The Application of Biomaterials for the Vaccine, Treatment, and Detection of SARS-CoV-2.

The coronavirus disease-19 (COVID-19) pandemic has had a significant impact on human life worldwide since 2019. Specific vaccines and antiviral agents are the most effective means of preventing and treating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. Additionally, antiviral protective equipment and early diagnosis also contribute to controlling the spread of COVID-19. The utilization of biomaterials in medicine and pharmaceuticals is crucial to ensure the positive impact of vaccines, antiviral agents, and protective equipment. In this review, we discuss the application of various types of biomaterials, including polymers, lipid nanoparticles, inorganic biomaterials, protein- or peptide-associated biomaterials, self-assembled biomaterials, and other biomaterials, for the vaccine, treatment, and prevention of COVID-19. Finally, we provide a perspective on future opportunities and challenges for developing biomaterials to combat other viral outbreaks and diseases.

Machine learning-based prediction of delirium 24 h after pediatric intensive care unit admission in critically ill children: A prospective cohort study.

BACKGROUND: Accurately identifying patients at high risk of delirium is vital for timely preventive intervention measures. Approaches for identifying the risk of developing delirium among critically ill children are not well researched. OBJECTIVE: To develop and validate machine learning-based models for predicting delirium among critically ill children 24 h after pediatric intensive care unit (PICU) admission. DESIGN: A prospective cohort study. SETTING: A large academic medical center with a 57-bed PICU in southwestern China from November 2019 to February 2022. PARTICIPANTS: One thousand five hundred and seventy-six critically ill children requiring PICU stay over 24 h. METHODS: Five machine learning algorithms were employed. Delirium was screened by bedside nurses twice a day using the Cornell Assessment of Pediatric Delirium. Twenty-four clinical features from medical and nursing records during hospitalization were used to inform the models. Model performance was assessed according to numerous learning metrics, including the area under the receiver operating characteristic curve (AUC). RESULTS: Of the 1576 enrolled patients, 929 (58.9 %) were boys, and the age ranged from 28 days to 15 years with a median age of 12 months (IQR 3 to 60 months). Among them, 1126 patients were assigned to the training cohort, and 450 were assigned to the validation cohort. The AUCs ranged from 0.763 to 0.805 for the five models, among which the eXtreme Gradient Boosting (XGB) model performed best, achieving an AUC of 0.805 (95 % CI, 0.759-0.851), with 0.798 (95 % CI, 0.758-0.834) accuracy, 0.902 sensitivity, 0.839 positive predictive value, 0.640 F1-score and a Brier score of 0.144. Almost all models showed lower predictive performance in children younger than 24 months than in older children. The logistic regression model also performed well, with an AUC of 0.789 (95 % CI, 0.739, 0.838), just under that of the XGB model, and was subsequently transformed into a nomogram. CONCLUSIONS: Machine learning-based models can be established and potentially help identify critically ill children who are at high risk of delirium 24 h after PICU admission. The nomogram may be a beneficial management tool for delirium for PICU practitioners at present.

Guidelines for the Management of Atopic Dermatitis in Children: A Systematic Review.

INTRODUCTION: Numerous guidelines have been published for atopic dermatitis management in children in recent years. To date, the quality of the newest guidelines has not been appraised. This study aimed to identify and evaluate guidelines for the management of atopic dermatitis in children. METHODS: We reviewed the literature retrieved from PubMed, Web of Science, Ovid, ScienceDirect, Embase, China National Knowledge Infrastructure, WanFang Data, and guidelines websites. Search period from January 1, 2016, to December 31, 2021. The following keywords were used for searching: "atopic dermatitis," "atopic eczema," "eczema," "guideline," and "consensus." The quality of the guidelines was assessed by two assessors using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument independently, and domain scores >60% were considered to have sufficient quality. The guideline recommendations were reviewed. RESULTS: Nineteen guidelines were included in the study. Three guidelines had a graded A level, which was recommended for use in practice. Eleven guidelines had a graded B level, which was recommended for use in revision. The remaining five guidelines were rated with C level, which was not recommended. The average score of six domains of AGREE II was 64.76%, 48.53%, 42.35%, 73.83%, 32.23%, and 70.17%, respectively. A consistency test showed an intraclass correlation coefficient range of 0.497 (95% CI: 0.105, 0.705) to 0.970 (95% CI: 0.93, 0.987) based on the two assessors' test results for the guidelines. CONCLUSIONS: Most guidelines were recommended for use with revision. No significant changes were observed in the primary management of atopic dermatitis in children compared to previous evidence. New biological agents and complementary alternative medicine are increasingly available, but the evidence for the treatment of atopic dermatitis in children is still limited.

Physical activity and depressive symptoms among community-dwelling older adults in the COVID-19 pandemic era: A three-wave cross-lagged study.

The aim of the study is to determine the trajectories of physical activity and depressive symptoms and their reciprocal relationship among community-dwelling older adults in the COVID-19 pandemic era. The study population consisted of a cohort of 511 participants aged 60 years and over, who were recruited from eight community health centers in Ya'an, China. The Physical Activity Scale for the Elderly and the Patient Health Questionnaire were respectively used to measure physical activity and depressive symptoms at three time points: before the COVID-19 outbreak (T0), during the outbreak period (T1), and after the subsidence of COVID-19 (T2). The results revealed that physical activity and depressive symptoms fluctuated substantially across T0, T1, and T2. In addition, more severe depressive symptoms at T0 and T1 were significantly associated with lower levels of physical activity at T1 and T2, but the obverse direction of physical activity being associated with subsequent depressive symptoms was not observed in the current study. These findings highlight the importance of supporting old people to remain physically active and combat mental distress early in a pandemic, and prevention and management of depressive symptoms may also be beneficial to promote physical activity.

A new visual design language for biological structures in a cell.

As part of a project to build a spatiotemporal model of the pancreatic ß-cell, we are creating an immersive experience called "World in a Cell" that can be used to integrate and create new educational tools. To do this, we have developed a new visual design language that uses tetrahedral building blocks to express the structural features of biological molecules and organelles in crowded cellular environments. The tetrahedral language enables more efficient animation and user interaction in an immersive environment.

Prevalence of post-traumatic stress disorders and associated factors one month after the outbreak of the COVID-19 among the public in southwestern China: a cross-sectional study.

BACKGROUND: The Coronavirus Disease 2019 (COVID-19) pandemic has rapidly spread across the whole world and brought strong psychological impact. This study aimed to evaluate the prevalence of post-traumatic stress disorders (PTSD) in the general people of southwestern China and associated factors 1 month after the outbreak of the COVID-19. METHODS: This study was started on 4-10 Feb 2020 based on online survey. The present work was carried out in the provinces of southeastern China, including Sichuan Province, Guizhou Province, Yunnan Province, and Chongqing City.1593 respondents aged 18 years and above administered to this study. Data on whether they have experienced confirmed or suspected COVID-19 of themselves/family members/acquaintances were also collected, and based on 'yes' answers, the number of affected individuals (via COVID-19) were categorized into four exposure levels i.e., non-affected, less, moderately, or significantly affected. The civilian version of the PTSD checklist and the self-reported information about COVID-19 were used. RESULTS: The prevalence of PTSD was approximately 25.2%(n = 401/1593). The chances of developing PTSD were 6.053(OR = 6.053, 95% CI 1.394 to 26.280) or 3.673(OR = 3.673, 95% CI 1.738 to 7.765) times higher among respondents who had been significantly and moderately affected than those who had not been affected, accordingly. Male (OR = 1.484, 95% CI 1.147 to 1.920),younger age individuals (40 ~ 49 age group/<30 age group, OR = 0.395, 95% CI 0.258 to 0.606) and health care workers (OR = 1.788, 95% CI 1.155 to 2.277) were at higher risk of developing PTSD. CONCLUSION: Our findings highlight that a positive correlation between the pandemic and PTSD. It is urgent to establish a screening and prevention systems for the population who are significantly exposed to COVID-19,and provide different psychological intervention strategies for different groups.

Post-Intensive Care Syndrome in Children: A Concept Analysis.

PROBLEM: Post-intensive care syndrome in paediatrics (PICS-p) is a term used to describe newly acquired or worsened impairment in one or more aspects of a child's physical, psychological, cognitive, and social functioning after discharge from the paediatric intensive care unit (PICU). However, consensus, conceptual insights, and assessment guidance are lacking for this syndrome. Therefore, this analysis aimed to define the concept of PICS-p to help practitioners and researchers understand the syndrome in detail using the Walker and Avant approach. ELIGIBILITY CRITERIA: We reviewed studies retrieved from several databases, namely PubMed, Google Scholar, Web of Science, Ovid, ScienceDirect, and the Springer database, using the following keywords: 'post-intensive care syndrome', 'PICU', 'children', 'PICS-p', and 'concept analysis'. Both quantitative and qualitative studies on PICS-p were included in the search. The articles were limited to those published up to November 21, 2020. SAMPLE: Of the 762 publications selected, 24 publications met the inclusion criteria. RESULTS: PICS-p is defined on the basis of the following aspects: (1) Physical dysfunction; (2) Cognitive dysfunction; (3) Psychological dysfunction; and (4) Social dysfunction. CONCLUSION: With the increasing success rate of PICU treatment, reduced case fatality is no longer the only outcome of critical illness in children. The long-term outcomes in children discharged from hospitals have attracted attention from families, hospitals, and communities. IMPLICATIONS: A clear definition of PICS-p will help medical staff understand PICS-p in detail and provide a theoretical basis for the diagnosis and treatment of this syndrome.

ProjectFlow: a configurable workflow management application for point of care research.

OBJECTIVE: To best meet our point-of-care research (POC-R) needs, we developed ProjectFlow, a configurable, clinical research workflow management application. In this article, we describe ProjectFlow and how it is used to manage study processes for the Diuretic Comparison Project (DCP) and the Research Precision Oncology Program (RePOP). MATERIALS AND METHODS: The Veterans Health Administration (VHA) is the largest integrated health care system in the United States. ProjectFlow is a flexible web-based workflow management tool specifically created to facilitate conduct of our clinical research initiatives within the VHA. The application was developed using the Grails web framework and allows researchers to create custom workflows using Business Process Model and Notation. RESULTS: As of January 2021, ProjectFlow has facilitated management of study recruitment, enrollment, randomization, and drug orders for over 10 000 patients for the DCP clinical trial. It has also helped us evaluate over 3800 patients for recruitment and enroll over 370 of them into RePOP for use in data sharing partnerships and predictive analytics aimed at optimizing cancer treatment in the VHA. DISCUSSION: The POC-R study design embeds research processes within day-to-day clinical care and leverages longitudinal electronic health record (EHR) data for study recruitment, monitoring, and outcome reporting. Software that allows flexibility in study workflow creation and integrates with enterprise EHR systems is critical to the success of POC-R. CONCLUSIONS: We developed a flexible web-based informatics solution called ProjectFlow that supports custom research workflow configuration and has ability to integrate data from existing VHA EHR systems.

"AFGP" bundles for an extremely preterm infant who underwent difficult removal of a peripherally inserted central catheter: A case report.

BACKGROUND: There have been few reports on level 3 difficult removal of peripherally inserted central catheter (PICC) in neonates. Here, we reported a case of an extremely preterm infant who underwent level 3 difficult removal of a PICC. CASE SUMMARY: Female baby A, weighing 1070 g at 27+1 wk of gestational age, was diagnosed with extremely preterm infant and neonatal respiratory distress syndrome. She underwent PICC insertion twice. The first PICC insertion went well; the second PICC was inserted in the right lower extremity, however, phlebitis occurred on the second day after the placement. On the third day of catheterization, phlebitis was aggravated, while the right leg circumference increased by 2.5 cm. On the fourth day of catheterization, more red swelling was found in the popliteal part, covering an area of about 1.5 cm × 4 cm, which was diagnosed as phlebitis level 3; thus, we decided to remove the PICC. During tube removal, the catheter rebounded and could not be pulled out (several conventional methods were performed). Finally, we successfully removed the PICC using a new approach termed "AFGP". On the 36th day of admission, the baby fully recovered and was discharged. CONCLUSION: The "AFGP" bundle approach was effective for an extremely preterm infant, who underwent level 3 difficult removal of a PICC.

Self-consciousness and depression in precocious pubertal children.

OBJECTIVE: To explore self-consciousness and depression in children with precocious puberty (PP) and analyse its effect on children of both sexes. METHODS: Sixty children with PP and 60 non-PP children matched for sex and age participated in the study. Children were assessed using the Birleson Depression Self-Rating Scale for Children and the Piers-Harris Children's Self-Concept Scale. RESULTS: There were significant differences in physical appearance and attributes, anxiety, happiness and satisfaction between PP children and non-PP children. PP children had significantly higher depression than non-PP children. In the PP group, girls were significantly more prone to anxiety and unhappiness than boys. Conclusion: There were sex differences in the effect of PP on children's self-consciousness, and girls were more prone to anxiety and unhappiness. More attention should be paid to improving the physical and mental health of children with PP.

[Effect of golden-hour body temperature bundle management on admission temperature and clinical outcome in preterm infants after birth].

OBJECTIVE: To study the effect of golden-hour body temperature bundle management strategy on admission temperature and clinical outcome in preterm infants with a gestational age of <34 weeks after birth. METHODS: The preterm infants who were born in the delivery room of the West China Second University Hospital of Sichuan University and admitted to the department of neonatology of this hospital within 1 hour after birth from December 2015 to June 2016 and from January to May, 2017 were enrolled. The 173 preterm infants who were admitted from January to May, 2017 were enrolled as the intervention group and were given golden-hour body temperature bundle management. The 164 preterm infants who were admitted from December 2015 to June 2016 were enrolled as the control group and were given conventional body temperature management. RESULTS: The intervention group had a significantly higher mean admission temperature than the control group (36.4±0.4°C vs 35.3±0.6°C; P<0.001). The incidence rate of hypothermia on admission in the intervention group was significantly lower than that in the control group (56.6% vs 97.6%; P<0.001). The intervention group had a significantly lower incidence rate of intracranial hemorrhage within one week after admission than the control group (15.0% vs 31.7%; P<0.05). CONCLUSIONS: Golden-hour body temperature bundle management for preterm infants within one hour after birth can reduce the incidence of hypothermia on admission and improve clinical outcome.