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Ongoing mutations of SARS‐CoV‐2 present challenges for vaccine development, promising renewed global efforts to create more effective vaccines against coronavirus disease (COVID‐19). One approach is to target highly immunogenic viral proteins, such as the spike receptor binding domain (RBD), which can stimulate the production of potent neutralizing antibodies. This study aimed to design and test a subunit vaccine candidate based on the RBD. Bioinformatics analysis identified antigenic regions of the RBD for recombinant protein design. In silico analysis identified the RBD region as a feasible target for designing a recombinant vaccine. Bioinformatics tools predicted the stability and antigenicity of epitopes, and a 3D model of the RBD‐angiotensin‐converting enzyme 2 complex was constructed using molecular docking and codon optimization. The resulting construct was cloned into the pET‐28a (+) vector and successfully expressed in Escherichia coli BL21DE3. As evidenced by sodium dodecyl‐polyacrylamide gel electrophoresis and Western blotting analyses, the affinity purification of RBD antigens produced high‐quality products. Mice were immunized with the RBD antigen alone or combined with aluminum hydroxide (AlOH), calcium phosphate (CaP), or zinc oxide (ZnO) nanoparticles (NPs) as adjuvants. Enzyme‐linked immunosorbent assay assays were used to evaluate immune responses in mice. In‐silico analysis confirmed the stability and antigenicity of the designed protein structure. RBD with CaP NPs generated the highest immunoglobulin G titer compared to AlOH and ZnO after three doses, indicating its effectiveness as a vaccine platform. In conclusion, the recombinant RBD antigen administered with CaP adjuvant NPs induces potent humoral immunity in mice, supporting further vaccine development. These results contribute to ongoing efforts to develop more effective COVID‐19 vaccines. [ABSTRACT FROM AUTHOR]

Background We prospectively evaluated whether serum cystatin C (CysC) detected acute kidney injury (AKI) earlier than basal serum creatinine (Cr). Methods In 107 pediatric patients at high risk of developing AKI, serum Cr and serum CysC were measured upon admission. Baseline estimated creatinine clearance (eCCl) was calculated using a CysC-based glomerular filtration rate (GFR) equation from a serum Cr measured at the pediatric intensive care unit (PICU) entrance. Results The median age was 10 months (interquartile range, 3-36 months). Serum Cr, serum CysC, and eCCl (mean ± standard deviation [range]) were 0.5 ± 0.18 mg/dl (0.2-1.1 mg/dl), 0.53 ± 0.78 (0.01-3.7 mg/l), and 72.55 ± 28.72 (20.6-176.2) ml/min per 1.73 [m.sup.2], respectively. The serum CysC level in patients with AKI was significantly higher than children with normal renal function (p Conclusions Our results identify that the sensitivity of serum CysC for detecting AKI is higher than that of serum Cr in a heterogeneous pediatric intensive care unit (PICU) population. Keywords Acute kidney injury * Serum cystatin C * Pediatric intensive care unit * Serum creatinine * Children, Introduction Acute kidney injury (AKI) is a common and potentially catastrophic complication among hospitalized and especially intensive care unit (ICU) patients with an ICU incidence of 11-67 % depending on [...]

Introduction: Most parents of hospitalized children suffer from psychological problems such as anxiety and stress. The use of coping mechanisms plays an important role in maternal adjustment of these parents. Spiritual self-care is one of the aspects of self-care, which plays an important role in stress adaptation. Therefore, this study was conducted to determine the effect of spiritual self-care training on the anxiety of mothers of premature infants admitted to NICUs. Methods: This classic experimental study was conducted on 64 mothers of neonates admitted to NICU. The selected mothers were divided into two groups of intervention (n=32) and control (n=32) by simple random method. The data were collected by Spielberger State and Trait Anxiety Inventory (STAI). Routine nursing care was provided to samples in the control group and those in the intervention group, received 6 training sessions (20-30 minutes) based on the selected educational content. Data were analyzed by SPSS-20 statistical software using descriptive statistics (table, mean, standard deviation) and inferential statistics (paired t-test, independent t-test, ANCOVA) at a significant level of 0.05. Conclusion: Before the intervention, the anxiety level of samples in the intervention group was 117.88 + 13.6 and in the control group was 119.88 + 17.85. The independent t-test did not show a significant difference between the two groups in that regard before the intervention (P = 0.54). ANCOVA test showed a significant difference between the two groups of intervention and control by removing the effect of pre-test (P <0.01 and Eta = 0.12), so that 12% of the changes in anxiety level was related to the spiritual self-care training of mothers. Discussion & Conclusion: Considering the effectiveness of spiritual self-care training on reducing the anxiety of mothers of hospitalized neonates, we can expect nurses as important members of multidisciplinary team to play an important role in identifying patients' spiritual needs and meeting them. Because spiritual self-care is considered as a low-cost, effective and low-risk care method. [ABSTRACT FROM AUTHOR]

The article features the HACCP Utilization and Food Safety Systems Professional Development Group's (HACCP PDG). Topics discussed include the mission of the group, members of HACCP PDG, and its work with other PDGs to organize sessions at International Association for Food Protection (IAFP) 2023. Also mentioned are the sessions at IAFP 2023 and information on how to join the HACCP Utilization and Food Safety Systems PDG.

Purpose: Knowing the epidemiological aspects of chronic kidney disease (CKD) in children is crucial for early recognition, identification of reversible causes, and prognosis. Here, we report the epidemiological characteristics of childhood CKD in Iran., Materials and Methods: This cross-sectional study was conducted during 1991 - 2009. The data were collected using the information in the Iranian Pediatric Registry of Chronic Kidney Disease (IPRCKD) core dataset., Results: A total of 1247 children were registered. The mean age of the children at registration was 0.69 ± 4.72 years (range, 0.25 -18 years), 7.79 ± 3.18 years for hemodialysis (HD), 4.24 ± 1.86 years for continuous ambulatory peritoneal dialysis (CAPD), and 3.4±1.95 years for the children who underwent the renal transplantation (RT) (P < .001). The mean year of follow-up was 7.19 ± 4.65 years. The mean annual incidence of CKD 2-5 stages was 3.34 per million age-related population (pmarp). The mean prevalence of CKD 2-5 stages was 21.95 (pmarp). The cumulative 1-, 5-, and 10-year patients' survival rates were 98.3%, 90.7%, and 84.8%, respectively. The etiology of the CKD included the congenital anomalies of the kidney and urinary tract (CAKUT) (40.01%), glomerulopathy (19.00%), unknown cause (18.28%), and cystic/hereditary/congenital disease (11.14%)., Conclusion: The incidence and prevalence rate of pediatric CKD in Iran is relatively lower than those reported in Europe and other similar studies. CAKUT was the main cause of the CKD. Appropriate management of CAKUT including early urological intervention is required to preserve the renal function. Herein, the long-term survival rate was higher among the children with CKD than the literature.

Background: Normal standard references of blood pressure (BP) for children and adolescents should be constructed according to anthropometric indices. Therefore , we aimed to produce BP reference percentiles by body mass index (BMI)., Methods: Data on demographic characteristics, anthropometric indices and BP values of 16246 3-18-year-old children and adolescents from 3 cross-sectional studies conducted in Tehran were included. To justify the need for BMI adjustment, quantile regression model was applied for different percentiles of systolic and diastolic BPs with age, sex, and the corresponding BMI percentiles. Then, Age- and sex-specific BP nomograms were constructed according to BMI., Results: All regression coefficients for BMI percentiles were significant in quantile regression of BPs, confirming the necessity for BMI-adjusted nomograms of BP. The BP percentiles for each gender by age and BMI are presented. All the BP percentiles rose steadily in all BMI percentiles with minor discrepancies between the two genders. As observed, the prevalence of hypertension is estimated to be lower among the lean subjects and higher among overweighs when the BMI-adjusted BP curves are considered., Conclusion: The reference database constructed in this survey is the first Iranian BP reference by age and BMI in children and adolescents, from it concluded that BMI-adjusted BP curves depict a more precise picture of the hypertension prevalence and present a more reliable classification standard for hypertension.