Digital technologies to unlock safe and sustainable opportunities for medical device and healthcare sectors with a focus on the combined use of digital twin and extended reality applications: A review.

Medical devices have increased in complexity where there is a pressing need to consider design thinking and specialist training for manufacturers, healthcare and sterilization providers, and regulators. Appropriately addressing this consideration will positively inform end-to-end supply chain and logistics, production, processing, sterilization, safety, regulation, education, sustainability and circularity. There are significant opportunities to innovate and to develop appropriate digital tools to help unlock efficiencies in these important areas. This constitutes the first paper to create an awareness of and to define different digital technologies for informing and enabling medical device production from a holistic end-to-end life cycle perspective. It describes the added-value of using digital innovations to meet emerging opportunities for many disposable and reusable medical devices. It addresses the value of accessing and using integrated multi-actor HUBs that combine academia, industry, healthcare, regulators and society to help meet these opportunities. Such as cost-effective access to specialist pilot facilities and expertise that converges digital innovation, material science, biocompatibility, sterility assurance, business model and sustainability. It highlights the marked gap in academic R&D activities (PRISMA review of best publications conducted between January 2010 and January 2024) and the actual list of U.S. FDA's approved and marketed artificial intelligence/machine learning (AI/ML), and augmented reality/virtual reality (AR/VR) enabled-medical devices for different healthcare applications. Bespoke examples of benefits underlying future use of digital tools includes potential implementation of machine learning for supporting and enabling parametric release of sterilized products through efficient monitoring of critical process data (complying with ISO 11135:2014) that would benefit stakeholders. This paper also focuses on the transformative potential of combining digital twin with extended reality innovations to inform efficiencies in medical device design thinking, supply chain and training to inform patient safety, circularity and sustainability.

Perceived factors informing the pre-acceptability of digital health innovation by aging respiratory patients: a case study from the Republic of Ireland.

It is appreciated that digital health is increasing in interest as an important area for efficiently standardizing and developing health services in Ireland, and worldwide. However, digital health is still considered to be in its infancy and there is a need to understand important factors that will support the development and uniform uptake of these technologies, which embrace their utility and ensure data trustworthiness. This constituted the first study to identify themes believed to be relevant by respiratory care and digital health experts in the Republic of Ireland to help inform future decision-making among respiratory patients that may potentially facilitate engagement with and appropriate use of digital health innovation (DHI). The study explored and identified expert participant perceptions, beliefs, barriers, and cues to action that would inform content and future deployment of living labs in respiratory care for remote patient monitoring of people with respiratory diseases using DHI. The objective of this case study was to generate and evaluate appropriate data sets to inform the selection and future deployment of an ICT-enabling technology that will empower patients to manage their respiratory systems in real-time in a safe effective manner through remote consultation with health service providers. The co-creation of effective DHI for respiratory care will be informed by multi-actor stakeholder participation, such as through a Quintuple Helix Hub framework combining university-industry-government-healthcare-society engagements. Studies, such as this, will help bridge the interface between top-down digital health policies and bottom-up end-user engagements to ensure safe and effective use of health technology. In addition, it will address the need to reach a consensus on appropriate key performance indicators (KPIs) for effective uptake, implementation, standardization, and regulation of DHI.

Current decontamination challenges and potentially complementary solutions to safeguard the vulnerable seafood industry from recalcitrant human norovirus in live shellfish: Quo Vadis?

Safeguarding the seafood industry is important given its contribution to supporting our growing global population. However, shellfish are filter feeders that bioaccumulate microbial contaminants in their tissue from wastewater discharged into the same coastal growing environments leading to significant human disease outbreaks unless appropriately mitigated. Removal or inactivation of enteric viruses is very challenging particularly as human norovirus (hNoV) binds to specific histo-blood ligands in live oyster tissue that are consumed raw or lightly cooked. The regulatory framework that sets out use of clean seawater and UV disinfection is appropriate for bacterial decontamination at the post-harvest land-based depuration (cleaning) stage. However, additional non-thermal technologies are required to eliminate hNoV in live shellfish (particularly oysters) where published genomic studies report that low-pressure UV has limited effectiveness in inactivating hNoV. The use of the standard genomic detection method (ISO 15, 216-1:2017) is not appropriate for assessing the loss of infectious hNoV in treated live shellfish. The use of surrogate viral infectivity methods appear to offer some insight into the loss of hNoV infectiousness in live shellfish during decontamination. This paper reviews the use of existing and potentially other combinational treatment approaches to enhance the removal or inactivation of enteric viruses in live shellfish. The use of alternative and complementary novel diagnostic approaches to discern viable hNoV are discussed. The effectiveness and virological safety of new affordable hNoV intervention(s) require testing and validating at commercial shellfish production in conjunction with laboratory-based research. Appropriate risk management planning should encompass key stakeholders including local government and the wastewater industry. Gaining a mechanistic understanding of the relationship between hNoV response at molecular and structural levels in individually treated oysters as a unit will inform predictive modeling and appropriate treatment technologies. Global warming of coastal growing environments may introduce additional contaminant challenges (such as invasive species); thus, underscoring need to develop real-time ecosystem monitoring of growing environments to alert shellfish producers to appropriately mitigate these threats.

Challenges and future opportunities to unlock the critical supply chain of personal and protective equipment (PPE) encompassing decontamination and reuse under emergency use authorization (EUA) conditions during the COVID-19 pandemic: Through a reflective circularity and sustainability lens.

Severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2), and the resulting coronavirus disease (COVID-19), was declared a public health emergency of global concern by the World Health Organization (WHO) in the early months of 2020. There was a marked lack of knowledge to inform national pandemic response plans encompassing appropriate disease mitigation and preparation strategies to constrain and manage COVID-19. For example, the top 16 "most cited" papers published at the start of the pandemic on core knowledge gaps collectively constitute a staggering 29,393 citations. Albeit complex, appropriate decontamination modalities have been reported and developed for safe reuse of personal and protective equipment (PPE) under emergency use authorization (EUA) where critical supply chain shortages occur for healthcare workers (HCWs) caused by the COVID-19 pandemic. Commensurately, these similar methods may provide solutions for the safe decontamination of enormous volumes of PPE waste promoting opportunities in the circular bioeconomy that will also protect our environment, habitats and natural capital. The co-circulation of the highly transmissive mix of COVID-19 variants of concern (VoC) will continue to challenge our embattled healthcare systems globally for many years to come with an emphasis placed on maintaining effective disease mitigation strategies. This viewpoint article addresses the rationale and key developments in this important area since the onset of the COVID-19 pandemic and provides an insight into a variety of potential opportunities to unlock the long-term sustainability of single-use medical devices, including waste management.

Potential disruptive effects of zoosporic parasites on peatland-based organic freshwater aquaculture: Case study from the Republic of Ireland.

Irish freshwater aquaculture holds great potential for aiding food security. However, its necessary expansion has been hampered by the adoption of important environmental EU directives. A novel peatland-based recirculating aquaculture multi-trophic pond system (RAMPS) was developed to assess its potential to assist in the sustainable development of industry whilst remaining aligned with environmental protection by adhering to organic aquaculture practices. Microalgae play a pivotal role in the farms' wastewater bioremediation. However, a collapse of the algal population within the system towards the end of the pilot study was observed. No relationship between physicochemical fluctuations and the collapse were indicated. Further investigations into the potential presence of biological agents were then conducted and fourteen species of zoosporic parasites from five different genera (Labyrinthula, Vampyrella, Amoeboaphelidium, Paraphelidium and Aphelidium) were identified after conducting next-generation sequencing (MinION). The presence of these species indicated the potential cause of algal collapse. Additionally, changes in weather conditions may have also contributed to the issue. Given the lack of data available on zoosporic parasites and their potential impact on organic aquaculture practices, additional research needs to be conducted. Developing a means to monitor and mitigate against these complex zoosporic parasites will inform food security, it will particularly help safeguard "organic" freshwater aquaculture where there is a reliance on using natural-based approaches to address disease mitigation. This information will in turn inform the replication of this RAMPs system in peatlands internationally creating local employment in green technologies, as communities' transition away from burning peat as fossil fuel. Also, zoosporic parasites may reduce important microalgae in peatland-based culture ponds that serve as exceptional sequesters of carbon. Findings of this study will inform related research that focus on the emergence of microbial pathogens in local aquatic ecosystems brought on by variances in climate.

Geobacillus stearothermophilus and Bacillus atrophaeus spores exhibit linear inactivation kinetic performance when treated with an industrial scale vaporized hydrogen peroxide (VH2O2) sterilization process.

AIMS: This study aims to determine the inactivation kinetics of Geobacillus stearothermophilus and Bacillus atrophaeus biological indicators, treated with vaporized hydrogen peroxide (VH2O2) at an industrial scale. There is an assumption that sterilization processes generate linear kinetic plots of treated biological indicators that are used for informing probability-based decision-making by the MedTech industry for effective sterilization treatments; however, this has not been reported for sterilization using VH2O2. METHODS AND RESULTS: Survivor curves were generated, and sterilization performances were separately determined using G. stearothermophilus and B. atrophaeus biological indicators following the development of appropriate process challenge devices (PCDs). Regression analysis revealed that the inactivation kinetics for VH2O2-treated microorganisms exhibited log linear profiles. The use of scanning electron microscope (SEM) revealed no significant topographical changes in the outer surface of these VH2O2-treated spores. CONCLUSIONS: Both biological indicators exhibited log linear inactivation kinetics when treated with an industrial scale vaporized hydrogen peroxide (VH2O2) sterilization process. Therefore, this novel finding corroborates and proves the appropriateness of using VH2O2 as a sterilization method in accordance with applicable ISO standards.

Pathogenic Drug Resistant Fungi: A Review of Mitigation Strategies.

Fungal pathogens cause significant human morbidity and mortality globally, where there is a propensity to infect vulnerable people such as the immunocompromised ones. There is increasing evidence of resistance to antifungal drugs, which has significant implications for cutaneous, invasive and bloodstream infections. The World Health Organization (WHO) published a priority list of fungal pathogens in October 2022, thus, highlighting that a crisis point has been reached where there is a pressing need to address the solutions. This review provides a timely insight into the challenges and implications on the topic of antifungal drug resistance along with discussing the effectiveness of established disease mitigation modalities and approaches. There is also a need to elucidate the cellular and molecular mechanisms of fungal resistance to inform effective solutions. The established fungal decontamination approaches are effective for medical device processing and sterilization, but the presence of pathogenic fungi in recalcitrant biofilms can lead to challenges, particularly during cleaning. Future design ideas for implantable and reusable medical devices should consider antifungal materials and appropriates for disinfection, and where it is relevant, sterilization. Preventing the growth of mycotoxin-producing fungi on foods through the use of appropriate end-to-end processes is advisable, as mycotoxins are recalcitrant and challenging to eliminate once they have formed.

Use of next generation sequencing and bioinformatics for profiling freshwater eukaryotic microalgae in a novel peatland integrated multi-trophic aquaculture (IMTA) system: Case study from the Republic of Ireland.

Development of integrated multi-trophic aquaculture (IMTA) systems constitutes a step change in the sustainable production of freshwater fish to meet emerging needs for high-protein foods globally. Recently, there has been a paradigm shift away from harvesting peat as a fuel towards the development of wettable peatland innovation (termed 'paludiculture'), such as aquaculture. Such eco-innovations support carbon sequestration and align with a balanced environmental approach to protecting biodiversity. This novel peatland-based IMTA process in the Irish midlands relies upon natural microalgae for waste treatment, recirculation and water quality where there is no use of pesticides or antibiotics. This novel IMTA system is powered with a wind turbine and the process has 'organic status'; moreover, it does not discharge aquaculture effluent to receiving water. However, there is a significant lack of understanding as to diversity of microalgae in this 'paludiculture'-based IMTA processes. This constitutes the first case study to use conventional microscopy combined with next-generation sequencing and bioinformatics to profile microalgae occurring in this novel IMTA system from pooled samples over a 12 month period in 2020. Conventional microscopy combined with classic identification revealed twenty genera of algae; with Chlorophyta and Charophyta being the most common present. However, algal DNA isolation, 16 s sequencing and bioinformatics revealed a combined total of 982 species from 341 genera across nine phyla from the same IMTA system, which emphasized a significant underestimation in the number and diversity of beneficial or potentially harmful algae in the IMTA-microbiome. These new methods also yield rich data that can be used by digital technologies to transform future monitoring and performance of the IMTA system for sustainability. The findings of this study align with many sustainability development goals of the United Nations including no poverty, zero hunger, good health and well-being, responsible consumption and production, climate change, and life below water.

Effectiveness of front line and emerging fungal disease prevention and control interventions and opportunities to address appropriate eco-sustainable solutions.

Fungal pathogens contribute to significant disease burden globally; however, the fact that fungi are eukaryotes has greatly complicated their role in fungal-mediated infections and alleviation. Antifungal drugs are often toxic to host cells and there is increasing evidence of adaptive resistance in animals and humans. Existing fungal diagnostic and treatment regimens have limitations that has contributed to the alarming high mortality rates and prolonged morbidity seen in immunocompromised cohorts caused by opportunistic invasive infections as evidenced during HIV and COVID-19 pandemics. There is a need to develop real-time monitoring and diagnostic methods for fungal pathogens and to create a greater awareness as to the contribution of fungal pathogens in disease causation. Greater information is required on the appropriate selection and dose of antifungal drugs including factors governing resistance where there is commensurate need to discover more appropriate and effective solutions. Popular azole fungal drugs are widely detected in surface water and sediment due to incomplete removal in wastewater treatment plants where they are resistant to microbial degradation and may cause toxic effects on aquatic organisms such as algae and fish. UV has limited effectiveness in destruction of anti-fungal drugs where there is increased interest in the combination approaches such as novel use of pulsed-plasma gas-discharge technologies for environmental waste management. There is growing interest in developing alternative and complementary green eco-biocides and disinfection innovation. Fungi present challenges for cleaning, disinfection and sterilization of reusable medical devices such as endoscopes where they (example, Aspergillus and Candida species) can be protected when harboured in build-up biofilm from lethal processing. Information on the efficacy of established disinfection and sterilization technologies to address fungal pathogens including bottleneck areas that present high risk to patients is lacking. There is a need to address risk mitigation and modelling to inform efficacy of appropriate intervention technologies that must consider all contributing factors where there is potential to adopt digital technologies to enable real-time analysis of big data, such as use of artificial intelligence and machine learning. International consensus on standardised protocols for developing and reporting on appropriate alternative eco-solutions must be reached, particularly in order to address fungi with increasing drug resistance where research and innovation can be enabled using a One Health approach.

Digital transformation of peatland eco-innovations ('Paludiculture'): Enabling a paradigm shift towards the real-time sustainable production of 'green-friendly' products and services.

The world is heading in the wrong direction on carbon emissions where we are not on track to limit global warming to 1.5 °C; Ireland is among the countries where overall emissions have continued to rise. The development of wettable peatland products and services (termed 'Paludiculture') present significant opportunities for enabling a transition away from peat-harvesting (fossil fuels) to developing 'green' eco-innovations. However, this must be balanced with sustainable carbon sequestration and environmental protection. This complex transition from 'brown to green' must be met in real time by enabling digital technologies across the full value chain. This will potentially necessitate creation of new green-business models with the potential to support disruptive innovation. This timely paper describes digital transformation of paludiculture-based eco-innovation that will potentially lead to a paradigm shift towards using smart digital technologies to address efficiency of products and services along with future-proofing for climate change. Digital transform of paludiculture also aligns with the 'Industry 5.0 - a human-centric solution'. However, companies supporting peatland innovation may lack necessary standards, data-sharing or capabilities that can also affect viable business model propositions that can jeopardize economic, political and social sustainability. Digital solutions may reduce costs, increase productivity, improve produce develop, and achieve faster time to market for paludiculture. Digitisation also enables information systems to be open, interoperable, and user-friendly. This constitutes the first study to describe the digital transformation of paludiculture, both vertically and horizontally, in order to inform sustainability that includes process automation via AI, machine learning, IoT-Cloud informed sensors and robotics, virtual and augmented reality, and blockchain for cyber-physical systems. Thus, the aim of this paper is to describe the applicability of digital transformation to actualize the benefits and opportunities of paludiculture activities and enterprises in the Irish midlands with a global orientation.

Microalgae as a natural ecological bioindicator for the simple real-time monitoring of aquaculture wastewater quality including provision for assessing impact of extremes in climate variance - A comparative case study from the Republic of Ireland.

Aquaculture is one of the fastest growing food producing industries globally, providing ~50% of fish for human consumption. However, the rapid growth of aquaculture presents a range of challenges including balancing environmental impact that can be influenced by variations in climatic conditions. Monitoring of physicochemical parameters is traditionally used to evaluate aquaculture output quality; however, this approach does not indicate the cumulative ecotoxicological effects on receiving waters. Specifically, this case study investigated the relationship between measuring traditional physicochemical parameters and the health of the alga Pseudokirchneriella subcapitata in order to evaluate the potential ecotoxicological effects of freshwater aquaculture on the receiving aquatic ecosystem in the Irish midlands. This constituted the first 2-year longitudinal study conducted in 2018 and 2019 that reports on the efficacy of using algae as a natural bioindicator to monitor and assess freshwater aquaculture wastewater from a traditional flow-through fish farm producing Eurasian Perch (Perca fluviatilis); monitoring was compared over a same six-month period in the same location each year. Findings demonstrated significant differences between the two monitoring periods when using P. subcapitata for assessing the quality of aquaculture intake (P = 0.030) and output (P = 0.039). No stimulatory effects were observed during 2019 unlike >50% rates experienced the previous year. These observations coincided with changes in climatic conditions whereby the 2018 period experienced extended levels of drought; whereas non-drought conditions were observed during 2019. Findings suggest that reliance upon traditional monitoring techniques may not provide sufficient robustness or versatility to address emerging issues, such as extremes in climate variance, which may influence the future intensive sustainability of freshwater aquaculture. This research supports the complementary use of P. subcapitata as a rapid and simple early-warning bioindicator for measuring aquaculture output quality on receiving aquatic ecosystems.

Development of a low-temperature extrusion process for production of GRAS bioactive-polymer loaded compounds for targeting antimicrobial-resistant (AMR) bacteria.

Antimicrobial resistance (AMR) is recognised globally as one of the greatest threats to human and animal health; thus, discovery of alternative antibacterial agents to address AMR is a priority challenge. This study constitutes the first report of a low-melting temperature, polymer- extrusion process for the smart delivery of thermally-sensitive antimicrobial bioactives, including generally-regarded-as-safe (GRAS) bioactives derived from various sources. Bioactives were assessed before and after extrusion by determining their respective minimum inhibitory concentrations (MIC). WHO-priority AMR-bacterial isolates causing zoonotic infections were evaluated along with use of standard ATCC strains. Findings revealed that this copolymer method was capable of delivering thermally-sensitive bioactives with varying degrees of growth inhibition against the AMR-bacterial strains. The extrusion process was found to increase the effect of nisin against MRSA (4-fold increase) and L. monocytogenes (6.4-fold increase), silver nitrate (AgNO3) against E. coli (3.6-fold increase) and S. epidermidis (1.25-fold increase), and chitosan against S. aureus (1.25-fold). Findings show the potential applicability of this polymer extrusion process for developing future bioactive-loaded polymer compounds; thus, highlighting the potential of converging bio-based industry with novel materials for enabling 'One-Health' solutions.

Efficacy of frontline chemical biocides and disinfection approaches for inactivating SARS-CoV-2 variants of concern that cause coronavirus disease with the emergence of opportunities for green eco-solutions.

The emergence of severe acute respiratory disease (SARS-CoV-2) variants that cause coronavirus disease is of global concern. Severe acute respiratory disease variants of concern (VOC) exhibiting greater transmissibility, and potentially increased risk of hospitalization, severity and mortality, are attributed to molecular mutations in outer viral surface spike proteins. Thus, there is a reliance on using appropriate counter-disease measures, including non-pharmaceutical interventions and vaccination. The best evidence suggests that the use of frontline biocides effectively inactivate coronavirus similarly, including VOC, such as 202012/01, 501Y.V2 and P.1 that have rapidly replaced the wild-type variant in the United Kingdom, South Africa and Brazil, respectively. However, this review highlights that efficacy of VOC-disinfection will depend on the type of biocide and the parameters governing the activity. VOC are likely to be similar in size to the wild-type strain, thus implying that existing guidelines for use and re-use of face masks post disinfection remain relevant. Monitoring to avoid injudicious use of biocides during the coronavirus disease era is required as prolonged and excessive biocide usage may negatively impact our receiving environments; thus, highlighting the potential for alternative more environmental-friendly sustainable biocide solutions. Traditional biocides may promote cross-antimicrobial resistance to antibiotics in problematical bacteria. The existing filtration efficacy of face masks is likely to perform similarly for VOC due to similar viral size; however, advances in face mask manufacturing by way incorporating new anti-viral materials will potentially enhance their design and functionality for existing and potential future pandemics.

Disposable face masks and reusable face coverings as non-pharmaceutical interventions (NPIs) to prevent transmission of SARS-CoV-2 variants that cause coronavirus disease (COVID-19): Role of new sustainable NPI design innovations and predictive mathematical modelling.

Best-published evidence supports the combined use of vaccines with non-pharmaceutical interventions (NPIs), to reduce the relative risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes COVID-19; this will enable a safe transition to achieving herd immunity. Albeit complex, the strategic public health goal is to bundle NPIs to keep the basic reproduction number R0 below one. However, validation of these NPIs is conducted using random clinical trials, which is challenging in a swiftly moving pandemic given the need for recruiting large participant cohort over a longitudinal analysis period. This review highlights emerging innovations for potentially improving the design, functionality and improved waste management of disposable face masks such as filtering facepiece (FFPs) respirators, medical masks, and reusable face coverings to help prevent COVID-19. It describes use of different mathematical models under varying scenarios to inform efficacy of single and combined use of NPIs as important counter-measures to break the cycle of COVID-19 infection including new SARS-CoV-2 variants. Demand for face masks during COVID-19 pandemic keeps increasing, especially for FFPs worn by medical workers. Collaborative and well-conducted randomised controlled trials across borders are required to generate robust data to inform common and consistent policies for COVID-19 and future pandemic planning and management; however, current use of systematic reviews of best available evidence can be considered to guide interim policies.

Innovations and technology disruptions in the food sector within the COVID-19 pandemic and post-lockdown era.

Background: COVID-19 pandemic has caused a global lockdown that has abruptly shut down core businesses and caused a worldwide recession. The forecast for a smooth transition for the agri-food and drink industry is, at best, alarming. Given that COVID-19 shutdown multiple core services (such as aviation, food services, supply chains, and export and import markets), there is an enormous deficiency in critical information to inform priority decision making for companies where this uncertainly is likely to impact negatively upon recovery. Scope and approach: The current article investigates potential innovations within the era of the COVID-19 crisis after framing them within the four issues of the food sector (food safety, bioactive food compounds, food security, and sustainability) that are directly affected by the pandemic. The prospect of foreseen innovations to disrupt the food sector during lockdown periods and the post-COVID-19 era is also discussed. Key findings and conclusions: Internet and Communication Technologies, blockchain in the food supply chain and other Industry 4.0 applications, as well as approaches that redefine the way we consume food (e.g., lab-grown meat, plant-based alternatives of meat, and valorization of a vast range of bioresources), are the innovations with the highest potential in the new era. There is also an equally pressing need to exploit social marketing to understand attitudes, perceptions, and barriers that influence the behavior change of consumers and the agri-food industry. Subsequently, this change will contribute to adapting to new norms forged by the COVID-19 pandemic, where there is a significant gap in knowledge for decision making.

Unlocking the surge in demand for personal and protective equipment (PPE) and improvised face coverings arising from coronavirus disease (COVID-19) pandemic - Implications for efficacy, re-use and sustainable waste management.

Currently, there is no effective vaccine for tackling the ongoing COVID-19 pandemic caused by SARS-CoV-2 with the occurrence of repeat waves of infection frequently stretching hospital resources beyond capacity. Disease countermeasures rely upon preventing person-to-person transmission of SARS-CoV2 so as to protect front-line healthcare workers (HCWs). COVID-19 brings enormous challenges in terms of sustaining the supply chain for single-use-plastic personal and protective equipment (PPE). Post-COVID-19, the changes in medical practice will drive high demand for PPE. Important countermeasures for preventing COVID-19 transmission include mitigating potential high risk aerosol transmission in healthcare setting using medical PPE (such as filtering facepiece respirators (FFRs)) and the appropriate use of face coverings by the general public that carries a lower transmission risk. PPE reuse is a potential short term solution during COVID-19 pandemic where there is increased evidence for effective deployment of reprocessing methods such as vaporized hydrogen peroxide (30 to 35% VH2O2) used alone or combined with ozone, ultraviolet light at 254 nm (2000 mJ/cm2) and moist heat (60 °C at high humidity for 60 min). Barriers to PPE reuse include potentially trust and acceptance by HCWs. Efficacy of face coverings are influenced by the appropriate wearing to cover the nose and mouth, type of material used, number of layers, duration of wearing, and potentially superior use of ties over ear loops. Insertion of a nose clip into cloth coverings may help with maintaining fit. Use of 60 °C for 60 min (such as, use of domestic washing machine and spin dryer) has been advocated for face covering decontamination. Risk of virus infiltration in improvised face coverings is potentially increased by duration of wearing due to humidity, liquid diffusion and virus retention. Future sustained use of PPE will be influenced by the availability of recyclable PPE and by innovative biomedical waste management.

ß-Glucan Metabolic and Immunomodulatory Properties and Potential for Clinical Application.

ß-glucans are complex polysaccharides that are found in several plants and foods, including mushrooms. ß-glucans display an array of potentially therapeutic properties. ß-glucans have metabolic and gastro-intestinal effects, modulating the gut microbiome, altering lipid and glucose metabolism, reducing cholesterol, leading to their investigation as potential therapies for metabolic syndrome, obesity and diet regulation, gastrointestinal conditions such as irritable bowel, and to reduce cardiovascular and diabetes risk. ß-glucans also have immune-modulating effects, leading to their investigation as adjuvant agents for cancers (solid and haematological malignancies), for immune-mediated conditions (e.g., allergic rhinitis, respiratory infections), and to enhance wound healing. The therapeutic potential of ß-glucans is evidenced by the fact that two glucan isolates were licensed as drugs in Japan as immune-adjuvant therapy for cancer in 1980. Significant challenges exist to further clinical testing and translation of ß-glucans. The diverse range of conditions for which ß-glucans are in clinical testing underlines the incomplete understanding of the diverse mechanisms of action of ß-glucans, a key knowledge gap. Furthermore, important differences appear to exist in the effects of apparently similar ß-glucan preparations, which may be due to differences in sources and extraction procedures, another poorly understood issue. This review will describe the biology, potential mechanisms of action and key therapeutic targets being investigated in clinical trials of ß-glucans and identify and discuss the key challenges to successful translation of this intriguing potential therapeutic.

Food Ingredients and Active Compounds against the Coronavirus Disease (COVID-19) Pandemic: A Comprehensive Review.

As media reports have noted, the COVID-19 pandemic has accelerated market mainstreaming of immune-boosting food bioactives, supplements, and nutraceuticals. However, most studies reporting on the potential of bioactives against COVID-19 transmission have been uploaded as preprints with little opportunity to revise content for benefit and impact. The current review discusses current best evidence and information underpinning the role of food ingredients and bioactive compounds in supporting immune functions in humans and animals, specifically in the prevention and treatment of COVID-19 disease. Up to now, some evidence from randomized population and clinical trials has suggested that vitamin D levels may be linked to COVID-19 transmission and severity. Numerous theoretical studies have pointed to polyphenols and particularly flavonoids as potential inhibitors of SARS-CoV-2 infection. There is also inconclusive evidence to support the future use of ß-glucan to address COVID-19 due in part to variability in immune response arising from heterogeneity in polysaccharide branch and chain length for different sources and the absence of a standardized extraction method. To confirm the promising outcomes and hypotheses for bioactive compounds, more randomized and controlled clinical studies are needed. The results of such studies would have a profound effect on the prospects of food supplements and nutraceuticals as potential prophylaxis against COVID-19 and serve to help consumers to protect themselves during the post-lockdown recovery era.

Unlocking challenges and opportunities presented by COVID-19 pandemic for cross-cutting disruption in agri-food and green deal innovations: Quo Vadis?

COVID-19 pandemic is on a trajectory to cause catastrophic global upheaval with the potential to alter geopolitical and socio-economic norms. Many countries are frantically responding with staggering financial stimulus recovery initiatives. This opinion-paper reviews challenges, opportunities, and potential solutions for the post-COVID-19 era that focuses on intensive sustaining of agri-food supply chain in tandem with meeting the high demand for new green deal innovation. For example, the development of wet peatland innovation, known as Paludiculture, can intensively sustain and blend agri-food and green innovations that will help support COVID-19 pandemic transitioning. The future looks bright for the creation of new sustainability multi-actor innovation hubs that will support, connect, and enable businesses to recover and pivot beyond the COVID-19 pandemic. The nexus between first 'Green Deal' initiative supporting 64 selected European Startups and SMEs (European Innovation Council) and 43 Irish Disruptive Technology projects are addressed in the context of cross-cutting developments and relevance to COVID-19. Candidate areas for future consideration will focus on climate action, digitization, manufacturing, and sustainable food production, security, and waste mitigation. Recommendations are also provided to facilitate community transitioning, training, enterprise, and employment to low carbon economy.