The COVID-19 pandemic is endangering the world due to the spread of respiration droplets with viruses. Medical workers and frontline staff need to wear respirators to protect themselves from ...breathing in the virus-containing respiration droplets. The most frequently used state-of-the-art respirators are of N95 standard; however, they lack self-decontamination capabilities. In addition, the viruses and bacteria can accumulate on the respirator surfaces, possessing high risks to the wearers over long-term usage. Photothermal decontamination is a contactless, fast, low-cost, and widely available method, capable of decontaminating the respirators. Herein, we report a plasmonic photothermal and superhydrophobic coating on N95 respirators, possessing significantly better protection than existing personal protection equipment. The plasmonic heating can raise the surface temperature to over 80 °C for this type of respirator within 1 min of sunlight illumination. The superhydrophobic features prohibit respiration droplets from accumulating on the respirator surfaces. The presence of the silver nanoparticles can provide additional protection via the silver ion’s disinfection toward microbes. These synergistic features of the composite coatings provide the N95 respirator with better protection and can inspire experts from interdisciplinary fields to develop better personal protection equipment to fight the COVID-19 pandemic.
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•Introduces Implantable Medical Device (IMD) technology and presents the new generation of IMDs with telemetry.•Explains the usage scenarios for communication with the IMD and ...introduces the associated threat model.•Shows tensions between security and safety and describes the technological limitations of current IMDs.•Extensively surveys the security mechanisms that have been proposed to thwart security threats in IMDs.•Summarizes the state-of-the-art to securize IMDs and points out future research directions.
Bioengineering is a field in expansion. New technologies are appearing to provide a more efficient treatment of diseases or human deficiencies. Implantable Medical Devices (IMDs) constitute one example, these being devices with more computing, decision making and communication capabilities. Several research works in the computer security field have identified serious security and privacy risks in IMDs that could compromise the implant and even the health of the patient who carries it. This article surveys the main security goals for the next generation of IMDs and analyzes the most relevant protection mechanisms proposed so far. On the one hand, the security proposals must have into consideration the inherent constraints of these small and implanted devices: energy, storage and computing power. On the other hand, proposed solutions must achieve an adequate balance between the safety of the patient and the security level offered, with the battery lifetime being another critical parameter in the design phase.
Summary
Medical devices are an important and growing aspect of healthcare provision and are increasing in complexity to meet established and emerging patient needs. Terminal sterilization plays a ...vital role in the provision of safe medical devices. While terminal sterilization technologies for medical devices include multiple radiation options, ethylene oxide remains the predominant nonthermal gaseous option, sterilizing c. 50% of all manufactured devices. Vaporized hydrogen peroxide (abbreviated VH2O2 by the International Organization for Standardization) is currently deployed for clinical sterilization applications, where its performance characteristics appear aligned to requirements, constituting a viable alternative low‐temperature process for terminal processing of medical devices. However, VH2O2 has operational limitations that create technical challenges for industrial‐scale adoption. This timely review provides a succinct overview of VH2O2 in gaseous sterilization and addresses its applicability for terminal sterilization of medical devices. It also describes underappreciated factors such as the occurrence of nonlinear microbial inactivation kinetic plots that may dictate a need to develop a new standard approach to validate VH2O2 for terminal sterilization of medical devices.
This study investigates the forces that contributed to severe shortages in personal protective equipment in the US during the COVID-19 crisis. Problems from a dysfunctional costing model in hospital ...operating systems were magnified by a very large demand shock triggered by acute need in healthcare and panicked marketplace behavior that depleted domestic PPE inventories. The lack of effective action on the part of the federal government to maintain and distribute domestic inventories, as well as severe disruptions to the PPE global supply chain, amplified the problem. Analysis of trade data shows that the US is the world's largest importer of face masks, eye protection, and medical gloves, making it highly vulnerable to disruptions in exports of medical supplies. We conclude that market prices are not appropriate mechanisms for rationing inputs to health because health is a public good. Removing the profit motive for purchasing PPE in hospital costing models, strengthening government capacity to maintain and distribute stockpiles, developing and enforcing regulations, and pursuing strategic industrial policy to reduce US dependence on imported PPE will help to better protect healthcare workers with adequate supplies of PPE.
•Market failure and government failure contributed to PPE shortage during COVID-19•Dysfunctional hospital budgeting models disincentivize adequate inventories of PPE•Federal government failed to maintain and distribute domestic inventories of PPE•Pursue strategic industrial policy to reduce US dependence on PPE supply chain•Market prices are inappropriate mechanisms for rationing inputs to health, like PPE
The high demand for personal protective equipment during the novel coronavirus outbreak has prompted the need to develop strategies to conserve supply. Little is known regarding decontamination ...interventions to allow for surgical mask reuse.
To identify and synthesize data from original research evaluating interventions to decontaminate surgical masks for the purpose of reuse.
MEDLINE, Embase, CENTRAL, Global Health, the WHO COVID-19 database, Google Scholar, DisasterLit, preprint servers, and prominent journals from inception to April 8th, 2020, were searched for prospective original research on decontamination interventions for surgical masks. Citation screening was conducted independently in duplicate. Study characteristics, interventions, and outcomes were extracted from included studies by two independent reviewers. Outcomes of interest included impact of decontamination interventions on surgical mask performance and germicidal effects.
Seven studies met eligibility criteria: one evaluated the effects of heat and chemical interventions applied after mask use on mask performance, and six evaluated interventions applied prior to mask use to enhance antimicrobial properties and/or mask performance. Mask performance and germicidal effects were evaluated with heterogeneous test conditions. Safety outcomes were infrequently evaluated. Mask performance was best preserved with dry heat decontamination. Good germicidal effects were observed in salt-, N-halamine-, and nanoparticle-coated masks.
There is limited evidence on the safety or efficacy of surgical mask decontamination. Given the heterogeneous methods used in studies to date, we are unable to draw conclusions on the most efficacious and safe intervention for decontaminating surgical masks.
The purpose of this study was to determine the potential for the Pentax AWS® and the Glidescope® to reduce the difficulty of tracheal intubation in patients at increased risk for difficult tracheal ...intubation, in a randomized, controlled clinical trial.
Seventy-five consenting patients presenting for surgery requiring tracheal intubation, and who were deemed to possess characteristics indicating an increased risk for difficult tracheal intubation, were randomly assigned to undergo intubation using a Macintosh, AWS®, or Glidescope® laryngoscope (n=25 patients per group). All patients were intubated by one of three anaesthetists experienced in the use of each laryngoscope.
Both the Glidescope® and the AWS® significantly reduced the intubation difficulty score compared with the Macintosh. The rate of successful tracheal intubation was lower with the Macintosh (84%) compared with the Glidescope® (96%) or the AWS® (100%). There were no differences in the duration of tracheal intubation attempts between the devices. Both the Glidescope® and the AWS® significantly reduced the need for additional manoeuvres and improved the Cormack and Lehane view obtained at laryngoscopy, compared with the Macintosh. Tracheal intubation with the AWS® but not the Glidescope® reduced the degree of haemodynamic stimulation compared with the Macintosh laryngoscope.
The AWS® and the Glidescope® laryngoscopes reduced the difficulty of tracheal intubation to a similar extent compared with the Macintosh laryngoscope, in patients at increased risk for difficult tracheal intubation.
Face masks, as they are used today in health care and in the community, can be largely traced back historically to a more recent period when a new understanding of contagion based on germ theory was ...applied to surgery. Red Cross workers fold reusable masks during the influenza pandemic, Boston, MA, USA, March, 1919 Courtesy National Archives (165-WW-269B-37) Medical researchers tested and compared the filtering efficiency of reusable masks with experiments involving the culture of bacteria nebulised though masks or spread by infectious volunteers wearing masks in an experimental chamber, as well as observational studies in clinical settings. ...another reason for switching to disposable masks was a desire to reduce labour costs, facilitate the management of supplies, and to respond to the increased demand for disposables that aggressive marketing campaigns had created among health-care workers. The home production of reusable masks for use in the community offers last resort solutions to some and comfort to many, but is unlikely to contribute more than marginally to solving the shortage of personal protective equipment globally.
To determine the association between access to adequate personal protective equipment (PPE) and mental health outcomes among a sample of U.S. nurses.
An online questionnaire was administered in May ...2020 to Michigan nurses via three statewide nursing organizations (n = 695 respondents). Multivariable logistic regression analysis was used to identify factors associated with mental health symptoms.
Nurses lacking access to adequate PPE (24.9%, n = 163) were more likely to report symptoms of depression (OR 1.96, 95% CI 1.31, 2.94; P = 0.001), anxiety (OR 1.64, 95% CI 1.12, 2.40; P = 0.01) and post-traumatic stress disorder (OR 1.83, 95% CI 1.22, 2.74; P = 0.003).
Healthcare organizations should be aware of the magnitude of mental health problems among nurses and vigilant in providing them with adequate PPE as the pandemic continues.
Modern health-care facilities rely on medical devices and equipment. However, keeping up with the development of new technology is unfeasible for many health facilities, especially in low-resource ...settings. Thus, the demand for refurbished medical devices is increasing worldwide, especially in low- and middle-income countries. Refurbished medical devices are restored devices that are rebuilt to meet safety and performance requirements comparable to their condition when new, without changing the intended use of the original device. While new medical devices are controlled by well-established and stringent safety and quality regulations, a great variation in the regulations of refurbished medical devices exists across countries. Here we discuss the different regulations and practices specific to refurbished medical devices in countries of major markets. We also explore the opportunities and challenges for expanding the refurbished medical device market. Finally, we suggest that regulatory guidelines pertaining to the import, sale, labelling and use of a refurbished medical product are needed, and authorities should implement these guidelines to ensure a high quality and safety standard of refurbished devices.
During the Covid-19 pandemic, personal protection equipment (PPE) was widely used to control the virus further spared. In this study, the presence of PPE wastes along the coastline of Bushehr port, ...the Persian Gulf from nine stations was investigated (4 times during 40 days), and their potential for microplastics (MPs) creation was preliminarily assessed. In total, more than 2380 PPE were collected in the study area. No significant differences were found between various beaches regarding their types and common activities. In addition, the estimated disposal rate of PPE per day and year is 350 and 127,750 items, respectively. More than 10% of the collected PPE from Bushehr's coastal areas on each sampling day were damaged. Based on the microscopic analysis, the left surgical masks and torn plastic gloves in the coastal regions are emerging sources of secondary microfibers and MP particles (mostly fragments and films) in the marine environments, respectively.
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•The coastal abundance of Covid-19 personal protective equipment (PPE) was investigated.•More than 2380 PPE were collected along the Bushehr shores, the Persian Gulf.•Blue surgical masks and polyethylene gloves were the most predominant discarded PPE.•The disposal rate of PPE items per day and year is 350 and 127,750 items, respectively.•PPE is an emerging source of microplastics in coastal environments.
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