Variation in the fitted filtration efficiency of disposable face masks by sex.

BACKGROUND & OBJECTIVE: Disposable face masks are a primary protective measure against the adverse health effects of exposure to infectious and toxic aerosols such as airborne viruses and particulate air pollutants. While the fit of high efficiency respirators is regulated in occupational settings, relatively little is known about the fitted filtration efficiencies of ear loop style face masks worn by the public. METHODS: We measured the variation in fitted filtration efficiency (FFE) of four commonly worn disposable face masks, in a cohort of healthy adult participants (N = 100, 50% female, 50% male, average age = 32.3 ± 9.2 years, average BMI = 25.5 ± 3.4) using the U.S. Occupational Safety and Health Administration Quantitative Fit Test, for an N95 (respirator), KN95, surgical, and KF94 masks. The latter three ear loop style masks were additionally tested in a clip-modified condition, tightened using a plastic clip to centrally fasten loops in the back of the head. RESULTS: The findings show that sex is a major determinant of the FFE of KN95, surgical, and KF94 masks. On average, males had an 11% higher FFE relative to females, at baseline testing. We show that a simple modification using an ear loop clip, results in improvements in the average FFE for females but provides comparatively minor changes for males. On average, females had a 20% increased FFE when a clip was worn behind the head, relative to a 6% increase for males. IMPACT: The efficacy of a disposable face mask as protection against air contaminants depends on the efficiency of the mask materials and how well it fits the wearer. We report that the sex of the wearer is a major determinant of the baseline fitted filtration efficiency (FFE) of commonly available ear loop style face masks. In addition, we show that a simple fit modifier, an ear loop clip fastened behind the head, substantially improves baseline FFE for females but produces only minor changes for males. These findings have significant public health implications for the use of face masks as a protective intervention against inhalational exposure to airborne contaminants.

Masked emotions: does children's affective state influence emotion recognition?

Introduction: Facial emotion recognition abilities of children have been the focus of attention across various fields, with implications for communication, social interaction, and human behavior. In response to the COVID-19 pandemic, wearing a face mask in public became mandatory in many countries, hindering social information perception and emotion recognition. Given the importance of visual communication for children's social-emotional development, concerns have been raised on whether face masks could impair their ability to recognize emotions and thereby possibly impact their social-emotional development. Methods: To this extent, a quasiexperimental study was designed with a two-fold objective: firstly, to identify children's accuracy in recognizing basic emotions (anger, happiness, fear, disgust, sadness) and emotional neutrality when presented with faces under two conditions: one with no-masks and another with faces partially covered by various types of masks (medical, nonmedical, surgical, or cloth); secondly, to explore any correlation between children's emotion recognition accuracy and their affective state. Sixty-nine (69) elementary school students aged 6-7 years old from Greece were recruited for this purpose. Following specific requirements of the second phase of the experiment students were assigned to one of three (3) distinct affective condition groups: Group A-Happiness, Group B-Sadness, and Group C-Emotional Neutrality. Image stimuli were drawn from the FACES Dataset, and students' affective state was registered using the self-reporting emotions-registration tool, AffectLecture app. Results: The study's findings indicate that children can accurately recognize emotions even with masks, although recognizing disgust is more challenging. Additionally, following both positive and negative affective state priming promoted systematic inaccuracies in emotion recognition. Most significantly, results showed a negative bias for children in negative affective state and a positive bias for those in positive affective state. Discussion: Children's affective state significantly influenced their emotion recognition abilities; sad affective states led to lower recognition overall and a bias toward recognizing sad expressions, while happy affective states resulted in a positive bias, improving recognition of happiness, and affecting how emotional neutrality and sadness were actually perceived. In conclusion, this study sheds light on the intriguing dynamics of how face masks affect children's emotion recognition, but also underlines the profound influence of their affective state.

Exploring the evocative qualities of masks' visual imagery and their associations with adversity and trauma.

Introduction: Studies suggest a relationship between the emotional evocativeness of visual imagery and viewer responses, however, there is limited understanding of these associations, especially as they relate to viewers' personal experiences of adversities. Methods: In this exploratory study, we examined the relationship between the visual content of mask images and viewers' responses. In an online survey 699 participants (of n = 1,010 total initial participants) rated 98 masks based on valence, arousal, and personal relevance and completed the Life Events Checklist. The masks included those created by service members (SMs) with traumatic brain injury (TBI), and post-traumatic stress disorder (PTSD), depicting physical, psychological, and moral injuries and matched neutral masks created by creative arts therapists and arts in health scholars. Findings: The findings indicated that responses to mask image content (traumatic versus neutral) were associated with viewers' personal history of adversity and trauma. Specifically, images representing injury/trauma provoked stronger reactions on valence and arousal than neutral images. Moreover, participants with personal histories of trauma had heightened emotional responses to distressing imagery. Discussion: These findings have implications for art therapists as well as for clinical and general populations in that these results highlight the potential impact of distressing imagery particularly for individuals with personal histories of experiencing or witnessing traumatic events.

Clinical Performance of I-gel® and BlockBuster™ Laryngeal Mask Airway in Adult Patients during General Anesthesia: A Randomized Comparison.

Background: Supraglottic devices have revolutionized the current practice of airway management. We compared the clinical performance of a recently introduced BlockBuster™ Laryngeal mask airway with i-gel® in adult patients under general anesthesia. Methods: Following Institutional ethical clearance, the present study was conducted on 62 patients belonging to American Society of Anesthesiologists physical status 1 and 2 of either sex in the age group of 20-60 years under general anesthesia. Patients were randomly assigned to i-gel® (I) and BlockBuster™ (B) groups (31 per group). Time for successful insertion, insertion success rate, ease of insertion, oropharyngeal leak pressures (OLPs), and complications were assessed. Results: Mean insertion time of device was less in Group I (13.52 ± 2.58 s) than that of Group B (14.10 ± 2.04 s), which was neither clinically nor statistically significant (P = 0.330). OLP in Group B (24.52 ± 2.77 cm of H2O) was found to be significantly higher compared to Group I (20.81 ± 2.56 cm of H2O) with P < 0.001. Overall insertion and first attempt success was similar (i-gel® 31/31 [100%] and 29/31 [93.5%] and BlockBuster™ 31/31 [100%] and 29/31 [93.5%], respectively). Ease of insertion (P = 0.684) and complications (P = 0.782) of both the devices were comparable. Conclusions: Both the devices are useful and effective for airway management in adult under general anesthesia. Having a high OLP and comparable insertion time, risk of aspiration may be further reduced with the use of BlockBuster™ in comparison to i-gel®.

How College Students Used Information From Institutions of Higher Education in the United States During COVID-19: Web-Based Cross-Sectional Survey Study.

BACKGROUND: The start of the COVID-19 pandemic resulted in the implementation of nonpharmaceutical interventions by US institutions of higher education at an unprecedented level. During the backdrop of an emerging pandemic, younger adults (eg, college students) had an overall lower risk for severe outcomes for SARS-CoV-2, making this population a potential source of transmission for age groups with high susceptibility and negative health outcomes. We examine how college students' level of concern for COVID-19 was influenced by different sources of information, their living status, income level, and other demographic identifiers and its association with prevention behavior change. OBJECTIVE: We sought to examine the level of concern, defined as the extent to which the participant would take corrective action to mitigate contracting or spreading the virus (to family or friends) by using personal protective equipment such as a face mask, practicing social distancing, and following other public health recommendations, among college students during the COVID-19 pandemic. METHODS: A cross-sectional, web-based survey was conducted in 2021 among 185 college students aged 18-41 years, with most living in New York City and the United States (n=134, 72.4%). Out of 185 college students, 94 provided their zip codes, with 51 of those college students indicating they lived in New York City areas. The participants completed the survey via a QR code. Study participants who did not complete the full survey or were not college students in any US college or university were excluded. Analyses were conducted using R (version 4.2.2; R Foundation for Statistical Computing). RESULTS: Of 185 respondents participated in the study, 25 (13.5.%) used emails from their schools, 51 (27.6%) used mainstream media, and 109 (58.9%) used social media and other sources to obtain information about COVID-19. Of the 109 participants who learned about the pandemic from social media, 91 (83.5%) were concerned; however, only 63% (32/51) and 60% (15/25) of the participants who sourced information from mainstream media and their schools' email, respectively, were concerned. Further, the participants who received information from social media and other sources were about 3 times more likely to be concerned about COVID-19 than participants who received information from the university via email (P=.036; OR=3.07, 95% CI: 1.06-8.83).. CONCLUSIONS: College students who received information from social media and other sources were more likely to be concerned about COVID-19 than students who received information from their school via emails.

Effect of Face Masks on Voice Quality Associated with Young and Older Chinese Adult Speakers.

OBJECTIVES: Face masks have become important after the pandemic, but the change in voice when wearing a face mask is still unclear. The study investigated the effect of face masks on the acoustic and perceptual characteristics of voice quality associated with young and older Chinese adults. METHODS: Voice samples of the sustained vowel /a/ and continuous speech produced by 44 older and 61 young adults with and without an ASTM level-3 surgical face mask were recorded and analyzed. Perceptual and acoustic parameters including mean fundamental frequency (F0) and intensity, perturbation measures (jitter and shimmer), harmonic-to-noise ratio (HNR), smoothed cepstral peak prominence (CPPs), and long-term average spectrum (LTAS) measures were obtained and compared. RESULTS: When comparing masked to unmasked voices, for both male and female speakers, F0 and intensity showed no significant changes, except for F0 of continuous speech, which increased significantly. Meanwhile, perturbation measures such as jitter and shimmer were reduced, while HNR and CPPs increased. In addition, LTAS measures included low-frequency mean spectral energy (MSE), high-frequency MSE, and spectral tilt (ST), which were different. For perceptual measures, the overall grade of dysphonia, and roughness were reduced, except for the breathiness among older male speakers, while the other vocal qualities were not changed. Between young and older speakers, significant differences in shimmer, CPPs, and perceived breathiness among male speakers, and low-frequency MSE among female speakers were found. CONCLUSION: Wearing a surgical mask appeared to change the perceived voice quality. This is supported by the change in perturbation and LTAS measures, and HNR and CPPs values. In addition, some differences between young and older adults were observed. Oral Communication effectiveness may be affected when wearing surgical masks due to changes in voice quality. Additionally, clinicians need to exercise hightened caution in evaluating the voice quality of clients when wearing face masks.

Upcycling of waste disposable medical masks to high value-added gasoline fuel and surfactants products by sub/supercritical water degradation and partial oxidation.

The amount of waste disposable medical masks (DMMs) and the potential environmental risk increased significantly due to the huge demand of disposable medical surgical masks. In this study, two effective and environmentally friendly processes, supercritical water degradation (SCWD) and subcritical water partial oxidation (SubCWPO), were proposed for the upcycling of DMMs. The optimal conditions for the SCWD process (conversion ratio>98 %) were 410 â„ƒ, 15 min, and 1:5 g/mL. The oil products obtained from the SCWD process were mainly small molecule hydrocarbons (C7-C12) with a content of 86 % and could be recycled as fuel feedstock for gasoline. Alkyl radicals in the SCWD reaction formed double bonds and ring structures through hydrogen capture reactions, ß-scission, and dehydrogenation reactions, and aromatic hydrocarbons were formed by olefin cyclization and cycloalkane dehydrogenation. The introduction of an oxidant (H2O2) to the reaction system could significantly reduce the reaction temperature and shorten the reaction time. At 350 â„ƒ, 15 min, 1:20 g/mL, V(H2O2): V (H2O) of 1:1, the conversion ratio of the SubCWPO process was 88 %, which was higher than that of the SCWD process at 400 â„ƒ (71.49 %). Oil products produced from the SubCWPO process were rich in alcohols and esters, which could be used as raw materials for nonionic surfactant of polyol and fatty acid ester. The abundant hydroxyl radical in the SubCWPO system trapped hydrogen atoms on PP and reacted with the resulting alkyl radical to form alkanols, which was oxidized to form acids. The esterification of acids and alkanols formed high level of esters. The SCWD and SubCWPO processes proposed in this study are believed to be promising strategies for DMMs degradation and the recovery of high value-added hydrocarbons.

Circuit-dependent carbon dioxide rebreathing during continuous positive airway pressure.

BACKGROUND: The current standard treatment for obstructive sleep apnea (OSA), continuous positive airway pressure (CPAP), is characterized by a low adherence rate due to various factors including circuit-dependent carbon dioxide (CO2) rebreathing, which can exacerbated by disparate factors, such as low PAP, use of auto-titrating PAP or ramps. However, risk factors for rebreathing are often overlooked or poorly understood in clinical practice. Therefore, our objective was to evaluate the extent of rebreathing occurring with commonly used CPAP masks across varying PAPs, tidal volumes, and respiratory rates. METHODS: In a bench study, we assessed the rebreathing rate of nine masks interfacing a CPAP with a lung simulator providing different breathing respiratory rates (15 or 20 breaths/min) and tidal volumes (400, 500, 600, 700 and 750 mL). Additionally, a theoretical model was developed to describe the likelihood of CO2 rebreathing from four different masks at various breathing settings. RESULTS: Overall, all masks performed worse in situations characterized by low PAPs, high tidal volumes, and high respiratory rates. However, Dreamwear, Nuance, Siesta, Vitera, and particularly V2 masks exhibited greater susceptibility to rebreathing compared to F20, P10, Brevida, and Rio masks for the same variations of PAPs or ventilatory parameters. The mathematical model suggested that the risk of rebreathing for Rio, P10 and Nuance mask is negligible for respiratory rates of 10 breaths/min or below. CONCLUSIONS: Circuit-dependent CO2 rebreathing can be a common occurrence and warrants careful mask selection upon CPAP therapy initiation for optimal clinical outcomes.

The social factors behind the mask: contextual effects on trait impressions from faces wearing a face mask.

The presence of face masks can significantly impact processes related to trait impressions from faces. In the present research, we focused on trait impressions from faces either wearing a mask or not by addressing how contextual factors may shape such inferences. In Study 1, we compared trait impressions from faces in a phase of the COVID-19 pandemic in which wearing masks was a normative behavior (T1) with those assessed one year later when wearing masks was far less common (T2). Results at T2 showed a reduced positivity in the trait impressions elicited by faces covered by a mask. In Study 2, it was found that trait impressions from faces were modulated by the background visual context in which the target face was embedded so that faces wearing a mask elicited more positive traits when superimposed on an indoor rather than outdoor visual context. Overall, the present studies indicate that wearing face masks may affect trait impressions from faces, but also that such impressions are highly flexible and can significantly fluctuate across time and space.

Impact of vaccine coverage and disruption to health services on COVID-19 in Ukraine.

COVID-19 surveillance in Ukraine ceased after the Russian invasion of the country in 2022, on a background of low vaccination rates of 34.5% for two doses at this time. We conducted a modelling study to estimate the epidemic trajectory of SARS-COV-2 in Ukraine after the start of the war. We use a COVID-19 deterministic Susceptible-Exposed-Infected-Recovered (SEIR) model for Ukraine to estimate the impact of increased vaccination coverage and masking as public health interventions. We fit the model output to case notification data between 6 January and 25 February 2022, then we forecast the COVID-19 epidemic trajectory in different scenarios of mask use and vaccine coverage. In the best-case scenario, 69% of the Ukrainian population would have been infected in the first half of 2022. Increasing mask use from 50 to 80% reduces cases and deaths by 17% and 30% respectively, while increasing vaccination rates to 60% and 9.6% for two and three doses respectively results in a 3% reduction in cases and 28% in deaths. However, if vaccination is increased to a higher coverage of 80% with two doses and 12.8% with three, or mask effectiveness is reduced to 40%, increasing vaccination coverage is more effective. The loss of health services, displacement, and destruction of infrastructure will amplify the risk of COVID-19 in Ukraine and make vaccine programs less feasible. Masks do not need the health infrastructure or cold-chain logistics required for vaccines and are more feasible for rapid epidemic control during war. However, increasing vaccine coverage will save more lives. Vaccination of refugees who have fled to other countries can be more feasibly achieved.

Effectiveness of respiratory face masks in reducing acute PM2.5 pollution exposure during peak pollution period in Delhi.

The cities of North India, such as Delhi, face a significant public health threat from severe air pollution. Between October 2021 and January 2022, 79 % of Delhi's daily average PM2.5 (Particulate matter with an aerodynamic diameter ≤ 2.5 µm) values exceeded 100 µg/m3 (the permissible level being 60 µg/m3 as per Indian standards). In response to this acute exposure, using Respiratory Face Masks (RFMs) is a cost-effective solution to reduce immediate health risks while policymakers develop long-term emission control plans. Our research focuses on the health and economic benefits of using RFMs to prevent acute exposure to PM2.5 pollution in Delhi for different age groups. Our findings indicate that, among the fifty chosen RFMs, M50 has greatest potential to prevent short-term excess mortality (908 in age ranges 5-44), followed by M49 (745) and M48 (568). These RFMs resulted in estimated economic benefits of 500.6 (46 %), 411.1 (37 %), and 313.4 (29 %) million Indian Rupee (INR), respectively during October-January 2021-22. By wearing RFMs such as M50, M49, and M48 during episodes of bad air quality, it is estimated that 13 % of short-term excess mortality and associated costs could be saved if at least 30 % of Delhi residents followed an alert issued by an operational Air Quality Early Warning System (AQEWS) developed by the Ministry of Earth Sciences. Our research suggests that RFMs can notably decrease health and economic burdens amid peak PM2.5 pollution in post-monsoon and winter seasons until long-term emission reduction strategies are adopted. It is suggested that an advisory may be crafted in collaboration with statutory bodies and should be disseminated to assist the vulnerable population in using RFMs during winter. The analysis presented in this research is purely science based and outcomes of study are in no way to be construed as endorsement of product.

Leaching potentials of microplastic fibers and UV stabilizers from coastal-littered face masks.

Synthetic fibrous textiles are ubiquitous plastic commodities in everyday existence. Nevertheless, there exists a dearth of understanding regarding their environmental occurrence and the releasing capacities of associated additives. In this study, ten additives were determined in twenty-eight kinds of daily used plastic products including face masks, synthetic clothing, and food containers. Our results revealed that a typical kind of fibrous plastic, face masks, contained a greater variety of additives with UV stabilizers in particular, when compared to other plastic commodities. The above phenomena triggered our field investigation for the occurrence and release potentials of face mask fibers and the co-existing UV stabilizers into the environment. We further collected 114 disposed masks from coastal areas and analyzed their UV stabilizer concentrations. Results showed that the abundance of littered face masks ranged from 40-1846 items/km2 along the Yangtze Estuary, China; and UV stabilizers were of 0.3 ± 0.7 ng/g and 0.7 ± 1.7 ng/g in main bodies and ear ropes, respectively. The UV stabilizer concentrations in the field collected masks were only ∼7 % of their new counterparts, implying their potential leaching after disposal. By simulating the weathering scenario, we predict that a substantial amount of microplastics, with 1.1 × 1010 polypropylene fibers and 3.7 × 1010 polyester fibers, are probably be released daily into the coastal environment after face masks disposal; whereas the accompanied leaching amount of UV stabilizers was relatively modest under the current scenario.

Whispers in the wind: Face mask sampling for Mycobacterium tuberculosis detection in children with pulmonary tuberculosis.

BACKGROUND: Recently, face mask sampling (FMS) confirmed detection of Mycobacterium tuberculosis DNA from exhaled breath in adults with TB. To date, no study has evaluated the use of FMS to detect pulmonary Tuberculosis (TB) in children. We developed a method for FMS of M. tuberculosis-specific DNA in children and performed a clinical exploration to assess feasibility in children. METHODS: Face masks were spiked, analysed on GeneXpert-Ultra, qPCR, and tNGS. Children with pulmonary TB were asked to wear three modified FFP2 masks for 30 minutes as part of an exploratory clinical study. RESULTS: Experiments with H37Ra M. tuberculosis strain showed a limit of 95% detection of 3.75 CFU (4.85-3.11; 95%CI) on GeneXpert-Ultra. Ten children with pulmonary TB participated in the clinical study. M. tuberculosis-specific DNA was detected on none of the face masks. CONCLUSIONS: Paediatric FMS has a low limit of detection for M. tuberculosis-specific DNA in vitro. However, M. tuberculosis DNA was not detected in any of thirty masks worn by children with pulmonary TB. This suggests that FMS in this form may not be more effective for detecting M. tuberculosis in children with TB than existing methods.

The effects of wearing face masks on the perception and mood of male healthy male adults during treadmill running: A pilot study.

In the past few years, the face mask has been recommended for the prevention of exposing others to COVID-19. Wearing a face mask may have the potential to increase dyspnea and discomfort during exercise; however, controversy exists on whether wearing face masks during exercise affects exercise performance, perception, and mood in runners. We investigated the physiological and perceptual responses of healthy male adults who had experienced long-distance running while exercising at different intensities. Nine healthy young adults who were long-distance runners wearing surgical face mask conducted an incremental treadmill protocol. The protocol was three 6-min stages (20%, 40%, and 60% of maximal heart rate, respectively). The rating of perceived exertion (RPE) and the feeling scale (FS) were measured. RPE was higher in mask condition than in unmask condition (No mask vs. Face mask, light; 8.22 vs. 8.78, p = 0.615, middle; 10.00 vs. 10.78, p = 0.345, high; 12.33 vs. 13.67, p = 0.044.), while FS was not different between conditions. The present study shows that wearing a mask may increase rating of perceived exertion and discomfort when the exercise intensity exceeds a certain threshold in healthy male adults who have experienced long-distance running.

Nanofiberous facemasks as protectives against pandemic respiratory viruses.

INTRODUCTION: Wearing protective face masks and respirators has been a necessity to reduce the transmission rate of respiratory viruses since the outbreak of the coronavirus (COVID-19) disease. Nevertheless, the outbreak has revealed the need to develop efficient air filter materials and innovative anti-microbial protectives. Nanofibrous facemasks, either loaded with antiviral nanoparticles or not, are very promising personal protective equipment (PPE) against pandemic respiratory viruses. AREAS COVERED: In this review, multiple types of face masks and respirators are discussed as well as filtration mechanisms of particulates. In this regard, the limitations of traditional face masks were summarized and the advancement of nanotechnology in developing nanofibrous masks and air filters was discussed. Different methods of preparing nanofibers were explained. The various approaches used for enhancing nanofibrous face masks were covered. EXPERT OPINION: Although wearing conventional face masks can limit viral infection spread to some extent, the world is in great need for more protective face masks. Nanofibers can block viral particles efficiently and can be incorporated into face masks in order to enhance their filtration efficiency. Also, we believe that other modifications such as addition of antiviral nanoparticles can significantly increase the protection power of facemasks.

Masks and respirators for prevention of respiratory infections: a state of the science review.

SUMMARYThis narrative review and meta-analysis summarizes a broad evidence base on the benefits-and also the practicalities, disbenefits, harms and personal, sociocultural and environmental impacts-of masks and masking. Our synthesis of evidence from over 100 published reviews and selected primary studies, including re-analyzing contested meta-analyses of key clinical trials, produced seven key findings. First, there is strong and consistent evidence for airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other respiratory pathogens. Second, masks are, if correctly and consistently worn, effective in reducing transmission of respiratory diseases and show a dose-response effect. Third, respirators are significantly more effective than medical or cloth masks. Fourth, mask mandates are, overall, effective in reducing community transmission of respiratory pathogens. Fifth, masks are important sociocultural symbols; non-adherence to masking is sometimes linked to political and ideological beliefs and to widely circulated mis- or disinformation. Sixth, while there is much evidence that masks are not generally harmful to the general population, masking may be relatively contraindicated in individuals with certain medical conditions, who may require exemption. Furthermore, certain groups (notably D/deaf people) are disadvantaged when others are masked. Finally, there are risks to the environment from single-use masks and respirators. We propose an agenda for future research, including improved characterization of the situations in which masking should be recommended or mandated; attention to comfort and acceptability; generalized and disability-focused communication support in settings where masks are worn; and development and testing of novel materials and designs for improved filtration, breathability, and environmental impact.

Relative efficacy of masks and respirators as source control for viral aerosol shedding from people infected with SARS-CoV-2: a controlled human exhaled breath aerosol experimental study.

BACKGROUND: Tight-fitting masks and respirators, in manikin studies, improved aerosol source control compared to loose-fitting masks. Whether this translates to humans is not known. METHODS: We compared efficacy of masks (cloth and surgical) and respirators (KN95 and N95) as source control for SARS-CoV-2 viral load in exhaled breath of volunteers with COVID-19 using a controlled human experimental study. Volunteers (N = 44, 43% female) provided paired unmasked and masked breath samples allowing computation of source-control factors. FINDINGS: All masks and respirators significantly reduced exhaled viral load, without fit tests or training. A duckbill N95 reduced exhaled viral load by 98% (95% CI: 97%-99%), and significantly outperformed a KN95 (p < 0.001) as well as cloth and surgical masks. Cloth masks outperformed a surgical mask (p = 0.027) and the tested KN95 (p = 0.014). INTERPRETATION: These results suggest that N95 respirators could be the standard of care in nursing homes and healthcare settings when respiratory viral infections are prevalent in the community and healthcare-associated transmission risk is elevated. FUNDING: Defense Advanced Research Projects Agency, National Institute of Allergy and Infectious Diseases, Centers for Disease Control and Prevention, the Bill & Melinda Gates Foundation, and The Flu Lab.

Comparison of i-gel® and LMA® Supreme™ for Facilitating Fiberoptic Endotracheal Intubation: A Prospective Randomized Trial.

Supraglottic airway (SGA) is an alternative to endotracheal intubation, however endotracheal intubation is often essential. One method to convert from an SGA to an endotracheal tube (ETT) is utilizing the SGA as a conduit for fiberoptic-guided advancement of an Aintree catheter (airway exchange catheter), and exchange of the SGA for an ETT. In this prospective randomized study, we compared two SGA devices in facilitating this exchange. Subjects were randomized to receive either the i-gel® or LMA® Supreme™ SGA. The SGA was placed and an Aintree intubation catheter was inserted through the SGA over a fiberoptic bronchoscope. Next, the SGA was removed, leaving the Aintree within the trachea, and an ETT was placed over the Aintree catheter and advanced into the trachea. The i-gel group exhibited shorter time to successful intubation (median, 191 vs. 434 seconds; P = .002). The i-gel group also had fewer study subjects requiring more than one attempt for successful Aintree placement (33% vs. 75%, P = .02). The i-gel group showed superior laryngeal view score (LVS) (6 vs. 4; P = .003). The i-gel SGA achieved a faster time to successful intubation, higher rate of first attempt Aintree placement, and superior LVS.

The Impact of Electrocautery Smoke on Surgical Staff and the Efficacy of Normal Surgical Masks Versus N95 Masks.

Electrocautery is a commonly used technique in surgical procedures, generating smoke that poses health risks to surgical staff. This study investigates the comparative efficacy of normal surgical masks versus N95 masks in mitigating the harmful effects of electrocautery smoke. Through a systematic review of literature spanning two decades, we explore the causes and effects of electrocautery smoke exposure, including potential long-term inhalation effects. Our findings highlight significant disparities in the protection offered by different masks and underscore the importance of adequate respiratory protection in surgical settings. In addition, we examine the factors influencing the generation and composition of electrocautery smoke, such as the power settings used, the type of tissue being cauterized, and the duration of the procedure. Furthermore, we discuss the potential health risks associated with long-term exposure to electrocautery smoke, including the possibility of respiratory conditions, cardiovascular effects, and carcinogenicity. Our analysis also addresses the importance of implementing appropriate smoke evacuation systems and optimizing operating room ventilation to minimize the concentration of smoke particles in the surgical environment. Overall, this comprehensive analysis provides valuable insights into the impact of electrocautery smoke in surgical settings and the varying levels of protection offered by different masks.

The influence of face mask color on perceptions of African American and white men.

Despite their widespread use during the COVID-19 pandemic, face masks hinder abilities to interpret facial expressions. Yet, they can also reduce the appearance of characteristics that are used to categorize individuals into racial groups, such as Afrocentric features. The color of a face mask might also promote associations with certain types of behavior and professional occupations (e.g., blue surgical mask connoting physician stereotypes; black masks potentially being associated with criminality). This study assessed whether the presence and color of a face mask impacted perceptions of a target male of varying race. White participants (N = 250) were presented with an African American or White male adult face from the Chicago Face Database (of equal age and attractiveness) wearing a blue or black surgical mask, or no mask (Photoshopped onto the face) and rated the man on emotions (happy, sad, angry) as well as how trustworthy, threatening, and attractive the target appeared. Targets wearing a blue surgical mask were judged as more trustworthy and attractive than those wearing no mask (perhaps due to association with medical professions), but these judgements were not qualified by race, despite the African American target's selection based on Afrocentric features. The color black on a face mask did not exacerbate negative perceptions of targets, perhaps suggesting a decline effect in previously demonstrated associations between this color and criminal actions. Unlike previous research performed at the beginning of the Covid-19 Pandemic on cloth masks shown to potentially exacerbate racial biases, surgical masks (pleated and made of polymeric materials), appear to lessen potential stereotyping of Black relative to White men.