MiXie, an Online Tool for Better Health Assessment of Workers Exposed to Multiple Chemicals

There is increasing concern for workers facing multiple chemical exposure. The accumulation of information on occupational conditions indicates the need to incorporate the concept of multiple exposures in the risk assessment process and to develop tools for assessing the potential impacts of multiple exposures on workers’ health. Our objective is to describe the MiXie online decision-making tool that can be used to assess the risk of exposure to multiple chemicals. The description includes the development of MiXie, the structure of its toxicological database according to the target organ or the mode of action, and the algorithm for quantitative analysis of a mixture. Two case studies of its use in evaluating the risks of multiple exposures in real workplace situations are presented. The case study in the printing industry showed increased risk for four toxicological classes (central nervous system damage, ocular damage, skin damage, and ototoxicity) associated with co-exposure to four chemicals during maintenance operations. The MiXie analysis also showed the presence of carcinogenic substances in the mixture and a risk to the development of the foetus. The case study in nail salons showed the presence of carcinogenic and sensitizing chemicals and an increased risk to upper airways. MiXie helps preventers evaluate the possible additive effects of mixtures, providing an easy-to-read diagnosis to identify risks incurred by co-exposed employees. In addition, MiXie identifies risky occupational situations that would go unnoticed without a multiple substance approach.

Dose–Response Relationship between High-Fidelity Simulation and Intensive Care Nursing Students’ Learning Outcomes: An Italian Multimethod Study

Background: The best application modality of high-fidelity simulation in graduate critical care nursing courses is still rarely investigated in nursing research. This is an important issue since advanced nursing skills are necessary to effectively respond to critically ill patients’ care needs. The aim of the study was to examine the influence of a modified teaching model based on multiple exposures to high-fidelity simulations on both the learning outcomes and the perceptions of graduate students enrolled in a critical care nursing course. Methods: A multimethod study involving a sample of graduate critical care nursing students was conducted. A theoretical teaching model focused on multiple exposures to high-fidelity simulations is currently applied as a teaching method in an Italian critical care nursing course. According to the Kirkpatrick model for evaluating training programs, the performance, self-efficacy, and self-confidence in managing critically ill patients were considered learning outcomes, while satisfaction with learning and students’ lived experiences during the experimental phases were considered students’ perceptions. Results: Multiple exposures to high-fidelity simulations significantly improved performance, self-efficacy, and self-confidence in managing virtual critically ill patients’ care needs. The satisfaction level was high, while lived experiences of participants were positive and allowed for better explanation of quantitative results of this study. Conclusions: Multiple exposures to high-fidelity simulations can be considered a valuable teaching method that can improve the learning outcomes of graduate nurses enrolled in an intensive care course.

Investigation of the Antibacterial Properties of Silver-Doped Amorphous Carbon Coatings Produced by Low Pressure Magnetron Assisted Acetylene Discharges

Hospital-acquired infections are responsible for a significant part of morbidity and mortality. Among the possible modes of transmission, this study focuses on environmental surfaces by developing innovative antibacterial coatings that can be applied on interior fittings in hospitals. This work aims to optimize a coating made of an amorphous carbon matrix doped with silver (a-C:H:Ag) produced by a hybrid PVD/PECVD process and to evaluate its antibacterial activity. We present a coating characterization (chemical composition and morphology) as well as its stability in an ageing process and after multiple exposures to bacteria. The antibacterial activity of the coatings is demonstrated against Escherichia coli (Gram-negative) and Staphylococcus aureus (Gram-positive) bacteria through several bioassays. Moreover, the data suggest a crucial role of silver diffusion towards the surface and nanoparticle formation to explain the very promising anti-bacterial activities reported in this work.

Exploring the Shift From HIV Pre-exposure Prophylaxis Awareness to Uptake Among Young Gay and Bisexual Men

Introduction: HIV pre-exposure prophylaxis (PrEP) in the form of a daily oral medication is highly effective at preventing HIV. In the United States, awareness about PrEP has steadily increased over time among individuals vulnerable to HIV, however awareness has not translated into widescale uptake. Estimates are that fewer than 20% of 1.2 million Americans for whom PrEP is indicated are utilizing it. We sought to understand how individuals moved from PrEP awareness to PrEP utilization.Methods: We conducted a series (n = 31) of in-depth interviews with young people, predominantly gay and bisexual men, ages 18–29 years old between February 2015 and January 2016, as part of the evaluation of a multi-year demonstration project funded to test innovative approaches to improve sexual health outcomes and curb the HIV epidemic in California. Interviews were audio-recorded and transcribed verbatim. We conducted a thematic analysis.Results: We present a continuum of PrEP awareness that spans three phases—basic, moderate and advanced. Participants rarely reported becoming well-informed about PrEP over the course of an initial exposure to PrEP information. Learning occurred after multiple exposures to PrEP information through numerous intersecting forms, messengers and formal and informal communication channels. Positively framed messages delivered by formal messengers emphasizing PrEP as a sensible HIV prevention strategy and explicitly communicating a regard for sexual wellness were overwhelmingly persuasive and facilitated movement to the advanced awareness phase. Once participants reached the advanced phase of PrEP awareness, uptake was possible.Conclusions: Our analysis provides insights into how PrEP awareness led to PrEP uptake among young gay and bi-sexual men. Building demand among those in the basic awareness phase took longer than those in the moderate phase. Individuals involved in formal and informal PrEP education can set reasonable expectations about whether, when and how eventual uptake may occur when keeping the continuum of PrEP awareness framework in mind. Many young, gay and bi-sexual male prospective PrEP users will benefit from positively framed messages that emphasize personal well-being, including social, sexual and emotional benefits of PrEP use.

Effects of Simulation-Based Learning on Nursing Students’ Learning Outcomes of a Gerontology Course

Simulation-Based Learning (SBL) is beneficial to nursing education. Nevertheless, recent studies have shown a side effect of being overwhelmed by repeated exposures to simulation. Thus, how many times simulation scenarios should be provided to students remains a question. The objectives of this study were to (1) explore the changes in nursing students’ perceived competence, self-efficacy, and learning satisfaction after repeated exposures to simulations, and (2) determine the acceptable frequency of SBL in the ‘Care of Older Adults’ course. A one-group repeated measurement experimental design with self-administered questionnaires in a convenient sample of 84 senior nursing undergraduate students was used at a university in southern Taiwan, and 79 students completed all measurements. After taking the baseline measurements (T0), students were exposed to 75-mininute simulation scenarios from Time 1 (T1) to Time 3 (T3) three weeks apart throughout the semester. Students’ perceived nursing competence, self-efficacy, and learning satisfaction were measured immediately after each exposure. There were statistically significant improvements from T0 to T3 (p < .001) in all three areas; however, no significant difference when comparing scores from T1 to T2 and from T2 to T3. To conclude, SBL is effective in improving nursing students’ perceived competence, self-efficacy, and learning satisfaction. While the primary changes occur at the first simulation effort, it is the accumulated multiple exposures collectively improve students’ learning outcomes. Multiple instructional strategies are recommended to maintain students’ learning interests to achieve optimal learning outcomes of the course across a semester.

The Exposome Approach in Allergies and Lung Diseases: Is It Time to Define a Preconception Exposome?

Emerging research suggests environmental exposures before conception may adversely affect allergies and lung diseases in future generations. Most studies are limited as they have focused on single exposures, not considering that these diseases have a multifactorial origin in which environmental and lifestyle factors are likely to interact. Traditional exposure assessment methods fail to capture the interactions among environmental exposures and their impact on fundamental biological processes, as well as individual and temporal factors. A valid estimation of exposure preconception is difficult since the human reproductive cycle spans decades and the access to germ cells is limited. The exposome is defined as the cumulative measure of external exposures on an organism (external exposome), and the associated biological responses (endogenous exposome) throughout the lifespan, from conception and onwards. An exposome approach implies a targeted or agnostic analysis of the concurrent and temporal multiple exposures, and may, together with recent technological advances, improve the assessment of the environmental contributors to health and disease. This review describes the current knowledge on preconception environmental exposures as related to respiratory health outcomes in offspring. We discuss the usefulness and feasibility of using an exposome approach in this research, advocating for the preconception exposure window to become included in the exposome concept.

Estimated Effective Lifetime Risks of Radiation-Induced Thyroid Cancer in Computed Tomography (CT) Brain Examination

Thyroid is one of the most radiosensitive organs in the human body. Although the scanning range of brain computed tomography (CT) does not include lower neck region, there is possibility for thyroid to be irradiated due to scattered radiation because of its location near to the external beam collimation. The objective of this study was to evaluate effective lifetime risk of radiation-induced thyroid cancer in young adults following brain CT examination. A total of 306 patient data within the age range between 18 and 39 years old were retrospectively analysed. Absorbed dose of the thyroid organ was obtained through the input of data using WAZA- ARI v2. Effective lifetime risk was calculated by multiplying equivalent dose of the thyroid organ with the lifetime attributable cancer risk adapted from Biological Effects in Ionising Radiation (BEIR) Report V11. The effective lifetime risks were recorded as 0.45 ± 0.70 per 100 000 and 0.93 ± 1.52 per 100 000 for single and multiple exposures, respectively. In terms of gender, woman data (0.99 ± 0.76; 1.95 ± 2.15) were found higher as compared to man data (0.13 ± 0.39; 0.35 ± 0.45) for both single and multiple exposure. The percentage difference of effective lifetime risks between single and multiple exposures was up to 107%. The effective lifetime risk noted in this study may be low, however, the long-term risk of cancer development should be considered. This study serves as preliminary reference when revising clinical protocol especially in those involving repeated exposures in young adult patients. Future study should include other radiosensitive organs exploring the effective lifetime risk of radiation induced cancer following CT procedure.

Acute Toxicity study of Synthesized drug and Herbal Product

Acute toxicity study describes the adverse effects of a substance that result either from a single exposure or from multiple exposures in a short period of time. Whenever an investigator administered a chemical substance or herbal drug to a biological system different types of interactions can occur and a series of dose-related responses result. In most cases these responses are desired and useful, but there are a number of other effects which are not advantageous. These may or may not be harmful to the patient. Acute toxicity study is involved in estimation of LD50. Also it determines the therapeutic index i.e ratio between the lethal dose and the pharmacologically effective dose in the same strain and species. This article Review the methods so for utilized for the determination of acute toxicity.

Measuring the effects of misinformation exposure on behavioural intentions

Misinformation has been a pressing issue since the beginning of COVID-19 pandemic, threatening our ability to effectively act on the crisis. More recently, the availability of vaccines in developed countries has not always translated into high vaccination rates, with online misinformation often presented as the culprit. Yet little is known about the actual effects of fake news on behavioural intentions. Does exposure to misinformation about COVID-19 vaccines indeed affects people’s intentions to receive such a vaccine? This paper attempts to answer this question through three preregistered experiments (N=3463). In Study 1, participants (n=1269) were exposed to fabricated pro- or anti-vaccine information or to neutral true information, and then asked about their intentions to get vaccinated, alongside a few other behavioural intentions. In Study 2, participants (n=1863) were exposed to true pro- and anti-vaccine information, while Study 3 (n=1548) compared the effects of single and multiple exposures to novel misinformation about COVID-19 vaccines. The results showed that exposure to false information on the vaccines did not affect the participants’ intentions to get vaccinated, even when multiple exposures led them to believe that the headlines were more accurate than in the single exposure conditions. An exploratory meta-analysis of studies 1 and 3 (n=2683) showed that exposure to false information about COVID-19 vaccines, regardless of whether it was in favour of or against vaccines, increased vaccination intentions. We conclude by cautioning researchers against equating exposure to misinformation or perceived accuracy of false news with actual behaviours.