Corrigendum to "Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents" [J Hosp Infect 104 (2020) 246-251]

Can pyrolysis handle biomedical wastes?: Assessing the potential of various biomedical waste treatment technologies in tackling pandemics

Globally, COVID-19 has not only caused tremendous negative health, social and economic impacts, but it has also led to environmental issues such as a massive increase in biomedical waste. The biomedical waste (BMW) was generated from centralized (hospitals, clinics, and research facilities) and extended (quarantine camps, COVID-19 test camps, and quarantined homes) healthcare facilities. Many effects, such as the possibility of infection spread, unlawful dumping/disposal, and an increase in toxic emissions by common BMW treatment facilities, are conjectured because of the rise in waste generation. However, it is also an opportunity to critically analyze the current BMW treatment scenario and implement changes to make the system more economical and environmentally sustainable. In this review, the waste disposal guidelines of the BMW management infrastructure are critically analyzed for many functional parameters to bring out possible applications and limitations of individual interventions. In addition, an investigation was made to select appropriate technology based on the environmental setting.

Synthesis and antimicrobial activity testing of quaternary ammonium silane compounds

With increasing health awareness of the pathogenic effects of disease-causing microorganisms, interest in and use (of medical textiles, disinfectants in medical devices, etc.) of antimicrobial substances have increased in various applications, such as medical textiles and disinfectants (alcohol-based and nonalcoholic), in medical devices There are several concerns with alcohol-based disinfectants, such as surface deformation of medical devices due to high alcohol content and damage to skin tissue caused by lipid and protein denaturation of cell membranes. Quaternary ammonium compounds (quats) were preferred because they have the potential to prepare water-based disinfectants. In this study, novel (3-chloropropyl)triethoxysilane (CPTMO) and (3-chloropropyl)triethoxysilane (CPTEO) based quaternary ammonium silane compounds (silane-quats) were developed using quats with carbon chain lengths of C12, C14, C16 and C18. Titration (ASTM D2074) was used to calculate the yield of the synthesis and the structures of the products were characterised by Fourier transform infrared spectroscopy (FTIR), nuclear magnetic resonance spectroscopy (13C NMR, 1H NMR) and gas chromatography-mass spectrometry (GC-MS).The in vitro antimicrobial activity of the synthesized samples was evaluated against Gram-positive (Staphylococcus aureus (S. aureus), Enterococcus hirae (E. hirae)) and Gram-negative (Escherichia coli (E. coli), Pseudomonas aeruginosa (P. aeruginosa)) bacteria and fungi (Candida albicans (C. albicans), Aspergillus brasiliensis (A. brasiliensis)) using the minimum inhibitory concentration (MIC) test. According to MIC tests, the silane-quats with the highest antimicrobial effects were dimethylhexadecyl[3-(trimethoxysilyl)propyl]ammonium chloride (SQ3), which had an MIC of < 16 μg/ml (ppm) against E. coli, S. aureus, E. hirae, C. albicans, and A. brasiliensis and 32 μg/ml against P. aeruginosa. The MIC test results also showed antimicrobial activity at least 2 times greater than that of the commercially available disinfectant benzalkonium chloride (BAC). Findings suggest that SQ3 (C16) holds promise as an effective medical disinfectant, presenting a novel approach to combating microbial infections in healthcare settings.

Lessons from the COVID-19 pandemic: the unequal burden of COVID-19 on vulnerable populations in the Brazilian Central-West

This study aimed to estimate the prevalence and identify social factors and preventive strategies associated with the coronavirus disease 2019 (COVID-19) in socio and economically vulnerable people (recyclable waste pikers, immigrants/refugees, and homeless people) in Goiânia, Goiás State, Central-Western Brazil. A cross-sectional study was conducted from July 2020 to October 2020. COVID-19 positivity was defined as a positive total anti-SARS-COV-2 antibody test and/or RNA test for SARS-COV-2. Univariable and multiple regression analyses were performed to identify the variables associated with COVID-19. Of the 594 participants, 47.3% were recyclable waste pickers, 29.6% were immigrants/refugees, and 23.1% were homeless people. The positivity for SARS-CoV-2 RNA was 14.1%, whereas for anti-SARS-CoV-2 a total of 30.8% were positive, and 39.4% were positive for at least one COVID-19 marker. Among the 541 individuals, being immigrants/refugees, not wearing a surgical mask, and having three or more people sleeping in the same room were associated with SARS-CoV-2 infection, while using TV news as the main source of information about the pandemic was a protective predictor of COVID-19. This study revealed ethnic and socioeconomic inequalities in the prevalence of COVID-19 among impoverished people in Brazil. Additionally, a high prevalence of COVID-19 was detected in all three groups. Developing new strategies to combat and prevent communicable diseases affecting this population is essential for mitigating future and ongoing pandemics.

Wandering Behavior and SARS-CoV-2 Infection in Veterans Affairs Community Living Center Residents

OBJECTIVE

Wandering behavior in nursing home (NH) residents could increase risk of infection. The objective of this study was to assess the association of wandering behavior with SARS-CoV-2 infection in Veterans Affairs (VA) Community Living Center (CLC) residents.

DESIGN

Retrospective cohort study.

SETTING & PARTICIPANTS

Veterans residing in 133 VA CLCs.

METHODS

We included residents with SARS-CoV-2 test from March 1, 2020 to December 31, 2020 from VA electronic medical records. We identified CLC residents with wandering on Minimum Data Set 3.0 assessments and compared them with residents without wandering. The outcome was SARS-CoV-2 infection, as tested for surveillance testing, in those with and without wandering. Generalized linear model with Poisson link adjusted for relevant covariates was used.

RESULTS

Residents (n = 9995) were included in the analytic cohort mean, (SD) age 73.4 (10.7); 388 (3.9%) women. The mean (SD) activities of daily living score in the overall cohort was 13.6 (8.25). Wandering was noted in 379 (3.8%) (n = 379) of the cohort. The exposure groups differed in prior dementia (92.6% vs 62.1%, standardized mean difference [SMD] = 0.8) and psychoses (41.4% vs 28.1%, SMD = 0.3). Overall, 12.5% (n = 1248) tested positive for SARS-CoV-2 and more residents among the wandering group were SARS-CoV-2 positive as compared with those in the group without wandering (19% [n = 72] vs 12.2% [n = 1176], SMD = 0.19). Adjusting for covariates, residents with wandering had 34% higher relative risk for SARS-CoV-2 infection (adjusted relative risk, 1.34; 95% CI, 1.04-1.69).

CONCLUSIONS AND IMPLICATIONS

CLC residents with wandering had a higher risk of SARS-CoV-2 infection. This may inform implementation of infection control and isolation policies as NHs attempt to balance ethical concepts of resident autonomy, proportionality, equity, and utilitarianism.

Efficacy of Three Antimicrobials Against two SARS-COV-2 Surrogates, Bovine Coronavirus and Human Coronavirus OC43, on Hard or Soft Nonporous Materials

The efficacy of three antimicrobials was evaluated against two severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) surrogates - bovine coronavirus (BCoV) and human coronavirus (HCoV) OC43 - on hard and soft nonporous materials. Three antimicrobials with three different active ingredients (chlorine, hydrogen peroxide, and quaternary ammonium compound + alcohol) were studied. Initially, a neutralization method was optimized for each antimicrobial. Then, we determined their efficacy against BCoV and HCoV OC43 in both suspension and on surfaces made with polyethylene terephthalate (PET) plastic and vinyl upholstery fabric. All tests were conducted under ambient environmental conditions with a soil load of 5% fetal bovine serum. After a 2-min exposure, all three antimicrobials achieved a >3.0 log10 reduction in viral titers in suspension. All three also reduced virus infectivity on both surface materials below the detection limit (0.6 log10 TCID50/carrier). Treatments in which the reduction in virus titer was <3.0 log10 were attributed to a decreased dynamic range on the carrier during drying prior to disinfection. The carrier data revealed that both surrogates were inactivated more rapidly (p <0.05) on vinyl or under conditions of high relative humidity. Three classes of antimicrobials were efficacious against both SARS-CoV-2 surrogate viruses, with BCoV demonstrating slightly less sensitivity compared to HCoV OC43. These findings also illustrate the importance of (1) optimizing the neutralization method and (2) considering relative humidity as a key factor for efficacy testing.

Nanoscale hyperthermia mesostructures for sustainable antimicrobial design

Sustainability is critical in addressing global challenges posed by prolonged pandemics that impact health, economies, and the environment. Here, we introduce a molecular engineering approach for thermoregulated antimicrobial management inspired by firewalking rituals. The study uses in situ spectroscopy and multi-scale modeling to validate a hierarchical design. Efficient light-to-thermal energy conversion is achieved by engineering the molecular band structure. Rapid nanoscale hyperthermia is facilitated through thermal engineering. This approach significantly reduces the half-life of pathogens such as Escherichia coli, influenza A, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to 1.4 min while maintaining a low perceived temperature on human skin. Standard disease infection and epidemic models show this technology's potential to flatten outbreak curves and delay peak infection rates, which is crucial during the early stages of pandemics when developing vaccines and antiviral drugs takes time. The scalable manufacturing and broad antimicrobial applicability hold great promise for controlling emerging infectious diseases and diverse bioprotective applications.

Factors associated with dental clinic use by clients in Nigeria during the COVID-19 pandemic

BACKGROUND

Nigeria, like many other countries, faced challenges in dental care provision during the COVID-19 pandemic, necessitating limited care to emergencies only. However, the impact of restricted access to dental services on oral health remains a concern, particularly with preventive maintenance care. This study aims to identify the factors associated with dental service utilization during the COVID-19 pandemic among patients attending dental clinics in Nigeria, and their sources of information about COVID-19.

METHODS

This cross-sectional study recruited 500 participants who had visited dental clinics before and during the pandemic. Data were collected through telephone interviews and online questionnaires between September and December 2021. Inferential analyses were conducted using ordered logistic regression models to assess the association between the independent (awareness of emergency dental treatments, knowledge of COVID-19 transmission routes in dentistry, awareness of required preparations in dental practice settings, fear of COVID-19 infection in dental settings), and dependent (utilization of dental services during the pandemic) variables after adjusting for confounding variables (age, sex, educational status, COVID-19 vaccinations status and COVID-19 status of live-in residents). The sources of COVID-19 information by dental patients was also identified. Statistical significance was established at 95% confidence level with a p value < 0.05.

RESULTS

Many participants were males (51.2%) and had tertiary education (61.6%). Fear of COVID-19 infection in dental settings was significantly associated with lower odds of utilizing dental care services during the pandemic (Adjusted Odds Ratio: -0.06, 95% Confidence Interval: -0.08, -0.01). The main sources of COVID-19 information were mass media and social networks, with only 42% receiving information from dental professionals.

CONCLUSION

Fear of COVID-19 infection in dental settings significantly influenced dental service utilization during the pandemic. Strategies to address fear and improve communication channels between dental professionals and patients are essential for promoting oral health during similar crises.

Light-Induced Transformation of Virus-Like Particles on TiO2

Titanium dioxide (TiO2) shows significant potential as a self-cleaning material to inactivate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and prevent virus transmission. This study provides insights into the impact of UV-A light on the photocatalytic inactivation of adsorbed SARS-CoV-2 virus-like particles (VLPs) on a TiO2 surface at the molecular and atomic levels. X-ray photoelectron spectroscopy, combined with density functional theory calculations, reveals that spike proteins can adsorb on TiO2 predominantly via their amine and amide functional groups in their amino acids blocks. We employ atomic force microscopy and grazing-incidence small-angle X-ray scattering (GISAXS) to investigate the molecular-scale morphological changes during the inactivation of VLPs on TiO2 under light irradiation. Notably, in situ measurements reveal photoinduced morphological changes of VLPs, resulting in increased particle diameters. These results suggest that the denaturation of structural proteins induced by UV irradiation and oxidation of the virus structure through photocatalytic reactions can take place on the TiO2 surface. The in situ GISAXS measurements under an N2 atmosphere reveal that the virus morphology remains intact under UV light. This provides evidence that the presence of both oxygen and UV light is necessary to initiate photocatalytic reactions on the surface and subsequently inactivate the adsorbed viruses. The chemical insights into the virus inactivation process obtained in this study contribute significantly to the development of solid materials for the inactivation of enveloped viruses.

Healthcare Providers' Adherence to COVID-19 Prevention and Control Practices in Health Records and Information Management, Ghana

Background

The impact of contracting coronavirus on healthcare providers (HCPs) affects their ability to combat the infection. The virus can be transmitted through droplets from sneezing, coughing, and yelling, making it essential for HCPs to plan ahead when dealing with patients with respiratory symptoms. The need to assess healthcare providers' perceived adherence to COVID-19 Prevention and Control Practices (PCP) in Health Records and Information Management is vital for optimizing healthcare operations and ensuring the safety of both patients and providers. This study assesses healthcare providers' perceived adherence to COVID-19 PCP in Health Records and Information Management. Subjects and Method. A cross-sectional survey was conducted to collect data from 1268 HCPs working in eight randomly selected hospitals across five regions in Ghana. The survey was carried out from May 15, 2022, to August 13, 2022. Simple random sampling was used to choose these eight facilities from a total of 204 hospitals. Within each facility, HCPs from various departments were selected using simple random sampling. The EpiInfo 7 software's StatCalc tool was used to choose a total sample size of 1268 from an estimated 4482 HCP-PR from the eight hospitals. Compliance with COVID-19 PCP was assessed using a 3-point scale, ranging from one (Yes always) to three (No). Cronbach's alpha reliability coefficient was used to examine the statistical reliability of the variables in the dataset. Cronbach's alpha was 0.73 overall, suggesting strong reliability. Bartlett's test for equal variances was used for comparative analysis of health facility and overall mean COVID-19 PCP in different areas of health facilities. IBM SPSS (version 23) statistical software was used for the data analysis process.

Results

A total of 1268 HCP-PR participated in the survey, resulting in a 99.6% response rate. Findings reveal that 760 healthcare professionals who handle patients' records (HCP-PR), constituting 60%, consistently followed COVID-19 protocols in the registration and clinic preparation zones. Another 390 individuals (30.7%) adhered to these protocols occasionally, while 119 (9.4%) failed to comply. Similarly, in the filing area, 739 respondents (58.3%) consistently adhered to COVID-19 protocols, 358 (28.3%) occasionally did so, and 170 (13.4%) did not follow the protocols at all. Regarding handling health records cautiously, 540 participants (42.5%) always did, 448 (35.3%) did so sometimes, and 280 (22.2%) neglected these precautions. Additionally, 520 respondents (41.0%) consistently followed COVID-19 precautions when handling computers and other equipment, 393 (31.0%) did so occasionally, and 355 (28.0%) did not adhere to these precautions.

Conclusion

The majority of respondents showed good compliance with COVID-19 protocol in the registration and clinic preparation areas. However, in the filing area, just over four out of every seven respondents consistently adhered to COVID-19 PCP. Additionally, four out of every seven participants did not comply with COVID-19 PCP when handling patients' records. Analysis reveals diverse adherence to COVID-19 PCP, and statistical tests show variable performance, highlighting standout health facilities.

Inactivation efficacy and mechanism of 9.375 GHz electromagnetic wave on coronavirus

Epidemics caused by pathogenic viruses are a severe threat to public health worldwide. Electromagnetic waves are a type of noncontact and nonionizing radiation technology that has emerged as an effective tool for inactivating bacterial pathogens. In this study, we used a 9.375 GHz electromagnetic wave to study the inactivation effect and mechanism of electromagnetic waves on MHV-A59, a substitute virus for pathogenic human coronavirus, and to evaluate the inactivation efficiency on different surface materials. We showed that 9.375 GHz electromagnetic waves inactivate MHV-A59 by destroying viral particles, envelopes, or genomes. We also found that 9.375 GHz electromagnetic waves can decrease the infectivity of viruses on the surface of inanimate materials such as plastic, glass, cloth, and wood. In conclusion, our results suggested that the 9.375 GHz electromagnetic wave is a promising disinfection technique for preventing the spread and infection of pathogenic viruses.

Antimicrobial Activity of Hydrogen Peroxide for Application in Food Safety and COVID-19 Mitigation: An Updated Review

Hydrogen peroxide (H2O2) is a well-known agent with a broad-spectrum antimicrobial activity against pathogenic bacteria, fungi, and viruses. It is a colorless liquid and commercially available in aqueous solution over a wide concentration range. It has been extensively used in the food industry by virtue of its strong oxidizing property and its ability to cause cellular oxidative damage in microbial cells. This review comprehensively documents recent research on the antimicrobial activity of H2O2 against organisms of concern for the food industry, as well as its effect against SARS-CoV-2 responsible for the COVID-19 pandemic. In addition, factors affecting the antimicrobial effectiveness of H2O2, different applications of H2O2 as a sanitizer or disinfectant in the food industry as well as safety concerns associated with H2O2 are discussed. Finally, recent efforts in enhancing the antimicrobial efficacy of H2O2 are also outlined.

The effects of mouth rinsing and gargling with mouthwash containing povidone-iodine and hydrogen peroxide on the cycle threshold value of Severe Acute Respiratory Syndrome Coronavirus 2: A randomized controlled trial of asymptomatic and mildly symptomatic patients

Background

Coronavirus disease 2019 can spread rapidly. Surgery in the oral cavity poses a high risk of transmission of severe acute respiratory syndrome coronavirus 2. The American Dental Association and the Centers for Disease Control and Prevention recommend the use of mouthwash containing 1.5% hydrogen peroxide (H 2O 2) or 0.2% povidone iodine (PI) to reduce the viral load in the upper respiratory tract and decrease the risk of transmission. The aim of the present study was to analyze the effect of mouth rinsing and gargling with mouthwash containing 1% PI, 0.5% PI, 3% H 2O 2, or 1.5% H 2O 2 and water on the cycle threshold (CT) value obtained by real-time reverse transcription polymerase chain reaction (RT-PCR).

Methods

This study is a randomized single blind controlled clinical trial which has been registered in the International Standard Randomized Controlled Trial Number (ISRCTN) registry on the 3 rd February 2022 (Registration number: ISRCTN18356379). In total, 69 subjects recruited from Persahabatan General Hospital who met the inclusion criteria were randomly assigned to one of four treatment groups or the control group. The subjects were instructed to gargle with 15 mL of mouthwash for 30 s in the oral cavity followed by 30 s in the back of the throat, three times per day for 5 days. CT values were collected on postprocedural days 1, 3, and 5.

Results

The results of the Friedman test significantly differed among the groups (n=15). The CT values increased from baseline (day 0) to postprocedural days 1, 3, and 5.

Conclusions

Mouth rinsing and gargling with mouthwash containing 1% PI, 0.5% PI, 3% H 2O 2, or 1.5% H 2O 2 and water increased the CT value.

Masks and respirators for prevention of respiratory infections: a state of the science review

SUMMARYThis narrative review and meta-analysis summarizes a broad evidence base on the benefits-and also the practicalities, disbenefits, harms and personal, sociocultural and environmental impacts-of masks and masking. Our synthesis of evidence from over 100 published reviews and selected primary studies, including re-analyzing contested meta-analyses of key clinical trials, produced seven key findings. First, there is strong and consistent evidence for airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other respiratory pathogens. Second, masks are, if correctly and consistently worn, effective in reducing transmission of respiratory diseases and show a dose-response effect. Third, respirators are significantly more effective than medical or cloth masks. Fourth, mask mandates are, overall, effective in reducing community transmission of respiratory pathogens. Fifth, masks are important sociocultural symbols; non-adherence to masking is sometimes linked to political and ideological beliefs and to widely circulated mis- or disinformation. Sixth, while there is much evidence that masks are not generally harmful to the general population, masking may be relatively contraindicated in individuals with certain medical conditions, who may require exemption. Furthermore, certain groups (notably D/deaf people) are disadvantaged when others are masked. Finally, there are risks to the environment from single-use masks and respirators. We propose an agenda for future research, including improved characterization of the situations in which masking should be recommended or mandated; attention to comfort and acceptability; generalized and disability-focused communication support in settings where masks are worn; and development and testing of novel materials and designs for improved filtration, breathability, and environmental impact.

Tree Species-Dependent Inactivation of Coronaviruses and Enteroviruses on Solid Wood Surfaces

The ongoing challenge of viral transmission, exemplified by the Covid pandemic and recurrent viral outbreaks, necessitates the exploration of sustainable antiviral solutions. This study investigates the underexplored antiviral potential of wooden surfaces. We evaluated the antiviral efficacy of various wood types, including coniferous and deciduous trees, against enveloped coronaviruses and nonenveloped enteroviruses like coxsackie virus A9. Our findings revealed excellent antiviral activity manifesting already within 10 to 15 min in Scots pine and Norway spruce, particularly against enveloped viruses. In contrast, other hardwoods displayed varied efficacy, with oak showing effectiveness against the enterovirus. This antiviral activity was consistently observed across a spectrum of humidity levels (20 to 90 RH%), while the antiviral efficacy manifested itself more rapidly at 37 °C vs 21 °C. Key to our findings is the chemical composition of these woods. Resin acids and terpenes were prevalent in pine and spruce, correlating with their antiviral performance, while oak's high phenolic content mirrored its efficacy against enterovirus. The pine surface absorbed a higher fraction of the coronavirus in contrast to oak, whereas enteroviruses were not absorbed on those surfaces. Thermal treatment of wood or mixing wood with plastic, such as in wood-plastic composites, strongly compromised the antiviral functionality of wood materials. This study highlights the role of bioactive chemicals in the antiviral action of wood and opens new avenues for employing wood surfaces as a natural and sustainable barrier against viral transmissions.

Physicochemical methods for disinfection of contaminated surfaces - a way to control infectious diseases

This paper represents the reviews of recent advancements in different physicochemical methods for disinfecting contaminated surfaces, which are considered to be responsible for transmitting different bacterial, viral, and fungal infectious diseases. Surface disinfection can be achieved by applying chemicals, UV-based processes, ionization radiation (gamma-ray, X-ray and electron beam), application of self-disinfecting surfaces, no-touch room disinfection methods, and robotic disinfection methods for built-in settings. Application of different chemicals, such as alcohols, hydrogen peroxide, peracetic acid, quaternary ammonium salts, phenol, and iodine solution, are common and economical. However, the process is time-consuming and less efficient. The use of UVC light (wavelength: 200-280 nm, generated by low vapor mercury lamps or pulse xenon light) has gained much attention for disinfecting fomites worldwide. In recent times, the combination of UV and H2O2, based on the principle of the advanced oxidation process, has been applied for disinfecting inanimate surfaces. The process is very efficient and faster than chemical and UV processes. Heavy metals like copper, silver, zinc, and other metals can inactivate microbes and are used for surface modification to produce self-disinfecting surfaces and used in healthcare facilities. In combination with UVB (280-315 nm) and UVA (315-400 nm), titanium oxide has been utilized for disinfecting contaminated surfaces. Ionization radiation, one of the advanced methods, can be used in disinfecting medical devices and drugs. Post-COVID-19 pandemic, the no-touch and robotic disinfection methods utilizing chemicals or UVC lights have received much importance in built-in settings. Among these methods, surface disinfection by applying chemicals by fogging/vaporization and UV radiation methods has been widely reported in the literature compared to other methods.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40201-024-00893-2.

Challenges of mesenchymal stem cells in the clinical treatment of COVID-19

The 2019 coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has brought an enormous public health burden to the global society. The duration of the epidemic, the number of infected people, and the widespread of the epidemic are extremely rare in modern society. In the initial stage of infection, people generally show fever, cough, and dyspnea, which can lead to pneumonia, acute respiratory syndrome, kidney failure, and even death in severe cases. The strong infectivity and pathogenicity of SARS-CoV-2 make it more urgent to find an effective treatment. Mesenchymal stem cells (MSCs) are a kind of pluripotent stem cells with the potential for self-renewal and multi-directional differentiation. They are widely used in clinical experiments because of their low immunogenicity and immunomodulatory function. Mesenchymal stem cell-derived exosomes (MSC-Exo) can play a physiological role similar to that of stem cells. Since the COVID-19 pandemic, a series of clinical trials based on MSC therapy have been carried out. The results show that MSCs are safe and can significantly improve patients' respiratory function and prognosis of COVID-19. Here, the effects of MSCs and MSC-Exo in the treatment of COVID-19 are reviewed, and the clinical challenges that may be faced in the future are clarified.

Implementation of stethoscope disinfection: an observational study on nursing staff practice and knowledge

Background

Healthcare-associated infections cause high mortality and morbidity, and lack of stethoscope disinfection is one of the reasons for healthcare-associated infections. Nurses who frequently use stethoscopes in the clinic do not disinfect stethoscopes at high rates. This study aimed to identify the frequency of stethoscope disinfection by nurses and their knowledge about the same.

Methods

This was a mixed-methods observational study. The quantitative part of the study included 202 nurses, the qualitative part included 12. Two researchers who made observations during stethoscope use recorded the procedures the nurses performed on the "Observation Form". Semi-structured in-depth interviews were conducted based on phenomenological methods.

Results

23.7% of the nurses disinfected their stethoscopes before contact with patients, 11.8% after contact with patients and 6.4% before and after contact with patients. The nurses used a stethoscope on an average of 7.42 patients without disinfecting it. In the qualitative interview, some nurses stated that they did not have information about the disinfectants to be used for stethoscopes and their effectiveness. Some of the participants in the present study stated that they did not receive training on stethoscope disinfection and that they did not know that there were guidelines about it.

Conclusion

Since there were deficiencies in the implementation of stethoscope disinfection as well as knowledge, the transfer of knowledge in this context must receive more attention in education and training.

Variations in the persistence of 5'-end genomic and subgenomic SARS-CoV-2 RNAs in wastewater from aircraft, airports and wastewater treatment plants

Wastewater sequencing has become a powerful supplement to clinical testing in monitoring SARS-CoV-2 infections in the post-COVID-19 pandemic era. While its applications in measuring the viral burden and main circulating lineages in the community have proved their efficacy, the variations in sequencing quality and coverage across the different regions of the SARS-CoV-2 genome are not well understood. Furthermore, it is unclear how different sample origins, viral extraction and concentration methods and environmental factors impact the reads sequenced from wastewater. Using high-coverage, amplicon-based, paired-end read sequencing of viral RNA extracted from wastewater collected directly from aircraft, pooled from different aircraft and airport buildings or from regular wastewater plants, we assessed the genome coverage across the sample groups with a focus on the 5'-end region covering the leader sequence and investigated whether it was possible to detect subgenomic RNA from viral material recovered from wastewater. We identified distinct patterns in the persistence of the different genomic regions across the different types of wastewaters and the existence of chimeric reads mapping to non-amplified regions. Our findings suggest that preservation of the 5'-end of the genome and the ability to detect subgenomic RNA reads, though highly susceptible to environment and sample processing conditions, may be indicative of the quality and amount of the viral RNA present in wastewater.

Effects of disinfectants on physical properties of denture base resins: A systematic review and meta-analysis

STATEMENT OF PROBLEM

The disinfection of removable dental prostheses and orthodontic appliances is essential to preventing transmission of pathogens. However, whether different disinfection solutions and durations affect the physical properties of denture base resins is unclear.

PURPOSE

The purpose of this systematic review and meta-analysis was to statistically analyze the influence of disinfectants on the physical properties of denture base resins.

MATERIAL AND METHODS

A systematic search in Medline, Embase, PubMed, and Cochrane Library databases was conducted to evaluate the effects of chemical disinfection on the physical properties of denture base resins such as surface morphology, roughness, hardness, and flexural strength. Of 1909 studies, 44 studies were included in the systematic review and 41 in the meta-analysis. Heterogeneity was analyzed by using I2 statistics. The influence of different disinfection solutions and durations on the physical properties was further analyzed, and the risk of bias evaluated. Statistical analyses were performed by using the RevMan 5.4 software program with the standardized mean differences (SMDs) and 95% confidence intervals (CIs).

RESULTS

Of the 44 included studies, 40 studies were assessed as having a low risk of bias, and 4 had an unclear risk of bias. Meta-analysis results showed that compared with the control, disinfection could not significantly affect surface roughness and hardness within 60 minutes of immersion in disinfectant solutions or flexural strength within 30 minutes (roughness: P=.79, I2=0%; flexural strength: P=.08, I2=0%; hardness: P=.05, I2=19%). In addition, the physical properties were not significantly affected when glutaraldehyde, chlorhexidine, and peracetic acid were repeatedly used for more than 30 minutes.

CONCLUSIONS

Most of the disinfectants did not reduce the physical properties of denture base resin within 30 minutes of immersion. Glutaraldehyde, chlorhexidine, and peracetic acid are recommended if longer immersion or repeated disinfection is required.

Application of failure mode and effect analysis in ICU admission of potentially COVID-19 infected patients

BACKGROUND

To analyze the admission and treatment process of potentially COVID-19-infected patients in the intensive care unit under normalization, prevention, and control of the pandemic.

METHODS

A multidisciplinary team was assembled to develop a flowchart of potentially COVID-19-infected patients admitted to the intensive care unit and identify potential failure steps and modes throughout the process using the failure mode and effect analysis method. Through risk priority number (RPN) analysis of each failure mode, those with the highest impact on nosocomial infection were identified, and the priority of implementation was determined. Related corrective measures have been developed to continuously improve clinical practice and management.

RESULTS

Eighty potential failure modes were identified, and 8 potential failure modes were identified with RPNs greater than 100. These high RPNs of the failure modes were associated with careless inquiries of epidemiological histories by nurses, inadequate implementation of management standards by nursing assistants, and exposure of attending physicians to potentially risky environments. Finally, 18 general corrective measures are proposed.

CONCLUSIONS

Application of the failure mode and effect analysis method for quality improvement is a powerful tool for predicting potential failures in the process and can suggest corrective measures that could help avoid nosocomial infection during a pandemic.

A review of the influence of environmental pollutants (microplastics, pesticides, antibiotics, air pollutants, viruses, bacteria) on animal viruses

Microorganisms, especially viruses, cause disease in both humans and animals. Environmental chemical pollutants including microplastics, pesticides, antibiotics sand air pollutants arisen from human activities affect both animal and human health. This review assesses the impact of chemical and biological contaminants (virus and bacteria) on viruses including its life cycle, survival, mutations, loads and titers, shedding, transmission, infection, re-assortment, interference, abundance, viral transfer between cells, and the susceptibility of the host to viruses. It summarizes the sources of environmental contaminants, interactions between contaminants and viruses, and methods used to mitigate such interactions. Overall, this review provides a perspective of environmentally co-occurring contaminants on animal viruses that would be useful for future research on virus-animal-human-ecosystem harmony studies to safeguard human and animal health.

Effect of 1% H2O2 on Three Salivary Stress Biomarkers, Cortisol, Alpha-Amylase, and sIgA

BACKGROUND

Due to the COVID-19 pandemic, several associations worldwide have been recommending the use of 1% hydrogen peroxide solution as a preprocedural mouth rinse before dental treatments to reduce viral load in saliva. This protocol is also employed in stress studies, especially in the context of dental treatment that uses salivary biomarkers as an indicator. However, the effect of 1% hydrogen peroxide as mouth rinse on salivary biomarkers remains unclear.

OBJECTIVE

This study aims to investigate the effects of 1% hydrogen peroxide solution as a preprocedural mouth rinse on 3 salivary stress biomarkers-salivary cortisol, salivary secretory IgA, and salivary α-amylase-both on chemical influence and mechanical irrigation.

MATERIALS AND METHODS

Ninety healthy participants with confirmed negative Reverse Transcription Polymerase Chain Reaction results for COVID-19 at most 2 days prior to the experiment were included in this study. All participants were randomly allocated into 3 groups: experimental (1% hydrogen peroxide solution), positive control (distilled water), and negative control (no mouth rinse). Saliva samples were collected before and after mouth rinsing with the respective solutions. Salivary biomarkers were analysed using specific enzyme-linked immunosorbent assay kits.

RESULTS

Salivary cortisol and salivary α-amylase did not significantly differ before and after rinsing, whilst salivary sIgA levels decreased in all 3 groups. Nonetheless, there were no significant differences in the changes of these biomarkers across the 3 groups.

CONCLUSIONS

This study shows that using 1% hydrogen peroxide solution as a preprocedural mouth rinse for universal precaution does not alter the levels of these 3 salivary biomarkers.

Identification and Measurement of Biomarkers at Single Microorganism Level for In Situ Monitoring Deep Ultraviolet Disinfection Process

Since the COVID-19 disease has been further aggravated, the prevention of pathogen transmission becomes a vital issue to restrain casualties. Recent research outcomes have shown the possibilities of the viruses existing on inanimate surfaces up to few days, which carry the risk of touch propagation of the disease. Deep ultraviolet germicide irradiation (UVGI) with the wavelength of 255-280nm has been verified to efficiently disinfect various types of bacteria and virus, which could prevent the aggravation of pandemic spread. Even though considerable experiments and approaches have been applied to evaluate the disinfection effects, there are only few reports about how the individual bio-organism behaves after ultraviolet C (UVC) irradiation, especially in the aspect of mechanical changes. Furthermore, since the standard pathway of virus transmission and reproduction requires the host cell to assemble and transport newly generated virus, the dynamic response of infectious cell is always the vital aspect of virology study. In this work, high power LEDs array has been established with 270nm UVC irradiation to evaluate disinfection capability on various types of bio-organism, and incubator embedded atomic force microscopy (AFM) is used to investigate the single bacterium and virus under UVGI. The real-time tracking of the living Vero cells infected with adenovirus has also been presented in this study. The results show that after sufficient UVGI, the outer shell of bacteria and viruses remain intact in structure, however the bio-organisms lost the capability of reproduction and normal metabolism. The experiment results also indicate that once the host cell is infected with adenovirus, the rapid production of newborn virus capsid will gradually destroy the cellular normal metabolism and lose mechanical integrity.

Enhanced enrichment of collected airborne coronavirus and influenza virus samples via a ConA-coated microfluidic chip for PCR detection

The severe acute respiratory syndrome (SARS-CoV-2) outbreak triggered global concern and emphasized the importance of virus monitoring. During a seasonal influenza A outbreak, relatively low concentrations of 103-104 viral genome copies are available per 1 m3 of air, which makes detection and monitoring very challenging because the limit of detection of most polymerase chain reaction (PCR) devices is approximately 103 viral genome copies/mL. In response to the urgent need for the rapid detection of airborne coronaviruses and influenza viruses, an electrostatic aerosol-to-hydrosol (ATH) sampler was combined with a concanavalin A (ConA)-coated high-throughput microfluidic chip. The samples were then used for PCR detection. The results revealed that the enrichment capacity of the ATH sampler was 30,000-fold for both HCoV-229E and H1N1 influenza virus, whereas the enrichment capacities provided by the ConA-coated microfluidic chip were 8-fold and 16-fold for HCoV-229E and H1N1 virus, respectively. Thus, the total enrichment capacities of our combined ATH sampler and ConA-coated microfluidic chip were 2.4 × 105-fold and 4.8 × 105-fold for HCoV-229E and H1N1 virus, respectively. This methodology significantly improves PCR detection by providing a higher concentration of viable samples.

Transmission of Viruses from Restroom Use: A Quantitative Microbial Risk Assessment

Restroom use has been implicated in a number of viral outbreaks. In this study, we apply quantitative microbial risk assessment to quantify the risk of viral transmission by contaminated restroom fomites. We estimate risk from high-touch fomite surfaces (entrance/exit door, toilet seat) for three viruses of interest (SARS-CoV-2, adenovirus, norovirus) through eight exposure scenarios involving differing user behaviors, and the use of hand sanitizer following each scenario. We assessed the impacts of several sequences of fomite contacts in the restroom, reflecting the variability of human behavior, on infection risks for these viruses. Touching of the toilet seat was assumed to model adjustment of the seat (open vs. closed), a common touch point in single-user restrooms (home, small business, hospital). A Monte Carlo simulation was conducted for each exposure scenario (10,000 simulations each). Norovirus resulted in the highest probability of infection for all exposure scenarios with fomite surfaces. Post-restroom automatic-dispensing hand sanitizer use reduced the probability of infection for each virus by up to 99.75%. Handwashing within the restroom, an important risk-reduction intervention, was not found to be as effective as use of a non-touch hand sanitizer dispenser for reducing risk to near or below 1/1,000,000, a commonly used risk threshold for comparison.

Healthcare Provider N95 Respirator Contamination Worn Behind Face Shields With SARS-CoV-2 During Routine Clinical Care of Patients With COVID-19

N95 respirator contamination with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during clinical care of patients with coronavirus disease 2019 is poorly understood. We performed a prospective observational study on healthcare provider's (HCP's) N95 respirators' and face shields' SARS-CoV-2 contamination during aerosol-generating procedures on SARS-CoV-2-positive patients housed in a COVID-19-specific unit. Medical masks worn on top of HCP's N95 respirators, and under face shields, during study aerosol-generating procedures were used as surrogates to detect contamination to avoid waste. Thirty-three HCPs were studied, and a total of 33 mask and 27 face shields were sampled. Masks were cut into 9 pieces and face shields were sampled twice, front and back, to determine locality of contamination; however, no positive samples were identified using standard polymerase chain reaction techniques with a CT value up to 40. All 9 mask piece samples were then pooled, as were face shield samples, using centrifugal concentration with polyethersulfone membranes. Once pooled and concentrated, overall, 9 (15%) samples were positive via real-time polymerase chain reaction: 5 from masks (15.2%) and 4 from face shields (14.8%).

The impacts of spatial-temporal heterogeneity of human-to-human contacts on the extinction probability of infectious disease from branching process model

In this study, we focus on the impacts of spatial-temporal heterogeneity of human-to-human contacts on the spread of infectious diseases and develop a multi-type branching process model by introducing random human-to-human contact mode into a structured population. We provide the general formulas of the generation size, extinction probability, and basic reproduction number of the proposed branching process model. The result shows that the natural temporal heterogeneity (i.e. random contacts over time) can lead to a higher extinction probability while remains the same basic reproduction number and generation size. This is also numerically verified by choosing the real contact distributions from different circumstances of four countries. In addition, we observe a non-monotonic pattern of the differences, against the transmission probability and the mean contact rate, between the extinction probabilities under the constant and random contact patterns. Given the spatial heterogeneity, we show that it can contribute to the increase of basic reproduction number, but also increase the extinction probability of the infectious disease. This study adds novel insights to the course of the impact of heterogeneity on the transmission dynamics and also provides additional evidence for the limited role of reproduction numbers.

Fluoride anodic films on stainless-steel fomites to reduce transmission infections

The growing concern arising from viruses with pandemic potential and multi-resistant bacteria responsible for hospital-acquired infections and outbreaks of food poisoning has led to an increased awareness of indirect contact transmission. This has resulted in a renewed interest to confer antimicrobial properties to commonly used metallic materials. The present work provides a full characterization of optimized fluoride anodic films grown in stainless steel 304L as well as their antimicrobial properties. Antibacterial tests show that the anodic film, composed mainly of chromium and iron fluorides, reduces the count and the percentage of the area covered by 50% and 87.7% for Pseudomonas aeruginosa and Stenotrophomonas maltophilia, respectively. Virologic tests show that the same treatment reduces the infectivity of the coronavirus HCoV-229E-GFP, in comparison with the non-anodized stainless steel 304L.IMPORTANCEThe importance of environmental surfaces as a source of infection is a topic of particular interest today, as many microorganisms can survive on these surfaces and infect humans through direct contact. Modification of these surfaces by anodizing has been shown to be useful for some alloys of medical interest. This work evaluates the effect of anodizing on stainless steel, a metal widely used in a variety of applications. According to the study, the fluoride anodic layers reduce the colonization of the surfaces by both bacteria and viruses, thus reducing the risk of acquiring infections from these sources.

A systematic overview of metal nanoparticles as alternative disinfectants for emerging SARS-CoV-2 variants

Coronaviruses are a diverse family of viruses, and new strains can emerge. While the majority of coronavirus strains cause mild respiratory illnesses, a few are responsible for severe diseases such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). SARS-CoV-2, the virus responsible for COVID-19, is an example of a coronavirus that has led to a pandemic. Coronaviruses can mutate over time, potentially leading to the emergence of new variants. Some of these variants may have increased transmissibility or resistance to existing vaccines and treatments. The emergence of the COVID-19 pandemic in the recent past has sparked innovation in curbing virus spread, with sanitizers and disinfectants taking center stage. These essential tools hinder pathogen dissemination, especially for unvaccinated or rapidly mutating viruses. The World Health Organization supports the use of alcohol-based sanitizers and disinfectants globally against pandemics. However, there are ongoing concerns about their widespread usage and their potential impact on human health, animal well-being, and ecological equilibrium. In this ever-changing scenario, metal nanoparticles hold promise in combating a range of pathogens, including SARS-CoV-2, as well as other viruses such as norovirus, influenza, and HIV-1. This review explores their potential as non-alcoholic champions against SARS-CoV-2 and other pandemics of tomorrow. This extends beyond metal nanoparticles and advocates a balanced examination of pandemic control tools, exploring their strengths and weaknesses. The manuscript thus involves the evaluation of metal nanoparticle-based alternative approaches as hand sanitizers and disinfectants, providing a comprehensive perspective on this critical issue.

Stability of Cytoplasmic Membrane of Escherichia coli Bacteria in Aqueous and Ethanolic Environment

The mechanism of action of any antibacterial agent or disinfectant depends largely on their interaction with the bacterial membrane. Herein, we use the SPICA (surface property fitting coarse graining) force-field and develop a coarse-grained (CG) model for the structure of the cytoplasmic membrane of Escherichia coli (E. coli) and its interaction with water and ethanol. We elucidate the impact of different concentrations of ethanol on the cytoplasmic membrane bilayers and vesicles of E. coli using the CG molecular dynamics (CG MD) simulations. Our modeling approach first focuses on the parametrization of the required force-field for POPG lipid and its interaction with water, ethanol, and POPE lipid. Subsequently, the structural stability of the E. coli bacterial membrane in the presence of high and low concentrations of ethanol is delineated. Both flat bilayers as well as vesicles of E. coli membrane were considered for the CG MD. Our results reveal that, at low ethanol concentrations (<30 mol %), the size of the E. coli vesicles increases with discernible deformations in their shapes. Because of ethanol-induced interdigitation, thinning of the E. coli vesicular membrane is also observed. However, at higher ethanol concentrations (>30 mol %), the integrity of the vesicles is lost because of deteriorating invasion of ethanol molecules into the vesicle bilayer and significant weakening of lipid-lipid interactions. At higher ethanol concentrations (40 and 70 mol %), both the multivesicle and single-vesicle bacterial membranes exhibit a similar rupturing pattern wherein the extraction of lipids from the membrane and formation of aggregates of the component lipids are observed. These aggregates consist of polar head groups of 3-5 POPE/POPG lipids with intertwined nonpolar tails.

Antiviral action of a functionalized plastic surface against human coronaviruses

Viruses may persist on solid surfaces for long periods, which may contribute to indirect transmission. Thus, it is imperative to develop functionalized surfaces that will lower the infectious viral load in everyday life. Here, we have tested a plastic surface functionalized with tall oil rosin against the seasonal human coronavirus OC43 as well as severe acute respiratory syndrome coronavirus 2. All tested non-functionalized plastic surfaces showed virus persistence up to 48 h. In contrast, the functionalized plastic showed good antiviral action already within 15 min of contact and excellent efficacy after 30 min over 90% humidity. Excellent antiviral effects were also observed at lower humidities of 20% and 40%. Despite the hydrophilic nature of the functionalized plastic, viruses did not adhere strongly to it. According to helium ion microscopy, viruses appeared flatter on the rosin-functionalized surface, but after flushing away from the rosin-functionalized surface, they showed no apparent structural changes when imaged by transmission electron microscopy of cryogenic or negatively stained specimens or by atomic force microscopy. Flushed viruses were able to bind to their host cell surface and enter endosomes, suggesting that the fusion with the endosomal membrane was halted. The eluted rosin from the functionalized surface demonstrated its ability to inactivate viruses, indicating that the antiviral efficacy relied on the active leaching of the antiviral substances, which acted on the viruses coming into contact. The rosin-functionalized plastic thus serves as a promising candidate as an antiviral surface for enveloped viruses.IMPORTANCEDuring seasonal and viral outbreaks, the implementation of antiviral plastics can serve as a proactive strategy to limit the spread of viruses from contaminated surfaces, complementing existing hygiene practices. In this study, we show the efficacy of a rosin-functionalized plastic surface that kills the viral infectivity of human coronaviruses within 15 min of contact time, irrespective of the humidity levels. In contrast, non-functionalized plastic surfaces retain viral infectivity for an extended period of up to 48 h. The transient attachment on the surface or the leached active components do not cause major structural changes in the virus or prevent receptor binding; instead, they effectively block viral infection at the endosomal stage.

A review on medical waste treatment in COVID-19 pandemics: Technologies, managements and future strategies

Since the outbreak of COVID-19 few years ago, the increasing of the number of medical waste has become a huge issue because of their harmful impact to environment. A major concern associated to the limitation of technologies for dealing with medical waste, especially conventional technologies, are overcapacities since pandemic occurs. Moreover, the outbreak of new viruses from post COVID-19 should become a serious attention to be prevented not only environmental issues but also the spreading of viruses to new pandemic near the future. The high possibility of an outbreak of new viruses and mutation near the future should be prevented based on the experience associated with the SARS-CoV-2 virus in the last 3 yr. This review presented information and strategies for handling medical waste during the outbreak of COVID-19 and post-COVID-19, and also information on the current issues related to technologies, such as incineration, pyrolysis/gasification, autoclaves and microwave treatment for the dealing with high numbers of medical waste in COVID-19 to prevent the transmission of SARS-CoV-2 virus, their advantages and disadvantages. Plasma technology can be considered to be implemented as an alternative technology to deal with medical waste since incinerator is usually over capacities during the pandemic situation. Proper treatment of specific medical waste in pandemics, namely face masks, vaccine vials, syringes, and dead bodies, are necessary because those medical wastes are mediums for transmission of the SARS-CoV-2 virus. Furthermore, emission controls from incinerator and plasma are necessary to be implemented to reduce the high concentration of CO2, NOx, and VOCs during the treatment. Finally, future strategies of medical waste treatment in the perspective of potential outbreak pandemic from new mutation viruses are discussed in this review paper.Implications: Journal of the air and waste management association may consider our review paper to be published. In this review, we give important information related to the technologies, managements and strategies for handling the medical waste and control the transmission of SARS-CoV-2 virus, starting from proper technology to control the high number of medical waste, their pollutants and many strategies for controlling the spreading of SARS-CoV-2 virus. Moreover, this review also describes some strategies associated with control the transmission not only the SARS-CoV-2 virus but also the outbreak of new viruses near the future.

Direct generation of DBPs from city dust during chlorine-based disinfection

Chlorine-based disinfectants, such as sodium hypochlorite, are extensively used in our daily lives. In particular, during the recent Covid-19 pandemic and post-pandemic period, excessive amounts of chlorine-based disinfectants were used both indoors and outdoors to interrupt virus transmission. However, the interaction between disinfectants and city dust during the disinfection process has not been sufficiently evaluated. In this study, we conducted a comprehensive investigation into the intrinsic characteristics (e.g. morphology, size, elemental composition, and organic content, etc.) of dust collected from various indoor and outdoor areas. The results showed that the organic carbon content of indoor dust reached 6.14 %, with a corresponding measured dissolved organic carbon value of 4.17 ± 0.23 mg/g (normalized to the dust weight). Concentrations of regulated DBPs, resulting from the interaction between dust and NaClO, ranged from 57.78 ± 2.72 to 102.80 ± 22.63 µg/g for THMs and from 119.18 ± 6.50 to 285.14 ± 36.95 µg/g for HAAs (normalized to the dust weight). More significantly, using non-target analysis through gas chromatography quadrupole time-of-flight mass spectrometry (GC-qTOF-MS), we identified a total of 68, 89, and 87 types of halogenated DBPs from three typical indoor and outdoor sites (R-QH, C-JS, and W-BR, respectively). These unknown DBPs included compounds with higher toxicity compared to regulated DBPs. These findings highlight that city dust is a significant source of DBP generation during chlorine-based disinfection, posing potential harm to both the ecological environment and human health.

High seroprevalence for SARS-CoV-2 infection in dogs: Age as risk factor for infection in shelter and foster home animals

SARS-CoV-2 has caused 775 outbreaks in 29 animal species across 36 countries, including dogs, cats, ferrets, minks, non-human primates, white-tailed deer, and lions. Although transmission from owners to dogs has been extensively described, no study to date has also compared sheltered, foster home and owner dogs and associated risk factors. This study aimed to identify SARS-CoV-2 infection and anti-SARS-CoV-2 antibodies from sheltered, fostered, and owned dogs, associated with environmental and management risk factors. Serum samples and swabs were collected from each dog, and an epidemiological questionnaire was completed by the shelter manager, foster care, and owner. A total of 111 dogs, including 222 oropharyngeal and rectal swabs, tested negative by RT-qPCR. Overall, 18/89 (20.22%) dogs presented IgG antibodies against the N protein of SARS-CoV-2 by magnetic ELISA, while none showed a reaction to the Spike protein. SARS-CoV-2 antibodies showed an age-related association, with 4.16 chance of positivity in adult dogs when compared with young ones. High population density among dogs and humans, coupled with repeated COVID-19 exposure, emerged as potential risk factors in canine virus epidemiology. Dogs exhibited higher seropositivity rates in these contexts. Thus, we propose expanded seroepidemiological and molecular studies across species and scenarios, including shelter dogs.

Guidelines for dental implants in the times of COVID-19

Since the first reported case in December 2019, COVID-19 has become a worldwide pandemic. Although primarily a zoonotic infection, human-to-human transmission is well reported now and the mode of spread is mainly via respiratory droplets during direct contact or via surfaces contaminated with the virus as it remains viable on the surfaces for a long time. Direct communication and consistent exposure to body fluids such as blood and saliva and the fact that routinely done dental procedures generate aerosols predisposing dental professionals to serious risk for COVID-19 infection. Hence, to ensure the smooth working and safety of dental professionals as well as the patients, a set of directives are of paramount importance. Various guidelines have been released for the efficient operation of dental professionals; however, no such recommendations/directives have been laid out pertaining to dental implants in particular. Here, we are presenting a set of recommendations for managing urgent implant-related treatment procedures.

Impact of coagulation on SARS-CoV-2 and PMMoV viral signal in wastewater solids

Wastewater surveillance (WWS) of SARS-CoV-2 has become a crucial tool for monitoring COVID-19 cases and outbreaks. Previous studies have indicated that SARS-CoV-2 RNA measurement from testing solid-rich primary sludge yields better sensitivity compared to testing wastewater influent. Furthermore, measurement of pepper mild mottle virus (PMMoV) signal in wastewater allows for precise normalization of SARS-CoV-2 viral signal based on solid content, enhancing disease prevalence tracking. However, despite the widespread adoption of WWS, a knowledge gap remains regarding the impact of ferric sulfate coagulation, commonly used in enhanced primary clarification, the initial stage of wastewater treatment where solids are sedimented and removed, on SARS-CoV-2 and PMMoV quantification in wastewater-based epidemiology. This study examines the effects of ferric sulfate addition, along with the associated pH reduction, on the measurement of SARS-CoV-2 and PMMoV viral measurements in wastewater primary clarified sludge through jar testing. Results show that the addition of Fe3+ concentrations in the conventional 0 to 60 mg/L range caused no effect on SARS-CoV-2 N1 and N2 gene region measurements in wastewater solids. However, elevated Fe3+ concentrations were shown to be associated with a statistically significant increase in PMMoV viral measurements in wastewater solids, which consequently resulted in the underestimation of PMMoV-normalized SARS-CoV-2 viral signal measurements (N1 and N2 copies/copies of PMMoV). The observed pH reduction from coagulant addition did not contribute to the increased PMMoV measurements, suggesting that this phenomenon arises from the partitioning of PMMoV viral particles into wastewater solids.

Searching for a sustainable economy: Work, cooperation, and territorial solutions

BACKGROUND

This article discusses expanded governance of territorial issues as the basis for a sustainable way of producing and commercializing, as well as the relevance of work analysis within this governance. This discussion is developed from the Functionality and Cooperation Economy approach and from Brazilian experiences of organic food production and community-based solid waste management.

OBJECTIVE

To identify and analyze the relationship between territorial issues and work activities in initiatives that seek territorial solutions for food and waste management in order to reflect on a sustainable economic transition and its challenges.

METHODS

This article presents a reflection, a posteriori, concerning the follow-up of two initiatives that seek a sustainable economy and that, facing territorial issues, adopted different economic strategies. The field of research, by which the intended reflections are guided, originated from two intervention projects conducted by two different research/intervention groups.

RESULTS

Our study highlights how the central focus on the effects of work in a territory can support the development of reflexivity and, consequently, the production of transversal cooperation and the sharing of material and immaterial resources, thereby leading to multifunctional territorial solutions.

CONCLUSION

This study presents how the co-construction of multifunctional territorial solutions, involving cooperation among different actors, can be developed by an analysis of the respective activities involved. This analysis confers centrality to real work in order to feed the governance devices and enable the development of relationships of trust, necessary for living and producing in harmony, along with the construction of conventions and dynamic cooperation.

A review on sterilization methods of environmental decontamination to prevent the coronavirus SARS-CoV-2 (COVID-19 virus): A new challenge towards eco-friendly solutions

In recent years, the COVID-19 pandemic is currently wreaking havoc on the planet. SARS-CoV-2, the Severe Acute Respiratory Syndrome Coronavirus, is the current term for this outbreak. Reports about this novel coronavirus have been presented since the pandemic's breakout, and they have demonstrated that it transmits rapidly from person to person, primarily by droplets in the air. Findings have illustrated that SARS-CoV-2 can survive on surfaces from hours to days. Therefore, it is essential to find practical solutions to reduce the virus's impact on human health and the environment. This work evaluated common sterilization methods that can decontaminate the environment and items. The goal is that healthcare facilities, disease prevention organizations, and local communities can overcome the new challenge of finding eco-friendly solutions. Further, a foundation of information encompassing various sterilization procedures and highlighting their limits to choose the most appropriate method to stop disease-causing viruses in the new context has been presented. The findings of this crucial investigation contribute to gaining insight into the comprehensive sterilization approaches against the coronavirus for human health protection and sustainable environmental development.

The Impact of Hydrogen Peroxide (H2O2) Fumigation on Bacterial Levels in Dental Office Environments: A Randomized Clinical Trial Investigation

BACKGROUND

Fumigation with hydrogen peroxide has proven to be a highly effective approach to maintaining biological safety within dental offices. The main purpose of this research was to investigate the efficacy of hydrogen peroxide (H2O2) fumigation in reducing bacterial levels in dental office environments.

METHODS

The study involved 30 participants diagnosed with moderate caries decay (ICDAS 3 and 4) in their mandibular molars. Sixty Petri dishes (two per patient) with Columbia Agar and 5% Sheep Blood were opened at the beginning of the caries treatment. After the completion of caries treatment and tooth restoration, 30 plates (G1 group) were closed. Following this, a 20 min fumigation procedure with 6% hydrogen peroxide biosanitizer using a compressed air device was conducted. After the fumigation, the remaining plates were closed (G2 group). The total number of bacteria CFUs (colony-forming units) in the dental office air was determined using the Koch sedimentation method.

RESULTS

The total bacterial colony (TBC) level, measured in cfu/m3, demonstrated a significant decrease in the number of bacteria following room environment fumigation (163.1 ± 145.7; G2 group) compared to non-fumigated samples (817.2 ± 208.2; G1 group) (p < 0.001). The predominant bacteria observed in the microbiological plates before fumigation were Micrococcus and Bacillus species, found in 80% (24/30) and 60% (18/30) of the plates, respectively. Application of H2O2 room fumigation resulted in a significant reduction in bacterial numbers: 79.2% (5/30) for Micrococcus species (p < 0.001), 83.3% (3/30) for Bacillus species (p < 0.001), and 100% (0/30) for Staphylococcus arlettae (p < 0.05).

CONCLUSION

Fumigation with 6% H2O2 is an effective method for reducing bacterial counts in a dental office environment.

Antiviral functionalization of cellulose using tannic acid and tannin-rich extracts

Due to seasonally appearing viruses and several outbreaks and present pandemic, we are surrounded by viruses in our everyday life. In order to reduce viral transmission, functionalized surfaces that inactivate viruses are in large demand. Here the endeavor was to functionalize cellulose-based materials with tannic acid (TA) and tannin-rich extracts by using different binding polymers to prevent viral infectivity of both non-enveloped coxsackievirus B3 (CVB3) and enveloped human coronavirus OC43 (HCoV-OC43). Direct antiviral efficacy of TA and spruce bark extract in solution was measured: EC50 for CVB3 was 0.12 and 8.41 μg/ml and for HCoV-OC43, 78.16 and 95.49 μg/ml, respectively. TA also led to an excellent 5.8- to 7-log reduction of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus infectivity. TA functionalized materials reduced infectivity already after 5-min treatment at room temperature. All the tested methods to bind TA showed efficacy on paperboard with 0.1 to 1% (w/v) TA concentrations against CVB3 whereas material hydrophobicity decreased activities. Specific signatures for TA and HCoV-OC43 were discovered by Raman spectroscopy and showed clear co-localization on the material. qPCR study suggested efficient binding of CVB3 to the TA functionalized cellulose whereas HCoV-OC43 was flushed out from the surfaces more readily. In conclusion, the produced TA-materials showed efficient and broadly acting antiviral efficacy. Additionally, the co-localization of TA and HCoV-OC43 and strong binding of CVB3 to the functionalized cellulose demonstrates an interaction with the surfaces. The produced antiviral surfaces thus show promise for future use to increase biosafety and biosecurity by reducing pathogen persistence.

The survival of murine hepatitis virus (a surrogate of SARS-CoV-2) on conventional packaging materials under cold chain conditions

Introduction

The cold chain conditions have been suggested to facilitate long-distance transmission of SARS-CoV-2, but it is unclear how viable the virus is on cold chain packaging materials.

Methods

This study used the MHV-JHM strain of murine hepatitis virus as a model organism to investigate the viability of SARS-CoV-2 on foam, plastic, cardboard, and wood sheets at different temperatures (-40°C, -20°C, and 4°C). In addition, the ability of peracetic acid and sodium hypochlorite to eliminate the MHV-JHM on plastic and cardboard sheets were also evaluated.

Results

The results indicate that MHV-JHM can survive on foam, plastic, or cardboard sheets for up to 28 days at -40°C and -20°C, and up to 14 days on foam and plastic surfaces at 4°C. Although viral nucleic acids were still detectable after storing at 4°C for 28 days, the corresponding virus titer was below the limit of quantification (LOQ).

Discussion

The study highlights that a positive nucleic acid test result may not indicate that the virus is still viable, and confirms that peracetic acid and sodium hypochlorite can effectively eliminate MHV-JHM on packaging materials under cold chain conditions.

Evaluation of the rate and pattern of suicide attempts and deaths by self-poisoning among Egyptians before and during the COVID-19 pandemic

Background

Concerns about increased suicidal attempts, especially by self-poisoning as a consequence of Coronavirus disease 2019 (COVID-19) pandemic have been raised worldwide.

Aim of the study

This study aimed to evaluate the rate and pattern of suicide attempts and deaths by self-poisoning among patients admitted to Tanta University Poisoning Control Center one year before and following COVID-19 pandemic declaration in Egypt. It was conducted on the medical records of 3,200 poisoned patients, from March 2019 to February 2021. Demographic, toxicological data and patients' outcomes were collected.

Results

During the pandemic year, 63.8% of total admitted patients alleged suicidal self-poisoning. Adults significantly decreased from 59% to 52.3%, while adolescents significantly increased from 34.6% to 41.7%. Monthly numbers of admitted suicidal self-poisoned patients significantly decreased during the lockdown but significantly increased from 7% to 26.5%, during the peak of the second wave of the pandemic as well as suicidal deaths (increased from 1.9% to 21.2%). Suicidal self-poisoning in females increased late in the pandemic year and suicidal self-poisoning deaths were significantly reported from rural areas (P = 0.025). The delay time was significantly longer, length of hospital stay was significantly shorter, intensive care unit admission rates and suicidal deaths were significantly increased during the pandemic year (P < 0.001, 0.026, <0.001, <0.001, respectively). Phosphides were the most commonly used poison for committing suicide and suicidal deaths during this year.

Conclusion

Psychological support should be directed to females and adolescents, especially from rural areas in Egypt to help reduce suicidal attempts and deaths by self-poisoning during any future pandemics and lockdowns.

Stability of pathogens on banknotes and coins: A narrative review

For the prevention of infectious diseases, knowledge about potential transmission routes is essential. Pathogens can be transmitted directly (i.e. respiratory droplets, hand-to-hand contact) or indirectly via contaminated surfaces (fomites). In particular, frequently touched objects/surfaces may serve as transmission vehicles for different clinically relevant bacterial, fungal, and viral pathogens. Banknotes and coins offer ample surface area and are frequently exchanged between individuals. Consequently, many concerns have been raised in the recent past, that banknotes and coins could serve as vectors for the transmission of disease-causing microorganisms. This review summarizes the latest research on the potential of paper currency and coins to serve as sources of pathogenic viral, bacterial, and fungal agents. In contrast to the current perception of banknotes and coins as important transmission vehicles, current evidence suggests, that banknotes and coins do not pose a particular risk of pathogen infection for the public.

A narrative review of alternative transmission routes of COVID 19: what we know so far

The Coronavirus disease 19 (COVID-19) pandemics, caused by severe acute respiratory syndrome coronaviruses, SARS-CoV-2, represent an unprecedented public health challenge. Beside person-to-person contagion via airborne droplets and aerosol, which is the main SARS-CoV-2's route of transmission, alternative modes, including transmission via fomites, food and food packaging, have been investigated for their potential impact on SARS-CoV-2 diffusion. In this context, several studies have demonstrated the persistence of SARS-CoV-2 RNA and, in some cases, of infectious particles on exposed fomites, food and water samples, confirming their possible role as sources of contamination and transmission. Indeed, fomite-to-human transmission has been demonstrated in a few cases where person-to-person transmission had been excluded. In addition, recent studies supported the possibility of acquiring COVID-19 through the fecal-oro route; the occurrence of COVID-19 gastrointestinal infections, in the absence of respiratory symptoms, also opens the intriguing possibility that these cases could be directly related to the ingestion of contaminated food and water. Overall, most of the studies considered these alternative routes of transmission of low epidemiological relevance; however, it should be considered that they could play an important role, or even be prevalent, in settings characterized by different environmental and socio-economic conditions. In this review, we discuss the most recent findings regarding SARS-CoV-2 alternative transmission routes, with the aim to disclose what is known about their impact on COVID-19 spread and to stimulate research in this field, which could potentially have a great impact, especially in low-resource contexts.

Environmental dissemination of respiratory viruses: dynamic interdependencies of respiratory droplets, aerosols, aerial particulates, environmental surfaces, and contribution of viral re-aerosolization

During the recent pandemic of COVID-19 (SARS-CoV-2), influential public health agencies such as the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) have favored the view that SARS CoV-2 spreads predominantly via droplets. Many experts in aerobiology have openly opposed that stance, forcing a vigorous debate on the topic. In this review, we discuss the various proposed modes of viral transmission, stressing the interdependencies between droplet, aerosol, and fomite spread. Relative humidity and temperature prevailing determine the rates at which respiratory aerosols and droplets emitted from an expiratory event (sneezing, coughing, etc.) evaporate to form smaller droplets or aerosols, or experience hygroscopic growth. Gravitational settling of droplets may result in contamination of environmental surfaces (fomites). Depending upon human, animal and mechanical activities in the occupied space indoors, viruses deposited on environmental surfaces may be re-aerosolized (re-suspended) to contribute to aerosols, and can be conveyed on aerial particulate matter such as dust and allergens. The transmission of respiratory viruses may then best be viewed as resulting from dynamic virus spread from infected individuals to susceptible individuals by various physical states of active respiratory emissions, instead of the current paradigm that emphasizes separate dissemination by respiratory droplets, aerosols or by contaminated fomites. To achieve the optimum outcome in terms of risk mitigation and infection prevention and control (IPAC) during seasonal infection peaks, outbreaks, and pandemics, this holistic view emphasizes the importance of dealing with all interdependent transmission modalities, rather than focusing on one modality.

Inactivation of human coronaviruses using an automated room disinfection device

The emergence of more virulent and epidemic strains of viruses, especially in the context of COVID-19, makes it more important than ever to improve methods of decontamination. The objective of this study was to evaluate the potential of on-demand production of chlorine species to inactivate human coronaviruses. The commercial prototype disinfection unit was provided by Unipolar Water Technologies. The Unipolar device generates active chlorine species using an electrochemical reaction and dispenses the disinfectant vapour onto surfaces with an aspirator. The minimum effective concentration and exposure time of disinfectant were evaluated on human hepatoma (Huh7) cells using 50% tissue culture infectious dose (TCID50) assay and human coronavirus 229E (HCoV-229E), a surrogate for pathogenic human coronaviruses. We showed that chlorine species generated in the Unipolar device inactivate HCoV-229E on glass surfaces at ≥ 400 parts per million active chlorine concentration with a 5 min exposure time. Here, inactivation refers to the inability of the virus to infect the Huh7 cells. Importantly, no toxic effect was observed on Huh7 cells for any of the active chlorine concentrations and contact times tested.

Antimicrobial Efficiency of Hypochlorous Acid and Its Effect on Some Properties of Alginate Impression Material

Dental clinicians and professionals need an affordable, nontoxic, and effective disinfectant against infectious microorganisms when dealing with the contaminated dental impressions. This study evaluated the efficiency of hypochlorous acid (HOCl) as an antimicrobial disinfectant by spraying technique for the alginate impression materials, compared with sodium hypochlorite, and its effect on dimensional stability and reproduction of details. HOCl with a concentration of 200 ppm for 5 and 10 min was compared with the control group (no treatment) as a negative control and with sodium hypochlorite (% 0.5) as a positive control. Candida albicans, Staphylococcus aureus, and Pseudomonas aeruginosa were selected to assess the antimicrobial activity with the colony forming unit test in addition to the dimensional stability and reproduction of details tests. The results revealed that HOCl had significant antimicrobial activity against all tested microorganisms and experimental time. Interestingly, HOCl showed no impact on the dimensional stability of alginate impression material. HOCl could be an effective antimicrobial agent for alginate impression material without interfering with their surface details and dimensional stability.

COVID-19 and changes in dental practices in the Brazilian Public Health System: perception of the oral health team

The aim of this study was to verify the perception of the oral health team regarding work safety and aspects related to changes in dental practices during the COVID-19 pandemic. A descriptive, exploratory, quantitative, and qualitative cross-sectional study was conducted using an electronic questionnaire sent via email to health professionals (n = 197) affiliated with the Brazilian Public Health System (SUS), from December 2020 to September 2021, in a municipality located in the northeast of the state of São Paulo, Brazil. The variables of interest were sociodemographic characteristics and those related to the professionals' perception of oral health care during the pandemic and its impact on these workers' occupational safety. Descriptive statistics were performed, and the absolute and relative frequencies of quantitative variables were calculated, whereas lexical analysis was performed for textual content using the descending hierarchical classification (CHD). Out of the total sample, elective and urgent/emergency care was provided by 58.95% (n = 56); physical barriers were absent between the teams in 54.74% (n = 52); minimally invasive techniques were applied in 71.58% (n = 68); personal protective equipment (PPE) was replaced in 81.05% (n = 77) between appointments; and occupational safety was reported by 49.47% (n = 47). Textual analysis showed a decrease in appointments and consultations, with a longer interval between appointments. The professionals noticed changes in dental practices during the pandemic, mainly regarding the use of PPE, the type of treatment performed, the number of treated patients, and the greater time interval between consultations. The physical infrastructure of health units and the availability of PPE to patients needed some adjustments. A significant number of workers felt safe in providing dental care during the pandemic.

Evaluation of Detection and Efficacy of Decontamination of Respiratory Pathogens Including SARS-CoV-2 on Basic Military Trainee Gas Masks

INTRODUCTION

Basic military trainee (BMT) gas mask training poses a potential mechanism of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) transmission. After training, gas masks are decontaminated. Insufficient decontamination can lead to viral transmission in the next training class. To our knowledge, the decontamination process has not been validated for efficacy in removing respiratory pathogens such as SARS-CoV-2.

MATERIALS AND METHODS

Inactivated strains of SARS-CoV-2, influenza A and B, and Bordetella pertussis were separately inoculated onto gas masks in the emitter area (n = 5). Pathogen detection in swabs collected from gas masks was performed by real-time polymerase chain reaction (RT-PCR) using the BioFire® RP2.1 panel and Biomeme Franklin system. For decontamination efficacy experiments, pathogens were inoculated onto gas masks, and contaminated areas were swabbed before and after decontamination, with detection using both PCR platforms. Lastly, 65 gas masks were swabbed after gas mask training, and again after the trainees and guardians decontaminated the masks, to identify the presence of any respiratory pathogen exhaled onto the gas masks.

RESULTS

All four pathogens were detected by both PCR platforms. The BioFire® FilmArray® was more sensitive than the Biomeme platform. Decontamination resulted in undetectable levels of all three viruses. B. pertussis was detected on one mask after decontamination. Experiments with live B. pertussis validated that decontamination eliminated all viable bacteria from gas masks. For BMT sampling, all masks were negative for SARS-CoV-2. One mask tested positive for coronavirus 229E. Once decontaminated, all masks tested negative.

CONCLUSIONS

BMT gas masks can be monitored for the presence of respiratory pathogens using RT-PCR. The decontamination process removed all viable respiratory pathogens tested from the gas masks. This study demonstrates that RT-PCR can be used to conduct pathogen surveillance on BMT gas masks after training and that the current decontamination process is effective to eliminate respiratory viruses including SARS-CoV-2.