Unmasked Group Research Articles

Does the use of surgical face masks reduce postoperative infections in traumatic wounds sutured outside hospital? A randomized study at a Norwegian casualty center

Objective To investigate if wearing surgical face mask by doctors and nurses during suturing of traumatic wounds has any impact on postoperative infection rate. Design Randomized controlled study with masked or unmasked health personnel groups. Setting A Norwegian Minor Injury Department. Subjects Adult patients with traumatic wounds sutured at the clinic between 7 October 2019 and 28 May 2020. Main outcome measures Postoperative infections of sutured wounds. Results One hundred and sixty-five patients with 176 wounds were included in the study. Nine out of 88 wounds (10.2%) in the masked group and 11 out of 88 wounds in the unmasked group (12.5%) had a wound infection. Conclusions Despite a higher percentage of postoperative infections in the unmasked than in the masked group (12.5% versus 10.2%), the difference was not statistically significant (p = .6). This might imply that the use of facemasks during suture of traumatic wounds in an outpatient setting does not significantly reduce the number of infections. However, due to the covid pandemic, the study had to be prematurely stopped before the planned number of participants had been recruited (n = 594). This increases the risk of type II error.

PATIENT-PHYSICIAN FACE MASKING'S INFLUENCE ON THE POST-INTRAVITREAL INJECTION ENDOPHTHALMITIS.

The authors sought to determine if universal face mask guidelines implemented during the coronavirus disease 2019 pandemic significantly influenced the incidence of endophthalmitis following intravitreal injections (IVI). This retrospective cohort study reviewed the electronic health records from a retina-only practice located in Michigan. This study evaluated patients receiving IVIs over two distinct time periods of April 2019 to March 2020 and April 2020 to March 2021, which comprised our unmasked and masked groups, respectively. The authors then calculated the incidence of endophthalmitis following IVI and evaluated the cases of post-injection endophthalmitis for both time periods. A total of 121,384 IVIs performed over the 2-year period of interest. Of these, 63,114 were unmasked and 58,270 were masked patient encounters. A total of 46 post-injection endophthalmitis cases were identified. Of these, 29 cases were from the unmasked period and 17 were from the masked period. This resulted in an incidence of endophthalmitis of 0.046% and 0.038% in the masked and unmasked groups, respectively. This difference did not rise to the level of statistical significance ( P = 0.1336). This study suggests that the incidence of post-injection endophthalmitis was not influenced by the implementation of ophthalmologist-patient face masking after IVI during the coronavirus disease 2019 pandemic.

Child mask mandates for COVID-19: a systematic review

BackgroundMask mandates for children during the COVID-19 pandemic varied in different locations. A risk-benefit analysis of this intervention has not yet been performed. In this study, we performed a systematic...

The Relationship Between Face Mask Use and Face-Touching Frequency in Public Areas: Naturalistic Study.

Throughout the COVID-19 pandemic in the United States, a major public health goal has been reducing the spread of the virus, with particular emphasis on reducing transmission from person to person. Frequent face touching can transmit viral particles from one infected person and subsequently infect others in a public area. This raises an important concern about the use of face masks and their relationship with face-touching behaviors. One concern discussed during the pandemic is that wearing a mask, and different types of masks, could increase face touching because there is a need to remove the mask to smoke, drink, eat, etc. To date, there have been few studies that have assessed this relationship between mask wearing and the frequency of face touching relative to face-touching behaviors. This study aimed to compare the frequency of face touching in people wearing a mask versus not wearing a mask in high-foot traffic urban outdoor areas. The purpose of this study was to assess if mask wearing was associated with increased face touching. Public webcam videos from 4 different cities in New York, New Jersey, Louisiana, and Florida were used to collect data. Face touches were recorded as pedestrians passed under the webcam. Adult pedestrians wearing masks were compared to those not wearing masks. Quantitative measures of frequency, duration, site of touch, and oral activities were recorded. Linear regression analysis was used to assess the association between mask use and face touching. Of the 490 observed subjects, 241 (49.2%) were wearing a mask properly and 249 (50.8%) were not. In the unmasked group, 33.7% (84/249) were wearing it improperly, covering the mouth only. Face touching occurred in 11.4% (56/490) of the masked group and 17.6% (88/490) in the unmasked group. Of those who touched their face, 61.1% (88/144) of people were not wearing a mask. The most common site of face touching was the perioral region in both groups. Both the masked and unmasked group had a frequency of face touching for 0.03 touches/s. Oral activities such as eating or smoking increased face touching in the unmasked group. Contrary to expectations, non-mask-wearing subjects touched their face more frequently than those who were wearing a mask. This finding is substantial because wearing a face mask had a negative association with face touching. When wearing a mask, individuals are less likely to be spreading and ingesting viral particles. Therefore, wearing a mask is more effective in preventing the spread of viral particles.

Myelitis and Myelopathies in the Era of COVID-19 (P4-10.003)

<h3>Objective:</h3> To characterize the clinical presentations of myelitis and myelopathies following SARS-CoV2 infection (COVID-19) or vaccination for COVID-19. <h3>Background:</h3> Neurologic complications of COVID-19 are well-described; however, myelopathies associated with COVID-19 are comparatively rarer events. Myelopathies associated with vaccination are even rarer than those seen with infection. There is a need to recognize and document these rare cases as the number of infections and vaccinations increase to refine diagnosis and treatment. <h3>Design/Methods:</h3> We reviewed the clinical profiles of 15 patients referred to the Johns Hopkins Myelitis &amp; Myelopathy Center between April 2020 and June 2022 for myelopathic syndromes suspected to be triggered by SARS-CoV-2 infection or COVID-19 vaccination. Each patient’s etiology was classified as vascular, inflammatory, unmasking of neurological disease, or unknown. <h3>Results:</h3> All vascular myelopathies (n=5) were associated with COVID-19 and presented as acute and subacute progressive bladder dysfunction and weakness with non-enhancing lesions on MRI. Inflammatory myelopathies were associated with vaccination (n=3) and COVID-19 (n=2) and were notable for CSF pleocytosis, elevated protein, and involvement of white matter tracts and grey matter on MRI. COVID-19 and vaccination were associated with unmasking underlying myelopathic disease (e.g., demyelinating or metabolic) in 4 patients. Among the vaccination group (n=5), 2 received one dose of the mRNA-1273 vaccine and 3 received one dose of the Ad26.COV2.S vaccine. One patient could not be classified. <h3>Conclusions:</h3> Initial imaging in vascular patients had subtle findings recognized in hindsight–early recognition on imaging could refine differential diagnosis. Patients with inflammatory etiologies generally only saw improvement in their symptoms after PLEX; early initiation can halt progression and improve outcomes. Among the unmasked group, patients had heterogeneous clinical presentations. Imaging in this group showed chronic lesions, unlike the other two groups. It is critical to identify the etiological factors in subjects with myelopathies in the setting of COVID-19 or vaccination to establish an appropriate treatment. <b>Disclosure:</b> Ms. Hao has nothing to disclose. Dr. Dominguez Penuela has nothing to disclose. Dr. Reyes-Mantilla has nothing to disclose. The institution of Dr. Barreras has received research support from Foundation for Sarcoidosis Research. The institution of Dr. Pardo-Villamizar has received research support from National Institutes of Health. The institution of Dr. Pardo-Villamizar has received research support from Bart McLean Fund for Neuroimmunology Research .

Investigation of the Effect of Using Surgical Face Masks on Aerobic and Anaerobic Performance of Children During Educational Games

Aim: This study aimed to examine the effect of participating in educational game activities with and without a surgical face mask on the aerobic and anaerobic performance levels of children aged 12-13. Methods: Two male groups, unmasked (n=22) and masked (n=22), participated in the study. Pre-test post-test experimental model was used in the study. The aerobic performances of the groups were determined by the 20m shuttle test, and the anaerobic performances of the groups were determined by the vertical jump test. After the pretest scores of the groups were taken, educational game activities were applied to both groups three days a week for eight weeks. At the end of the eighth week, post-test scores were obtained. These data were presented as arithmetic mean and standard deviation. Independent sample t test was used to compare independent groups and paired sample t test was used to compare dependent groups. Results: Significance level was set as p&lt;0.05. When the pretest and posttest values of age, height and body weight of the groups were compared between the groups, no significant difference was observed (p&lt;0.005). However, when looked at the in-group scores, it was observed that there was a significant difference in the body weight values of the masked group (p˂0.001). In addition, there was a significant difference between the pretest and posttest aerobic performance (MaxVO2) scores of both groups within the group comparison (p˂0.001), but no significant difference was found in the groups’ anaerobic performance scores (p&lt;0.005). However, there was no significant difference between the pretest scores between the groups, while a significant difference was observed between the post-test aerobic (p˂0.001) and anaerobic (p&lt;0.005) scores. Conclusion: As a result, children's participation in regular educational games activities both with and without masks contributes positively to their aerobic performance and it can be said that the aerobic (16.69%) and anaerobic (1.01%) performance scores percentages of the masked group improved more than the unmasked group. Keywords: COVID-19, Surgical Face Mask, Aerobic, Anaerobic, Educational Game.

Measuring Droplets Expelled During Endoscopy to Investigate COVID-19 Transmission Risk

Measuring Droplets Expelled During Endoscopy to Investigate COVID-19 Transmission Risk

The Contribution of the Lower Third of the Face to Perceived Age: Do Masks Make You Appear Younger?

BackgroundThere is evidence that changes to the midface and lower third of the face in isolation contribute significantly to one’s perception of the overall facial age. Since the spread of the coronavirus disease 2019 (COVID-19), mask wearing has become commonplace. To date, there have been no studies that explore how covering the lower third of the face impacts the perception of age.ObjectivesThe authors hypothesized that covering the lower third of the face with a mask will make a person appear younger.MethodsOne hundred consecutive plastic surgery patients were photographed in a standardized fashion, both masked and unmasked. A questionnaire for factors known to contribute to facial aging was administered. These photographs were randomized to 6 judges who estimated the patients’ age and also quantified facial rhytids with the validated Lemperle wrinkle assessment score of 6. Data were analyzed using PROC MIXED analysis.ResultsMasked patients on average appeared 6.17% younger (mean difference = 3.16 years, P < 0.0001). Wrinkle assessment scores were 9.81% lower in the masked group (mean difference = 0.21, P = 0.0003). All subgroups appeared younger in a mask except for patients aged 18 to 40 years chronological age (P = 0.0617) and patients BMI > 35 (P = 0.5084).ConclusionsThe mask group appeared younger and had lower overall and visible wrinkle assessment scores when compared with the unmasked group. This has implications for our understanding of the contributions of the lower third of the face to overall perceived facial age.

Unmasking of Previously Asymptomatic Central Venous Stenosis following Percutaneous Transluminal Angioplasty of Hemodialysis Access

PurposeTo determine the frequency of new-onset symptoms of central venous stenosis (CVS) after percutaneous transluminal angioplasty (PTA) of a hemodialysis access–related stenosis in patients with previously asymptomatic CVS and to identify risk factors for this phenomenon. Materials and MethodsRetrospective review was performed of patients treated with PTA for an access-related stenosis (excluding central vein interventions) between 2001 and 2016 who returned within 3 months with symptoms of CVS (ie, “unmasking”): 39 patients met these criteria. A control group of 122 patients who had untreated asymptomatic CVS and did not experience unmasking was selected. Fistulograms were graded for degree of CVS. A total of 51% of the unmasked group was male, with an average age of 65 years; 57% of the control group was male, with an average age of 63 years. ResultsThe incidence of unmasking among patients with untreated asymptomatic CVS was 4.9%. A total of 90% of the unmasked group (35 of 39) had upper-arm access, compared with 77% of the control group (94 of 122; P = .017). A total of 28% of unmasked-group patients (11 of 39) underwent thrombectomy, vs 4% of controls (5 of 122; P < .0001). A total of 54% of unmasked-group patients (21 of 39) had significant brachiocephalic vein stenosis, vs 26% of controls (32 of 122; P = .001). A total of 8% of unmasked-group patients (3 of 39) had superior vena cava stenosis, vs none of the 122 controls (P = .01). A total of 64% of unmasked-group patients (25 of 39) had extensive collateral vessels, vs 24% of controls (29 of 122; P < .0001). ConclusionsThe incidence of unmasking of asymptomatic CVS is low. Prophylactic treatment of asymptomatic CVS therefore remains generally inadvisable. However, patients undergoing declotting with extensive collateral vessels might warrant treatment of asymptomatic CVS.

Disposable surgical face masks for preventing surgical wound infection in clean surgery.

Surgical face masks were originally developed to contain and filter droplets containing microorganisms expelled from the mouth and nasopharynx of healthcare workers during surgery, thereby providing protection for the patient. However, there are several ways in which surgical face masks could potentially contribute to contamination of the surgical wound, e.g. by incorrect wear or by leaking air from the side of the mask due to poor string tension. To determine whether the wearing of disposable surgical face masks by the surgical team during clean surgery reduces postoperative surgical wound infection. In December 2015, for this seventh update, we searched: The Cochrane Wounds Specialised Register; The Cochrane Central Register of Controlled Trials; Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE and EBSCO CINAHL. We also searched the bibliographies of all retrieved and relevant publications. There were no restrictions with respect to language, date of publication or study setting. Randomised controlled trials (RCTs) and quasi-randomised controlled trials comparing the use of disposable surgical masks with the use of no mask. Two review authors extracted data independently. We included three trials, involving a total of 2106 participants. There was no statistically significant difference in infection rates between the masked and unmasked group in any of the trials. We identified no new trials for this latest update. From the limited results it is unclear whether the wearing of surgical face masks by members of the surgical team has any impact on surgical wound infection rates for patients undergoing clean surgery.

The perturbation paradigm modulates error-based learning in a highly automated task: outcomes in swallowing kinematics.

Traditional motor learning studies focus on highly goal-oriented, volitional tasks that often do not readily generalize to real-world movements. The goal of this study was to investigate how different perturbation paradigms alter error-based learning outcomes in a highly automated task. Swallowing was perturbed with neck surface electrical stimulation that opposes hyo-laryngeal elevation in 25 healthy adults (30 swallows: 10 preperturbation, 10 perturbation, and 10 postperturbation). The four study conditions were gradual-masked, gradual-unmasked, abrupt-masked, and abrupt-unmasked. Gradual perturbations increasingly intensified overtime, while abrupt perturbations were sustained at the same high intensity. The masked conditions reduced cues about the presence/absence of the perturbation (pre- and postperturbation periods had low stimulation), but unmasked conditions did not (pre- and postperturbation periods had no stimulation). Only hyo-laryngeal range of motion measures had significant outcomes; no timing measure demonstrated learning. Systematic-error reduction occurred only during the abrupt-masked and abrupt-unmasked perturbations. Only the abrupt-masked perturbation caused aftereffects. In this highly automated task, gradual perturbations did not induce learning similarly to findings of some volitional, goal-oriented adaptation task studies. Furthermore, our subtle and brief adjustment of the stimulation paradigm (masked vs. unmasked) determined whether aftereffects were present. This suggests that, in the unmasked group, sensory predictions of a motor plan were quickly and efficiently modified to disengage error-based learning behaviors.

Disposable surgical face masks for preventing surgical wound infection in clean surgery

BACKGROUND: Surgical face masks were originally developed to contain and filter droplets containing microorganisms expelled from the mouth and nasopharynx of healthcare workers during surgery, thereby providing protection for the patient. However, there are several ways in which surgical face masks could potentially contribute to contamination of the surgical wound, e.g. by incorrect wear or by leaking air from the side of the mask due to poor string tension. OBJECTIVES: To determine whether disposable surgical face masks worn by the surgical team during clean surgery prevent postoperative surgical wound infection. SEARCH METHODS: We searched The Cochrane Wounds Group Specialised Register (searched 14 September 2011); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 3); Ovid MEDLINE (2008 to August Week 5 2011); Ovid MEDLINE (In-Process &Other Non-Indexed Citations September 13, 2011); Ovid EMBASE (2008 to 2011 Week 35); and EBSCO CINAHL (2008 to 9 September 2011). SELECTION CRITERIA: Randomized controlled trials (RCTs) and quasi-randomized controlled trials comparing the use of disposable surgical masks with the use of no mask. DATA COLLECTION AND ANALYSIS: Two review authors extracted data independently. MAIN RESULTS: Three trials were included, involving a total of 2113 participants. There was no statistically significant difference in infection rates between the masked and unmasked group in any of the trials. AUTHORS' CONCLUSIONS: From the limited results it is unclear whether the wearing of surgical face masks by members of the surgical team has any impact on surgical wound infection rates for patients undergoing clean surgery.

Disposable surgical face masks for preventing surgical wound infection in clean surgery.

Surgical face masks were originally developed to contain and filter droplets of microorganisms expelled from the mouth and nasopharynx of healthcare workers during surgery, thereby providing protection for the patient. However there are several ways in which surgical face masks could potentially contribute to contamination of the surgical wound. To identify and review all randomised controlled trials evaluating disposable surgical face masks worn by the surgical team during clean surgery to prevent post-operative surgical wound infection. All relevant publications about disposable surgical face masks were sought through the Specialised Trials Register of the Cochrane Wounds Group (March 2001). Manufacturers and distributors of disposable surgical masks as well as professional organisations including the National Association of Theatre Nurses and the American Operating Room Nurses Association were contacted for details of unpublished and ongoing studies. Randomised controlled trials (RCTs) and quasi-randomised controlled trials comparing the use of disposable surgical masks with the use of no mask were included. Data were extracted independently by AL and PE. Two randomised controlled trials were included involving a total of 1453 patients. In a small trial there was a trend towards masks being associated with fewer infections, whereas in a large trial there was no difference in infection rates between the masked and unmasked group. Neither trial accounted for cluster randomisation in the analysis. From the limited results it is unclear whether wearing surgical face masks results in any harm or benefit to the patient undergoing clean surgery.

The Ultrastructure of the Organic Phase Associated with the Inorganic Substance in Calcified Tissues

An organic phase is closely associated with the mineral substance is all calcified matrices, where it can be demonstrated as crystal-bound proteins by biochemical methods and as crystal ghosts by electron microscopy. Interest in crystal ghosts derives chiefly from the observation that they have the same shape, arrangement, and orientation as inorganic crystallites, which suggests they may have a role in their formation. Histochemically, crystal ghosts of epiphyseal cartilage react with colloidal iron (pH 2.0), acidic phosphotungstic acid, ruthenium red, and a number of cations including calcium, barium, magnesium, lanthanum, strontium, and terbium chloride. Their reactivity is removed by methylation and only incompletely restored by saponification. Moreover, the crystal ghosts located at the periphery of the calcified areas contain vic-glycol groups, as shown by their reactivity with periodic acid-silver nitrate and periodic acid-thiosemicarbazide-osmium. All these reactions show that the crystal ghosts of epiphyseal cartilage contain acidic, probably sulfate groups and, at least initially, vic-glycol groups. Their reactivity decreases as the calcification process is completed. Although the available data are not sufficient to allow a full understanding of the nature and function of these structures, they seem to play an important role in calcification. The hypothesis is presented that crystal ghosts are preformed in calcifying matrices and are activated by the unmasking of the reactive groups in their polymeric molecule; the unmasked groups then link up with inorganic ions in such a way to form organic-inorganic structures the inorganic ions of which are arranged in an apatitelike configuration and the filamentlike shape of which is the same as that of the polymeric molecule.

Trial of the Use of Masks in the Gynaecological Operating Theatre

A randomly controlled trial was performed on 41 women having gynaecological surgery in which the team of surgeons and nurses wore or did not wear masks. After major abdominal surgery, 3 of 5 patients in the unmasked group developed wound infections whereas no infection was observed in the 4 patients of the masked group. A greater number of Streptococci were also found by settle-plates on the operating table in the unmasked group. No infection was recorded after minor or vaginal surgery.

The unmasking of delivery room routine

SummaryThe incidence of puerperal infection was determined in a control series of 1750 consecutive mothers, while face masks were worn routinely in the delivery room. Face masks were then totally abandoned in the delivery room and the incidence of puerperal infection was again determined in a further series of 1750 consecutive mothers. There was no difference in the incidence of puerperal infection between the masked and unmasked groups, suggesting that face masks do not contribute to the prevention of puerperal infection.

Halloween Masks and Deindividuation

Diener, Fraser, Beaman. and Kelem (1976) examined the effects of anonymity. group presence. and assignment of responsibility on stealing by trick-or-treating children. To create a nonanonymous condition, the experimenter identified each child and address. In the anonymous cells, the costumed children were nor identified. They found significantly more stealing when the children remained anonymous. The results were interpreted as support for Zimbardo's (1969) suggestion that anonymity leads to deindividuation which lowers behavioral restraints. The present study was designed to examine a costume manipulation of anonymity (mask vs no mask). In light of Zimbardo's specification of anonymity as an antecedent of deindividuation and the Diener, et nl. finding, it was predicted that children wenring masks would violate candy rules more often than children not wearing masks. In accord with the Diener, ec al. (1976) procedure, children who were nor accompanied by an adult were greeted by a female experimenter who explained that each child was allowed to take two candies from a bowl of individually wrapped candies. The experimenter answered questions, indicated she had to return to her work and exited. An unseen observer recorded whether or nor each child was wearing a mask and how many candies the child took. Of the 58 unaccompanied children who came to the three homes participating in this study, 31 (53%) took more than two candies. Thimynine children wore masks and 24 of them (62%) violated the rule. Nineteen children did nor wear masks and only seven of them (37%) were violaters. A chi-square test suggested a tendency for masked children to violate more often than nonmasked children fx2 = 3.14. p < .lo). The sex of the children did not produce a statistically significant effect. While no formal aaempt was made to estimate the children's ages, each oI the six experimenters reported that the masked and unmasked groups did not appear to differ in terms of age, the approximate range being 9 to 13 yr. It appears that costume masks can serve to elicit a state of deindividuation and lead to lowered restraints on behavior of young children.

Crotamine conformation: Effect of pH and temperature

The pH-isomers of crotamine were characterized by spectropolarimetric titration. The neutral isomer (I) found at pH range between 4 and 8·5 corresponds to the native conformation. After heating at 80°C for 30 min in 8 M urea, it retains full biological activity and the small spectral changes induced by heating are readily reversible. Compared to the neutral isomer, the acid isomer (II) occurs at pH values lower than 2·0 and has an unmasked group presumably a carboxyl, with a p K′ of 2·6. The basic isomer (III) has two groups with ap K′ of 9·7 exposed. Also, the exposure of the N-terminal tyrosyl in II and the tyrosyl and two tryptophanyl residues in III are revealed by difference spectrophotometry. Both II and III represent partially pH-denatured conformations which undergo further structural unfolding upon heating. The unfolding ▵H° for isomers II and III were determined to be 8·2 and 6·1 kcal/mole, respectively. In addition, the spectral ▵H° calculated from the spectrophotometric data gives information about the spatial displacement of residues (mainly tryptophanyl and tyrosyl) which are more pronounced in III than in II.

Factors Affecting the Release by Dilute Acid of Hidden Prototropic Groups in Carbonylhemoglobin

Abstract A ferrohemoglobin, horse COHb, titrated with acid and back-titrated with base in the absence of air and with more rapid mixing (⅕ sec) than in earlier work, exhibits much more complex unmasking behavior (prototropic groups) than previously reported for the ferri form, Hb+. The numbers and kinds of groups liberated by exposure to acid depend not only on pH, but on salt concentrations, and on time of exposure as well. Under mild conditions of denaturation, all the groups unmasked appear to be remasked so rapidly at higher pH that a meaningful back titration curve has not been obtained. With more severe treatment, regeneration and remasking are manageably slower, and it is clear that masked basic groups, including (but not solely) imidazoles, appear. Loss of α helix, when brought about by mild acid treatment, is recovered at higher pH values which depend on the severity of the denaturation process. With the most severe treatment, about 24 groups titrating at pH g 3 are unmasked; about half of these appear to be imidazole. The number is in fair agreement with that recently calculated by Tanford and Nozaki for ferrihemoglobin. Evidence is presented that exposure of the ferroprotein to low pH (below 3) produces results (unmasked groups, regenerability of Cotton effects, and Soret band absorption) which are quantitatively different from those accompanying the maximum attainable degree of unfolding at longer times at higher pH. The pH and time of exposure to acid may determine whether unfolding of the ferroprotein occurs with or without detachment of the prosthetic group.