Nitric oxide (NO) is a comprehensive regulator of vascular and airway tone. Endogenous NO produced by nitric oxide synthases regulates multiple signaling cascades, including activation of soluble guanylate cyclase to generate cGMP, relaxing smooth muscle cells. Inhaled NO is an established therapy for pulmonary hypertension, especially in neonates, and has been recently proposed for treatment of hypoxic respiratory failure and acute respiratory distress syndrome due to COVID-19. In this review, we summarize the effects of endogenous and exogenous NO on protein S-nitrosylation, which is the selective and reversible covalent attachment of a nitrogen monoxide group to the thiol side chain of cysteine. This post-translational modification targets specific cysteines based on the acid/base sequence of surrounding residues, with significant impacts on protein interactions and function. S-nitrosothiol (SNO) formation is tightly compartmentalized and enzymatically controlled, but also propagated by non-enzymatic transnitrosylation of downstream protein targets. Redox-based nitrosylation and denitrosylation pathways dynamically regulate the equilibrium of SNO-proteins. We review the physiological roles of SNO proteins, including nitrosohemoglobin and autoregulation of blood flow through hypoxic vasodilation, and pathological effects of nitrosylation including inhibition of critical vasodilator enzymes; and discuss the intersection of NO source and dose with redox environment, in determining the effects of protein nitrosylation.

Automotive radar is one of the key sensor technologies for active safety and comfort advanced driver assistance systems(ADAS). Vehicles equipped with radar sensors can determine the range, velocity and angle of arrival of multiple targets simultaneously in a highly dynamic environment. At 77 GHz, road infrastructure and buildings are an ever present source of clutter that can affect crucial target detection. Guardrails present a unique clutter challenge due to their ubiquity, proximity to ego vehicle and extremely large radar cross section(RCS). Due to their large RCS, guardrails can mask the existence of soft targets such as pedestrians in their vicinity. Therefore, it is crucial for sensor perception algorithms to identify and filter out the effects of guardrails. This paper presents a full-physics, simulation-based study of several full-scale road traffic scenes with different guardrail arrangements. By studying the Range-Doppler(RD) plots of each of the scenes at 77 GHz, we demonstrate the distinctly different radar signatures of guardrails in four key road settings that normally occur in driving. Using the results from this study, we characterize both the range and velocity behavior of various guardrail sections. Results from this study can be used to train perception algorithms to accurately identify and filter out guardrail systems in different driving scenarios and thus potentially prevent future accidents.

Huanglongbing (HLB) is the most devastating citrus disease worldwide. The causal organism of the disease is spread by an insect vector, Diaphorina citri, commonly known as Asian citrus psyllid (ACP). Current management of HLB relies either on physical removal of the infected plants or on chemical control of ACP. Both methods are not overly effective and costly. In addition, public concerns regarding insecticide residues in fruit have greatly increased in recent years. It has been hypothesized that plant volatiles could act as repellents to ACP, thus reduce the incidence of HLB. To test this hypothesis, the repellency of fresh tissues of 41 aromatic plant species to ACP was investigated. The repellency of individual species was determined using a Y-tube olfactometer. Our results showed that volatiles of five plant species were highly effective in repelling ACP with repellency as much as 76%. Among these, the tree species, Camptotheca acuminate, and the two shrubs, Lantana camara and Mimosa bimucronata, could potentially be planted as a landscape barrier. The two herbs, Capsicum annuum and Gynura bicolor, could potentially be used as interrow plantings in orchards. This is the first time that the repellency of fresh tissues from a diverse range of plant species to ACP has been determined. Although further field evaluation of various interplanting regimes and landscape barriers are needed to assess their effectiveness, our results showed that these aromatic species, being highly repellent to ACT, offer great potential as more cost-effective and environmentally sustainable alternatives to the current methods of managing HLB.

Interspecific hybrid frequencies can vary considerably across contact zones of a single pair of progenitor species. The reasons for this are not well understood, but could help explain processes such as species diversification or the range expansion of invasive hybrids. The widespread cattails Typha latifolia and T. angustifolia seldom hybridize in some parts of their range, but in other areas produce the dominant hybrid T. × glauca. We used a combination of field and greenhouse experiments to investigate why T. × glauca has invaded wetlands in the Laurentian Great Lakes region of southern Ontario, Canada, but is much less common in the coastal wetlands of Nova Scotia in eastern Canada. One potentially important environmental difference between these two regions is salinity. We therefore tested three hypotheses: 1) T. latifolia and T. angustifolia in Nova Scotia are genetically incompatible; 2) the germination or growth of T. × glauca is reduced by salinity; and 3) T. latifolia, a main competitor of T. × glauca, is locally adapted to saline conditions in Nova Scotia. Our experiments showed that Nova Scotia T. latifolia and T. angustifolia are genetically compatible, and that saline conditions do not impede growth of hybrid plants. However, we also found that under conditions of high salinity, germination rates of hybrid seeds were substantially lower than those of Nova Scotia T. latifolia. In addition, germination rates of Nova Scotia T. latifolia were higher than those of Ontario T. latifolia, suggesting local adaptation to salinity in coastal wetlands. This study adds to the growing body of literature which identifies the important roles that local habitat and adaptation can play in the distributions and characteristics of hybrid zones.

Abstract: Purpose: We aimed to evaluate whether early TRAP exposure is associated with the development of AR during preschool years, stratified by sex, parental allergy, or stressful family events. Methods: A nested case-control study including 398 was conducted in Shenyang. TRAP exposure in early childhood was estimated by nitrogen oxides (NOx) air dispersion modeling. We used multinomial logistic regression models to assess the association between early TRAP exposure and preschool children AR, stratified by potential confounders including sex, parental allergy, or stressful family events. Results: Life-time prevalence of AR in children aged 4 years (6.4%) was associated with TRAP exposure during early children, with an increased odds ratio (OR) [adjusted OR=2.18; 95% confidence interval (CI),1.35 to 3.52] for an interquartile range (38 μg/m3) increase in NOx levels. A relative risk for AR of of 1.88 (95% CI, 1.26 to 2.81) with boys, of 1.91 (95% CI, 1.28 to 2.85) among with eczema during the first year, of 2.94 (95% CI, 1.77 to 4.87) with parents allergy, of 4.14 (95% CI, 2.65 to 6.49) with stressful family events, was also observed. TRAP exposure was significantly associated with AR in preschool children who are boys (adjusted OR=2.13; 95% CI, 1.31 to 3.45), with parental having allergy (adjusted OR=2.06, 95% CI, 1.27 to 3.36), and a history of stressful family events (adjusted OR=1.94, 95% CI, 1.18 to 3.20). Conclusions: Early childhood TRAP exposure, boys, parental allergy, stressful family events may contribute to AR in children at 4 years of age.

Idiopathic ventricular arrhythmias (VA) are common and treatment options include anti-arrhythmic drugs (AAD) or catheter ablation. Patients presenting with idiopathic VA which is originating from the left ventricular summit (LVS) poses a particular challenge as the success for catheter ablation is low and AAD’s may not be used long-term due to side effects. Ivabradine is an inhibitor of funny current (If) in cardiac pacemaker cells by blocking hyperpolarization-activated cyclic nucleotide-gated (HCN) and recommended for the treatment of heart failure with reduced ejection fraction and stable coronary artery disease. Recently, several cases described patients with atrial and junctional ectopic tachycardias who were successfully treated with ivabradine. In the present case, we reported the use of ivabradine in the treatment of idiopathic VA which was originated from the LVS and was resistant to multiple AAD’s and catheter ablation.

Case PresentationA 62 year old man with a past medical history of hypertension and mild coronary artery disease underwent dual chamber permanent pacemaker (PPM) implantation in April of 2015 for complete heart block. A Boston Scientific Ingenio K173 (Boston Scientific, St. Paul, MN) generator was inserted and connected to 2 Medtronic 5076 pacing leads (Medtronic, Minneapolis, MN) which were positioned in the right atrium (RA) and right ventricle (RV). The operative report noted “normal testing results” with an acute RV lead bipolar pacing threshold of 0.6 V at 0.4 msec and pacing impedance of 550 Ω. The PPM was programmed DDDR 60-130 bpm with RA and RV lead outputs programmed 3 times threshold.He had no further syncope after implant but continued to complain of intermittent lightheadedness as soon as a week out from the implant. Multiple pacemaker interrogations revealed stable atrial and ventricular lead function and he was told that his symptoms were likely due to low blood pressure which resulted in his blood pressure medicines being adjusted. The patient presented to his local hospital with recurrent syncope without warning 14 months after the initial implant. PPM interrogation recorded noise resulting in RV pacing inhibition (Figure 1). RV bipolar lead pacing threshold was 0.6 V at 0.4 msec and the pacing impedance measured 660 Ω. Historical RV lead pacing threshold and impedance trends were stable. RV lead oversensing was suspected and pocket manipulation, deep inspiration, Valsalva maneuver, arm isometrics, left arm extension, abduction and adduction did not duplicate the noise. The device was reprogrammed to asynchronous mode (DOO at 80 bpm) and the patient was transferred to our hospital for lead extraction.After confirming the interrogation findings, a chest radiograph was performed which showed no obvious fracture, gross dislodgement or lead discontinuity. What is the likely cause of the noise on the RV lead and this patient’s recurrent syncopal episodes?

Introduction: no data are provided about the effect of triple combination therapy with Lopinavir/Ritonavir (LPN/RTN), hydroxychloroquine (HQ) and azithromycin (AZT) on corrected QT (QTc) interval and arrhythmic risk, in COVID-19 patients. This study aims to describe the incidence of extreme QTc interval prolongation among COVID-19 patients on this experimental treatment and to identify the clinical features associated with extreme QTc prolongation. Materials and methods: data of 87 COVID-19 patients, treated with triple combination including LPN/RTN, HQ and AZT, were analyzed. QT interval was obtained by the tangent method and corrected for heart rate using Bazett’s formula. Extreme QTc interval prolongation was considered an absolute QTc interval ≥ 500 ms or an increase in QTc intervals of 60 milliseconds or greater (ΔQTc ≥ 60 milliseconds) compared with baseline. Results: Hypertension (66.7%) and diabetes (25.3%) were the most prevalent cardiovascular comorbidities. 20 patients (23%) showed extreme QTc interval prolongation; No clinical, electrocardiographic or pharmacological characteristics have been associated to extreme QTc prolongation, except the history of ischemic stroke (P= 0,007). One torsade de pointes (TdP) in patient with QTc extreme prolongation (QTc: 560 ms) after 5 days of therapy was recorded. Conclusions: We observed a high incidence of extreme QTc interval prolongation among COVID-19 patients on triple combination therapy. The incidence of malignant arrhythmias seems to be low, a careful electrocardiographic monitoring would be advisable.

Letter to the Editor, BJOG Exchange

Anthropogenic effects, such as nitrogen (N) enrichment and mowing, are constantly changing the function and structure of grassland ecosystems. In order to test whether the magnitude and frequency of N addition, as well as occurrence of mowing, affects gross N turnover. We designed a long-term field experiment which included 5 levels of N addition (0, 2, 10, 20, and 50 g N m-2 yr-1) and mowing in a typical grassland of northern China. To test the effects of N addition frequency, the amount of N applied was separated evenly by two times (twice a year, low frequency) or twelve times (monthly, high frequency) that results were compared against a control site where none of the treatments were applied. Mowing effects were also considered at each N treatment levels. Our results showed that the N level, the frequency of N addition, and mowing significantly influenced gross ammonification (GA) and nitrification (GN) rates. Specifically, the effect of N addition frequency was significantly different under the highest N addition level (50 g N m-2 yr-1), lower frequency (twice a year) significantly increased N turnover rates. Mowing significantly increased the GA rate, while decreased GN rate both under the highest N addition level (50 g N m-2 yr-1) and lower N addition frequency. Further long-term study of the effects of the interactions between N addition and mowing on N turnover will be needed for understanding the mechanisms by which nutrient cycling in typical grassland ecosystems may change in the future.

Understanding community assembly mechanism is essential for us to predict community dynamics and restoration process in the context of intensive human activities. In this study, we aimed to explore how the removal of shrub canopy influenced the community assembly in shrub-encroached grassland by both trait-based and phylogenetic approaches. We carried out an experiment of shrub canopy removal with three frequencies (no removal, removal once and twice a year) in a shrub-encroached grassland in China. We investigated community species composition under each treatment and collected plant functional traits for each species. We calculated the standard effect size (SES) of phylogenetic and trait-based functional diversity based on null model analysis to determine the dominant community assembly process. By phylogenetic analysis, the random process drove the community assembly, being independent of the removal frequencies and locations; while by trait-based approach, random process dominated the assembly in communities under ‘no removal’ treatment beneath shrub and under ‘removal twice a year’ treatment in shrub-interspace when using some certain single traits, and the limiting similarity process dominated the assembly in the rest communities. Removal of shrub canopy twice a year released more niches which promoted the performance of herbaceous species beneath shrub and promoted the settlement of annuals in shrub-interspace. Compared with phylogenetic analysis, the results of trait-based approach were more sensitive to the human activities. All these findings indicated that removal of shrub canopy twice a year would be an effective way for the restoration of shrub-encroached grassland.

Screening strategies for SARS-CoV-2 in pregnant women at term gestationAntonio Ragusa1, Alessandro Svelato1, Martina Bartolone2, Caterina De Luca3

This study investigates propagation effects of CMORPH rainfall estimation errors on streamflow simulation for a headwater catchment of the Zambezi River. Model simulations (2006-2012) by the Representative Elementary Watershed (REW) framework are carried out for uncorrected and for bias corrected CMORPH product (the Climate Prediction Center Morphing technique of the National Oceanic and Atmospheric Administration, or NOAA). As a benchmark to assessments, the model is run for in-situ observed rainfall obtained from 6 stations at a daily timestep. Analysis of CMORPH rainfall necessitates bias correction. A suite of performance indicators indicates that uncorrected CMORPH estimates show substantial augmentation of rainfall error to streamflow simulation mismatch whereas bias corrected estimates show attenuation of error. The ɛ-NSGAII algorithm is selected for single and multi-objective calibration to assess CMORPH error propagation to REW streamflow results. Improved hydrograph simulation is achieved by multi-objective calibration. Flow discharge simulation during the dry season shows more substantial error attenuation compared to wet season high flow discharge simulation. Further, this study shows that ratios of model based actual evapotranspiration over rainfall (ETa/R) and stream flow over rainfall (Qs/R) (runoff coefficient) at seasonal base change subject to selected uncorrected and corrected CMORPH. REW water storage (ΔS) is affected as well as calibrated model parameters. The paper provides new insights on propagation effects of satellite based rainfall errors in stream flow modelling.

Over the last two decades, the medical community witnessed an outstanding and accelerated development on minimally invasive therapies. With the dorsal spine of supportive data from large randomized control trials, transcatheter aortic valve replacement (TAVR), aortic and mitral valve-in-valve, mechanical circulatory support and peripheral endovascular interventions all share the need of accessing a vascular bed with a large bore catheter. Nevertheless, to date, there has yet to be a universal consensus on defining large-bore vascular access (LBVA) in the world of transcatheter therapies. We explore the evolution, characteristics and vascular compatibility of the current commercially available devices, analyze the devices along with access site-specific complications rates and finally review the present methods for percutaneous vascular closure.

Backgrounds: Allergic rhinitis (AR) is highly prevalent worldwide, but its treatment is poor. Myofascial trigger point (MTrP) injections have been effectively used for the management of many chronic painful diseases. Latent MTrPs (we called Qi points, QiPs) could be with autonomic nerve phenomena. Little is known about the correlation between QiPs and AR. Therefore, we proposed the hypothesis that QiPs might play a role in the pathophysiological mechanisms of AR. The current study was designed to investigate the efficacy and safety of QiPs injection therapy for AR. Methods: Sixty-five patients who suffered from moderate to severe AR were enrolled in this study. All patients received QiPs injection therapy in the referred facial and cervical muscles only once. The total nasal symptom score (TNSS) and side-effects was collected during the following 24 weeks. Results: The patients reported that their nasal and eye symptoms were significantly improved compared to those previously reported. The TNSS in the 15 minutes after treatment was significantly lower compared with the score before treatment, and the effect was maintained for at least 24 weeks. No obvious side effects were recorded during the treatment or the follow-up period. Conclusions: QiPs injection therapy provided long-term clinical efficacy with few adverse events in moderate to severe AR patients. QiPs inflammation in the facial and cervical regions, which causes nasal mucous oversecretion by regulating upper cervical sympathetic nerve ganglion and sphenopalatine ganglion activity, might play a novel role in the etiology of AR.

Aims: This study investigated the safety, tolerability, and PK after administration of a specific Cannabis sativa cultivar extract, standardised to CBD content as sublingual wafer or oil formulation compared to nabiximols oromucosal spray. Methods: For the single-dose study, the design was an open-label, four-way crossover in 12 healthy volunteers randomised to receive a sequence of four different single doses of CBD as a sublingual wafer (25 or 50 mg CBD), oil solution (50 mg CBD), or nabiximols oromucosal spray (20 mg CBD, 21.6 mg THC). For the multiple-dose study, sublingual wafer (50 mg CBD) was administered twice a day for five days. Results: The extract was generally well tolerated by participants when administered in either wafer or oil form, with some adverse events, including mild or moderate somnolence, sedation and altered mood. The relative bioavailability of CBD after administration as a sublingual wafer was comparable with that of oil solution with 90% confidence interval of 83–131%. The median maximum concentrations of CBD after administration of oil solution and wafer was 9.4 and 11.9 ng mL-1, respectively. Maximum concentrations of CBD occurred 4 hours after administration, with an estimated terminal elimination half-life of 6 hours. There was no statistically significant difference between the AUC0-t of CBD after administration of oil solution or wafer compared with nabiximols oromucosal spray. Conclusion: Oil solution and sublingual wafer formulations of the extract standardised with CBD were well tolerated and demonstrated safe and achieved equivalent concentrations of CBD when compared to an available commercial formulation.

Background: An understanding of deprescribing processes in primary care is an important step in designing policy initiatives and healthcare systems to optimise appropriate antidepressant discontinuation. Aim: To explore GPs perceptions and experiences of discontinuing antidepressants. Design and setting: Following ethical approval, a qualitative study was undertaken with GPs affiliated with a University education and research network for general practice in Ireland. Method: Semi-structured interviews undertaken with a purposive sample of GPs (n=10) between July 2019 and March 2020, were transcribed and analysed using Braun and Clarkes (2013) thematic analysis framework. Results: Five themes emerged: Clinical dilemmas; personalised therapy; medication tapering toolkit; talk therapy and concerns around tapering. GPs described being less likely to engage in deprescribing in those with recurrent depression, older patients and those with comorbidities. Fear associated with patient relapse was described by all participants. GPs felt limited access to psychological services impacted on care and that prompts to review might facilitate deprescribing. Conclusions: GPs are confident in their role of managing mild to moderate depression in the community and deprescribing antidepressants. This study provides an insight into factors that influence GPs decisions to deprescribe antidepressants and the barriers and facilitators for GPs in this role.

Factor V Leiden mutation is commonly associated with venous thromboembolism. Although there are cases reported with prosthetic valve thrombosis, no native valve thrombosis has been reported in the literature. In this case report, we presented the concomitant aortic valve thrombosis and sinus of Valsalva aneurysm in a patient with a Factor V Leiden mutation. To the best of our knowledge, our case is the first in the literature.

A document by Jacqueline Montoya, written on Authorea.

In this case series, four patients developed or presented with severe infections. In addition to antimicrobial therapy, they were treated with a new matrix therapy technology called CACIPLIQ20®. CACIPLIQ20® markedly improved the outcomes of all cases in terms of healing times and range of motion despite healing by secondary intention.

Comparative studies of genetic diversity and population structure can shed light on the ecological and evolutionary factors governing host–parasite interactions. Even though they are considered of major biological importance, little is known about the adaptation potential of invasive parasites in their new ranges. Here, the genetic diversification of Varroa destructor, a novel parasite of Apis mellifera originating from Asia, was investigated using population genetics to compare how the genetic structure of the parasite changed in response to its interactions with distinct European populations of its new host. To do so, mites infesting two categories of hosts in four European regions were compared: (i) adapted hosts surviving through means of natural selection, thereby expected to impose strong selective pressure on the mites, and (ii) susceptible host populations, surviving because acaricides are applied, therefore characterized by a relaxed selection imposed by the host. Significant genetic divergence was found across regions, reflecting partially the invasion pattern of V. destructor throughout Europe, but also local adaptation of the mite to the host populations. Additionally, varying degrees of genotypic changes were found between mites from adapted and susceptible colonies. Altogether, these results indicate that V. destructor managed to overcome the genetic bottlenecks following its introduction in Europe and that host-mediated selection fostered changes in the genetic structure of this mite at diverse geographical scales. These findings highlight the potential of parasites to adapt to their local host populations and confirm that adaptations developed within co-evolutionary dynamics are a major determinant of population genetic changes.

Soil fungal communities are vital for post-fire ecosystem restoration because of their ability to cycle nutrients and form symbiotic partnerships with regenerating trees. However, understanding is limited about how high-severity wildfires influence the fungal community of ecosystems adapted to low-severity fires. We studied an 11-year-old chronosequence of high-severity burn ponderosa pine (Pinus ponderosa) in eastern Washington, USA. Using Illumina MiSeq of the ITS1, we examined changes in soil nutrients, drivers of ectomycorrhizal (EcM) and saprobic fungal richness, community shifts, and post-fire fungal succession. High-severity wildfires reduced EcM fungal richness by an average of 45.8% and saprobic richness by 11.7%, leading to significant, long-term alterations to the post-fire fungal communities that did not return to unburned levels even after 11 years. Over time, differences in the post-fire fungal community were driven by the dominance of several pyrophilous fungi, including the EcM Ascomycete genera Pustularia and Wilcoxina, and the saprobic Basidiomycete genus Geminibasidium, which decreased in abundance with time post-fire. EcM fungi and saprobes were intimately linked to the soil environment: total carbon, total nitrogen, and their interaction with fire predicted ectomycorrhizal richness, while total carbon, time since fire, and the interaction between time since fire and treatment predicted saprobic species richness. We conclude that high-severity wildfires reduced EcM richness and significantly altered the EcM and saprobic fungal communities of this fire-adapted ecosystem, selecting resilient and fire-adapted species, such as W. rehmii and Geminibasidium sp., thus initiating post-fire succession.

Water resources are crucial for maintaining daily life and healthy ecological environment. In order to gain a harmonious development among water resources and economic development in Chaohu Lake Watershed, it is urgent to quantify the lake-inflow. However, the accurate inflow forecast is severely limited by the lack of information regarding river flow (flow into Chaohu Lake). This paper attempts to overcome these problems through applying the integrated model, which coupled the water balance method and the Xin’anjiang model that the improved single objective particle swarm optimization was added. Meanwhile, the coupled model parameters were calibrated based on the objective function that the maximum weighted average Nash-Sutcliffe efficiency of the flood events with discontinuous time. In addition, the three copula functions (Clayton, Frank and Gumbel-Hougaard method) embodying bivariate probability distribution of annual precipitation and annual highest water level, were performed to select the typical year. According to the results of frequency analysis, Gumbel-Hougaard method is applied to select the typical hydrological years, including high inflow (2016), medium inflow (2007) and low inflow year (1978). Additionally, the calibration and verification results of the coupled model suggest that the simulation results are best in the high inflow year, followed by the media inflow year and the low inflow year. Also, annual lake inflow simulation in normal inflow year is 19.4×108 m3, while the findings of the annual average land surface runoff of the study area is 18.9×108 m3, indicating that the coupled water balance method and Xin’anjiang model have been proved to be robust in determining inflow in ungauged stream. The results of this present provides a basis for determining the appropriate operation and management of water resources systems.

Sheep and goat pox (SGP) and orf are economically important transboundary animal diseases of small ruminants in India. The current study investigated an outbreak of mixed infection with Goatpox virus (GTPV) and Orf virus (ORFV) that occurred in an extensive system of goat rearing. Based on clinical sings and postmortem findings the disease was preliminary diagnosed as goat pox. The overall morbidity rate of 85.71% (60/70) was reported. The morbidity rate in young animals (100%; 30/30) was higher than adults (75%; 30/40). The overall mortality rate recorded was 40% (28/70), whereas the case fatality rate of 20% and 66.67% in adults and young animals respectively. Preliminary molecular diagnosis revealed presence of capripoxvirus followed by specific confirmation as GTPV by PCR-RFLP and sequencing of major envelope protein gene P32 of CaPV. The ORFV was detected and confirmed by PCR amplification and sequencing of complete B2L gene from the scab samples collected from affected goats. Phylogenetic analysis and multiple sequence analysis of GTPV and ORFV virus isolates from current outbreak showed highest homology to their respective Indian isolates from different parts of country. The present study reported co-infection of GTPV and ORFV in goats, which might have contributed to high morbidity. Therefore, the outbreak is epidemiologically significant and emphasis should be given in future for continuous serological/clinical surveillance of mixed infections in small ruminants’ health management.