Tuberculosis (TB) is a re-emerging disease occurring worldwide and causing multi-billion-dollar loss and human death annually. The situation is worse in developing countries like Ethiopia, where lower knowledge, attitude, and practice (KAP) of the people is imminent. A questionnaire-based cross-sectional study was conducted to assess KAP of livestock ouners towards human and bovine Tuberculosis. A total of 349 study participants were addressed through face to face interview. Descriptive statistics and Pearson’s chi-squares analysis were used to observe the data and the association between outcome (KAP) and predictor variables. Out of the 349 respondents interviewed, 223 (63.9%) of them were males, while 126 (36.1%) were females. The KAP measuring interview indicated that almost all (97.4%) of the participants know human tuberculosis, while 84(24.1%) are aware of bovine tuberculosis cause and mode of transmission. Inhalation was reported as a common route of transmission for human TB (41.1%). In contrast, 50% of the respondent mentioned inhalation, contact, and ingestion of raw animal products as the main route of TB transmission from animal to human. Among those who have heard of bTB, only 56 (66.7%) of respondents consider bovine tuberculosis as a significant threat to public health. The study showed that there is a lower KAP on bovine TB among cattle owners. Therefore, community awareness promotion and health education on human and bovine TB should be operated under a “One Health” umbrella

In last decades, many alleviation measures were proposed in order to improve the life of fretting fatigue affected components. The aim of such palliatives is that to counteract the high stress gradients that arise near the contact surface. In such a context, the shot peening treatment is worth noting. Therefore, in the present paper, the fatigue life of shot-peened aluminium and titanium alloy specimens, subject to fretting fatigue under partial slip regime, is assessed by means of the Carpinteri et al. criterion for fretting fatigue. Firstly, according to the superposition principle, the relaxed residual stresses (due to the shot peening treatment) are combined with the stress components due to fretting fatigue loading. Then fretting fatigue assessment is performed. In such a context, a novel theoretical law for the relaxed residual stress field is here proposed, the implementation of which shows very promising results in terms of fatigue life estimation of the shot-peened specimens examined.

A Time-Reversal ( TR) imaging method for multiple targets that incorporates fewer transmitters is suggested using temporal filtering and Frequency Focusing (FF) matrices. This study is intended for the detection of malignant breast tumors with minimal microwave radiation. A couple of scenarios with two and four tumors are considered here. Using only two transmitters and twelve receivers, we show that two tumors could be detected in an inhomogeneous tissue breast. The results are compared with conventional TR Multiple Signal Classification method (MUSIC), which requires more transmitters. It is shown that several well-resolved tumors that exceed transmitters could be detected by subregion Spatio-Temporal Filtering (SSTF). In our proposed method, we used the orthogonal subspace instead of the signal subspace to have a higher Signal to Clutter Ratios (SCR). Since the Born approximation is not used, multiple scattering is considered. In addition, white Gaussian noise is added to measurement simulations. A 3-GHz modulated Gaussian pulse with a 1-GHz bandwidth is employed for illuminating the medium. Finite-Element Time-Domain method (FETD) is used in the measurement simulations, and the analytic Green’s function of the background is utilized for backpropagation. Several simulations are provided that show the effectiveness of this approach.

Coronavirus disease 2019 (COVID-19) is a global health problem which is challenging healthcare worldwide. In this critical review, we discussed the advantages and limitations of the rapid implementation of salivary diagnostic platforms to COVID-19. The diagnostic test of COVID-19 by invasive nasopharyngeal collection is uncomfortable to the patients and requires specialized training to healthcare professionals in order to perform an appropriate collection of samples. Additionally, these professionals are in close contact with infected patients or suspected cases of COVID-19, leading to increased contamination risk for frontline healthcare workers (Scylla). Although there is a colossal demand for novel diagnostic platforms with non-invasive and self-collection samples to COVID-19, the implementation of the salivary platforms remains in debate due to its accuracy (Charybdis). Up to date, clinical trials supports the potential of detecting SARS-CoV-2 RNA in saliva as a biomarker for COVID-19, providing a self-collection, non-invasive, safety, and comfortable procedure. Therefore, the salivary diagnosis is suitable to protect healthcare professionals and others frontline workers, and may encourage patients to be tested due to its advantages over the current invasive methods. Furthermore, we expected that salivary diagnostic devices to COVID-19 continue to be used with austerity without excluding traditional gold standard specimens to detect SARS-CoV-2.

This study is a global meta-analysis of the effects of grassland plant species richness on aboveground and belowground carbon and nitrogen dynamics. Observations from 73 studies in grasslands totaling 1385 paired observations of plant mixtures and monocultures were compiled. Response variables included nine carbon and six nitrogen processes to plant diversity, examined the effects of experimental types and age on the responses, and predicted the carbon and nitrogen balance following different biodiversity loss scenario in grasslands. We found that carbon and nitrogen functions significantly enhanced in plant mixtures, but varied with experimental types. Most of the attributes was significantly correlated with species richness and experimental age, the relationship between species richness and carbon and nitrogen processes was interacted with experimental duration in the field experiments, except for soil respiration, fungal biomass, and soil nitrate nitrogen. Importantly, our results showed that the declines in soil carbon and nitrogen pool accelerated following plant diversity loss. Our meta-analysis revealed that the plant diversity has ubiquitous impacts on carbon and nitrogen cycles in grasslands, likely driven by complementarity effects of plant diversity on plant productivity and biomass, underlined interactive effects of plant diversity, experimental types and age, and climate on carbon and nitrogen processes, and suggested that the reduction in carbon and nitrogen stocks in grasslands will be larger following biodiversity loss in the future.

The ability for marine ecosystems to maintain productivity and functionality under long term changes in resource availability relies on the diversity of functional groups. Nevertheless, the complexity of zooplankton interactions is rarely considered in trophic studies because of the lack of detailed information about feeding interactions in nature. In this study, we used DNA metabarcoding to detect trophic interactions of a wide range of micro- and mesozooplankton including ciliates, rotifers, cladocerans, copepods and their prey, by sequencing 16- and 18S rRNA genes. Our study demonstrates that functional group diversity goes beyond both phylogeny and size and reinforces the importance of diversity in resource use for stabilizing food web efficiency by allowing for alternative pathways of energy transfer. We further demonstrate the importance of ciliates and rotifers in recycling organic matter from degraded filamentous cyanobacteria within the pelagic zone, contributing to ecosystem production. The approach used in this study is a suitable entry point to ecosystem-wide food web modeling considering species-specific resource use of key consumers.

Ethiopia is one of the well-endowed countries in Sub-Saharan Africa in terms of natural resources. However, land degradation is a major problem in the country. The objective of this study was to assess farmers’ perception on soil and water conservation (SWC) practices and its implication on land degradation. Data were collected using questionnaires, interviews, and focus group discussions from 117 randomly selected households. The result indicated that the perception of farmers on SWC practices was significantly influenced by age, sex, marital status, household size, educational qualification, farm-size (ha), farmers’ experience, distance from the homestead, and household income. Besides, greater than 50% of the respondents were aware of the causes of land degradation by indicating population growth, over-cultivation, overgrazing; soil erosion, poor farming practices, and poverty as the major causes. Furthermore, most of the respondents (>75%) were aware of the consequences of land degradation by pointing out the loss of agricultural productivity, the difficulty of farming, and loss in livestock productivity as the major ones. Moreover, about 72.5% of the respondents indicated that land degradation on their farm-field was severe. The SWC measures practiced in the study area include cutoff drains, contour farming, waterways, check dams, fallowing, application of manures, and soil bunds. Thus, it can be concluded that the perception of SWC practices is affected by many factors. Besides, land degradation in the study area can be deceased first by creating awareness in the society on the consequences of land degradation and then implementing SWC measures.

A study of cannabinoid content in commercially available cold-pressed hemp seed oil (CPHSO) manufactured in North America and assayed using a validated low-LOQ analytical method with UHPLC-MS/MS quantitation was conducted. Thirty CPHSO samples from small, medium, and large-scale manufacturers were voluntarily submitted. Samples were produced from eleven known cultivars grown in three Canadian provinces and six US States, plus one sample from seeds imported from Poland and pressed in the USA. Oil density was measured for each sample, as were the content of sixteen cannabinoids with validated commercial reference standards, and reported in parts-per-million (ppm). Observational and statistical methods were used to examine variances in analyte concentrations, demonstrating significant differences in cannabinoid concentrations between samples. Several per-sample and per-analyte heatmaps aided in the visual examination of variances. A two-phase series of linear regressions were performed on normally distributed cannabinoids with raw and trimmed data sets to determine if content variations correlated to manufacturer cleaning, handling, and storage procedures, or if the variation was influenced more by cultivar. The research findings suggest that variance in cannabinoid content is likely most influenced by cultivar, but do not rule out contributions by supplier handling and processing techniques.

Litters carry out the cycling and storage of multiple nutrients and heavy metals, and thus litter mineral elements sharp many key ecosystem processes. Understanding the global geographic patterns of litter elements is needed for plant nutrition and biogeochemical models, but such knowledge is largely limited to N and P. By compiling data on 12 mineral elements in leaf litter from 1, 666 species, we show that elements differed largely in their retranslocation efficiencies and among plant functional types. Elements in leaf litter responded to latitude in a similar manor as those in green leaves, except for N. Disproportionate resorption acted as a negative feedback and caused leaf litter N to decline with latitude, a trend contrary to green leaf N; litter P increased with latitude as predicted by the Plant Physiological Hypotheses. The rest elements generally declined with latitude, supporting the Temperature-Biogeochemistry Hypotheses. Soil nutrients likely had indirect effects on these latitudinal patterns via controls on green leaves, while woody plant distribution per se had modest effects. Overall, we suggest that fundamental constraints on plant nutrient conservation and usage strategies lead to predictable global-scale patterns in multiple litter elements.

Abstract. Pseudomonas aeruginosa and Staphylococcus aureus are bacterial pathogens frequently associated with pulmonary complications and disease progression in cystic fibrosis (CF) patients. However, these bacteria increasingly show multiple resistance to antibiotics, necessitating novel management strategies. One possibility is phage therapy, where lytic bacteriophages (phages; bacteria-specific viruses) are administered to kill target bacterial pathogens. Recent publication of case reports of phage-therapy treatment of antibiotic-resistant lung infections in CF has garnered significant attention. These cases exemplify the renewed interest in phage therapy, as an older concept that is newly updated to include rigorous collection and analysis of patient data to assess clinical benefit, while informing the development of clinical trials. As outcomes of these trials become public, the results will valuably gauge the potential usefulness of phage therapy to address the rise in antibiotic-resistant bacterial infections. In addition, we highlight the further need for basic research on accurately predicting the different responses of target bacterial pathogens when phages are administered alone, sequentially or as mixtures (cocktails), and whether within-cocktail interactions among phages hold consequences for the efficacy of phage therapy in patient treatment.

Abstract INTRODUCTION: Effective Airway Clearance Techniques (ACT) is the key step in the management of Bronchiectasis. The aim of this study was to evaluate the efficacy of 3% Hypertonic Saline (HS) pre-medication in ACT in children with non Cystic Fibrosis (non-CF) bronchiectasis. METHODS: Five to 15 year old children with non-CF bronchiectasis were randomized either to receive 200µg of inhaled salbutamol followed by hypertonic saline nebulization (test) or only 200µg of inhaled salbutamol, prior to chest physiotherapy which is the conventional ACT (controls) for 8 weeks. After completion of first phase both groups went through one month washout period, before being crossed over to the opposite arms in the second phase. Spirometric parameters were recorded at the end of each phase. RESULTS: Fifty two children completed the study. Baseline characteristics of the two groups were similar. A significantly higher mean improvement was seen in predicted Forced Expiratory Volume in one second(FEV1) in the HS arm during phase 1 [HS=14.15±5.50 vs. conventional =5.04±5.55, p=0.001] and phase II [HS =10.81±5.51 vs. conventional =3.54 ±5.13, p=0.001]. HS arm showed a significantly higher mean improvement in predicted Forced Vital Capacity(FVC) in phase I[HS=13.77±5.73 vs. conventional= 7.54±4.90, p=0.001] and phase II, [HS=9.42±7.00 vs. conventional =4.42±4.00, p=0.003). Mean number of exacerbations experienced by a single child during phase I (2 months) were significantly less (p=0,001) in HS group compared to that of conventional group. CONCLUSIONS: Incorporating HS nebulization into ACT is an effective strategy to improve dynamic lung volumes and morbidity in children with non-CF bronchiectasis.

Mesonephric adenocarcinoma (MA) is a rare tumor entity develops from mesonephric remnants.we demonstrate a well-differentiated case underdiagnosed as endometrial hyperplasia on a ThinPrep cytology test.

Objective: To examine the effect of prenatal maternal anxiety on birthweight and preterm birth, controlling for genetic confounding using a sibling comparison design. Design: This is a population-based prospective cohort study with a comparison of a population level analysis and a sibling analysis. Setting: This study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health (https://www.fhi.no/en/studies/moba/ ). Sample: Women and their chiold participating in the MoBa (n= 78,117) and women participating with more than one pregnancy (n=12,480). Methods: Associations between prenatal maternal anxiety (measured across the 17th and 30th weeks) and birth outcomes (birthweight and gestational age) were examined using linear regression with adjustment for family-shared confounding in a sibling comparison design. Main outcomes: Birthweight (in grams) and gestational age (ultrasound measure in days) were obtained from the Medical Birth Registry of Norway. Results: The maternal anxiety score during pregnancy was inversely associated with newborn’s birthweight (Beta = -112,8 95% CI: –142.7, -83.0) and gestational age (Beta=-1.77, 95% CI: -2.42, -1.13) after adjustment for several covariates. The association of the maternal anxiety score with both newborn’s birthweight (Beta=-173.9, 95% CI: -252.3, -95.4) and gestational age (Beta=-1.08, 95% CI: -2.91, -0.75) remained but was largely weakened after further adjusting for the shared-family confounding in the sibling comparison design. Conclusion: The link between maternal prenatal anxiety and birthweight and gestational age remained after adjusting for shared family confounding, yet estimates were weakened after adjusting for environmental covariates.

Fever clinics are designed to provide prompt assessment, management, laboratory examination and decision-making for the potential infected cases, which serves as the crucial first-line of defense to control nosocomial infection. Guided by the primary principle of ‘early assessment, early detection, and early isolation’, fever clinics played a significant role in triaging suspected cases and minimize the risk of nosocomial infection during the Coronavirus Disease 2019 (COVID-19) combat in China. However, fever clinics failed to function normally as expected, with an astonishing number of healthcare workers infected. In this comment, we systematically evaluated the current limitations of fever clinics and recommended several countermeasures, aiming to enhance and maximize the capability and capacity of fever clinics for acute infectious diseases.

Cardiac intimal sarcoma are extremely rare and aggressive primary malignant cardiac tumors. Here, we reported the case of a young man initially operated for a tumor of the left atrium, causing a dynamic obstruction of the mitral valve and (mis-)diagnosed as a myxoma at the histopathological analysis. Patient presented a local recurrence at 3 months and was reoperated. Pathology revealed this time the presence of an intimal sarcoma. Patient received adjuvant chemotherapy. Despite a good local control, the one-year follow-up PET scan revealed the presence of a metastasis in the left adrenal gland that was surgically resected. This paper aims to highlight the risk of misdiagnosis in case of cardiac tumors, the hypothetical concept of malignant transformation of a cardiac myxoma, the aggressive course of the extremely rare cardiac intimal sarcoma and the therapeutic modalities available to treat this pathology.

We reported a 34-year-old man who was diagnosed as primary cardiac angiosarcoma. The diagnosis was delayed until one month after he first entered the hospital. Because cardiac angiosarcoma is easy to be misdiagnosed as pneumonia or other diseases due to its rarity. Although surgical therapy is always considered as a method that can prolong survival time, highly malignant tumors with local infiltration and systemic metastasis lead to poor prognosis. We stressed that primary cardiac malignancy should be noticed when a young patient presented as unexplained pericardial effusion or refractory pneumonia. Early diagnosis can provide more possibilities for treatments.

This paper is concerned with a predator-prey model with prey-taxis and linear prey harvesting under the homogeneous Neumann boundary condition. The stability of the unique positive constant solution of the predator-prey model without prey-taxis is derived. Also, the emergence of Hopf bifurcation is concluded by choosing the proper Hopf bifurcation parameters. Moreover, the existence of non-constant positive steady states is investigated by the introduce of prey-taxis. The conclusions show that prey harvesting and prey-taxis can enrich the dynamics.

Epidemiologic studies performed in the Melbourne Sexual Health Center over several years have explored and emphasized the role of sexual transmission in the pathogenesis of sporadic bacterial vaginosis (BV) as well as recurrent BV (Fethers KA., et al. Infect. Dis. 2008; 47: 1426-1435). Some of the most definitive studies documenting details of heterosexual sexual transmission followed. There can be little doubt as to the causal role of sexual transmission in BV particularly with regard to the initial episode (Cherpes, TL., et al. Sex. Transm. Dis 2008; 35: 78-83). The present study adds solid molecular data to their previous epidemiologic data that recurrent BV is more likely to occur in a heterosexual woman with a single regular male partner (Ratten L., et al BJOG 2020 xxxx): Moreover, the risk is mitigated by use of an oral contraceptive and barrier contraceptives. Specifically, Ratten et al conclude that sex is associated with persistence of non-optimal, BV-associated vaginal dysbiosis following appropriate antimicrobial treatment for BV in a cohort followed prospectively, likely the result of sexual transmission from a regular partner. The key term used in the title of the study is persistence, which implies that the non-optimal vaginal microbiota fails to resolve, as opposed to future reintroduction from the same guilty partner. Persistence in this context, unfortunately, also indirectly suggests that inadequate antimicrobial treatment is currently prescribed to women, perhaps sufficient to relieve symptoms and meet diagnostic criteria of satisfactory response, but insufficient to eradicate BV pathogens. The author emphasizes needed improvement in the, so far, futile male partner therapy to prevent female reinfection, a goal that has repeatedly eluded experts to date.The unanswered question facing patients and clinicians alike is the role of sexual reinfection as opposed to vaginal relapse in the causation and likelihood of BV recurrence. The tone of the article would indicate that reinfection is the more likely causal mechanism of BV recurrence, by emphasizing “persistence” and outweighing the role of unexplained relapse. In dealing with a symptomatic patient suffering from an episode of recurrent BV, it is currently not possible to differentiate relapse from reinfection unless the patient declares herself to be celibate, ergo relapse is the cause of recurrence. The clinical picture is identical as are Amsel or Nugent criteria. Unfortunately, molecular microbiome studies have not revealed significant differences between sequential episodes regardless of causation. We lack a “unique fingerprint” to differentiate cause or nature of the recurrent episode. Even with reinfection, sexual or otherwise, details of pathogenesis are still lacking. We know too that coitus can elicit symptoms of BV (post coital malodor) even with use of a condom. The role of receptive oral-vulvovaginal sex is also undetermined, as is the role of penile – anorectal penetration although the latter was found to be minimal in the latest study by Ratten L., et al. (BJOG 2020 xxxx): Moreover, not all longitudinal studies have revealed that heterosexual sex is a major factor in recurrence (Sobel J.D., et al. Infect. Drug Resist. 2019: 12; 2297-2307).The role of sex and reinfection in causation of RBV will depend significantly upon the population studied, including biologic and behavioral differences. Determination of causation of BV recurrence in different patient populations should be personalized and acknowledged as we admit our current limitations. Will more effective male treatment help reduce BV recurrence? Hopefully but still unknown. Determining all the causes of vaginal microbiota persistence, including the role of biofilm, remains a challenge.No disclosures: A completed disclosure of interest form is available to view online as supporting information.

In this paper, we consider a class of non-cooperative critical nonlocal equation system with variable exponents of the form: $$ \left\{ \begin{array}{lll} -(-\Delta)_{p(\cdot,\cdot)}^su - |u|^{p(x)-2}u = F_u(x,u,v) + |u|^{q(x)-2}u, \quad &\mbox{in}\,\,\mathbb{R}^N,\\ (-\Delta)_{p(\cdot,\cdot)}^sv + |v|^{p(x)-2}v = F_v(x,u,v) + |v|^{q(x)-2}u, \quad &\mbox{in}\,\,\mathbb{R}^N,\\ u, v \in W^{s,p(\cdot,\cdot)}(\mathbb{R}^N), \end{array}\right. $$ where $\nabla F = (F_u, F_v)$ is the gradient of a $C^1$-function $F: \mathbb{R}^N\times \mathbb{R}^2 \rightarrow \mathbb{R}^+$ with respect to the variable $(u, v) \in \mathbb{R}^2$. We also assume that$\{x \in \mathbb{R}^N: q(x) = p_s^\ast(x)\} \neq \emptyset$, here $p_s^\ast(x)=Np(x,x)/(N-sp(x,x))$ is the critical Sobolev exponent for variable exponents. With the help of the Limit index theory and the concentration-compactness principles for fractional Sobolev spaces with variable exponents, we establish the existence of infinitely many solutions for the problem under the suitable conditions on the nonlinearity.

This work presents analytical and numerical results for the position- and momentum-space information entropies, of the 1s2-state of helium-like ions, using different interaction potentials. The potentials that we used are the Yukawa potential (YP), and the exponential-cosine-screened Coulomb potential (ECSCP). The investigated studies allow us to relate the position-space information with the momentum-space information of Shannon and Fisher, as well as Shannon entropy power, and the Fisher-Shannon information product, through different famous relations. The calculation is done using the one-electron charge density of entangled two-parameter wave function. On one hand, the results that are presented for ten members in the helium isoelectronic sequence demonstrate with precision the effect of correlation on bare charge distributions. On the other hand, it leads to some very important results for both the correlated and uncorrelated values of the informatic entropies. Analytical formula for the momentum-space information entropies are given. The effect of the nuclear charge and the screening parameter on the information expressions has been studied for both potentials. Detailed computational and numerical values and characteristics of these information quantities, as a function of the screening parameter, are reported here for the first time. New inequality has been proposed with Fisher’s total value to measure the correlation of two electrons.

Objective: The purpose of this study was to develop a dynamic nomogram model to predict the risk of spontaneous preterm birth at <32 weeks in twin pregnancy. Design: A retrospective analysis and multicentre validation study Setting and Population: Women with twin pregnancies followed up in two tertiary medical centres from January 2017 to March 2019. Methods: Data on maternal demographic characteristics, transvaginal cervical length and funneling were extracted. The prediction model was constructed with independent variables determined by logistic regression analyses. The risk score was calculated according to the dynamic nomogram model. Main outcome measures: The risk of spontaneous preterm birth at <32 weeks in twin pregnancy. Results: In total, 1065 twin pregnancies were eligible for the study, of which the data of 764 cases (92 twin preterm cases (<32 weeks) and 672 control cases) were obtained from a tertiary medical centre as the training group and those of 301 cases (36 twin preterm cases (<32 weeks) and 265 control cases) from the other tertiary medical centre as the external validation group. Based on logistic regression analyses, we built a dynamic nomogram model with satisfactory discrimination in both the training group(C-index: 0.856, 95% CI: 0.813-0.899) and external validation group(C-index: 0.808, 95% CI: 0.751-0.865). The restricted cubic splines and ROC curve supported the performance of the prediction model. Conclusions: We developed and validated a dynamic nomogram model to predict the individual probability of preterm birth in twin pregnancy at <32 weeks.

Objective To investigate the fertility status and pregnancy outcome in women with hemoglobin H disease in southern China. Design Retrospective analysis. Setting The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Population 28 young women with Hb H disease. Methods Clinic characteristics were included during their pregnancies over a 12-year period and their babies’ outcomes were assessed.. Main outcome measures Genotype, methods of conception and delivery, complications during pregnancies, and frequency of transfusion. Hb and serum ferritin levels. Babies’ birth weight, Apgar scores at 1 minute. Results Four genotypes, namely, - -/-α3.7, - -/-α4.2, - -/αWSα, - -/αQSα, and - -/αCSα, were found among these women. The most frequent ethnic background was Zhuang (57.14%). 59 pregnancies occurred. 56 conceptions were spontaneous. Six pregnancies were terminated because of Hb Bart’s hydrops fetalis. 44 resulted in successful deliveries of 46 neonates, and 17 were via cesarean section. The mean gestational period of delivery was 38 weeks, the rate of pregnancy complications was 50%. The majority of these women were never transfused before or during their pregnancy, except those with genotype –/αCSα. and the mean birth weight of the 46 neonates was 2815.00±503.26g. The mean hemoglobin concentration and median serum ferritin level were significantly decreased during the pregnancy. Conclusions Despite the good pregnancy outcome for women with Hb H disease, the pregnancy course is still considered high risk. Close monitoring of maternal and fetal conditions should be performed by multidisciplinary team to ensure the best outcome.

Background Respiratory viral infections are an important cause of acute respiratory tract infections. They are caused by both Influenza and non influenza viruses. Respiratory viral infections are known to be associated with severe clinical outcome especially in the critically ill. A constant surveillance is needed for early etiological identification which can help in timely and appropriate management. Methods In this retrospective study, clinical records of all adult liver disease patients with clinically confirmed ARI, whose request for respiratory viral testing were received in the virology laboratory during September 2016 - March 2019 were reviewed. Respiratory viruses were identified by real time PCR on FilmArray 2.0 instrument (BioFire Diagnostics, Utah, USA) using Respiratory panel as per the manufacturer’s instructions. Results Of the 603 patients of liver disease with clinically confirmed influenza like illness, over all incidence of respiratory viral infection was 24.3% (n= 147). Infections by non-influenza viruses (87, 59.1%) were more than influenza group of viruses. Mortality was higher in non influenza group (43, 49.4%) as compared to influenza (24, 40%) [p=0.015] being maximum in Rhinovirus, 22 (32.8%). Two peaks were observed in both influenza and non influenza groups, first in the months of January and February and the other one in August and October. Conclusion With the emergence of SARS- CoV-2 it has now become imperative for a constant surveillance of the non influenza viruses for early etiological identification of the respiratory viral infection for proper and timely management in the critically ill.

Background: The modulations of subcutaneous allergen immunotherapy (SCIT) on lymphocyte subsets and cytokine productions are not fully clarified. Objective: We investigated the changes of T-lymphocyte subsets and serum Dermatophagoides pteronyssinus specific immunoglobulin G4 (Der-p-sIgG4), and cytokine productions in allergic asthmatics during Der-p SCIT. Methods: This study involved 20 allergic asthmatics receiving 156-week Der-p SCIT, 20 patients without SCIT (non-SCIT). Symptom and medication scores (SMS), serum Der-p-sIgG4 levels, CD4+CD25+Foxp3+ T regulatory (Treg), CD4+IL-4-IFN-γ+ T-helper (Th) 1, CD4+IL-4+IFN-γ- Th2 lymphocyte percentage in peripheral blood mononuclear cells (PBMCs) with/without Der-p extract stimulation at weeks 0, 4, 12, 16, 52, 104, and 156 were measured. Serum from SCIT and non-SCIT patients were incubated with Der-p allergen and Der-p sensitized PBMCs. Levels of interleukin (IL) -4, IL-5, IL-10, IL-13, IL-17, interferon (IFN) -γ, tumor necrosis factor (TNF) -α and transfer growth factor (TGF) -β1 in supernatant were detected. Results: SCIT patients had significantly lower SMS after week 52. Der-p-sIgG4 levels in SCIT patients significantly increased at week 16 compared to non-SCIT subjects. CD4+IL-4+IFN-γ- Th2 percentage in SCIT patients showed a significant decrease from week 104 to 156 comparing to week 0, while no change was observed in CD4+CD25+Foxp3+ Treg and CD4+IL-4-IFN-γ+ Th1 percentage. IL-5, IL-13, IL-4, IL-17, and TNF-α levels in supernatant of Der-p-sensitized PBMCs, cultured with serum of SCIT patients after 16 weeks decreased significantly compared with non-SCIT patients, and showed significant reverse associations with Der-p-sIgG4 levels. Conclusion: SCIT down-regulated Th2 cytokine productions associated reversely with Dep-p-sIgG4 levels in Der-p allergic asthma patients.