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A globally implemented unified phylogenetic classification for human respiratory syncytial virus (HRSV) below the subgroup level remains elusive. We formulated global consensus of HRSV classification on the basis of the challenges and limitations of our previous proposals and the future of genomic surveillance. From a high-quality curated dataset of 1,480 HRSV-A and 1,385 HRSV-B genomes submitted to GenBank and GISAID (https://www.gisaid.org) public sequence databases through March 2023, we categorized HRSV-A/B sequences into lineages based on phylogenetic clades and amino acid markers. We defined 24 lineages within HRSV-A and 16 within HRSV-B and provided guidelines for defining prospective lineages. Our classification demonstrated robustness in its applicability to both complete and partial genomes. We envision that this unified HRSV classification proposal will strengthen HRSV molecular epidemiology on a global scale.

Nucleocapsid antibody assays can be used to estimate SARS-CoV-2 infection prevalence in regions implementing spike-based COVID-19 vaccines. However, poor sensitivity of nucleocapsid antibody assays in detecting infection after vaccination has been reported. We derived a lower cutoff for identifying previous infections in a large blood donor cohort (N = 142,599) by using the Ortho VITROS Anti-SARS-CoV-2 Total-N Antibody assay, improving sensitivity while maintaining specificity >98%. We validated sensitivity in samples donated after self-reported swab-confirmed infections diagnoses. Sensitivity for first infections in unvaccinated donors was 98.1% (95% CI 98.0-98.2) and for infection after vaccination was 95.6% (95% CI 95.6-95.7) based on the standard cutoff. Regression analysis showed sensitivity was reduced in the Delta compared with Omicron period, in older donors, in asymptomatic infections,

To support the ongoing management of viral respiratory diseases while transitioning out of the acute phase of the COVID-19 pandemic, many countries are moving toward an integrated model of surveillance for SARS-CoV-2, influenza virus, and other respiratory pathogens. Although many surveillance approaches catalyzed by the COVID-19 pandemic provide novel epidemiologic insight, continuing them as implemented during the pandemic is unlikely to be feasible for nonemergency surveillance, and many have already been scaled back. Furthermore, given anticipated cocirculation of SARS-CoV-2 and influenza virus, surveillance activities in place before the pandemic require review and adjustment to ensure their ongoing value for public health. In this report, we highlight key challenges for the development of integrated models of surveillance. We discuss the relative strengths and limitations of different surveillance practices and studies as well as their contribution to epidemiologic assessment, forecasting, and public health decision-making.

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The article discusses autosomal-recessive agammaglobulinemia caused by genetic abnormalities affecting B cell development, with a focus on the role of Transcription Factor 3 (TCF-3) in regulating gene expression and immune cell function. The study presents four cases of patients with TCF-3 mutations and diverse clinical presentations, including recurrent infections, hypogammaglobulinemia, and neutropenia. The research highlights the clinical variability of TCF-3 mutations and their impact on immune cell development and function, emphasizing the need for further studies to understand the underlying mechanisms. [Extracted from the article]

Human bocavirus (HBoV) is an emerging pathogen causing gastroenteritis/respiratory tract infection. Shellfish has been implicated in foodborne HBoV dissemination. The present investigation aimed at synthesising shellfish-associated HBoV data. Shellfish-HBoV data were mined from public repositories using topic-specific algorithm. A total of 30 data sources was identified of which 5 were synthesised. The average HBoV positivity and sample-size was 12 ± 9.2 and 134.2 ± 113.6, respectively. HBoV was studied in mollusc with 3.7–83.3% crude prevalence. The pooled HBoV prevalence in shellfish was 9.2% (7.2–11.8; 5 studies) and 12.9% (1.8–53.9; 5 studies) in common-effects and random-effects model respectively, with 0.12–94.89% prediction interval (PI). Sensitivity analysis yielded 8.7% (6.7–11.2; PI = 1.99–29.48%) prevalence. HBoV1 and HBoV2 pooled prevalence in shellfish was 7.91% (1.61–31.09; 3 studies) and 12.52% (0.01–99.60; 3 studies), respectively. HBoV3 prevalence was reported in one single study as 6.96% (4.41–10.35). In conclusion, the present study revealed high HBoV prevalence in shellfish, signifying the need to characterise HBoV and subtypes circulating in non-mollusc shellfish. Furthermore, there is an urgent need to mitigate the food safety risk that may result from HBoV contaminated shellfish since shellfish-borne HBoV is not routinely assessed and might be underestimated at present. [ABSTRACT FROM AUTHOR]

Objective: Sapropterin dihydrochloride is the first drug for the therapy of phenylketonuria, which is a rare disease that occurs one of 10,000–15,000 newborns. As a result, detailed and comprehensive reports on the safety of sapropterin in large, real-world populations are required. The purpose of this study is to undertake a complete analysis of sapropterin's adverse events (AEs) using the FDA Adverse Event Reporting System (FAERS) database. Methods: We retrieved reports of adverse events with sapropterin as the principal suspect from FAERS between the first quarter of 2008 and the first quarter of 2024. The Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), and Bayesian Confidence Propagation Neural Network (BCPNN) were utilized to detect AE signals. Results: The study collected 4,953 suspected AE cases from the FAERS database, with sapropterin as the major suspect. A total of 130 positive signals were obtained utilizing the ROR, PRP, and BCPNN. The FAERS database revealed that common clinical AEs of sapropterin included vomiting, upper respiratory infection, rhinorrhea, and a reduction in amino acid concentrations. Furthermore, we detected probable unexpected adverse events (AEs) using disproportionality analysis, including gastroesophageal reflux disease, flatulence, influenza, ear infection, viral infection, pharyngitis streptococcal, spontaneous abortion, and nephrolithiasis. Conclusion: By analyzing huge amounts of real-world data from the FAERS database, we found potential novel AEs of sapropterin using disproportionate analysis. It is advantageous for healthcare professionals and pharmacists to focus on efficiently managing sapropterin's high-risk adverse events, improving drug levels in clinical settings, and ensuring patient medication safety. [ABSTRACT FROM AUTHOR]

Background: Bovine respiratory disease (BRD) is common in intensively raised cattle and is often treated with antibiotics. For practitioners, knowledge of the bacteria involved in an outbreak and their antibiotic susceptibility is warranted. To this end, samples from the upper or lower respiratory tract of calves can be submitted for bacteriological culture and susceptibility testing of relevant isolates. However, it is debated whether isolates from the upper respiratory tract are representative of bacteria causing infections in the lower respiratory tract. In this study, we used MALDI-TOF MS, multilocus sequence typing (MLST) and core-genome multilocus sequence typing (cgMLST) to compare culture results of 219 paired samples (sample pairs) of deep nasal swabs (DNS) and tracheobronchial lavage (TBL). The sample pairs came from 171 calves in 30 calf groups across 25 farms with 48 calves sampled twice. Results: The predominant bacterial pathogen was Pasteurella multocida, which was isolated from 37.4% of DNS and 22.4% of TBL. There was no statistically significant difference in isolation frequency of P. multocida between calves considered healthy and those suspected for BRD for DNS (P = 0.778) or TBL (P = 0.410). Among the 49 sample pairs where P. multocida was isolated from TBL, the same species was isolated from DNS in 29 sample pairs (59.2%). Isolates from 28 of these sample pairs were evaluated by MLST, and in 24 pairs (86.0%) P. multocida from DNS and TBL were of the same sequence type (ST). Moreover, cgMLST showed that the genetic distance between isolates within 21 of the 28 sample pairs (75.0%), was less than two alleles, and DNS and TBL isolates were considered identical. In seven sample pairs (25%), the genetic distance was greater, and DNS and TBL isolates were considered nonidentical. Conclusions: Pasteurella multocida was readily isolated from DNS and in calves where this species was isolated also from TBL, DNS and TBL isolates were identical in 75% of the sample pairs. This suggests that during an outbreak of BRD, submission of DNS samples from 4 to 6 calves could be a convenient approach for practitioners seeking guidance on P. multocida present in the lower respiratory tract and their antibiotic susceptibility. [ABSTRACT FROM AUTHOR]

Endophilin A2, the sole endophilin A family member expressed in hematopoietic cells, regulates various aspects of membrane dynamics, including autophagy and endocytosis. Recent studies in rodents highlight the essential role of endophilin A2 in modulating immune responses. Here we report a homozygous frameshift variant in the SH3GL1 gene (NM_003025.3:c.427delC; p.Leu143Serfs*9), detected by whole exome sequencing in a 14-year-old boy with predominantly antibody deficiency. The patient who is issued from a consanguineous Lebanese family, presents since the age of 18 months with recurrent respiratory tract infections, low peripheral B cell counts and pan-hypogammaglobulinemia, with no history of opportunistic infections. This defect is associated with decrease in switched memory B cells development, impaired in-vitro B cell proliferation and diminished in-vitro IgG production. The detected variant in SH3GL1 segregates with the disease in the family. It significantly decreases the expression of the protein in the patient's peripheral blood compared to healthy controls, thus confirming its pathogenicity. Interestingly, endophilin A2-deficient Sh3gl1−/− mice have been reported to present defects in germinal center B cell responses and in the production of high-affinity IgG. Our data suggests that endophilin A2 deficiency impairs antibody production in humans. Reporting further cases with mutations in SH3GL1 is needed to better characterize the inborn error of immunity linked to this gene. [ABSTRACT FROM AUTHOR]

Chronic neutropenia causes involve nutritional deficiencies and inborn errors of immunity(IEI), such as severe congenital neutropenia. To classify common chronic neutropenia causes in a pediatric immunology unit. We enrolled 109 chronic neutropenia patients admitted to a pediatric immunology department between 2002–2022. We recorded clinical/laboratory features and genetic characteristics. The male/female ratio was 63/46. Fifty-eight patients had parental consanguinity(57.4%). 26.6% (n = 29) patients had at least one individual in their family with neutropenia. Common symtpoms at presentation were upper respiratory tract infections(URTI)(31.1%), oral aphthae(23.6%), skin infections(23.6%), pneumonia(20.8%), and recurrent abscesses(12.3%). Common infections during follow-up were URTI(56.8%), pneumonia(33%), skin infections(25.6%), gastroenteritis(18.3%), and recurrent abscesses(14,6%). Common long-term complications were dental problems(n = 51), osteoporosis(n = 22), growth retardation(n = 14), malignancy(n = 16)[myelodysplastic syndrome(n = 10), large granulocytic leukemia(n = 1), acute lymphoblastic leukemia(n = 1), Hodgkin lymphoma(n = 1), EBV-related lymphoma(n = 1), leiomyosarcoma(n = 1), and thyroid neoplasm(n = 1)]. We performed a genetic study in 86 patients, and 69(71%) got a genetic diagnosis. Common gene defects were HAX-1(n = 26), ELA-2 (ELANE)(n = 10), AP3B1(n = 4), and ADA-2(n = 4) gene defects. The IEI ratio(70.6%) was high. GCSF treatment(93.4%), immunoglobulin replacement therapy(18.7%), and HSCT(15.9%) were the treatment options. The mortality rate was 12.9%(n = 14). The most common long term complications were dental problems that is three times more common in patients with known genetic mutations. We prepared an algorithm for chronic neutropenia depending on the present cohort. An important rate of inborn errors of immunity, especially combined immunodeficiency(11.9%) was presented in addition to congenital phagocytic cell defects. Early diagnosis will allow us tailor the disease-specific treatment options sooner, preventing irreversible consequences. [ABSTRACT FROM AUTHOR]

Objective: This community-public-private-academic coalition project implemented and evaluated the effectiveness of a rural, community-based egg intervention that aimed to support the nutrition and health of children living in rural, poor communities from Intibucá, Honduras, during the COVID-19 pandemic. Design: This investigator-blind, non-randomized, controlled study was informed by a community health improvement process and participatory research. Women from 13 communities were given a microloan to start an egg farm that supplied 1 egg daily to 201 children ages 6–24 months for 1 year (intervention group). Control communities (n = 14) were selected from neighboring municipalities with similar sociodemographic backgrounds based on size. Sociodemographic-, anthropometric-, and morbidity data were collected biannually between January 2021 to January 2022. Outcome changes were compared with linear-, generalized- or Poisson- mixed models adjusted by sex, age, maternal education, breastfeeding status, assets, adults living at home, baseline outcomes, and community-cluster. Results: Baseline to 6- and 12-month weekly frequency of egg intake significantly increased in the intervention vs. the control group: 6-month change = 1.86; 95%CI (1.61, 2.14); 12-month change = 1.63; 95%CI (1.42, 1.87 p<0.001), respectively. Baseline to 12-month changes in the intervention group were not significant for length/height-for-age-z-scores = 0.12, p = 0.187; weight-for-length/height-z-scores = -0.02, p = 0.78; and diarrhea prevalence, AOR = 1.69; 95%CI (0.53, 5.42), p = 0.378. Lower odds of respiratory infections were observed for the intervention vs. the control group at 6- and 12-month post: AOR = 0.28; 95%CI (0.12, 0.63), p = 0.002; AOR = 0.30; 95%CI (0.12, 0.75), p = 0.010, respectively. Conclusions and relevance: Children in the intervention group reported consuming eggs more days per week relative to the control group. Lower odds of respiratory infections were observed in the intervention group throughout the study. Ongoing follow-up will offer more insights on the intervention's effectiveness in linear growth, dietary diversity, food security, and other nutritional outcomes. [ABSTRACT FROM AUTHOR]

Purpose: The present study explored the molecular characterization of human Adenovirus (HAdV) and its strains among hospitalized SARI cases in the pediatric unit of a tertiary care hospital in North-East India. Methods: Nasal and throat swabs were collected from 70 patients of Pediatric Unit, of a tertiary hospital in NE India from April 2023-October 2023. The samples were screened for the presence of HAdV using an adenovirus-specific Real-Time PCR Kit. For molecular characterization, Next Generation Sequencing (NGS) was performed by targeting the hexon gene of HAdV followed by post-sequencing analysis. Results: Overall, 18.57% (13/70) of samples were positive for HAdV. In context of the severity of illness, 3/13 adenovirus-positive patients (23.07%) died after hospitalization, had severe pneumonia among which two were of less than one year of age. Molecular characterization using NGS indicated that 4/13 individuals were infected with HAdV-B type 3 and 5/13 patients were infected with HAdV type 7. Notably, 4/7 cases of severe pneumonia were under five years of age and associated with HAdV type 7 infection. The ratio of non-synonymous to synonymous mutation (dN/dS) was comparatively low in HAdV type 7 positive samples (dN/dS=0.31). No non-synonymous mutation was observed in HAdV-B type 3 positive samples. The higher neutrophil percentage among the death cases suggested an acute immune response. Conclusion: The study demonstrated HAdV type 7 and HAdV-B type 3 as strains associated with pediatric SARI cases from April 2023-October 2023. Further, HAdV type 7 infection was primarily linked with lower respiratory tract infections mainly severe pneumonia. [ABSTRACT FROM AUTHOR]

Viral infections in humans often cause excessive inflammation. In some viral infections, inflammation can be serious and even fatal, while in other infections it can promote viral clearance. Viruses can escape from the host immune system via regulating inflammatory pathways, thus worsening the illness. MicroRNAs (miRNAs) are tiny non-coding RNA molecules expressed within diverse tissues as well as cells and are engaged in different normal pathological and physiological pathways. Emerging proof suggests that miRNAs can impact innate and adaptive immunity, inflammatory responses, cell invasion, and the progression of viral infections. We discuss some intriguing new findings in the current work, focusing on the impacts of different miRNAs on host inflammatory responses and virus-mediated inflammation. A better understanding of dysregulated miRNAs in viral infections could improve the identification, prevention, and treatment of several serious diseases. [ABSTRACT FROM AUTHOR]

Introduction: Human Adenoviruses (HAdV) have been implicated in a variety of infections, including conjunctivitis, respiratory tract infections, genitourinary infections and gastroenteritis. Epidemic Keratoconjunctivitis (EKC) is a severe ocular surface infection strongly associated with HAdV, known to occur in widespread outbreaks. HAdV species B, D and E are associated with ocular manifestations ranging from simple follicular conjunctivitis (types 3, 4, 7) and pharyngoconjunctival fever (types 3, 7, 14) to the more severe EKC (types 8, 19, 37, 53, 54, 56 and 64). Viral cell cultures of conjunctival specimens help confirm adenovirus infection through the characteristic Cytopathic Effect (CPE) and Polymerase Chain Reaction (PCR) is the best standard method to diagnose viral conjunctivitis due to its sensitivity, accuracy and rapidity. Aim: To diagnose HAdV in clinically suspected cases of viral conjunctivitis using real-time PCR. To isolate HAdV in viral cell culture and confirm it by observing its characteristic CPE and performing adenoviral real-time PCR. Materials and Methods: A cross-sectional descriptive study was conducted from July 2023 to September 2023 at the state-level Virus Research and Diagnostic Laboratory (VRDL) at Bangalore Medical College and Research Institute (BMCRI), Bengaluru, Karnataka, India. A total of 45 conjunctival swab samples from patients with suspected viral conjunctivitis, who attended the Ophthalmology Outpatient Department (OPD) or were admitted to the wards, were included in the study. Conjunctival swab samples collected in Viral Transport Medium (VTM) were centrifuged at 3000 rpm for five minutes at 4°C. Real-time PCR was performed and samples positive for HAdV by real-time PCR were taken up for viral cell culture. Confirmatory PCR was conducted for samples showing CPEs in the cell line. The data collected were analysed using descriptive statistics. Results: The majority of patients in the present study were in the age group of 18-45 years, comprising 25 (56%) of the total patients. Out of 45 conjunctival samples tested, 8 samples were positive in adenovirus real-time PCR. All eight PCR-positive samples showed a CPE in viral cell culture on the A549 cell line. The study found PCR positivity in 8 samples (17.7%), while adenoviral recovery from cell culture was observed in 6 samples (13.3%). Conclusion: Real-time PCR has become the standard diagnostic procedure for detecting adenovirus conjunctivitis. Rapid and accurate diagnosis is key to interrupting the contagious spread of adenoviral conjunctivitis, along with timely treatment. [ABSTRACT FROM AUTHOR]

Objectives: Following the COVID-19 pandemic, global epidemiological trends demonstrate a return to pre-pandemic levels of respiratory syncytial virus (RSV) and influenza (Flu) A/B viruses. For the appropriate clinical management of viral infections, reliable and timely diagnosis is crucial. The clinical presentation of these respiratory viral infections shows significant overlaps; thus, the syndromic diagnosis of these infections becomes challenging. The goal of this study was to compare the performance of three multiplex real-time PCR-based platforms for the detection of SARS-CoV-2, Flu A, Flu B, and RSV. Materials and Methods: A retrospective study was performed on 200 de-identified nasopharyngeal and oropharyngeal specimens. All samples were tested simultaneously on three PCR-based platforms for the detection of SARS-CoV-2, Flu A, Flu B, and RSV: HealthTrackRx's real-time PCR Open Array® respiratory panel, TrueMark™ SARS-CoV-2, Flu A, Flu B, RSV Select Panel, and BioFire® RP2.1 Panel. The positive and negative predictive value of each test was evaluated at a 95% confidence interval. Results: Among the 200 tested samples, the TrueMark™ and OpenArray® laboratory-developed tests (LDTs) showed a 100% concordance for the detection of SARS-CoV-2, Flu A, Flu B, and RSV. Overall agreement of 100% was observed for nasopharyngeal samples between the laboratory-developed tests and FDA-approved BioFire® RP2.1 Panel. Diagnostic results for these four respiratory viruses, in clinical samples, between the LDTs and the FDA-approved comparator demonstrated full concordance. Conclusions: Respiratory viral infections represent one of the major global healthcare burdens. Consequently, the accurate detection and surveillance of these viruses are critical, particularly when these viruses are known to co-circulate. The excellent performance and full concordance of the LDTs, with the BioFire® Respiratory RP2.1 panel, in detecting SARS-CoV-2, Flu A, Flu B, and RSV shows that these tests can be confidently implemented for the clinical testing of respiratory viral infections. [ABSTRACT FROM AUTHOR]

Moderate‐late preterm‐born infants experience more frequent and severe respiratory tract infections and wheezing compared to term‐born infants. Decreasing the risk on respiratory tract infections and wheezing in this group is vital to improve quality of life and reduce medical consumption during infancy, but also to reduce the risk on asthma and COPD later in life. Until now, moderate‐late preterm infants are underrepresented in research and mechanisms underlying their morbidity are largely unknown, although they represent 80% of all preterm‐born infants. In order to protect these infants effectively, it is essential to understand the role of the immune system in early life respiratory health and to identify strategies to optimize immune development and respiratory health. This review elaborates on risk factors and preventative measures concerning respiratory tract infections and wheezing in preterm‐born infants, exploring their impact on the immune system and microbiome. Factors discussed are early life antibiotic use, birth mode, feeding type and living environment. Further, differences in adaptive and innate immune maturation between term and preterm infants are discussed, as well as differences in local immune reactions in the lungs. Finally, preventative strategies are being explored, including microbiota transplantation, immune modulation (through pre‐, pro‐, syn‐ and postbiotics, bacterial lysates, vaccinations, and monoclonal antibodies) and antibiotic prophylaxis. [ABSTRACT FROM AUTHOR]

Background: Viral infection is a common trigger of severe respiratory illnesses in early life and a risk factor for later asthma development. The mechanism leading to asthma could involve an aberrant airway immune response to viral infections, but this has rarely been studied in a human setting. Objectives: To investigate in situ virus‐specific differences in upper airway immune mediator levels during viral episodes of respiratory illnesses and the association with later asthma. Methods: We included 493 episodes of acute respiratory illnesses in 277 children aged 0–3 years from the COPSAC2010 mother–child cohort. Levels of 18 different immune mediators were assessed in nasal epithelial lining fluid using high‐sensitivity MesoScale Discovery kits and compared between children with and without viral PCR‐identification in nasopharyngeal samples. Finally, we investigated whether the virus‐specific immune response was associated with asthma by age 6 years. Results: Viral detection were associated with upregulation of several Type 1 and regulatory immune mediators, including IFN‐ɣ, TNF‐α, CCL4, CXCL10 and IL‐10 and downregulation of Type 2 and Type 17 immune mediators, including CCL13, and CXCL8 (FDR <0.05). Children developing asthma had decreased levels of IL‐10 (FDR <0.05) during viral episodes compared to children not developing asthma. Conclusion: We described the airway immune mediator profile during viral respiratory illnesses in early life and showed that children developing asthma by age 6 years have a reduced regulatory (IL‐10) immune mediator level. This provides insight into the interplay between early‐life viral infections, airway immunity and asthma development. [ABSTRACT FROM AUTHOR]

Background and objectives: Viral respiratory infections significantly affect young children, particularly extremely premature infants, resulting in high hospitalization rates and increased health‐care burdens. Nasal epithelial cells, the primary defense against respiratory infections, are vital for understanding nasal immune responses and serve as a promising target for uncovering underlying molecular and cellular mechanisms. Methods: Using a trans‐well pseudostratified nasal epithelial cell system, we examined age‐dependent developmental differences and antiviral responses to influenza A and respiratory syncytial virus through systems biology approaches. Results: Our studies revealed differences in innate‐receptor repertoires, distinct developmental pathways, and differentially connected antiviral network circuits between neonatal and adult nasal epithelial cells. Consensus network analysis identified unique and shared cellular‐viral networks, emphasizing highly relevant virus‐specific pathways, independent of viral replication kinetics. Conclusion: This research highlights the importance of nasal epithelial cells in innate antiviral immune responses and offers crucial insights that allow for a deeper understanding of age‐related differences in nasal epithelial cell immunity following respiratory virus infections. [ABSTRACT FROM AUTHOR]

Introduction: Influenza A is a virus from the Orthomixoviridae family responsible for high lethality rates and morbidity, despite clinically proven vaccination strategies and some anti-viral therapies. The eicosanoid Lipoxin A4 (LXA4) promotes the resolution of inflammation by decreasing cell recruitment and pro-inflammatory cytokines release, but also for inducing activation of apoptosis, efferocytosis, and macrophage reprogramming. Objective: Here, we evaluated whether a synthetic lipoxin mimetic, designated AT-01-KG, would improve the course of influenza A infection in a murine model. Method: Mice were infected with influenza A/H1N1 and treated with AT-01-KG (1.7 μg/kg/day, i.p.) at day 3 post-infection. Results: AT-01-KG attenuated mortality, reducing leukocyte infiltration and lung damage at day 5 and day 7 post-infection. AT-01-KG is a Formyl Peptide Receptor 2 (designated FPR2/3 in mice) agonist, and the protective responses were not observed in fpr2/3 −/− animals. In mice treated with LXA4 (50 μg/kg/day, i.p., days 3–6 post-infection), at day 7, macrophage reprogramming was observed, as seen by a decrease in classically activated macrophages and an increase in alternatively activated macrophages in the lungs. Furthermore, the number of apoptotic cells and cells undergoing efferocytosis was increased in the lavage of treated mice. Treatment also modulated the adaptive immune response, increasing the number of T helper 2 cells (Th2) and regulatory T (Tregs) cells in the lungs of the treated mice. Conclusion: Therefore, treatment with a lipoxin A4 analog was beneficial in a model of influenza A infection in mice. The drug decreased inflammation and promoted resolution and beneficial immune responses, suggesting it may be useful in patients with severe influenza. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To learn about a project that aimed to support teams caring for children and young people to reflect on their experiences and the effects of the coronavirus disease 2019 (COVID-19) pandemic • To recognise the need to ensure staff are adequately prepared to manage any future surges in respiratory illness effectively • To be aware of the potential long-term effects of the COVID-19 pandemic on emotional health and well-being. The coronavirus disease 2019 (COVID-19) pandemic was a challenging experience for children and young people’s services, and the workforce. The Valuing All Staff Together programme was a one-year project hosted by the North West Paediatric Critical Care, Surgery in Children, Long Term Ventilation Operational Delivery Network to support teams caring for children and young people to reflect on their experiences of the COVID-19 pandemic. Using an online survey, focus groups and interviews, it gave staff the opportunity to explore and understand the effects of the pandemic and the subsequent surge in demand, including how these affected services and the emotional health and well-being of staff. This would enable better preparation for future surges in respiratory illness in terms of learning, training and development. This article describes the programme’s aim, method and findings, and the main recommendations for practice. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Upper respiratory infections are a frequent problem in pet rabbits and rodents, and Mycoplasma pulmonis is 1 of the most common causes of respiratory infections in pet rats. M pulmonis was detected in 1967 in laboratory rabbits via culture of the nares and oropharynx, but overall, Mycoplasma is not commonly identified in the upper airway of rabbits. The objective of this study was to compare the prevalence of Mycoplasma sp detection via next-generation DNA sequencing on nasal swabs obtained from healthy and unhealthy rabbits. METHODS: The of nasal swabs from both healthy and unhealthy rabbits submitted for next-generation DNA sequencing from January 2022 to February 2023 were reviewed. Data gathered included signalment, whether or not Mycoplasma sp was detected, and the cell count and relative predominance of Mycoplasma sp compared to other organisms. RESULTS: 91 rabbits met the inclusion criteria, of which 49 were healthy and 42 were unhealthy. Overall, 52 of 91 (57.1%) rabbits were positive and 39 of 91 (42.8%) were negative for Mycoplasma sp. Mycoplasma positivity was significantly (P < .001) more common in healthy rabbits (37/49 [75.5%]) compared to unhealthy rabbits (15/42 [35.7%]). CLINICAL RELEVANCE: The fact that Mycoplasma positivity was common in both groups of rabbits, and particularly common in rabbits without upper respiratory signs, suggests that Mycoplasma may be normal nasal flora in rabbits. Further research is needed to determine whether Mycoplasma could function as an opportunistic pathogen in rabbits. [ABSTRACT FROM AUTHOR]

Objective In 2020, in-line with the recommendations of the Turkish Neonatal Society, a new palivizumab indication was added for preterm infants with 29 0/7 to 31 6/7 weeks of gestational age. This study aimed to determine the risk factors of hospitalizations due to lower respiratory tract infections (LRTIs) and respiratory syncytial virus (RSV) in preterm infants (29 0/7 –31 6/7 weeks of gestational age) who were or were not within the scope of palivizumab indication during the first two RSV seasons (2018–2019 and 2019–2020) and the next two RSV seasons (2020–2021 and 2021–2022) to evaluate the validity of the new indication of palivizumab reimbursement scope. Methods This study was a two-center retrospective and prospective cohort study and included all preterm infants (29 0/7 –31 6/7 weeks) aged 90 days and younger during the RSV season (October–March). The primary outcome was to compare the hospitalization rates between patients who received palivizumab and those who did not. The secondary outcome was to identify the risk factors for patients hospitalized due to LRTIs. Results Of the 122 preterm infants included in the study, 48.3% (n = 59) were in the prophylaxis group (Group 1) and 51.7% (n = 63) were in the non-prophylaxis group (Group 2). It was noteworthy that 53.8% (n = 14) of the 26 infants hospitalized due to LRTIs were in Group 1 and 46.2% (n = 12) were in Group 2 (p = 0.682). Of the RSV PCR-positive infants, 62.5%(n = 5) were in Group 1 and 37.5% (n = 3) were in Group 2 (p = 0.30). The median length of hospitalization was similar in the groups (p = 0.123). Conclusion The indication for palivizumab prophylaxis can be determined more clearly for our country in light of national multicenter studies with an increased sample size. [ABSTRACT FROM AUTHOR]

This study aims to investigate the clinical characteristics of infections following induction chemotherapy for acute myeloid leukemia (AML) in children and identify risk factors associated with severe infections. Newly diagnosed children with AML treated at the Hematology Oncology Center of Beijing Children's Hospital affiliated to Capital Medical University (referred to as the "Beijing ward") and Baoding Hospital of Beijing Children's Hospital (referred to as the "Baoding ward") between November 2019 and August 2022 were enrolled. The diagnosis and treatment of the patients were carried out in accordance with the CCLG-AML 2019 protocol. Their essential information and infection-related indicators were collected. The various indicators between the two centers were compared. The incidence of infection in children with AML was 100%, with a severe infection rate of 15.3% and an infection-related mortality rate of 2.4%. Respiratory infections accounted for 39.7% of all infections events, and unspecified site infection for 32.2%. Bacterial infections were predominant at 51.2%. The bed unit area (BUA) varied significantly with 4.1 m2 in the Beijing ward and 10 m2 in the Baoding ward. Significant differences were observed in gastrointestinal infections (P < 0.001) and severe infections (P = 0.014) between the two wards. Several factors were identified as risk factors for severe infections, including BUA difference (OR = 4.353, 95% CI: 1.078–17.578), time of entering neutropenia phase after chemotherapy (OR = 6.369, 95% CI: 1.713–23.675) and bloodstream infection (OR = 7.466, 95% CI: 1.889–29.507). Respiratory tract infections and infections of unspecified site are most common during induction phase for pediatric AML. Bacteria, especially G− bacteria, are the leading pathogens. Risk factors for severe infections include a small BUA, entering neutropenia phase ≤ 5.5 days after chemotherapy, and bloodstream infection. Recognizing these risk factors can aid in the early identification and intervention of severe infections. [ABSTRACT FROM AUTHOR]

Acute respiratory tract infections (ARTIs) are a heterogenous group of diseases. Often, it is difficult to obtain a precise diagnosis in general practice but also difficult to determine when the patient is recovered. The lack of a precise definition of recovery after ARTI complicates scientific research aiming to optimize diagnostics and compare treatments. The study aimed to define cutoff points to determine the end of an ARTI as a proxy for recovery in patients diagnosed with ARTI in general practice using a validated patient-reported outcome instrument; The ARTI Questionnaire (ARTIQ). A total of 259 participants was divided in 2 groups—1 with ARTI and 1 without. Histograms and area under the curve were calculated for each of the 5 dimensions within the ARTIQ to evaluate the discriminative effect. For the most discriminative dimensions receiver operating comparison curves were performed to determine relevant cutoff points for having or not having ARTI symptoms and serve as a proxy for recovery in clinical research. The highest discriminative effect was found in 2 dimensions: "physical—upper airways" and "physical—lower airways." When combining these dimensions, the area under the curve was 0.97. Sensitivity, specificity, and predictive values were calculated for selected cutoff points. Cutoff points serving as proxy for recovery from ARTI using a patient-reported outcome were identified. The specific cutoff point for a certain research project must be selected considering the specific clinical situation of interest. • It is difficult to define when a patient has recovered after acute respiratory tract infection (ARTI) complicating clinical research trying to optimize diagnostics or compare treatments. • The study presents an approach to measure recovery after ARTI diagnosed in general practice—using a patient-reported outcome instrument to determine end of ARTI as a proxy for recovery. • A more precise definition of recovery after ARTI will enhance the quality of clinical research on diagnostics and new treatment modalities on ARTI in general practice. [ABSTRACT FROM AUTHOR]

Background: Asthma is a heterogeneous disease that affects millions of children and adults. There is a lack of objective gold standard diagnosis that spans the ages; instead, diagnoses are made by clinician assessment based on a cluster of signs, symptoms and objective tests dependent on age. Yet, there is a clear morbidity associated with chronic asthma symptoms. Machine learning has become a popular tool to improve asthma diagnosis and classification. There is a paucity of literature on the use of Bayesian machine learning algorithms to predict asthma diagnosis in children. This paper develops a prediction model using the Bayesian additive regression trees (BART) and compares its performance to various machine learning algorithms in predicting the diagnosis of childhood asthma. Methods: Clinically relevant variables collected at or before 3 years of age from 2794 participants in the CHILD Cohort Study were used to predict physician-diagnosed asthma at age 5. BART and six other commonly used machine learning algorithms, namely adaptive boosting, logistic regression, decision tree, neural network, random forest, and support vector machine were trained. Measures of performance including sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve were calculated. The confidence intervals were calculated using Bootstrapping samples. Important predictors and interaction effects associated with asthma were also identified using BART. Results: BART, logistic regression and random forest showed the highest area under the ROC curve compared to other machine learning algorithms. Based on BART, recurrent wheeze, respiratory infection and food sensitization at 3 years of age were the most important predictors. The three most important interaction effects were found to be interaction terms of respiratory infection at 3 years and recurrent wheezing at 3 years, maternal asthma and paternal asthma, and maternal wheezing and inhalant sensitization of child at 3 years. Conclusions: BART demonstrated promising prediction performance when compared to other machine learning algorithms. Future research could validate the BART in an external cohort to evaluate its reliability and generalizability. [ABSTRACT FROM AUTHOR]

• Pelargonium odoratissimum is a rich source of pharmacologically potent metabolites. • Monoterpenes, sesquiterpenes and polyphenols are the leading metabolites of P. odoratissimum. • An overview of the industrial application of P. odoratissimum in pharmaceuticals, supplements, perfumery, cosmetics and soaps production. • The potential of P. odoratissimum in comparison with other Pelargonium species has been reported. It is estimated that about 80 % of the world's population use traditional medicine to treat various diseases. Many herbs of the genus Pelargonium are used in traditional medicine to treat diarrhea, dysentery, fever, respiratory tract infections, liver ailments, wounds, gastroenteritis, hemorrhage, kidney and bladder disorders, and other diseases. They are sources of various biologically active molecules such as volatiles like monoterpenes, sesquiterpenes, or non-volatile metabolites from the group of phenolics, such as tannins, phenolic acids, and flavonoids. This genus is rich in essential oils, which have a wide industrial application in perfumery, cosmetics, soap and cream production due to their good antioxidant potential and anti-ageing/rejuvenating properties. This review therefore contains and discusses the current scientific findings on Pelargonium odoratissimum (L.) L'Hér. – a lesser known member of the genus Pelargonium , alone and in comparison with other Pelargonium species. Studies on the composition of this particular species, as well as its biological potential and prospects for industrial use will be addressed in order to shed new light on its potential applications. [ABSTRACT FROM AUTHOR]

AbstractIntroductionMethodsResultsConclusionDuring recent years, the world—including Scandinavia—has experienced significant challenges with shortages of antibiotics. In Scandinavia, phenoxymethylpenicillin is recommended as first-line antibiotic treatment for most acute respiratory tract infections (ARTIs). However, the Scandinavian countries each constitute rather small markets for phenoxymethylpenicillin. The aim of this discussion paper is to enlighten the differences in Scandinavian ARTI antibiotic treatment recommendations. This information is fundamental for exploring the potential of harmonizing treatment recommendations in Denmark, Norway and Sweden—to help ensure sufficient future supply of phenoxymethylpenicillin.Information from national ARTI antibiotic treatment recommendations from respectively Denmark, Norway and Sweden has been collated.Several discrepancies exist in recommendations. Adult dosage varies from a minimum of 660 mg x 4 (Denmark) to a maximum of 2000 mg × 3 (Sweden). Within Norway and Sweden, variations in recommended dosage also exist between the different types of ARTIs. A main challenge is that the tablet strengths recommended, and available on the market in the three countries, differs.Also, antibiotic treatment durations vary significantly between countries and infections treated—from five to 10 days of treatment.In the capacity of a well-established network for antibiotic stewardship, we have enlightened the differences in Scandinavian ARTI antibiotic treatment recommendations. This paper is the first step moving forward to scrutinizing the potential for harmonizing recommendations for Denmark, Norway and Sweden—to help ensure continued supply of phenoxymethylpenicillin for use within the Scandinavian countries. [ABSTRACT FROM AUTHOR]

Mouse alveolar macrophages actively patrol the alveolar airspace and mask microbial antigens to limit damaging inflammation. Restraining human neutrophil expansion during viral upper respiratory infections can avoid excessive inflammation and prevent worsened clinical outcomes. The role and landscape of type I and type III interferons during human viral respiratory infections is context, age, and anatomical region dependent. Human lungs contain long-lived tissue-resident memory T and B cells with diverse phenotypes and functions. To preserve constant air exchange and host survival, the immune system of the mammalian respiratory tract is required to balance its capacity to tolerate commensal microorganisms with protection against pathogens, while avoiding excessive and damaging inflammation. These immune functions are further influenced by the highly divergent anatomical and functional characteristics of the upper airways, trachea, and lungs. New research offers key insights into mechanisms of immune system adaptation to each unique environment, increasing our understanding of the pathogenesis of respiratory infection and (excessive) inflammation. The respiratory tract is exposed to infection from inhaled pathogens, including viruses, bacteria, and fungi. So far, a comprehensive assessment that integrates common and distinct aspects of the immune response along different areas of the respiratory tract has been lacking. Here, we discuss key recent findings regarding anatomical, functional, and microbial factors driving regional immune adaptation in the mammalian respiratory system, how they differ between mice and humans, and the similarities and differences with the gastrointestinal tract. We demonstrate that, under evolutionary pressure, mammals evolved spatially organized immune defenses that vary between the upper and lower respiratory tract. Overall, we propose that the functional specialization of the immune response along the respiratory tract has fundamental implications for the management of infectious or inflammatory diseases. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion The first evidence‐based Finnish guidelines for paediatric lower respiratory tract infections (LRTIs) were published in 2014 and completely updated in 2023. This paper, by the interdisciplinary working group that developed the 2023 guidelines, summarises the main recommendations.The 2023 guidelines were produced after a systematic review. Strong evidence was at least two separate, high‐quality studies, moderate evidence was at least one high‐quality study and weak evidence was at least one satisfactory study. The authors have now summarised the key points.There was strong evidence that antitussives and beta‐sympathomimetics were not effective for bronchitis‐related cough and that laryngitis should be treated with oral corticosteroids, with adrenaline inhalations added in severe cases. Also, that amoxicillin for 5 days provided sufficient treatment for paediatric community‐acquired pneumonia and that children with apparent viral pneumonia could be observed without antimicrobial therapy. There was moderate evidence that corticosteroids or inhaled agents were not effective for bronchiolitis and that administering salbutamol with a holding chamber could relieve symptoms of wheezing bronchitis. Also, pertussis should be considered for unvaccinated infants with coughs.The 2023 guidelines aim to improve acute evidence‐based treatment of LRTIs, through appropriate antibiotics, inhaled drugs, corticosteroids, radiology and laboratory testing. [ABSTRACT FROM AUTHOR]

Coronavirus is a family of viruses that cause upper respiratory infections in humans. Drug properties can be obtained by studying the molecular structure of corresponding drugs. The calculation of the topological index of a drug structure enables scientists to have a better understanding of the physical chemistry and biological characteristics of drugs. In this paper, we study topological indices and find the exact formulas for general topological indices m S O γ (G) and K A (γ , η) 1 (G). By the appropriate choice of parameters γ and η, several new/old inequalities that reveal topological indices are obtained. [ABSTRACT FROM AUTHOR]

A 10-month-old boy with a weight of 5 kg demonstrated recurrent respiratory infections after birth, respiratory distress after feeding, and slow weight gain. At the time of presentation, he had been experiencing a cough accompanied by pyrexia for > 20 days. Prenatal ultrasound examinations revealed no abnormalities. He was born at full term via cesarean delivery and weighed 2.9 kg at birth. He was hospitalized three times because of pneumonia. [ABSTRACT FROM AUTHOR]

A 54-year-old Egyptian man with a 5-day history of worsening cough, high-grade fever, and progressive dyspnea was referred to our hospital. A 3-day course of ceftriaxone provided in an outpatient setting showed no clinical improvement. Medical history was unremarkable, except for bilateral pulmonary embolism diagnosed 3 years earlier. The patient actively smoked and denied the use of alcohol and illicit drugs. The patient worked as cook and had lived in Switzerland for the past 10 years. Five weeks before the actual presentation, he had traveled to Egypt. One of his children showed symptoms of a respiratory infection approximately 2 weeks before that. His only regular medication was rivaroxaban. [ABSTRACT FROM AUTHOR]

Ozanimod (Zeposia®), an orally administered sphingosine 1-phosphate (S1P) receptor modulator (S1PRM) that is selective for the S1P1 and S1P5 receptor subtypes, is approved in the USA for relapsing forms of multiple sclerosis (RMS). In pivotal phase III clinical trials in patients with RMS, ozanimod significantly reduced annualised relapse rates and the number of new or enlarging T2 lesions and gadolinium-enhancing lesions, and was associated with reduced brain volume loss, compared with interferon (IFN)-β1a. However, there were no significant differences in 3- and 6-month disability progression between the groups. Ozanimod was generally well tolerated, with the most common adverse reactions including upper respiratory tract infection and hepatic transaminase elevation. Efficacy and tolerability were sustained over more than 6 years with continued treatment. S1PRM-related adverse events seen with ozanimod are generally manageable with screening and/or monitoring. Notably, ozanimod does not require first-dose cardiac monitoring in the USA. In conclusion, ozanimod is a valuable once-daily oral disease-modifying therapy that extends the available treatment options for patients with RMS. Plain Language Summary: In multiple sclerosis (MS), lymphocytes (a type of immune cell) are thought to enter the CNS and attack the myelin sheath surrounding neurons. Relapsing forms of MS (RMS) involve episodes of neurological dysfunction with complete or partial recovery. Sphingosine 1-phosphate (S1P) receptor modulators (S1PRMs) are an oral treatment for RMS that prevent the movement of lymphocytes from lymphoid tissues into peripheral blood and, therefore, into the CNS. Ozanimod (Zeposia®) is an S1PRM that is selective for the S1P1 and S1P5 receptor subtypes. In clinical trials in patients with RMS, ozanimod significantly reduced annualised relapse rates and disease activity as seen on MRI compared with interferon (IFN)-β1a; however, there were no differences in disability progression between the groups. Ozanimod was generally well tolerated; common adverse reactions included upper respiratory tract infection and hepatic transaminase elevation. Ozanimod requires screening and monitoring for certain adverse events that are associated with S1PRMs but does not require first-dose cardiac monitoring in the USA. In conclusion, ozanimod is a valuable once-daily oral disease-modifying therapy that extends the available treatment options for patients with RMS. [ABSTRACT FROM AUTHOR]

Epidemiologic studies have suggested a possible association between air pollution and chronic obstructive pulmonary disease (COPD), but it is controversial and difficult to draw causal inferences. Five methods were adopted to evaluate the causal relationship between air pollution and COPD in European and East Asian populations by using MR Analysis. A statistically significant causal relationship between PM2.5 and COPD was observed in the European population (OR: 2.34; 95% CI: 1.06–5.05; p = 0.033). Statistical significance remained after adjustment for confounding factors (adjusted OR: 2.28; 95% CI: 1.01–5.20; p = 0.048). In East Asian populations, PM2.5 absorbance, a proxy for black carbon, was statistically associated with COPD (OR: 1.41; 95% CI: 1.09–1.81; p = 0.007). We did not adjust for confounders in East Asian populations, as the association was independent of known confounders (e.g. smoking, respiratory tract infections, etc.). In conclusion, increased concentrations of PM2.5 and PM2.5 absorbance were associated with an increased risk of COPD. [ABSTRACT FROM AUTHOR]

Background and Objective: Understanding the seasonal behaviours of respiratory viruses is crucial for preventing infections. We evaluated the seasonality of respiratory viruses using time‐series analyses. Methods: This study analysed prospectively collected nationwide surveillance data on eight respiratory viruses, gathered from the Korean Influenza and Respiratory Surveillance System. The data were collected on a weekly basis by 52 nationwide primary healthcare institutions between 2015 and 2019. We performed Spearman correlation analyses, similarity analyses via dynamic time warping (DTW) and seasonality analyses using seasonal autoregressive integrated moving average (SARIMA). Results: The prevalence of rhinovirus (RV, 23.6%–31.4%), adenovirus (AdV, 9.2%–16.6%), human coronavirus (HCoV, 3.0%–6.6%), respiratory syncytial virus (RSV, 11.7%–20.1%), influenza virus (IFV, 11.7%–21.5%), parainfluenza virus (PIV, 9.2%–12.6%), human metapneumovirus (HMPV, 5.6%–6.9%) and human bocavirus (HBoV, 5.0%–6.4%) were derived. Most of them exhibited a high positive correlation in Spearman analyses. In DTW analyses, all virus data from 2015 to 2019, except AdV, exhibited good alignments. In SARIMA, AdV and RV did not show seasonality. Other viruses showed 12‐month seasonality. We describe the viruses as winter viruses (HCoV, RSV and IFV), spring/summer viruses (PIV, HBoV), a spring virus (HMPV) and all‐year viruses with peak incidences during school periods (RV and AdV). Conclusion: This is the first study to comprehensively analyse the seasonal behaviours of the eight most common respiratory viruses using nationwide, prospectively collected, sentinel surveillance data. [ABSTRACT FROM AUTHOR]

Aim: To explore whether children in specialist care with COVID-19 have increased post-discharge health care use when compared with children in specialist care with 1) respiratory syncytial virus (RSV) infection, and 2) other respiratory tract infections (RTIs). Methods: In 34,214 children aged 1 month to 5 years who were registered as having one or more hospital visit (outpatient or inpatient) with a diagnosis of COVID-19 (N = 128), RSV infection (N = 4,009), or other RTIs (N = 34,458) from 2017 to 2021, we used a difference-in-differences study design to investigate individual all-cause primary and specialist health care use from 12 weeks prior to 12 weeks after the hospital visit, stratified by infants (1 to 11 months) and children (1 to 5 years). Results: We found a slight increase in primary health care use in the first 4 weeks after the hospital visit for infants with COVID-19 when compared with infants with RSV infection (6 per 10,000; 95% CI [2, 13], a 0.52% relative increase). For infants diagnosed with COVID-19, we found a similar post-visit increase in inpatients when compared with infants with RSV infection, which lasted for 12 weeks. Conclusions: Our findings imply a slightly increased health care use among infants after a hospital visit for COVID-19 than among infants with other RTIs, the potential etiological mechanisms of which deserve future clinical research. Severe COVID-19 in young children will not represent any markedly increased burden on the health services. [ABSTRACT FROM AUTHOR]

This article discusses a case of eosinophilic angiocentric fibrosis (EAF) with atypical clinical presentation involving the skin and upper respiratory tract. EAF is a rare fibroinflammatory condition that primarily affects the orbit and upper respiratory tract. The patient in this case initially presented with a firm plaque on her thigh, which later became inflamed and coincided with upper respiratory tract infections. The diagnosis was confirmed through skin and nasal mucosa biopsies, which revealed characteristic histopathological findings, including eosinophils and IgG4+ plasma cells. The patient's symptoms improved with treatment using methotrexate and prednisone. This case highlights the importance of recognizing the diverse and atypical manifestations of EAF for accurate diagnosis and management. [Extracted from the article]

Hospital patients with infectious respiratory diseases frequently require oxygen which may be delivered by a face mask, and the quantitative effect of such masks on the emission of infectious respiratory aerosol is relevant to hospital acquired respiratory infections. This article reports the evaluation of the efficiency of aerosol particle volume reduction by oxygen face masks with and without exhalation filtering capability, for a medium concentration, high concentration non-rebreather and a venturi mask. The masks include two prototype filtering oxygen masks, and also type IIR surgical and FFP2 masks for reference. The evaluation was with a breathing and coughing manikin, measuring the relative volume of aerosol particles transmitted to the environment with and without a mask in place. Mask efficiency fraction indices, MEF, and relative performance factors, RPF, were calculated by a model which included the particle size spectrum arising from human breathing, speaking and coughing to produce indices for each of these activities. In this manikin model non-filtering medium and high concentration oxygen face masks reduced aerosol emission, with fractional efficiencies between 0.12 on breath and 0.65 on cough. Compared to non-filtering masks, currently available filtering oxygen masks reduced aerosol particle volume emission by factors up to 1.2 on breath and 2.4 on cough, and with prototype filtering masks reduction was up to a factor of 6.1 for breathing and 5.1 for cough. Validation in humans and modeling of the clinical environment is required to estimate the effect of such reductions in aerosol emission on healthcare acquired infections. [ABSTRACT FROM AUTHOR]

Human adenoviruses are the causative agents of 5–7% of viral respiratory infections, mainly caused by species B and C. They can infect all age groups, but children are usually at high risk of infections. Adenovirus epidemiology is well documented in East-Asian countries but little is known about adenovirus circulation in Europe in recent years. This multicentre retrospective study aimed to investigate the circulation and molecular epidemiology of hAdVs. This surveillance collected a total of 54463 respiratory specimens between January 1, 2022 and June 20, 2023 were tested for the presence of respiratory viruses. Our results showed that adenovirus was detected in 6.6 % of all cases of acute respiratory infection included in the study and the median age of positive patients was 3 years, with male children in 1–2 years age group being the most affected. 43.5 % of adenovirus cases were co-infected with at least one other respiratory virus, and rhinovirus was co-detected in 54 % of cases. Genotyping of adenovirus allowed the identification of 6 different genotypes circulating in Italy, among which type B3 was the most frequently detected. [ABSTRACT FROM AUTHOR]

While respiratory syncytial virus (RSV) is one of the most common pathogens in adults admitted to the ICU due to respiratory diseases, no reports regarding the occurrence rate of RSV infections in adults in Japan during the COVID-19 pandemic exist. We conducted this retrospective study to examine the exact occurrence rate of RSV infections in adults. We reviewed all patients (≥18 years) with any respiratory symptoms who received quantitative polymerase chain reaction (PCR) using nasopharyngeal samples for respiratory viruses by GeneLEAD at the Aichi Medical University Hospital between November 2022 and November 2023. A total of 541 adult patients who underwent PCR test were enrolled in this study. RSV was identified in 18 cases (3.3 %); 8 (1.5 %) upper and 10 (1.8 %) lower respiratory tract infections. Influenza A and SARS-CoV-2 were found in 10 (1.8 %) and 61 (11.3 %), respectively. Patients with RSV infections and COVID-19 had more comorbidities than those with Influenza virus infections. As for RSV-associated with lower respiratory tract infection cases, 10 developed acute respiratory failure, resulting in 1 fatal case due to pneumonia and 1 died of septic shock due to ileus. The 30-, 90-day mortality rates were 1 (6 %) and 2 (11 %) respectively. About 3 % of adults had RSV infections during the COVID-19 pandemic. The outcomes of RSV infections in adults were similar to those by COVID-19. Those with comorbidities should have a preventive method against RSV infections, the same as for COVID-19. [ABSTRACT FROM AUTHOR]

In the study the clinical profile of 168 children diagnosed with acute bronchiolitis in the First Pediatric Department of UMBAL Burgas AD is analyzed,. The minimum age being 1 month and the maximum age being 24 months. Patients were divided into four age groups. The duration of the infection of the upper respiratory tract before the development of broncho-obstructive syndrome, the days with a clinic of acute viral infection before the appearance of broncho-obstructive syndrome, the presence of a temperature above 38.5, tachypnea, rapid heart activity, dyspnea, cyanosis, as a symptom of decreased oxygenation, etc. Conclusions were made regarding the clinical profile of the patients and the complications of the disease. [ABSTRACT FROM AUTHOR]

The Hajj pilgrimage, one of the largest annual gatherings in the world, presents unique medical challenges due to the convergence of millions of individuals from diverse geographical and cultural backgrounds. This study aims to identify the most prevalent diseases and health disorders encountered during the Hajj season, highlighting the risks posed by overcrowding, environmental conditions, and the physical demands of the pilgrimage. Key findings indicate that respiratory infections, including upper and lower tract infections, are among the most common health issues, exacerbated by close contact among pilgrims. Heat-related disorders, such as heat exhaustion and heatstroke, are prevalent due to extreme temperatures, particularly affecting vulnerable populations. Gastrointestinal disorders, primarily from foodborne illnesses and traveler's diarrhea, also pose significant health risks. Additionally, chronic disease exacerbation, infectious disease outbreaks, injuries from falls and stampedes, dermatological issues, and psychological stress further complicate the health landscape during Hajj. The results underscore the importance of implementing effective public health measures, including vaccination programs, hygiene education, and mental health support, to enhance the safety and well-being of pilgrims. This survey provides valuable insights for health authorities and organizers to improve preparedness and response strategies for future Hajj seasons. [ABSTRACT FROM AUTHOR]

Neutrophils represent one of the host's first lines of defense against invading pathogens. However, an aberrant activation can cause damage to the host. In the case of respiratory infections with viral or bacterial pathogens, one of the most common complications is the development of acute respiratory distress syndrome, in which neutrophil infiltration into the lung is a hallmark. Neutrophils gain expression of chemokine receptors under inflammatory conditions, and their activation can amplify the neutrophil responses. Earlier studies showed that neutrophils recruited to the lung mucosa during bacterial infection upregulate expression of CCR3 and ex vivo stimulation of CCR3 results in an increased neutrophil activation. Therefore, the modulation of effector functions or migration of neutrophils to target sites through chemokine receptors constitutes an opportunity for pharmacological intervention. We aimed to determine whether the blockade of the CCR3 using the specific antagonist SB-328437 reduces neutrophil recruitment and inflammation in the lung in the lipopolysaccharide (LPS)-induced lung injury model and influenza infection in mice. We found that neutrophils acquire CCR3 expression in the lung alveolar space. The intraperitoneal administration of SB-328437 reduced neutrophil recruitment to the lung alveolar space and reduced tissue damage in both the LPS-induced lung injury model and influenza infection. Moreover, treatment with SB-328437 reduced the percentage of neutrophils producing TNFα and neutrophil activation in the alveolar space. Together, these data suggest that CCR3 blockade might be a pharmacological strategy to prevent the aberrant neutrophil activation that results detrimental for the host but preserves sufficient effector response to control the pathogen. [ABSTRACT FROM AUTHOR]

Background/Objectives: The external environment constantly influences human health through many factors, including air quality, access to green spaces, exposure to pollutants, and climate change. Contamination poses a substantial threat to human well-being; conversely, environmental factors also positively impact health. The purpose of this study is to provide a comprehensive review of the complex relationship between various environmental factors and human health. While individual studies have explored specific aspects, a broader integrative understanding is lacking. Methods: Through databases (PubMed, Cochrane, Copernicus), 4888 papers were identified, with 166 selected for detailed analysis. Results: We summarized recent research, identifying multiple associations between environmental factors such as air pollution, climate change, solar radiation, and meteorological conditions and their impact on various health outcomes, including respiratory, cardiovascular, metabolic and gastrointestinal, renal and urogenital, neurological and psychological health, infectious and skin diseases, and major cancers. We use chord diagrams to illustrate these links. We also show the interaction between different environmental factors. Findings begin with exploring the direct impact of environmental factors on human health; then, the interplay and combined effects of environmental factors, elucidating their (often indirect) interaction and collective contribution to human health; and finally, the implications of climate change on human health. Conclusions: Researchers and policymakers need to consider that individuals are exposed to multiple pollutants simultaneously, the "multipollutant exposure phenomenon". It is important to study and regulate environmental factors by considering the combined impact of various pollutants rather than looking at each pollutant separately. We emphasize actionable recommendations and solutions. [ABSTRACT FROM AUTHOR]

Background: The impact of COVID-19 on pregnancy remains a critical area of research, with growing evidence suggesting that maternal infection, particularly in the third trimester, may lead to significant complications Aims: The primary aim was to investigate the maternal and neonatal outcome of pregnant Jordanian women with COVID-19. The secondary aim included exploring demographics, obstetrics characteristics, and comorbidities among these women. Methods: A retrospective comprehensive review of the records of 300 cases of pregnant women with COVID-19, who were treated between November 2020 and April 2021 at Queen Alia Military Hospital (a main referral center for patients with COVID-19) in Jordan. All cases were confirmed by the rapid antigen test (RAT) + long polymerase chain reaction (PCR) test used to detect SARS-CoV-2 by amplifying viral RNA from patient samples. Women infected with COVID-19 were categorized into four groups according to the RCOG guidelines for COVID-19 infection in pregnancy: asymptomatic, mild, moderate, and severe cases. All cases were managed following the Royal College of Obstetricians and Gynecologists protocol for COVID-19 in pregnancy. Data extracted from patient's records included demographic information, COVID-19 clinical manifestations, obstetric history, diagnostic findings, treatment plans, comorbidities, gestational age at diagnosis, treatment protocols, and maternal and neonatal outcomes. Results: The mean age was 29.7 years; 98.3% were nonsmokers; 8% had previous miscarriages, and 67.3% had the infection in the third trimester. Iron deficiency anemia affected 30.3%, while 18.3% had comorbidities, mainly hypothyroidism. Most women were asymptomatic 61.7%, but 33% had respiratory symptoms, 4.7% needed intensive care unit (ICU) admission, and 2.7% resulted in maternal deaths. First-trimester and second-trimester miscarriages were recorded in 2.67% and 3.67% of cases, respectively, while preterm labor occurred in 3.0% of pregnancies. Additionally, age and hospitalization duration had a positive correlation with the neonatal outcomes (r = 0.349, p < 0.01), (r = 0.376, p < 0.01), respectively. Furthermore, COVID-19 presentation and treatment options demonstrated a strong positive correlation (p-value <0.01). On the other hand, maternal death had a strong negative correlation with poor neonatal outcomes (r = −0.776, p < 0.01). Conclusion: The study showed that COVID-19 in pregnant women, particularly in the third trimester, is associated with significant neonatal complications, with age, hospitalization duration, and COVID-19 severity strongly impacting outcomes. [ABSTRACT FROM AUTHOR]

In order to evaluate the impact of olive activities on the population health in Fez rural, which is affected by air pollution, a retrospective study of acute respiratory infections (ARI) and chronic was studied (about ten years) in the commune of Ain Taoujdate (30 km of Fez center), known by its strong pollution particularly that of the air caused by industrial activity. Method using was the examination of medical records from 2004 to 2015. Analyzing the evolution of respiratory infections at Ain Taoujdate, we noticed a remarkable and repetitive increase, during olive tree campaign and in the spring (in each year), following the air pollution in the commune and abundance of pollen (pollinosis). Very high cases of pneumopathies recorded during the month of December 2004 and which reached 305 and 124 cases successively and which corresponds to the most important triturating activity during these twelve years of study. On the other hand the asthma crisis of Ain Taoujdate, shows a very large value in olive oil milling season. The main cause seems to be air pollution of Ain Taoujdate, since a large oil mill that releases a huge amount of fume is installed close to the population. Statistical analyzes using principal component analysis (PCA) and ascending hierarchical classification (HAC), were able to show an eventual correlation. This work excludes microbial infections; its limitation is the absence of air quality data and was the consequences to take stock of the impact of air pollution caused by oil mills on respiratory health. [ABSTRACT FROM AUTHOR]

Objectives: We performed a systematic review and meta-analysis on long-term exposure to nitrogen dioxide (NO2) and ozone (O3) with mortality, to expand evidence that informed 2021 the WHO Air Quality Guidelines and guide the Health Risks of Air Pollution in Europe project. Methods: We included cohorts investigating NO2 and O3 mortality from all-causes, respiratory diseases, chronic obstructive pulmonary disease (COPD), acute lower respiratory infections (ALRI); and NO2 mortality from circulatory, ischemic heart, cerebrovascular diseases and lung cancer. We pooled estimates by random-effects models and investigated heterogeneity. We assessed the certainty of the evidence using the Grading of Recommendations Assessment Development approach and Evaluation (GRADE). Results: We selected 83 studies for NO2 and 26 for O3 for the meta-analysis. NO2 was associated with all outcomes, except for cerebrovascular mortality. O3 was associated with respiratory mortality following annual exposure. There was high heterogeneity, partly explained by region and pollutant levels. Certainty was high for NO2 with COPD and ALRI, and annual O3 with respiratory mortality. Conclusion: An increasing body of evidence, with new results from countrywide areas and the Western Pacific, supports certainty, including new outcomes. [ABSTRACT FROM AUTHOR]

Poor indoor air quality is one of the factors that can cause health problems. Tuberculosis (TB) and acute respiratory infections (ARIs) are among the diseases often associated with indoor air quality. In 2022, the highest number of TB cases was recorded in Surabaya, with 4739 cases. The research location, at the Wonokusumo Public Health Center, still reported a high number of TB cases, with 126 cases in 2022 and 84 cases in 2023. The use of Cyclone Ventilator Modification (CVM) has shown to improve the indoor air quality of occupants. This study aims to analyze the capability and the time required for the CVM to enhance the indoor air quality in homes of TB and ARI patients, using indicators such as temperature, humidity, airborne microbiology, air flow rate, PM2.5 dust particles, and lighting. This experimental study uses a One Group Pre‐Test Post‐Test Design to test changes following the experiment. The device operates on the principle of improving air quality, including temperature, humidity, air flow rate, lighting, and the ability to reduce airborne microbiology and PM2.5 dust particles indoors. The effectiveness of the CVM in improving indoor air quality for TB and ARI patients is analyzed using a paired T‐test analysis, revealing significant differences in indoor air quality indicators before and after the device's operation. The results obtained show that the two‐tailed significance value is less than 0, indicating a significant difference between the initial and final variables. After CVM operation in five homes with eight replications, the CVM's effectiveness was optimal in relation to room area/volume. This study was conducted as a simple step to minimize pollutants and improve indoor air quality. These findings can be applied and utilized to create healthier buildings or homes. [ABSTRACT FROM AUTHOR]

Background: Parents of children in pediatric intensive care units have varied communication experiences with health care professionals. Little is known about factors associated with parents' perceptions of miscommunication. Objective: To examine children's clinical and parents' demographic and psychosocial factors associated with perceptions of miscommunication in the pediatric intensive care unit. Methods: This study was a cross-sectional survey of parents of children admitted to the pediatric intensive care unit between January 1, 2018, and February 29, 2020, with a stay of greater than 24 hours. Results: Most of the 200 parent respondents were female (83.4%), White (71.4%), and non-Hispanic (87.9%); median age was 39 years (mean [SD], 40.2 [8.75] years); 17.6% were Black or African American. Among 210 children, mean (SD) age was 6.1 (6.02) years, mean (SD) stay was 4.5 (6.2) days, 38.6% were admitted because of respiratory illness, and the admission was the first for 51.0%. Of the parents, 16.5% reported miscommunication in the pediatric intensive care unit. In multivariable linear regressions, parents' stress (β = 0.286), parents' views of clinician communication (β = −0.400), parents' trust in physicians (β = −0.147), and length of stay (β = 0.122) accounted for 45% of the explained variance in parent-perceived miscommunication (R2 = 0.448, F = 41.19, P <.001). Conclusions: Parental stress and trust in physician scores were associated with perceived miscommunication. Further research is needed to understand the causes and consequences of miscommunication in order to support hospitalized children and their parents. [ABSTRACT FROM AUTHOR]