In Situ Polymerization-Mediated Antigen Presentation.

Activating antigen-presenting cells is essential to generate adaptive immunity, while the efficacy of conventional activation strategies remains unsatisfactory due to suboptimal antigen-specific priming. Here, in situ polymerization-mediated antigen presentation (IPAP) is described, in which antigen-loaded nanovaccines are spontaneously formed and efficiently anchored onto the surface of dendritic cells in vivo through co-deposition with dopamine. The resulting chemically bound nanovaccines can promote antigen presentation by elevating macropinocytosis-based cell uptake and reducing lysosome-related antigen degradation. IPAP is able to prolong the duration of antigen reservation in the injection site and enhance subsequent accumulation in the draining lymph nodes, thereby eliciting robust antigen-specific cellular and humoral immune responses. IPAP is also applicable for different antigens and capable of circumventing the disadvantages of complicated preparation and purification. By implementation with ovalbumin, IPAP induces a significant protective immunity against ovalbumin-overexpressing tumor cell challenge in a prophylactic murine model. The use of the SARS-CoV-2 Spike protein S1 subunit also remarkably increases the production of S1-specific immunoglobulin G in mice. IPAP offers a unique strategy for stimulating antigen-presenting cells to boost antigen-specific adaptive responses and proposes a facile yet versatile method for immunization against various diseases.

Nurses' Work Concerns and Disenchantment During the COVID-19 Pandemic: Machine Learning Analysis of Web-Based Discussions.

BACKGROUND: Web-based forums provide a space for communities of interest to exchange ideas and experiences. Nurse professionals used these forums during the COVID-19 pandemic to share their experiences and concerns. OBJECTIVE: The objective of this study was to examine the nurse-generated content to capture the evolution of nurses' work concerns during the COVID-19 pandemic. METHODS: We analyzed 14,060 posts related to the COVID-19 pandemic from March 2020 to April 2021. The data analysis stage included unsupervised machine learning and thematic qualitative analysis. We used an unsupervised machine learning approach, latent Dirichlet allocation, to identify salient topics in the collected posts. A human-in-the-loop analysis complemented the machine learning approach, categorizing topics into themes and subthemes. We developed insights into nurses' evolving perspectives based on temporal changes. RESULTS: We identified themes for biweekly periods and grouped them into 20 major themes based on the work concern inventory framework. Dominant work concerns varied throughout the study period. A detailed analysis of the patterns in how themes evolved over time enabled us to create narratives of work concerns. CONCLUSIONS: The analysis demonstrates that professional web-based forums capture nuanced details about nurses' work concerns and workplace stressors during the COVID-19 pandemic. Monitoring and assessment of web-based discussions could provide useful data for health care organizations to understand how their primary caregivers are affected by external pressures and internal managerial decisions and design more effective responses and planning during crises.

The Psychological Pressures of Breast Cancer Patients During the COVID-19 Outbreak in China-A Comparison With Frontline Female Nurses.

Objective: During the outbreak of the COVID-19 epidemic in China, breast cancer (BC) patients and healthcare workers faced several challenges, resulting in great psychological stress. We measured the psychological status of BC patients and female nurses and compared the severity within the two groups at the peak time-point of the COVID-19 outbreak. Methods: A total of 207 BC patients and 684 female nurses were recruited from Wuhan. They completed an anonymous questionnaire online using the most popular social media software in China, WeChat. The psychological status of BC patients and of female nurses was measured using the Chinese versions of the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder scale (GAD-7), the 7-item Insomnia Severity Index (ISI), and the 22-item Impact of Event Scale-Revised (IES-R) for evaluation of post-traumatic stress disorder (PTSD). The differences between the two groups were analyzed. Results: The scores of BC patients and frontline female nurses for the four scales were significantly higher than those of non-frontline female nurses (P < 0.001). There were similar scores between BC patients and frontline female nurses for PHQ-9, GAD-7, and IES-R (P = 0.789, P = 0.101, P = 0.158, respectively). Notably, the scores of BC patients for ISI were significantly higher than those of the frontline female nurses (P = 0.016). A considerable proportion of BC patients reported symptoms of depression (106/207, 51.2%), anxiety (130/207, 62.8%), insomnia (106/207, 51.2%), and PTSD (73/207, 35.5%), which was more severe than that of female nurses. Conclusions: BC patients experienced great psychological pressure during the COVID-19 outbreak. The incidents of symptomatic anxiety, depression, sleep disorders, and PTSD were significantly comparable to that of frontline female nurses, and episodes of insomnia among BC participants were more serious than for frontline female nurses.

Nurses endured high risks of psychological problems under the epidemic of COVID-19 in a longitudinal study in Wuhan China.

BACKGROUND: Health care workers, especially frontline nurses, faced great challenges during the coronavirus disease 2019 (COVID-19) outbreak. AIMS: To assess the magnitude of the psychological status and associated risk factors among nurses in the pandemic center in Wuhan, China. METHODS: In this study, we enrolled nurses from Renmin Hospital of Wuhan University. The questionnaire was designed to obtain basic information of the participants, and included four psychological assessment scales. We issued the questionnaires at two different points of time. We conducted the first survey on January 29 to February 2 (outbreak period) with 709 eligible responses, and the second survey on February 26 to February 28 (stable period) with 621 eligible responses. The nurses from Wuchang Fangcang shelter hospital were also enrolled in the second survey. RESULTS: During the pandemic, over one-third of nurses suffered from depression, anxiety, and insomnia. In the outbreak period, the nurses showed significantly higher risks for depression, anxiety, and posttraumatic stress disorder (PTSD) symptoms than those in the stable period (P < 0.01). Notably, the nurses from the Fangcang shelter hospitals were more likely to present psychological problems than those from other frontline or non-frontline (all P < 0.001) units, especially for insomnia (38.3% with severe insomnia). The nurses from the frontline, with worse physical condition and uncertain concerns about this pandemic as compared to the others, were more likely to bear psychological problems. Thus, online psychological information and sufficient protection conditions were effective interventions to help mitigate psychological distress. The nurses from Fangcang shelter hospitals suffered a significantly higher risk of psychological problems than those from other units. CONCLUSION: The psychological status of nurses needs more attention during the COVID-19 pandemic, especially for those who fought in the frontline during the peak of the outbreak.