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Viral infections are major threats to human health (1,2). Because of the advent of high-throughout sequencing, researchers are identifying new viruses with an unprecedented speed (3), and continuous attempts at [...]

Candida nivariensis is emerging as a highly resistant species of the Candida glabrata complex causing invasive and mucocutaneous infections. In this study, three cases of vulvovaginal candidiasis caused by C. nivariensis are described and identified by Internal Transcribed Spacer 1–2 sequencing. All isolates were susceptible in vitro to anidulafungin, micafungin, caspofungin, 5-flucytosine, posaconazole, voriconazole, itraconazole, amphotericin B, and showed dose-dependent susceptibility to fluconazole. In two patients, three doses of oral fluconazole were effective, while one patient developed clinical fluconazole resistance with a new relapse after 6 months. Increasing the weekly dose of fluconazole showed to be effective in this patient.

Trichophyton indotineae, a new species of dermatophytes, has become a significant concern in treating dermatophytosis due to the high level of terbinafine resistance reported in this organism. This is the first report of Trichophyton indotineae infection in Central Vietnam. Antifungal susceptibility testing showed that this isolate was susceptible to itraconazole, voriconazole, and terbinafine. Therefore, the patient was successfully treated with oral itraconazole and ketoconazole topical cream.

Objectives To explore the application value of body mass index (BMI)-based kilovoltage peak (kVp) selection and contrast injection protocol combined with different adaptive statistical iterative reconstruction V (ASIR-V) strengths in renal computed tomography angiography (CTA) in reducing radiation and contrast medium (CM) doses. Methods One-hundred renal CTA patients were prospectively enrolled and were divided into individualized kVp group (group A, n  = 50) and conventional 100 kVp group (group B, n  = 50), both with automatic tube current modulation and CM of Iohexol at 350 mgI/mL concentration. Group A: 70 kVp, noise index (NI) of 18 and CM dose rate of 17 mgI/kg/s for 10 s for BMI <25 kg/m2 patients; 80 kVp, NI = 17, and CM dose rate of 19 mgI/kg/s for 10 s for 25 kg/m2≤BMI≤30 kg/m2 patients. Group B: 100 kVp, 50 mL of CM at the flow rate of 4.5 mL/s. The objective image quality, effective radiation dose, CM dose, injection rate, and image quality were compared between the 2 groups. Results There was no significant difference in patient characteristics between the 2 groups (P  >.05). Compared to group B, group A significantly reduced effective radiation dose by 28.4%, CM dose by 27.2%, and injection rate by 22.7% (all P  <.001). The 2 groups had similar SD values in erector spine (P  >.05). Group A had significantly higher CT values, SNR, and CNR values of the renal arteries than group B (all P  <.001). The 2 radiologists had excellent agreement (Kappa value > 0.8) in the subjective scores of renal CTA images and showed no statistically significant difference between the 2 groups (4.57 ± 0.42 vs 4.41 ± 0.49) (P  >.05). Conclusions BMI-based scan and reconstruction protocol in renal CTA significantly reduces radiation and contrast doses while maintaining diagnostic image quality. Advances in knowledge (i) BMI-based individualized tube voltage selection and contrast injection protocol in renal CTA reduces both radiation and contrast doses over conventional protocol. (ii) The combination of lower kVp and higher weight ASIR-V maybe used to improve image quality in terms of contrast enhancement and image noise under lower radiation and contrast dose conditions. (iii) Renal CTA of normal size (BMI ≤ 30 kg/m2) patients acquired at low radiation dosage and low iodine contrast dose through the combination of low tube voltage and ASIR-V algorithm achieves excellent diagnostic image quality with a good inter-rater agreement. [ABSTRACT FROM AUTHOR]

The impact of stratospheric intrusions (SIs) on Central and Eastern China (CEC) with severe ozone pollution presents a range of uncertainties, underscoring the imperative for sustained research endeavors. In this study, we propose a traceability assessment method that can derive high-resolution critical source areas (CSAs) of SIs by utilizing ambient air quality observations, global ozone (re)analysis data, and customized Lagrangian simulations. This approach enables us to facilitate a meticulous and systematic examination of the impact of direct and indirect SIs on tropospheric and near-surface ozone in six important sub-regions within the CEC during the spring and summer of 2019, as well as the unique circulations driving SIs, from a more refined and targeted tracing perspective. The findings reveal that impacts of indirect intrusions are more efficient at monthly scales, with contributions to tropospheric ozone reaching up to twice the magnitude of direct intrusions. The impacts of direct intrusions are more pronounced at daily scales, primarily occurring in May. In terms of contribution to near-surface ozone, the eastern plains frequently witness ozone exceedance events, with the most substantial impact from SIs observed (e.g., contributing 15.8 % and 16.7 % to near-surface ozone in North China and East China, respectively), showcasing a remarkable ability to capture descending lower-stratospheric air. In contrast, the Loess Plateau and Central China, situated in central and western high-altitude regions, receive more intrusive ozone into the troposphere but exhibit minimal contributions to near-surface ozone. The indirect intrusions that generate the above impact come from three to four CSAs located thousands of kilometers away, evenly distributed latitudinally within the westerlies between 40 and 70° N (spaced 70 longitudes apart). These CSAs are intricately linked to the evolution of synoptic-scale Rossby waves or subtropical westerly jets, with western Siberia or Europe and north Africa identified as the most significant CSAs. Conversely, the CSAs for direct intrusions are relatively concentrated, with those influencing the middle troposphere originating from the Tibetan Plateau and those influencing the lower troposphere predominantly located in Mongolia and central Russia, just a few hundred kilometers from the CEC. These sources are associated with typical atmospheric circulations such as the northeast cold vortex and the South Asian High, where the intensity of the intrusion system plays a more crucial role than its frequency of occurrence. This study provides valuable insights for forecasting and mitigating the impact of SIs on ozone pollution in China and contributes to addressing the broader challenges posed by climate change. [ABSTRACT FROM AUTHOR]