Search Results (236)

Aim of the study: To investigate the detection rate of respiratory viruses identified by multiplex real-time PCR (MPL real-time PCR) in respiratory specimens collected from hospitalized patients with acute lower respiratory tract infections (LRTI) over a five-year period (2020–2024), and to emphasize the importance of MPL real-time PCR testing in identifying respiratory viruses responsible for severe lower respiratory tract infections requiring hospitalization. Subjects and Methods: This cross-sectional retrospective study analyzed 15,936 respiratory specimens collected from hospitalized patients between 2020 and 2024. Seventeen respiratory viruses were detected using MPL real-time PCR. Statistical comparisons were performed using the chi-square test. Results and Discussion: The overall respiratory virus detection rate was 31.88% and was significantly higher in children than in adults (52.98% vs. 18.10%). The most frequently detected viruses were rhinovirus, influenza A, respiratory syncytial virus, and parainfluenza virus type 3, while influenza A and SARS-CoV-2 predominated in adults. During the peak of the COVID-19 pandemic in 2021, SARS-CoV-2 accounted for 78.92% of detected viruses, accompanied by marked suppression of other respiratory pathogens. Measles virus re-emerged in 2024, predominantly affecting children (17.65%). Most Respiratory virus-positive cases (82.8%) involved single-agent infections. Conclusions: Hospitalized acute LRTI cases often lack distinctive clinical signs to identify viral pathogens. MPL real-time PCR provides simultaneous multi-virus detection, enabling accurate etiological diagnosis and strengthening hospital-based viral surveillance, particularly in resource-limited settings. Full article

Background: Viral respiratory tract infections (RTIs) frequently lead to emergency department (ED) presentations and hospital admissions, particularly among older adults and individuals with underlying health conditions. Identifying patients at increased risk for hospitalization is essential for optimizing triage and resource allocation. This study aimed to determine independent demographic, clinical, and virological predictors of hospital admission among adults presenting with confirmed viral RTIs. Methods: A retrospective cohort study was conducted at a tertiary hospital between September 2022 and May 2024. Adult patients with molecularly confirmed viral RTIs were included. Demographic, clinical, and microbiological data were extracted from electronic medical records. Predictors of admission were assessed using univariate and multivariate logistic regression. Results: Among 311 patients, 147 (47.3%) required hospitalization. Hospitalized patients were significantly older and more likely to present with fever, cough, tachypnea, dyspnea, chest pain, comorbidities, and lower or mixed respiratory tract infections (all p < 0.001). In multivariate analysis, older age, fever, cough, and lower or mixed RTIs were strong independent predictors of admission. Several viral pathogens, including human rhinovirus, non–SARS-CoV-2 coronaviruses, influenza A, and parainfluenza virus, were associated with reduced odds of hospitalization. Conclusions: Age, comorbidity burden, and lower respiratory tract involvement are key determinants of hospitalization in viral RTIs. Integrating clinical and virological data may improve risk stratification and guide ED triage during seasonal and emerging respiratory virus activity. Full article

Background: Respiratory tract infections (RTIs) represent one of the most prevalent reasons for visits to Pediatric Emergency Departments (PEDs). Because viral and bacterial presentations frequently overlap, a substantial proportion of antibiotic prescriptions in pediatric acute care are potentially unnecessary, contributing to antimicrobial resistance. Rapid Diagnostic Tests (RDTs) for respiratory viruses have been suggested as tools to enhance diagnostic precision and support antimicrobial stewardship. However, evidence regarding their real-world impact in pediatric emergency settings is limited. Objectives: This study aimed to assess the association between point-of-care RDT results and antibiotic management in a tertiary PED, focusing on both the discontinuation of antibiotics in children already receiving treatment and the avoidance of new antibiotic prescriptions in untreated children. The secondary objective was to evaluate the short-term safety through 72-h return visits. Methods: A retrospective cohort study was conducted at a tertiary PED during two epidemic seasons (December–February 2023–2024 and 2024–2025). Children aged <18 years who underwent RDTs for febrile respiratory illnesses were included. Patients were stratified based on whether they were already receiving antibiotic therapy at presentation. The primary outcomes were antibiotic discontinuation among treated patients and initiation among untreated patients. Unplanned return visits to the PED within 72-h post-discharge were used as a pragmatic short-term safety outcome to capture early clinical deterioration. RDTs (SD Biosensor Standard F Antigen) were performed at the bedside with a turnaround time of 10–15 min. Results: A total of 1238 children were included, of whom 330 (26.6%) tested positive for influenza and/or adenovirus. Among the 234 children already receiving antibiotics, discontinuation was significantly more frequent in the RDT-positive group (p < 0.001; OR 0.044). Among the 1004 untreated children, antibiotic prescription was significantly lower in the positive group than in the negative group (p < 0.001; OR 0.097). Return visits within 72-h did not differ between the groups in either cohort. No invalid tests occurred. Conclusions: Influenza/adenovirus RDT positivity was associated with lower antibiotic initiation among untreated children and higher discontinuation among those already receiving antibiotics, with no differences in 72-h return visits. These findings suggest a potential role for bedside viral testing as a decision-support tool for antibiotic management in the PED. Full article

Background/Objectives: Respiratory tract infections (RTIs) remain a leading cause of morbidity worldwide and are frequently associated with the emergence of multidrug-resistant pathogens. In this context, natural compounds represent a valuable source of novel antimicrobial and immunomodulatory agents. The present study aimed to evaluate the antibacterial, anti-inflammatory, and antioxidant activities of Protegol, a natural food supplement enriched in bioactive phytochemicals including hydroalcoholic extracts of propolis and hedge mustard (Sisymbrium officinale (L.) Scop.) aerial parts, together with honey, against clinically relevant bacterial strains and in cellular models of inflammation and oxidative stress. Furthermore, the ability of the multi-herbal formulation to alter the permeability of the bacterial cell wall was assessed. Methods: The antibacterial properties of Protegol were evaluated by determining its minimum inhibitory (MIC) and minimum bactericidal concentrations (MBC) against a panel of Gram-positive and Gram-negative bacteria, using the broth microdilution method. Cell wall permeability was investigated through the propidium iodide (PI) uptake assay. The anti-inflammatory potential was investigated in LPS-stimulated RAW 264.7 macrophages by measuring nitric oxide (NO) production with the Griess assay. The antioxidant activity was evaluated in BALB/3T3 fibroblasts exposed to hydrogen peroxide, using the DCFH-DA assay. Results: Protegol exhibited a broad-spectrum antibacterial effect, with MIC values ranging from 1.5 to 6.2 mg/mL and MBC values between 3.1 and 12.4 mg/mL. The strongest activity was observed against Staphylococcus aureus and Streptococcus pyogenes, including clinical isolates, while moderate efficacy was detected against resistant Klebsiella pneumoniae strains. PI uptake assays confirmed a dose-dependent disruption of bacterial membrane integrity, supporting a direct effect of Protegol on cell wall permeability. In macrophages, Protegol significantly and dose-dependently reduced NO release, lowering production to 44% at the highest concentration tested. In BALB/3T3 cells, Protegol markedly decreased ROS accumulation to 24% at the same concentration. Conclusions: Overall, the findings support the potential of Protegol as a natural adjuvant to the conventional therapies for respiratory tract health by counteracting bacterial pathogens, reducing inflammation, and mitigating oxidative stress, thereby supporting host defense mechanisms in the context of respiratory tract infections. Full article

Root-knot nematodes (RKNs), Meloidogyne spp., are the most economically important plant parasites with a worldwide distribution and a very wide host spectrum. The use of rhizobacteria for biocontrol has seen a marked increase in recent years, with particular emphasis on members of the Bacillaceae family in Brazil. This work reports on five years of experience using Bacillus-based products as nematicides, including both commercial and experimental formulations. Trials on cotton (200–300 mL/100 kg of seeds) against M. incognita race 3 produced inconsistent results: one trial achieved approximately 50% control, while another showed no significant effect. In soybean, Bacillus-based biological products (200–300 mL/100 kg) were able to reduce the final population of M. javanica and M. incognita by an average of approximately 30%, although in some cases, no effect was observed. The use of different doses of a product containing the RTI 545 strain (B. thuringiensis) resulted in control efficiencies of approximately 60–80% at a dose of 500 mL/100 kg, when applied as a seed treatment in soybean. This dose is too high to employ in field conditions. In tomato crop, strain S2538 of Priestia aryabhattai and strain RTI 545 (150 mL/100 kg) reduced the final population of M. incognita by 45–50%, confirming the results obtained in previous trials. Additionally, microscopic observations of Bacillus spp. against Meloidogyne spp. in soybean were made during histopathological studies. The bacteria were found to colonize root tissues early, including the cortex and vascular cylinder, probably producing chemical compounds and later disrupting giant cells. This microscopic observation suggests a mechanism aligned with induced resistance. Currently, biological products must be used in integrated management, such as resistant varieties, crop rotation, and other agronomic practices that aim to balance the physical, chemical and biological conditions of soils. Full article

This study presents the development and experimental validation of a novel wind turbine emulator (WTE) based on a doubly fed induction generator (DFIG). The proposed architecture employs an induction motor (IM) driven by a variable frequency drive (VFD) to emulate wind turbine dynamics, offering a cost-effective and low-maintenance alternative to traditional DC motor-based systems. The contribution of this work lies, therefore, not in the hardware topology itself, but in the complete real-time software implementation of the control system using C language and RTLib, which enables higher sampling rates, faster PWM updates, and improved execution reliability compared with standard Simulink/RTI approaches. The proposed control structure integrates tip–speed ratio (TSR)-based maximum power point tracking (MPPT) with flux-oriented vector control of the DFIG, fully coded in C to provide optimized real-time performance. Experimental results confirm the emulator’s ability to accurately replicate real wind turbine behavior under varying wind conditions. The test bench demonstrates fast dynamic response, with rotor currents settling in 11–18 ms, and active/reactive powers stabilizing within 25–30 ms. Overshoots remain below 10%, and steady-state errors are limited to ±1 A for currents and ±100 W/±50 VAR for powers, ensuring precise power regulation. The speed tracking error is approximately 0.61 rad/s, validating the system’s ability to follow dynamic references with high accuracy. Additionally, effective decoupling between active and reactive loops is achieved, with minimal cross-coupling during step changes. Full article

Background: This study aimed to assess whether methylprednisolone treatment, while effective in reducing COVID-19 mortality, increases the risk of intensive-care-unit-acquired respiratory tract infections (RTI-ICU) in critically ill patients. Methods: This was a multicenter prospective cohort study conducted in ten countries across Latin America and Europe. It included patients over 18 years of age with confirmed SARS-CoV-2 infection who required ICU admission. A multivariable logistic regression analysis and propensity score matching (PSM) were performed to determine the association between methylprednisolone treatment and RTI-ICU. Results: A total of 3239 patients were included, of whom 1527 patients (47.1%) were treated with methylprednisolone. Methylprednisolone treatment was associated with a higher risk of developing RTI-ICU (OR = 1.59; 95% CI: 1.33–1.91). Patients with RTI-ICU had a significantly higher average number of days on invasive mechanical ventilation (IMV) (24.6, SD: 15.9 vs. 9.5, SD: 11.7; p < 0.001), longer hospital stays (40 days, SD: 24.9 vs. 24.4 days, SD: 18.7; p < 0.001), and higher ICU mortality (39.2%, 259/660 vs. 29.2%, 754/2579; p < 0.001). Conclusions: Methylprednisolone treatment is associated with an increased risk of RTI-ICU in critically ill patients with COVID-19. RTI-ICU was linked to higher mortality, a greater need for invasive mechanical ventilation, prolonged ICU stay, elevated leukocyte and C-reactive protein levels, and a higher comorbidity burden. However, methylprednisolone may not be the sole factor explaining these differences, as residual confounding related to baseline disease severity and comorbidities could have influenced the outcomes. Full article

Respiratory tract infections (RTIs) are amongst the leading causes of hospitalizations in children with Down syndrome (DS). Their elevated susceptibility likely stems from structural differences in the airways and immune system abnormalities. The aim of this study was to characterize immune cells in prenatal Trisomy 21 (T21) lungs, potentially explaining vulnerability to RTIs. Single-cell RNA sequencing was used to profile immune cells in prenatal T21 (n = 5) and non-T21 (n = 4) prenatal lungs. Spatial phenotypes were assessed via fluorescent in situ hybridization and immunofluorescent staining on prenatal lung tissue sections. Gene expression analysis was also performed on isolated immune cells from lung single-cell suspensions. Several major immune cell populations were identified. A total of 84 DEGs were identified in at least 1 of the 14 different clusters. A significant decrease in the percentage of B cells was observed in T21 lungs (FDR = 0.0037, * p < 0.05). Furthermore, qRT-PCR demonstrated B cell markers were significantly decreased in T21, including those associated with B cell maturation (* p < 0.05 and ** p < 0.01). Several of these markers were also decreased at the protein level (i.e., CD20 and CD38; * p < 0.05 and ** p < 0.01). Our data demonstrate changes in the T21 pulmonary immune system in utero, primarily within the B cell population, which may contribute to the increased susceptibility to RTIs observed in children with DS. Full article

Background: Acne vulgaris is a multifactorial disease with significant clinical and psychosocial impacts. Methods: The purpose of this study was to evaluate the efficacy of a combination therapy including oral isotretinoin and a non-ablative 675 nm red-light laser compared with laser monotherapy. Thirteen young patients with active facial acne of varying severity were enrolled and divided into two groups: Seven subjects received laser monotherapy treatment (RT group), while six underwent combined laser and isotretinoin therapy (RTI group). The laser protocol consisted of six weekly sessions, with a 5-point pain scale used to monitor tolerability. Standardized photographs were obtained at baseline and at a 3-month follow-up after the last treatment. Each patient completed the Acne Radar Questionnaire, and lesion severity was assessed using the Global Evaluation Acne (GEA) scale. Results: All patients completed the study without adverse events. Scores from the Acne Radar Questionnaire improved in both groups, while the GEA scale demonstrated a significant reduction in lesion severity, confirmed by photographic comparison. Pain was reported as mild in most cases, and no discontinuations occurred. Conclusions: These findings indicate that the 675 nm laser is a safe and effective therapeutic option for acne vulgaris, with isotretinoin addition resulting in more rapid and pronounced clinical improvement. Full article

Direct power control (DPC) is a widely accepted control scheme utilized in renewable energy applications owing to its several advantages over other control mechanisms, including its simplicity, ease of implementation, and faster response. However, DPC suffers from inherent drawbacks and limitations that constrain its applicability. These restrictions include notable ripples in active power and torque, as well as poor power quality brought on by the usage of a hysteresis regulator for capacity management. To address these issues and overcome the limitations of DPC, this study proposes a novel approach that incorporates artificial neural networks (ANNs) into DPC. The proposed technique focuses on doubly fed induction generators (DFIGs) and is validated through experimental testing. ANNs are employed to recompense for the deficiencies of the hysteresis controller and switching table. The intelligent DPC technique is then compared to three other strategies: classic DPC, backstepping control, and integral sliding-mode control. Various tests are conducted to compare the ripple ratio, current quality, durability, response time, and reference tracking. The validity and robustness of the proposed intelligent DPC for DFIGs are verified through both simulation and experimental results obtained from the MATLAB/Simulink environment and the Real-Time Interface (RTI) of the dSPACE DS1104 controller card. The results confirm that the intelligent DPC outperforms conventional control strategies in terms of stator current harmonic distortion, dynamic response, power ripple minimization, reference tracking accuracy, robustness, and overshoot reduction. Overall, the intelligent DPC exhibits superior performance across all evaluated criteria compared to the alternative approaches. Full article

Wearable, rectifiable aerosol photometers (WRAPs), instruments with combined nephelometer and on-board filter-based sampling capabilities, generally show strong correlations with reference instruments across a range of ambient and household PM_2.5 concentrations. However, limited data exist on their performance when challenged by mixed aerosol exposures, such as those found in dusty occupational environments. Understanding how these instruments perform across a spectrum of environments is critical, as they are increasingly used in human health studies, including those in which concurrent PM_2.5 and coarse dust exposures occur simultaneously. The authors collected co-located, ~24 h. breathing zone gravimetric and nephelometer PM_2.5 measures using the MicroPEM v3.2A (RTI International) and the UPAS v2.1 PLUS (Access Sensor Technologies). Samples were collected from adult brick workers (n = 93) in Nepal during work and non-work activities. Median gravimetric/arithmetic mean (AM) PM_2.5 concentrations for the MicroPEM and UPAS were 207.06 (interquartile range [IQR]: 216.24) and 737.74 (IQR: 1399.98) µg/m³, respectively (p < 0.0001), with a concordance correlation coefficient (CCC) of 0.26. The median stabilized inverse probability-weighted nephelometer PM_2.5 concentrations, after gravimetric correction, for the MicroPEM and UPAS were 169.16 (IQR: 204.98) and 594.08 (IQR: 1001.00) µg/m³, respectively (p-value < 0.0001), with a CCC of 0.31. Digital microscope photos and electron micrographs of filters confirmed large particle breakthrough for both instruments. A possible explanation is that the miniaturized pre-separators were overwhelmed by high dust exposures. This study was unique in that it evaluated personal PM_2.5 monitors in a high dust occupational environment using both gravimetric and nephelometer-based measures. Our findings suggest that WRAPs may substantially overestimate personal PM_2.5 exposures in environments with concurrently high PM_2.5 and coarse dust levels, likely due to large particle breakthrough. This overestimation may obscure associations between exposures and health outcomes. For personal PM_2.5 monitoring in dusty environments, the authors recommend traditional pump and cyclone or impaction-based sampling methods in the interim while miniaturized pre-separators for WRAPs are designed and validated for use in high dust environments. Full article

Various AML treatment regimens might trigger different immunological mechanisms against leukemic cells. The role of different immune cell subsets in the mediation of antileukemic processes is not clear. In this study, we longitudinally assessed (leukemia specific) immune subtype compositions in 17 AML patients before stem cell transplantation (SCT) at different timepoints in the course and in different stages of the disease using flow cytometry. Further we correlated immune cell compositions with patients’ response to induction therapy and the median survival (3.8 months in our cohort) of the patients. Finally, we compared immune cell profiles from patients before and after SCT. (1) Patients in CR (compared to dgn and PD) were characterized by higher frequencies of leukemia-derived DC (DCleu), (leukemia-specific—IFNg or TNFα producing or CD107a degranulating) anti-tumor relevant T cells (Tgd, Tβ7), central/effector memory cells (Tcm, Tem), alongside with lower frequencies of (leukemia-specific) regulatory T cells. (2) Patients with higher frequencies of (leukemia-specific) antitumor relevant T cells, (leukemia-specific) memory T cells and NK cells demonstrated a prolonged median survival time and/or responded better to induction (RTI) treatment (3) Comparing patients before and after SCT, only minimal differences were observed. However, patients in CR_preSCT exhibited higher frequencies of DC, Tcm, Tβ7 and leukemia-specific iNKT cells compared to patients in CR_postSCT. (1) Immune monitoring qualifies to quantify (leukemia-specific) immune cells in different stages and under different treatment strategies in the course of AML. (2) Higher frequencies of activating and antitumor relevant leukemia-specific immune cell subtypes found after ‘costimulatory’ (especially KitM induced) treatment’ and in CR. (3) In particular, DC/DCleu, (leukemia-specific) antitumor-relevant T (memory) and NK cells seem to dominate in CR and positively influence RTI and survival. (4) Monitoring of (leukemia-specific) immune cell subtypes contribute to quantify individual AML patients’ antileukemic potential in different stages and treatment groups and also could be used to predict patients’ survival. Full article

This paper presents an efficient algorithm for Explicit Model-Following (EMF) control using an Output-derivative Feedback Control (OFC) scheme within the Reciprocal State Space (RSS) framework, aimed at overcoming the performance limitations associated with state-derivative dependence. For Lipschitz Nonlinear Systems (LNS), two approaches are proposed: a linear EMF (LEMF) strategy, which transforms the system into a Linear Parameter-Varying (LPV) representation via the Differential Mean Value Theorem (DMVT) to facilitate controller design, and a nonlinear EMF (NEMF) scheme, which enables the direct tracking of a nonlinear reference model. The stability of the closed-loop system is ensured by deriving control gains through Linear Quadratic Regulator (LQR) optimization. The proposed algorithms are validated through Real-Time Implementation (RTI) on an Arduino DUE platform, demonstrating their effectiveness and practical feasibility. Full article

Background: Pediatric road traffic injuries (RTIs) represent a significant public health concern, particularly in countries like Romania, where road infrastructure and safety remain challenges. Despite recent economic reclassification, Romania continues to report high rates of pediatric traffic-related injuries. Non-fatal RTIs often result in long-term physical and psychological harm. This study aims to assess age- and gender-specific injury patterns and mechanisms of non-fatal RTIs in children and adolescents, using data from “St. Mary’s” Emergency Clinical Hospital for Children in Iași over a ten-year period to inform targeted prevention strategies. Methods: This 10-year retrospective study (2015–2024) was conducted at “St. Mary’s” Emergency Clinical Hospital for Children in Iași, Romania, a regional referral center. Data from 1074 pediatric patients (aged 1 month–17 years, 11 months) with RTIs were analyzed using ICD-10 codes and verified manually. Variables included demographics, injury type, mechanism, and treatment. Patients were stratified into four age groups. Statistical analysis was performed using IBM SPSS Statistics 25, with significance set at p < 0.05. Results: The highest incidence was observed among boys (77.7%) and children aged 10–14 years. Car passengers and cyclists constituted the most frequently affected groups, with only 11% of passengers appropriately restrained and 78% of cyclists not wearing helmets. Common injuries included excoriations, thoracic contusions, and abdominal trauma, with notable variations by age and sex. Thoracic injuries were more frequent among girls, whereas younger children exhibited a higher incidence of abdominal trauma. Conclusions: The findings emphasize critical safety gaps in child restraint and helmet use and highlight the urgent need for targeted, age-specific road safety interventions and improved public health education. Full article

Objectives: This study aimed to identify differences in risk factors for carbapenem-resistant Enterobacteriaceae (CRE) infections across different anatomical sites and to explore risk factors associated with mortality in CRE-infected patients. Methods: Patients who underwent CRE screening and were subsequently diagnosed with CRE infections were included and categorized by infection site: respiratory tract (RTI), urinary tract (UTI), and bloodstream (BSI). Forty ICU patients without CRE infection were randomly selected as controls. Statistical comparisons were performed using the Mann–Whitney U or Chi-square test, as appropriate. Potential risk factors were evaluated via univariate and multivariate analyses, and a predictive model was constructed, with its performance assessed using ROC curve analysis. Results: CRE colonization was identified as a common independent risk factor across all three groups (RTI, UTI, and BSI). Infection-site-specific analyses revealed independent risk factors: RTI was associated with mechanical ventilation, UTI with trauma, and BSI with gastrointestinal injury. Predictive models for RTI, UTI, and BSI demonstrated good discrimination, with ROC AUCs of 0.94, 0.94, and 0.95, respectively. In the analysis of Survived versus Deceased patients, the BSI group had the highest mortality, though the difference was not statistically significant. Deceased patients exhibited significantly higher PCT levels than Survived patients (p = 0.005). Prior use of carbapenems and antifungal agents, as well as Ln(PCT), were independently associated with mortality in CRE-infected patients. Conclusions: Risk factors for CRE infections vary across anatomical sites, with CRE colonization, mechanical ventilation, trauma, and gastrointestinal injury playing key roles. Overuse of antibiotics and elevated inflammatory responses are associated with increased mortality. These findings provide evidence for early identification of high-risk patients and optimization of individualized treatment strategies. Full article