Outlining the economic significance of the role of global supply chains (GSCs) in the organisation of the global economy, this paper initially presents some indications of health and safety outcomes in low- and middle-income counties (LMICs) where GSCs source much of the production destined for use in advanced economies. It goes on to discuss the operational dynamics of these chains and the corporate priorities that they reflect, which, it argues, do little to improve the poor work health and safety (WHS) outcomes in LMICs. It then examines evidence for the effectiveness of various private and public regulatory strategies that are claimed to bring about improved health and safety practices and outcomes among GSC suppliers in these countries. The paper critically evaluates this evidence and argues that, while there may be some examples of effective strategies and regulatory practices in particular contexts, their overall influence remains limited. It identifies and discusses the principal reasons for these limitations and concludes that the global regulation of conditions of labour – including WHS – at the end of GSCs falls well short of universal best practice and is, more generally, insufficient to counter the economic forces working against the maintenance of adequate standards of worker protection.

Background: Carbapenem-resistant Enterobacterales (CRE) infections are an urgent public health threat. An estimated 12,700 CRE (including E. coli, Klebsiella spp., and Enterobacter spp.) infections occurred in the United States in 2020. While the estimated incidence of CRE infections has been relatively stable between 2012 and 2020, organism-specific trends, including those for organisms not typically included in CRE surveillance definitions, have not been described. We estimated the annual rate of carbapenem-resistant Enterobacterales infections, disaggregated by organism, from 2012 to 2022. Methods: Data on inpatient hospitalizations from a dynamic cohort of short-term acute care hospitals reporting microbiology data between 2012 and 2022 were obtained from the PINC AI Database and the BD Insights Research Database. We included patients with clinical isolates of E. coli, Enterobacter spp., Klebsiella spp., Citrobacter spp., Serratia marcescens, Proteus mirabilis, and Morganella spp. and sufficient susceptibility results to identify carbapenem resistance. We limited our analysis to incident isolates, defined as a patient’s first isolate of a given organism and carbapenem resistance phenotype in a 14-day period. We calculated the annual rate of carbapenem-resistant infections per 10,000 hospitalizations for each organism. Results: There were 3,018,792 incident isolates from 55.8 million hospitalizations included in the analysis. Overall, 31,226 incident carbapenem-resistant isolates were identified. The rate of carbapenem-resistant infections varied by organism and over time (Table 1). The rate of carbapenem-resistant Klebsiella spp. infections appeared to decline from 3.94 in 2012 to 2.44 infections per 10,000 hospitalizations in 2022. The rate of carbapenem-resistant Enterobacter spp. infections appeared to increase from 1.05 in 2012 to 1.44 infections per 10,000 hospitalizations in 2022. The rate of carbapenem-resistant E. coli infections also appeared to increase, from 0.61 in 2012 to 0.85 infections per 10,000 hospitalizations in 2022. Rates of carbapenem-resistant Proteus mirabilis, Morganella spp., Citrobacter spp., or Serratia marcescens infections were similar in 2022 compared to 2012. Conclusions: Disaggregating data by organism revealed heterogeneous trends, with apparent increases in rates of carbapenem-resistant Enterobacter spp. and E. coli infections and apparent decreases in rates of carbapenem-resistant Klebsiella spp. infections. Organism-specific CRE analyses may provide additional insight into CRE epidemiology.

The 16-8-, 8-5-, 5-2-, 2-1-, 1-0.5-, 0.5-0.3-, 0.3-0.1-, and <0.1-μm size fractions were centrifuged from a Georgia (U.S.A.) sedimentary kaolin and a hydrothermal kaolin from the Sasso mine (Italy) and analyzed by scanning electron microscopy (SEM), X-ray powder diffraction (XRD), infrared spectroscopy (IR), differential thermal analysis (DTA) and thermogravimetry (TGA) together with the corresponding whole rocks. All size fractions of the Georgia sample consisted dominantly of well-crystallized, fine-grained kaolinite, associated with minor quantities of smectite. Some halloysite-like elongate particles were noted by SEM in the intermediate size fractions, minor amounts of quartz were identified in the coarsest size fractions, and < 1% noncrystalline material and traces of organic material were suspected in the finest size fraction. The crystallinity of the kaolinite as measured by XRD and IR varied moderately with size. IR suggested that nacrite-like stacking disorder increased with decreasing size for particles < 5 μm in size.

In the Sasso sample kaolinite dominated all size fractions and was accompanied by dickite in the coarse and by halloysite in the fine size fractions. Regular mixed-layer illite/smectite (I/S) was present in all size fractions and dominated in the finest. Abundant quartz and traces of alunite were identified in the whole rock and coarsest size fractions. The kaolinite in this sample showed marked variation in stacking order and crystallinity, as shown by changes in XRD, IR, and DTA patterns.

The observed compositional and structural variations in the size fractions of the Georgia sedimentary kaolin are small, as expected from formational environment, which was characterized by low temperatures and relative stable genetic conditions. The much more marked differences in composition within the size fractions of the Sasso hydrothermal kaolin are likely a result of the broad range of temperatures and fluid chemistry of its formational environment. The sequence dickite-well-crystallized kaolinite-kaolinite-halloysite is probably temperature-dependent.

The adsorption mechanisms of divalent cations in zeolite nanopore channels can vary as a function of their pore dimensions. The nanopore inner-sphere enhancement (NISE) theory predicts that ions may dehydrate inside small nanopore channels in order to adsorb more closely to the mineral surface if the nanopore channel is sufficiently small. The results of an electron paramagnetic resonance (EPR) spectroscopy study of Mn and Cu adsorption on the zeolite minerals zeolite Y (large nanopores), ZSM-5 (intermediate nanopores), and mordenite (small nanopores) are presented. The Cu and Mn cations both adsorbed via an outer-sphere mechanism on zeolite Y based on the similarity between the adsorbed spectra and the aqueous spectra. Conversely, Mn and Cu adsorbed via an inner-sphere mechanism on mordenite based on spectrum asymmetry and peak broadening of the adsorbed spectra. However, Mn adsorbed via an outer-sphere mechanism on ZSM-5, whereas Cu adsorbed on ZSM-5 shows a high degree of surface interaction that indicates that it is adsorbed closer to the mineral surface. Evidence of dehydration and immobility was more readily evident in the spectrum of mordenite than in that of ZSM-5, indicating that Cu was not as close to the surface on ZSM-5 as it was when adsorbed on mordenite. Divalent Mn cations are strongly hydrated and are held strongly only in zeolites with small nanopore channels. Divalent Cu cations are also strongly hydrated, but can dehydrate more easily, presumably due to the Jahn-Teller effect, and are held strongly in zeolites with medium-sized nanopore channels or smaller.

Three years after the beginning of the COVID-19 pandemic, better knowledge on the transmission of respiratory viral infections (RVI) including the contribution of asymptomatic infections encouraged most healthcare centers to implement universal masking. The evolution of the SARS-CoV-2 epidemiology and improved immunization of the population call for the infection and prevention control community to revisit the masking strategy in healthcare. In this narrative review, we consider factors for de-escalating universal masking in healthcare centers, addressing compliance with the mask policy, local epidemiology, the level of protection provided by medical face masks, the consequences of absenteeism and presenteeism, as well as logistics, costs, and ecological impact. Most current national and international guidelines for mask use are based on the level of community transmission of SARS-CoV-2. Actions are now required to refine future recommendations, such as establishing a list of the most relevant RVI to consider, implement reliable local RVI surveillance, and define thresholds for activating masking strategies. Considering the epidemiological context (measured via sentinel networks or wastewater analysis), and, if not available, considering a time period (winter season) may guide to three gradual levels of masking: (i) standard and transmission-based precautions and respiratory etiquette, (ii) systematic face mask wearing when in direct contact with patients, and (iii) universal masking. Cost-effectiveness analysis of the different strategies is warranted in the coming years. Masking is just one element to be considered along with other preventive measures such as staff and patient immunization, and efficient ventilation.