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Background:Aspergillus species are becoming a major public health concern worldwide due to the increase in the incidence of aspergillosis and emergence of antifungal resistance. In this study, we surveyed all Aspergillus species isolated from aspergillosis patients in Zhongshan Hospital Fudan University, Shanghai, China, from 2019 to 2021.Methods: We characterized the susceptibility profiles of these Aspergillus species to medical azoles (voriconazole, itraconazole and posaconazole) using YeastOneTM broth microdilution system. To determine the underlying antifungal resistance mechanisms in azole-resistant A. fumigatus (ARAf) isolates, we characterized mutations in the cyp51A gene. Genotypic diversity of sampled A. fumigatus was investigated using CSP-typing.Results: A total of 112 Aspergillus isolates (81 A. fumigatus, 17 A. flavus, 5 A. niger, 2 A. terreus, 2 A. lentulus, 2 A. oryzae, 1 A. nidulans, 1 A. versicolor and 1 A. sydowii) from 105 patients diagnosed with aspergillosis (including proven or probable invasive aspergillosis, chronic pulmonary aspergillosis, allergic bronchopulmonary aspergillosis and cutaneous aspergillosis) were obtained. Eight isolates (7 A. fumigatus and 1 A. niger) from seven patients were either azole non-susceptible or non-wild type. Azole non-susceptible or non-wild type rate was 7.1%/isolate and 6.7%/patient analysed. Four ARAf harbored TR34/L98H mutation, whereas one carried TR46/Y121F/T289A allele. The 81 A. fumigatus isolates were spread across 8 CSP types with t01 to be the predominant type (53.1%). ARAf isolates were distributed over CSP types t01, t02, t04A and t11.Conclusion: Results from this study provided us with an understanding of the antifungal resistance and related characteristics of Aspergillus species in Eastern China. Further comparisons of our results with those in other countries reflect potential clonal expansion of A. fumigatus in our region. Further surveillance study is warranted to guide antifungal therapy and for epidemiological purposes. [ABSTRACT FROM AUTHOR]

In recent years, the wide executive - employee pay gap has become intensely controversial and it is now seen as a hot global issue. The issue has become increasingly prominent, resulting in the public asking government to intervene and control executive remuneration. Against this background, a series of remuneration control policies have been announced in China by the Ministry of Finance, the Ministry of Human Resources and Social Security and other departments. These policies have won widespread social and media acclaim. Unfortunately though, corporate executive remuneration has mostly continued to increase, rising in some companies even as performance declines. Given this background, research on influences on and economic consequences of the executive - employee pay gap in tourism enterprises has important practical significance. Based on the tournament theory, social comparison theory, managerial power theory and multiple regression models, this paper conducted theoretical analysis and multiple regression analysis of managerial power relationships, the executive-employee pay gap and firm performance for Chinese listed companies in the tourism sector during 2006~2012. All financial data and relevant information on executives and employees used in this study came from annual financial reports of listed tourism companies. Referring to the relevant provisions of China's Company Law, company executives are defined as the manager, deputy manager, chief financial officer, board secretary and other persons specified in the articles of association. Based on the annual reports of five listed Chinese tourism companies, the following job titles are considered as executives: (1) Huangshan Tourism: assistant president; (2) Xi'an Catering: chairman, vice chairman; (3) Xi'an Tourism: deputy party secretary and commissioner for discipline inspection; (4) Beijing Tourism: assistant chairman; and (5) Guilin Tourism: operations director, technical director, investment director, sales director, assistant general manager. As analyzed in this paper, executive pay includes only monetary income, and excludes hidden income, on-the-job consumption and the market value of shares executives may hold in the company. This paper used Excel and SPSS statistical software for data processing and regression analysis. The results showed that managerial power theory did not apply to the tourism industry, and managerial power did not significantly affect the executive - employee pay gap and firm performance. Secondly, the executive - employee pay gap and tourism enterprise performance showed a significant inverse U-shaped relationship. When the annual executive - employee pay gap exceeds the critical value of 205000.97 Yuan, it will negatively affect the performance of a tourism enterprise. It is suggested that rational design of pay incentive mechanisms and pay structure optimization should be adopted to avoid the negative effects arising from a large executive - employee pay gap. Specifically, executive pay structures can take the form of basic salary + performance bonus + stock options. Simultaneously, in addition to appropriately increasing the basic salaries and bonuses of general staff, employee stock ownership plans or virtual stock option plans should be adopted to achieve positive interaction between employee revenue growth and long-term corporate development. [ABSTRACT FROM AUTHOR]

Abstract: Stabilizing piles are used worldwide to stabilize unstable slopes. However to date, there is little coverage in the scientific literature on the effects of the pore water pressure and the shear strength of the slip zone on the lateral force acting on the piles. This paper presents and compares two methods to estimate the lateral force acting on the stabilizing piles. These are the limit equilibrium method (LEM), and the finite element shear strength reduction method (FE-SRM). For both methods, the COMSOL software was used to model the infiltration of reservoir water and rainfall into the sliding mass. The distribution of lateral force was then simulated by the normal stress distribution on the piles with FE-SRM in PLAXIS 8.2 software. The effect of shear strength of the slip zone on the lateral force and its distribution were also studied. The lower Ercengyan landslide in the Three Gorges Reservoir was used as study area, with four different hydrological scenarios based on the reservoir water level fluctuations and rainfall amounts. The results show that the lateral force with the LEM method is slightly greater than with the FE-SRM method. The lateral force reaches a peak when the level of the reservoir rises to 175m combined with high rainfall amount, and decreases linearly as the effective shear strength of the slip zone increases. The distribution of the lateral force is parabolic, and varies with the shear strength parameters of the slip zone. In conclusion, the LEM and FE-SRM methods can be used to calculate the lateral force acting on the stabilizing piles, and estimate the lateral force distribution. This technique effectively analyzes the behavior of stabilizing piles for landslides. It can be applied in the routine practical design of stabilizing piles in the Three Gorges Reservoir as well as other similar areas. [Copyright &y& Elsevier]

Background: Abiotrophia (ABI) and Granulicatella (GRA) are rare causative pathogens in infective endocarditis (IE). This study aims to describe the epidemiology, clinical characteristics, and outcome of ABI/GRA-IE. The main features of ABI/GRA-IE were compared with Viridans group streptococci (VGS) IE., Methods: From January 2015 to December 2023, a total of 1531 definite IE in Zhongshan Hospital, Fudan University, Shanghai, China were retrospectively enrolled in this study. Clinical and laboratory data were collected., Results: Forty-five ABI/GRA-IE cases were identified, representing 2.9% of all IE cases in Zhongshan Hospital between 2015 and 2023, compared to 20.1% of VGS-IE. ABI and GRA IE shared similar clinical characteristics. Congenital valvulopathy was reported in 21 (46.7%) ABI/GRA-IE and 85 (28.8%) VGS-IE (P = 0.025). Pulmonary valve was more frequently affected in ABI/GRA-IE (6 [13.3%]) than VGS-IE (7 [2.4%]) (P = 0.002). Congestive heart failure was observed in 30 (66.7%) ABI/GRA-IE and 103 (34.9%) VGS-IE (P < 0.001). Systemic embolization excluding central nervous system (CNS) occurred in 13 (28.9%) ABI/GRA-IE and 39 (13.2%) VGS-IE (P = 0.012). In-hospital mortality was reported as 4.4% in ABI/GRA-IE and 3.7% in VGS-IE (P = 0.854)., Conclusion: GRA/ABI-IE was approximately one-seventh as prevalent as VGS-IE. Congestive heart failure and systemic embolization (excluding CNS) were more frequent in GRA/ABI-IE compared to VGS-IE. Mortality of ABI/GRA-IE in this study was comparable to that of VGS-IE and lower than previously reported results., (© 2024. The Author(s).)

Background: Metagenomic next-generation sequencing (mNGS), with its comprehensiveness, is widely applied in microbiological diagnosis. Etiological diagnosis is of paramount clinical importance in patients with skin and soft tissue infections (SSTIs). However, the clinical application of mNGS in SSTIs is relatively less studied., Materials and Methods: From April 1, 2017 to December 31, 2019, 96 SSTI cases were collected. The positive rates of pathogens detected by mNGS and culture were compared by analyzing tissue samples, pus, swabs, and/or interstitial fluids obtained from the infected parts. Modification of the antibiotic treatment strategy due to mNGS was also assessed., Results: The sensitivity of mNGS for detecting pathogens in SSTI cases was superior to that of culture testing (67.7% vs 35.4%; p < 0.01). Significantly higher identification rates for viruses (10.4% vs 0.0%; p < 0.01) and anaerobes (11.5% vs 1.0%; p < 0.01) were obtained with mNGS compared to culture. Of note, rare pathogens such as Vibrio vulnificus and Bartonella henselae were also detected by mNGS. Importantly, the proportion of multi-pathogen SSTIs detected by mNGS was higher than that of multi-pathogen SSTIs detected by culture (16.7% vs 6.3%; p = 0.035). The rate of targeted antibiotic treatment was significantly higher in mNGS-positive cases than in mNGS-negative cases (41.7% vs 3.8%; p < 0.01). In culture-negative and mNGS-positive cases, the improvement rate was higher than that in mNGS-negative cases, but this was not statistically significant (75.0% vs 73.1%; p = 0.864)., Conclusions: mNGS is a promising tool for the etiological diagnosis of SSTIs, particularly in identifying viruses, anaerobes, and multi-pathogen infections. The application of mNGS testing in clinical practice could change antibiotic treatment strategies and partly benefit clinical outcomes., (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Metagenomic next-generation sequencing (mNGS) was suggested to potentially replace traditional microbiological methodology because of its comprehensiveness. However, clinical experience with application of the test is relatively limited., Methods: From April 2017 to December 2017, 511 specimens were collected, and their retrospective diagnoses were classified into infectious disease (347 [67.9%]), noninfectious disease (119 [23.3%]), and unknown cases (45 [8.8%]). The diagnostic performance of pathogens was compared between mNGS and culture. The effect of antibiotic exposure on detection rate was also assessed., Results: The sensitivity and specificity of mNGS for diagnosing infectious disease were 50.7% and 85.7%, respectively, and these values outperformed those of culture, especially for Mycobacterium tuberculosis (odds ratio [OR], 4 [95% confidence interval {CI}, 1.7-10.8]; P < .01), viruses (mNGS only; P < .01), anaerobes (OR, ∞ [95% CI, 1.71-∞]; P < .01) and fungi (OR, 4.0 [95% CI, 1.6-10.3]; P < .01). Importantly, for mNGS-positive cases where the conventional method was inconclusive, 43 (61%) cases led to diagnosis modification, and 41 (58%) cases were not covered by empirical antibiotics. For cases where viruses were identified, broad-spectrum antibiotics were commonly administered (14/27), and 10 of 27 of these cases were suspected to be inappropriate. Interestingly, the sensitivity of mNGS was superior to that of culture (52.5% vs 34.2%; P < .01) in cases with, but not without, antibiotic exposure., Conclusions: mNGS could yield a higher sensitivity for pathogen identification and is less affected by prior antibiotic exposure, thereby emerging as a promising technology for detecting infectious diseases.