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As a cross-border, transboundary crisis, the COVID-19 pandemic affected societies worldwide, compromising socio-technical systems across geographical, judicial, and administrative borders. The outbreak can be considered a health crisis, but due to the measures taken to control the spread of the virus, it also exposed the global medical supply chain's vulnerability. Formal authorities struggling to restore the supply chain caused serious problems in the crisis response as the supply of vital medical equipment was scrutinized. However, unexpected allies including social entrepreneurial initiatives provided bottom-up solutions to restore the broken supply chain. This paper seeks to bring attention to how social entrepreneurs respond to a crisis alongside the formal crisis governance system and generate resources related to product development and logistics. By presenting a case study about how Refugee Company's "Mondmaskerfabriek" (Face Mask Factory) engaged with the cross-border dimension of the COVID-19 crisis, we show how a social enterprise was able to establish a supply chain and domestically produce personal protection equipment. As the article shows, both crisis management scholars and policy makers should pay more attention to the potential of social entrepreneurial activities during crisis. [ABSTRACT FROM AUTHOR]

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Abstract Background In radiologically guided interventions, medical practitioners are subjected to radiation exposure, which may lead to radiation-induced diseases. In this study, novel radiation shields for the head and neck were evaluated for their potential to reduce radiation exposure. Method An anthropomorphic phantom was exposed on its left side to scattered radiation from beneath to simulate the exposure of an operator in a x-ray operating room. Thermoluminescent dosimeters (TLDs) were positioned at different depths in five slices in the phantom, measuring personal dose equivalent. Two different set up situations were evaluated: a head protector designed to reduce radiation in the upper section of the head; and a novel thyroid protector prototype extended in the front and on both sides, designed to reduce radiation in the lower and middle sections of the head. A standard thyroid collar prototype and a ceiling mounted lead glass shield were used as comparisons. Furthermore, the head protector was evaluated in a clinical study in which TLDs were positioned to measure scattered radiation exposure to the heads of operators during endovascular interventions. Results The extended thyroid protector reduced the scattered radiation in the throat, chin, and ear slices. Some shielding effect was seen in the brain and skull slices. The head protector showed a shielding effect in the skull slice up to two cm depth where it covered the phantom head. As expected, the ceiling mounted lead glass shield reduced the scattered radiation in all measuring points. Conclusions A ceiling mounted lead glass shield is an effective radiation protection for the head, but in clinical practice, optimal positioning of a ceiling mounted lead shield may not always be possible, particularly during complex cases when radiation protection may be most relevant. Added protection using these novel guards may compliment the shielding effect of the ceiling mounted lead shield. The head protector stand-alone did not provide sufficient protection of the head. The extended thyroid protector stand-alone provided sufficient protection in the lower and middle sections of the head and neck. Graphical Abstract

Background: In radiologically guided interventions, medical practitioners are subjected to radiation exposure, which may lead to radiation-induced diseases. In this study, novel radiation shields for the head and neck were evaluated for their potential to reduce radiation exposure. Method: An anthropomorphic phantom was exposed on its left side to scattered radiation from beneath to simulate the exposure of an operator in a x-ray operating room. Thermoluminescent dosimeters (TLDs) were positioned at different depths in five slices in the phantom, measuring personal dose equivalent. Two different set up situations were evaluated: a head protector designed to reduce radiation in the upper section of the head; and a novel thyroid protector prototype extended in the front and on both sides, designed to reduce radiation in the lower and middle sections of the head. A standard thyroid collar prototype and a ceiling mounted lead glass shield were used as comparisons. Furthermore, the head protector was evaluated in a clinical study in which TLDs were positioned to measure scattered radiation exposure to the heads of operators during endovascular interventions. Results: The extended thyroid protector reduced the scattered radiation in the throat, chin, and ear slices. Some shielding effect was seen in the brain and skull slices. The head protector showed a shielding effect in the skull slice up to two cm depth where it covered the phantom head. As expected, the ceiling mounted lead glass shield reduced the scattered radiation in all measuring points. Conclusions: A ceiling mounted lead glass shield is an effective radiation protection for the head, but in clinical practice, optimal positioning of a ceiling mounted lead shield may not always be possible, particularly during complex cases when radiation protection may be most relevant. Added protection using these novel guards may compliment the shielding effect of the ceiling mounted lead shield. The head protector stand-alone did not provide sufficient protection of the head. The extended thyroid protector stand-alone provided sufficient protection in the lower and middle sections of the head and neck. [ABSTRACT FROM AUTHOR]

Background: Healthcare providers carry the occupational risk of being exposed to pathogens. Personal Protection Equipment (PPE) requires proficiency whenever used. Yet, evidence shows significant errors and variation in competency when applying PPE. Objective: In this study, we developed a three-phase intervention to promote PPE proficiency. Methods: Education and assessment of participants' PPE knowledge and skills occurred at a large academic university in Western Canada. Participants first completed an online module; second, they experienced one-on-one coaching and deliberate practice with infection control professionals; and third, participants managed a COVID-19 clinical simulation scenario. The measured outcomes include a 15-item pre- and post-knowledge test and a pre- and post-skills assessment of donning and doffing behaviors. These behaviors were observed from video recordings and were assessed using two standardized checklists. Results: Knowledge and donning/doffing post-test scores (11.73, 0.95, and 0.96, respectively) were significantly higher after completing all three phases of the educational intervention, p <.001. Conclusions: An online module alone is insufficient for PPE knowledge and skill development. Rather, a module followed by practice and simulation allows learners to gain proficiency. [ABSTRACT FROM AUTHOR]

Abstract Background In otolaryngology outpatient clinics, patients frequently present with unilateral vocal cord paralysis (UVCP). During the pandemic, various new protocols were designed to identify UVCP. An experienced otolaryngologist must conduct a thorough history-taking, examination, and investigation to determine the cause of UVCP. Objectives To evaluate various causes of UVCP during the pandemic. Methods Thirty patients with UVCP on 70-degree rigid endoscopy were studied. Detailed general and systemic examinations were done. All COVID-19 precautions were followed during the evaluation, and real-time reverse transcription-polymerase chain reaction was done before the endoscopic procedure. High-resolution computed tomography scan of skull base to mediastinum with contrast was performed for etiology. Patients were treated according to the standard protocols. Follow-up at 1, 3, and at 6 months was performed. Results The mean age was 42.3 ± 14.83 years. All the patients had presented with a change in voice. Twenty percent had UVCP post a surgical procedure. No cause could be found in 16.67% of patients. Five patients had succumbed to complications relating to their other prevailing conditions. At 6 months, 10 patients continued to have palsy, 9 showed paresis, and 6 showed complete mobility of the cords. Conclusion During the pandemic, diagnosing and following up such patients were a challenge. Investigating a cause of UVCP, the symptoms of which might be trivial at presentation, leads to discover a much sinister cause. UVCP in post-covid mucormycosis was an entity requiring multimodality management. Pandemic-induced restrictions lead to formulations of newer protocols for tackling this entity.

The coronavirus pandemic has raised public awareness of one of the many hazards that healthcare workers face daily: exposure to harmful pathogens. The anaesthesia workplace encompasses the operating room, interventional radiology suite, and other sites that contain many other potential occupational and environmental hazards. This review article highlights the work-based hazards that anaesthesiologists and other clinicians may encounter in the anaesthesia workplace: ergonomic design, physical, chemical, fire, biological, or psychological hazards. As the anaesthesia work environment enters a post-COVID-19 pandemic phase, anaesthesiologists will do well to review and consider these hazards. The current review includes proposed solutions to some hazards and identifies opportunities for future research.

Background: In otolaryngology outpatient clinics, patients frequently present with unilateral vocal cord paralysis (UVCP). During the pandemic, various new protocols were designed to identify UVCP. An experienced otolaryngologist must conduct a thorough history-taking, examination, and investigation to determine the cause of UVCP. Objectives: To evaluate various causes of UVCP during the pandemic. Methods: Thirty patients with UVCP on 70-degree rigid endoscopy were studied. Detailed general and systemic examinations were done. All COVID-19 precautions were followed during the evaluation, and real-time reverse transcription-polymerase chain reaction was done before the endoscopic procedure. High-resolution computed tomography scan of skull base to mediastinum with contrast was performed for etiology. Patients were treated according to the standard protocols. Follow-up at 1, 3, and at 6 months was performed. Results: The mean age was 42.3 ± 14.83 years. All the patients had presented with a change in voice. Twenty percent had UVCP post a surgical procedure. No cause could be found in 16.67% of patients. Five patients had succumbed to complications relating to their other prevailing conditions. At 6 months, 10 patients continued to have palsy, 9 showed paresis, and 6 showed complete mobility of the cords. Conclusion: During the pandemic, diagnosing and following up such patients were a challenge. Investigating a cause of UVCP, the symptoms of which might be trivial at presentation, leads to discover a much sinister cause. UVCP in post-covid mucormycosis was an entity requiring multimodality management. Pandemic-induced restrictions lead to formulations of newer protocols for tackling this entity. [ABSTRACT FROM AUTHOR]

A new way to measure the penetration efficiency of a face mask is introduced. It has a number of advantages over the currently used measurement systems in which a stationary mask is impacted with a moving aerosol during which the upstream and downstream particle concentrations are compared. The equivalent system described here instead moves a mask through a stationary aerosol in a closed chamber and compares the particle concentrations before and after the movement of the mask. This system provides many advantages, such as greater simplicity, greater accuracy, an exact constant aerosol flow speed through a mask, more easily made concentration measurements, more realistic impacts, more controlled averaging, the absence of the need for preliminary impacts during flow stabilization, and a lower cost. A laboratory prototype of the system has been fabricated and seen to perform as expected. Data obtained from this prototype are displayed, analyzed, and used to demonstrate the consistency and repeatability of the system. A portable fully-automated compact prototype has also been designed and fabricated. This device can be easily operated, and the total time required to test a mask, from material insertion to result display, is only a few minutes. [ABSTRACT FROM AUTHOR]

Nanotechnology has allowed for significant progress in architectural, artistic, archaeological, or museum heritage conservation for repairing and preventing damages produced by deterioration agents (weathering, contaminants, or biological actions). This review analyzes the current treatments using nanomaterials, including consolidants, biocides, hydrophobic protectives, mechanical resistance improvers, flame-retardants, and multifunctional nanocomposites. Unfortunately, nanomaterials can affect human and animal health, altering the environment. Right now, it is a priority to stop to analyze its advantages and disadvantages. Therefore, the aims are to raise awareness about the nanotoxicity risks during handling and the subsequent environmental exposure to all those directly or indirectly involved in conservation processes. It reports the human–body interaction mechanisms and provides guidelines for preventing or controlling its toxicity, mentioning the current toxicity research of main compounds and emphasizing the need to provide more information about morphological, structural, and specific features that ultimately contribute to understanding their toxicity. It provides information about the current documents of international organizations (European Commission, NIOSH, OECD, Countries Normative) about worker protection, isolation, laboratory ventilation control, and debris management. Furthermore, it reports the qualitative risk assessment methods, management strategies, dose control, and focus/receptor relationship, besides the latest trends of using nanomaterials in masks and gas emissions control devices, discussing their risk of toxicity. [ABSTRACT FROM AUTHOR]

ABSTRACT: Severe fever with thrombocytopenia syndrome (SFTS), an emerging infectious disease with high mortality, was first reported in 2009 in China and subsequently endemic to South Korea, Japan, Vietnam, and Myanmar. This disease is transmitted predominantly by tick bites and potentially human-to-human. Personal protective equipments (PPEs) have been recommended to prevent SFTS human-to-human transmission, whereas the specific use of PPEs and the effect on viral transmission have rarely been reported. This report identified a family cluster of six patients with SFTS virus (SFTSV) infection. All five secondary patients had been wearing gloves and masks when exposed to the blood of the index patient, but none of them wore goggles or face shields for eye protection. Ocular route was suggested as a highly possible mode for SFTSV transmission through epidemiological, serological, and phylogenetic analysis. Eye protection should be stressed for clinicians when exposed to blood or bloody secretions.

Wearing high-quality masks plays a critical role in reducing COVID-19 transmission. However, no study has investigated socioeconomic inequality in the quality of masks. Addressing this gap, this paper explored the relationships between mask’s quality and family economic status. The cross-sectional survey was conducted in two Chinese universities by distributing structured questionnaires to assess participants’ characteristics including family economic status, and meanwhile collecting their masks to evaluate the quality by measuring particle filtration efficiency. The valid responses were obtained from 912 students with mean age of 19.556 ± 1.453 years and were analyzed by using fractional or binary logistic regression. Three main findings were presented. First, inequality existed in the quality of masks. 36.07% of students were using unqualified masks with average filtration efficiency of 0.795 ± 0.119, which was much lower than China’s national standard (0.9). Of those masks with identified production date, 11.43% were manufactured during COVID-19 outbreak when market was flooded with counterfeit production, and thus were of poor quality with average filtration efficiency of 0.819 ± 0.152. Second, better family economic status was associated with better masks’ filtration efficiency and greater probability of using qualified masks. Third, students with better family economic status tend to use masks with individual packaging, and unique patterns and special designs, which may lead to inequality on a psychological level. Our analysis reveals the hidden socioeconomic inequality that exist behind cheap masks. In facing the challenges of future emerging infectious diseases, it is important to address the inequity to ensure equal access to affordable qualified personal protection equipment.

Summary: Purpose: The COVID-19 pandemic has put tremendous strain on healthcare systems. Surgical societies worldwide have advised minimizing non-essential surgeries in order to preserve hospital resources. Given the medical resources and COVID-19 incidence between countries across the world differ, so should colorectal practices. No formal guidelines have emerged from Asia. We wanted to find out what the current practice was in Asian colorectal centres outside China. Introduction: The COVID-19 pandemic has significantly impacted surgical practice worldwide. At the time of the writing of this paper, there are over 4.2 million cases reported with deaths exceeding 290 000 patients.1 With an abrupt disruption to worldwide supply chains, societal lockdowns and surge of cases into many hospitals, resource allocation was diverted and prioritised for all COVID-19 related services. Methods: A questionnaire survey of current colorectal practice was carried out involving 3 major colorectal cancer centres, one each from 3 major cities: Singapore, Taichung and Daegu. Components of the survey include infrastructure and manpower, case selection, surgical approach, operating room management and endoscopy practice. Results: All 3 centres continued to provide standard-of-care colorectal cancer surgery despite the COVID-19 pandemic. Two centres deferred surgery for benign colorectal conditions. Minimally Invasive Surgery (MIS) was still the preferred approach when indicated but with protocolized precautions undertaken. Other services such as pelvic exenteration, TATME and pelvic lymph node dissection were still offered if oncologically indicated. Elective diagnostic endoscopy services have also continued in two centres. Conclusion: Elective colorectal services continue to take place in the 3 surveyed Asian hospitals with heightened precautions. Provided there is adequate resource, colorectal cancer services should still continue to prevent consequences of neglecting or delaying cancer treatment. Practice should hence be tailored to the local resource of individual centres accordingly.

Objectives. Following the SARS-CoV-2 pandemic, all health care professionals were forced to change their methods of managing patients who come to the hospital for different diseases. The purpose of our study is to report the experience of this period, regarding: the study of demography in the presentation of facial and maxillary facial fractures, as well as the description of precautions taken and changes in management methods during the treatment of these cases. Materials and Methods. The study was performed in a tertiary care hospital, as a descriptive study on 30 consecutive patients with faciomaxillary trauma admitted to our hospital since the onset of the Covid-19 lockdown. The demographic data and the management protocol of the patient with facial fractures were noted and interpreted. Results. We found that several men suffered maxillofacial injuries as a result of RTA, despite the lockdown. Middle face fractures were the most common that required surgery. Sixteen patients underwent surgery in view of malocclusion and complex facial lacerations. Intra operative important steps were taken to reduce aerosol generation in the form of quick intubation, lower power settings of bipolar cautery and drill, islet application and use of self-drilling screws thereby reducing OT time as well. Post op. minimal malocclusion was seen in 5 (30%) patients who had undergone arch bar application and in 2 (12%) patient who had undergone islet application. Conclusions. Understanding patient demography is crucial for redistribution of hospital resources especially during a pandemic. Adaptable and flexible guidelines are required at every stage to ensure adequate patient treatment as well as limit any cross infection. Proper fixation of all fractures as per universal recommendations should be preferred always.

Background and aim: Headaches related to the use of personal protective equipment (PPE) could affect performance at work in healthcare personnel. Our aim was to describe the prevalence and risk factors for headaches related to PPE, in the personnel of a specialized coronavirus disease 2019 (COVID-19) tertiary hospital. Methods: In this cross-sectional survey study, we invited healthcare workers from COVID-19 referral center in Mexico (May 22–June 19, 2020) to answer a standardized structure questionnaire on characteristics of new-onset PPE-related headache or exacerbation of primary headache disorder. Participants were invited regardless of whether they had a current headache to avoid selection bias. This is the primary analysis of these data. Results: Two hundred and sixty-eight subjects were analyzed, 181/268 (67.5%) women, 177/268 (66%) nurses, mean age 28 years. The prevalence of PPE-related headache was 210/268 (78.4%). Independent risk factors were occupation other than physician (OR 1.59, 95% CI 1.20–2.10), age > 30 years (OR 2.54, 95% CI 1.25–5.14), and female sex (OR 3.58, 95% CI 1.86–6.87). In the 6-month follow-up, 13.1% of subjects evolve to chronic headache, with stress as predictive risk factor. Conclusion: The frequency of PPE-associated headache is high, and a subgroup could evolve to chronic headache. More studies are necessary to improve the knowledge about this condition. [ABSTRACT FROM AUTHOR]

Objectives: Primary focused question for this systematic review (SR) was "Which is the evidence about surfaces decontamination and protection masks for SARS‐Cov‐2 in dental practice?" Secondary question was "Which is the evidence about surfaces decontamination and protection masks against airborne pathogens and directly transmitted viral pathogens causing respiratory infections?" Materials and Methods: PRISMA guidelines were used. Studies on surface decontamination and protective masks for SARS‐CoV‐2 in dental practice were considered. Studies on other respiratory viruses were considered for the secondary question. Results: No studies are available for SARS‐CoV‐2. Four studies on surface disinfection against respiratory viruses were included. Ethanol 70% and sodium hypochlorite 0,5% seem to be effective in reducing infectivity by > 3log TCID. Four RCTs compared different types of masks on HCW. The single studies reported no difference for laboratory‐diagnosed influenza, laboratory‐diagnosed respiratory infection, and influenza‐like illness. A meta‐analysis was not considered appropriate. Conclusions: There is lack of evidence on the efficacy of surface disinfection and protective masks to reduce the spread of SARS‐CoV‐2 or other respiratory viruses in dentistry. However, the consistent use of respirator and routine surface disinfection is strongly suggested. There is urgent need of data on the efficacy of specific protection protocols for dental HCW against viral infections. [ABSTRACT FROM AUTHOR]

Abstract Background The COVID-19 pandemic led to widespread use of personal protection equipment (PPE), including filtering face piece (FFP) masks, throughout the world. PPE. Previous studies indicate that PPE impairs neurocognitive performance in healthcare workers. Concerns for personnel safety have led to special recommendations regarding basic life support (BLS) in patients with a potential SARS-CoV-2 infection, including the use of PPE. Established instruments are available to assess attention and dexterity in BLS settings, respectively. We aimed to evaluate the influence of PPE with different types of FFP masks on these two neuropsychological components of EMS personnel during BLS. Methods This was a randomized controlled non-inferiority triple-crossover study. Teams of paramedics completed three 12-min long BLS scenarios on a manikin after having climbed three flights of stairs with equipment, each in three experimental conditions: (a) without pandemic PPE, (b) with PPE including a FFP2 mask with an expiration valve and (c) with PPE including an FFP2 mask without an expiration valve. The teams and intervention sequences were randomized. We measured the shift in concentration performance using the d2 test and dexterity using the nine-hole peg test (NHPT). We compared results between the three conditions. For the primary outcome, the non-inferiority margin was set at 20 points. Results Forty-eight paramedics participated. Concentration performance was significantly better after each scenario, with no differences noted between groups: d2 shift control versus with valve − 8.3 (95% CI − 19.4 to 2.7) points; control versus without valve − 8.5 (− 19.7 to 2.7) points; with valve versus without valve 0.1 (− 11.1 to 11.3) points. Similar results were found for the NHPT: + 0.3 (− 0.7 to 1.4), − 0.4 (− 1.4 to 0.7), 0.7 (− 0.4 to 1.8) s respectively. Conclusion Attention increases when performing BLS. Attention and dexterity are not inferior when wearing PPE, including FFP2 masks. PPE should be used on a low-threshold basis.

Coronavirus disease 2019 (COVID-19) is a type of viral pneumonia that has paralysed the entire world both in terms of health and economy. It has been recently declared as a global pandemic. All the health care professionals must be aware of the disease entity and take precautionary measures to control its transmission from person to person, particularly in hospital settings. In this article, we propose essential steps that can be implemented at the departmental and institutional levels to do endoscopic diagnostic procedures effectively during COVID-19 outbreak and to break the transmission chain. [ABSTRACT FROM AUTHOR]

• Ocular route is suggested as a highly possible mode for severe fever with thrombocytopenia syndrome (SFTS) virus transmission. • Greater exposure to blood from patients with SFTS may result in poor prognosis. • Excretions from patients with SFTS without bleeding may confer lower transmission risk. Severe fever with thrombocytopenia syndrome (SFTS), an emerging infectious disease with high mortality, was first reported in 2009 in China and subsequently endemic to South Korea, Japan, Vietnam, and Myanmar. This disease is transmitted predominantly by tick bites and potentially human-to-human. Personal protective equipments (PPEs) have been recommended to prevent SFTS human-to-human transmission, whereas the specific use of PPEs and the effect on viral transmission have rarely been reported. This report identified a family cluster of six patients with SFTS virus (SFTSV) infection. All five secondary patients had been wearing gloves and masks when exposed to the blood of the index patient, but none of them wore goggles or face shields for eye protection. Ocular route was suggested as a highly possible mode for SFTSV transmission through epidemiological, serological, and phylogenetic analysis. Eye protection should be stressed for clinicians when exposed to blood or bloody secretions. [ABSTRACT FROM AUTHOR]

Abstract Background Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a highly contagious airborne virus inducing pandemic coronavirus disease 2019 (COVID-19). This is most relevant for medical staff working under harmful conditions in emergencies often dealing with patients and an undefined SARS-CoV-2 status. We aimed to measure the effect of high-class filtering facepieces (FFP) in emergency medical service (EMS) staff by analyzing seroprevalence and history of positive polymerase chain reaction (PCR) for SARS-CoV-2. Method This observational cohort study included workers in EMS, who were compared with hospital staff (HS) and staff, which was not directly involved in patient care (NPC). All direct patient contacts of EMS workers were protected by FFP2/N95 (filtering face piece protection class 2/non-oil-based particulates filter efficiency 95%) masks, whereas HS was protected by FFP2/N95 exclusively when a patient had a proven or suspected SARS-CoV-2 infection. NPC was not protected by higher FFP. The seroprevalence of SARS-CoV-2 antibodies was analyzed by immunoassay by end of 12/2020 together with the history of a positive PCR. In addition, a self-assessment was performed regarding the quantity of SARS-CoV-2 positive contacts, about flu symptoms and personal belief of previous COVID-19 infections. Results The period in which contact to SARS-CoV-2 positive patients has been possible was 10 months (March to December 2020)—with 54,681 patient contacts documented for EMS—either emergencies (n = 33,241) or transportation services (n = 21,440). Seven hundred-thirty (n = 730) participants were included into the study (n = EMS: 325, HS: 322 and NPC: 83). The analysis of the survey showed that the exposure to patients with an unknown and consecutive positive SARS-CoV-2 result was significantly higher for EMS when compared to HS (EMS 55% vs. HS 30%, p = 0.01). The incidence of a SARS-CoV-2 infection in our cohort was 1.2% (EMS), 2.2% (HS) and 2.4% (NPC) within the three groups (ns) and lowest in EMS. Furthermore, the belief of previous COVID-19 was significant higher in EMS (19% vs. 10%), Conclusion The consistent use of FFP2/N95 in EMS is able to prevent work-related SARS-CoV-2 infections in emergency situations. The significance of physical airway protection in exposed medical staff is still relevant especially under the aspect of new viral variants and unclear effectiveness of new vaccines. Graphical Abstract

The lack of certified personal protective equipment (PPE) and the high number of quite ambitious requirements to laser protection clothes (protective, flexible, light-weight, processible, sewable, wearable, ...) give rise to the development of a new kind of layered and functionalized textiles: Existing protective textiles acting as a substrate are coated with an additional layer consisting of compounds which can react in an energy-consuming, i.e. endothermic, manner. We report on recent progress on textile substrates which are equipped with endothermic mixtures of Fe 2 O 3 /C, SiO 2 /C, or Al 2 O 3 /Fe as well as compounds containing crystal water that can also be thermally decomposed, such as magnesium carbonate hydroxide hydrate. The resulting temperatures as well as the resistance to laser irradiation at 1064 nm after a duration of 30 s are used to judge the suitability for future personal protective equipment. A combination of an already available polyester textile substrate with the new magnesium carbonate hydroxide hydrate layer and a highly absorbing aluminum foil, treated by a Plasma Chemical Oxidation (PCO) method, shows promising results for application in laser protection textiles. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has put tremendous strain on healthcare systems. Surgical societies worldwide have advised minimizing non-essential surgeries in order to preserve hospital resources. Given the medical resources and COVID-19 incidence between countries across the world differ, so should colorectal practices. No formal guidelines have emerged from Asia. We wanted to find out what the current practice was in Asian colorectal centres outside China. The COVID-19 pandemic has significantly impacted surgical practice worldwide. At the time of the writing of this paper, there are over 4.2 million cases reported with deaths exceeding 290 000 patients. 1 With an abrupt disruption to worldwide supply chains, societal lockdowns and surge of cases into many hospitals, resource allocation was diverted and prioritised for all COVID-19 related services. A questionnaire survey of current colorectal practice was carried out involving 3 major colorectal cancer centres, one each from 3 major cities: Singapore, Taichung and Daegu. Components of the survey include infrastructure and manpower, case selection, surgical approach, operating room management and endoscopy practice. All 3 centres continued to provide standard-of-care colorectal cancer surgery despite the COVID-19 pandemic. Two centres deferred surgery for benign colorectal conditions. Minimally Invasive Surgery (MIS) was still the preferred approach when indicated but with protocolized precautions undertaken. Other services such as pelvic exenteration, TATME and pelvic lymph node dissection were still offered if oncologically indicated. Elective diagnostic endoscopy services have also continued in two centres. Elective colorectal services continue to take place in the 3 surveyed Asian hospitals with heightened precautions. Provided there is adequate resource, colorectal cancer services should still continue to prevent consequences of neglecting or delaying cancer treatment. Practice should hence be tailored to the local resource of individual centres accordingly. [ABSTRACT FROM AUTHOR]

Introduction: Doctors are at increased risk of exposure to SARS-CoV-2 virus, and use of N95 respirators has emerged as a key preventive measure. This study aimed to study the real-world experiences, practices and adverse effects of N95 respirator usage amongst doctors of India. Methods: An analytical, cross-sectional online survey was conducted between November 2020 and January 2021. Real-world usage characteristics of N-95 respirators were collected via a pre-validated questionnaire (use, reuse, wearing and disposal practices) and compared amongst different sub-cohorts. Results: 453 responses from physicians were analyzed. The most important adjunct to the N95 respirator perceived by the respondents was the full-face shield (81.9%). Most doctors had to purchase extra mask per month (median = 5) and this was more amongst the medical specialties (p = 0.006). Highest mean VAS scores for adverse events were reported for breathing on exertion (6.62 ± 2.25) and ear pain (6.34 ± 2.69). VAS ear pain was higher in ages < 40 and doctors working in the public sector (p = 0.017 and p = 0.019 respectively). Conclusion: There are many inadequacies with regard to proper mask removal and doffing techniques among doctors in India. The major adverse effects faced by the doctors on prolonged mask usage were ear pain and breathing on exertion. However, it can be noted in spite of these deficiencies; there is generally good adherence to protocols and good practices of mask usage in hospital setting.

BACKGROUND: An appropriate match between a product and its end-users requires anthropometric data, which show variations among different countries. Proper Personal Protection Equipment (PPE) fit is key for safety and comfort. Chile had no head and facial anthropometric data available in order to design face/head PPE. OBJECTIVE: To describe face/head anthropometric characteristics of Chilean workers. Additionally, this study compared those dimensions against other populations (United States (US), South Korea and China). METHODS: An anthropometric survey involving 21 measures was conducted between September 2013 to May 2016 using stratified sampling. The measurements were based on ISO/TS 16976-2 and ISO 15535 to ensure the highest standards possible, and a total of 474 workers, aged from 18 to 66 years old, participated in the survey. RESULTS: The biggest differences were in Neck circumference, Weight, Nose breadth, Nose protrusion, Bitragion chin arc, Face length, Subnasale-sellion length, Face width, Bigonial breadth and Bitragion subnasal arc. Head length of Chileans were longer than Chinese and South Korean ones, but shorter than US Head length. Chilean Head breadth is smaller than Chinese and South Korean ones. Chileans Face length was the largest observed. Face width of Chileans was smaller than US and Chinese ones. Gender specific differences were also observed in the inter-country comparisons. Chilean males had larger anthropometric dimensions than females. CONCLUSION: Chilean Head and face dimensions differed significantly when compared against US, South Korean and Chines Head and Face dimensions. Chileans have longer and narrower faces with wider mouths, with a head size in between the US and Asian heads. Face and head PPE for Chileans should use dimensions in the current paper in order to ensure proper fit. [ABSTRACT FROM AUTHOR]

Interventional cardiology procedures (ICPs) have become the mainstay treatments in cardiology diseases and increased rapidly. This study aims to assess the occupational health hazards (OHHs) related to the long-time wearing of lead personal protective equipment and reveal health protection needs in interventional cardiologists. We invited interventional and non-interventional cardiologists in tertiary hospitals in China to participate in an online cross-sectional survey on their health status, utilization of personal protective equipment (PPE), and personal health protection (PHP) needs. Propensity score methods were used for comparisons of OHHs between the matched interventional and non-interventional cardiologists. Totally, 642 interventional and 402 non-interventional cardiologists completed the survey. The interventional cardiologists had significantly higher incidence of body pain (56.6% vs. 24.2%, p < 0.001), bone and joint disease (21.7% vs. 8.6%, p = 0.001), cataract (3.5% vs. 0%, p = 0.039), and anxiety (8.1% vs. 2.5%, p = 0.029) than the matched non-interventional cardiologists. The risk of back pain was independently associated with female gender, performing percutaneous coronary intervention procedure or ≥ 2 types of ICP, and the personal annual volume of ICPs. Only 3.3% of interventional cardiologists were satisfied with PPE and 83.0% of them complained of physical toll caused by heavy PPE. 90.7% were willing to conduct ICP without radiation exposure. Body pain was the main OHH in interventional cardiologists likely due to wearing heavy lead PPE for long working hours. Besides training more interventional cardiologists, the adoption of emerging technologies without heavy lead PPE will be a promising way to reduce the OHH burden. • The interventional cardiologists in China experience significantly higher incidence of body pain, mainly of the back. • The risk of back pain was independently associated with female gender, performing PCI or ≥2 types procedures, and the volume of procedures. • Interventional cardiologists are not fully satisfied with the current lead personal protective equipment due to its heavy weight. • Most of interventional cardiologists are willing to conduct interventional cardiology procedures without radiation exposure. [ABSTRACT FROM AUTHOR]

Introduction: The lack of interest and knowledge related to personal protection equipment (PPE) and infection control measures might have a detrimental effect on dental occupational workers. Aim: The purpose of this study was to evaluate the knowledge and perception of dental practitioners about PPE to limit the spread of coronavirus disease 2019 (COVID-19). Materials and Methods: This cross-sectional descriptive study was conducted between May and June 2020 among the dental practitioners working in public and private sectors of Saudi Arabia. An online questionnaire was distributed among dental practitioners across Saudi Arabia using E-mails or WhatsApp software. The questionnaire consisted of two parts: (1) basic demographic characteristics (gender, professional status, type of dental setup, and working experience) and (2) knowledge and attitude regarding the use of a face mask, gloves, gowns, and personal hygiene. Descriptive statistics were performed to summarize frequencies and percentages. Results and Discussion: The total number of the responses received was 535 (68.8% – male and 31.2% – female). Only 17.8% knew that surgical masks are made of nonwoven fabric and that the middle layer acts as a barrier (39.8%). Regarding gloves, 57.4% of the participants agreed that latex/nitrile gloves are more reliable and durable. On the contrary, satisfactory knowledge regarding face shield, gown, hand hygiene, and infection control measures was observed. Conclusions: This study showed a low level of certain PPE knowledge among dental practitioners. However, knowledge and perception about biosafety, face shield, gown, hand hygiene, and infection control measures were found to be higher and adequate among the participants.

Background: The COVID-19 pandemic led to widespread use of personal protection equipment (PPE), including filtering face piece (FFP) masks, throughout the world. PPE. Previous studies indicate that PPE impairs neurocognitive performance in healthcare workers. Concerns for personnel safety have led to special recommendations regarding basic life support (BLS) in patients with a potential SARS-CoV-2 infection, including the use of PPE. Established instruments are available to assess attention and dexterity in BLS settings, respectively. We aimed to evaluate the influence of PPE with different types of FFP masks on these two neuropsychological components of EMS personnel during BLS. Methods: This was a randomized controlled non-inferiority triple-crossover study. Teams of paramedics completed three 12-min long BLS scenarios on a manikin after having climbed three flights of stairs with equipment, each in three experimental conditions: (a) without pandemic PPE, (b) with PPE including a FFP2 mask with an expiration valve and (c) with PPE including an FFP2 mask without an expiration valve. The teams and intervention sequences were randomized. We measured the shift in concentration performance using the d2 test and dexterity using the nine-hole peg test (NHPT). We compared results between the three conditions. For the primary outcome, the non-inferiority margin was set at 20 points. Results: Forty-eight paramedics participated. Concentration performance was significantly better after each scenario, with no differences noted between groups: d2 shift control versus with valve − 8.3 (95% CI − 19.4 to 2.7) points; control versus without valve − 8.5 (− 19.7 to 2.7) points; with valve versus without valve 0.1 (− 11.1 to 11.3) points. Similar results were found for the NHPT: + 0.3 (− 0.7 to 1.4), − 0.4 (− 1.4 to 0.7), 0.7 (− 0.4 to 1.8) s respectively. Conclusion: Attention increases when performing BLS. Attention and dexterity are not inferior when wearing PPE, including FFP2 masks. PPE should be used on a low-threshold basis. [ABSTRACT FROM AUTHOR]

Background and Aims: A pilot study among anesthesiologists, revealed a wide variation among individual practices including skipping pre-anesthetic airway assessment during COVID-19 pandemic because of the fear of getting infected. Risk of infection during pre-anesthetic airway assessment has not been studied. The primary objective of the survey was to evaluate the practices of airway examination by anesthesiologists during this pandemic period. Secondary objectives were to study the effects of institutional factors and other individual practices on risk modification and the incidence of COVID-19 infection among anesthesiologists. Material and Methods: A survey was conducted using a pre-validated questionnaire comprising of 35 questions. The questionnaire was circulated among 4676 members of the Indian Society of Anaesthesiologists (ISA) through Google Forms by email. Results: Of the 4676 members contacted via email, 470 were returned undelivered. From the remaining 4206 questionnaire recipients, 456 completed responses were obtained giving a response rate of 10.8%. Percentage, mean and standard deviation were calculated using EZR software. The conduct of pre-anesthetic airway assessment has decreased by 31.7% during the pandemic, leading to 5.2% of participants encountering unanticipated difficult airway. Among the respondents, eight percent were infected. Conclusion: Avoidance of preoperative airway assessment by anesthesiologists during the COVID-19 pandemic has led to rising unanticipated difficult airway undermining the patient safety. Adherence to recommended practices ensures safety from risk of COVID-19 infection. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this survey was to understand the impact the Covid-19 pandemic has or has had on the work, training, and wellbeing of professionals in the field of diagnostic neuroradiology. Methods: A survey was emailed to all ESNR members and associates as well as distributed via professional social media channels. The survey was held in the summer of 2020 when the first wave had subsided in most of Europe, while the second wave was not yet widespread. The questionnaire featured a total of 46 questions on general demographics, the various phases of the healthcare crisis, and the numbers of Covid-19 patients. Results: One hundred sixty-seven responses were received from 48 countries mostly from neuroradiologists (72%). Most commonly taken measures during the crisis phase were reduction of outpatient exams (87%), reduction of number of staff present in the department (83%), reporting from home (62%), and shift work (54%). In the exit phase, these measures were less frequently applied, but reporting from home was still frequent (33%). However, only 22% had access to a fully equipped work station at home. While 81% felt safe at work during the crisis, fewer than 50% had sufficient personal protection equipment for the duration of the entire crisis. Mental wellbeing is an area of concern, with 61% feeling (much) worse than usual. Many followed online courses/congresses and considered these a viable alternative for the future. Conclusion: The Covid-19 pandemic substantially affected the professional life as well as personal wellbeing of neuroradiologists. [ABSTRACT FROM AUTHOR]

COVID-19 has had a significant impact on the health care workers derived, among other factors, due to the lack of adequate personal protection equipment, especially face masks and respirators. The forms of transmission are reviewed, taking into consideration that the main route of infections is through aerosols, microparticles smaller than 60-100 microns that are exhaled during aerosol generating procedures (AGP) or even through coughing, sneezing or speaking; and that these forms of transmission are capable of remaining floating for prolonged periods of time in closed spaces. Although the N95 are indicated for the care of patients diagnosed or suspected of COVID-19 because they offer greater protection against aerosols, they are not always available due to their scarcity derived from their high consumption worldwide. In this review the most appropriate alternatives for the shortage crisis are analyzed, trying to prioritize those who have access to materials with filtering efficiency and face sealing to avoid leaks. The appearance of new and more contagious varieties of the virus should obligate all health care workers to always use respirators or medical face masks with greater efficiency within the hospital environment and not only during aerosol generating procedures. [ABSTRACT FROM AUTHOR]

The correct management of patients with coronavirus disease-2019 (COVID-19) and acute coronary syndrome is still uncertain. We describe the percutaneous treatment of an unprotected left main coronary artery in a patient who is positive for COVID-19 with unstable angina, dyspnea and fever. Particular attention will be dedicated to the measures adopted in the catheterization laboratory to protect the staff and to avoid further spread of the infection. (Level of Difficulty: Intermediate.)

Abstract Introduction Transmission of SARS-CoV-2 to health care workers (HCW) poses a major burden in the current COVID-19 pandemic. Unprotected exposure to a COVID-19 patient is a key risk factor for HCWs. Transmission mainly occurs by droplet transmission, or by aerosol generating procedures. Respirators such as filtering face piece masks (FFP2), also called respirators, are required to prevent transmission during aerosol generating procedures, as part of the personal protective equipment (PPE) for HCWs. However, many HCW were infected due to lack of PPE, or failure to use them. Therefore, the worldwide shortage of respirators triggered the development of reprocessing used FFP2 respirators or N95 respirators as standard in the US. Our proposal with H2O2 plasma sterilization for decontamination allows to reprocess FFP2, while they still meet the filtration efficiency required by EN 149. The protocol is simple, uses available resources in hospitals and can be rapidly implemented to decrease the shortage of respirators during this crisis. The goal of the study was the evaluate if respirators can be reprocessed and still fulfill the requirements for filtration efficiency outlined by EN 149. Methods Used FFP2 respirators – Model 3 M Aura™ 1862+ − were sterilized using a low temperature process hydrogen peroxide (H2O2), V-PRO® maX Low Temperature, a FDA (Food and Drug Administration) approved method to decontaminate FFP2 respirators. Decontaminated respirators were further checked for residual peroxide by a single-gas detector for H2O2. The total inward leakage of the protective respirators was quantitatively tested with 10 test persons in an atmosphere charged with paraffin aerosol according to the European Standard EN 149. The fit factor was calculated as the inverse of the total inward leakage. Results Ten new and ten decontaminated FFP2 respirators were tested for filtration efficiency. None of the respirators exceeded the maximum acceptable concentration of peroxide. More than 4000 respirators have been reprocessed so far, at cost of approximately 0.3 Euro/piece. Conclusions FFP2 respirators can be safely reprocessed once after decontamination with plasma peroxide sterilization, whereafter they still fulfill EN 149 requirements. This allows to almost double the current number of available FFP2 respirators.

Objectives: During the COVID-19 pandemic, dentists have had to work under stressful conditions due to the nature of their work. Personal protection equipment (PPE) has become mandatory for work in the dentistry field. This study aimed to examine dentists' practices and attitudes regarding the use of PPE and the associated drawbacks and cost implications during the pandemic.Methods: A questionnaire-based survey was used and was divided into five sections dedicated to collect demographic variables and to examine the dentists' practices, attitudes toward PPE, drawbacks, and cost of using PPE. Mann-Whitney U and Kruskal-Wallis tests were used to compare different sections of the questionnaire and linear regression was used to determine the predictors of the dentists' practices and attitudes toward PPE.Results: The mean of practices regarding use of PPE was 5.41 ± 1.71 (median 6), attitude toward using PPE scored 2.26 ± 0.90 (median 2), while the means of drawbacks and cost recorded equal scores of 5.22 ± 1.24 (median 5) and 1.68 ± 0.74 (median 2), respectively. The recently graduated dentists, those with postgraduate degrees and those working in the private sector demonstrated higher levels of practices on PPE than their counterparts. Regression analysis revealed that practices of PPE can be predicted on the basis of qualifications and work place, whereas attitude toward PPE is significantly influenced by qualification only.Conclusions: The study participants demonstrated satisfactory levels of practices and positive attitudes toward PPE. While complaints from using PPE and their cost were moderately affected.

Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a highly contagious airborne virus inducing pandemic coronavirus disease 2019 (COVID-19). This is most relevant for medical staff working under harmful conditions in emergencies often dealing with patients and an undefined SARS-CoV-2 status. We aimed to measure the effect of high-class filtering facepieces (FFP) in emergency medical service (EMS) staff by analyzing seroprevalence and history of positive polymerase chain reaction (PCR) for SARS-CoV-2. Method: This observational cohort study included workers in EMS, who were compared with hospital staff (HS) and staff, which was not directly involved in patient care (NPC). All direct patient contacts of EMS workers were protected by FFP2/N95 (filtering face piece protection class 2/non-oil-based particulates filter efficiency 95%) masks, whereas HS was protected by FFP2/N95 exclusively when a patient had a proven or suspected SARS-CoV-2 infection. NPC was not protected by higher FFP. The seroprevalence of SARS-CoV-2 antibodies was analyzed by immunoassay by end of 12/2020 together with the history of a positive PCR. In addition, a self-assessment was performed regarding the quantity of SARS-CoV-2 positive contacts, about flu symptoms and personal belief of previous COVID-19 infections. Results: The period in which contact to SARS-CoV-2 positive patients has been possible was 10 months (March to December 2020)—with 54,681 patient contacts documented for EMS—either emergencies (n = 33,241) or transportation services (n = 21,440). Seven hundred-thirty (n = 730) participants were included into the study (n = EMS: 325, HS: 322 and NPC: 83). The analysis of the survey showed that the exposure to patients with an unknown and consecutive positive SARS-CoV-2 result was significantly higher for EMS when compared to HS (EMS 55% vs. HS 30%, p = 0.01). The incidence of a SARS-CoV-2 infection in our cohort was 1.2% (EMS), 2.2% (HS) and 2.4% (NPC) within the three groups (ns) and lowest in EMS. Furthermore, the belief of previous COVID-19 was significant higher in EMS (19% vs. 10%), Conclusion: The consistent use of FFP2/N95 in EMS is able to prevent work-related SARS-CoV-2 infections in emergency situations. The significance of physical airway protection in exposed medical staff is still relevant especially under the aspect of new viral variants and unclear effectiveness of new vaccines. [ABSTRACT FROM AUTHOR]

Introduction: The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) virus has affected many people in India in 2020. This has put a huge strain on hospitals and healthcare workers. Burn patients usually require hospitalisation and surgery, which adds to the burden of care provided by healthcare workers. Modifications in management protocol during a pandemic are of utmost importance to prevent transmission of Coronavirus Disease-2019 (COVID-19) while simultaneously treating burn patients. Aim: To study burn demography and describe changes in burn management protocol during COVID-19 pandemic. Materials and Methods: This descriptive study was done from March to July 2020, during the COVID-19 pandemic’s initial stages in India, at a tertiary care hospital in Southern India. During these months, screening protocol and guidelines for admission and testing of patients for COVID-19 were followed as given by Indian Council of Medical Research (ICMR). All burn patients who visited the hospital’s Emergency Room (ER) during this period were included in the study. Those patients whose records were incomplete were excluded from the study. Detailed documentation was done of patient’s burn history, travel history and contact history by healthcare workers wearing level 1 Personal Protection Equipment (PPE). Demographic details were collected and entered into Microsoft excel spread sheet and the percentages were calculated. Results: A total of 77 burn patients visited the ER and 44 patients required admission. A total of 22 (50%) of the admissions were children. A total of 45 patients (58.44%) had sustained scald burns, 23 patients (29.87%) sustained flame burns and nine patients (11.69%) sustained electric burns. Thirty two patients sustained burns upto 20% and 12 patients had major burns (>20%). Nine patients underwent surgery. There were two fatalities. All patients were seen by healthcare workers wearing level 1 PPE. No COVID-19 positive patient was reported during our study period. Conclusion: There was an increase in paediatric burn accidents during the COVID-19 pandemic in India due to crowded and congested homes and a lack of continuous supervision from adults otherwise occupied with work done remotely from home. It is routine practice to admit only critical burn patients or in situations where home care is not possible. Minor burns dressing must be done at home instead of; at Out Patient Department (OPD) visit. Lifesaving surgeries in children were done using live skin donor. Diagnosis, treatment, physiotherapy and follow-up of patients through tele-consultation to avoid spread of COVID19 virus was encouraged. [ABSTRACT FROM AUTHOR]

Surface wetting prevents surface fogging on transparent materials by facilitating filmwise condensation with specific chemistry, but suffers from material and geometry selectivity. Extreme environments associated with high humidity and mechanical loading further limit their anti‐fogging persistence. Here, a stretchable anti‐fogging tape (SAT) that can be applied to diverse transparent materials with varied curvatures for persistent fogging prevention is reported. The SAT consists of three synergistically combined transparent layers: i) a stretchable and tough layer with large elastic recovery, ii) an endurant anti‐fogging layer insensitive to ambient humidity, and iii) a robustly and reversibly adhesive layer. The SAT maintains high total transmittance (>90%) and low diffuse transmittance (<5%) in high‐humidity environments, under various modes of mechanical deformations, and over a prolonged lifetime (193 days tested so far). Two applications are demonstrated, including the SAT‐adhered eyeglasses and goggles for clear fog‐free vision, and the SAT‐adhered condensation cover for efficient solar‐powered freshwater production. [ABSTRACT FROM AUTHOR]

A face mask is a vital component of personal protective equipment to prevent potentially contagious respiratory infections. There was a lack of evidence showing the proportion and determinants of face mask use in Ethiopia. Therefore, this study aimed to identify face mask utilization determinants to prevent spread of the Covid-19 pandemic among quarantined adults in Tigrai region, northern Ethiopia. A total of 331 participants selected using a systematic random sampling method were included in the study. An interviewer-administered questionnaire was employed. After describing the variables using frequencies, means, and standard deviations, multivariable logistic regression determined factors associated with face mask utilization to prevent COVID-19 spread. The study participants were primarily males (70%) and mean age was 30.5 (SD = 11) years. Nearly half of the participants reported they did not wear a face mask when leaving home. Face mask utilization was significantly associated with knowledge score, employment status, gender, age, and educational status of the study participants. [ABSTRACT FROM AUTHOR]

Purpose Of Review: Personal protection equipment (PPE)-associated headache is an unusual secondary headache disorder that predominantly occurs in healthcare workers as a consequence of the donning of protective respirators, face masks and/or eyewear. The appreciation of this entity is important given the significant ramifications upon the occupational health of healthcare workers and could additionally have an impact on persons living with pre-existing headache disorder(s).Recent Findings: There has been a renewed interest and recognition of PPE-associated headaches amongst healthcare professionals, largely brought about by the ongoing COVID-19 pandemic which has besieged healthcare systems worldwide. De novo PPE-associated headaches may present with migrainous or tension-type features and can be viewed as a subtype of external compression headache. The prognosis of the disorder is generally favourable, given that most headaches are short-lived without long-term sequalae. Several aetiologies have been postulated to account for the development of these headaches. Notably, these headaches can affect the occupational health and work performance of healthcare workers. In this review, we discuss the epidemiology, clinical characteristics, probable etiopathogenesis, management and prognosis of PPE-associated headaches in the context of the COVID-19 pandemic. Future directions for research and PPE development are proposed. [ABSTRACT FROM AUTHOR]

Introduction: The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) virus has affected many people in India in 2020. This has put a huge strain on hospitals and healthcare workers. Burn patients usually require hospitalisation and surgery, which adds to the burden of care provided by healthcare workers. Modifications in management protocol during a pandemic are of utmost importance to prevent transmission of Coronavirus Disease-2019 (COVID-19) while simultaneously treating burn patients. Aim: To study burn demography and describe changes in burn management protocol during COVID-19 pandemic. Materials and Methods: This descriptive study was done from March to July 2020, during the COVID-19 pandemic’s initial stages in India, at a tertiary care hospital in Southern India. During these months, screening protocol and guidelines for admission and testing of patients for COVID-19 were followed as given by Indian Council of Medical Research (ICMR). All burn patients who visited the hospital’s Emergency Room (ER) during this period were included in the study. Those patients whose records were incomplete were excluded from the study. Detailed documentation was done of patient’s burn history, travel history and contact history by healthcare workers wearing level 1 Personal Protection Equipment (PPE). Demographic details were collected and entered into Microsoft Excel spread sheet and the percentages were calculated. Results: A total of 77 burn patients visited the ER and 44 patients required admission. A total of 22 (50%) of the admissions were children. A total of 45 patients (58.44%) had sustained scald burns, 23 patients (29.87%) sustained flame burns and nine patients (11.69%) sustained electric burns. Thirty two patients sustained burns upto 20% and 12 patients had major burns (>20%). Nine patients underwent surgery. There were two fatalities. All patients were seen by healthcare workers wearing level 1 PPE. No COVID-19 positive patient was reported during the study period. Conclusion: There was an increase in paediatric burn accidents during the COVID-19 pandemic in India due to crowded and congested homes and a lack of continuous supervision from adults otherwise occupied with work done remotely from home. It is routine practice to admit only critical burn patients or in situations where home care is not possible. Minor burns dressing must be done at home instead of; at Outpatient Department (OPD) visit. Lifesaving surgeries in children were done using live skin donor. Diagnosis, treatment, physiotherapy and follow-up of patients through teleconsultation to avoid spread of COVID19 virus was encouraged.

This paper presents the influence of fabric structures and stab angles on single-pass stab impact and the repeated and multi-angle stabbings of 3-dimensional (3D) warp interlock structural fabrics based on the high-molecular-weight polyethylene (HMWPE) yarns. Five kinds of samples with different structures were experimentally tested using the drop weight stabbing impact equipment at the same impact energy. Radar charts are plotted to demonstrate the differences among different parameters to a better understanding and a more global characterization of single-pass stabbing impact. An image analysis methodology of Structure From Motion (SFM) is used to compare the fabric deformation in Z direction after the stabbing tests. Results indicated that fabric structures have significant effects on the stab impact property that the orthogonal/through-the-thickness interlock fabric has a good stab impact resistance. Besides, the fabric with stab angle of 90° exhibited better single-pass stab impact property than the counterparts with stab angle of 0°. More importantly, the double-pass stabbing tests are compared to the ones of the single-pass stabbing which shows that a better condition occurs when the stab angles are identical in each pass.

• This systematic review and meta-analysis evaluated the effectiveness of the use of masks to prevent SARS-CoV-2 transmission. • This study demonstrated the protective effects of masks against COVID-19 infection on HCWs and other populations. • The detailed analysis in different populations, countries and mask types were conducted to better clarify the effectiveness of wearing masks. Based on the status of the COVID-19 global pandemic, there is an urgent need to systematically evaluate the effectiveness of wearing masks to protect public health from COVID-19 infection. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement was consulted to report this systematic review. We conducted a systematic review and meta-analysis to evaluate the effectiveness of using face masks to prevent the spread of SARS-CoV-2. Relevant articles were retrieved from PubMed, Web of Science, ScienceDirect, Cochrane Library, and Chinese National Knowledge Infrastructure, VIP (Chinese) database. There were no language restrictions. This study was registered with PROSPERO under the number CRD42020211862. A total of 6 studies were included, involving 4 countries, after a total of 5,178 eligible articles were searched in databases and references. In general, wearing a mask was associated with a significantly reduced risk of COVID-19 infection (OR = 0.38, 95% CI: 0.21-0.69, I2 = 54.1%). For the healthcare workers group, masks were shown to have a reduced risk of infection by nearly 70%. Sensitivity analysis showed that the results were robust. The results of this systematic review and meta-analysis support the conclusion that wearing a mask could reduce the risk of COVID-19 infection. Robust randomized trials are needed in the future to better provide evidence for these interventions. [ABSTRACT FROM AUTHOR]

Personal protective equipment (PPE) is always considered the last and sometimes the most important safety shield against pesticides' hazards health risks. The spread of pests and low-quality pesticides, especially in developing countries, has increased health hazard potential among farmers. The present study aimed to assess farmers' health risks when using PPE (composite index) by exploring its most important predictive factors. A sample of 370 farmers in Ardabil province, Iran, was selected based on the multistage sampling method. The results reveal that most farmers use three types of PPE when applying pesticides. Based on their perception of pesticides' health risk, the number of PPE used differs. The highest health hazard in using PPE and the minimum perception of health risks caused by pesticides among farmers are related to the pesticides Paraquat and Chlorpyrifos. Also, the most important predictive factors of the composite index were found to be farm size, pesticides' health risk perception, previous experiences with harmful effects of chemical pesticides on health (especially among large-scale farmers), training courses, and ability to afford PPE-related costs, respectively. Accordingly, farmers' safety and health programs in the region should focus on reducing or replacing the mentioned high-risk pesticides. Reducing government subsidies for high-risk pesticides, establishing government subsidies for farmers' PPE, providing extension training (especially for small-scale farmers), and receiving ongoing training feedback to improve farmers' health risk perception of pesticides and the need to use PPE will effectively reduce farmers' health risks. [ABSTRACT FROM AUTHOR]

Objective: Examine the effect of a universal facemask policy for healthcare workers (HCW) and incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity. Methods: Daily number of symptomatic HCW tested, SARS-CoV-2 positivity rates, and HCW job-descriptions were collected pre and post Universal HCW facemask policy (March 26, 2020). Multiple change point regression was used to model positive-test-rate data. SARS-CoV-2 testing and positivity rates were compared for pre-intervention, transition, post-intervention, and follow-up periods. Results: Between March 12 and August 10, 2020, 19.2% of HCW were symptomatic for COVID-19 and underwent SARS-CoV-2 testing. A single change point was identified-March 28-30 (95% probability). Before the change point, the odds of a tested HCW having a positive result doubled every 4.5 to 7.5 days. Post-change-point, the odds of a tested HCW having a positive result halved every 10.5 to 13.5 days. Conclusions: Universal facemasks were associated with reducing HCW's risk of acquiring COVID-19. [ABSTRACT FROM AUTHOR]