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Face shields, masks with vents less effective at limiting COVID-19 spread, study finds

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Sept. 1 (UPI) — Clear plastic face shields and masks with exhalation valves are less effective than cloth or surgical masks in preventing COVID-19 spread, according to an analysis published Tuesday by the journal Physics of Fluid.

In experiments intended to recreate airborne dispersion of respiratory droplets — microscopic fluid from the nose, mouth and throat — that spread the virus, cloth and surgical masks performed much better at limiting their release.

Although many people have opted for clear plastic face shields for comfort reasons — particularly in warmer climates — they may not be the safest choice, the data showed.

“As students return to schools and universities, some have wondered if it is better to use face shields, as they are more comfortable and easier to wear for longer periods of time,” study co-author Siddhartha Verma said in a statement.

“If these shields are not as effective … you would be essentially putting everyone in a tight space with droplets accumulating over time, which could potentially lead to infections,” said Verma, an assistant professor of ocean and mechanical engineering at Florida Atlantic University.

Wearing face coverings has become a key component of efforts to control the spread of COVID-19 since the early stages of the pandemic, as the virus is spread by airborne respiratory droplets.

Although some people across the country have objected to wearing face coverings, many states have made them mandatory, particularly in public indoor spaces such as schools, stores and restaurants.

The U.S. Centers for Disease Control and Prevent recommends cloth face masks for the public and not the surgical and N95 masks needed by health care providers.

For this study, Verma and his colleagues used a hollow mannequin head and simulated a cough or sneeze with a pressure impulse from a manual pump. Tracers composed of droplets of distilled water and glycerin were expelled through the mouth opening, and laser sheets visualized the spread and movement of the ejected droplets.

Clear plastic face shields block the initial forward motion of a simulated jet of a cough or a sneeze, but the expelled droplets can move around the visor with relative ease and spread out over a large area depending on light ambient disturbances, the researchers said.

Similarly, masks equipped with an exhalation port show that a large number of droplets pass through the exhale valve unfiltered, which make it ineffective in stopping the spread the COVID-19 virus if the person wearing the mask is infected.

To minimize the community spread of COVID-19, it’s best to use high-quality cloth or surgical masks that are of a plain design instead of face shields and masks equipped with exhale valves, the researchers said.

“Even the very best masks have some degree of leakage,” Verma said. “It’s still important to maintain physical distance while wearing them to mitigate transmission.”



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Low-dose electrical stimulation helps adults with dyslexia read, study finds

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Sept. 8 (UPI) — Electrical stimulation of the brain improves reading accuracy in adults with dyslexia, according to a study published Tuesday by PLOS Biology.

Transcranial alternating current stimulation, a non-invasive procedure that delivers low-dose electricity to the brain over a period of 20 minutes, was found to improve phonological processing — or ability to discern how words sound or are pronounced — and reading accuracy in 15 adults with dyslexia, the researchers said.

The beneficial effect on phonological processing was most pronounced in those individuals who had poor reading skills, while a slightly disruptive effect was observed in very good readers, they said.

Dyslexia, known commonly as a reading disorder, affects up to 10% of the population, and is characterized by lifelong difficulties with written material,” according to the researchers, who are from the University of Geneva in Switzerland.

Although several possible causes have been proposed for dyslexia, the predominant one is a phonological deficit, or a difficulty in processing word sounds, the researchers said.

The phonological deficit in dyslexia is associated with changes in rhythmic or repetitive patterns of electrical activity in the brain, specifically “low-gamma” oscillations, measuring at 30 hertz or volts, in the left auditory cortex, they said.

However, studies have yet to prove that these these oscillations affect a person’s ability to process word sounds and cause dyslexia, the researchers said.

For this study, the researchers applied transcranial alternating current stimulation over the left auditory cortex in 15 adults with dyslexia and 15 fluent readers for 20 minutes.

At a dose of 30 hertz or volts, the approach resulted in significant improvement in reading accuracy in those with dyslexia, the researchers said.

However, the same improvements were not seen following application of a higher, 60-hertz dose, they said.

The results demonstrate for the first time that low-gamma oscillatory activity causes deficits in phonemic processing and may pave the way to non-invasive treatments aimed at normalizing oscillatory function in auditory cortex in people with dyslexia, the researchers said.

They plan “to investigate whether normalizing oscillatory function in very young children could have a long-lasting effect on the organization of the reading system [and] explore even less invasive means of correcting oscillatory activity,” study co-author Silvia Marchesotti, a post-doctural researcher at the University of Geneva, said in a press release.



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Surgery may help sleep apnea patients who struggle with CPAP

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Continuous positive airway pressure may be the go-to treatment for sleep apnea, but many people struggle to use it every night. For those who cannot tolerate CPAP, new research finds that a combination of surgical techniques may bring relief.

The “multilevel” treatment includes removing the tonsils, repositioning the palate — roof of the mouth — and using radiofrequency to slightly reduce the size of the tongue. In combination, these procedures open up the airway and reduce breathing obstruction, the researchers said.

The study found that the multilevel surgery technique reduced the number of times people stopped breathing — apnea events — during sleep and improved daytime sleepiness. People also reported better quality of life after the treatment.

“Obstructive sleep apnea is common and many people cannot use the main treatments, like CPAP masks. Surgery is a valid option when an expert surgeon is involved, and it can improve outcomes,” said the study’s lead author, Dr. Stuart MacKay. He’s an honorary clinical professor of otolaryngology, head and neck surgery at University of Wollongong, in Australia.

The researchers said that nearly one billion people worldwide suffer from sleep apnea. The airway becomes blocked during sleep, and as a result people stop breathing for short periods of time, multiple times throughout the night. People with sleep apnea have a higher risk of daytime sleepiness, motor vehicle crashes, and heart disease and stroke.

CPAP does a good job at keeping your airway open as you sleep, but the treatment — including a mask and a long tube — can be hard to get used to. The study authors said only about half of people with sleep apnea try CPAP.

For the new study, the researchers recruited 102 overweight or obese people with sleep apnea from six clinical centers in Australia, who were in their 40s, on average. The goal was to see if surgery could help adults with moderate or severe obstructive sleep apnea who weren’t able to tolerate or adhere to CPAP devices.

Half of the volunteers were randomly assigned to receive the sleep apnea surgery, while the other 51 continued with medical treatment. Medical management consisted of encouraging weight loss, drinking less alcohol, changing sleep posture and medical treatment for nasal obstruction.

MacKay said the multilevel surgical technique is widely available in many parts of the world. For the patients in this study, surgeries were performed by seven experienced surgeons.

Six months after the surgical procedures, volunteers in the surgery group had about a 27% decrease in the number of apnea events at night. Those on medical treatment had just a 10% decrease.

People in the surgical group also had major improvements in levels of snoring and daytime sleepiness, as well as a boost to quality of life.

As with any surgical procedure, there are risks.

“The main risks of pain and bleeding are confined to the two weeks after surgery. Bleeding occurs in about one in every 25 patients. Long-term risks related to taste disturbance, feeling of sticking in the throat, swallow dysfunction are very rare, although they do occur transiently in some,” MacKay said.

Dr. Steven Feinsilver is director of the Center for Sleep Medicine at Lenox Hill Hospital in New York City. He said, “Sleep apnea is a very common disease, about as common as diabetes, and similar to diabetes is associated with increased risk for cardiovascular events, such as stroke and heart disease.”

He added that “CPAP works, but is a difficult treatment.”

Feinsilver said that surgery that could provide a permanent cure has long been the goal for treatment.

“This study shows that relatively minor surgery, performed in a standardized fashion by skilled surgeons, can significantly improve sleep apnea compared to ‘medical treatment’ (essentially no treatment),” he said.

But he noted that even though people reported improvement, their nighttime breathing wasn’t back in the normal range.

“This is certainly a major improvement, but it remains unclear whether outcomes (such as cardiovascular risk) will be significantly impacted,” Feinsilver said. Also, he suggested that this multilevel surgery may only be an option for a select group of patients.

The report was published online Sept. 4 in the Journal of the American Medical Association.

More information

Learn more about sleep apnea treatments from the U.S. National Heart, Lung, and Blood Institute.

Copyright 2020 HealthDay. All rights reserved.



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COVID-19-related heart, lung issues ease over time in survivors, study shows

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Long-term heart and lung damage can occur in COVID-19 patients, but it may ease with time, according to a new study.

A second study found that COVID-19 patients recover faster if they begin rehabilitation as soon as possible after getting off a respirator or leaving intensive care.

“The bad news is that people show lung impairment from COVID-19 weeks after discharge the good news is that the impairment tends to ameliorate over time, which suggests the lungs have a mechanism for repairing themselves,” said researcher Sabina Sahanic, a clinical Ph.D. student at University Clinic in Innsbruck, Austria.

“The findings from this study show the importance of implementing structured follow-up care for patients with severe COVID-19 infection. Importantly, CT unveiled lung damage in this patient group that was not identified by lung function tests,” she said.

Both studies were presented at a virtual meeting of the European Respiratory Society.

Sahanic’s research included 86 hospitalized COVID-19 patients in Austria who were enrolled between April 29 and June 9.

The patients, average age 61, were evaluated six, 12 and 24 weeks after leaving the hospital. At their first visit, more than half had at least one persistent symptom — mainly breathlessness and coughing. CT scans showed that 88% still had lung damage.

By their second visit at 12 weeks, patients’ symptoms had improved and 56% had signs of lung damage. Findings from the evaluations at 24 weeks weren’t available yet.

“Knowing how patients have been affected long-term by the coronavirus might enable symptoms and lung damage to be treated much earlier and might have a significant impact on further medical recommendations and advice,” Sahanic said in a meeting news release.

The other study included 19 patients with severe COVID-19. They spent an average of three weeks in intensive care and two weeks in a pulmonary ward before being transferred to a clinic for about three weeks of pulmonary rehabilitation.

A walking test evaluated their weekly progress. At the start of rehab, they could walk only an average of 16% of the distance they should manage to walk if healthy.

That average increased to 43% after three weeks of rehab. While a significant improvement, it’s still far below normal, the researchers noted.

“The most important finding was that patients who were admitted to pulmonary rehabilitation shortly after leaving intensive care progressed faster than those who spent a longer period in the pulmonary ward where they remained inactive,” said study author Yara Al Chikhanie. She’s a Ph.D. student at the Dieulefit Santé clinic for pulmonary rehabilitation and the Hp2 Lab at Grenoble Alps University in France.

“The sooner rehabilitation started and the longer it lasted, the faster and better was the improvement in patients’ walking and breathing capacities and muscle gain,” Al Chikhanie said in the release.

Patients who started rehabilitation in the week after coming off their ventilators progressed faster than those who were admitted after two weeks, she added. But how soon they can start rehab depends on when their doctors deem them medically stable.

“Despite the significant improvement, the average period of three weeks in rehabilitation wasn’t enough for them to recover completely,” Al Chikhanie said.

Data and conclusions presented at meetings are usually considered preliminary until peer-reviewed for publication in a medical journal.

More information

The U.S. Centers for Disease Control and Prevention has more on COVID-19.

Copyright 2020 HealthDay. All rights reserved.



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