Post-COVID-19 Pandemic Rebound of Macrolide-Resistant Mycoplasma pneumoniae Infection: A Descriptive Study.

The rebound characteristics of respiratory infections after lifting pandemic control measures were uncertain. From January to November 2023, patients presenting at a teaching hospital were tested for common respiratory viruses and Mycoplasma pneumoniae using a combination of antigen, nucleic acid amplification, and targeted next-generation sequencing (tNGS) tests. The number and rate of positive tests per month, clinical and microbiological characteristics were analyzed. A rapid rebound of SARS-CoV-2 was followed by a slower rebound of M. pneumoniae, with an interval of 5 months between their peaks. The hospitalization rate was higher, with infections caused by respiratory viruses compared to M. pneumoniae. Though the pediatric hospitalization rate of respiratory viruses (66.1%) was higher than that of M. pneumoniae (34.0%), the 4094 cases of M. pneumoniae within 6 months posed a huge burden on healthcare services. Multivariate analysis revealed that M. pneumoniae-infected adults had more fatigue, comorbidities, and higher serum C-reactive protein, whereas children had a higher incidence of other respiratory pathogens detected by tNGS or pathogen-specific PCR, fever, and were more likely to be female. A total of 85% of M. pneumoniae-positive specimens had mutations detected at the 23rRNA gene, with 99.7% showing A2063G mutation. Days to defervescence were longer in those not treated by effective antibiotics and those requiring a change in antibiotic treatment. A delayed but significant rebound of M. pneumoniae was observed after the complete relaxation of pandemic control measures. No unusual, unexplained, or unresponsive cases of respiratory infections which warrant further investigation were identified.

Estimating ecological sustainability in the Guangdong-Hong Kong-Macao Greater Bay Area, China: Retrospective analysis and prospective trajectories.

In recent decades, rapid urbanization and intensified global climate change have resulted in a significant difference of environment and resources distribution on space, which would cause trouble for accurate assessment of regional ecological sustainable development, especially in the large urban agglomerations. The parameters used in previous assessment methods have normally ignored spatial heterogeneity, leading to deviations in the evaluation accuracies against the context above. By incorporating remote sensing technology, this study proposed an improved emergy ecological footprint (EEF) method and a novel ecological sustainability index to comprehensively analyze the variability of ecological security states (ESS) from 1994 to 2018 in the Guangdong-Hong Kong-Macao Greater Bay Area (GBA) and to predict its sustainable growth potential based on a combined factorial decomposition and scenario analysis. Results showed that the pixel-based emergy analysis revealed significant heterogeneity over time and space under the impact of climate change and intense land use activities during the study period. The emergy carrying capacity per capita (ecc) and the emergy ecological footprint per capita (eef) also showed a significant difference between the nine cities in the GBA. In addition, the traditional EEF method, which does not consider the spatiotemporal variation, has indeed overestimated the GBA's ecc by 15% compared with our results. The ESS of the GBA gradually worsened from slight insecurity in the 1990s to moderate insecurity in 2018. If the current trends in socio-economic activities and climate change continue according to the RCP8.5 scenario in the IPCC, the ESS of the GBA will reach the extreme insecurity state in 2050. However, our scenarios show that industrial structure adjustment, energy structure optimization, and especially biological resource conservation can reduce the EFI by approximately 6.52%, 23.4%, and 30.6%, respectively. Consequently, effective implementation of the above measures can limit the increase both in emergy ecological deficit and emergy ecological footprint intensity (EFI) and, together, contribute to a higher security status in the GBA in 2050.

Tropical tall forests are more sensitive and vulnerable to drought than short forests.

Our limited understanding of the impacts of drought on tropical forests significantly impedes our ability in accurately predicting the impacts of climate change on this biome. Here, we investigated the impact of drought on the dynamics of forest canopies with different heights using time-series records of remotely sensed Ku-band vegetation optical depth (Ku-VOD), a proxy of top-canopy foliar mass and water content, and separated the signal of Ku-VOD changes into drought-induced reductions and subsequent non-drought gains. Both drought-induced reductions and non-drought increases in Ku-VOD varied significantly with canopy height. Taller tropical forests experienced greater relative Ku-VOD reductions during drought and larger non-drought increases than shorter forests, but the net effect of drought was more negative in the taller forests. Meta-analysis of in situ hydraulic traits supports the hypothesis that taller tropical forests are more vulnerable to drought stress due to smaller xylem-transport safety margins. Additionally, Ku-VOD of taller forests showed larger reductions due to increased atmospheric dryness, as assessed by vapor pressure deficit, and showed larger gains in response to enhanced water supply than shorter forests. Including the height-dependent variation of hydraulic transport in ecosystem models will improve the simulated response of tropical forests to drought.

A comprehensive framework for seasonal controls of leaf abscission and productivity in evergreen broadleaved tropical and subtropical forests.

Relationships among productivity, leaf phenology, and seasonal variation in moisture and light availability are poorly understood for evergreen broadleaved tropical/subtropical forests, which contribute 25% of terrestrial productivity. On the one hand, as moisture availability declines, trees shed leaves to reduce transpiration and the risk of hydraulic failure. On the other hand, increases in light availability promote the replacement of senescent leaves to increase productivity. Here, we provide a comprehensive framework that relates the seasonality of climate, leaf abscission, and leaf productivity across the evergreen broadleaved tropical/subtropical forest biome. The seasonal correlation between rainfall and light availability varies from strongly negative to strongly positive across the tropics and maps onto the seasonal correlation between litterfall mass and productivity for 68 forests. Where rainfall and light covary positively, litterfall and productivity also covary positively and are always greater in the wetter sunnier season. Where rainfall and light covary negatively, litterfall and productivity are always greater in the drier and sunnier season if moisture supplies remain adequate; otherwise productivity is smaller in the drier sunnier season. This framework will improve the representation of tropical/subtropical forests in Earth system models and suggests how phenology and productivity will change as climate change alters the seasonality of cloud cover and rainfall across tropical/subtropical forests.

Quantifying the biophysical effects of forests on local air temperature using a novel three-layered land surface energy balance model.

The well-documented energy balance dynamics within forest ecosystems are poorly implemented in studies of the biophysical effects of forests. This results in limitations to the accurate quantification of forest cooling/warming on local air temperature. Taking into consideration the forest air space, this study proposes a three-layered (canopy, forest air space and soil [CAS]) land surface energy balance model to simulate air temperature within forest spaces (Taf) and subsequently to evaluate its biophysical effects on forest cooling/warming, i.e., the air temperature gradient (∆Ta) between the Taf and air temperature of open spaces (Tao) (∆Ta = Taf - Tao). We test the model using field data for 23 sites across 10 cities worldwide; the model shows satisfactory performance with the test data. High-latitude forests show greater seasonal dynamics of ∆Ta, generating considerable cooling of local air temperatures in warm seasons but minimal cooling or even warming effects during cool seasons, while low-latitude tropical forests always exert cooling effects with less interannual variability. The interannual dynamics of ∆Ta are significantly related to the seasonality of solar geometry and canopy leaf phenology. The differences between forest canopy temperature (Tc) and Tao, which are the two most important terms attributed by the CAS model in impacting Taf, explain a large part of forest cooling and warming (May-July: R2 = 0.35; November-January: R2 = 0.51). The novel CAS model provides a feasible way to represent the energy balance within forest ecosystems and to assess its impacts on local air temperatures globally.

Photodynamic therapy in combination with ranibizumab versus ranibizumab monotherapy for wet age-related macular degeneration: A systematic review and meta-analysis.

OBJECTIVE: To evaluate the efficacy and safety between photodynamic therapy (PDT) combined with intravitreal ranibizumab (IVR) and ranibizumab monotherapy in treating wet age-related macular degeneration (AMD). METHODS: A systematic search was performed in the PubMed, Embase, Web of Science and the Cochrane Library databases through December 31, 2017. The methodological quality of the references was evaluated according to the Cochrane quality assessment. RevMan 5.3 software was used to perform the meta-analysis. RESULTS: Eight RCTs involving 817 participants were included. Wet AMD eyes in the mono-group achieved better best-corrected vision acuity (BCVA) than the combination group in month 12 (WMD = -0.19, 95% CI = -0.32 to -0.06, P = 0.004, I2 = 18%). The proportion of patients gaining more than 15 letters from baseline in the mono-group was larger than that in the combination group (RR = 0.70, 95% CI: 0.56 to 0.87, P = 0.001). However, the number of ranibizumab injections with combination therapy was smaller than that with mono-therapy (MD = -1.13, 95% CI: -2.11 to -0.15, P = 0.02, I2 = 85%). No significant differences were observed in the proportions of patients losing more than 15 letters, central retinal thickness (CRT), lesion size of choroidal neovascularization (CNV) and adverse events. CONCLUSIONS: Combination therapy decreased the number of injections of ranibizumab, although its BCVA improvement was inferior to that of monotherapy over 12 months of follow-up. Given the inherent limitations of the included trials, more studies are needed to further validate and update the findings in this area.

Global pattern for the effect of climate and land cover on water yield.

Research results on the effects of land cover change on water resources vary greatly and the topic remains controversial. Here we use published data worldwide to examine the validity of Fuh's equation, which relates annual water yield (R) to a wetness index (precipitation/potential evapotranspiration; P/PET) and watershed characteristics (m). We identify two critical values at P/PET=1 and m=2. m plays a more important role than P/PET when m<2, and a lesser role when m>2. When P/PET<1, the relative water yield (R/P) is more responsive to changes in m than it is when P/PET>1, suggesting that any land cover changes in non-humid regions (P/PET<1) or in watersheds of low water retention capacity (m<2) can lead to greater hydrological responses. m significantly correlates with forest coverage, watershed slope and watershed area. This global pattern has far-reaching significance in studying and managing hydrological responses to land cover and climate changes.