1
|
Greenhalgh T, MacIntyre CR, Baker MG, Bhattacharjee S, Chughtai AA, Fisman D, Kunasekaran M, Kvalsvig A, Lupton D, Oliver M, Tawfiq E, Ungrin M, Vipond J. Masks and respirators for prevention of respiratory infections: a state of the science review. Clin Microbiol Rev 2024; 37:e0012423. [PMID: 38775460 DOI: 10.1128/cmr.00124-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Abstract
SUMMARYThis narrative review and meta-analysis summarizes a broad evidence base on the benefits-and also the practicalities, disbenefits, harms and personal, sociocultural and environmental impacts-of masks and masking. Our synthesis of evidence from over 100 published reviews and selected primary studies, including re-analyzing contested meta-analyses of key clinical trials, produced seven key findings. First, there is strong and consistent evidence for airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other respiratory pathogens. Second, masks are, if correctly and consistently worn, effective in reducing transmission of respiratory diseases and show a dose-response effect. Third, respirators are significantly more effective than medical or cloth masks. Fourth, mask mandates are, overall, effective in reducing community transmission of respiratory pathogens. Fifth, masks are important sociocultural symbols; non-adherence to masking is sometimes linked to political and ideological beliefs and to widely circulated mis- or disinformation. Sixth, while there is much evidence that masks are not generally harmful to the general population, masking may be relatively contraindicated in individuals with certain medical conditions, who may require exemption. Furthermore, certain groups (notably D/deaf people) are disadvantaged when others are masked. Finally, there are risks to the environment from single-use masks and respirators. We propose an agenda for future research, including improved characterization of the situations in which masking should be recommended or mandated; attention to comfort and acceptability; generalized and disability-focused communication support in settings where masks are worn; and development and testing of novel materials and designs for improved filtration, breathability, and environmental impact.
Collapse
Affiliation(s)
- Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - C Raina MacIntyre
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Michael G Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Shovon Bhattacharjee
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
- School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, Australia
| | - Abrar A Chughtai
- School of Population Health, University of New South Wales, Sydney, Australia
| | - David Fisman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Mohana Kunasekaran
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Amanda Kvalsvig
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Deborah Lupton
- Centre for Social Research in Health and Social Policy Research Centre, Faculty of Arts, Design and Architecture, University of New South Wales, Sydney, Australia
| | - Matt Oliver
- Professional Standards Advocate, Edmonton, Canada
| | - Essa Tawfiq
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Mark Ungrin
- Faculty of Veterinary Medicine; Department of Biomedical Engineering, Schulich School of Engineering; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Joe Vipond
- Department of Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
2
|
Zhang Y, Ding H, Gao H, Liu J, Wang F, Wu Y. Factors influencing speech improvement following maxillary complete-arch implant-supported restorations: A retrospective study. Clin Oral Implants Res 2024. [PMID: 38867397 DOI: 10.1111/clr.14311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 04/14/2024] [Accepted: 05/21/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVE This study explored factors affecting speech improvement in patients with an edentulous maxilla after the delivery of a complete-arch implant-supported fixed dental prosthesis (IFDP). MATERIALS AND METHODS Patients who had received IFDP for edentulous maxilla were enrolled, and various potential speech improvement-related factors were considered, including patient demographics, anterior residual bone volume, preoperative facial features, preoperative acoustic parameters, and adaptation time. Acoustic analysis and perceptual ratings were used to assess three fricatives [s], [f], and [ɕ]. Correlation and regression analyses were conducted to assess the association between changes in fricatives and potential factors (α = .05). RESULTS The study included 50 patients (18 females and 32 males, aged 50.62 ± 15.71 years, range 19-76). Significant correlations were found among the change in the center of gravity (ΔCoG) of [s] and anterior residual bone volume, zygomatic implants number and proportion (p < .05). These correlations were largely mirrored in the perceptual score (ΔPS) changes. After controlling for age, sex, preoperative acoustic parameters, and adaptation time, the ΔCoG and ΔPS of fricatives were mainly correlated with the anterior residual bone volume, preoperative acoustic parameters, and adaptation time. CONCLUSION Speech improvements post-IFDP delivery are mainly related to preoperative speech characteristics, anterior residual bone volume, and adaptation time. The residual bone volume's impact on consonants varies with specific articulatory gestures. This study provides insights into forecasting speech outcomes following IFDP restoration and provides recommendations and methods for data collection in developing future prediction models.
Collapse
Affiliation(s)
- Yun Zhang
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Hongwei Ding
- Speech-Language-Hearing Centre, School of Foreign Languages, Shanghai Jiao Tong University, Shanghai, China
- National Research Centre for Language and Well-Being, Shanghai, China
| | - Hanqi Gao
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Jie Liu
- Speech-Language-Hearing Centre, School of Foreign Languages, Shanghai Jiao Tong University, Shanghai, China
- National Research Centre for Language and Well-Being, Shanghai, China
| | - Feng Wang
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yiqun Wu
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| |
Collapse
|
3
|
Tiewald C, Seibel A, Schienle A. A positive side effect of wearing face coverings for socially anxious females: Findings from a speech task. Heliyon 2024; 10:e23733. [PMID: 38187227 PMCID: PMC10767500 DOI: 10.1016/j.heliyon.2023.e23733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 12/04/2023] [Accepted: 12/12/2023] [Indexed: 01/09/2024] Open
Abstract
Background Wearing face masks has become more common due to the COVID-19 pandemic. Until now, it has not been investigated whether socially anxious individuals can reduce their acute anxiety symptoms by wearing face masks during a speech task. Method Fifty-nine socially anxious females were asked to prepare and give an oral presentation. Participants were randomly allocated either to a group that was asked to wear a face mask during the task, or to a group that was not asked to wear a face mask during the task. Dependent variables included physiological parameters (systolic/diastolic blood pressure, heart rate) and self-reports (valence and arousal at baseline, as well as directly before and after the presentation). Results The analyses showed that the group without face masks had a higher systolic blood pressure than the group with face masks, directly before as well as after the presentation. The two groups did not differ in the other measures. Conclusion Wearing face masks has a small stress-reducing effect on socially anxious females.
Collapse
Affiliation(s)
- Carina Tiewald
- Department of Clinical Psychology, University of Graz, Graz, Austria
| | - Arved Seibel
- Department of Clinical Psychology, University of Graz, Graz, Austria
| | - Anne Schienle
- Department of Clinical Psychology, University of Graz, Graz, Austria
| |
Collapse
|
4
|
Silva MT, Occhi-Alexandre IGP, Teixeira LC. Association Between Vocal Symptoms, Communication, Work Environment, and Sense of Coherence in Hospital Health Professionals. J Voice 2023:S0892-1997(23)00370-3. [PMID: 38129270 DOI: 10.1016/j.jvoice.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE This study aimed to associate the presence of vocal symptoms with sociodemographic and occupational data, work environment self-perception, oral communication wearing a face mask, and the sense of coherence (SOC). METHOD This cross-sectional analytical observational study included 66 health professionals from a Brazilian hospital. They answered an online questionnaire on sociodemographic aspects, self-perception of the physical work environment, and oral communication at work. The Voice Symptom Scale (VoiSS) and Sense of Coherence Scale (SOC-13) were also applied. The significance level was set at 5% for the statistical analysis. RESULTS The self-perception of vocal symptoms was 62%. Professionals who considered the noise in their work environment unsatisfactory had more vocal symptoms (P = 0.005), especially in the limitation (P = 0.013) and physical (P = 0.028) domains of the VoiSS. Professionals with higher self-perceived vocal symptoms also reported incoordination between breathing, speech, and articulation (P = 0.041) and self-perceived difficulty being heard with a protective mask (P = 0.033). Professionals with a higher self-perceived score in the limitation domain of the VoiSS also had a higher self-perceived effort to speak with a mask (P = 0.035) and a higher self-perception that other people find it difficult to hear them with a face mask (P = 0.050). There was a weak negative correlation between VoiSS and SOC (P < 0.05) and between its domains (P < 0.05). CONCLUSION Self-perception of voice symptoms is high among health professionals in a Brazilian public hospital. The presence of these symptoms is related to the perception of a noisy work environment and communication difficulties due to the use of a face mask. The lower the ability to cope with stressful situations, the larger the presence of voice symptoms among health professionals.
Collapse
Affiliation(s)
- Melyssa Tamietti Silva
- School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil.
| | | | - Letícia Caldas Teixeira
- School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| |
Collapse
|
5
|
Drouin JR, Rojas JA. Influence of face masks on recalibration of phonetic categories. Atten Percept Psychophys 2023; 85:2700-2717. [PMID: 37188863 PMCID: PMC10185375 DOI: 10.3758/s13414-023-02715-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2023] [Indexed: 05/17/2023]
Abstract
Previous research demonstrates listeners dynamically adjust phonetic categories in line with lexical context. While listeners show flexibility in adapting speech categories, recalibration may be constrained when variability can be attributed externally. It has been hypothesized that when listeners attribute atypical speech input to a causal factor, phonetic recalibration is attenuated. The current study investigated this theory directly by examining the influence of face masks, an external factor that affects both visual and articulatory cues, on the magnitude of phonetic recalibration. Across four experiments, listeners completed a lexical decision exposure phase in which they heard an ambiguous sound in either /s/-biasing or /ʃ/-biasing lexical contexts, while simultaneously viewing a speaker with a mask off, mask on the chin, or mask over the mouth. Following exposure, all listeners completed an auditory phonetic categorization test along an /ʃ/-/s/ continuum. In Experiment 1 (when no face mask was present during exposure trials), Experiment 2 (when the face mask was on the chin), Experiment 3 (when the face mask was on the mouth during ambiguous items), and Experiment 4 (when the face mask was on the mouth during the entire exposure phase), listeners showed a robust and equivalent phonetic recalibration effect. Recalibration manifested as greater proportion /s/ responses for listeners in the /s/-biased exposure group, relative to listeners in the /ʃ/-biased exposure group. Results support the notion that listeners do not causally attribute face masks with speech idiosyncrasies, which may reflect a general speech learning adjustment during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Julia R Drouin
- Division of Speech and Hearing Sciences, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
- Department of Communication Sciences and Disorders, California State University Fullerton, Fullerton, CA, USA.
| | - Jose A Rojas
- Department of Communication Sciences and Disorders, California State University Fullerton, Fullerton, CA, USA
| |
Collapse
|
6
|
Mutlu A, Celik S, Kilic MA. Effects of Personal Protective Equipment on Speech Acoustics. SISLI ETFAL HASTANESI TIP BULTENI 2023; 57:434-439. [PMID: 37900335 PMCID: PMC10600612 DOI: 10.14744/semb.2023.22556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/22/2023] [Accepted: 06/08/2023] [Indexed: 10/31/2023]
Abstract
Objectives The transmission of severe acute respiratory syndrome coronavirus-2 occurs primarily through droplets, which highlights the importance of protecting the oral, nasal, and conjunctival mucosas using personal protective equipment (PPE). The use of PPE can lead to communication difficulties between healthcare workers and patients. This study aimed to investigate changes in the acoustic parameters of speech sounds when different types of PPE are used. Methods A cross-sectional study was conducted, enrolling 18 healthy male and female participants. They were instructed to produce a sustained [ɑː] vowel for at least 3 s to estimate voice quality. In addition, all Turkish vowels were produced for a minimum of 200 ms. Finally, three Turkish fricative consonants ([f], [s], and [ʃ]) were produced in a consonant/vowel/consonant format with different vowel contexts within a carrier sentence. Recordings were repeated under the following conditions: no PPE, surgical mask, N99 mask, face shield, surgical mask + face shield, and N99 mask + face shield. All recordings were subjected to analysis. Results Frequency perturbation parameters did not show significant differences. However, in males, all vowels except [u] in the first formant (F1), except [ɔ] and [u] in the second formant (F2), except [ɛ] and [ɔ] in the third formant (F3), and only [i] in the fourth formant (F4) were significant. In females, all vowels except [i] in F1, except [u] in F2, all vowels in F3, and except [u] and [ɯ] in F4 were significant. Spectral moment values exhibited significance in both groups. Conclusion The use of different types of PPE resulted in variations in speech acoustic features. These findings may be attributed to the filtering effects of PPE on specific frequencies and the potential chamber effect in front of the face. Understanding the impact of PPE on speech acoustics contributes to addressing communication challenges in healthcare settings.
Collapse
Affiliation(s)
- Ahmet Mutlu
- Department of Otorhinolaryngology, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Türkiye
- Department of Otorhinolaryngology, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Türkiye
| | - Serdal Celik
- Department of Otorhinolaryngology, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Türkiye
- Department of Otorhinolaryngology, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Türkiye
| | - Mehmet Akif Kilic
- Department of Otorhinolaryngology, Umraniye Training and Research Hospital, Istanbul, Türkiye
| |
Collapse
|
7
|
Barsties v. Latoszek B, Jansen V, Watts CR, Hetjens S. The Impact of Protective Face Coverings on Acoustic Markers in Voice: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:5922. [PMID: 37762863 PMCID: PMC10531748 DOI: 10.3390/jcm12185922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/09/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Wearing respiratory protective masks (RPMs) has become common worldwide, especially in healthcare settings, since the onset of the COVID-19 pandemic. Hypotheses have suggested that sound transmission could be limited by RPMs, which possibly affects the characteristics of acoustic energy and speech intelligibility. The objective of this study was to investigate the effect of RPMs on acoustic measurements through a systematic review with meta-analysis. METHODS Five database searches were conducted, ranging from their inception to August 2023, as well as a manual search. Cross-sectional studies were included that provided data on widely used gender-independent clinical acoustic voice quality measures (jitter, shimmer, HNR, CPPS, and AVQI) and habitual sound pressure level (SPL). RESULTS We found nine eligible research studies with a total of 422 participants who were compared both without masks and with different types of masks. All included studies focused on individuals with vocally healthy voices, while two of the studies also included those with voice disorders. The results from the meta-analysis were related to medical/surgical and FFP2/(K)N95 masks. None of the acoustic measurements showed significant differences between the absence and presence of masks (p > 0.05). When indirectly comparing both mask types, statistical significance was identified for parameters of jitter, HNR, CPPS and SPL (p < 0.001). CONCLUSIONS The present meta-analysis indicates that certain types of RPMs have no significant influence on common voice quality parameters and SPL compared to recordings without masks. Nevertheless, it is plausible that significant differences in acoustic parameters might exist between different mask types. Consequently, it is advisable for the clinical practice to always use the same mask type when using RPMs to ensure high comparability and accuracy of measurement results.
Collapse
Affiliation(s)
| | - Viktoria Jansen
- Speech-Language Pathology, SRH University of Applied Health Sciences, 40210 Düsseldorf, Germany
| | - Christopher R. Watts
- Harris College of Nursing & Health Sciences, Texas Christian University, Fort Worth, TX 76109, USA
| | - Svetlana Hetjens
- Department for Medical Statistics and Biomathematics, Medical Faculty Mannheim, University of Heidelberg, 68165 Mannheim, Germany
| |
Collapse
|
8
|
Gao Y, Feng Y, Wu D, Lu F, He H, Tian C. Effect of Wearing Different Masks on Acoustic, Aerodynamic, and Formant Parameters. J Voice 2023:S0892-1997(23)00191-1. [PMID: 37541926 DOI: 10.1016/j.jvoice.2023.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/16/2023] [Accepted: 06/16/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVE This study aimed to investigate the effects of different types of masks on acoustic, aerodynamic, and formant parameters in healthy people. METHODS Our study involved 30 healthy participants, 15 of each gender, aged 20-40 years. The tests were conducted under four conditions: without a mask, after wearing a surgical mask, after wearing a head-mounted N95 mask, and after wearing an ear-mounted N95 mask. Voice recording was done with the mask on. The acoustic parameters include mean fundamental frequency (F0), mean intensity, percentage of jitter (local), percentage of shimmer (local), mean noise to harmonic ratio (NHR), aerodynamic parameter, maximum phonation time (MPT), and formant parameters (/a/, /i/, /u/ three vowels F1, F2). RESULTS The main effect of mask type was significant in MPT, mean F0, mean HNR, /a/F1, /a/F2, /i/F2. However, the effect sizes and power in /a/F2, /i/F2 were low. MPT, mean F0 and mean HNR significantly increased and /a/F1 significantly decreased after wearing the head-mounted n95 mask. The mean F0 and mean HNR increased significantly after wearing the ear-mounted n95 mask. No significant changes were observed in parameters after wearing the surgical mask in this study. When the statistics are performed separately for males and females, the results obtained are similar to those previously obtained for unspecified males and females. CONCLUSION After wearing the surgical mask, this study found insignificant changes in mean F0, jitter (local), shimmer (local), mean NHR, mean intensity, MPT, and the vowels F1 and F2. This may be due to the looser design of the surgical mask and the relatively small attenuation of sound. N95 masks have a greater effect on vocalization than surgical masks and may cause changes in F0 and HNR after wearing an N95 mask. In the present study, no significant changes in jitter and shimmer were observed after wearing the mask. In addition, there was a significant reduction in /a/F1 after wearing the N95 headgear mask may owing to its high restriction of jaw mobility. In future studies, the change in jaw movement amplitude after wearing the mouthpiece can be added to investigate.
Collapse
Affiliation(s)
- Yongxiang Gao
- Department of Hearing and Language Rehabilitation, Ningbo Rehabilitation Hospital, Ningbo, Zhejiang Province, China
| | - Yan Feng
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Di Wu
- College of Life and Environmental Sciences, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Feiao Lu
- Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital(Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Hualan He
- Department of Hearing and Language Rehabilitation, Ningbo Rehabilitation Hospital, Ningbo, Zhejiang Province, China
| | - Chenghua Tian
- College of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China.
| |
Collapse
|
9
|
Calà F, Manfredi C, Battilocchi L, Frassineti L, Cantarella G. Speaking with mask in the COVID-19 era: Multiclass machine learning classification of acoustic and perceptual parameters. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 153:1204. [PMID: 36859154 DOI: 10.1121/10.0017244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
The intensive use of personal protective equipment often requires increasing voice intensity, with possible development of voice disorders. This paper exploits machine learning approaches to investigate the impact of different types of masks on sustained vowels /a/, /i/, and /u/ and the sequence /a'jw/ inside a standardized sentence. Both objective acoustical parameters and subjective ratings were used for statistical analysis, multiple comparisons, and in multivariate machine learning classification experiments. Significant differences were found between mask+shield configuration and no-mask and between mask and mask+shield conditions. Power spectral density decreases with statistical significance above 1.5 kHz when wearing masks. Subjective ratings confirmed increasing discomfort from no-mask condition to protective masks and shield. Machine learning techniques proved that masks alter voice production: in a multiclass experiment, random forest (RF) models were able to distinguish amongst seven masks conditions with up to 94% validation accuracy, separating masked from unmasked conditions with up to 100% validation accuracy and detecting the shield presence with up to 86% validation accuracy. Moreover, an RF classifier allowed distinguishing male from female subject in masked conditions with 100% validation accuracy. Combining acoustic and perceptual analysis represents a robust approach to characterize masks configurations and quantify the corresponding level of discomfort.
Collapse
Affiliation(s)
- F Calà
- Department of Information Engineering, Università degli Studi di Firenze, Firenze, Italy
| | - C Manfredi
- Department of Information Engineering, Università degli Studi di Firenze, Firenze, Italy
| | - L Battilocchi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - L Frassineti
- Department of Information Engineering, Università degli Studi di Firenze, Firenze, Italy
| | - G Cantarella
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| |
Collapse
|
10
|
Jarnig G, Kerbl R, van Poppel MNM. Effects of Wearing FFP2 Masks on SARS-CoV-2 Infection Rates in Classrooms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13511. [PMID: 36294092 PMCID: PMC9603337 DOI: 10.3390/ijerph192013511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/12/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
In this retrospective cohort study involving 614 secondary school students, the likelihood of becoming infected with SARS-CoV-2 in schools with different focus (sports focus vs. general branch; the only difference in the sports focus school was that PE was allowed at all times without restrictions) and different prevailing restrictions were compared. A significantly higher likelihood of infection with SARS-CoV-2 was found in sports classes during the period with a strict FFP-2 mask requirement compared to general branch classes (for Delta from November 2021 to December 2021, and for Omicron from January 2022 to February 2022). The higher likelihood of infection was observed both during the Delta and the Omicron wave. After the relaxation of the mitigation measures, however, students in general branch classes showed a clear "catch-up" of infections, leading to a higher incidence of infections during this phase. By the end of the observation period (30 April 2022), only a small difference in cumulative SARS-CoV-2 infection rates (p = 0.037, φ = 0.09) was detected between classes with a sports focus and those without a sports focus. The results suggest that SARS-CoV-2 transmission can be reduced in school classes by mandatory FFP-2 mask use. In many cases, however, infection appears to be postponed rather than avoided.
Collapse
Affiliation(s)
- Gerald Jarnig
- Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria
| | - Reinhold Kerbl
- Department of Pediatrics and Adolescent Medicine, LKH Hochsteiermark, 8700 Leoben, Austria
| | | |
Collapse
|
11
|
Aguillon-Hernandez N, Jusiak R, Latinus M, Wardak C. COVID-19 masks: A barrier to facial and vocal information. Front Neurosci 2022; 16:982899. [PMID: 36213730 PMCID: PMC9540850 DOI: 10.3389/fnins.2022.982899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/26/2022] [Indexed: 11/13/2022] Open
Abstract
With the COVID-19 pandemic, we have become used to wearing masks and have experienced how masks seem to impair emotion and speech recognition. While several studies have focused on facial emotion recognition by adding images of masks on photographs of emotional faces, we have created a video database with actors really wearing masks to test its effect in more ecological conditions. After validating the emotions displayed by the actors, we found that surgical mask impaired happiness and sadness recognition but not neutrality. Moreover, for happiness, this effect was specific to the mask and not to covering the lower part of the face, possibly due to a cognitive bias associated with the surgical mask. We also created videos with speech and tested the effect of mask on emotion and speech recognition when displayed in auditory, visual, or audiovisual modalities. In visual and audiovisual modalities, mask impaired happiness and sadness but improved neutrality recognition. Mask impaired the recognition of bilabial syllables regardless of modality. In addition, it altered speech recognition only in the audiovisual modality for participants above 70 years old. Overall, COVID-19 masks mainly impair emotion recognition, except for older participants for whom it also impacts speech recognition, probably because they rely more on visual information to compensate age-related hearing loss.
Collapse
|
12
|
Gao X, Ma K, Yang H, Wang K, Fu B, Zhu Y, She X, Cui B. A rapid, non-invasive method for fatigue detection based on voice information. Front Cell Dev Biol 2022; 10:994001. [PMID: 36176279 PMCID: PMC9513181 DOI: 10.3389/fcell.2022.994001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/24/2022] [Indexed: 11/19/2022] Open
Abstract
Fatigue results from a series of physiological and psychological changes due to continuous energy consumption. It can affect the physiological states of operators, thereby reducing their labor capacity. Fatigue can also reduce efficiency and, in serious cases, cause severe accidents. In addition, it can trigger pathological-related changes. By establishing appropriate methods to closely monitor the fatigue status of personnel and relieve the fatigue on time, operation-related injuries can be reduced. Existing fatigue detection methods mostly include subjective methods, such as fatigue scales, or those involving the use of professional instruments, which are more demanding for operators and cannot detect fatigue levels in real time. Speech contains information that can be used as acoustic biomarkers to monitor physiological and psychological statuses. In this study, we constructed a fatigue model based on the method of sleep deprivation by collecting various physiological indexes, such as P300 and glucocorticoid level in saliva, as well as fatigue questionnaires filled by 15 participants under different fatigue procedures and graded the fatigue levels accordingly. We then extracted the speech features at different instances and constructed a model to match the speech features and the degree of fatigue using a machine learning algorithm. Thus, we established a method to rapidly judge the degree of fatigue based on speech. The accuracy of the judgment based on unitary voice could reach 94%, whereas that based on long speech could reach 81%. Our fatigue detection method based on acoustic information can easily and rapidly determine the fatigue levels of the participants. This method can operate in real time and is non-invasive and efficient. Moreover, it can be combined with the advantages of information technology and big data to expand its applicability.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Bo Cui
- *Correspondence: Xiaojun She, ; Bo Cui,
| |
Collapse
|
13
|
Derrick D, Kabaliuk N, Longworth L, Pishyar-Dehkordi P, Jermy M. Speech air flow with and without face masks. Sci Rep 2022; 12:837. [PMID: 35039580 PMCID: PMC8763952 DOI: 10.1038/s41598-021-04745-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/28/2021] [Indexed: 01/02/2023] Open
Abstract
Face masks slow exhaled air flow and sequester exhaled particles. There are many types of face masks on the market today, each having widely varying fits, filtering, and air redirection characteristics. While particle filtration and flow resistance from masks has been well studied, their effects on speech air flow has not. We built a schlieren system and recorded speech air flow with 14 different face masks, comparing it to mask-less speech. All of the face masks reduced air flow from speech, but some allowed air flow features to reach further than 40 cm from a speaker's lips and nose within a few seconds, and all the face masks allowed some air to escape above the nose. Evidence from available literature shows that distancing and ventilation in higher-risk indoor environment provide more benefit than wearing a face mask. Our own research shows all the masks we tested provide some additional benefit of restricting air flow from a speaker. However, well-fitted mask specifically designed for the purpose of preventing the spread of disease reduce air flow the most. Future research will study the effects of face masks on speech communication in order to facilitate cost/benefit analysis of mask usage in various environments.
Collapse
Affiliation(s)
- Donald Derrick
- New Zealand Institute of Language, Brain, and Behaviour, University of Canterbury, Christchurch, 8041, New Zealand.
| | - Natalia Kabaliuk
- Department of Mechanical Engineering, University of Canterbury, Christchurch, 8041, New Zealand
| | - Luke Longworth
- Department of Mechanical Engineering, University of Canterbury, Christchurch, 8041, New Zealand
| | | | - Mark Jermy
- Department of Mechanical Engineering, University of Canterbury, Christchurch, 8041, New Zealand
| |
Collapse
|