Expansion and transmission dynamics of high risk carbapenem-resistant Klebsiella pneumoniae subclones in China: An epidemiological, spatial, genomic analysis.

AIMS: Carbapenem-resistant Klebsiella pneumonia (CRKP) is a global threat that varies by region. The global distribution, evolution, and clinical implications of the ST11 CRKP clone remain obscure. METHODS: We conducted a multicenter molecular epidemiological survey using isolates obtained from 28 provinces and municipalities across China between 2011 and 2021. We integrated sequences from public databases and performed genetic epidemiology analysis of ST11 CRKP. RESULTS: Among ST11 CRKP, KL64 serotypes exhibited considerable expansion, increasing from 1.54% to 46.08% between 2011 and 2021. Combining our data with public databases, the phylogenetic and phylogeography analyses indicated that ST11 CRKP appeared in the Americas in 1996 and spread worldwide, with key clones progressing from China's southeastern coast to the inland by 2010. Global phylogenetic analysis showed that ST11 KL64 CRKP has evolved to a virulent, resistant clade with notable regional spread. Single-nucleotide polymorphism (SNP) analysis identified BMPPS (bmr3, mltC, pyrB, ppsC, and sdaC) as a key marker for this clade. The BMPPS SNP clade is associated with high mortality and has strong anti-phagocytic and competitive traits in vitro. CONCLUSIONS: The high-risk ST11 KL64 CRKP subclone showed strong expansion potential and survival advantages, probably owing to genetic factors.

A comparative study of general and severe mycoplasma pneumoniae pneumonia in children.

OBJECTIVES: The increasing prevalence of severe Mycoplasma pneumoniae pneumonia (SMPP) poses a significant threat to the health of children. This study aimed to characterise and assess the outcomes in children with SMPP. METHODS: We retrospectively analysed children hospitalised for M. pneumoniae pneumonia (MPP) between January and December 2022. Retrospectively, demographic, clinical, underlying diseases, laboratory and radiological findings, and treatment outcomes were collected and analysed. Disease severity was defined as severe or general according to the Guideline for diagnosis and treatment of community-acquired pneumonia in children (2019 version). RESULTS: Over a 12-month observation period, 417 children with MPP were enrolled, 50.6% (211/417) of whom had SMPP, with the peak incidence observed in winter. Of the 211 children with SMPP, 210 were treated and discharged with improvement, while one child with congenital heart disease died of cardioembolic stroke. A significantly higher proportion of patients with SMPP had underlying diseases, extrapulmonary complications (myocardial and digestive system involvement), and bacterial co-infection. A total of 25 (12%) children with SMPP received mechanical ventilation. The median duration of mechanical ventilation was 3 days. All children were treated with macrolide antibiotic. A significantly higher proportion of patients with SMPP received antibiotic other than macrolides, methylprednisolone sodium succinate, intravenous immunoglobulin and anticoagulation, compared with patients with general MPP (GMPP). Children with SMPP had significantly higher levels of white blood cells, neutrophil percentage, C-reactive protein, procalcitonin, interferon-γ, interleukin (IL)-2, IL-5, IL-6, IL-8, IL-10 and significantly lower percentages of lymphocytes, monocytes, and natural killer cells, compared with GMPP group. CONCLUSION: Our findings suggest that severely ill children have more pronounced inflammatory reaction and extrapulmonary complications. For effective management of children with SMPP, hormonal, prophylactic, anticoagulant therapy, as well as the use of antibiotics other than macrolides for bacterial co-infections, could be incorporated into treatment regimens.

Respiratory syncytial virus subtypes in children with bronchiolitis: does it correlate with clinical severity?

BACKGROUND: In this retrospective study, we aimed to evaluate the factors associated with the severity of respiratory syncytial virus (RSV) bronchiolitis in children aged under 2 years who were admitted to the Children's Hospital of Hebei between June 2018 and January 2019. METHODS: Sputum samples positive for RSV via multiplex PCR were subtyped using real-time PCR. Data collected included risk factors for disease severity, demographics, microbiology, and outcomes. RESULTS: Of the 82 children with RSV bronchiolitis, 79 were treated and discharged with improvement, while 3 died. All three patients had underlying medical conditions, including complex congenital heart disease and severe combined immunodeficiency. Further, disease severity was associated with preexisting underlying disease, fever duration, and bacterial co-infection, but not with the RSV subtype. CONCLUSIONS: Our findings suggest that an appropriate therapeutic regimen should include the detection of bacterial co-infections and the identification of underlying diseases for the effective management of severe RSV bronchiolitis.

Simple route for high-throughput fabrication of metasurfaces using one-step UV-curable resin printing.

Phase-gradient metasurfaces are two-dimensional (2D) optical elements that can manipulate light by imposing local, space-variant phase changes on an incident electromagnetic wave. These metasurfaces hold the potential and the promise to revolutionize photonics by providing ultrathin alternatives for a wide range of common optical elements such as bulky refractive optics, waveplates, polarizers, and axicons. However, the fabrication of state-of-the-art metasurfaces typically requires some time-consuming, expensive, and possibly hazardous processing steps. To overcome these limitations on conventional metasurface fabrication, a facile methodology to produce phase-gradient metasurfaces through one-step UV-curable resin printing is developed by our research group. The method dramatically reduces the required processing time and cost, as well as eliminates safety hazards. As a proof-of-concept, the advantages of the method are clearly demonstrated via a rapid reproduction of high-performance metalenses based on the Pancharatnam-Berry phase gradient concept in the visible spectrum.

Demonstration of 120 Gbit/s turbulence-resilient coherent optical communication employing cylindrical vector beam multiplexing.

Free space optical (FSO) communication has gained widespread attention due to its advantages, including high confidentiality, high communication capacity, and no limitation of spectrum. One of the great challenges in FSO communication is the transmission performance degradation in atmospheric turbulence channel due to wavefront distortion and scintillation. Here, we proposed and experimentally demonstrated a 120 Gbit/s vector beam multiplexed coherent optical communication system with turbulence-resilient capacity. Four multiplexed vector beams, each carrying a 30 Gbit/s quadrature phase-shift keying signal, propagate through different turbulence conditions. The influence of turbulence channel on the vector beam impairments is experimentally investigated. Under the weaker turbulence conditions, the system bit error rates are below the forward error correction threshold of 3.8 × 10-3. In comparison with the Gaussian mode, the communication interruption probability of the vector beams system decreases from 36% to 12%-18% under stronger turbulence conditions.

Epidemiology and clinical severity of the serotypes of human parainfluenza virus in children with acute respiratory infection.

BACKGROUND: Acute respiratory infections (ARI) are a threat to human health and survival, resulting in many paediatric hospitalisations. However, the epidemiological and clinical severity characteristics of the human parainfluenza virus (PIV), one of the most prevalent respiratory viruses, are not well understood in children. METHODS: To identify the epidemiological features of PIV infection, in 2019, hospitalised children with ARI were screened using multiplex polymerase chain reaction (PCR) for PIV and 10 other common respiratory pathogens. Subtyping of randomly selected PIV-positive samples was performed using reverse transcription-PCR. Demographics, epidemiology, clinical manifestations, diagnosis, and outcomes were compared between PIV subtypes. RESULTS: The annual detection rate for PIV was 14.9%, with a peak from April to September. Children under one year of age had the highest rate of PIV infection (45.5%) compared to other age groups. Of the 121 sequenced samples, 58.7%, 36.4% and 4.9% were positive for PIV-3, PIV-1 and PIV-2, respectively, and no PIV-4 was detected. Severe infections were associated with pre-existing underlying diseases and co-infections, but not with PIV serotype. After excluding cases of co-infection, we found that PIV-2 infection was associated with upper respiratory tract infections, whereas PIV-1 and PIV-3 mainly caused lower respiratory tract infections. Apart from the proportion of patients with fever, there were no significant differences among the three subtypes in terms of clinical symptoms, severity, and outcome. CONCLUSION: Here, PIV was the main pathogen causing ARI in hospitalised children. Appropriate attention should be paid to children with underlying diseases and co-infections to prevent the worsening of severe PIV infection.

Comparative study of diagnostic efficacy of sputum and bronchoalveolar lavage fluid specimens in community-acquired pneumonia children treated with fiberoptic bronchoscopy.

BACKGROUND: Community-acquired pneumonia (CAP) is usually diagnosed in children, and the type of respiratory specimen is critical. Differences in pathogens detection between induced sputum (IS) and bronchoalveolar lavage fluid (BALF) have not been evaluated. METHODS: In 2018, paired sputum and BALF samples from CAP hospitalised children with indications for bronchoalveolar lavage (BAL) were subjected to multiplex PCR for the detection of 11 common respiratory pathogens. RESULTS: A total of 142 children with paired sputum and BALF were tested. The overall positivity rate was 85.9% (122/142) for sputum and 80.3% (114/142) for BALF. The two specimens presented almost perfect agreement between the detection on M. pneumoniae, influenza A, influenza B, bocavirus and RSV. In contrast, adenovirus had the lowest kappa value of 0.156, and a false negative rate (FNR) of 66.7%. Rhinovirus had the highest false positive rate (FPR) as 18.5%. The consistent rate was significantly higher in school-age children than those under 1 year old (p = .005). Bacterial co-infection in BALF specimens were observed in 14.8% (21/142). Of the 11 discordant pairs of specimens, 9 cases were sputum(+)/BALF(-) with adenovirus predominating. CONCLUSION: Our findings suggest that the consistency of results between sputum and BALF is pathogen specific. Careful consideration needs to be given to whether sputum can be used as a substitute for BALF when children are young or co-infections with bacteria are suspected.

Rapid two-stage amplification in a single tube for simultaneous detection of norovirus GII and group a rotavirus.

The most prevalent viruses currently causing diarrhea are norovirus and rotavirus, and rapid and sensitive detection methods are essential for the early diagnosis of disease. The purpose of this study was to establish a sensitive single-tube two-stage nucleic acid amplification method-reverse transcription recombinase-assisted PCR (RT-RAP)-for simultaneous detection of norovirus GII and group A Rotavirus, with the first stage consisting of isothermal reverse transcription recombinase-aided amplification (RT-RAA) and the second stage consisting of qPCR (quantitative PCR). RT-RAP is more sensitive than either RT-RAA or qRT-PCR (quantitative RT-PCR) alone. And the addition of a barrier that can be disassembled after heating enabled the detection of samples within 1 h in a single closed tube. Sensitivity was 10 copies/reaction of norovirus (Novs) GII and group A rotavirus (RVA). In parallel, two hundred fecal specimens were used to evaluate the method and compare it with a commercial fluorescent quantitative RT-PCR. The data showed kappa values of 0.957 and 0.98 (p < 0.05) for detecting Novs GII and RVA by the two methods, indicating the potential of the newly established assay to be applied to clinical and laboratory testing.

Divergent control and variation in bacterial and fungal necromass carbon respond to the abandonment of rice terraces.

The abandonment of rice terraces in hilly agroecosystems in recent decades has caused substantial changes in microbial characteristics and their impact on microbial necromass carbon (MNC) and soil organic carbon (SOC). Nevertheless, the regulatory mechanisms and impact pathways of MNC remain unclear. Here, soil samples were collected from 0 to 120 cm soil profiles in rice terraces, dry land (DL), and forest land (FL) for analysis. After converting rice terraces to DL and FL, MNC decreased significantly by 31.12% and 38.33%, while SOC decreased significantly by 51.26% and 29.87% respectively. These reductions are due to the loss of terrace management practices and associated functions. There were no significant changes in bacterial necromass carbon (BNC), whereas fungal necromass carbon (FNC) experienced a significant decrease. As a result, the decline in SOC may be primarily attributed to the reduction in FNC. BNC and FNC were regulated by bacterial life history strategies and fungal biomass, respectively. However, bacterial copiotrophs experienced a significant reduction after rice terrace abandonment. The regulation of BNC may be influenced by other factors, potentially offsetting the negative impact of abandonment. Dissolved organic carbon and bulk density were the primary control factors for bacterial community composition and fungal biomass, respectively. Additionally, the impact of soil layers on the alterations in MNC and SOC was more significant compared to the abandonment of rice terraces. These findings indicate that short-term abandonment of rice terraces results in a decrease in SOC, potentially compromising the ecological service function of the hilly agroecosystems. In the face of rapid population growth and global warming, it is crucial to minimize terrace abandonment and enhance utilization rates. This approach will effectively support sustainable terrace management and ecological services.

Polarization multiplexing metasurface for dual-band achromatic focusing.

We propose a dual-band achromatic focusing metasurface based on polarization multiplexing and dispersion engineering. An anisotropic resonant phase meta-atom is designed to realize independent nonlinear phase manipulation along the orthogonal directions. Achromatic focusing metasurface and broadband reflectarray antenna are further constructed in the microwave region with a computer-assisted particle swarm optimization algorithm. The standard deviation of focus offset at 11-16 GHz (for x-polarization) and 18-24 GHz (for y-polarization) are compressed to 19.83% and 16.60% of the dispersive metasurface, respectively. The radiation gains of the reflectarray antenna increase by an average of 19.49 dB and 15.08 dB in the broadband region compared with the bare standard rectangle waveguides. Furthermore, such an achromatic metasurface can be utilized to realize different functions with polarization selectivity and applied to other frequency ranges, which holds great promise in integrated optics.

Full-space beam scanning based on transmission reflection switchable quadratic phase metasurface.

Beam scanning based on metasurfaces is widely discussed in recent years owing to its high integration, lightweight, and low cost. However, most of the reported beam scanning metasurfaces operate in either transmission or reflection mode. Here, we propose a full-space beam scanning metasurface based on transmission reflection switchable meta-atom and the quadratic phase distribution. As a validation, a metasurface array with 400 units (20 × 20) was experimentally demonstrated. Beam scanning of ± 35 ° was achieved in both transmission mode and reflection mode. A larger scanning angle (± 45 °) was further verified simulatively with a 900-units (30 × 30) array. The method provides an avenue for expanding the space of electromagnetic wave manipulation and may have great potential in wireless communication and radar detection.

Optically transparent infrared selective emitter for visible-infrared compatible camouflage.

Visible-infrared compatible camouflage is significant to enhance the equipment survivability through counteracting the modern detecting and surveillance systems. However, there are still great challenges in simultaneously achieving multispectral camouflage with high transmittance in visible, low emissivity in the atmospheric windows and high emissivity in the non-atmospheric window, which can be attributed to the mutual influence and restriction within these characteristics. Here, we proposed an optically transparent infrared selective emitter (OTISE) composed of three Ag-ZnO-Ag disk sub-cells with anti-reflection layers, which can synchronously improve the visible transmittance and widen absorption bandwidth in the non-atmospheric window by enhancing and merging resonance response of multi-resonators. Test results reveal that low emissivity in infrared atmospheric windows, high emissivity in the 5-8 µm non-atmospheric window and high optical transparency have been obtained. In addition, the radiative flux of OTISE in 3-5 µm and 8-14 µm are respectively 34.2% and 9.3% of that of blackbody and the energy dissipation of OTISE is 117% of that of chromium film. Meanwhile, it keeps good optical transparency due to the ultrathin Ag film. This work provides a novel strategy to design the optically transparent selective emissive materials, implying a promising application potential in visible and infrared camouflage technology.

Polarization-dependent spatial channel multiplexing dynamic hologram in the visible band.

In this work, we propose dynamic holography based on metasurfaces combining spatial channel multiplexing and polarization multiplexing. In this design, spatial channels can provide up to 3N holographic frames, which not only increase the possibility of dynamic control but also increase the privacy of the holographic display. This design is also sensitive to polarization, so it further expands the spatial channel capacity. For the left and right circular polarization incident light, there are different dynamic pixel schemes. Therefore, this approach holds promise in the holographic display, optical storage, optics communication, optical encryption, and information processing.

Broadband achromatic metasurfaces for sub-diffraction focusing in the visible.

Conventional achromatic optical systems are matured to achieve effective chromatic aberration correction and diffraction-limited resolution by the multiple bulky lenses. The emergence of the super-oscillation phenomenon provides an effective method for non-invasive far-field super-resolution imaging. Nevertheless, most super-oscillatory lenses are significantly restricted by the chromatic aberration due to the reliance on delicate interference; on the other hand, most achromatic lenses cannot break the diffraction limit. In this article, a single-layer broadband achromatic metasurface comprising sub-wavelength anisotropic nanostructures has been proposed to achieve sub-diffraction focusing with a focal length of f=60 µm and a diameter of 20 µm in the visible ranging from 400 nm to 700 nm, which are capable of generating sub-diffraction focal spots under the left-handed circularly polarized incident light with arbitrary wavelength in the working bandwidth at the same focal plane. This method may find promising potentials in various applications such as super-resolution color imaging, light field cameras, and machine vision.

Topology-optimized catenary-like metasurface for wide-angle and high-efficiency deflection: from a discrete to continuous geometric phase.

We investigate the topology optimization of geometric phase metasurfaces for wide-angle and high-efficiency deflection, where adjoint-based multi-object optimization approach is adopted to improve the absolute efficiency while maintaining the polarization conversion characteristic of geometric phase metasurfaces. We show that, for the initially discrete geometric phase metasurfaces with different materials and working wavelengths, the topology shapes gradually evolve from discrete structures to quasi-continuous arrangements with the increment of optimization iteration operations. More importantly, the finally optimized metasurfaces manifest as catenary-like structure, providing significant improvements of absolute efficiency. Furthermore, for the initial structure with catenary distribution, the corresponding optimized metasurface also has a catenary-like topology shape. Our results on the topology-optimized geometric phase metasurfaces reveal that, from the perspective of numerical optimization, the continuous catenary metasurfaces is superior to the discrete geometric phase metasurfaces.

Super-oscillatory metasurface doublet for sub-diffraction focusing with a large incident angle.

Based on the delicate interference behavior of light in the far field, the optical super-oscillatory phenomenon has been successfully applied in non-invasive sub-diffraction focusing and super-resolution imaging in recent years. However, the optical super-oscillatory field is particularly sensitive to the change of incident angle, leading to a limited field of view for super-resolution imaging. In this paper, a super-oscillatory metasurface doublet is proposed to achieve far-field sub-diffraction focusing with an incident angle of up to 25°. The constructed doublet, consisting of high-aspect-ratio rectangular nanopillars with high efficiency, is further demonstrated through a full-wave simulation, and the numerical results indicate that the sub-diffraction foci with about 0.75 times of the diffraction limit is achieved for different incident angles. The proposed super-oscillatory metasurface doublet may find intriguing applications in label-free super-resolution microscopy and optical precise fabrication.

Generalized Pancharatnam-Berry Phase in Rotationally Symmetric Meta-Atoms.

Pancharatnam-Berry geometric phase has attracted enormous interest in subwavelength optics and electromagnetics during the past several decades. Traditional theory predicts that the geometric phase is equal to twice the rotation angle of anisotropic elements. Here, we show that high-order geometric phases equal to multiple times the rotation angle could be achieved by meta-atoms with highfold rotational symmetries. As a proof of concept, the broadband angular spin Hall effect of light and optical vortices is experimentally demonstrated by using plasmonic metasurfaces consisting of space-variant nanoapertures with C2, C3, and C5 rotational symmetries. The results provide a fundamentally new understanding of the geometric phase as well as light-matter interaction in nanophotonics.

Prospective case-control study of enterovirus detection differences in children's cerebrospinal fluid between multiplex PCR and real-time RT-PCR assay.

BACKGROUND: Viral encephalitis is common in childhood. It is an acute brain parenchymal inflammation caused by a variety of viral infection, and enterovirus accounts for the majority. Due to atypical clinical manifestations, pathogenic testing is important for assisting clinical diagnosis. The purpose of this study was to evaluate the performance of the multiplex PCR assay compared with quantitative real-time PCR for enterovirus detection. METHODS: A prospective case-control study was performed involving 103 pediatric patients suspected for viral encephalitis and cerebrospinal fluid (CSF) samples were collected and tested for 9 pathogens using multiplex PCR assay during April to November in 2018. In parallel, an aliquot of samples was tested for enterovirus infection by real-time PCR assay. RESULTS: There were 85.4% children were confirmed as viral encephalitis on discharge, the remaining ones were diagnosed as other CNS diseases, such as epilepsy. The specificity of the two methods was the same as that of the clinical diagnosis, but the sensitivity and consistency with clinical diagnosis of multiplex PCR were both higher than the real-time PCR. Besides of enterovirus, multiplex PCR could also detect coinfection of enterovirus with Epstein-Barr virus and mumps virus. CONCLUSION: Results of multiplex PCR method are more consistent with the clinical diagnosis and are superior to real-time PCR for detecting enterovirus in CSF.

Integrated multispectral real-time imaging system based on metasurfaces.

In this paper, a highly integrated array-based imaging system, composed of a lens array and a metasurface array, is proposed to achieve multispectral real-time imaging within a wide range of 400-1100 nm numerically. Each channel has an achromatic bandwidth of 50 nm and an aperture of about 5 mm, with the system average efficiency reaching over 91%. It breaks the restrictions of cumbersome volumes and limited materials that deteriorate the performance of conventional systems, facilitating miniaturization and integration. Moreover, the design method is also suitable for other spectral bands, widening applications of metasurfaces in multispectral imaging.

Minimized two- and four-step varifocal lens based on silicon photonic integrated nanoapertures.

Integration of optical waveguide and subwavelength structure may help address the problems of large footprint, low robustness, and small operation bandwidth, those of that are typically inborn in traditional integrated optical devices. Here, a design method of an ultra-compact small footprint lens is proposed. Combing particle swarm optimization (PSO) algorithm with spatial multiplexing technology, we successfully integrated two- and four-step varifocal lenses on SOIs chips with small footprint of 35×35 µm2, non-mechanically leading to 2.5× and 3.4× zoom capacity, respectively. The proposed designed method may shed a new light on compact on-chip display devices and offer an alternative approach to design integrated optical communication with high information storage capacity.