Best practices for communication while wearing facemasks: A scoping review.

INTRODUCTION: Facemasks are an important piece of personal protective equipment (PPE) to mitigate the spread of respiratory illnesses, but they can impede communication between patients and healthcare providers. The purpose of this scoping review is to identify effective communication practices while wearing facemasks. DESIGN: Scoping review using a systematic search of articles from the PubMed, CINAHL, and Embase databases. METHODS: The PEO (population, exposure, outcome) methodology was selected for this systematic scoping review. The population of interest (P) includes humans of all ages (children, adults, and older adults); the exposure of interest (E) is PPE that covers the mouth (i.e., facemasks); and the outcome of interest (O) is successful or unsuccessful communication practices. The Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals appraisal guidelines were used to determine the level and quality of the research. RESULTS: Thirty-nine articles met the inclusion criteria. Seventeen of these were high- or good-quality research studies, and the remaining 22 were non-research articles included with separate analysis as part of the scoping review. The 17 articles encompassed 2656 participants. The highest quality evidence indicated that standard surgical masks have the least impact on speech perception compared to other non-transparent mask types, and that recognizing emotions is less accurate with facemasks, necessitating compensatory actions (i.e., reducing extraneous noise, using a microphone to amplify voice, and employing clear speech). Evidence was contradictory regarding the use of transparent masks. Evidence was of limited quality for other non-verbal and verbal communication strategies. CONCLUSION: Awareness of communication challenges is crucial when wearing facemasks. More high-quality studies are needed to evaluate communication techniques when speakers are wearing facemasks. Basic strategies such as selecting an appropriate mask type, reducing extraneous noise, using microphones, verbalizing emotions, and employing clear speech appear to be beneficial. CLINICAL RELEVANCE: The findings of this scoping review highlight the importance of considering communication challenges while wearing facemasks in the healthcare settings. The review suggests that selecting an appropriate mask type, reducing extraneous noise, verbalizing emotions, and employing clear speech are some strategies that may be effective in mitigating the impact of facemasks on communication between patients and healthcare providers.

Association between Dental Caries and Handgrip Strength: In a Population-Based Study in Korea (KNHANES 2016-2018).

This study aimed to verify the relationship between handgrip strength and oral health using data from the Korea National Health and Nutrition Examination Survey, representing Korean adults. Data from the seventh survey (2016−2018) conducted by the Korea Centers for Disease Control and Prevention were utilized, and 10,607 final study participants were recruited according to the selection and exclusion criteria. A complex sample logistic regression analysis was performed to confirm the relationship between handgrip strength and dental caries according to the sex of the study participants. On analyzing the correlation in men, "C1 (DMFT: 11−32)," when compared to "C4 (DMFT: 0−3)," in Model 1 without adjustment for potential confounders, was 2.92 (95% confidence interval [CI]: 2.15−3.97) times more likely to be associated with lower handgrip strength, and a statistically significant result was detected (p < 0.001). Additionally, significant odds ratios (ORs) were confirmed for all adjusted models. In women, the ORs in Model 1 without adjustment for potential confounders were 1.41 times (95% CI: 1.14−1.75) and demonstrated a significant result; however, the results were not significant in all adjusted models 2−4. Resultantly, a significant association was detected between dental caries and handgrip strength in Korean adults.

Combination of Bifidobacterium longum and Galacto-Oligosaccharide Protects the Skin from Photoaging.

Overexposure to ultraviolet B (UVB) irradiation induces photoaging that is characterized by the formation of wrinkles and loss of skin elasticity. To understand the mechanism of action of probiotics and prebiotics in skin protection against photoaging, we investigated the effects of dietary supplementation with the probiotic, Bifidobacterium longum, and prebiotic, galacto-oligosaccharide, on UVB-induced photoaging in hairless mice. We measured short chain fatty acid (SCFA) levels, antioxidant enzyme activity, and inflammatory signaling protein levels to elucidate the possible mechanisms underlying the effects of the dietary supplements B. longum and galacto-oligosaccharide. We observed that dietary supplementation with B. longum and galacto-oligosaccharide, individually and in combination, exerted protective effects against UVB-induced photoaging, showing anti-inflammatory and antioxidative effects. In particular, supplementation with the combination of B. longum and galacto-oligosaccharide showed stronger protective effects than supplementation with the probiotic or prebiotic alone. In addition, the serum levels of SCFAs and acetate were increased following dietary supplementation with B. longum and galacto-oligosaccharide, especially in combination. Therefore, we suggest that the combination of B. longum and galacto-oligosaccharide may potentially be used as a functional food to protect UVB-induced photoaging.

Simultaneous Determination of Multi-Mycotoxins in Cereal Grains Collected from South Korea by LC/MS/MS.

An improved analytical method compared with conventional ones was developed for simultaneous determination of 13 mycotoxins (deoxynivalenol, nivalenol, 3-acetylnivalenol, aflatoxin B1, aflatoxin B2, aflatoxin G1, aflatoxin G2, fumonisin B1, fumonisin B2, T-2, HT-2, zearalenone, and ochratoxin A) in cereal grains by liquid chromatography-tandem mass spectrometry (LC/MS/MS) after a single immunoaffinity column clean-up. The method showed a good linearity, sensitivity, specificity, and accuracy in mycotoxin determination by LC/MS/MS. The levels of 13 mycotoxins in 5 types of commercial grains (brown rice, maize, millet, sorghum, and mixed cereal) from South Korea were determined in a total of 507 cereal grains. Mycotoxins produced from Fusarium sp. (fumonisins, deoxynivalenol, nivalenol, and zearalenone) were more frequently (more than 5%) and concurrently detected in all cereal grains along with higher mean levels (4.3-161.0 ng/g) in positive samples than other toxins such as aflatoxins and ochratoxin A (less than 9% and below 5.2 ng/g in positive samples) from other fungal species.

Aflatoxin B1 Detoxification by Aspergillus oryzae from Meju, a Traditional Korean Fermented Soybean Starter.

Aflatoxins are classified as Group 1 (carcinogenic to humans) by the International Agency for Research on Cancer. In this study, a total of 134 fungal strains were isolated from 65 meju samples, and two fungal isolates were selected as potential aflatoxin B1 (AFB1)-biodetoxification fungi. These fungi were identified as Aspergillus oryzae MAO103 and A. oryzae MAO104 by sequencing the beta-tubulin gene. The two A. oryzae strains were able to degrade more than 90% of AFB1 (initial concentration: 40 µg/l) in a culture broth in 14 days. The mutagenic effects of AFB1 treated with A. oryzae MAO103 and MAO104 significantly decreased to 5.7% and 6.4%, respectively, in the frame-shift mutation of Ames tests using Salmonella typhimurium TA98. The base-substituting mutagenicity of AFB1 was also decreased by the two fungi. Moreover, AFB1 production by Aspergillus flavus was significantly decreased by the two A. oryzae strains on soybean-based agar plates. Our data suggest that the two AFB1-detoxifying A. oryzae strains have potential application to control AFB1 in foods and feeds.

Biodegradation of Ochratoxin A by Aspergillus tubingensis Isolated from Meju.

Ochratoxin A (OTA), a mycotoxin, contaminates agricultural products and poses a serious threat to public health worldwide. Microbiological methods are known to be a promising approach for OTA biodegradation because physical and chemical methods have practical limitations. In the present study, a total of 130 fungal isolates obtained from 65 traditional Korean meju (a fermented starter for fermentation of soybeans) samples were examined for OTA-biodegradation activity using thin-layer chromatography. Two fungal isolates were selected for OTA-biodegradation activity and were identified as Aspergillus tubingensis M036 and M074 through sequence analysis of the beta-tubulin gene. After culturing both A. tubingensis isolates in Soytone-Czapek medium containing OTA (40 ng/ml), OTA-biodegradation activity was analyzed using high-performance liquid chromatography (HPLC). Both A. tubingensis strains degraded OTA by more than 95.0% after 14 days, and the HPLC analysis showed that the OTA biodegradation by the A. tubingensis strains led to the production of ochratoxin α, which is much less toxic than OTA. Moreover, crude enzymes from the cultures of A. tubingensis M036 and M074 led to OTA biodegradation of 97.5% and 91.3% at pH 5, and 80.3% and 75.3% at pH 7, respectively, in a buffer solution containing OTA (40 ng/ml) after 24 h. In addition, the OTA-biodegrading fungi did not exhibit OTA production activity. Our data suggest that A. tubingensis isolates and their enzymes have the potential for practical application to reduce levels of OTA in food and feed.

Pluronic/chitosan shell cross-linked nanocapsules encapsulating magnetic nanoparticles.

We have developed novel Pluronic/chitosan nanocapsules encapsulating iron oxide nanoparticles. These nanocapsules were produced by dispersing hydrophobically-modified iron oxide nanoparticles and amine-reactive Pluronic derivatives in an organic solvent, and subsequently emulsification in an aqueous chitosan solution by ultrasonication. The resultant shell cross-linked nanocapsules had a unique core/shell type nanoreservoir architecture: an inner core encapsulating magnetic nanoparticles and a hydrophilic Pluronic/chitosan polymer shell layer, as confirmed by thermogravimetric analysis and transmission electron microscopy. Confocal laser scanning microscopy revealed that the rhodamine-labeled nanocapsules were efficiently internalized by human lung carcinoma cells upon exposure to an external magnetic field. The present study suggested that these novel nanomaterials could be dually utilized for the magnetically-triggered delivery of various anti-cancer agents and for cancer diagnosis with magnetic resonance imaging.

Amine-functionalized gold nanoparticles as non-cytotoxic and efficient intracellular siRNA delivery carriers.

Gold nanoparticles chemically modified with primary amine groups were developed as intracellular delivery vehicles for therapeutic small interfering RNA (siRNA). The positively charged gold nanoparticles could form stable polyelectrolyte complexes through electrostatic interactions with negatively charged siRNA-polyethylene glycol (PEG) conjugates having a cleavable di-sulfide linkage under reductive cytosol condition. The resultant core/shell type polyelectrolyte complexes surrounded by a protective PEG shell layer had a well-dispersed nanostructure with a hydrodynamic diameter of 96.3+/-25.9 nm, as determined by dynamic light scattering and transmission electron microscopy. Confocal laser scanning microscopy revealed that the nanosized polyelectrolyte complexes were efficiently internalized in human prostate carcinoma cells, and thus enhanced intracellular uptake of siRNA. Furthermore, the siRNA/gold complexes significantly inhibited the expression of a target gene within the cells without showing severe cytotoxicity. The current study demonstrated that positively charged gold nanoparticles could be potentially applied for intracellular delivery of siRNA.