The Knowledge, Attitudes, and Practices of Parents Regarding Sun Protection for Their Children.

OBJECTIVE: To evaluate the knowledge, attitudes, and practices of parents toward protecting their children against skin cancer and the sun. METHODS: This cross-sectional study was performed in Turkey from March through October 2022. The authors used a questionnaire investigating the parents' and children's characteristics, attitudes, and practices toward sun protection and the Skin Cancer and Sun Knowledge (SCSK) scale to collect data. RESULTS: Of 465 parents, 60.2% were women, 83.2% were light-skinned, 20.2% perceived their children as risk-free, 43.8% perceived their children as low risk in terms of skin cancer, 14.6% examined their children from head to foot, 62.3% applied sunscreen to their children, 9.7% made them wear long-sleeved clothing, 60.0% made them wear headgear, 61.1% made them remain in the shade or under a sunshade, and 32.3% made them wear sunglasses. The mean parental SCSK scale score was 14.3 ± 4.1. Scale scores were higher among those who perceived their children as being at high risk for skin cancer (P = .000), whose children had not experienced red or painful sunburn in the previous year (P = .000), and who informed their children about sun protection (P = .000). CONCLUSIONS: Although knowledge of skin cancer and solar protection was high, parental perception of the risk of skin cancer was very low, and attitudes toward skin examination were also very relaxed.

Practical cooling interventions for preventing heat strain in indoor factory workers in Thailand.

BACKGROUND: Occupational heat stress, exacerbated by factors such as climate change and insufficient cooling solutions, endangers the health and productivity of workers, especially in low-resource workplaces. OBJECTIVE: To evaluate the effectiveness of two cooling strategies in reducing physiological strain and productivity of piece-rate workers over a 9-h work shift in a southern Thailand sawmill. METHODS: In a crossover randomized control trial design, 12 (33 ± 7 y; 1.58 ± 0.05 m; 51 ± 9 kg; n = 5 females) medically screened sawmill workers were randomly allocated into three groups comprising an established phase change material vest (VEST), an on-site combination cooling oasis (OASIS) (i.e., hydration, cold towels, fans, water dousing), and no cooling (CON) across 3 consecutive workdays. Physiological strain was measured via core temperature telemetry and heart rate monitoring. Productivity was determined by counting the number of pallets of wood sorted, stacked, and stowed each day. RESULTS: Relative to CON, OASIS lowered core temperature by 0.25°C [95% confidence interval = 0.24, 0.25] and heart rate by 7 bpm [6, 9] bpm, compared to 0.17°C [0.17, 0.18] and 10 [9,12] bpm reductions with VEST. It was inconclusive whether productivity was statistically lower in OASIS compared to CON (mean difference [MD] = 2.5 [-0.2, 5.2]), and was not statistically different between VEST and CON (MD = 1.4 [-1.3, 4.1]). CONCLUSIONS: Both OASIS and VEST were effective in reducing physiological strain compared to no cooling. Their effect on productivity requires further investigation, as even small differences between interventions could lead to meaningful disparities in piece-rate worker earnings over time.

Occupational orthopedic problems and its relation to personal radiation protection in interventional radiology.

PURPOSE: Several studies report occupational orthopedic problems among interventional cardiologists. These health problems are usually multifactorial. However, the personal protective equipment used should play a major role. An online survey was conducted to determine the frequency of such health problems among interventional radiologists and to correlate them with the use of personal radiation protective clothing. MATERIAL AND METHODS: An anonymous online survey that comprised of 17 questions was sent via e-mail to 1427 members of the German Society for Interventional Radiology (DeGIR) in Germany, Austria and Switzerland. The questions were focused on interventional workload, the use of personal radiation protection apparel and orthopedic problems. Given the different scale levels, the associations between the variables were analyzed using different statistical methods. A significance level of p < 0.05 was chosen. RESULTS: There were 221 survey responders (15.5% response rate). About half of responders (47.7%) suffered from more than five episodes of orthopedic problems during their interventional career. Lumbar spine was involved in 81.7% of these cases, cervical spine in 32.8%, shoulder in 28.5% and knee in 24.7%. Because of orthopedic problems, 16.1% of the responders had to reduce and 2.7% had to stop their interventional practice. The number of affected body regions correlates with the fit of the radiation protection means (p < 0.05, r = 0.135) and the reduction of activity as an interventional radiologist (p < 0.05, r = -0.148). CONCLUSION: Overall, the survey reveals widespread orthopedic problems at several body regions among interventional radiologists, associated with the fit of radiation protection systems, among other factors. A connection between the orthopaedic complaints and the radiation protection system used could not be established.

Evaluating workplace protection factors (WPFs) of different firefighter PPE interface control measures for select volatile organic compounds (VOCs).

Structural firefighters are exposed to a complex set of contaminants and combustion byproducts, including volatile organic compounds (VOCs). Additionally, recent studies have found structural firefighters' skin may be exposed to multiple chemical compounds via permeation or penetration of chemical byproducts through or around personal protective equipment (PPE). This mannequin-based study evaluated the effectiveness of four different PPE conditions with varying contamination control measures (incorporating PPE interface design features and particulate blocking materials) to protect against ingress of several VOCs in a smoke exposure chamber. We also investigated the effectiveness of long-sleeve base layer clothing to provide additional protection against skin contamination. Outside gear air concentrations were measured from within the smoke exposure chamber at the breathing zone, abdomen, and thigh heights. Personal air concentrations were collected from mannequins under PPE at the same general heights and under the base layer at abdomen and thigh heights. Sampled contaminants included benzene, toluene, styrene, and naphthalene. Results suggest that VOCs can readily penetrate the ensembles. Workplace protection factors (WPFs) were near one for benzene and toluene and increased with increasing molecular weight of the contaminants. WPFs were generally lower under hoods and jackets compared to under pants. For all PPE conditions, the pants appeared to provide the greatest overall protection against ingress of VOCs, but this may be due in part to the lower air concentrations toward the floor (and cuffs of pants) relative to the thigh-height outside gear concentrations used in calculating the WPFs. Providing added interface control measures and adding particulate-blocking materials appeared to provide a protective benefit against less-volatile chemicals, like naphthalene and styrene.

Occupational dose measurement in interventional cardiology practice.

Ensuring the safety of healthcare workers in interventional cardiology necessitates effective monitoring of occupational radiation exposure. This study aims to assess the accuracy of the over-apron single dosimetric approach compared with double dosimetric methods and explore the relationship between under-apron and over-apron doses. This investigation showed that the prescribed annual dose constraint of 20 mSv year-1 was not exceeded by the maximum annual occupational doses determined by dosimetric algorithms, which were 0.13 ± 0.02, 0.15 ± 0.02 and 0.27 ± 0.04 mSv, respectively. The study demonstrated excellent statistically significant correlations among single and double dosimetric algorithms and between direct under-apron and over-apron doses. Consequently, single dosimetric algorithms could effectively estimate doses for double dosimetric algorithms, highlighting the limited added value of under-apron measurements. These findings significantly impact the practice of interventional cardiology in Sri Lanka, playing a crucial role in enhancing radiation protection measures.

The Impact of Acculturation on Skin Cancer Risk and Protective Behaviors in Hispanic Populations.

The US Hispanic population faces rising skin cancer risks and poorer clinical outcomes, despite lower incidence rates. Acculturation, adopting elements of the dominant culture, may influence skin cancer attitudes and behaviors among Hispanics. We systematically reviewed PubMed articles from 2000 to 2023. Peer-reviewed English articles that assessed the relationship between acculturation and skin cancer in the Hispanic population were included. Andreeva et al. observed that lower acculturation levels correlated with increased use of shade and protective clothing (P < 0.05). More acculturated Latinos were more likely to use sunscreen, but this association weakened after adjusting for covariates (P > 0.48). Heckman et al. highlighted significant differences in skin cancer concern among Hispanic youth, with less acculturated individuals expressing greater worry (P < 0.05). Coups et al. found that higher acculturation was linked to less sun protective clothing usage and more frequent sunburns. Their subsequent online survey indicated that English-acculturated Hispanics engaged less in protective behaviors. Viola et al. reported that English-acculturated Hispanics perceived greater suntan benefits and had lower perceptions of skin cancer risk, severity, and concerns about photo-aging, along with higher melanoma risk factors, compared to Spanish-acculturated Hispanics. Acculturation influences skin cancer attitudes and behaviors in Hispanics. Tailored interventions based on acculturation levels are essential to reduce skin cancer risk. For example, educating English-acculturated Hispanics about skin cancer risks and prioritizing knowledge dissemination for Spanish-acculturated individuals may be effective approaches. These findings emphasize the need for targeted skin cancer prevention efforts to address disparities among US Hispanics.

Effective role of tannic acid in the fabrication of hydrophobic, oleophilic, antibacterial, boron nitride/chlorobutyl rubber nanocomposite for reusable protective clothing and oil-water separation.

Boron Nitride (h-BN) possesses unique qualities like increased thermal conductivity, non-toxic nature, and environmental friendliness; hence, it is a good reinforcing agent for chlorobutyl rubber (CIIR). Tannic acid (TA) holds excellent bio-functional properties and is considered as an exceptional bio-exfoliating agent. Hence, in this study, we have utilized the bio-exfoliating ability of TA to exfoliate h-BN and evaluate its efficiency in reinforcing the CIIR matrix. Results demonstrate the exceptional role of tannic acid in imparting multifunctionality to chlorobutyl rubber. CIIR matrix introduced with h-BN:TA (h-BN:TA/CIIR) display excellent mechanical performance due to the reinforcing effect shown by excess TA in addition to the exfoliating effect. In addition, h-BN:TA/CIIR composite exhibited superior antimicrobial activity against S. aureus. The retention of thermal decontamination efficiency of the composites with increase in the number of cycles ensures their promising application in the field of reusable gloves and chemical protective clothing. The exfoliated filler created a tortuous path inside the matrix which prevents the permeation of solvent. Hence the work intends to synergize the hydrophobic nature of h-BN, exfoliating capacity of TA and the barrier abilities of CIIR for the adsorption of oil from oil-water mixture and portrays the future of the trio in water purification.

Are Welsh primary schools Sunproofed? Results of a national survey, part 1: scoping the landscape of sun safety policies in Wales.

BACKGROUND: Schools with formal sun safety polices generally show better sun safety practices than schools without. OBJECTIVES: To understand the extent to which Welsh primary schools have sun safety policies; to identify the key characteristics of policies; to assess whether policy adoption varies by school characteristics; and to consider what support schools need to develop sun safety policies. METHODS: An online multiple-choice survey on sun safety was distributed to all 1241 primary schools in Wales. RESULTS: In total, 471 (38.0%) schools responded. Of these, 183 (39.0%) reported having a formal sun safety policy. Welsh medium schools (P = 0.036) and schools in North Wales (P = 0.008) were more likely to report having a policy. Schools with a higher percentage of pupils receiving free school meals (P = 0.046) and with lower attendance rates (P = 0.008) were less likely to report having a sun safety policy. The primary reasons for schools not having a policy included being 'not aware of the need' (34.6%); 'need assistance with policy or procedure development' (30.3%); and 'not got around to it just yet' (26.8%). CONCLUSIONS: With less than half of schools reporting a sun safety policy and variation in the presence/absence of a policy by school characteristics, our survey revealed inconsistency in formal sun safety provision in Welsh schools. The findings also suggest that schools are unaware of the importance of sun safety and need support to develop and implement policies. This snapshot of the current situation in primary schools in Wales provides a basis upon which the comprehensiveness, effectiveness and implementation of sun safety policies can be further evaluated.

Skin cancer survivorship and sun protection behaviors in the United States.

BACKGROUND: Skin cancer survivors are more vulnerable to subsequent skin cancers and other malignancies, but previous studies have not examined in detail their sun protection behavior prevalence by sociodemographic factors. We aimed to understand the sociodemographic disparities in the prevalence of three important types of sun protection behaviors: using sunscreen, seeking shade, and wearing protective clothing, among skin cancer survivors and those without skin cancer history. METHODS: We used the 2015 U.S. National Health Interview Survey to analyze 29,523 participants, of which 772 were skin cancer survivors and 28,751 were those without skin cancer history. We assessed overall and specific sun protection behavior prevalence based on using sunscreen, seeking shade, and wearing protective clothing. Weighted Poisson regression was used to estimate prevalence ratios. RESULTS: Melanoma and nonmelanoma skin cancer survivors had similar overall sun protection behavior (p > .05). Among all skin cancer survivors, 36.0% infrequently used sunscreen, 50.2% infrequently wore protective clothing, 47.8% infrequently sought shade, and 30.0% lacked frequent overall sun protection, which significantly differed from those without skin cancer history (p < .0001). The prevalence of frequent overall sun protection behavior was lower for those who were younger at survey, males, less educated, single or never married, or lived in poverty, regardless of their skin cancer history (p < .01). CONCLUSIONS: By identifying subpopulations with higher prevalence of infrequent sun protection among those with or without skin cancer history, our findings may encourage efforts to reduce sociodemographic disparities in sun protection behaviors and promote primary and tertiary skin cancer prevention.

Evaluation of disposable protective garments against epoxy resin permeation and penetration from anti-corrosion coatings.

INTRODUCTION: Epoxy-based resin formulations are a frequent cause of allergic and irritant contact dermatitis in the construction and painting industries. Cases of epoxy resin contact dermatitis continue to persist across many sectors and are likely attributable to the growing use of epoxy products, including epoxy-based anti-corrosion coatings and inadequate skin protection. There are no published performance data against epoxy resins for garment materials and gloves to guide proper material selection in the workplace. OBJECTIVES: The objective of this study was to evaluate the resistance of 5 protective garment materials against permeation and penetration by bisphenol A diglycidyl ether and its higher oligomers found commonly in epoxy-based anti-corrosion coatings. METHODS: Five disposable garment materials were evaluated for resistance to bisphenol A diglycidyl ether monomers and oligomers during contact with epoxy-based anti-corrosion coatings, including latex gloves, nitrile gloves, Tyvek coveralls, polypropylene/polyethylene (PP/PE) coveralls, and a cotton T-shirt. A permeation test cell system was used to evaluate each garment material against an epoxy-based zinc-rich primer and an epoxy-based intermediate coating using a realistic application method. Glass fiber filters were used to collect permeating and penetrating epoxy resin during a 120-min test period. Bisphenol A diglycidyl ether quantification was performed with high-performance liquid chromatography-electrospray ionization-tandem mass spectrometry. Paint loading, coating thickness, and homogeneity were assessed on polytetrafluoroethylene filters sprayed in series in permeation test cells. RESULTS: Latex gloves provided the least resistance to permeation by BADGE in coating formulations, with a maximum cumulative permeation over the 2-h test interval of 21.7 ng cm-2 with the primer and 513.8 ng cm-2 with the intermediate coating product. Nitrile gloves were not permeated by either coating formulation. The Tyvek coveralls provided greater protection as compared to the PP/PE coveralls. The cotton T-shirt was penetrated by bisphenol A diglycidyl ether more frequently than any of the tested garment materials and resulted in a maximum cumulative penetration of 128 ng cm-2 with the primer and 28.0 ng cm-2 with the intermediate coating. CONCLUSION: Although all the garment materials evaluated during this study provided sufficient protection to prevent cumulative permeation in excess of the established acceptable permeation thresholds, the use of nitrile gloves and Tyvek coverall is highly recommended to minimize skin exposure to bisphenol A diglycidyl ether. We recommend cotton T-shirts to be used under Tyvek coveralls as a secondary layer of skin protection and for added comfort, but not as a primary protection layer.

Behaviorally segmented audiences for managing sunscreen chemical pollution risk in protected coastal natural resource areas.

This audience segmentation of visitors at coastal parks in Hawaii and North Carolina addresses an emergent natural resource management concern and risk to aquatic ecosystems: sunscreen chemical pollution. Four audiences were identified that correspond to different behavioral profiles: sunscreen protection tourists, multimodal sun protection tourists, in-state frequent park visitors, and frequent beachgoers who skip sunscreen. The second-largest audience, sunscreen protection tourists, represents 29% of visitors at Cape Lookout National Seashore and 25% at Kaloko-Honokohau National Historical Park. This group ranks of most concern for chemical pollution because they use sunscreen, but not typically mineral formulations or other methods such as protective clothing, and they have lower levels of sunscreen chemical issue awareness. The identification of similar audience segments across regions with differing cultural characteristics and sunscreen regulation status suggests the robustness of the model and its indicator variables, with implications for both environmental protection and public health. Further, coastal visitors' interest in enacting pro-environmental sun protection behaviors during their next park or beach visit indicates the potential for natural resource managers to holistically address risks in both domains through targeted interventions with audiences of most concern.

The effect of a new design of patient gowns for prone position patients after vitrectomy: A non-randomized, concurrent, controlled study.

BACKGROUND: The existing patient clothing is not suitable for patients that have to maintain a prone position for a long time after vitrectomy. OBJECTIVE: To investigate the effect of a new design of patient gowns for prone position patients after vitrectomy. METHOD: This study designed a kind of patient's gown for prone position patients. A non-randomized, concurrent, controlled study was conducted on 212 patients who met the inclusion criteria for the prone position after vitrectomy in Grade III at a Class A hospital department of ophthalmology in Zhejiang Province from April to August 2020. The experimental group (106 patients in prone position) and the control group (106 patients in common position) were managed by the same group of nurses. The study recorded and compared the comfort degree of patients' clothing used in the course of operation rehabilitation between the two groups and the satisfaction degree of doctors with nurses to patients' clothing used in the prone position. RESULTS: The satisfaction degree and comfort degree of patients and the health care providers in the experiment group were significantly higher than those in the control group (p< 0.001). CONCLUSION: The process of making patient gowns for prone position patients is simple, which can improve the safety and comfort of patients when they were in the prone position. The new design also facilitated the treatment and nursing procedures of the medical staff and improved satisfaction among patients and medical staff.

The formative evaluation and pre-testing of a SunSmart policy implementation support toolkit targeting sun safe hat-wearing in NSW primary schools.

ISSUE ADDRESSED: Strategies that support the implementation of the SunSmart program in primary schools are essential to optimising policy uptake. Evidence outlining the type of support required, however, is lacking. This project explored the usefulness of an implementation support approach to sun safe hat-wearing in schools. METHODS: Formative research was undertaken with 16 primary schools in Greater Western Sydney to explore current sun protection behaviours and practices, perceived barriers and motivators of sun safe hat-wearing, and resource needs. Based on these insights, a resource toolkit was developed and tested in 14 demonstration sites. Follow-up interviews evaluated the usefulness of the toolkit and implementation support approach. RESULTS: Sun safe hat-wearing practices varied among schools. Commonly reported motivators included school policies, role modelling, incentives and knowledge. Commonly reported barriers included negative social norms, forgetfulness, cost and lack of understanding. Formative insights informed the development of the 'Motivation, Access, Triggers' Model and a 23-resource toolkit. Following toolkit rollout, champions reported that the ability to select resources according to local needs was useful, and most found that the toolkit supported their school with sun safe hat-wearing. CONCLUSIONS: A toolkit with local champions and leadership buy-in has the potential to improve policy implementation. The opportunity to prioritise resource selection enables schools to address their specific needs in line with their sun protection policy. SO WHAT?: The provision of policy implementation support can help schools overcome the challenges of transforming a written SunSmart policy into practice.

Design and performance evaluation of a firefighting protective suit with an incorporated liquid-cooled system.

A liquid-cooled garment with active cooling function can make up for deficiency of the human thermoregulatory system and passive thermal insulation of the firefighting protective suit. Fabrics treated at different inlet temperatures and pipeline intervals were applied in multilayered liquid-cooled fabric assemblies (LCFAs). The heat absorbed by the skin and the second-degree burn time were evaluated by the stored energy test under low heat radiation. Results indicated that the thermal protective performance of the LCFAs was significantly improved, with the second-degree burn time increasing more than 50% on average. There was a strong negative correlation between the thermal protective performance and cooling effect under different pipeline intervals, while the negative correlation was weak for different inlet temperatures. The results gained from this study may provide valuable insight for design of the inlet temperature and pipeline interval of a liquid-cooled system in the firefighting protective suit.

Fit of fire boots: exploring internal morphology using computed tomography.

Fit of fire boots is a crucial factor in the safety and performance of firefighters on the hostile fireground. Firefighters have reported that ill-fitting fire boots restrict their lower body movement and sometimes cause very dangerous situations by falling off behind the wearer. By using computed tomography, this study demonstrates the potential to quantify and visualize the fit of fire boots, which previously relied on subjective feedback from the wearers. The high-resolution three-dimensional (3D) models of two fire boot products allowed a detailed observation and measurement of the internal space of the boots. Also, the boot's internal dimension was compared to the foot measurement of local firefighters, showing the significant differences between the two boots. Lastly, simulation wrapping the 3D scanned foot with the boot revealed large void spaces around the toe box and ankle, as well as the narrower ball width of the boot than the foot.

Close-Range Fire Inflicting Behind Armor Blunt Trauma: Case-Series and Implications for Battlefield Care.

Behind armor blunt trauma (BABT) is a non-penetrating injury caused by energy transfer and rapid deformation of protective body armor. Although modern military body armor is designed to prevent penetrating trunk injuries, high-energy projectiles can produce a significant energy transfer to tissues behind the armor and inflict injuries such as fractures or organ contusions. However, knowledge of BABT is limited to biomechanical and cadaver modeling studies and rare case reports. We report two cases of BABT resulting from close-range fire and discuss the potential implications for triaging patients with BABT in battlefield scenarios. In the first case, a 19-year-old male soldier sustained a single close-range 5.56-mm assault rifle gunshot to his chest body armor. The soldier initially reported mild pain in the parasternal region and assessment revealed a 4 cm × 3 cm skin abrasion. Following emergency department evaluation, the soldier was diagnosed with a non-displaced transverse fracture of the sternal body. In the second case, a 20-year-old male sustained five machine gun bullets (7.62 mm) to his body armor. Computed tomography of the chest revealed pulmonary contusions in the right lower and middle lobes. Both soldiers achieved full recovery and returned to combat duty within several weeks. These cases highlight the potential risks of energy transfer from high-velocity projectiles impacting body armor and the need for frontline providers to be aware of the risk of underlying blunt injuries. Further reporting of clinical cases and modeling studies using high-velocity projectiles could inform recommendations for triaging, evacuating, and assessing individuals with BABT.

Bioinspired Hierarchical Multi-Protective Membrane for Extreme Environments via Co-Electrospinning-Electrospray Strategy.

Extreme environments can cause severe harm to human health, and even threaten life safety. Lightweight, breathable clothing with multi-protective functions would be of great application value. However, integrating multi-protective functions into nanofibers in a facile way remains a great challenge. Here, a one-step co-electrospinning-electrospray strategy is developed to fabricate a superhydrophobic multi-protective membrane (S-MPM). The water contact angle of S-MPM can reach up to 164.3°. More importantly, S-MPM can resist the skin temperature drop (11.2 °C) or increase (17.2 °C) caused by 0 °C cold or 70 °C hot compared with pure electrospun membrane. In the cold climate (-5 °C), the anti-icing time of the S-MPM is extended by 2.52 times, while the deicing time is only 1.45 s due to the great photothermal effect. In a fire disaster situation, the total heat release and peak heat release rate values of flame retarded S-MPM drop sharply by 24.2% and 69.3%, respectively. The S-MPM will serve as the last line of defense for the human body and has the potential to trigger a revolution in the practical application of next-generation functional clothing.

User experience of wearing comfort of reusable versus disposable surgical gowns and environmental perspectives: A cross-sectional survey.

OBJECTIVE: To determine the user experience of wearing comfort of reusable sterile surgical gowns and compare these gowns with conventional disposable surgical gowns. DESIGN: Cross-sectional survey. SETTING: An academic hospital in the Netherlands. POPULATION: Gynaecologists, surgeons, residents and operating room assistants (n=80). METHODS: Quantitative and qualitative data were obtained via a written questionnaire. Participants provided subjective comments and scored the reusable gown on each individual topic with a score from 1 to 5 (1 = unsatisfactory, 2 = moderate, 3 = good, 4 = very good, 5 = excellent) and compared the reusable gown with the conventional disposable alternative (better, equal or worse). MAIN OUTCOME MEASURES: Wearing comfort: ventilation and temperature regulation, fit and length, functionality, barrier function and ease of use. RESULTS: The results of the overall scores of the reusable gown are scored as 'very good' (mean 4.3, SD ± 0.5) by its users. Regarding comparison of the gowns, more than 79% (lowest score 79%, highest score 95%) of the participants scored the reusable gown equal or higher on six of seven topics. The topic 'ease of use' was scored equal or higher by 59% of the participants. Subjective comments provided information on possible improvements. CONCLUSIONS: The findings of this study demonstrate that there is professional acceptance regarding the utilisation of reusable surgical gowns. To facilitate broader adoption, it is imperative to foster collaboration among suppliers and healthcare institutions. The reusable surgical gown is an environmentally sustainable, safe and comfortable alternative in the operating room.