Hand hygiene during COVID-19: Recommendations from the American Contact Dermatitis Society

Water, soap, and hand-disinfectant exposure during the COVID-19 pandemic and self-reported hand eczema in frontline workers: A cross-sectional study

BACKGROUND

During the COVID-19 pandemic, increased hand hygiene practices were implemented. Impaired skin health on the hands among healthcare workers has been reported previously. Knowledge of how worker in other occupations have been affected is scarce.

OBJECTIVES

To investigate self-reported hand water-, and soap exposure and use of hand disinfectants, and hand eczema (HE) in frontline workers outside the hospital setting and in IT personnel during the COVID-19 pandemic.

METHODS

In this cross-sectional study, a questionnaire was sent out between 1 March and 30 April in 2021, to 6060 randomly selected individuals representing six occupational groups.

RESULTS

A significant increase in water exposure and hand disinfectant use was shown: Relative position (RP) 19; 95% confidence interval (CI) 0.17-0.21 and RP = 0.38: 95% CI 0.36-0.41, respectively. Newly debuted HE was reported by 7.4% of the population, more frequently among frontline workers (8.6%) compared to IT personnel (4.9%).

CONCLUSIONS

Water and soap exposure and use of hand disinfectants increased during COVID-19 pandemic, which may increase the risk of hand eczema. This highlights the importance of communication and implementation of preventive measures to protect the skin barrier also in occupations other than healthcare workers.

Introducing the model of repeated exposure of skin to antiseptics: Randomised pilot trial

INTRODUCTION

Intensified hand hygiene measures were recommended for preventing the spread of SARS-CoV-2. However, these measures can lead to skin damage and the development of hand eczema, particularly among health professionals.

OBJECTIVES

This pilot study aimed to evaluate the effects of repeated antiseptic use on healthy skin under controlled conditions and to assess the emollient use.

METHODS

Twelve healthy volunteers (nine females, age = 22.3 ± 2.8 years (mean ± SD), Fitzpatrick phototypes II and III) with no skin diseases were recruited. Antiseptic was applied daily for 3 weeks on the volar sides of forearms. Emollient cream was also applied daily. Skin assessments were performed using non-invasive methods (transepidermal water loss-TEWL, skin hydration, erythema and melanin content).

RESULTS

Prolonged antiseptic use increased TEWL, decreased hydration and elevated erythema and melanin levels. Emollient cream significantly reduced TEWL and improved hydration on antiseptic-treated sites, and also enhanced hydration on intact skin.

CONCLUSIONS

Prolonged use of antiseptics can have adverse effects on the skin, including barrier disruption and inflammation. Emollient showed promise in improving skin hydration and reducing the damage caused by antiseptics. Further research with a larger sample is needed to confirm these findings and assess emollient efficacy during frequent antiseptic use.

Surgical Hand Antisepsis: Environmental and Cost Impact in Hand Surgery

Health care systems, including operating rooms, are a considerable contributor to environmental waste. Given ongoing concerns regarding water scarcity in the United States and worldwide, action to reduce water utilization should be taken. Traditional water-based hand scrubbing wastes an estimated 11 L of water per scrub. Waterless hand rubbing with an alcohol-based solution has been shown to be as effective as traditional water-based hand scrubbing in surgical hand antisepsis and in preventing surgical site infections. Furthermore, alcohol-based rubbing results in less waste and reduced costs when compared with water-based hand scrubbing. The hand surgery operating room, including minor procedure rooms, serves as an opportunity to decrease water use and reduce the environmental impact of our field. Waterless alcohol-based hand rubbing for antisepsis may also be an opportunity to save money and provide value-based care to our patients.

What we learned from the infection control and what we need in the future: A quantitative and qualitative study on hospital infection prevention and control practitioners (HIPCPs) in Tianjin, China

BACKGROUND

In December 2022, the epidemic prevention and control policy was upgraded, and China entered a different stage of epidemic control. This study aims to identify implications for better infection control and health care supply during the epidemic.

METHODS

A longitudinal quantitative and qualitative study was performed based on 2 comprehensive questionnaire surveys among 497 hospital infection prevention and control practitioners (HIPCPs) before and during the epidemic peak in Tianjin, China.

RESULTS

The workload (8.2 hours vs 10.14 hours, P = 0) and self-reported mental health problems (23.5% vs 61.8%, P < .05) among the HIPCPs increased significantly in the peak period. Ward reconstruction and resource coordination were the most needed jobs in hospital infection control, and rapidly increased medical waste during the epidemic needs to be considered in advance. Community support for health care personnel and their families, maintaining full PPE to reduce simultaneous infection of medical staff, and clinical training of infectious diseases for medical staff, especially doctors, in advance are the most important things we learned.

CONCLUSION

Although it has been 4 years since the first outbreak of coronavirus disease 2019, more improvements should be made to prepare for the next epidemic of potential diseases.

Skin- and Eco-Friendly Hand Sanitizer: A Novel Composition of Natural Extracts to Prevent the Spread of Respiratory Viruses

Respiratory diseases caused by viruses are a serious global health threat. Although the use of hand sanitizers containing alcohol and synthetic antiseptic agents is recognized as an effective, simple, and low-cost measure to combat viral transmission, they can harm human health and the environment. Thus, this work aimed to study the efficacy of combining Camellia sinensis and Chamomilla recutita extracts in a skin- and eco-friendly leave-on hand sanitizer to prevent the spread of respiratory viruses. An oil-in-water emulsion containing C. recutita oily extract (5.0%), C. recutita glycolic extract (0.2%) and C. sinensis glycolic extract (5.0%) showed virucidal activity against HAdV-2 (respiratory virus) and two surrogate viruses of SARS-CoV-2 (HSV-1 and MVH-3), showing great potential to prevent the spread of respiratory viruses. These natural extracts combined are also promising to combat a broad spectrum of other viruses, in the form of antiseptic mouthwashes or throat sprays, surface disinfectants, and veterinary products, among others. Complementally, the developed hand sanitizer demonstrated efficacy against bacteria and fungus.

The effect of a training program on adolescents' stress levels and healthy lifestyle behaviors during the Covid-19 pandemic: A randomized controlled study

TOPIC

Adolescence is the period when people adopt healthy lifestyle behaviors and turn them into habits. Healthy lifestyle behaviors are a significant step toward a long and healthy life.

PURPOSE

This study investigated the effect of a training program on adolescents' stress levels and healthy lifestyle behaviors during the COVID-19 pandemic.

METHODS

This randomized controlled study was conducted between May and July 2021. The sample consisted of 100 adolescents living in a city in the south of Turkey. Participants were randomized into intervention and control groups using block randomization. The intervention group participated in an online (Zoom) training program consisting of two 45 min sessions once a week for 8 weeks. Data were collected using the adolescent stress questionnaire (ASQ) and the adolescent lifestyle profile (ALP).

RESULTS

The results showed that 73% (n: 73) of the participants had developed hygiene habits since the onset of the pandemic. However, the pandemic negatively affected participants' dietary habits (45%, n: 45), physical activity (70%, n: 70), coping mechanisms (68%, n: 68), sleep patterns (54%, n: 54), Internet/social media/video game addiction (64%, n: 64), and interpersonal relationships (57%, n: 57). The intervention group had a lower mean ASQ posttest score and a higher mean ALP posttest score than the control group. The intervention group had a lower mean ASQ posttest score than their pretest score. The intervention group also had a higher mean ALP posttest score than their pretest score.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The training program helped adolescents feel less stress and adopt more healthy lifestyle behaviors. Pediatric nurses should identify risk factors and design and implement appropriate plans to help adolescents go through future pandemics with as little damage as possible. Parents and educators should support adolescents against the adverse impacts of events such as the COVID 19 pandemic.

Factors associated with the disinfection of devices attached to peripheral intravenous catheters performed by the nursing team in pediatric units

Background

Peripheral intravenous catheterization, as well as drug administration through it, represents one of the most performed procedures by the Nursing team and, for that, precautions need to be adopted to offer harm-free care.

Objective

To verify the association of Nursing professionals' work shift and training time with proper disinfection of intravenous catheter devices in pediatric units.

Methods

A cross-sectional and analytical study conducted between June and August 2021 in three hospitalization units of a Pediatric Hospital. The inclusion criterion was drug administration via peripheral intravenous catheters performed by Nursing professionals. The data were analyzed according to inferential statistics, adopting p ≤ .05 as significance level.

Results

There were a total of 385 observations of drug administration procedures. The device was not disinfected in 60.3% of the cases, there was no friction at the suitable time in 86.3%, and the disinfectant was not allowed to dry in 72.5%. The work shift exerted no influence on performance of the disinfection procedure (p = .376). However, longer training time was associated with a lower rate in performing such procedure (p < .001).

Conclusion

Performing friction below the recommended time can cause a false sense of prevention of catheter-associated bloodstream infection; therefore, training sessions and strategies for adherence to the disinfection procedures should be considered, mainly for professionals with more training time.

Variations in Food Safety Concerns, Hygiene Practices, and Purchasing Behaviors During Pandemic Era: What We Learnt from Coronavirus Disease 2019

The purpose of the study is to evaluate the food safety concerns, purchasing behaviors, and hygiene practices of individuals who contracted and did not contract the severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection. A total of 2393 individuals 18-65 years years of age, 760 who contracted and 1633 who did not contract SARS-CoV-2 infection, participated in the study. Participants were administered a questionnaire to assess demographic information, food safety concerns, hygiene practices, purchasing behavior, and fear of the coronavirus disease 2019 (COVID-19). Results indicated that 56.3% of participants expressed concern about food safety, and 67% were concerned about infected individuals while shopping. Participants who did not contract COVID-19 had higher levels of food safety concerns and generally adhered to better hygiene practices such as handwashing, hygienic food preparation, sanitizer use, and cleaning and disinfection practices (p < 0.05). Overall, purchasing behaviors did not significantly differ by the infection status, except for a significant difference in reduced purchase frequency (p < 0.001). In addition, purchasing behavior varied in relation to fear levels (p < 0.05). As the pandemic appears to be increasingly controlled, the insights gained from managing outbreaks might contribute to improved understanding and preparedness for global pandemics and food safety education in the future.

Assessment of Hygiene Practices, Awareness, and Water Consumption Regarding Covid-19 Among Children in a Refugee Camp

INTRODUCTION

At the outbreak of infectious diseases, the response of different communities to the disease varies, and children are most affected by the collective anxiety and grief that consequently arises. In this research, the behavior of children and their parents in terms of hygiene and precautions before and during the COVID-19 pandemic was investigated.

METHODOLOGY

The focus of the present research was on sanitation facilities, particularly access to end-use of water for hand washing. The research was conducted in Barika Camp, Kurdistan, Iraq and 311 parents and children were interviewed. A data collection team consisting of two females and one male was responsible for gathering data, primarily from women who served as the main respondents. Questionnaires consisted of three main parts: demography, COVID-19 pandemic effects, and sanitary shelter specifications.

RESULT

The results demonstrated that the behavior of refugees during the COVID-19 pandemic regarding the priority of child protection, type of disinfectants, and water consumption has significantly altered. These changes mainly depended on the women's age and education level.

DISCUSSION

Overall results showed that in 61.09% of the participants, the number of hand washes and in 58.58%, the washing time increased, leading to water shortage in the refugee camp.

Physico-Chemical Investigation and Antimicrobial Efficacy of Ozonated Oils: The Case Study of Commercial Ozonated Olive and Sunflower Seed Refined Oils

Drug resistance represents one of the great plagues of our time worldwide. This largely limits the treatment of common infections and requires the development of new antibiotics or other alternative approaches. Noteworthy, the indiscriminate use of antibiotics is mostly responsible for the selection of mutations that confer drug resistance to microbes. In this regard, recently, ozone has been raising interest for its unique biological properties when dissolved in natural oils. Ozonated oils have been reported to act in a non-specific way on microorganisms hindering the acquisition of advantageous mutations that result in resistance. Here, we focused on the antimicrobial effect of two commercial olive (OOO) and sunflower seeds (OSO) oils. Nuclear magnetic resonance spectroscopy and thermal analysis showed the change in the chemical composition of the oils after ozonation treatment. Different ozonated oil concentrations were then used to evaluate their antimicrobial profile against Candida albicans, Enterococcus faecalis, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli by agar diffusion and broth dilution methods. Cytotoxicity was also evaluated in keratinocytes and epithelial cells. Overall, our results revealed that both OOO and OSO showed a potent microbicidal effect, especially against C. albicans (IC50 = OOO: 0.3 mg/mL and OSO: 0.2 mg/mL) and E. faecalis (IC50 = OOO: 0.4 mg/mL and OSO: 2.8 mg/mL) albeit exerting a certain effect also against S. aureus and E. coli. Moreover, both OOO and OSO do not yield any relevant cytotoxic effect at the active concentrations in both cell lines. This indicates that the ozonated oils studied are not toxic for mammalian cells despite exerting a potent antimicrobial effect on specific microorganisms. Therefore, OOO and OSO may be considered to integrate standard therapies in the treatment of common infections, likely overcoming drug resistance issues.

Effects of public health interventions and zero COVID policy on paediatric diseases: A Southern China study

Background

With the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in schools and communities, clinical evidence is needed to determine the impact of the pandemic and public health interventions under the zero coronavirus disease policy on the occurrence of common infectious diseases and non-infectious diseases among children.

Methods

The current study was designed to analyse the occurrence of common infectious diseases before and after the pandemic outbreak in southern China. Data was obtained for 1 801 728 patients admitted into children's hospitals in Guangzhou between January 2017 and July 2022. Regression analysis was performed for data analysis.

Results

The annual occurrence of common paediatric infectious diseases remarkably decreased after the pandemic compared to the baseline before the pandemic and the monthly occurrence. Cases per month of common paediatric infectious diseases were significantly lower in five periods during the local outbreak when enhanced public health measures were in place. Cases of acute non-infectious diseases such as bone fractures were not reduced. Non-pharmaceutical interventions decreased annual and monthly cases of paediatric respiratory and intestinal infections during the coronavirus disease 2019 (COVID-19) pandemic, especially when enhanced public health interventions were in place.

Conclusions

Our findings provide clinical evidence that public health interventions under the dynamic zero COVID policy in the past three years had significant impacts on the occurrence of common respiratory and intestinal infectious diseases among children and adolescents but little impact on reducing non-infectious diseases such as leukaemia and bone fracture.

A Novel Handrub Tablet Loaded with Pre- and Post-Biotic Solid Lipid Nanoparticles Combining Virucidal Activity and Maintenance of the Skin Barrier and Microbiome

OBJECTIVE

This study aimed to develop a holobiont tablet with rapid dispersibility to provide regulation of the microbiota, virucidal activity, and skin barrier protection.

METHODS

A 23 factorial experiment was planned to define the best formulation for the development of the base tablet, using average weight, hardness, dimensions, swelling rate, and disintegration time as parameters to be analyzed. To produce holobiont tablets, the chosen base formulation was fabricated by direct compression of prebiotics, postbiotics, and excipients. The tablets also incorporated solid lipid nanoparticles containing postbiotics that were obtained by high-pressure homogenization and freeze-drying. The in vitro virucidal activity against alpha-coronavirus particles (CCoV-VR809) was determined in VERO cell culture. In vitro analysis, using monolayer cells and human equivalent skin, was performed by rRTq-PCR to determine the expression of interleukins 1, 6, 8, and 17, aquaporin-3, involucrin, filaggrin, FoxO3, and SIRT-1. Antioxidant activity and collagen-1 synthesis were also performed in fibroblast cells. Metagenomic analysis of the skin microbiome was determined in vivo before and after application of the holobiont tablet, during one week of continuous use, and compared to the use of alcohol gel. Samples were analyzed by sequencing the V3-V4 region of the 16S rRNA gene.

RESULTS

A handrub tablet with rapid dispersibility was developed for topical use and rinse off. After being defined as safe, the virucidal activity was found to be equal to or greater than that of 70% alcohol, with a reduction in interleukins and maintenance or improvement of skin barrier gene markers, in addition to the reestablishment of the skin microbiota after use.

CONCLUSIONS

The holobiont tablets were able to improve the genetic markers related to the skin barrier and also its microbiota, thereby being more favorable for use as a hand sanitizer than 70% alcohol.

COVID-19 on the spectrum: a scoping review of hygienic standards

The emergence of COVID-19 in Wuhan, China, rapidly escalated into a worldwide public health crisis. Despite numerous clinical treatment endeavors, initial defenses against the virus primarily relied on hygiene practices like mask-wearing, meticulous hand hygiene (using soap or antiseptic solutions), and maintaining social distancing. Even with the subsequent advent of vaccines and the commencement of mass vaccination campaigns, these hygiene measures persistently remain in effect, aiming to curb virus transmission until the achievement of herd immunity. In this scoping review, we delve into the effectiveness of these measures and the diverse transmission pathways, focusing on the intricate interplay within the food network. Furthermore, we explore the virus's pathophysiology, considering its survival on droplets of varying sizes, each endowed with distinct aerodynamic attributes that influence disease dispersion dynamics. While respiratory transmission remains the predominant route, the potential for oral-fecal transmission should not be disregarded, given the protracted presence of viral RNA in patients' feces after the infection period. Addressing concerns about food as a potential viral vector, uncertainties shroud the virus's survivability and potential to contaminate consumers indirectly. Hence, a meticulous and comprehensive hygienic strategy remains paramount in our collective efforts to combat this pandemic.

Inactivation of airborne pathogenic microorganisms by plasma-activated nebulized mist

The airborne microorganisms in the aerosols are one main transmission way of pathogenic microorganisms and therefore inactivation of microorganisms in aerosols could effectively prevent the transmission of pathogenic microorganisms to control epidemics. The mist nebulized by plasma-activated air could effectively inactivate bacteria and could be developed for the sterilization of microorganisms in aerosols. In this study, the plasma-activated nebulized mist (PANM) was applied for the inactivation of microorganisms in aerosols and efficiently inactivated the bacteria, yeast, and viruses in aerosols after 2-min treatment. The PANM treatment caused morphologic changes and damage to the bacteria cells in aerosols. The PANM could also inactivate the microorganisms attached to the surface of the treatment chamber and the bacteria attached to the skin of mice within 6-min treatment. The biosafety assays demonstrated that the PANM treatment exhibited no effects on the behavior, hematological and serum biochemical parameters of blood, and organs from the mice. This study would supply an efficient, broad-spectrum, and safe aerosol sterilization strategy based on plasma technology to prevent the transmission of airborne microorganisms.

Evaluation of dressings preventing facial medical device-related pressure injury in medical staff during the COVID-19 pandemic: A systematic review and network meta-analysis

AIM

This study systematically compared the efficacy of various dressings that may prevent facial medical device-related pressure injury (MRDPI) in medical staff during the COVID-19 pandemic.

BACKGROUND

During the COVID-19 pandemic, medical staff who are required to wear masks, goggles and other personal protective equipment (PPE) are susceptible to facial MRDPI, which exacerbates working conditions. Dressings can effectively prevent or alleviate MRDPI, but it is unclear which dressings are most effective.

DESIGN

A systematic review and network meta-analysis, in accordance with PRISMA.

METHODS

A comprehensive literature search was conducted in four English and four Chinese databases to identify relevant studies published up to 8 September 2022. The selected studies were randomised controlled trials, with populations comprising medical staff who wore PPE during the COVID-19 pandemic and included an observation and control group.

RESULTS

The network meta-analysis of the 12 selected articles showed that foam dressing, hydrocolloid dressing and petrolatum gauze were better than conventional protection for preventing MRDPI. The surface under the cumulative ranking curve indicated that foam dressing was the best preventative.

CONCLUSION

Foam dressing is more effective than other dressings in preventing facial MRDPI in medical staff. When PPE must be worn for many hours, such as during the COVID-19 pandemic, medical staff can use foam dressings to prevent MRDPI.

RELEVANCE TO CLINICAL PRACTICE

The results support the use of dressings, especially foam dressings, to prevent MRDPI in healthcare workers. The appropriate dressings are recommended to prevent MRDPI associated with wearing PPE.

Hand Sanitizer Gels: Classification, Challenges, and the Future of Multipurpose Hand Hygiene Products

Hand hygiene is a crucial measure in the prevention and control of infections, and there is a growing awareness among individuals who are making a conscious effort to maintain hand cleanliness. With the advent of the SARS-CoV-2 outbreak, the demand for hand hygiene products has also gradually shifted towards those with antimicrobial properties. Among these products, hand sanitizer gels (HSGs) have gained considerable popularity as an efficient method of hand cleaning, due to their rapid drying and sustained antimicrobial efficacy. Concurrently, there has been a growing interest in novel HSGs that offer additional functions such as skin whitening, moisturizing, and anti-inflammatory effects. These novel HSGs effectively address concerns associated with the ingestion of antimicrobial ingredients and demonstrate reduced skin irritation, thereby alleviating hand dermatological issues. This review provides an extensive overview of the application scenarios, classification, and challenges associated with HSGs while emphasizing the emergence of novel components with biological functions, aiming to contribute to the advancement of hand hygiene practices and offer novel insights for the development of novel HSGs with outstanding antimicrobial properties with other multiple biological functions and desirable biosafety profiles.

Identifying Health-Related Conditions Associated with Tinnitus in Young Adults

OBJECTIVE

The present study investigated the epidemic of tinnitus in college-aged young adults. Our first objective was to identify health conditions associated with tinnitus in young adults. The second objective was to evaluate the predictive utility of some known risk factors.

STUDY DESIGN

A cross-sectional design was used to investigate the prevalence and risk factors for tinnitus.

SETTING

A questionnaire was distributed, reaching out to a large college-aged population. A total of 2258 young adults aged 18-30 years were recruited from April 2021 to February 2022.

INTERVENTIONS

A questionnaire was administered to investigate the epidemiology of tinnitus in a population of college-aged young adults.

RESULTS

About 17.7% of young adults reported bothersome tinnitus perception lasting for ≥5 min in the last 12 months. The prevalence of chronic tinnitus (bothersome tinnitus for ≥1 year) and acute tinnitus (bothersome tinnitus for <1 year) was 10.6% and 7.1%, respectively. About 19% of the study sample reported at least one health condition. Individuals reporting head injury, hypertension, heart disease, scarlet fever, and malaria showed significantly higher odds of reporting chronic tinnitus. Meningitis and self-reported hearing loss showed significant associations with bothersome tinnitus. The prevalence of chronic tinnitus was significantly higher in males reporting high noise exposure, a positive history of reoccurring ear infections, European ethnic background, and a positive health history. Risk modeling showed that noise exposure was the most important risk factor for chronic tinnitus, followed by sex, reoccurring ear infections, and a history of any health condition. A positive history of COVID-19 and self-reported severity showed no association with tinnitus. Individuals reporting reoccurring ear infections showed a significantly higher prevalence of COVID-19.

CONCLUSIONS

While young adults with health conditions are at a higher risk of reporting tinnitus, the predictive utility of a positive health history remains relatively low, possibly due to weak associations between health conditions and tinnitus. Noise, male sex, reoccurring ear infections, European ethnicity, and a positive health history revealed higher odds of reporting chronic tinnitus than their counterparts. These risk factors collectively explained about 16% variability in chronic tinnitus, which highlights the need for identifying other risk factors for chronic tinnitus in young adults.

Contact dermatitis caused by prevention measures during the COVID-19 pandemic: a narrative review

Introduction

During the outbreak of Coronavirus disease 2019 (COVID-19), health care workers wore personal protective equipment including masks, gloves and goggles for a long time. In order to reduce the transmission routes of the virus, public places were sprayed with disinfectant. Moreover, the body, hands and clothing were frequently disinfected and washed for hygiene purposes. Studies have shown that these practices could easily irritate the skin and damage the skin barrier. Long-term irritation or exposure to allergens may lead to the occurrence of contact dermatitis (CD).

Methods

Subject headings were searched via the National Library of Medicine (PubMed) and web of science databases: COVID-19; contact dermatitis; adverse skin reaction; PPE; dermatitis; mask; glory; hand hygiene, disinfection; face shield; goggle; protect cloth. A total of 246 and 646 articles were retrieved from the two databases, respectively. 402 articles remained after removing duplicates. Reviews, non-English articles, articles that could not be accessed to read or did not conform to our topic were excluded. Finally, a total of 32 cross-sectional studies, 9 case reports and 2 randomized controlled trials were included.

Discussion

This article reviews reports of CD caused by various prevention and hygiene measures during the COVID-19 pandemic. The amount of skin damage caused by COVID-19 prevention measures could be decreased by improved education about skin management.

Enhancing Biocidal Capability in Cuprite Coatings

The SARS-CoV-2 global pandemic has reinvigorated interest in the creation and widespread deployment of durable, cost-effective, and environmentally benign antipathogenic coatings for high-touch public surfaces. While the contact-kill capability and mechanism of metallic copper and its alloys are well established, the biocidal activity of the refractory oxide forms remains poorly understood. In this study, commercial cuprous oxide (Cu2O, cuprite) powder was rapidly nanostructured using high-energy cryomechanical processing. Coatings made from these processed powders demonstrated a passive "contact-kill" response to Escherichia coli (E. coli) bacteria that was 4× (400%) faster than coatings made from unprocessed powder. No viable bacteria (>99.999% (5-log10) reduction) were detected in bioassays performed after two hours of exposure of E. coli to coatings of processed cuprous oxide, while a greater than 99% bacterial reduction was achieved within 30 min of exposure. Further, these coatings were hydrophobic and no external energy input was required to activate their contact-kill capability. The upregulated antibacterial response of the processed powders is positively correlated with extensive induced crystallographic disorder and microstrain in the Cu2O lattice accompanied by color changes that are consistent with an increased semiconducting bandgap energy. It is deduced that cryomilling creates well-crystallized nanoscale regions enmeshed within the highly lattice-defective particle matrix. Increasing the relative proportion of lattice-defective cuprous oxide exposed to the environment at the coating surface is anticipated to further enhance the antipathogenic capability of this abundant, inexpensive, robust, and easily handled material for wider application in contact-kill surfaces.

The Prevalence and Clinical Features of Skin Irritation Caused by Infection Prevention Measures During COVID-19 in Riyadh Region, Saudi Arabia

INTRODUCTION

Coronavirus disease 2019 (COVID-19) or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), caused by a novel coronavirus (CoV), was reported at the end of 2019 and caused a severe public health concern. It caused high mortalities by respiratory failure among infected people and was declared a pandemic by the World Health Organization (WHO) in March 2020. This virus caused infections through air or direct contact which documented a huge number of fatalities.

AIM

This study aims to examine the impact of the COVID-19 pandemic on skin eczema of the general public in the Riyadh region of Saudi Arabia.

METHODS

This is a descriptive, cross-sectional, survey-based study, that was conducted via an online survey distributed to the general population of Riyadh for the period between January and February 2023. Data was collected through a questionnaire which was distributed through the social media websites.

RESULTS

A total of 697 participants were involved in this study. Around one-fifth of the study participants (19.5%) reported that they suffer from some form of allergy and have family history of allergy (21.8%). Eczema was the most common type of allergy among the study participants accounting for 32.4%. A total of 116 participants (16.6%) reported that they have personal history of hand eczema or other skin disease on the hands. Cleaning and sterilization materials were reported as the most common cause of dryness and irritation of eczema (62.1%). Around 41.0% of the participants reported that they noticed a worsening of their symptoms after the pandemic, of which dryness was the most commonly reported sign noticed getting worse by 68.1% of the participants. The vast majority of the participants (89.7%) reported that new skin symptoms emerged on their hands after the beginning of the pandemic, of which dryness was reported by all the participants.

CONCLUSION

A considerable proportion of participants, particularly those with a history of hand eczema, experienced dermatological difficulties, including skin damage, due to the usage of COVID-19 preventive strategies. Thus, we recommend increasing the use of innovative infection prevention approaches and skin protection measures, such as regular hand hydration and maybe the use of less toxic skin disinfectants.

Development and Evaluation of an FDM Printed Nasal Device for CPZ Solid Nanoparticles

Nasal drug delivery has been a focus of scientific interest for decades. A number of drug delivery systems and devices are available and have been highly successful in providing better and more comfortable therapy. The benefits of nasal drug delivery are not in question. The nasal surface provides an excellent context for the targeted delivery of active substances. In addition to the large nasal surface area and intensive absorption, the active substances delivered through the nose overcome the blood-brain barrier and can be delivered directly to the central nervous system. Formulations for nasal administration are typically solutions or liquid dispersed systems such as emulsions or suspensions. Formulation techniques for nanostructures have recently undergone intensive development. Solid-phase heterogeneous dispersed systems represent a new direction in pharmaceutical formulations. The wide range of possible examples and the variety of excipients allow for the delivery of a wide range of active ingredients. The aim of our experimental work was to develop a solid drug delivery system that possesses all of the above-mentioned advantageous properties. In developing solid nanosystems, we not only exploited the advantages of size but also the adhesive and penetration-enhancing properties of excipients. During formulation, several amphiphilic compounds with adhesion properties and penetration enhancing effects were incorporated. We used chlorpromazine (CPZ), which is mainly used in the treatment of psychotic disorders such as schizophrenia and bipolar disorder. Chlorpromazine has been previously investigated by our team in other projects. With the availability of previous methods, the analytical characterization of the drug was carried out effectively. Due to the frequent and severe side effects of the drug, the need for therapeutic dose reduction is indisputable. In this series of experiments, we succeeded in constructing drug delivery systems. Finely divided Na nanoparticles were formed using a Büchi B90 nanospray dryer. An important step in the development of the drug carrier was the selection of suitable inert carrier compounds. Particle size determination and particle size distribution analysis were performed to characterize the prepared nanostructures. As safety is the most important aspect of any drug formulation, all components and systems were tested with different biocompatibility assays. The tests performed demonstrated the safe applicability of our systems. The bioavailability of chlorpromazine was studied as a function of the ratio of the active ingredient administered nasally and intravenously. As described above, most nasal formulations are liquids, but our system is solid, so there is currently no tool available to accurately target this system. As a supplement of the project, a nasal dosing device was developed, corresponding to the anatomical structure; a prototype of the device was made using 3D FDM technology. Our results lay the foundation for the design and industrial scaling of a new approach to the design and production of a high-bioavailability nasal medicinal product.

Understanding the role of personal experiences and contextual variables in shaping risk reduction preferences

This article explores how preferences for risk reduction during the COVID-19 pandemic are influenced by personal experiences and contextual variables such as having a close friend or relative who has been infected by the virus (closeness), the severity of the illness (severity), people's own perceptions of being in a risky group (risk group), change in employment status due to the pandemic (employment situation), and vaccination status (vaccination status and altruistic vaccination). We conducted a choice experiment (CE) in Chile, Colombia, and Costa Rica. The attributes of the experiment were risk reduction, latency, and cost. Then, we estimated a mixed logit model to capture preference heterogeneity across the countries. The attributes presented in the CE were statistically significant, with the expected sign in each country. The variables closeness and employment situation presented homogeneous behavior in each country; however, severity, risk group, and vaccination status showed mixed results. We found that preferences were more heterogeneous for the attributes of the CE than for the personal experiences and contextual variables. Understanding the impact of these variables is essential for generating more effective risk reduction policies. For instance, methodologies such as the value of statistical life base their calculations on society's valuation of risk reduction. We provide evidence that the preferences for risk reduction vary due to the everyday situations that individuals face in the context of the pandemic. The latter may cause distortions in the values used to evaluate policies aimed at mitigating the outbreak.

Real-time hand rubbing quality estimation using deep learning enhanced by separation index and feature-based confidence metric

Hand hygiene plays a crucial role in healthcare environments which can cease infections and diseases from spreading. It is also regarded as the second most effective way to control the transmission of COVID-19. The World Health Organization (WHO) recommends a 12-step guideline for alcohol-based hand rubbing. Compliance with this guideline is vital in order to clean the hands thoroughly. Hence, an automated system can help to improve the quality of this procedure. In this study, a large-scale and diverse dataset for both real and fake hand rubbing motions is collected as the first stage of building a reliable hand hygiene system. In the next stage, various pre-trained networks were analyzed and compared using a swift version of the Separation Index (SI) method. The proposed Swift SI method facilitates choosing the best pre-trained network without fine-tuning them on the whole dataset. Accordingly, the Inception-ResNet architecture achieved the highest SI among Inception, ResNet, Xception, and MobileNet networks. Fine-tuning the Inception-ResNet model led to an accuracy of 98% on the test dataset, which is the highest score in the literature. Therefore, from the proposed approach, a lightweight version of this model with fewer layers but almost the same accuracy is produced and examined. In the final stage, a novel metric, called Feature-Based Confidence (FBC), is devised for estimating the confidence of models in prediction. The proposed confidence measure is able to profoundly differentiate models with similar accuracy and determine the superior one. Based on the metrics results, the Inception-ResNet model is about 2x slower but 5% more confident than its lightweight version. Putting all together, by addressing the real-time application concerns, a Deep Learning based method is offered to qualify the hand rubbing process. The model is also employed in a commercial machine, called DeepHARTS, to estimate the quality of the hand rubbing procedure in different organizations and healthcare environments.

New insights from nanotechnology in SARS-CoV-2 detection, treatment strategy, and prevention

The recent outbreak of SARS-CoV-2 resulted into the deadly COVID-19 pandemic, which has made a profound impact on mankind and the world health care system. SARS-CoV-2 is mainly transmitted within the population via symptomatic carriers, enters the host cell via ACE2 and TMPSSR2 receptors and damages the organs. The standard diagnostic tests and treatment methods implemented lack required efficiency to beat SARS-CoV-2 in the race of its spreading. The most prominently used diagnostic test,reverse transcription-polymerase chain reaction (a nucleic acid-based method), has limitations including a prolonged time taken to reveal results, limited sensitivity, a high rate of false negative results, and lacking specificity due to a homology with other viruses. Furthermore, as part of the treatment, antiviral drugs such as remdesivir, favipiravir, lopinavir/ritonavir, chloroquine, daclatasvir, atazanavir, and many more have been tested clinically to check their potency for the treatment of SARS-CoV-2 but none of these antiviral drugs are the definitive cure or suitable prophylaxis. Thus, it is always required to combat SARS-CoV-2 spread and infection for a better and precise prognosis. This review answers the above mentioned challenges by employing nanomedicine for the development of improved detection, treatment, and prevention strategies for SARS-CoV-2. In this review, nanotechnology-based detection methods such as colorimetric assays, photothermal biosensors, molecularly imprinted nanoparticles sensors, electrochemical nanoimmunosensors, aptamer-based biosensors have been discussed. Furthermore, nanotechnology-based treatment strategies involving polymeric nanoparticles, metallic nanoparticles, lipid nanoparticles, and nanocarrier-based antiviral siRNA delivery have been depicted. Moreover, SARS-CoV-2 prevention strategies, which include the nanotechnology for upgrading personal protective equipment, facemasks, ocular protection gears, and nanopolymer-based disinfectants, have been also reviewed. This review will provide a one-site informative platform for researchers to explore the crucial role of nanomedicine in managing the COVID-19 curse more effectively.

Bio-nanocomposites films based on unmodified and modified thermoplastic starch reinforced with chemically modified nanoclays

The use of polymers capable of being degraded by the action of microorganisms and/or enzymes without causing harmful effects is a strategy in waste management and environmental care. In this work, bio-nanocomposites based on thermoplastic starch (TPS) were synthesized by reactive extrusion using a twin-screw extruder. Two strategies were evaluated to reduce the disadvantages of TPS for packaging applications. First, starch was chemically modified producing the reaction of native starch with chemical reagents that introduce new functional groups to reduce the water adsorption. And two, nano-fillers were incorporated into TPS in order to enhance the mechanical and barrier properties, driving to materials with improved performance/cost ratio. The synergistic strategies of chemical modification and incorporation of modified nanoclays were also effective to reduce the dependence of properties of TPS with the environment humidity and the evolution thereof over time, which influences the performance during the service life of the product.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10853-023-08354-1.

The Imprint of Exposome on the Development of Atopic Dermatitis across the Lifespan: A Narrative Review

Atopic dermatitis (AD) is a chronic inflammatory skin condition that affects more than 200 million people worldwide, including up to 20% of children and 10% of the adult population. Although AD appears frequently in childhood and often continues into adulthood, about 1 in 4 adults develop the adult-onset disease. The prenatal period, early childhood, and adolescence are considered critical timepoints for the development of AD when the exposome results in long-lasting effects on the immune system. The exposome can be defined as the measure of all the exposures of an individual during their lifetime and how these exposures relate to well-being. While genetic factors could partially explain AD onset, multiple external environmental exposures (external exposome) in early life are implicated and are equally important for understanding AD manifestation. In this review, we describe the conceptual framework of the exposome and its relevance to AD from conception and across the lifespan. Through a spatiotemporal lens that focuses on the multi-level phenotyping of the environment, we highlight a framework that embraces the dynamic complex nature of exposome and recognizes the influence of additive and interactive environmental exposures. Moreover, we highlight the need to understand the developmental origins of AD from an age-related perspective when studying the effects of the exposome on AD, shifting the research paradigm away from the per se categorized exposome factors and beyond clinical contexts to explore the trajectory of age-related exposome risks and hence future preventive interventions.

SHEA/IDSA/APIC Practice Recommendation: Strategies to prevent healthcare-associated infections through hand hygiene: 2022 Update

The purpose of this document is to highlight practical recommendations to assist acute-care hospitals in prioritization and implementation of strategies to prevent healthcare-associated infections through hand hygiene. This document updates the Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals through Hand Hygiene, published in 2014. This expert guidance document is sponsored by the Society for Healthcare Epidemiology (SHEA). It is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America, the Association for Professionals in Infection Control and Epidemiology, the American Hospital Association, and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise.

Occupational Skin Dermatitis among Healthcare Workers Associated with the COVID-19 Pandemic: A Review of the Literature

The skin is the outermost layer of the human body and is continually exposed to numerous external stimuli, which can cause unwanted skin irritation. Occupational skin diseases are the most prevalent form of work-related illness and are found in a variety of sectors, particularly healthcare. During the recent COVID-19 pandemic, healthcare professionals experienced a variety of unexpected, unusual occupational skin diseases associated with COVID-19-engaged employment. Because the clinical characteristics of these types of skin inflammation are unique, this review focuses on the characteristics of a large category of occupational workers, namely COVID-19-engaged healthcare professionals. Furthermore, we examined the potential pathogeneses of occupational skin disorders associated with COVID-19-engaged labor, as well as different preventative methods.

Comprehensive insight into triclosan-from widespread occurrence to health outcomes

Humans are exposed to the variety of emerging environmental pollutant in everyday life. The special concern is paid to endocrine disrupting chemicals especially to triclosan which could interfere with normal hormonal functions. Triclosan could be found in numerous commercial products such as mouthwashes, toothpastes and disinfectants due to its antibacterial and antifungal effects. Considering the excessive use and disposal, wastewaters are recognized as the main source of triclosan in the aquatic environment. As a result of the incomplete removal, triclosan residues reach surface water and even groundwater. Triclosan has potential to accumulate in sediment and aquatic organisms. Therefore, the detectable concentrations of triclosan in various environmental and biological matrices emerged concerns about the potential toxicity. Triclosan impairs thyroid homeostasis and could be associated with neurodevelopment impairment, metabolic disorders, cardiotoxicity and the increased cancer risk. The growing resistance of the vast groups of bacteria, the evidenced toxicity on different aquatic organisms, its adverse health effects observed in vitro, in vivo as well as the available epidemiological studies suggest that further efforts to monitor triclosan toxicity at environmental levels are necessary. The safety precaution measures and full commitment to proper legislation in compliance with the environmental protection are needed in order to obtain triclosan good ecological status. This paper is an overview of the possible negative triclosan effects on human health. Sources of exposure to triclosan, methods and levels of detection in aquatic environment are also discussed.

Two-year impact of COVID-19 pandemic on hospitalized patients with skin diseases in China

To investigate the clinical characteristics of skin disorders among hospitalized patients before and during the coronavirus disease 2019 (COVID-19) pandemic, a retrospective study was conducted based on hospitalized patients with skin diseases from Xiangya Hospital of Central South University, the largest hospital in the south-central region of China, between January 1, 2018, and December 31, 2021. A total of 3039 hospitalized patients were enrolled in the study, including 1681 patients in the prepandemic group and 1358 patients in the pandemic group. The total number of hospitalized patients in the pandemic group decreased by 19.2%, with an increased proportion of patients over 60 years of age (39.8% vs. 35.8%). Moreover, compared with the prepandemic group, there were decreases in the occurrence of most skin diseases in the pandemic group, but the proportions of keratinolytic carcinoma (6.6% vs. 5.2%), dermatitis (24.0% vs. 18.9%), and psoriasis (18.0% vs. 14.8%) were higher in the pandemic group. In addition, longer hospital stays (β = 0.07, SE = 0.02, P = 1.35 × 10^-3 ) and higher hospital costs (β = 0.06, SE = 0.03, p = 0.031) were found in the pandemic group through general linear models, even after the corresponding adjustment. In summary, the COVID-19 pandemic has had a lasting impact on patients with skin diseases, with fewer hospitalized patients, increased proportions of older patients, longer hospital stays, and increased hospital costs. These findings will facilitate better preparation for the most effective response to future pandemics.

The Influence of Azidated Glycerol as a New Low Temperature Stabilizer on the Colloidal Properties of Natural Rubber Latex: For Latex Marine Transportation

Natural rubber latex (NRL) is normally transported to a destination in colloid/liquid form. It requires large storage containers such as drums and the probability of latex leakage during transportation is high. This is prevalent especially when transporting latex by sea. To prevent latex spillage, the liquid form of NRL is transformed into solid/frozen latex by freezing. However, the coagulation/destabilization of NRL by freezing has been acknowledged as a problem for years. Therefore, this study proposed a new low temperature stabilizer named azidated glycerol (AG) to be incorporated in NRL liquid before the freezing process. AG was prepared by a chemical reaction of pure glycerol with sodium azide. NRL containing AG was then frozen at a temperature of -4 °C. After 24 h of freezing, the frozen latex was thawed at ambient temperature for 1 h followed by heating in a water bath at 40 °C for another 1 h. The regenerated latex was then allowed to stand at room temperature before testing. The effect of AG on the colloid properties before and after the freeze-thaw processes was studied. The production of AG was confirmed by the appearance of a peak in the range of 2160-2120 cm^-1, corresponding to N=N=N stretching, confirming the introduction of an azide group into the glycerol molecule. Modifying NRL with AG did not significantly influence the TSC of latex. Increasing the AG content up to 0.4 phr resulted in an increase in MST from 699 s to 828 s. An AG content of 0.2 phr resulted in the highest anionically stabilized latex as indicated by zeta potential values of -59.63 mV (before freezing) and -56.27 mV (after thawing). It is concluded that the AG produced in this study can be used as an anti-freeze stabilizer for NRL and is suitable for latex marine transportation.

The flip side of frequent sanitising and hand washing

The stratum corneum is the outermost layer of the epidermis. It acts as an interface with the external environment and functions as a barrier that prevents microorganisms and allergens from penetrating the skin, while preventing bodily fluids, electrolytes and proteins from being lost in a process aimed at maintaining homeostasis. With the novel coronavirus disease 2019 (COVID-19) outbreak, there has been an increase in hygiene practice, particularly hand washing and the use of hand sanitisers. These practices have undoubtedly assisted a great deal in combatting the rate of transmission and contributed immensely to saving lives. However, repeated hand washing and the use of sanitisers have both been linked with marked skin dryness and contact dermatitis. This especially holds true when the above-mentioned practices are carried out in the absence of intermittent hand moisturiser usage.

Allergic diseases in children in the age of the COVID-19 pandemic

COVID-19 coronavirus infection caused by the SARS-CoV-2 virus has become a real disaster for all of humanity. Today, issues related to diagnostics, clinical presentations, treatment of the complications, preventive measures, including vaccination for a new coronavirus infection, are relevant. It is also important to identify risk factors for a severe course of the disease, features of the development of infection against the background of comorbid conditions and different immunological reactivity of the human body. The comorbidity of allergic and infectious diseases is based on the common humoral and cellular mechanisms of the immune response. The trigger for the development of allergic diseases is often the viruses of measles and chickenpox, influenza, parainfluenza, rhinoviruses, enteroviruses, respiratory syncytial viruses, coronaviruses, and others. Most allergic patients are predisposed to acute respiratory viral infections. COVID-19 occurs in 0.39–12.3% of children. Children tend to have milder disease than adults and have low mortality rates. At the same time, one should not forget about the adequate support for patients with chronic diseases, especially children with allergic diseases. Viruses and preventive hygiene measures associated with a pandemic are triggers of an exacerbation of bronchial asthma and atopic dermatitis. Early diagnosis, adequate treatment of allergic diseases in children, and provision of doctors with information are also problematic. It is important to understand which patients with bronchial asthma are at particular risk and how inhaled glucocorticosteroids may influence the course and outcome of COVID-19. International associations and societies have developed guidelines for the management of children with allergies during the COVID-19 pandemic. Inhaled glucocorticosteroids for bronchial asthma reduce the expression of genes of the main target receptors for the SARS-CoV-2 virus. Anti-inflammatory therapy for asthma, primarily inhaled glucocorticosteroids, should be continued until asthma control is achieved, which will help reduce the risk of an unfavorable course of COVID-19.

Dermatological impact of hand hygiene practices during COVID-19: A cross-sectional web-based survey among doctors in a tertiary care hospital in Eastern India

BACKGROUND

The COVID-19 pandemic continues to persist throughout the world with intermittent exacerbation. The changing trend of hand hygiene practices during this pandemic has led to new onset or aggravation of pre-existing hand eczema, especially among doctors. There is a paucity of studies regarding skin changes seen with changing hand hygiene practices in the Indian subcontinent.

OBJECTIVES

To estimate the frequency of various cutaneous manifestations and associated factors with hand hygiene practices in doctors during COVID-19 via a web-based online questionnaire survey.

METHODS

It was a cross-sectional web-based survey conducted at a tertiary care teaching institute from July 2021 to September 2021. Those doctors (faculty, residents, and interns) of the hospital completing the questionnaire with electronic informed consent were included in the study.

RESULTS

A total of 143 doctors completed the survey. The most common symptoms were dryness in 60 (42%) and itching in 25 (17.5%) doctors. The most common skin changes were scaling in 30 (21%) and redness in 16 (11.2%) doctors. There was a significant association between skin changes and frequency of hand washing and hand sanitizer use (p value < 0.05).

CONCLUSION

The prevalence of hand changes and symptoms was 77% in doctors in our study. The most commonly seen hand changes were scaling followed by redness and symptoms observed were dryness and itching.

Questionnaire-Based Study Evaluating the Hand Hygiene Practices and the Impact of Disinfection in the COVID-19 Pandemic on Hand Skin Conditions in Poland

During the COVID-19 pandemic, disinfection became an integral part of everybody's life in order to avoid spreading the coronavirus. In 2021, an original anonymous online survey was carried out. The questions concerned the usage of disinfectants. The study population included 56 subjects diagnosed by a physician with hand eczema (HE-derm group) and 114 subjects with no hand skin disease diagnosed by a specialist (non-derm). The HE and non-HE groups were distinguished. Nearly 80% of the HE group, and 10% of the non-HE group, experienced worsening of hand skin lesions caused by increased skin disinfection. HE-group respondents more often declared the occurrence of new hand skin symptoms, over 80% of the subjects of this group had more than 1 new symptom (compared to nearly 40% of the non-HE group). Exacerbations of the skin disease were more frequently observed by the HE group during the pandemic. There was a statistically significant decrease of the quality of life in the HE group compared to the non-HE group during the pandemic. The COVID-19 pandemic caused an increase in the prevalence of hand skin symptoms and deterioration of the skin condition. Education on appropriate disinfection techniques and skincare, as well as early dermatological intervention, might allow us to limit the development of hand skin diseases.

Evaluation of evidence of prevention and management of facial pressure injuries in medical staff

AIM

This systematic review evaluated the quality of evidence for the prevention and management of facial pressure injuries in medical staff.

DESIGN

This review was presented in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

METHODS

We retrieved the relevant studies from 19 databases. Using the literature evaluation standards and evidence grading system of the Australian Joanna Briggs Institute Evidence-Based Health Care Center, we evaluated the quality of the literature encompassing different types of research and assessed their levels of evidence.

RESULTS

A total of 13 studies were included, including seven expert consensuses, two recommended practices, one clinical decision, one best practice information booklet, one systematic review and one randomized controlled trial. In the end, 31 best evidence were summarized, including skin cleaning and care, PPE placement and movement, reasonable use of dressings, treatment measures and education and training.

Acceptability of an alcohol-based handrub gel with superfatting agents among healthcare workers: a randomized crossover controlled study

Introduction

Healthcare workers often experience skin dryness and irritation from performing hand hygiene frequently. Low acceptability and tolerability of a formulation are barriers to hand hygiene compliance, though little research has been conducted on what specific types of formulation have higher acceptability than others.

Objective

To compare the acceptability and tolerability of an ethanol-based handrub gel with superfatting agents to the isopropanol-based formulations (a rub and a gel formulation) currently used by healthcare workers at the University of Geneva Hospitals, Geneva, Switzerland.

Methods

Forty-two participants were randomized to two sequences, testing the isopropanol-based formulation that they are using currently (Hopirub® or Hopigel®), and the ethanol-based formulation containing superfatting agents (Saniswiss Sanitizer Hands H1). Participants tested each of the formulations over 7–10 day work shifts, after which skin condition was assessed and feedback was collected.

Results

H1 scored significantly better than the control formulations for skin dryness (P = 0.0209), and participants felt less discomfort in their hands when using that formulation (P = 0.0448). H1 caused less skin dryness than Hopirub®/Hopigel® (P = 0.0210). Though overall preference was quite polarized, 21 participants preferred H1 intervention formulation and 17 preferred the Hopirub®/Hopigel® formulation that they normally used in their care activities.

Conclusion

We observed a difference in acceptability and strongly polarized preferences among the participants' reactions to the formulations tested. These results indicate that giving healthcare workers a choice between different high-quality products is important to ensure maximum acceptability.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13756-022-01129-4.

Decreased febrile neutropenia during inpatient chemotherapy for urologic cancer during coronavirus disease 2019 pandemic

Since 2020, the coronavirus disease 2019 pandemic has led to the widespread practice of hand hygiene and wearing face masks, not only among medical personnel, but also among the general population. Thus, the impact of the coronavirus disease 2019 pandemic on the incidence of febrile neutropenia should be verified. This study aimed to examine the incidence of febrile neutropenia in hospitalized patients receiving chemotherapy at Kanazawa University Hospital. Among inpatients at the Department of Urology receiving chemotherapy, we compared the incidence of febrile neutropenia between 317 cases in 2018-2019 and 276 cases in 2020. We retrospectively analyzed the factors of febrile neutropenia via binomial logistic regression analysis based on patient characteristics and the characteristics of primary diseases, with statistical significance set at p < 0.05. Febrile neutropenia occurred in 20/317 cases in 2018-2019 and 1/276 cases in 2020, with a significant decrease in the latter (p = 0.005). In a multivariate analysis, we identified the following independent risk factors for febrile neutropenia: non-coronavirus disease 2019 era (p = 0.005), first course of therapy (p = 0.005), malnutrition (p = 0.032), and past history of febrile neutropenia (p = 0.018). Due to the coronavirus disease 2019 pandemic, hygiene policies for medical personnel and quarantine measures for patients were thoroughly implemented. Therefore, the incidence of febrile neutropenia in 2020 decreased to 1/15 of the previous incidence. Thus, the hygiene for medical personnel and patients during the expected period of chemotherapy-induced neutropenia is important for febrile neutropenia prevention.

The Long-COVID Experience Changed People's Vaccine Hesitancy but Not Their Vaccination Fear

Starting in early 2020, the COVID-19 pandemic has been responsible, worldwide, for millions of deaths and patients with long-COVID syndrome. In an attempt to stop the spread of the virus, the blanket administration of COVID-19 vaccines proved to be the most effective measure, yet the existence and availability of functional vaccines did not and, still, do not ensure the willingness and intent of people to be vaccinated. This study assessed the similarities and differences in vaccine fears and vaccine hesitancy through between clusters of subjects: people that were not infected with COVID-19, people that had COVID but did not develop long-lasting symptoms, and people that were infected with COVID and developed long-COVID syndrome. From the sample of 1111 Italian people, it was found that individuals who experienced mild symptoms showed higher vaccine hesitancy (confidence, complacency, and collective responsibility) than those who did not contract COVID-19. People affected by long-COVID showed a lower overall hesitancy than individuals who had COVID-19 without incurring long-lasting symptoms and, thus, essentially resembled people who had no experience of COVID-19 infection in terms of the vaccine hesitancy scores. Vaccine fear remained unchanged across all three of the examined clusters.

Hajj 2021: Role of mitigation measures for health security

PURPOSE

After the impressive results of the 2020 Hajj management, Saudi authorities decided to expand the quota to 60,000 pilgrims in 2021, which resulted in a convenient and successful experience.

PATIENTS AND METHODS

This was a retrospective pre and post-study study conducted on all pilgrims attending the 2021 Hajj using the polymerase chain reaction (PCR) test surveillance with paired-swab samples (pre-Hajj and post-Hajj) to evaluate the risk potential of COVID-19 among Hajj pilgrims, the effectiveness of preventive measures and the potential effect of the Hajj ritual as a huge mass gathering on the epidemiological situation of the Saudi Arabian population.

RESULT

Forty-one cases had positive COVID-19 infections out of a total of 58,428 pilgrims who attended the 2021 Hajj season, as detected by nonmandatory pre- and post-Hajj PCR. Notably, the 2021 Hajj season achieved a decreasing leg of the COVID-19 pandemic curve. The adjusted incidence rate in KSA from July 11th to August 7th ranged from 19 to 24 cases per 100,000 population. In contrast, the incidence rate for the same duration in Hajj ranged from 3 to 7 cases per 100,000 pilgrims.

CONCLUSION

The Saudi mitigation plan ensured the safety of pilgrims and healthcare workers for Hajj, successfully limited the risk of COVID-19 transmission inside and contributed to global health security. The success story of Hajj in 2020 and 2021 during the pandemic represents a successful model for planning, achieving and managing future mass gatherings by integrating technology with global and national health policies and public health measures.

Impact of COVID-19 Awareness on Protective Behaviors during the Off-Peak Period: Sex Differences among Chinese Undergraduates

COVID-19 remains an extreme threat in higher education settings, even during the off-peak period. Appropriate protective measures have been suggested to prevent the spread of COVID-19 in a large population context. Undergraduate students represent a highly vulnerable fraction of the population, so their COVID-19 protective behaviors play critical roles in enabling successful pandemic prevention. Hence, this study aims to understand what and how individual factors contribute to undergraduate students' protective behaviors. After building multigroup structural equation models using data acquired from the survey taken by 991 undergraduates at a large research university in eastern China, I found that students' COVID-19 awareness was positively associated with their protective behaviors, such as wearing a mask, using hand sanitizer, and maintaining proper social distance, but not with getting vaccinated. In addition, I found students with higher COVID-19 awareness were more likely to have more COVID-19 knowledge than those with less awareness. Furthermore, sex differences were observed in the mediation effects of COVID-19 awareness on wearing a mask and getting vaccinated, via COVID-19 knowledge, respectively. The results of this study have implications in helping higher education stakeholders enact effective measures to prevent the spread of the pandemic.

Topical non-pharmacological treatment of eczema: an Italian consensus

Eczematous diseases (contact dermatitis, atopic dermatitis, hand eczema) are among the most frequent findings in dermatological clinical practice. A large body of evidence exists on structural and functional skin barrier damage in eczematous diseases, and on the importance of interventions aimed to repair such damage. While there is substantial agreement on pharmacological treatment, more sparse data are available on role, indications and usefulness of topical non-pharmacological treatments, despite significant research and progress in the composition and technology of emollients, cleansers and barrier creams significantly changed and expanded the functional activities of these products. This often leads to inadequate prescription and/or use, which increase individual and social costs of the disease and make the products useless or, in some cases, even counterproductive. This consensus document, discussed and compiled in a series of meetings by a group of Italian dermatologists experienced in the field of eczematous diseases, summarizes epidemiology and clinical features of the nosological entities of the "eczema family", illustrates the chemical/biochemical structure of emollients, cleansers and barrier creams, and aims to help physicians to exploit the full potential of available products, by providing a detailed but practical guide on characteristics, indications and correct use of non-pharmacological treatments currently available for eczematous diseases.

Body care activities and its consequences related to COVID-19 pandemic

BACKGROUND

Symptoms of illnesses related to COVID-19 disease include also dermatological changes. Moreover, modification of cosmetic and hygenic habits are widely noted.

AIM

The aim of this paper is to review the literature focused on skin manifestations related to COVID-19 disease.

MATERIALS AND METHODS

In order to obtain information contained in this review article electronic databases, such as Google Scholar and PubMed, was searched. Only peer-reviewed articles published in the past two years have been studied.

RESULTS AND DISCUSSION

People have changed their cosmetics and hygenic habits, what has an impact on spreading COVID-19 disease, as well as on the beauty industry and human health.

CONCLUSION

More emphasis should be placed on increasing knowledge about skin lesions, which may appear in course of the disease or are associated with changes in hygenic and cosmetics habits.

Rapid-killing efficacy substantiates the antiseptic property of the synergistic combination of carvacrol and nerol against nosocomial pathogens

Globally, new classes of synthetic and natural antibiotics and antivirulents have continuously been validated for their potential broad-spectrum antagonistic activity with the aim of identifying an effective active molecule to prevent the spread of infectious agents in both food industry and medical field. In view of this, present study is aimed at evaluating the rapid killing efficacy of bioactive molecules Carvacrol (C) and Nerol (N) through British Standard European Norm 1276: phase2/step1 (EN1276) protocol. Active molecules C and N showed broad-spectrum antimicrobial activity against the test strains Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli and Enterococcus hirae at concentration range of 78.125, 625, 156.25 and 312.5 μg/mL, respectively, for C, and 625 μg/mL for N. Whereas, combinatorial approach showed efficient activity with four times reduced concentration of C and N at 78.125 and 156.25 µg/mL, respectively, against test strains. Further, EN1276 results proved the rapid killing efficacy of test strains in 1 min of contact time with significant (> 5 log) growth reduction at 100X concentration of actives. SEM analysis and reduced concentration of protease, lipids and carbohydrate contents of treated group biofilm components ascertained preformed biofilm disruption potential of C + N on polystyrene and nail surfaces. C + N at synergistic concentration exhibited no adverse effect on HaCaT cells at 78.125 µg/mL (C) + 156.25 µg/mL (N). Taken together, based on the observed experimental results, present study evidence the antiseptic/disinfectant ability of C + N and suggest that the combination can preferentially be used in foam-based hand wash formulations.

Incidence of skin diseases in healthcare workers before and during the COVID-19 pandemic at Trieste Hospitals (northeastern Italy)

BACKGROUND

Occupational skin diseases (OSDs) are common in healthcare workers (HCWs).

OBJECTIVES

To investigate and compare the incidence and clinical features of OSDs amongst HCWs before and during the COVID-19 pandemic.

MATERIALS & METHODS

Incident cases of OSDs were investigated in the cohort of HCWs at Trieste Hospitals from July 1, 2018 (3340 workers) to October 31, 2021 (137,532 person-months).

RESULTS

The monthly incidence was ranging from 0 to 11.90 cases per 10,000 person-months in pre-COVID-19 period (cumulative incidence 4.22; 95%CI 2.9-6.0) and from 0 to 13.61 cases per 10,000 person-months in COVID-19 period (cumulative incidence 5.06; 95%CI 3.6-6.9). The incidence rate ratio (IRR) between COVID-19 and pre-COVID-19 period was 1.22 (95% CI 0.73-1.98). The incidence of OSDs in the COVID-19 period was 6.1 (4.2-8.6) and 2.7 (95%CI 1.1-5.6) cases * 10,000 person-months for women and men, respectively with an IRR of 2.25 (95%CI 0.98-5.9). Incidence in nurses in the COVID-19 period was 6.7 (95%CI 4.2-10.2) cases * 10,000 person-months.

CONCLUSIONS

Incidence of OSDs was a little bit higher during the COVID-19 pandemic compared to the previous period but fluctuation of numbers were mainly related to calendar period, with higher incidence in winter and spring. Incidence data were higher than that observed in 2004-2013 in the same cohort. Face dermatitis cases doubled after the start of COVID-19 pandemic. Overall data demonstrated a non-significant increase of OSDs in HCWs during the pandemic, probably due to the preventive strategies set up in our cohort over the years. This article is protected by copyright. All rights reserved.

Effect of New Surfactants on Biological Properties of Liquid Soaps

Liquid soaps are the basic cosmetics used to clean the skin of the hands. Frequent hand washing prevents viral contamination but may damage the skin’s hydro-lipid layer, leading to various types of irritation. Therefore, four liquid soap formulas were developed with three amphoteric surfactants: Cocamidopropyl Betaine (LS II), CocamidopropylHydroxysultaine (LS III), and newly synthesized Evening PrimroseaamidopropylSulfobetaine (LS IV). We evaluated the skin irritating potential (zein number, bovine albumin test) and cytotoxicity (AlamarBlue™, Cell viability, and Cell cycle assays) on HaCaT cell line. We observed lower values of the zein number and bovine albumin tests after adding soaps with surfactants (the highest differences in LS IV) compared to the base soap (LS I). However, LS I and LS II did not differ in cytotoxic assays. Therefore, adding LS III and LS IV seems potentially more dangerous to the cells. However, it should be noted that cells were continuously exposed to liquid soaps for more than 24 h, so its cytotoxic effects after dermal use in humans may be unnoticeable. Concluding, results suggest that the newly synthesized LS IV should improve the safety of liquid hand washing soaps.

Determinants of observing health protocols related to preventing COVID-19 in adult women: A qualitative study in Iran

Background

The best way to prevent COVID-19 is to observe health protocols. Therefore, identifying the reasons of following these protocols in order to plan and make intervention seems necessary. Therefore, the purpose of this study was to identify the determinants of observing health protocols related to prevention of COVID-19 among the Iranian adult women with a qualitative approach.

Method

In this qualitative study, the conventional content analysis approach was used. saturation was obtained after face-to-face semi-structured interviews with 38 women from Kermanshah who were selected through purposeful sampling and snowball sampling. Guba and Lincoln criteria were used for the strength of the research and Graneheim and Lundman method was used for its analysis.

Results

After analyzing the interviews, 5 categories, 12 subcategories and 110 initial codes were obtained. Categories and sub-categories were: 1- Individual factors (personality traits, health literacy about COVID-19); 2- Perceived risk having underlying disease in oneself and family, history of getting COVID-19 and death in close relatives; 3- Fear of the destructive consequences of the disease (concern about the economic consequences of getting the disease, concern about the treatment process); 4- Social and cultural factors (social monitoring, religious insight, ability to properly manage social interactions, impressionability from important others); 5- Environmental factors (supportive living environment, access to health and anti-infective materials).

Conclusion

Increasing the adherence of adult women to health instructions related to COVID-19 requires interventions at different levels of individual, environmental and social, and without accurate knowledge of the customs and culture of a society effective interventions cannot be established.

Association between years with incidence of communicable diseases focused on COVID-19 and hand hygiene among adults in South Korea: a cross-sectional study

Background

Handwashing is important considering the impact of communicable diseases on the public. We aimed to identify the association between years with incidence of communicable diseases during the coronavirus disease 2019 (COVID-19) pandemic and hand hygiene in South Korea.

Methods

This cross-sectional study evaluated 5 years (2013, 2015, 2017, 2019, and 2020) of data from the Korea Community Health Survey and included 1,034,422 adults. Multinomial logistic regression analysis was performed to assess handwashing frequency by year. Receiver operating characteristic analysis was used to determine the cut-off point for handwashing frequency.

Results

The always/frequently handwashing rate was 44.7%. This tendency was stronger in adults with each ascending year, with reference to 2013 (2015, odds ratio [OR] = 1.10, 95% confidence interval [CI] = 1.08, 1.13; 2017, OR = 1.10, 95% CI = 1.08, 1.13; 2019, OR = 1.17, 95% CI = 1.14, 1.20; 2020, OR = 3.21, 95% CI = 3.14, 3.29). Among women, the OR of frequently/always handwashing was 3.55 times higher (95% CI = 3.45, 3.66) in 2020 than in 2013. This OR was 2.95 among men (95% CI = 2.86, 3.04). In influenza-vaccinated participants, the OR of frequent/always handwashing was 3.25 times higher in 2020 than in 2013 (95% CI = 3.15, 3.36), while in non-vaccinated participants it was 3.17 (95% CI = 3.08, 3.27). Among adults who practiced physical distancing during the COVID-19 pandemic, the OR was 1.36 times higher (95% CI = 1.29, 1.42) with frequent handwashing, 1.64 times higher (95% CI = 1.57, 1.70) than those who did not practice it.

Conclusions

There was a strong tendency toward frequent handwashing over the years; the trend was even greater in 2020 during the COVID-19 pandemic. Given that communicable diseases and handwashing are closely related, it is necessary to promote hand hygiene for prevention.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13951-x.

Improving Recovery of Irritant Hand Dermatitis in Healthcare Workers With Workplace Interventions During the COVID-19 Pandemic

Introduction:

Occupational hand dermatitis is common among healthcare workers, with increased incidence during the COVID-19 pandemic. Irritant contact dermatitis accounts for the majority of occupational hand dermatitis and is largely due to frequent contact with hand hygiene products. Long-term prognosis of occupational contact dermatitis is often very poor. This study aims to identify and implement suitable workplace interventions to aid in the recovery of occupational irritant hand dermatitis among healthcare workers during the COVID-19 pandemic.

Methods

A quality improvement (QI) project was performed in a tertiary hospital using the Plan-Do-Study-Act model. Healthcare workers seen at the Occupational Dermatology Clinic from March 2020 to May 2021 for the first time for likely occupational irritant dermatitis were targeted for the project. Four workplace interventions were implemented: (a) substitute current alcohol-based hand rub (ABHR) with a different, gentler ABHR, (b) alternate ABHR with gentle hand wash products, (c) temporary job modification with less clinical work (d) switch latex gloves to nitrile gloves. The improvement was assessed after 2 months of workplace intervention using a visual analogue scale, based on changes seen on photographs taken at the baseline and monthly review. The target improvement was set at 70% after 2 months of workplace interventions.

Results

A total of 21 participants were included in the QI project. All participants were found to have significant improvement in their hand condition. The estimated mean reduction of signs and symptoms was 80% in comparison to their baseline hand condition before intervention.

Conclusion

Workplace interventions such as substituting irritant hand hygiene products with gentler alternatives and temporary reduction in clinical duties may be useful in improving the recovery rate of irritant hand dermatitis among healthcare workers. Areas with high hand hygiene workload or high incidences of hand dermatitis may opt to implement systemic workplace changes.