Respiratory Infectious Diseases Research Articles

An analytical study of facemask performance to mitigate respiratory diseases transmission through coughs and sneezes

Upper respiratory infectious diseases are often transmitted through ejected droplets and aerosols at high velocity by coughs or sneezes. In its early stages, the rapid spread of the COVID-19 virus could not be fully controlled without face masks and social distancing, and the measures' effectiveness was in doubt due to the uncertainty of air leakage around the mask edges. This study aims to analytically investigate the effect of wearing face masks on the contamination distance around a coughing infected person in still air. The effect of mask design and the presence of gaps around the mask edges was also investigated in this study. A steady-state analytical model was developed to estimate the contamination distance as a function of mask properties and the gap width around the mask edges. The model was validated against experimental observations, showing good agreement. Results revealed that the effectiveness of a face mask in reducing contamination distances is highly dependent on the tightness of the mask fit around the wearer's face. Masks with high packing density, such as N95, were found to be ineffective with gap widths wider than 0.2 mm around the mask edges due to their high resistance, which diverts most of the flow to leak around the edges. For such wide gaps, more permeable cloth masks with packing densities below 1 % reduce the contamination distance more effectively, despite having a low filtration capacity, by impeding the inertia of the ejected particles.

The application status of sequencing technology in global respiratory infectious disease diagnosis.

Next-generation sequencing (NGS) has revolutionized clinical microbiology, particularly in diagnosing respiratory infectious diseases and conducting epidemiological investigations. This narrative review summarizes conventional methods for routine respiratory infection diagnosis, including culture, smear microscopy, immunological assays, image techniques as well as polymerase chain reaction(PCR). In contrast to conventional methods, there is a new detection technology, sequencing technology, and here we mainly focus on the next-generation sequencing NGS, especially metagenomic NGS(mNGS). NGS offers significant advantages over traditional methods. Firstly, mNGS eliminates assumptions about pathogens, leading to faster and more accurate results, thus reducing diagnostic time. Secondly, it allows unbiased identification of known and novel pathogens, offering broad-spectrum coverage. Thirdly, mNGS not only identifies pathogens but also characterizes microbiomes, analyzes human host responses, and detects resistance genes and virulence factors. It can complement targeted sequencing for bacterial and fungal classification. Unlike traditional methods affected by antibiotics, mNGS is less influenced due to the extended survival of pathogen DNA in plasma, broadening its applicability. However, barriers to full integration into clinical practice persist, primarily due to cost constraints and limitations in sensitivity and turnaround time. Despite these challenges, ongoing advancements aim to improve cost-effectiveness and efficiency, making NGS a cornerstone technology for global respiratory infection diagnosis.

Peri-anaesthetic complications in 1798 equids undergoing high-field elective orthopaedic MRI at a tertiary referral hospital.

Antimicrobial prophylaxis for elective orthopaedic magnetic resonance imaging (MRI) in equids is a topic of debate among practitioners and can have negative detrimental effects on patients if used unnecessarily. To describe the complications with elective orthopaedic MRI of horses, mules, and donkeys under general anaesthesia without the use of peri-anaesthetic antimicrobial prophylaxis at a single large tertiary referral centre. We hypothesised that horses, mules, and donkeys undergoing general anaesthesia for elective orthopaedic MRI, without antimicrobial prophylaxis, will not be at increased risk of complications, including increased risk of infectious respiratory disease. Retrospective cross-sectional study. This retrospective study of 1798 systemically healthy equids that underwent elective orthopaedic MRI under general anaesthesia without peri-anaesthetic antimicrobial prophylaxis between January 2009 and May 2020. A total of 1655 MRIs were included in the study, with 25 (1.5%) horses having complications. The most common complication was post-anaesthetic fever in 11 (0.7%) horses, of which 4 (0.2%) horses went on to develop pneumonia and one horse was diagnosed with equine herpesvirus (respiratory). Seven (0.4%) horses developed transient post-anaesthetic femoral neuropathy and 7 (0.4%) horses had mild post-anaesthetic colic that resolved with initial medical management. No horses were euthanised or died in this study. The retrospective nature of the study led to non-randomised case selection, and some records were incomplete. These findings suggest that peri-anaesthetic antimicrobial prophylaxis may not be necessary for performance and sport horses undergoing general anaesthesia for elective orthopaedic MRI.

Sensitive dual-channel lateral flow immunoassay tagged with high brightness latex microsphere for simultaneous detection of respiratory viral antigens

Respiratory infectious diseases pose a serious threat to human health worldwide. Timely diagnosis is crucial for effective clinical management and infection control. Herein, we developed a dual-channel lateral flow immunoassay (DC-LFIA) for simultaneous sensitive detection of influenza A virus (IAV) and respiratory syncytial virus (RSV) nucleoprotein (NP) antigens. The high brightness latex microspheres (HB-LMs) exhibiting typical absorption peak at 540 nm with uniform size and excellent optical stability, were prepared by a simple surfactant-free emulsion polymerization by mixing Sudan red, which overcame the complexity and color instability met for traditional synthesis methods. After affinity evaluation, two antibody pairs have good affinity for IAV NP and RSV NP were separately identified. Then, combining antibody pairs as probes and HB-LMs as based signal tag, a DC-LFIA was constructed, by which the visual limit of detection is 25 pg/mL, 100 pg/mL for IAV NP and RSV NP, respectively, 10-fold more sensitive than gold nanoparticles based LFIA. The calculated limit of detection (S/N=3) of IAV NP and RSV NP was improved 22.8- and19.5-fold, respectively, in comparison with gold nanoparticles based LFIA. Additionally, the developed sensor shows excellent specificity and reproducibility. Furthermore, the as-proposed method was validated through the analysis of clinical samples, in good agreement with commercial colloidal gold kits. Thus, the developed DC-LFIA has great potential for clinical application in the multiplex detection of respiratory viral antigens.

Forecasting and analyzing influenza activity in Hebei Province, China, using a CNN-LSTM hybrid model

BackgroundInfluenza, an acute infectious respiratory disease, presents a significant global health challenge. Accurate prediction of influenza activity is crucial for reducing its impact. Therefore, this study seeks to develop a hybrid Convolution Neural Network—Long Short Term Memory neural network (CNN-LSTM) model to forecast the percentage of influenza-like-illness (ILI) rate in Hebei Province, China. The aim is to provide more precise guidance for influenza prevention and control measures.MethodsUsing ILI% data from 28 national sentinel hospitals in the Hebei Province, spanning from 2010 to 2022, we employed the Python deep learning framework PyTorch to develop the CNN-LSTM model. Additionally, we utilized R and Python to develop four other models commonly used for predicting infectious diseases. After constructing the models, we employed these models to make retrospective predictions, and compared each model’s prediction performance using mean absolute error (MAE), root mean square error (RMSE), mean absolute percentage error (MAPE), and other evaluation metrics.ResultsBased on historical ILI% data from 28 national sentinel hospitals in Hebei Province, the Seasonal Auto-Regressive Indagate Moving Average (SARIMA), Extreme Gradient Boosting (XGBoost), Convolution Neural Network (CNN), Long Short Term Memory neural network (LSTM) models were constructed. On the testing set, all models effectively predicted the ILI% trends. Subsequently, these models were used to forecast over different time spans. Across various forecasting periods, the CNN-LSTM model demonstrated the best predictive performance, followed by the XGBoost model, LSTM model, CNN model, and SARIMA model, which exhibited the least favorable performance.ConclusionThe hybrid CNN-LSTM model had better prediction performances than the SARIMA model, CNN model, LSTM model, and XGBoost model. This hybrid model could provide more accurate influenza activity projections in the Hebei Province.

Electrochemical Monitoring of Respiratory Infectious Disease on Nanostructured Surface Functionalized with Biosynthetic Multimer Aptamers

Multivalent aptamers have gained substantial interest owing to their enhanced affinity towards target analytes compared to their monomeric counterparts due to their capability to bind simultaneously to diverse regions of a target molecule, fostering more robust and enduring interactions. This study focuses on engineering the surface-based production and modification of multivalent aptamers through room temperature rolling circle amplification technique and chemically modified primers. This process starts with immobilizing modified primers onto an electrode to generate and arrange biosynthesised multivalent aptamers. These bio-engineered multivalent aptamers are utilized as bio-receptors for capturing a specific target (in this case, the SARS-CoV-2 spike protein). The entire surface amplification procedure is extensively characterized using electrochemical, microscopy, and spectroscopy methods, determining the optimal amplification duration for biosensing applications. Impressively, multivalent aptasensors shows substantially increased response signals and affinity compared to monomeric aptasensors. Moreover, the influence of surface structures on response signals is explored by employing both flat screen-printed gold electrodes and nano-/microisland (NMI) electrodes. NMIs-based multimeric aptasensors demonstrate notably heightened sensitivity in detecting SARS-CoV-2 spike protein within the range of 10 to 106 fg/mL in saliva and buffer media. Finally, the signal of the proposed aptasensor has been successfully assessed using several patient samples.

2236 Emergency department attendance stratified by cause and frailty status: a national cohort study of over 155 million patients

Abstract Introduction Data are limited on whether the causes of Emergency Department (ED) attendance and clinical outcomes vary by frailty status. Methods Using data from the Nationwide Emergency Department Sample, all ED attendances from 2016 to 2018 were stratified by the cause of attendance and Hospital Frailty Risk Score (HFRS) category. Logistic regression was used to determine adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) of ED and overall mortality. Results A total of 155,497,048 ED attendances were included, of which 125,809,960 (80.9%) had a low HFRS (<5), 27,205,257 (17.5%) had an intermediate HFRS (5–15) and 2,481,831 (1.6%) had a high HFRS (>15). The most common cause of ED attendance in the high HFRS group was infectious diseases (43.0%), followed by cardiovascular diseases (CVD) (24.0%) and respiratory diseases (10.2%). Musculoskeletal diseases were the most common cause of admission for the low HFRS group (21.2%), followed by respiratory diseases (20.6%), and gastrointestinal diseases (18.5%). On adjusted analysis, high HFRS patients had increased overall mortality (combined ED and in-hospital) across most attendance causes, compared to their low HFRS counterparts (p < 0.001). High HFRS patients with infectious diseases (aOR 23.88 95% CI 23.42–24.34), CVD (aOR 2.58 95% CI 2.55–2.61) and respiratory diseases (aOR 36.90 95% CI 36.18–37.62) had an increased risk of overall mortality, compared to their low-risk counterparts (p < 0.001). Conclusions A significant proportion of patients attending the ED are frail, with the cause of attendance varying by frailty status. Frailty is associated with increased overall mortality across most attendance causes.

Pharmacological mechanisms of Ma Xing Shi Gan Decoction in treating influenza virus-induced pneumonia: intestinal microbiota and pulmonary glycolysis.

Influenza virus is one of the most common pathogens that cause viral pneumonia. During pneumonia, host immune inflammation regulation involves microbiota in the intestine and glycolysis in the lung tissues. In the clinical guidelines for pneumonia treatment in China, Ma Xing Shi Gan Decoction (MXSG) is a commonly prescribed traditional Chinese medicine formulation with significant efficacy, however, it remains unclear whether its specific mechanism of action is related to the regulation of intestinal microbiota structure and lung tissue glycolysis. This study aimed to investigate the mechanism of action of MXSG in an animal model of influenza virus-induced pneumonia. Specifically, we aimed to elucidate how MXSG modulates intestinal microbiota structure and lung tissue glycolysis to exert its therapeutic effects on pneumonia. We established a mouse model of influenza virus-induced pneumoni, and treated with MXSG. We observed changes in inflammatory cytokine levels and conducted 16S rRNA gene sequencing to assess the intestinal microbiota structure and function. Additionally, targeted metabolomics was performed to analyze lung tissue glycolytic metabolites, and Western blot and enzyme-linked immunosorbent assays were performed to assess glycolysis-related enzymes, lipopolysaccharides (LPSs), HIF-1a, and macrophage surface markers. Correlation analysis was conducted between the LPS and omics results to elucidate the relationship between intestinal microbiota and lung tissue glycolysis in pneumonia animals under the intervention of Ma Xing Shi Gan Decoction. MXSG reduced the abundance of Gram-negative bacteria in the intestines, such as Proteobacteria and Helicobacter, leading to reduced LPS content in the serum and lungs. This intervention also suppressed HIF-1a activity and lung tissue glycolysis metabolism, decreased the number of M1-type macrophages, and increased the number of M2-type macrophages, effectively alleviating lung damage caused by influenza virus-induced pneumonia. MXSG can alleviate glycolysis in lung tissue, suppress M1-type macrophage activation, promote M2-type macrophage activation, and mitigate inflammation in lung tissue. This therapeutic effect appears to be mediated by modulating gut microbiota and reducing endogenous LPS production in the intestines. This study demonstrates the therapeutic effects of MXSG on pneumonia and explores its potential mechanism, thus providing data support for the use of traditional Chinese medicine in the treatment of respiratory infectious diseases.

Unravelling the complex interplay of age, comorbidities, and multimorbidities in COVID-19 disease progression: Clinical implications and future perspectives

IntroductionThe COVID-19 infection as an inflammatory disease has posed significant challenges to global public health due to multi-factor risks associated with it leading to disease severity and mortality. Understanding the effect of age and comorbidities on overall disease progression is crucial to identify highly susceptible individuals and to develop effective disease management strategies in a resource limited country like Pakistan. MethodologyA retrospective study was conducted on hospitalized COVID-19 patients to assess the prevalence of various comorbidities among different age groups and their effect on disease severity and mortality rate. ResultsIn this retrospective study, a cohort of 618 hospitalized COVID-19 patients was analyzed, consisting of 387 males (62.6 %) and 231 females (37.4 %). Notably, the young age group (15–24 years), had the lowest frequency of hospitalized COVID-19 patients, while no case was observed in children (≤14 years) showing a significant association (p < 0.001) of age and disease prevalence. Comorbidities were observed in 63.9 % of COVID-19 patients including hypertension (HTN), diabetes mellitus (DM), ischemic heart diseases (IHD), asthma, chronic kidney disease (CKD) and tuberculosis (TB). The most common comorbidities were HTN (42.1 %) followed by DM (33.8 %), IHD (16.5 %), asthma (11.2 %), CKD (7.9 %) and TB (1.9 %).Furthermore, the study revealed a significant association between comorbidities, age groups, and the need for non-invasive ventilation (NIV) (p < 0.001), mechanical ventilation (MV) (p < 0.001), and intensive care unit (ICU) admission (p < 0.001). Patients with specific comorbidities and those in the older age group (≥65 years) demonstrated a higher need for these interventions. However, patients without any comorbidity consistently exhibited the highest cumulative proportion of survival at each time point, indicating better overall survival outcomes. In contrast, patients with multimorbidities of DM/HTN/IHD, HTN/IHD, and DM/HTN/CKD had comparatively lower survival rates and higher mortality rates (p < 0.001). ConclusionThis research highlights the significant impact of age, comorbidities and multimorbidities on the severity and mortality of COVID-19 patients. It highlights the importance of considering these factors in tailoring effective management strategies for patients with COVID-19 or other infectious respiratory diseases.

Impact of Educational Films on Antibiotic Prescription among Physicians: A Web-Based Survey in Japan.

Although antibiotics are most frequently prescribed for respiratory tract infections, effective interventions for their proper use by physicians have not been fully established. We assessed the impact of educational films on the rates of antibiotic prescriptions for respiratory tract infections using fictitious scenarios. In this nationwide web-based survey prospective study, a total of 1100 physicians were included. The physicians were required to view educational short films and determine the need for prescribing antibiotics in 10 fictitious scenarios involving adults diagnosed with different acute respiratory tract infectious diseases. The antibiotic prescription rates for each scenario were compared before and after viewing the educational short film. The rates of antibiotic prescription significantly decreased after viewing the educational film, especially in cases with a narrowly defined common cold (from 51% to 15%), mild pharyngolaryngitis (from 71% to 25%), and acute bronchitis without chronic respiratory underlying diseases (from 63% to 23%). Alternatively, a slight decrease in rates was observed in cases with moderate or severe rhinosinusitis (from 94% to 79%), moderate or severe acute pharyngitis (from 88% to 69%), and acute bronchitis with chronic lung disease (from 70% to 58%), for which antibiotics are recommended. Educational short films may encourage the proper use of antibiotics for respiratory tract infections; however, the possibility of undertreatment in patients requiring antibiotics must be considered.

Repetition in social contacts: implications in modelling the transmission of respiratory infectious diseases in pre-pandemic and pandemic settings.

The spread of viral respiratory infections is intricately linked to human interactions, and this relationship can be characterized and modelled using social contact data. However, many analyses tend to overlook the recurrent nature of these contacts. To bridge this gap, we undertake the task of describing individuals' contact patterns over time by characterizing the interactions made with distinct individuals during a week. Moreover, we gauge the implications of this temporal reconstruction on disease transmission by juxtaposing it with the assumption of random mixing over time. This involves the development of an age-structured individual-based model, using social contact data from a pre-pandemic scenario (the POLYMOD study) and a pandemic setting (the Belgian CoMix study), respectively. We found that accounting for the frequency of contacts impacts the number of new, distinct, contacts, revealing a lower total count than a naive approach, where contact repetition is neglected. As a consequence, failing to account for the repetition of contacts can result in an underestimation of the transmission probability given a contact, potentially leading to inaccurate conclusions when using mathematical models for disease control. We, therefore, underscore the necessity of acknowledging contact repetition when formulating effective public health strategies.

Improvement of Echinacea purpurea and Ganoderma lucidum Extracts with Cell Model on Influenza A/B Infection.

Since 2019, COVID-19 has been raging around the world. Respiratory viral infectious diseases such as influenza and respiratory syncytial virus (RSV) infection are also prevalent, with influenza having the ability to cause seasonal pandemics. While vaccines and antiviral drugs are available to prevent and treat disease, herbal extracts would be another option. This study investigated the inhibitory effects of extracts of Echinacea purpurea (EP) and Ganoderma lucidum (G. lucidum) and the advanced G. lucidum drink (AG) on influenza A/B viruses. To determine whether EP and G. lucidum extracts enhance cell immunity and thus prevent virus infection or act to directly suppress viruses, cell survival and hemagglutination (HA) assays were used in this study. Cells were treated with samples at different concentrations (each sample concentration was tested from the highest non-cytotoxic concentration) and incubated with influenza A/B for 24 h, with the results showing that both G. lucidum and EP extracts and mixtures exhibited the ability to enhance cell survival against viruses. In the HA assay, AG and EP extract showed good inhibitory effect on influenza A/B viruses. All of the samples demonstrated an improvement of the mitochondrial membrane potential and improved resistance to influenza A/B virus infection. EP and G. lucidum extracts at noncytotoxic concentrations increased cell viability, but only AG and EP extract directly decreased influenza virus titers. In conclusion, results indicate the ability of EP and G. lucidum extract to prevent viruses from entering cells by improving cell viability and mitochondrial dysfunction and EP extract showed direct inhibition on viruses and prevented viral infection at post-infection strategy.

An Ultra-Compact and Low-Cost LAMP-Based Virus Detection Device.

Timely and accurate detection of viruses is crucial for infection diagnosis and treatment. However, it remains a challenge to develop a portable device that meets the requirement of being portable, powerless, user-friendly, reusable, and low-cost. This work reports a compact &empty;30 × 48 mm portable powerless isothermal amplification detection device (material cost ∼$1 USD) relying on LAMP (Loop-Mediated Isothermal Amplification). We have proposed chromatographic-strip-based microporous permeation technology which can precisely control the water flow rate to regulate the exothermic reaction. This powerless heating combined with phase-change materials can maintain a constant temperature between 50 and 70 °C for a duration of up to 49.8 min. Compared with the conventional methods, it avoids the use of an additional insulation layer for heat preservation, greatly reducing the size and cost. We have also deployed a color card and a corresponding algorithm to facilitate color recognition, data analysis, and storage using a mobile phone. The experimental results demonstrate that our device exhibits the same limit of detection (LOD) as the ProFlex PCR for SARS-CoV-2 pseudovirus samples, with that for both being 103 copies/μL, verifying its effectiveness and reliability. This work offers a timely, low-cost, and easy way for respiratory infectious disease detection, which could provide support in curbing virus transmission and protecting the health of humans and animals, especially in remote mountainous areas without access to electricity or trained professionals.

Psychometric validation of the Chinese versions of EQ-5D-Y-3L and the experimental EQ-TIPS in children and adolescents with COVID-19.

Respiratory infectious diseases like COVID-19 profoundly impacts the health of children and adolescents, but validated instruments to measure their impacts on health-related quality of life (HRQoL) are lacking. The EQ-5D-Y-3L, widely used for youth HRQoL, now features a Chinese value set. The experimental EQ-TIPS addresses HRQoL assessment for toddlers and infants. This study tested the psychometric properties of both instruments in paediatric COVID-19 patients, and compared the performance of self-complete and proxy EQ-5D-Y-3L. This longitudinal study recruited 861 COVID-19 patients aged 0-18 years and their parental caregivers, with 311 dyads completing the follow-up. Digital administration included the EQ-TIPS, the EQ-5D-Y-3L, and Overall Health Assessment (OHA). Controls comprised 231 healthy children. Analysis encompassed known-group validity, child-parent agreement, and responsiveness to change in disease severity and OHA. COVID-19 children exhibited lower HRQoL than non-infected peers. The EQ-TIPS and the EQ-5D-Y-3L distinguished groups by disease presence, severity and symptoms, showing moderate to good known-group validity (ESs: 0.45-1.39 for EQ-TIPS, 0.44-1.91 for self-complete EQ-5D-Y-3L, and 0.32-1.67 for proxy EQ-5D-Y-3L). Child-parent agreement was moderate to good for EQ-5D-Y-3L (ICC: 0.653-0.823; Gwet's AC1: 0.470-0.738), and responsiveness was good for both EQ-TIPS Level Sum Score (LSS) (ESs: 1.21-1.39) and EQ-5D-Y-3L index scores (ESs: 1.00-1.16). This study demonstrates the reliability, validity, and responsiveness of the experimental EQ-TIPS and the EQ-5D-Y-3L in paediatric COVID-19 patients. It is the first evidence of the EQ-TIPS' responsiveness, supporting its use in assessing the impact of COVID-19 on paediatric HRQoL.

Otitis media with effusion in patients with COVID-19: A single-center study in China

BackgroundThe swift global spread of coronavirus disease 2019 (COVID-19), a respiratory ailment primarily marked by pulmonary symptoms, has been linked to the involvement of various organs, including the intestines, kidneys, throat, and ears. Otitis media with effusion (OME), often succeeding an upper respiratory tract infection, mirrors its incidence. As a respiratory infectious disease, it prompts the query of whether the COVID-19 pandemic has spurred an uptick in OME and whether the COVID-19 virus persists in middle ear effusion (MEE) for an extended period. MethodsTo gauge the incidence of OME in the population during the COVID-19 pandemic, a tailored questionnaire was disseminated and subsequently analyzed. Assessing the rise in OME incidence during the pandemic, we compared the proportion of OME cases in the otology outpatient department between pandemic and non-pandemic periods. Statistical analysis involved a t-test. Simultaneously, MEE was collected from patients with COVID-19-associated OME during the pandemic to ascertain the presence of SARS-CoV-2 in MEE via polymerase chain reaction. ResultsBased on the questionnaire data, the estimated OME incidence in the population is approximately 31.4 %. In contrast to the non-pandemic period, the percentage variation in the OME outpatient proportion was 71.4 % (P < 0.05). Among the 61 MEE samples, 13 polymerase chain reaction results were positive, constituting 21.31 %. Nasopharyngeal swabs yielded negative results. Notably, only one patient experienced OME recurrence after 1 month of auripuncture. ConclusionsCOVID-19 can trigger an escalation in OME cases. Even when nasopharyngeal swabs show negative results, SARS-CoV-2 can endure in MEE for an extended duration, suggesting the potential for asymptomatic COVID-19 transmission and recurrence within the population.

Assessment of Epidemiological Trend of Influenza-Like Illness in Italy from 2010/2011 to 2023/2024 Season: Key Points to Optimize Future Vaccination Strategies against Influenza.

Seasonal influenza is an acute respiratory infectious disease due to influenza viruses, causing a relevant number of illnesses and deaths each year worldwide. Influenza is a preventable disease by vaccination. The aim of this study was to assess the epidemiology of seasonal influenza in Italy through the analysis of data from the epidemiological and virological RespiVirNet surveillance system for the season 2010/2011 to 2023/2024 to identify the epidemiological key points to plan the most appropriate vaccination strategies. The cumulative and maximum weekly incidence of influenza-like illness (ILI) and epidemic period (beginning, end, duration in weeks) were assessed in the pre-pandemic period (2010/2011-2019/2020) and they were compared to the pandemic and post-pandemic one. In all seasons, children reported the highest incidence values of ILI and longer epidemic periods in contrast with the older population. The epidemic seasons 2020/2021 and 2021/2022 had abnormal trends while in the last seasons 2022/2023 and 2023/2024 the epidemiological and virological trends of ILI were confirmed as reported in the pre-pandemic period but with high intensity. Influenza virus A was predominant: the H3N2 subtype circulated more than virus H1N1pdm09. In the few seasons when influenza virus B was the most frequent influenza agent, it co-circulated with influenza virus A. The monitoring of cases is the fundamental tool to better understand the epidemiology of influenza and to optimize future preventive strategies.

TOLL-LIKE RECEPTORS AND BRONCHIAL ASTHMA: PART 2

For the last decade, the attention of researchers has been attracted by Toll-like receptors that provide recognition of pathogens and trigger an immune response to them. As participants in acute infectious processes, with inadequate stimulation associated with mutation of genes regulating expression of the receptors, they cause the initiation or exacerbation of asthma in predisposed individuals. At the same time, the reduced function of the receptors leads to an insufficient immune response in respiratory infectious diseases, which also leads to an exacerbation of bronchial asthma. In addition, Toll-like receptors are direct elements of the pathogenesis of bronchial asthma, supporting or reducing inflammation. Thus, Toll-like receptors can not only aggravate the course of asthma, but also prevent exacerbations of the disease. Knowledge of the role of these receptors in the pathophysiology of bronchial asthma is necessary to improve diagnostic methods and timely detection of the disease. Using data on the effects realized by the receptors, medicines are being developed that are antagonists or agonists of a Toll-like receptors. The use of medicines acting on receptors in the treatment and prevention of asthma in the future may lead to increased control over the course of the disease.

Assessment of airborne viral transmission risks in a large-scale building using onsite measurements and CFD method

Screening patients for potential respiratory infections through nucleic acid sampling was a critical non-pharmacologic intervention during a respiratory infectious disease pandemic. Evaluating the cross-infection risk of crowded activities conducted indoors is necessary. We conducted a field study of this event in a large-scale stadium and measured the variation in CO2 concentrations. We conducted simulations on the stadium's flow field, CO2 and N2O concentration distribution using the CFD method, which was validated by the on-site measured data. We simulated the diffusion of virus aerosols exhaled by the sampled individuals under an all-fresh and primary return air system, respectively. It was found that space morphology and airflow pattern are the main factors influencing the concentration distribution of human exhaled contaminants. Primary return air systems can reduce the infection risk for sampled individuals by the filtration system and improve the airflow pattern. With the ratio of fresh air to return air of 1.2, the primary return air systems with 70 %, 85 %, and 95 % filtration levels can reduce the infection risk by an average of 54.5 %, 58.3 %, and 62.1 %, respectively, compared to all-fresh air system. It is necessary to optimize the processes and queue setups for nucleic acid sampling activities in the room based on the room airflow characteristics and the return air system using an efficient filtration system.

Technologies and main functionalities of the telemonitoring application reCOVeryaID.

The COVID-19 pandemic has highlighted the need to take advantage of specific and effective patient telemonitoring platforms, with specific reference to the constant monitoring of vital parameters of patients most at risk. Among the various applications developed in Italy, certainly there is reCOVeryaID, a web application aimed at remotely monitoring patients potentially, currently or no longer infected with COVID-19. Therefore, in this paper we present a system model, consisting of a multi-platform intelligent telemonitoring application, that enables remote monitoring and provision of integrated home care to both patients symptomatic, asymptomatic and pre-symptomatic with severe acute respiratory infectious disease or syndrome caused by viruses belonging to the Coronavirus family, as well as simply to people with respiratory problems and/or related diseases (chronic obstructive pulmonary disease or asthma). In fact, in this paper we focus on exposing the technologies and various functionalities offered by the system, which constitute the practical implementation of the theoretical framework described in detail in another paper. Specifically, the reCOVeryaID telemonitoring application is a stand-alone, knowledge base-supported application that can promptly react and inform physicians if dangerous trends in a patient's short- and long-term vital signs are detected, thus enabling them to be monitored continuously, both in the hospital and at home. The paper also reports an evaluation of user satisfaction, carried out by actual patients and medical doctors.

Evaluation of airborne transmission of respiratory contaminants in a passenger car cabin with window opening

Exhaled aerosols can be suspended in the air for long periods, facilitating the transmission of highly infectious respiratory diseases. The risk of exposure to occupants varies due to different usage conditions and driving scenarios of moving vehicles. Therefore, the present study investigates the airborne transmission of contaminants generated by coughing in a moving vehicle and explores the relationship between aerosol dispersion and fluid exchange between the interior and exterior domains of the car under the influence of window opening configurations, seating layouts and driving speeds. The results show that the cross-opening configurations provide a superior contaminant removal efficiency. The effect of seating layout on removal efficiency is significant, although it has a slight effect on air change rate (ACH). The best removal efficiency can be obtained when the passenger sits in the front seat with the right front window opening. Furthermore, the in-cabin ACH is almost linearly correlated with the driving speed. Higher speeds reduce contaminant concentrations faster. However, the risk of driver exposure does not depend solely on ACH, the peak cumulative contaminant concentration and residence time also need to be considered. This study offers data for the prevention and control of respiratory infectious diseases.