Chemically crosslinked polyacrylamide (PAAm) nanocomposite hydrogels were prepared with inorganic nano-silicate, Laponite, and dopamine methacrylamide (DMA). DMA consists of a biomimetic adhesive side chain covalently linked to a polymerizable methacrylate monomer. Copolymerizing DMA into a PAAm hydrogel strongly enhanced the interfacial interaction between the polymer network and Laponite. Nanocomposite hydrogels demonstrated reduced water content and increased materials properties that were dependent on both the Laponite and DMA contents. While increasing Laponite content alone improved materials properties moderately, these improvements were drastically enhanced when DMA is incorporated as measured by both unconfined compression testing and oscillatory rheometry. DMA-containing nanocomposite hydrogels demonstrated increased stiffness as well as excellent energy dissipation capability. Nanocomposite hydrogels with relatively low DMA and Laponite contents (2 to 3 wt% for each) demonstrated maximum compressive stress, elastic modulus, toughness, and storage and loss moduli values that were over an order of magnitude higher than control gels.DMA-containing nanocomposite hydrogels also demonstrated improved fracture resistance to compressive loading, capable of repeated compressed to 80% strain without rest for over 10 times while exhibiting compressive stress of over 1.1 MPa. The catechol side chain of DMA likely formed strong physical bonds with Laponite, which can dissipate fracture energy while minimizing permanent damage to the network architecture.

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Background: Blacks are dying from the novel coronavirus of 2019 (COVID-19) at disproportionate rates and tend to have more COVID-19 vaccine hesitancy than Whites. These disparities may be attributable to health knowledge and government/medical mistrust stemming from negative experiences with the medical system historically and presently (e.g., the Tuskegee Experiment, provider maltreatment). Method: The present study assessed COVID-19 vaccine hesitancy and the effectiveness of a 1.5 h, dialogue-based, web intervention hosted by an academic–community partnership team. The webinar included approximately 220 male and female, English speaking, Black churchgoers in the western U.S. The webinar focused on the psychology of fear and facts about the vaccine development. Results: The sample was mostly females who had higher vaccine hesitancy than men. A third of participants feared hospitalization if they contracted COVID-19. Many participants reported that learning facts about COVID-19 was most impactful. Statistical analyses indicated an increased willingness to get vaccinated after the webinar in comparison to before (t(25) = −3.08, p = 0.005). Conclusion: The findings suggest that virtual webinars may be effective at reducing COVID-19 vaccine hesitancy among Black churchgoers and may be applicable in addressing other health behaviors.

Coronavirus disease 2019 (COVID-19) has highlighted inequities in mortalities and associated illnesses among non-Hispanic Black and Hispanic/Latino individuals. Immunization against COVID-19 is critical to ending the pandemic, especially within racial and ethnically minoritized communities. However, vaccine hesitancy and institutional mistrust in these communities, resulting from decades of mistreatment, structural racism, and barriers to vaccination access, have translated into low vaccination uptake. Trustworthy relationships with healthcare professionals and partnerships with faith and community leaders are critical to increasing vaccination rates within these minoritized communities. Loma Linda University researchers collaborated with local faith and community organizations in San Bernardino County, CA, to rapidly implement a three-tiered approach to increase the vaccination rates within non-Hispanic Black and Hispanic/Latino communities. This community–academic partnership model provided over 1700 doses of the COVID-19 vaccine within these vaccine-hesitant, targeted minoritized communities. As over 100,000 individuals are diagnosed with COVID-19 daily and updated vaccines targeting variants of the Omicron strain are expected to rollout in the coming months, the development of sustainable programs aimed at increasing vaccine uptake within vulnerable communities are of the utmost importance.

Background In the U.S., non-Hispanic Black individuals are disproportionately represented amongst COVID-19 mortalities. The COVID-19 vaccines are poised to change this outcome; however, inequitable access and decades of medical mistreatment have resulted in healthcare mistrust and an associated low uptake within this group. Loma Linda University (LLU) houses the largest mass vaccination site in San Bernardino County (SBC) California; nevertheless, there has been a perpetual low representation of Black vaccinees. To increase the number of Black persons vaccinated, a selected team at LLU leveraged a community-academic partnership model to address vaccine hesitancy and increase access to the COVID-19 vaccines. The objective of this study was to evaluate the number of Black persons vaccinated in community settings compared to the mass clinic. Methods LLU developed a tiered approach to increase COVID-19 vaccinations within Black SBC communities. The first tier engaged faith leaders with the academic community in disseminating COVID-19 health information, the second included culturally representative LLU healthcare professionals in the delivery of COVID-19 educational webinars, and the third was to conduct low barrier, remote-site vaccination clinics, within targeted Black communities. Following these efforts, we compared the number of Black individuals vaccinated in the LLU mass clinic to those vaccinated in the community remote-site clinics. Results The remote-site COVID-19 vaccination clinics commenced in February 2021. From February 1 until April 30, 2021, 24,808 individuals were vaccinated in the LLU mass clinic with a first dose (Pfizer or Moderna) or single dose (Janssen) of a COVID-19 vaccine, however, only 908 (3.7%) were Black vaccinees. Contrastingly, the LLU remote site clinics vaccinated 1,542 individuals with a first or single dose of a COVID-19 vaccine. Of those vaccinees, 675 (44%) were Black. Conclusion The multi-tiered community approach (remote-site vaccination clinics) resulted in a necessary overrepresentation of Black vaccinees, previously underrepresented in the LLU traditional mass vaccination clinic effort (44% vs. 3.7%, respectively). Further research is warranted to examine the key elements to increase vaccinations amongst minoritized groups. COVID-19 Vaccination Comparisons Between Models This table includes data from the Loma Linda University Mass Vaccination Clinic and the Remote-Site Vaccination Efforts compared to the San Bernardino County Demographics Disclosures All Authors: No reported disclosures

Study Objective: SARS-CoV-2 was declared a pandemic March 11, 2020 by the WHO. Adult health care systems faced tremendous challenges in volume and acuity; however, morbidity and mortality among children is low and pediatric emergency departments (EDs) have been spared the same challenges. Treatment of SARS-CoV-2 patients and efforts to curb disease transmission affected health care delivery in the United States causing negative effects on the delivery of routine primary care, the closures of schools, the implementation of shelter-in-place orders, and the cancellation of typical activities for children. The impact of these factors and the COVID-19 epidemic on pediatric EDs has yet to be fully understood. Our study contributes by demonstrating the COVID-19 epidemic's impact on our tertiary care pediatric ED and level 1 trauma center.Methods: This retrospective time series study was conducted in a southern state with data coming from three sources: 1. State Office of EMS 2. ED visits and admissions 3. Hospital trauma database. The hospital is a free-standing children's hospital with an annual ED census around 75,000 prior to 2020. The hospital is the only state certified pediatric level I trauma center. Strict criteria exist for triggering trauma team activation. Four years of data were analyzed for number of patients seen, number and percent of patients admitted to a critical care unit, number and percent patients who met trauma activation criteria, and number of EMS transfers. This study was deemed exempt by the institutional review board since data were de-identified and aggregate. Data were managed using Excel TM .Results: Overall volume decreased 34% from 74,513 (2019) to 48,924 (2020) in contrast to trends of volume from 2017 through 2019, which had shown a steady increase by an additional 1,100 patients per year. Annual admission rate rose from 13.4-13.9% in 2017-2019 to 18.6% in 2020. The institution saw a linear increase in combined admission rates to the intensive care and intermediate care units from a high of 23.7% (2019) to 25.4% (2020) with a corresponding decrease in admission rates to acute care floors. Rate of admission to inpatient psychiatry unit increased from an average yearly rate of 7.2-7.7% in 2017-2019 to 9.3% in 2020. The number of patients transferred via EMS to our institution from outside facilities increased 8.8% from 1,868 in 2019 to 2,034 in 2020. Trauma alert activations increased from 0.65% of total patient volume in 2019 to 1.2% in 2020 with a noticeable increase in firearm related injuries from 44 in 2019 to 66 in 2020.Conclusion: While total volumes of patients seen in our tertiary pediatric ED showed a significant decrease during the COVID-19 pandemic there were significant increases in acuity as evidenced by admission rate, admission location, and number of interfacility transfers to our pediatric emergency department. There were also significant increases in psychiatric admissions and trauma alerts.