Virucidal activity of formaldehyde solutions used for preservation of allograft tympano-ossicular systems

Objective: Allograft tympano-ossicular systems (ATOS) can provide superior outcomes in particular circumstances, for example, in case of a need for total reconstruction of the eardrum and chain. ATOS are preserved in a 2.7%–4% formaldehyde solution after procurement at room temperature (15-25°C) for 2–5 days, followed by 4 °C for a total storage of at least 14 days. This study aimed to review the literature on the virucidal effect of formaldehyde on viruses such as human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: Narrative review of the literature available on the virucidal effect of formaldehyde, as searched in the scientific database PubMed. Results: Both free and intracellular HIV as well as HBV and HCV are significantly reduced at low concentrations of formaldehyde and short exposure time. Factors increasing the effectivity of formaldehyde solutions are high concentration, long exposure time, and high temperature. It has been demonstrated that HIV-infected allografts are disinfected by formaldehyde preservation. No case of HIV, HBV, or HCV transmission through ATOS has been reported. Coronaviruses closely related to SARS-CoV-2, such as SARS-CoV and MERS-CoV, are inactivated by low concentrations of formaldehyde solution, even at short exposure times. Conclusion: These findings indicate that formaldehyde is effective in inactivating HIV, HBV, HCV, and coronaviruses. ATOS are stored in a high concentration formaldehyde solution for a long period. The applied preservation method of ATOS, including temporary storage at room temperature, should be maintained for effective inactivation. The formaldehyde preservation method in combination with donor screening and serological and nucleotide amplification testing make ATOS a very safe reconstruction material.

Elective otological healthcare under COVID-19 contaminations risks

The COVID-19 pandemic has raised unprecedented challenges for all types of medical personnel and health care workers. The avidity of the novel coronavirus for oropharynx and nasopharynx renders otolaryngologists at particular risk of infection. Therefore, the resumption of elective otological care requires personal protective equipment (PPE), thorough (pre)screening and irrefutable hand hygiene. A literature search was conducted on May 5th, 2020. All recommendations concerning otological ENT (Ear Nose Throat), both during outpatient consultation and in the operating theatre, were scored for abundance. Highly recurrent advice was using PPE during each patient encounter, social distancing in the waiting room and teleconsultation before each consultation. Concerning audiological testing, most articles advised social distancing during testing and remote hearing screeners. For resumption of elective otological surgery, preoperative screening, adequate PPE, and minimal staffing to reduce the contamination risk were most frequently advised. Awaiting an effective vaccination for the novel coronavirus, all elective otological health care requires critical appraisal of each case to assess the infectious risks for both patient and health care personnel.

COVID-19 and olfactory dysfunction - an ENT perspective to the current COVID-19 pandemic

The current COVID-19 or Sars-CoV-2 pandemic increased awareness of hyposmia or anosmia, as this can be an accompanying symptom. In mild cases, anosmia without rhinorrhea can be the only presenting symptom of this infection. Timely identification can lead to early detection of otherwise asymptomatic carriers. History taking and essential clinical assessment with appropriate protective measures can be performed in patients in whom COVID-19 is suspected. Patients with anosmia without nasal obstruction should be considered COVID-19 suspect and this should initiate testing or self-isolation. As for treatment of hyposmia or anosmia, the authors do not advise treatment with systemic corticosteroids in patients with COVID-19. Based on expert opinion, nasal corticosteroids can be considered, with a preference for spray formulation. Patients who were already using topical or inhalation corticosteroids for proven pre-existing disease (such as asthma and/or allergy) should be advised to continue their maintenance therapy. ENT (Ear Nose Throat) focus on hyposmia and anosmia should be continued, to gain additional knowledge of the disease mechanisms of COVID-19 and improve follow-up, not only on the pneumological aspects but also to evaluate the impact on quality of life of potentially long-term side effects caused by anosmia.

SUSTAINABLE BLENDED TEACHING PRACTICES: LESSONS LEARNED FROM INSTRUCTOR PERSPECTIVES

The higher education (HE) sector has undergone drastic changes due to the preventive measures needed to cope with the Covid-19 pandemic since March 2020. As a result, most traditional classroom teaching had to move to synchronous or asynchronous online instruction. In the post-Covid-19 era, institutions will, at least partially, go back to teaching in person, and blended teaching (BT) practices will conceivably become the true norm. Although BT practices have been employed and researched extensively over the past two decades, a deeper or more extensive blending of courses will still be a major switch for many teachers and students. More than ever, it is vital for instructors not just to understand how to blend but also to understand the evolution of BT practices and the choices made to arrive at sustainable practices that positively impact the learning experience. In this article, the authors aim to elaborate on the contexts which stimulate or provide a catalyst for the use and subsequent growth of sustainable BT practices in HE. A mixed approach of inductive and deductive thematic analysis is used to analyze 26 interviews of instructors, considered either as pioneers or experienced BT adopters in six HE institutions across Europe (Belgium, Denmark, Finland, Ireland, Netherlands, UK). This preliminary analysis revealed that the identified over-arching themes, the drivers and enablers that promote BT, are dynamic in nature and vary in diverse contexts. This study can give insights into BT adoption and help instructors and institutions improve planning or (re)design of courses into successful and sustainable BT practices. © 2021 Virtual Simulation Innovation Workshop, SIW 2021. All rights reserved.