Field trial assessing the antimicrobial decontamination efficacy of gaseous ozone in a public bus setting

The widespread COVID-19 pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) necessitated measures aimed at preventing the spread of SARS-CoV-2. To mitigate the risk of fomite-mediated transmission, environmental cleaning and disinfection regimes have been widely implemented. However, conventional cleaning approaches such as surface wipe downs can be laborious and more efficient and effective disinfecting technologies are needed. Gaseous ozone disinfection is one technology which has been shown to be effective in laboratory studies. Here, we evaluated its efficacy and feasibility in a public bus setting, using murine hepatitis virus (a related betacoronavirus surrogate) and the bacteria Staphylococcus aureus as test organisms. An optimal gaseous ozone regime resulted in a 3.65-log reduction of murine hepatitis virus and a 4.73-log reduction of S. aureus, and decontamination efficacy correlated with exposure duration and relative humidity in the application space. These findings demonstrated gaseous ozone disinfection in field settings which can be suitably translated to public and private fleets that share analogous characteristics. Graphical abstract Unlabelled Image

Field trial assessing the antimicrobial decontamination efficacy of gaseous ozone in a public bus setting.

The widespread COVID-19 pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) necessitated measures aimed at preventing the spread of SARS-CoV-2. To mitigate the risk of fomite-mediated transmission, environmental cleaning and disinfection regimes have been widely implemented. However, conventional cleaning approaches such as surface wipe downs can be laborious and more efficient and effective disinfecting technologies are needed. Gaseous ozone disinfection is one technology which has been shown to be effective in laboratory studies. Here, we evaluated its efficacy and feasibility in a public bus setting, using murine hepatitis virus (a related betacoronavirus surrogate) and the bacteria Staphylococcus aureus as test organisms. An optimal gaseous ozone regime resulted in a 3.65-log reduction of murine hepatitis virus and a 4.73-log reduction of S. aureus, and decontamination efficacy correlated with exposure duration and relative humidity in the application space. These findings demonstrated gaseous ozone disinfection in field settings which can be suitably translated to public and private fleets that share analogous characteristics.

Ambient fine particulate matter exposures and oxidative protein damage in early pregnant women

The association between oxidative protein damage in early pregnant women and ambient fine particulate matter (PM2.5) is unknown. We estimated the effect of PM2.5 exposures within seven days before blood collection on serum 3-nitrotyrosine (3-NT) and advanced oxidation protein products (AOPP) in 100 women with normal early pregnancy (NEP) and 100 women with clinically recognized early pregnancy loss (CREPL). Temporally-adjusted land use regression model was applied for estimation of maternal daily PM2.5 exposure. Single-day lag effect of PM2.5 was analyzed using multivariable linear regression model. Net cumulative effect and distributed lag effect of PM2.5 within seven days were analyzed using distributed lag non-linear model. In all 200 subjects, the serum 3-NT were significantly increased with the single-day lag effects (4.72%–8.04% increased at lag 0–2), distributed lag effects (2.32%–3.49% increased at lag 0–2), and cumulative effect within seven days (16.91% increased). The single-day lag effects (7.41%–10.48% increased at lag 0–1), distributed lag effects (3.42%–5.52% increased at lag 0–2), and cumulative effect within seven days (24.51% increased) of PM2.5 significantly increased serum 3-NT in CREPL group but not in NEP group. The distributed lag effects (2.62%–4.54% increased at lag 0–2) and cumulative effect within seven days (20.25% increased) of PM2.5 significantly increased serum AOPP in early pregnant women before the coronavirus disease (COVID-19) pandemic but not after that. In conclusion, PM2.5 exposures were associated with oxidative stress to protein in pregnant women in the first trimester. Wearing masks may be potentially preventive in PM2.5 exposure and its related oxidative protein damage. Whether PM2.5–associated systemic 3-NT increase contributes to the pathogenic mechanisms of spontaneous abortion remains to be further investigated.

The Efficacy of Hospice Care for Terminally Ill Emergency Patients During the Coronavirus 2019 Pandemic.

Objective: This study aimed to explore the efficacy of hospice care for terminally ill emergency patients in the COVID-19 context. Methods: A total of 86 terminally ill emergency patients at the authors' hospital from February 2020 to October 2020 were included in this study, they were randomly allocated into a control (n = 42) and an intervention (n = 44) group, respectively. The control group received routine nursing care, and the intervention group received hospice care. Results: Following treatment, the survival time (as the primary outcome) in the intervention group was longer than in the control group (P < 0.05). Distress thermometer and psychological pain-related factor scores for the intervention group were lower than those of the control group (P < 0.001 for both). The comfort scores of all dimensions in the intervention group were higher than in the control group (P < 0.05). The scores for survival puzzle, symptom distress, independence, and mental well-being in all dimensions related to a sense of dignity were lower in the intervention than in the control group (P < 0.05 for all). The intervention group's yield, avoidance, and total scores were lower than in the control group, whereas the face score was higher than in the control group (P < 0.05 for all). Conclusion: In the current COVID-19 context, the telehealth (psychological, physical, online remote support, critical illness communication, and death education) approach adopted by the Anning care team for terminally ill emergency patients and other aspects of peace care could help improve the physical and mental health of patients. Hospice care can minimise the physical and psychological pain of terminally ill patients in the emergency department and assist them in their final stage of life by providing a calming and comfortable environment.

Effect Analysis of "Four-Step" Training and Assessment Tool in the Prevention and Control of COVID-19.

Purpose: To improve the ability of infection prevention and control (IPC) of medical staff during the COVID-19 epidemic period, the "four-step" mode of whole staff training and assessment was used. Methods: During the period from March 9 to March 18, 2020, 5425 medical staff from The First Affiliated Hospital of Nanjing Medical University were selected as the objects of this study. There are four stages in the training assessment mode. The first stage is the basic assessment stage; the second stage releases the electronic version of the knowledge point manual; the third stage conducts online exercises; the fourth stage conducts the final assessment. Results: In the first stage, the participation rate of medical staff was 95.04%. In the fourth stage, the participation rate of medical staff was 98.01%. The average score of female medical staff in the first stage and the fourth stage was higher than that of males (P< 0.001). The average score of medical staff under 30 years old in the first stage and the fourth stage was higher than that of other age groups (P< 0.05). In the fourth stage, the correct rate of each part of exercises in the knowledge points of IPC was higher than that in the first stage (P< 0.001). In the two stages, the two parts of "COVID-19 prevention and control" and "multi-drug resistant bacteria prevention and control" had the highest accuracy, while the "disinfection and sterilization" and "infectious disease management" had the lowest accuracy (P< 0.001). Conclusion: The "four-step" infection control training assessment mode has realized "full participation" and "effective training", and the level of medical staff's IPC has been significantly improved.

AudienceMR: Extending the Local Space for Large-Scale Audience with Mixed Reality for Enhanced Remote Lecturer Experience

AudienceMR is designed as a multi-user mixed reality space that seamlessly extends the local user space to become a large, shared classroom where some of the audience members are seen seated in a real space, and more members are seen through an extended portal. AudienceMR can provide a sense of the presence of a large-scale crowd/audience with the associated spatial context. In contrast to virtual reality (VR), however, with mixed reality (MR), a lecturer can deliver content or conduct a performance from a real, actual, comfortable, and familiar local space, while interacting directly with real nearby objects, such as a desk, podium, educational props, instruments, and office materials. Such a design will elicit a realistic user experience closer to an actual classroom, which is currently prohibitive owing to the COVID-19 pandemic. This paper validated our hypothesis by conducting a comparative experiment assessing the lecturer’s experience with two independent variables: (1) an online classroom platform type, i.e., a 2D desktop video teleconference, a 2D video screen grid in VR, 3D VR, and AudienceMR, and (2) a student depiction, i.e., a 2D upper-body video screen and a 3D full-body avatar. Our experiment validated that AudienceMR exhibits a level of anxiety and fear of public speaking closer to that of a real classroom situation, and a higher social and spatial presence than 2D video grid-based solutions and even 3D VR. Compared to 3D VR, AudienceMR offers a more natural and easily usable real object-based interaction. Most subjects preferred AudienceMR over the alternatives despite the nuisance of having to wear a video see-through headset. Such qualities will result in information conveyance and an educational efficacy comparable to those of a real classroom, and better than those achieved through popular 2D desktop teleconferencing or immersive 3D VR solutions.

The prevalence and risk factors for depressive symptoms in frontline nurses under COVID-19 pandemic based on a large cross-sectional study using the propensity score-matched method.

INTRODUCTION: To explore the prevalence of depressive symptoms and the associated risk factors in frontline nurses under COVID-19 pandemic. METHODS: This cross-sectional study was conducted from February 20, 2020 to March 20, 2020 and involved 562 frontline nurses. The effective response rate was 87.68%. After propensity score matched, there were 498 participants left. Extensive characteristics, including demographics, dietary habits, life-related factors, work-related factors, and psychological factors were collected based on a self-reported questionnaire. Specific scales measured the levels of sleep quality, physical activity, depressive symptoms, perceived organization support and psychological capital. Adjusted odds ratios and 95% confidence intervals were determined by binary paired logistic regression. RESULTS: Of the nurses enrolled in the study, 50.90% had depressive symptoms. Three independent risk factors were identified: poor sleep quality (OR = 1.608, 95% CI: 1.384-1.896), lower optimism of psychological capital (OR = 0.879, 95% CI: 0.805-0.960) and no visiting friend constantly (OR = 0.513, 95% CI: 0.286-0.920). CONCLUSIONS: This study revealed a considerable high prevalence of depressive symptoms in frontline nurses during the COVID-19 outbreak, and identified three risk factors, which were poor sleep quality, lower optimism of psychological capital, and no visiting friend constantly. Protecting mental health of nurses is important for COVID-19 pandemic control and their wellbeing. These findings enrich the existing theoretical model of depression and demonstrated a critical need for additional strategies that could address the mental health in frontline nurses for policymakers.