Respiratory droplets, naturally produced during expiration, can transmit pathogens from infected individuals. Wearing a face mask is crucial to prevent such transmission, yet the perception of dyspnea and uncomfortable breathing remains a common concern, particularly during epidemics. The aim of this study was to investigate the impact of face mask use on the perception of dyspnea, cardiopulmonary parameters, and facial temperature during physical activity. A randomized crossover study was conducted on healthy adults at a physiology laboratory located in the Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia, in November 2022. Participants underwent five stages of physical exercise tests based on the Bruce Protocol under three conditions: without any face mask (control), wearing a surgical mask, and an N95 mask, forming the study\'s main groups. Dyspnea perception (measured by the Modified Borg Dyspnea Scale), cardiopulmonary parameters (heart rate, oxygen saturation, respiratory rate, blood pressure, and mean arterial pressure) and facial temperature were measured before the exercise test (pre-workout), at the end of stage 1, 2, 3, 4, 5, and after the whole exercise test (post-workout). A two-way repeated measures ANOVA was conducted, considering two factors: the type of mask (control, surgical mask, N95 mask) and the various stages of the exercise test. A total of 36 healthy adults were included in the study. We found that dyspnea perception was much worse in the N95 mask group, particularly during vigorous exercise. There was no significant difference between groups in cardiopulmonary parameters. However, participants wearing N95 had a greater supralabial temperature than those wearing surgical masks or no mask at all. It is recommended to undertake a more in-depth evaluation of cardiopulmonary physiological measures.

UNASSIGNED: The widespread use of surgical masks during the COVID-19 pandemic has posed challenges in interpreting facial emotions. As the mouth is known to play a crucial role in decoding emotional expressions, its covering is likely to affect this process. Recent evidence suggests that facial expressions impact behavioral responses only when their emotional content is relevant to subjects\' goals. Thus, this study investigates whether and how masked emotional faces alter such a phenomenon.
UNASSIGNED: Forty participants completed two reaching versions of the Go/No-go task in a counterbalanced fashion. In the Emotional Discrimination Task (EDT), participants were required to respond to angry, fearful, or happy expressions by performing a reaching movement and withholding it when a neutral face was presented. In the Gender Discrimination Task (GDT), the same images were shown, but participants had to respond according to the poser\'s gender. The face stimuli were presented in two conditions: covered by a surgical mask (masked) or without any covering (unmasked).
UNASSIGNED: Consistent with previous studies, valence influenced behavioral control in the EDT but not in the GDT. Nevertheless, responses to facial emotions in the EDT exhibited significant differences between unmasked and masked conditions. In the former, angry expressions led to a slowdown in participants\' responses. Conversely, in the masked condition, behavioral reactions were impacted by fearful and, to a greater extent, by happy expressions. Responses to fearful faces were slower, and those to happy faces exhibited increased variability in the masked condition compared to the unmasked condition. Furthermore, response accuracy to masked happy faces dramatically declined compared to the unmasked condition and other masked emotions.
UNASSIGNED: In sum, our findings indicate that surgical masks disrupt reactions to emotional expressions, leading people to react less accurately and with heightened variability to happy expressions, provided that the emotional dimension is relevant to people\'s goals.

The outbreak of COVID-19 has created renewed attention on research and large scale manufacturing of face masks. In the last two decades, usage of face masks for respiratory protection has gained increased importance as a measure to control the maladies and fatalities due to exposure to particulate pollutants and toxic pathogens. Numerous variants of surgical and high-performance respirator masks are available in the market, and yet the fibrous materials science researchers, manufacturers and public health agencies are making concerted efforts towards improvising them with respect to self-sterilisability, facial fit, thermo-physiological comfort, reusability and biodegradability, while maintaining or rather enhancing the filtration efficiency. This review article presents a compendium of materials, design and performance standards of existing face masks, as well as elaborates on developments made for their performance enhancement. The criticality of inculcation of good hygiene habits and earnest compliance to correct mask donning and doffing practices has also been highlighted. This review is expected to make valuable contributions in the present COVID-19 scenario when donning a face mask has become mandatory.

UNASSIGNED: During the coronavirus disease-2019 pandemic, masks have become mandatory for protection against the virus transmitted by breathing. This study examined the impact of surgical masks used daily on civilian facial skin.
UNASSIGNED: Moisture, elasticity, pore, melanin, acne, wrinkle, and sensitivity parameters of 83 volunteers were measured numerically using an API-100 skin analyzer and camera recordings. Numerical values were compared following the device\'s algorithm calibrated according to age, gender, and race. Finally, the obtained data were statistically evaluated and compared with the averages.
UNASSIGNED: Pore, melanin, acne, and wrinkle parameters were higher without gender discrimination, whereas moisture and elasticity parameters were low. While a significant increase was observed in women for sensitivity, the increase was not statistically significant in men.
UNASSIGNED: The negative effects of long-term daily wearing of surgical masks on facial skin were statistically significant. Therefore, taking outdoor breaks during mask use, washing the face intermittently, using moisturizing and purifying cosmetic products, and anti-wrinkle effects have been proposed to reduce the possible defects.

UNASSIGNED: The purpose of this study is to examine the effect of quality control circle (QCC) activities on increasing the mask-wearing compliance of hospitalized patients diagnosed with tuberculosis (TB) during external examinations.
UNASSIGNED: To assess the mask-wearing compliance of patients diagnosed with TB admitted to a ward in our hospital in 2019, who visited other departments, we conducted activities in accordance with the ten steps of the QCC. We outlined the causes of non-compliance and developed and implemented improvement plans. We compared the results obtained before and after the implementation of the QCC to assess the enhancement in patient compliance concerning wearing masks during external examinations, particularly among individuals diagnosed with pulmonary tuberculosis.
UNASSIGNED: The compliance rate for mask-wearing during external examinations rose from an initial 32.61% (45/138) prior to the intervention to 83.71% (149/178) following the intervention. The difference between the two groups was statistically significant (χ2 = 85.635, P < 0.001). The following countermeasures and implementation measures were formulated: (1) Increasing public health education and awareness; (2) Strengthening the training of nursing staff to enhance their knowledge; (3) Providing free surgical masks; (4) Establishing an effective monitoring system with the department of auxiliary examinations.
UNASSIGNED: QCC interventions were significantly effective in enhancing adherence to mask-wearing protocols during external examinations of hospitalized patients with tuberculosis. Such improvements contribute substantially to the mitigation of tuberculosis transmission within clinical and healthcare environments.

UNASSIGNED: COVID-19 has radically changed medical practice. The main objective of this study was to assess the impact of surgical mask (SM) on voice quality analyzes in a group of patient with different common benign vocal organic pathologies.
UNASSIGNED: A cross-over study.
UNASSIGNED: A group of 20 patients with different organic benign vocal pathologies was recruited from the ENT consultation of the University Hospital of Charleroi in Belgium.
UNASSIGNED: On the day of the assessment, each subject underwent an endonasal laryngeal videostroboscopy followed by a voice analysis (VA) with and without a new SM. The following parameters were analyzed: fundamental frequency, maximum frequency, range in amplitude and frequency of the voice, jitter and maximum phonatory time.
UNASSIGNED: In this research, we showed that VA can be performed with an SM while not changing the measured vocal parameters. These results also suggest that for the same individual a VA performed before the pandemic without SM could be compared to one with a SM to follow the patient\'s evolution of his or her voice quality.
UNASSIGNED: The wearing of an SM during VA should always be recommended in case of immunodeficiency, a contagious disease of the patient or during a (new) pandemic.

Under certain circumstances, masks are an effective and immediate solution to reduce the spread of viral infection. However, the impact of masks on the ability to perform vigorous exercise remains an area of concern. Primarily, this impact has been explored in healthy subjects, yielding contradictory findings, and little is known of it among COVID-19-infected individuals. This study examined the effects of surgical masks, N-95 masks, and unmasked conditions on the performance and perceived exertion (RPE) of infected vs. non-infected young women during high-intensity, repeated sprint exercise (5mSRT). Following a familiarization session, eighty-three (42 COVID-19-previously infected (PIG) and 43 non-infected (NIG)), female participants (age 20.02 ± 1.05 years, BMI 21.07 ± 2.1 kg/m2) were randomly assigned to one of three mask conditions: unmasked, surgical mask, or N95 mask. All participants attended three test sessions (i.e., one session for each mask condition) at least one week apart. At the beginning of each test session, data related to participants\' physical activity (PA) and sleep behaviours during the previous week were collected. In each test session, participants performed the 5mSRT, during which performance indicators (best distance (BD), total distance (TD), fatigue index (FI) and percentage decrement (PD)) were collected, along with RPE. ANOVA indicated no significant main effects of Groups and Masks, and no significant interaction for Groups × Masks for BD, FI, PD, RPE and most sleep and PA behaviours (p > 0.05). For TD, the Groups × Mask interaction was significant (p = 0.031 and ƞp2 = 0.042). Posthoc analysis revealed, in the unmasked condition, there was no difference in TD between PIG and NIG (p > 0.05). However, when wearing a surgical mask, PIG covered lower TD compared to NIG (p < 0.05). Additionally, different types of masks did not affect TD in NIG, while PIG performed the worst using the surgical mask (p < 0.05). These results suggest post-COVID-19 individuals can maintain physical fitness through regular exercise (i.e., sport science curricula) in unmasked conditions, but not when wearing a surgical mask. Furthermore, the impact of different types of face masks on physical performance seems to be minimal, particularly in uninfected populations; future research is warranted to further explore this impact in post-COVID conditions.

Mask use during the coronavirus disease 2019 (COVID-19) pandemic has been widely recommended and mandated worldwide. However, there is a lack of comprehensive research on the potential adverse health effects of mask usage. This study aimed to investigate and evaluate the negative effects of surgical mask use on scientifically proven cardiopulmonary functions in undergraduate and associate degree students, as well as its impact on coronaphobia. A total of 145 volunteer university students (49 males, 96 females, with a mean age of 20 years) were enrolled in the study, which consisted of two 120-minute sessions. Blood oxygen saturation, heart rate, and blood pressure were assessed before and immediately after each session. The Coronavirus-19 Phobia Scale was utilized to measure levels of COVID-19 phobia. While a time-dependent decrease in oxygen saturation level, blood pressure, and heart rate was measured when vital signs were evaluated at 1 and 120 minutes, none of the values fell outside the reference range. The study also investigated the effects of mask use on various symptoms including headaches, visual impairment, facial discomfort, earaches, shortness of breath, and anxiety. Significantly increased occurrences of all these symptoms were observed at the 60th and 120th minute compared with the baseline. The participants enrolled in the study demonstrated a moderate level of COVID-19 phobia based on the mean total score. Furthermore, high scores were recorded in the psychological and social sub-dimensions, while lower scores were recorded in the economic and psychosomatic sub-dimensions. In the post-COVID-19 normalization phase, the use of a surgical mask during a 120-minute course was found to have no significant impact on cardiopulmonary functions, but moderately affected coronaphobia scores.

BACKGROUND: Our study aimed to compare the prevalence of postoperative fever during the COVID-19 pandemic period with that of the preceding non-pandemic period.
METHODS: A retrospective analysis was conducted on patients with pectus excavatum (PE) undergoing minimally invasive repair (also called NUSS procedure) at Nanjing Children\'s Hospital from January 1, 2017 to March 1, 2019 (Group 2019), and from January 1, 2020 to March 1, 2021 (Group 2021). Data from a total of 284 patients, consisting of 200 (70.4%) males and 84 (29.6%) females with an average age of 9.73 ± 3.41 (range, 4 to 17) years, were collected. The presence of post-operative fever (defined as a forehead temperature of 37.5℃ or above within 72 h post-surgery), as well as the time of operation, duration of postoperative mechanical ventilator and urinary catheter use, and length of hospitalization were all assessed in admitted patients from Group 2019 (n = 144) and Group 2021 (n = 140). Postoperative white blood cell (WBC), C-reactive protein (CRP) levels, and prevalence of postoperative complications (i.e., pneumothorax, pulmonary atelectasis, pneumonia, wound infection, and dehiscence) were also determined.
RESULTS: Our results showed a statistically significant decrease in the incidence of postoperative fever within 24 to 72 h of surgery in patients admitted from Group 2019 as compared to Group 2021 (p < 0.001), as well as a decrease in peak body temperature within 72 h (p < 0.05). Meanwhile, no significant differences were observed in age and body mass index (BMI), time of operation, or duration of postoperative mechanical ventilator and urinary catheter use between the two groups (p > 0.05). The average hospitalization length of Group 2021 was significantly shorter than Group 2019 (12.49 ± 2.57 vs. 11.85 ± 2.19 days, p < 0.05). Furthermore, while the WBC count between the two groups 24 h after surgery showed a statistical difference (p < 0.05), no differences in CRP levels or the incidence of postoperative complications were observed (p > 0.05).
CONCLUSIONS: The prevalence of postoperative fever within 72 h of surgery and the length of hospital stay for patients with PE undergoing NUSS surgery were both decreased in Group 2021. We propose that the above phenomenon may be related to increased used of personal protection equipment (such as surgical masks and filtering facepiece respirators (FFRs)) by physicians, nurses, and the patients themselves.

There are very limited methods of relieving dyspnea that are independent of the causative disease. L-menthol olfactory stimulation is reported to be effective for dyspnea during exercise and inspiratory resistance. Therefore, we examined the effects of L-menthol olfactory stimulation on exertional dyspnea during the 6 min walking distance test (6MWT) in patients with chronic breathlessness syndrome. The subjects who consented to the study were divided into two groups. In Group A, the first 6MWT was performed as usual (placebo) while wearing a surgical mask, and the second 6MWT was performed under the L-menthol condition. In Group B, the first 6MWT was performed under the L-menthol condition, and the second 6MWT was performed as a placebo. A total of 16 subjects (70.8 ± 9.5 years) were included in the analysis. As for the effect of reducing dyspnea, a significant difference was observed in Group A patients who underwent the L-menthol condition in the second 6MWT (p = 0.034). In the comparison of the 6 min walking test under the L-menthol condition and the placebo, the modified Borg scale gain was significantly different between the L-menthol condition and the placebo (p = 0.007). Our results suggested that the L-menthol olfactory stimulation reduced dyspnea on exertion in patients with chronic breathlessness syndrome.