Double-Network Protein Hydrogels as Flexible Pressure Sensors for Contactless Delivery

To meet the growing demand for sustainable development and ecofriendliness, hydrogels based on biopolymers have attracted widespread attention for developing flexible pressure sensors. Natural globular proteins exhibit great potential for developing biobased pressure sensors owing to their advantages of high water solubility, easy gelation, biocompatibility, and low production cost. However, realizing globular protein hydrogel-based sensors with interfacial and bulk toughness for pressure sensing and use in wearable devices remains a challenge. This study focuses on developing a high-performance flexible pressure sensor based on a biobased protein hydrogel. Consequently, a flexible protein/polyacrylamide (PAM) hydrogel with a featured double-network (DN) structure linked covalently with hydrogen bonds was first synthesized via a one-pot method based on natural ovalbumin (OVA). The unique DN structure of the as-synthesized OVA/PAM hydrogel affords excellent mechanical performance, flexibility, and adhesion properties. The mechanical properties of the DN hydrogel were enhanced after further cross-linking with Fe3+ and treatment with glycerol. Subsequently, the flexible pressure sensor was constructed by sandwiching a microstructured OVA/PAM dielectric layer between two flexible silver nanowire electrodes. The obtained sensor exhibits a high sensitivity of 2.9 kPa-1 and a short response time of 18 ms, ensuring the ability to monitor physiological signals. Based on its excellent performance, the fabricated sensor was used for monitoring the signals obtained using practical applications such as wrist bending, finger knocking, stretching, international Morse code, and pressure distribution. Particularly, we implemented a contactless delivery system using the fabricated OVA-based pressure sensors linked to unmanned vehicles and global positioning systems, providing a solution for low-risk commodity distribution during Coronavirus disease 2019 (COVID-19).

Double-Network Protein Hydrogels as Flexible Pressure Sensors for Contactless Delivery

To meet the growing demand for sustainable development and ecofriendliness, hydrogels based on biopolymers have attracted widespread attention for developing flexible pressure sensors. Natural globular proteins exhibit great potential for developing biobased pressure sensors owing to their advantages of high water solubility, easy gelation, biocompatibility, and low production cost. However, realizing globular protein hydrogel-based sensors with interfacial and bulk toughness for pressure sensing and use in wearable devices remains a challenge. This study focuses on developing a high-performance flexible pressure sensor based on a biobased protein hydrogel. Consequently, a flexible protein/polyacrylamide (PAM) hydrogel with a featured double-network (DN) structure linked covalently with hydrogen bonds was first synthesized via a one-pot method based on natural ovalbumin (OVA). The unique DN structure of the as-synthesized OVA/PAM hydrogel affords excellent mechanical performance, flexibility, and adhesion properties. The mechanical properties of the DN hydrogel were enhanced after further cross-linking with Fe3+ and treatment with glycerol. Subsequently, the flexible pressure sensor was constructed by sandwiching a microstructured OVA/PAM dielectric layer between two flexible silver nanowire electrodes. The obtained sensor exhibits a high sensitivity of 2.9 kPa-1 and a short response time of 18 ms, ensuring the ability to monitor physiological signals. Based on its excellent performance, the fabricated sensor was used for monitoring the signals obtained using practical applications such as wrist bending, finger knocking, stretching, international Morse code, and pressure distribution. Particularly, we implemented a contactless delivery system using the fabricated OVA-based pressure sensors linked to unmanned vehicles and global positioning systems, providing a solution for low-risk commodity distribution during Coronavirus disease 2019 (COVID-19). © 2023 American Chemical Society.

Virologic and Immunologic Outcomes in People Living with HIV in a Correctional Setting During the SARS-CoV-2 Pandemic

Background. It is known that the pandemic increased the risk of severe illness from SARS-CoV-2 infection in immunocompromised patients as compared to the general public. To combat this issue, telemedicine was utilized in various settings, but there is very little data on the adequate continuity of care (COC) and sustainability of telehealth throughout the pandemic. There is even less data on the effects of the pandemic in special populations, such as people living with human immunodeficiency virus (PLWH) and within the correctional setting. The purpose of this study was to investigate rates of HIV virologic suppression (VS) and the sustainability of telemedicine throughout the SARS-CoV-2 pandemic. Methods. This was a retrospective, pre-post cohort study of PLWH who received antiretroviral therapy (ART) within Illinois Department of Corrections (IDOC) / University of Illinois Chicago telemedicine clinic between 3/2019 and 3/2021. Patients who were released from IDOC or reincarcerated during the study period were excluded. The primary endpoint compared the rate of HIV VS pre-, peri- and post-SARS-CoV-2 restrictions. Secondary endpoints included change in immunologic function pre-, peri- and post-SARS-CoV-2 restrictions, incidence of SARS-CoV-2 infection, number of hospitalizations, development of virologic failure, and change in ART post-pandemic. Other factors known to influence COC were also collected. Results. Of 320 patients screened, 225 were included. The majority were Black males (73.7%) and 95.1% had a CD4 T-cell count > 200 cells/mm3 at baseline. Approximately 88% of patients were on a single tablet regimen, with most receiving bictegravir/emtricitabine/tenofovir alafenamide. Rates of HIV VS are summarized in Figure 1 and secondary outcomes are summarized in table 1. Factors associated with disruption of COC included non-adherence to appointments (62.6%) and ART (4.4%). Conclusion. Results demonstrated that PLWH within IDOC had sustained VS and COC throughout the SARS-CoV-2 pandemic with telemedicine. These results describe how the pandemic impacted PLWH in a correctional setting and future studies could contribute to creating national guidance for telemedicine models to streamline clinical practice.

RELATIONSHIPS BETWEEN VACCINE CONFIDENCE AND VACCINE UPTAKE AT A STUDENT-RUN CLINIC FOR THE UNINSURED IN EAST HARLEM

BACKGROUND: The East Harlem Health Outreach Partnership (EHHOP) is a student-run clinic that serves a particularly vulnerable patient population lacking access to basic health insurance, largely because many do not meet USA residency requirements. COVID-19 has exacerbated the existing health disparities faced by our patients, who are predominantly Black and/or Hispanic/Latino living in East Harlem, one of the hardest hit neighborhoods in NYC. We hypothesized that high engagement in longitudinal care through the student-run clinic is associated with especially high rates of vaccine confidence and vaccine uptake. METHODS: This study included phone interviews with 63 EHHOP patients between 12/13/20 and 3/3/21. We asked 14 questions in order to measure vaccine confidence, COVID-19 sentiment, and patient trust. Patients were ages 21-78 with an even distribution of male and female patients. Most interviews were conducted in Spanish with professional translators, and the survey was created both in English and Spanish. All questions were scored on a 1-5 scale of agreement with a given. Patients were then followed through December of 2021 in order to ascertain vaccine uptake over time. RESULTS: 95.2% of those interviewed are now confirmed to be vaccinated (60/63), 3.2% have refused (2/63), and only 1.6% have unknown status (1/63). Both patients who chose not to be vaccinated had responded they were unlikely to get the COVID-19 vaccine. When comparing those likely to get the vaccine versus those who were not, the most highly significant differences in scores came when asking whether patients are more likely to take the vaccine due to their physician recommending it, and when asked whether they generally trusted those recommending they get the vaccine (p = 4.8E-5 and 4.3E-6 respectively). The next most significant differences were in perceptions of whether the vaccine would be effective and whether they felt the vaccine was created too quickly (p = 3.3E-2 and 5.3E-3 respectively). We also have precise day of first dose information for 51/60 vaccinated respondents. While there may be confounders, we found that choosing to be vaccinated earlier correlated most significantly with whether individuals were likely to take the vaccine, whether the trusted those recommending the vaccine, and whether they felt the vaccine was created too quickly (p = 3.6E-2, 1.5E-2, and 1.4E-2 respectively). CONCLUSIONS: These data indicate that the strongest predictors of vaccine uptake rate and timing are not just vaccine confidence in general, but specifically trust in those recommending the vaccine. This indicates that even in the context of marginalized populations often underserved by the healthcare system, longitudinal trust-building relationships may be a significant part of successful vaccine uptake. Those with the highest burden of disease should be given preferential treatment with high-quality, longitudinal care, and such care is shown to make a great difference in the context of vaccine uptake.

Fieldwork for public health responses during pandemics: lessons from the New South Wales Health experience with COVID-19

Problem: Fieldwork is a vital component of public health emergency response, yet little has been published on undertaking fieldwork safely. Safety is of particular importance with emerging pandemic viruses, which can pose additional risks to public health fieldwork staff. Context: During a pandemic, surge health staff may be drawn from diverse professional backgrounds;they may have limited experience in fieldwork or be unfamiliar with the risks posed by a novel virus. Novel pathogens pose dangers to fieldwork staff, particularly when there are global or local shortages of personal protective equipment. Action: During the coronavirus disease 2019 (COVID-19) pandemic, New South Wales (NSW) Health's Public Health Emergency Operations Centre (PHEOC) deployed staff for fieldwork in a range of settings. The PHEOC developed a protocol to systematize planning, risk assessment and management for COVID-19 fieldwork. The protocol was accompanied by training, discussion exercises and debriefs to support PHEOC fieldwork staff. Lessons learned: Effective fieldwork is an essential component of outbreak investigation and management, including stakeholder management. Here, we share and discuss key elements of the NSW Health protocol to support fieldwork during outbreak responses for emerging communicable diseases across various resource contexts. Limited understanding of novel viruses, particularly in the early phases of a pandemic, must be considered in decisions to deploy fieldwork staff and implement precautionary risk mitigation approaches. Planning is essential to protect staff and ensure ethical allocation of resources. Through appropriate selection of teams and training, surge staff can be supported to effectively conduct fieldwork.

Analysis on the Social and Economic Impacts of Internet Platforms : (Based on Survey Data from WeChat (China) during 2019-2020)

In recent years, the global economy has been going through a critical period of economic growth driver transformation, with further economic slowdown. At the same time, the outbreak of COVID-19 has brought a severe blow to the world's economy. Against these backdrops, the digital economy has presented extraordinary resilience of development, bringing unprecedented opportunities to various industries and injecting new momentum to social and economic development. How large is the impact of the Internet platform economy on economic and social development? Will it increase the overall employment or influence the employment structure? Has the Internet platform truly stabilized the economy and society during the outbreak? Through case studies on the survey data from WeChat during 2019-2020, this paper employs questionnaire-based statistical approach and the expenditure approach applied in measuring national economic accounting to unveil the impacts of Internet platforms on economic and social development, hoping to provide reference to future studies in the field. © 2020 ITU.

EFFICACY OF EARLY PRONE POSITIONING IN PATIENTS WITH COVID-19 PNEUMONIA REQUIRING SUPPLEMENTAL OXYGEN, HIGH FLOW NASAL CANNULA, OR NONINVASIVE VENTILATION

SESSION TITLE: Respiratory Care Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: To assess the effect of awake prone positioning (PP) in non-intubated patients with COVID-19 pneumonia and acute hypoxic respiratory failure on oxygenation, escalation to ICU, and mortality. METHODS: A prospective observational cohort study was conducted on a dedicated COVID-19 respiratory step-down unit within an urban, tertiary care, teaching hospital from 4/30/20-5/31/20. The unit was managed by internal medicine residents and hospitalists. Inpatients with documented COVID-19 pneumonia and those under investigation who required supplemental oxygen (nasal cannula, non-rebreather face mask, high flow nasal cannula, non-invasive ventilation) were encouraged to self-prone for at least 30 minutes and up to 4 hours per day (in 2, 2 hour sessions) for 3 to 5 days. Exclusion criteria: inability to provide verbal consent, inability to self-prone or change position, primary team’s safety concerns, inability to protect airway, impending intubation, acute VTE diagnosed in the past 48hr, hypotension, recent intubation or ICU stay during the current admission. SpO2, oxygen delivery modality, and S/F ratios were monitored during PP and until discharge. All patients received usual COVID-19 care according to local institutional guidance. RESULTS: 22 patients were screened for study inclusion, 14 patients were enrolled, 1 could not tolerate PP due to back pain and 2 were transferred to the ICU within 24 hours of enrollment. Of the 11 subjects ultimately analyzed, 55% were male, 45% were female, median age was 55. 2 had underlying lung disease and 2 had no comorbid conditions. 2 died during admission (both DNI), 9 were discharged home, and none were intubated. Only one required home oxygen on discharge. 9 of 11 patients (82%) successfully completed at least 3 days of PP. The median cumulative time spent prone was 10 hours, the mean was 10.3 hours (range: 4 hours-13.5 hours). Of the 9 who survived, 100% demonstrated an improvement in S/F ratio with PP and 8 of 9 patients (89%) continued to maintain improved S/F ratios after completing the PP intervention. CONCLUSIONS: PP is generally well tolerated, and no patients experienced desaturation with PP. Our experience is similar to others who proned patients with ARDS who required HFNC or NIV. While the optimal duration of PP remains unclear, patients who can tolerate at least 4 hours of PP appeared to maintain their S/F ratio gains through discharge. A non-sustained or lack of S/F response to PP appeared associated with worse outcomes. The impact of PP on escalation to ICU in our study remains unclear. CLINICAL IMPLICATIONS: PP is an easily implemented, low cost, and low risk intervention that could potentially aid in improving oxygenation in patients with severe COVID-19 pneumonia who have not been intubated and require varying levels of supplemental oxygen support. A lack of improvement in oxygenation with PP may also aid in identifying patients with worse outcomes. DISCLOSURES: No relevant relationships by Jacob Bell, source=Web Response No relevant relationships by Abhinav Bhalla, source=Web Response No relevant relationships by Patricia Dharapak, source=Web Response No relevant relationships by Tsz Keung Eng, source=Web Response No relevant relationships by Justin Gasper, source=Web Response No relevant relationships by Dewan Giri, source=Web Response No relevant relationships by Steven Lim, source=Web Response No relevant relationships by Paru Patrawalla, source=Web Response No relevant relationships by Paru Patrawalla, source=Web Response No relevant relationships by David Steiger, source=Web Response No relevant relationships by Anqi Zheng, source=Web Response