Impact of the COVID-19 pandemic on social media utilization, influences related to parental vaccine decision making, and opinions on trustworthy social media vaccination campaigns: A qualitative analysis

There is a continued need for research to better understand the influence social media has on parental vaccination attitudes and behaviors, especially research capturing the effects of the COVID-19 pandemic. The goal of this study was to explore parents' perspectives related to the impact the pandemic had on 1) social media engagement, 2) vaccine messaging on social media, and 3) factors to guide future intervention development. Between February and March 2022, 6 online, synchronous, text-based focus groups were conducted with parents of adolescents aged 11 to 17 years. Participants who all utilized social media were recruited from across the United States. Qualitative data were analyzed using content analysis. A total of 64 parents participated. Average age was 47 years, and participants were predominantly White (71.9%), female (84.3%), and engaged with social media multiple times per day (51.6%). Participants (95.3%) viewed obtaining all recommended vaccines as important or very important; however, overall vaccination rates for their adolescents were varied (50% ≥1 dose HPV; 59.4% MenACWY; 78.1% Tdap; 65.6% Flu; 81.3% COVID-19). Three themes emerged highlighting the pandemic's impact on parent's (1) general patterns of social media use, (2) engagement about vaccines on social media and off-line behaviors related to vaccination, and (3) perspectives for developing a credible and trustworthy social media intervention about vaccination. Participants reported fatigue from contentious vaccine-related content on social media and desired future messaging to be from recognizable health institutions/associations with links to reputable resources. Plus, providers should continue to provide strong vaccine recommendations in clinic.

Factors Associated With Guideline-concordant and Excessive Cervical Cancer Screening: A Mixed Methods Study

INTRODUCTION

National guidelines recommend cervical cancer screening with Papanicolaou (Pap) testing at 3-year intervals or with human papillomavirus (HPV) testing alone or HPV/Pap cotesting at 5-year intervals for average-risk individuals aged 30-65 years.

METHODS

We explored factors associated with clinician-reported guideline-concordant screening, as well as facilitators and barriers to appropriate cervical cancer screening.

RESULTS

A national sample of clinicians (N = 1,251) completed surveys; a subset (n = 55) completed interviews. Most (94%) screened average-risk patients aged 30-65 years with cotesting. Nearly all clinicians who were categorized as nonadherent to national guidelines were overscreening (98%). Guideline concordant screening was reported by 47% and 82% of those using cotesting and HPV testing, respectively (5-year intervals), and by 62% of those using Pap testing only (3-year intervals). Concordant screening was reported more often by clinicians who were aged <40 years, non-Hispanic, and practicing in the West or Midwest, and less often by obstetrician-gynecologists and private practice physicians. Concordant screening was facilitated by beliefs that updated guidelines were evidence-based and reduced harms, health care system dissemination of guidelines, and electronic medical record prompts. Barriers to concordant screening included using outdated guidelines, relying on personal judgment, concern about missing cancers, inappropriate patient risk assessment, and lack of support for guideline adoption through health care systems or electronic medical records.

CONCLUSIONS

Most clinicians screened with Pap/HPV cotesting and approximately one-half endorsed a 5-year screening interval. Clinician knowledge gaps include understanding the evidence underlying 5-year intervals and appropriate risk assessment to determine which patients should be screened more frequently. Education and tracking systems can promote guideline-concordant screening.

HPV vaccine recommendations by age: A survey of providers in federally qualified health centers

Clinician recommendation remains a critical factor in improving HPV vaccine uptake. Clinicians practicing in federally qualified health centers were surveyed between October 2021 and July 2022. Clinicians were asked how they recommended HPV vaccination for patients aged 9-10, 11-12, 13-18, 19-26, and 27-45 y (strongly recommend, offer but do not recommend strongly, discuss only if the patient initiates the conversation, or recommend against). Descriptive statistics were assessed, and exact binomial logistic regression analyses were utilized to examine factors associated with HPV vaccination recommendation in 9-10-y-old patients. Respondents (n = 148) were primarily female (85%), between the ages of 30-39 (38%), white, non-Hispanic (62%), advanced practice providers (55%), family medicine specialty (70%), and practicing in the Northeast (63%). Strong recommendations for HPV vaccination varied by age: 65% strongly recommended for ages 9-10, 94% for ages 11-12, 96% for ages 13-18, 82% for age 19-26, and 26% for ages 27-45 y. Compared to Women's Health/OBGYN specialty, family medicine clinicians were less likely to recommend HPV vaccination at ages 9-10 (p = .03). Approximately two-thirds of clinicians practicing in federally qualified health centers or safety net settings strongly recommend HPV vaccine series initiation at ages 9-10. Additional research is needed to improve recommendations in younger age groups.

Comparing Web-Based and Blended Training for Coping With Challenges of Flexible Work Designs: Randomized Controlled Trial

BACKGROUND

Workers with flexible work designs (FWDs) face specific challenges, such as difficulties in detaching from work, setting boundaries between work and private life, and recovering from work.

OBJECTIVE

This study evaluated the effectiveness of an intervention in improving the recovery, work-life balance, and well-being of workers with FWDs compared with a waitlist control group. It also compares the effectiveness of a web-based training format and blended training format.

METHODS

In the web-based training format, participants individually completed 6 web-based modules and daily tasks over 6 weeks, learning self-regulation strategies to meet the particular challenges of FWDs. In the blended training format, participants attended 3 group sessions in addition to completing the 6 web-based modules. In a randomized controlled trial, participants were assigned to a web-based intervention group (196/575, 34.1%), blended intervention group (198/575, 34.4%), or waitlist control group (181/575, 31.5%). Study participants self-assessed their levels of primary outcomes (psychological detachment, satisfaction with work-life balance, and well-being) before the intervention, after the intervention, at a 4-week follow-up, and at a 6-month follow-up. The final sample included 373 participants (web-based intervention group: n=107, 28.7%; blended intervention group: n=129, 34.6%; and control group: n=137, 36.7%). Compliance was assessed as a secondary outcome.

RESULTS

The results of multilevel analyses were in line with our hypothesis that both training formats would improve psychological detachment, satisfaction with work-life balance, and well-being. We expected blended training to reinforce these effects, but blended training participants did not profit more from the intervention than web-based training participants. However, they reported to have had more social exchange, and blended training participants were more likely to adhere to the training.

CONCLUSIONS

Both web-based and blended training are effective tools for improving the recovery, work-life balance, and well-being of workers with FWDs. Group sessions can increase the likelihood of participants actively participating in web-based modules and exercises.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00032721; https://drks.de/search/en/trial/DRKS00032721.

A phase 1 trial of adoptive transfer of vaccine-primed autologous circulating T cells in ovarian cancer

We have previously shown that vaccination with tumor-pulsed dendritic cells amplifies neoantigen recognition in ovarian cancer. Here, in a phase 1 clinical study ( NCT01312376 /UPCC26810) including 19 patients, we show that such responses are further reinvigorated by subsequent adoptive transfer of vaccine-primed, ex vivo-expanded autologous peripheral blood T cells. The treatment is safe, and epitope spreading with novel neopeptide reactivities was observed after cell infusion in patients who experienced clinical benefit, suggesting reinvigoration of tumor-sculpting immunity.

Examining the perceived impact of the COVID-19 pandemic on cervical cancer screening practices among clinicians practicing in Federally Qualified Health Centers: A mixed methods study

Background

The COVID-19 pandemic led to reductions in cervical cancer screening and colposcopy. Therefore, in this mixed methods study we explored perceived pandemic-related practice changes to cervical cancer screenings in federally qualified health centers (FQHCs).

Methods

Between October 2021 and June 2022, we conducted a national web survey of clinicians (physicians and advanced practice providers) who performed cervical cancer screening in FQHCs in the United States during the post-acute phase of the COVID-19 pandemic, along with a sub-set of qualitative interviews via video conference, to examine perceived changes in cervical cancer screening practices during the pandemic.

Results

A total of 148 clinicians completed surveys; a subset (n=13) completed qualitative interviews. Most (86%) reported reduced cervical cancer screening early in the pandemic, and 28% reported continued reduction in services at the time of survey completion (October 2021- July 2022). Nearly half (45%) reported staff shortages impacting their ability to screen or track patients. Compared to clinicians in Obstetrics/Gynecology/Women's health, those in family medicine and other specialties more often reported reduced screening compared to pre-pandemic. Most (92%) felt that screening using HPV self-sampling would be very or somewhat helpful to address screening backlogs. Qualitative interviews highlighted the impacts of staff shortages and strategies for improvement.

Conclusions

Findings highlight that in late 2021 and early 2022, many clinicians in FQHCs reported reduced cervical cancer screening and of pandemic-related staffing shortages impacting screening and follow-up. If not addressed, reduced screenings among underserved populations could worsen cervical cancer disparities in the future.

Funding

This study was funded by the American Cancer Society, who had no role in the study's design, conduct, or reporting.

A cross-sectional survey examining clinician characteristics, practices, and attitudes associated with adoption of the 2019 American Society for Colposcopy and Cervical Pathology risk-based management consensus guidelines

BACKGROUND

The 2019 American Society for Colposcopy and Cervical Pathology (ASCCP) risk-based management consensus guidelines are the most recent national guidelines for the management of abnormal cervical cancer screening tests. These guidelines benefit patients by concentrating testing and treatment in those at highest cervical cancer risk. Adoption of guidelines often occurs slowly, with few studies examining the factors associated with guideline-adherent management of abnormal results.

METHODS

To elucidate the factors associated with the use of the 2019 ASCCP guidelines among clinicians who perform cervical cancer screening, physicians and advanced practice professionals who perform cervical cancer screening were cross-sectionally surveyed. Clinicians responded to screening vignettes with differing recommendations for management between the 2019 and prior management guidelines. Screening vignette 1 involved reduction of invasive testing on a low-risk patient; screening vignette 2 involved increased surveillance testing on a high-risk patient. Binomial logistic regression models determined the factors associated with the use of the 2019 guidelines.

RESULTS

A total of 1251 clinicians participated from across the United States. For screening vignettes 1 and 2, guideline-adherent responses were given by 28% and 36% of participants, respectively. Management recommendations differed by specialty and were incorrect in different situations: there was inappropriate invasive testing by obstetrics and gynecology physicians (vignette 1) and inappropriate discontinuation of screening by family and internal medicine physicians (vignette 2). Regardless of their chosen response, over half erroneously believed they were guideline adherent.

CONCLUSIONS

Many clinicians who believe they are following appropriate guidelines may not realize their management strategy is inconsistent with the 2019 guidelines. Education initiatives tailored to clinician specialty could address the understanding of current guidelines, encourage the use of updated guidelines, maximize patient benefits, and minimize harms.

PLAIN LANGUAGE SUMMARY

The 2019 American Society for Colposcopy and Cervical Pathology risk-based management consensus guidelines are the most recent national guidelines for abnormal cervical cancer screening test management. We surveyed over 1200 obstetrics and gynecology (OB/GYN), family medicine, and internal medicine physicians and advanced practice providers about their screening and abnormal results follow-up practices in relation to guidelines. Few clinicians are following the 2019 guidelines. Management recommendations differed by clinician specialty and were incorrect in different situations: there was inappropriate invasive testing by OB/GYN physicians and inappropriate screening discontinuation by family and internal medicine physicians. Education tailored by clinician specialty could address the understanding of current guidelines, encourage the use of updated guidelines, maximize patient benefits, and minimize harms.

Examining the association of clinician characteristics with perceived changes in cervical cancer screening and colposcopy practice during the COVID-19 pandemic: a mixed methods assessment

Background

The COVID-19 pandemic led to reductions in cervical cancer screening and colposcopy. Therefore, in this mixed method study we explored perceived pandemic-related practice changes to cervical cancer screenings and colposcopies.

Methods

In 2021, a national sample of 1251 clinicians completed surveys, including 675 clinicians who performed colposcopy; a subset (n=55) of clinicians completed qualitative interviews.

Results

Nearly half of all clinicians reported they were currently performing fewer cervical cancer screenings (47%) and colposcopies (44% of those who perform the procedure) than before the pandemic. About one-fifth (18.6%) of colposcopists reported performing fewer LEEPs than prior to the pandemic. Binomial regression analyses indicated that older, as well as internal medicine and family medicine clinicians (compared to OB-GYNs), and those practicing in community health centers (compared to private practice) had higher odds of reporting reduced screening. Among colposcopists, internal medicine physicians and those practicing in community health centers had higher odds of reporting reduced colposcopies. Qualitative interviews highlighted pandemic-related care disruptions and lack of tracking systems to identify overdue screenings.

Conclusions

Reductions in cervical cancer screening and colposcopy among nearly half of clinicians more than 1 year into the pandemic raise concerns that inadequate screening and follow-up will lead to future increases in preventable cancers.

Funding

This study was funded by the American Cancer Society, who had no role in the study's design, conduct, or reporting.

Employees' work breaks and their physical and mental health: Results from a representative German survey

This study aimed to investigate the prevalence of three characteristics of work break organization, namely skipping work breaks, interruptions of work breaks, and meal break duration, and their relationships with physical and mental health. We used data from the BAuA-Working Time Survey 2017, a representative workforce survey in Germany, and restricted the sample to 5979 full-time employees. Logistic regression analyses were conducted with in total five health complaints as dependent variables: back pain and low back pain, pain in the neck and shoulder region, general tiredness, faintness, or fatigue, physical exhaustion, and emotional exhaustion. Many employees often skipped their work breaks (29%) and experienced break interruptions (16%). Frequent skipping of work breaks was significantly positively, that is detrimentally, related to all five health complaints and frequent interruptions of work breaks also, except for neck and shoulder pain. Meal break duration was significantly negatively, that is beneficially, related to physical exhaustion.

Neoantigen-specific CD8 T cells with high structural avidity preferentially reside in and eliminate tumors

The success of cancer immunotherapy depends in part on the strength of antigen recognition by T cells. Here, we characterize the T cell receptor (TCR) functional (antigen sensitivity) and structural (monomeric pMHC-TCR off-rates) avidities of 371 CD8 T cell clones specific for neoantigens, tumor-associated antigens (TAAs) or viral antigens isolated from tumors or blood of patients and healthy donors. T cells from tumors exhibit stronger functional and structural avidity than their blood counterparts. Relative to TAA, neoantigen-specific T cells are of higher structural avidity and, consistently, are preferentially detected in tumors. Effective tumor infiltration in mice models is associated with high structural avidity and CXCR3 expression. Based on TCR biophysicochemical properties, we derive and apply an in silico model predicting TCR structural avidity and validate the enrichment in high avidity T cells in patients' tumors. These observations indicate a direct relationship between neoantigen recognition, T cell functionality and tumor infiltration. These results delineate a rational approach to identify potent T cells for personalized cancer immunotherapy.

TCR sequencing and cloning methods for repertoire analysis and isolation of tumor-reactive TCRs

T cell receptor (TCR) technologies, including repertoire analyses and T cell engineering, are increasingly important in the clinical management of cellular immunity in cancer, transplantation, and other immune diseases. However, sensitive and reliable methods for repertoire analyses and TCR cloning are still lacking. Here, we report on SEQTR, a high-throughput approach to analyze human and mouse repertoires that is more sensitive, reproducible, and accurate as compared with commonly used assays, and thus more reliably captures the complexity of blood and tumor TCR repertoires. We also present a TCR cloning strategy to specifically amplify TCRs from T cell populations. Positioned downstream of single-cell or bulk TCR sequencing, it allows time- and cost-effective discovery, cloning, screening, and engineering of tumor-specific TCRs. Together, these methods will accelerate TCR repertoire analyses in discovery, translational, and clinical settings and permit fast TCR engineering for cellular therapies.

The calcium-sensing receptor modulates the prostaglandin E2 pathway in intestinal inflammation

Introduction: The prostaglandin E2 (PGE2) pathway is one of the main mediators of intestinal inflammation. As activation of the calcium-sensing receptor (CaSR) induces expression of inflammatory markers in the colon, we assessed the impact of the CaSR on the PGE2 pathway regulation in colon cancer cells and the colon in vitro and in vivo. Methods and Results: We treated CaSR-transfected HT29 and Caco-2 colon cancer cell lines with different orthosteric ligands or modulators of the CaSR and measured gene expression and PGE2 levels. In CaSR-transfected HT29CaSR-GFP and Caco-2CaSR-GFP cells, the orthosteric CaSR ligand spermine and the positive allosteric CaSR modulator NPS R-568 both induced an inflammatory state as measured by IL-8 gene expression and significantly increased the expression of the PGE2 pathway key enzymes cyclooxygenase (COX)-2 and/or prostaglandin E2 synthase 1 (PGES-1). Inhibition of the CaSR with the calcilytic NPS 2143 abolished the spermine- and NPS R-568-induced pro-inflammatory response. Interestingly, we observed cell-line specific responses as e.g. PGES-1 expression was affected only in HT29CaSR-GFP but not in Caco-2CaSR-GFP cells. Other genes involved in the PGE2 pathway (COX-1, or the PGE2 receptors) were not responsive to the treatment. None of the studied genes were affected by any CaSR agonist in GFP-only transfected HT29GFP and Caco-2GFP cells, indicating that the observed gene-inducing effects of spermine and R-568 were indeed mediated by the CaSR. In vivo, we had previously determined that treatment with the clinically approved calcimimetic cinacalcet worsened symptoms in a dextran sulfate sodium (DSS)-induced colitis mouse model. In the colons of these mice, cinacalcet significantly induced gene expression of PGES-2 and the EP3 receptor, but not COX-2; while NPS 2143 increased the expression of the PGE2-degrading enzyme 15-hydroxyprostaglandin dehydrogenase (15-PGDH). Importantly, neither treatment had any effect on the colons of non-DSS treated mice. Discussion: Overall, we show that activation of the CaSR induces the PGE2 pathway, albeit with differing effects in vitro and in vivo. This may be due to the different microenvironment in vivo compared to in vitro, specifically the presence of a CaSR-responsive immune system. Since calcilytics inhibit ligand-mediated CaSR signaling, they may be considered for novel therapies against inflammatory bowel disease.

Emergency preparedness is a healthcare issue: COVID-19 pandemic's influence on attitudes and behaviors among a national sample of parents

BACKGROUND

Improving household emergency preparedness (EP) is a public health priority, yet little is known about what influence the COVID-19 pandemic had on families' EP. This study aimed to explore current EP attitudes and behaviors.

METHODS

We conducted online focus groups in Winter 2022 with a nationwide sample of parents of adolescents. We held six 90-min focus groups of 9-15 participants using a semi-structured interview script that elicited parental knowledge and attitudes related to household EP. Two researchers conducted qualitative content analysis on focus group transcripts. First-level coding within and across scripts was used to identify broad categories or themes regarding EP. The process was reviewed continuously to verify data and coding procedures. Three investigators independently verified the final themes that emerged.

RESULTS

Participants (N = 64) were mostly female (n = 54, 84.3%), white (n = 46, 71.9%), and college-educated (n = 49, 76.6%). Major themes included: 1) Expanded awareness and behavioral change related to EP due to the COVID-19 pandemic, 2) Reconceptualization of planning for family health as part of EP, 3) Changing perspectives related to vaccination as a component of EP, and 4) Perspectives related to discussing EP with their health care provider.

CONCLUSIONS

EP was described as a healthcare issue and healthcare providers were identified as trusted sources of EP information. Interventions to support providers' ability to assist with individual EP health action plans, including discussing vaccination as part of preparedness are needed.

Multi-source datasets acquired over Toulouse (France) in 2021 for urban microclimate studies during the CAMCATT/AI4GEO field campaign

The CAMCATT-AI4GEO extensive field experiment took place in Toulouse, a city in the southwest of France, from 14^th to 25^th June 2021 (with complementary measurements performed on the 6 September 2021). Its main objective was the acquisition of a new reference dataset on an urban site to support the development and validation of data products from the future thermal infrared (TIR) satellite missions such as TRISHNA (CNES/ISRO), LSTM (ESA) and SBG (NASA). With their high spatial (between 30-60m) and temporal (2-3 days) resolutions, the future TIR satellite data will allow a better investigation of the urban climate at the neighbourhood scale. However, in order to validate the future products of these missions such as LST, air temperature, comfort index and Urban Heat Island (UHI), there is a need to accurately characterise the organisation of the city in terms of 3D geometry, spectral optical properties and both land surface temperature and emissivity (LST and LSE) at several scales. In this context, the CAMCATT-AI4GEO field campaign provides a set of airborne VISNIR-SWIR (Visible Near InfraRed - ShortWave InfraRed) hyperspectral imagery, multispectral thermal infrared (TIR) imagery and 3D LiDAR acquisitions, together with a variety of ground data collected, for some of them, simultaneously to the flight. The ground dataset includes surface reflectance measured spectrally with ASD spectroradiometers and in six spectral bands spreading from shortwave to thermal infrared and for two viewing angles with a SOC410-DHR handheld reflectometer. It is completed with LST and LSE retrieved from thermal infrared radiance acquired in six spectral bands with CIMEL radiometers. It also includes meteorological data coming from four radio soundings (one of which was taken during the flight), data routinely collected at the Blagnac airport reference station as well as air temperature and humidity acquired using instrumented cars following two different itineraries. In addition, a link is provided to access the data routinely collected by the network of weather stations set up by Toulouse Metropole in the city and its surroundings. This data paper describes this new reference urban dataset which can be useful for many applications such as calibration/validation of at-surface radiance, LST and LSE data products as well as higher level products such as air temperature or comfort index. It also provides valuable opportunities for other applications in urban climate studies, such as supporting the validation of microclimate models.

Integrating Mobile and Portable Technologies With In-Person and Telehealth Care to Increase Perinatal Healthcare Equity for the Unstably Housed

Pregnant people living in rural areas are at an increased risk of experiencing poor perinatal outcomes due, in part, to the need to travel long distances to see a perinatal care provider. Telehealth care has been used successfully to increase access to perinatal care but requires patients to have access to broadband Internet access and devices capable of establishing secure connections so they can participate in their care. This places an additional burden on unstably housed pregnant persons who may not have access to the required technology. The Midwifery Integrated Home Visitation Program was developed to bridge this digital divide by bringing perinatal care services to the unstably housed at their desired location of care. The included case studies outline how telehealth and portable technology were used to address the medical and nonmedical needs of unstably housed pregnant people. They also outline how bridging the digital divide by combining in-person perinatal care with mobile technology, portable technology, and telehealth care has the potential to decrease unnecessary emergency department care and ambulance use while facilitating the receipt of appropriate care and thus potentially preventing poor perinatal outcomes.

Adequate Prenatal Care: An Integrative Review

INTRODUCTION

Prenatal care (PNC) is a core element of preventive care and is vital in identifying and managing conditions that can put the pregnant person and the fetus at risk. National and international guidelines differ in what is considered adequate or quality PNC. Indices of care adequacy rely only on number of attended PNC visits without regard to factors that affect a patient's ability to obtain care or the quality of the care received. This integrative review explored stakeholders' perceptions of adequate and quality PNC.

METHODS

Three electronic databases, CINAHL, PubMed, and Web of Science, were searched to identify original research articles published between 2012 and April 2022. Studies conducted in the United States, published in a peer-reviewed journal, and having a primary focus on the components of adequate or quality PNC were included. The quality of included studies was assessed via the Quality Assessment Tool for Studies with Diverse Designs.

RESULTS

Thirteen articles met inclusion criteria. The concepts of adequate or quality PNC were not well defined in the literature. Studies revealed a variety of approaches to assessing individual components of PNC with at times conflicting results of what adequate or quality PNC is. Viewpoints regarding adequacy or quality of PNC were limited by the perceptions and interpretations of individual stakeholders, who included researchers, public health officials, insurers, health care providers, and patients.

DISCUSSION

Ideas of how to redesign PNC were affected by study setting and stakeholders, as well as the emergence and integration of telehealth into PNC delivery. This review is a first step in identifying the gap in the research literature regarding how these concepts are defined and measured. Future research is needed to identify the relevant components of PNC that are necessary to reach consensus definitions of both adequacy and quality of PNC.

Message testing in India for COVID-19 vaccine uptake: What appeal and what messenger are most persuasive?

Few studies have examined the relationships between the different aspects of vaccination communication and vaccine attitudes. We aimed to evaluate the influence of three unique messaging appeal framings of vaccination from two types of messengers on COVID-19 vaccine acceptance in India. We surveyed 534 online participants in India using Amazon Mechanical Turk (MTurk) from December 2021 through January 2022. We assessed participants' perception of three messaging appeals of vaccination - COVID-19 disease health outcomes, social norms related to vaccination, and economic impact of COVID-19 - from two messengers, healthcare providers (HCP) and peers. Using a multivariable multinomial logistic regression, we examined participants' ad preference and vaccine hesitancy. Participants expressed a high level of approval for all of the ads, with >80% positive responses for all questions across ads. Overall ads delivered by health care workers were preferred by a majority of participants in our study (n = 381, 71.4%). Ad preference ranged from 3.6% (n = 19) social norm/peer ad to 32.4% (n = 173) health outcome/HCP ad and half of participants preferred the health outcome ad (n = 279, 52.3%). Additionally, vaccine hesitancy was not related to preference (p = .513): HCP vs. peer ads (p = .522); message type (p = .284). The results suggest that all three appeals tested were generally acceptable, as well as the two messenger types, although preference was for the health care provider messenger and health outcome appeal. Individuals are motivated and influenced by a multitude of factors, requiring vaccine messaging that is persuasive, salient, and induces contextually relevant action.

What message appeal and messenger are most persuasive for COVID-19 vaccine uptake: Results from a 5-country survey in India, Indonesia, Kenya, Nigeria, and Ukraine

Effective strategies to encourage COVID-19 vaccination should consider how health communication can be tailored to specific contexts. Our study aimed to evaluate the influence of three specific messaging appeals from two kinds of messengers on COVID-19 vaccine acceptance in diverse countries. We surveyed 953 online participants in five countries (India, Indonesia, Kenya, Nigeria, and Ukraine). We assessed participants’ perceptions of three messaging appeals of vaccination—COVID-19 disease health outcomes, social norms related to COVID-19 vaccination, and economic impact of COVID-19—from two messengers, healthcare providers (HCP), and peers. We examined participants’ ad preference and vaccine hesitancy using multivariable multinomial logistic regression. Participants expressed a high level of approval for all the ads. The healthcare outcome–healthcare provider ad was most preferred among participants from India, Indonesia, Nigeria, and Ukraine. Participants in Kenya reported a preference for the health outcome–peer ad. The majority of participants in each country expressed high levels of vaccine hesitancy. However, in a final logistic regression model participant characteristics were not significantly related to vaccine hesitancy. These findings suggest that appeals related to health outcomes, economic benefit, and social norms are all acceptable to diverse general populations, while specific audience segments (i.e., mothers, younger adults, etc.) may have preferences for specific appeals over others. Tailored approaches, or approaches that are developed with the target audience’s concerns and preferences in mind, will be more effective than broad-based or mass appeals.

Effects of the COVID 19 Pandemic on School Nurses' Resiliency and Ability to Cope: A Mixed Methods Study in the State of Hawaii

This mixed-method study examined school nurses' experiences during the Coronavirus Disease 2019 pandemic related to role change, psychological feelings, and coping/resiliency in the State of Hawaii. A total of 30 school nurses completed a Brief Resilience Coping Scale plus a series of open-ended questions in January 2022. On the coping scale, over 40% of participants scored high, 52% scored medium, and 7% scored a low resilient/coping level. We did not identify any association between coping level and participant characteristics. Three qualitative themes emerged: 1) school nurses experience chronic negative emotions related to the pandemic, 2) school nurses demonstrate attributes of resilience, and 3) school nurses utilize positive coping techniques. The pandemic created significant stresses and negative emotions among school nurses. Yet, school nurses reported effective coping strategies and demonstrated strength/resilience. Support and open communication between school nurses, their employers, and other school-based stakeholders is needed to provide continued support for school nurses.

COVID-19 Vaccine Communication via Chatbot: A Qualitative Study on Message Preferences of Young Adults and Public Health Workers in Urban American Communities

Background

Automated conversational agents, or chatbots, have a role in reinforcing evidence-based guidance delivered through other media and offer an accessible, individually tailored channel for public engagement. In early-to-mid 2021, young adults and minority populations disproportionately affected by COVID-19 in the United States were more likely to be hesitant toward COVID-19 vaccines, citing concerns regarding vaccine safety and effectiveness. Successful chatbot communication requires purposive understanding of user needs.

Objective

We aimed to review the acceptability of messages to be delivered by a chatbot named VIRA from Johns Hopkins University. The study investigated which message styles were preferred by young, urban-dwelling Americans as well as public health workers, since we anticipated that the chatbot would be used by the latter as a job aid.

Methods

We conducted 4 web-based focus groups with 20 racially and ethnically diverse young adults aged 18-28 years and public health workers aged 25-61 years living in or near eastern-US cities. We tested 6 message styles, asking participants to select a preferred response style for a chatbot answering common questions about COVID-19 vaccines. We transcribed, coded, and categorized emerging themes within the discussions of message content, style, and framing.

Results

Participants preferred messages that began with an empathetic reflection of a user concern and concluded with a straightforward, fact-supported response. Most participants disapproved of moralistic or reasoning-based appeals to get vaccinated, although public health workers felt that such strong statements appealing to communal responsibility were warranted. Responses tested with humor and testimonials did not appeal to the participants.

Conclusions

To foster credibility, chatbots targeting young people with vaccine-related messaging should aim to build rapport with users by deploying empathic, reflective statements, followed by direct and comprehensive responses to user queries. Further studies are needed to inform the appropriate use of user-customized testimonials and humor in the context of chatbot communication.

Impact of the COVID-19 Pandemic on the Hawai'i Nursing Workforce: A Cross-sectional Survey

The coronavirus disease (COVID-19) pandemic has placed extraordinary strain on health care systems. This has led to increased stress among health care workers, and nurses in particular, which has had a negative impact on their physical and psychosocial wellbeing. This is likely to negatively impact the nursing workforce at the state and national levels as the pandemic continues. The purpose of this study was to assess whether nurses licensed in Hawai'i have considered leaving the workforce. A cross-sectional online survey was conducted among Hawai'i nurses at all levels of licensure, with 421 responding. Of these nurses, 97 (23.0%) reported considering leaving the workforce, with safety (39.2%) and family/caregiver strain (32.0%) being the most common reasons. Reconsidering whether they should stay employed in their current roles (Odds ratio [OR] 2.05; 95% CI 1.56 - 2.69) and fear to continue providing direct patient care (OR 1.97; 95% CI 1.54 - 2.54) were associated with increased odds of having considered leaving the workforce. Based on these results, the State of Hawai'i and local health care organizations need to adjust their nursing workforce estimates and address how to alleviate nurses' stressors and safety concerns to mitigate a potential workforce shortage. Research is needed to develop interventions to support and empower nurses in their current roles but also address future emergency preparedness.

Influence de la précarité sociale et du soutien social perçu, sur le retour au travail des femmes ayant un cancer du sein, dans l’année suivant le début des traitements adjuvants

L’objectif est d’étudier les liens entre précarité sociale, soutien social perçu et retour au travail (RAT) dans la première année suivant le début des traitements adjuvants du cancer du sein. Soixante-huit patientes incluses au début des traitements adjuvants (T0) ont été suivies à 3 (T1) et 12 mois (T2). Le soutien informatif des amis à T0 favorise le RAT à T1. La précarité et le soutien négatif à T0 et T2 sont des freins au RAT à T2. La prise en charge du RAT doit être proposée et adaptée dès le début des traitements.

Work-Time Control and Exhaustion: Internal Work-to-Home Interference and Internal Home-to-Work Interference as Mediators

Strong work-time control (WTC) has been linked to reduced employee exhaustion, with work-to-home interference as an underlying mechanism. In this study, we aimed to investigate the mediation effect of both directions of internal work–home interference, namely internal work-to-home interference (IWHI) and internal home-to-work interference (IHWI). The analysis is based on data from the 2015, 2017, and 2019 BAuA-Working Time Survey, a representative German panel study. Cross-lagged panel models were estimated separately for IWHI and IHWI, based on the balanced panel (n = 3390). We investigated the hypothesized indirect as well as potential direct, reversed, and reciprocal effects of the constructs. WTC had a small but significant indirect effect on exhaustion via IWHI. Contrary to assumptions, WTC positively affected IHWI. Unexpectedly, there was no significant effect of IHWI on exhaustion. Hence, only IWHI was identified to mediate WTC’s effect on exhaustion. This implies that WTC helps employees avoid exhaustion from psychological preoccupation with work during free time. In addition, analyses suggested reversed and reciprocal relationships between the investigated constructs. Further investigation is needed to explore the role of psychological preoccupation with private matters during work time in the context of WTC and employee well-being.

Organic-Inorganic Hybrid Material Synthesis by on Line Coupling Twin Screw Extruder with a Microwave Oven

A new process for elaborating continuously organic-inorganic hybrid materials by reactive extrusion is presented. This synthesis consists in formulating a copolymer of ethylene and vinyl acetate (EVA)/tetrapropoxysilane (TPOS or Si(OC3H7)4)/catalyst blend by a corotating twin screw extruder followed by two successive reaction steps: on line microwave crosslinking reaction and hydrolysis-condensation reactions leading to a silica network cografted onto the organic matrix.

Extrusion feed rate (Q), temperature, microwave oven power (P), and microwave curing time (tmw) were studied. Crosslinking density was evaluated before and after hydrolysis-condensation reactions and compared with the previous results obtained in static conditions. These materials tailored by an on line process present a permanent elasticity at high temperature (up to 200 °C) and a certain optical transparency. This new approach offers the possibility to synthesize massive samples based on organic-inorganic hybrid material.

Boundaryless working hours and recovery in Germany

OBJECTIVE

Due to recent trends such as globalization and digitalization, more and more employees tend to have flexible working time arrangements, including boundaryless working hours. The aim of this study was to investigate the relationships of various aspects of boundaryless working hours (overtime, Sunday work, and extended work availability) with employees' state of recovery. Besides, we examined the mediating and moderating role of recovery experiences (psychological detachment, relaxation, mastery, and control) in these relationships.

METHODS

We used data from 8586 employees (48% women; average age of 48 years) who took part in the 2017 BAuA-Working Time Survey, a representative study of the German working population. Regression analyses were conducted to test main effects as well as mediation and moderation.

RESULTS

Overtime work, Sunday work, and extended work availability were negatively related to state of recovery. Psychological detachment mediated these relationships. Furthermore, we found that relaxation and control mediated the association between extended work availability and state of recovery. However, no relevant moderating effects were found.

CONCLUSIONS

Altogether, our findings indicate that various aspects of boundaryless working hours pose a risk to employees' state of recovery and that especially psychological detachment is a potential mechanism in these relationships. In addition, the results suggest that a high level of recovery experiences cannot attenuate these negative relationships in leisure time. Therefore, employers and employees alike should try to avoid or minimize boundaryless working hours.

Undergraduate nursing students' COVID-19 vaccine intentions: A national survey

Introduction

In December 2020, the first two COVID-19 vaccines were approved in the United States (U.S.) and recommended for distribution to front-line personnel, including nurses. Nursing students are being prepared to fill critical gaps in the health care workforce and have played important supportive roles during the current pandemic. Research has focused on vaccine intentions of current health care providers and less is known about students’ intentions to vaccinate for COVID-19.

Methods

A national sample of undergraduate nursing students were recruited across five nursing schools in five U.S. regions in December 2020. The survey measured perceived risk/threat of COVID-19, COVID-19 vaccine attitudes, perceived safety and efficacy of COVID-19 vaccines, sources for vaccine information and level of intention to become vaccinated [primary, secondary (i.e., delayed), or no intention to vaccinate].

Results

The final sample consisted of 772 students. The majority (83.6%) had intentions to be vaccinated, however of those 31.1% indicated secondary intention, a delay in intention or increased hesitancy). The strongest predictors of primary intention were positive attitudes (OR = 6.86; CI = 4.39–10.72), having lower safety concerns (OR = 0.26; CI = 0.18–0.36), and consulting social media as a source of information (OR = 1.56; CI = 1.23–1.97). Asian (OR = 0.47; CI = 0.23–0.97) and Black (OR 0.26; CI = 0.08–0.80) students were more likely to indicate secondary intention as compared to primary intention. Students in the Midwest were most likely to indicate no intention as compared to secondary intention (OR = 4.6; CI = 1.32–16.11).

Conclusions

As the first two COVID-19 vaccines were approved/recommended in the U.S. nursing students had overall high intentions to vaccinate. Findings can guide development of educational interventions that reduce concerns of vaccine safety that are delivered in a way that is supportive and affirming to minoritized populations while being respectful of geo-political differences.

Assessing licensed nurses COVID-19 vaccine attitudes and intentions: a cross-sectional survey in the state of Hawaii

Nurses are the largest single occupation of health care providers and at greatest risk for exposure to and acquisition of Coronavirus Disease 2019 (COVID-19). In December 2020, nurses in Hawaii were recruited for an online survey that measured perceived risk/threat of COVID-19, vaccine attitudes, and perceived safety of COVID-19 vaccines, as well as level of intention: primary, secondary (i.e., delayed), or no intention to vaccinate. The final sample consisted of 423 nurses. Participants were primarily Asian (27.9%) and White (45.2%). The majority were 18-50 years (65.5%) and female (87.0%), held an RN license (91.7%), and identified as a staff nurse (57.7%) in the hospital setting (56.7%). Among participants, 52.3% indicated primary intention, 27.9% secondary intention, and 19.9% no intention to vaccinate. The strongest predictors of any level of intention were greater positive attitudes toward COVID-19 vaccination and lower concerns related to COVID-19 vaccine safety. Findings can guide interventions to support vaccine acceptance for those who initially decline vaccination.

[Aconitine poisoning due to confusion of aconite leaves with lovage]

Due to a mix-up an older couple (69 years and 71 years) ate a meal with herbs from their garden that contained leaves of monkshood (Aconitum napellus). The monkshood plants grew close to the herbs in their garden. Both patients developed the typical symptoms of aconitine poisoning with paresthesia, hypotension and bradycardia. Over the course of time both developed cardiac arrhythmia with ventricular extrasystoles and required monitoring on the intensive care unit (ICU). The husband was more severely affected and needed catecholamines for successful treatment of hypotension (70/40 mmHg) and bradycardia (45 bpm). The toxicological analysis of the patients' serum taken 3.5 h after ingestion led to the detection of 1.8 ng/ml and 2.0 ng/ml aconitine, respectively. The patients were discharged in good general condition after 1 and 2 days, respectively. Monkshood (Aconitum napellus) is one of the most toxic native plants that can also be found in gardens due to its popularity as an ornamental plant. All parts of the plant contain toxic diterpenoid alkaloids, such as aconitine. Aconitine causes persistent activation of the fast voltage-gated sodium channels resulting in severe cardiac and neurological toxicity. Treatment of aconitine-induced ventricular arrhythmias is challenging as they are often refractory to electrical cardioversion and antiarrhythmic drugs.

Growth regulators and their reflection on different hop genotypes cultivated under in vitro conditions

Hops is a new culture in Brazil. Tissue culture can be an important technique for rapid hop propagation. This paper aims to characterize responses from different genotypes under different growth regulators through the interrelationship of response variables important to hop in vitro growth. Three genotypes were cultivated in six culture media with different combinations of growth regulators, BAP (6-benzylaminopurine), IAA (3-indolacetic acid) and GA3 (gibberellic acid). The means were compared by orthogonal contrasts and the interrelationship of the response variables was performed by path analysis. American genotypes showed favorable root development under the BAP + IAA combination, while the use of IAA improved shoot development. The origin of genotypes was important for defining the best protocol for in vitro cultivation. The path coefficient showed that the variable number of shoots has stronger direct effect on the number of nodal segments. Additionally, in tissue culture assays, the use of a covariable and proper error distribution significantly increased experimental accuracy.

Feasibility of a prehabilitation program before major abdominal surgery

Objective

Prehabilitation programs claim to improve exercise capacity and postoperative outcomes. The study aim was to assess the feasibility of a prehabilitation program and its effects on fitness and clinical outcomes after major abdominal surgery.

Methods

In this prospective pilot study, patients were assigned to high-intensity physical exercise training with 3 training sessions per week for 3 weeks preoperatively. Feasibility of this intervention was assessed based on recruitment and adherence to the training program. Impact on fitness (VO2 AT) was evaluated and correlated with complications and length of stay (LOS).

Results

Of 980 eligible patients, 87 patients (8.9%) were approached for inclusion. Main obstacles to not approach patients were insufficient time (&lt; 3 weeks) prior to scheduled surgery (n = 276, 28.2%) or screening failure (n = 312, 31.8%). Out of these 87 patients, 24 (28%) declined to participate, 43 (49%) met exclusion criteria and 20 (23%) were included. Six patients (30%) could not complete the prehabilitation program due to contra-indication for exercise training evidenced during the test (n = 3), lack of motivation (n = 2) and modification of the planned operating date (n = 1). VO2 AT increased from 9.8 to 11.5 ml/min/kg (p = 0.050). There were no correlations between the change in VO2 AT and postoperative complications (r = -0.133, p = 0.649) and LOS (r = -0.94, p = 0.750).

Conclusion

Prehabilitation programs are difficult to implement and many patients are either not eligible or not motivated. Future efforts should concentrate on those patients who are most likely to benefit from these time- and cost-intensive interventions.

Undergraduate nursing students' perceptions on nursing education during the 2020 COVID-19 pandemic: A national sample

BACKGROUND

In 2020, nursing educational programs were abruptly interrupted and largely moved online due to the COVID-19 pandemic.

PURPOSE

To explore nursing students' perspectives about the effects of the pandemic on their education and intention to join the nursing workforce.

METHODS

Undergraduate nursing students from 5 universities across 5 United States regions were invited to participate in an online survey to elicit both quantitative and qualitative data.

FINDINGS

The final sample included quantitative data on 772 students and qualitative data on 540 students. Largely (65.1%), students reported that the pandemic strengthened their desire to become a nurse; only 11% had considered withdrawing from school. Qualitatively, students described the effect of the pandemic on their psychosocial wellbeing, adjustment to online learning, and challenges to clinical experiences.

CONCLUSION

Findings highlighted the need to develop emergency education preparedness plans that address student wellbeing and novel collaborative partnerships between schools and clinical partners.

Congruence is not everything: a response surface analysis on the role of fit between actual and preferred working time arrangements for work-life balance

Working time arrangements that match employees' preferences have been proposed as determinants of employees' well-being, an assumption rooted in person-environment fit theory. The aim of this study was to investigate the role of fit and misfit between actual and preferred working time arrangements (length of working hours, control over the beginning and end of workdays, and workplace segmentation) for employees' satisfaction with work-life balance. We analyzed data from 8,580 employees from the BAuA-working time survey - a representative study among the working population in Germany - by means of polynomial regression and response surface analyses. Analyses did not point toward congruence effects but revealed significant main effects: Satisfaction with work-life balance was higher in case of shorter actual and longer preferred weekly working hours, and it was decreased if employees worked longer than they preferred. Moreover, more supplies and lower preferences in terms of control over the beginning and end of workdays, more workplace segmentation supplies, and lower workplace segmentation preferences were related to higher satisfaction with work-life balance. Overall, this study sheds light on the roles of fit and misfit between actual and preferred working time arrangements for employees' work-home interface. Findings suggest that while employees' preferences should find entrance into the design of work schedules, congruence is not a precondition for achieving a good work-life balance. Most importantly, for a good work-life balance, working hours should not be longer than preferred, and employees should have some control over their scheduling and possibilities to segment work and private life.

Working time dimensions and well-being: a cross-national study of Finnish and German health care employees

Health care professionals often face irregular working hours and high work pace. We studied associations of the five working time dimensions duration (weekly working hours), timing (shift work and weekend work), on-call work, working time autonomy, and work tempo (deadline and performance pressure) with well-being among health care employees in Finland and Germany. We used data on working time dimensions and indicators of well-being (work-life conflict, poor perceived health, sleep difficulties, and fatigue) from a cohort of 5050 hospital employees (Working Hours in the Finnish Public Sector Study 2015, WHFPS) and 1450 employees in the health care sector in Germany responding to the German BAuA-Working Time Survey in 2015 (BAuA-WTS). Findings from logistic regression analyses showed that high work tempo was associated with increased work-life conflict (WHFPS: odds ratio [OR] = 3.64, 95%CI 3.04-4.36 and BAuA-WTS: OR = 2.29, 95%CI 1.60-3.27), sleep difficulties (OR = 1.75, 95%CI 1.43-2.15 and OR = 1.33, 95%CI 1.03-1.71) and fatigue (OR = 2.13, 95%CI 1.77-2.57 and OR = 1.64, 95%CI 1.29-2.10) in both datasets. Weekend work was associated with increased work-life conflict (OR = 1.48, 95%CI 1.27-1.72 and OR = 1.61, 95%CI 1.12-2.32); and high working time autonomy with decreased work-life conflict (control over the timing of breaks: OR = 0.65, 95%CI 0.55-0.78 and OR = 0.52, 95%CI 0.33-0.81). The associations between other working time dimensions and well-being were less consistent. These results suggest that tight deadlines, performance pressure, weekend work and lack of working time autonomy are linked to impaired well-being among health care employees.

Prise en charge psychologique des femmes ayant un cancer du sein. Quelles différences interindividuelles sur le développement post-traumatique durant la première année suivant le diagnostic ?

Objectif : Évaluer les différences interindividuelles relatives aux changements psychologiques positifs vécus, selon que les patientes bénéficient ou non d’un suivi psychologique.

Matériel et méthodes : Le PTGI a été administré, auprès de 68 patientes atteintes d’un cancer du sein (Mâge = 46,97 ; ET = 6,92), au début des traitements adjuvants (T0) puis 6 (T1) et 12 mois (T2) après.

Résultats : Les femmes ayant reçu un suivi psychologique rapportent, à T0 et T1, de plus hauts scores de PTG, relations aux autres, nouvelles opportunités par rapport à celles qui n’ont pas bénéficié d’un suivi.

Conclusion : Ces résultats confirment qu’une prise en charge psychologique du cancer du sein permet un meilleur ajustement à la maladie.

Health and work-life balance across types of work schedules: A latent class analysis

This study explores how different aspects of working time demands (e.g., shift work) and working time control (e.g., beginning/end of workday) can be clustered into distinct types of work schedules and how they relate to health and work-life balance. Data from 13,540 full-time employees interviewed in the 2015 BAuA-Working Time Survey was used. By means of latent class analysis, we extracted six types of work schedules. Subjective health was highest in the flexible extended and flexible standard schedules, both featuring high working time control. Work-life balance was highest in the flexible standard and rigid standard schedules and lowest in schedules with high working time demands, namely the extended shift, rigid all-week, and rigid extended schedules. Employees with high working time demands and low control represent risk groups prone to impairments of well-being. Overall, this study offers an intuitive taxonomy for the design of sustainable work schedules.

Dessine-moi une réalité plus belle : la réalité virtuelle vue par les patientes atteintes d’un cancer du sein

Une enquête réalisée auprès de 300 femmes atteintes d’un cancer du sein a permis d’examiner leur intérêt pour la réalité virtuelle (RV), les modalités d’immersion attendues ainsi que leurs attentes vis-à-vis de ce dispositif. Les résultats indiquent que la majorité des femmes (93 %) souhaiterait avoir recours à la RV durant leurs traitements, sachant que leurs préférences d’immersion portent sur un environnement naturel accompagné de musique et/ou de relaxation guidée. La RV est envisagée comme un outil pertinent pour s’évader, mieux accepter les soins et réguler leurs émotions. Pour faciliter l’immersion virtuelle, cette étude souligne combien il est important de connaître leurs aspirations personnelles pour leur offrir un soutien technologique individualisé.

Antecedents of Health-Promoting Leadership and Workload as Moderator

This study builds on the theory of planned behavior and investigates antecedents of health-promoting leadership behaviors (HPL behaviors): positive health-promoting leadership attitude (HPL attitude) as well as perceived health-promoting leadership norms (perceived HPL norms), and lack of perceived health-promoting leadership behavioral control (perceived HPL behavioral control). Furthermore, based on the conservation of resources theory, these antecedents are conceptualized as personal and job resources with managers’ perceived workload being examined as a moderating boundary condition, suggesting that workload as a job demand facilitates resource loss. A survey was administered to 315 managers. Data were analyzed using hierarchical linear regression analysis and moderation analysis. Results revealed that HPL attitude and perceived HPL norms were positively related to HPL behaviors, whereas a lack of perceived HPL behavioral control was negatively related to HPL behaviors. Furthermore, high workload weakened the relationship between perceived HPL norms and HPL behaviors. Workload did not moderate the relationships between the antecedents HPL attitude and lack of perceived HPL behavioral control, and HPL behaviors. Organizations should offer interventions to foster positive HPL attitude, give managers opportunities for HPL behavioral control, and promote perceived HPL norms. They should acknowledge that high workload may inhibit perceived HPL norms. Intervention approaches with regard to personnel and organizational development for practitioners are discussed. This study contributes to the literature by testing direct antecedents of HPL behaviors. Moreover, this study is the first to test workload as a boundary condition.

Cloud distribution evaluated by the WRF model during the EUSO-SPB1 flight

EUSO-SPB1 was a balloon-borne mission of the JEM-EUSO (Joint Experiment Missions for Extreme Universe Space Observatory) Program aiming at the ultra-high energy cosmic ray (UHECR) observations from space. We operated the EUSO-SPB1 telescope consisting of 1 m2 Fresnel refractive optics and multi-anode photomultiplier tubes. With a total of 2304 channels, each performed the photon counting every 2.5 µs, allowing for spatiotemporal imaging of the air shower events in an ~ 11°× 11° field of view. EUSO-SPB1 was the first balloon-borne fluorescence detector with a potential to detect air shower events initiated by the EeV energy cosmic rays. On 24 April 2017 UTC, EUSO-SPB1 was launched on the NASA’s Super Pressure Balloon that flew at ~16 – 33 km flight height for ~12 days. Before the flight was terminated, ~27 hours of data acquired in the air shower detection mode were transmitted to the ground. In the present work, we aim at evaluating the role of the clouds during the operation of EUSO-SPB1. We employ the WRF (Weather Research and Forecasting) model to numerically simulate the cloud distribution below EUSO-SPB1. We discuss the key results of the WRF model and the impact of the clouds on the air shower measurement and the efficiency of the cosmic ray observation. The present work is a part of the collaborative effort to estimate the exposure for air shower detections.

Kinetically Enhanced Fabrication of Homogeneous Biomimetic and Functional Emulsion Droplets

Characterized by a fluid and deformable interface, ligand-functionalized emulsion droplets are used as model probes to address biophysical, biological, and developmental questions. Functionalization protocols usually rely on the use of headgroup-modified phospholipids that are dissolved in the oil phase prior to emulsification, leading to a broad range of surface densities within a given droplet population. With the aim to coat particles homogeneously with biologically relevant lipids and proteins (streptavidin, immunoglobulins, etc.), we developed a reliable surface decoration protocol based on the use of polar cosolvents to dissolve the lipids in the aqueous phase after the droplet production. We show that the surface density of the lipids at the interface has a narrow normal distribution for droplets having the same size. We performed titration isotherms for lipids and biologically relevant proteins on these drops. Then, we studied the influence of the presence of surfactants in the medium on lipid insertion and compared the results for a range of polar cosolvents of increasing polarity. To assess both the generality and the biocompatibility of the method, we show that we can produce more sophisticated, monodisperse functional magnetic emulsions with a very high surface homogeneity. Using an oil denser than the surrounding culture medium, we show that IgG-coated droplets can be used as probes for phagocytosis experiments.