Comparison of the inward leakage rate between N95 filtering facepiece respirators and modified surgical masks during the COVID-19 pandemic

BACKGROUND@#Owing to shortage of surgical and N95 filtering facepiece respirators (FFRs) during the COVID-2019 pandemic, various masks were developed to prevent infection. This study aimed to examine the inward leakage rate (ILR) of sealed face masks and modified surgical masks using a quantitative fit test and compared it with the ILR of unmodified N95 FFRs.@*METHODS@#We conducted paired comparisons of ILRs of bent nose-fit wire masks, double masks, and N95 FFRs from October to December 2021. To measure the protective effectiveness of masks, participants wore masks, and the number of particles outside and inside the mask were measured. The ILR was based on the percentage of particles entering the mask using a fit tester.@*RESULTS@#We enrolled 54 participants (20 men and 34 women) in this study. The median ILR for surgical masks without and with a W-shaped bend in the nose-fit wire were 96.44% and 50.82%, respectively. The nose-fit wire adjustment reduced the ILR of surgical masks by a mean of 28.57%, which was significantly lower than the ILR without adjustment (P < 0.001). For double masks, with surgical or polyurethane masks on top of the W-shaped mask, the ILR did not differ significantly from that of N95. Although the filtration performance of double surgical masks matched that of N95 masks, their ILR was notably higher, indicating that double masks do not provide equivalent protection.@*CONCLUSIONS@#Wearing N95 masks alone is effective in many cases. However, surgical mask modifications do not guarantee consistent effectiveness. Properly selected, sealed masks with a good fit overcome leakage, emphasizing their crucial role. Without evidence, mask-wearing may lead to unexpected infections. Education based on quantitative data is crucial for preventing adverse outcomes.

AI Rudi's Experience in Treating Acne with Triple Chinese Medicinal Groups Combined with Chinese Medicinal Mask / 中医杂志

To summarize the clinical experience of Professor AI Rudi in treating acne with triple Chinese medicinal groups combined with Chinese medicinal mask. It is believed that the pathogenesis and treatment of male and female acne are different. The key mechanism of male acne is the dysfunction of the "lung-spleen and stomach-large intestine" axis， and the method of three jiao differentiation should be used. Clinically， the triple Chinese medicinal group， Rendongteng （Lonicera japonica） - Qishe （Portulaca oleracea） - Shicangpu （Acorus gramineus）， can scatter wind to relieve heat， and diffuse and disperse upper jiao； group Baihua Sheshecao （Scleromitrion diffusum） - Baixianpi （Dictamnus dasycarpus） - Tanxiang （Santalum album） can clear heat and drain dampness， and regulate middle jiao； group Huaimi （Styphnolobium japonicum） - Juemingzi （Senna tora） - Baizhu （Atractylodes macrocephala） can tonify and moisten to unblock the lower jiao. The core mechanism of female acne is the imbalance of the function of the "liver and kidney- Tiangui （reproduction-stimulating essence， corresponds with the tenth heavenly stem） - Chong and ren" axis， and the method of staged tratment based on menstrual cycle should be used. Before the menstrual period， group Tusizi （Cuscuta chinensis） - Yujing （Curcuma longa） - Qianghuoyu （Hansenia forbesii） can tonify kidney and relax liver； during the menstrual period， group Chuanxiong （Rhizoma Ligustici Chuangxiong） - Yimucao （Leonurus japonicus）- Cansha （Bombycis Faeces） can invigorate blood and regulate menstrual flow； after the menstrual period， group Huangjing （Polygonatum sibiricum） - Shanyurou （Corni Fructus） - Roucongrong （Cistanche deserticola） can nourish blood， assist yang and boost yin. Meanwhile， we attached importance to the internal and external treatment. Based on the internal administration of traditional Chinese medicine， Chinese medicinal masks were used for external application， commonly used in self-prescribed Xianglian Jinhuang Powder （香连金黄散） combined with Huoxue Powder （活血散） as the prescription for Chinese medicinal mask.

A comparative analysis of ocular surface parameters before and after N95 face mask use among healthcare workers

Objectives@#This study determined whether the use of an N95 face mask was associated with changes in ocular surface parameters and dry eye symptomatology among healthcare workers with no baseline dry eye disease. @*Methodology@#This was a prospective, analytical, quasi-experimental study. The ocular surface and dry eye symptomatology of 33 healthcare workers (n=66 eyes) were evaluated at baseline and 3 hours after use of 3M™ VFlex™ Particulate Respirator 9105 N95 mask (3M, Minnesota, USA). The following parameters were measured: ocular surface disease index (OSDI), tear break-up time (TBUT), tear break-up pattern (TBUP), non-invasive TBUT (NIKBUT), tear meniscus height (TMH), meibography, and bulbar conjunctival redness.@*Results@#Among all the parameters tested, only OSDI and bulbar redness showed significant changes when pre-N95 and post-N95 values were compared. Although each was interpreted as normal, the median OSDI score improved from 7 to 1 (p < 0.001). Median bulbar conjunctival redness score worsened from 0.9 to 1.1 (p < 0.001). @*Conclusion@#Among healthcare workers with no dry eye disease, the use of the 3M™ Vflex™ Particulate Respirator 9105 N95 mask was not associated with changes in TBUT, TBUP, NIKBUT, TMH, and meibogaphy. An improvement of dry eye symptoms was reported after VFlex™ mask use.

Analyzing the result of half-mask respirator fit testing in workers exposed to organic solvents and its influencing factors / 中国职业医学

ObjectiveTo analyze the results of fit testing and its influencing factors on half-mask respirator among workers exposed to organic solvents. Methods A total of 84 workers exposed to organic solvents were selected as the research subjects using a convenience sampling method. The qualitative fit test apparatus of respiratory protection was tested after the workers had put on the half-mask respirats, and 11 facial indicators of the subjects were measured. Results The overall pass rate of the respirator fit testing was 71.4% (60/84). The lowest pass rate was 63.1% (53/84), which occurred during bending movements of workers. The head width, minimum forehead width, face length, nose length, nose depth, head circumference and head length were higher in workers who passed respirator fit testing, compared with those in the failing group (all P<0.05). The result of binary logistic regression analysis showed that gender and face width were influencing factors of the respirator fit testing (both P<0.05). Female workers had a lower pass rate of the fit testing than male workers, and workers with larger face width had a lower pass rate in the fit testing. Conclusion Drastic movement may lead to a decrease in the seal of half-mask respirator of workers exposed to organic solvents. When providing half-mask respirator to workers exposed to organic solvents, employers need to pay attention to the fit of respirators of female works and those with larger face width to ensure the effectiveness of respiratory protection for workers.

Effects of mask-wearing exercise on heart rate,blood oxygen saturation and end-expiratory carbon dioxide:a Meta-analysis / 中国组织工程研究

OBJECTIVE:Masks are one of the most important defenses against the virus.However,the impact of wearing masks during daily activities or sports on respiratory and circulatory function remains controversial.A comprehensive quantitative evaluation of the effects of mask-wearing on human heart rate,oxygen saturation and end-expiratory carbon dioxide by Meta-analysis was conducted.The effects of wearing different types of masks at different exercise intensities and time of exercise on the human respiratory and circulatory system were explored. METHODS:By February 2023,with"mask,face mask,N95,training,sports,running,walking,cycling"as the Chinese search terms and"masks,respiratory protective devices,N95 respirators,surgical face masks,exercise,resistance training,explosive training,muscle exercises"as English search terms,the experimental studies addressing the influence of exercise with a mask on hemodynamic indexes were retrieved from CNKI,Web of Science,PubMed,Cochrane Library and WanFang databases.The outcome indicators included three continuous variables-exercise center rate,blood oxygen saturation and end-expiratory carbon dioxide.Stata16.0 software was used to analyze the outcome indicators of the included literature.The PEDro scale was used as a quality assessment tool,and the funnel plot was used to analyze the impact of publication bias. RESULTS:Totally 25 articles involving 857 healthy children and adults were included in this Meta-analysis.The overall methodological quality was high,with 22 studies scoring 6 points on the PEDro scale,2 studies scoring 7 points and 1 study scoring 8 points.The meta-analysis results showed that compared with the control group,exercise with masks had no significant effect on heart rate(SMD=0.02,95%CI:-0.11 to 0.15,P=0.81),but increased end-expiratory carbon dioxide(SMD=0.60,95%CI:0.37 to 0.83,P=0.00),decreased oxygen saturation(SMD=-0.28,95%CI:-0.47 to-0.09,P=0.03).Intensity and duration were the factors that affected the heterogeneity between studies.Wearing a mask during high-intensity exercise significantly increased heart rate(SMD=-0.20,95%CI:-0.36 to-0.04,P=0.02).The effect of high-intensity and short-time exercise on blood oxygen saturation was significantly higher than that of other exercises(SMD=-0.40,95%CI:-0.70 to-0.10;SMD=-0.25,95%CI:-0.45 to-0.04).For end-expiratory carbon dioxide,maintaining a certain intensity and increasing the exercise time or increasing the intensity further increased the index significantly,reaching a moderate effect size(SMD=0.61,95%CI:0.06 to 1.15;SMD=0.58,95%CI:0.04 to 1.13). CONCLUSION:Existing evidence suggests that exercise with masks may have the adverse effect of increasing end-expiratory carbon dioxide and decreasing blood oxygen saturation.The influence of different exercise test time and intensities on the three outcome indexes was different.Wearing a mask during high-intensity exercise can significantly increase heart rate and decrease blood oxygen saturation.Maintaining moderate intensity for a long period or further increasing the intensity of exercise will lead to increased end-expiratory carbon dioxide levels.

Cosmetic attributes (oiliness reduction and firmness) from face masks composed of red, green and black clays / Atributos cosméticos (redução de oleosidade e melhora de firmeza) de máscaras faciais compostas por argilas vermelha, verde e preta

The appearance of skin strongly influences people´s self-esteem and well-being. Among the characteristics that affect the most, we can cite acne and wrinkles. Therefore, minimizing those characteristics by using cosmetics has important value for the consumer. Nowadays, there is a demand for natural ingredients, mainly concerning cosmetic products. The use of clays in beauty care is old, with therapeutic uses since Prehistory. There is an essential advantage in using clays for cosmetic purposes, as it is a low-cost, environmentally friendly, natural, and abundant ingredient, which is chemically inert with a low level of toxicity (when in adequate conditions), easy to apply and remove, dries, and hardens fast. In this research work, we aimed at developing and investigating the effect of formulations containing red, green, and black clays as active components in oiliness reduction, and firmness and elasticity improvement in vivo, as well as characterizing clays mineralogically. All clays presented different compositions. Black clay was the one with the simplest mineralogic content, lowest density, and smallest particle size. It was the richest in Si and Al. Green clay presented expandable smectite and the highest density. Red clay presented the largest particle average size and was the richest in iron content. By thermal analysis, clays presented two characteristic events: the water loss (dehydration) and the dihydroxylation of kaolinite, turning into meta kaolinite. In Sebumetry, clays showed a significant reduction of skin oiliness on the forehead in both concentrations after 2h of contact compared to control, baseline, and placebo. However, after 4h (2h after removal), no significant difference was observed with the control. In the Cutometry, clays did not present significant efficacy in skin firmness and elasticity improvement when compared to control and placebo sites, thus, further studies should be performed comparing the efficacy of different vehicles with dispersed clays. Finally, clay mask formulations were developed with black, red, and green clay dispersed in an oil-free gel vehicle, which proved to be adequate for oily skin

A aparência da pele influencia fortemente autoestima e o bem-estar das pessoas. Dentre as características que mais afetam podemos citar acne e rugas. Portanto, minimizar estas características com o uso de cosméticos tem um valor importante para o consumidor. Atualmente existe uma procura por ingredientes naturais, principalmente no que diz respeito a produtos cosméticos. O uso das argilas nos cuidados de beleza é antigo, com usos terapêuticos desde a Pré-História. Há uma vantagem essencial na utilização de argilas para fins cosméticos, pois é um ingrediente de baixo custo, ecologicamente correto, natural, e abundante, que é quimicamente inerte e tem baixo nível de toxicidade (quando usado em condições adequadas), fácil de aplicar e remover, seca, e endurece rapidamente. Neste trabalho de pesquisa, objetivamos desenvolver e investigar o efeito de formulações contendo argilas vermelha, verde e preta como componentes ativos na redução da oleosidade e na melhoria da firmeza e elasticidade in vivo, bem como caracterizar mineralogicamente as argilas. Todas as argilas apresentaram diferentes composições. A argila preta foi a de conteúdo mineralógico mais simples, mais baixa densidade, e menor tamanho de partícula. Foi a mais rica em Si e Al. A argila verde apresentou esmectita expansível e mais alta densidade. A argila vermelha apresentou o maior tamanho médio de partícula e foi a mais rica em ferro. Segundo a análise térmica, as argilas apresentaram dois eventos característicos: a perda de água (desidratação) e a desidroxilação da caulinita, transformando-se em meta-caulinita. Na Sebumetria, as argilas demonstraram significativa redução na oleosidade da pele na testa em ambas as concentrações após 2h de contato comparada ao controle, basal e placebo. Porém, após 4h (2h após remoção), nenhuma diferença significativa foi observada com o controle. Na Cutometria, as argilas não apresentaram Eficácia significativa na melhora da firmeza e elasticidade quando comparadas aos sítios controle e placebo, portanto, mais estudos devem ser realizados comparando a eficácia de diferentes veículos com argilas dispersas. Finalmente, as formulações de máscaras de argilas foram desenvolvidas com argilas preta, vermelha e verde dispersas em um veículo em gel livre de oleosidade, o qual provou ser adequado para pele oleosa

Reasons for the use of masks in open areas after the Peruvian government announced that it will no longer be mandatory in the context of COVID-19 in 2022

Introduction: In Peru, a high proportion of fully immunized people against COVID-19 has been achieved, which has mitigated the severity of the disease. Thus, under the recommendation of experts, the Peruvian government issued Supreme Decree 118-2022-PCM, which indicated that the use of masks is optional in open and ventilated enclosed spaces as of October 1, 2022. Objective: The aim of the present study was to find out the reasons why people continued to wear masks even though it was not mandatory in outdoor environments. Methods: A total of 335 people participated, with an average age of 26.11 years (73.1% women). A data collection form was prepared where sociodemographic and health information was requested; in addition, the question "Why do you continue to wear mask despite it being optional in open and closed ventilated spaces?" was included. The data obtained from the last open question of the instrument was analyzed by means of a discursive textual analysis (DTA) and an exploratory analysis through IRAMUTEQ. Results: Results indicate that people continue to wear masks, despite the lifting of the restrictions, to avoid contagion of COVID-19 and other respiratory diseases. In addition, the prevention of possible infection and transmission of the virus also focused on the family and vulnerable people. Discussion: It is concluded that the practice of wearing masks may be influenced by individual perceptions of risk and interpretations of responsibility and solidarity towards others.

Introducción: En el Perú, se logró una alta proporción de personas completamente inmunizados contra COVID-19 que ha mitigado la severidad de la enfermedad. Es así que, bajo la recomendación de expertos el gobierno peruano emitió el Decreto Supremo 118-2022-PCM, donde se indicó que el uso de la mascarilla es opcional en espacios abiertos y espacios cerrados ventilados a partir del 1 de octubre del 2022. Objetivo: El presente estudio fue conocer las razones por las cuales las personas continuaron usando mascarilla a pesar de que no era obligatorio en ambientes exteriores. Metodología: Participaron un total de 335 personas con un promedio de edad de 26.11 años (73.1% mujeres). Se elaboró una ficha de recolección de datos donde se solicitó información sociodemográfica y de salud; además, se incluyó la pregunta "¿por qué sigue utilizando la mascarilla a pesar de que es opcional en espacios abiertos y cerrados ventilados?" Los datos obtenidos de la última pregunta abierta del instrumento se analizaron mediante un análisis textual discursivo (ATD) y un análisis exploratorio a través de IRAMUTEQ. Resultados: Los resultados indicaron que, las personas seguían utilizando mascarillas, a pesar de estar levantadas las restricciones, para evitar contagios de la COVID-19 y de otras enfermedades respiratorias. Además, esta prevención de una posible infección y transmisión del virus es enfocada también a la propia familia y personas vulnerables. Discusión: Se concluye que, la práctica de usar mascarillas puede estar influenciada por las percepciones individuales del riesgo y las interpretaciones de responsabilidad y solidaridad frente a los demás.

Knowledge, intention, and practice of wearing face mask by common people to ensure protection against COVID-19 during pandemic

Background: Since the outbreak of global pandemic, wearing face mask not only protects the individual but also limits the spread of corona virus infection in the community. However, certain sociocultural and personal factors have created hinderance in wearing face mask by general people against COVID-19 virus. Aims and Objectives: The aim and objective of this study is to assess the knowledge, intension, and practice of wearing face mask among common people. Materials and Methods: It was a cross-sectional study conducted among general people in a part of Western Odisha after ethical approval. A total of 1050 adults above 18 years participated in this study. The data were collected from different locality of the town using a pretested self-administered questionnaire by all authors and research assistants of this project. The period of study was from July 2021 to December 2021. The results were tabulated, processed, and analyzed using SPSS-20. Results: Regarding knowledge score, we observed that 57% had average, 18% had poor, and 25% had good knowledge. Furthermore, we found 42% participants had positive intention and 58% had negative intention. Again we assessed that 35% of participants were practicing face mask appropriately and 65% practicing inappropriately. Conclusion: In this study, the score of knowledge, intention, and also the practice of wearing face mask against COVID-19 was lower than the average as compared to previous researches. Hence, health authorities should promote the people to wear mask and encourage awareness programs for the benefit of the society.

A comparison between propofol and sevoflurane for easy insertion of laryngeal mask airway among adults in minor elective surgeries: An observational study

Background: The laryngeal mask airway (LMA) has reached ample popularity for the management of airway during surgery. Propofol, used as induction agent, causes change in blood pressure and heart rate (HR) while insertion of LMA. Sevoflurane, whereas, has the potential to be a good induction agent as propofol. We have compared propofol and sevoflurane for easy insertion of LMA among adults in minor surgeries. Aim and Objectives: The primary objective of the study was to compare the ease of insertion of LMA and its characteristics related to insertion among adults in minor elective surgeries using intravenous propofol or inhalational sevoflurane. While time taken to set induction and actual event of LMA insertion along with number of attempts, jaw relaxation time, LMA insertion time, apnea time, monitoring hemodynamic changes, and occurrence of complications were taken as secondary objectives. Materials and Methods: It was a prospective and observational study done in Department of Anesthesiology and Operation Theaters of Fortis Hospital, Kolkata, after getting ethical approval. Total 100 patients were recruited by consecutive sampling and divided into two groups - P (propofol) and S (sevoflurane) group. Anesthesia induction time, jaw relaxation time, LMA insertion time, etc. were noted. LMA insertion conditions were assessed by a 3-point scale using six variables, total score was calculated for each group. Hemodynamic parameters and induction complications were also recorded. Results: There was no significant difference in demographic parameters, American Society of Anesthesiologists class, Modified Mallampati Grading, and LMA size, between the groups. LMA insertion time was comparable between the two groups. Regarding complications, there was no incidence of coughing while minor gagging (4%) and laryngospasm (6%) were noted only with sevoflurane. Final summation of scores showed excellent insertion characteristics with propofol (94%) and sevoflurane (84%), respectively, with no significant difference. Conclusion: Inhalational sevoflurane may be regarded as a viable alternative to inj. propofol for insertion of laryngeal mask among adults in minor elective surgeries.

Inferior altitudinal visual loss and mask-wearing practices: A case series

Face mask-wearing practices and their impact on the visual field bear particular importance in the coronavirus disease 2019 (COVID-19) pandemic era. This case series examines 10 participants with no history of ocular impairment or visual field defects who underwent age-corrected visual field testing in both eyes with different types of face masks. Wearing duckbill N95 masks was consistently associated with increased accuracy errors in the inferior altitudinal visual field when compared to wearing surgical masks or no masks. These findings support public health guidance that has previously attributed the risks of falls and accidents to face mask wearing.

Comparison results of the population's COVID-19 preventive behaviours / Монголын Анагаах Ухаан

Background@#As of September 21, 2021, 65.3 percent of Mongolia's population was vaccinated at full dose. However, as of COVID-19 confirmed cases, Mongolia is in the top five countries in the West Pacific. This indicates that there is a lack of practice to prevention from coronavirus infection in the population.@*Goal @#This survey aims to compare the level of knowledge, attitudes, and practices of the population towards coronavirus infection with the results of the baseline survey results @*Material and Methods@#This is a cross-sectional study. A total of 1896 people aged 15-60 years old participated in the study. The survey data were collected using quantitative (questionnaire) and qualitative (observation) methods. The research methodology was approved at the Scientific Committee of the National Center for Public Health on November 9, 2021 (Protocol № 5) and the Medical Ethics Review Committee of the Ministry of Health on January 20, 2022 (Resolution №261) was issued the Ethical permission of the survey. @*Results@#Out of 14 knowledge questions that should be known about coronavirus infection, survey participants had known in an average of 8.27 ± 3.73 (95%CI: 8.12-8.43) correct answers, which was lower than the results of the baseline study. The average knowledge score of the surveyed participants of the follow-up survey (9.23±3.2, 95%CI: 9.09-9.38) was smaller than the baseline survey by 0.96 percent. 54.5 percent of surveyed participants believed that the pandemic is “very dangerous”. However, it has decreased by 25.6 percent compared to the baseline survey. Positive attitudes toward the right place at the onset of symptoms of COVID-19 and non-discrimination against infected people are more prevalent in a population with a high average knowledge score. In the baseline study, the average duration to wear a mask was 29 hours, while in the follow-up survey, it was 4.2 hours, which shows improvement in the correct behavior. @*Conclusions@#As the population’s level of education increased, the average knowledge score on the coronavirus infection has increased, and the statistically significant high of the participant with higher education levels was 8.81±3.53 (p=0.0001). In the baseline survey, 64.9 percent of the participants had an attitude toward a discriminant person infected with COVID-19, whereas it was declined by 41.9 percent in the follow-up survey. The practice of wearing masks in crowded places and outdoors were increased by 6.8 percent from the baseline survey. Compared to the baseline survey results, in the follow-up survey, practices of wearing masks in the workplace or indoor environment (73.0%) had increased.

Association of face mask use with self-reported cardiovascular symptoms during the COVID-19 pandemic

INTRODUCTION@#Countries are mandating the use of face masks to stem the spread of coronavirus disease 2019 (COVID-19). Face mask use has been associated with discomfort due to its effects on thermoregulation, breathing and oxygenation. We evaluated the prevalence and severity of self-reported cardiovascular symptoms before and during face mask use.@*METHODS@#This was a cross-sectional study of 1,001 participants residing in Singapore, who participated in a self-administered questionnaire between 25 April 2020 and 4 May 2020. Symptom severity before and during mask use, and health-seeking behaviour information were collected. The study outcome was self-reported worsening of cardiovascular symptoms and its association with the type of mask worn, duration of mask worn per day, and intensity of physical activities during mask use.@*RESULTS@#The most common symptom reported during mask use was dyspnoea. Independent predictors for self-reported cardiovascular symptoms during mask use were moderate-high physical activity during mask use (odds ratio [OR] 1.634, 95% confidence interval [CI] 1.176-2.270, P = 0.003), duration of mask use for ≥3 h (OR 1.672, 95% CI 1.189-2.352, P = 0.003) and type of mask used, after adjusting for age, sex, healthcare-based worker status and presence of comorbidities. N95 mask was associated with worse symptoms when compared to surgical mask. Participants with ≥3 worsening symptoms or worsening dyspnoea, palpitations, fatigue and dizziness were more likely to seek medical help.@*CONCLUSION@#Face mask use has been proven to be an effective way in curbing COVID-19 transmission. However, participants in this study had concerns regarding its use and these concerns should be urgently addressed to enable mask use policies to be enacted.

Second-generation laryngeal mask airway as an alternative to endotracheal tube in prolonged laparoscopic abdominal surgery: a comparative analysis of intraoperative gas exchanges

INTRODUCTION@#Laryngeal mask airway (LMA), which is used in difficult airway maintenance conditions during emergencies, is rarely used in prolonged surgery despite its advantages over endotracheal tube (ETT). In this study, we conducted a comparative analysis of intraoperative gas exchanges between second-generation LMA and ETT during prolonged laparoscopic abdominal surgery.@*METHODS@#Prolonged surgery was defined as a surgery lasting more than 2 h. In total, 394 patients who underwent laparoscopic liver resection via either second-generation LMA or ETT were retrospectively analysed. The following parameters were compared between the two groups of patients: end-tidal pressure of carbon dioxide (ETCO2), tidal volume (TV), respiratory rate (RR), peak inspiratory pressure (PIP), arterial partial pressure of carbon dioxide (PaCO2), pH and ratio of arterial partial pressure of oxygen to fractional inspired oxygen (PFR) during surgery. In addition, the incidence of postoperative pulmonary complications (PPCs), including pulmonary aspiration, was compared.@*RESULTS@#The values of ETCO2, TV, RR and PIP during pneumoperitoneum were comparable between the two groups. Although PaCO2 at 2 h after induction was higher in patients in the LMA group (40.5 vs. 38.5 mmHg, P < 0.001), the pH and PFR values of the two groups were comparable. The incidence of PPC was similar.@*CONCLUSION@#During prolonged laparoscopic abdominal surgery, second-generation LMA facilitates adequate intraoperative gas exchange and may serve as an alternative to ETT.

Cross-sectional study on the use of masks among occupational groups with high-risk positions for overseas import and pollution transmission / 中华劳动卫生职业病杂志

Objective: To investigate the wearing of masks and the knowledge of masks among high-risk positions for overseas import and pollution transmission. Methods: From May 14 to 17, 2022, a convenient sampling method was used to conduct an online survey among 963 workers in high-risk positions for overseas import and pollution transmission in Beijing. The behaviors of individual use and wearing masks, the distribution and supervision of the unit, the knowledge of personal mask protection and the subjective feelings of wearing masks were analyzed. The χ(2) test and logistic regression model were used to analyze the influencing factors of the correct selection of masks. Results: The majority of the workers in high-risk positions for overseas import and pollution transmission were male (86.0%, 828/963), age concentration in 18-44 years old (68.2%, 657/963), and the majority of them had college or bachelor degrees (49.4%, 476/963). 79.4%(765/963) of the workers chose the right type of masks, female, 45-59 years old and high school education or above were the risk factors for correct selection of masks (P <0.05). Workers had good behaviors such as wearing/removing masks, but only 10.5% (101/963) could correctly rank the protective effect of different masks. 98.4% (948/963) of the workers believed that their work units had provided masks to their employees, and 99.1% (954/963) and 98.2%(946/963) of them had organized training and supervision on the use of masks, respectively. 47.4%(456/963) of the workers were uncomfortable while wearing masks. Conclusion: The overall selection and use of masks among occupational groups in high-risk positions for overseas import and pollution transmission in China need to be further standardized. It is necessary to strengthen supervision and inspection on the use of masks among occupational groups, and take improvement measures to improve the comfort of wearing masks.

Clinical Efficacy of Da Vinci Robot-assisted Subxiphoid Versus Lateral Thoracic Approach for Treatment of Anterior Mediastinal Tumors / 肿瘤防治研究

Objective To compare the perioperative efficacy and safety of da Vinci robot-assisted thoracoscopic surgery (RATS) for treatment of anterior mediastinal tumors through subxiphoid versus lateral thoracic approaches under the laryngeal mask anesthesia. Methods We retrospectively analyzed the clinical data of 102 patients with anterior-mediastinal tumors treated by RATS under laryngeal mask anesthesia completed by the same operator. Forty-five patients underwent the subxiphoid approach (subxiphoid group), and 57 patients were treated with the lateral thoracic approach (lateral thoracic group). The operating time, intraoperative bleeding, and total postoperative drainage volume in the two groups were compared and analyzed. Results All patients successfully completed resection of the anterior mediastinal tumor without the occurrence of perioperative death. In terms of total postoperative drainage volume, postoperative drainage time, postoperative hospital stay, and VAS pain on postoperative days 2 and 3, the subxiphoid group was more advantages (P < 0.05). No statistically significant difference was found between the two groups in terms of operative time, docking time, total operative time, intraoperative bleeding volume, postoperative day 1 VAS pain score, or postoperative complications (P > 0.05). Conclusion The subxiphoid approach of RATS is safe and feasible for resection of anterior mediastinal tumors. Compared with the lateral thoracic approach, the subxiphoid approach has advantages in terms of rapid postoperative recovery and postoperative pain.

Accuracy of airway ultrasonic parameters in predicting difficult mask ventilation in obese patients / 中华麻醉学杂志

Objective:To evaluate the accuracy of airway ultrasonic parameters in predicting difficult mask ventilation (DMV) in obese patients.Methods:Ninety-six patients of both sexes, aged >18 yr, with body mass index of 28- <40 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, scheduled for elective surgery under general anesthesia with endotracheal intubation, were selected. The airway was evaluated at 1 day before surgery to record the thyromental distance, modified Mallampati classification and upper lip bite test classification. Before anesthesia induction, the mandibular condylar motion, longitudinal cross-sectional area and transverse diameter of the tongue were measured by ultrasound, and the tongue volume was calculated. Mask ventilation was performed after anesthesia induction, DMV classification was recorded, DMV was defined as DMV classification Ⅲ and Ⅳ, and the patients were divided into non-DMV group (NDMV group) and DMV group. Spearman correlation analysis was used to analyze the correlation between each parameter and DMV, the receiver operating characteristic (ROC) curve was used to evaluate the accuracy of each parameter in predicting DMV, and the cut-off value was determined based on the principle of Jorden index at maximum. Results:Ninety-six patients were finally included in the study, with 64 patients in NDMV group and 32 patients in DMV group. Compared with NDMV group, the increase in age, modified Mallampati grade, upper lip biting test grade, longitudinal cross-sectional area of tongue, transverse diameter of tongue and volume of tongue were significantly increased, and the thyromental distance and mandibular condylar motion were decreased in DMV group ( P<0.05). Age ( r=0.283), modified Mallampati grade ( r=0.668), upper lip biting test classification ( r=0.826), tongue longitudinal cross-sectional area ( r=0.598), tongue transverse diameter ( r=0.578) and tongue volume ( r=0.707) were positively correlated with DMV ( P<0.01), and thyromental distance ( r=-0.623) and mandibular condylar motion ( r=-0.666 ) were negatively correlated with DMV ( P<0.05). The area under curve (95% confidence interval) of tongue longitudinal cross-sectional area, tongue transverse diameter, tongue volume, and mandibular condylar motion for DMV prediction were 0.870 (0.780-0.961), 0.858 (0.768-0.948), 0.937 (0.864-1.000), 0.912 (0.835-0.990), respectively ( P<0.01), and the predicted cut-off values were 22.61 cm 2, 4.29 cm, 100.60 cm 3 and 1.18 cm, respectively, the sensitivity was 90%, 83%, 90% and 90%, respectively, the specificity was 80%, 80%, 95% and 95%, respectively. Conclusions:Tongue volume and mandibular condylar motion measured by ultrasound are highly accurate in predicting DMV in obese patients. Tongue volume> 100.60 cm 3 or mandibular condylar motion< 1.18 cm suggests a high risk of DMV.

Relationship between Staphylococcus aureus Colonization and Face Mask-associated Adverse Cutaneous Reactions during the COVID-19 Pandemic

Background@#Adverse reactions on the skin due to face masks are well documented following the COVID-19 pandemic. This study aims to investigate Staphylococcus aureus colonization in relation to face mask-associated adverse cutaneous reactions (FMACR)@*Methods@#This was a case-control study involving adult patients attending dermatology clinic, Hospital Tengku Ampuan Afzan, Pahang, Malaysia. FMACR was determined via a structured interview. Subjects and healthy controls were matched for age and gender. Skin swabs from the alar crease and glabella were obtained and cultured. The possible risk factors for FMACR including type of mask, frequency of change, average duration of use, and skin care practices were also attained. @*Results@#A total of 114 adult participants, which consisted of 57 case and 57 control were recruited. Itching was the most frequent (32; 32.4%) FMACR noted, followed by acne (31; 31.4%) and rashes (22; 22.2%). The presence of facial dermatoses and oily skin type increased the risk of FAMCR (adjusted OR=5.96, 95% CI (1.96,18.12), p=0.002 and adjusted OR=1.94, 95% CI (0.28,13.28), p=0.009) respectively. Cosmetic use was associated with lower risk of FMACR, (adjusted OR=0.16, 95% CI (0.05, 0.56), p=0.004). No significant association was noted between S. aureus skin colonization and FMACR (p=0.409). @*Conclusion@#Staphylococcus aureus skin colonization was not associated with FMACR. Risk factors for FMACR were the presence of facial dermatoses and oily skin type while cosmetic use appears to have a protective effect.

Relationship between Staphylococcus aureus Colonization and Face Mask-associated Adverse Cutaneous Reactions during the COVID-19 Pandemic

Background@#Adverse reactions on the skin due to face masks are well documented following the COVID-19 pandemic. This study aims to investigate Staphylococcus aureus colonization in relation to face mask-associated adverse cutaneous reactions (FMACR).@*Methods@#This was a case-control study involving adult patients attending dermatology clinic, Hospital Tengku Ampuan Afzan, Pahang, Malaysia. FMACR was determined via a structured interview. Subjects and healthy controls were matched for age and gender. Skin swabs from the alar crease and glabella were obtained and cultured. The possible risk factors for FMACR including type of mask, frequency of change, average duration of use, and skin care practices were also attained. @*Results@#A total of 114 adult participants, which consisted of 57 case and 57 control were recruited. Itching was the most frequent (32; 32.4%) FMACR noted, followed by acne (31; 31.4%) and rashes (22; 22.2%). The presence of facial dermatoses and oily skin type increased the risk of FAMCR (adjusted OR=5.96, 95% CI (1.96,18.12), p=0.002 and adjusted OR=1.94, 95% CI (0.28,13.28), p=0.009) respectively. Cosmetic use was associated with lower risk of FMACR, (adjusted OR=0.16, 95% CI (0.05, 0.56), p=0.004). No significant association was noted between S. aureus skin colonization and FMACR (p=0.409).@*Conclusion@#Staphylococcus aureus skin colonization was not associated with FMACR. Risk factors for FMACR were the presence of facial dermatoses and oily skin type while cosmetic use appears to have a protective effect.

Application of aerosol inhalation of esketamine combined with Ⅰ-gel laryngeal mask and Wellead occluder in single lung ventilation / 临床麻醉学杂志

Objective To investigate the effectiveness of esketamine aerosol inhalation combined with Ⅰ-gel laryngeal mask and Wellead bronchial occluder for thoracoscopic single lung ventilation surgery.Methods Seventy-five thoracic surgery patients,39 males and 36 females,aged 28-64 years,BMI 18-25 kg/m2,ASA physical status Ⅰ or Ⅱ,were selected for thoracoscopic surgery.Patients were randomly di-vided into three groups by digital table method:esketamine nebulizing inhalation combined with Ⅰ-gel laryn-geal mask and Wellead bronchial sealer group(group EW),Ⅰ-gel laryngeal mask combined with Wellead bronchial sealer group(group LW),and tracheal catheter combined with Wellead bronchial sealer group(group TW),25 cases in each group.The insertion time,extraction time,awakening time,and the highest PETCO2 value during single lung ventilation were recorded in the three groups.Airway peak pressure(Ppeak)and dynamic lung compliance(Cdyn)were recorded during 15 minutes of supine double-lung ven-tilation and 15 minutes of lateral single-lung ventilation.The changes of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8)and other inflammatory factors in alveolar lavage fluid at 10 mi-nutes before single lung ventilation(T0),10(T1),30(T2),60 minutes(T3)after single lung ventila-tion,and at the end of single lung ventilation(T4),lung collapse score on the operative side,postoperative coughing,hoarseness,sore throat,and atelectasis occurred.Results Compared with group TW,the ex-traction time and awakening time of groups EW and LW were significantly shortened(P＜0.05),Ppeak was significantly decreased and Cdyn was significantly increased in group EW during double lung and single lung ventilation(P＜0.05),and Ppeak was significantly decreased and Cdyn was significantly increased in group LW during single lung ventilation(P＜0.05),TNF-α,IL-6 and IL-8 were significantly decreased at T2-T4 in groups EW and LW(P＜0.05),and the incidence of cough and throat pain was significantly de-creased(P＜0.05).Compared with group LW,Ppeak and Cdyn were significantly decreased in group EW during double lung and single lung ventilation(P＜0.05),and TNF-α,IL-6,and IL-8 were significantly decreased at T2-T4(P＜0.05).There were no significant differences in the insertion time,the highest val-ue of PET CO2 and the lung collapse score among the three groups,and no case of atelectasis occurred among the three groups.Conclusion The use of esketamine aerosol inhalation combined with Ⅰ-gel laryngeal mask and Wellead bronchial occluder for thoracoscopic surgery can ensure the required ventilation during surgery,significantly reduce airway irritation during general anesthesia induction and recovery,reduce pneumonia re-action,and improve lung compliance,which is worthy of clinical promotion.

Effects of chewing gum on mask contamination

Aims@#The aim of this study was to evaluate whether chewing gum affects mask contamination.@*Methodology and results@#Two groups of participants were requested to wear a mask for 15 min with (experimental group) or without (control group) chewing gum. Then, masks were collected and CFU calculation and 16S rDNA sequencing was performed. We found that temperature, humidity and bacterial CFU inside of the mask significantly increased when wearing a mask while chewing gum. Staphylococcus epidermidis was found in both groups. Staphylococcus aureus, Staphylococcus haemolyticus, Streptococcus oralis, Streptococcus parasanguinis and Bacillus wiedmannii were found in only the experimental group.@*Conclusion, significance and impact of study@#Chewing gum significantly increased the temperature, humidity and bacterial CFU inside the mask. Staphylococcus epidermidis, S. aureus, S. haemolyticus, S. oralis, S. parasanguinis and B. wiedmannii were detected inside the mask after chewing gum.