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Respiratory disorders and tail biting represent common issues in pig husbandry. Dietary supplementation with a combination of microbes and herbal extracts could offer welfare benefits. The aim of this study was to investigate the effect of a fermented herbal extract (FHE), a blend of fermented herbs, lactobacilli and yeasts, on behavior, aspects of health and productivity in rearing and fattening pigs. Two commercial Austrian welfare label farms, raising pigs with intact tails, were included over three batches covering all seasons. Animals were kept from weaning to slaughter in control (CON; n = 11 and 9) and treatment pens (FHE; n = 11 and 9) during rearing and fattening, respectively. Behavior as well as body, tail and ear lesions were assessed at the end of the rearing and at the middle and end of the fattening period, productivity data was measured on farm while slaughter data were additionally recorded at the abattoir. Data were analyzed using (generalized) linear mixed models. One main finding of this study was the significantly lower prevalence of the indicator “tail shorter” of FHE-fed pigs compared to control (CON) pigs at the end of rearing (FHE = 7.2 %, CON = 38.8 %; p = 0.012). The higher prevalence of intact tails in the FHE group may suggest a beneficial effect of the supplement on behavior, with a possible reduction in tail-biting activity in rearing pigs. During fattening, FHE pigs also coughed and sneezed less during behavioral observations on farm (p = 0.026). Nevertheless, slaughter findings concerning the respiratory tract did not differ. Overall, the present results suggest a potential of FHE to avert abnormal behavior and promote aspects of respiratory health in rearing and fattening pigs, which warrants further investigation.

Oci Tasijawa,1 Vernando Yanry Lameky2 1Book Publisher, Ghema Berkat Abadi, Ambon, Maluku, Indonesia; 2Department of Nursing, Universitas Kristen Indonesia Maluku, Ambon, Maluku, IndonesiaCorrespondence: Vernando Yanry Lameky, Department of Nursing, Universitas Kristen Indonesia Maluku, Jl. Ot pattimaipauw, Ambon, Maluku, Indonesia, Email vernandoyanrylameky@gmail.com

Background Flour dust, with an inherent allergic nature, increases vulnerability to various respiratory ailments. We systemically reviewed and compared literature-reported pulmonary function parameters to quantify pulmonary dysfunction among individuals with high flour dust exposure (among flour mill workers) and relatively un-exposed groups. Methods Studies that compared pulmonary function parameters for flour dust exposed and unexposed control groups were systemically searched in PubMed, Scopus and Embase from inception to June 2024. The Newcastle Ottawa scale was used to assess the risk of bias among included studies. With the random effect model, we pooled (along with 95% CI) the mean difference for forced expiratory volume in the first second (FEV 1 ), forced vital capacity (FVC), the ratio of FEV 1 & FVC, mid-expiratory flow (FEF25-75%), peak expiratory flow rate (PEFR) and other pulmonary function parameters. Cochran-Q test and I 2 statistics were applied to determine heterogeneity. Results This quantitative synthesis included twenty-two studies involving 2,482 flour dust exposed and 1,925 control participants. The pooled mean difference for FEV 1 , FVC, FEV 1 /FVC, PEFR and FEF 25 − 75% were − 0.43 L (-0.57, -0.29; I 2  = 88.7), -0.49 L (-0.64, -0.33; I 2  = 89.3), -3.5% (-6.49, -0.5; I 2  = 89.7), -1.36 L/s (-1.70, -1.03; I 2  = 90.4) and − 0.34 L/s (-0.63, -0.06; I 2  = 77.3). The pooled odds ratio for obstructive [12.9 (3.41, 49.2); I 2  = 82.4)] and restrictive changes [5.11 (0.55, 47.4); I 2  = 81.6] were significantly higher among the exposed than controls. As per the bias assessment majority of studies rated with moderate to severe risk of bias. Conclusion Study observed pulmonary function deficits associated with exposure to flour dust. However, considering the quality of primary studies and higher heterogeneity, high-quality larger studies with longitudinal design are required to affirm the effects of flour dust on lung function.

Background The use of stimulants, such as crack-cocaine, is a global public health concern. Crack-cocaine use is increasing in the UK, but available data is focused on those who inject or also use opioids. To address this gap, characteristics of people using crack-cocaine in England, including respiratory problems among those who smoke, and variation in these by gender are described. Methods Adults self-reporting crack-cocaine use in the past 28 days, recruited by specialist services and peer networks in six sites during 2023, completed a self-report survey about demographic characteristics, drug use, crack use practices, health problems and service use. Bivariable analyses and logistic regression were used to explore gender-related differences in crack-cocaine use and crack-related respiratory problems. Results The participants’ ( n  = 731) median age was 42 years and 71% were men. Overall, 54% were stably housed, 71% had ever been imprisoned and 28% reported emergency department attendance in past 6 months. In the past 28 days, 99% had smoked crack-cocaine (44% shared pipes), with 30% injecting crack. Poly-sedative use was common including heroin (78%), pregabalin/gabapentin (41%), and benzodiazepines (28%), with 62% receiving opioid substitution therapy. Use of drugs normally smoked was common (90% tobacco, 62% cannabis and 25% spice). Women reported less polydrug use but more often vaped nicotine. Crack-related respiratory symptoms among those smoking crack were reported by 67% of women and 58% of men. In both men and women these symptoms were associated with increasing time since first crack-cocaine use and pregabalin/gabapentin use. In men they were also associated with food insecurity; smoking tobacco; temporary employment; and use in abandoned buildings or at friend’s place; reduced odds were associated with current heroin use and using with a close friend. Among women, having a respiratory symptom was also associated with sharing pipes. Conclusions Respiratory health problems are common among those smoking crack-cocaine, particularly among women. In combination with high poly-sedative use, this poses a mortality risk from respiratory depression. UK service provision is focused on prevention of opiate and injection-related risks. Services for people who use crack-cocaine and low-threshold respiratory care pathways require prioritisation to reduce avoidable morbidity and mortality.

Objectives: The purpose of this study was to present a systematic review of the health-related problems of factory workers in the textile and fashion industry. These workers endure long sitting postures, poor workspace conditions, and long working hours to complete their overload of tasks. This situation results in several health problems that affect the productivity, mental health, and well-being of the workers.Methods: The relevant data (21 article publications) were obtained from the Scopus database. Analysis of the 21 articles was grouped under 3 research themes based on the critical reading of the content and abstracts: respiratory problems, musculoskeletal disorders, and psychological stressors and other health issues.Results: The findings show that factory workers are exposed to dust particles of cotton and other raw materials, fumes, and chemicals from manufacturing processes. This prolonged exposure without the use of personal protective equipment (PPE) leads to respiratory diseases like byssinosis that affect the workers’ health. Additionally, working in a particular posture due to the workstation design for prolonged hours causes musculoskeletal disorders or pains. Workers also suffer from anxiety, depression, and stress from workload and pressure, hence making them unstable with reduced productivity.Conclusions: The findings of the study reinforce the need for a safe workspace and spacious work environment, provision of PPE, training in occupational hazards, frequent health checks, and ergonomic assessment of workstations to reduce prolonged work postures. Stakeholders, employers, policymakers, and governments should collaborate to safeguard and protect the well-being and health of the workers at these factories.

Ventilator-associated pneumonia (VAP) is the most frequent life-threatening nosocomial infection in intensive care units. The diagnostic is difficult because radiological and clinical signs are inaccurate and could be associated with various respiratory diseases. The concept of infection-related ventilator-associated complication has been proposed as a surrogate of VAP to be used as a benchmark indicator of quality of care. Indeed, bundles of prevention measures are effective in decreasing the VAP rate. In case of VAP suspicion, respiratory secretions must be collected for bacteriological secretions before any new antimicrobials. Quantitative distal bacteriological exams may be preferable for a more reliable diagnosis and therefore a more appropriate use antimicrobials. To improve the prognosis, the treatment should be adequate as soon as possible but should avoid unnecessary broad-spectrum antimicrobials to limit antibiotic selection pressure. For empiric treatments, the selection of antimicrobials should consider the local prevalence of microorganisms along with their associated susceptibility profiles. Critically ill patients require high dosages of antimicrobials and more specifically continuous or prolonged infusions for beta-lactams. After patient stabilization, antimicrobials should be maintained for 7–8 days. The evaluation of VAP treatment based on 28-day mortality is being challenged by regulatory agencies, which are working on alternative surrogate endpoints and on trial design optimization.

Acute respiratory distress syndrome represents a complex syndrome with considerable morbidity and mortality, for which there exist no targeted treatment strategies. However, recent advances in clinical care have improved outcomes, and we will review a number of these approaches here, as well as explore the mechanisms underlying the benefit of intervention that might point us in the direction toward future treatment and preventive strategies for this devastating syndrome.

Bolus residue is significant risk factor for postswallow aspiration. A retrospective study was performed to evaluate the role of bolus residue and its relation with respiratory problems in children with esophageal atresia. Children were evaluated for demographic features, type of esophageal atresia, associated anomalies, and respiratory problems. The videofluoroscopic swallowing evaluation (VFSE) was performed, and scored by using the penetration aspiration scale (PAS), bolus residual score (BRS) and normalized residual ratio scale (NRRS). Children with and without respiratory problems were also compared in terms of aspiration and bolus residue. Forty-one children with a median age of 15 months (1–138 months), male:female ratio of 26:15 was included. 65.9% (n = 27) of children were type-C and 24.4% (n = 10) were type-A EA. In 61% (n = 25) of children had liquid aspiration (PAS ≥ 6) and 9.8% (n = 4) had aspiration in pudding consistencies. Children with aspiration in liquids had significantly higher NRRS and BRS scores in vallecular residue for pudding consistencies when compared to children without aspiration (p < 0.05). No difference was detected in terms of PAS scores and bolus residual parameters between children with and without respiratory problems (p > 0.05). Children with aspiration in liquids have higher scores of BRS and NRRS at the level of vallecular especially in pudding consistencies. VFSE findings for bolus residue did not show significant relation with respiratory problems. Respiratory morbidity in children with EA is multifactorial and may not only explained by bolus residuals and aspiration.

Vehicular emission is an important contributor to air pollution in the urban environment and impacts the health of commuters as well as drivers. The in-vehicle concentration of pollutants is known to be higher than the ambient environment and varies with the mode of transport. Thus, this study attempts to assess the health impacts of air pollution exposure on auto rickshaws and cab drivers. The study was conducted in Delhi using a triangular approach involving a health perception survey, lung function test and in-vehicle monitoring of particulate matter (PM 1 , PM 2.5 , PM 10 ) concentration to assess the health impacts of air pollution on auto rickshaw and cab drivers. A total of 150 respondents (75 from each occupation) were surveyed, and spirometry was performed for 40 respondents (20 from each occupation). Binary logistic regression showed auto rickshaw drivers were exposed to significantly higher in-vehicle PM concentrations in summers and winters and, thus, had a significantly higher risk of developing respiratory, ophthalmic and dermatological health symptoms ( p < 0.05 and relative risk >1). Pulmonary function test showed obstructive lung impairment was reported only among auto rickshaw drivers (6%) and restrictive lung impairment was also more prevalent among auto rickshaw drivers (48%) than cab drivers (33%), suggesting a greater vulnerability of auto rickshaw drivers to respiratory health issues. Lung function impairment was associated with age ( p = 0.002). The health and well-being of individuals is a matter of global concern, also highlighted in sustainable development goal no. 3. However, it was observed that neither auto rickshaw drivers nor cab drivers used formal/standard protective measures mainly due to unawareness or unaffordability. The study suggests increasing awareness and formulating guidelines to highlight the use of proper protective measures by these vulnerable groups and specific policy measures to protect outdoor workers like auto rickshaw drivers.

Acute respiratory distress syndrome (ARDS) is characterized by acute diffuse lung injury, which results in increased pulmonary vascular permeability and loss of aerated lung tissue. This causes bilateral opacity consistent with pulmonary edema, hypoxemia, increased venous admixture, and decreased lung compliance such that patients with ARDS need supportive care in the intensive care unit to maintain oxygenation and prevent adverse outcomes. Recently, advances in understanding the underlying pathophysiology of ARDS led to new approaches in managing these patients. In this review, we want to focus on recent scientific evidence in the field of ARDS research and discuss promising new developments in the treatment of this disease.