Exosome-Based COVID-19 Vaccine.

Extracellular vesicles (EVs) enable cell-to-cell communication and, by delivering antigens, can stimulate the immune response strongly. Approved in use SARS-CoV-2 vaccine, candidates immunize with the viral spike protein delivered via viral vectors, translated by injected mRNAs, or as a pure protein. Here, we outline a novel methodological approach for generating SARS-CoV-2 vaccine using exosome that delivers antigens from the SARS-CoV-2 structural proteins. Engineered EVs can be loaded with viral antigens, thus acting as antigens presenting EVs, eliciting strong and targeted CD8(+) T cell and B cell, offering a unique approach to vaccine development. Engineered EVs thus portray a safe, adaptable, and effective approach for a virus-free vaccine development.

Changes in Daily Life, Physical Activity, GAD, Depression, and Personal Hygiene of Adolescents in South Korea Due to the COVID-19.

This study used raw data obtained from the Adolescents' Health Behavior Survey by government-affiliated agency open data. A total of 109,796 students were sampled. A comparative analysis was performed based on the year 2020 and when the COVID-19 pandemic occurred, in which we analyzed changes in adolescents' depression and panic anxiety perception and dietary habits, physical factors, physical activity, and handwashing habits. There was no weight control in the second year compared to the first year of the COVID-19 pandemic, and obesity also increased. The continuation of the non-contact situation caused by COVID-19 led to a worsening of subjective health awareness, and the experience of generalized anxiety disorder, depression, sadness and hopelessness, and suicidal thoughts and attempts increased. The frequency of washing hands with soap before meals and after using the toilet at school or at home was reduced. As a result of this analysis, we believe that there needs to be a system of support in place to address the academic gaps and deficiencies in learning caused by COVID-19, and that psychological and emotional support needs to be strengthened at this time, as well as the issues to be supported after the end of the non-contact situation.

Quality Improvement: Implementing Nurse Standard Work in Emergency Department Fast-Track Area to Reduce Patient Length of Stay.

INTRODUCTION: The average length of stay of a fast-track area of a large urban hospital was excessively long, which affected the patient experience and the rate at which patients left without being seen. One approach to reducing average length of stay is to create nurse standard work. Nurse standard work was a defined set of process and procedures that reduce variability within a nurse's workflow. METHODS: Nurse standard work was created by a team of nurses assisted by management engineering using lean methodology and A3 problem solving. Data were gathered about average length of stay and left without being seen for patients in the emergency department fast-track area of an urban emergency department from October 2018 to June 2020. This period includes 5 months before the intervention start, 4 months during nurse standard work implementation, 9 months using nurse standard work before the unit was repurposed during COVID-19, and 3 months during COVID-19. RESULTS: Nurse standard work helped reduce average length of stay in the emergency department fast-track area from 205 minutes before project initiation to 150.4 minutes in the 7 months after implementing nurse standard work. The time spent walking for supplies was reduced from 422 and 272 seconds before nurse standard work to 25 and 30 seconds for the nurse technician and nurse, respectively, after nurse standard work. Left without being seen was decreased from 4.7% in October of 2018 to 0.7% by March of 2020. DISCUSSION: Nurse standard work reduced the amount of time that nurses spent performing support tasks and reduced delays in providing patient care, which then allowed more time for nurses to interact directly with patients. Nurse standard work provides a clear task sequence that eliminates delays in treating patients, but it also allows for fast identification of delays that do occur and simplifies problem solving to eliminate reoccurrence of delays. Therefore, nurse standard work is an essential component of efforts to reduce patient average length of stay in health care processes and reduce left without being seen to the national standard of less than 2%.

Effect of the Standardization of Service Platforms for High-Involvement PropTech Services

In this study, we focus on the innovation resistance that has appeared in the process of accepting changed information technology services after the COVID-19 pandemic. Based on a survey of property technology (PropTech) service users in Korea, this study proposes an extended technology acceptance model that considers the antecedent variables of the information systems success model to implement a standard PropTech service platform, and analyzes the influence of the selected parameters. Service quality was applied as the antecedent variable to define system quality and service standards, considering the establishment of the service standards process suggested by the company. The selected parameters were the demand for the personalization of the service and the resistance to innovation, which implies the degree to which consumers refuse to accept new technologies. To this end, we conducted a questionnaire survey of 524 PropTech users from 11 October 2021 to 15 November 2021. This study analyzes the factors affecting consumers' continued use intention in order to derive the service standardization of PropTech operations, and presents the mediating effects of innovation resistance and personalization to derive the implications for service standardization. The implications of this study are as follows: first, the possibility of innovation resistance in the PropTech service sector and its mechanisms are presented. Second, the necessity of redefining the quality dimension is proposed. Finally, we identify that additional research on innovation resistance to PropTech services is needed.

Automatic detection of mesiodens on panoramic radiographs using artificial intelligence.

This study aimed to develop an artificial intelligence model that can detect mesiodens on panoramic radiographs of various dentition groups. Panoramic radiographs of 612 patients were used for training. A convolutional neural network (CNN) model based on YOLOv3 for detecting mesiodens was developed. The model performance according to three dentition groups (primary, mixed, and permanent dentition) was evaluated, both internally (130 images) and externally (118 images), using a multi-center dataset. To investigate the effect of image preprocessing, contrast-limited histogram equalization (CLAHE) was applied to the original images. The accuracy of the internal test dataset was 96.2% and that of the external test dataset was 89.8% in the original images. For the primary, mixed, and permanent dentition, the accuracy of the internal test dataset was 96.7%, 97.5%, and 93.3%, respectively, and the accuracy of the external test dataset was 86.7%, 95.3%, and 86.7%, respectively. The CLAHE images yielded less accurate results than the original images in both test datasets. The proposed model showed good performance in the internal and external test datasets and had the potential for clinical use to detect mesiodens on panoramic radiographs of all dentition types. The CLAHE preprocessing had a negligible effect on model performance.

Possibility of exosome­based coronavirus disease 2019 vaccine (Review).

Coronavirus disease 2019 (COVID­19) is a global pandemic that can have a long­lasting impact on public health if not properly managed. Ongoing vaccine development trials involve classical molecular strategies based on inactivated or attenuated viruses, single peptides or viral vectors. However, there are multiple issues, such as the risk of reversion to virulence, inability to provide long­lasting protection and limited protective immunity. To overcome the aforementioned drawbacks of currently available COVID­19 vaccines, an alternative strategy is required to produce safe and efficacious vaccines that impart long­term immunity. Exosomes (key intercellular communicators characterized by low immunogenicity, high biocompatibility and innate cargo­loading capacity) offer a novel approach for effective COVID­19 vaccine development. An engineered exosome­based vaccine displaying the four primary structural proteins of SARS­CoV­2 (spike, membrane, nucleocapside and envelope proteins) induces humoral and cell mediated immunity and triggers long­lasting immunity. The present review investigated the prospective use of exosomes in the development of COVID­19 vaccines; moreover, exosome­based vaccines may be key to control the COVID­19 pandemic by providing enhanced protection compared with existing vaccines.