A Model of High-Speed Endovascular Sonothrombolysis with Vortex Ultrasound-Induced Shear Stress to Treat Cerebral Venous Sinus Thrombosis.

This research aims to demonstrate a novel vortex ultrasound enabled endovascular thrombolysis method designed for treating cerebral venous sinus thrombosis (CVST). This is a topic of substantial importance since current treatment modalities for CVST still fail in as many as 20% to 40% of the cases, and the incidence of CVST has increased since the outbreak of the coronavirus disease 2019 pandemic. Compared with conventional anticoagulant or thrombolytic drugs, sonothrombolysis has the potential to remarkably shorten the required treatment time owing to the direct clot targeting with acoustic waves. However, previously reported strategies for sonothrombolysis have not demonstrated clinically meaningful outcomes (e.g., recanalization within 30 min) in treating large, completely occluded veins or arteries. Here, we demonstrated a new vortex ultrasound technique for endovascular sonothrombolysis utilizing wave-matter interaction-induced shear stress to enhance the lytic rate substantially. Our in vitro experiment showed that the lytic rate was increased by at least 64.3% compared with the nonvortex endovascular ultrasound treatment. A 3.1-g, 7.5-cm-long, completely occluded in vitro 3-dimensional model of acute CVST was fully recanalized within 8 min with a record-high lytic rate of 237.5 mg/min for acute bovine clot in vitro. Furthermore, we confirmed that the vortex ultrasound causes no vessel wall damage over ex vivo canine veins. This vortex ultrasound thrombolysis technique potentially presents a new life-saving tool for severe CVST cases that cannot be efficaciously treated using existing therapies.

Prevention of nosocomial COVID-19 infections in otorhinolaryngology-head and neck surgery.

Coronavirus disease 2019 (COVID-19) has rapidly evolved into a pandemic, causing a global public health crisis. Many frontline healthcare workers providing ear, nose and throat services have been reported to contract COVID-19 at work. Early during the COVID-19 outbreak, several medical professionals in Otolaryngology-Head and Neck Surgery were infected in Wuhan, China. A series of measures were then taken immediately, which successfully halted the spread of the disease. Here we would like to share the lessons we have learned, and our experience to protect our health care workers during the COVID-19 pandemic.

Using Telemedicine during the COVID-19 Pandemic: How Service Quality Affects Patients' Consultation.

The COVID-19 epidemic put pressure on the traditional healthcare system and offline consultation methods. Telemedicine platforms provide a more convenient and safer channel for online health communication. Based on the signaling theory, our study explores the impacts of three dimensions of physicians' service quality (need fulfillment, security, and responsiveness) on online patient consultation on telemedicine platforms. A negative binomial model was used to test cross-sectional data of 2982 physicians obtained from Haodf.com. The results show the following: (1) the need fulfillment dimension variables positively affect online patient consultation; (2) the security dimension variables positively affect online patient consultation; (3) the responsiveness dimension variables positively affect online patient consultation. Our results contribute to the theoretical aspect of signaling theory and service quality in the context of telemedicine platforms and have several practical implications for telemedicine platform physicians and platform operators.

The cuter, the better? The impact of cuteness on intention to purchase AI voice assistants: A moderated serial-mediation model.

Due to the lockdown, more and more people are used to communicating with AI voice assistants during the post-COVID era. This study investigates the relationship between the perceived cuteness of AI voice assistants and the intention to purchase via a moderated serial-mediation model. We tested a PLS-SEM model with 284 survey data from an online experiment. The findings indicate that: (1) different cuteness appearances lead to different levels of perceived cuteness; (2) perceived cuteness positively affects intention to purchase; (3) the positive direct effect is serial mediated by social presence and user engagement; (4) the serial mediation effect is negatively moderated by perceived risk of service failure, which means the positive influence of perceived cuteness on intention to purchase is weakened at a high level of perceived risk. Our research has both theoretical and managerial contributions, which also reminds enterprises to grasp the cuteness degree of the product.

Post-COVID-19 human memory impairment: A PRISMA-based systematic review of evidence from brain imaging studies.

Many people with coronavirus disease 2019 (COVID-19) report varying degrees of memory impairment. Neuroimaging techniques such as MRI and PET have been utilized to shed light on how COVID-19 affects brain function in humans, including memory dysfunction. In this PRISMA-based systematic review, we compared and summarized the current literature looking at the relationship between COVID-19-induced neuropathological changes by neuroimaging scans and memory symptoms experienced by patients who recovered from COVID-19. Overall, this review suggests a correlational trend between structural abnormalities (e.g., cortical atrophy and white matter hyperintensities) or functional abnormalities (e.g., hypometabolism) in a wide range of brain regions (particularly in the frontal, parietal and temporal regions) and memory impairments in COVID-19 survivors, although a causal relationship between them remains elusive in the absence of sufficient caution. Further longitudinal investigations, particularly controlled studies combined with correlational analyses, are needed to provide additional evidence.

Non-covalent cyclic peptides simultaneously targeting Mpro and NRP1 are highly effective against Omicron BA.2.75.

Available vaccine-based immunity may at high risk of being evaded due to substantial mutations in the variant Omicron. The main protease (Mpro) of SARS-CoV-2 and human neuropilin-1 (NRP1), two less mutable proteins, have been reported to be crucial for SARS-CoV-2 replication and entry into host cells, respectively. Their dual blockade may avoid vaccine failure caused by continuous mutations of the SARS-CoV-2 genome and exert synergistic antiviral efficacy. Herein, four cyclic peptides non-covalently targeting both Mpro and NRP1 were identified using virtual screening. Among them, MN-2 showed highly potent affinity to Mpro (K d = 18.2 ± 1.9 nM) and NRP1 (K d = 12.3 ± 1.2 nM), which was about 3,478-fold and 74-fold stronger than that of the positive inhibitors Peptide-21 and EG3287. Furthermore, MN-2 exhibited significant inhibitory activity against Mpro and remarkable anti-infective activity against the pseudotyped variant Omicron BA.2.75 without obvious cytotoxicity. These data demonstrated that MN-2, a novel non-covalent cyclic peptide, is a promising agent against Omicron BA.2.75.

Dual-targeting cyclic peptides of receptor-binding domain (RBD) and main protease (Mpro) as potential drug leads for the treatment of SARS-CoV-2 infection.

The receptor-binding domain (RBD) and the main protease (Mpro) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) play a crucial role in the entry and replication of viral particles, and co-targeting both of them could be an attractive approach for the treatment of SARS-CoV-2 infection by setting up a "double lock" in the viral lifecycle. However, few dual RBD/Mpro-targeting agents have been reported. Here, four novel RBD/Mpro dual-targeting peptides, termed as MRs 1-4, were discovered by an integrated virtual screening scheme combining molecular docking-based screening and molecular dynamics simulation. All of them possessed nanomolar binding affinities to both RBD and Mpro ranging from 14.4 to 39.2 nM and 22.5-40.4 nM, respectively. Further pseudovirus infection assay revealed that the four selected peptides showed >50% inhibition against SARS-CoV-2 pseudovirus at a concentration of 5 µM without significant cytotoxicity to host cells. This study leads to the identification of a class of dual RBD/Mpro-targeting agents, which may be developed as potential and effective SARS-CoV-2 therapeutics.

Why should I consult? The impact of social support on patient consultation in online healthcare communities

The COVID-19 epidemic put the traditional healthcare system and offline consultation method under strain. Patient consultations through online healthcare communities (OHCs) provide patients and physicians with a more convenient and secure route. Based on the social support theory, this study explores the impact of three dimensions of social support from physicians—information diagnosticity, source credibility, and emotional support—on patient consultations in OHCs and their moderating effect on patients’ compliments. We utilized Python Spiders to retrieve data from Haodf.com and gathered 2,982 physician reports. The model uses OLS regression with fixed effect estimations. The results show that these three dimensions of social support are positively impacted by consultation. Furthermore, patients’ compliments weaken the positive relationship between the three dimensions of physicians’ social support and patient consultations. This study contributes to the literature on social support theory in OHCs by exploring the physicians’ social support dimension and its impact on patient consultation. Moreover, this study makes practical contributions to physicians and platform administrators in OHCs.

Promoting Interdisciplinary Integration of Cybersecurity Knowledge, Skills and Career Awareness in Preservice Teacher Education

K-12 teachers and students are vulnerable to cybersecurity attacks and mostly ill-prepared to deal with them. The COVID-19 pandemic has only increased these risks because of the reliance on digital technology in education and increased free time young children and adolescents spend online. Simultaneously, the U.S. is facing an extreme shortage of cybersecurity professionals. Given the rise of cyberattacks and the need for cybersecurity professionals, a concerted effort to prepare preservice teachers to integrate cybersecurity education across the K-12 curriculum is needed. In our vision for 2025, all preservice teachers across the country are prepared to integrate age-appropriate cybersecurity concepts, skills and career awareness in the curriculum regardless of their content area or grade level specialization. We propose a repository of stand-alone activities and full curricula developed through collaboration among K-12 educators, teacher educators, and cybersecurity experts that could be adopted across teacher education programs. We use the elementary grades as a context for providing examples of some activities that might be included in the repository. We also provide recommendations for developing such a repository and for individual teacher educators who want integrate cybersecurity education in preservice teacher education right now.

Effects of role overload, work engagement and perceived organisational support on nurses' job performance during the COVID-19 pandemic.

AIMS: We aim to study the effect of role overload, work engagement and perceived organisational support on nurses' job performance, including task performance, interpersonal facilitation and job dedication. BACKGROUND: Many nurses have suffered from role overload at work during the COVID-19 pandemic. However, the investigations of the influence mechanisms and boundary conditions through and under which role overload is associated with job performance have shown inconsistent results. METHODS: A total of 595 Chinese nurses were studied from November 2020 to February 2021. Confirmatory factor analysis, maximum likelihood estimation and bootstrapping analysis were used to test the mediating process and the moderating effect. RESULTS: Work engagement partly mediated the relationships of role overload with task performance (ß = -.253, p < .001, 95% CI: [-.315, -.204]) and interpersonal facilitation (ß = -.202, p < .001, 95% CI: [-.261, -.145]); work engagement also fully mediated the relationship between role overload and job dedication (ß = -.239, p < .001, 95% CI: [-.302, -.186]). Perceived organisational support moderated the relationships of role overload with task performance, interpersonal facilitation and work dedication (ß = -.171, p < .001, ß = -.154, p < .001 and ß = -.175, p < .001, respectively). CONCLUSIONS: Work engagement is the linchpin linking role overload to distal outcomes of job performance. Perceived organisational support mitigates the ways in which role overload undermines job performance. IMPLICATIONS FOR NURSING MANAGEMENT: Hospital administrators can minimize the effects of role overload and create a more supportive organisational environment to promote the job performance of nurses.

Impact of the COVID-19 pandemic on neonatal admissions in a tertiary children's hospital in southwest China: An interrupted time-series study.

BACKGROUND: The unprecedented coronavirus disease 2019 (COVID-19) pandemic has caused millions of infections worldwide and represents a significant challenge facing modern health care systems. This study was conducted to investigate the impact of lockdown measures in a tertiary Children's Hospital in southwest China, which might be used to predict long-term effects related to health-seeking behavior of parents/caregivers. METHODS: This study included newborns enrolled over a span of 86 weeks between January 4, 2019, and August 27, 2020. We designated two time periods for analysis purposes: a stable pre-COVID period(55 weeks between January 4, 2019, and January 23, 2020) and a COVID-impacted period (31 weeks between January 24, 2020, and August 27, 2020). An interrupted time-series analysis was employed to compare changes and trends in hospital admissions and disease spectra before and after the period of nonpharmaceutical interventions (NPIs). Furthermore, this study was conducted to evaluate whether the health-seeking behavior of parents/caregivers was influenced by pandemic factors. RESULTS: Overall, 16,640 infants were admitted to the neonatology department during the pre-COVID period (n = 12,082) and the COVID-impacted period (n = 4,558). The per week neonatal admissions consistently decreased following the first days of NPIs (January 24, 2020). The average weekly admission rates of 220/week pre-COVID period and 147/week COVID-impacted period. There was an evident decrease in the volume of admissions for all disease spectra after the intervention, whereas the decrease of patients complaining about pathological jaundice-related conditions was statistically significant (p<0.05). In the COVID-impacted period, the percentage of patients who suffered from respiratory system diseases, neonatal encephalopathy, and infectious diseases decreased, while the percentage of pathological jaundice-related conditions and gastrointestinal system diseases increased. The neonatal mortality rates (NMRs) increased by 8.7% during the COVID-impacted period compared with the pre-COVID period. CONCLUSIONS: In summary, there was a significant decline in neonatal admissions in a tertiary care hospital during the COVID-19 Pandemic and the associated NPIs. Additionally, this situation had a remarkable impact on disease spectra and health-seeking behavior of parents/caregivers. We, therefore, advise continuing follow-ups and monitoring the main health indicators in vulnerable populations affected by this Pandemic over time.

Mesenchymal stem cell treatment improves outcome of COVID-19 patients via multiple immunomodulatory mechanisms.

The infusion of coronavirus disease 2019 (COVID-19) patients with mesenchymal stem cells (MSCs) potentially improves clinical symptoms, but the underlying mechanism remains unclear. We conducted a randomized, single-blind, placebo-controlled (29 patients/group) phase II clinical trial to validate previous findings and explore the potential mechanisms. Patients treated with umbilical cord-derived MSCs exhibited a shorter hospital stay (P = 0.0198) and less time required for symptoms remission (P = 0.0194) than those who received placebo. Based on chest images, both severe and critical patients treated with MSCs showed improvement by day 7 (P = 0.0099) and day 21 (P = 0.0084). MSC-treated patients had fewer adverse events. MSC infusion reduced the levels of C-reactive protein, proinflammatory cytokines, and neutrophil extracellular traps (NETs) and promoted the maintenance of SARS-CoV-2-specific antibodies. To explore how MSCs modulate the immune system, we employed single-cell RNA sequencing analysis on peripheral blood. Our analysis identified a novel subpopulation of VNN2+ hematopoietic stem/progenitor-like (HSPC-like) cells expressing CSF3R and PTPRE that were mobilized following MSC infusion. Genes encoding chemotaxis factors - CX3CR1 and L-selectin - were upregulated in various immune cells. MSC treatment also regulated B cell subsets and increased the expression of costimulatory CD28 in T cells in vivo and in vitro. In addition, an in vivo mouse study confirmed that MSCs suppressed NET release and reduced venous thrombosis by upregulating kindlin-3 signaling. Together, our results underscore the role of MSCs in improving COVID-19 patient outcomes via maintenance of immune homeostasis.

Mapping the Accessibility of Medical Facilities of Wuhan during the COVID-19 Pandemic

In December 2019, the coronavirus disease 2019 (COVID-19) pandemic attacked Wuhan, China. The city government soon strictly locked down the city, implemented a hierarchical diagnosis and treatment system, and took a series of unprecedented pharmaceutical and non-pharmaceutical measures. The residents’ access to the medical resources and the consequently potential demand–supply tension may determine effective diagnosis and treatment, for which travel distance and time are key indicators. Using the Application Programming Interface (API) of Baidu Map, we estimated the travel distance and time from communities to the medical facilities capable of treating COVID-19 patients, and we identified the service areas of those facilities as well. The results showed significant differences in service areas and potential loading across medical facilities. The accessibility of medical facilities in the peripheral areas was inferior to those in the central areas;there was spatial inequality of medical resources within and across districts;the amount of community healthcare centers was insufficient;some communities were underserved regarding walking distance;some medical facilities could be potentially overloaded. This study provides reference, in the context of Wuhan, for understanding the spatial aspect of medical resources and residents’ relevant mobility under the emergency regulation, and re-examining the coordination of emergency to improve future planning and utilization of medical facilities at various levels. The approach can facilitate policymakers to assess potential loading of medical facilities, identify low-accessibility areas, and deploy new medical facilities. It also implies that the accessibility analysis can be rapid and relevant even only with open-source data.

Sub10 μm macroporous aramid substrates with a hierarchically structured interface for organic solvent nanofiltration

Compared with traditional methods for elaborately tailoring the active layer of thin-film composite (TFC) membranes, this study focused on building novel substrates for potential applications in developing organic solvent nanofiltration (OSN) membranes. One kind of “three-parts” hierarchically structured interface with nanospheres and macro surface pores was successfully prepared via Michael addition and Schiff's base (M&S) reactions between N-(2-aminoethyl)-3-aminopropyl triethoxysilane (NAE-A) and glycerite (a natural polyphenol) in the aramid substrate. The thickness was reduced to sub10 μm with the aid of the high-speed spin coating process coupling nonsolvent-induced phase separation (HSSC-co-NIPS) method. The composition characterization results demonstrated the introduction of glycerite, and the reactions occurred in/on the substrate. Scanning electron microscopy (SEM) images clearly showed that the sub10 μm substrate contained a “three-level” hierarchically structured interface that included: (1) a “stalk-like” structure;(2) glycerite-NAE-A silane (GNAS) nanospheres;and (3) the substrate surface. These phenomena also resulted in better surface hydrophilicity. All types of organic solvents, including harsh solvents, such as tetrahydrofuran (THF) and N,N-dimethylformamide (DMF), had stable permeability within the substrate, as did apolar n-hexane and isopar™ G. Therefore, the as-prepared TFC OSN membrane, which had an extremely short polymerization time, retained broad-spectrum solvent stability and had the highest solvent permeance in acetonitrile (24.5 ± 0.4 L m−2 h−1·bar−1). In addition, the resultant TFC membrane almost completely rejected the popular macrolide antibiotic azithromycin (AZM, 748.98 g mol−1) in ethanol, which is used to treat COVID-19.

Serial computed tomographic findings and specific clinical features of pediatric COVID-19 pneumonia: A case report.

BACKGROUND: A series of recent cases of pneumonia in Wuhan, Hubei Province, China, was caused by the 2019 novel coronavirus [2019-nCoV, also called severe acute respiratory syndrome (SARS)-CoV-2]. The World Health Organization officially named the disease as coronavirus disease 2019 (COVID-19). With the global spread of COVID-19, similar cases have appeared in other areas of China, and there are a few reports of pediatric patients with COVID-19 pneumonia. CASE SUMMARY: A 7-year-old girl was diagnosed with COVID-19 and presented with irregular fever, sore throat and diarrhea. Chest computed tomography revealed patchy consolidation and ground-glass opacities in multiple areas. The lesions were mainly distributed in the bronchial bundles or subpleural areas of both lungs, particularly in the right lower lobe. The patient also presented with diarrhea, mild kidney injury, and live coronavirus was found in her feces. She was given antiviral agents (lopinavir and ritonavir), and follow-up detection showed that these abnormalities were markedly decreased within 3 d. CONCLUSION: The clinical symptoms and prognosis of COVID-19 in pediatric patients may be different from those in adult patients, and the fecal-oral transmission of SARS-CoV-2 should be considered.