Respiratory Infectious Diseases Research Articles

Research on Nursing of Patients with Mild Respiratory Infectious Diseases

Objective: To explore the current home care programs and effects of patients with mild respiratory tract infections caused by influenza virus, Mycoplasma pneumoniae and novel coronavirus, so as to provide a reference for subsequent related research. Methods: PubMed, WebofScience core collection, China National Knowledge Infrastructure (CNKI), Wanfang Data and China Biology Medicine Database were searched by computer for literature screening, data extraction and summary on the existing home care programs and effects of patients with mild respiratory infectious diseases. Results: in 14 articles. Chinese researchers on defining the concept of mild and standard is a bit different, can be integrated to respiratory tract infection as the main performance, such as dry throat, sore throat, cough, fever, etc. Nursing programs generally included preventive nursing combined with health guidance intervention, personalized symptom nursing, cluster nursing, etc. Conclusion: the infection of respiratory tract infection caused by mild standard has not been unified, a direct impact on the late judge condition and formulate the related nursing operation timing, means and methods. At present, the commonly used nursing methods can effectively shorten the course of disease and relieve symptoms, but there is no specific mechanism research in the existing literature, and further exploration is needed to clarify its effect in the future.

A study on contaminant leakage from Airborne Infection Isolation room during medical staff entry; Implementation of walking motion on hypothetical human model in CFD simulation

The recent outbreak of respiratory infectious diseases such as Middle East Respiratory Syndrome (MERS) and Coronavirus Disease-19 (COVID-19) highlights the critical role of Air Infection Isolation (AII) rooms in preventing the spread of disease. However, the risk of contaminant leakage from the AII room during medical staff interactions remains a significant challenge. This study advances our understanding by employing Computational Fluid Dynamics (CFD) simulations with a novel approach. While CFD simulations mitigate some limitations of field experiments, such as measurement resolution and variable changes, their accuracy is often limited by the oversimplification of models, particularly in representing human models and movement. Unlike prior studies, we incorporate minimal simplification, featuring a human model with Personal Protective Equipment (PPE) and realistic walking motions. This study explores four distinct scenarios with varied human movements, offering a comprehensive analysis of airflow and contaminant dispersion in AII rooms. The results indicated significant differences in airflow patterns and contaminant distribution when realistic walking motion was implemented in the human model, as opposed to simplified movement models. The contaminant leakage from the AII room ranged from 20.6 % to 28.6 %, suggesting that prior studies may underestimate infection risks due to oversimplified human models and motions. These findings underscore the importance of implementing realistic human models and motions in CFD simulations for accurate infection risk assessment in AII rooms. Additionally, our study opens pathways for future research to explore more complex human interactions in clinical settings, enhancing infection control strategies.

Intranasal B5 promotes mucosal defence against Actinobacillus pleuropneumoniae via ameliorating early immunosuppression

ABSTRACT Actinobacillus pleuropneumoniae (APP) is an important pathogen of the porcine respiratory disease complex, which leads to huge economic losses worldwide. We previously demonstrated that Pichia pastoris-producing bovine neutrophil β-defensin-5 (B5) could resist the infection by the bovine intracellular pathogen Mycobacterium bovis. In this study, the roles of synthetic B5 in regulating mucosal innate immune response and protecting against extracellular APP infection were further investigated using a mouse model. Results showed that B5 promoted the production of tumour necrosis factor (TNF)-α, interleukin (IL)-1β, and interferon (IFN)-β in macrophages as well as dendritic cells (DC) and enhanced DC maturation in vitro. Importantly, intranasal B5 was safe and conferred effective protection against APP via reducing the bacterial load in lungs and alleviating pulmonary inflammatory damage. Furthermore, in the early stage of APP infection, we found that intranasal B5 up-regulated the secretion of TNF-α, IL-1β, IL-17, and IL-22; enhanced the rapid recruitment of macrophages, neutrophils, and DC; and facilitated the generation of group 3 innate lymphoid cells in lungs. In addition, B5 activated signalling pathways associated with cellular response to IFN-β and activation of innate immune response in APP-challenged lungs. Collectively, B5 via the intranasal route can effectively ameliorate the immune suppression caused by early APP infection and provide protection against APP. The immunization strategy may be applied to animals or human respiratory bacterial infectious diseases. Our findings highlight the potential importance of B5, enhancing mucosal defence against intracellular bacteria like APP which causes early-phase immune suppression.

Prediction of transmission routes of respiratory infectious diseases in indoor environment: Based on droplet evaporation and sedimentation analysis

Many respiratory infectious diseases are believed to be transmitted from person to person through droplet nuclei in the air or contact with droplet-contaminated surfaces. Most studies related to droplet evaporation only focus on the evaporation process, without dividing the transmission routes of diseases caused by droplet evaporation. In this paper, the actual size of droplet nuclei was analyzed, and droplet evaporation and the changes in component content were predicted. Especially considering the dynamic effect of evaporation on droplets size change, a more realistic sedimentation model was established, and the probability of pathogen transmission through different routes and the corresponding droplet size distribution range were analyzed. The results showed that the size of droplet nuclei and the rate of the evaporation process together determined the time required for droplet evaporation. The number of droplets still suspended in the air after the end of evaporation is much higher than the number of droplets settling on the ground. In addition, the differences in component content during the evaporation process may affect the inactivation of pathogens in droplets. This study provided a reference for the prevention and control strategies of respiratory infectious diseases in indoor environments.

Omega-3 long-chain polyunsaturated fatty acids and their bioactive lipids: A strategy to improve resistance to respiratory tract infectious diseases in the elderly?

Age-related changes in organ function, immune dysregulation, and the effects of senescence explain in large part the high prevalence of infections, including respiratory tract infections in older persons. Poor nutritional status in many older persons increases susceptibility to infection and worsens prognosis. Interestingly, there is an association between the amount of saturated fats in the diet and the rate of community-acquired pneumonia. Polyunsaturated fatty acids, particularly omega-3 long chain polyunsaturated fatty acids (ω-3 LC-PUFAs) including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have well-known anti-inflammatory, immunomodulatory, and antimicrobial effects, which may, in theory, be largely induced by PUFAs-derived lipids such as specialized pro-resolving mediators (SPMs). In adults, preliminary results of studies show that ω-3 LC-PUFAs supplementation can lead to SPM generation. SPMs have a crucial role in the resolution of inflammation, a factor relevant to survival from infection independent of the pathogen’s virulence. Moreover, the immune system of older adults appears to be more sensitive to ω-3 PUFAs. This review explores the effects of ω-3 LC-PUFAs, and PUFA bioactive lipid-derived SPMs in respiratory tract infections and the possible relevance of these data to infectious disease outcomes in the older population. The hypothesis that PUFAs have beneficial effects via SPM generation will need to be confirmed by animal experiments and patient-derived data.

Summary of key viral respiratory infectious diseases surveillance in some countries and regions in the world

Respiratory virus infections spread quickly, and some diseases are even more likely to cause a global epidemic. In order to explore how better to carry out surveillance of viral respiratory infectious diseases, the author searched the surveillance situation of key viral respiratory infectious diseases in America, Europe, and China, et al., then put forward several suggestions such as strengthening application of information technology, broaden monitoring channels, building early monitoring and early warning mechanisms.

Current Situation and Mental Health of Pregnant Women During the Prevention and Control of Novel Coronavirus Infection: A Cross-Sectional Study on the Investigation of Influencing Factors.

COVID-19 is a highly contagious respiratory infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which became a global public health crisis. In the past 3 years, the COVID-19 pandemic has resulted in a dramatic increase in the occurrence of psychological symptoms such as depression, anxiety, and stress in global populations. Therefore, it is important to help pregnant women cope with major public emergencies and improve their physical and mental health. To investigate the status and influencing factors of anxiety, insomnia, and psychological stress disorder in pregnant women with COVID-19 to provide a theoretical basis for psychological intervention in pregnant women in the case of public health emergency events. A cross-sectional survey was conducted with 435 pregnant women from multiple tertiary hospitals in Zhengzhou from November 6 to December 6, 2022. The questionnaire contents included the general information of pregnant women, insomnia scale, generalized anxiety scale, and the revised version of the Accident Impact Scale. There are 251 pregnant women with anxiety (57.7%, 95% CI: (53.0%-62.4%).There are 166 pregnant women with insomnia.(38.2%, 95% CI: 33.6%-42.7%), There are 314 pregnant women with stress disorder.(72.2%, 95% CI: 68.0%-76.4%). During the epidemic prevention and control period, whether pregnant women had a history of adverse pregnancy had a statistically significant difference in anxiety, insomnia and stress disorders. During the COVID-19 pandemic, pregnant women appeared to generally have anxiety, insomnia, and stress disorders. Poor pregnancy history is a protective factor for pregnant women with anxiety, insomnia, and post-traumatic stress disorder. In the case of similar public health emergencies, attention bias modification (ABM) may be a potential intervention measure to provide potentially new ideas for alleviating the psychological disorders of pregnant women during this special period.

Impact of community mask mandates on SARS-CoV-2 transmission in Ontario after adjustment for differential testing by age and sex.

Mask use for prevention of respiratory infectious disease transmission is not new but has proven controversial during the SARS-CoV-2 pandemic. In Ontario, Canada, irregular regional introduction of community mask mandates in 2020 created a quasi-experiment useful for evaluating the impact of such mandates; however, Ontario SARS-CoV-2 case counts were likely biased by testing focused on long-term care facilities and healthcare workers. We developed a regression-based method that allowed us to adjust cases for under-testing by age and gender. We evaluated mask mandate effects using count-based regression models with either unadjusted cases, or testing-adjusted case counts, as dependent variables. Models were used to estimate mask mandate effectiveness, and the fraction of SARS-CoV-2 cases, severe outcomes, and costs, averted by mask mandates. Models using unadjusted cases as dependent variables identified modest protective effects of mask mandates (range 31-42%), with variable statistical significance. Mask mandate effectiveness in models predicting test-adjusted case counts was higher, ranging from 49% (95% CI 44-53%) to 76% (95% CI 57-86%). The prevented fraction associated with mask mandates was 46% (95% CI 41-51%), with 290,000 clinical cases, 3,008 deaths, and loss of 29,038 quality-adjusted life years averted from 2020 June to December, representing $CDN 610 million in economic wealth. Under-testing in younger individuals biases estimates of SARS-CoV-2 infection risk and obscures the impact of public health preventive measures. After adjustment for under-testing, mask mandates emerged as highly effective. Community masking saved substantial numbers of lives, and prevented economic costs, during the SARS-CoV-2 pandemic in Ontario, Canada.

Systematic online academic resource (SOAR) review: Pediatric respiratory infectious disease.

Free open access medical education (FOAM) resources have become increasingly popular in graduate medical education. Despite their accessibility, the assessment of FOAM resources' quality is challenging due to their decentralized nature and the diverse qualifications of their authors and distribution platforms. In this first pediatric systematic online academic resource (SOAR) review, we utilized a systematic methodology to aggregate and assess the quality of FOAM resources on pediatric respiratory infectious disease topics. We searched 177 keywords using FOAMSearch, the top 50 FOAM websites on the Social Media Index, and seven additional pediatric emergency medicine-focused blogs. Following a basic initial screen, resources then underwent full-text quality assessment utilizing the revised Medical Education Translational Resources: Impact and Quality (rMETRIQ) tool. The search yielded 44,897 resources. After 44,456 were excluded, 441 underwent quality assessment. A total of 36/441 posts (8% of posts) reached the high-quality threshold score (rMETRIQ ≥ 16). The most frequent topics overall were pneumonia and bronchiolitis. A total of 67/441 posts (15% of posts) were found to have a rMETRIQ score of less than or equal to 7, which may indicate poor quality. We systematically identified, described, and performed quality assessment on FOAM resources pertaining to the topic of pediatric respiratory infectious disease. We found that there is a paucity of high-quality posts on this topic. Despite this, the curated list of high-quality resources can help guide trainees and educators toward relevant educational information and suggest unmet needs for future FOAM resources.

Evaluation of the District Health Information System in District Kotli, Azad Jammu and Kashmir: A Retrospective Analysis.

It is essential to implement a high-quality electronic database for keeping important information. The District Health Information System (DHIS) is an active data-keeping system in Pakistan. This study aimed to evaluate the patients' data from the DHIS dashboard for the District Headquarters Hospital, Kotli, Azad Jammu and Kashmir (AJK). The data was requested from the hospital administration at District Headquarters Hospital, Kotli, AJK, and the data was analyzed after permission was granted. The data was given in two forms; one was a hard copy of the data for August and September and the other was a comma-separated values file for October and November, 2023. The highest frequency of patients was received in the department of emergency and trauma and the patient's median age was between 15 and 49 years. The second department was medicine with the >50 years of age. Common conditions that needed more attention were chronic obstructive pulmonary disease, acute respiratory infection, diarrhea, pneumonia, diabetes mellitus, hypertension, and ischemic heart disease. For nations with constrained healthcare systems and funds, primary health care (PHC) is the only viable approach for managing non-communicable diseases (NCDs). However, PHC systems intended for infectious diseases have not sufficiently adapted to the growing requirement of chronic care for NCD. Research using health information databases offers numerous benefits, such as the evaluation of large data sets and unexpected prevalence of disease in certain populations, such as a higher prevalence of disease in one gender or age group. Health information system-based data analysis or studies are less expensive and faster but lack scientific control over data collection.

Dynamics and optimal control for a spatial heterogeneity model describing respiratory infectious diseases affected by air pollution

Air pollution has a serious impact on the spread of respiratory infectious diseases. However, the concentration of air pollution is not the same in different places. In order to characterize the spatial heterogeneity and the diffusion of pollutants, this paper proposes a spatial heterogeneity model, where the transmission rate is closely related to air pollution. The dynamics are established in terms of the basic reproduction number R0: if R0≤1, the disease-free equilibrium is globally asymptotically stable; if R0>1, there exists at least one endemic equilibrium and the disease is uniformly persistent. Our findings suggest that spatial heterogeneity, increased pollutants emission, and limited movement of infected individuals will all contribute to the spread of the respiratory infectious diseases. Subsequently, the corresponding strategies are introduced into the model to control the prevalence of the diseases. Under the minimization of the objective function, the necessary condition for the optimal control is acquired with the help of Pontryagin’s maximum principle. Numerical simulations are applied to validate the theoretical results of threshold dynamics and to demonstrate the influences of inflow and clearance rates of pollutants on threshold dynamics and optimal control.

Analysis of SARS-CoV-2 transmission in a university classroom based on real human close contact behaviors

Due to high-population density, frequent close contact, possible poor ventilation, university classrooms are vulnerable for transmission of respiratory infectious diseases. Close contact and long-range airborne are possibly main routes for SARS-CoV-2 transmission. In this study, taking a university classroom in Beijing for example, close contact behaviors of students were collected through a depth-detection device, which could detect depth to each pixel of the image, based on semi-supervised learning. Finally, >23 h of video data were obtained. Using Computational Fluid Dynamics, the relationship between viral exposure and close contact behaviors (e.g. interpersonal distance, relative facial orientations, and relative positions) was established. A multi-route transmission model (short-range airborne, mucous deposition, and long-range airborne) of infectious diseases considering real close contact behaviors was developed. In the case of Omicron, the risk of infection in university classrooms and the efficacy of different interventions were assessed based on dose-response model. The average interpersonal distance in university classrooms is 0.9 m (95 % CI, 0.5 m–1.4 m), with the highest proportion of face-to-back contact at 87.0 %. The risk of infection of susceptible students per 45-min lesson was 1 %. The relative contributions of short-range airborne and long-range airborne transmission were 40.5 % and 59.5 %, respectively, and the mucous deposition was basically negligible. When all students are wearing N95 respirators, the infection risk could be reduced by 96 %, the relative contribution of long-range airborne transmission increases to 95.6 %. When the fresh air per capita in the classroom is 24 m3/h/person, the virus exposure could be decreased by 81.1 % compared to the real situation with 1.02 m3/h/person. In a classroom with an occupancy rate of 50 %, after optimized arrangement of student distribution, the infection risk could be decreased by 62 %.

Effects of public health interventions and zero COVID policy on paediatric diseases: A Southern China study.

With the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in schools and communities, clinical evidence is needed to determine the impact of the pandemic and public health interventions under the zero coronavirus disease policy on the occurrence of common infectious diseases and non-infectious diseases among children. The current study was designed to analyse the occurrence of common infectious diseases before and after the pandemic outbreak in southern China. Data was obtained for 1 801 728 patients admitted into children's hospitals in Guangzhou between January 2017 and July 2022. Regression analysis was performed for data analysis. The annual occurrence of common paediatric infectious diseases remarkably decreased after the pandemic compared to the baseline before the pandemic and the monthly occurrence. Cases per month of common paediatric infectious diseases were significantly lower in five periods during the local outbreak when enhanced public health measures were in place. Cases of acute non-infectious diseases such as bone fractures were not reduced. Non-pharmaceutical interventions decreased annual and monthly cases of paediatric respiratory and intestinal infections during the coronavirus disease 2019 (COVID-19) pandemic, especially when enhanced public health interventions were in place. Our findings provide clinical evidence that public health interventions under the dynamic zero COVID policy in the past three years had significant impacts on the occurrence of common respiratory and intestinal infectious diseases among children and adolescents but little impact on reducing non-infectious diseases such as leukaemia and bone fracture.

The relationship between use of SGLT2is and incidence of respiratory and infectious diseases and site-specific fractures: a meta-analysis based on 32 large RCTs.

We aimed to evaluate the relationship between use of sodium-glucose cotransporter-2 inhibitors (SGLT2is) and incidence of various respiratory and infectious diseases and site-specific fractures. Large randomized controlled trials (RCTs) of SGLT2is enrolling more than 400 subjects were included. Outcomes of interest were various serious adverse events regarding to respiratory and infectious disorders and site-specific fractures. Meta-analysis was done using risk ratio (RR) and 95% confidence interval (CI) as effect size. Thirty-two large RCTs were included in this meta-analysis. Use of SGLT2is was significantly associated with the lower incidences of 6 kinds of noninfectious respiratory diseases {e.g., Asthma (RR 0.64, 95% CI 0.43-0.96; P = 0.0299), Chronic obstructive pulmonary disease [COPD] (RR 0.75, 95% CI 0.62-0.91; P = 0.0027), and Respiratory failure (RR 0.78, 95% CI 0.61-0.99; P = 0.0447)} and 4 kinds of infectious respiratory diseases {e.g., Bronchitis (RR 0.61, 95% CI 0.46-0.81; P = 0.0007), and Pneumonia (RR 0.85, 95% CI 0.78-0.93; P = 0.0002)}. Use of SGLT2is was not significantly associated with the incidences of 31 kinds of site-specific fractures (e.g., Hip fracture, Femoral neck fracture, and Spinal fracture; P > 0.05). Our meta-analysis confirmed the benefits of SGLT2is against 6 kinds of noninfectious respiratory diseases (e.g., Asthma, COPD, and Respiratory failure) and 4 kinds of infectious respiratory diseases (e.g., Bronchitis, and Pneumonia). These findings suggest a likelihood that SGLT2is might be used to prevent or treat these respiratory diseases. Moreover, our meta-analysis for the first time revealed no association between use of SGLT2is and incidence of various site-specific fractures.

Social Awareness and Use of Face Masks among Medical Students in Association with the COVID-19 Pandemic

A cross-sectional, descriptive study was conducted to assess the level of social awareness and use of face mask in association with the COVID-19 pandemic among the medical students of Ad-din Sakina Women’s Medical College, Jashore, Bangladesh, between January and February of 2022. The study was carried out in the Department of Community Medicine. A total of 354 students of the same medical college participated in the survey. Data was collected by structured questionnaire and data processing and statistical analysis were done by using SPSS version 25.0. The age of the respondents was between 18 and 26 years. The mean age was 21.73 years. 82.8% of respondents were Muslims and 15.3% were Hindu. The average monthly family income of respondents was about 53,000 BDT. 83% of the respondents used face masks for the protection against COVID-19. 70.3% of the respondents relied more on the surgical type of mask. According to the survey the main mode of transmission of virus was found to be through respiratory droplets by 87.3% of the respondents. However, 13% failed to recognize droplet inhalation as a source of transmission. 92.1% of the respondents believed that the route of transmission includes eyes, nose, and mouth. Among the respondents 96% sanitize hand and face properly and 87.3% maintain social distance. It was found out that 7.1 percent of the respondents were affected by COVID-19 and 100% respondents were vaccinated against COVID-19. These findings clearly showed a satisfactory level of awareness and attitudes among the medical students towards COVID-19. Promoting the use of facemasks and educating the public about mask-wearing as an effective tool in disease prevention may also help to increase the public’s perceived benefits, which may then also contribute to increasing mask-wearing compliance. Facemasks play a pivotal role in the prevention and control of infectious respiratory disease transmission. CBMJ 2024 January: vol. 13 no. 01 P: 71-76

Therapeutic potential of Lonicerae japonicae flos against emerging respiratory viral infections

BackgroundRespiratory infections continue to rank among the leading global causes of death, and the emergence of new infectious respiratory diseases remains a persistent concern. Throughout Chinese history, particularly in the context of combating the plague, Lonicerae japonicae flos (LJF), a vital component of traditional Chinese herbal medicine, has been extensively utilized for its therapeutic potential due to its antioxidant, anti-inflammatory, and antimicrobial properties. This review concentrated on summarizing the roles and mechanism of LJF on the treatment of respiratory infections, and analyzing the potential therapeutic values of emerging respiratory infectious disease. MethodsThe literature with desired information about LJF was gained from electronic databases, including PubMed, Science Direct, Web of Science, Embase, and China National Knowledge Infrastructure. The literature search was conducted using the keywords “Lonicerae japonicae flos”, “Honeysuckle”, “Jin Yin Hua” and “LJF”, from 1985 to 2023. ResultsThrough summarizing and analyzing extensive fundamental and clinical studies on LJF, we have discovered that the bioactive molecules derived from LJF and prescriptions containing LJF could play a crucial role in combating viral infections. The antiviral mechanism involves interacting with viral genes and proteins, enhancing innate and acquired immune responses, influencing the processes of apoptosis, autophagy, pyroptosis, and etc. ConclusionIn light of preparing for future outbreaks of emerging respiratory infectious disease, pharmacological research and drug development based on LJF hold great significance and offer a promising trajectory.

Unveiling the silent threat of new onset atrial fibrillation in covid-19 hospitalized patients: A retrospective cohort study.

COVID-19, a highly infectious respiratory disease, has been associated with a range of cardiovascular complications. One of the most commonly reported cardiovascular issues in COVID-19 patients is the development of arrhythmias. Among all types of arrhythmias, atrial fibrillation is the most frequently observed. Atrial fibrillation is characterized by an irregular and often rapid heartbeat, and it can be a serious and potentially life-threatening condition. To investigate the incidence and association of new onset atrial fibrillation in COVID-19 hospitalized patients and its impact on survival. A retrospective cross-sectional study that encompassed all patients, both positive and negative for COVID-19, who were consecutively admitted to the Aga Khan University Hospital in Karachi, a tertiary care facility, from June 2021 to December 2021. A total of 1,313 patients who met the inclusion criteria of our study were enrolled as participants. These patients were then stratified into two groups based on COVID-19 status: the study group (COVID-19 positive) comprised 626 (47.7%) patients and the control group (COVID-19 negative) consisted of 687 (52.3%) patients. The incidence of new-onset atrial fibrillation was 85 (13.6%) in COVID-19 positive compared to 43 (5.2%) in COVID-19 negative group. The study found a strong association between COVID-19 and new-onset atrial fibrillation in both univariate (unadjusted odd ratio 2.35 [95% CI, 1.60-3.45], p-value < 0.01) and a multiple-adjusted regression analysis (adjusted odd ratio 3.86 [95% CI, 2.31-6.44], p-value < 0.01). These findings highlight the importance of vigilant monitoring of cardiovascular complications in COVID-19 patients, especially those with pre-existing conditions that predispose them to the development of atrial fibrillation. The study underscores the need for prompt recognition and management of new onset atrial fibrillation in COVID-19 patients, as this may mitigate the risk of adverse outcomes and improve overall prognosis.

Pathogenic Characteristics of an Infection with Canine Influenza Virus and Streptococcus equi subsp. zooepidemicus Alone or in Combination in Mice

Both Streptococcus equi subsp. zooepidemicus (SEZ) and canine influenza virus (CIV) are two important pathogens causing infectious respiratory disease in dogs and are frequently codetected in respiratory secretions. However, the clinical significance of viral/bacterial coinfection remains unknown. This study investigated the pathogenic characteristics of infection with CIV and SEZ alone or in combination in mice. Our data indicated that the severity of the disease is related to the challenge order of CIV and SEZ. Coinfection of CIV and SEZ induced higher weight loss in mice than single infection, except for the VB group (viral followed by secondary bacterial infection). Compared with the concurrent or sequential infection groups of CIV and SEZ, mice in the CIV–SEZ preincubation group exhibited more obvious weight loss, higher mortality, and significantly enhanced burden of SEZ and CIV in tissues. Interestingly, viral and bacterial preincubation before coinfection caused typical pulmonary fibrosis in mice. Correspondingly, transforming growth factor (TGF)-β was upregulated, and its canonical small mother against decapentaplegic (Smad) 2/3 signaling was noticeably induced. Further investigation indicated that the activity of the viral neuraminidase (NA) enzyme upon sialic acid was considerably increased due to the direct interaction of CIV with SEZ, which may be related to the activation of the TGF-β signaling pathway. These findings implicate an unexpected contribution of the direct interaction between CIV and SEZ to synergistic pathogenicity.

Earthquake-Related Lung Diseases; A Bibliometric Analysis of Publications

Aim: Earthquake-related lung diseases (ERLD) can be seen as direct and indirect disaster results. ERLD such as inhalation of dust and particulates from collapsed buildings in earthquakes, aspiration of water and pathogens due to tsunami after earthquakes, pulmonary thromboembolism, infectious respiratory diseases, and chest traumas can develop after earthquakes. The aim of this bibliometric review is to explore the intellectual structure of ERLD publications.&#x0D; Material and Methods: A search strategy for databases related to the ERDL area was developed. 334 articles were accessed in the Web of Science database. As a result of the full-text readings, 152 articles remained, and 152 articles were subjected to citation and co-citation analysis with bibliometric software. In addition to this research, methodologies based on cluster analysis were used to examine the intellectual structure of the field.&#x0D; Results: When the time period of the publications is examined, it is seen that the first publication was published in 1996. When the top three authors are examined, Yanai shares the ranking with 6 publications, Ueda 6 publications, and Kobayashi 5 publications. Japan, also an earthquake country, is in first place with 50 publications. Three main clusters were identified. These clusters are “chest traumas: types, frequency, and medical intervention strategies," “earthquake preparedness and earthquake response capacity," and "respiratory tract infections and an earthquake."&#x0D; Conclusion: In addition to identifying the most influential journals, authors, and countries on earthquakes in the area of ERLD, this research identified the dominant research themes in this field. Our research outlines the area of ERLD, provides an agenda for future research, and contributes to the fact that the relationship between earthquakes and pulmonary diseases is studied more deeply.

Challenges and opportunities for online education of veterinary sciences in Kazakhstan

The Severe Acute Respiratory Syndrome Coronavirus Infectious Disease 2019 (SARS-COVID-19) pandemic has dramatically improved the attitude that society has toward educational opportunities that are administered online. In many cases, digital platforms were adapted and utilized without formal evaluation of the needs, constraints, and opportunities associated with their use. Here, the eight historical faculties of veterinary sciences of Kazakhstan were surveyed to gather data on the use of online technology for the discipline in the country and the limitations, opportunities, and challenges associated with its use. Results show that technological resources, institutional support, and faculty and instructors' attitudes are highly favorable for the implementation of online education programs consistently throughout the country. In contrast, students' motivations and skills are perceived as variable, although generally favorable, at different locations. The results here provide insights into the challenges and opportunities associated with using online technology for instruction in veterinary sciences in Kazakhstan, which will help create the foundations for implementing this type of program in the country and region.