[The Psychological Distress of First-Line Nurses Caring for COVID-19 Patients: A Systematic Review].

BACKGROUND: The World Health Organization officially declared an end to the COVID-19 Public Health Emergency three years after the initial outbreak of COVID-19. Healthcare providers worldwide were overwhelmed during the pandemic, which greatly affected the mental health and turnover intention of nurses. Conducting a systematic review of psychological distress in first-line nurses during the pandemic may facilitate future research on pandemic-related resilience. PURPOSE: A systematic review of the literature on psychological distress among first-line nurses caring for patients with COVID-19 was conducted. METHODS: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 Statement. We searched the CINAHL, PubMed, Embase, and Airiti Library databases using the English and Chinese keywords ("COVID-19 first-line nurse" OR "COVID-19 frontline nurse") AND ("psychological distress" OR "PTSD" OR "depression" OR "anxiety" OR "insomnia" OR "stress" OR "burnout" OR "fear") to identify Chinese and English articles published between December 2019 and March 2023. The quality of the included studies was assessed using tools from the Joanna Briggs Institute. RESULTS: A total of 20 articles covering 16 quantitative studies and 4 qualitative studies were included in the analysis. The quantitative findings revealed that first-line nurses experienced high task load and moderate or above-average burnout. Between 19.1% and 72.3% of the first-line nurses reported stress, and more than 30% experienced insomnia. At the peak of the pandemic, anxiety and distress levels were high. At 8-week follow-ups, while anxiety had decreased, distress levels had not. Qualitative findings included the identification of fear as a common symptom of psychological distress in first-line nurses. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Further research is needed to better support frontline caregivers and facilitate their recovery from the moderate to severe psychological distress associated with pandemics.

Health-related quality of life predicts length of hospital stay and survival rates for pediatric patients receiving allogeneic hematopoietic cell transplantation.

PURPOSE: We examined the association between health-related quality of life (HRQoL) of pediatric patients during hospitalization for allogeneic hematopoietic cell transplantation (HCT) and length of hospital stay, and 1-year survival. METHODS: Primary family caregivers were proxy-assessors for the Pediatric Quality of Life (PedsQL) Stem Cell Transplant Module at three time points: 5-days pre-HCT (T0); 14-days post-HCT (engraftment, T1); and 1-week before hospital discharge (T2). Cox regression analyses determined predictors of the overall 1-year survival after allogeneic HCT. RESULTS: Thirty-nine eligible caregivers completed all assessments. The mean age of the pediatric patients was 9.07 years (SD = 5.2). PedsQL Stem Cell Transplant Module scores decreased from 71.33 (SD = 13.26) at T0 to 55.41(SD = 13.05) at T1 (p < 0.001) and increased to 68.46 (SD = 13.97) at T2 (p < 0.001). There was no significant difference between scores at T0 and T2. Longer length of hospital stay was associated with children who were younger and had greater relative changes in scores on the caregiver-proxy PedsQL Stem Cell Transplant Module from T0 to T1. PedsQL Stem Cell Transplant Module scores ≥ 58.07 at T2 were associated with higher 1-year survival rates (Hazard Ratio = 0.12, 95% Confidence Interval = 0.02-0.78; p = 0.03). CONCLUSION: Our findings suggest that assessment of HRQoL during early HCT can add prognostic value beyond demographic and HCT factors. Understanding the HRQoL status during hospitalization for HCT could help identify pediatric patients with low prospects of 1-year survival in order to provide support interventions to improve HRQoL and survival rates.

[Challenges to the Nursing Practicum During the COVID-19 Pandemic].

The COVID-19 pandemic has greatly impacted first-line medical staff as well as nursing-student clinical practicum programs. How to cooperate with the government's pandemic-prevention policies and reduce the gap between education and clinical practice represent significant challenges. In this paper, Chang Gung University of Science and Technology (CCUST) is used as an example to show how schools in Taiwan have effectively adapted the fundamentals of nursing practicum programs to the current pandemic using e-learning, group discussions, case analysis, clinical skill practice, and clinical case simulation scenario exercises. The program at CCUST both takes into account the safety of students and has achieved all critical nursing practice goals. After implementation of these adjustments, satisfaction among nursing students with the practicum environment and the clinical instructors was found to be significantly higher for the on-campus clinical practicum than for the off-campus clinical practicum. Furthermore, the results of qualitative data analyses show that nursing students in the on-campus practicum gained significant knowledge and experience and commented positively on their experience. For example, the students indicated that they were satisfied with the simulated clinical environment of the CCC, the teaching strategies and adaptability of the instructor, and the application of virtual reality scenario cases to enhance skill proficiency and learning outcomes. The adjusted nursing clinical practicum described in this paper may be used as a reference to ensure the quality of nursing clinical practicum programs is maintained during epidemics.

Risk Factors in and Long-Term Survival of Patients with Post-Transplantation Diabetes Mellitus: A Retrospective Cohort Study.

Post-transplant diabetes mellitus (PTDM) is associated with infection, cardiovascular morbidity, and mortality. A retrospective cohort study involving patients who underwent renal transplantation in a transplantation center in Taiwan from January 2000 to December 2018 was conducted to investigate the incidence and risk factors of PTDM and long-term patient and graft survival rates. High age (45-65 vs. <45 years, adjusted odds ratio (aOR) = 2.90, 95% confidence interval (CI) = 1.64-5.13, p < 0.001), high body mass index (>27 vs. <24 kg/m2, aOR = 5.35, 95% CI = 2.75-10.42, p < 0.001), and deceased organ donor (cadaveric vs. living, aOR = 2.01, 95% CI = 1.03-3.93, p = 0.04) were the three most important risk factors for the development of PTDM. The cumulative survival rate of patients and allografts was higher in patients without PTDM than in those with PTDM (p = 0.007 and 0.041, respectively). Concurrent use of calcineurin inhibitors and mammalian target of rapamycin inhibitors (mTORis) decreased the risk of PTDM (tacrolimus vs. tacrolimus with mTORi, aOR = 0.28, 95% CI = 0.14-0.55, p < 0.001). Investigating PTDM risk factors before and modifying immunosuppressant regimens after transplantation may effectively prevent PTDM development.

Effectiveness of a Three-Stage Intervention in Reducing Caregiver Distress During Pediatric Hematopoietic Stem Cell Transplantation: A Randomized Controlled Trial.

More than one fourth of primary caregivers report clinically significant distress during the hematopoietic stem cell transplantation (HSCT) process. Providing early support to primary caregivers could reduce caregiver distress and improve the quality of life. This study examined the effects of a three-stage caregiver support intervention designed to reduce caregiver distress and improve quality of life during pediatric HSCT hospitalization. A two-group comparative study was conducted with repeated measures. Participants were randomly assigned to an intervention group or a control group. The intervention group received the support intervention 5 days before the transplant, 14 days after transplant, and 1 week before hospital discharge. The control group received standard support provided in the hospital ward. Measures were obtained at all three time points from self-report questionnaires, which were related to anxiety, depression, perceived stress, and quality of life. Findings indicated that primary caregivers in the intervention group (n = 22) reported significantly lower levels of perceived stress and higher levels of quality of life than the control group (n = 23) at 14 days after transplant. In the intervention group, caregiver distress significantly decreased from pretransplant through 14 days after transplant, while over the same period caregiver quality of life significantly increased. The intervention effectively changed the trend of distress and quality of life for caregivers of children during the process of HSCT and hospitalization. The findings of this study suggest that it is important to provide early targeted interventions at critical junctures for caregivers at risk of adverse outcomes.

Exploring the concerns and experiences of parents of children scheduled to receive haematopoietic stem cell transplant.

AIMS: To explore the concerns and experiences of parents of children scheduled to receive allogeneic haematopoietic stem cell transplantation. DESIGN: A qualitative secondary analysis of interview data from an intervention study. METHODS: A total of 28 parents (4 fathers and 24 mothers) were recruited from a children's hospital, which performs approximately one-third of all paediatric haematopoietic stem cell transplantation cases in Taiwan. Data were collected between September 2015-August 2018 by one researcher with face-to-face interviews, which were tape-recorded and transcribed verbatim. The data were analysed using inductive content analysis to extract the main themes. RESULTS: Five themes describing parental concerns prior to paediatric haematopoietic stem cell transplantation were identified: the child became their first priority, seeking solutions, an interweaving of hope and uncertainty, grateful for the chance of a cure and the long road to recovery. CONCLUSION: Understanding the concerns and experiences of our participants as they navigated the pre-transplantation period could reduce parents' uncertainty and improve the care of their child. IMPACT: These experiences provide information that could be used by healthcare professionals to develop support interventions and strategies tailored to the individual needs of each parent, which could prepare parents for their child's haematopoietic stem cell transplantation.

Comparison of the effectiveness of teaching strategies for a pediatric pain management program for undergraduate nursing students: A quantitative evaluation using an objective structured clinical examination.

Pain is a common experience for hospitalized children; however, nursing students are often not adequately trained in pediatric pain management. Innovative teaching strategies, such as e-learning, have been employed for instructing students, however success of these platforms has not been quantitatively measured. This study compared students' knowledge and skill performance following a researcher-designed pain management program administered with three teaching strategies: traditional face-to-face, e-learning, or blended learning. Undergraduate nursing students in Taiwan (N = 296) randomly assigned to one of the teaching strategies participated. Knowledge of pain management, and pain management skills were quantified. A subjective assessment of attitudes towards learning found no significant difference between groups. Knowledge of pediatric pain management did not differ significantly between groups (p = 0.36). A 15-item objective structured clinical examination (OSCE) measured the competency of pain management skills; scores were not significantly different, regardless of teaching strategy (p = 0.70). Traditional face-to-face teaching was as effective as both innovative strategies. Evaluating students' skills following a pain management program with an OSCE provided a quantitative assessment of competency. Innovative strategies for teaching pediatric pain management could be a cost-effective way to provide flexible learning opportunities for nursing students who are distant from educational institutions.

Improving medication safety by cloud technology: Progression and value-added applications in Taiwan.

OBJECTIVES: To develop and implement an integrated cloud technology with the aim of ensuring medication reconciliation during transitions of care and improve medication safety in aged societies. METHODS: PharmaCloud is a new technical platform adopted by the National Health Insurance Administration of Taiwan to collect patients' medication information via cloud technology. Using this platform, healthcare providers can access patients' medication-related information with patient consent. Our hospital applied this technology and developed several approaches to collect and detect medication-related information and alert physicians for the purpose of enhancing patients' medication safety. In addition, pharmacists were involved in the admission process to access medication data and provide optimal suggestions to physicians. Several indicators, including a reduction in the number of drug items in each prescription and medication expenditure, were employed to evaluate the overall effects of the cloud inquiry. RESULTS: After the application of PharmaCloud, the average number of prescribed drug items significantly decreased (change of 0.04 to -0.35 per prescription, p < 0.05), and the median medication expenditure significantly decreased by an average of 3.55 USD, (p < 0.05) per prescription. Intra-hospital medication duplication rates also showed a downward trend. CONCLUSIONS: The use of the cloud technology and value-added applications significantly improved patient medication safety. Further long-term beneficial effects in terms of medication safety and medical cost savings are expected.

First assessment of interferon gamma release assay results among healthcare workers at a general hospital in China.

INTRODUCTION: China has a very high tuberculosis (TB) burden. The interferon-gamma release assay (IGRA) is more specific for the diagnosis of latent tuberculosis infection (LTBI) than the tuberculin skin test, especially among populations with a high degree of coverage by the BCG vaccine. OBJECTIVES: To evaluate the first screening of healthcare workers (HCW) for LTBI using the IGRA at a general hospital in Beijing. METHODS: A pilot screening program for LTBI was triggered by accidental contact between HCW and two patients with active TB in the emergency department (ED). Given the necessity of estimating the overall LTBI prevalence in the institution, a sample of 518 HCW was enrolled in our cross-sectional study. The second IGRA was repeated with 43 of the 121 HCW in the ED after exposure to index TB cases. Data on putative risk factors were collected with a self-administered questionnaire. RESULTS: The prevalence of LTBI in the targeted population was 21.8%. Differences in the prevalence of LTBI were significantly related to age, employment duration, and history of occupational exposure. A lack of childhood BCG vaccination was independently associated with the prevalence of LTBI (adjusted OR: 1.686, 95% CI: 1.045-2.723, P = .0325). No new LTBI was diagnosed 12 weeks postexposure. No HCW adopted the preventive treatment for LTBI. CONCLUSIONS: Considering the high morbidity of LTBI among HCW even in general hospitals, it is essential to formulate government policies and institutional operation protocols for the systematic screening, registration, and administration of prophylaxes for the control of LTBI.

Evaluating the utility of Binax NOW Streptococcus pneumoniae urinary antigen test in adults with community acquired pneumonia in China.

INTRODUCTION: Binax NOW rapid immunochromatographic membrane test (ICT), a rapid method for detection of Streptococcus pneumoniae antigen, has been used widely in Europe and America, but rarely in China. OBJECTIVE: Our aim is to evaluate the utility of the ICT among adult patients with community acquired pneumonia (CAP) in China. METHODS: Adult patients with CAP were prospectively recruited from 12 general hospitals. ICT tests were done in all patients and clinical data were recorded. Qualified sputum culture was used as the standard for determining the diagnostic usefulness of ICT test. RESULT: Thousand hundred fifty four CAP patients were enrolled in analysis, with median (IQR) age of 48 (35) years. 276 (23.9%) patients had underling diseases, 770 (66.7%) had received antibiotics before ICT test. Overall, the positive rate of ICT test was 3.3%, with sensitivity and specificity 57.9% and 96.6%, respectively. Disease severity, chronic obstructive pulmonary disease (COPD), increased age; respiratory rate (RR), neutrophil ratio, blood urea nitrogen (BUN), procalcitonin (PCT) and the decreased oxygenation index were associated with positive results of ICT tests. Patients with BUN >7 mmol/L, CURB-65 3-5, PCT > 2ng/mL were the top three groups with highest positive rate of ICT test (22.6%, 22.2% and 21.1% respectively). CONCLUSION: ICT test has a moderate sensitivity and high specificity in adults with CAP in China. Patients classified as sever pneumonia, or those with BUN > 7 mmol/L, or PCT > 2 ng/mL are more likely to have positive results.

Differences in inflammatory marker patterns for adult community-acquired pneumonia patients induced by different pathogens.

INTRODUCTION: The inflammatory marker patterns of community-acquired Pneumonia (CAP) induced by different microorganisms in adult patients remained unclear. OBJECTIVES: We aim to explore the inflammatory marker patterns of adult CAP patients induced by different pathogens. METHODS: Adult CAP patients with definite etiologies were enrolled from September 2010 to June 2012. They were divided into three groups according to the causative pathogens: typical bacteria, Mycoplasma pneumoniae (MP), and viruses. Twenty-seven cytokines and bactericidal/permeability-increasing protein (BPI) levels of serum collected within 7 days onset in these groups were compared. RESULTS: One hundred twenty-four cases were enrolled for serum detection and analysis, including 10 typical bacterial pneumonia patients, 56 cases with MP pneumonia and 58 with viral pneumonia. Three kinds (PDGF-BB, IP-10, RANTES) of 27 cytokines and BPI levels were significantly elevated in patients with acute pneumonia than healthy controls. Distinct inflammatory marker patterns were released by different pathogens: typical bacterial pneumonia patients had highest levels of BPI, IL-6, IL-8, IL-1rα; while patients caused by MP presented higher levels of PDGF-BB, IL-17A, G-CSF than those caused by viruses. Rhinovirus owned a higher inflammatory response level than the other viruses. The area under the curve (AUC) of PDGF-BB to differentiate MP and virus infection was biggest, which was 0.708. CONCLUSION: Distinct inflammatory marker patterns were released by different pathogens during acute pneumonia. Significantly increased level of PDGF-BB was observed in acute pneumonia for the first time. It showed a better ability to differentiate MP and virus infection.

[The Establishment and Examination of the Reliability, Validity, Discrimination, and Difficulty of Nursing Objective Structured Clinical Examination (OSCE)].

BACKGROUND: The objective structured clinical examination (OSCE) is one of the evaluation strategies used to examine the clinical competence of nursing students. More attention needs to be paid to establishing an examination that is based on the standardized protocol and on reliability and validity. PURPOSE: The aims of this study were to develop an OSCE that is based on a standardized protocol and to analyze the content validity and predictive validity, inter-rater consistency, internal consistency, item-to-total correlation, and the degree of discrimination and difficulty of this OSCE. METHODS: Based on the blueprint for OSCEs that use an 8-station format, this study used a descriptive, cross-sectional design and a sample population of 207 senior students who were preparing for their last-mile practicum at a nursing technology university in northern Taiwan. The study period lasted from September 2015 to October 2016. Furthermore, the validity, reliability, degree of discrimination, and difficulty of the OSCE were examined. RESULTS: An OSCE with an eight-station format was developed. The content validity index (CVI) was .85-1.0, inter-rater reliability was .80-1.0, Cronbach' alpha internal consistency was .53-.82, and item-to-total correlation was .36-.63. In addition, the level of difficulty of the OSCE was easy to moderate and the discrimination of the OSCE ranged from fair to excellent. Meanwhile, the OSCE scores of the participants appeared to be a valid predictor of scores on the last mile practicum. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: According to the standardized protocol of OSCE development, an 8- station nursing OSCE format is reliable and valid, providing fair levels of difficulty and discrimination. The developed OSCE may be applied to evaluate the clinical competence of nursing students prior to beginning their last mile practicum. The results from the present study may provide a reference for nursing educators who are responsible for developing OSCE evaluation strategies.

The Effect of Hypnosis on Anxiety in Patients With Cancer: A Meta-Analysis.

BACKGROUND: Anxiety is a common form of psychological distress in patients with cancer. One recognized nonpharmacological intervention to reduce anxiety for various populations is hypnotherapy or hypnosis. However, its effect in reducing anxiety in cancer patients has not been systematically evaluated. AIM: This meta-analysis was designed to synthesize the immediate and sustained effects of hypnosis on anxiety of cancer patients and to identify moderators for these hypnosis effects. METHODS: Qualified studies including randomized controlled trials (RCT) and pre-post design studies were identified by searching seven electronic databases: Scopus, Medline Ovidsp, PubMed, PsycInfo-Ovid, Academic Search Premier, CINAHL Plus with FT-EBSCO, and SDOL. Effect size (Hedges' g) was computed for each study. Random-effect modeling was used to combine effect sizes across studies. All statistical analyses were conducted with Comprehensive Meta-Analysis, version 2 (Biostat, Inc., Englewood, NJ, USA). RESULTS: Our meta-analysis of 20 studies found that hypnosis had a significant immediate effect on anxiety in cancer patients (Hedges' g: 0.70-1.41, p < .01) and the effect was sustained (Hedges' g: 0.61-2.77, p < .01). The adjusted mean effect size (determined by Duvan and Tweedie's trim-and-fill method) was 0.46. RCTs had a significantly higher effect size than non-RCT studies. Higher mean effect sizes were also found with pediatric study samples, hematological malignancy, studies on procedure-related stressors, and with mixed-gender samples. Hypnosis delivered by a therapist was significantly more effective than self-hypnosis. LINKING EVIDENCE TO ACTION: Hypnosis can reduce anxiety of cancer patients, especially for pediatric cancer patients who experience procedure-related stress. We recommend therapist-delivered hypnosis should be preferred until more effective self-hypnosis strategies are developed.

Mortality prediction to hospitalized patients with influenza pneumonia: PO2 /FiO2 combined lymphocyte count is the answer.

INTRODUCTION: Community-acquired pneumonia (CAP) severity scores perform well in predicting mortality of CAP patients, but their applicability in influenza pneumonia is powerless. OBJECTIVES: The aim of our research was to test the efficiency of PO2 /FiO2 and CAP severity scores in predicting mortality and intensive care unit (ICU) admission with influenza pneumonia patients. METHODS: We reviewed all patients with positive influenza virus RNA detection in Beijing Chao-Yang Hospital during the 2009-2014 influenza seasons. Outpatients, inpatients with no pneumonia and incomplete data were excluded. We used receiver operating characteristic curves (ROCs) to verify the accuracy of severity scores or indices as mortality predictors in the study patients. RESULTS: Among 170 hospitalized patients with influenza pneumonia, 30 (17.6%) died. Among those who were classified as low-risk (predicted mortality 0.1%-2.1%) by pneumonia severity index (PSI) or confusion, urea, respiratory rate, blood pressure, age ≥65 year (CURB-65), the actual mortality ranged from 5.9 to 22.1%. Multivariate logistic regression indicated that hypoxia (PO2 /FiO2 ≤ 250) and lymphopenia (peripheral blood lymphocyte count <0.8 × 109 /L) were independent risk factors for mortality, with OR value of 22.483 (95% confidence interval 4.927-102.598) and 5.853 (95% confidence interval 1.887-18.152), respectively. PO2 /FiO2 combined lymphocyte count performed well for mortality prediction with area under the curve (AUC) of 0.945, which was significantly better than current CAP severity scores of PSI, CURB-65 and confusion, respiratory rate, blood pressure, age ≥65 years for mortality prediction (P < 0.001). The scores or indices for ICU admission prediction to hospitalized patients with influenza pneumonia confirmed a similar pattern and PO2 /FiO2 combined lymphocyte count was also the best predictor for predicting ICU admission. CONCLUSION: In conclusion, we found that PO2 /FiO2 combined lymphocyte count is simple and reliable predictor of hospitalized patients with influenza pneumonia in predicting mortality and ICU admission. When PO2 /FiO2 ≤ 250 or peripheral blood lymphocyte count <0.8 × 109 /L, the clinician should pay great attention to the possibility of severe influenza pneumonia.

Quality of Life After Hematopoietic Stem Cell Transplantation in Pediatric Survivors: Comparison With Healthy Controls and Risk Factors.

BACKGROUND: Hematopoietic stem cell transplantation has prolonged life for children with life-threatening diseases. Quality of life is an essential outcome for evaluating the long-term effects of transplantation. OBJECTIVE: The aims of this study were to compare the quality of life of children posttransplantation to that of healthy peers and explore the variables associated with the quality of life of posttransplant children. METHODS: A cross-sectional study was conducted with 43 pediatric transplantation survivors and 43 age- and sex-matched healthy peers. RESULTS: The mean age of the transplant group was 12.06 years. The mean time since transplant was 3.73 years. After covariate adjustment, there was no difference between posttransplant and healthy children in each domain and overall quality of life, except for physical functioning where the posttransplant children had lower scores than did the healthy group. Chronic graft-versus-host disease was found to be the primary factor associated with poor posttransplant overall quality of life and emotional and social functioning. Sociodemographic variables, symptom distress, and caregiver depression were not correlated with posttransplant quality of life. CONCLUSIONS: The quality of life of pediatric transplantation survivors was comparable to that of healthy peers. IMPLICATIONS FOR PRACTICE: The finding that children after transplant may achieve quality of life similar to their healthy peers is important information for parents to consider as they consider treatment options. For those sick children who cannot regularly attend school, their emotional and social functioning should be closely monitored.

Enhanced H-filter based on Fåhræus-Lindqvist effect for efficient and robust dialysis without membrane.

A novel microfluidic device for highly efficient and robust dialysis without membrane is highly desired for the development of portable or wearable microdialyzer. Here we report an enhanced H-filter with pillar array based on Fåhræus-Lindqvist effect (F-L effect) for highly efficient and robust membraneless dialysis of simplified blood for the first time. The H-filter employs two fluids laminarly flowing in the microchannel for continuously membraneless dialysis. With pillar array in the microchannel, the two laminar flows, with one containing blood cells and small molecules and another containing dialyzate solution, can form a cell-free layer at the interface as selective zones for separation. This provides enhanced mixing yet extremely low shear for extraction of small molecules from the blood-cell-containing flow into the dialyzate flow, resulting in robust separation with reduced cell loss and improved efficiency. We demonstrate this by first using Chlorella pyrenoidosa as model cells to quantitatively study the separation performances, and then using simplified human blood for dialysis. The advanced H-filter, with highly efficient and robust performance for membraneless dialysis, shows great potential as promising candidate for rapid blood analysis/separation, and as fundamental structure for portable dialyzer.

Microfluidic-based fabrication, characterization and magnetic functionalization of microparticles with novel internal anisotropic structure.

Easy fabrication and independent control of the internal and external morphologies of core-shell microparticles still remain challenging. Core-shell microparticle comprised of a previously unknown internal anisotropic structure and a spherical shell was fabricated by microfluidic-based emulsificaiton and photopolymerization. The interfacial and spatial 3D morphology of the anisotropic structure were observed by SEM and micro-CT respectively. Meanwhile, a series of layer-by-layer scans of the anisotropic structure were obtained via the micro-CT, which enhanced the detail characterization and analysis of micro materials. The formation mechanism of the internal anisotropic structure may be attributed to solution-directed diffusion caused by the semipermeable membrane structure and chemical potential difference between inside and outside of the semipermeable membrane-like polymerized shell. The morphology evolution of the anisotropic structure was influenced and controlled by adjusting reaction parameters including polymerization degree, polymerization speed, and solute concentration difference. The potential applications of these microparticles in microrheological characterization and image enhancement were also proposed by embedding magnetic nanoparticles in the inner core.

Microfluidic Fabrication of Bio-Inspired Microfibers with Controllable Magnetic Spindle-Knots for 3D Assembly and Water Collection.

A simple and flexible approach is developed for controllable fabrication of spider-silk-like microfibers with tunable magnetic spindle-knots from biocompatible calcium alginate for controlled 3D assembly and water collection. Liquid jet templates with volatile oil drops containing magnetic Fe3O4 nanoparticles are generated from microfluidics for fabricating spider-silk-like microfibers. The structure of jet templates can be precisely adjusted by simply changing the flow rates to tailor the structures of the resultant spider-silk-like microfibers. The microfibers can be well manipulated by external magnetic fields for controllably moving, and patterning and assembling into different 2D and 3D structures. Moreover, the dehydrated spider-silk-like microfibers, with magnetic spindle-knots for collecting water drops, can be controllably assembled into spider-web-like structures for excellent water collection. These spider-silk-like microfibers are promising as functional building blocks for engineering complex 3D scaffolds for water collection, cell culture, and tissue engineering.