Surgical mask designed for endoscopic procedures to prevent the diffusion of droplets

Protocol of a randomised controlled trial to assess medical staff's inhalation exposure to infectious particles exhaled by patients during oesophagogastroduodenoscopy and the efficacy of surgical masks in this context

BACKGROUND

Aerosol-generating procedures such as oesophagogastroduodenoscopy (OGD) result in infectious particles being exhaled by patients. This substantially increases the medical staff's risk of occupational exposure to pathogenic particles via airway inhalation and facial mucosal deposition. Infectious particles are regarded as a key route of transmission of SARS-CoV-2 and, thus, represents a major risk factor for medical staff during the ongoing COVID-19 pandemic. There is a need for quantitative evidence on medical staff's risk of multiroute exposure to infectious particles exhaled by patients during OGD to enable the development of practical, feasible and economical methods of risk-reduction for use in OGD and related procedures. This randomised controlled trial (RCT)-Personal protective EquiPment intervention TrIal for oesophagogastroDuodEnoscopy (PEPTIDE)-aims to establish a state-of-the-art protocol for quantifying the multiroute exposure of medical staff to infectious particles exhaled by patients during real OGD procedures.

METHOD AND ANALYSIS

PEPTIDE will be a prospective, two-arm, RCT using quantitative methods and will be conducted at a tertiary hospital in China. It will enrol 130 participants (65 per group) aged over 18. The intervention will be an anthropomorphic model with realistic respiratory-related morphology and respiratory function that simulates a medical staff member. This model will be used either without or with a surgical mask, depending on the group allocation of a participant, and will be placed beside the participants as they undergo an OGD procedure. The primary outcome will be the anthropomorphic model's airway dosage of the participants' exhaled infectious particles with or without a surgical mask, and the secondary outcome will be the anthropomorphic model's non-surgical mask-covered facial mucosa dosage of the participants' exhaled infectious particles. Analyses will be performed in accordance with the type of data collected (categorical or quantitative data) using SPSS (V.26.0) and RStudio (V.1.3.959).

ETHICS AND DISSEMINATION

Ethical approval for this RCT was obtained from the Ethics Committee of Peking Union Medical College Hospital (ZS-3377). All of the potential participants who agree to participate will provide their written informed consent before they are enrolled. The results will be disseminated through presentations at national and international conferences and publications in peer-reviewed journals.

TRIAL REGISTRATION NUMBER

NCT05321056.

The Sustainability Evaluation of Masks Based on the Integrated Rank Sum Ratio and Entropy Weight Method

Due to the seriousness of COVID-19, masks are considered to be as a key and effective device to cut off the spread of viruses and are widely used by people, such as doctors and patients. Hundreds of millions of masks used worldwide in daily life will inevitably cause huge pollution and damage to the environment. However, existing research has not yet provided a method to simultaneously evaluate the economic, environmental, and social aspects of sustainable design of masks, which brings great barriers and challenges for designers to make sustainability decisions on masks and consumers’ behavioral decisions on mask purchases. Consequently, on the basis of principles of sustainability evaluation of masks, this work evaluates ten masks of different materials (including two newly designed masks) by using a novel hybrid of rank-sum ratio and entropy weight method. The results indicate that some disposable masks also show better sustainability than reusable masks, and in addition, the integrated rank-sum ratio and entropy weight method can effectively realize the sustainability evaluation of masks. The main contribution is to furnish an effective decision-making reference for sustainability evaluation of masks while greatly reducing the negative impacts of masks on the environment during the epidemic.

Pediatric Endoscopy During COVID-19 Times

The global COVID-19 pandemic has led to healthcare resources being diverted or stretched, especially during periods of lock-down in affected countries. Disruptions to normal services have resulted in reduced or delayed provision of endoscopy in many countries, with consequent impacts on diagnosis or management of digestive diseases and upon endoscopy training. This review article aims to highlight key aspects of the impact of the pandemic upon endoscopy services, with a focus upon endoscopy in children.