Failure of early mycological clearance in HIV-negative cryptococcal meningitis

BACKGROUND: Negative cerebrospinal fluid (CSF) cultures at 2 weeks after antifungal treatment (early mycological clearance [EMC]) should be a treatment goal of cryptococcal meningitis (CM). However, EMC in human immunodeficiency virus (HIV)-negative patients with CM is poorly understood. METHODS: We conducted a retrospective review of medical records and 1-year follow-up of 141 HIV-negative patients with CM with an initial positive CSF culture for RESULTS: Of 141 patients, 28 (19.9%) had EMC failure. The 1-year mortality rate was 5.7% (8/141). Multivariate analysis showed that non-amphotericin B (AmB)-based regimens, baseline log CONCLUSIONS: EMC failure in HIV-negative CM is attributed to non-AmB-based therapy and is associated with lo

A Nanostructure with Dual-Band Plasmonic Resonance and Its Sensing Application

A nanostructure plays a crucial role in surface plasmon resonance applications. In this paper, a new nanostructure with strong dual-band surface plasmonic resonance is proposed. The nanostructure resonant behavior in terms of wavelength position, magnitude and bandwidth was developed, and its ability to detect refraction indices, particularly for solution concentration determination, is theoretically studied by using the integration commercial code CST Studio Suite. A high enhancement factor 232 times that of common dipoles and dual bands (wavelengths = 778 and 1118 nm) are achieved from the structure. The dependence of resonance on the environmental index with different increments and detection effects on three solutions are further investigated. The results demonstrate that the resonant wavelength linearly increase with increased index, and resonant peak decrease. Meanwhile, the bandwidth of the resonance spectrum is broadened by the growth of index. The sensitivity is more than 950 nm/RIU and the resolution is about 10-3 refractive index units (RIU) when we detect the environmental index by the resonant wavelength. However, the sensitivity is about 231307 (V/m)/RIU by using the resonant peak for detection. This study may be useful in the fields of biosensors, solar batteries, microstructure devices, and measurements

Analysis of the relationship between drug susceptibility of Cryptococcus neoformans isolates and mortality in HIV-negative cryptococcal meningitis

Objectives: The relationship between antifungal susceptibility and mortality of cryptococcal meningitis (CM) in HIV-negative patients is poorly understood. Methods: We conducted a retrospective analysis of 1-year follow-up of 200 HIV-negative CM patients with an initial cerebrospinal fluid (CSF) culture for Cryptococcus neoformans. According to the cut-off values of minimum inhibitory concentration (MIC), two groups of five antifungal agents were classified: amphotericin B (AmB), ≤0.5 µg/mL, >0.5 µg/mL; 5-flucytosine (5-FC), ≤4 µg/mL, >4 µg/mL; fluconazole (FLU), ≤4 µg/mL, >4 µg/mL; itraconazole (ITR), ≤0.125 µg/mL, >0.125 µg/mL; and voriconazole (VOR), <0.25 µg/mL, ≥0.25 µg/mL. Comparisons were performed to analyse clinical features, laboratory, modified Rankin Scale (mRS) scores, and CSF findings under different prognosis outcomes in 1-year. Results: All of Cryptococcus neoformans isolates were sensitive to AmB and VOR, most of them were sensitive to 5-FC and FLU (95.5% and 90.5%, respectively) while only 55.0% of them were susceptible to ITR. Minimum inhibitory concentrations of ITR and VOR were significantly related to baseline mRS scores. All-cause mortality was not significantly related to MICs in Cryptococcus neoformans strains. The combination of actual antifungal agents and two groups of the MICs values for antifungal agents had no significant effects on all-cause mortality. Conclusion: Most Cryptococcus neoformans isolates were sensitive to AmB, VOR, 5-FC, and FLU. Because of the small number of deaths, we are not able to comment on whether MIC is associated with mortality of CM in HIV-negative patients

The wax gourd genomes offer insights into the genetic diversity and ancestral cucurbit karyotype

The botanical family Cucurbitaceae includes a variety of fruit crops with global or local economic importance. How their genomes evolve and the genetic basis of diversity remain largely unexplored. In this study, we sequence the genome of the&nbsp;wax gourd (Benincasa hispida), which bears giant fruit up to 80 cm in length and weighing over 20 kg. Comparative analyses of six cucurbit genomes reveal that the wax gourd genome represents the most ancestral karyotype, with the predicted ancestral genome having 15 proto-chromosomes. We also resequence 146 lines of diverse germplasm and build a variation map consisting of 16 million variations. Combining population genetics and linkage mapping, we identify a number of regions/genes potentially selected during domestication and improvement, some of which likely contribute to the large fruit size in wax gourds. Our analyses of these data help to understand genome evolution and function in cucurbits