Diagnostic value and clinical use of metagenomic next-generation sequencing for invasive pulmonary aspergillosis.

OBJECTIVE: To compare the diagnostic efficacy of metagenomic next generation sequencing (mNGS) with traditional fungal culture, (1,3)-ß-D glucan (G) test, and galactomannan (GM) test in diagnosing invasive pulmonary aspergillosis (IPA) and to explore the advantages and disadvantages of mNGS for IPA diagnosis. METHODS: A retrospective analysis was conducted on 136 patients admitted to the Department of Respiratory and Critical Care Medicine of Affiliated Hospital of Putian University from March 2018 to March 2020. Among them, there were 66 patients with IPA (IPA group) and 70 without (non-IPA group). Baseline data, inflammatory factors, cytokines, and specimens such as bronchoalveolar lavage fluid (BALF) and blood of these patients were collected. Fungal culture test, G test, GM test and mNGS test were performed. Information included for analysis encompassed patients' host factors, clinical features, chest scanning images, laboratory test results, and treatment outcome. RESULTS: There was no statistical difference in the baseline data or inflammatory factors in patients between the IPA group and the non-IPA group. Further analysis showed that the sensitivity of mNGS in diagnosing IPA was 53.03%, which was higher than that of traditional fungal culture test (27.27%), G test (31.82%), and GM test (34.85%). Notably, when combining fungal culture, G test, GM test, and mNGS, the sensitivity increased to 69.70%, with a specificity of 97.14%. The sensitivity of the combined test was higher than that any of the tests alone for diagnosing IPA. CONCLUSION: mNGS test offers superior diagnostic performance for IPA in comparison to traditional tests, particularly for testing samples like bronchoalveolar lavage fluid and bronchial secretions. The test result remains valuable even after aspergillus treatment. In addition, the use of mNGS in conjunction with other traditional tests, such as fungal culture test, G test, and GM test, can enhance the diagnostic efficacy for IPA.

Dressing AgNWs with MXenes Nanosheets: Transparent Printed Electrodes Combining High-Conductivity and Tunable Work Function for High-Performance Opto-Electronics.

High-work function transparent electrodes (HWFTEs) are key for establishing Schottky and Ohmic contacts with n-type and p-type semiconductors, respectively. However, the development of printable materials that combine high transmittance, low sheet resistance, and tunable work function remains an outstanding challenge. This work reports a high-performance HWFTE composed of Ag nanowires enveloped conformally by Ti3C2Tx nanosheets (TA), forming a shell-core network structure. The printed TA HWFTEs display an ultrahigh transmittance (>94%) from the deep-ultraviolet (DUV) to the entire visible spectral region, a low sheet resistance (<15 Ω sq-1), and a tunable work function ranging from 4.7 to 6.0 eV. The introduction of additional oxygen terminations on the Ti3C2Tx surface generates positive dipoles, which not only increases the work function of the TA HWFTEs but also elevates the TA/Ga2O3 Schottky barrier, resulting in a high self-powered responsivity of 18 mA W-1 in Ga2O3 diode DUV photodetectors, as demonstrated via experimental characterizations and theoretical calculations. Furthermore, the TA HWFTEs-based organic light-emitting transistors exhibit exceptional emission brightness of 5020 cd m-2, being four-fold greater than that in Au electrodes-based devices. The innovative nano-structure design, work function tuning, and the revealed mechanisms of electrode-semiconductor contact physics constitute a substantial advancement in high-performance optoelectronic technology.

Oxidation of Toluene over the Pt-Embedded Mesoporous CeO2 Hollow Nanospheres with Advanced Catalytic Performances.

In this study, the novel Pt-embedded mesoporous CeO2 hollow nanospheres (Pt-MS-CeO2-H) with varying Pt contents (0.5-3.0 wt %) were facilely prepared. The Pt nanoparticles were one-pot embedded within the mesoporous shell of Pt-MS-CeO2-H and assisted with the reduction Ostwald ripening process. The traditional preparation methods often face challenges, such as the uneven distribution or aggregation of nanoparticles, as well as difficulty in maintaining high catalytic activity at low Pt content. Compared with the traditional supported Pt/MS-CeO2 catalyst, the embedding strategy facilitated precise control over the position, distribution, and uniformity of Pt nanoparticles within the CeO2 mesoporous shell. Additionally, the encapsulation process of Pt nanoparticles played a pivotal role in generating oxygen vacancies and activating surface chemical adsorption of oxygen. Resultantly, the toluene oxidation performances of 1Pt-MS-CeO2-H catalyst showed much lower T90 (171 °C) than 1Pt/MS-CeO2 (311 °C). To elucidate the underlying reasons, in situ diffuse reflectance infrared Fourier transform spectroscopy of toluene oxidation was employed to identify the reaction intermediates and pathways over these catalysts. In summary, the Pt-embedded mesoporous CeO2 hollow nanosphere catalysts were considered as potential candidates when designing high-performance toluene catalytic oxidation catalysts.

Heterometallic Molecular and Ionic Isomers.

Numerous descriptions of structural isomerism in metal complexes do not list any molecular vs ionic isomers. At the same time, one of the most striking examples of structural isomerism in organic chemistry is molecular urea, which has the same atomic composition as the chemically distinct ionic ammonium cyanate. This iconic organic couple now meets its inorganic heterometallic counterpart. We introduce a new class of structural isomers, molecular vs ionic, that can be consummated in complex and coordinatively unsaturated polynuclear/heterometallic compounds. We report inorganic molecular and ionic isomers of the composition [NaCrFe (acac)3(hfac)3] (acac = acetylacetonate; hfac = hexafluoroacetylacetonate). Heterometallic molecular [CrIII(acac)3-Na-FeII(hfac)3] (1m) and ionic {[CrIII(acac)3-Na-CrIII(acac)3]+[FeII(hfac)3-Na-FeII(hfac)3]-} (1i) isomers have been isolated in pure form and characterized. While both ions are heterobimetallic trinuclear entities, the neutral counterpart is a heterotrimetallic trinuclear molecule. The two isomers exhibit distinctly different characteristics in terms of solubility, volatility, mass spectrometry ionization, and thermal behavior. Unambiguous assignment of the positions and oxidation/spin states of the Periodic Table neighbors, Fe and Cr, in both isomers have been made by a combination of characterization techniques that include synchrotron X-ray resonant diffraction, synchrotron X-ray fluorescence spectroscopy, Mössbauer spectroscopy, and DART mass spectrometry. The transformation between the two isomers that does take place in solutions of noncoordinating solvents has also been tested.

Encapsulation of the vanadium substituted Keggin polyoxometalates [α-PVW11O40]4- and [α-PV2W10O40]5- in HKUST-1.

Two POM@MOF hybrid materials composed of a copper-based metal-organic framework (MOF) [Cu3(C9H3O6)2(H2O)3]n (HKUST-1) encapsulating vanadium-substituted Keggin polyoxometalates (POM), [α-PVW11O40]4- (PVW11) and [α-PV2W10O40]5- (PV2W10), were prepared and characterized. PVW11@HKUST-1 and PV2W10@HKUST-1 were synthesized hydrothermally by self-assembly of HKUST-1 in the presence of the preformed POMs, [α-PVW11O40]4- and [α-PV2W10O40]5-, respectively. The two POM@MOF composites were characterized by X-ray diffraction, TGA, BET surface area analysis and FT-IR and Raman spectroscopy. The electronic structure of the POM@MOF materials and their respective constituents is surveyed using solid state UV-vis reflectance spectroscopy. The UV-vis spectra order the oxidizing strength of the POM constituents ([α-PV2W10O40]5- > [α-PVW11O40]4-) and reveal the distinct electronic structure of the POM@MOF materials obtained by synthetic encapsulation of mono- and di-vanadium substituted Keggin polyoxotungstates in HKUST-1.

Fluoridation of D-A Ambipolar Polymers to Accelerate Ion Migration toward High-Performance Symmetric Dual-Ion Energy Storage Devices.

Dual-ion electrochemical energy storage devices have attracted much attention due to their cost effectiveness and high operating voltage. Electrochemical properties such as the specific capacity of dual-ion energy storage devices are closely related to ion migration. However, the ion migration of dual-ion energy storage devices is slow, especially the cation migration, resulting in limited discharge capacity and poor rate performance. In this study, fluorinated and nonfluorinated ambipolar conductive polymers were prepared as electrode materials. The effects of fluorination on aggregation and solvent were studied as well as its role in improving ion migration. The results show that fluorination can increase the force of fluorination on the solvent, reduce the level of binding of the solvent to the ion, and regulate the aggregation state. Compared with the unfluorinated polymer of PEPOPE, the ion migration and electrochemical kinetics of PEPFEP were significantly improved, and the PEPFPE (71 F/cm3) has a higher negative specific capacity than PEPOPE (24 F/cm3) at a current density of 5 A/cm3.

DNA hypo-methylation and expression of GBP4 induces T cell exhaustion in pancreatic cancer.

Immunotherapy for pancreatic ductal carcinoma (PDAC) remains disappointing due to the repressive tumor microenvironment and T cell exhaustion, in which the roles of interferon-stimulated genes were largely unknown. Here, we focused on a typical interferon-stimulated gene, GBP4, and investigated its potential diagnostic and therapeutic value in pancreatic cancer. Expression analysis on both local samples and public databases indicated that GBP4 was one of the most dominant GBP family members present in the PDAC microenvironment, and the expression level of GBP4 was negatively associated with patient survival. We then identified DNA hypo-methylation in regulatory regions of GBP4 in PDAC, and validated its regulatory role on GBP4 expression via performing targeted methylation using dCas9-SunTag-DNMAT3A-sgRNA-targeted methylation system on selected DNA locus. After that, we investigated the downstream functions of GBP4, and chemotaxis assays indicated that GBP4 overexpression significantly improved the infiltration of CD8+T cells, but also induced upregulation of immune checkpoint genes and T cell exhaustion. Lastly, in vitro T cell killing assays using primary organoids suggested that the PDAC samples with high level of GBP4 expression displayed significantly higher sensitivity to anti-PD-1 treatment. Taken together, our studies revealed the expression patterns and epigenetic regulatory mechanisms of GBP4 in pancreatic cancer and clarified the effects of GBP4 on T cell exhaustion and antitumor immunology.

Cu site differentiation in tetracopper(i) sulfide clusters enables biomimetic N2O reduction.

Copper clusters feature prominently in both metalloenzymes and synthetic nanoclusters that mediate catalytic redox transformations of gaseous small molecules. Such reactions are critical to biological energy conversion and are expected to be crucial parts of renewable energy economies. However, the precise roles of individual metal atoms within clusters are difficult to elucidate, particularly for cluster systems that are dynamic under operating conditions. Here, we present a metal site-specific analysis of synthetic Cu4(µ4-S) clusters that mimic the Cu Z active site of the nitrous oxide reductase enzyme. Leveraging the ability to obtain structural snapshots of both inactive and active forms of the synthetic model system, we analyzed both states using resonant X-ray diffraction anomalous fine structure (DAFS), a technique that enables X-ray absorption profiles of individual metal sites within a cluster to be extracted independently. Using DAFS, we found that a change in cluster geometry between the inactive and active states is correlated to Cu site differentiation that is presumably required for efficient activation of N2O gas. More precisely, we hypothesize that the Cu δ+⋯Cu δ- pairs produced upon site differentiation are poised for N2O activation, as supported by computational modeling. These results provide an unprecedented level of detail on the roles of individual metal sites within the synthetic cluster system and how those roles interplay with cluster geometry to impact the reactivity function. We expect this fundamental knowledge to inform understanding of metal clusters in settings ranging from (bio)molecular to nanocluster to extended solid systems involved in energy conversion.

BCL6 overexpression in CD4+ T cells induces Tfh-like transdifferentiation and enhances antitumor efficiency of CAR-T therapy in pancreatic cancer.

PDAC is a typical "cold tumor" characterized by low immune cell infiltration and a suppressive immune microenvironment. We previously observed the existence of a rare group of follicular helper T cells (Tfh) that could enhance antitumor immune responses by recruiting other immune cells in PDAC. In this study, we ectopically expressed BCL6 in CD4+ T cells, and successfully induced Tfh-like transdifferentiation in vitro. This strategy provided abundant Tfh-like cells (iTfhs) that can recruit CD8+ T cells like endogenous Tfhs. Subsequently, Chimeric Antigen Receptors (CARs) against both MSL (Mesothelin) and EPHA2 (Ephrin receptor A2) were used to modify iTfh cells, and the CAR-iTfh cells significantly improved infiltration and antitumor cytotoxicity of co-cultured CD8+ T cells. After that, combinatory administration of CAR-iTfh & CAR-CD8 T cell therapy displayed a better effect in repressing the PDAC tumors in xenograft mouse models, compared to conventional CAR-CD4 & CAR-CD8 combinations, and the models received the CAR-iTfh & CAR-CD8 T cells displayed a significantly improved survival rate. Our study revealed the plasticity of Thelper differentiation, expanded the source of Tfh-like cells for cell therapy, and demonstrated a novel and potentially more efficient cellular composition for CAR-T therapy.

Dislocation response of ECC-RC composite supporting structures of tunnels passing through active fault.

To address the problems of the conventional composite supporting structures (CCSSs) such as insufficient anti-dislocation performance and deformation capacity, this study used Engineered Cementitious Composite (ECC) lining sections instead of the traditional lining sections and optimized support design parameters, resulting in the development of novel ECC-RC composite supporting structures (ECSSs) of tunnels passing through active fault. The dislocation response characteristics and their parameter sensitivity of the ECSS was revealed by way of 1/25-scale fault dislocation model tests and finite element analysis. The test results show that the mechanical response characteristics and the failure modes of the CCSS and the ECSS are similar under reverse fault dislocation. Compared with the CCSS, the anti-dislocation performance of the ECSS is significantly improved by introducing of the ECC lining and optimizing the design parameters. The vertical deformation of the ECSS and the range of influence under the same dislocation are significantly decreased, and the strain are reduced to different degrees. This phenomenon shows that by improving the material properties, shortening the spacing of aseismatic joints and optimising the thickness of the shock absorption layer, the stress conditions and applicability under deformation of the structure are improved. The ECSS benefits from the crack resistance and toughening effect of fibres, the degree and scope of cracking of the ECSS are significantly reduced compared with those of the CCSS, and internal and external through cracks and local spalling are absent. The results of finite element analysis show that the overall damage degree of the ECSS is decreased and the damage range is increased by decreasing the strength of the surrounding rock in the fault zone. The fault dislocation response pattern of the ECSS varies depending on the fault type. The damage degree caused by different fault types follows the order of normal fault, strike-slip fault, and reverse fault from large to small. However, the damage range caused by the strike-slip fault is significantly larger compared to normal fault and reverse fault. In the design of fault resistance, the surrounding rock conditions of the fault zone and the form of fault dislocation should be considered.

Inhibition of Transmural Inflammation in Crohn's Disease by Orally Administered Tumor Necrosis Factor-Alpha Deoxyribozymes-Loaded Pyroptosis Nanoinhibitors.

Crohn's disease (CD) is a refractory chronic inflammatory bowel disease (IBD) with unknown etiology. Transmural inflammation, involving the intestine and mesentery, represents a characteristic pathological feature of CD and serves as a critical contributor to its intractability. Here, this study describes an oral pyroptosis nanoinhibitor loaded with tumor necrosis factor-α (TNF-α) deoxyribozymes (DNAzymes) (DNAzymes@degradable silicon nanoparticles@Mannose, Dz@MDSN), which can target macrophages at the site of inflammation and respond to reactive oxygen species (ROS) to release drugs. Dz@MDSN can not only break the inflammatory cycle in macrophages by degrading TNF-α mRNA but also reduce the production of ROS mainly from macrophages. Moreover, Dz@MDSN inhibits excessive pyroptosis in epithelial cells through ROS clearance, thereby repairing the intestinal barrier and reducing the translocation of intestinal bacteria to the mesentery. Consequently, these combined actions synergistically contribute to the suppression of inflammation within both the intestine and the mesentery. This study likely represents the first successful attempt in the field of utilizing nanomaterials to achieve transmural healing for CD, which also provides a promising treatment strategy for CD patients.

Development of raw-image ray-bundling for focused and unfocused plenoptic 3D-PTV.

This paper introduces a new plenoptic 3D particle tracking velocimetry (3D-PTV) technique called raw-image ray-bundling (RIRB), which combines the 3D clustering algorithm of light-field ray-bundling (LFRB) with the raw image segmentation concept of epipolar triangular connectivity (ETC). The combined approach provides flexibility towards accommodating both unfocused and focused plenoptic cameras. Additionally, the RIRB algorithm bypasses the computational step of perspective-view generation in LFRB, thereby allowing lower specification microlens arrays (MLA) to be used without excessive loss of measurement resolution. As part of RIRB's development, synthetic particle-field data and experimental dot-panel targets were used to demonstrate the viability of RIRB. The latter was performed through a VEO640 high-speed camera retrofitted for plenoptic imaging with a 2.5 mm focal-length, F/10 MLA. For the synthetic dataset, RIRB demonstrated better performance than LFRB in processing low-resolution images, with mean errors below 0.85% of the field-of-view (FOV). Additionally, a synthetic Hagen-Poiseuille flow dataset was used to demonstrate the feasibility of RIRB for 3D flow velocimetry using both high and low-resolution images. For the experimental dataset, x/y errors below 0.15% of the FOV and z error below 1.0% were achieved. The combination of synthetic and experimental validations suggests RIRB is a promising approach for 3D triangulation from both focused and unfocused raw plenoptic images, overcoming the low-resolution issue inherent with perspective-view decoding in plenoptic systems.

Raman spectrometer with vertical flow method for solutions containing organic solvents.

The vertical flow (VF) method improves generation and collection efficiency in Raman spectroscopy. It enhances all Raman signals, including undesired signals of organic solvents having a considerably large Raman cross section. We constructed a Raman spectrometer using the VF method to overcome this drawback and introduced a spatial line rejection mask to eliminate unnecessary bands. In addition, the design of the VF unit was improved to resist organic solvents. A VF unit with a 60-µm pinhole enhanced the signal 168 times. The spatial mask effectively eliminated the large Raman bands of the solvent and enabled a longer exposure time. The increase in the dynamic range improved the signal-to-noise ratio by 10 % in methanol and acetonitrile measurements. Raman spectrometer with the VF method and spatial mask enables us to record the Raman spectrum of solute molecules without the disturbance of solvent bands.

Impact of total parenteral nutrition v. exclusive enteral nutrition on postoperative adverse outcomes in patients with penetrating Crohn's disease undergoing surgical resection: a retrospective cohort study.

Achieving optimal nutritional status in patients with penetrating Crohn's disease is crucial in preparing for surgical resection. However, there is a dearth of literature comparing the efficacy of total parenteral nutrition (TPN) v. exclusive enteral nutrition (EEN) in optimising postoperative outcomes. Hence, we conducted a case-matched study to assess the impact of preoperative EEN v. TPN on the incidence of postoperative adverse outcomes, encompassing overall postoperative morbidity and stoma formation, among penetrating Crohn's disease patients undergoing bowel surgery. From 1 December 2012 to 1 December 2021, a retrospective study was conducted at a tertiary centre to enrol consecutive patients with penetrating Crohn's disease who underwent surgical resection. Propensity score matching was utilised to compare the incidence of postoperative adverse outcomes. Furthermore, univariate and multivariate logistic regression analyses were conducted to identify the risk factors associated with adverse outcomes. The study included 510 patients meeting the criteria. Among them, 101 patients in the TPN group showed significant improvements in laboratory indicators at the time of surgery compared with pre-optimisation levels. After matching, TPN increased the occurrence of postoperative adverse outcomes (92·2 % v. 64·1 %, P = 0·001) when compared with the EEN group. In the multivariate analysis, TPN showed a significantly higher OR for adverse outcomes than EEN (OR = 4·241; 95 % CI 1·567-11·478; P = 0·004). The study revealed that penetrating Crohn's disease patients who were able to fulfil their nutritional requirements through EEN exhibited superior nutritional and surgical outcomes in comparison with those who received TPN.

Cluster dynamics of heterometallic trinuclear clusters during ligand substitution, redox chemistry, and group transfer processes.

Stepwise metalation of the hexadentate ligand tbsLH6 (tbsLH6 = 1,3,5-C6H9(NHC6H4-o-NHSiMe2tBu)3) affords bimetallic trinuclear clusters (tbsL)Fe2Zn(thf) and (tbsL)Fe2Zn(py). Reactivity studies were pursued to understand metal atom lability as the clusters undergo ligand substitution, redox chemistry, and group transfer processes. Chloride addition to (tbsL)Fe2Zn(thf) resulted in a mixture of species including both all-zinc and all-iron products. Addition of ArN3 (Ar = Ph, 3,5-(CF3)2C6H3) to (tbsL)Fe2Zn(py) yielded a mixture of two trinuclear products: (tbsL)Fe3(µ3-NAr) and (tbsL)Fe2Zn(µ3-NAr)(py). The two imido species were separated via crystallization, and outer sphere reduction of (tbsL)Fe2Zn(µ3-NAr)(py) resulted in the formation of a single product, [2,2,2-crypt(K)][(tbsL)Fe2Zn(µ3-NAr)]. These results provide insight into the relationship between heterometallic cluster structure and substitutional lability and could help inform both future catalyst design and our understanding of metal atom lability in bioinorganic systems.

A narrow-bandgap RuI3 nanoplatform to synergize radiotherapy, photothermal therapy, and thermoelectric dynamic therapy for tumor eradication.

Therapeutic resistance is an essential challenge for nanotherapeutics. Herein, a narrow bandgap RuI3 nanoplatform has been constructed firstly to synergize radiotherapy (RT), photothermal therapy (PTT), and thermoelectric dynamic therapy (TEDT) for tumor eradication. Specifically, the photothermal performance of RuI3 can ablate tumor cells while inducing TEDT. Noteworthy, the thermoelectric effect is found firstly in RuI3, which can spontaneously generate an electric field under the temperature gradient, prompting carrier separation and triggering massive ROS generation, thus aggravating oxidative stress level and effectively inhibiting HSP-90 expression. Moreover, RuI3 greatly enhances X-ray deposition owing to its high X-ray attenuation capacity, resulting in a pronounced computed tomography imaging contrast and DNA damage. In addition, RuI3 possesses both catalase-like and glutathione peroxidase-like properties, which alleviate tumor hypoxia and reduce antioxidant resistance, further exacerbating 1O2 production during RT and TEDT. This integrated therapy platform combining PTT, TEDT, and RT significantly inhibits tumor growth. STATEMENT OF SIGNIFICANCE: RuI3 nanoparticles were synthesized for the first time. RuI3 exhibited the highest photothermal properties among iodides, and the photothermal conversion efficiency was 53.38 %. RuI3 was found to have a thermoelectric effect, and the power factor could be comparable to that of most conventional thermoelectric materials. RuI3 possessed both catalase-like and glutathione peroxidase-like properties, which contributed to enhancing the effect of radiotherapy.

Research on multilateral collaboration strategies in agricultural seed quality assurance.

Seeds, as the initial products in agricultural systems, play a pivotal role in ensuring quality, fundamental to national food security and sustainable agricultural development. This study introduces a concept integrating public governance and evolutionary game theory to construct a quadripartite evolutionary game model involving seed companies, certification agencies, farmers, and governmental departments. It considers the strategic choices of these stakeholders under varying economic motivations and market mechanisms, as well as the influence of external regulation and incentives on game strategies. The existence conditions for evolutionarily stable strategy combinations are determined using the Lyapunov first method, and MATLAB is employed for numerical simulation analysis to validate the game analysis under initial conditions. The simulation results reveal two potential equilibrium points corresponding to different strategic choices among stakeholders. The study finds that producing high-quality seeds and the refusal of certification agencies to engage in rent-seeking are crucial for ensuring seed quality. Additionally, the cost-benefit ratio of seed companies, the speculative cost of certification agencies, and the rights-protection cost of farmers are key determinants in the evolution of seed quality assurance strategies. This research also holds practical significance in enhancing seed quality assurance mechanisms and fostering sustainable development in agriculture.

Do Weather Conditions Still Have an Impact on the COVID-19 Pandemic? An Observation of the Mid-2022 COVID-19 Peak in Taiwan.

Since the onset of the COVID-19 pandemic in 2019, the role of weather conditions in influencing transmission has been unclear, with results varying across different studies. Given the changes in border policies and the higher vaccination rates compared to earlier conditions, this study aimed to reassess the impact of weather on COVID-19, focusing on local climate effects. We analyzed daily COVID-19 case data and weather factors such as temperature, humidity, wind speed, and a diurnal temperature range from 1 March to 15 August 2022 across six regions in Taiwan. This study found a positive correlation between maximum daily temperature and relative humidity with new COVID-19 cases, whereas wind speed and diurnal temperature range were negatively correlated. Additionally, a significant positive correlation was identified between the unease environmental condition factor (UECF, calculated as RH*Tmax/WS), the kind of Climate Factor Complex (CFC), and confirmed cases. The findings highlight the influence of local weather conditions on COVID-19 transmission, suggesting that such factors can alter environmental comfort and human behavior, thereby affecting disease spread. We also introduced the Fire-Qi Period concept to explain the cyclic climatic variations influencing infectious disease outbreaks globally. This study emphasizes the necessity of considering both local and global climatic effects on infectious diseases.

Clinical application value of metagenome next-generation sequencing in pulmonary diffuse exudative lesions: a retrospective study.

Objective: This study aims to investigate the clinical application value of Metagenome Next-Generation Sequencing (mNGS) for pulmonary diffuse exudative lesions. Methods: From January 1, 2014, to November 31, 2021, 136 cases with chest radiologic presentations of pulmonary diffuse exudative lesions admitted to Fujian Provincial Hospital were included in the study; of those, 77 patients underwent mNGS pathogen detection. Based on the pathogen detection outcomes and clinical diagnoses, patients were categorized into an infection group (IG) and a non-infection group (NIG). A comparison was made between the diagnostic efficacy of the mNGS technique and traditional culture methods. Meanwhile, 59 patients clinically identified as having infectious pulmonary diffuse exudative lesions but who did not receive mNGS testing were designated as the non-NGS infection group (non-IG). A retrospective cohort study was conducted on patients in both the IG and non-IG, with a 30-day all-cause mortality endpoint used for follow-up. Outcomes: When compared to conventional culture methods, mNGS demonstrated an approximate 35% increase in sensitivity (80.0% vs 45.5%, P<0.001), without significant disparity in specificity (77.3% vs 95.5%, P=0.185). Under antibiotic exposure, the positivity rate detected by mNGS was notably higher than that by traditional culture methods, indicating that mNGS is less affected by exposure to antibiotics (P<0.05). Within 30 days, the all-cause mortality rate for patients in the IG versus the non-IG was 14.55% and 37.29%, respectively (P<0.05). Following a COX regression analysis to adjust for confounding factors, the analysis revealed that a CURB-65 score ≥3 points (HR=3.348, P=0.001) and existing cardiovascular disease (HR=2.473, P=0.026) were independent risk factors for these patients. Conversely, mNGS testing (HR=0.368, P=0.017) proved to be an independent protective factor. Conclusion: mNGS technology makes it easier to pinpoint the cause of pulmonary diffuse infectious exudative lesions without much interference from antibiotics, helping doctors spot and diagnose these issues early on, thereby playing a key role in helping them decide the best treatment approach for patients. Such conclusions may have a bias, as the performance of traditional methods might be underestimated due to the absence of complete results from other conventional diagnostic techniques like serological testing and PCR.

Long-term outcomes of intestinal penetrating Crohn's disease following successful nonoperative management.

There is a paucity of data on the surgical or medical treatment for abscess/fistula complicating Crohn's disease after successful nonsurgical management. We conducted a cohort study to investigate the long-term outcomes and the risk factors for the requirement of subsequent surgical intervention in Crohn's disease patients with complicating fistulas/abscess following successful nonsurgical management. Data were collected on penetrating Crohn's disease experiencing successful nonsurgical treatment between December 2012 and December 2021. Long-term outcomes and risk factors of surgery were assessed by univariate and multivariate analysis, and subgroup analysis was performed based on penetrating phenotype including abscess, fistula, and phlegmon. A total of 523 penetrating Crohn's disease patients; there were 390, 125, and 60 patients complicated with fistulas, abscess, and phlegmon, respectively. Long-term outcomes showed that BMI < 18.5 (kg/m 2 ), the recurrent abscess, and stricture were independent risk factors of surgery. Biologics and resolution of abscess were independent protective factors of surgery. Furthermore, in 399 patients undergoing early surgery, stricture and BMI < 18.5 (kg/m 2 ) were independent risk factors, and biologics and abscess resolution were protective of the early surgery. Subgroup analysis based on fistula, abscess, and phlegmon phenotype also demonstrated that concomitant stricture was an independent risk factor and the use of biologics was protective of surgical resection. Our data indicate that biologics can delay the requirement of surgery and may be given to patients with penetrating complicating Crohn's disease who have been successfully treated nonoperatively, but surgical resection should be considered in the setting of malnutrition and stenosis formation.