Respiratory droplets serve as a viable transmission mechanism for many viruses and other pathogens. Facemasks are commonly used to minimize the risk of this transmission. However, information on the size-resolved filtration efficiency of commonly available commercial facemasks is not readily available in the literature. To fill this gap, the current study performs aerosolized chamber experiments to evaluate the filtration efficiencies of commonly available commercial facemasks' materials in a size range of 0.3-10 µm. Results rank the performance of filtration through commercial facemasks' materials as follows (values in brackets indicate the average filtration efficiencies across 0.3-10 µm) 6-Layer N95 mask (0.918) > N95 mask - without valve (0.88) > KN95 mask (0.84) > N95 mask -with valve (0.834) > Heavy knitted cotton mask (0.808) > Surgical mask (0.778) > Cotton mask-2 layers (0.744) > Nylon fabric mask-2 layers (0.740) > T-shirt fabric mask-2 layers (0.708) > T-shirt fabric mask-1 layer (0.648). The size-resolved filtration efficiencies through the material across the evaluated commercial facemasks ranged from 38-83% in the size range of 0.3-0.5 µm, 55-88% in the size range of 0.5-1 µm, 69-93% in the size range of 1-2.5 µm, 76-96% in the size range of 2.-5 µm, and 86-99% in the size range of 5-10 µm. Subsequently, the filtration efficiencies of materials post washing (with detergent in warm water and allowing to dry completely) were also evaluated. CX5461 The average reduction in filtration efficiencies post washing are as follows 6-Layer N95 mask 3%, N95 mask - without valve 2%, KN95 mask 4%, N95 mask -with valve 3%, Heavy knitted cotton mask 4%, Surgical mask 18%, Cotton mask-2 layers 11%, Nylon fabric mask-2 layers 6%, T-shirt fabric mask-2 layers 6%, T-shirt fabric mask-1 layer 8%. This decrease in the filtration efficiency was more pronounced for the sub-micron particles than the super-micron ones.
Ventilator-associated event (VAE) surveillance provides an objective means to measure and compare complications that develop during mechanical ventilation by identifying patients with sustained increases in ventilator settings after a period of stable or decreasing ventilator settings. The impact of the Covid-19 pandemic on VAE rates and characteristics is unknown.
To compare the incidence, causes, and outcomes of VAE during the Covid-19 pandemic year vs pre-pandemic years and amongst ventilated patients with and without Covid-19.
In this retrospective cohort study of mechanically ventilated adults at four academic and community hospitals in Massachusetts, we compared VAE incidence rates between March 1-August 31 for each of 2017-2020 (corresponding to the timeframe of the pandemic first wave in 2020) and among Covid-19 positive and negative patients in 2020. The medical records of 200 randomly selected patients with VAEs in 2020 (100 with Covid-19, 100 without) were analyzed to compare conditions precissive ARDS versus less than 15% in patients without Covid-19. These findings provide insight into the natural history of Covid-19 in ventilated patients and may inform targeted strategies to mitigate complications in this population.
VAE rates per 100 episodes of mechanical ventilation and per 1000 ventilator days were higher amongst Covid-19 positive versus negative patients. Over 50% of VAEs in Covid-19 patients were caused by progressive ARDS versus less than 15% in patients without Covid-19. These findings provide insight into the natural history of Covid-19 in ventilated patients and may inform targeted strategies to mitigate complications in this population.
Palliative care focuses on improving quality of life for patients with life-limiting conditions. While previous studies have shown palliative care to be associated with reduced acute health care use in people with cancer and other illnesses, these findings may not generalize to patients with COPD.
We examined the association between palliative care and rates of days at home, location of death, and acute health care use in patients with COPD.
We used health administrative databases in Ontario, Canada to identify patients with advanced COPD hospitalized between April 2010 and March 2017 and followed until March 2018. Patients who received palliative care were matched 11 to those who did not on age, sex, long-term oxygen, previous COPD hospitalizations and propensity scores. Rate ratios (RR) were estimated using Poisson models with generalized estimating equations to account for matching.
Among 35,492 patients, 1,788 (5%) received palliative care. In the matched cohort (1,721 pairs), people with COPD receiving palliative care had similar rates of days at home (RR=1.01, 95% CI [0.97, 1.05]) but were more likely to die at home (16.4% vs. 10.0%, p<0.001) compared to those who did not receive palliative care. Rates of healthcare utilization were similar except for increased hospitalizations in the palliative care group (RR=1.09, 95% CI [1.01, 1.18]).
Receipt of palliative care did not reduce days at home or healthcare utilization but was associated with a modest increase in proportion dying at home. Future work should evaluate palliative care strategies designed specifically for patients with COPD.
Receipt of palliative care did not reduce days at home or healthcare utilization but was associated with a modest increase in proportion dying at home. Future work should evaluate palliative care strategies designed specifically for patients with COPD.Using a standardized campus climate survey that was disseminated across three modes of administration (N = 5,137), this study assesses the nonresponse bias of two web-based versions to a self-administered paper-and-pencil version conducted at a Southeastern 4-year university. Significant differences emerged across all three modes of administration and victimization measures (bullying, sexual assault, rape, emotional abuse, and intimate partner violence [IPV]). Respondents were more likely to report victimization in the web-based surveys administered to online-only classes and via mass email compared to the paper survey. Policy implications, especially as it relates to survey administration, are discussed.CX5461
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