Intraocular pressure modulation with thermal stimuli

ABSTRACT Purpose: This study aimed to determine whether early-stage intraocular pressure can be modulated using a thermal face mask. Methods: In this prospective clinical study, healthy participants were randomized on a 1:1:1 allocation ratio to three mask groups: hypothermic (G1), normothermic (G2), and hyperthermic (G3). After randomization, 108 eyes from 108 participants were submitted to clinical evaluations, including measurement of initial intraocular pressure (T1). The thermal mask was then applied for 10 minutes, followed by a second evaluation of intraocular pressure (T2) and assessment of any side effects. Results: The hypothermic group (G1) showed a significant reduction in mean intraocular pressure between T1 (16.97 ± 2.59 mmHg) and T2 (14.97 ± 2.44 mmHg) (p<0.001). G2 showed no significant pressure difference between T1 (16.50 ± 2.55 mmHg) and T2 (17.00 ± 2.29 mmHg) (p=0.054). G3 showed a significant increase in pressure from T1 (16.53 ± 2.69 mmHg) to T2 (18.58 ± 2.95 mmHg) (p<0.001). At T1, there was no difference between the three study groups (p=0.823), but at T2, the mean values of G3 were significantly higher than those of G1 and G2 (p<0.00). Conclusion: Temperature was shown to significantly modify intraocular pressure. Thermal masks allow the application of temperature in a controlled, reproducible manner. Further studies are needed to assess the duration of these effects and whether they are reproducible in patients with pathologies that affect intraocular pressure.

Incidence of hordeola and chalazia during the COVID-19 pandemic: the role of mask wear.

CLINICAL RELEVANCE: Understanding the associations between mask wear and hordeola and chalazia formation are important for eyecare physicians as they may be overlooked as a direct cause. The literature on these possible relationships is limited. BACKGROUND: The intention of this study was to determine if there was an increased incidence of internal/external hordeola and chalazia secondary to the implementation of mask wear due to the COVID-19 pandemic in an academic clinical setting. METHODS: A retrospective chart review of electronic medical records at the Illinois Eye Institute was conducted. Cases were categorised into two groups: pre-COVID/pre- mask wear (December 2018-February 2020) and during the pandemic/mask wear (May 2020-July 2022). Demographic data were also compared between the two groups. RESULTS: A total of 163 cases of hordeola and chalazia were reported pre-COVID, with an increase to 225 during the pandemic/mask wear period. Due to the reduction in patient visits because of COVID restrictions, an incidence analysis was conducted to determine occurrence rates per 1000 visits. The pre-COVID period showed a total incidence rate of 3.06 cases per 1000 patients (hordeola 1.6/chalazia 1.57) while during the mask wearing period the incidence rate increased to 6.32 cases per 1000 patients (hordeola 2.5/chalazions 3.82). A total incidence rate ratio was calculated to be 2.1 (hordeola 1.6/chalazia 2.6) correlating to a greater chance of developing the conditions during mask wear. CONCLUSIONS: An increase in the incidence of chalazia and hordeola were noted in the mask wear/pandemic group when compared to the pre-mask wear group. Increased mask wear may be a principal cause of hordeola and chalazia.

Craniometric determinants of the fitted filtration efficiency of disposable masks.

Introduction: Exposure to harmful aerosols is of increasing public health concern due to the SARS-CoV-2 pandemic and wildland fires. These events have prompted risk reduction behaviors, notably the use of disposable respiratory protection. This project investigated whether craniofacial morphology impacts the efficiency of disposable masks (N95, KN95, surgical masks, KF94) most often worn by the public to protect against toxic and infectious aerosols. This project was registered with ClinicaltTrials.gov (NCT05388201; registration May 18, 2022). Methods: One-hundred participants (50 men, 50 women) visited the Environmental Protection Agency's Human Studies Facility in Chapel Hill, NC between 2022-2023. Craniometrics and 3D scans were used to separate participants into four clusters. Boosting and elastic net regression yielded five measurements (bizygomatic breadth, nose length, bizygomatic nasal arc, neck circumference, ear breadth) that were the best predictors of filtration efficiency based on overall model fit. Fitted filtration efficiency was quantified for each mask at baseline and when tightened using an ear-loop clip. Results: The mean unmodified mask performance ranged from 55.3% (15.7%) in the large KF94 to 69.5% (12.3%) in the KN95. Modified performance ranged from 66.3% (9.4%) in the surgical to 80.7% (12.0%) in the KN95. Clusters with larger face width and neck circumference had higher unmodified mask efficiency. Larger nose gap area and nose length decreased modified mask performance. Discussion: We identify face width, nose size, nose shape, neck circumference, and ear breadth as specific features that modulate disposable mask fit in both unmodified and modified conditions. This information can optimize guidance on respiratory protection afforded by disposable ear-loop masks.

Million Microfiber Releases: Comparing Washable and Disposable Face Masks.

The extensive use of single-use or disposable face masks has raised environmental concerns related to microfiber contamination. In contrast, research on the potential release and ecological impact of microfibers from washable masks (WMs), suggested as an eco-friendly alternative, is currently lacking. Here, we comprehensively investigated the release of microfibers from disposable and WMs of different types in simulated aquatic environments and real-life scenarios, including shaking, disinfection, hand washing, and machine washing. Using a combination of wide-field fluorescence microscopy, He-ion microscopy, and confocal µ-Raman spectroscopy, we revealed that disposable masks (DMs) released microfibers ranging from 18 to 3042 microfiber/piece, whereas WMs released 6.1 × 104-6.7 × 106 microfibers/piece depending on the simulated conditions above. Another noteworthy finding was the observed negative correlation between microfiber release and the proportion of reinforcement (embossing) on the DM surfaces. Microfibers from tested DMs primarily comprised polypropylene (PP), while WMs predominantly released poly(ethylene terephthalate) (PET) and cellulose microfibers. Furthermore, acute toxicological analyses unveiled that PP microfibers (0.01-50 mg/L) from DMs impacted zebrafish larval swimming behavior, while PET microfibers from WMs delayed early-stage zebrafish hatching. This study offers new insights into the source of microfiber contamination and raises concerns about the environmental implications linked to the use of washable face masks.

The real-world effectiveness of preschoolers wearing masks on campus to prevent respiratory infectious diseases: a cohort study.

Background: Respiratory infections are common in the pediatric population. Preschoolers, especially those in kindergarten and 3-6 years old, are highly vulnerable to various respiratory infections. Objective: To investigate the efficacy of indoor mask-wearing in mitigating respiratory infections in preschoolers in a real-world campus setting. Methods: The study was conducted over a 115-day period in a kindergarten. Eligible children were assigned into study and control groups. The study group wore masks indoors but not outdoors, and the control group did not wear masks in either setting. We used a questionnaire to collect participant information, including age, height, weight, monthly dietary living expenses, family annual income, parent education level, primary caregiver, number of family members, and number of children under 6 years of age in the household. Incidences of clinical respiratory infections were recorded. We calculated the relative risk and analyzed the relationship between mask-wearing and respiratory infections by inter-group comparison, logistic regression, and Cox regression analyses. Results: A total of 135 preschoolers were included, with 35 and 100 preschoolers in the study and control groups, respectively. Baseline comparisons showed a significant difference in the number of children under 6 years old in the household between the two groups. Mask-wearing did not significantly reduce the risk of respiratory infections (RR = 1.086, 95% CI: 0.713, 1.435). Logistic and Cox regression analyses also showed no significant relationship between mask-wearing and occurrence of respiratory infections after controlling for potential confounders (OR = 0.816, 95% CI: 0.364, 1.826, and HR = 0.845, 95% CI: 0.495, 1.444). Conclusion: Indoor mask-wearing did not reduce the incidence of respiratory infections in preschoolers in a real-world campus setting. However, this study included a small number of preschoolers and observed them for a short period of time. Preschoolers were instructed to wear masks only when indoors. These factors could lead to bias and limit the generalizability of the study results.

Masks As a New Hotspot for Antibiotic Resistance Gene Spread: Reveal the Contribution of Atmospheric Pollutants and Potential Risks.

The consumption of disposable surgical masks (DSMs) considerably increased during the coronavirus pandemic in 2019. Herein, we explored the spread of antibiotic resistance genes (ARGs) and the potential risks of antibiotic resistant bacteria (ARB) on DSMs. At environmentally relevant concentrations, the conjugate transfer frequency (CTF) of ARGs increased by 1.34-2.37 folds by 20 µg/m3 of atmospheric water-soluble inorganic ions (WSIIs), and it increased by 2.62-2.86 folds by 80 ng/m3 of polycyclic aromatic hydrocarbons (PAHs). Total suspended particulates (TSP) further promoted the CTF in combination with WSIIs or PAHs. Under WSII and PAH exposure, gene expression levels related to oxidative stress, cell membrane, and the adenosine triphosphate (ATP) were upregulated. WSIIs predominantly induced cellular contact, while PAHs triggered ATP formation and membrane damage. Molecular dynamics simulations showed that WSIIs and PAHs reduced membrane lipid fluidity and increased membrane permeability through interactions with the phosphatidylcholine bilayer. DSM filtering performance decreased, and the CTF of ARGs increased with the wearing time. The gut simulator test showed that ARB disrupted the human gut microbial community and increased total ARG abundance but did not change the ARG abundance carried by ARB themselves. A mathematical model showed that long-term WSII and PAH exposure accelerated ARG dissemination in DSMs.

Energy usage of spruce with waste face masks and spent coffee grounds as fuel in a pellet boiler.

It is necessary to reduce dependency on fossil fuels for heating and waste generation, while also utilizing the energy potential of waste materials. One possibility is to create fuel pellets where waste makes up a small proportion so that the properties of the wood are not significantly altered with. This article investigates the energy usage of pellets containing spent coffee grounds (5 % or 10 %) and waste face masks (5 % or 10 %), with spruce sawdust as the primary input material (80 % or 90 %). The elemental, thermogravimetric, calorific value, mechanical durability, emission and performance characteristics, and ash melting temperatures of the pellets were evaluated during the experiment. The results were compared with respect to pure spruce sawdust pellets and the specified limit values for wood pellets in commercial and residential applications as specified in ISO 17225 [18]. Both tested samples met the element content limit (N, S, Cl, As, Cd, Cr, Cu, Pb, Hg, Ni, and Zn) for the highest quality grade (A1). No significant amounts of harmful elements were detected. The samples also complied with the limits of moisture content, ash content, and net calorific value (also known as lower calorific value). All samples met the emission limits in their respective classes (3, 4, or 5) according to STN EN 303-5+A1 [35]. However, the samples failed to meet the limit values for mechanical durability and ash melting temperatures. Despite this, the manufactured pellet samples represent a suitable fuel product for combustion purposes as a more sustainable thermal energy fuel.

Interfaces for Home Noninvasive Ventilation.

The choice of interface used to deliver noninvasive ventilation (NIV) is a critical element in successfully and safely establishing home NIV in people with sleep hypoventilation syndromes. Both patient-related and equipment-related factors need to be considered when selecting an interface. Recognizing specific issues that can occur with a particular style of mask is important when troubleshooting NIV problems and attempting to minimize side effects. Access to a range of mask styles and designs to use on a rotational basis is especially important for patients using NIV on a more continuous basis, those at risk of developing pressure areas, and children.

COVID-19 Impact on Refugees Mask-Wearing Behaviors and Intentions.

COVID-19 challenged countries in addressing population and raising awareness about mask-wearing during pandemic; Lebanon is a refugee hotspot, with humanitarian responsibility for their protection. The goal of this study is to emphasize the need of raising awareness among vulnerable populations and studying their mask-wearing behavior and intentions. This research draws on findings from a survey characterized by refugees' representatives from NGO, focusing on the behaviors and implications of refugees' mask-wearing. To address the study question, a customized survey based on Theory of Interpersonal Behavior was undertaken, in which the behavior of refugees was impacted by their desire to engage in an activity. The findings show that refugees are influenced by other people's mask-wearing behavior; they view masks as providing protection and aim to use them in the future provided all enabling conditions are met. Artificial intelligence might be a better monitor for this behavior in the future.

COVID-19: did the masks work?

During the early stages of the COVID-19 pandemic, we called for mandatory public masking to 'flatten the curve'. We helped formulate a national standard (SWiFT 19) for barrier facemasks, and, using a novel laser-based approach, we determined that mask efficacy is dependent on both fabric and fit; with both variables being inversely related. Herein, we take a retrospective view of the role of masks during the pandemic and surmise that, on the balance of evidence to date, masks were effective at stemming the spread of SARS-CoV-2 and may well be an effective early control strategy for potential future respiratory pandemics.

Face coverings, which cover the nose and mouth, are a means of preventing infections that travel in the air. These include viruses such as SARS-CoV-2, which causes COVID-19. Face coverings, or masks, played a key role during the COVID-19 pandemic by reducing person-to-person spread of the virus. The key features of a mask that make it effective are the material from which it is made and how closely the mask fits the face. A loosely fitting mask, for example, will lead to gaps around the nose and cheeks through which droplets can escape. A better fitting mask will have less leakage. Masks made from light single-layer material is less able to prevent droplet penetration than thicker, multi-layered fabric. Properly fashioned and fitted face masks are an effective means of slowing the spread of infections that travel in the air.

Dimensions of Alexithymia and Identification of Emotions in Masked and Unmasked Faces.

Alexithymia, a multifaceted personality construct, is known to be related to difficulties in the decoding of emotional facial expressions, especially in case of suboptimal stimuli. The present study investigated whether and which facets of alexithymia are related to impairments in the recognition of emotions in faces with face masks. Accuracy and speed of emotion recognition were examined in a block of faces with and a block of faces without face masks in a sample of 102 healthy individuals. The order of blocks varied between participants. Emotions were recognized better and faster in unmasked than in masked faces. Recognition performance was worst and slowest for participants starting the task with masked faces. In the whole sample, there were no correlations of alexithymia facets with accuracy and speed of emotion recognition for masked and unmasked faces. In participants starting the task with masked faces, the facet externally oriented thinking was positively correlated with reaction latencies of correct responses for masked faces. Our findings indicate that an externally oriented thinking style could be linked to a less efficient identification of emotions from faces wearing masks when task difficulty is high and support the utility of a facet approach in alexithymia research.

Perceptions of Exposure and Mask Use in Wildland Firefighters.

Wildland firefighters are exposed to airborne particulates, polycyclic aromatic hydrocarbons (PAHs), and other hazardous substances. Respiratory protection is indicated, but information is lacking on the tasks and conditions for which mask wearing should be advised. Studies to assess respiratory protection in wildland firefighters were carried out in western Canada in 2021 and 2023. Sampling pumps measured airborne exposures and urinary 1-hydroxypyrene (1-HP) was assayed to indicate PAH absorption. Participants in 2021 reported the time for which they wore the mask during each task. In 2023, the use of masks was reported, and firefighters rated the smoke intensity. In 2021, 72 firefighters were monitored over 164 shifts and, in 2023, 89 firefighters were monitored for 263 shifts. In 2021, mask wearing was highest for those engaged in initial attack and hot spotting. Urinary 1-HP at the end of rotation was highest for those reporting initial attack, working on a prescribed fire and mop-up. In 2023, firefighter ratings of smoke intensity were strongly associated with measured particulate mass and with urinary 1-HP, but masks were not worn more often when there was higher smoke intensity. The data from the literature did not provide a clear indication of high-exposure tasks. Better task/exposure information is needed for firefighters to make informed decisions about mask wearing.

Efficacy of powered air-purifying respirators (PAPRs) for source control of simulated respiratory aerosols.

BACKGROUND: Loose-fitting powered air-purifying respirators (PAPRs) are a popular alternative to the use of filtering facepiece respirators for health care workers. Although PAPRs protect the wearer from aerosol particles, their ability to block infectious aerosol particles exhaled by the wearer from being released into the environment (called source control) is unclear. METHODS: The source control performance of 4 PAPRs with loose-fitting facepieces were tested using a manikin that exhales aerosol particles. The PAPRs were tested by themselves and in combination with a face-worn product intended to provide source control (either a surgical mask or an N95 filtering facepiece respirator). RESULTS: Two PAPR facepieces with filtration panels significantly reduced the release of exhaled aerosols into the environment, while 3 facepieces without such panels did not. Wearing a surgical mask or respirator under the facepiece significantly improved the source control performance. CONCLUSIONS: Most PAPR facepieces do not block aerosols exhaled by the wearer. Facepieces designed to filter exhaled particles can prevent aerosols from being released into the environment. Wearing a surgical mask or a filtering facepiece respirator under the facepiece can also provide source control, but PAPRs are not typically certified for use with masks and respirators.

Adsorption characteristics and mechanisms of bisphenol A on novel nitrogen-modified biochar derived from waste masks and biomass.

Resource utilization of waste masks has become an urgent scientific issue. In this work, with sustainably, waste masks and biomass were co-pyrolysis with oxygen limitation to prepare mask-based biochar (MB). Then, urea was introduced to prepare novel nitrogen modified mask-based biochar (NMB) via a one-step hydrothermal synthesis method. The adsorption characteristics of NMB on the emerging environmental pollutant, bisphenol A (BPA), were evaluated via batch adsorption tests. Moreover, the physicochemical properties of the materials were characterized with various advanced techniques. Also, the roles of waste masks and nitrogen modification were explored. The adsorption mechanisms of NMB on BPA were revealed as well as the performance differences between different adsorbents. The results showed that waste masks participated in thermochemical reactions, shaped the microsphere structure of biochar, and increased the types of surface functional groups. The nitrogen modification enriched the surface elemental composition and activated the specific surface area via the mesopore. These would enhance the adsorption performance. The maximum adsorption of BPA by NMB was 62.63 mg·g-1, which was approximately 2.35-5.58 times higher than that of the control materials. Temkin model and pseudo-second-order model optimally simulate the isothermal and kinetic adsorption, respectively. The adsorption mechanisms are jointly by physical and chemical adsorption, which mainly includes π-π interaction, hydrogen bonding, intraparticle diffusion, surface adsorption, and ion exchange. After discussion and evaluation, NMB has lower preparation process cost (7.21 USD·kg-1) and safety, with potential for environmental applications. This study aims to expand new ideas for the comprehensive utilization of waste masks and the preparation of eco-friendly materials. Moreover, it provides a theoretical basis for the removal of BPA.

Electrospun nonwoven fabric of poly(ε-caprolactone)/n-phosphonium chitosan for antiviral applications: Fabrication, characterization, and potential efficacy.

This work reports the virucidal properties of nonwoven fibers developed via electrospinning with polycaprolactone (PCL) and chitosan quaternized with phosphonium salt (NPCS), emphasizing the influence of NPCS concentration on the structure of fibers and their performance against the MHV-3 coronavirus. The addition of NPCS enhances solutions conductivity and viscosity, leading to fibers containing a finer porous structure with a more hydrophilic and smoother surface, thereby making them a potent barrier against respiratory particles, which is a key factor for protective face masks. In terms of degradation, NPCS paced-up the process, suggesting potential environmental benefits. PCL/NPCS (90/10) fibers exhibit a 99 % coronavirus inhibition within a five-minute exposure without cellular toxicity, while also meeting breathability standards for medical masks. These findings suggest the use of NPCS as a promising strategy to design materials with remarkable virucidal performance and physical characteristics that reinforce their use in the field of biomaterials engineering.

Hazardous effects of plastic microfibres from facial masks to aquatic animal health: Insights from zebrafish model.

Facial masks are a source of plastic microfibres (PMFs) in the aquatic environment, an emerging risk factor for aquatic organisms. However, little is known concerning its impact during the early developmental stages of fish. Thus, the current study aimed to evaluate the potential interaction and developmental toxicity of PMFs derived from leachate of surgical masks (SC-Msk) and N-95 facial masks (N95-Msk) using a multi-biomarker approach in developing zebrafish (Danio rerio). PMFs from both facial masks were obtained and characterized by multiple techniques. Zebrafish embryos were exposed to environmentally relevant concentrations of PMFs from both facial masks (1000, 10,000, and 100,000 particle L-1), and the toxicity was analysed in terms of mortality, hatching rate, neurotoxicity, cardiotoxicity, morphological changes, reactive oxygen species (ROS) levels, cell viability, and behavioural impairments. The results showed that both facial masks can release PMFs, but the N95-Msk produced a higher concentration of PMFs than SC-Msk. Both PMFs can interact with zebrafish chorion and don't cause effects on embryo mortality and hatching; however, zebrafish embryos showed cardiotoxic effects, and larvae showed increased agitation, average speed, and distance travelled, indicating the behavioural impairments induced by PMFs derived from facial masks. Overall, results showed the risk of PMFs to the health of freshwater fish, indicating the need for greater attention to the disposal and ecotoxicological effects of facial masks on aquatic organisms.

Comprehensive risk assessment of the inhalation of plasticizers from the use of face masks.

Disposable masks, formed mainly from polymers, often incorporate various chemical additives to enhance their performance. These additives, which include plasticizers, may be released during mask usage, presenting a novel source of human exposure to these compounds. In this study, the presence of 16 organophosphate esters (OPEs), 11 phthalates, and four alternative plasticizers, in four various types of face masks, were studied, as well as their release during simulated mask use (artificial laboratory conditions). Total plasticizer concentrations exhibited minimal variation across different mask types, with mean values of 7.27 µg/face mask for surgical, 8.61 µg/face mask for reusable, 11.0 µg/face mask for KN-95, and 13.9 µg/face mask for FFP2 masks. To explore plasticizer release behavior, inhalation experiments were conducted under different conditions. The findings revealed a significant temperature-dependent enhancement in plasticizer release from masks, subsequently increasing human inhalation exposure. The inhalation experiments showed variation in the release percentages, ranging from 0.1 to 95 %, depending on the specific compound and mask type. Notably, OPEs exhibited a mean release percentage of 1.0 %, similar to phthalates, which showed a 1.2 % release. Although alternative plasticizers were less frequently released, they still presented a notable percentage of release of 4.1 %. Daily intake estimations via inhalation ranged from 0.01 to 9.04 ng/kg body weight (bw)/day for these additives. Using these estimations, carcinogenic and non-carcinogenic risks associated with this exposure to these compounds were evaluated. All calculated values for the specific compounds studied in this paper remained below the established threshold limits. However, they do represent an additional exposure pathway that, when considered alongside other more predominant routes such as indoor/outdoor inhalation, dermal absorption, and dietary intake, makes the total exposure worthy of consideration.

School mask policies and SARS-CoV-2 seroprevalence among school-age children-United States, September to December 2021.

During September to December 2021, school mask policies to mitigate SARS-CoV-2 transmission varied throughout the US. We compared infection-induced seroprevalence estimates and estimated seroconversion among children residing in areas with and without school mask requirements. We estimated infection-induced seroprevalence among children in three age groups (5-17, 5-11, and 12-17 years) in areas with and without school district mask requirements for two time points: September 1-30, 2021 and December 15, 2021 to January 14, 2022. Robust Poisson regression models estimated population seroconversion over the semester among initially seronegative children. Permutation tests assessed for significant differences in the estimated population seroconversion due to incident infections by school district mask policy. Residing in an area with no school mask requirement was associated with higher infection-induced seroprevalence among children aged 5-17 years (adjusted prevalence ratio [aPR] = 1.18, 95% confidence interval [CI]: 1.10, 1.26), and those aged 5-11 years (aPR) = 1.21, 95% CI: 1.10, 1.32) and those aged 12-17 years (aPR = 1.16, 95% CI: 1.07, 1.26), compared with areas requiring masks in school. Estimated population seroconversion during the semester was also significantly higher among children in districts without mask policies than those with school mask requirements among all age groups (5-17 years: 23.7% vs 18.1%, P < 0.001; 5-11 years: 6.4% vs 4.5%, P = 0.002;12-17 years: 27.2% vs 21.0%, P < 0.001). During the U.S. Fall 2021 semester, areas with school mask requirements had lower infection-induced seroprevalence and an estimated lower proportion of seroconversion due to incident infection among school-aged children compared with areas without school mask requirements; causality cannot necessarily be inferred from these associations. IMPORTANCE: During the U.S. Fall 2021 school semester, the estimated proportion of previously uninfected school-aged children who experienced a first infection with SARS-CoV-2 was lower in areas where public school district policies required masks for all staff and students compared with areas where the school districts had no mask requirements. Because children are more likely than adults to experience asymptomatic or mild SARS-CoV-2 infections, the presence of infection-induced antibodies is a more accurate measure of infection history than clinical testing. The proportion of children with these antibodies (i.e., seroprevalence) can improve our understanding of SARS-CoV-2 by detecting more infections and eliminating potential bias due to local testing and reporting practices. Enhanced robustness of surveillance for respiratory infections in children, including records of mitigation policies in communities and schools, as well as seroprevalence data, would establish a better evidence base for policy decisions and response measures during future respiratory outbreaks.

Efficacy and safety of the disposable eyelid warming masks in the treatment of dry eye disease due to Meibomian gland dysfunction.

BACKGROUND: Warm compresses are the routine treatment for Meibomian gland dysfunction (MGD) in daily life, but in order to achieve satisfactory efficacy, the treatment needs to be sustained over a long time, which can have an impact on the patient compliance. A more convenient warm compresses will help improve the patient compliance. Therefore, the purpose of the study is to investigate the efficacy and safety of the disposable eyelid warming masks for treatment of dry eye disease (DED) due to MGD. METHODS: This was a randomized, controlled, non-masked, two-center clinical trial. One hundred and forty-four patients were treated by the masks or the hot towel twice daily for 12 weeks. Patients were evaluated at baseline, 4-week and 12-week visits for subjective symptoms, objective signs and safety assessments, including ocular symptom scores, ocular surface disease index (OSDI), tear break-up time (BUT), corneal fluorescein staining (CFS), Schirmer I test (SIT), meibum quality, meibum expressibility, and adverse events (AEs). RESULTS: A totle of 134 patients were followed in the study. The mean age of the masks group (14 males and 52 females) and the hot towel group (20 males and 48 females) was 43.7 ± 13.5 years and 39.5 ± 13.9 years, respectively. At 4-week visit, there were significant statistical differences in ocular symptom scores, OSDI and CFS between two groups (P < 0.05). Except for SIT, the treatment group showed a greater improvement in subjective symptoms and objective signs than the control group at 12-week visit. (P < 0.05). In addition, 40 AEs occurred in 27 patients (37.5%) in the treatment group, and 34 AEs occurred in 21 patients (29.17%) in the control group. No serious AEs were reported. CONCLUSIONS: The masks had a good efficacy and safety in the treatment of DED due to MGD, and might offer an attractive treatment option for some patients. TRIAL REGISTRATION: The study was registered at Chinese Clinical Trial Registry (ChiCTR1900025443) on August 26, 2019.

Bioaerosols emission from source facilities in a wastewater treatment plant: Critical exposure time and sensitivity analysis.

Overexposure of sewage workers to bioaerosol released from wastewater treatment plants (WWTPs) can cause serious infections, but practical method for controlling their health risk is lacking. In this study, reverse quantitative microbial risk assessment was used to estimate the daily critical exposure time (CET) of sewage workers exposing to Staphylococcus aureus bioaerosol emitted by three emission sources facilities in a WWTP based on either U.S. EPA or WHO benchmark, and sensitivity analysis was conducted to analyze the influence of various parameters on the outcomes of CET. The results showed that the CET of females was always 1.12-1.29 times that of males. In addition, the CET after wearing face masks was 28.28-52.37 times as long as before. The working time can be determined based on the CET results of male workers wearing face masks exposed to the inverted-umbrella aeration tank (14.73-550.98 min for U.S. EPA benchmark and 55.07-1972.24 min for WHO benchmark). In each scenario, the variable parameter exposure concentration (ec) always showed the most influence on the CET results. After wearing the face masks, the removal fraction by employing face masks also had a significant effect on the results, only second to ec. Therefore, the wearing of face mask is the most convenient and effective measure to prolong the CET. Furthermore, practical methods to reducing bioaerosol concentration in WWTPs exposure are also necessary to extend CET and safeguard worker health. This study enriches the application range of reverse quantitative microbial risk assessment framework and provides theoretical support for stakeholders to establish reasonable working time threshold guidelines, and practical method and novel perspective to protect the on-site health risks of sewage workers exposing to various facilities.