Comparative study of infection control practices in DOTS/sputum microscopy centre in two different districts of state of Uttarakhand and Uttar Pradesh of India.

BACKGROUND & OBJECTIVE: Tuberculosis (TB) is endemic in India. TB is transmitted through droplet infection and the transmission occurs when a person inhales droplet nuclei containing of Mycobacterium tuberculosis. Infection control practices play a major role in controlling the TB infection in healthcare settings and further prevents TB infection in the HCWs. The aim of the study is to conduct the cross sectional study for infection control practices in DOTS cum Sputum Microscopy Centre's under NTEP in Ghaziabad (Uttar Pradesh) & Dehradun (Uttarakhand) districts with the objective to assess the compliance of infection control measures by HCWs in DOTS cum Sputum Microscopy Centre's and to suggest the suitable measures and/or model to reduce the transmission of infection to the HCWs and to the community at large. MATERIALS & METHODS: The cross sectional study is conducted for two years in two districts of different state having high burden of TB disease in UP and low burden of disease in UK state. All DOTS cum Sputum Microscopy centres of both selected districts i.e. 100% sample size are covered in the study. RESULTS: Hand washing is the most efficient and cost-effective practice for prevention and control of infection. In Dehradun district 66.66% (12) centers and in Ghaziabad district 57.14% (16) centers have adequate hand washing facility available at DOTS and sputum microscopy lab. Unavailability of adequate PPE will lead to the infection. In Dehradun district, 55.56% (10) centers have adequate PPE available whereas in Ghaziabad District 21.43% (6) centers have adequate PPE available. Training on infection prevention and control for HCWs are provided in 27.78% (5) DOTS/sputum microscopy center in Dehradun whereas none of the DOTS/sputum microscopy center in Ghaziabad district are given training on infection prevention & control for HCWs in last one year. Adequate ventilation plays an important role in transmission of TB/MDR TB or any respiratory infection. HCWs working in DOTS/Sputum microscopy center are at risk to contact the TB/MDR TB infection if there is no proper ventilation in their working places. In 33.33% (6) DOTS/sputum microscopy center in Dehradun & 28.57% (8) in Ghaziabad district have adequate ventilation. Layout of DOTS room and for sputum microscopy center are suggested to reduce the risk of transmission of TB/MDR-TB and other respiratory pathogens amongst HCWs who are working in DOTS cum sputum microscopy center. CONCLUSION: DOTS cum Sputum Microscopy Centers of both districts in different states are having deficient infection control practices. Staff is not adequately trained in infection prevention and control practices.

PE/PPE Proteome and ESX-5 Substrate Spectrum in Mycobacterium marinum.

PE/PPE proteins secreted by the ESX-5 type VII secretion system constitute a major protein repertoire in pathogenic mycobacteria and are essential for bacterial survival, pathogenicity, and host-pathogen interaction; however, little is known about their expression and secretion. The scarcity of arginine and lysine residues in PE/PPE protein sequences and the high homology of their N-terminal domains limit protein identification using classical trypsin-based proteomic methods. This study used endoproteinase AspN and trypsin to characterize the proteome of Mycobacterium marinum. Twenty-seven PE/PPE proteins were uniquely identified in AspN digests, especially PE_PGRS proteins. These treatments allowed the identification of approximately 50% of the PE/PPE pool encoded in the genome. Moreover, EspG5 pulldown assays retrieved 44 ESX-5-associated PPE proteins, covering 85% of the PPE pool in the identified proteome. The identification of PE/PE_PGRS proteins in the EspG5 interactome suggested the presence of PE-PPE pairs. The correlation analysis between protein abundance and phylogenetic relationships found potential PE/PPE pairs, indicating the presence of multiple PE/PE_PGRS partners in one PPE. We validated that EspG5 interacted with PPE31 and PPE32 and mapped critical residues for complex formation. The modified proteomic platform increases the coverage of PE/PPE proteins and elucidates the expression and localization of these proteins.

Factors Associated with Personal Protective Equipment Usage Rates in the Central States: Generalized Multilevel Multinomial Models.

OBJECTIVES: This study examined the factors affecting the use of personal protective equipment (PPE) among US agriculture producers, specifically focusing on chemical, respiratory, and hearing protection. The primary goals were to identify demographic and farm-related factors linked to lower PPE usage and to explore the associations between PPE use and self-reported injuries or diseases in this occupational context. METHODS: We developed generalized multilevel multinomial logistic regressions for the agricultural safety and health survey data from 2018 and 2020. Our models aimed to explore associations between PPE use, covariates, and their impact on skin diseases, hearing loss, and respiratory diseases. The hierarchical structure of the data was accommodated by designating the survey year as the level-3 variable and the state of residence as the level-2 variable, further delineating the nested structure of the respondents. We proposed using Adaptive Quadrature methods to approximate marginal maximum likelihood function, along with Gauss-Hermite quadrature weights when estimating fixed-effects and random effects in the proposed models. Missing data in this hierarchical structure were addressed through a multiple imputation method. RESULTS: Our findings revealed older age is associated with lower PPE usage across all types. Males exhibited higher PPE use, particularly for chemical (OR: 1.26, 95% CI: 1.08, 1.47) and respiratory protection (OR: 1.33, 95% CI: 1.18, 1.52). Producers on grain-only farms showed increased chemical PPE use (OR: 1.26, 95% CI: 1.10, 1.43) compared to those on livestock-only farms. Additionally, individuals spending 0%-24% of their worktime on the farm/ranch demonstrated lower PPE use than those who spent more time engaged in farm-related activities. CONCLUSION: The study underscores the importance of addressing low PPE usage among agriculture producers. Interventions tailored to specific groups, such as female producers, livestock-only farms, older-aged producers, and part-time producers, can effectively improve PPE use. By identifying these high-risk groups, interventions can be better adapted and targeted to enhance the adoption of PPE, subsequently reducing the risk of health hazards in the agriculture sector.

Relationships between effective safety training, safety knowledge and personal protective equipment related behaviors among firefighters.

INTRODUCTION: Firefighter injuries and fatalities have been attributed to improper or ineffective use of personal protective equipment (PPE). Although studies have examined predictors of PPE to include situational, leadership, stressors and other psychosocial factors, research has not thoroughly examined the relationships between effective safety training administration, knowledge creation, and the influence of those factors on PPE use among firefighters. METHOD: This study aimed to assess those relationships by using structural equation modeling analysis. RESULTS: The model fit was good, and findings confirmed the hypothesized model and relationships, which included a positive, significant relationship between effective safety training and safety knowledge and positive, significant relationships between safety knowledge and PPE-related safety behavior outcomes, including the effective use of PASS devices, the correct use of SCBA and PPE during overhaul operations, and the correct use and inspection of PPE among firefighters in general. PRACTICAL APPLICATIONS: Findings support the importance of safety training in the fire service to bolster knowledge and correct PPE use.

Using Caring Theory to Guide Application of Psychological PPE to Support Graduate Nurse Wellbeing in a Pandemic and Beyond.

The COVID-19 pandemic disrupted lives worldwide, including students pursuing secondary education. This disruption caused increased worry, anxiety, and overall stress in students. Graduate-level nursing students also not only experienced stress related to educational disruptions but also due to work and home life upheaval as well. Faculty were challenged to support students in reducing educational stress and anxiety. While the Institute for Healthcare Improvement introduced the concept of 'Psychological Personal Protective Equipment' (PPE) to support the mental well-being of healthcare workers, this article explores how faculty implemented psychological PPE in graduate-level education using Swanson's Theory of Caring as the theoretical framework during the pandemic and how these constructs can continue to support student wellbeing in today's challenging environment.

The collateral effects of COVID-19 on coastal and marine environments.

The COVID-19 pandemic has generated a global health and economic crisis, significantly impacting coastal and marine environments. Lockdowns and restrictions, while necessary for public health, led to both positive and negative environmental consequences. Reduced human activity resulted in decreased pollution and habitat disruption, allowing for ecosystem recovery and improved water quality. However, the surge in single-use plastics and personal protective equipment (PPE) during the pandemic exacerbated plastic pollution. Additionally, the economic downturn severely affected coastal communities reliant on tourism and fisheries, highlighting the need for sustainable recovery strategies. This Special Issue explores these collateral effects, emphasizing the importance of adaptive management and resilient governance in safeguarding coastal and marine ecosystems against future crises.

Detection of Pharmaceutical Personal Protective Equipment in Video Stream.

Pharmaceutical manufacturing is a complex process, where each stage requires a high level of safety and sterility. Personal Protective Equipment (PPE) is used for this purpose. Despite all the measures of control, human factor (improper PPE wearing) causes numerous losses for human health and material property. This research proposes solid computer vision system for ensuring safety in pharmaceutical laboratories. For this we have tested wide range of state-of-the-art object detection methods. Composing previously obtained results in this sphere with our own approach to this problem, we have reached the high accuracy (mAP@0.5) ranging from 0.77 up to 0.98 in detecting all the elements of common set of PPE used in pharmaceutical laboratories. Our system is the step towards safe medicine producing.

COVID-19: did the masks work?

During the early stages of the COVID-19 pandemic, we called for mandatory public masking to 'flatten the curve'. We helped formulate a national standard (SWiFT 19) for barrier facemasks, and, using a novel laser-based approach, we determined that mask efficacy is dependent on both fabric and fit; with both variables being inversely related. Herein, we take a retrospective view of the role of masks during the pandemic and surmise that, on the balance of evidence to date, masks were effective at stemming the spread of SARS-CoV-2 and may well be an effective early control strategy for potential future respiratory pandemics.

Face coverings, which cover the nose and mouth, are a means of preventing infections that travel in the air. These include viruses such as SARS-CoV-2, which causes COVID-19. Face coverings, or masks, played a key role during the COVID-19 pandemic by reducing person-to-person spread of the virus. The key features of a mask that make it effective are the material from which it is made and how closely the mask fits the face. A loosely fitting mask, for example, will lead to gaps around the nose and cheeks through which droplets can escape. A better fitting mask will have less leakage. Masks made from light single-layer material is less able to prevent droplet penetration than thicker, multi-layered fabric. Properly fashioned and fitted face masks are an effective means of slowing the spread of infections that travel in the air.

Respiratory Morbidity Among Seed-Processing Industry Workers: A Cross-Sectional Study in Rural West Bengal, 2022-2023.

Background: Seed processing workers are exposed to dust particles generated during the processing of seeds, which can have adverse effects on their respiratory health. Aim: to estimate the prevalence and patterns of respiratory morbidity among seed processing workers in Hooghly district, West Bengal, India, and to explore their use of respiratory personal protective equipment (PPE). Methods: A cross sectional observational study was conducted in 5 seed processing plants from December 2022 to February 2023. A sample size of 129 workers was selected using probability proportionate to population size to select seed processing plants and simple random sampling to select workers at selected plants. Data on sociodemographic characteristics, occupational profile, substance use patterns, respiratory PPE use, and respiratory symptoms were collected through structured interviews. Spirometry was performed with a hand held tabletop spirometer (RMS Helios 401) to assess respiratory function. Results: 52.7% of participants reported at least one chronic respiratory symptom, while 17.1% had evident respiratory morbidity based on spirometry results, with most having restrictive patterns (10.1%). Multivariable regression analysis revealed that factors associated with respiratory morbidity included increasing work years of exposure [1.10 (1.02 1.18)], irregular use of respiratory PPE [4.36 (1.22 15.57)], and primary or below education level [6.09 (1.38 26.98)]. Conclusion: The study highlights the high prevalence of respiratory symptoms and morbidity among seed processing workers. It emphasizes the importance of implementing effective respiratory protection measures and raising awareness about occupational lung diseases in this industry. Further research and interventions are needed to improve the respiratory health and well being of seed processing workers.

Wearable Sensor Node for Safety Improvement in Workplaces: Technology Assessment in a Simulated Environment.

Personal protective equipment (PPE) has been universally recognized for its role in protecting workers from injuries and illnesses. Smart PPE integrates Internet of Things (IoT) technologies to enable continuous monitoring of workers and their surrounding environment, preventing undesirable events, facilitating rapid emergency response, and informing rescuers of potential hazards. This work presents a smart PPE system with a sensor node architecture designed to monitor workers and their surroundings. The sensor node is equipped with various sensors and communication capabilities, enabling the monitoring of specific gases (VOC, CO2, CO, O2), particulate matter (PM), temperature, humidity, positional information, audio signals, and body gestures. The system utilizes artificial intelligence algorithms to recognize patterns in worker activity that could lead to risky situations. Gas tests were conducted in a special chamber, positioning capabilities were tested indoors and outdoors, and the remaining sensors were tested in a simulated laboratory environment. This paper presents the sensor node architecture and the results of tests on target risky scenarios. The sensor node performed well in all situations, correctly signaling all cases that could lead to risky situations.

Development of an experimental technique to determine the barrier performance of medical gloves when stretched.

Protective clothing standards, such as test methods published by ASTM International, play an integral role in ensuring the performance of personal protective equipment. The standard tests are not without limitations and are periodically reviewed and often updated. Some tests may not be reflective of in-use conditions. A new test cell was designed using sanitary fixtures to evaluate the effect of glove stretch on barrier performance using fluorescein solution as the challenge agent for enhanced visualization and fluorometer detection. Domed-shaped and flat screens were developed to permit and limit glove stretch within the test cell. The barrier performance of glove swatches was evaluated for both stretched and unstretched states. Latex, nitrile, and vinyl glove models of various thicknesses were evaluated. The tests were conducted following pressure and time parameters specified in ASTM F903, ASTM F1670, and ASTM F1671. Fluorescein solution movement, which may occur through penetration, was measured using a fluorometer. Glove stretch caused a reduction in glove thickness ranging from 16% to 40%. Overall, 21 sample failures were found (16.7%; n = 126) regardless of test condition. Nitrile gloves provided better barrier efficacy with the lowest failure rates (2.38%; 1 failure out of 42) compared to latex (19.4%; 7 failures out of 36) and vinyl gloves (27.1%; 13 failures out of 48). Differences in failure rates between stretched and unstretched gloves were insignificant; however, the latex material showed a 2.5 times increase in failures when stretched compared to unstretched. The new test apparatus was able to differentiate between the barrier performance of different glove materials. The use of a domed screen allowed the gloves to stretch, a condition that better represents the state of gloves when in use. Analysis of samples collected from the glove surface opposite to the exposure may provide a way to assess chemical permeation in addition to penetration.

Effects of Wearing Personal Protective Equipment on Serum Cortisol Levels and Physiological Variables in Healthcare Workers: A Randomised Controlled Trial in a Simulated Pandemic Environment.

INTRODUCTION: The COVID-19 pandemic has necessitated the widespread use of personal protective equipment (PPE), particularly in high-risk environments. Full-body PPE is favoured for its comprehensive protection against the virus but poses challenges to the body's thermoregulatory system as it inhibits air exchange. This randomised trial was undertaken to investigate the effects of wearing a commonly used gown-type full-body PPE kit in a simulated environment. METHODS: Initially, 65 healthy males were recruited and randomly divided into two groups: a study group wearing a full-body PPE kit (gown-type, full-body PPE kit with trousers, a gown-type shirt with a hood, a shoe cover, an N95 face mask, and an optional face shield) and a control group without PPE. They remained seated for three hours while wearing the PPE kit. Room conditions mimicked non-air-conditioned hospital scenarios, with temperature and humidity recorded and ventilation provided through open doors and windows, along with ceiling fan cooling. Activities with minimal physical exertion were allowed, and access to the toilet was kept to a minimum. Subjects underwent assessments of heart rate, respiratory rate, temperature, blood pressure, heart rate variability (HRV), and blood samples for serum cortisol before donning the PPE kit and entering a simulated ICU/WARD environment and after doffing. RESULTS: A total of 60 participants completed the study (30 in each group). Compared to the controls, serum cortisol levels significantly increased in the PPE groups, and HRV data indicated increased sympathetic activity in the PPE group. CONCLUSION:  Wearing a full-body PPE kit (gown-type upper garment with trousers) was found to have a significant impact on cortisol levels and physiological variables in a simulated environment. This suggests that in situations like the COVID-19 pandemic that warrant the use of such PPE kits, appropriate measures should be taken to provide better thermal stability for maintaining the well-being of healthcare workers.

Evaluation of self-contained breathing apparatus (SCBA) weight on firefighter stamina, comfort, and postural stability.

Firefighters wear personal protective equipment to protect them from the thermal and chemical environment in which they operate. The self-contained breathing apparatus (SCBA) provides isolation of the airway from the hazardous fireground. National standards limit SCBA weight, however, integration of additional features could result in an SCBA exceeding the current limit. The purpose of this study was to examine the effects of increased SCBA weight on firefighters' physiological responses, work output, dynamic stability, and comfort. Completion of simulated firefighting activities induced a strong physiological response. Peak oxygen consumption was higher with the lightest SCBA than the heaviest SCBA. Few other physiological differences were noted as SCBA weight increased. Importantly, increased SCBA weight resulted in significantly more negative perceptions by the firefighters and a trend towards significance for the duration of work time prior to reaching volitional fatigue. These results should be considered when assessing changes to existing SCBA weight limits.

Increased SCBA weight above existing national standards resulted in negative perceptions by the firefighters, but not significant physiological changes after two simulated bouts of firefighting activity. SCBA weight had a nearly significant impact on the time firefighters worked before reaching volitional fatigue, with heavier SCBA trending towards decreased working time.

Occupational accidents and the use of PPE: a global meta-analysis.

Occupational accidents, despite continuous safety updates, are still a scourge in the occupational and forensic spheres, constituting, among other things, the subject of a large share of litigation. Demographic data can help to understand the areas where the application of health surveillance is lacking. This meta-analysis sets out to analyse data from studies on accidents at work, focusing on the correlation between the areas in which accidents occur and whether or not personal safety equipment is used, in relation to the different regulations in force. For the selection of the data, a systematic review was carried out according to the PRISMA guidelines, with the primary objective of identifying the trend of occupational accidents in specific geographical areas, which differ in terms of the attention paid to preventive aspects. The data we highlighted showed, regarding the type of accident, substantial differences between low-income countries and industrialised countries (stratified according to the Human Development Index) and, an overall indifference as to whether or not individual safety devices were used, revealing that, despite the continuous normative evolution in the field of safety at work, even today, the investigative data on the actual application of the regulations, during accidents at work, is underestimated and little researched.

Assessing personal protective equipment usage and its correlation with knowledge, attitudes, performance, and safety culture among workers in small and medium-sized enterprises.

BACKGROUND: The use of personal protective equipment (PPE) should be a culture of a workplace, and deeply rooted in worker behavior and attitude during their practice. According to the recent studies only 64% of the workers use PPE properly. The present study aims to investigate the utilization of PPE among workers in small and medium-sized enterprises (SMEs), and its relationship with knowledge, attitude, performance, and safety culture among workers. METHODS: This cross-sectional study was carried out using a questionnaire tool across SMEs in Kashan city in year 2023. The used tool included three questionnaires: demographic, safety culture, and knowledge, attitude and performance. Study papulation was 529 SMEs. Totally, the sample size was 369 persons and questionnaires were distributed among the workers of SMEs. Finally, SPSS software was used for statistical analysis and structural equation modeling. Various statistical tests including T-Test, ANOVA, RMSEA, CFI, TLI, and the chi-square ratio were employed. RESULTS: The mean values (standard deviation) of age and work experience were 35.19 (12.33), and 15.60 (1.69) years, respectively. Among the 369 participants, 267 participants (72.4%) indicated that they use some PPE, although not all types. However, 102 individuals (27.7%) do not employ any PPE. The lowest score for safety culture dimension was attributed to safety training at 1.58. The results of the final model indicate that the assumed relationships between variables, as outlined in the study objectives, were well established, with all connections proving statistically significant. CONCLUSION: It can be concluded that the missing of inadequate legal supervision for small industries exists. Therefore, it can be inferred that if supervision and regulation are enhanced for safety training and implementation that may lead to increased usage of PPE.

Management of SARS-CoV-2 Prevention Methods in Dental Offices-A Cross-Sectional Study in Bucharest, Romania.

We compared the managing of prevention methods for SARS-CoV-2 infections in dental offices before and immediately after the COVID-19 pandemic. The purpose of this study was to find out the varieties of infection prevention methods used by dentists before and during the pandemic and compare them. We designed a digital transversal questionnaire with 15 closed questions that was sent to 150 dentists in Bucharest, Romania. We received n = 112 valid answers during July-August 2021 from dentists of all age groups (25-60 years), with a sex ratio of 0.36, which agreed to anonymously participate in this study. The results showed an increase in types and amount of personal protection equipment (i.e., ocular/facial protection, supplemental gown, and upgrading the FFP1 masks to FFP2 or FFP3). Ocular protection showed statistical significance by gender but not by age group. Vaccination rate against SARS-CoV-2 was at 80% of the participant dentists at the time of the survey and had statistical significance. However, vaccination status of the patients did not alter dentists' protection protocol.

Mixed-methods study of medical students' attitudes toward peer physical examinations in Japan.

BACKGROUND: Most Japanese medical schools likely continue to rely on peer physical examination (PPE) as a tool to for teaching physical examination skills to students. However, the attitudes of medical students in Japan toward PPEs have not be identified. Therefore, we evaluated students' attitudes toward PPE in a Japanese medical school as a preparation for developing a PPE policy tailored to the context of Japanese culture. METHODS: We conducted a mixed-methods study with an explanatory sequential approach, in which qualitative data were used to interpret the quantitative findings. Surveys and interviews were conducted with medical students and junior residents at a Japanese university. A total of 63 medical students and 50 junior residents responded to the questionnaire. We interviewed 16 participants to reach theoretical saturation and investigated the attitudes of medical students toward PPE and the themes emerging from the interview data, providing detailed descriptions of the quantitative findings. RESULTS: Female participants were significantly more likely than male participants to report varying degrees of resistance to being a model patient during PPE (male: 59.7%, female: 87%, p < 0.001). Most of the participants who took on the role of patients that involved undressing were males. The participants expected improvements in issues related to the guarantee of freedom to refuse to be a model patient and measures to protect confidentiality. Approximately 22% of the participants reported that they witnessed incidental findings (including variations within the normal range) in front of other students during PPE. CONCLUSIONS: The findings imply that medical students expect high levels of autonomy and confidentiality when volunteering as model patients during PPE. Thus, developing a PPE policy suitable for Japanese culture may be effective in establishing a student-centered PPE environment.

The RXLR effector PpE18 of Phytophthora parasitica is a virulence factor and suppresses peroxisome membrane-associated ascorbate peroxidase NbAPX3-1-mediated plant immunity.

Phytophthora parasitica causes diseases on a broad range of host plants. It secretes numerous effectors to suppress plant immunity. However, only a few virulence effectors in P. parasitica have been characterized. Here, we highlight that PpE18, a conserved RXLR effector in P. parasitica, was a virulence factor and suppresses Nicotiana benthamiana immunity. Utilizing luciferase complementation, co-immunoprecipitation, and GST pull-down assays, we determined that PpE18 targeted NbAPX3-1, a peroxisome membrane-associated ascorbate peroxidase with reactive oxygen species (ROS)-scavenging activity and positively regulates plant immunity in N. benthamiana. We show that the ROS-scavenging activity of NbAPX3-1 was critical for its immune function and was hindered by the binding of PpE18. The interaction between PpE18 and NbAPX3-1 resulted in an elevation of ROS levels in the peroxisome. Moreover, we discovered that the ankyrin repeat-containing protein NbANKr2 acted as a positive immune regulator, interacting with both NbAPX3-1 and PpE18. NbANKr2 was required for NbAPX3-1-mediated disease resistance. PpE18 competitively interfered with the interaction between NbAPX3-1 and NbANKr2, thereby weakening plant resistance. Our results reveal an effective counter-defense mechanism by which P. parasitica employed effector PpE18 to suppress host cellular defense, by suppressing biochemical activity and disturbing immune function of NbAPX3-1 during infection.

The collateral effects of COVID-19 on marine pollution.

The COVID-19 pandemic has gained significant attention to the intersection of public health crises and environmental challenges, particularly in the context of marine pollution. This paper examines the various impacts of the pandemic on marine environments, focusing on the pollution attributed to single-use plastics (SUPs) and personal protective equipment (PPE). Drawing on a comprehensive analysis of literature and case studies, the paper highlights the detrimental effects of increased plastic waste on marine ecosystems, biodiversity, and human health. Statistical data and graphical representations reveal the scale of plastic pollution during the pandemic, emphasizing the urgent need for mitigation strategies. The study evaluates innovative monitoring techniques and future recommendations, emphasizing stakeholder collaboration in sustainable waste management. By broadening geographic examples and comparative analyses, it provides a global perspective on the pandemic's impact, highlighting the importance of international cooperation for safeguarding marine ecosystems.