Spark Discharge Aerosol-generated copper-based nanoparticles: Structural & optical properties; application on the antiviral (SARS-CoV-2) and antibacterial improvement of face masks

Nanoparticle formation by Spark Discharge Aerosol Generation offers low-cost fabrication of nanoparticles, without the use of chemicals or vacuum. It produces aerosol particles of a few nanometers in size with high purity. In this work, copper-based - CuO (tenorite) and Cu- nanoparticles are produced, characterized and used to modify face mask air filters, achieving the introduction of antibacterial and antiviral properties. A range of characterization techniques have been employed, down to the atomic level. The majority of the particles are CuO (of a few nanometers in size that agglomerate to form aggregates), the remainder being a small number of larger Cu particles. The particles were deposited on various substrates, mainly fiber filters in order to study them and use them as biocidal agents. On face masks, their antibacterial activity against Escherichia coli (E.coli) results in a 100% decrease in bacteria cell viability. Their antiviral activity on face masks results in a 90% reduction of the Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) viability, 15 minutes post the application of the virus stock solution. This highlights the effectiveness of this approach, its simplicity, its low cost and its excellent environmental credentials.

Personal Air-Quality Monitoring with Sensor-Based Wireless Internet-of-Things Electronics Embedded in Protective Face Masks

In this paper, the design and research of a sensor-based personal air-quality monitoring device are presented, which is retrofitted into different personal protective face masks. Due to its small size and low power consumption, the device can be integrated into and applied in practical urban usage. We present our research and the development of the sensor node based on a BME680-type environmental sensor cluster with a wireless IoT (Internet of Things)-capable central unit and overall low power consumption. The integration of the sensor node was investigated with traditional medical masks and a professional FFP2-type mask. The filtering efficiency after embedding was validated with a head model and a particle counter. We found that the professional mask withstood the embedding without losing the protective filtering aspect. We compared the inner and outer sensor data and investigated the temperature, pressure, humidity, and AQI (Air Quality Index) relations with possible sensor data-fusion options. The novelty is increased with the dual-sensor layout (inward and outward). It was found that efficient respiration monitoring is achievable with the device. With the analysis of the recorded data, characteristic signals were identified in an urban environment, enabling urban altimetry and urban zone detection. The results promote smart city concepts and help in endeavors related to SDGs (Sustainable Development Goals) 3 and 11.

Interpersonal distance perception during the normalization of an pandemic situation: Effects of mask-wearing and vaccination

This study aimed to evaluate the effect of anti-pandemic measures, including wearing a face mask and receiving vaccinations, on interpersonal distance (IPD) during the normalization stage of the COVID-19 pandemic. Virtual reality (VR) technology was used to simulate the experimental environment and a confederate in different conditions. Thirty-one participants were asked to approach the virtual confederate, who could exhibit three vaccination states and two mask-wearing conditions, actively and passively in both indoor and outdoor environments. ANOVA results showed that the participants kept a smaller IPD from the confederate wearing a face mask (IPD = 125.6 cm) than from the one without a face mask (IPD = 154.2 cm). The effects of vaccination states were significant, with the largest distance for an unvaccinated confederate (IPD = 182.3 cm) and the smallest distance for the confederate who had received a booster vaccine (IPD = 111.5 cm). Significant effects of environment were also found, with the participants maintaining a larger IPD in an outdoor environment (IPD = 143.4 cm) than in an indoor room (IPD = 136.4 cm). Additionally, the IPD collected when the participants were passively approached (IPD = 149.6 cm) was significantly larger than that obtained when they actively approached the confederate (IPD = 130.3 cm). Moreover, when the participants faced a confederate who had received a booster vaccine and wore a mask, the IPD was not significantly different from that collected before the COVID-19 pandemic in both the active and passive patterns. These findings help us to better understand the nature of IPD and human behaviors during the normalization stage of the pandemic and provide scientific suggestions for policymakers to develop pandemic-prevention measures.

Influence of metal oxide catalyst on co-pyrolysis of biomass and COVID-19 waste

The disposal of waste generated by the COVID-19 pandemic is still a challenge to the government in most countries. The present study shines its light on the catalytic effect of metal oxide on converting COVID-19 waste i.e. used face masks into valuable products through co-pyrolysis. The co-pyrolysis trial was carried out for a mixture of waste face mask (WFM) and Moringa oleifera (MO) biomass at a constant temperature of 450°C for 15 min of resident time. This investigation focuses on studying the catalytic effect of calcium oxide (CaO) on the by-products of the pyrolysis process. From the FT-IR studies, it is observed that the CaO catalyst assisted to reduce oxygen as well as sulphur and carboxylic acids in the bio-oil due to its strong basic nature. The FE-SEM images suggest the increase in porous structure with catalytic pyrolysis (CP) char compared to non-catalytic pyrolysis (NCP) char. The catalytic activity of CaO increased the alcoholic content with a reduction in aldehydes and ketones in the bio-oil. The addition of WFM to the biomass with CaO catalyst pyrolysis (CP) delivered a higher oil yield of 52% compared to non-catalytic pyrolysis (NCP).

N95 respirators alter facial skin physiological functions and lipidome composition in health care personnel

BACKGROUND

During the coronavirus disease 2019 pandemic, wearing medical respirators and masks was essential to prevent transmission.

OBJECTIVE

To quantify the effects of N95 mask usage by measuring facial skin biophysical characteristics and changes in the lipidome.

METHODS

Sixty healthy volunteers wore N95 respirators for 3 or 6 h. Facial images were acquired and physiological parameters were measured in specific facial areas, before and after mask-wearing. Lipidome analysis was also performed.

RESULTS

After N95 respirator usage, facial erythema was observed in both the 3 and 6 h groups. Both sebum secretion and trans-epidermal water loss increased significantly in mask-covered cheeks and chins after 6 h of mask wearing compared with before mask wearing (p < 0.05). Principal component analysis revealed significant differences in lipid composition after mask wearing compared with before. The ceramide subclass NS exhibited a positive correlation with stratum corneum hydration, whereas the AP subclass was negatively correlated with trans-epidermal water loss in the 6 h group.

CONCLUSION

Prolonged wear of N95 respirators may impair facial skin function and alter lipidome composition.

An antimicrobial zinc ion fiber for COVID-19 prevention in nonwoven face coverings for healthcare settings

The COVID-19 pandemic created an unprecedented increase in the usage of personal protective equipment (PPE) in the healthcare industry, especially in the form of face coverings. Subsequently, guidelines related to breathability and wear comfort were published by the Centers for Disease Control (CDC) as an influx of various new materials entered the PPE market. This study evaluated a proprietary, novel, zinc-ion embedded fiber with the ability to deactivate bacteria and viruses, including SARS-COV-2, for its wear comfort in a nonwoven disposable mask in comparison to a commercially available surgical face mask which served as the control. Ten healthy, full-time, career, firefighters participated in this study wearing both masks in a randomized fashion. A medical task simulation (MTS) protocol was developed to replicate nursing task metabolic rates, per the compendium of physical activities, via a graded treadmill walking exercise. Participant ratings including ease of mask fit, overall mask comfort, facial comfort, breathability, and facial temperature sensation were recorded before, during, and after the 50-minute protocol in a controlled environmental chamber. The 100% nylon, zinc ion mask was rated as slightly cooler at the beginning of the trial (at 0.8 vs. 1.3), than the commercially available polypropylene mask. The polypropylene mask also reached a perceived mask facial comfort (MFC) rating of 1.6 just 35 min into the protocol whereas the zinc ion mask did not reach a rating of slight discomfort until the end of the exercise. Findings indicate the novel zinc-ion embedded mask was as comfortable, if not more so, than the commercially available nonwoven mask with more favorable ratings for longer durations. Not only do the zinc properties provide enhanced protection, but they maintain, if not improve, wearer comfort.

Comparison of nasal and face mask ventilation in anaesthetised obese adults: A randomised controlled study

Background and Aims

The use of a face mask while inducing general anaesthesia (GA) in obese patients is often ineffective in providing adequate ventilation. Although nasal mask ventilation has demonstrated effectiveness for continuous positive airway pressure (CPAP) in obese patients with obstructive sleep apnoea (OSA), it has not yet been applied to the induction of anaesthesia. This study evaluated the efficacy of nasal mask ventilation against standard face mask ventilation in anaesthetised obese patients with body mass index (BMI)>25 kg/m2.

Methods

Ninety adult patients with BMI >25 kg/m2 were randomly assigned to receive either facemask (Group FM) or nasal-mask (Group NM) ventilation during induction of GA. Expired tidal volume (VtE), air leak, peak inspiratory pressure (PIP), plateau pressure (PPLAT), oxygen saturation (SpO2), and end-tidal carbon dioxide (EtCO2) were recorded for10 breaths, and their mean was analysed.

Results

The mean (standard deviation) VtE measured was not significantly higher in Group NM [455.98 (55.64) versus 436.90 (49.50) mL, P = 0.08, degree of freedom (df):88, mean difference (95% confidence interval [CI]) -19.08 (-41.14, 2.98) mL]. Mean air-leak [16.44 (22.16) versus 31.63 (21.56) mL, P = 0.001, df: 88, mean difference 95%CI: 15.19 (6.03,24.35)], mean PIP [14.79 (1.39) versus 19.94 (3.05) cmH2O, P = 0.001, df: 88, mean difference, 95%CI: 5.15 (4.16, 6.14)], and mean PPLAT [12.04 (1.21) versus 16.66 (2.56) cmH2O, P = 0.001, df: 88, mean difference 95% CI: 4.62 (3.78, 5.45)] were significantly lower in Group NM. EtCO2, SpO2, and haemodynamic measurements were similar between the two groups.

Conclusion

Nasal mask ventilation is an effective ventilation method and can be used as an alternative to face mask ventilation in anaesthetised obese adults with BMI>25 kg/m2.

Utility of the capabilities, opportunities, motivations model for understanding changes in behavior

BACKGROUND

Wearing face coverings to prevent airborne viral transmission has at times been legally mandated, followed by periods when rules were relaxed. The present study tracks changes in face covering and the impacts on people's perceptions of their capabilities, opportunities and motivations.

METHODS

Three-wave survey. At wave 1 (25 January-6 February 2022), 10 622 UK adults reported: (a) sociodemographic characteristics; (b) face covering in work, public transport and indoor leisure settings and (c) capabilities, opportunities and motivations. Measures were repeated 1-18 March 2022 and 20 May-6 June 2022. Data were analyzed descriptively, within-participants analysis of covariance (ANCOVA) and multiple linear regression.

RESULTS

Face covering decreased over time as rules around the wearing of face coverings relaxed. Perceptions of capabilities, opportunities and motivations to wear face coverings were consistently associated with the actual wearing of face coverings, with marked decreases in motivations over time.

CONCLUSIONS

Decreases in motivations seem to explain best the reasons for declining levels of face covering. Further work is required to develop interventions to change people's motivations and promote the wearing of face coverings, should they be required in the future.

The Impact of Medical Face Masks and Rehabilitation Duration on the Performance Output and Outcomes of Cardiologic Rehabilitants

During the COVID-19 pandemic, wearing a medical face mask became mandatory in daily life and also in cardiological rehabilitation. In order to investigate whether the performance and outcomes of cardiological rehabilitation were affected by face masks, we compared data from patients who underwent rehabilitation with face masks with data from patients without face masks. In total, 114 patients from an ambulant rehabilitation center were included. Of them, 60 patients completed rehabilitation without a face mask (NFM). In contrast, 54 patients (with a face mask, WFM) completed their rehabilitation during the COVID-19 pandemic and had to wear medical face masks for the entire day and also during ergometer training or other interventions. Subgroups were formed with patients who accepted to extend rehabilitation for one week (4 WG); the other patients only completed 3-week rehabilitation (3 WG). We analyzed the performance and outcomes of all groups (NFM; WFM, 3 WG and 4 WG). At baseline, no group differences were detected. All groups significantly improved their power output and heart rate recovery, without any group differences. We conclude that face masks and also an additional rehabilitation week do not affect the exercise performance or outcomes of out-house cardiological rehabilitation.

Impact of the COVID-19 pandemic on behavioral changes in healthcare workers in Italy

Introduction

During the COVID-19 pandemic, adherence to wearing face mask and washing hands procedures and achieving high COVID-19 vaccine coverage among healthcare workers (HCWs) were essential to minimize morbidity and possible death and limit the transmission of the virus. The objectives of the cross-sectional survey were to explore the influence of COVID-19 on the use of preventive measures and vaccination willingness among HCWs in the southern part of Italy and the associated factors.

Methods

The survey was carried out from 15 June 2023 to 15 July 2023 among 521 HCWs who worked in three randomly selected public hospitals. All data were collected through a self-administered questionnaire.

Results

HCWs had a positive change in the use of preventive measures if they did not often/always use them before the pandemic, but they are using in the current epidemiologic context and they were willing to use in a future epidemic situation. A positive change in the adherence to face mask-wearing (24.6%) was more likely among those with at least 5 years of university degree, nurses/midwives, and who had worked in COVID-19 wards. A positive change in alcohol-based hand rubbing (3.1%) was more likely in HCWs in Emergency/Critical/Infectious Diseases wards compared with medical wards. HCWs who were more likely to believe that the COVID-19 vaccine should be mandatory for them (58.1%) had at least 5 years of university degree, in Emergency/Critical/Infectious Diseases wards compared with surgical and medical wards, had received more than three doses of this vaccine, were more concerned to get infected during their activity, and had received information from scientific journals. HCWs more willing to receive the COVID-19 vaccine every year (39.8%) were males, physicians, those in Emergency/Critical/Infectious Diseases wards compared with medical wards, who had received more than three doses of this vaccine, who believed that this vaccine should be mandatory for HCWs, and who needed additional information.

Discussion

The survey showed that the COVID-19 pandemic had an impact on the use of preventive measures among HCWs, not necessarily for the improvement or increase. Educational messages on the importance of these measures regarding the promotion and recommendation of the vaccine need to be investigated and applied among HCWs in order to reduce vaccination gaps and the spread of the infection.

Accuracy and Speed of Emotion Recognition With Face Masks

Wearing face masks is one of the important actions to prevent the spread of COVID-19 among people around the world. Nevertheless, social interaction is limited via masks, and this impacts the accuracy and speed of emotional perception. In the present study, we assess the impact of mask-wearing on the accuracy and speed of emotion recognition. Fifty people (female n = 39, male n = 11) aged 19-28 participated in the study (M = 21.1 years). We used frontal photos of a Kosova woman who belonged to the same participants' age group, with a grey background. Twelve different pictures were used that showed the emotional states of fear, joy, sadness, anger, neutrality, and disgust, in masked and unmasked conditions. The experiment was conducted in a controlled laboratory setting. Participants were faster for identifying emotions like joy (1.507 ms) and neutral (1.971 ms). The participants were more accurate (emotions identification) in unmasked faces (M = 85.7%) than in masked faces (M = 73.8%), F(1,98) = 20.73, MSE = 1027.66, p ≤ .001, partial η² = 0.17. Masks make confusion and reduce the accuracy and speediness of emotional detection. This may have a notable impact on social interactions among peoples.

Green Synthesized Polymeric Iodophors with Thyme as Antimicrobial Agents

Antimicrobial resistance (AMR) is a growing concern for the future of mankind. Common antibiotics fail in the treatment of microbial infections at an alarming rate. Morbidity and mortality rates increase, especially among immune-compromised populations. Medicinal plants and their essential oils, as well as iodine could be potential solutions against resistant pathogens. These natural antimicrobials abate microbial proliferation, especially in synergistic combinations. We performed a simple, one-pot synthesis to prepare our formulation with polyvinylpyrrolidone (PVP)-complexed iodine (I2), Thymus Vulgaris L. (Thyme), and Aloe Barbadensis Miller (AV). SEM/EDS, UV-vis, Raman, FTIR, and XRD analyses verified the purity, composition, and morphology of AV-PVP-Thyme-I2. We investigated the inhibitory action of the bio-formulation AV-PVP-Thyme-I2 against 10 selected reference pathogens on impregnated sterile discs, surgical sutures, cotton gauze bandages, surgical face masks, and KN95 masks. The antimicrobial properties of AV-PVP-Thyme-I2 were studied by disc diffusion methods and compared with those of the antibiotics gentamycin and nystatin. The results confirm AV-PVP-Thyme-I2 as a strong antifungal and antibacterial agent against the majority of the tested microorganisms with excellent results on cotton bandages and face masks. After storing AV-PVP-Thyme-I2 for 18 months, the inhibitory action was augmented compared to the fresh formulation. Consequently, we suggest AV-PVP-Thyme-I2 as an antimicrobial agent against wound infections and a spray-on contact killing agent.

Evaluating Droplet Survivability on Face Masks with X-ray Microtomography

When a person talks, coughs, or sneezes, respiratory droplets are expelled and inevitably land on several surfaces, representing a route for respiratory disease transmission. Here, face masks act as a barrier by obstructing the passage of droplets during exhalation and inhalation. Being constantly exposed to respiratory events and carrying droplet residue, understanding the evaporation and absorption dynamics for tiny droplets on face masks and the fate of viral particle deposition is necessary to analyze the contamination risk. We explore the ideal design for masks from the interaction of mask surfaces with surrogate respiratory droplets by X-ray microscopy and microtomography. We show that the respiratory droplet survivability is significantly reduced in masks with a hydrophilic surface where absorption takes place, leading to a reduction of the postevaporation droplet residue at the mask surface compared with a hydrophobic surface. The results allow us to propose a better mask layer design dependent on wettability, reducing the risk of contamination from respiratory droplets.

Occurrence of phthalates in facemasks used in India and its implications for human exposure

Synthetic polymers with additives are used in the manufacturing of face masks (FMs); hence, FMs could be a potential source of exposure to phthalic acid esters (PAEs). India stands second in the world in terms of the FMs usage since the beginning of Covid-19 pandemic. However, little is known about the PAEs content of FMs used in India. Some PAEs, such as DEHP and DBP are suspected endocrine disrupting chemicals (EDCs); hence, wearing FM may increase the risk of exposure to these EDCs. In this study, we collected 91 samples of FMs from eight Indian cities and analyzed for five PAEs viz. DMP, DEP, DBP, BBP, and DEHP. The PAEs contents in FMs ranged from 101.79 to 27,948.64 ng/g. The carcinogenic risk of N 95 with filter, N-95, and cloth masks was higher than the threshold levels. The findings indicate the need to control PAEs in FMs through regulatory actions.

Face Mask and Tear Film Stability: A Pilot Study of the Objective Measurement of Tear Break-Up Time

(1) Background: Mask-associated dry eye (MADE) has been associated with increased dry eye symptoms, apparently due to reduced tear break-up time (TBUT). This study aimed to determine the short-term impact of surgical face mask (FM) on tear film stability by measuring non-invasive tear break-up time (NIBUT). (2) Methods: Twenty-six healthy participants had NIBUT evaluated without FM, with surgical FM and with a surgical FM secured to the skin with adhesive tape (TFM). NIBUT-first was measured with Keratograph 5M (K5M, Oculus, Wetzlar, Germany). Each participant had NIBUT measured in four sessions on four consecutive days. Session 1: without FM vs. with FM. Session 2: with FM vs. without FM. Session 3: without FM vs. with TFM. Session 4: with TFM vs. without FM (3). The time between each measured setting was 2 min. Results: The mean ± SD NIBUT without FM was 8.9 ± 3.7, with FM 10.2 ± 4.1, and with TFM 8.4 ± 3.8 s. No significant differences were observed in NIBUT in any of the evaluated settings: without FM vs. with FM (p = 0.247), without FM vs. with TFM (p = 0.915), and with FM vs. with TFM (p = 0.11). (4) Conclusions: This study did not find a significant short-term effect of FM on NIBUT. Other variables or longer periods of exposure might trigger the symptoms and ocular surface alterations in MADE.

Facial mask for prevention of allergic rhinitis symptoms

Objectives

We reviewed the role of facial masks in preventing allergic rhinitis (AR) symptoms.

Methods

The literature survey was performed in PubMed, EBSCO, UpToDate, and Proquest Central databases of Kırıkkale University and Google and Google Scholar databases.

Results

Aeroallergens are microscopic airborne particles that trigger AR symptoms. In sensitive people, the type 1 hypersensitivity reaction against these allergens occurs when these microparticles enter the nasal mucosa via inhalation. Pollens, molds, dust mites, and animal dander are only some of the allergens suspected of contributing to AR symptoms. The treatment guidelines for AR extensively encompass allergy avoidance and environmental management as the first-line treatment. It is recommended that those who experience seasonal symptoms try to avoid their triggers whenever possible. While medical masks filter out particles larger than 3 μm, FFP2 masks are effective against particles as small as 0.004 μm. Since both mask types are effective in filtering pollen larger than 5 μm in size, they can be used to prevent pollen exposure. The "antiviral protection" provided by medical and FFP2 masks to hospital employees is roughly equivalent. Thus, both should be effective against direct local (eye) or indirect inhaled (nose, bronchial) pollen exposure. For the masks to do their job, they need to fit correctly.

Conclusion

Face mask affects AR patients' quality of life and reduces AR symptoms' severity.

Influenza Resurgence after Relaxation of Public Health and Social Measures, Hong Kong, 2023

Soon after a mask mandate was relaxed (March 1, 2023), the first post-COVID-19 influenza season in Hong Kong lasted 12 weeks. After other preventive measures were accounted for, mask wearing was associated with an estimated 25% reduction in influenza transmission. Influenza resurgence probably resulted from relaxation of mask mandates and other measures.

Effective communication between nursing professionals and patients after the implementation of mask-wearing requirements in the clinical setting: A cross-sectional study

This study aimed to evaluate staff nurses' perspectives on the use of face masks in effective communication and relationship management skills with patients in the hospital setting. The study surveyed registered nurses (RNs) who work with adult patients in different hospital units. An online survey was completed by RNs who were selected by convenience sampling. RNs' communication with patients was perceived as moderately affected by the use of face masks. Statistically significant differences were found when comparing communication with years of professional experience. Participants who had over 10 years of experience reported having greater difficulty in their communication with patients when using face masks. The effect of provider-patient relationship on effective nurse-patient face-mask communication was statistically significant and negative. This study shows that some participants found face masks used in the clinical setting may affect nurse-patient communication, as well as the nurses' ability to manage their relationships with patients. The findings of this study support the need for targeted research into effective communication strategies when face mask use is needed in the healthcare setting.

Effects of wearing an opaque or transparent face mask on the perception of facial expressions: A comparative study between Japanese school-aged children and adults

The negative side effects of mask-wearing on reading facial emotional cues have been investigated in several studies with adults post-2020. However, little is known about children. This study aimed to determine the negative influence of mask-wearing on reading emotions of adult faces by Japanese school-aged children, compared to Japanese adults. We also examined whether this negative influence could be alleviated by using a transparent face mask instead of an opaque one (surgical mask). The performance on reading emotions was measured using emotion categorization and emotion intensity rating tasks for adult faces. As per the findings, the accuracy of emotion recognition in children was impaired for various facial expressions (disgust, fear, happy, neutral, sad, and surprise faces), except for angry faces. Conversely, in adults, it was impaired for a few facial expressions. The perceived intensity for happy faces with a surgical mask was weaker in both children and adults than in those without the mask. A negative influence of wearing surgical masks was generally not observed for faces wearing a transparent mask in both children and adults. Thus, negative side effects of mask-wearing on reading emotions are observed for more facial expressions in children than in adults; transparent masks can help remedy these.

Recognition of masked and unmasked facial expressions in males and females and relations with mental wellness

Background

While the effects of mask wearing/facial occlusion are known to impair facial expression recognition, little is known about the role of mental wellness on facial expression recognition, as well as the influence of sex on misattribution errors (i.e., confusions between emotions). In this large study, we aimed to address the relation between facial expression recognition and loneliness, perceived stress, anxiety, and depression symptoms in male and female adults.

Methods

We assessed the influence of mask-wearing on facial expression recognition [i.e., accuracy and response time (RT)] via an online study in N = 469 adult males and females across Canada.

Results

Expectedly, recognition was impaired under masked conditions (i.e., lower accuracy, longer RTs, more misattribution errors). Females were faster and more accurate than males, with less misattribution errors. A novel finding was that people with higher perceived stress were less accurate at identifying masked fearful faces. Perceived stress influenced the relation between sex and RT to masked happy faces; males with high stress scores were slower to recognize masked happy faces, the opposite was true for females. Finally, this study was among the first to show that higher loneliness predicted shorter RT to unmasked faces.

Impact

Our results show that facial expression recognition is impaired by mask-wearing, and that sex and mental health features are important predictors of performance. Such insight could be detrimental in certain sectors of the population (e.g., health care or education), and inform policies being adopted in future pandemics.

Face processing and early event-related potentials: replications and novel findings

This research explores early Event-Related Potentials (ERPs) sensitivity to facial stimuli, investigating various facial features aimed to unveil underlying neural mechanisms. Two experiments, each involving 15 undergraduate students, utilized a multidimensional stimulus set incorporating race, gender, age, emotional expression, face masks, and stimulus orientation. Findings highlight significant modulations in N170 and P200 amplitudes and latencies for specific attributes, replicating prior research and revealing novel insights. Notably, age-related facial feature variations, facial inversion, and the presence of face masks significantly impact neural responses. Several speculative explanations are proposed to elucidate these results: First, the findings lend support to the idea that the increased N170 amplitude observed with facial inversion is closely tied to the activation of object-sensitive neurons. This is further bolstered by a similar amplitude increase noted when masks (effective objects) are added to faces. Second, the absence of an additional amplitude increase, when inverting face images with face masks suggests that neural populations may have reached a saturation point, limiting further enhancement. Third, the study reveals that the latency deficit in N170 induced by facial inversion is even more pronounced in the subsequent ERP component, the P200, indicating that face inversion may impact multiple stages of face processing. Lastly, the significant increase in P200 amplitude, typically associated with face typicality, for masked faces in this study aligns with previous research that demonstrated elevated P200 amplitudes for scrambled faces. This suggests that obscured faces may be processed as typical, potentially representing a default state in face processing.

Study of Face Mask-associated Dry Eye among Medical Students

Purpose

The purpose of this study was to evaluate face mask-associated factors causing dry eye among medical students.

Methodology

This was a cross-sectional study conducted on undergraduate medical and dental students, of all phases, while they were attending offline classes and were required to wear face masks in accordance with the government regulations. Sociodemographic data, ocular and medical history, face mask-wearing practices, screen usage, and quantification of symptoms using the modified Ocular Surface Disease Index (OSDI) questionnaire were collected. Objective tests were conducted in students having dry eye. The association of quantitative variables was done using ANOVA, Mann-Whitney, and Kruskal-Wallis test, whereas the Chi-square test was done for qualitative variables. Multivariate logistic regression was used to identify the risk factors for varying severity of dry eye.

Results

The mean age of the 410 students was 21 ± 1.6 years. According to the OSDI, 39.51% (162/410) of students had dry eyes, 23.41% (96/410) had mild dry eye, 8.78% (36/410) had moderate dry eye, and 7.32% (30/410) had severe dry eye. Face mask-associated factors which were significantly linked to dry eye were N95 masks, loose-fit masks, and 6-8 h of continuous mask use. The Schirmer's test and tear film break-up time were performed on 29 and 20 students, respectively, mean values being 19.25 ± 5.29 mm and 10.15 ± 1.41 s for nonsevere and 6.53 ± 1.55 mm and 5.3 ± 0.98 s for severe dry eye, respectively.

Conclusion

It is important to educate medical students and create awareness regarding "face mask-appropriate behavior" to reduce the chances of dry eye secondary to face masks use.

Effects of face masks on fairness in on-site personnel selection during a pandemic

Introduction

Despite significant challenges, personnel selection procedures had to continue as on-site testing in the Covid-19 pandemic. Health and safety measures and specifically the use of face masks threaten to limit the fairness of cognitive testing and behavioral observation in the assessment center.

Methods

In this study, we compare the performance and pass rates of pilot selection under three different conditions in the selection campaigns of 2019 (pre-pandemic), 2020 (health and safety measures without mask), and 2021 (health and safety measures with mask).

Results

Mask wearing and other health and safety measures had no influence on the objective parameters of pilot selection. However, for some of the areas of competence in the assessment center subjective observability was rated lower for the condition with face masks.

Discussion

We conclude that the fairness and precision of selection processes are not compromised by wearing face masks and that a high degree of standardization in diagnostic instruments prevents a partially reduced subjective observability from affecting the selection's outcome.

Mask wearing provides psychological ease but does not affect facial expression intensity estimation

During the COVID-19 pandemic, wearing a face mask became a global daily practice. Japanese people were already accustomed to wearing masks due to their collectivistic culture, which prioritizes conformity and group harmony. In such a culture, where individuals are concerned about how others perceive them and their actions, wearing masks can be a self-protective action to prevent, escape, or reduce the severity of perceived negative feelings. Previous studies indicate that people experiencing anxiety tend to have negative biases when evaluating emotional expressions on faces. Therefore, we hypothesized that wearing a mask can reduce the negative feelings caused by social pressure, emotion processing, especially intensity perception. While our findings confirmed that wearing a mask reduced negative feelings caused by social pressure, there was no significant change in emotion intensity recognition performance. This null result might be attributed to the small effect size of the association between negative bias in emotion processing and an individual's state. In future studies, it would be valuable to include participants from non-collectivistic cultures to gain a broader understanding of the impact of wearing masks on emotion processing.

The sci-commodity sensibilities of performative Covid-19 face masking

This article explores how extravagantly visible mask-wearing relates with consumer culture. Methodologically, three purposively chosen case studies of spectacular or performative mask-wearing are used to show what the face mask can teach us about consumer culture in a pandemic. First, a Daily Mail (UK) article in which an 'elderly shopper' is shamed for wearing a sanitary towel as a face mask is used to explore the politics of disposable commodities. Second, the multiplying portraits of people wearing masks archived under Instagram's #MaskSelfie hashtag allows an examination of how consumer-citizenship is performed. Third, the presence of extremely expensive luxury designer masks, as evidenced by Rich Mnisi's Swarovski-encrusted offering, is a base for considering how virtue signalling has become a platform for luxury branding. Building on these three examples, the argument is made that waste, selfies and luxury are modalities for a pandemic commodity politics that is layered over and into the scientific citizenship signalled by the wearing of face masks. Together these create what I call a 'sci-commodity' sensibility, in which the face mask as a technology has become integrated with the modalities of consumption. This has resonance with ongoing debates about the object, subject and brand in consumer culture.

Transnasal Humidified Rapid-Insufflation Ventilatory Exchange Versus Conventional Facemask Breathing for Preoxygenation During Rapid Sequence Induction

INTRODUCTION

Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE), if used for pre-oxygenation and apnoeic oxygenation, has the propensity to extend the safe apnoea time and thereby decrease the incidence of desaturation during rapid sequence induction (RSI) for emergency surgeries. Hence, we proposed to evaluate the comparative efficacy of pre-oxygenation with the use of conventional facemask breathing versus THRIVE during RSI in patients undergoing general anaesthesia (GA) for emergency surgeries.

MATERIALS AND METHODS

Eighty patients undergoing RSI under GA for emergency abdominopelvic surgery were divided randomly into two groups. Patients were preoxygenated for three minutes with 100% oxygen via either a high-flow nasal cannula at a flow of 60 L/minute using THRIVE or a tightly-held, snuggly-fitting facemask at a flow of 12L/minute using a circle system. RSI was administered followed by laryngoscopy and endotracheal intubation. Arterial partial pressure of oxygen (PaO2) measured immediately after successful endotracheal intubation was our primary outcome. The lowest peripheral oxygen saturation (SpO2), apnoea time, number of attempts at laryngoscopy, use of any rescue manoeuvres, and any adverse event were also recorded. Data thus collected were statistically analysed.

RESULTS

No statistically significant difference in PaO2 value was observed after successful intubation, lowest SpO2, apnoea time, number of attempts at laryngoscopy, use of any rescue manoeuvres, and adverse event between both the groups (p>0.05).

CONCLUSION

We conclude that though not superior to conventional facemasks, THRIVE is a safe, practicable, and efficient pre-oxygenation tool during RSI of GA for patients undergoing emergency surgeries.

The Influence of COVID-19 in Endocrine Research: Critical Overview, Methodological Implications and a Guideline for Future Designs

The COVID-19 pandemic has changed many aspects of people's lives, including not only individual social behavior, healthcare procedures, and altered physiological and pathophysiological responses. As a result, some medical studies may be influenced by one or more hidden factors brought about by the COVID-19 pandemic. Using the literature review method, we are briefly discussing the studies that are confounded by COVID-19 and facemask-induced partiality and how these factors can be further complicated with other confounding variables. Facemask wearing has been reported to produce partiality in studies of ophthalmology (particularly dry eye and related ocular diseases), sleep studies, cognitive studies (such as emotion-recognition accuracy research, etc.), and gender-influenced studies, to mention a few. There is a possibility that some other COVID-19 related influences remain unrecognized in medical research. To account for heterogeneity, current and future studies need to consider the severity of the initial illness (such as diabetes, other endocrine disorders), and COVID-19 infection, the timing of analysis, or the presence of a control group. Face mask-induced influences may confound the results of diabetes studies in many ways.

Impact of mandatory masking amid the COVID-19 pandemic on outdoor smoking: an interrupted time-series analysis of a 33-month unobtrusive observational study

Background

Mask-wearing in outdoor public places in Hong Kong was mandated on 29 July 2020, amid the COVID-19 pandemic. We aimed to evaluate the impact of mandatory masking with no exemption for smoking on outdoor smoking.

Methods

We conducted 253 unobtrusive observations at 10 outdoor smoking hotspots in 33 months from July 2019 to March 2022 and counted smokers and non-smoking pedestrians in fixed boundaries. We conducted interrupted time-series analyses on the monthly mean volume of smokers (persons per hour) using generalized linear models. The independent variables were as follows: time since the first observation, implementation of the mask regulation, time since the regulation, seasonality, and waves 1-5 outbreaks. We checked the robustness of the association using the daily mean volume of smokers as the dependent variable. Two sensitivity analyses were conducted to include the hotspot location or the number of all pedestrians as an offset.

Results

Monthly outdoor smoking decreased immediately after the regulation (incidence rate ratio [IRR]: 0.505, 95% confidence interval [CI]: 0.374 to 0.680, P < 0.001). Daily smoking analysis and the two sensitivity analyses supported the results. However, monthly outdoor smoking increased by 11% since the regulation (IRR: 1.110, 95% CI: 1.074 to 1.147, P < 0.001). An exception was observed at the most severe wave 5 outbreak when monthly outdoor smoking decreased (IRR: 0.415, 95% CI: 0.327 to 0.525, P < 0.001).

Conclusion

Outdoor smoking fell immediately after mandatory masking, rebounded to pre-pandemic levels, and decreased again at the most severe wave 5.

How does the continued use of the mask affect the craniofacial region? A cross-sectional study

OBJECTIVE

The aim was to compare the effects between pre-pandemic mask-free living versus pandemic-related continuous mask use.

METHODS

A retrospective study was carried out. This study was conducted with 542 face mask users. Assessments included presence, frequency and impact of headache, temporomandibular disorders, and quality of life (QoL).

RESULTS

Continuous mask use had a large main effect on headache, temporomandibular pain, and QoL (p < .0001; d = 1.25), but this effect was nuanced by mask type. Participants who declared suffering from headache increased by 84% with cloth masks, and by 25% with FFP2 masks. Temporomandibular pain increased by 50% and by 39% when wearing surgical masks and FFP2, respectively (p < .06; d = .19). The mask type did not nuance the effect on headache impact (p > .05; d = .06). QoL decreased regardless of mask type (p < .05; d = .21), the decrease being 38% for surgical masks, and 31% for either cloth or FFP2 masks.

CONCLUSIONS

Continuous mask use, regardless of type, increased existence of headache, headache impact, temporomandibular pain, and reduced QoL.

Hidden faces, altered perceptions: the impact of face masks on interpersonal perception

The pandemic has made wearing masks commonplace, prompting researchers to investigate their effects on interpersonal perception. Findings indicate masks obstruct face identification and expression recognition, with lower face cues being most affected. When judging attractiveness, masks can enhance the appeal of less attractive faces, but reduce the appeal of more attractive faces. Trust and speech perception outcomes are inconclusive. Future studies could focus on individual differences in how masks influence our perception of others.

A pilot study evaluating the anti-aging benefits of a CO2 -emitting facial mask

BACKGROUND

Since 1936, injectable carboxytherapy has been used for the treatment of circulatory issues and lack of tissue trophism. In the last 25 years, it has been applied to aesthetic issues, especially those related to the signs and symptoms of skin aging. Presently, carboxytherapy is available as a combination of transcutaneous gels that produce CO₂ with benefit for atrophic skin.

OBJECTIVE

The objective of this study was to investigate the efficacy and safety of a topical carboxy mask on facial photoaging after short term use of 4 weeks and long term use of 10 weeks.

METHODS

The short term study was conducted for 14 days after 3 times weekly application of the facial mask for 1 h followed by a regression phase with evaluations at days 21 and 28. 11 healthy female subjects age 45-75 years were enrolled. Subjects applied the facial mask for 45 min, 3 times per week during the 2-week treatment period. The long term study was conducted for 10 weeks on 35 subjects 35-65 years with mild to moderate facial photoaging of Fitzpatrick skin types I-VI. Subjects underwent photography, elasticity, hydration, and VAS questionnaire assessments.

RESULTS

The short term 4 week study demonstrated improvement in laser-Doppler measured blood flow and skin hydration. The long term 10 week study demonstrated improvement in firmness (16%, p = 0.001), sagging (9%, p = 0.023), and overall skin appearance (12%, p = 0.002). These findings were supported by the retraction time decrease at week 10 (-10%, p = 0.05).

SUMMARY

The combination of two gels produced the liberation of CO₂ , which improved short term skin hydration after 4 weeks of use and improved longer term skin elasticity after 10 weeks of use.

Public interest in different types of masks and its relationship with pandemic and policy measures during the COVID-19 pandemic: a study using Google Trends data

Google Trends data have been used to investigate various themes on online information seeking. It was unclear if the population from different parts of the world shared the same amount of attention to different mask types during the COVID-19 pandemic. This study aimed to reveal which types of masks were frequently searched by the public in different countries, and evaluated if public attention to masks could be related to mandatory policy, stringency of the policy, and transmission rate of COVID-19. By referring to an open dataset hosted at the online database Our World in Data, the 10 countries with the highest total number of COVID-19 cases as of 9th of February 2022 were identified. For each of these countries, the weekly new cases per million population, reproduction rate (of COVID-19), stringency index, and face covering policy score were computed from the raw daily data. Google Trends were queried to extract the relative search volume (RSV) for different types of masks from each of these countries. Results found that Google searches for N95 masks were predominant in India, whereas surgical masks were predominant in Russia, FFP2 masks were predominant in Spain, and cloth masks were predominant in both France and United Kingdom. The United States, Brazil, Germany, and Turkey had two predominant types of mask. The online searching behavior for masks markedly varied across countries. For most of the surveyed countries, the online searching for masks peaked during the first wave of COVID-19 pandemic before the government implemented mandatory mask wearing. The search for masks positively correlated with the government response stringency index but not with the COVID-19 reproduction rate or the new cases per million.

The influence of the type of face mask used by healthcare providers during the SARS-CoV-2 pandemic on the report of pain: a cross-sectional study in a pediatric emergency department

Background

During 4 months of the severe acute respiratory coronavirus 2 (SARS-CoV-2) pandemic, nurses in a pediatric emergency department (ED) used surgical and clear face masks in triage. This study aimed to find out if the type of face mask influenced children's reports of pain.

Methods

A retrospective cross-sectional analysis of the pain scores of all patients aged 3-15 years who visited the ED during the 4-month period was performed. Multivariate regression was used to control for the potential confounders of demographics, diagnosis (medical, trauma), nurse experience, ED time of arrival, and triage acuity level. Self-reports of pain ≥1/10 and pain ≥4/10 were the dependent variables.

Results

Overall, 3,069 children attended the ED during the study period. Triage nurses wore surgical and clear face masks in 2,337 and 732 nurse-patient encounters, respectively. The two types of face masks were used in similar proportions of nurse-patient encounters. Compared with the clear face mask, wearing a surgical face mask was associated with a lower likelihood of reporting pain ≥1/10, and a lower likelihood of reporting pain ≥4/10; [adjusted odds ratio (aOR) =0.68; 95% confidence interval (CI): 0.56-0.82], and (aOR =0.71; 95% CI: 0.58-0.86), respectively.

Conclusions

The findings suggest that the type of face mask used by the nurse influenced the report of pain. This study provides preliminary evidence that covered face masks worn by healthcare providers might have a negative impact on the child's report of pain.

Face mask use during the COVID-19 pandemic was associated with breathing difficulties in adolescent patients with asthma

AIM

Face masks have been used to prevent severe acute respiratory syndrome coronavirus 2 transmission. We investigated the impact of face mask use on paediatric patients with asthma.

METHODS

Between February 2021 and January 2022, we surveyed adolescents aged 10-17 attending the paediatric outpatient clinic at the Lillebaelt Hospital, Kolding, Denmark with asthma, other breathing problems or no breathing problems.

RESULTS

We recruited 408 participants (53.4% girls) with a median age of 14 years: 312 in the asthma group, 37 in the other breathing problems group and 59 in the no breathing problems group. Most participants experienced mask-related breathing impairment. The relative risk (RR) of experiencing severe breathing problems, compared to no problems, was more than four times as high for adolescents with asthma (RR 4.6, 95% CI 1.3-16.8, p=0.02) than adolescents with no breathing problems. More than a third (35.9%) of the asthma group experienced mild asthma and 3.9% had severe asthma. Girls experienced more mild (RR 1.9, 95% CI 1.2-3.1, p<0.01) and severe (RR 6.6, 95% CI 3.1-13.8, p< 0.01) symptoms than boys. Age had no effect. Adequate asthma control minimised negative effects.

CONCLUSION

Face masks caused significant breathing impairment in most adolescents, particularly in those with asthma.

Cerium Oxide Nanoparticles/Polyacrylonitrile Nanofibers as Impervious Barrier against Viral Infections

BACKGROUND

Using face masks is one of the protective measures to reduce the transmission rate of coronavirus. Its massive spread necessitates developing safe and effective antiviral masks (filters) applying nanotechnology.

METHODS

Novel electrospun composites were fabricated by incorporating cerium oxide nanoparticles (CeO2 NPs) into polyacrylonitrile (PAN) electrospun nanofibers that can be used in the future in face masks. The effects of the polymer concentration, applied voltage, and feeding rate during the electrospinning were studied. The electrospun nanofibers were characterized using SEM, XRD, FTIR, and tensile strength testing. The cytotoxic effect of the nanofibers was evaluated in the Vero cell line using the MTT colorimetric assay, and the antiviral activity of the proposed nanofibers was evaluated against the human adenovirus type 5 (ADV-5) respiratory virus.

RESULTS

The optimum formulation was fabricated with a PAN concentration of 8%, w/v loaded with 0.25%, w/v CeO2 NPs with a feeding rate of 26 KV and an applied voltage of 0.5 mL/h. They showed a particle size of 15.8 ± 1.91 nm and a zeta potential of -14 ± 0.141 mV. SEM imaging demonstrated the nanoscale features of the nanofibers even after incorporating CeO2 NPs. The cellular viability study showed the safety of the PAN nanofibers. Incorporating CeO2 NPs into these fibers further increased their cellular viability. Moreover, the assembled filter could prevent viral entry into the host cells as well as prevent their replication inside the cells via adsorption and virucidal antiviral mechanisms.

CONCLUSIONS

The developed cerium oxide nanoparticles/polyacrylonitrile nanofibers can be considered a promising antiviral filter that can be used to halt virus spread.

Unmasking a New Type of Gastrointestinal Foreign Body in the COVID-19 Era

The incidence of foreign body ingestion has increased during the coronavirus disease 2019 pandemic. As face masks became increasingly available, we report a case of accidental ingestion of the metal strip insert of a surgical mask. After initially progressing, its progress halted after 24 hours. This case highlights the challenges of timing the endoscopic removal of long objects, especially considering the reduced endoscopic availability during the pandemic. Despite only causing local trauma, the strip was impacted at the duodenojejunal flexure with the potential to cause obstruction. Limiting morbidity relies on urgent removal and prevention of similar ingestions by emphasizing the safe use and storage of masks.

Compliance with face mask use during the COVID-19 pandemic: a community observational study in Singapore

Introduction

Widespread mask use is an important intervention for control of the coronavirus disease 2019 pandemic. However, data on the factors affecting mask use are lacking. In this observational study, we evaluated the proportion of and factors influencing face mask use and related hygiene practices.

Methods

We observed randomly selected members from the public in 367 venues across Singapore, and recorded the proportion of individuals with full compliance with mask use and mask hygiene (hand hygiene before and after touching the mask or face). Logistic regression analyses were used to determine variables associated with mask and hand hygiene compliance.

Results

We made 3,821 observations - 2,149 (56.2%) females, 3,569 (93.4%) adults (≥21 years), 212 (5.5%) children (6-20 years) and 40 (1.0%) children (2-5 years). The overall full compliance rate (correct mask use), poor compliance rate (incorrect mask use) and absent mask use were 84.5%, 12.9% and 2.6%, respectively. The factors - male gender, fabric mask usage and crowded indoor venues - were associated with lower mask compliance. Face or mask touching behaviour was observed in 10.7% and 13.7% of individuals observed, respectively. Only one individual performed hand hygiene before and after touching the mask.

Conclusion

The rate of mask compliance was high, probably due to legislation mandating mask usage. However, specific factors and crowded indoor venues associated with lower mask compliance were identified. We also noted an issue with the absence of hand hygiene before and after face or mask touching. These issues may benefit from targeted public health messaging.

Adsorption Studies on the Removal of Anionic and Cationic Dyes from Aqueous Solutions Using Discarded Masks and Lignin

The carbon materials derived from discarded masks and lignin are used as adsorbent to remove two types of reactive dyes present in textile wastewater: anionic and cationic. This paper introduces the results of batch experiments where Congo red (CR) and Malachite green (MG) are removed from wastewater onto the carbon material. The relationship between adsorption time, initial concentration, temperature and pH value of reactive dyes was investigated by batch experiments. It is discovered that pH 5.0-7.0 leads to the maximum effectiveness of CR and MG removal. The equilibrium adsorption capacities of CR and MG are found to be 232.02 and 352.11 mg/g, respectively. The adsorption processes of CR and MG are consistent with the Freundlich and Langmuir adsorption models, respectively. The thermodynamic processing of the adsorption data reveals the exothermic properties of the adsorption of both dyes. The results show that the dye uptake processes follow secondary kinetics. The primary adsorption mechanisms of MG and CR dyes on sulfonated discarded masks and alkaline lignin (DMAL) include pore filling, electrostatic attraction, π-π interactions and the synergistic interactions between the sulphate and the dyes. The synthesized DMAL with high adsorption efficiency is promising as an effective recyclable adsorbent for adsorbing dyes, especially MG dyes, from wastewater.

Face mask correlation with allergic rhinitis symptoms severity during COVID-19 pandemic: A cross-sectional study

Background

Face mask is the first line to protect the respiratory mucosa from the coronavirus particles in aerocells and droplets and without this, the exposure of the mucosa to the virus and allergens trigger the immune and inflammatory system. These lead to Allergic Rhinitis (AR) symptoms or virus infection.

Aim

This study discusses about the effects of face mask on the severity of AR symptoms using the Sino-Nasal Outcome Test (SNOT-22) in AR cases during the Corona Virus Disease 2019 (COVID-19) pandemic.

Method

In this cross-sectional study, 54 cases previously diagnosed as moderate and severe AR based on Allergic Rhinitis and its Impact on Asthma and Visual Analog Scale score referred to the tertiary allergy clinic were involved, while 5 of them were excluded. AR symptoms before and during the pandemic were compared based on the SNOT-22 questionnaire. Demographics, AR severity, and comorbidities were registered.

Results

The mean age was 31.4 ± 13.5 years with the male-female ratio of 1.4. The mean SNOT-22 score was 36.1 ± 20.3 before and 29.5 ± 16.8 during the pandemic. Although 36.7% (n: 18) of all participants had severe symptoms before the pandemic, 10.2% (n: 5) had severe AR symptoms during the pandemic. 53.0% (n: 26) of patients had moderate AR symptoms, and 36.7% (n: 18) had mild AR symptoms in the pandemic. There was no significant difference between each paired subgroup in AR symptom changes but the symptom improvement was significant in most of the subgroups when compared to the pre-pandemic period. Smoking had an adverse effect on AR symptoms (p: 0.034).

Conclusion

Face mask affects the quality of life in AR patients and improves the severity of AR symptoms during COVID-19 pandemic. Smoking worsens this severity. Age, gender, pet ownership, underlying conditions, and previous COVID-19 infection were not associated with AR symptoms severity and alteration in the AR individuals' quality of life during the COVID-19 pandemic.

Masking the truth: the impact of face masks on deception detection

Because of the pandemic, face masks have become ubiquitous in social interactions, but it remains unclear how face masks influence the ability to discriminate between truthful and deceptive statements. The current study manipulated the presence of face masks, statement veracity, statement valence (positive or negative), and whether the statements had been practiced or not. Despite participants' expectations, face masks generally did not impair detection accuracy. However, participants were more accurate when judging negatively valenced statements when the speaker was not wearing a face mask. Participants were also more likely to believe positively rather than negatively valenced statements.

All-Fabric Triboelectric Nanogenerator (AF-TENG) Smart Face Mask: Remote Long-Rate Breathing Monitoring and Apnea Alarm

Since the beginning of the COVID-19 pandemic, the use of face masks has become not only mandatory in several countries but also an acceptable approach for combating the pandemic. In the quest for designing an effective and useful face mask, triboelectric nanogenerators (TENGs) have been recently proposed. Novel functionalities are provided with the use of TENGs in face masks due to the induced triboelectrification generated by the exhaled and inhaled breath, allowing their use as an energy sensor. Nonetheless, within the face mask, the presence of nontextile plastics or other common triboelectric (TE) materials can be undesired. Herein, we propose the use of an all-fabric TENG (AF-TENG) with the use of high molecular weight polyethylene (UHMWPE) and cotton fabric as negative and positive triboelectric layers, respectively. With these materials, it is possible to detect the breathing of the patient, which in the case of not detecting a signal over a few minutes can trigger an alarm locally, providing valuable time. Also, in this article, we have sent breathing signals locally and remotely to distances up to 20 km via Wi-Fi and LoRa, the same as warning signals in the case of detecting anomalies. This work reveals the use of TENGs in smart face masks as an important tool to be used in difficult epidemiological periods to the general public, bringing much more comfort and relaxation to patients and elderly in today's society, and based on pristine eco-friendly materials.

Facilitators and barriers of preventive behaviors against COVID-19 during Ramadan: A phenomenology of Indonesian adults

Introduction

Intercity mobility restriction, physical distancing, and mask-wearing are preventive behaviors to reduce the transmission of COVID-19. However, strong cultural and religious traditions become particular challenges in Indonesia. This study uses the Behavior Change Wheel to explore barriers and facilitators for intercity mobility restriction, physical distancing, and mask-wearing during Ramadan.

Methods

Semi-structured in-depth interviews with 50 Indonesian adults were conducted between 10 April and 4 June 2020. Having mapped codes into the Capacity, Opportunity, Motivation - Behavior (COM-B), and Theoretical Domain Framework (TDF) model, we conducted summative content analysis to analyze the most identified factors to preventive behaviors and proposed interventions to address those factors.

Results

Belief about the consequence of preventive behaviors was the most mentioned facilitator to all preventive behaviors among compliers. However, optimism as a TDF factor was commonly mentioned as a barrier to preventive behaviors among non-compliers, while environmental context and resources were the most commonly mentioned factors for intercity mobility restriction.

Conclusions

Public health intervention should be implemented considering the persuasion and involvement of religious and local leaders. Concerning job and economic context, policy related to the intercity mobility restriction should be reconsidered to prevent a counterproductive effect.

Spatiotemporal Trends in Self-Reported Mask-Wearing Behavior in the United States: Analysis of a Large Cross-sectional Survey

BACKGROUND

Face mask wearing has been identified as an effective strategy to prevent the transmission of SARS-CoV-2, yet mask mandates were never imposed nationally in the United States. This decision resulted in a patchwork of local policies and varying compliance, potentially generating heterogeneities in the local trajectories of COVID-19 in the United States. Although numerous studies have investigated the patterns and predictors of masking behavior nationally, most suffer from survey biases and none have been able to characterize mask wearing at fine spatial scales across the United States through different phases of the pandemic.

OBJECTIVE

Urgently needed is a debiased spatiotemporal characterization of mask-wearing behavior in the United States. This information is critical to further assess the effectiveness of masking, evaluate the drivers of transmission at different time points during the pandemic, and guide future public health decisions through, for example, forecasting disease surges.

METHODS

We analyzed spatiotemporal masking patterns in over 8 million behavioral survey responses from across the United States, starting in September 2020 through May 2021. We adjusted for sample size and representation using binomial regression models and survey raking, respectively, to produce county-level monthly estimates of masking behavior. We additionally debiased self-reported masking estimates using bias measures derived by comparing vaccination data from the same survey to official records at the county level. Lastly, we evaluated whether individuals' perceptions of their social environment can serve as a less biased form of behavioral surveillance than self-reported data.

RESULTS

We found that county-level masking behavior was spatially heterogeneous along an urban-rural gradient, with mask wearing peaking in winter 2021 and declining sharply through May 2021. Our results identified regions where targeted public health efforts could have been most effective and suggest that individuals' frequency of mask wearing may be influenced by national guidance and disease prevalence. We validated our bias correction approach by comparing debiased self-reported mask-wearing estimates with community-reported estimates, after addressing issues of a small sample size and representation. Self-reported behavior estimates were especially prone to social desirability and nonresponse biases, and our findings demonstrated that these biases can be reduced if individuals are asked to report on community rather than self behaviors.

CONCLUSIONS

Our work highlights the importance of characterizing public health behaviors at fine spatiotemporal scales to capture heterogeneities that may drive outbreak trajectories. Our findings also emphasize the need for a standardized approach to incorporating behavioral big data into public health response efforts. Even large surveys are prone to bias; thus, we advocate for a social sensing approach to behavioral surveillance to enable more accurate estimates of health behaviors. Finally, we invite the public health and behavioral research communities to use our publicly available estimates to consider how bias-corrected behavioral estimates may improve our understanding of protective behaviors during crises and their impact on disease dynamics.

A Comparison of the Effect of Facemasks on Perceived Breathability and Air Quality during Daily Activities and Indoor Exercises

Transmission of COVID-19 occurs predominantly through respired droplets and aerosols containing the SARS-CoV-2 virus. As a solution, face masks have been used to protect against infection. Wearing face masks during indoor exercises is essential to prevent the spread of virus-containing respiratory droplets and aerosols. However, previous studies have not investigated all elements, including the users' perceived breathability (PB) and perceived air quality (PAQ) when wearing a face mask during indoor exercises. The current study aimed to assess users' perceived comfort (PC) of face masks based on assessment criteria of PB and PAQ during moderate to vigorous exercises, and compare them with those during normal daily activities. Data on PC, PB, and PAQ were collected from an online questionnaire survey from 104 participants doing regular moderate to vigorous exercises. Within-subjects comparison with self-controlled case series design was performed to compare PC, PB, and PAQ between wearing face masks during exercises and daily activities. Results showed that the degree of dissatisfaction with PC, PB, and PAQ while wearing face masks and performing indoor exercises is higher than when performing daily activities (p < 0.05). The significance of the study implies that masks comfortable for daily activities may not remain the same during moderate to vigorous exercises, especially during indoor exercises.

Current status of active cooling, deep body temperature measurement, and face mask wearing in heat stroke and heat exhaustion patients in Japan: a nationwide observational study based on the Heatstroke STUDY 2020 and 2021

Aim

The study aimed to determine the current status of face mask use, deep body temperature measurement, and active cooling in patients suffering from heat stroke and heat exhaustion in Japan.

Methods

This was a prospective, observational, multicenter study using data from the Heatstroke STUDY 2020-2021, a nationwide periodical registry of heat stroke and heat exhaustion patients. Based on the Bouchama heatstroke criteria, we classified the patients into two groups: severe and mild-to-moderate. We compared the outcomes between the two groups and reclassified them into two subgroups according to the severity of the illness, deep body temperature measurements, and face mask use. Cramer's V was used to determine the effect sizes for a comparison between groups.

Results

Almost all patients in this study were categorized as having degree III based on the Japanese Association for Acute Medicine heatstroke criteria (JAAM-HS). However, the severe group was significantly worse than the mild-to-moderate group in outcomes like in-hospital death and modified Rankin Scale scores, when discharged. Heat strokes had significantly higher rates of active cooling and lower mortality rates than heat stroke-like illnesses. Patients using face masks often use them during labor, sports, and other exertions, had less severe conditions, and were less likely to be young male individuals.

Conclusions

It is suggested that severe cases require a more detailed classification of degree III in the JAAM-HS criteria, and not measuring deep body temperature could have been a factor in the nonperformance of active cooling and worse outcomes.

Microbiological Profile of Infectious Keratitis During Covid-19 Pandemic

Purpose

The Covid-19 pandemic introduced significant changes in our daily life, including the widespread use of face masks. The purpose of this study was to assess if significant changes occurred in the microbiological profile of infectious keratitis.

Patients and Methods

A retrospective study was performed, based on a survey review of the electronic medical records of all patients with presumed infectious keratitis, between March 2020 and October 2021. The microbiological isolates in this sample (pandemic group) were compared with those obtained in our center between 2009 and 2018 (pre-pandemic group).

Results

A total of 194 samples were included in the pandemic group. We obtained a culture-positivity rate of 43.3%, which was significantly higher when compared with the pre-pandemic data (35.15%, p = 0.033). Several further significant differences were found between the pandemic and the pre-pandemic groups: the proportion of bacteria, including gram-positive and gram-negative groups, was higher in our sample (pre-pandemic vs pandemic: 76.78% vs 83.33%, p = 0.010; 53.35% vs 60.71%, p = 0.016; 23.43% vs 34.52%, p = 0.005, respectively); two populations of Gram-positive bacteria found in this study were not isolated in the pre-pandemic sample - Dolosigranulum pigrum and Propionibacterium spp.; and two bacterial isolates were significantly increased in our sample - Corynebacterium spp. (18.41% vs 29.76%, p = 0.003) and Pseudomonas aeruginosa (9.00% vs 16.66%, p = 0.012).

Conclusion

In conclusion, significant changes were found in the microbiological profile of infectious keratitis in our center during the Covid-19 pandemic. While these changes could be related to face mask use, more observational and experimental studies are needed to explore this possible association.

Identifying targets for interventions to support public use of face coverings

OBJECTIVES

Interventions to promote the wearing of face coverings if required in the future can only be developed if we know why people do or do not wear them. Study aims were, therefore, to assess public adherence to wearing face coverings to reduce transmission of SARS-CoV-2 and to gauge why people were or were not wearing face coverings in work, public transport, and indoor leisure settings.

DESIGN

Cross-sectional survey.

METHODS

10,622 adults (25 January-6 February 2022) who were representative of the UK population were asked about their (a) wearing of face coverings in work, public transport, and leisure settings; (b) sociodemographic characteristics; and (c) perceptions of capabilities, opportunities, and motivations ("COM-B"). Data were analysed descriptively, using within-participants ANOVA and multiple linear regression.

RESULTS

Participants reported mostly wearing face coverings in public transport settings (>80%), but substantially less in work (<50%) and leisure (<30%) contexts. Perceptions of capabilities, opportunities, and motivations to wear face coverings were consistently associated with the actual wearing of face coverings across the three settings, but there were marked deficits in automatic motivation and social opportunity. People living in England, describing themselves as White, and men were least likely to wear face coverings.

CONCLUSIONS

Interventions targeted at men, people living in England, and those describing themselves as White that focus on increasing capabilities, providing greater opportunities and boosting motivations are suggested to promote the wearing of face coverings, with particular focus on addressing automatic motivation and social opportunity.

The effect of risk perception, mask use, and social distance behavior on perceived stress in the COVID-19 process: A sectional study

PURPOSE

This study was carried out to determine the effect of high school students' perception of risk of COVID-19, wearing masks and social distance behavior on stress during the COVID-19 pandemic.

METHOD

This descriptive study was performed on 1034 participants between the ages of 15 and 18 between June 21 and July 2, 2021. "Descriptive Questionnaire," "COVID-19 Risk Perception Form," "Mask Wear Behavior Form," "Social Distance Behavior Form," and "Perceived Stress Scale" were used in data collection.

RESULTS

It was determined that 81.4% of the students used disposable medical masks, and 50.6% of them used the mask they wore for one day. In the characteristics of the risk perception of COVID-19, 31% have a risk perception, 45% are afraid to contact people returning from abroad, 58.8% avoid going to crowded places, 66.8% are afraid of contacting people with flu symptoms. It was found that they always kept sufficient distance while communicating with others. As a result of the multiple regression, it was determined that gender, mask type, mask usage frequency, risk perception, social distance behavior, and mask-wearing behavior had a statistically significant effect on the perceived stress level (p < 0.05).

CONCLUSIONS

These results provide theoretical inferences for public health policies targeting the high school students to develop accurate risk perception and protective behaviors.

Electrospinning of Potential Medical Devices (Wound Dressings, Tissue Engineering Scaffolds, Face Masks) and Their Regulatory Approach

Electrospinning is the simplest and most widely used technology for producing ultra-thin fibers. During electrospinning, the high voltage causes a thin jet to be launched from the liquid polymer and then deposited onto the grounded collector. Depending on the type of the fluid, solution and melt electrospinning are distinguished. The morphology and physicochemical properties of the produced fibers depend on many factors, which can be categorized into three groups: process parameters, material properties, and ambient parameters. In the biomedical field, electrospun nanofibers have a wide variety of applications ranging from medication delivery systems to tissue engineering scaffolds and soft electronics. Many of these showed promising results for potential use as medical devices in the future. Medical devices are used to cure, prevent, or diagnose diseases without the presence of any active pharmaceutical ingredients. The regulation of conventional medical devices is strict and carefully controlled; however, it is not yet properly defined in the case of nanotechnology-made devices. This review is divided into two parts. The first part provides an overview on electrospinning through several examples, while the second part focuses on developments in the field of electrospun medical devices. Additionally, the relevant regulatory framework is summarized at the end of this paper.