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Objectives In order to provide a more comprehensive understanding of the effects of SARS‐CoV‐2 on oral health and possible saliva transmission, we performed RNA‐seq profiles analysis from public databases and also a questionnaire survey on oral‐related symptoms of COVID‐19 patients. Materials and methods To analyse ACE2 expression in salivary glands, bulk RNA‐seq profiles from four public datasets including 31 COVID‐19 patients were recruited. Saliva and oropharyngeal swabs were collected. SARS‐CoV‐2 nucleic acids in saliva were detected by real‐time polymerase chain reaction (RT‐PCR). Additionally, a questionnaire survey on various oral symptoms such as dry mouth and amblygeustia was also carried out on COVID‐19 patients. Results ACE2 expression was present at detectable levels in the salivary glands. In addition, of four cases with positive detection of salivary SARS‐CoV‐2 nucleic acids, three (75%) were critically ill on ventilator support. Furthermore, we observed the two major oral‐related symptoms, dry mouth (46.3%) and amblygeustia (47.2%), were manifested by a relatively high proportion of 108 COVID‐19 patients who accepted the questionnaire survey. Conclusions This study confirms the expression of ACE2 in the salivary glands and demonstrates the possibility of SARS‐CoV‐2 infection of salivary glands. Saliva may be a new source of diagnostic specimens for critically ill patients, since it can be easily collected without any invasive procedures. In addition, dry mouth and amblygeustia can be considered as initial symptoms of COVID‐19 infection. In this study, based on the confirmation of ACE2 receptor expression in salivary glands through database analysis, it was assumed and confirmed that RNA of SARS‐COV‐2 could be detected in saliva samples. At the same time, we also clinically observed that the initial oral‐related symptoms of SARS‐COV‐2 infection may be amblygeustia and dry mouth.

Objectives Exosomes, as important players in intercellular communication due to their ability to transfer certain molecules to target cells, are believed to take similar effects in promoting bone regeneration with their derived stem cells. Studies have suggested that umbilical cord mesenchymal stem cells (uMSCs) could promote angiogenesis. This study investigated whether exosomes derived from uMSCs (uMSC‐Exos) could enhance fracture healing as primary factors by promoting angiogenesis. Materials and Methods uMSCs were obtained to isolate uMSC‐Exos by ultrafiltration, with exosomes from human embryonic kidney 293 cells (HEK293) and phosphate‐buffered saline (PBS) being used as control groups. NanoSight, laser light scattering spectrometer, transmission electron microscopy and Western blotting were used to identify exosomes. Next, uMSC‐Exos combined with hydrogel were transplanted into the fracture site in a rat model of femoral fracture. Bone healing processes were monitored and evaluated by radiographic methods on days 7, 14, 21 and 31 after surgery; angiogenesis of the fracture sites was assessed by radiographic and histological strategies on post‐operative day 14. In vitro, the expression levels of osteogenesis‐ or angiogenesis‐related genes after being cultured with uMSC‐Exos were identified by qRT‐PCR. The internalization ability of exosomes was determined using the PKH67 assay. Cell cycle analysis, EdU incorporation and immunofluorescence staining, scratch wound assay and tube formation analysis were also used to determine the altered abilities of human umbilical vein endothelial cells (HUVECs) administered with uMSC‐Exos in proliferation, migration and angiogenesis. Finally, to further explore the underlying molecular mechanisms, specific RNA inhibitors or siRNAs were used, and the subsequent effects were observed. Results uMSC‐Exos had a diameter of approximately 100 nm, were spherical, meanwhile expressing CD9, CD63 and CD81. Transplantation of uMSC‐Exos markedly enhanced angiogenesis and bone healing processes in a rat model of femoral fracture. In vitro, other than enhancing osteogenic differentiation, uMSC‐Exos increased the expression of vascular endothelial growth factor (VEGF) and hypoxia inducible factor‐1α (HIF‐1α). uMSC‐Exos were taken up by HUVECs and enhanced their proliferation, migration and tube formation. Finally, by using specific RNA inhibitors or siRNAs, it has been confirmed that HIF‐1α played an important role in the uMSC‐Exos‐induced VEGF expression, pro‐angiogenesis and enhanced fracture repair, which may be one of the underlying mechanisms. Conclusions These results revealed a novel role of exosomes in uMSC‐mediated therapy and suggested that implanted uMSC‐Exos may represent a crucial clinical strategy to accelerate fracture healing via the promotion of angiogenesis. HIF‐1α played an important role in this process. Exosomes from human umbilical cord mesenchymal stem cells enhance fracture healing through HIF‐1α‐mediated promotion of angiogenesis in a rat model.

Objective Longitudinal studies have indicated VCAM‐1+ mesenchymal stem/stromal cells (MSCs) as promising resources in regenerative medicine, yet the abundance in gene expression is far from adequate in the advantaged and “discarded” hUC‐MSCs. Thus, high‐efficient preparation and systematic dissection of the signatures and biofunctions of the subpopulation is the prerequisite for large‐scale clinical applications. Materials and methods We primarily took advantage of a cytokine‐based programming strategy for large‐scale VCAM‐1+ hUC‐MSC generation (III‐MSCs). Thereafter, we conducted multifaceted analyses including cytomorphology, immunophenotype, cell vitality, multilineage differentiation, whole‐genome analysis, tube formation and Matrigel plug assay, lymphocyte activation and differentiation, and systemic transplantation for aplastic anaemia (AA) treatment. Results III‐MSCs with high‐proportioned VCAM‐1 expression were obtained by combining IL‐1β, IL‐4 with IFN‐γ, which exhibited comparable immunophenotype with untreated hUC‐MSCs (NT‐MSCs) but revealed multidimensional superiorities both at the cellular and molecular levels. Simultaneously, systemic infusion of III‐MSCs could significantly ameliorate clinicopathological features and finally help facilitate haematopoietic reconstruction and immunoregulation in AA mice. Conclusions We have established a high‐efficient procedure for large‐scale generation of III‐MSCs with preferable signatures and efficacy upon aplastic anaemia in mice. Our findings suggested that III‐MSCs were advantageous sources with multifaceted characteristics for regenerative medicine. Longitudinal studies have indicated the preferable potential of VCAM‐1+ mesenchymal stem/stromal cells (MSCs) in regenerative medicine, yet the low abundance is the lingering issue. Herein, we have established a high‐efficient procedure for large‐scale generation of III‐MSCs with preferable signatures and efficacy upon aplastic anaemia in mice.

Purpose Twitter is being increasingly used by nursing professionals to share ideas, information, and opinions about the global pandemic, yet there continues to be a lack of research on how nurse sentiment is associated with major events happening on the frontline. The purpose of the study was to quantitatively identify sentiments, emotions, and trends in nurses' tweets and to explore the variations in sentiments and emotions over a period in 2020 with respect to the number of cases and deaths of COVID‐19 worldwide. Design A cross‐sectional data mining study was held from March 3, 2020 through December 3, 2020. The tweets related to COVID‐19 were downloaded using the tweet IDs available from a public website. Data were processed and filtered by searching for keywords related to nursing in the profile description field using the R software and JMP Pro Version 16 and the sentiment analysis of each tweet was done using AFINN, Bing, and NRC lexicon. Findings A total of 13,868 tweets from the Twitter accounts of self‐identified nurses were included in the final analysis. The sentiment scores of nurses' tweets fluctuated over time and some clear patterns emerged related to the number of COVID‐19 cases and deaths. Joy decreased and sadness increased over time as the pandemic impacts increased. Conclusions Our study shows that Twitter data can be leveraged to study the emotions and sentiments of nurses, and the findings suggest that the emotional realm of nurses was affected during the COVID‐19 pandemic according to the emotional trends observed in tweets. Clinical Relevance The study provides insight into what nurses are feeling, and findings from this study highlight the importance of developing and implementing interventions targeted at nurses at the workplace to prevent mental health consequences.

Introduction COVID‐19 can be considered a unique and complex form of trauma with potentially devastating consequences for nurses in general and new nurses specifically. Few studies have been published that explain how relatively new nurses were prepared for COVID‐19 in terms of knowledge and skill and how these nurses fared physically and emotionally. Design A qualitative descriptive design utilizing purposive sampling to recruit a diverse group of nurses who were within 2 years post‐graduation from nursing school. Methods In‐depth interviews of 29 nurses were conducted using a semi‐structured interview guide to elicit data, which was coded and analyzed using thematic analysis. Results Six main themes and multiple subthemes were identified in the data. The main themes were: “We were not prepared,” “I was just thrown in,” “Avoiding infection,” “It was so sad,” “We did the best we could,” and “I learned so much.” Conclusion The nurses who participated in this study expressed fear, weariness, exhaustion, isolation, and distress, observations echoed by studies from other countries. Retention of new nurses in acute care settings has always been a concern. In the recent Current Population Survey, a 4% reduction in nurses under 35 years of age has been reported, imperiling the retention of an effective workforce for decades to come. Clinical Relevance A recent report suggests that a larger than expected number of young nurses have left the profession in the wake of the pandemic. Staff shortages threaten the ability of the remaining nurses to do their jobs. This is the time to listen to the needs of new nurses to retain them in the profession and to avoid an even greater shortage in the near future.

Objectives Interleukin‐6 (IL‐6) is critical for the development of non‐small‐cell lung cancer (NSCLC). Recently, we identified T‐cell immunoglobulin domain and mucin domain 4 (TIM‐4) as a new pro‐growth player in NSCLC progression. However, the role of TIM‐4 in IL‐6‐promoted NSCLC migration, invasion and epithelial‐to‐mesenchymal transition (EMT) remains unclear. Materials and Methods Expressions of TIM‐4 and IL‐6 were both evaluated by immunohistochemical staining in NSCLC tissues. Real‐time quantitative PCR (qPCR), Western blot, flow cytometry and RT‐PCR were performed to detect TIM‐4 expression in NSCLC cells with IL‐6 stimulation. The roles of TIM‐4 in IL‐6 promoting migration and invasion of NSCLC were detected by transwell assay. EMT‐related markers were analysed by qPCR and Western blot in vitro, and metastasis was evaluated in BALB/c nude mice using lung cancer metastasis mouse model in vivo. Results High IL‐6 expression was identified as an independent predictive factor for TIM‐4 expression in NSCLC tissues. NSCLC patients with TIM‐4 and IL‐6 double high expression showed the worst prognosis. IL‐6 promoted TIM‐4 expression in NSCLC cells depending on NF‐κB signal pathway. Both TIM‐4 and IL‐6 promoted migration, invasion and EMT of NSCLC cells. Interestingly, TIM‐4 knockdown reversed the role of IL‐6 in NSCLC and IL‐6 promoted metastasis of NSCLC by up‐regulating TIM‐4 via NF‐κB. Conclusions TIM‐4 involves in IL‐6 promoted migration, invasion and EMT of NSCLC.

Purpose To identify factors responsible for hospital health care workers' intention to leave their job during the COVID‐19 pandemic. Design A cross‐sectional study was performed. Methods A self‐administered questionnaire was delivered to solicit hospital health care workers' demographics, intention to leave, workplace environment, and changes related to COVID‐19 from July to November 2020 in Taiwan. Principal component analysis was performed to compare group‐related factors. Multiple logistic regression was used to determine the risk factors for the intention of health care workers to leave their job. Findings Among the 1209 health care workers (mean age, 36.3 years) who participated in the study, intention to leave the job was found to be related to factors relating to COVID‐19, including perceived risk, affected social relationships, and increased workload and job stress, after adjustment for demographic and work factors. Supportive administration/management were protective factors against leaving the job. These results were supported by sensitivity analyses. Conclusions Our findings suggest that the intention of health care workers to leave their job during a pandemic is related to potentially modifiable factors relating to the infection itself and work environment. Clinical relevance High perceived risk of COVID‐19, affected social relationaops, and increased workload and job stress were positively associated with the intention of health care workers to leave their job, whereas supportive administration and management were protective factors against leaving the job. Development of workplace strategies is important to help mitigate these above factors, improve psychological wellbeing, and promote workforce stability.

Sustainable energy from biomass is one of the most promising alternative energy sources and is expected to partially replace fossil fuels. Tobacco industries have normally rid their processing residues by landfilling or incineration, affecting the environment negatively. These residues can be used to either extract high-value chemicals or generate bio-energy via hydrothermal liquefaction. The main liquid product or bio-oil consists of highly complicated chemicals. In this work, the bio-oil from hydrothermal liquefaction of tobacco processing residues was generated in a batch reactor at biomass-to-deionized water ratio of 1:3, temperature of 310°C, and 15 min residence time, yielding the maximum liquid products for more than 50% w/w. The liquid products were analyzed, using two-dimensional gas chromatography and time-of-flight mass spectrometry (GC × GC/TOF MS). This technique allowed for a highly efficient detection of numerous compounds. From the results, it was found that hydrothermal liquefaction can cleave biopolymers (cellulose, hemicellulose, and lignin) in tobacco residues successfully. The hydrothermal liquefaction liquid products can be separated into heavy organic, light organic, and aqueous phase fractions. By GC × GC/TOF MS, the biopolymers disintegrated into low molecular weight compounds and classified by their chemical derivatives and functional groups could be detected. The major chemical derivative/functional groups found were cyclic ketones and phenols for heavy organic and light organic, and carboxylic acids and N-containing compounds for the aqueous phase. Additionally, by the major compounds found in this work, simple pathway reactions occurring in the hydrothermal liquefaction reaction were proposed, leading to a better understanding of the hydrothermal liquefaction process for tobacco residues.