I did a search and couldn't find if anyone had talked about this but I haven't looked at every post.
I am interested in talking about this! I haven't talked about it here (this is actually my first post here), but I have been working on something for that with my players.
I am a big fan of Numenera and the effort mechanic. So far, I am working on incorporating a similar thing into Masks. The first thing I wanted to do was dissect its purpose and effect on the mentality of the player, and try to bring this in with similar effects. That is when I noticed that when hacking effort into AW (and even Masks), it gets counter-intuitive for players quickly. Basically: "why would I ever voluntarily take assured damage in a game when I usually have options to avoid damage unless I want it, even on an utter failure?" So I interpret this as the effort is the actual rolling of dice: if the outcome is uncertain and interesting, but it's not important enough for the player to roll dice, then the player shouldn't be rolling dice - the MC should be making a move, or moving on. This became a sort of a mental block for me, so I would be interested to hear your thoughts on the conundrum of "hurt yourself when there is normally no risk of doing so for better chances."
Anyways, undeterred, I have started looking at temporary conditions in addition to actual harm as sources of drama to fuel these effort uses. In Apocalypse World, conditions are basically just fiction (like "poisoned by sickleroot") with moves attached to that ("when you come into contact with the poison, roll +Hard"). However, in Masks, conditions are mechanized as emotional states (which is because the stats are emotional qualities), and these negatively affect the success of the basic moves (at least, until xyz happens in-character to remove the condition). This means they work just like a temporary debility might.
This led me to creating two pools (one for physical threats called stamina, and another for mental threats called focus) which are a significant power boost to player characters when taken in context, but the basic idea is that each has 3 points in it, and they exist to soak up the fictional damage which would normally cause things like debilities or harm in any AW game. And let players spend 1 pool point when it makes sense to treat a miss as a hit, a 7-9 as a 10+, and on a 10+ the spent point is refunded.
Last basic thing, was enforcing the pool's being above 0. So I created three special conditions, similar to Numenera's four. Having both pools at 1 or more means you are "good", one pool empty is "impaired" (costs 2 pool points to spend while impaired), and both pools empty is "drained" (and you can no longer take a debility in place of taking harm while drained - basically meaning you are more inclined to be hurt badly when things go wrong while Taking Harm).