Voriconazole plus flucytosine is not superior to amphotericin B deoxycholate plus flucytosine as an induction regimen for cryptococcal meningitis treatment.

BACKGROUND: The efficacy and side effects of voriconazole plus 5-flucytosine (Vori + 5-FC) versus amphotericin B deoxycholate plus 5-flucytosine (AmBd + 5-FC) as an induction treatment for cryptococcal meningitis are unknown. METHODS: Forty-seven patients treated with Vori + 5-FC and 92 patients treated with AmBd + 5-FC were included in the current study after propensity score matching (PSM) at a ratio of 1:2. Two-week laboratory test results and 90-day mortality were compared between the two groups. RESULTS: After 2 weeks of induction treatment, the CSF Cryptococcus sterile culture rate was 57.1% in the Vori + 5-FC group and 76.5% in the AmBd + 5-FC group (p = .026). No difference was found in the normalization of CSF indicators (glucose, total protein, intracranial pressure and India ink sterile rate) between the two groups. Both the Vori + 5FC regimen and AmBd + 5-FC regimen obviously decreased haemoglobin concentrations, platelet counts and serum potassium levels (all p ≤ .010). Notably, the Vori + 5FC regimen did not influence serum creatinine levels (p = .263), while AmBd + 5FC increased serum creatinine levels (p = .019) after 2-week induction treatment. The Vori + 5-FC group and AmBd + 5-FC group had similar 90-day cumulative survival rates (89.9% vs. 87.8%, p = .926). CONCLUSION: The Vori + 5-FC regimen was associated with low 2-week CSF sterile culture and was not superior to AmBd + 5-FC as induction therapy in terms of the 90-day cumulative survival rate of CM patients.

Fine-Grained 3D Modeling and Semantic Mapping of Coral Reefs Using Photogrammetric Computer Vision and Machine Learning.

Corals play a crucial role as the primary habitat-building organisms within reef ecosystems, forming expansive structures that extend over vast distances, akin to the way tall buildings define a city's skyline. However, coral reefs are vulnerable to damage and destruction due to their inherent fragility and exposure to various threats, including the impacts of climate change. Similar to successful city management, the utilization of advanced underwater videography, photogrammetric computer vision, and machine learning can facilitate precise 3D modeling and the semantic mapping of coral reefs, aiding in their careful management and conservation to ensure their survival. This study focuses on generating detailed 3D mesh models, digital surface models, and orthomosaics of coral habitats by utilizing underwater coral images and control points. Furthermore, an innovative multi-modal deep neural network is designed to perform the pixel-wise semantic segmentation of orthomosaics, enabling the projection of resulting semantic maps onto a 3D space. Notably, this study achieves a significant milestone by accomplishing semantic fine-grained 3D modeling and rugosity evaluation of coral reefs with millimeter-level accuracy, providing a potent means to understand coral reef variations under climate change with high spatial and temporal resolution.