New findings on clinical experience on surface-guided radiotherapy for frameless non-coplanar stereotactic radiosurgery treatments.

PURPOSE: The aim of this study was to assess the accuracy of a surface-guided radiotherapy (SGRT) system for setup and intra-fraction motion control in frameless non-coplanar stereotactic radiosurgery (fSRS) using actual patient data immobilized with two different types of open-faced masks and employing a novel SGRT systems settings. METHODS AND MATERIALS: Forty-four SRS patients were immobilized with two types of open-faced masks. Sixty lesions were treated, involving the analysis of 68 cone-beam scans (CBCT), 157 megavoltage (MV) images, and 521 SGRT monitoring sessions. The average SGRT translations/rotations and 3D vectors (MAG-Trasl and MAG-Rot) were compared with CBCT or antero-posterior MV images for 0° table or non-coplanar beams, respectively. The intrafraction control was evaluated based on the average shifts obtained from each monitoring session. To assess the association between the SGRT system and the CBCT, the two types of masks and the 3D vectors, a generalized estimating equations (GEE) regression analysis was performed. The Wilcoxon singed-rank test for paired samples was performed to detect differences in couch rotation with longitudinal (LNG) and lateral (LAT) translations and/or yaw. RESULTS: The average SGRT corrections were smaller than those detected by CBCT (≤0.5 mm and 0.1°), with largest differences in LNG and yaw. The GEE analysis indicated that the average MAG-Trasl, obtained by the SGRT system, was not statistically different (p = 0.09) for both mask types, while, the MAG-Rot was different (p = 0.01). For non-coplanar beams, the Wilcoxon singed-rank test demonstrated no significantly differences for the corrections (LNG, LAT, and yaw) for any table rotation except for LNG corrections at 65° (p = 0.04) and 75° (p = 0.03) table angle position; LAT shifts at 65° (p = 0.03) and 270° (p < 0.001) table angle position, and yaw rotation at 30° (p = 0.02) table angle position. The average intrafraction motion was < 0.1 mm and 0.1° for any table angle. CONCLUSION: The SGRT system used, along with the novel workflow performed, can achieve the setup and intra-fraction motion control accuracy required to perform non-coplanar fSRS treatments. Both masks ensure the accuracy required for fSRS while providing a suitable surface for monitoring.

Functionalized Face Masks as Smart Wearable Sensors for Multiple Sensing.

Wearable sensors provide continuous physiological information and measure deviations from healthy baselines, resulting in the potential to personalize health management and diagnosis of diseases. With the emergence of the COVID-19 pandemic, functionalized face masks as smart wearable sensors for multimodal and/or multiplexed measurement of physical parameters and biochemical markers have become the general population for physiological health management and environmental pollution monitoring. This Review examines recent advances in applications of smart face masks based on implantation of digital technologies and electronics and focuses on respiratory monitoring applications with the advantages of autonomous flow driving, enrichment enhancement, real-time monitoring, diversified sensing, and easily accessible. In particular, the detailed introduction of diverse respiratory signals including physical, inhalational, and exhalant signals and corresponding associations of health management and environmental pollution is presented. In the end, we also provide a personal perspective on future research directions and the remaining challenges in the commercialization of smart functionalized face masks for multiple sensing.

The influence of N95 and surgical masks on carbon dioxide levels: A comprehensive systematic review and meta-analysis.

Objectives: This study aimed to assess the impact of wearing N95 and surgical masks on carbon dioxide (CO2) concentrations during various activity levels, to understand the implications for mask use in different settings, especially in light of the COVID-19 pandemic. Study design: Systematic Review and Meta-Analysis. Methods: A systematic review was conducted, retrieving 6798 articles from PubMed, Web of Science, and Scopus databases. Twenty-nine articles met the inclusion criteria. Mask types were categorized into N95 and surgical masks, while activities were classified as low, medium, and high. Results: The meta-analysis revealed CO2 concentrations (mmHg) for different scenarios: No mask (37.91, 95 % CI: 36.46, 39.35), N95-low (36.83, 95 % CI: 33.57, 40.10), N95-moderate (37.85, 95 % CI: 36.51, 39.20), N95-high (39.51, 95 % CI: 38.00, 41.02), N95 with exhalation valve (35.82, 95 % CI: 32.89, 38.75), N95 without exhalation valve (38.45, 95 % CI: 37.10, 39.81), surgical mask-low (38.31, 95 % CI: 34.48, 42.14), surgical mask-moderate (35.05, 95 % CI: 31.12, 38.97), surgical mask-high (36.07, 95 % CI: 34.18, 37.96). Conclusions: Our findings indicate that N95 masks lead to higher CO2 accumulation during various activities compared to surgical masks. Moreover, surgical masks exhibit higher CO2 concentrations during low activity compared to moderate and high activities. Notably, CO2 concentrations are higher in N95 masks without an exhalation valve compared to those with a valve. No significant difference was observed between not wearing a mask and wearing either N95 or surgical masks in terms of CO2 accumulation. These results provide important insights for mask selection and usage recommendations in different scenarios.

A New Paradigm on Waste-to-Energy Applying Hydrovoltaic Energy Harvesting Technology to Face Masks.

The widespread use of single-use face masks during the recent epidemic has led to significant environmental challenges due to waste pollution. This study explores an innovative approach to address this issue by repurposing discarded face masks for hydrovoltaic energy harvesting. By coating the face masks with carbon black (CB) to enhance their hydrophilic properties, we developed mask-based hydrovoltaic power generators (MHPGs). These MHPGs were evaluated for their hydrovoltaic performance, revealing that different mask configurations and sizes affect their efficiency. The study found that MHPGs with smaller, more structured areas exhibited better energy output, with maximum open-circuit voltages (VOC) reaching up to 0.39 V and short-circuit currents (ISC) up to 65.6 µA. The integration of CB improved water absorption and transport, enhancing the hydrovoltaic performance. More specifically, MHPG-1 to MHPG-4, which represented different sizes and features, presented mean VOC values of 0.32, 0.17, 0.19 and 0.05 V, as well as mean ISC values of 16.57, 15.59, 47.43 and 3.02 µA, respectively. The findings highlight the feasibility of utilizing discarded masks in energy harvesting systems, offering both environmental benefits and a novel method for renewable energy generation. Therefore, this work provides a new paradigm for waste-to-energy (WTE) technologies and inspires further research into the use of unconventional waste materials for energy production.

Exploring the impact of parents' face-mask wearing on dyadic interactions in infants at higher likelihood for autism compared with general population.

Since the COVID-19 pandemic, both the public and researchers have raised questions regarding the potential impact of protective face-mask wearing on infants' development. Nevertheless, limited research has tested infants' response to protective face-mask wearing adults in real-life interactions and in neurodiverse populations. In addition, scarce attention was given to changes in interactive behavior of adults wearing a protective face-mask. The aims of the current study were (1) to examine differences in 12-month-old infants' behavioral response to an interactive parent wearing a protective face-mask during face-to-face interaction, (2) to investigate potential differences in infants at higher likelihood for autism (HL-ASD) as compared with general population (GP) counterparts, and (3) to explore significant differences in parents' behaviors while wearing or not wearing a protective face-mask. A total of 50 mother-infant dyads, consisting of 20 HL-ASD infants (siblings of individuals with autism) and 30 GP infants, participated in a 6-min face-to-face interaction. The interaction was videotaped through teleconferencing and comprised three 2-min episodes: (a) no mask, (b) mask, and (c) post-mask. Infants' emotionality and gaze direction, as well as mothers' vocal production and touching behaviors, were coded micro-analytically. Globally, GP infants exhibited more positive emotionality compared with their HL-ASD counterparts. Infants' negative emotionality and gaze avoidance did not differ statistically across episodes. Both groups of infants displayed a significant increase in looking time toward the caregiver during the mask episode. No statistically significant differences emerged in mothers' behaviors. These findings suggest that the use of protective face-masks might not negatively affect core dimensions of caregiver-infant interactions in GP and HL-ASD 12-month-old infants.

Face Mask Therapy and Comprehensive Orthodontic Treatment for Skeletal Class III Malocclusion: A Case Report.

Aim: This article aims to report a case of face mask therapy and comprehensive orthodontic treatment for skeletal class III malocclusion in a 16-year-old girl. Background: Treating skeletal class III malocclusion in a growing patient is crucial, as it can help avoid the need for additional surgery. Early treatment also lessens the negative impacts of the patient's facial abnormality on their social life because surgery is only done later. Case description: In this case report, a 14-year-old female patient presented with skeletal class III malocclusion with primary complaints of anterior crossbite. There was no relevant medical history. Face mask therapy and fixed appliance therapy were components of the treatment approach that successfully corrected the malocclusion. The total period of treatment was 20 months. Conclusion: The treatment resulted in a harmonious face, a well-aligned smile arch, stable dental and skeletal relationships, and significant esthetic improvements, including improved facial symmetry and profile. Significance: A growing teen who has a skeletal class III malocclusion and a maxillary deficit may be helped by a combination of face mask therapy and thorough orthodontic treatment. This case report outlines the use of the aforementioned technique to successfully treat a 14-year-old child with class III malocclusion and maxillary deficiencies.Early management of skeletal class III malocclusion in developing adolescents is vital as it can potentially eliminate the necessity for future surgical intervention, leading to improved treatment outcomes.Careful case selection, patient cooperation, and long-term stability enable a successful, stable, and esthetically pleasing treatment outcome. How to cite this article: Le LN, Do TT, P Le KV. Face Mask Therapy and Comprehensive Orthodontic Treatment for Skeletal Class III Malocclusion: A Case Report. Int J Clin Pediatr Dent 2024;17(3):368-376.

Mathematical assessment of control strategies against the spread of MERS-CoV in humans and camels in Saudi Arabia.

A new mathematical model for the transmission dynamics and control of the Middle Eastern respiratory syndrome (MERS), a respiratory virus caused by MERS-CoV coronavirus (and primarily spread to humans by dromedary camels) that first emerged out of the Kingdom of Saudi Arabia (KSA) in 2012, was designed and used to study the transmission dynamics of the disease in a human-camel population within the KSA. Rigorous analysis of the model, which was fitted and cross-validated using the observed MERS-CoV data for the KSA, showed that its disease-free equilibrium was locally asymptotically stable whenever its reproduction number (denoted by $ {\mathbb R}_{0M} $) was less than unity. Using the fixed and estimated parameters of the model, the value of $ {\mathbb R}_{0M} $ for the KSA was estimated to be 0.84, suggesting that the prospects for MERS-CoV elimination are highly promising. The model was extended to allow for the assessment of public health intervention strategies, notably the potential use of vaccines for both humans and camels and the use of face masks by humans in public or when in close proximity with camels. Simulations of the extended model showed that the use of the face mask by humans who come in close proximity with camels, as a sole public health intervention strategy, significantly reduced human-to-camel and camel-to-human transmission of the disease, and this reduction depends on the efficacy and coverage of the mask type used in the community. For instance, if surgical masks are prioritized, the disease can be eliminated in both the human and camel population if at least 45% of individuals who have close contact with camels wear them consistently. The simulations further showed that while vaccinating humans as a sole intervention strategy only had marginal impact in reducing the disease burden in the human population, an intervention strategy based on vaccinating camels only resulted in a significant reduction in the disease burden in camels (and, consequently, in humans as well). Thus, this study suggests that attention should be focused on effectively combating the disease in the camel population, rather than in the human population. Furthermore, the extended model was used to simulate a hybrid strategy, which combined vaccination of both humans and camels as well as the use of face masks by humans. This simulation showed a marked reduction of the disease burden in both humans and camels, with an increasing effectiveness level of this intervention, in comparison to the baseline scenario or any of the aforementioned sole vaccination scenarios. In summary, this study showed that the prospect of the elimination of MERS-CoV-2 in the Kingdom of Saudi Arabia is promising using pharmaceutical (vaccination) and nonpharmaceutical (mask) intervention strategies, implemented in isolation or (preferably) in combination, that are focused on reducing the disease burden in the camel population.

Open-Face Masks in Radiotherapy: Enhancing Therapeutic Strategies for Head and Neck and Brain Cancer Patients-A Comprehensive Scoping Review.

Introduction: The main goal of radiotherapy (RT) is to deliver a precise dose to the target while sparing the surrounding normal tissue and minimizing side effects. Appropriate patient immobilization is crucial, especially for head and neck cancer (HNC) and Brain Cancer (BC). Conventional closed-face masks (CFMs), while effective in minimizing head motion, can cause significant discomfort, anxiety, and claustrophobia. Open-face masks (OFMs) have been developed to increase patient comfort while providing precise immobilization. Methods: Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) extension for scoping reviews and the Arskey and O'Malley framework, an electronic search of EMBASE, PubMed, SCOPUS, and Web of Science was conducted to identify original studies reporting the use and description of OFMs in clinical practice up to April 2024. The inclusion criteria were English-language articles focusing on OFMs for HNC and BC patients undergoing RT. Results: Of 618 titles, 19 articles fulfilled the selection criteria. Most studies were comparative (n = 13) or observational (n = 6). The articles were categorized by treatment site, resulting in three groups: BC (n = 14, 68.4%), HNC (n = 4, 21.4%), and mixed (n = 2, 10.5%), which includes both BC and HNC. Of note, 82.4% (n = 16) of the included studies were published from 2020 onwards, emphasizing the recent adoption of OFM in clinical practice. Conclusions: The reviewed studies show that OFMs, in combination with SGRT, offer significant advantages in terms of patient comfort and positioning accuracy in HNC and BC treatments. Reproducibility in the sub-millimeter and sub-degree range can be achieved, which supports the use of OFMs in clinical practice. Future research should explore innovative combinations of immobilization and monitoring to further improve RT outcomes and ensure precise treatment while increasing patient comfort.

Pre-oxygenation using high flow humidified nasal oxygen or face mask oxygen in pregnant people - a prospective randomised controlled crossover non-inferiority study (The HINOP2 study).

BACKGROUND: Airway guidelines recommend pre-oxygenation of obstetric patients to an end tidal oxygen concentration (etO2) ≥90%. High flow nasal oxygen (HFNO) achieves this in 60% of pregnant people. However face mask (FM) pre-oxygenation also may not achieve this target in all patients. In this study we determined whether HFNO pre-oxygenation is non-inferior to FM pre-oxygenation. METHODS: This randomised controlled crossover non-inferiority trial was conducted on healthy participants of gestational age ≥37 weeks in a simulated environment. Participants underwent pre-oxygenation for three minutes with HFNO and FM oxygen in randomised order. HFNO was delivered at a maximal flow of 70 l.min-1 and FM oxygen at 10 l.min-1. The primary outcome was etO2 on first expired breath after pre-oxygenation. Non-inferiority was defined as a mean difference in first etO2 between groups of ≤5%. RESULTS: Seventy participants were randomised with 62 analysed. Age (mean (SD)), gestation (median (IQR)), and body mass index (median (IQR)), were 34.7 (4.6) years, 39 (38.4, 39.4) weeks, 29 (26.6, 32.4) kg.m-2 respectively. First etO2 after HFNO pre-oxygenation was greater than after FM pre-oxygenation (HFNO pre-oxygenation mean (SD) 90.2 (3.9)% versus FM pre-oxygenation 88.7 (3.0)%; mean difference = 1.45%, 95% CI 0.19 to 2.72%; p = 0.025. Forty-four (71%) participants achieved ≥90% first etO2 concentration after HFNO pre-oxygenation versus 27 (44%) after FM pre-oxygenation (p = 0.002). CONCLUSIONS: In this cohort of pregnant people at term in a simulated environment, pre-oxygenation with HFNO was not inferior to FM pre-oxygenation. FM pre-oxygenation did not achieve pre-oxygenation targets in over 50% of participants.

Airflow detailed analysis through a face mask using the schlieren technique.

This work presents an exhaustive visualization of the airflow expulsed by a person while breathing, talking, exhaling, and blowing inside a closed room wearing a disposable face mask like those used in hospitals for patient protection and those who care for them. An optical schlieren experimental arrangement was used to obtain some of the relevant physical characteristics of the airflow, such as its refractive index gradient, the distribution of temperature, and the associated velocity field for all the tests developed. We tested three face masks, one of the surgical types and the others of the N95 series with denominations KN95 and 3MN95 (Aura TC-84A-8590). The results show appreciable differences between the masks evaluated; the surgical mask was the one that allowed the most abrupt output airflow through it in the field of view of the experimental setup. However, were also found some differences in the performance of the KN95 and 3MN95 masks. The KN95 face mask had the best performance since it expulsed to its surroundings the lowest airflow with different physical properties to the input airflow. The results obtained are relevant since it was possible to estimate the expulsed airflow velocity as a function of the distance for every face mask tested, which allows for understanding its filtering capacity by restricting the flow of potential pathogens from the mouth or nose of one person to another. Undoubtedly, the airflow behavior determination around a face mask can help to reduce the risk of spreading infectious airborne particles.

Evaluation of eyelid features' changes before and after COVID-19 pandemic amongst healthcare and home office workers.

PURPOSE: To evaluate the eyelid features' changes after N95 face mask (FM) usage in healthcare workers through the new type of Coronavirus Disease 2019 (COVID-19) pandemic and make a comparison with home-office workers as a control group with a computer vision algorithm. MATERIALS AND METHODS: Sixty healthcare workers and forty control participants with similar demographic features included. Standardized biometric photographs which were taken before and after the COVID-19 pandemic, analyzed by the ImageJ program (NIH, Bethesda, Md.) software. The distances between the central light reflex on the cornea and the upper (UE) and lower eyelid (LE) were recorded as the marginal reflex distances. (MRD1, MRD2 respectively) Parameters of pretarsal show (PTS) of UE and brow pupil diameter (BPD) were analyzed for both of the eyes. RESULTS: There were no significant differences among the groups' measurements before the COVID-19 pandemic. In healthcare workers' group after the pandemic, values of MRD1, PTS, BPD showed a significant decrease in their right eye (p = 0.001, p = 0.002, p = 0.001 respectively) and same values reduced in the left eyes as well when compared with pre-pandemic measurements. (p = 0.048, p = 0.001, p = 0.001 respectively) PTS and BPD values were decreased for both right and left eyes of the controls. (p = 0.044, p = 0.001 and p = 0.001, p = 0.001 respectively) MRD1 measurements after the pandemic showed no difference either in the right or left eyes of the control group after the pandemic. (p = 0.071 and p = 0.065 respectively). DISCUSSION: Results showed that both BPD and PTS values decreased independently from the previous FM usage in both of the groups. Even though MRD1 values remained within the normal values, a significant decrease was detected in the healthcare workers group which suggested the cause was newly developed upper eyelid (UE) dermatochalasis after long hours of FM usage. Although it is hard to make a truly objective evaluation both usage of standardized biometric photographs and a computer-based measurement system makes the results reliable.

[Le port du masque affecte l'identification des expressions faciales émotionnelles, surtout chez les personnes âgées]. / Wearing face masks makes identifying emotional facial expressions harder, especially for older adults.

Younger adults have difficulties identifying emotional facial expressions from faces covered by face masks. It is important to evaluate how face mask wearing might specifically impact older people, because they have lower emotion identification performance than younger adults, even without face masks. We compared performance of 62 young and 38 older adults in an online task of emotional facial expression identification using masked or unmasked pictures of faces with fear, happiness, anger, surprise, and neutral expression, from different viewpoints. Face masks affected performance in both age groups, but more so in older adults, specifically for negative emotions (anger, fear), in favour of the saliency hypothesis as an explanation for the positive advantage. Additionally, face masks more affected emotion recognition on profile than on three-quarter or full-face views. Our results encourage using clearer and full-face expressions when dealing with older people while wearing face masks.

Incomplete Faces Do but Masked Faces Do Not Affect Mind Perception.

The human face plays a critical role in how we perceive the minds of others. The current research across two studies explored whether face masks also impact mind perception, with the expectation that they lead to lower attributions of agency and experience to individuals, making them seem less mentally capable due to their association with reduced facial expression perception and impaired communication. In the first study, participants' ratings of masked and unmasked faces for agency and experience did not yield significant differences, suggesting that wearing a face mask does not affect the perception of the mind. To explore whether these findings applied when the lower face was cropped instead of masked, results of the second study showed that removing the lower face led to decreased agency ratings, but similar to the first study, there were no changes in experience ratings. Altogether, our results showed that wearing face masks does not reduce the perception of mental capacity. Moreover, female faces received higher ratings for both agency and experience compared to male faces. The complex relationship between face masks, gender, and mind perception warrants further exploration.

Antimicrobial Face Masks and Mask Covers with a Salt-Coated Stacked Spunbond Polypropylene Fabric: Effective Inactivation of Resilient Pathogens and Prevention of Contact Transmission.

In response to the ongoing threat posed by respiratory diseases, ensuring effective transmission protection is crucial for public health. To address the drawbacks of single-use face masks/respirators, which can be a potential source of contact-based transmission, we have designed an antimicrobial face mask and mask covering utilizing a stack of salt-coated spunbond (SB) fabric. This fabric acts as an outer layer for the face mask and as a covering over a conventional mask, respectively. We evaluated the universal antimicrobial performance of the salt-coated three-stacked SB fabric against enveloped/nonenveloped viruses and spore-forming/nonspore-forming bacteria. The distinctive pathogen inactivation efficiency was confirmed, including resistant pathogens such as human rhinovirus and Clostridium difficile. In addition, we tested other filter attributes, such as filtration efficiency and breathability, to determine the optimal layer for salt coating and its effects on performance. Our findings revealed that the outer layer of a conventional face mask plays a crucial role in contact transmission through contaminated face masks and respirators. Through contact transmission experiments using droplets involving three types of contaminants (fluorescent dyes, bacteria, and viruses), the salt-coated stacked SB fabric demonstrated a superior effect in preventing contact transmission compared to SB or meltblown polypropylene fabrics─an issue challenging to existing masks. Our results demonstrate that the use of salt-coated stacked SB fabrics as (i) the outer layer of a mask and (ii) a mask cover over a mask enhances overall filter performance against infectious droplets, achieving high pathogen inactivation and low contact-based transmission while maintaining breathability.

Fabric structure and polymer composition as key contributors to micro(nano)plastic contamination in face masks.

The surge in face mask use due to COVID-19 has raised concerns about micro(nano)plastics (MNPs) from masks. Herein, focusing on fabric structure and polymer composition, we investigated MNP generation characteristics, mechanisms, and potential risks of surgical polypropylene (PP) and fashionable polyurethane (PU) masks during their wearing and photoaging based on stereomicroscope, µ-Fourier transform infrared spectroscopy (µ-FTIR), and scanning electron microscope (SEM) techniques. Compared with new PP and PU masks (66 ± 16 MPs/PP-mask, 163 ± 83 MPs/PU-mask), single- and multiple-used masks exhibited remarkably increased MP type and abundance (600-1867 MPs/PP-mask, 607-2167 MPs/PU-mask). Disinfection exacerbated endogenous MP generation in masks, with washing (416 MPs/PP-mask, 30,708 MPs/PU-mask) being the most prominent compared to autoclaving (219 MPs/PP-mask, 553 MPs/PU-mask) and alcohol spray (162 MPs/PP-mask, 18,333 MPs/PU-mask). Photoaging led to massive generation of MPs (8.8 × 104-3.7 × 105 MPs/PP-layer, 1.0 × 105 MPs/PU-layer) and NPs (5.2 × 109-3.6 × 1013 NPs/PP-layer, 3.5 × 1012 NPs/PU-layer) from masks, presenting highly fabric structure-dependent aging modes as "fragmentation" for fine fiber-structure PP mask and "erosion" for 3D mesh-structure PU mask. The MNPs derived from PP/PU mask caused significant deformities of Zebrafish (Danio rerio) larvae. These findings underscore the potential adverse effects of masks on humans and aquatic organisms, advocating to enhance proper use and rational disposal for masks.

The role of the environment: how mask wearing varies across different activities.

BACKGROUND: People's decisions to engage in protective health behaviors, such as mask wearing during the COVID-19 pandemic, are influenced by environmental and social contexts. Previous research on mask wearing used a single question about general mask usage in public, which may not reflect actual behavior in every setting. The likelihood of wearing a mask during one activity is also related to the likelihood of wearing a mask in another or avoiding an activity entirely. This analysis compared responses between a general question and activity-specific questions and identified patterns of mask-wearing behavior across activities. METHODS: Online, opt-in, cross-sectional surveys were conducted every 2 months from November 2020 to May 2021 (n = 2508), with quota sampling and weighting to achieve a representative sample of the U.S. POPULATION: Respondents were asked how frequently they wore a mask in public and during 12 specific activities including: on public transportation, while shopping, and attending social gatherings indoors and outdoors. Spearman's rank order correlation was used to compare the frequency of mask wearing reported using a general question versus an activity specific question. Additionally, a latent class analysis was conducted to identify patterns of mask wearing behavior across activities. RESULTS: There was little to no correlation (r = .16-0.33) between respondents' general attitudes towards mask wearing and their reported frequency of mask wearing in different activities. Latent class analysis identified six distinct groups based on their mask wearing behaviors and avoidance of certain activities. The largest group (29%) avoided ten of the twelve activities and always wore a mask during activities that could not be avoided. Additional groups included those who avoided most activities but made exceptions when around friends or family (20%), part time mask wearers (18%), and never mask wearers (6%). CONCLUSIONS: The findings suggest that activity-specific questions provide more accurate and useful information than a single general question. Specific, context based, questions allow for analyses that consider the nuances of people's decision-making regarding engaging in protective health behaviors, such as mask wearing, thus enabling public health professionals to create targeted guidelines and messages.

The Impact of Mask-Wearing on Allergic Rhinitis Symptoms During the COVID-19 Pandemic Among the Saudi Population: A Cross-Sectional Study.

BACKGROUND: Allergic rhinitis (AR) is an inflammatory disease of the nasal mucosa caused by certain allergens that may be found indoors or outdoors, and it greatly impacts the patient's quality of life. The COVID-19 epidemic offers an excellent chance to examine how using a face mask affects allergy. AIM: The present study aimed to evaluate the impact of face mask wearing on AR symptoms among subjects living in the northern, southern, eastern, western, and central regions of Saudi Arabia. SUBJECTS AND METHODS: This cross-sectional, survey-based study was undertaken in all Saudi Arabia regions in 2022. We included female and male adults living in Saudi Arabia who have AR and completed the Arabic version of an electronic self-administered questionnaire. RESULTS: The overall received responses were 2252. According to the study eligibility criteria, we assessed the data of 470 participants who self-reported to have been diagnosed with AR. There was no significant change in the proportions of nasal symptoms severity before and after wearing face masks during the pandemic (p = 0.867), while a significant negative change was observed in the rates of moderate and severe ophthalmic symptoms (p < 0.001). The need for AR drugs was significantly increased during the pandemic (no need for drugs was reported by 45.3% before the pandemic and by 37.9% during the pandemic, p < 0.001). However, the use of AR drugs was significantly associated with the improvement of AR symptoms (p < 0.001); complete and partial eliminations of AR symptoms were higher with the use of masks during the pandemic (11.3% and 36.8%) than before the pandemic period (10.6% and 34.5%). CONCLUSIONS: Face mask usage was not associated with improved symptoms or severity of AR. Wearing the masks was associated with increased severity of ophthalmic symptoms. The use of face masks was associated with a significant increase in the partial and complete elimination of AR symptoms with the use of AR drugs, particularly with the constant use of masks.

Sevoflurane Induction With Snorkel Technique in an Adult With Mask and Needle Phobia.

Snorkel breathing involves mouth breathing into a snorkel tube and is necessary for underwater activities. Anesthesiologists may have difficulty when dealing with adults who have a concomitant face mask and needle fear because both inhalation and intravenous induction cannot be performed. This case report describes a novel use of the snorkel breathing technique for anesthetic gas induction in an adult with face mask fear. A 24-year-old female with mask and needle fear underwent a craniotomy and biopsy of a frontal lesion while under general endotracheal anesthesia. During anesthesia induction, the patient was directed to hold the breathing tube tightly between her lips and breathe via her mouth into it with sevoflurane at 8% dial setting and 6 L/min of fresh gas flow. The snorkel approach was effectively used to induce anesthesia with better patient cooperation, and an intravenous cannula was inserted.

Wearing surgical face mask has no significant impact on auscultation assessment.

Objective: During the COVID-19 pandemic, universal mask-wearing became one of the main public health interventions. Because of this, most physical examinations, including lung auscultation, were done while patients were wearing surgical face masks. The aim of this study was to investigate whether mask wearing has an impact on pulmonologist assessment during auscultation of the lungs. Methods: This was a repeated measures crossover design study. Three pulmonologists were instructed to auscultate patients with previously verified prolonged expiration, wheezing, or crackles while patients were wearing or not wearing masks (physician and patients were separated by an opaque barrier). As a measure of pulmonologists' agreement in the assessment of lung sounds, we used Fleiss kappa (K). Results: There was no significant difference in agreement on physician assessment of lung sounds in all three categories (normal lung sound, duration of expiration, and adventitious lung sound) whether the patient was wearing a mask or not, but there were significant differences among pulmonologists when it came to agreement of lung sound assessment. Conclusion: Clinicians and health professionals are safer from respiratory infections when they are wearing masks, and patients should be encouraged to wear masks because our research proved no significant difference in agreement on pulmonologists' assessment of auscultated lung sounds whether or not patients wore masks.