Disinfection Of Equipment Research Articles

Investigation of SARS-CoV-2 Genome in the Indoor Air and High-Touch Surfaces.

This study aimed to investigate the presence/absence of SARS-CoV-2 genome in the air and high-touch surfaces. This cross-sectional study was conducted from late-2020 to mid-2021 in the sections of Intensive Care Unit (ICU), emergency, infectious disease ward, and nursing station of the COVID-19 patient reception center in Kerman, Iran. The presence/absence of SARS-CoV-2 genome in the 60 samples of high-touch surfaces and 23 air samples was analyzed by reverse transcription polymerase chain reaction (RT-PCR). Fisher’s exact test was used to compare the number of positive samples in different sampling sites. The genome of SARS-CoV-2 was found in the eight samples (13.32%) taken from the high-touch surfaces (two samples in COVID-19 ICU, two samples in general ICU, two samples in emergency ward, and two samples in nursing station) and two air samples (8.70%) (one sample in the general ICU and one sample in the emergency ward). Statistical analysis showed that there was no significant difference between the type of sampling site and the positive cases of SARS-CoV-2 in the surface samples (p value = 0.80) and air samples (p value = 0.22). According to the results, the SARS-CoV-2 can find in the high-touch surfaces and indoor air of the COVID-19 patient reception centers. Therefore, suitable safety and health measures should be taken, including regular and accurate disinfection of surfaces and equipment and proper ventilation to protect healthcare workers and prevent disease transmission. More studies are recommended to investigate the SARS-CoV-2 concentration in the high-touch surfaces and air samples in the similar researches, efficacy of different disinfectants used on the high-touch surfaces and compare the effect of type of ventilation (natural or mechanical) on the viral load.

Impact of COVID-19 on Obstructive Sleep Apnea

The coronavirus disease 2019 (COVID-19) pandemic has caused major psychological distress, mental health problems, sleep disturbances, anxiety, and depression. Among them, obstructive sleep apnea (OSA) is known as a comorbidity of diabetes, cardiovascular disease, asthma, obesity, high blood pressure, and chronic obstructive pulmonary disease, and these are poor prognostic factors for COVID-19 morbidity. Therefore, it is important to properly diagnose and treat sleep apnea during the COVID-19 pandemic. Due to the pandemic of COVID-19, in-lab sleep studies such as polysomnography (PSG) tend to slightly decrease, and alternative methods such as home sleep apnea tests (HSAT) and telemedicine tend to emerge relatively. In the post-COVID-19 era, HSAT with a technically adequate device and telemedicine may become an important modality for the diagnosis and treatment of OSA. In addition, the protection of PSG technicians and the disinfection of equipment and the environment of in-lab sleep studies are emphasized. If COVID-19 is ruled out, the use of positive airway pressure devices for therapeutic purposes is not restricted, but efforts should be made to minimize the risk of aerosol generation. Infection and quality control in PSG are important and inevitable issues, and regulation within each institution will be required during and after the COVID-19 pandemic.

Seed germination responses of broomrape species (Phelipanche ramosa and Phelipanche aegyptiaca) to various sanitation chemicals

AbstractBranched broomrape, an obligate root parasitic weed, has recently re-emerged in tomato fields in several California counties. California produces more tomato than any other state, and the outbreak of this noxious weed could potentially wreak havoc on the industry’s economy. Preventive measures must be taken to stop or reduce the spread of branched broomrape seeds to other areas. Branched broomrape can produce thousands of tiny seeds, which can easily spread with farm machinery over short and long distances. To prevent branched broomrape seed dispersal, sanitation and disinfection of farm equipment are necessary before entering a new farm. We tested the effectiveness of various ammonium compounds, including didecyl dimethyl ammonium chloride (DDAC), alkyl dimethyl benzyl ammonium chloride (ADBC), didecyl dimethyl ammonium bromide (DDAB), ammonium bromide (AB), and ammonium chloride (AC) on prevention of branched broomrape seed germination. Dose-response analysis showed that three chemical products, ADBC, DDAB, and DDAC, could completely inhibit branched broomrape seeds (potentially making them nonviable) at 1%, 1%, and 10% wt/vol concentrations, respectively. These three compounds were further tested in an exposure duration experiment that additionally included Egyptian broomrape. Only 10 min of exposure to these compounds was needed to prevent germination of both branched and Egyptian broomrape seeds at 1% (ADBC, DDAB) and 10% wt/vol (DDAC). Lower concentrations can provide similar inhibition effects when combined with longer exposure times. Egyptian broomrape seeds were more sensitive than branched broomrape seeds. Findings suggest that quaternary ammonium compounds could be used as potential sanitation agents to disinfect agriculture machinery from branched and Egyptian broomrape seeds.

EFFECT OF PLASMA-CHEMICALLY ACTIVATED AQUEOUS SOLUTIONS ON THE PROCESS OF DISINFECTION OF FOOD PRODUCTION EQUIPMENT

Abstract. In food production, it is essential to implement preventive measures aimed at improving the quality of products, namely decontaminating them of microorganisms causing food poisoning. Effective sanitisation of food production equipment allows preventing products’ contamination by pathogenic microflora and by microorganisms that lead to spoilage of food. The paper presents a study of the effect of plasma-chemically activated aqueous solutions on the process of disinfection of food production equipment. Activated aqueous solutions have been characterised, and it has been shown how they affect pathogenic microflora present on the surfaces of equipment involved in meat production and processing. Analysis of microbiological indicators (QMAFAnМand coliform bacteria) has shown that the number of pathogenic bacteria decreased by half on all surfaces of the processing room even at the peroxide concentration 100 mg/l, while at the concentration 500 mg/l, we observed complete destruction of pathogenic microflora both in the poultry slaughter room and in the diseased animal slaughterhouse. The disinfecting properties of plasma-chemically activated aqueous solutions in the process of production of chicken mincehave been analysed. After the surfaces of the cutters were treated with the activated aqueous solutions having the peroxide concentration 500 mg/l, the equipment was found to be completely sterile: no microflora was detected in the wipe samples, and this dynamics was observed for 7 days. The use of the disinfectant proposed stops the development of any microflora on the surface of technological equipment. The level of microbiological contamination of the finished meat product (chicken mince) after treating the equipment with plasma-chemically activated solutions has been studied, their peroxide concentrations being 100 to 700 mg/l. No pathogenic microflora (in particular, nocoliform bacteria and mould) was detected in the finished meat products obtained after the equipment was treated with the disinfectant solution at a concentration higher than 500 mg/l. Plasma-chemically activated aqueous solutions with the concentration of peroxides 500 mg/l are considered optimal for disinfection of the technological surfaces and equipment of meat processing enterprises, since they ensure complete removal of pathogenic microflora and allow obtaining a product free from pathogens.

Acinetobacter baumannii Infection-Related Mortality in Hospitalized Patients: Risk Factors and Potential Targets for Clinical and Antimicrobial Stewardship Interventions.

Due to resistance and scarcity of treatment options, nosocomial Acinetobacter baumannii infections are associated with significant fatality rates. We investigated the factors contributing to infection-related deaths to develop tailored stewardship interventions that could reduce these high mortality rates. We reviewed the medical records of adult inpatients with A. baumannii infections over two years. Patient demographics and clinical data were collected and statistically analyzed. The study included 321 patients with positive A. baumannii microbiological cultures, with respiratory infections accounting for 58.6%, soft tissues 29.3%, bacteremia 8.6%, urine 2.1%, and others 1.4%. The study population’s median (IQR) age was 62.6 (38.9–94.9) years, and hospital stay was 20 (9.5–40) days. Statistical analysis revealed that various risk factors contribute significantly to high in-hospital all-cause mortality (44%), as well as 14-day and 28-day mortality rates. Deaths increased by a factor of 1.04 with every additional year of age (p = 0.000), admission to the critical care unit (p = 0.000, OR: 2.86), and patients admitted with an infectious diagnosis had nearly three times the mortality rate as those admitted with other diagnoses (p = 0.000, OR: 3.12). Male gender (p < 0.001, OR: 2.14), any comorbid conditions (p = 0.000, OR: 5.29), prolonged hospitalization (>7 days) (p = 0.023, OR: 1.98), and hospital acquisition of infection (p = 0.027, OR: 1.68) were among the most significant predictors of mortality. All variables were investigated for their impact on all-cause, 14-day, and 28-day mortality rates. Improving multidisciplinary infection control practices, regular disinfection of patient care equipment, and optimal intubation practice that avoids unnecessary intubation are necessary interventions to reduce infection-related mortality rates. Better antibiotic selection and de-escalation, shorter hospital stays whenever possible, prompt medical stabilization of comorbid conditions, and fewer unnecessary admissions to critical care units will all lead to improved outcomes.

Efficacy of Dry Heat Treatment against Clostridioides difficile Spores and Mycobacterium tuberculosis on Filtering Facepiece Respirators.

The COVID-19 pandemic has required novel solutions, including heat disinfection of personal protective equipment (PPE) for potential reuse to ensure availability for healthcare and other frontline workers. Understanding the efficacy of such methods on pathogens other than SARS-CoV-2 that may be present on PPE in healthcare settings is key to worker safety, as some pathogenic bacteria are more heat resistant than SARS-CoV-2. We assessed the efficacy of dry heat treatment against Clostridioides difficile spores and Mycobacterium tuberculosis (M. tb) on filtering facepiece respirator (FFR) coupons in two inoculums. Soil load (mimicking respiratory secretions) and deionized water was used for C. difficile, whereas, soil load and PBS and Tween mixture was used for M. tb. Dry heat treatment at 85 °C for 240 min resulted in a reduction equivalent to 6.0-log10 CFU and 7.3-log10 CFU in C. difficile spores inoculated in soil load and deionized water, respectively. Conversely, treatment at 75 °C for 240 min led to 4.6-log10 CFU reductions in both soil load and deionized water. C. difficile inactivation was higher by >1.5-log10 CFU in deionized water as compared to soil load (p < 0.0001), indicating the latter has a protective effect on bacterial spore inactivation at 85 °C. For M. tb, heat treatment at 75 °C for 90 min and 85 °C for 30 min led to 8-log10 reduction with or without soil load. Heat treatment near the estimated maximal operating temperatures of FFR materials (which would readily eliminate SARS-CoV-2) did not achieve complete inactivation of C. difficile spores but was successful against M. tb. The clinical relevance of surviving C. difficile spores when subjected to heat treatment remains unclear. Given this, any disinfection method of PPE for potential reuse must ensure the discarding of any PPE, potentially contaminated with C. difficile spores, to ensure the safety of healthcare workers.

Fast and deep disinfection for face masks recycle using vacuum ultraviolet irradiation

Nowadays, trillions of used face masks have caused serious environmental pollution, biological risk and energy waste due to improper disposal. It is highly necessary to disinfect and recycle the used masks. In this paper, a sustainable vacuum ultraviolet (VUV) treatment for disinfection of N95 masks was first studied. Typical antibiotic-resistant E. coli were completely inactivated with decreased abundances by 65.82% for 16S rRNA and 76.75% for SHV-4 (an antibiotic-resistance gene) in 5 min, which was further decreased by more than 90% after the prolonged treatment. The mechanism was demonstrated that VUV could damage the exterior structure and interior DNA of E. coli cells due to the synergy of UV, O3 and extensive reactive oxygen species (ROS). The treated N95 masks had no structural damage and functional decline, and were up to the reuse standard. Moreover, a VUV disinfection equipment was fabricated, which can inactivate E. coli cells on the face masks in a few seconds and keep the used masks intact after 20 cycles of disinfection. This study provides a fast, deep and economical disinfection strategy for masks recycling, which can effectively reduce the consumption of fossil energy and plastic pollution to maintain sustainable development.

Ozonation: an Evolving Disinfectant Technology for the Food Industry.

The food processing industry is currently facing challenges in delivering safe, healthy, and high-quality food. Constant monitoring at each step of the supply chain of food is vital to resolve the issue of food contamination. To achieve this aim and to meet consumer prospects, the technologies promoting the concept of clean label food have been widely cherished. Ozonation is one such advanced technology that assists in maintaining food product quality and safety. Its manifold approach and zero-by-product production make it a promising food disinfectant technique. Ozone due to its oxidative property has been widely used in sanitizing, washing, odor removal, water treatment, and in equipment, fruits, vegetable, and meat processing disinfection. Ozonation in foods is done in such a way that no nutritional, sensory, and physicochemical characteristics are altered. In this review, an attempt is made to give an overview of the impact and contribution of ozone as a disinfectant in food processing while comparing it with conventional disinfectants and its overall application in the food industry.

Hygeia – An Automated Disinfection Booth using FAR UVC

This paper addressed the current gaps of the health and safety protocols followed by the health workers and other front-line workers in conducting disinfection of self and personal protective equipment (PPE) after using it. The current disinfection system disinfects surfaces, water, air, materials, utensils, rooms, compartments, foods and other already came in various ways. Some of these include gas disinfecting, alcohol, chlorine, bleach, detergents, steams, hot water, hot gas, chemicals, UV rays and more in which according to them, still poses risk among health workers and front-line workers not during the duty but on the doping and donning of the PPE. The researchers used the Agile Scrum methodology of software development; thus, user stories were collected during stakeholders’ meeting. The meeting includes the researchers, RHU personnel and the front-liners. This allows all the concerned individuals and agencies to express their concern and needs during the donning and doffing process. After the meeting, the researchers decided to develop Hygeia, a system of interconnected electronic devices that aims to automate the disinfection of booths using UVC light as disinfectant. It used the concept of IOT which Arduino Microcontroller, Raspberry Pi, Sensors, Motors, Relay, Switches, Pumps and Water Valves were used to deliver its specified functions. Daily standup meetings were conducted in order to monitor the progress of the project and if it meets the needs of the client before delivering the fully potential product. Keywords: Micro-controllers, Internet of Things, Ultraviolet C, CoVid Response

New ways to prevent nosocomial infection (literature review)

The problem of prevention of nosocomial infection is one of the central in the work of medical organizations, and interest in it from clinicians remains high. Nosocomial infection is one of the main causes of death in a hospital setting and significantly increases the risk of death. Nosocomial infections lengthen the time spent in the hospital and increase the material costs of diagnosing and treating the underlying disease. Due to the high prevalence, more and more new methods of prevention of nosocomial infections appear and the existing ones are being improved. The basis of all methods is the observance of the rules of asepsis and antisepsis, but the importance of the socio-economic aspect of the policy of medical organizations and institutions is not excluded. Currently, examples of successful preventive measures are hand hygiene, sterilization and disinfection of medical equipment, prevention of environmental pollution, timely disposal of waste, compliance with precautions for isolation and continuous monitoring of data on the spread of nosocomial infections. However, despite significant progress in the study and application of preventive measures in practice, the problem of nosocomial infection remains unresolved. Difficulty for the development of a trend towards a decrease in the incidence of nosocomial infections is the specificity of pathogens and an increase in their resistance. Research and the search for effective, convenient and cost-effective methods and means of prevention of nosocomial infection must continue, as the implementation of programs for prevention and control of infections in the future can reduce the length of hospital stay and avoid other additional costs.

Recomendaciones para la realización de broncoscopia en pacientes pediátricos en la pandemia COVID-19

Introduction: a bronchoscopy is a fundamental tool in respiratory clinical conditions, but it can be a source of transmission of infectious agents such as SARS-COV-2. Therefore, it is urgent to adopt international recommendations for our environment. In this study, we need indications, contraindications, and biosafety measures to perform bronchoscopy in patients with SARS-COV-2 infection.Methods: the first phase consists of an analysis of the state of scientific research with a source of exploration on an academic basis. Subsequently, the elaboration of questions with the PICO methodology, using the PRISMA strategy. These were voted on by 18 Pediatric Bronchoscopist Pulmonologists who answered a survey and defined the agreement strength as strong, moderate and weak, based on expert agreement.Results: the indications with the highest level of an agreement are suspicion of foreign body aspiration and massive hemoptysis. The contraindications with the highest level of an agreement are non-urgent conditions, thermoplasty, stent placement. The general recommendations with the highest degree of agreement are a notification to the anesthesiologist and surgical team. The recommendations during and after the procedure are to use personal protective equipment, proper removal of it, and disinfection of equipment with 75% alcohol.Conclusions: bronchoscopy is a procedure inherent to critical care areas, the high training of the personnel assigned to these tasks is a fundamental principle for the success of its execution. Our project reaches a high level of agreement among the participating experts, which allows the elaboration of the Mexican Bronchoscopy Consensus.

Effectiveness of Online Patient Safety Education on the Competency of Nurses in Intensive Care Units: A Quasi-experimental Study

Background &amp; Aims: Maintaining patient safety (PS) is one of professional and ethical duties of health care providers. Nurses, as the largest professional group in the health system, have a potential and significant power in influencing the health care quality. Their competency in PS is essential to ensure quality and safe care. Education plays a vital role in improving PS and providing high quality nursing care. Due to the prevalence of COVID-19 and the need to observe social distancing, it is not possible to hold face-to-face courses. Hence, e-learning is a valuable option during this pandemic. This study aims to evaluate the effectiveness of online PS education on the competence of nurses in intensive care units (ICUs). Materials &amp; Methods: This is a single-group quasi-experimental study with a pre-test/post-test design that was conducted in 2020 in Tehran, Iran. Participants were 50 nurses working in the ICUs of Hazrate Rasoole Akram Hospital and Firoozgar Hospital affiliated to Iran University of Medical Sciences, who were by a proportional stratified sampling method. The content of the educational program was prepared using clinical guidelines and the literature which included materials about (1) PS and its different aspects (medication error, hemovigilance, pressure ulcer, fall, nosocomial infections, hand hygiene, surface and equipment disinfection, and waste management), (2) PS culture, (3) the effects of human factors and teamwork on error incidence, (4) importance of communication with patients before and after the occurrence of errors and giving appropriate feedback on errors, (5) root cause analysis of errors, (6) activity analysis after an adverse event, and (7) risk management. The program was prepared using Storyline version 3 software. Educational content was provided to participants on Telegram application. Before and three months after the intervention, data were collected using the Patient Safety Competency Self-evaluation (PSCSE) questionnaire. Data were analyzed by descriptive statistics (frequency, mean, and standard deviation) and inferential statistics (paired t-test) in SPSS software, version 22. Results: The mean scores of PS knowledge (21.75±3.28), attitude (61.52±4.19) and skill (84.66±53.7) after the intervention were significantly higher compared to their pretest scores (P&lt;0.001). The mean of total competency score (167.93±11.61) was also significantly higher after the intervention. Results showed that the educational program improved the nurses' competence by 17.86%. The education had the highest effect on PS knowledge, followed by PS skills and attitudes. Conclusion: Online education can increase PS knowledge, skills, and attitudes in ICU nurses and can ultimately promote their competence in PS. Nursing managers can use e-learning method to provide in-service training and retraining courses on familiarity with PS concepts, which can help manage medical errors caused by nurses. This learning method is recommended for nurses working in ICUs, especially during the COVID-19 pandemic.

Biosecurity practices in hatcheries of high value fishes

The present study was conducted to know the status of biosecurity from some commercial fish hatcheries producing high value fish seeds including gulsha (Mystus cavasius), shing (Heteropneustes fossilis) and koi (Anabas testudineus) in Mymensingh and Jessore districts. Data was collected from 90 hatcheries of each district through questionnaire interview. Biosecurity status of hatcheries was evaluated through some previously set criteria including infrastructure, restriction on entry of visitors, use of foot bath, protective clothing, hatchery hygiene, disinfection and sanitation, record keeping, hatchery personnel’s academic qualification and training. Severe lacking on some biosecurity measures were observed such as use of foot bath, restriction on visitors, record keeping system, pest control management, proper disinfection of equipment, and feed inspection. No hatchery owners were found to use any protective clothing and vaccination. Some biosecurity measures were found quite satisfactory such as good hygiene (86%), cleaning of hatchery units (100%), water quality (78%), stocking of disease free broods (77.50%) and internal quarantine procedure (80%). Hatchery owners reported some diseases in brood fishes which included gill and fin rot, abdominal distension, ulcerative hemorrhagic lesion and whitish appurtenance. Overall the biosecurity status in hatcheries was not that satisfactory. It is thus important to improve biosecurity status in fish hatcheries through updated training of hatchery personnel.

Longitudinal Assessment of Contamination Patterns on Workstations on Wheels (WOWs)

Background Representations of contamination on portable medical equipment inform strategies to prevent transmission and healthcare-associated infections (HAIs). While periodic disinfection of equipment is required in most hospitals, the complexity of demands on staff may limit their ability to adequately disinfect multiple surfaces and touch points on a piece of equipment. The purpose of this study was to determine if current disinfection practices were effectively managing bioburden on WOWs on our hospital wards. Methods Samples were collected using press plate for four weeks from 10 WOWs on three medical-surgical units in our hospital. The sampling scheme limited the ability of staff to anticipate sampling and ensured multiple surfaces on each WOW were consistently sampled. Aerobic bacterial colony counts were calculated after 24 hours of incubation. Bayesian multilevel models estimated the mean bioburden and compared bioburden from different locations on WOWs. Results Out of the 452 samples, the estimated mean colony count (95% credible interval) was 29.2 (16.1-51.1). The incident risk-ratio comparing the handle to the other surfaces on the WOWs were 0.43 (0.32-0.55) for the keyboard, 0.29 (0.22-0.38) for the tray, and 0.22 (0.16-0.29) for the mouse. Conclusions The handle used for moving the WOW around, had greater bioburden compared to the keyboard, tray, or the mouse. Difference in the bioburden may reflect number of touches and lack of hand hygiene when moving equipment. The lower bioburden on keyboards and mouses may conversely reflect greater attention to hand hygiene or may be an artifact of sampling (less contact with press plates). The correlation of bioburden to HAI transmission was not studied here so the significance of bioburden alone in the absence of HAI monitoring is uncertain. Representations of contamination on portable medical equipment inform strategies to prevent transmission and healthcare-associated infections (HAIs). While periodic disinfection of equipment is required in most hospitals, the complexity of demands on staff may limit their ability to adequately disinfect multiple surfaces and touch points on a piece of equipment. The purpose of this study was to determine if current disinfection practices were effectively managing bioburden on WOWs on our hospital wards. Samples were collected using press plate for four weeks from 10 WOWs on three medical-surgical units in our hospital. The sampling scheme limited the ability of staff to anticipate sampling and ensured multiple surfaces on each WOW were consistently sampled. Aerobic bacterial colony counts were calculated after 24 hours of incubation. Bayesian multilevel models estimated the mean bioburden and compared bioburden from different locations on WOWs. Out of the 452 samples, the estimated mean colony count (95% credible interval) was 29.2 (16.1-51.1). The incident risk-ratio comparing the handle to the other surfaces on the WOWs were 0.43 (0.32-0.55) for the keyboard, 0.29 (0.22-0.38) for the tray, and 0.22 (0.16-0.29) for the mouse. The handle used for moving the WOW around, had greater bioburden compared to the keyboard, tray, or the mouse. Difference in the bioburden may reflect number of touches and lack of hand hygiene when moving equipment. The lower bioburden on keyboards and mouses may conversely reflect greater attention to hand hygiene or may be an artifact of sampling (less contact with press plates). The correlation of bioburden to HAI transmission was not studied here so the significance of bioburden alone in the absence of HAI monitoring is uncertain.

The Impact of COVID-19 on the Physical Well-being of Nursing and Medical Personnel: An Integrative Review

Objective: To highlight the impact of responding to COVID-19 on the physical well-being of nursing and medical personnel. Method: This integrative literature review includes Spanish, English, and Portuguese articles. From July 10 to 16, 2020, the search was carried out in the Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Health Sciences Literature, Web of Science, SciVerse Scopus, and National Library of Medicine databases. Twenty-five studies were analyzed, and the results are presented descriptively and in tables. Results: Of the total number of articles, 52 % addressed coronavirus infection and related factors as an impact on nursing and medical personnel’s physical well-being resulting from responding to COVID-19, 28 % addressed sleep quality and predictors, and 20 % addressed damage stemming from the use of personal protective equipment or other preventive measures. Conclusions: Responding to COVID-19 has been conducive to coronavirus infection among personnel due to the work process and prevention measures, poor sleep quality due to mental disorders and lack of social support, and physical harm, such as headaches and skin injuries, due to the use of protective equipment and hand disinfection.

Arduino Based Covid Disinfection Box

The work titled “Arduino Based Covid Disinfection box” aims to build a disinfection box which will sterilize various day-to-day objects like masks and keys. Outbreaks of the virus are highly contagious and life-threatening. One of the necessary steps in the fight against the outbreak of the epidemic and victory over the global pandemic is the disinfection of infected surfaces. Keeping public places safe and clean can be quite challenging, especially if other people are in frequent contact with each other. Common areas and high-contact surfaces are manually disinfected using the hand-held disinfectant. Manual disinfection exposes a cleaner to a contaminated surface by increasing the risk of infection. The use of disinfection box reduces the risk of infection, and overcomes the costs associated with manual cleaning agents. Excessive use of the disinfectant can cause serious health problems. This pandemic forced us to develop and build secure disinfection equipment for UVC disinfection for public spaces. UVC Rays can easily be skipped during manual cleaning and are not harmful to human skin and eyes. The disinfection box provides an effective and efficient solution for disinfecting high-risk and contact surfaces without human intervention.

The impact and public health response of chiropractors to the COVID-19 pandemic: a survey across four continents

BackgroundThe unprecedented impact of COVID-19 on healthcare professionals has implications for healthcare delivery, including the public health guidance provided to patients. This study aims to assess the response and impact of COVID-19 on chiropractors internationally, and examines the public health response of chiropractors to the COVID-19 pandemic practising under a musculoskeletal spine-care versus subluxation-based care paradigm.MethodsA survey was distributed to chiropractors in Australia, Canada, Denmark, Hong Kong, United Kingdom and United States (Oct. 2nd–Dec. 22nd, 2020) via professional bodies/publications, and social media. Questions were categorised into three domains: socio-demographic, public health response and business/financial impact. Multivariable logistic regression explored survey items associated with chiropractors practising under different self-reported paradigms.ResultsA total of 2061 chiropractors representing four global regions completed the survey. Our recruitment method did not allow the calculation of an accurate response rate. The vast majority initiated COVID-19 infection control changes within their practice setting, including increased disinfecting of treatment equipment (95%), frequent contact areas (94%) and increased hand hygiene (94%). While findings varied by region, most chiropractors (85%) indicated that they had implemented regulator advice on the use of personal protective equipment (PPE). Suspension of face-to-face patient care during the peak of the pandemic was reported by 49% of the participants with 26% implementing telehealth since the pandemic began. Chiropractors practising under a musculoskeletal spine-care paradigm were more likely to implement some/all regulator advice on patient PPE use (odds ratio [OR] = 3.25; 95% confidence interval [CI]: 1.57, 6.74) and practitioner PPE use (OR = 2.59; 95% CI 1.32, 5.08); trust COVID-19 public health information provided by government/World Health Organisation/chiropractic bodies (OR = 2.47; 95% CI 1.49, 4.10), and initiate patient telehealth in response to COVID-19 (OR = 1.46; 95% CI 1.02, 2.08) compared to those practising under a subluxation-based paradigm.ConclusionsChiropractors who responded to our survey made substantial infectious control changes in response to COVID-19. However, there was regional variation in the implementation of the advised practitioner and patient use of PPE and limited overall use of telehealth consultations by chiropractors during COVID-19. Musculoskeletal spine-care chiropractors were more adaptive to certain COVID-19 public health changes within their practice setting than subluxation-based chiropractors.

Lessons Learned From the Resilience of Chinese Hospitals to the COVID-19 Pandemic: Scoping Review.

BackgroundThe SARS-CoV-2 pandemic has brought substantial strain on hospitals worldwide; however, although the success of China’s COVID-19 strategy has been attributed to the achievements of the government, public health officials, and the attitudes of the public, the resilience shown by China’s hospitals appears to have been a critical factor in their successful response to the pandemic.ObjectiveThis paper aims to determine the key findings, recommendations, and lessons learned in terms of hospital resilience during the pandemic; analyze the quality and limitations of research in this field at present; and contribute to the evaluation of the Chinese response to the COVID-19 outbreak, building on a growing literature on the role of hospital resilience in crisis situations.MethodsWe conducted a scoping review of evidence on the resilience of hospitals in China during the COVID-19 crisis in the first half of 2020. Two online databases (the China National Knowledge Infrastructure and World Health Organization databases) were used to identify papers meeting the eligibility criteria. After extracting the data, we present an information synthesis using a resilience framework. Articles were included in the review if they were peer-reviewed studies published between December 2019 and July 2020 in English or Chinese and included empirical results pertaining to the resilience of Chinese hospitals in the COVID-19 pandemic.ResultsFrom the publications meeting the criteria (n=59), we found that substantial research was rapidly produced in the first half of 2020 and described numerous strategies used to improve hospital resilience, particularly in three key areas: human resources; management and communication; and security, hygiene, and planning. Our search revealed a focus on interventions related to training, health care worker well-being, eHealth/telemedicine, and workplace organization, while other areas such as hospital financing, information systems, and health care infrastructure were less well represented in the literature. We also noted that the literature was dominated by descriptive case studies, often lacking consideration of methodological limitations, and that there was a lack of both highly focused research on specific interventions and holistic research that attempted to unite the topics within a resilience framework.ConclusionsWe identified a number of lessons learned regarding how China’s hospitals have demonstrated resilience when confronted with the SARS-CoV-2 pandemic. Strategies involving interprovincial reinforcements, online platforms and technological interventions, and meticulous personal protective equipment use and disinfection, combined with the creation of new interdisciplinary teams and management strategies, reflect a proactive hospital response to the pandemic, with high levels of redundancy. Research on Chinese hospitals would benefit from a greater range of analyses to draw more nuanced and contextualized lessons from the responses to the crisis.

Effects of Sterilization Methods on Different 3D Printable Materials for Templates of Physician-Modified Aortic Stent Grafts Used in Vascular Surgery-A Preliminary Study.

Three-dimensionally-printed aortic templates are increasingly being used to aid in the modification of stent grafts in the treatment of urgent, complex aortic disorders, often of an emergency nature. The direct contact between the aortic template and the stent graft implies the necessity of complete sterility. Currently, the efficacy of sterilizing aortic templates and the effect of sterilization on the geometry of tubular aortic models are unknown. A complex case of aortic arch dissection was selected to prepare a 3D-printed aortic arch template, which was then manufactured in six popular printing materials: polylactic acid (PLA), nylon, polypropylene (PP), polyethylene terephthalate glycol (PETG), and a rigid and flexible photopolymer resin using fused deposition modeling (FDM) and stereolithography (SLA). The 3D models were contaminated with Geobacillus stearothermophilus broth and Bacillus atrophaeus. The sterilization was performed using three different methods: heat (105 °C and 121 °C), hydrogen peroxide plasma, and ethylene oxide gas. Before and after sterilization, the aortic templates were scanned using computed tomography to detect any changes in their morphology by comparing the dimensions. All sterilization methods were effective in the elimination of microorganisms. Steam sterilization in an autoclave at 121 °C caused significant deformation of the aortic templates made of PLA, PETG, and PP. The other materials had stable geometries, and changes during mesh comparisons were found to be submillimeter. Similarly, plasma, gas, and heat at 105 °C did not change the shapes of aortic templates observed macroscopically and using mesh analysis. All mean geometry differences were smaller than 0.5 mm. All sterilization protocols tested in our study were equally effective in destroying microorganisms; however, differences occurred in the ability to induce 3D object deformation. Sterilization at high temperatures deformed aortic templates composed of PLA, PETG, and PP. This method was suitable for nylon, flexible, and rigid resin-based models. Importantly, plasma and gas sterilization were appropriate for all tested printing materials, including PLA, PETG, PP, nylon, flexible and rigid resins. Moreover, sterilization of all the printed models using our novel protocol for steam autoclaving at 105 °C was also 100% effective, which could represent a significant advantage for health centers, which can therefore use one of the most popular and cheap methods of medical equipment disinfection for the sterilization of 3D models as well.

Portable Ultraviolet-C Chambers for Inactivation of SARS-CoV-2.

The goal of this project was to create and optimize the performance of portable chambers for reliable ultraviolet (UV) disinfection of personal protective equipment (PPE) and enable its safe reuse. During unforeseen times of high demand for PPE, such as during the coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), single-use PPE supply can be quickly depleted. UV radiation has been shown to disinfect materials with high efficacy. This paper reports the design and construction of two 280 nm ultraviolet-C (UV-C) disinfection chambers in the form of portable chambers with 46 cm × 46 cm × 46 cm interior dimensions, one using light-emitting diodes and the other using mercury vapor lamps. This paper summarizes and presents a review of SARS-CoV-2 UV deactivation research during 2020 to 2021. Additionally, this paper discusses efforts to increase the uniformity and overall intensity of the UV-C radiation within the chambers through the installation of a UV-reflective, porous polytetrafluoroethylene (PTFE) material. A calculator prototype was additionally designed to calculate the reduction of SARS-CoV-2 as a result of UV-C disinfection, and the prototype code is presented. The paper describes the selection of UV-C radiation sources for the chambers and the chambers' mechanical and electrical design, PTFE installation, testing, and safety considerations.