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BACKGROUND: Dental outpatient departments, characterized by close proximity and unmasked patients, present a considerable risk of respiratory infections for health care workers (HCWs). However, the lack of comprehensive data on close contact (<1.5m) between HCWs and patients poses a significant obstacle to the development of targeted control strategies. METHODS: An observation study was conducted at a hospital in Shenzhen, China, utilizing depth cameras with machine learning to capture close-contact behaviors of patients with HCWs. Additionally, questionnaires were administered to collect patient demographics. RESULTS: The study included 200 patients, 10 dental practitioners, and 10 nurses. Patients had significantly higher close-contact rates with dental practitioners (97.5%) compared with nurses (72.8%, P < .001). The reason for the visit significantly influenced patient-practitioner (P = .018) and patient-nurse (P = .007) close-contact time, with the highest values observed in prosthodontics and orthodontics patients. Furthermore, patient age also significantly impacted the close-contact rate with nurses (P = .024), with the highest rate observed in patients below 14 years old at 85% [interquartile range: 70-93]. CONCLUSIONS: Dental outpatient departments exhibit high HCW-patient close-contact rates, influenced by visit purpose and patient age. Enhanced infection control measures are warranted, particularly for prosthodontics and orthodontics patients or those below 14 years old.

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Low photo-induced carrier recombination rate, exceptional light absorption, and advantageous recycling performance are crucial attributes of semiconductor photocatalyst for wastewater purification. Herein, based on in-situ reaction, close-contact S-scheme bismuth chromate/bismuth oxide/ferroferric oxide@porous carbon microspheres (Cr2Bi3O11-Bi2O3/Fe3O4@PCs) (F-CBFP) was fabricated using alginates as precursor. Due to the abundance of functional groups on the porous carbon (PCs), Bi2O3 and Cr2Bi3O11 nanoparticles (NPs) are in situ deposited onto the highly conductive 3D magnetic porous Fe3O4@PCs microsphere surface, which not only form tight interfacial contacts and reduces interfacial potential barriers but also prevent agglomeration or shedding of the NPs during photocatalytic reactions. Moreover, density functional theory (DFT) calculations further confirm that the formation of a robust built-in electric field (BIEF) within F-CBFP prompts photo-induced electrons in the conduction band (CB) of Bi2O3 to combine with holes in the valence band (VB) of Cr2Bi3O11, effectively constructing a S-scheme heterojunction system. Also, Fe3O4 can act as a Fenton catalyst, activating the H2O2 generated by Cr2Bi3O11 under illumination. In wastewater treatment, the obtained F-CBFP shows remarkable photo-Fenton degradation (towards methyl orange (97.8 %, 60 min) and tetracycline hydrochloride (95.3 %, 100 min)) and disinfection performance (100 % E. coli inactivation), and exceptional cyclic stability.

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BACKGROUND: A long-term follow-up of close contacts to monitor their infection status is essential to formulate a promising screening strategy. The study aimed to assess the dynamics of tuberculosis (TB) infection using Interferon-γ release assay (IGRA) and determine risk factors associated with TB infection. METHODS: Definite TB patients were interviewed and their household contacts were screened for TB infection by IGRA during 12-month longitudinal investigation. RESULTS: We included in our analyses 184 household contacts of 92 index TB patients. 87 individuals (47.3%) in contact group progressed to TB infection, of whom 86 developed into IGRA positive within 24 weeks. Close contacts with a higher age and comorbidities are easier to exhibit TB infection. Analysis showed that risk factors for becoming IGRA-positive individuals included residence, older age, comorbidities, BCG scar and high bacterial load. Contacts with BCG scar had a lower IGRA-positive rate. CONCLUSION: IGRA conversion generally occurs within 24 weeks after exposure. The TB transmission happens since subclinical TB stage and the presence of BCG scar is an independent protective factor reducing risk of TB infection among close contacts. Repeated IGRA tests are sensible to conducted among close contacts at 24 weeks after exposure to identify the IGRA-positive individuals.

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Due to high-population density, frequent close contact, possible poor ventilation, university classrooms are vulnerable for transmission of respiratory infectious diseases. Close contact and long-range airborne are possibly main routes for SARS-CoV-2 transmission. In this study, taking a university classroom in Beijing for example, close contact behaviors of students were collected through a depth-detection device, which could detect depth to each pixel of the image, based on semi-supervised learning. Finally, >23 h of video data were obtained. Using Computational Fluid Dynamics, the relationship between viral exposure and close contact behaviors (e.g. interpersonal distance, relative facial orientations, and relative positions) was established. A multi-route transmission model (short-range airborne, mucous deposition, and long-range airborne) of infectious diseases considering real close contact behaviors was developed. In the case of Omicron, the risk of infection in university classrooms and the efficacy of different interventions were assessed based on dose-response model. The average interpersonal distance in university classrooms is 0.9 m (95 % CI, 0.5 m-1.4 m), with the highest proportion of face-to-back contact at 87.0 %. The risk of infection of susceptible students per 45-min lesson was 1 %. The relative contributions of short-range airborne and long-range airborne transmission were 40.5 % and 59.5 %, respectively, and the mucous deposition was basically negligible. When all students are wearing N95 respirators, the infection risk could be reduced by 96 %, the relative contribution of long-range airborne transmission increases to 95.6 %. When the fresh air per capita in the classroom is 24 m3/h/person, the virus exposure could be decreased by 81.1 % compared to the real situation with 1.02 m3/h/person. In a classroom with an occupancy rate of 50 %, after optimized arrangement of student distribution, the infection risk could be decreased by 62 %.

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Background: In Japan, on April 20, 2020, the definition of a close contact regarding coronavirus disease (COVID-19) was changed from a long-term contact time to a specified contact time of 15 min and from a contact distance of 2 m to 1 m. Objectives: We aimed to determine the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rate among close contacts of patients with COVID-19 and determine the impact of the infection on transmission among close contacts. Methods: The numbers of SARS-CoV-2 tests, SARS-CoV-2-positive cases, and close contacts of patients with COVID-19 were assessed between March 2020 and February 2021 in Fukui Prefecture, Japan. The study period was subdivided into 3 periods. The second and third period contained data with the changed definition of close contact. Results: Overall, 32,238 SARS-CoV-2 tests were performed. There were 545 patients with COVID-19 and 1487 close contacts, of whom 267 tested positive. The highest infection rate occurred in period 3. Distance, protective measures, and contact time with COVID-19 patients influenced the increased infection rate. The infection rate showed a rising trend from 11.1% in period 1 to 19.2% and 20.0% in periods 2 and 3, respectively (Cochran-Armitage test; P < 0.004). Multivariate analysis revealed that female sex was an independent risk factor for infection of close contacts (odds ratio: 2.23; 95% confidence interval: 1.700-2.930). Conclusions: Female sex is a risk factor for transmission by close contacts. The rate of infection among close contacts may be associated with contact time, contact distance, and protective measures.

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Objective: We aimed to use network meta-analysis to compare the impact of infection risk factors of close contacts with COVID-19, identify the most influential factors and rank their subgroups. It can provide a theoretical basis for the rapid and accurate tracking and management of close contacts. Methods: We searched nine databases from December 1, 2019 to August 2, 2023, which only took Chinese and English studies into consideration. Odd ratios (ORs) were calculated from traditional meta-estimated secondary attack rates (SARs) for different risk factors, and risk ranking of these risk factors was calculated by the surface under the cumulative ranking curve (SUCRA). Results: 25 studies with 152647 participants identified. Among all risk factors, the SUCRA of type of contact was 69.6 % and ranked first. Among six types of contact, compared with transportation contact, medical contact, social contact and other, daily contact increased risk of infection by 12.11 (OR: 12.11, 95 % confidence interval (CI): 6.51-22.55), 7.76 (OR: 7.76, 95 % CI: 4.09-14.73), 4.65 (OR: 4.65, 95 % CI: 2.66-8.51) and 8.23 OR: 8.23, 95 % CI: 4.23-16.01) times, respectively. Overall, SUCRA ranks from highest to lowest as daily contact (94.7 %), contact with pollution subjects (78.4 %), social contact (60.8 %), medical contact (31.8 %), other (27.9 %), transportation contact (6.4 %). Conclusion: The type of contact had the greatest impact on COVID-19 close contacts infection among the risk factors we included. Daily contact carried the greatest risk of infection among six types of contact, followed by contact with pollution subjects, social contact, other, medical contact and transportation contact. The results can provide scientific basis for rapid assess the risk of infection among close contacts based on fewer risk factors and pay attention to high-risk close contacts during management, thereby reducing tracking and management costs.

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A 16-year old girl consulted for repeated axillary abscesses. The bacteriological culture yielded monomicrobial Staphylococcus aureus. Faced with these recurrent abscesses in an immunocompetent patient playing a close contact sport, the biologist suspected the strain to harbor a virulence factor explaining these recurrences.

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Introducción: Además de las consecuencias del SARS-CoV-2 sobre los pacientes renales infectados, mantener la actividad durante la pandemia ha supuesto todo un reto dada la escasez de personal por las ausencias por enfermedad. Objetivo: Analizar la incidencia de contagios por Covid-19 entre los profesionales de hemodiálisis, sus características y su repercusión en bajas laborales en las diferentes oleadas.Material y Método: Estudio observacional longitudinal desde el 3/03/2020 hasta el 23/04/2022 (776 días) en una media de 406 profesionales sanitarios y no sanitarios de 18 unidades de diálisis y dos unidades administrativas de apoyo de la Fundación Renal Iñigo Álvarez de Toledo.La recogida de datos se realizó a través de la comunicación de las distintas supervisoras al departamento de recursos humanos. Resultados: 179 profesionales de un promedio de 406 (44,1%) se infectaron en el periodo de estudio, siendo el 52% enfermeras, 25% auxiliares, 11% nefrólogos y 12% otros profesionales. Un 40,2% de los casos presentaron síntomas. Un total de 160 contagiados estuvo ausente por enfermedad (89,3%), con una media de 15,9±14,3 días. En el 71,6% se detectó un contacto estrecho (todos fuera de las unidades) y esta identificación de contactos fue creciente según avanzaban las oleadas, pasando de un 6,7% en la 1ª ola a un 40% en la 6ª ola (p=0,016). Conclusiones: La sintomatología ha sido leve, al menos de dos semanas de ausencia por enfermedad; los contactos estrechos detectados han sido fundamentalmente comunitarios, sin registrarse contagios a través de los pacientes renales en las unidades. (AU)

Introduction: In addition to the consequences of SARS-CoV-2 infection in renal patients, maintaining dialysis activity during the pandemic has been a significant challenge due to staff shortages resulting from illness-related absences. Objetives: To analyze the incidence of COVID-19 infections among hemodialysis professionals, their characteristics, and their impact on work absences during different waves of the pandemic.Material and Method: Longitudinal observational study conducted from March 3, 2020, to April 23, 2022 (776 days), involving an average of 406 healthcare and non-healthcare professionals from 18 dialysis units and two administrative support units of the Renal Foundation. Data collection was carried out through communication from various supervisors to the human resources department.Results: During the study period, 179 professionals out of an average of 406 (44.1%) became infected. Among these, 52% were nurses, 25% were nursing assistants, 11% were nephrologists, and 12% were other professionals. 40.2% of cases exhibited symptoms. A total of 160 infected individuals were absent from work due to illness (89.3%), with an average duration of 15.9 ± 14.3 days. In 71.6% of cases, close contacts were identified outside the dialysis units, and this contact identification increased with each wave of the pandemic, rising from 6.7% in the 1st wave to 40% in the 6th wave (p=0.016).Conclusions: The symptoms have generally been mild, with absences from work lasting at least two weeks. Close contacts were mainly identified within the community, and there were no recorded infections transmitted through renal patients in the units. (AU)

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BACKGROUND: The emergence of omicron variants exhibiting antigenic changes has led to an increase in breakthrough infection among individuals with a wild-type SARS-CoV-2 vaccine booster. The correlation between post-booster spike-specific antibodies and omicron infection risk remains unclear. METHODS: This prospective cohort study included SARS-CoV-2-naive healthcare workers with three-dose BNT162b2. Post-booster spike-specific IgG and interferon-γ levels were measured. Breakthrough infection was documented during a 10-month omicron-predominant period. Household and healthcare contacts were followed to identify subsequent infections. The IgG titers were additionally measured at the end of follow-up, and the titers at exposure were estimated from the two-point titers. RESULTS: Of 333 participants, 89 developed infection, of whom 37 (41.6 %) were household contacts. Kaplan-Meier curves indicated that higher IgG titers were significantly correlated with lower cumulative infection incidence (p = 0.029), whereas the interferon-γ levels were not (p = 0.926). Multivariate Cox analysis showed that increasing IgG titers were associated with a reduced hazard ratio (HR) of 0.26 (95% CI, 0.12-0.55). Household exposure posed a greater infection risk than healthcare exposure (HRs, 11.24 [6.88-18.40] vs. 2.82 [1.37-5.44]). The difference in geometric mean IgG titers of infected and uninfected participants was significant among household contacts (20,244 AU/mL vs. 13,842 AU/mL, p = 0.031). Estimation of IgG titers at exposure showed a significantly higher infection incidence in those exposed with titers of <3,000 AU/mL than in those with higher titers (79.2 % vs. 32.3 %, p < 0.001). CONCLUSIONS: Spike-specific antibodies induced by a wild-type SARS-CoV-2 vaccine booster are suggested to be effective in protecting against omicron infection. Household exposure would be a significant source of infection for hospital healthcare workers.

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BACKGROUND: Effective prevention against COVID-19 is urgently required to control vaccine breakthrough infection. Laboratory and clinical data suggested that Keigai-rengyo-to (KRT) performs biological activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We investigated whether KRT could prevent SARS-CoV-2 in medical personnel exposed to patients with COVID-19. METHODS: We conducted an open-label controlled clinical trial of medical personnel after COVID-19 vaccination at our hospital (ClinicalTrials.gov: UMIN000048389). Participants were close contacts recently exposed (<72 h) to patients with COVID-19. We provided the participants with KRT (7.5 g/day for 5 days) or no drug as a control. The primary endpoint was nicking endonuclease amplification reaction or polymerase chain reaction confirming incident SARS-CoV-2 infection. Safety was assessed in all treated participants. RESULTS: Between January and September 2022, 38 close contacts were assigned: 20 to the KRT group and 18 to the control group. During 2 weeks of follow-up, 10/38 (26%) participants had new-onset COVID-19. The incidence of COVID-19 was significantly lower in the KRT group (2/20; 10%) than in the control group (8/18; 44%), with a medium effect size (p < 0.05; phi coefficient = -0.391; total absolute risk reduction: 34.4% points). The number needed to treat to prevent the occurrence of a COVID-19 case was 2.9. The overall relative risk was 0.23 (95% confidence interval: 0.06-0.78). No serious safety problems were detected. CONCLUSION: Post-exposure prophylaxis with KRT can prevent the onset of COVID-19 in close contacts after vaccination. More randomized clinical trials with larger samples are required to better evaluate KRT as a post-exposure prophylaxis of SARS-CoV-2.

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During infectious disease outbreaks, some infected individuals may spread the disease widely and amplify risks in the community. People whose daily activities bring them in close proximity to many others can unknowingly become superspreaders. The use of contact tracking based on social networks, GPS, or mobile tracking data can help to identify superspreaders and break the chain of transmission. We propose a model that aims at providing insight into risk factors of superspreading events. Here, we use a social force model to estimate the superspreading potential of individuals walking in a bidirectional corridor. First, we applied the model to identify parameters that favor exposure to an infectious person in scattered crowds. We find that low walking speed and high body mass both increase the expected number of close exposures. Panic events exacerbate the risks while social distancing reduces both the number and duration of close encounters. Further, in dense crowds, pedestrians interact more and cannot easily maintain the social distance between them. The number of exposures increases with the density of person in the corridor. The study of movements reveals that individuals walking toward the center of the corridor tend to rotate and zigzag more than those walking along the edges, and thus have higher risks of superspreading. The corridor model can be applied to designing risk reduction measures for specific high volume venues, including transit stations, stadiums, and schools.

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Close contact routes, including short-range airborne and large-droplet routes, play an important role in the transmission of SARS-CoV-2 in indoor environments. However, the exposure risk of such routes is difficult to quantify due to the lack of data on the close contact behavior of individuals. In this study, a digital wearable device, based on semi-supervised learning, was developed to automatically record human close contact behavior. We collected 337,056 s of indoor close contact of school and university students from 194.5 h of depth video recordings in 10 types of indoor environments. The correlation between aerosol exposure and close contact behaviors was then evaluated. Individuals in restaurants had the highest close contact ratio (64%), as well as the highest probability of face-to-face pattern (78%) during close contact. Accordingly, university students showed greater exposure potential in dormitories than school students in homes, however, a lower exposure was observed in classrooms and postgraduate student offices in comparison with school students in classrooms. In addition, restaurants had the highest aerosol exposure volume for both short-range inhalation and direct deposition on the facial mucosa. Thus, the classroom was established as the primary indoor environment where school students are exposed to aerosols.

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OBJECTIVES: The effectiveness of social distancing during the coronavirus disease 2019 (COVID-19) pandemic has been evaluated using the magnitude of changes in population mobility. This study aimed to investigate a direct indicator-namely, the number of close contacts per patient with confirmed COVID-19. METHODS: From week 7, 2020 to week 43, 2021, population movement changes were calculated from the data of two Korean telecommunication companies and Google in accordance with social distancing stringency levels. Data on confirmed cases and their close contacts among residents of Gyeonggi Province, Korea were combined at each stage. Pearson correlation analysis was conducted to compare the movement data with the change in the number of contacts for each confirmed case calculated by stratification according to age group. The reference value of the population movement data was set using the value before mid-February 2020, considering each data's characteristics. RESULTS: In the age group of 18 or younger, the number of close contacts per confirmed case decreased or increased when the stringency level was strengthened or relaxed, respectively. In adults, the correlation was relatively low, with no correlation between the change in the number of close contacts per confirmed case and the change in population movement after the commencement of vaccination for adults. CONCLUSIONS: The effectiveness of governmental social distancing policies against COVID-19 can be evaluated using the number of close contacts per confirmed case as a direct indicator, especially for each age group. Such an analysis can facilitate policy changes for specific groups.

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Mpox virus is known to be transmissible from the onset of clinical manifestations. We report the first case in Japan of a man who contracted mpox through close contact with an individual with pre-symptomatic infection. Given that transmission before symptom onset has recently been reported from various countries, the importance of prophylaxis for reducing the risk of infection and controlling the disease should be emphasized.

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Introduction: Coronavirus disease 2019 has become a major global public health concern in December 2019. However, finding and excluding close contacts of COVID-19 infectors is a critical but difficult issue. This study aimed to introduce a new method of epidemiological investigation named space-time companions, which was adopted in Chengdu, China, in November 2021. Methods: An observational investigation was conducted during a small outbreak of COVID-19 in Chengdu, China in November 2021. A new method of epidemiological investigation called space-time companion was adopted in this outbreak, which was defined as the one who stayed in the same spatiotemporal grid (range: 800 m * 800 m) with the confirmed COVID-19 infector for more than 10 min in the last 14 days. A flow chart was used to describe the screening process of space-time companions in detail and illustrate the space-time companion epidemic management method. Results: The COVID-19 epidemic outbreak in Chengdu was effectively controlled for approximately one incubation period (14 days). After four rounds of space-time companions screening, more than 450,000 space-time companions were screened, including 27 COVID-19 infectors. Moreover, in the subsequent rounds of nucleic acid testing for all people in the city, no infected person were found proving the end of this epidemic outbreak. Conclusion: The space-time companion provides a new idea for screening close contacts of the COVID-19 infector and other similar infectious diseases, which can serve as a supplement to traditional epidemiological history surveys to verify and avoid missing close contacts.

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BACKGROUND: Individuals in close contact with active pulmonary tuberculosis (TB) patients showed a high risk of recent infection and, once infected, higher risk of developing active TB in the following years post-exposure. But the peak time of active disease onset is unclear. This study aims to estimate post exposure TB incidence risk among close contacts to provide reference for clinical and public health strategies. METHODS: We searched PubMed, Web of Science, and EMBASE for articles published until December 1, 2022. The incidence rates were quantitatively summarized by means of meta-analysis using the random-effect model. RESULTS: Of the 5616 studies, 31 studies included in our analysis. For baseline close contacts results, the summarized prevalence of Mycobacterium tuberculosis (MTB) infection and active TB was found to be 46.30% (95% CI: 37.18%-55.41%) and 2.68% (95% CI: 2.02%-3.35%), respectively. During the follow-up, the 1-year, 2-year and 5-year cumulative incidence of TB in close contacts were 2.15% (95% CI: 1.51%-2.80%), 1.21% (95% CI: 0.93%-1.49%) and 1.11% (95% CI: 0.64%-1.58%), respectively. Individuals with a positive result of MTB infection testing at baseline showed significantly higher cumulative TB incidence as compared to those negatives (3.80% vs. 0.82%, p < 0.001). CONCLUSIONS: Individuals with close contact to active pulmonary TB patients are bearing significant risk of developing active TB, particularly within the first-year post-exposure. Population with recent infections should be an important priority for active case finding and preventive intervention worldwide.

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Classrooms are high-risk indoor environments, so analysis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in classrooms is important for determining optimal interventions. Due to the absence of human behavior data, it is challenging to accurately determine virus exposure in classrooms. A wearable device for close contact behavior detection was developed, and we recorded >250,000 data points of close contact behaviors of students from grades 1 to 12. Combined with a survey on students' behaviors, we analyzed virus transmission in classrooms. Close contact rates for students were 37 ± 11% during classes and 48 ± 13% during breaks. Students in lower grades had higher close contact rates and virus transmission potential. The long-range airborne transmission route is dominant, accounting for 90 ± 3.6% and 75 ± 7.7% with and without mask wearing, respectively. During breaks, the short-range airborne route became more important, contributing 48 ± 3.1% in grades 1 to 9 (without wearing masks). Ventilation alone cannot always meet the demands of COVID-19 control; 30 m3/h/person is suggested as the threshold outdoor air ventilation rate in a classroom. This study provides scientific support for COVID-19 prevention and control in classrooms, and our proposed human behavior detection and analysis methods offer a powerful tool to understand virus transmission characteristics and can be employed in various indoor environments.

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From 6 Jan 22 to 17 Feb 22, a total of 729,367 close contacts classified into four distinct groups (i.e., household, social, school and nursing/ welfare home contacts) were managed by the Health Risk Warning system. High COVID-19-positive rates were demonstrated amongst household contacts, i.e., 10.9% (37,220/342,302) were detected via antigen rapid test kits and 56.5% (4,952/8,767) were detected via polymerase chain reaction testing. Household contacts represent the highest risk of being infected by virtue of the sustained close-proximity interactions in the household setting. Social, school and nursing/ welfare home contacts continue to remain at-risk groups for close monitoring. At a population level, household and symptomatic close contacts should be the groups of focus in the early phases of the pandemic, including future potential waves involving COVID-19 variants of concern.

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COVID-19 has been spread globally, with ships posing a significant challenge for virus containment due to their close-quartered environments. The most effective method for preventing the spread of the virus currently involves tracking and physically isolating close contacts. In this paper, we propose the Close Contact Identification Algorithm (CCIA). The probability density of user location points may be higher in a certain spatial range such as a cabin where there are more location points. The characteristics of CCIA include using Kernel Density Estimation (KDE) to calculate the probability density of each user location point and seeking the maximum Euclidean distance between location points in each cluster for merging clusters. CCIA is capable of calculating the probability density of each location point, a feature that other clustering algorithms, such as Kmeans, Hierarchical, and DBSCAN, cannot achieve. The contribution of CCIA is using the probability density of each location point to identify close contacts in ship environments. The performance of CCIA shows more accurate clustering compared to Kmeans, Hierarchical, and DBSCAN. CCIA can effectively identify close contacts and enhance the capabilities of user devices in mitigating the spread of COVID-19 within ship environments.

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Patients treated with radionuclide therapy usually require restrictions on certain activities for a period of time following treatment to optimise protection of the public and ensure the legal dose limit is not exceeded. Software may be used to calculate necessary restriction periods for an individual based on longitudinal dose rate measurements from the time of radiopharmaceutical administration. A spreadsheet program has been used for this purpose in Australian hospitals for the last two decades. However, this spreadsheet has a limitation in that it uses an approximation in the calculation of dose from a contact pattern, which affects the calculated restriction period. A computer program called Dorn was developed that provides the same functionality as the spreadsheet but without this approximation. Proffered radiation safety advice from Dorn and the spreadsheet were compared. Advice from the spreadsheet and Dorn were compared for 55 patients who underwent iodine-131 therapy for differentiated thyroid cancer. The restriction periods for caring for infants, close contact with children and sleeping with a partner were typically about 13 h longer in Dorn than in the spreadsheet, but in some cases were over a week shorter or a month longer. If the Dorn program is used clinically in place of the spreadsheet, some patients will enjoy shorter restriction periods and the therapy provider can be more confident in their compliance with regulatory requirements and best practice. Dorn is freely available fromhttps://doi.org/jg5f.

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