Evaluation of steam heat as a decontamination approach for SARS-CoV-2 when applied to common transit-related materials.

AIMS: The purpose of this study was to evaluate the efficacy of steam heat for inactivation of SARS-CoV-2 when applied to materials common in mass transit installations. METHODS AND RESULTS: SARS CoV-2 (USA-WA1/2020) was resuspended in either cell culture media or synthetic saliva, inoculated (∼1 × 106 TCID50) onto porous and nonporous materials and subjected to steam inactivation efficacy tests as either wet or dried droplets. The inoculated test materials were exposed to steam heat ranging from 70°C to 90°C. The amount of infectious SARS-CoV-2 remaining after various exposure durations ranging from 1 to 60 s was assessed. Higher steam heat application resulted in higher inactivation rates at short contact times. Steam applied at 1-inch distance (∼90°C at the surface) resulted in complete inactivation for dry inoculum within 2 s of exposure (excluding two outliers of 19 test samples at the 5-s duration) and within 2-30 s of exposure for wet droplets. Increasing the distance to 2 inches (∼70°C) also increased the exposure time required to achieve complete inactivation to 15 or 30 s for materials inoculated with saliva or cell culture media, respectively. CONCLUSIONS: Steam heat can provide high levels of decontamination (>3 log reduction) for transit-related materials contaminated with SARS-CoV-2 using a commercially available steam generator with a manageable exposure time of 2-5 s.

Valorisation of hazardous medical waste using steam injected plasma gasifier: a parametric study on the modelling and multi-objective optimisation by integrating Aspen plus with RSM.

The COVID-19 Pandemic has a detrimental effect on the environment related to the exponential rise in medical waste (MW). Extraction of energy from the toxic MW with the latest gasification technology instead of conventional incineration is of utmost importance to promote sustainable development. This present study investigates the processing of MW for the generation of enriched hydrogen syngas using steam injected plasma gasifier. Modelling of Plasma gasifier was performed in Aspen Plus and Model validation was done with the experimental result and, a good agreement was attained. Sensitivity analysis was implemented on MW in which the influence of gasification temperature, equivalence ratio (ER), and Steam/Biomass (S/B) on the producer gas (PG) composition, gas yield, H2/CO ratio, cold gas efficiency (CGE), and the higher heating value (HHV) was calculated. Furthermore, Response surface methodology (RSM) has been incorporated for the multi-objective optimisation of the variable gasification parameters. R2 values obtained from ANOVA for H2, CGE, and HHV are 98.62%, 99.10%, and 98.9% respectively. Using the response optimiser, the optimum values of H2, CGE, and HHV were found to be 0.43 (mole frac), 89.95%, and 7.49 MJ/Nm3 for temperature at 1560.60°C, equivalence ratio 0.1, and S/B 0.99, respectively. The observed coefficient of desirability was about 0.97.

Release of microplastics and nanoplastics in water from disposable surgical masks after disinfection.

During the COVID-19 pandemic, disposable surgical masks were generally disinfected and reused due to mask shortages. Herein, the role of disinfected masks as a source of microplastics (MPs) and nanoplastics (NPs) was investigated. The amount of MPs and NPs released from masks disinfected by UV ranged from 1054 ± 106 to 2472 ± 70 and from 2.55 ± 0.22 × 109 to 6.72 ± 0.27 × 109 particles/piece, respectively, comparable to that of the undisinfected masks, and the MPs were changed to small-sized particles. The amount of MPs and NPs released after alcohol and steam treatment were respectively lower and higher than those from undisinfected masks, and MPs were shifted to small-sized particles. The amount of MPs and NPs released in water after autoclaving was lower than for undisinfected masks. In all, the amount of fibers released after disinfection decreased greatly, and certain disinfection processes were found to increase the amount of small-sized NPs released from masks into aqueous environments.

Molecular diversity and phenotypic pleiotropy of ancient genomic regulatory loci derived from human endogenous retrovirus type H (HERVH) promoter LTR7 and HERVK promoter LTR5_Hs and their contemporary impacts on pathophysiology of Modern Humans.

Timelines of population-level effects of viruses on humans varied from the evolutionary scale of million years to contemporary spread of viral infections. Correspondingly, these events are exemplified by: (i) emergence of human endogenous retroviruses (HERVs) from ancient germline infections leading to stable integration of viral genomes into human chromosomes; and (ii) wide-spread viral infections reaching a global pandemic state such as the COVID-19 pandemic. Despite significant efforts, understanding of HERV's roles in governance of genomic regulatory networks, their impacts on primate evolution and development of human-specific physiological and pathological phenotypic traits remains limited. Remarkably, present analyses revealed that expression of a dominant majority of genes (1696 of 1944 genes; 87%) constituting high-confidence down-steam regulatory targets of defined HERV loci was significantly altered in cells infected with the SARS-CoV-2 coronavirus, a pathogen causing the global COVID-19 pandemic. This study focused on defined sub-sets of DNA sequences derived from HERVs that are expressed at specific stages of human preimplantation embryogenesis and exert regulatory actions essential for self-renewal and pluripotency. Evolutionary histories of LTR7/HERVH and LTR5_Hs/HERVK were charted based on evidence of the earliest presence and expansion of highly conserved (HC) LTR sequences. Sequence conservation analyses of most recent releases 17 primate species' genomes revealed that LTR7/HERVH have entered germlines of primates in Africa after the separation of the New World Monkey lineage, while LTR5_Hs/HERVK successfully colonized primates' germlines after the segregation of Gibbons' species. Subsequently, both LTR7 and LTR5_Hs undergo a marked ~ fourfold-fivefold expansion in genomes of Great Apes. Timelines of quantitative expansion of both LTR7 and LTR5_Hs loci during evolution of Great Apes appear to replicate the consensus evolutionary sequence of increasing cognitive and behavioral complexities of non-human primates, which seems particularly striking for LTR7 loci and 11 distinct LTR7 subfamilies. Consistent with previous reports, identified in this study, 351 human-specific (HS) insertions of LTR7 (175 loci) and LTR5_Hs (176 loci) regulatory sequences have been linked to genes implicated in establishment and maintenance of naïve and primed pluripotent states and preimplantation embryogenesis phenotypes. Unexpectedly, HS-LTRs manifest regulatory connectivity to genes encoding markers of 12 distinct cells' populations of fetal gonads, as well as genes implicated in physiology and pathology of human spermatogenesis, including Y-linked spermatogenic failure, oligo- and azoospermia. Granular interrogations of genes linked with 11 distinct LTR7 subfamilies revealed that mammalian offspring survival (MOS) genes seem to remain one of consistent regulatory targets throughout ~ 30 MYA of the divergent evolution of LTR7 loci. Differential GSEA of MOS versus non-MOS genes identified clearly discernable dominant enrichment patterns of phenotypic traits affected by MOS genes linked with LTR7 (562 MOS genes) and LTR5_Hs (126 MOS genes) regulatory loci across the large panel of genomics and proteomics databases reflecting a broad spectrum of human physiological and pathological traits. GSEA of LTR7-linked MOS genes identified more than 2200 significantly enriched records of human common and rare diseases and gene signatures of 466 significantly enriched records of Human Phenotype Ontology traits, including Autosomal Dominant (92 genes) and Autosomal Recessive (93 genes) Inheritance. LTR7 regulatory elements appear linked with genes implicated in functional and morphological features of central nervous system, including synaptic transmission and protein-protein interactions at synapses, as well as gene signatures differentially regulated in cells of distinct neurodevelopmental stages and morphologically diverse cell types residing and functioning in human brain. These include Neural Stem/Precursor cells, Radial Glia cells, Bergman Glia cells, Pyramidal cells, Tanycytes, Immature neurons, Interneurons, Trigeminal neurons, GABAergic neurons, and Glutamatergic neurons. GSEA of LTR7-linked genes identified significantly enriched gene sets encoding markers of more than 80 specialized types of neurons and markers of 521 human brain regions, most prominently, subiculum and dentate gyrus. Identification and characterization of 1944 genes comprising high-confidence down-steam regulatory targets of LTR7 and/or LTR5_Hs loci validated and extended these observations by documenting marked enrichments for genes implicated in neoplasm metastasis, intellectual disability, autism, multiple cancer types, Alzheimer's, schizophrenia, and other brain disorders. Overall, genes representing down-stream regulatory targets of ancient retroviral LTRs exert the apparently cooperative and exceedingly broad phenotypic impacts on human physiology and pathology. This is exemplified by altered expression of 93% high-confidence LTR targets in cells infected by contemporary viruses, revealing a convergence of virus-inflicted aberrations on genomic regulatory circuitry governed by ancient retroviral LTR elements and interference with human cells' differentiation programs.

Investigation of the Thermal Comfort Properties of Masks Used during the COVID-19 Pandemic.

SARS-CoV-2, the causative agent of COVID-19, which was officially declared a pandemic by the World Health Organization (WHO) on 11 March 2020, is transmitted from person to person through respiratory droplets and close contact and can cause severe respiratory failure and pneumonia. Currently, while the worldwide COVID-19 pandemic is still ongoing and countries are taking strict precautions to protect populations against infection, the most effective precautions still seem to be social distancing and wearing a mask. The question of how effective masks were in the early stages of the COVID-19 pandemic has been widely discussed, both in public and scientific circles, and the protection of different mask types has been examined. This study aimed to examine the comfort conditions provided by the different mask types to the user during use. For this purpose, single-ply, double-ply, three-ply, cloth, FFP1, FFP2, and FFP3 masks with different standards were examined, with and without a valve. To conduct the experiments, the novel thermal head measurement system, developed within the scope of this study, was used specifically for mask comfort studies. Thanks to the developed measurement system, the thermal resistance and water vapor resistance values of different masks were measured, and their comfort conditions were evaluated. According to the findings, cloth masks provide a comfortable condition, with lower thermal resistance and water vapor resistance values than other masks. In addition, it was observed that surgical masks offer better thermal comfort conditions, although they have lower protection than FFP masks.

National emissions inventory and future trends in greenhouse gases and other air pollutants from civil airports in China.

Civil aviation is an important source of air pollutants, but this field has received insufficient attention in China. Based on the standard emissions model of the International Civil Aviation Organization (ICAO) and actual flight information from 241 airports, this study estimated a comprehensive emissions inventory for 2010-2020 by considering the impacts of mixing layer height. The results showed that annual pollutant emissions rapidly trended upward along with population and economic growth; however, the emissions decreased owing to the impacts of the COVID-19 pandemic. In 2020, the emissions of carbon monoxide (CO), nitrogen oxides (NOX), particulate matter (PM), methane (CH4), nitrous oxide (N2O), carbon dioxide (CO2), and water vapor (H2O) were 34.34, 65.73, 0.10, 0.34, 0.40, 14,706.26, and 5733.11 Gg, respectively. The emissions of total volatile organic compounds (VOCs) from China's civil airports in 2020 were estimated at 17.20 Gg; the major components were formic acid (1.70 Gg), acetic acid (1.62 Gg), 1-butylene (1.03 Gg), acetone (0.96 Gg), and acetaldehyde (0.93 Gg). The distribution of pollutant emissions was consistent with the level of economic development, mainly in Beijing, Guangzhou, and Shanghai. In addition, we estimated future pollution trends for the aviation industry under four scenarios. Under the comprehensive scenario, which considered the impacts of economic growth, passenger turnover, cargo turnover, COVID-19, and technological efficiency, the levels of typical pollutants were expected to increase by nearly 1.51-fold from 2010 to 2035.

Decontamination Assessment of Nanofiber-based N95 Masks.

As the world battles with the outbreak of the novel coronavirus, it also prepares for future global pandemics that threaten our health, economy, and survivor. During the outbreak, it became evident that use of personal protective equipment (PPE), specially face masks, can significantly slow the otherwise uncontrolled spread of the virus. Nevertheless, the outbreak and its new variants have caused shortage of PPE in many regions of the world. In addition, waste management of the enormous economical and environmental footprint of single use PPE has proven to be a challenge. Therefore, this study advances the theme of decontaminating used masks. More specifically, the effect of various decontamination techniques on the integrity and functionality of nanofiber-based N95 masks (i.e. capable of at least filtering 95% of 0.3 µm aerosols) were examined. These techniques include 70% ethanol, bleaching, boiling, steaming, ironing as well as placement in autoclave, oven, and exposure to microwave (MW) and ultraviolet (UV) light. Herein, filtration efficiency (by Particle Filtration Efficiency equipment), general morphology, and microstructure of nanofibers (by Field Emission Scanning Electron microscopy) prior and after every decontamination technique were observed. The results suggest that decontamination of masks with 70% ethanol can lead to significant unfavorable changes in the microstructure and filtration efficiency (down to 57.33%) of the masks. In other techniques such as bleaching, boiling, steaming, ironing and placement in the oven, filtration efficiency dropped to only about 80% and in addition, some morphological changes in the nanofiber microstructure were seen. Expectedly, there was no significant reduction in filtration efficiency nor microstructural changes in the case of placement in autoclave and exposure to the UV light. It was concluded that, the latter methods are preferable to decontaminate nanofiber-based N95 masks.

Evaluation of the Microbiological Effectiveness of Three Accessible Mask Decontamination Methods and Their Impact on Filtration, Air Permeability and Physicochemical Properties.

The need to secure public health and mitigate the environmental impact associated with the massified use of respiratory protective devices (RPD) has been raising awareness for the safe reuse of decontaminated masks by individuals and organizations. Among the decontamination treatments proposed, in this work, three methods with the potential to be adopted by households and organizations of different sizes were analysed: contact with nebulized hydrogen peroxide (H2O2); immersion in commercial bleach (NaClO) (sodium hypochlorite, 0.1% p/v); and contact with steam in microwave steam-sanitizing bags (steam bag). Their decontamination effectiveness was assessed using reference microorganisms following international standards (issued by ISO and FDA). Furthermore, the impact on filtration efficiency, air permeability and several physicochemical and structural characteristics of the masks, were evaluated for untreated masks and after 1, 5 and 10 cycles of treatment. Three types of RPD were analysed: surgical, KN95, and cloth masks. Results demonstrated that the H2O2 protocol sterilized KN95 and surgical masks (reduction of >6 log10 CFUs) and disinfected cloth masks (reduction of >3 log10 CFUs). The NaClO protocol sterilized surgical masks, and disinfected KN95 and cloth masks. Steam bags sterilized KN95 and disinfected surgical and cloth masks. No relevant impact was observed on filtration efficiency.

Decontamination Efficiency of Thermal, Photothermal, Microwave, and Steam Treatments for Biocontaminated Household Textiles.

With the outbreak of the COVID-19 pandemic, textile laundering hygiene has proved to be a fundamental measure in preventing the spread of infections. The first part of our study evaluated the decontamination efficiency of various treatments (thermal, photothermal, and microwave) for bio contaminated textiles. The effects on textile decontamination of adding saturated steam into the drum of a household textile laundering machine were investigated and evaluated in the second part of our study. The results show that the thermal treatment, conducted in a convection heating chamber, provided a slight reduction in efficiency and did not ensure the complete inactivation of Staphylococcus aureus on cotton swatches. The photothermal treatment showed higher reduction efficiency on contaminated textile samples, while the microwave treatment (at 460 W for a period of 60 s) of bio contaminated cotton swatches containing higher moisture content provided satisfactory bacterial reduction efficiency (more than 7 log steps). Additionally, the treatment of textiles in the household washing machine with the injection of saturated steam into the washing drum and a mild agitation rhythm provided at least a 7 log step reduction in S. aureus. The photothermal treatment of bio contaminated cotton textiles showed promising reduction efficiency, while the microwave treatment and the treatment with saturated steam proved to be the most effective.

Coronavirus disease-associated mucormycosis (CAM): A case control study during the outbreak in India.

The recent second wave of COVID-19 cases in India has been marked by an unexpected increase in cases of mucormycosis reported in the context of COVID illness. Herein we aim to identify risk factors that may explain the sudden surge of cases and help develop preventive strategies. MATERIAL: We performed a case-control study comparing cases diagnosed with CAM and those who had recovered from COVID-19 without developing mucormycosis (controls). Information on comorbidities, glycemic control, and practices related to COVID-19 treatment was recorded. OBSERVATION: 100 patients of CAM (cases) and 150 patients of COVID-19 without mucormycosis (controls) were included in the study. The spectrum of involvement of CAM cases included rhino-sinus (n=98, 98%), rhino orbital (n=58, 58%), rhino-orbito-cerebral (n=29, 29%). In CAM group symptoms of mucormycosis began a mean of 13.46 days after onset of COVID-19. The mean age of the CAM study group was 51.16 years with 69 males (69%) and 31 females (31.0). The most frequent comorbidities seen in our study population was diabetes (n=113, 45.2%) and hypertension (n=54, 21.6%). Diabetes was significantly more frequent among cases than controls (89% vs 24%, p <0.001). 31% of patients in CAM case group showed a common practise of steam inhalation during covid illness. Most common symptom reported in CAM was related to the eye which included eye pain (58%), lid swelling (54%), eye swelling (47%). Sino-nasal symptoms were nasal discharge (25%), nasal stuffiness (21%), and epistaxis (4%). Other common symptoms were headache (51%) and facial pain (36%). On examination of nasal cavity, crusting and ulceration were present in 83% patients. Eye involvement was present in 60% of cases, of which 27% of cases had vision loss. For definitive diagnosis of CAM, Potassium hydroxide (KOH) mount was positive for aseptate hyphae in 31 patients (31%). Use of systemic steroids for the management of COVID-19, was more frequent in CAM case group than control group (n=70, 70%). The CAM case group showed mean Hba1c of 10.7 ± 2.45, mean Serum Iron levels was 49.01 ± 18.69, mean ferritin was 913.37, mean CRP was 131.56 and mean LDH was 428.70. CONCLUSION: Overzealous use of steroids, uncontrolled sugars and repeated steam inhalation provided a favourable environment for the growth of mucormycosis. Judicious use of steroids and stringent glycemic control are vital to preventing mucormycosis.

In vitro virucidal efficacy of a dry steam disinfection system against Human Coronavirus, Human Influenza Virus, and Echovirus.

This in vitro study was aimed to assess the efficacy of dry steam in inactivating Human Coronavirus OC43 (HCoV-OC43) as surrogate of SARS-CoV-2, Human Influenza Virus A/H1N1/WSN/33 and Echovirus 7 on stainless steel, polypropylene, and cotton. The virus models were chosen on the basis of their transmission route and environmental resistance. Tests were carried out under a laminar flow cabinet, where two panels of each material were contaminated with a viral suspension. The inocula were left to dry and then the virus on untreated panel (control) was collected by swabbing in order to determine the initial titer. The other panel was treated using a professional vacuum cleaner equipped with a dry steam generator. Dry steam is generated in a boiler where tap water is heated up to 155 °C at 5.5 bar pressure and then during the passage along the flexible hose the temperature decreases to a value between 100 °C and 110 °C at the output. The dry steam was applied for four sec with a window wiper on metal and plastic panels or a brush covered by a microfiber cap on cotton, simulating the steam application during routine cleaning. After the treatment, infectious virus possibly remained on the surface was collected following the same swabbing procedure applied for controls. HCoV-OC43 and Echovirus 7 were titrated by end-point method on HCT-8 line cells and Vero cells, respectively, while Human Influenza Virus was quantified by plaque reduction assay on MDCK cells. Dry steam resulted effective against the three viruses on all tested materials, achieving a mean Log10 reduction factor ≥4 in viral titer of treated samples compared with controls according to UNI EN 14476:2019. Thus, dry steam may be proposed as an ease to use, effective, fast, and nontoxic alternative to chemicals for surface disinfection without damaging materials. Therefore, this device could be employed not only in healthcare facilities but also in occupational, domestic, and community settings, with advantages for environment and human health.

Can sterilization of disposable face masks be an alternative for imported face masks? A nationwide field study including 19 sterilization departments and 471 imported brand types during COVID-19 shortages.

BACKGROUND: Face masks, also referred to as half masks, are essential to protect healthcare professionals working in close contact with patients with COVID-19-related symptoms. Because of the Corona material shortages, healthcare institutions sought an approach to reuse face masks or to purchase new, imported masks. The filter quality of these masks remained unclear. Therefore, the aim of this study was to assess the quality of sterilized and imported FFP2/KN95 face masks. METHODS: A 48-minute steam sterilization process of single-use FFP2/KN95 face masks with a 15 minute holding time at 121°C was developed, validated and implemented in the Central Sterilization Departments (CSSD) of 19 different hospitals. Masks sterilized by steam and H2O2 plasma as well as new, imported masks were tested for particle filtration efficiency (PFE) and pressure drop in a custom-made test setup. RESULTS: The results of 84 masks tested on the PFE dry particle test setup showed differences of 2.3±2% (mean±SD). Test data showed that the mean PFE values of 444 sterilized FFP2 face masks from the 19 CSSDs were 90±11% (mean±SD), and those of 474 new, imported KN95/FFP2 face masks were 83±16% (mean±SD). Differences in PFE of masks received from different sterilization departments were found. CONCLUSION: Face masks can be reprocessed with 121 °C steam or H2O2 plasma sterilization with a minimal reduction in PFE. PFE comparison between filter material of sterilized masks and new, imported masks indicates that the filter material of most reprocessed masks of high quality brands can outperform new, imported face masks of unknown brands. Although the PFE of tested face masks from different sterilization departments remained efficient, using different types of sterilization equipment, can result in different PFE outcomes.

Assessment of laparoscopic instrument reprocessing in rural India: a mixed methods study.

BACKGROUND: Laparoscopy is a minimally-invasive surgical procedure that uses long slender instruments that require much smaller incisions than conventional surgery. This leads to faster recovery times, fewer post-surgical wound infections and shorter hospital stays. For these reasons, laparoscopy could be particularly advantageous to patients in low to middle income countries (LMICs). Unfortunately, sterile processing departments in LMIC hospitals are faced with limited access to equipment and trained staff which poses an obstacle to safe surgical care. The reprocessing of laparoscopic devices requires specialised equipment and training. Therefore, when LMIC hospitals invest in laparoscopy, an update of the standard operating procedure in sterile processing is required. Currently, it is unclear whether LMIC hospitals, that already perform laparoscopy, have managed to introduce updated reprocessing methods that minimally invasive equipment requires. The aim of this study was to identify the laparoscopic sterile reprocessing procedures in rural India and to test the effectiveness of the sterilisation equipment. METHODS: We assessed laparoscopic instrument sterilisation capacity in four rural hospitals in different states in India using a mixed-methods approach. As the main form of data collection, we developed a standardised observational checklist based on reprocessing guidelines from several sources. Steam autoclave performance was measured by monitoring the autoclave cycles in two hospitals. Finally, the findings from the checklist data was supported by an interview survey with surgeons and nurses. RESULTS: The checklist data revealed the reprocessing methods the hospitals used in the reprocessing of laparoscopic instruments. It showed that the standard operating procedures had not been updated since the introduction of laparoscopy and the same reprocessing methods for regular surgical instruments were still applied. The interviews confirmed that staff had not received additional training and that they were unaware of the hazardous effects of reprocessing detergents and disinfectants. CONCLUSION: As laparoscopy is becoming more prevalent in LMICs, updated policy is needed to incorporate minimally invasive instrument reprocessing in medical practitioner and staff training programmes. While reprocessing standards improve, it is essential to develop instruments and reprocessing equipment that is more suitable for resource-constrained rural surgical environments.

Fluid mechanics of facial masks as personal protection equipment (PPE) of COVID-19 virus.

A fluid mechanics model of inhaled air gases, nitrogen (N2) and oxygen (O2) gases, and exhaled gas components (CO2 and water vapor particles) through a facial mask (membrane) to shield the COVID-19 virus is established. The model was developed based on several gas flux contributions that normally take place through membranes. Semiempirical solutions of the mathematical model were predicted for the N95 facial mask accounting on several parameters, such as a range of porosity size (i.e., 1-30 nm), void fraction (i.e., 10-3%-0.3%), and thickness of the membrane (i.e., 10-40 µm) in comparison to the size of the COVID-19 virus. A unitless number (Nr) was introduced for the first time to describe semiempirical solutions of O2, N2, and CO2 gases through the porous membrane. An optimum Nr of expressing the flow of the inhaled air gases, O2 and N2, through the porous membrane was determined (NO2 = NN2 = -4.4) when an N95 facial mask of specifications of a = 20 nm, l = 30 µm, and ε = 30% was used as a personal protection equipment (PPE). The concept of the optimum number Nr can be standardized not only for testing commercially available facial masks as PPEs but also for designing new masks for protecting humans from the COVID-19 virus.

The COVID-19 pandemic and N95 masks: reusability and decontamination methods.

BACKGROUND: With the current SARS-CoV-2 pandemic, many healthcare facilities are lacking a steady supply of masks worldwide. This emergency situation warrants the taking of extraordinary measures to minimize the negative health impact from an insufficient supply of masks. The decontamination, and reuse of healthcare workers' N95/FFP2 masks is a promising solution which needs to overcome several pitfalls to become a reality. AIM: The overall aim of this article is to provide the reader with a quick overview of the various methods for decontamination and the potential issues to be taken into account when deciding to reuse masks. Ultraviolet germicidal irradiation (UVGI), hydrogen peroxide, steam, ozone, ethylene oxide, dry heat and moist heat have all been methods studied in the context of the pandemic. The article first focuses on the logistical implementation of a decontamination system in its entirety, and then aims to summarize and analyze the different available methods for decontamination. METHODS: In order to have a clear understanding of the research that has already been done, we conducted a systematic literature review for the questions: what are the tested methods for decontaminating N95/FFP2 masks, and what impact do those methods have on the microbiological contamination and physical integrity of the masks? We used the results of a systematic review on the methods of microbiological decontamination of masks to make sure we covered all of the recommended methods for mask reuse. To this systematic review we added articles and studies relevant to the subject, but that were outside the limits of the systematic review. These include a number of studies that performed important fit and function tests on the masks but took their microbiological outcomes from the existing literature and were thus excluded from the systematic review, but useful for this paper. We also used additional unpublished studies and internal communication from the University of Geneva Hospitals and partner institutions. RESULTS: This paper analyzes the acceptable methods for respirator decontamination and reuse, and scores them according to a number of variables that we have defined as being crucial (including cost, risk, complexity, time, etc.) to help healthcare facilities decide which method of decontamination is right for them. CONCLUSION: We provide a resource for healthcare institutions looking at making informed decisions about respirator decontamination. This informed decision making will help to improve infection prevention and control measures, and protect healthcare workers during this crucial time. The overall take home message is that institutions should not reuse respirators unless they have to. In the case of an emergency situation, there are some safe ways to decontaminate them.

Filtering Facepiece Respirator (N95 Respirator) Reprocessing: A Systematic Review.

IMPORTANCE: The COVID-19 pandemic has resulted in a persistent shortage of personal protective equipment; therefore, a need exists for hospitals to reprocess filtering facepiece respirators (FFRs), such as N95 respirators. OBJECTIVE: To perform a systematic review to evaluate the evidence on effectiveness and feasibility of different processes used for decontaminating N95 respirators. EVIDENCE REVIEW: A search of PubMed and EMBASE (through January 31, 2021) was completed for 5 types of respirator-decontaminating processes including UV irradiation, vaporized hydrogen peroxide, moist-heat incubation, microwave-generated steam, and ethylene oxide. Data were abstracted on process method, pathogen removal, mask filtration efficiency, facial fit, user safety, and processing capability. FINDINGS: Forty-two studies were included that examined 65 total types of masks. All were laboratory studies (no clinical trials), and 2 evaluated respirator performance and fit with actual clinical use of N95 respirators. Twenty-seven evaluated UV germicidal irradiation, 19 vaporized hydrogen peroxide, 9 moist-heat incubation, 10 microwave-generated steam, and 7 ethylene oxide. Forty-three types of N95 respirators were treated with UV irradiation. Doses of 1 to 2 J/cm2 effectively sterilized most pathogens on N95 respirators (>103 reduction in influenza virus [4 studies], MS2 bacteriophage [3 studies], Bacillus spores [2 studies], Escherichia virus MS2 [1 study], vesicular stomatitis virus [1 study], and Middle East respiratory syndrome virus/SARS-CoV-1 [1 study]) without degrading respirator components. Doses higher than 1.5 to 2 J/cm2 may be needed based on 2 studies demonstrating greater than 103 reduction in SARS-CoV-2. Vaporized hydrogen peroxide eradicated the pathogen in all 7 efficacy studies (>104 reduction in SARS-CoV-2 [3 studies] and >106 reduction of Bacillus and Geobacillus stearothermophilus spores [4 studies]). Pressurized chamber systems with higher concentrations of hydrogen peroxide caused FFR damage (6 studies), while open-room systems did not degrade respirator components. Moist heat effectively reduced SARS-CoV-2 (2 studies), influenza virus by greater than 104 (2 studies), vesicular stomatitis virus (1 study), and Escherichia coli (1 study) and preserved filtration efficiency and facial fit for 11 N95 respirators using preheated containers/chambers at 60 °C to 85 °C (5 studies); however, diminished filtration performance was seen for the Caron incubator. Microwave-generated steam (1100-W to 1800-W devices; 40 seconds to 3 minutes) effectively reduced pathogens by greater than 103 (influenza virus [2 studies], MS2 bacteriophage [3 studies], and Staphylococcus aureus [1 study]) and maintained filtration performance in 10 N95 respirators; however, damage was noted in least 1 respirator type in 4 studies. In 6 studies, ethylene oxide preserved respirator components in 16 N95 respirator types but left residual carcinogenic by-product (1 study). CONCLUSIONS AND RELEVANCE: Ultraviolet germicidal irradiation, vaporized hydrogen peroxide, moist heat, and microwave-generated steam processing effectively sterilized N95 respirators and retained filtration performance. Ultraviolet irradiation and vaporized hydrogen peroxide damaged respirators the least. More research is needed on decontamination effectiveness for SARS-CoV-2 because few studies specifically examined this pathogen.

Promising phytochemicals of traditional Indian herbal steam inhalation therapy to combat COVID-19 - An in silico study.

BACKGROUND: COVID-19, the presently prevailing global public health emergency has culminated in international instability in economy. This unprecedented pandemic outbreak pressingly necessitated the trans-disciplinary approach in developing novel/new anti-COVID-19 drugs especially, small molecule inhibitors targeting the seminal proteins of viral etiological agent, SARS-CoV-2. METHODS: Based on the traditional medicinal knowledge, we made an attempt through molecular docking analysis to explore the phytochemical constituents of three most commonly used Indian herbs in 'steam inhalation therapy' against well recognized viral receptor proteins. RESULTS: A total of 57 phytochemicals were scrutinized virtually against four structural protein targets of SARS-CoV-2 viz. 3CLpro, ACE-2, spike glycoprotein and RdRp. Providentially, two bioactives from each of the three plants i.e. apigenin-o-7-glucuronide and ellagic acid from Eucalyptus globulus; eudesmol and viridiflorene from Vitex negundo and; vasicolinone and anisotine from Justicia adhatoda were identified to be the best hit lead molecules based on interaction energies, conventional hydrogen bonding numbers and other non-covalent interactions. On comparison with the known SARS-CoV-2 protease inhibitor -lopinavir and RdRp inhibitor -remdesivir, apigenin-o-7-glucuronide was found to be a phenomenal inhibitor of both protease and polymerase, as it strongly interacts with their active sites and exhibited remarkably high binding affinity. Furthermore, in silico drug-likeness and ADMET prediction analyses clearly evidenced the usability of the identified bioactives to develop as drug against COVID-19. CONCLUSION: Overall, the data of the present study exemplifies that the phytochemicals from selected traditional herbs having significance in steam inhalation therapy would be promising in combating COVID-19.

Frozen steamed breads and boiled noodles: Quality affected by ingredients and processing.

Chinese steamed breads (CSB) and noodles are staple foods for many people. The production of frozen steamed products and boiled noodles has kept increasing. This is due to the increasing demand of ready-to-eat frozen food products from the market. Frozen storage significantly increases the self-life of the products and reduces the production costs. On the other hand, the freezing and frozen storage lead to quality loss of the frozen products. This review summarizes effects of freezing and frozen storage on diverse quality attributes (e.g., structural and textural properties) of frozen northern-type steamed breads and boiled noodles. Food safety of the frozen products related to the COVID-19 pandemic is discussed. To counteract the quality loss of the frozen products, suitable processing methods, selection of basic ingredients and uses of various food additives can be done. Research gaps to improve the textural, cooking and nutritional quality of frozen CSB and noodles are suggested.