A rapid review of the use of face mask in preventing the spread of COVID-19

Investigating effects of FFP2 wearing during physical activity on gas exchange, metabolism and affective state using a randomized controlled trial

Concerns are repeatedly raised about possible adverse respiratory effects of wearing filtering face pieces (FFP) during physical activity. This study compared the impact of FFP type 2 (NF95) on pulmonary function, blood gas values, metabolism and discomfort during light, moderate and vigorous physical activity. Healthy adults (n = 13; 6 females, 7 males; mean 31.3, SD 5.5 years) participated in this randomized two-armed (Ergometer cycling with a FFP type 2 vs. no mask) crossover trial. Baseline cardiopulmonary exercise testing and two interventions (masked and unmasked ergometer cycling 40%, 50% and 70% VO2max, 10 min each) were separated by 48 h washout periods. Spiroergometric data (End tidal carbon dioxide partial pressure PetCO2; breathing frequency; inspiration time), blood gas analysis outcomes (capillary carbon dioxide partial pressure, pCO2) and subjective response (Breathing effort and perceived exertion) were contrasted between conditions using ANOVAs. All participants completed the crossover trial, seven started with the FFP2 condition (No adverse events or side effects). FFP2 decreased breathing frequency, prolonged inspiration time, increased perceived breathing effort and PetCO2 (p < .05). Blood pCO2 in millimetres mercury increased during exercise with 50%VO2max (mean 36.67, SD 3.19 vs. mean 38.46, SD 2.57; p < .05) and 70%VO2max (35.04, 2.84 vs. 38.17, 3.43; p < .05) but not during exercise with 40%VO2max (36.55, 2.73 vs. 38.70). Perceived exertion was not affected (p > 0.05) by mask wearing. Conclusion: Mask-induced breathing resistance decreased respiratory performance and limited pulmonary gas exchange. While FFP2 affected subjective breathing effort per se, invasive diagnostics showed that statistically significant metabolic effects are induced from moderate intensity upwards. Trial registration: DRKS-ID: DRKS00030181, Date of registration: 05/09/2022 (German Register for Clinical Trials).

Mask-inspired moisture-transmitting and durable thermochromic perovskite smart windows

Thermochromic perovskite smart windows (TPWs) are a cutting-edge energy-efficient window technology. However, like most perovskite-based devices, humidity-related degradation limits their widespread application. Herein, inspired by the structure of medical masks, a unique triple-layer thermochromic perovskite window (MTPW) that enable sufficient water vapor transmission to trigger the thermochromism but effectively repel detrimental water and moisture to extend its lifespan is developed. The MTPW demonstrates superhydrophobicity and maintains a solar modulation ability above 20% during a 45-day aging test, with a decay rate 37 times lower than that of a pristine TPW. It can also immobilize lead ions and significantly reduce lead leakage by 66 times. Furthermore, a significant haze reduction from 90% to 30% is achieved, overcoming the blurriness problem of TPWs. Benefiting from the improved optical performance, extended lifespan, suppressed lead leakage, and facile fabrication, the MTPW pushes forward the wide applications of smart windows in green buildings.

Higher Frequency of Healthcare Professionals is Associated With a Low Incidence of COVID-19-Related Death

The COVID-19 pandemic has affected over 200 countries with varying levels of infection and mortality rates. To understand the impact of healthcare resources and cultural factors, a cross-sectional study was conducted on 76 countries. The study used K-means clustering to identify 2 distinct clusters and performed a Welch's test to compare different parameters. The countries were then plotted on the Inglehart-Welzel global cultural map. By incorporating this framework, researchers can systematically scrutinize the intricate interplay of cultural factors. This will provide valuable context for understanding individuals' behaviors, preferences, and decision-making as they pertain to the challenges posed by COVID-19 and its mitigation strategies. The results showed that countries with higher levels of healthcare professionals had a lower death rate, even with a relatively high rate of infection. These countries also had higher levels of individual self-expression. The study highlights the importance of adhering to recommended protocols, as neglect can result from a lack of self-expression, leading to an increase in the spread of communicable diseases. It also emphasizes crucial role of healthcare professionals in managing crisis related to the pandemic.

Factors Associated with SARS-CoV-2 Infection Evaluated by Antibody Response in a Sample of Workers from the Emilia-Romagna Region, Northern Italy

Factors associated with SARS-CoV-2 infection risk are still debated. This case-control study aims to investigate the possible relationship between SARS-CoV-2 infection, evaluated through antibody response, and the main sociodemographic, occupational, clinical-anamnestic, and biochemical factors in a population of Modena province (Northern Italy), mainly workers. Both workers who voluntarily joined the screening campaign proposed by companies and self-referred individuals who underwent serological testing were enrolled. Subjects with antibody positivity were recruited as cases (n = 166) and subjects tested negative (n = 239) as controls. A questionnaire on sociodemographic, occupational, and clinical data was administered through telephone interviews. Serum zinc/iron/copper/chromium/nickel, vitamins D/B12, folates, triglycerides, and LDL/HDL/total cholesterol were measured. Cases lived more often in urban areas (61.8% vs. 57%). Cases and controls did not differ significantly by working macrocategories, but the percentage of workers in the ceramic sector was higher among cases. Low adherence to preventive measures in the workplace was more frequent among seropositives. Folate concentration was significantly lower among cases. Therefore, adequate folate levels, living in rural areas, and good adherence to preventive strategies seem protective against infection. Workers in the ceramic sector seem to be at greater risk; specific factors involved are not defined, but preventive interventions are needed.

Environmental and behavioral factors associated with household transmission of SARS-CoV-2 in children and adolescents

Objective

To analyze the association between risk behaviors and environmental factors and SARS-CoV-2 infection in children and adolescents in the family environment.

Methods

Cross-sectional study. A total of 267 children and adolescents aged 5-19 years who have contact with COVID-19-positive essential workers were tested between June and October 2020. Behavioral and environmental variables associated with SARS-CoV-2 infection were investigated. Association between these variables was performed using Poisson regression.

Results

SARS-CoV-2 prevalence was 25.1%. Following the confirmation of COVID-19 diagnosis of the index case, 92.1% of adults reported hand hygiene and 83.5% showed habits of respiratory etiquette. However, 12.7% wore masks in common areas of the residence before COVID-19. Sharing common objects was a risk factor for SARS-CoV-2 infection in the sample.

Conclusion

Sharing objects among family members was identified as a risk factor associated with SARS-CoV-2 infection in children and adolescents who lived with infected adults. There was high frequency of hand hygiene and low prevalence of mask use.

Characteristics associated with attitudes and behaviors towards mask wearing during the COVID-19 pandemic: The Trojan Pandemic Response Initiative

BACKGROUND

Attitudes and behaviors towards mask wearing may influence the ability to reduce transmission of COVID-19 and other diseases.

METHODS

University students, staff, and faculty (N = 9653) responded to an email invitation to complete electronic surveys (November 2021 and April 2022). Surveys included 19 items measuring attitudes and behaviors towards mask wearing from the Understanding America Study. Linear mixed models including variables for sex, age group, division, race and ethnicity, political affiliation, and history of COVID-19, were used to estimate the mean difference of the mean score for attitudes and behavior between Time 1 (November 2021) and Time 2 (April 2022).

RESULTS

Participants were mostly female (62.1%), students (70.6%), White (39.5%) and Asian (34.7%). More than half identified their political affiliation as Democrat (65.5%). Characteristic variable-by-time interactions for difference in mean mask attitude scores difference were significant at Time 1 (T1) and Time 2 (T2) between Black and White participants (B = 0.18 (0.05), 95% CI: 0.07, 0.28, p = 0.001), Asian and White participants (B = 0.07 (0.02), 95% CI: 0.03-0.12, p = 0.001), participants with self-reported history of COVID-19 and no history of COVID-19 (B= -0.13 (0.02), 95% CI: -0.07, -0.18, p < 0.0001), females and males (B = 0.07 (0.02), 95% CI: 0.03, 0.11, p = 0.001), Republicans and Democrats (B= -0.18 (0.04), 95%CI: -0.26, -0.10, p < 0.0001) and Independents and Democrats (B= -0.10 (0.03), 95%CI: -0.15, -0.05, p < 0.0001). Mean difference in mean scores for mask behaviors at Time and Time 2 were significant between participants with COVID-19 and participants who did not have COVID-19 (B= -0.12 (0.04), 95% CI: -0.19, -0.04, p = 0.004), students compared to faculty and staff (B=-0.22 (0.05), -0.32, -0.12, p < 0.0001), between Republicans and Democrats (B-= -0.16 (0.07), 95% CI: -0.28, -0.03, p = 0.020, and between Independents and Democrats (B=-0.08 (0.04), 95% CI: -0.16, -0.002, p = 0.04).

CONCLUSION

Race and ethnicity, political affiliation, and division may affect attitudes and behaviors in mask wearing. Further investigation into how characteristics influence public health measures such as mask wearing is needed to contain the spread of the COVID-19 virus, other infectious diseases, and future pandemics.

Impact of Lifting Mask Mandates on COVID-19 Incidence and Mortality in Portugal: An Ecological Study

INTRODUCTION

The use of face masks in public was one of several COVID-19 non-pharmaceutical interventions adopted to mitigate the pandemic in Portugal. The aim of this study was to evaluate the impact of lifting the mask mandate on the April 22, 2022 on COVID-19 incidence and mortality in mainland Portugal and in the Azores. As a secondary objective, we aimed to evaluate the evolution of COVID-19 cases in a setting without a mask mandate (Azores islands) and in a setting with a mask mandate (Madeira islands).

MATERIAL AND METHODS

Surveillance data on laboratory-confirmed COVID-19 cases and COVID-19 deaths were used to conduct an interrupted time series analysis to estimate changes in daily incidence and deaths during a mask mandate period (28th March - 21st April 2022) and during a post-mask mandate period (22nd April - 15th May 2022), in mainland Portugal and the Azores. In a second phase, for each group of islands, we fitted a negative binomial regression model, with daily COVID-19 incident cases as the primary outcome of interest, and relative frequency of Omicron BA.5 lineage as explanatory variable.

RESULTS

Significant changes in trends were observed for the overall incidence rate and COVID-19 deaths; increasing trends were observed for COVID-19 incidence and deaths in the post mandate period [5.3% per day; incidence rate ratio (IRR): 1.053; 95% confidence interval (CI): 1.029 - 1.078] and [3.2% per day; mortality rate ratio (MRR): 1.032; 95% CI: 1.003 - 1.062], respectively. For every unit increase in the percentage of Omicron BA.5 lineage there was a 1.5% increase per day (IRR: 1.015; 95% CI: 1.006 - 1.024) in COVID-19 incidence rate in the Azores islands, while for Madeira islands an increase of 0.05% COVID-19 cases per day was observed (IRR: 1.005; 95% CI: 1.000 - 1.010).

CONCLUSION

Lifting the mask mandate in Portugal was associated with an increase in COVID-19 incidence and deaths, thus highlighting the positive effect of face mask policies in preventing respiratory virus transmission and saving lives.

The experiences of Red Crescent relief workers during the COVID-19 pandemic in Iran: a qualitative phenomenological study

BACKGROUND

The daily increase of infected individuals and mortalities related to COVID-19 in Iran increased public fear and anxiety and affected the job performance of many health workers, including the Iranian Red Crescent Society, as one of the organizations responding to COVID-19.

METHODS

This study aimed to explore the experiences of Red Crescent rescuers, using a qualitative method with an interpretative phenomenological analysis (IPA), and by conducting semi-structured and in-depth interviews with Red Crescent relief workers from Mashhad in September 2020. Participants were selected by purposive sampling.

RESULTS

Rescuers in the Red Crescent Society, had gained different experiences during the COVID-19 pandemic. The experiences were categorized into four main themes. These main themes were: (1) Psychological disorders, (2) Organizational support (3) Mis-management (both structural and human factors), and (4) Opportunities.

CONCLUSION

The COVID-19 epidemic did create unique opportunities to understand the pitfalls of the Red Crescent aid services. Red Crescent rescue workers suffered from psychological symptoms, and mismanagement was also present. Psychological support and organizational improvements should be implemented.

Balance Ability and Quality of Life in Older Adult with Recovery from Mild COVID-19

BACKGROUND

In this study, we aimed to assess the ability to balance and quality of life (QoL) among older adults without a history of coronavirus disease 2019 (COVID-19) and those who had recovered from mild COVID-19.

METHODS

We recruited 80 older adults and categorized them into the following two groups based on their history of COVID-19: those without COVID-19 (n=40) and those who had recovered from mild COVID-19 (n=40). We assessed the participants' ability to balance using the multi-directional reach test and timed up and go (TUG) test, and evaluated their QoL using the Short Form-36.

RESULTS

Compared with older adults without a history of COVID-19, those who had recovered from mild COVID-19 demonstrated no differences in the scores of the forward, backward, right, and left directions (p>0.05), but a significantly longer duration for the TUG test (p=0.02) and a reduced QoL.

CONCLUSION

Our study results demonstrated decreased ability to balance and poor QoL among older adults who had recovered from mild COVID-19.

Impacts of public health and social measures on COVID-19 in Europe: a review and modified Delphi technique

Introduction

The emergence of the COVID-19 pandemic in early 2020 led countries to implement a set of public health and social measures (PHSMs) attempting to contain the spread of the SARS-CoV-2 virus. This study aims to review the existing literature regarding key results of the PHSMs that were implemented, and to identify the PHSMs considered to have most impacted the epidemiological curve of COVID-19 over the last years during different stages of the pandemic.

Methods

The PHSM under study were selected from the Oxford COVID-19 Government Response Tracker (OxCGRT), supplemented by topics presented during the Rapid Exchange Forum (REF) meetings in the scope of the Population Health Information Research Infrastructure (PHIRI) project (H2020). The evidence- based review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to identify which reviews have already been published about each PHSMs and their results. In addition, two modified Delphi panel surveys were conducted among subject matter experts from 30 European countries to uphold the results found.

Results

There were 3,212 studies retrieved from PubMed, 162 full texts assessed for eligibility and 35 included in this PHSMs summary. The measures with clearest evidence on their positive impact from the evidence-based review include social distancing, hygiene measures, mask measures and testing policies. From the modified Delphi panel, the PHSMs considered most significant in the four periods analyzed were case isolation at home, face coverings, testing policy, and social distancing, respectively.

Discussion

The evidence found has significant implications for both researchers and policymakers. The study of PHSMs' impact on COVID-19 illustrates lessons learned for future pan- and epidemics, serving as a contribution to the health systems resilience discussion. These lessons, drawn from both the available scientific evidence and the perspectives of relevant subject matter experts, should also be considered in educational and preparedness programs and activities in the public health space.

Influence of Face Masks on Physiological and Subjective Response during 130 Min of Simulated Light and Medium Physical Manual Work-An Explorative Study

BACKGROUND

Undesirable side effects from wearing face masks during the ongoing COVID-19 pandemic continue to be discussed and pose a challenge to occupational health and safety when recommending safe application. Only few studies examined the effects of continuously wearing a face mask for more than one hour. Therefore, the influence of wearing a medical mask (MedMask) and a filtering facepiece class II respirator (FFP2) on the physiological and subjective outcomes in the course of 130 min of manual work was exploratively investigated. Physical work load and cardiorespiratory fitness levels were additionally considered as moderating factors.

METHODS

Twenty-four healthy subjects (12 females) from three different cardiorespiratory fitness levels each performed 130 min of simulated manual work with light and medium physical workload using either no mask, a MedMask or FFP2. Heart rate, transcutaneous oxygen and carbon dioxide partial pressure (P_tcO₂, P_tcCO₂) as well as perceived physical exertion and respiratory effort were assessed continuously at discrete time intervals. Wearing comfort of the masks were additionally rated after the working period.

RESULTS

There was no difference in time-dependent changes of physiological outcomes when using either a MedMask or a FFP2 compared to not wearing a mask. A stronger increase over time in perceived respiratory effort occurred when the face masks were worn, being more prominent for FFP2. Physical workload level and cardiorespiratory fitness level were no moderating factors and higher wearing comfort was rated for the MedMask.

CONCLUSION

Our results suggest that using face masks during light and medium physical manual work does not induce detrimental side effects. Prolonged wearing episodes appeared to increase respiratory effort, but without affecting human physiology in a clinically relevant way.

Solid waste motor tricycle operators in Kumasi, Ghana, harbour respiratory pathogens; a public health threat

BACKGROUND

The use of motor tricycles in transporting municipal solid waste (MSW) within urban and peri-urban towns in Ghana is on the increase. This activity often leads to the introduction of pathogen-containing bioaerosols into the environment, as well as to the tricycle operators. We sought to investigate the prevalence and associated risk factors of respiratory pathogens among solid waste tricycle operators.

METHODS

A cross-sectional study was conducted among 155 solid waste transporters who use motor tricycles using semi-structured interviews. Nasopharyngeal swabs were obtained from participants and screened for respiratory pathogens using Polymerase Chain Reaction (PCR).

RESULTS

Pathogens detected in participants were SARS-CoV-2 (n = 10, 6.5%) and Streptococcus pneumoniae (n = 10, 6.5%), constituting an overall prevalence of 12.9% and co-infection rate of 1.3%. The most common self-reported symptoms were cough (n = 67, 43.2%), sore throat (n = 44, 28.4%) and difficulty in breathing (n = 22, 14.2%). Adherence to the use of gloves (n = 117, 75.5%) and nose mask (n = 110, 71.0%) was high. There was a significant association between the detection of respiratory pathogens and the use of gloves, use of more than one PPE and exposure to other pollutants (p < 0.05). Individuals who were exposed to "other pollutants" significantly had lower odds of becoming infected with respiratory pathogens (Adj. OR (95% CI): 0.119(0.015,0.938).

CONCLUSION

Although prevalence of respiratory pathogens is generally low, strict adherence to PPE use could further reduce its rates to even lower levels. Governmental health institutions and informal solid waste transporters should address challenges related to exposure to pollutants, use of gloves, and multiple PPE.

Monitoring indoor air quality using smart integrated gas sensor module (IGSM) for improving health in COPD patients

Technology advancement, industrialisation, and globalisation have been significant reasons for air pollution outdoors and indoors. It may surprise us that we spend about 80% of our time indoors breathing toxic, stale, polluted air, making us sluggish and fretful. In contrast to outdoor air, indoor air does not recycle consistently. It traps and builds pollutants from wood and coal stoves, furniture and building materials, paints and solvents, cigarette smoke, and cleaning supplies. The prolonged exposure to these hidden pollutants can prompt respiratory disorders such as lung disease, pneumonitis, asthma, pulmonary hypertension, and chronic obstructive pulmonary disease (COPD). It is enduring and is not curable, which has been a threat to humanity for ages. COPD's major cause is airborne particulate matter and other toxic compounds emitted from indoor and outdoor sources. Outdoor air pollution can be controlled only by acquiring changes in the vast population, wherein for indoor, every individual may create a major impact on improving air purity, thereby promoting health. The proposed design model for monitoring indoor air quality was tested in a normal and stimulating environment where we live. Parameters tested included temperature, humidity, amount of PM2.5, and the concentration of CO, CO₂, and NH₃. These parameters were monitored for five to 6 h per day for 8 days. Results indicate that the total air quality lies in the moderate range. Further study will be helpful to utilise this module as an effective Indoor air quality (IAQ) monitoring system. HIGHLIGHTS: • A simple, effective, inexpensive integrated gas sensor module (IGSM) has been proposed in this study to monitor the indoor air quality index (IAQI). • Indoor air quality was tested in a normal and stimulating environment for 8 days. • The integrated gas sensor module (IGSM) was composed of sensors in series, and the outputs for the respective parameter were measured easily. • Among the parameters tested, CO and PM2.5 lie in the moderate range, while other pollutants within the normal range reveal that the tested air quality is moderate.

Attitudes of preschool children and their families towards face mask during the COVID 19 pandemic

Aim: The use of face masks, compliance with hygiene and distance rules were among the leading measures during pandemic. But some authorities didn’t recommend face masks to preschool children. In this study we aimed to evaluate the attitudes of preschool children and their families towards face masks. Materials and Methods: We performed a survey between February-March 2022 to 189 volunteer participants who have preschool children,in pediatric health and diseases outpatient clinics in two different centers. Survey was consisted of 40 questions and 4 parts: 1. Demographic characteristics 2. Covid 19 3. Use of face masks 4.Compliance with hygiene and distance rules Results: Fifty three percent of the children used face mask. It was observed that the presence of a family member obsessed with cleaning caused a statistically higher increase in the number of handwashing in children(p:0,019). Mothers who were university graduates taught the children more distance rules(p.0.014), the number of handwashing increased in their children (:0.001) and the rate of using face masks was higher (p:0.036). Having a family member who have had Covid 19 was inversely proportional to the use of face masks in children (p:0.001) and correct use (p:0.033). It was observed that the rate of wearing masks was higher in children who used glasses (92%, p:0.006). Discussion: Half of the preschool children used face masks regularly. Covid 19 rate was higher in the families whose children didn’t use face masks in community. Face masks can be recommended to preschool children who can use it, during the pandemic.

Limitations in evaluating COVID-19 protective face masks using open circuit spirometry systems: respiratory measurement mask introduces bias in breathing pressure and perceived respiratory effort

Objective.In response to the COVID-19 pandemic and the resulting widespread use of protective face masks, studies have been and are being conducted to investigate potential side effects of wearing masks on the performance and physiological parameters of wearers. The purpose of the present study is to determine whether and to what extent the use of a respiratory measurement (RM) mask-which is normally used during open-circuit spirometry-influences the results of these types of studies.Approach.34 subjects were involved in this intra-subject study with a cross-over design. Four different protective face masks, Community Mask, medical Mouth-Nose-Protection Mask, Filtering Face Piece Mask Class 2 (FFP2), and FFP2 with exhalation valve (FFP2ex), were tested at rest and during deep breathing by using or not using a RM mask (RM versus noRM). Breathing pressure inside the protective face masks was measured during inhalation and exhalation, and subjects rated breathing effort using an 11-stage Borg scale.Main results.The use of an additional RM mask-worn over the protective face masks-significantly increased inspiratory pressures under all mask conditions. The respiratory pressure rises to a level that substantially distorts the results. Expiratory pressure was also significantly increased except for the FFP2ex mask condition. The perceived respiratory effort was significantly increased by 1.0 to 2.8 steps on the Borgs scale for all mask conditions compared with noRM.Significance.We strongly recommend avoiding the use of RM masks for evaluating the effects of protective face masks on human physiology and subjective perception.

Effects of Wearing a Mask During Exercise on Physiological and Psychological Outcomes in Healthy Individuals: A Systematic Review and Meta-Analysis

BACKGROUND

Wearing face masks in public is an effective strategy for preventing the spread of viruses; however, it may negatively affect exercise responses. Therefore, this review aimed to explore the effects of wearing different types of face masks during exercise on various physiological and psychological outcomes in healthy individuals.

METHODS

A literature search was conducted using relevant electronic databases, including Medline, PubMed, Embase, SPORTDiscus, Web of Science, and Cochrane Central Register of Controlled Trials on April 05, 2022. Studies examining the effect of mask wearing (surgical mask, cloth mask, and FFP2/N95 respirator) during exercise on various physiological and psychological parameters in apparently healthy individuals were included. For meta-analysis, a random effects model was used. Mean difference (MD) or standardized MD (SMD) with 95% confidence intervals (CI) were calculated to analyze the total effect and the effect in subgroups classified based on face mask and exercise types. The quality of included studies was examined using the revised Cochrane risk-of-bias tool.

RESULTS

Forty-five studies with 1264 participants (708 men) were included in the systematic review. Face masks had significant effects on gas exchange when worn during exercise; this included differences in oxygen uptake (SMD - 0.66, 95% CI - 0.87 to - 0.45), end-tidal partial pressure of oxygen (MD - 3.79 mmHg, 95% CI - 5.46 to - 2.12), carbon dioxide production (SMD - 0.77, 95% CI - 1.15 to - 0.39), and end-tidal partial pressure of carbon dioxide (MD 2.93 mmHg, 95% CI 2.01-3.86). While oxygen saturation (MD - 0.48%, 95% CI - 0.71 to - 0.26) decreased slightly, heart rate was not affected. Mask wearing led to higher degrees of rating of perceived exertion, dyspnea, fatigue, and thermal sensation. Moreover, a small effect on exercise performance was observed in individuals wearing FFP2/N95 respirators (SMD - 0.42, 95% CI - 0.76 to - 0.08) and total effect (SMD - 0.23, 95% CI - 0.41 to - 0.04).

CONCLUSION

Wearing face masks during exercise modestly affected both physiological and psychological parameters, including gas exchange, pulmonary function, and subjective discomfort in healthy individuals, although the overall effect on exercise performance appeared to be small. This review provides updated information on optimizing exercise recommendations for the public during the COVID-19 pandemic.

SYSTEMATIC REVIEW REGISTRATION NUMBER

This study was registered in the International Prospective Register of Systematic Review (PROSPERO) database (registration number: CRD42021287278).

Current methods of preventing infectious disease and managing febrile neutropenia in childhood cancer patients: a nationwide survey in Japan

BACKGROUND

Preventing infection and managing febrile neutropenia (FN) is mandatory for children with cancer undergoing chemotherapy. However, the current situation in Japan is unknown.

METHODS

We conducted a nationwide web-based questionnaire survey in 153 institutions treating childhood cancer in Japan. We asked about the type prophylaxis used to prevent infectious disease and manage FN. If patients with childhood cancer were managed by both pediatricians and surgeons at the same institution, we asked both to reply.

RESULTS

We received replies from 117 departments at 111 centers: of these, 108 were from pediatricians. Laminar air flow for neutropenic patients, and frequent hand sanitization with ethanol, were widespread. Twenty-eight percent and forty percent of departments performed active surveillance by taking cultures from patients and the environment, respectively, before initiation of chemotherapy. Forty-four percent of departments administered prophylactic intravenous antibiotics according to patient status. Many departments measured serum (1,3)-β-D glucan, procalcitonin, and aspergillus galactomannan at the onset of FN. Twenty-eight percent of departments used carbapenem as empirical therapy for FN. Some departments used prophylactic granulocyte-colony stimulating factor for acute leukemia. Seventy-two percent of departments used prophylactic immunoglobulin for hypogammaglobinemia caused by chemotherapy. Palivizumab was administered widely for respiratory syncytial virus prophylaxis in immunocompromised infants.

CONCLUSION

As a whole, intensive care for infectious prophylaxis or FN is applied in Japan; however, the methods vary among centers, and some are excessive or inadequate. Therefore, it is desirable to conduct clinical trials and establish adequate care protocols for infection in children with cancer in Japan.

Efficacy of personal protective equipment to prevent environmental infection of COVID-19 among healthcare workers: a systematic review

BACKGROUND

Healthcare workers (HCWs) employed personal protective equipment (PPE) during the COVID-19 pandemic, crucial to protecting themselves from infection. To highlight the efficacy of PPE in preventing environmental infection among HCWs, a systematic review was conducted in line with PRISMA guidance.

METHODS

A search of the PubMed and Web of Science databases was conducted from January 2019 to April 2021 using pre-defined search terms. Articles were screened by three researchers. The approved papers were read in full and included in this review if relevance was mutually agreed upon. Data were extracted by study design and types of PPEs.

RESULTS

47 of 108 identified studies met the inclusion criteria, with seven reviews and meta-analyses, seven cohort, nine case-control, fifteen cross-sectional studies, four before and after, four case series, and one modeling studies. Wearing PPE offered COVID-19 protection in HCWs but required adequate training. Wearing surgical masks provided improved protection over cloth masks, while the benefit of powered air-purifying respirators is less clear, as are individual gowns, gloves, and/or face shields.

CONCLUSIONS

Wearing PPE, especially facial masks, is necessary among HCWs, while training in proper use of PPE is also important to prevent COVID-19 infection.

Comparison of health-oriented cross-regional allocation strategies for the COVID-19 vaccine: a mathematical modelling study

BACKGROUND

Controlling the epidemic spread and establishing the immune barrier in a short time through accurate vaccine demand prediction and optimised vaccine allocation strategy are still urgent problems to be solved under the condition of frequent virus mutations.

METHODS

A cross-regional Susceptible-Exposed-Infected-Removed dynamic model was used for scenario simulation to systematically elaborate and compare the effects of different cross-regional vaccine allocation strategies on the future development of the epidemic in regions with different population sizes, prevention and control capabilities, and initial risk levels. Furthermore, the trajectory of the cross-regional vaccine allocation strategy, calculated using a particle swarm optimisation algorithm, was compared with the trajectories of other strategies.

RESULTS

By visualising the final effect of the particle swarm optimisation vaccine allocation strategy, this study revealed the important role of prevention and control (including the level of social distancing control, the speed of tracking and isolating exposed and infected individuals, and the initial frequency of mask-wearing) in determining the allocation of vaccine resources. Most importantly, it supported the idea of prioritising control in regions with a large population and low initial risk level, which broke the general view that high initial risk needs to be given priority and proposed that outbreak risk should be firstly considered instead.

CONCLUSIONS

This is the first study to use a particle swarm optimisation algorithm to study the cross-regional allocation of COVID-19 vaccines. These data provide a theoretical basis for countries and regions to develop more targeted and sustainable vaccination strategies.KEY MESSAGEThe innovative combination of particle swarm optimisation and cross-regional SEIR model to simulate the pandemic trajectory and predict the vaccine demand helped to speed up and stabilise the construction of the immune barrier, especially faced with new virus mutations.We proposed that priority should be given to regions where it is possible to prevent more infections rather than regions where it is at high initial risk, thus regional outbreak risk should be considered when making vaccine allocation decisions.An optimal health-oriented strategy for vaccine allocation in the COVID-19 pandemic is determined considering both pharmaceutical and non-pharmaceutical policy interventions, including speed of isolation, degree of social distancing control, and frequency of mask-wearing.

Seroprevalence of SARS-CoV-2 antibodies among public transport workers in Sweden

INTRODUCTION

Public transportation is an essential societal function in crisis situations like the coronavirus disease 2019 (COVID-19) pandemic. Bus drivers and other public transport workers are essential workers that need to keep working despite the risk of contagion. The SARS-CoV-2 virus may pose an occupational health risk to public transport workers and especially to bus drivers as they interact with passengers in a confined area. By analyzing antibodies towards SARS-CoV-2 proteins in blood samples it is possible to measure if an individual has been infected by COVID-19. Here, we report the prevalence of antibodies among bus drivers and other public transport employees in Stockholm, Sweden and relate it to socio-demographic factors.

METHODS

Seroprevalence of IgG antibodies towards SARS-CoV-2 proteins was investigated in a sample of 262 non-vaccinated public transport workers (182 men and 40 women) recruited between April 26 and May 7, 2021. Most of the participants were bus drivers (n = 222). The relationship between socio-demographic factors and seroprevalence was investigated with logistic regression.

RESULTS

The seroprevalence was 50% in the total sample of public transport workers. Among bus drivers, 51% were seropositive compared to 44% seropositive among the other public transport workers. The difference was not significant. The seroprevalence was higher than the national seroprevalence in Sweden during the same period (18.3% in non-vaccinated people aged 20-64 years). The logistic regression model using Wald forward selection showed that men had a higher risk of being seropositive (OR 2.7, 95% CI 1.3 - 5.8) and there was a higher risk with increasing number of people in the household (OR 1.3, 95% CI 1.1 - 1.6).

CONCLUSIONS

These findings could imply an occupational risk for COVID-19 infection among public transport workers. Infection control measures are warranted during virus epidemics to assure bus drives' safety and reduce transmission in public transport.

The face behind the Covid-19 mask - A comprehensive review

The threat of epidemic outbreaks like SARS-CoV-2 is growing owing to the exponential growth of the global population and the continual increase in human mobility. Personal protection against viral infections was enforced using ambient air filters, face masks, and other respiratory protective equipment. Available facemasks feature considerable variation in efficacy, materials usage and characteristic properties. Despite their widespread use and importance, face masks pose major potential threats due to the uncontrolled manufacture and disposal techniques. Improper solid waste management enables viral propagation and increases the volume of associated biomedical waste at an alarming rate. Polymers used in single-use face masks include a spectrum of chemical constituents: plasticisers and flame retardants leading to health-related issues over time. Despite ample research in this field, the efficacy of personal protective equipment and its impact post-disposal is yet to be explored satisfactorily. The following review assimilates information on the different forms of personal protective equipment currently in use. Proper waste management techniques pertaining to such special wastes have also been discussed. The study features a holistic overview of innovations made in face masks and their corresponding impact on human health and environment. Strategies with SDG3 and SDG12, outlining safe and proper disposal of solid waste, have also been discussed. Furthermore, employing the CFD paradigm, a 3D model of a face mask was created based on fluid flow during breathing techniques. Lastly, the review concludes with possible future advancements and promising research avenues in personal protective equipment.

Emergence of infectious diseases and role of advanced nanomaterials in point-of-care diagnostics: a review

Infectious outbreaks are the foremost global public health concern, challenging the current healthcare system, which claims millions of lives annually. The most crucial way to control an infectious outbreak is by early detection through point-of-care (POC) diagnostics. POC diagnostics are highly advantageous owing to the prompt diagnosis, which is economical, simple and highly efficient with remote access capabilities. In particular, utilization of nanomaterials to architect POC devices has enabled highly integrated and portable (compact) devices with enhanced efficiency. As such, this review will detail the factors influencing the emergence of infectious diseases and methods for fast and accurate detection, thus elucidating the underlying factors of these infections. Furthermore, it comprehensively highlights the importance of different nanomaterials in POCs to detect nucleic acid, whole pathogens, proteins and antibody detection systems. Finally, we summarize findings reported on nanomaterials based on advanced POCs such as lab-on-chip, lab-on-disc-devices, point-of-action and hospital-on-chip. To this end, we discuss the challenges, potential solutions, prospects of integrating internet-of-things, artificial intelligence, 5G communications and data clouding to achieve intelligent POCs.

Ceiling impact on air disinfection performance of Upper-Room Germicidal Ultraviolet (UR-GUV)

This study used Computational Fluid Dynamics (CFD) to investigate air disinfection for SARS-CoV-2 by the Upper-Room Germicidal Ultraviolet (UR-GUV), with focus on ceiling impact. The study includes three indoor settings, i.e., low (airport bus), medium (classroom) and high (rehearsal room) ceilings, which were ventilated with 100% clean air (CA case), 80% air-recirculation with a low filtration (LF case), and 80% air-recirculation with a high filtration (HF case). According to the results, using UR-GUV can offset the increased infection risk caused by air recirculation, with viral concentrations in near field (NF) and far field (FF) in the LF case similar to those in the CA case. In the CA case, fraction remaining (FR) was 0.48-0.73 with 25% occupancy rate (OR) and 0.49-0.91 with 45% OR in the bus, 0.41 in NF and 0.11 in FF in the classroom, and 0.18 in NF and 0.09 in FF in the rehearsal room. Obviously, UR-GUV performance in NF can be improved in a room with a high ceiling where FR has a power relationship with UV zone height. As using UR-GUV can only extend the exposure time to get infection risk of 1% (T _1% ) to 8 min in NF in the classroom, and 47 min in NF in the rehearsal room, it is necessary to abide by social distancing in the two rooms. In addition, T _1% in FF was calculated to be 18.3 min with 25% OR and 21.4% with 45% OR in the airport bus, showing the necessity to further wear a mask.

Comparison of measurement systems for assessing number- and mass-based particle filtration efficiency

The particle filtration efficiency (PFE) of a respirator or face mask is one of its key properties. While the physics of particle filtration results in the PFE being size-dependent, measurement standards are specified using a single, integrated PFE, for simplicity. This integrated PFE is commonly defined concerning either the number (NPFE) or mass (MPFE) distribution of particles as a function of size. This relationship is non-trivial; it is influenced by both the shape of the particle distribution and the fact that multiple practical definitions of particle size are used. This manuscript discusses the relationship between NPFE and MPFE in detail, providing a guide to practitioners. Our discussion begins with a description of the theory underlying different variants of PFE. We then present experimental results for a database of size-resolved PFE (SPFE) measurements for several thousand candidate respirators and filter media, including filter media with systematically varied properties and commercial samples that span 20%-99.8% MPFE. The observed relationships between NPFE and MPFE are discussed in terms of the most-penetrating particle size (MPPS) and charge state of the media. For the sodium chloride particles used here, we observed that the MPFE was greater than NPFE for charged materials and vice versa for uncharged materials. This relationship is observed because a shift from NPFE to MPFE weights the distribution toward larger sizes, while charged materials shift the MPPS to smaller sizes. Results are validated by comparing the output of a pair of automated filter testers, which are used in gauging standards compliance, to that of MPFE computed from a system capable of measuring SPFE over the 20 nm-500 nm range.

An Investigation of temporomandibular pain, headache, and fatigue in relation with long-term mask use during the COVID-19 pandemic period

OBJECTIVE

To investigate the effects of long-term mask use on temporomandibular pain, headache, and fatigue during the COVID-19 pandemic period via a survey.

METHODS

The survey was sent online, and symptoms associated with mask use, perception of mask discomfort, temporomandibular dysfunction, fatigue, headache, and trigger points of temporomandibular joint were evaluated.

RESULTS

For the study, 909 people were screened. Head, neck, face, throat, ear, and jaw pain, cheek tension, teeth clamping, acne, mask trace, palpitation, and voice and sleep disorders were different between groups (p < 0.05). The individuals' temporomandibular dysfunction and fatigue were different between groups (p < 0.05).

CONCLUSION

Long-term mask use can cause many symptoms, such as headache, jaw pain, and fatigue. Furthermore, increased mask-wearing time can trigger all these symptoms. The authors recommend relaxing breaks and exercises for neck, jaw, and face muscles along with the use of appropriate masks to minimize negative symptoms.

Madness of the crowd: Understanding mass behaviors through a multidisciplinary lens

Mass or crowd behaviors refer to those that occur at a group level and suggest that crowds behave differently to individuals. Mass behaviors are typically triggered by a significant societal event. The ongoing COVID-19 pandemic has provided many tangible examples of crowd behaviors that have been observed globally, suggesting possible common underlying drivers. It is important to provide a deeper understanding of such behaviors to develop mitigation strategies for future population-level challenges. To gain deeper insight into a variety of crowd behaviors, we perform a conceptual analysis of crowd behaviors using three detailed case studies covering observable behavior (panic buying and health protective actions) and mass beliefs (conspiracy theories) that have resulted or shifted throughout the pandemic. The aim of this review was to explored key triggers, psychological drivers, and possible mitigation strategies through a mixture of theory and published literature. Finally, we create experimental mathematical models to support each case study and to illustrate the effects of manipulating key behavioral factors. Overall, our analyses identified several commonalties across the case studies and revealed the importance of Social Identity Theory and concepts of trust, social connection, and stress.

Effect Of Surgical And N95 Facial Masks On Exercise Tolerance, Heart Rate, Respiratory Rate And Blood Oxygen Saturation

Background — Although wearing masks is inevitable these days, the effects of wearing them on physiologic parameters have not been reported. This study aimed to assess the effects of wearing no mask, a three-layer standard surgical mask, and wearing an N95 mask on blood oxygen saturation, aerobic tolerance, and performance during exercise. Methods — Twenty-one participants were enrolled in the study. Each participant was monitored with electrocardiography (ECG) while performing an exercise tolerance test using the Bruce treadmill protocol. Testing was conducted three times on different dates. Participants did not use any mask in the first test but did wear surgical and N95 masks during the second and third tests respectively. Respiratory rate (RR) was assessed for 10 seconds and then multiplied by 6. Heart rate (HR) was monitored by ECG, and oxygen saturation levels were monitored (O2Sat) via digital pulse-oximetry. Assessments were done before warm-up, at the middle and end of each Bruce stage, and as well at 1, 2, and 5 minutes into recovery (masks were worn during recovery). Results — HR, RR, and O2Sat measured data were all significantly different between the three trials at end-stage 3 of Bruce treadmill protocol (p<0.05). Although HR was still higher through the recovery period in the N95 trial in comparison with other trials (p<0.05), RR and O2Sat measured data were not different in the recovery phase. Conclusion — HR, RR, O2Sat and exercise tolerance are significantly affected by wearing surgical and N95 masks.

Dry Heat as a Potential Decontamination Method on the Filtration Efficiency of Filtering Facepiece Respirators

Filtering facepiece respirators have been widely used in the fields of occupational health and public hygiene, especially during the COVID-19 pandemic. In particular, disposable respirators have been in high demand, and the waste generated from these disposable products poses a problem for the environment. Here, we aimed to test a practical decontamination method to allow for the reuse of KN95 respirators. In this study, three types of KN95 respirators were heated at 80 °C and 90 °C for different durations (15 min, 30 min, 45 min, 1 h, 2 h, 3 h, 4 h, 6 h, 8 h, 10 h, and 24 h). The filtration efficiencies of the tested KN95 respirators before and after heating were measured, and the changes in microstructure were imaged with a scanning electron microscope (SEM). In addition, a neural network model based on the nonlinear autoregressive with external input (NARX) to predict the filtration efficiency of the KN95 respirator was established. The results show that the temperature and time of dry heating affected particle prevention. The higher the temperature and the longer the heating time, the more obvious the decline in the filtration efficiency of the respirators. When the heating temperature reached 100 °C, the respirator may be no longer suitable for reuse. These results show that a dry heat temperature between 70 °C and 90 °C, and a heating time between 30 min and 2 h is assumed to be a suitable and effective decontamination method for respirators.

Effects of Wearing Face Masks on Cardiorespiratory Parameters at Rest and after Performing the Six-Minute Walk Test in Older Adults

The effects of wearing cloth masks and surgical masks were investigated on respiratory rate, heart rate, blood pressure, oxygen saturation and perceived exertion at rest and after performing a six-minute walk test (6MWT) in older adults. Forty older adults were recruited and randomized into six groups including wearing no mask, cloth masks and surgical masks, at rest and during the 6MWT. At rest, all subjects sat quietly wearing no mask, a cloth mask or a surgical mask. All subjects performed a 6MWT by walking as fast as possible without running while wearing no mask, a cloth mask or a surgical mask. Respiratory rate, heart rate, blood pressure, oxygen saturation and perceived exertion were assessed before and after the rest and the 6MWT. Results showed that cloth masks and surgical masks did not impact cardiorespiratory parameters at rest or after performing a 6MWT, while an increase in perceived exertion was apparent in the groups wearing surgical masks and cloth masks after performing the 6MWT (p < 0.01). Cloth masks and surgical masks did not have an impact on cardiorespiratory fitness at rest and after performing the 6MWT in older adults.

Highly sensitive electrochemical aptasensor for SARS-CoV-2 antigen detection based on aptamer-binding induced multiple hairpin assembly signal amplification

In this work, a brief electrochemical aptasensor was developed for highly sensitive detection of SARS-CoV-2 antigen utilizing an aptamer-binding induced multiple hairpin assembly strategy for signal amplification. In the presence of SARS-CoV-2, a pair of aptamers was brought in a close proximity according to the aptamer-protein antigen binding, which initiated strand displacement reaction thereby triggering a multiple hairpin assembly to obtain long linear DNA concatemers on the electrode surface. As the fabricated hairpin probes were labeled with biotin, massive streptavidin-alkaline phosphatases (ST-ALP) could be further introduced on the electrode interface via biotin-streptavidin interaction thus generating strong electrochemical signal in electrolyte solution containing 1-naphthol phosphate. Benefiting from the non-enzymatic multiple hairpin assembly signal amplification strategy, the designed aptasensor for SARS-CoV-2 spike protein detection exhibited the wide linear range from 50 fg·mL⁻¹ to 50 ng·mL⁻¹ and low detection limit of 9.79 fg·mL⁻¹. Meaningfully, this proposed electrochemical assay provided a potential application for the point of care analysis of viral diseases under ambient temperature.

Fabrication of a highly protective 3D-printed mask and evaluation of its viral filtration efficiency using a human head mannequin

Facemasks are one of the most effective and low-cost prophylactics for COVID-19. In the spring 2020, when a severe shortage of facemasks occurred worldwide, various types of 3D-printed masks were designed and proposed. However, the protective effects conferred by most of these masks were not experimentally evaluated. Here, we provide a new simple design of 3D-printed mask and evaluate its protective effect in a viral filtration test using a human head mannequin. The developed mask can be constructed with a low-cost 3D printer, with an approximate production cost of US $4. This mask has three parts: the main part, wearing parts, and a piece of non-woven fabric filter. The volume of the filter, which needs to be changed daily, was reduced to approximately 1/10 of that of commercially available surgical masks used in this study. The developed mask is fabricated from polylactic acid, a biodegradable plastic, and its surface contour contacting the face may be adjusted after softening the material with hot water at 60-80°C. The viral filtration efficiency of the developed mask was found to be over 80%. This performance is better than that of commercially available facemasks, such as surgical masks and cloth masks, and equal to those of KN95 and KF94.

Co-Yudh: A Convolutional Neural Network (CNN)-Inspired Platform for COVID Handling and Awareness

The COVID-19 pandemic has been a menace to the World. According to WHO, a mortality rate of 1.99% is reported as of 28th November 2021. The need of the hour is to implement certain safety measures that may not eradicate but at least put a restriction on the rising number of COVID-19 cases all over the World. To ensure that the COVID-19 protocols are being abided by, a Convolutional Neural Network (CNN)-based framework “Co-Yudh” is being developed that comprises features like detecting face masks and social distancing, tracking the number of COVID-19 cases, and providing an online medical consultancy. The paper proposes two algorithms based on CNN for implementing the above features such as real-time face mask detection using the Transfer Learning approach in which the MobileNetV2 model is used which is trained on the Simulated Masked Face Dataset (SMFD). Further, the trained model is evaluated on the novel dataset—Mask Evaluation Dataset (MED). Additionally, the YOLOv4 model is used for detecting social distancing. It also uses web scraping for tracking the number of COVID-19 cases which updates on a daily basis. This is an easy-to-use framework that can be installed in various workplaces and can serve all the purposes to keep a check on the COVID-19 protocols in the area. Our preliminary results are quite satisfactory when tested against different environmental variables and show promising avenues for further exploration of the technique. The proposed framework is a more improved version of the existing works done so far.

The Emotional Impact of Maskne in the Era of COVID-19: A Commentary on the Future of a Multi-Modality Approach

Over the past two years, the world has experienced the destructive effects of the SARS-CoV-2 pandemic, better known as COVID-19. The use of surgical face masks was declared necessary by many governments around the world to protect citizens from catching the rapidly spreading virus. Albeit surgical masks contributing to stopping the spread of SARS-CoV-2, many people have reported rashes closely resembling acne on their chins ever since wearing face masks became mandatory. This article studies the acne that results from masks worn to prevent the transmission of the SARS-CoV-2. Acne due to the wearing of masks (“Maskne”) is a new challenge that has affected the population and can decay the mental health of societies and individuals. The exploration of the mental and physical health effects of “Maskne” help us to form treatments that emphasize the association of improving mental health to decrease acne and enhancing quality of life.

The Social Meanings of Artifacts: Face Masks in the COVID-19 Pandemic

Since the beginning of the COVID-19 pandemic, research has explored various aspects of face mask use. While most of the research explores their effectiveness to prevent the spread of the virus, a growing body of literature has found that using face masks also has social meaning. But what social meaning does it have, and how does this meaning express itself in people's practice? Based on 413 qualitative interviews with residents in five European countries (Austria, Belgium, Germany, Ireland, and Switzerland), we found that the meanings of face masks have changed drastically during the first months of the pandemic. While in spring 2020 people wearing them had to fear stigmatization, in autumn of 2020 not wearing masks was more likely to be stigmatized. Throughout the first year of the pandemic, we found that mask wearing had multiple and partly seemingly contradictory meanings for people. They were perceived as obstacles for non-verbal communication, but also a way to affirm friendships and maintain social contacts. They also signaled specific moral or political stances on the side of face mask wearers and non-wearers alike, expressed their belonging to certain communities, or articulated concern. In sum, our findings show how face masks serve as scripts for people to navigate their lives during the COVID-19 pandemic. We conclude that public and political discussions concerning face masks should include not only evidence on the epidemiological and infectiological effects of face masks, but also on their social meanings and their social effects.

Mask-wearing intentions on airplanes during COVID-19 - Application of theory of planned behavior model

The COVID-19 pandemic has devastated the air transport industry, forcing airlines to take measures to ensure the safety of passengers and crewmembers. Among the many protective measures, mask mandate onboard the airplane is an important one, but travelers' mask-wearing intentions during flight remain uninvestigated especially in the US where mask use is a topic of on-going debate. This study focused on the mask use of airline passengers when they fly during COVID-19, using the theory of planned behavior (TPB) model to examine the relationship between nine predicting factors and the mask-wearing intention in the aircraft cabin. A survey instrument was developed to collect data from 1124 air travelers on Amazon Mechanical Turk (MTurk), and the data was statistically analyzed using structural equation modeling and logistic regression. Results showed that attitude, descriptive norms, risk avoidance, and information seeking significantly influenced the travelers' intention to wear a mask during flight in COVID-19. Group analysis further indicated that the four factors influenced mask-wearing intentions differently on young, middle-aged, and senior travelers. It was also found that demographic and travel characteristics including age, education, income, and travel frequency can be used to predict if the airline passenger was willing to pay a large amount to switch to airlines that adopted different mask policies during COVID-19. The findings of this study fill the research gap of air travelers' intentions to wear a mask when flying during a global pandemic and provide recommendations for mask-wearing policies to help the air transport industry recover from COVID-19.

Surface Functionalization of Non-Woven Fabrics Using a Novel Silica-Resin Coating Technology: Antiviral Treatment of Non-Woven Fabric Filters in Surgical Masks

Masks are effective for preventing the spread of COVID-19 and other respiratory infections. If antimicrobial properties can be applied to the non-woven fabric filters in masks, they can become a more effective countermeasure against human-to-human and environmental infections. We investigated the possibilities of carrying antimicrobial agents on the fiber surfaces of non-woven fabric filters by applying silica-resin coating technology, which can form silica-resin layers on such fabrics at normal temperature and pressure. Scanning electron microscopy and electron probe microanalysis showed that a silica-resin layer was formed on the fiber surface of non-woven fabric filters. Bioassays for coronavirus and quantitative reverse transcription-polymerase chain reactions (RT-PCR) revealed that all antimicrobial agents tested loaded successfully onto non-woven fabric filters without losing their inactivation effects against the human coronavirus (inhibition efficacy: >99.999%). These results indicate that this technology could be used to load a functional substance onto a non-woven fabric filter by vitrifying its surface. Silica-resin coating technology also has the potential of becoming an important breakthrough not only in the prevention of infection but also in various fields, such as prevention of building aging, protection of various cultural properties, the realization of a plastic-free society, and prevention of environmental pollution.

Patterns Among Healthcare Workers of Bangalore About Face Mask Usage: A Single-Center Observational Study

Introduction

Face masks prevent acute respiratory infections. Healthcare workers are prone to infections owing to their direct and constant exposure to infected patients. This pioneering study in Bangalore city, analyzed the awareness and attitude of healthcare staff toward using a face mask.

Methods

This observational study was conducted among 290 subjects (mean age, 33.89 ± 7.88 years; male:female ratio, 1:2.67). The study included all the healthcare workers from various departments. Data on basic demographic characteristics, attitude, awareness, and observations on the use of face mask were collected.

Results

A large proportion of the sample were from the nursing department (n = 161, 55.51%). Most of the healthcare workers believed that making wearing a mask mandatory in public was very effective (80%) and 79% believed that wearing a mask could prevent the spread of coronavirus. Most of the healthcare workers said they would wear masks even when not mandatory. Most of them used an N95 mask or an N95 mask along with a surgical mask. Almost all were conscious of wearing the mask above the nose, covering the mouth and chin (289, 99.65%). A significantly higher number of doctors (medical postgraduates) (17, 45.95%, p = 0.01) used two masks when compared with others. Significantly fewer doctors (4, 10.81%) and other healthcare staff (8, 22.22%) reused masks (p = 0.002). Most of them used the mask only once, and those who reused it, cleaned it on alternate days (< 0.001). Sun-drying or air-drying, preceded by washing with detergent or soap, were the cleaning methods used, and most used paper or plastic bags to store the masks when not in use. Most of them did not use hand sanitizer before wearing the mask but followed all other precautions and measures to prevent infection.

Conclusions

Most of the healthcare workers believed the use of masks could prevent virus transmission. A significantly higher number of doctors used two masks when compared with other healthcare staff. Significantly fewer doctors and other healthcare staff reused masks when compared with nurses and technicians.

Effects of Face Masks on Physical Performance and Physiological Response during a Submaximal Bicycle Ergometer Test

The ongoing COVID-19 pandemic requires wearing face masks in many areas of our daily life; hence, the potential side effects of mask use are discussed. Therefore, the present study explores whether wearing a medical face mask (MedMask) affects physical working capacity (PWC). Secondary, the influence of a filtering facepiece mask with exhalation valve class 2 (FFP2exhal) and a cotton fabric mask (community mask) on PWC was also investigated. Furthermore, corresponding physiological and subjective responses when wearing face masks as well as a potential moderating role of subjects’ individual cardiorespiratory fitness and sex on face mask effects were analyzed. Thirty-nine subjects (20 males, 19 females) with different cardiorespiratory fitness levels participated in a standardized submaximal bicycle ergometer protocol using either a MedMask, FFP2exhal, community mask, or no mask (control) on four days, in randomized order. PWC130 and PWC150 as the mechanical load at the heart rates of 130 and 150 beats per minute were measured as well as transcutaneous carbon dioxide partial pressure, saturation of peripheral capillary oxygen, breathing frequency, blood pressure, perceived respiratory effort, and physical exhaustion. Using the MedMask did not lead to changes in PWC or physiological response compared to control. Neither appeared changes exceeding normal ranges when the FFP2exhal or community mask was worn. Perceived respiratory effort was up to one point higher (zero-to-ten Likert scale) when using face masks (p < 0.05) compared to control. Sex and cardiorespiratory fitness were not factors influencing the effects of the masks. The results of the present study provide reason to believe that wearing face masks for infection prevention during the COVID-19 pandemic does not pose relevant additional physical demands on the user although some more respiratory effort is required.

Deep Learning Models for Multiple Face Mask Detection under a Complex Big Data Environment

The Covid-19 (coronavirus) pandemic creates a worldwide health crisis. According to the WHO, the effective protection system is wearing a face mask in public places. Many studies proved that carrying a face mask is also one of the precautions to decrease the possibility of viral transmission. Strict monitoring of face mask being worn by people is now enforced in many countries. Manual observation and monitoring is quite tedious. Hence, automated systems have been researched using well-kwown face mask detection methods. However, this research paper, deals with some deep learning models which can be effectively used to detect multiple face masks in a crowded environment when the amount of incoming data from sensors is huge or in otherwise stated to a Big data problem. Hence, standalone face detection models are not quite suited. Deep learning models are required in such Big data scenario which forms the essence of this study.

Effects of Telemedicine on Pediatric Clinical Care During COVID-19

Coronavirus disease 2019 (COVID-19) has provided unprecedented opportunity for the growth of telemedicine in pediatrics. Clinics rapidly expanded their telemedicine capabilities and converted in-person visits to virtual visits to offer patients continued care while limiting infection risks. Although the transition to video visits has several benefits-patient convenience, versatility of care, ease of follow up, and management of chronic conditions-these gains are only available to those who have the requisite technology access and literacy needed to conduct a video visit. The need for technology-dependent care stands to further widen preexisting disparities in access to care for those who cannot use or afford the necessary technology. Our article explores some of these benefits and challenges and reminds us that although telemedicine has proven to have high utility for many patients, there are improvements that must still be made to ensure equitable accessibility and durability of virtual visits. [Pediatr Ann. 2021;50(12):e503-e508.].

Influences of climatic and non-climatic factors on COVID-19 outbreak: A review of existing literature

Coronavirus disease 2019 (COVID-19) has become a significant global public health issue resulting from SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2). COVID-19 outbreak approaches an unprecedented challenge for human health, the economy, and societies. The transmission of the COVID-19 is influenced by many factors, including climatic, environmental, socioeconomic, and demographic. This study aimed to investigate the influences of climatic and sociodemographic determinants on COVID-19 transmission. The climatic variables considered herein were air temperature, relative humidity, wind speed, air pollution, and cumulative precipitation. Sociodemographic variables included population density, socioeconomic conditions, misinformation, and personal hygiene practices towards the pandemic. Review results indicated that lower temperatures and greater incidence of COVID-19 are reported in a more significant number of studies. Another factor linked to COVID-19 occurrence was the humidity. However, the results were varied; some research reported positive, and others reported negative relationships. In addition, poor air quality, along with strong winds, makes the virus more vulnerable to spreading, leading to a spike in COVID-19 cases. PM2.5, O3, and NO2 also showed a strong correlation with the recent epidemic. The findings on rainfall were inconsistent between studies. Among the non-climatic factors, population density, education, and income were credited as potential determinants for the coronavirus outbreak. Climatic and sociodemographic factors showed a significant correlation on the COVID-19 outbreak. Thus, our review emphasizes the critical importance of considering climatic and non-climatic factors while developing intervention measures. This study's core findings will support the decision-makers in identifying climatic and socioeconomic elements that influence the risks of future pandemics.

Passenger exposure to respiratory aerosols in a train cabin: Effects of window, injection source, output flow location

Nowadays the use of public transportation (PT) has been identified as high risk as due to the transfer of particles carrying the coronavirus from an infected passenger to others. This study puts forward a new computational framework for predicting the spread of droplets produced while the infected passenger talking inside the cabin of a train during various scenarios, including the changes in the outflows' location and the infected passenger's position. CFD was used to conduct the study, using the Euler-Lagrange approach to capture the transmission of particles, and Reynolds-averaged Navier-Stokes equations (RANS) to compute the airflow field. The results revealed that opening the window reduces the duration of particles inside the domain. So that when the window is open, the particle's shelf time can decrease to 25 percent comparing with closed mode. It was found that the passenger sitting next to the infected passenger encountered the highest infection risk. The conclusions made in this work show that the most desirable situation is obtained when the infected passenger is sitting next to the exits, whether the window is closed or open. The results of this paper offer comprehensive insights into how to keep indoor environments safe against infection aerosols.

Protective measures are associated with the reduction of transmission of COVID-19 in Bangladesh: A nationwide cross-sectional study

Coronavirus disease 2019 (COVID-19) pandemic has become a major public health issue globally. Preventive health measures against COVID-19 can reduce the health burden significantly by containing the transmission. A few research have been undertaken on the effectiveness of preventive strategies such as mask use, hand washing, and keeping social distance in preventing COVID-19 transmission. The main aim of this study was to determine the association of the preventive measures with the reduction of transmission of COVID-19 among people. Data was collected during January 06, 2021 to May 10, 2021 from 1690 participants in Bangladesh. A validated questionnaire was used to collect both the online and offline data. Chi-square test and logistic regression analyses were performed to determine the association among the variables. The prevalence of COVID-19 was 11.5% (195 of 1690) among the population. Age, gender, occupation and monthly income of the participants were significantly associated with the likelihood of following the preventive measures. The risk of infection and death reduced significantly among the participants following preventive measures (p = .001). The odds of incidence was lower among the participants using masks properly (OR: 0.02, 95% CI: 0.01-0.43), maintaining social distances (OR: 0.04, 95% CI: 0.01-0.33), avoiding crowded places (OR: 0.07, 95% CI: 0.02-0.19) and hand shaking (OR: 0.17, 95% CI: 0.09-0.41). This study suggests that preventive health measures are significantly associated with the reduction of the risk of infection of COVID-19. Findings from this study will help the policymakers to take appropriate steps to curb the health burden of COVID-19.

Unmasking People’s Opinions behind Mask-Wearing during COVID-19 Pandemic—A Twitter Stance Analysis

Wearing a mask by the general public has been a controversial issue from the beginning of the COVID-19 pandemic as the public authorities have had mixed messages, either advising people not to wear masks if uninfected, to wear as a protective measure, to wear them only when inside a building/room with insufficient air flow or to wear them in all the public places. To date, the governments have had different policies regarding mask-wearing by the general public depending on the COVID-19 pandemic evolution. In this context, the paper analyzes the general public’s opinion regarding mask-wearing for the one-year period starting from 9 January 2020, when the first tweet regarding mask-wearing in the COVID-19 context has been posted. Classical machine learning and deep learning algorithms have been considered in analyzing the 8,795,633 tweets extracted. A random sample of 29,613 tweets has been extracted and annotated. The tweets containing news and information related to mask-wearing have been included in the neutral category, while the ones containing people’s opinions (for or against) have been marked using a symmetrical approach into in favor and against categories. Based on the analysis, it has been determined that most of the mask tweets are in the area of in favor or neutral, while a smaller percentage of tweets and retweets are in the against category. The evolution of the opinions expressed through tweets can be further monitored for extracting the public perspective on mask-wearing in times of COVID-19.

The Impact of Tape Sealing Face Masks on Visual Field Scores in the Era of COVID-19: A Randomized Cross-over Study

PRECIS

Tape sealing of the face mask can prevent fogging artifacts of visual field testing. Here, we demonstrate that tape sealing can improve visual field scores even when fogging artifacts are not obvious.

PURPOSE

The purpose of this study was to demonstrate that visual field scores improve when the face masks are taped to prevent fogging artifacts.

METHODS

A Single-center, randomized 2×2 cross-over study. Twenty-six visual fields of 13 patients of the glaucoma outpatient clinic were included. Patients were randomized in either sequence 1 (Octopus visual field examination without tape sealing, followed by examination with tape sealing) or sequence 2 (examination with, followed by without tape sealing).

RESULTS

The results for mean defect and square root of loss variance differ significantly in the examination with and without tape sealing [mean difference (without-with) 0.39 dB, 95% confidence interval: 0.07-0.70 dB, P=0.018 and 0.49 dB, 95% confidence interval: 0.19-0.79 dB, P=0.003, respectively]. There was no sequence effect (P=0.967) for mean defect nor the square root of loss variance (P=0.779). A significant effect for period (P=0.023) for mean defect was yielded.

CONCLUSION

Tape sealing of face masks during visual field testing prevented fogging artifacts and improved visual field scores even when fogging artifacts were not obvious and should be considered in clinical practice.

PM2.5 as a major predictor of COVID-19 basic reproduction number in the USA

Many studies have proposed a relationship between COVID-19 transmissibility and ambient pollution levels. However, a major limitation in establishing such associations is to adequately account for complex disease dynamics, influenced by e.g. significant differences in control measures and testing policies. Another difficulty is appropriately controlling the effects of other potentially important factors, due to both their mutual correlations and a limited dataset. To overcome these difficulties, we will here use the basic reproduction number (R₀) that we estimate for USA states using non-linear dynamics methods. To account for a large number of predictors (many of which are mutually strongly correlated), combined with a limited dataset, we employ machine-learning methods. Specifically, to reduce dimensionality without complicating the variable interpretation, we employ Principal Component Analysis on subsets of mutually related (and correlated) predictors. Methods that allow feature (predictor) selection, and ranking their importance, are then used, including both linear regressions with regularization and feature selection (Lasso and Elastic Net) and non-parametric methods based on ensembles of weak-learners (Random Forest and Gradient Boost). Through these substantially different approaches, we robustly obtain that PM_2.5 is a major predictor of R₀ in USA states, with corrections from factors such as other pollutants, prosperity measures, population density, chronic disease levels, and possibly racial composition. As a rough magnitude estimate, we obtain that a relative change in R₀, with variations in pollution levels observed in the USA, is typically ~30%, which further underscores the importance of pollution in COVID-19 transmissibility.