Medical masks have been shown to significantly influence speech communication in healthy people. The effect of mask-wearing on phonatory capability and daily communication exchanges in patients with voice disorders remains unclear. To evaluate the effect of the medical mask on acoustic parameters in patients with a voice disorder, we measured the voice frequency, quality, and intensity.

Thirty-three healthy and 44 voice disorder patients were involved in this study, including 27 patients with vocal-fold lesions and 17 with primary functional dysphonia. Perceptual evaluation and acoustic parameters, including F0 (fundamental frequency), jitter, shimmer, and maximum vocal intensity, were analyzed without and with medical masks.

With medical mask-wearing, the maximum vocal intensity significantly decreased in all patients with voice disorders (p < 0.05), especially in patients with lesions of vocal folds (p < 0.05) and functional dysphonia (p < 0.05). The perceptual evaluation roughness scales also increased in patients with lesions of vocal folds (p < 0.05) and functional dysphonia (p < 0.05) with mask-wearing. There were no significant effects of mask-wearing on acoustic parameters for healthy participants.

The intensity was influenced when wearing medical masks in patients with disordered voices. The voice perceptual roughness scales also significantly increased compared to those without medical masks.

Health Workers Safety (HWS) is a global health priority and essential at all times, in stable situations, in emergencies, in disease epidemics or pandemics. This study aimed to assess HWS during the COVID-19 Pandemic.

This cross-sectional study was conducted in 2022 in east Azerbaijan province, Iran. HWS was assessed based on 22 indicators suggested by WHO EMRO. We selected 15 PHC facilities and six wards from two hospitals randomly. Data collected (qualitative and quantitative) using national digital health records, staff records, and indicator-specific tools. In addition to measuring the indicator's value, the indicators' feasibility was also assessed. Descriptive and inferential statistics with SPSS-16 were used for data analysis.

Totally, 325 Health Workers (HWs) (218 from PHC facilities and 107 from hospitals) participated in the study. Most of the participants in PHC facilities and hospitals were Community Health Workers (CHWs) (Moragheb Salamat) (45.4%) and nurses (37.38%), respectively. Most of HWs had completed the full vaccination schedule for Hepatitis B and COVID-19. Personal Protective Equipment (PPE) safety protocols were adhered by most of HWs within a healthcare facility. None of managers had attended nationally certified training for mental health support for health and care workers. Less than 20% of HWs participated in the work burnout prevention courses and most of HWs complained about work overload, or burnout. The job satisfaction level of hospital HWs (60.20%) was significantly higher than that of HWs from PHC facilities (57.18%) (P < 0.001).

Even though the mental health of HWs was not as expected, the indicators related to physical health and occupational health were at a suitable level. Also, there is not a system in PHC to audit the application of safety measures to mitigate the risk of contracting COVID-19. We recommend creating a specific system (precise and detailed) for HWs' safety and applying safety measures in the PHC routine programs.

Personal protective equipment (PPE) has attracted more attention since the outbreak of the epidemic in 2019. Advanced nano techniques, such as electrospinning, can provide new routes for developing novel PPE. However, electrospun antibacterial PPE is not easily obtained. Fibers loaded with photosensitizers prepared using single-fluid electrospinning have a relatively low utilization rate due to the influence of embedding and their inadequate mechanical properties. For this study, monolithic nanofibers and core-shell nanofibers were prepared and compared. Monolithic F1 fibers comprising polyethylene oxide (PEO), poly(vinyl alcohol-co-ethylene) (PVA-co-PE), and the photo-antibacterial agent vitamin K3 (VK3) were created using a single-fluid blending process. Core-shell F2 nanofibers were prepared using coaxial electrospinning, in which the extensible material PEO was set as the core section, and a composite consisting of PEO, PVA-co-PE, and VK3 was set as the shell section. Both F1 and F2 fibers with the designed structural properties had an average diameter of approximately 1.0 μm, as determined using scanning electron microscopy and transmission electron microscopy. VK3 was amorphously dispersed within the polymeric matrices of F1 and F2 fibers in a compatible manner, as revealed using X-ray diffraction and Fourier transform infrared spectroscopy. Monolithic F1 fibers had a higher tensile strength of 2.917 ± 0.091 MPa, whereas the core-shell F2 fibers had a longer elongation with a break rate of 194.567 ± 0.091%. Photoreaction tests showed that, with their adjustment, core-shell F2 nanofibers could produce 0.222 μmol/L ·OH upon illumination. F2 fibers had slightly better antibacterial performance than F1 fibers, with inhibition zones of 1.361 ± 0.012 cm and 1.296 ± 0.022 cm for E. coli and S. aureus, respectively, but with less VK3. The intentional tailoring of the components and compositions of the core-shell nanostructures can improve the process-structure-performance relationship of electrospun nanofibers for potential sunlight-activated antibacterial PPE.

A new generation of an FFP2 (Filtering Face Piece of type 2) smart face mask is achieved by integrating broadband hybrid nanomaterials and a self-assembled optical metasurface. The multifunctional FFP2 face mask shows simultaneously white light-assisted on-demand disinfection properties and versatile biosensing capabilities. These properties are achieved by a powerful combination of white light thermoplasmonic responsive hybrid nanomaterials, which provide excellent photo-thermal disinfection properties, and optical metasurface-based colorimetric biosensors, with a very low limit of pathogens detection. The realized system is studied in optical, morphological, spectroscopic, and cell viability assay experiments and environmental monitoring of harmful pathogens, thus highlighting the extraordinary properties in reusability and pathogens detection of the innovative face mask.

The aim of this study is to understand the significance of a disaster-related competence framework for Portuguese general nurses and identify from ICN - Core Competencies in Disaster Nursing version 2.0 core competencies description, those that are considered crucial for a competent preparedness and response in disaster scenarios.

Research suggests that the occurrence of disasters will be more recurrent, requiring that nurses, pillars of any health system, have knowledge, skills and preparedness to face these events.

An exploratory, cross-sectional qualitative study was carried out. Delphi method was used for data collection.

The study group consisted of technical-scientific council's presidents or coordinators/directors of nursing courses, nurses integrated in the Portuguese Council of Nurses and National Nursing Specialty Colleges and nurses with experience in the field of disasters.

Findings revealed that there is consensus on sixteen competencies, considered relevant for developing general nurse knowledge and competence, both at a national or international level, in the field of disasters.

The development of these competencies which establishes practice standards, building nurses skills and knowledge and ultimately, influencing nursing level-entry curricula's, conferring professional autonomy and self-regulation, in the field of disaster are fundamental. Furthermore, this study may serve as a reference for future alignment of competency frameworks between European Union countries or others.

Due to their excellent properties, antimicrobial fiber membranes are widely applied in bioprotective materials. This work addresses the preparation of thermoplastic polyurethane (TPU)-based fiber membranes with active antimicrobial properties. 2-hydroxypropyl trimethyl ammonium chloride-terminated hyperbranched polymer (HBP-HTC) was synthesized and used as an antimicrobial agent. The fiber membranes were obtained by electrospinning a mixed solution of HBP-HTC and TPU. Different electrospinning conditions were investigated, such as the spinning voltage and drum rotation speed. The fiber membrane prepared under a 22 kV anode voltage and 100 rpm rotation speed had an average fiber diameter of 1.66 μm with a concentrated diameter distribution. Antibacterial tests showed that when the fiber membrane was loaded with 1500 mg/kg of HBP-HTC, the antibacterial rates of E. coli as well as S. aureus both reached 99.99%, exhibiting excellent proactive antimicrobial performance. Moreover, the protective performance of the fiber membrane was outstanding, with a filtration efficiency of 99.9%, a hydrostatic pressure resistance greater than 16,758 Pa, and a moisture permeability of 2711.0 g⋅(m2⋅d)-1.

Virucidal filter materials were prepared by electrospinning a solution of 28 wt % poly(vinylidene difluoride) in N,N-dimethylacetamide without and with the addition of 0.25 wt %, 0.75 wt %, 2.0 wt %, or 3.5 wt % Cu(NO3)2 · 2.5H2O as virucidal agent. The fabricated materials had a uniform and defect free fibrous structure and even distribution of copper nanoclusters. X-ray diffraction analysis showed that during the electrospinning process, Cu(NO3)2 · 2.5H2O changed into Cu2(NO3)(OH)3. Electrospun filter materials obtained by electrospinning were essentially macroporous. Smaller pores of copper nanoclusters containing materials resulted in higher particle filtration than those without copper nanoclusters. Electrospun filter material fabricated with the addition of 2.0 wt % and 3.5 wt % of Cu(NO3)2 · 2.5H2O in a spinning solution showed significant virucidal activity, and there was 2.5 ± 0.35 and 3.2 ± 0.30 logarithmic reduction in the concentration of infectious SARS-CoV-2 within 12 h, respectively. The electrospun filter materials were stable as they retained virucidal activity for three months.

During the severe acute respiratory syndrome coronavirus 2 pandemic, hospital resources, particularly critical care units, were overburdened and this had a significant impact on both the therapies and the prognosis of these patients. This study aimed to identify factors and therapies that may improve prognosis and other factors associated with increased mortality. A secondary objective was to evaluate the impact that obesity had on these patients. An observational study was conducted on 482 patients aged 18 years or older who were diagnosed with SARS-CoV-2 pneumonia and admitted to the Intensive Care Units of 3 national hospitals registered in the CIBERESUCICOVID database between September 2020 and March 2021. After identifying the sample profile, risk factors were analyzed, the predictive model was constructed, and crude odd ratios were calculated for each factor. Additionally, logistic regression was used to build the multivariate model adjusting for potential confounders. The final model included only the variables selected using the Backward method. A sample of 335 men (69.5%) and 145 women (30.08%) aged 61.94 ± 12.75 years with a body mass index (BMI) of 28.05 (25.7; 31.2) was obtained. A total of 113 patients received noninvasive mechanical ventilation. The most common comorbidities were: high blood pressure (51.04%), obesity (28%), diabetes mellitus (23.44%), other metabolic diseases (21.16%), chronic heart failure (18.05%), chronic obstructive pulmonary disease (11.62%), and chronic kidney disease (10.16%). In-hospital, 3-month and 6-month post-discharge mortality in patients with BMI > 30 (n = 135) versus BMI ≤ 30 (n = 347) was significantly different (P = .06). Noninvasive mechanical ventilation failed in 42.4% of patients with BMI > 30 compared to 55% of patients with BMI ≤ 30. This study identified the factors associated with failure of mechanical ventilation. The most common comorbidities were congestive heart failure, high blood pressure, chronic kidney disease, severe liver disease, diabetes mellitus, and solid organ transplantation. In terms of ventilatory support, patients who received high-flow nasal oxygen therapy on admission had lower mortality rates. The use of renal replacement therapy was also significantly associated with higher mortality.

World Health Organization declared the coronavirus disease (COVID-19) as a global pandemic on March 11, 2020. The aim of this study was to determine the effectiveness and reliability of voice analysis performed with surgical masks and respirators during the pandemic and to discuss its routine applicability.

This prospective study included 204 patients who applied to our clinic between the ages of 18 and 55, whose preoperative SARS-Cov-2 PCR tests were negative. Voice analyses were performed on each patient without a mask, with a surgical mask and with a valved face-filtering piece-3 (FFP3) respirator respectively. The F0, shimmer, jitter, s/z ratio, maximum phonation time and harmonic/noise ratio (HNR) values obtained from the voice analyses were compared with each other.

No significant difference was found in terms of F0, Jitter, Shimmer, HNR, s/z and maximum phonation time values in the voice analyses performed without a mask and with a surgical mask. With an FFP3, a significant difference was found in only the Shimmer and HNR values compared to the other analysis values. When we look at the data with sex distinction, in the group of female and male patients, when the data of voice analysis obtained in three situations were compared, different results were obtained from the female and male group.

In conclusion, it should be decided by the physician to perform the voice analysis with a surgical mask or with an FFP3, considering the clinically desired parameters.

The contamination of coastal ecosystems by personal protective equipment (PPE) emerged as a significant concern immediately following the declaration of the COVID-19 pandemic by the World Health Organization (WHO). Hence, numerous studies have assessed PPE occurrence on beaches worldwide. However, no predictors on PPE contamination was so far pointed out. The present study investigated social and landscape drivers affecting the PPE density in coastal environments worldwide using a meta-analysis approach. Spatial variables such as urban modification levels, coastal vegetation coverage, population density (HPD), distance from rivers (DNR), and poverty degree (GGRDI) were derived from global satellite data. These variables, along with the time elapsed after WHO declared the pandemic, were included in generalized additive models as potential predictors of PPE density. HPD consistently emerged as the most influential predictor of PPE density (p < 0.00001), exhibiting a positive effect. Despite the presence of complex non-linear relationships, our findings indicate higher PPE density in areas with intermediate GGRDI levels, indicative of emerging economies. Additionally, elevated PPE density was observed in areas located further away from rivers (p < 0.001), and after the initial months of the pandemic. Despite the uncertainties associated with the varied sampling methods employed by the studies comprising our database, this study offers a solid baseline for tackling the global problem of PPE contamination on beachesguiding monitoring assessments in future pandemics.

(1) Background: COVID-19 presented many challenges to effective treatments, such as managing cardiovascular insufficiency while mitigating risks to healthcare providers. This study utilized NICaS, a non-invasive hemodynamic monitor that provides advanced data via whole-body impedance analysis. We investigated the associated trends in hemodynamic parameters obtained by the NICaS device and their correlation with in-hospital all-cause mortality during COVID-19 hospitalization in the intensive care unit. (2) Methods: Data from 29 patients with COVID-19 admitted to the intensive care unit and monitored with NICaS between April 2020 and February 2021 were analyzed retrospectively. (3) Results: Decreasing cardiac output and cardiac power were significantly associated with death. Total peripheral resistance was significantly increasing in non-survivors as was total body water percentage. Those admitted with a heart rate above 90 beats per minute had a significantly reduced survival. (4) Conclusions: Non-invasive hemodynamic monitoring via the NICaS device is simple and effective in evaluating critically ill patients with COVID-19 and may help guide clinical management via remote monitoring. Controlling tachycardia may help ensure adequate oxygen supply-demand ratio. A hint toward a beneficiary effect of a restrictive fluid balance may be observed.

This study presents a 3D medical simulation that employs reinforcement learning (RL) and interactive reinforcement learning (IRL) to teach and assess the procedure of donning and doffing personal protective equipment (PPE). The simulation is motivated by the need for effective, safe, and remote training techniques in medicine, particularly in light of the COVID-19 pandemic. The simulation has two modes: a tutorial mode and an assessment mode. In the tutorial mode, a computer-based, ill-trained RL agent utilizes RL to learn the correct sequence of donning the PPE by trial and error. This allows students to experience many outlier cases they might not encounter in an in-class educational model. In the assessment mode, an IRL-based method is used to evaluate how effective the participant is at correcting the mistakes performed by the RL agent. Each time the RL agent interacts with the environment and performs an action, the participants provide positive or negative feedback regarding the action taken. Following the assessment, participants receive a score based on the accuracy of their feedback and the time taken for the RL agent to learn the correct sequence. An experiment was conducted using two groups, each consisting of 10 participants. The first group received RL-assisted training for donning PPE, followed by an IRL-based assessment. Meanwhile, the second group observed a video featuring the RL agent demonstrating only the correct donning order without outlier cases, replicating traditional training, before undergoing the same assessment as the first group. Results showed that RL-assisted training with many outlier cases was more effective than traditional training with only regular cases. Moreover, combining RL with IRL significantly enhanced the participants' performance. Notably, 90% of the participants finished the assessment with perfect scores within three iterations. In contrast, only 10% of those who did not engage in RL-assisted training finished the assessment with a perfect score, highlighting the substantial impact of RL and IRL integration on participants' overall achievement.

Personal protective equipment (PPE) is critical to the safety of health professionals and vital to clinical practice. However, there is little known about the cognitive and emotional impact of PPE on health professionals' performance, comfort, and well-being.

A mixed-method, cross-sectional, observational study was adopted. An online survey consisting of 5-point Likert scale questions and free-text comments canvassed the opinions of patient-facing health professionals.

An overall negative impact of PPE on health professionals' ability to carry out work was found from 185 responses from medicine, nursing, and allied health disciplines, including increased fatigue, poor communication, and feeling uncomfortable.

There are significant negative impacts of PPE on health professionals' ability to carry out work, impairing communication, task efficiency, and comfort. Personal protective equipment is an essential infection control practice requiring further research, design, and testing to overcome challenges.

Personal protective equipment has important environmental impacts, assessing these impacts is therefore an important element of personal protective equipment design. We applied carbon footprinting methodology to Bubble-PAPR™, a novel, part-reusable and part-recyclable powered air-purifying respirator, designed at our institution. Current guidance states that disposable respirator masks can be worn for 1-h in the United Kingdom, whilst the Bubble-PAPR™ allows prolonged use.

Following a detailed use-case analysis, the carbon footprint of each component was estimated using a bottom-up (attributional) cradle-to-grave process-based analysis. Modelling considered the use of virgin or closed loop recycled polyvinyl chloride for the disposable hood element, and disposal via infectious or recycling waste streams to estimate a per-use carbon footprint.

The per-use carbon footprint with manufacture from virgin polyvinyl chloride and disposal via incineration is 0.805 kgCO2e. With nine cycles of closed loop recycling and manufacture of the polyvinyl chloride hood (10 uses), the carbon footprint falls to an average of 0.570 kgCO2e per use.

Carbon footprinting may contribute to the value proposition of this novel technology. We estimate that a single Bubble-PAPR™ use has a higher carbon footprint than disposable respirator mask-based PPE. However, this is mitigated in circumstances when multiple disposable mask changes are required (e.g. prolonged use) and use may be justifiable when user comfort, visualisation and communication with patients and colleagues are essential.

Older people hospitalized for COVID-19 are a vulnerable group due to the disease itself, aging and often loss of hearing and vision. Person-centered care, where patients have opportunities to communicate and participate in their own care, is important. However, because healthcare staff needed to wear personal protective equipment during the pandemic, to protect the patients and themselves, providing person-centered care was often difficult. This study aims to describe older hospitalized patients' experiences both of being cared for, while having COVID-19, and of the care provided by healthcare staff wearing PPE.

Fourteen older patients, over 65 years of age, were interviewed, and the data were analyzed using qualitative content analysis. The study adhered to Consolidated criteria for reporting qualitative research guidelines.

Three subthemes and one overall theme, "The desire for survival overshadows difficulties", emerged in the analysis. The main findings revealed that the older hospitalized patients experienced the care they received from the healthcare staff as satisfactory. The older patients reported understanding and accepting that the pandemic situation meant that their ability to participate in their own care and communicate with healthcare staff were given lower priority.

Older hospitalized patients need to be provided person-centered care, and situations such as a pandemic are no exception. Care tasks that are not acute in nature, e.g., planning for patients' return home, could be conducted by healthcare staff not required to wear PPE.

This study explores fears and worries regarding SARS-CoV-2 risk of infection and transmission to relatives, co-workers, and patients in relation to non-pharmacological preventive interventions among healthcare workers (including physicians, nurses, aides, cleaners, maintenance, and security staff) in a healthcare institution in Barcelona (Spain), during the first and second waves of the SARS-CoV-2 pandemic.

The research used an explorative qualitative approach. Six focus groups and ten individual interviews were conducted online and audio-recorded, transcribed verbatim and analysed using thematic analysis and mixed coding.

Forty professionals participated in the study. Four common themes emerged in all groups: challenges related to the lack of pandemic preparedness, concerns about personal protective equipment, unclear guidelines for case and contact tracing, and communication-related difficulties.

This study emphasizes the key recommendations to improve non-pharmacological preventive interventions to reduce workers' fears and worries about the risk of infection and spreading the infection to others, including families. Above all, these should include ensuring the availability, and correct use of adequate personal protective equipment, improve guidelines on case and contact tracing, and setting effective communication channels for all workers of the organization. These recommendations must be reinforced in maintenance and security personnel, as well as night shift nurses and aides, to also reduce health inequalities.

The availability and correct use of personal protective equipment (PPE) to prevent and control infections plays a critical role in the safety of medical students in clinical placements. This study explored their experiences and perspectives in their final clerkship year with PPE during the COVID-19 pandemic.

This qualitative study was based on social constructivism and was conducted in 2021 at the Charité - Universitätsmedizin Berlin. In three online focus group discussions, 15 medical students in their final clerkship year reported their experiences with PPE training and use during the COVID-19 pandemic. Data were recorded, transcribed and analysed based on Kuckartz's approach to content analysis. We drew upon the a priori dimensions of the capability, opportunity, motivation - behaviour (COM-B) model as main categories as well as emergent issues raised by the study participants (subcategories).

In addition to the three main categories of the COM-B model, eleven subcategories were identified through inductive analysis. The study participants reported several factors that hindered the correct use of PPE. In the area of capabilities, these factors were related to learning experience with PPE in terms of both theoretical and practical learning together with later supervision in practice. In the area of opportunities, these factors included the limited availability of some PPE components, a lack of time for PPE instruction and supervision and inappropriate role modelling due to the inconsistent use of PPE by physicians and nursing staff. The area of motivation to use PPE was characterized by an ambivalent fear of infection by the SARS-CoV-2 virus and the prioritization of patient safety, i.e., the need to prevent the transmission of the virus to patients.

Our study revealed several limitations pertaining to the enabling factors associated with the trainable behaviour "correct use of PPE". The concept of shared responsibility for student safety was used to derive recommendations for future improvement specifically for the medical school as an organization, the teachers and supervisors, and students themselves. This study may guide and stimulate other medical schools and faculties to explore and analyse components of student safety in clinical settings in times of infectious pandemics.

To qualitatively examine the impact of COVID-19 on nursing homes over the course of the pandemic from the perspective of nursing home administrators.

In-depth, semi-structured interviews with nursing home administrators, repeated 3 months apart for a total of 4 each from July 2020 through December 2021.

Administrators from a total of 40 nursing homes from 8 health care markets across the United States.

Interviews were conducted virtually or via phone. The research team identified overarching themes using applied thematic analysis, and iteratively coded transcribed interviews.

Nursing home administrators across the United States reported challenges of managing nursing homes during a pandemic. We found their experiences could generally be categorized into 4 stages, not necessarily coinciding with surge levels of the virus. The initial stage was characterized by fear and confusion. The second stage, by a "new normal," a term administrators used to report feeling better prepared for an outbreak and how residents, staff, and families began to adjust to life with COVID. Administrators started using the phrase "a light at the end of the tunnel" to describe the third stage, characterized by the hope associated with the availability of vaccinations. The fourth stage was marked by "caregiver fatigue" as nursing homes experienced numerous breakthrough cases. Some challenges, like staffing issues and uncertainty about the future, were reported throughout the pandemic, as was a continued mission to keep residents safe.

As the ability of nursing homes to provide safe, effective care faces unprecedented and continued challenges, the insights reported here from longitudinal perspectives of nursing home administrators may help policy makers develop solutions to encourage high-quality care. Knowing how the needs for resources and support vary across the progression of these stages has the potential to be helpful in addressing these challenges.

The COVID-19 pandemic has had a global impact on the environment and economy and has affected hospital administration and patient behaviour. Since human-to-human coronavirus transmission occurs via droplets and physical contact, health care professionals are particularly vulnerable to contracting COVID-19. Many cytopathology laboratories updated their workflow, established new standard biosafety protocols, and built digital pathology or telescope platforms to mitigate these risks and deal with the shortage of health care personnel. The COVID-19 pandemic also disrupted medical education-all indoor training events, including conferences, multidisciplinary tumour boards, seminars, and microscope inspections were postponed. As a result, many laboratories now use new web-based applications and platforms to maintain educational programs and multidisciplinary tumour boards. To comply with government directives, health care facilities postponed non-emergency surgeries, reduced the number of routine medical examinations, restricted visitor numbers, and scaled back cancer screening activities, resulting in a sharp decline in cytopathology diagnoses, cancer screening specimens, and molecular testing for cancer. Subsequent misses or delays in the diagnosis and treatment of cancer were not uncommon. This review aims to provide comprehensive summaries of the consequences of the COVID-19 pandemic for cytopathology, particularly in terms of cancer diagnosis, workload, human resources, and molecular testing.

The novel coronavirus pandemic (COVID-19) has necessitated a global increase in the use of face masks to limit the airborne spread of the virus. The global demand for personal protective equipment has at times led to shortages of face masks for the public, therefore makeshift masks have become commonplace. The severe acute respiratory syndrome caused by coronavirus-2 (SARS-CoV-2) has a spherical particle size of ~97 nm. However, the airborne transmission of this virus requires the expulsion of droplets, typically ~0.6-500 µm in diameter (by coughing, sneezing, breathing, and talking). In this paper, we propose a face covering that has been designed to effectively capture SARS-CoV-2 whilst providing uncompromised comfort and breathability for the wearer. Herein, we describe a material approach that uses amorphous silica microspheres attached to cotton fibres to capture bioaerosols, including SARS CoV-2. This has been demonstrated for the capture of aerosolised proteins (cytochrome c, myoglobin, ubiquitin, bovine serum albumin) and aerosolised inactivated SARS CoV-2, showing average filtration efficiencies of ~93% with minimal impact on breathability.

The purpose of the study was to investigate the effect of the surgical masks and N95 masks on the acoustic and aerodynamic parameters of voice assessment during the coronavirus disease 2019 pandemic. The challenge of the study was to enable each inexperienced participant to perform a number of acoustic and aerodynamic voice assessment in a qualified and homogeneous manner without and with medical masks, and to minimize the individual differences. There were 32 healthy participants recruited in the study, including 16 males and 16 females. The acoustic parameters analyzed included fundamental frequency, standard deviation of fundamental frequency (fundamental frequency standard deviation), percentage of jitter (%), percentage of shimmer (%), glottal-to-noise excitation ratio (GNE), and the parameters of irregularity, noise and overall severity. The aerodynamic parameters included s time, z time, s/z ratio and maximum phonation time. When wearing surgical masks, the GNE ratio (P = .043) significantly increased, whereas noise (P = .039) and s time (P = .018) significantly decreased. When wearing N95 masks, the percentage of shimmer (P = .049), s time (P = .037) and s/z ratio (P = .048) significantly decrease. In general, performing voice assessment with a medical mask proved to be reliable for most of the acoustic and aerodynamic parameters. It is worth noting that the shimmer (%), could be slightly impacted when wearing N95 masks. Wearing surgical masks might slightly influence the measurement of noise and higher GNE ratio. The s/z ratio could be affected when wearing N95 masks. The contribution of the study is to explore acoustic and aerodynamic parameters that might be easily affected by wearing masks during the voice assessment, and provide references for clinical evaluation of voice disorders during the pandemic of coronavirus disease 2019.

Appropriate use of personal protective equipment (PPE) could significantly reduce the risk of viral transmission and infection. This study aimed to assess the use of PPE among dentists during the COVID-19 pandemic in China, explore its influencing factors, and provide some practical recommendations.

An online cross-sectional survey was conducted among 384 Chinese dentists in September 2022. The questionnaire comprised a series of questions about demographic characteristics, compliance with proper PPE use, personal barriers to use, and exposure risk estimation.

Of the 384 respondents, 57.3% had unacceptable compliance with the proper use of PPE during COVID-19. Medical surgical mask is the most common for dental professionals to wear (93.8%), followed by goggles or face shield (63.8%), and isolation gown (53.1%). Unexpectedly, only 63.3% of respondents always change masks with guidelines. The condition for changing goggles/face shields and isolation gowns is even worse (45.6 and 37.0%, respectively). Visual barriers, physical discomfort, complex procedures, and heavy workload were the most common personal barriers to use. According to the results of Chi-square test and correlation analysis, PPE use compliance was associated with age, years of practice, medical institution type, and exposure risk estimation.

Chinese dental professionals need to improve their compliance with the proper use of PPE, especially those in the 31-40 age group, with 11-15 experience years and working in private dental clinics. Increasing compliance with PPE may be achieved by addressing personal barriers to use, human resource shortages, and perceptions of exposure risk.

Recent global outbreak of COVID-19 has raised serious awareness about our abilities to protect ourselves from hazardous pathogens and volatile organic compounds. Evidence suggests that personal protection equipment such as respiratory masks can radically decrease rates of transmission and infections due to contagious pathogens. To increase filtration efficiency without compromising breathability, application of nanofibers in production of respiratory masks have been proposed. The emergence of nanofibers in the industry has since introduced a next generation of respiratory masks that promises improved filtration efficiency and breathability via nanometric pores and thin fiber thickness. In addition, the surface of nanofibers can be functionalized and enhanced to capture specific particles. In addition to conventional techniques such as melt-blown, respiratory masks by nanofibers have provided an opportunity to prevent pathogen transmission. As the surge in global demand for respiratory masks increases, herein, we reviewed recent advancement of nanofibers as an alternative technique to be used in respiratory mask production.

The amount of aerosol generation associated with the use of positive pressure ventilation via a supraglottic airway device has not been quantified. We conducted a two-group, two-centre, prospective cohort study in which we recruited 21 low-risk adult patients scheduled for elective surgery under general anaesthesia with second-generation supraglottic airway devices. An optical particle sizer and an isokinetic sampling probe were used to record particle concentrations per second at different size distributions (0.3-10 μm) during use as well as baseline levels during two common activities (conversation and coughing). There was a median (IQR [range]) peak increase of 2.8 (1.5-4.5 [1-28.1]) and 4.1 (2.0-7.1 [1-18.2]) times background concentrations during SAD insertion and removal. Most of the particles generated during supraglottic airway insertion (85.0%) and removal (85.3%) were < 3 μm diameter. Median (IQR [range]) aerosol concentration generated by insertion (1.1 (0.6-5.1 [0.2-22.3]) particles.cm^-3 ) and removal (2.1 (0.5-3.0 [0.1-18.9]) particles.cm^-3 ) of SADs were significantly lower than those produced during continuous talking (44.5 (28.3-70.5 [2.0-134.5]) particles.cm^-3 ) and coughing (141.0 (98.3-202.8 [4.0-296.5]) particles.cm^-3 ) (p < 0.001). The aerosol levels produced were similar with the two devices. The proportion of easily inhaled and small particles (<1 μm) produced during insertion (57.5%) and removal (57.5%) was much lower than during talking (99.1%) and coughing (99.6%). These results suggest that the use of supraglottic airway devices in low-risk patients, even with positive pressure ventilation, generates fewer aerosols than speaking and coughing in awake patients.

Since the COVID-19 pandemic outbreak, over 760 million confirmed cases and over 6.8 million deaths have been reported globally, according to the World Health Organization. While the SARS-CoV-2 virus carried by COVID-19 patients can be identified though the reverse transcription-polymerase chain reaction (RT-PCR) test with high accuracy, clinical misdiagnosis between COVID-19 and pneumonia patients remains a challenge. Therefore, we developed a novel CovC-ReDRNet model to distinguish COVID-19 patients from pneumonia patients as well as normal cases. ResNet-18 was introduced as the backbone model and tailored for the feature representation afterward. In our feature-based randomized neural network (RNN) framework, the feature representation automatically pairs with the deep random vector function link network (dRVFL) as the optimal classifier, producing a CovC-ReDRNet model for the classification task. Results based on five-fold cross-validation reveal that our method achieved 94.94%, 97.01%, 97.56%, 96.81%, and 95.84% MA sensitivity, MA specificity, MA accuracy, MA precision, and MA F1-score, respectively. Ablation studies evidence the superiority of ResNet-18 over different backbone networks, RNNs over traditional classifiers, and deep RNNs over shallow RNNs. Moreover, our proposed model achieved a better MA accuracy than the state-of-the-art (SOTA) methods, the highest score of which was 95.57%. To conclude, our CovC-ReDRNet model could be perceived as an advanced computer-aided diagnostic model with high speed and high accuracy for classifying and predicting COVID-19 diseases.

A novel ZnO-MoO₃-ZnMoO₃@graphene GZM composite catalyst prepared by microwave hydrothermal process for personal protective equipment textiles (PPE) is presented in this study. The results indicated that the GZM with defect vacancy sites of two types as observed by EPR showed significantly superior inactivation of the E. coli bacteria compared to GZM without the lower defect vacancy sites and concomitant lower electron densities. Photocatalytic activated oxidation by the GZM composites coatings was observed to proceed in acceptable times as well as the bacterial inactivation (log bact. C/C_o > 10⁷ within 3 h). Defect sites in the GZM seem to be important leading to the bacterial inactivation process. DFT calculations on the GZM with and without catalyst defect sites were carried out. The electron densities were estimated by the Fourier mapping. The results found in this study showed the potential of GZM-PPE for practical applications.

Face masks have proven to be a useful protection from airborne viruses and bacteria, especially in the recent years pandemic outbreak when they effectively lowered the risk of infection from Coronavirus disease (COVID-19) or Omicron variants, being recognized as one of the main protective measures adopted by the World Health Organization (WHO). The need for improving the filtering efficiency performance to prevent penetration of fine particulate matter (PM), which can be potential bacteria or virus carriers, has led the research into developing new methods and techniques for face mask fabrication. In this perspective, Electrospinning has shown to be the most efficient technique to get either synthetic or natural polymers-based fibers with size down to the nanoscale providing remarkable performance in terms of both particle filtration and breathability. The aim of this Review is to give further insight into the implementation of electrospun nanofibers for the realization of the next generation of face masks, with functionalized membranes via addiction of active material to the polymer solutions that can give optimal features about antibacterial, antiviral, self-sterilization, and electrical energy storage capabilities. Furthermore, the recent advances regarding the use of renewable materials and green solvent strategies to improve the sustainability of electrospun membranes and to fabricate eco-friendly filters are here discussed, especially in view of the large-scale nanofiber production where traditional membrane manufacturing may result in a high environmental and health risk.

We aimed to design and produce a low-cost, ergonomic, hood-integrated powered air-purifying respirator (Bubble-PAPR) for pandemic healthcare use, offering optimal and equitable protection to all staff. We hypothesised that participants would rate Bubble-PAPR more highly than current filtering face piece (FFP3) face mask respiratory protective equipment (RPE) in the domains of comfort, perceived safety and communication.

Rapid design and evaluation cycles occurred based on the identified user needs. We conducted diary card and focus group exercises to identify relevant tasks requiring RPE. Lab-based safety standards established against British Standard BS-EN-12941 and EU2016/425 covering materials; inward particulate leakage; breathing resistance; clean air filtration and supply; carbon dioxide elimination; exhalation means and electrical safety. Questionnaire-based usability data from participating front-line healthcare staff before (usual RPE) and after using Bubble-PAPR.

Overseen by a trial safety committee, evaluation progressed sequentially through laboratory, simulated, low-risk, then high-risk clinical environments of a single tertiary National Health Service hospital.

15 staff completed diary cards and focus groups. 91 staff from a range of clinical and non-clinical roles completed the study, wearing Bubble-PAPR for a median of 45 min (IQR 30-80 (15-120)). Participants self-reported a range of heights (mean 1.7 m (SD 0.1, range 1.5-2.0)), weights (72.4 kg (16.0, 47-127)) and body mass indices (25.3 (4.7, 16.7-42.9)).

Preuse particulometer 'fit testing' and evaluation against standards by an independent biomedical engineer.Primary:Perceived comfort (Likert scale).Secondary: Perceived safety, communication.

Mean fit factor 16 961 (10 participants). Bubble-PAPR mean comfort score 5.64 (SD 1.55) vs usual FFP3 2.96 (1.44) (mean difference 2.68 (95% CI 2.23 to 3.14, p<0.001). Secondary outcomes, Bubble-PAPR mean (SD) versus FFP3 mean (SD), (mean difference (95% CI)) were: how safe do you feel? 6.2 (0.9) vs 5.4 (1.0), (0.73 (0.45 to 0.99)); speaking to other staff 7.5 (2.4) vs 5.1 (2.4), (2.38 (1.66 to 3.11)); heard by other staff 7.1 (2.3) vs 4.9 (2.3), (2.16 (1.45 to 2.88)); speaking to patients 7.8 (2.1) vs 4.8 (2.4), (2.99 (2.36 to 3.62)); heard by patients 7.4 (2.4) vs 4.7 (2.5), (2.7 (1.97 to 3.43)); all p<0.01.

Bubble-PAPR achieved its primary purpose of keeping staff safe from airborne particulate material while improving comfort and the user experience when compared with usual FFP3 masks. The design and development of Bubble-PAPR were conducted using a careful evaluation strategy addressing key regulatory and safety steps.

NCT04681365.

During the COVID-19 pandemic, the staff in the intensive care unit (ICU) was materially, physically and emotionally challenged. This qualitative study investigated the effects that ICU staff experienced and were considered of value to be permanently implemented.

ICU in an university medical centre during the first wave of the COVID-19 pandemic.

An opportunity-centric approach was applied in individual semi-structured interviews to optimise the achieved results and was guided by the theoretical model of appreciative inquiry (AI).

Fifteen ICU staff members (8 nurses and 7 intensivists) participated.

Working during the COVID-19 pandemic catalysed interprofessional collaboration and team learning in the ICU on an individual and team level, centred around a common goal: taking care of critically ill patients with COVID-19. The effect of interprofessional collaboration was that provisions were taken care of quicker than usual, without bureaucratic delays. However, this effect was experienced to be transient. Also, ICU staff perceived limited possibilities to help patients and families around the palliative phase, and they perceived a lack of appreciation from higher management. This is a point of future attention: how to make this perceived lack of appreciation more visible to all (ICU) staff.

Regarding our primary question, the ICU staff voiced that the direct communication and collaboration are the most important elements of the COVID-19 peak they would like to preserve. Furthermore, it was learnt that consolation and support for family members should not be forgotten. Considering the results, we believe that further research concerning team reflexivity might contribute to (or enhance) our knowledge about working together during and after a crisis.

Background Since the beginning of the novel coronavirus disease in Wuhan city of China in 2019 and its spreading worldwide and taking the form of a pandemic, many healthcare workers (HCWs) were affected by coronavirus disease 2019 (COVID-19) infection. Though we have used many types of personal protective equipment (PPE) kits while taking care of COVID-19 patients, we have seen COVID-19 susceptibility in different working areas were different. The pattern of infection in different working areas depended on HCWs following COVID-19 appropriate behavior. Therefore, we planned to estimate the susceptibility of front-line HCWs and second-line HCWs to getting COVID-19 infection. Aim To determine the risk of COVID-19 in front-line healthcare workers as compared to second-line healthcare workers. Method and materials We planned a retrospective cross-sectional analysis of COVID-19-positive healthcare workers from our institute within six months. Their nature of duty was analyzed and they were divided into two groups: 1) Front-line HCWs were defined as those who were working or who have worked in screening areas of the outpatient department (OPD) or COVID-19 isolation wards within the prior 14 days and provided direct care to patients with confirmed or suspected COVID-19. 2) Second-line HCWs were those who were working in the general OPD or non-COVID-19 areas of our hospital and did not have contact with COVID-19-positive patients. Results A total of 59 HCWs became COVID-19 positive during the study period, 23 as front-line and 36 as second-line HCWs. The mean (SD) duration of work as a front-line worker was 51 and as a second-line worker was 84.4 hours. Fever, cough, body ache, loss of taste, loose stools, palpitation, throat pain, vertigo, vomiting, lung disease, generalized weakness, breathing difficulty, loss of smell, headache, and running nose were present in 21 (35.6%), 15 (25.4%), 9 (15.3%), 10 (16.9%), 3 (5.1%), 5 (8.5%), 5 (8.5%), 1 (1.7%), 4 (6.8%), 2 (3.4%), 11 (18.6%), 4 (6.8%), 9 (15.3%), 6 (10.2%) and 3 (5.1%), respectively. To predict the risk of getting COVID-19 infection in HCWs, binary logistic regression with COVID-19 diagnosis as the output variable was modeled with hours of working in COVID-19 wards as front-line and second-line workers as independent variables. The results showed that there was a 1.18 times increased risk of acquiring the disease for every one-hour excess of working as a front-line worker, whereas, for second-line workers, it was slightly lower, with a 1.11 times increased risk for developing COVID-19 disease with every one hour increase in duty hours. Both these associations were statistically significant (p=0.001 for front-line and 0.006 for second-line HCWs). Conclusion COVID-19 has taught us the importance of COVID-19 appropriate behavior in preventing the spread of respiratory organisms. Our study has shown that both the front-line and second-line HCWs are at increased risk of getting the infection and proper use of a PPE kit or mask can decrease the spread of such respiratory pathogens.

During the first year of the COVID-19 pandemic, facemasks became mandatory, with a great preference for disposable ones. However, the benefits of face masks for health safety are counteracted by the environmental burden related to their improper disposal. An unprecedented influx of disposable face masks entering the environment has been reported in the last two years of the pandemic, along with their implications in natural environments in terms of their biodegradability, released contaminants and ecotoxicological effects. This critical review addresses several aspects of the current literature regarding the (bio)degradation and (eco)toxicity of face masks related contaminants, identifying uncertainties and research needs that should be addressed in future studies. While it is indisputable that face mask contamination contributes to the already alarming plastic pollution, we are still far from determining its real environmental and ecotoxicological contribution to the issue. The paucity of studies on biodegradation and ecotoxicity of face masks and related contaminants, and the uncertainties and uncontrolled variables involved during experimental procedures, are compromising eventual comparison with conventional plastic debris. Studies on the abundance and composition of face mask-released contaminants (microplastics/fibres/ chemical compounds) under pre- and post-pandemic conditions should, therefore, be encouraged, along with (bio)degradation and ecotoxicity tests considering environmentally relevant settings. To achieve this, methodological strategies should be developed to overcome technical difficulties to quantify and characterise the smallest MPs and fibres, adsorbents, and leachates to increase the environmental relevancy of the experimental conditions.

The development of fascinating materials with functional properties has revolutionized the humankind with materials comfort, stopped the spreading of diseases, relieving the environmental pollution pressure, economized government research funds, and prolonged their serving life. The outbreak of Coronavirus Disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has triggered great global public health concern. Face masks are crucial tools to impede the spreading of SARS-CoV-2 from human to human. However, current face masks exhibit in a variety of colors (opaque), like blue, black, red, etc., leading to a communication barrier between the doctor and the deaf-mute patient when wearing a mask. High optical transparency filters can be utilized for both personal protection and lip-reading. Thus, shaping face air filter into a transparent appearance is an urgent need. Electrospinning technology, as a mature technology, is commonly used to form nanofiber materials utilizing high electrical voltage. With the alteration of the diameters of nanofibers, and proper material selection, it would be possible to make the transparent face mask. In this article, the research progress in the transparent face air filter is reviewed with emphasis on three parts: mechanism of the electrospinning process and light transmission, preparation of transparent face air filter, and their innovative potential. Through the assessment of classic cases, the benefits and drawbacks of various preparation strategies and products are evaluated, to provide general knowledge for the needs of different application scenarios. In the end, the development directions of transparent face masks in protective gear, particularly their novel functional applications and potential contributions in the prevention and control of the epidemic are also proposed.

To report the details of provision of personal protective equipment to midwives during the COVID-19 pandemic in Peru METHODS: This is a non-experimental, descriptive, cross-sectional study. An online survey of 679 midwives working at public healthcare centres was conducted via questionnaires. The following aspects were outlined: method of supply and frequency of delivery of personal protective equipment, type of personal protective equipment provided by the institution, and self-purchase. Furthermore, features of the midwives' workplace were described. For statistical analysis, absolute frequencies and relative proportions were used for categorical variables, and mean and standard deviation were used for numerical variables.

The most important finding of this study is that a large proportion of midwives (66.6%) did not receive new personal protective equipment for each shift; 41.9% of midwives who received personal protective equipment during each shift exclusively provided services in the COVID-19 ward, whereas 27.6% did not. The least received supplies were of N95 respirator masks (41.7%) and disposable isolation suit gown (50.5%). Only a certain proportion of midwives (38.6%) were trained by their own institutions on the use of personal protective equipment.

The provision of personal protective equipment to midwives and training on personal protective equipment were insufficient at all workplaces. Therefore, measures must be taken to increase the supply of this material to midwives who are essential workers in reproductive health.

Waste generated by healthcare facilities during the COVID-19 pandemic has become a new source of pollution, particularly with the widespread use of single-use personal protective equipment (PPE). Releasing microplastics (MPs) and microfibers (MFs) from discarded PPE becomes an emerging threat to environmental sustainability. MPs/MFs have recently been reported in a variety of aquatic and terrestrial ecosystems, including water, deep-sea sediments, air, and soil. As COVID-19 spreads, the use of plastic-made PPE in healthcare facilities has increased significantly worldwide, resulting in massive amounts of plastic waste entering the terrestrial and marine environments. High loads of MPs/MFs emitted into the environment due to excessive PPE consumption are easily consumed by aquatic organisms, disrupting the food chain, and potentially causing chronic health problems in humans. Thus, proper management of PPE waste is critical for ensuring a post-COVID sustainable environment, which has recently attracted the attention of the scientific community. The current study aims to review the global consumption and sustainable management of discarded PPE in the context of COVID-19. The severe impacts of PPE-emitted MPs/MFs on human health and other environmental segments are briefly addressed. Despite extensive research progress in the area, many questions about MP/MF contamination in the context of COVID-19 remain unanswered. Therefore, in response to the post-COVID environmental remediation concerns, future research directions and recommendations are highlighted considering the current MP/MF research progress from COVID-related PPE waste.

Introduction Accurate and appropriate use of personal protective equipment (PPE) is an integral component in infection prevention and control policy to ensure healthcare workers' safety. Poor compliance with personal protective behaviours and inconsistent use of PPE has been identified as the main cause of transmission of nosocomial infections in healthcare settings and this reduced compliance is linked to many individual, environmental, and organizational factors. Therefore, the current study was carried out to identify various factors influencing PPE use among healthcare workers.  Materials and methods A descriptive cross-sectional survey has been carried out among healthcare workers selected from two selected tertiary care hospitals in central India. Data on compliance with PPE and factors influencing compliance were collected using a three-point rating scale and structured questionnaire. Quantile regression was performed to identify the factors associated with adherence to PPE use among healthcare workers. Results The median score for compliance with PPE use among healthcare workers was found to be 22 with an interquartile range (IQR) of 16-24. The multiple quantile regression found that variables such as occupation (p<0.001), institutional policy (p=0.003), quality of PPE (p=0.002), availability of PPE (p<0.001), and improper size (p=0.042) were significantly associated with PPE compliance by healthcare workers. Conclusion The current study highlights the importance of taking adequate measures by the government and healthcare organizations to eliminate various factors hindering PPE compliance levels among healthcare workers to ensure consistent use of PPE by healthcare workers to safeguard themselves and patients.

Health care professionals (HCP) were obliged to wear personal protective equipment (PPE) during pandemic in order to minimize the risk of transmission of the emerging virus. The objective of the study was to estimate the prevalence of adverse effects related to the wear of PPE among HCP and to determinate their predictive factors.

This was a cross-sectional study including a representative sample of 300 randomized HCP at Hedi Chaker University Hospital Sfax, Tunisia, during the period August-September 2021. Data collection was carried out by an anonymous self-administered questionnaire.

PPE related adverse effects were noted among 87 HCP with a prevalence of 57.2%. Multivariate analysis showed that factors independently associated with PPE adverse effects were female gender (Adjusted Odds Ratio (AOR) = 1.8; p = 0.048), chronic diseases (AOR = 0.29; p = 0.001) and previous infection with COVID-19 (AOR = 0.46; p = 0.004). Frequent use of bleach or other disinfection product without protection and use of hot water at work were independently associated with a high risk of adverse effects ((AOR = 2.22; p = 0.003) and (AOR = 2.83; p = 0.005), respectively). Similarly, a duration of use of PPE>4 h per day (AOR = 1.98; p = 0.039), as well as use of visors and/or glasses (AOR = 1.84; p = 0.045) were independently associated with PPE related adverse effects.

The prevalence of adverse effects related to the wear of PPE was alarmingly high among HCP. Multiple risk factors were highlighted, notably professional aspects. Adequate and repetitive training for caregivers on the correct use of PPE remain essential to manage this problem.

COVID-19 pandemic has affected all crucial aspects of daily life, including; food security, education, gender relation, mental health, and environmental air pollution, in addition to the impact of the lockdown that had far-reaching effects in different strata of life.

To study the impact of COVID-19 on people with respect to their mental and social suffering and consequences.

This cross sectional study was conducted during the period from November 2020 through August 2021. A sample of 1,000 attendants to four teaching hospitals and eight PHCCs, was collected. The mental and social sequels of COVID-19 were assessed for all participants whether previously infected or not.

Out of the total sample (1,000), 389 had a history of infection with COVID-19. The main mental symptoms reported were depression (67.8%), and anxiety (46.9%), males and females equally reported symptoms of anxiety, while depressive symptoms were reported more among females (59.9%), Fear and worries of the participants about their health and their families' was the main reason for mental symptoms (94.7%).

Symptoms of depression and anxiety in time of COVID-19 are prevalent. Suspending educational activities was the most social burden that affect people while increase the price of food and cessation of work were the main causes of economic burden.

Objective: Out-of-hospital cardiac arrest (OHCA) is a prominent cause of death worldwide. As indicated by the high proportion of COVID-19 suspicion or diagnosis among patients who had OHCA, this issue could have resulted in multiple fatalities from coronavirus disease 2019 (COVID-19) occurring at home and being counted as OHCA. Methods: We used the MeSH term "heart arrest" as well as non-MeSH terms "out-of-hospital cardiac arrest, sudden cardiac death, OHCA, cardiac arrest, coronavirus pandemic, COVID-19, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)." We conducted a literature search using these search keywords in the Science Direct and PubMed databases and Google Scholar until 25 April 2022. Results: A systematic review of observational studies revealed OHCA and mortality rates increased considerably during the COVID-19 pandemic compared to the same period of the previous year. A temporary two-fold rise in OHCA incidence was detected along with a drop in survival. During the pandemic, the community's response to OHCA changed, with fewer bystander cardiopulmonary resuscitations (CPRs), longer emergency medical service (EMS) response times, and worse OHCA survival rates. Conclusions: This study's limitations include a lack of a centralised data-gathering method and OHCA registry system. If the chain of survival is maintained and effective emergency ambulance services with a qualified emergency medical team are given, the outcome for OHCA survivors can be improved even more.

Endotracheal intubation is a procedure commonly performed in the emergency department (ED). Endotracheal intubation poses a risk of exposure to infectious aerosol droplets.

The present study aims to test the effect of using an aerosol box (AB) and personal protective equipment (PPE) on the intubation time while performing endotracheal intubation manikin.

The study participants (11 emergency specialists, 11 emergency physicians, and 11 general practitioners) performed endotracheal intubation on a training manikin in three different airway simulations. Simulation 1 had neither PPE nor AB, simulation 2 had PPE, and simulation 3 had both PPE and AB. The intubation times, the number of intubation attempts, and the discomfort caused by the AB were recorded.

There was no significant difference in the number of intubation attempts between the physicians according to their position and airway simulations (p > 0.05). There was a significant difference at all time points except for the time to endotracheal tube cuff inflation in three different airway simulations using PPE and an AB (p < 0.05). The median intubation times were longer using PPE and an AB.

The use of PPE and an AB significantly increases the total intubation time.

Aeromedical evacuation missions to transport highly infectious critical COVID-19 patients involve multiple factors, therefore planning is essential in their preparation. The management of specialist nurses is cross-cutting, as they participate in the planning, organisation and implementation of aero-evacuation protocols, delivery of care and operational safety procedures throughout the operation, with an integrated aeromedical crew working as a team alongside the air crew.

To study the management of nurses specialised in the aero-evacuation of highly infectious critical patients during the COVID-19 pandemic.

Through a systematic search of the biomedical literature, this study was conducted according to the standards of the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA. The literature search included articles published from 2019 to August 2020 and meta-search engines, yielding a total of 142 articles, and a triangulation of information was performed. A total of 11 articles were eventually included in the review, and the validity of each article was determined according to the guidelines of the Joanna Briggs Institute level of evidence.

The systematic review identified 11 studies that use different methodological considerations for conducting an aeromedical evacuation and covering key aspects for a successful operation.

The management of specialist nurses has a direct impact on the aeromedical evacuation of the critical patient. It covers planning, organisation, and operational safety, applied in the instruction, training, execution and strict monitoring of the work of the aeromedical crew as a solid team. This contributes to the success of the aero-evacuation mission and the infectious patient's high likelihood of survival during the COVID-19 pandemic.

Nanofibrous filter materials were prepared by electrospinning a solution of 28 wt% poly(vinylidene fluoride) in N,N-dimethylacetamide with and without the addition of 2 wt% AgNO₃, Cu(NO₃)₂·2.5H₂O or ZnCl₂. X-ray diffraction, scanning electron microscopy with energy dispersive X-ray spectroscopy, inductively coupled plasma mass spectroscopy, thermogravimetric analysis, contact angle measurement, nitrogen sorption, and mercury intrusion porosimetry methods were used for the characterization of physical structure as well as the chemical composition of the electrospun materials. Particle filtration efficiency and antiviral activity against the SARS-CoV-2 alpha variant were tested in order to estimate the suitability of the prepared electrospun filter materials for application as indoor air filtration systems with virucidal properties. All filter materials prepared with salts demonstrated very high particle filtration efficiency (≥98.0%). The best antiviral activity was demonstrated by a material containing Cu(NO₃)₂·2.5H₂O in the spinning solution, which displayed the decrease in the number of infectious virions by three orders of magnitude after a contact time of 12 h. Materials with the addition of AgNO₃ and ZnCl₂ decreased the number of infectious virions after the same contact time by only ∼8 and ∼11 times, respectively.

Background Healthcare workers are committed to learning from each other's experience to safely optimize patient management of COVID-19. Acute hypoxemic failure is common in COVID-19 patients, and nearly 3.2% may require intubation. Intubation is an aerosol-generating procedure (AGP) that might predispose the performer to COVID-19 infection. This survey was intended to evaluate the practices during tracheal intubation in COVID-19 intensive care units (ICUs) and analyze them against the recommendations of the All India Difficult Airway Association (AIDAA) for safe practice. Methodology It was a web-based, multicentric cross-sectional survey. The choices in the questions were based on guidelines for airway management in COVID-19. Survey questions were divided into two parts - the first part consisted of demographics and general information, and the second part focused on safe intubation practices. Results A total of 230 responses were obtained from physicians all over India, presuming their active involvement in COVID-19 cases, of which 226 responses were taken into account. Two-thirds of responders did not receive any training before ICU posting. The Indian Council of Medical Research (ICMR) guideline was followed by 89% of responders for personal protective equipment use. Intubation in COVID-19 patients was predominantly conducted by a senior anesthesiologist/intensivist in the team and a senior resident (37.2%). Rapid sequence intubation (RSI) and modified RSI were preferable among the responder's hospitals (46.5% vs. 33.6%). In most centers, responders used direct laryngoscope for intubation (62.8%), whereas video laryngoscope was used by 34%. Most responders confirmed the endotracheal tube (ETT) position by visual inspection (66.3%) over end-tidal carbon dioxide (EtCO2) concentration tracing (53.9%). Conclusions Safe intubation practices were followed in most of the centers across India. However, teaching and training, preoxygenation methods, alternative ventilation strategies, and confirmation of intubation pertinent to COVID-19 airway management need more attention.

Aeromedical evacuation missions to transport highly infectious critical COVID-19 patients involve multiple factors, therefore planning is essential in their preparation. The management of specialist nurses is cross-cutting, as they participate in the planning, organisation and implementation of aero-evacuation protocols, delivery of care and operational safety procedures throughout the operation, with an integrated aeromedical crew working as a team alongside the air crew.

To study the management of nurses specialised in the aero-evacuation of highly infectious critical patients during the COVID-19 pandemic.

Through a systematic search of the biomedical literature, this study was conducted according to the standards of the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA. The literature search included articles published from 2019 to August 2020 and meta-search engines, yielding a total of 142 articles, and a triangulation of information was performed. A total of 11 articles were eventually included in the review, and the validity of each article was determined according to the guidelines of the Joanna Briggs Institute level of evidence.

The systematic review identified 11 studies that use different methodological considerations for conducting an aeromedical evacuation and covering key aspects for a successful operation.

The management of specialist nurses has a direct impact on the aeromedical evacuation of the critical patient. It covers planning, organisation, and operational safety, applied in the instruction, training, execution and strict monitoring of the work of the aeromedical crew as a solid team. This contributes to the success of the aero-evacuation mission and the infectious patient's high likelihood of survival during the COVID-19 pandemic.