A Web-Based COVID-19 Tool for Testing Residents in Retirement Homes: Development Study

BACKGROUND

Long-term care facilities have been widely affected by the COVID-19 pandemic. Empirical evidence demonstrated that older people are the most impacted and are at higher risk of mortality after being infected. Regularly testing care facility residents is a practical approach to detecting infections proactively. In many cases, the care staff must perform the tests on the residents while also providing essential care, which in turn causes imbalances in their working time. Once an outbreak occurs, suppressing the spread of the virus in retirement homes (RHs) is challenging because the residents are in contact with each other, and isolation measures cannot be widely enforced. Regular testing strategies, on the other hand, have been shown to effectively prevent outbreaks in RHs. However, high-frequency testing may consume substantial staff working time, which results in a trade-off between the time invested in testing and the time spent providing essential care to residents.

OBJECTIVE

We developed a web application (Retirement Home Testing Optimizer) to assist RH managers in identifying effective testing schedules for residents. The outcome of the app, called the "testing strategy," is based on dividing facility residents into groups and then testing no more than 1 group per day.

METHODS

We created the web application by incorporating influential factors such as the number of residents and staff, the average rate of contacts, the amount of time spent to test, and constraints on the test interval and size of groups. We developed mixed integer nonlinear programming models for balancing staff workload in long-term care facilities while minimizing the expected detection time of a probable infection inside the facility. Additionally, by leveraging symmetries in the problem, we proposed a fast and efficient local search method to find the optimal solution.

RESULTS

Considering the number of residents and staff and other practical constraints of the facilities, the proposed application computes the optimal trade-off testing strategy and suggests the corresponding grouping and testing schedule for residents. The current version of the application is deployed on the server of the Where2Test project and is accessible on their website. The application is open source, and all contents are offered in English and German. We provide comprehensive instructions and guidelines for easy use and understanding of the application's functionalities. The application was launched in July 2022, and it is currently being tested in RHs in Saxony, Germany.

CONCLUSIONS

Recommended testing strategies by our application are tailored to each RH and the goals set by the managers. We advise the users of the application that the proposed model and approach focus on the expected scenarios, that is, the expected risk of infection, and they do not guarantee the avoidance of worst-case scenarios.

Assessing the impact of forest structure disturbances on the arboreal movement and energetics of orangutans—An agent-based modeling approach

Agent-based models have been developed and widely employed to assess the impact of disturbances or conservation management on animal habitat use, population development, and viability. However, the direct impacts of canopy disturbance on the arboreal movement of individual primates have been less studied. Such impacts could shed light on the cascading effects of disturbances on animal health and fitness. Orangutans are an arboreal primate that commonly encounters habitat quality deterioration due to land-use changes and related disturbances such as forest fires. Forest disturbance may, therefore, create a complex stress scenario threatening orangutan populations. Due to forest disturbances, orangutans may adapt to employ more terrestrial, as opposed to arboreal, movements potentially prolonging the search for fruiting and nesting trees. In turn, this may lead to changes in daily activity patterns (i.e., time spent traveling, feeding, and resting) and available energy budget, potentially decreasing the orangutan's fitness. We developed the agent-based simulation model BORNEO (arBOReal aNimal movEment mOdel), which explicitly describes both orangutans' arboreal and terrestrial movement in a forest habitat, depending on distances between trees and canopy structures. Orangutans in the model perform activities with a motivation to balance energy intake and expenditure through locomotion. We tested the model using forest inventory data obtained in Sebangau National Park, Central Kalimantan, Indonesia. This allowed us to construct virtual forests with real characteristics including tree connectivity, thus creating the potential to expand the environmental settings for simulation experiments. In order to parameterize the energy related processes of the orangutans described in the model, we applied a computationally intensive evolutionary algorithm and evaluated the simulation results against observed behavioral patterns of orangutans. Both the simulated variability and proportion of activity budgets including feeding, resting, and traveling time for female and male orangutans confirmed the suitability of the model for its purpose. We used the calibrated model to compare the activity patterns and energy budgets of orangutans in both natural and disturbed forests . The results confirm field observations that orangutans in the disturbed forest are more likely to experience deficit energy balance due to traveling to the detriment of feeding time. Such imbalance is more pronounced in males than in females. The finding of a threshold of forest disturbances that affects a significant change in activity and energy budgets suggests potential threats to the orangutan population. Our study introduces the first agent-based model describing the arboreal movement of primates that can serve as a tool to investigate the direct impact of forest changes and disturbances on the behavior of species such as orangutans. Moreover, it demonstrates the suitability of high-performance computing to optimize the calibration of complex agent-based models describing animal behavior at a fine spatio-temporal scale (1-m and 1-s granularity).

Particle Stiffness and Surface Topography Determine Macrophage-Mediated Removal of Surface Adsorbed Particles

Cellular surface recognition and behavior are driven by a host of physical and chemical features which have been exploited to influence particle-cell interactions. Mechanical and topographical cues define the physical milieu which plays an important role in defining a range of cellular activities such as material recognition, adhesion, and migration through cytoskeletal organization and signaling. In order to elucidate the effect of local mechanical and topographical features generated by the adsorption of particles to an underlying surface on primary human monocyte-derived macrophages (MDM), a series of poly(N-isopropylacrylamide) (pNIPAM) particles with differing rigidity are self-assembled to form a defined particle-decorated surface. Assembly of particle-decorated surfaces is facilitated by modification of the underlying glass to possess a positive charge through functionalization using 3-aminopropyltriethoxysilane (APTES) or coating with poly(L-lysine) (PLL). MDMs are noted to preferentially remove particles with higher degrees of crosslinking (stiffer) than those with lower degrees of crosslinking (softer). Alterations to the surface density of particles enabled a greater area of the particle-decorated surface to be cleared. Uniquely, the impact of particle adsorption is evinced to have a direct impact on topographical recognition of the surface, suggesting a novel approach for controllably affecting cell-surface recognition and response.

Highly Conductive Collagen by Low-Temperature Atomic Layer Deposition of Platinum

In modern biomaterial-based electronics, conductive and flexible biomaterials are gaining increasing attention for their wide range of applications in biomedical and wearable electronics industries. The ecofriendly, biodegradable, and self-resorbable nature of these materials makes them an excellent choice in fabricating green and transient electronics. Surface functionalization of these biomaterials is required to cater to the need of designing electronics based on these substrate materials. In this work, a low-temperature atomic layer deposition (ALD) process of platinum (Pt) is presented to deposit a conductive thin film on collagen biomaterials, for the first time. Surface characterization revealed that a very thin ALD-deposited seed layer of TiO₂ on the collagen surface prior to Pt deposition is an alternative for achieving a better nucleation and 100% surface coverage of ultrathin Pt on collagen surfaces. The presence of a pure metallic Pt thin film was confirmed from surface chemical characterization. Electrical characterization proved the existence of a continuous and conductive Pt thin film (∼27.8 ± 1.4 nm) on collagen with a resistivity of 295 ± 30 μΩ cm, which occurred because of the virtue of TiO₂. Analysis of its electronic structures showed that the presence of metastable state due to the presence of TiO₂ enables electrons to easily flow from valence into conductive bands. As a result, this turned collagen into a flexible conductive biomaterial.

Effects of pillar size modulation on the magneto-structural coupling in self-assembled BiFeO3–CoFe2O4 heteroepitaxy

The magneto-structural coupling of BiFeO₃ (BFO)–CoFe₂O₄ (CFO)/LaAlO₃ (LAO) heteroepitaxy with various lateral sizes of CFO pillars embedded in a BFO matrix was investigated.

Revealing the Role of Epithelial Mechanics and Macrophage Clearance during Pulmonary Epithelial Injury Recovery in the Presence of Carbon Nanotubes

Wound healing assays are extensively used to study tissue repair mechanisms; they are typically performed by means of physical (i.e., mechanical, electrical, or optical) detachment of the cells in order to create an open space in which live cells can lodge. Herein, an advanced system based on extensive photobleaching-induced apoptosis; providing a powerful tool to understand the repair response of lung epithelial tissue, consisting of a small injury area where apoptotic cells are still intact, is developed. Notably, the importance of epithelial mechanics and the presence of macrophages during the repair can be understood. The findings reveal that individual epithelial cells are able to clear the apoptotic cells by applying a pushing force, whilst macrophages actively phagocytose the dead cells to create an empty space. It is further shown that this repair mechanism is hampered when carbon nanotubes (CNTs) are introduced: formation of aberrant (i.e., thickening) F-actins, maturation of focal adhesion, and increase in traction force leading to retardation in cell migration are observed. The results provide a mechanistic view of how CNTs can interfere with lung repair.