 of 160 university students were surveyed, 94.8% were young (18-25 years). The semester of studies that represented the highest percentage was eighth cycle. Most of the ítems in the questionnaire obtained a score of 3 points according to the Likert scale. 96.8% of university students stated that they would get vaccinated as soon as they could. It was found that the influential factor in the posture before SARS-CoV-2 immunization was the effectiveness of the vaccine in reducing mortality from COVID-19. Conclusions: It is concluded that the majority of students were in favor of vaccination. Also, the effectiveness of the vaccine in reducing mortality from COVID-19 was the only influential factor.

Bakgrund, de restriktioner och rekommendationer som människor fått förhålla sig till under COVID-19 pandemin har inneburit en annorlunda och förändrad vardag. En grupp som blivit drabbad är högskole- och universitetsstudenter som bland annat fått byta de fysiska klassrummen mot diverse online plattformar. Tidigare forskning har utförts, men hur aktivitetsmönstret har förändrats är dock mindre utforskat. Syftet med studien var att kartlägga förändring i aktivitetsmönstret hos högskole- och universitetsstudenter under COVID-19 pandemin. Metoden som användes hade en kvantitativ design i form av tvärsnittsstudie. Ett bekvämlighetsurval användes och respondenter rekryterades via sociala medier (Facebook). Populationen bestod av 49 studenter. Deskriptiv statistik användes för att beskriva insamlade data. Resultatet visade på en förändring i studenternas aktivitetsmönster och en koppling mellan förlust av meningsfulla aktiviteter, nöjdhet gällande sin aktivitetsfördelning samt upplevd vardagsbalans kunde urskiljas. Slutsats, övergripande hade förändringarna i studenternas aktivitetsmönster påverkats till det negativa. Författarna till föreliggande studie har en förhoppning om att studien ska leda till ökad förståelse gällande människors aktivitetsmönster som relaterar till den hälsoproblematik som kan uppstå under situationer som den rådande COVID-19 pandemin. / Background, this thesis describes the restrictions and recommendations that people have had to follow during the COVID-19 pandemic, and how these have led to a different and altered everyday life. College- and University students are one group that have been affected, especially since they had to switch from in-person learning to online platforms. There have been prior studies regarding the health of students and how their health has been affected during the pandemic, however the extent to which the occupational pattern of students has changed has been less explored. The purpose of this study was to investigate the change in student’s occupational patterns during the COVID-19 pandemic. The method that was used was a quantitative design. A convenience sample was used, and the respondents were recruited through social media platforms (Facebook). The population included 49 students. Descriptive statistics were used to describe the data that was collected from the survey. Results, the study showed a change in student’s occupational patterns during the COVID-19 pandemic and a connection was seen between loss of meaningful activities, satisfaction regarding their activity distribution, and perceived everyday balance. In conclusion, the overall changes in student’s occupational patterns had a negative effect. The authors expect that this study will lead to a higher understanding of the occupational patterns that relate to the health problems that can occur during situations such as the COVID-19 pandemic.

Bakgrund: Covid-19 pandemin som orsakades av Sars-Cov-2-viruset innebar en betydande utmaning för världen. I synnerhet påverkades hälso- och sjukvården av dess framfart. Sjuksköterskor som arbetade inom slutenvården under denna tid var särskilt utsatta och föremål för en rad olika upplevelser både positiva och negativa. Dessa erfarenheter är värdefulla att analysera för att bättre kunna hantera kommande pandemier. Syfte: Att undersöka sjuksköterskors upplevelser inom slutenvården under covid-19 pandemin. Metod: Litteraturöversikt genomförd i enlighet med Fribergs metod. Elva kvalitativa originalartiklar valdes från databaserna PubMed och Cinahl Complete för analys. Resultat: Tre huvudteman identifierades vilka var: Rädsla, Osäkerhet och Sjuksköterskans upplevelser rörande yrkesrollen. Slutsats: Rädsla var en dominerande upplevelse bland sjuksköterskor och antog ett flertal olika former. Sjuksköterskor upplevde även osäkerhet relaterat till det oklara kunskapsläget, föränderlig information, den egna kompetensen samt brist på material och personal. Sjuksköterskor upplevde både positiva och negativa känslor relaterade till yrkesrollen. Förberedelse i form av utbildning av sjuksköterskor och allmänhet, genomtänkta rutiner och riktlinjer samt förbättrad lagerhållning av skyddsmaterial är viktigt för att minska negativa effekter under kommande pandemier. / Background: The Covid-19-pandemic caused by the Sars-Cov-2-virus constituted a significant challenge for the world. In particular the healthcare systems were affected during its course. Nurses working within inpatient care were especially vulnerable and might have had several different experiences, which could be either negative or positive. These experiences are valuable and worth analyzing in order to be better prepared for forthcoming pandemics. Aim: To analyze nurses´experiences in inpatient care during the Covid-19 pandemic. Method: A literary overview conducted in accordance with the method of Friberg. Eleven qualitative original articles were selected from the databases PubMed and Cinahl Complete and analyzed. Results: Three main themes were identified which were: Fear, uncertainty and nurses experiences related to the profession. Conclusions: Fear was a dominant experience among nurses and took a variety of forms. Nurses also experience uncertainty related to the unclear state of knowledge, changing information, their own competence and due to a shortage of materials and other staff. Nurses experienced both positive and negative emotions in relation to their profession. Preparation in the form of eduaction for both nurses and the general public, well-thought-out routines and guidelines as well as improved stockpiling of protective equipment is essential to reduce the negative effects of future pandemics.