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Chawla H, Anand P, Garg K, Bhagat N, Varmani SG, Bansal T, McBain AJ, Marwah RG. A comprehensive review of microbial contamination in the indoor environment: sources, sampling, health risks, and mitigation strategies. Front Public Health 2023; 11:1285393. [PMID: 38074709 PMCID: PMC10701447 DOI: 10.3389/fpubh.2023.1285393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/25/2023] [Indexed: 12/18/2023] Open
Abstract
The quality of the indoor environment significantly impacts human health and productivity, especially given the amount of time individuals spend indoors globally. While chemical pollutants have been a focus of indoor air quality research, microbial contaminants also have a significant bearing on indoor air quality. This review provides a comprehensive overview of microbial contamination in built environments, covering sources, sampling strategies, and analysis methods. Microbial contamination has various origins, including human occupants, pets, and the outdoor environment. Sampling strategies for indoor microbial contamination include air, surface, and dust sampling, and various analysis methods are used to assess microbial diversity and complexity in indoor environments. The review also discusses the health risks associated with microbial contaminants, including bacteria, fungi, and viruses, and their products in indoor air, highlighting the need for evidence-based studies that can relate to specific health conditions. The importance of indoor air quality is emphasized from the perspective of the COVID-19 pandemic. A section of the review highlights the knowledge gap related to microbiological burden in indoor environments in developing countries, using India as a representative example. Finally, potential mitigation strategies to improve microbiological indoor air quality are briefly reviewed.
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Affiliation(s)
- Hitikk Chawla
- Institute for Cell Biology and Neuroscience, Goethe University Frankfurt, Frankfurt, Germany
| | - Purnima Anand
- Department of Microbiology, Bhaskaracharya College of Applied Sciences, University of Delhi, New Delhi, India
| | - Kritika Garg
- Department of Biosciences and Bioengineering, Indian Institute of Technology Roorkee, Roorkee, India
| | - Neeru Bhagat
- Department of Microbiology, Bhaskaracharya College of Applied Sciences, University of Delhi, New Delhi, India
| | - Shivani G. Varmani
- Department of Biomedical Science, Bhaskaracharya College of Applied Sciences, University of Delhi, New Delhi, India
| | - Tanu Bansal
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Andrew J. McBain
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Ruchi Gulati Marwah
- Department of Microbiology, Bhaskaracharya College of Applied Sciences, University of Delhi, New Delhi, India
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2
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Potisk T, Remškar M, Pirker L, Filipič G, Mihelič I, Ješelnik M, Čoko U, Ravnik M. Single-Layer and Double-Layer Filtration Materials Based on Polyvinylidene Fluoride-Co-hexafluoropropylene Nanofibers Coated on Melamine Microfibers. ACS APPLIED NANO MATERIALS 2023; 6:15807-15819. [PMID: 37706065 PMCID: PMC10496027 DOI: 10.1021/acsanm.3c02592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/08/2023] [Indexed: 09/15/2023]
Abstract
In this work, we demonstrate selected optimization changes in the simple design of filtration masks to increase particle removal efficiency (PRE) and filter quality factor by combining experiments and numerical modeling. In particular, we focus on single-layer filters fabricated from uniform thickness fibers and double-layer filters consisting of a layer of highly permeable thick fibers as a support and a thin layer of filtering electrospun nanofibers. For single-layer filters, we demonstrate performance improvement in terms of the quality factor by optimizing the geometry of the composition. We show significantly better PRE performance for filters composed of micrometer-sized fibers covered by a thin layer of electrospun nanofibers. This work is motivated and carried out in collaboration with a targeted industrial development of selected melamine-based filter nano- and micromaterials.
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Affiliation(s)
- Tilen Potisk
- Laboratory
for Molecular Modeling, National Institute
of Chemistry, SI-1001 Ljubljana, Slovenia
- Faculty
of Mathematics and Physics, University of
Ljubljana, SI-1001 Ljubljana, Slovenia
| | - Maja Remškar
- Jožef
Stefan Institute, SI-1000 Ljubljana, Slovenia
| | - Luka Pirker
- Jožef
Stefan Institute, SI-1000 Ljubljana, Slovenia
- J. Heyrovsky
Institute of Physical Chemistry, Czech Academy
of Sciences, 182 23 Prague 8, Czech Republic
| | | | | | | | - Urban Čoko
- Laboratory
for Molecular Modeling, National Institute
of Chemistry, SI-1001 Ljubljana, Slovenia
- Faculty
of Mathematics and Physics, University of
Ljubljana, SI-1001 Ljubljana, Slovenia
| | - Miha Ravnik
- Faculty
of Mathematics and Physics, University of
Ljubljana, SI-1001 Ljubljana, Slovenia
- Jožef
Stefan Institute, SI-1000 Ljubljana, Slovenia
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3
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Jiang F, Shangguan D. Researching and designing educational games on the basis of “self-regulated learning theory”. Front Psychol 2022; 13:996403. [DOI: 10.3389/fpsyg.2022.996403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 10/20/2022] [Indexed: 11/13/2022] Open
Abstract
As one of the important research fields of educational technology, the potential of educational games has been widely recognized by academic researchers. However, in terms of practical application, it is difficult to balance education and recreation, and problems have also arisen in learners’ cognitive development and skill enhancement. On this basis, this paper initially compares the educational and entertainment aspects of educational games from a learning motivation perspective. It draws on the theory of self-regulated learning and ARCS learning to establish an ARCS learning motivation model and educational game design framework. Finally, it develops a bio evolution education game that is based on this framework, and this verifies that this framework can feasibly guide practice. In drawing on the theory of autonomous learning, this paper discusses the design framework of stimulating and sustaining learning in educational games, and establishes a bridge between user learning behavior and entertainment behavior. This will provide a theoretical and case study reference for the integration of educational purpose and game entertainment into educational games.
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Hasegawa Y, Lau SK. A qualitative and quantitative synthesis of the impacts of COVID-19 on soundscapes: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 844:157223. [PMID: 35810914 PMCID: PMC9262645 DOI: 10.1016/j.scitotenv.2022.157223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 07/04/2022] [Accepted: 07/04/2022] [Indexed: 05/07/2023]
Abstract
The current prolonged coronavirus disease (COVID-19) pandemic has substantially influenced numerous facets of our daily lives for over two years. Although a number of studies have explored the pandemic impacts on soundscapes worldwide, their works have not been reviewed comprehensively nor systematically, hence a lack of prospective soundscape goals based upon global evidence. This review study examines evidence of the COVID-19 crisis impacts on soundscapes and quantifies the prevalence of unprecedented changes in acoustic environments. Two key-research classes were identified based on a systematic content analysis of the 119 included studies: (1) auditory perceptual change and (2) noise level change due to the COVID-19 pandemic/lockdown. Our qualitative synthesis ascertained the substantial adverse consequences of pandemic soundscapes on human health and well-being while beneficial aspects of the COVID-19 pandemic on soundscapes were yet identified. Furthermore, meta-analysis results highlight that the observed average noise-level reduction (148 averaged samples derived from 31 studies) varied as a function of the stringency level of the COVID-19 confinement policies imposed by the governments, which would be further moderated by urban morphology and main noise sources. Given these collective findings, we propose soundscape materiality, its nexus with related the United Nations' sustainable development goals (SDGs), and prospective approaches to support resilient soundscapes during and after the pandemic, which should be achieved to enhance healthy living and human well-being.
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Affiliation(s)
- Yoshimi Hasegawa
- Department of Architecture, National University of Singapore, Singapore.
| | - Siu-Kit Lau
- Department of Architecture, National University of Singapore, Singapore.
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5
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Jia X, Shahzad K, Klemeš JJ, Jia X. Changes in water use and wastewater generation influenced by the COVID-19 pandemic: A case study of China. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2022; 314:115024. [PMID: 35447447 PMCID: PMC8986492 DOI: 10.1016/j.jenvman.2022.115024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 03/19/2022] [Accepted: 04/03/2022] [Indexed: 05/12/2023]
Abstract
This paper examines and projects the water use and wastewater generation during and after the SARS-CoV-2 (COVID-19) in China, and discussed the water use/wastewater generation pattern changes among different sectors. Existing studies on the impact of pandemic spread-prevention measures on water consumption and wastewater treatment during the pandemic are reviewed. The water use and wastewater discharge in China through the COVID-19 period are then projected and analyzed using Multivariate Linear Regression. The projection is carried out for years 2019-2023 and covers an (estimated) full process of pre-pandemic, pandemic outbreak, and recovery phase and provides essential information for determining the complete phase impact of the COVID-19. Two scenarios, i.e. the recovery scenario and the business as usual scenario, are set to investigate the water use and wastewater generation characteristics after the pandemic. The results imply that in both scenarios, the water use in China shows a V-shaped trend from 2019 to 2023 and reached a low point in 2020 of 5,813✕108 m3. The wastewater discharge shows an increasing trend throughout the COVID period in both scenarios. The results are also compared with the water consumption and wastewater generation during the SARS-CoV-1 period. The implication for policymakers is the possible increase of water use and wastewater discharge in the post COVID period and the necessity to ensure the water supply and control of water pollution and wastewater discharge.
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Affiliation(s)
- Xuexiu Jia
- Sustainable Process Integration Laboratory - SPIL, NETME Centre, Faculty of Mechanical Engineering, Brno University of Technology - VUT Brno, Technická 2896/2, 616 69, Brno, Czech Republic.
| | - Khurram Shahzad
- Center of Excellence in Environmental Studies, King Abdulaziz University, Jeddah, 21589, Saudi Arabia.
| | - Jiří Jaromír Klemeš
- Sustainable Process Integration Laboratory - SPIL, NETME Centre, Faculty of Mechanical Engineering, Brno University of Technology - VUT Brno, Technická 2896/2, 616 69, Brno, Czech Republic.
| | - Xiaoping Jia
- Qingdao University of Science and Technology, 99 Songling Rd, Laoshan District, Qingdao, Shandong, China.
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de Lima E Silva JR, de Lima ARB, da Silva DL, Rosa Filho JS, Adam ML. Contrasting tourism regimes due to the COVID-19 lockdown reveal varied genomic toxicity in a tropical beach in the Southern Atlantic. ENVIRONMENTAL MONITORING AND ASSESSMENT 2022; 194:464. [PMID: 35639171 PMCID: PMC9152653 DOI: 10.1007/s10661-022-10112-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 05/15/2022] [Indexed: 05/26/2023]
Abstract
Tourist occupancy in coastal environments threatens the stability of various coastal ecosystems and is thus a cause for concern for the environmental sector. As such, it is important to perform environmental monitoring in a way that analyses and quantifies the environmental impact of coastal ecosystems. Porto de Galinhas beach (Pernambuco - Brazil) has one of the highest visitation rates in Brazil and suffered from restrictions to human mobility due to the COVID-19 pandemic. These restrictions allowed for the evaluation of the impact of tourism on Porto de Galinhas beach and the effects that the lack of tourist occupancy had during the lockdown period of 2020. Blood samples from the species Abudefduf saxatilis were collected monthly over a period of 1 year and during the lockdown quarter, in order to perform micronucleus (MN) and nuclear morphological alteration (NMA) tests, and data were analyzed at a seasonal level (dry/rainy period) using a comet assay. For the control group, A. saxatilis samples were collected in an environmentally protected area on Tamandaré beach (68 km from Porto de Galinhas). The MN and NMA tests showed a greater frequency of genomic damage when there was greater tourist flow. In relation to rain seasonality, the comet assay showed a greater incidence of genomic damage during the dry period, where there was a higher rate of tourist migration, compared to the rainy period. The lockdown period presented a lower incidence of genotoxic damage compared to the period without restrictions on human mobility and the control. The results show that tourism has been causing a significant environmental impact on Porto de Galinhas beach. The data collected during the lockdown period demonstrated how the absence of human movement results in changes that are favorable to environmental recuperation, as illustrated by the lower frequency of genomic damage.
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Affiliation(s)
| | | | - Demétrios Lucas da Silva
- Programa de Pós - Graduação em Biologia Animal, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - José Souto Rosa Filho
- Programa de Pós - Graduação em Oceanografia, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - Mônica Lúcia Adam
- Programa de Pós - Graduação em Biologia Animal, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
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7
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Jiménez D, Torres Arias M. Immunouniverse of SARS-CoV-2. Immunol Med 2022; 45:186-224. [PMID: 35502127 DOI: 10.1080/25785826.2022.2066251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
SARS-CoV-2 virus has become a global health problem that has caused millions of deaths worldwide. The infection can present with multiple clinical features ranging from asymptomatic or mildly symptomatic patients to patients with severe or critical illness that can even lead to death. Although the immune system plays an important role in pathogen control, SARS-CoV-2 can drive dysregulation of this response and trigger severe immunopathology. Exploring the mechanisms of the immune response involved in host defense against SARS-CoV-2 allows us to understand its immunopathogenesis and possibly detect features that can be used as potential therapies to eliminate the virus. The main objective of this review on SARS-CoV-2 is to highlight the interaction between the virus and the immune response. We explore the function and action of the immune system, the expression of molecules at the site of infection that cause hyperinflammation and hypercoagulation disorders, the factors leading to the development of pneumonia and subsequent severe acute respiratory distress syndrome which is the leading cause of death in patients with COVID-19.
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Affiliation(s)
- Dennis Jiménez
- Departamento de Ciencias de la Vida y Agricultura, Carrera de Ingeniería en Biotecnología, Universidad de las Fuerzas Armadas ESPE, Sangolquí, Pichincha, Ecuador
| | - Marbel Torres Arias
- Departamento de Ciencias de la Vida y Agricultura, Carrera de Ingeniería en Biotecnología, Universidad de las Fuerzas Armadas ESPE, Sangolquí, Pichincha, Ecuador.,Laboratorio de Inmunología y Virología, CENCINAT, GISAH, Universidad de las Fuerzas Armadas, Sangolquí, Pichincha, Ecuador
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8
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Akbar F, Suleman M, Israr M, Ali SS, Zaman N, Khan O, Ali J, Ahmad W, Rahat MA, Rasool A, Shah M, Hussain Z, Ali M. Effect of temperature and humidity on coronavirus infection in Pakistan. GENE REPORTS 2021; 26:101441. [PMID: 34841127 PMCID: PMC8605813 DOI: 10.1016/j.genrep.2021.101441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/15/2021] [Accepted: 11/13/2021] [Indexed: 11/10/2022]
Abstract
Ongoing Coronavirus epidemic (COVID-19) identified first in Wuhan, China posed huge impact on public health and economy around the globe. Both cough and sneeze based droplets or aerosols encapsulated COVID-19 particles are responsible for airborne transmission of this virus and caused an unexpected escalation and high mortality worldwide. Current study intends to investigate the correlation of COVID-19 epidemic with meteorological parameters, particularly temperature and humidity. A data set of Epidemiological data of COVID-19 for highly infected provinces of Pakistan was collected from the official website of (https://www.covid.gov.pk/) and weather data was collected from (https://www.timeanddate.com/) during the time period of 1st March to 30th September 2020. The GrapPad prism 5 Software was used to calculate the mean and standard error of mean (SEM). In the current study the incident of daily covid cases is recorded higher in the month of June while the less number of case were reported in the month of May as compared to the other months (April, May, June, July, September and August) in the four province of Pakistan. We also find out that the incident of Covid19 were high at higher temperature (like the average temperature in the month of June 37 °C) while less cases were reported in May the average temperature was 29.5 °C. Furthermore the incident of covid cases were less reported at low humidity while more intendant with high humidity. Pearson's (r) determine the strength of the relationship between the variables. Pearson's correlation coefficient test employed for data analysis revealed that temperature average (TA) and average humidity is not a significant correlated with COVID-19 pandemic. The results obtained from the current analysis for selected parameters indirect correlation of COVID-19 transmission with temperature variation, and humidity. In the present study association of parameters is not correlated with COVID-19 pandemic, suggested need of more strict actions and control measures for highly populated cities. These findings will be helpful for health regulatory authorities and policy makers to take specific measures to combat COVID-19 epidemic in Pakistan.
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Affiliation(s)
- Fazal Akbar
- Center for Biotechnology and Microbiology, University of Swat, Pakistan
| | - Muhammad Suleman
- Center for Biotechnology and Microbiology, University of Swat, Pakistan
| | - Muhammad Israr
- Department of Forensic Sciences, University of Swat-, Pakistan
| | - Syed Shujait Ali
- Center for Biotechnology and Microbiology, University of Swat, Pakistan
| | - Nasib Zaman
- Center for Biotechnology and Microbiology, University of Swat, Pakistan
| | - Owais Khan
- Center for Biotechnology and Microbiology, University of Swat, Pakistan
| | - Jawad Ali
- Center for Biotechnology and Microbiology, University of Swat, Pakistan
| | - Waqar Ahmad
- Center for Biotechnology and Microbiology, University of Swat, Pakistan
| | - Murad Ali Rahat
- Department of Forensic Sciences, University of Swat-, Pakistan.,Department of Genetics, Hazara University, Mansehra, Pakistan
| | - Akhtar Rasool
- Center for Biotechnology and Microbiology, University of Swat, Pakistan.,Centre for Animal Sciences and Fisheries, University of Swat -, Pakistan
| | - Muzafar Shah
- Centre for Animal Sciences and Fisheries, University of Swat -, Pakistan
| | - Zahid Hussain
- Center for Biotechnology and Microbiology, University of Swat, Pakistan
| | - Mohammad Ali
- Center for Biotechnology and Microbiology, University of Swat, Pakistan
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Thiele-Bruhn S. The role of soils in provision of genetic, medicinal and biochemical resources. Philos Trans R Soc Lond B Biol Sci 2021; 376:20200183. [PMID: 34365823 DOI: 10.1098/rstb.2020.0183] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Intact, 'healthy' soils provide indispensable ecosystem services that largely depend on the biotic activity. Soil health is connected with human health, yet, knowledge of the underlying soil functioning remains incomplete. This review highlights selected services, i.e. (i) soil as a genetic resource and hotspot of biodiversity, forming the basis for providing (ii) biochemical resources and (iii) medicinal services and goods. Soils harbour an unrivalled biodiversity of organisms, especially microorganisms. Some of the abilities of autochthonous microorganisms and their relevant enzymes serve (i) to improve natural soil functions and in particular plant growth, e.g. through beneficial plant growth-promoting, symbiotic and mycorrhizal microorganisms, (ii) to act as biopesticides, (iii) to facilitate biodegradation of pollutants for soil bioremediation and (iv) to yield enzymes or chemicals for industrial use. Soils also exert direct effects on human health. Contact with soil enriches the human microbiome, affords protection against allergies and promotes emotional well-being. Medicinally relevant are soil substrates such as loams, clays and various minerals with curative effects as well as pharmaceutically active organic chemicals like antibiotics that are formed by soil microorganisms. By contrast, irritating minerals, soil dust inhalation and misguided soil ingestion may adversely affect humans. This article is part of the theme issue 'The role of soils in delivering Nature's Contributions to People.
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Affiliation(s)
- Sören Thiele-Bruhn
- Soil Science, University of Trier, Behringstrasse 21, D-54286 Trier, Germany
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Bonilla-Aldana DK, Jimenez-Diaz SD, Arango-Duque JS, Aguirre-Florez M, Balbin-Ramon GJ, Paniz-Mondolfi A, Suárez JA, Pachar MR, Perez-Garcia LA, Delgado-Noguera LA, Sierra MA, Muñoz-Lara F, Zambrano LI, Rodriguez-Morales AJ. Reply to "Misconceptions and misinformation about bats and viruses". Int J Infect Dis 2021; 106:197-198. [PMID: 33647513 PMCID: PMC8043817 DOI: 10.1016/j.ijid.2021.02.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- D Katterine Bonilla-Aldana
- Semillero de Investigación en Zoonosis (SIZOO), Grupo de Investigación BIOECOS, Fundación Universitaria Autónoma de las Américas, Sede Pereira, Pereira, Risaralda, Colombia
| | - S Daniela Jimenez-Diaz
- Semillero de Investigación en Zoonosis (SIZOO), Grupo de Investigación BIOECOS, Fundación Universitaria Autónoma de las Américas, Sede Pereira, Pereira, Risaralda, Colombia
| | | | - Mateo Aguirre-Florez
- Grupo Colaborativo de Investigación en Enfermedades Transmitidas por Vectores, Zoonóticas y Tropicales de Risaralda (GETZ), Pereira, Risaralda, Colombia
| | | | - Alberto Paniz-Mondolfi
- Laboratory of Medical Microbiology, Department of Pathology, Molecular and Cell-based Medicine, The Mount Sinai Hospital-Icahn School of Medicine at Mount Sinai, New York, USA; Laboratorio de Señalización Celular y Bioquímica de Parásitos, Instituto de Estudios Avanzados (IDEA), Caracas, Caracas, Venezuela; Academia Nacional de Medicina, Caracas, Venezuela
| | - Jose Antonio Suárez
- Investigador SNI Senacyt Panamá, Clinical Research Deparment, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Panama
| | - Monica R Pachar
- Medicine Department-Infectious Diseases Service, Hospital Santo Tomas, Panama City, Panama
| | - Luis A Perez-Garcia
- Instituto de Investigaciones Biomédicas IDB/Incubadora Venezolana de la Ciencia, Cabudare, Edo. Lara, Venezuela
| | - Lourdes A Delgado-Noguera
- Instituto de Investigaciones Biomédicas IDB/Incubadora Venezolana de la Ciencia, Cabudare, Edo. Lara, Venezuela
| | - Manuel Antonio Sierra
- Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras (UNAH), Tegucigalpa, Honduras
| | - Fausto Muñoz-Lara
- Departamento de Medicina Interna, Hospital Escuela, Tegucigalpa, Honduras; Departamento de Medicina Interna, Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras (UNAH), Tegucigalpa, Honduras
| | - Lysien I Zambrano
- Departments of Physiological and Morphological Sciences, School of Medical Sciences, Universidad Nacional Autónoma de Honduras (UNAH), Tegucigalpa, Honduras
| | - Alfonso J Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia.
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