Delivery of gene therapy in haemophilia treatment centres in the United States: Practical aspects of preparedness and implementation.

INTRODUCTION: Haemophilia treatment centres (HTCs) and healthcare providers (HCPs) will need to adapt to a new treatment paradigm with the emergence of adeno-associated virus (AAV)-based gene therapy for the treatment of haemophilia in adults. AIM: This review examines the upcoming patient and institutional journeys, along with practical aspects of preparedness for clinical delivery of gene therapy by HTCs. METHODS: Based on our clinical experience and examination of published literature, we explored the parallel journeys for patients and treatment centres to navigate before, during, and after administration of gene therapy. RESULTS: The patient journey includes: information gathering; decision making; comprehensive patient assessment; preparation for the infusion itself; short- and long-term monitoring; lifestyle modifications; and the possible need for immunosuppressive treatment. Informed decision-making may require patient education with extensive discussions and an understanding that not all people with haemophilia will choose or be eligible for gene therapy, although eligibility criteria continue to evolve. The institutional journey includes: consideration of biosafety procedures; planning for product procurement, handling, storage, and administration; development of detailed protocols and guidance documents; contingency planning for immunosuppressive and haemostatic management; consideration of clinical capabilities and staff training needs; coordination of efforts by the full multidisciplinary team; and collaboration between referring, dosing, and follow-up treatment centres. Documented protocols and guidance documents are pivotal for this complex therapy to ensure safe handling, optimal delivery, and post-infusion management and follow-up. CONCLUSION: Successful implementation of this new treatment modality will require communication and collaboration among multiple stakeholders.

SARS-CoV-2 and other pathogens in municipal wastewater, landfill leachate, and solid waste: A review about virus surveillance, infectivity, and inactivation.

This review discusses the techniques available for detecting and inactivating of pathogens in municipal wastewater, landfill leachate, and solid waste. In view of the current COVID-19 pandemic, SARS-CoV-2 is being given special attention, with a thorough examination of all possible transmission pathways linked to the selected waste matrices. Despite the lack of works focused on landfill leachate, a systematic review method, based on cluster analysis, allows to analyze the available papers devoted to sewage sludge and wastewater, allowing to focalize the work on technologies able to detect and treat pathogens. In this work, great attention is also devoted to infectivity and transmission mechanisms of SARS-CoV-2. Moreover, the literature analysis shows that sewage sludge and landfill leachate seem to have a remote chance to act as a virus transmission route (pollution-to-human transmission) due to improper collection and treatment of municipal wastewater and solid waste. However due to the incertitude about virus infectivity, these possibilities cannot be excluded and need further investigation. As a conclusion, this paper shows that additional research is required not only on the coronavirus-specific disinfection, but also the regular surveillance or monitoring of viral loads in sewage sludge, wastewater, and landfill leachate. The disinfection strategies need to be optimized in terms of dosage and potential adverse impacts like antimicrobial resistance, among many other factors. Finally, the presence of SARS-CoV-2 and other pathogenic microorganisms in sewage sludge, wastewater, and landfill leachate can hamper the possibility to ensure safe water and public health in economically marginalized countries and hinder the realization of the United Nations' sustainable development goals (SDGs).

Religious Support as a Contribution to Face the Effects of Social Isolation in Mental Health During the Pandemic of COVID-19.

Coping with the COVID-19 pandemic has required measures to contain the contagion, including social isolation. However, this and other factors have caused mental health problems, both in patients and health professionals and in family members or asymptomatic population. Religious support can be an ally for this type of confrontation. In the case of the COVID-19 pandemic, spiritual/religious care has been restricted and insufficient. When accessible to patients and frontline professionals, they are offered by virtual means, almost always by recorded media and made available in bulk. This essay argues, based on references in the areas of psychology, psychoneuroimmunology, biosafety, and military, that the face-to-face and personalized relationship between religious leaders, patients, health professionals, family members, and faith communities is as essential as possible for the dignified treatment victims, referral to spiritual needs and resilience of society, in addition to contributing to the improvement of the immune response of all. Practical examples are cited in the areas of military chaplaincy and hospital civilian chaplaincy. The essay also proposes the adoption of protocols already published by WHO and other safety measures such as the use of robotics and the recruitment/training of mass chaplains. In addition to contributing to the improvement of COVID-19 pandemic coping processes, the study also contributes to improving the delivery of spiritual/religious care as an ally to physical and mental, individual, and collective health.

Southeast Asia Strategic Multilateral Dialogue on Biosecurity.

A strategic multilateral dialogue related to biosecurity risks in Southeast Asia, established in 2014, now includes participants from Singapore, Malaysia, Indonesia, Thailand, Philippines, and the United States. This dialogue is conducted at the nonministerial level, enabling participants to engage without the constraints of operating in their official capacities. Participants reflect on mechanisms to detect, mitigate, and respond to biosecurity risks and highlight biosecurity issues for national leadership. Participants have also identified factors to improve regional and global biosecurity, including improved engagement and collaboration across relevant ministries and agencies, sustainable funding for biosecurity programs, enhanced information sharing for communicable diseases, and increased engagement in international biosecurity forums.

[Biohazards in research laboratories]. / Rischio biologico nei laboratori di ricerca.

SUMMARY: Objectives. To deal with biohazards in research laboratories (RL), identify exposure features, types and incidence of laboratory-acquired infections/diseases (LAI), and prevention strategies. Methods. Literature search and appraisal, non-systematic, last 40 years; legislation, guidelines and good practices evaluation. Results. Biohazards are relevant in RL, in various biomedical, agri-food and industrials sectors, with a variety of LAI (especially viruses and bacteria), modes of exposure and transmission; LAI decrease after preventive measures, vaccinations and clinical treatments; LAI underestimation, due to underreporting and subclinical LAI; need to implement and comply with well-known and available technical and scientific guidelines, good medical and laboratory practices; need for specific health education and training; lack of reporting and epidemiologic surveillance systems, with consequent limited data on risk assessment and effectiveness of preventive interventions. Conclusions. The roles of the occupational physician must be underlined, especially for risk assessment, health and clinicepidemiologic surveillance, with the need to monitor seconeffectiveness of preventive interventions, particularly for biosafety and biosecurity levels in RL. It should be useful to increase capacity of epidemiologic surveillance for LAI, through networking or dedicated websites, in order to collect and analyze accidents, injuries, infections, or adverse events occurred to workers in RL.

Assessing knowledge, attitudes, and practices of healthcare workers regarding medical waste management at a tertiary hospital in Botswana: A cross-sectional quantitative study.

BACKGROUND: Medical waste management (MWM) is of concern to the medical and general community. Adequate knowledge regarding management of healthcare waste is an important precursor to the synthesis of appropriate attitudes and practices of proper handling and disposal of medical waste by healthcare workers (HCWs). AIMS AND OBJECTIVES: This study was designed to investigate knowledge, attitudes, and practices of doctors, nurses, laboratory technicians, and housekeeping staff, regarding MWM at a tertiary hospital in Gaborone, Botswana. MATERIALS AND METHODS: This was a cross-sectional quantitative study using a self-administered questionnaire involving 703 participants. Data were analyzed using SAS software. Descriptive statistics were used to summarize the data. Responses for attitude of respondents were analyzed using nonparametric tests. RESULTS: The completion rate for this study was 90% with (632/703) questionnaires analyzed. Majority of respondents were nurses 60% (422/703), followed by housekeeping staff 24.3% (171/703), doctors 10.95% (77/703), and laboratory technicians 4.7% (33/703). The study showed that 66.9% (423/632) of respondents had some training in MWM, and 90.5% (572/632) claimed to have knowledge regarding the consequences of poor MWM, particularly health risks. There was a significant agreement among the respondents that segregation of medical waste should be done at the point of generation (mean score = 4.43 out of 5). Majority of respondents reported that the healthcare facility had a color-coding system (mean score = 4.59) and identified "lack of knowledge of the dangers of improper waste management by HCWs" as the major obstacle to MWM. CONCLUSION: This study showed that MWM practice at this facility was above average, although improvements were required in accessing waste disposal points and availability of personal protective equipment. Ongoing training should be provided to HCWs on MWM, with more attention to knowledge of regulatory requirements, and involvement of HCWs in development of MWM policies to enhance compliance.

Enzymatic activity of fungi isolated from crops.

AIM: To detect and assess the activity of extracellular hydrolytic enzymes and to find differences in enzymograms between fungi isolated from wheat and rye samples and grown on Czapek-Dox Broth and Sabouraud Dextrose Broth enriched with cereal (wheat or rye). Isolated strains were also classified in the scale of biosafety levels (BSL). MATERIAL AND METHODS: The study used 23 strains of fungi cultured from samples of wheat and rye (grain, grain dust obtained during threshing and soil) collected in the Lublin region (eastern Poland). API ZYM test (bioMérieux) was carried out according to the manufacturer's instructions. Classification of BSL (Biosafety levels) was based on the current literature. RESULTS: High enzymatic activity was found in strains cultured in media containing 1% of wheat grain (Bipolaris holmi, Penicillium decumbens) and with an addition of 1% of rye grain (Cladosporium herbarum, Aspergillus versicolor, Alternaria alternata). The total number of enzymes varied depending on the type of media, and in most cases it was higher in the culture where an addition of cereal grains was used. CONCLUSIONS: Isolated strains of fungi reveal differences in the profiles of the enzyme assay. It can be assumed that the substrate enriched in grains stimulate the higher activity of mold enzymes.

International Society for the Advancement of Cytometry cell sorter biosafety standards.

Flow cytometric cell sorting of biological specimens has become prevalent in basic and clinical research laboratories. These specimens may contain known or unknown infectious agents, necessitating precautions to protect instrument operators and the environment from biohazards arising from the use of sorters. To this end the International Society of Analytical Cytology (ISAC) was proactive in establishing biosafety guidelines in 1997 (Schmid et al., Cytometry 1997;28:99-117) and subsequently published revised biosafety standards for cell sorting of unfixed samples in 2007 (Schmid et al., Cytometry Part A J Int Soc Anal Cytol 2007;71A:414-437). Since their publication, these documents have become recognized worldwide as the standard of practice and safety precautions for laboratories performing cell sorting experiments. However, the field of cytometry has progressed since 2007, and the document requires an update. The new Standards provides guidance: (1) for laboratory design for cell sorter laboratories; (2) for the creation of laboratory or instrument specific Standard Operating Procedures (SOP); and (3) on procedures for the safe operation of cell sorters, including personal protective equipment (PPE) and validation of aerosol containment.

Analysis of aerosol generation during Er:YAG laser-assisted caries treatment: A randomized clinical trial.

BACKGROUND: Maintaining biosafety in dental practice involves the effective elimination of aerosols produced during dental treatment. OBJECTIVES: To assess the quantity of aerosols and aerobic bacteria in the air during the treatment of caries. MATERIAL AND METHODS: The study involved 60 patients with a total of 60 molar teeth (n = 60) in the mandible who were divided into 2 groups based on caries treatment method. Group 1 (G1, n = 30) received treatment with a conventional dental turbine (W&H Synea TA-98LC; W&H, Burmoos, Austria), while group 2 (G2, n = 30) underwent treatment with an Er:YAG (erbium-doped yttrium aluminium garnet) laser (LightWalker, Fotona, Slovenia). Measurements of aerosol particles between 0.3 Em and 10.0 Em near the operatorfs mouth were taken using the PC200 laser particle counter (Trotec GmbH, Schwerin, Germany). The number of aerobic bacteria in the air was determined using 60 Petri plates with a microbiological medium (Columbia agar with 5% sheep blood) and the sedimentation method. A control group (G3) was established to measure initial aerosol levels and initial total number of bacteria colony-forming units (CFUs) before each treatment. RESULTS: In G1 (dental turbine), the median value of aerosol particles was 57,021 (42,564.67,568), while in G2 (Er:YAG laser), it was significantly lower at 33,318 (28,463.35,484) (p < 0.001). The median total bacteria count per cubic meter of air in G1 (conventional dental turbine + high volume evacuator (HVE)), G2 (Er:YAG laser + HVE) and G3 (control group before caries treatment) were 734 (420.988), 158 (96.288) and 48 (32.74), respectively, with a statistically significant difference between the groups (p < 0.001). CONCLUSIONS: The use of Er:YAG laser during caries treatment resulted in a 41.6% reduction in aerosol amounts and a 78.5% decrease in the total bacterial count (TBC) compared to treatment with a dental turbine.

Unveiling the efficacy of latex gloves in preventing viral infections during needlestick injuries: An in vitro mixed-methods study.

BACKGROUND: Gloves are personal protective equipment designed to prevent contamination and reduce the spread of microorganisms. This study aimed to assess in vitro the physical integrity of latex gloves and the retention of biological contamination in healthcare simulation. METHOD: Three different batches of latex procedure gloves from five different brands and specific batches were evaluated before use for physical integrity by the standard protocols of the Society for Testing and Materials (ASTM) and of the American Food and Drug Administration (FDA). Moreover, the retention of biological contamination by latex procedure gloves in needlestick injury simulation with crystal violet and bacteriophages were applied in order to mimic human blood and virus presence. RESULTS: Brands D and C showed the best and worst results in the immediate inspections and after 2 min, respectively. For Brand C, damage occurred in one finger/region in a total of 12 gloves, while seven gloves were damaged/unable to be worn. Brand D presented only two gloves with tears and/or holes in one finger/region. Regarding the viral contamination, in a simulated needlestick injury, data showed no significant difference among the groups. CONCLUSION: All glove brands presented physical damage that might affect the spread of microorganisms. The gloves did not exert an additional protective effect during a needlestick injury simulation in accordance with the two techniques used in this study.

Biosafety measures for Alicyclobacillus spp. strains across various levels of biohazard.

Alicyclobacillus bacteria are important contaminants in the beverage industry because their spores remain in the product after usual pasteurization. At the same time, their impact on human health has yet to be characterized, as it is generally assumed to be low or non-existent. However, these bacteria are causing quality concerns mainly due to odor and taste changes of the product. Since potential health effects are not precisely known, an experimental assessment was performed, including a biosafety assessment of six viable and non-viable vegetative and spore forms of Alicyclobacillus spp. strains using cell cultures and rodent study. The monolayer of Caco-2 (Cancer coli-2) cells was investigated for its adsorption effect on the epithelium of the small intestine of mice. Lactate dehydrogenase leakage (LDH) and transepithelial electrical resistance (TEER) tests were used to ensure the integrity of the cell membrane and tight junctions. The methylthiazole tetrazolium bromide (MTT) assay examined in vitro cytotoxicity in Caco-2 and HepG2 cell lines. The hemolysis of erythrocytes was spectrophotometrically measured. The results showed negligible cytotoxicity or non-toxic response in mice. In conclusion, Alicyclobacillus spp. exhibited biocompatibility with negligible cytotoxicity and minimal safety concerns.

The Efficient Disposal of Biomedical Waste Is Critical to Public Health: Insights from the Central Pollution Control Board Guidelines in India.

Biomedical waste (BMW), encompassing hazardous medical materials, poses environmental and public health risks if not correctly managed. The Central Pollution Control Board (CPCB) in India is a statutory organization that oversees BMW disposal standards, aimed at mitigating these hazards. BMW mismanagement is a major problem and potentially poses threats to the environment as well as public health. During the coronavirus disease 2019 (COVID-19) pandemic, increased use of personal protective equipment (PPE) and other medical equipment was witnessed which led to a marked raised BMW generation. To ensure proper and optimized BMW management, CPCB established guidelines and rules to be followed by the medical facilities as well as the common BMW treatment facilities (CBWTFs). The challenges in implementing proper waste management practices were lack of awareness and inadequate infrastructure. Strategies for better BMW management were proposed, including color-coded bins, improved infrastructure, advanced technology, and awareness campaigns. Highlighting CPCB's vital role, this emphasizes healthcare facilities' proactive role in implementing and evolving regulations for sustainable BMW disposal, ensuring both public health and environmental well-being through compliance and responsible waste management partnerships.

Comparison of concentrations of toxic elements in the hair of first-year students of RUDN University from different regions of the world: a cross-sectional study.

Due to the development of the metallurgical and energy industries and the operation of incinerators, more and more environmental pollution is occurring. Toxic elements accumulate in the biosphere and affect the state of the population of the regions of large-scale production or the disposal of industrial waste. The main goal of this study was to compare the toxic elements hair composition in people from different regions of the world. The concentrations of toxic and potentially toxic elements (Al, As, Be, Cd, Hg, Pb, Sn) in 198 people, first-year students of People's Friendship University of Russia, who arrived from different regions of the world, were measured with inductively coupled plasma mass spectrometry. Students were divided into 6 groups: from South and East Asia, from Latin America, from Arab countries, Central Asia and Afghanistan, from South and Central Africa, from Iran and Azerbaijan, and from Russia, Ukraine, and Moldova. Medians of the concentrations of elements in the hair in the general group were 5.8 µg/g for Al, 30 ng/g for As, 0.6 ng/g for Be, 9.0 ng/g for Cd, 0.11 µg/g for Hg, 0.24 µg/g for Pb, and 0.11 µg/g for Sn. All these values fall within the normal range. Students from Russia, Moldova, and Ukraine showed a significantly higher Sn content (0.28 µg/g) in their hair than subjects from other regions except for Latin America, p<0,05. Except for As, cases of exceeding their recommended concentrations in the hair were identified. However, the proportion of subjects with deviations in each group was not high - not more than 7%. In all regions, a positive correlation was found between Cd, Pb, and Sn, p<0.05, r>0.5 for all. Cases of exceeding the maximum permissible concentrations of various toxic elements in the hair were detected in people from all regions of the Earth included in the study. And although the overall picture of the content of toxic elements in the hair of students from all regions in our study does not look critical, the results of previous studies, as well as information about the total deterioration of the environmental situation throughout the Earth, necessitate further large-scale environmental studies.

Inactivation of biohazards in healthcare wastewater by E-Beam and Gamma irradiation: a comparative study.

The main objective of this study is to evaluate the effect of irradiation by Gamma rays and Electron Beam (E-Beam) on naturally occurring microorganisms shed in healthcare wastewater issued from multi-specialties hospital. We examined the susceptibility of naturally occurring total indicator bacteriophages towards Gamma rays and E-Beam irradiation to evaluate their appropriateness as viral indicators for healthcare wastewater quality control. Results showed that healthcare wastewater is a rich matrix containing bacteriophages surrogates of pathogenic waterborne viruses (4.5 Log10 PFU/100 mL for SOMCPH and 2.3 Log10 PFU/100 mL for FRNAPH), antibiotic resistant bacteria (Mean concentrations from 2.3 to 5.5 Log10 CFU/100 mL), molds and yeasts (2.7 Log10 CFU/100 mL), and spores of Clostridium perfringens (Mean concentration of 3.3 Log10 CFU/100 mL). After E-Beam irradiation, naturally occurring bacteria in healthcare wastewater showed lower resistance patterns (D10 values ranging between 0.21 ± 0.005 and 0.59 ± 0.005) compared to those obtained after Gamma irradiation (D10 values ranging between 0.25 ± 0.015 and 0.70 ± 0.0001). Spores of Clostridium perfringens were the most resistant assayed microbes either after E-Beam (D10 values of 3.74 ± 0.005) or Gamma irradiation (D10 values of 4.77 ± 0.025) of collected samples. According to inactivation patterns, a dose of 10 kGy was sufficient for a complete inactivation of spores. Bacteriophages isolated from healthcare wastewater showed the same resistance patterns as those previously obtained in urban treated sewage and were inactivated using higher doses than waterborne bacteria (D10 values of SOMCPH 1.46 ± 0.057; D10 values of FRNAPH 1.03 ± 0.057). Their resistance to irradiation treatment in such complex matrix corroborates their use to survey the viral quality of healthcare wastewater before their discharge in the urban sanitation network. D10 value analysis showed that bacteria and bacteriophages inactivation by E-Beam irradiation required lower doses than those required for their inactivation using Gamma rays. According to inactivation patterns, a dose of 7 kGy was sufficient for total inactivation of both pathogenic bacteria and viruses. Thus, E-Beam irradiation seems to be an efficient physical pre-treatment process for healthcare wastewater treatment prior to its discharge in urban sanitation system to ensure compliance with environmental standards and protect public health.

Perception of biohazards: a focus on schools in Western Attica, Greece.

Biological disasters endanger the lives of teachers and students, causing serious disturbances to schools, and forcing them to shut down for a short or long period of time. Over the last few decades, the Greater Athens area and Attica Prefecture in Greece have experienced several natural disasters. These events have highlighted problems and weaknesses in emergency planning for school communities at both local and regional level, and have shown the need for new precautionary measures and effective risk management for modern society and school communities. The present study reports an investigation of the perception of the risk posed by biological hazards to teacher safety. The investigation utilized a questionnaire survey of teachers working in the secondary education directorate in Western Attica, which was carried out between May and December 2019. The teachers' perceptions of the extent to which their safety was affected by biohazards (i.e., infectious diseases and weather-related diseases) were investigated using a 5-point scale ranging from affected a lot (- 2) to not affected at all (+ 2). A multivariate statistical technique-principal component analysis-was used to explore the results of the survey. The results showed that the teachers' feelings of safety were affected a lot (- 2) or affected enough (- 1) by biohazards. 61.5% (n = 72) of the participants reported that their feelings of safety were affected a lot or enough by infectious diseases, and 55.6% (n = 65) of the participants noted that their feelings of safety were affected a lot or enough by weather-related diseases. Compared to other natural, technological, or social hazards, biological hazards seem to have a greater impact on teachers' feelings of safety. These results could have implications for the design of risk management plans for school communities.

Safety in Medical Laboratories: Perception and Practice of University Students and Laboratory Workers.

Background: Several safety-related accidents occur in the laboratories because of insufficient regulations, inappropriate implementation of safety measures, or unawareness attitude and practices toward safety precautions. Thus, establishment of efficient regulations and safe habits toward workplace safety is crucial to prevent or minimize such accidents. Here we investigate the levels of laboratory safety awareness among undergraduate medical science students and laboratory workers at major hospitals in Taif, Saudi Arabia. Methods: An anonymous cross-sectional survey was conducted on a random sample of 185 students and workers. The survey was categorized into five sections: (1) variable demographic items, (2) orientation around the warning signage of medical laboratory picograms, (3) assess participants' attitudes toward laboratory safety, (4) assess participants' safety awareness and practices in medical laboratories, and (5) assess participants' knowledge in dealing with emergency equipment and related procedures. Results: Data analyses indicate that workers are generally more aware of the key aspects of laboratory safety. Although students demonstrated moderate to good knowledge of major laboratory signage, there are some areas of deficiency, particularly regarding the use of fire extinguishers. Of interest is that female students are more familiar with laboratory signage than male students, although general laboratory safety awareness among students is poor. Students also showed poor awareness of certain critical aspects of safety practices and emergency procedures. Conclusion: The study data reveal inadequate awareness and knowledge of certain laboratory safety aspects among undergraduate students. Therefore, academic institutions should introduce effective safety regulations, education, and training to improve student safety.

Beauty centers: an overview of their biosafety conditions in Valledupar, Colombia.

INTRODUCTION: The risk of transmission of microorganisms in aesthetic and beauty centers is high when mitigation measures are not adopted; thus, it is necessary to constantly review the conditions of these centers, in order to prevent diseases and make the corresponding decisions. OBJECTIVES: To assess biosafety conditions of beauty centers in Valledupar, Colombia. METHODS: This study followed a descriptive methodology and was based on the administration of a survey focused on determining which services are provided in beauty centers, on which activities are developed by their staff, and the conditions under which services are provided. RESULTS: Study results that 93% of centers are legally constituted; furthermore, the most commonly provided service was hairdressing, with 21%. Only 9% of workers were covered by a social insurance system. In terms of social insurances, centers did not comply with minimum requirements. CONCLUSIONS: The aesthetic centers in Valledupar are not complying with requirements from biosafety protocols set forth by legislation and are thus adopting inadequate procedures.

The clinical practice of Pediatric Dentistry post-COVID-19: The current evidences.

The Severe Acute Respiratory Syndrome (SARS) caused by SARS-CoV-2 virus has quickly spread all over the world, directly affecting the dentistry practice. This study aimed to perform a literature review about the current evidences on biosafety practices and clinical recommendations regarding the return to the elective dental care in the practice of Pediatric dentistry. An electronic search was performed in PubMed, Scopus, Web of Science and Grey literature databases using the terms "Pediatric dentistry" and "COVID-19". Initially, 38 studies were retrieved. After title and abstract were read, it was identified that 22 studies referred specifically to children's dental practice. A total of 19 studies were included in this study. The COVID-19 pandemic will imply significant changes in the reorientation of dental practices, from biosafety issues to technical procedures. Greater rigor in the use of Personal Protective Equipment (PPE) may cause strangeness for children. Consequently, an improvement in the management of patient's behavior before and during the treatment and new approaches to perform the procedures will be demanded. Non-aerosol techniques and minimally invasive procedures will be preferable whenever possible. Professionals will need to be constantly updated based on what the scientific literature recommends. The moment is suitable for the use of preventive practice and minimally invasive techniques.

Reflections on biosafety in acupuncture.

BACKGROUND: Acupuncture is an integrative and complementary practice for which biosafety standards are essential. OBJECTIVE: To elicit a reflection on biosafety in acupuncture to reduce occupational hazards associated with infection as adverse effect for both provider and patient. METHODS: The present theoretical essay is grounded on references intentionally selected from June through October 2019. RESULTS: Infection is the adverse effect most frequently reported for acupuncture practice, which involves considerable risk of microorganism inoculation. Provider awareness should be raised to comply with biosafety principles and thus ensure their and patient safety without any negative implications for the effectiveness of treatment. CONCLUSION: We recommended providers to adopt universal biosafety practices during acupuncture procedures.

INTRODUÇÃO: A acupuntura integra o escopo das práticas integrativas e complementares em saúde, sendo de extrema importância o uso das normas de biossegurança durante essa técnica. OBJETIVO: Refletir sobre biossegurança em acupuntura visando diminuir riscos ocupacionais relacionados ao evento adverso de infecção, tanto para o profissional quanto para o paciente. MÉTODO: Para a elaboração desta reflexão teórica, utilizaram-se estudos da literatura selecionados de forma intencional. As reflexões sobre biossegurança em acupuntura ocorreram no período de junho a outubro de 2019. RESULTADOS: As infecções constituem os efeitos adversos associados à acupuntura mais relatados na literatura. Nessa prática, verifica-se elevado potencial de inoculação de microrganismos. Assim, devem-se seguir os princípios de promoção em biossegurança conscientizando os profissionais sobre a importância de tais cuidados para a própria segurança e a do paciente, sem minimizar a eficácia do tratamento. CONCLUSÕES: Recomenda-se adoção das práticas universais de biossegurança durante a realização de procedimentos de acupuntura.

Biomedical waste management practice in dentistry.

Biomedical Waste Management practice in Dentistry is an important issue. Therefore, it is of interest to document awareness on such issues among clinical practitioners, academicians and students. A survey was completed using a questionnaire from 355 dentists consisting of 201 students, 39 academicians and 115 clinicians in India. Analysis of the survey data shows that majority of students, practitioners, and academicians are aware of laws binding with such issues. However, the Biomedical Waste Management practice among them is not satisfactory. Therefore, education on such issues among clinical practitioners, academicians and students is critical in this part of the globe.