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Category: 3. Business

  • 5 Things to Know Before the Stock Market Opens

    5 Things to Know Before the Stock Market Opens

    Stock futures are pointing to a sharply higher open this morning after major indexes closed last week at record highs; investor sentiment is getting a boost after President Donald Trump said he was optimistic the U.S. would reach a trade deal with China and address ownership of social media app TikTok; Avidity Biosciences (RNA) shares are surging after Swiss pharmaceutical maker Novartis (NVS) said it would acquire the biotechnology firm; and U.S.-listed shares of Argentine companies are soaring after President Javier Milei’s political party posted victories in legislative elections there.  Here’s what you need to know today.

    1. Major Stock Indexes Poised to Open Higher After Hitting Record Highs

    Stock futures are higher this morning amid optimism about an apparent easing of trade tensions between the U.S. and China, while investors prepare for an expected rate cut by the Federal Reserve and a flurry of earnings reports from major technology companies later in the week. The three major U.S. stock indexes come into today’s session at record highs after each gained about 2% last week following a mild inflation report that reaffirmed expectations that the Fed will cut its key rate on Wednesday. Futures tied to the Dow Jones Industrial Average were up 0.5% recently, while those linked to the the benchmark S&P 500 and the tech-heavy Nasdaq added 0.9% and 1.3%, respectively. Bitcoin was trading at $115,400, up from a low over the weekend around $111,000. Gold futures were down 2.6% at $4,030 an ounce, as the precious metal continues to step back from recent highs. The yield on the 10-year Treasury note, which affects borrowing costs on a wide array of consumer loans, rose to 4.02% from 4.00% at Friday’s close. Crude oil futures were down slightly at around $61.40 after jumping last week following a move by the U.S. to place sanctions on Russian oil firms.

    2. Trump Sounds Positive Note on U.S.-China Trade Talks

    President Donald Trump said early Monday that the U.S. is positioned to reach a trade deal with China, as the the president gets set to meet with Chinese leader Xi Jinping on Thursday in South Korea. “I have a lot of respect for President Xi, and we are going to come away with the deal,” Trump said. U.S. and Chinese negotiators over the weekend reached a framework for a trade deal that could result in a reduction of tariffs and trade barriers between the two countries. The deal will reportedly delay the implementation of 100% tariffs on Chinese imports that were slated to begin on Nov. 1, while China’s export controls on rare earth elements are also expected to be delayed as the two sides continue negotiations. Trump also expects the two countries to reach a deal on ownership of the social media app TikTok. The U.S. also announced that separate trade and mineral agreements were reached with Malaysia and Cambodia, while trade pact frameworks were struck with Thailand and Vietnam.  Shares of U.S. chipmakers Nvidia (NVDA) and Advanced Micro Devices (AMD), which are seeking to sell into Chinese markets, were both up more than 2% in premarket trading.

    3. Trump Says Canada Will Face Additional 10% Tariffs for Reagan Ad

    Trump said that the U.S. will slap an additional 10% tariff on Canadian goods after the Ontario provincial government ran an ad criticizing tariffs during the World Series on Friday. Ontario Premier Doug Ford said that broadcasts of the ad would end on Monday. Trump has criticized the ad for featuring comments from former President Ronald Reagan, which he described as a “serious misrepresentation of the facts.” Trump had placed a tariff of 35% on Canadian goods not covered by the USMCA agreement, though tariffs on some products like steel and aluminum are subject to levies of 50%. Trump had previously said trade negotiations with Canada would be “terminated” over the ad.

    4. Novartis Agrees to Acquire Biotech Firm Avidity Biosciences

    Shares of Avidity Biosciences (RNA) are soaring in premarket trading after Swiss pharmaceutical giant Novartis (NVS) agreed to buy the biotechnology company in a deal valued at $12 billion. Avidity will spin off part of its early-stage precision cardiology business before closing the deal in the first half of 2026, Novartis said in a statement. “The Avidity team has built robust programs with industry-leading delivery of RNA therapeutics to muscle tissue,” Novartis CEO Vas Narasimhan said. “We look forward to developing these programs to meaningfully change the trajectory of diseases for patients.” Shares of Avidity jumped more than 40% ahead of the opening bell, while Novartis shares were down about 1%.

    5. U.S.-Listed Argentine Shares Rise on President Milei’s Legislative Victory

    Shares of U.S.-listed Argentine companies are surging after President Javier Milei’s La Libertad Avanza party won a landslide legislative victory. President Donald Trump had offered to provide financial support for Argentina but said that the bailout hinged on the outcome of the election. “BIG WIN in Argentina for Javier Milei, a wonderful Trump Endorsed Candidate?,” Trump said on Truth Social. Shares of financial services companies Grupo Financiero Galicia SA (GGAL), Banco BBVA Argentina SA (BBAR) and Banco Macro SA (BMA) each gained more than 30% in premarket trading. Shares of oil company YPF (YPF) jumped about 25%, while shares of e-commerce firm MercadoLibre (MELI) added 7%.

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  • Bessent lists Fed chair finalists, Trump says decision by end of year

    Bessent lists Fed chair finalists, Trump says decision by end of year

    U.S. Treasury Secretary Scott Bessent speaks to reporters at the White House in Washington, D.C., Oct. 22, 2025.

    Kevin Lamarque | Reuters

    Treasury Secretary Scott Bessent on Monday confirmed that the list of candidates to replace Federal Reserve Chair Jerome Powell has been winnowed down to five, and President Donald Trump said the replacement is likely to be named by the end of the year.

    Speaking to reporters on Air Force One, Bessent said the finalists are current Fed Governors Christopher Waller and Michelle Bowman, National Economic Council Director Kevin Hassett, former Fed Governor Kevin Warsh, and BlackRock executive Rick Rieder, according to several media outlets.

    Those names were reported earlier this month by CNBC.

    Bessent, who had been rumored to be a top candidate as well, said he has been conducting interviews and that he expects to do one more round before presenting a “good slate” to Trump after the Thanksgiving holiday.

    Trump, also speaking to reporters Monday on Air Force One, said he anticipates naming a replacement by the end of the year. Powell’s term doesn’t expire until May. Powell then can either step down from the Fed entirely or continue serving a term as governor that lasts until 2028.

    The Federal Open Market Committee meets this week, with an interest rate decision due Wednesday. Markets are pricing in a near certainty that the committee will lower its benchmark overnight borrowing rate by a quarter percentage point, which would follow a similar cut in September.

    Trump has three appointees on the seven-member board of governors: Waller and Bowman, as well as Stephen Miran, who is filling an unexpired term that ends in January. Miran, who was confirmed in September as the head of the Council of Economic Advisers, is not expected to be reappointed. He has campaigned for the FOMC to be more aggressive in easing.

    Should Powell opt to leave the Fed, that would give Trump four appointees. Trump thus far has been unsuccessful in trying to remove Governor Lisa Cook from the board. A rotating cast of five regional presidents joins the governors as voters during the FOMC meeting.

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  • Gold falls as potential US-China trade deal dents safe-haven demand – Reuters

    1. Gold falls as potential US-China trade deal dents safe-haven demand  Reuters
    2. Gold declines as US-China trade optimism offsets Fed rate cut bets  FXStreet
    3. Gold prices slide further as easing US-China tensions curb haven demand  Investing.com
    4. US debt accelerates through $38 trillion: Has gold peaked?  KITCO
    5. A Gold Crash Everyone Saw Coming Lures Bargain Hunters Worldwide  Bloomberg.com

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  • Nissan pools carbon emissions with electric vehicle maker BYD to avoid EU penalties | Electric, hybrid and low-emission cars

    Nissan pools carbon emissions with electric vehicle maker BYD to avoid EU penalties | Electric, hybrid and low-emission cars

    The Japanese carmaker Nissan is to team up with its Chinese electric vehicle rival BYD in an attempt to offset their carbon emissions and avoid EU penalties for 2025, it has confirmed.

    It is part of a wider offsetting scheme the EU has sanctioned for the car industry that could help manufacturers of combustion engine cars head off an estimated £13bn in fines.

    Nissan said in a statement: “Nissan has formed a pool with BYD for its CO2 fleet emissions in Europe for the 2025 calendar year. The scope of the agreement covers passenger vehicles within EU markets and will contribute to Nissan’s commitment towards zero emissions in a sustainable way, while continuing to support the EU’s 2050 decarbonisation target.”

    It added that it had entered into the agreement to “ensure the business is better able to comply with EU regulations and continue the transition towards our own goal of zero emissions”.

    Chinese exports of EVs to the EU are already posing an existential crisis to the European car industry but are now, like Tesla, helping traditional car firms meet their decarbonisation targets courtesy of an EU regulation that in effect allows car firms to “pool” emissions.

    The EU has already extended the period for compliance with emissions rules from one year to three years, fuelling fears this will further delay the already slow take-up of EVs in the EU, particularly in southern Europe, but also in key states such as France and Germany.

    Fredrik Eklund, responsible for carbon credits trading at the Chinese-owned Swedish brand Polestar, which only makes electric vehicles, said: “It risks delaying the transition from legacy cars to EVs. We are already seeing car manufacturers pushing at the 2027 expiry date, but from our point of view and from the point of view of society, we really don’t want to delay this.”

    Under the rules, car manufacturers have to meet emissions targets of 93.6g of CO2 per kilometre.

    But under the car pooling arrangement, car manufacturers can pay electric car companies to use their zero emissions record to average out the pollution from sales of their combustion engine cars to avoid fines.

    The industry in the past has said the 2025 emissions targets could have led to as much as €15bn (£13.03bn) in fines.

    The latest car pooling agreement, confirmed by Nissan, mirrors that of other companies who have teamed up with other big name electric car brands including Tesla and Polestar.

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    Polestar has a pooling arrangement with Mercedes-Benz, Volvo and Smart cars, while Tesla’s zero emissions record is being mopped up by Toyota, Ford, Mazda, Alfa Romeo and Suzuki.

    The price car companies are paying EV firms to offset their emissions remains confidential. But in January it was reported that carbon credit sales accounted for almost 3% of Tesla’s $72bn (£54bn) total revenue in the first nine months of last year – just over £1.6bn.

    The car industry is now fighting for a softening of the EU’s 2035 target for banning the sale of new combustion engine cars, arguing that the public is still not prepared to make the switch in sufficient numbers, citing lack of infrastructure in southern and central Europe as part of the problem.

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  • SLC7A11 as a bridge between ferroptosis and disulfidptosis: a promising target for tumor treatment | Cell Communication and Signaling

    SLC7A11 as a bridge between ferroptosis and disulfidptosis: a promising target for tumor treatment | Cell Communication and Signaling

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  • Eli Lilly buys Adverum in eye disease gene therapy punt

    Eli Lilly buys Adverum in eye disease gene therapy punt

    As part of the deal, Eli Lilly will acquire Adverum’s lead candidate ixo-vec, an intravitreal gene therapy for wAMD treatment. Credit: Tada Images via Shutterstock.com.

    Eli Lilly has agreed to acquire eye disease specialist Adverum Biotechnologies, bucking a recent trend of big pharma companies deciding to steer clear of the cell and gene therapy sector.

    Eli Lilly has offered Adverum $3.56 per share in cash, including an additional $8.91 in milestone payments. The latter depends on US approval of the biotech’s lead gene therapy candidate, ixo-vec, within seven years and achieving more than $1bn in annual global sales within ten years. This brings the total consideration to $12.47 a share, valuing the deal at a possible $261.7m.

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    The share offer agreed on 24 October reflects a nearly 15% discount from the $4.18 closing price on 23 October.

    For Adverum, the potential buyout from Eli Lilly provides financial respite. The biotech has been struggling for cash in recent times – holding $44.4m to its name in July 2025. The lack of capital had increased jeopardy for ixo-vec, an intravitreal gene therapy that advanced into a Phase III trial (NCT06856577) for the treatment of wet age-related macular degeneration (wAMD) in March 2025.

    Indeed, Eli Lilly stated that without a $65m loan given to Adverum to continue ongoing clinical trials, the biotech would only be able to finance itself through October before having to wind down operations.

    Despite having to help fund ixo-vec’s development, which has been granted fast track and regenerative medicine advanced therapy (RMAT) designations by the US Food and Drug Administration (FDA), Eli Lilly could use the candidate to enter the lucrative wAMD market. The AMD sector, which also includes the dry form, is expected to reach $27.5bn across 7MM by 2031 (7MM: US, France, Germany, Italy, Spain, UK, and Japan), according to GlobalData analysis.

    There is no gene therapy approved with a wAMD indication, with current treatments working via the anti–vascular endothelial growth factor (VEGF) mechanism, such as Regeneron’s blockbuster Eylea (aflibercept). The therapy is administered every four weeks for the first five months, followed by a single injection every two months. For Eli Lilly’s soon-to-be acquired ixo-vec, this could offer patients a one-and-done treatment.

    Lilly molecule discovery group vice-president Andrew Adams said: “Ixo-vec has the potential to transform wAMD treatment from a paradigm of chronic care with repeated intravitreal injections to a convenient one-time therapy.”

    Adverum CEO Laurent Fischer: “[Lilly’s] scientific depth and global reach offer the opportunity to accelerate our vision to deliver a transformative one-and-done therapy that can potentially restore and preserve vision for millions of patients living with wAMD.”

    Lilly bucks big pharma trend

    This is not the first time in 2025 that Eli Lilly has swooped in to rescue a cash-strapped biotech specialising in gene therapies. In April, the big pharma signed a licensing deal worth up to $1.4bn for Sangamo Therapeutics’ neurology-targeting gene therapy.

    However, Lilly’s recent deals, which includes a $1.3bn acquisition of RNA-based gene therapy developer Rznomics in May 2025, goes against the grain of big pharma generally opting to retreat from the cell and gene therapy sector.  

    Earlier this month, Galapagos wound down its cell and gene therapy division after failing to sell the unit. Japanese pharma Takeda also abandoned its cell therapy research, pivoting instead towards small molecules, biologics and antibody-drug conjugates (ADCs).

    In addition, Gilead Sciences’ Kite Pharma terminated its cell therapy collaboration with Shoreline in September 2025, ending a research partnership valued at $2.3bn.  

    Cell & Gene Therapy coverage on Pharmaceutical Technology is supported by Cytiva.

    Editorial content is independently produced and follows the highest standards of journalistic integrity. Topic sponsors are not involved in the creation of editorial content.

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  • Bitcoin faces a new civil war over how its blockchain should be used

    Bitcoin faces a new civil war over how its blockchain should be used

    I recently had the pleasure of visiting the lovely mountain town of Lugano, Switzerland, whose appeal lies in that it is basically Italy but administered by the Swiss. That’s according to Tether CEO Paolo Ardoino, one of the prime backers of Plan B, a Bitcoin conference where I hosted a discussion on the growing trend of nation states embracing the original cryptocurrency.

    The event had an upbeat vibe—not surprising since everyone there worshipped Bitcoin—but it was also clear there was trouble in paradise. It turns out there is a growing schism over Bitcoin’s codebase, and whether it should be modified to permit the blockchain to include more non-financial data.

    The notion of including data unrelated to Bitcoin transactions is hardly new and, indeed, the very first block on the blockchain includes a reference to a newspaper headline about bank bailouts. Now, though, Bitcoin’s biggest and most influential group of coders, known as Core, are planning to tweak their software in order to significantly lift the restrictions on how much non-payment information can be included in a block.

    For the Core crowd, this is a simple and pragmatic way to promote new uses for Bitcoin and, in the process, drum up extra fees for miners at a time when the blockchain’s lottery payment is 3.125 Bitcoins, and set to halve again in 2028. A fast-growing rival faction, though, wants nothing to do with the scheme and is promoting a Bitcoin client software of its own called Knots.

    That faction’s software is led by an influential Bitcoin developer, who is a devout Catholic and reportedly named it Knots after the “whip of knots” Jesus used to drive money changers from a temple. According to a lawyer I spoke with on the Knots side, the software is necessary to protect the blockchain from what he decried as spammers and “scam adjacency” projects that promote things like Bitcoin NFTs. 

    If you’ve encountered Bitcoiners in person or online, you’re aware they’re not known for their tact. That is true of prominent figures from Bitcoin’s early days who have been denouncing each other on stage in Lugano and on X. These high profile partisans include Peter Todd and Jameson Lopp for the Core faction, and Nick Szabo and Luke Dashjr for the rival Knots sect.

    This latest schism (you can read a helpful breakdown here) hearkens back to the Bitcoin block size wars that raged from 2015 to 2017, and ultimately saw the “small blockers”—who favored keeping Bitcoin blocks at 1MB—prevail over rivals who claimed boosting the blocks to 2MB or more would be more commercially viable. That fight produced bad blood that has lasted to this day.

    In the current fight, Knots is still the smaller faction, but has already become the client of choice for over 20% of Bitcoin node operators. Its growing popularity lies not only in Knots’ position on expanding the blockchain, but from a perception that the Core crowd has grown arrogant and out-of-touch with Bitcoin’s core values. The Core folks, meanwhile, dismiss the Knots faction as lying trouble-makers.

    I lack the authority to weigh in on much of this, other than to observe that this latest battle for the soul of Bitcoin reinforces what I’ve said for years: Bitcoin is a marvelous technology, but also a religion. And with any religion, there will be divisions between old-line believers and more modern adherents. Happily for the crowd in Lugano, there was a moment of unity that came with the unveiling of a restored Satoshi Nakamoto statue on the city’s beautiful lakefront. Bitcoin’s factions may be at war but there’s no doubt they still worship a common god.

    Jeff John Roberts
    jeff.roberts@fortune.com
    @jeffjohnroberts

    DECENTRALIZED NEWS

    If you can’t beat ‘em, join ‘em: JPMorgan Chase’s CEO continues to soften his longtime anti-crypto stance as his bank announced that it will let borrowers use Bitcoin and Ethereum for loan collateral by the end of year. (Bloomberg)

    COIN upgrade: Coinbase’s forthcoming crypto token could be worth $12 billion to $34 billion, said a JPM analyst, who cited the token and the slowing growth of DEXes as reasons to upgrade the stock ahead of third-quarter earnings this week. (DL News)

    Here we ICO again? In assessing Coinbase’s $375 million acquisition of Echo, which was founded by crypto influencer Cobie and helps token projects raise funds, one journalist speculated it could inaugurate the return of 2016-style initial coin offerings. (Bloomberg) 

    DAT doesn’t add up: Following a Fortune exposé pointing to potential insider trading ahead of public company pivots to digital asset treasuries, a new report provides evidence that insiders tied to some popular DATs are using share sales to circumvent token lockups. (Unchained)

    Trump picks a CFTC chair: The White House selected longtime lawyer and crypto guy Mike Selig to lead the agency. The choice of Selig, which came after the Winklevii helped torpedo the original frontrunner, was hailed by industry vets who are eager to finalize a key bill that will divide responsibilities between the SEC and CFTC. (Politico)

    MAIN CHARACTER OF THE WEEK

    Changpeng Zhao, cofounder of Binance.

    Samsul Said—Bloomberg/Getty Images

    CZ was the easy choice for main character of the week after finally securing a Presidential pardon. Critics, pointing to a $2 billion deal involving the Trump family’s stablecoin and Binance, blasted the pardon as massively corrupt while many on Crypto Twitter claimed it was fair since CZ—who pleaded guilty—had allegedly been the target of a political prosecution.

    MEME O’ THE MOMENT

    A screenshot of a twitter post that juxtaposes two Bitcoin statues.
    In Lugano, Switzerland, Bitcoiners unveiled a refurbished statue of Satoshi Nakamoto.

    @Globalstats11

    Bitcoin devotees seeking to make a pilgrimage have a growing number of options. In addition to the refurbished Satoshi statue unveiled in Lugano, there is one in Budapest as well. Can a formal shrine—or perhaps a Bitcoin theme park—be far behind?

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  • Mitigation of alkaline stress and iron deficiency in Petunia hybrida through resveratrol-induced physiological and nutrient responses | BMC Plant Biology

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  • Clinical characteristics and prognostic analysis of concurrent Pneumocystis jirovecii pneumonia in patients with malignancies: a retrospective study | BMC Infectious Diseases

    Clinical characteristics and prognostic analysis of concurrent Pneumocystis jirovecii pneumonia in patients with malignancies: a retrospective study | BMC Infectious Diseases

    General characteristics of malignancy-PJP patients

    Fifty-six patients with an identified diagnosis of malignancy-PJP were enrolled in our study after a detailed medical record review. Thirty-four patients were male (60.7%), 22 patients were female (39.3%), and the mean age was 63 (52, 68) years. The underlying malignancies are shown in Fig. 1. Most patients had solid malignancies (45, 80.4%), and 11 (19.6%) had non-solid malignancies. According to the involved system, 23 (41.1%) patients had non-hematological malignancies, and 33 (58.9%) had hematological malignancies.

    Fig. 1

    The underlying malignancies of enrolled 56 malignancy-PJP patients. Other hematological malignancies: multiple myeloma and aplastic anemia; other non-hematological malignancies: prostate cancer, nasopharyngeal cancer, and breast cancer

    The main clinical manifestations of PJP were fever (52, 92.9%), cough (47, 83.9%), expectoration (41, 73.2%), and dyspnea (47, 83.9%). Bilateral (56, 100%), ground-glass opacities (GGOs) (48, 85.7%), and patches (45, 80.4%) were the most common chest CT manifestations. Consolidations (24, 42.9%), nodular (24, 42.9%), and pleural thickening (32, 57.1%) were observed on some chest CTs of patients with malignancy-PJP. Low peripheral CD4+ T-cell [125.0 (66.0, 207.0)/µL] counts were common in patients with malignancy-PJP.

    Some patients were complicated with other infections, such as CMV (25, 44.6%), bacterial HAP (23, 41.1%), oral candida infection (6, 10.7%), aspergillus infection (6, 10.7%), and Nocardia infection (2, 3.6%). Most patients experienced respiratory failure (47, 83.9%), approximately half of the patients needed intensive care unit (ICU) support, and 29 patients (51.8%) died.

    After PJP diagnosis, most patients (50, 89.3%) were prescribed 15 mg/kg/d trimethoprim-sulfamethoxazole (TMP-SMX). More than one-third of our patients (21, 37.5%) were also prescribed a combination of second-line anti-PJP medications, such as caspofungin, clindamycin and primaquine.

    Differences in the clinical characteristics and prognosis between PJP patients with non-hematological and hematological malignancies

    According to the involved system, the 56 patients were divided into a non-hematological malignancy group and a hematological malignancy group. The differences in clinical characteristics, laboratory test results (Table 1) and imaging findings (Table 2) between the two groups were analyzed.

    Table 1 The clinical characteristics between non-hematological malignancy-PJP group and hematological malignancy-PJP group
    Table 2 The chest CT features in non-hematological malignancy-PJP group and hematological malignancy-PJP group

    There were no significant differences in age, sex or comorbidities between the two groups. Compared with patients in the non-hematological malignancy group, more patients in the hematological malignancy group needed invasive mechanical ventilation support (60.6% vs. 43.5%, p = 0.03). Patients in the hematological malignancy group were more prone to respiratory failure and higher mortality, but the difference was not statistically significant. The time from diagnosis of oncological disease to PJP infection [72 (38.0, 112.5) days vs. 153 (92.5, 223.5) days, p < 0.01] and the time from chemotherapy to PJP infection [79.0 (46.5, 415.5) days vs. 229.0 (116.0, 677.5) days, p = 0.04] were shorter in the hematological malignancy group than in the non-hematological malignancy group. In terms of chest CT features, pleural thickening was more common in the non-hematological malignancy group than in the hematological malignancy group (73.9% vs. 45.5%, p = 0.03). However, there were no significant differences in the minimal albumin level, peripheral lymphocyte count or inflammatory marker levels between the two groups.

    Differences between the survival and non-survival groups of patients with malignancy-PJP

    The 56 patients were divided into a survival group (27 patients) and a non-survival group (29 patients) according to their clinical outcome. Compared with those in the survival group, more patients in the non-survival group were complicated with CMV (62.1% vs. 25.9%, p < 0.01) and bacterial HAP (58.6% vs. 22.2%, p < 0.01). However, there were no significant differences in clinical symptoms, chest CT features, chemotherapy before PJP infection or anti-PJP treatment between the two groups.

    In terms of laboratory test results, in the non-survival group, the peripheral lymphocyte count [0.4 (0.3, 0.7) × 109/L vs. 0.8 (0.5, 1.4) × 109/L, p < 0.01], platelet count [138.0 (74.0, 197.5) × 109/L vs. 212.0 (160.8, 265.3) × 109/L, p < 0.01], minimal albumin level [21.7 ± 5.3 g/L vs. 26.6 ± 4.6 g/L, p < 0.001], T-cell count [307.0 (151.0, 377.0)/µL vs. 447.0 (245.5, 920.5)/µL, p = 0.01) and CD4+ T-cell count [123.0 (37.0, 163.0)/µL vs. 146.0 (97.0, 417.0)/µL, p = 0.03] were significantly lower than those in the survival group. However, D-dimer [8.3 (2.0, 15.6) mg/L vs. 1.9 (0.9, 6.3) mg/L, p = 0.01], high-sensitivity C-reactive protein [107.0 (36.3, 191.3) mg/L vs. 42.2 (6.9, 87.0) mg/L, p < 0.01] and lactate dehydrogenase [588.0 (441.0, 789.5) U/L vs. 319.0 (255.0, 481.0) U/L, p < 0.01] levels were greater in the non-survival group than in the survival group.

    Prognostic analysis for patients with malignancy-PJP

    As shown in Table 3, univariate Cox regression analysis revealed that non-solid malignancies, decreased lymphocyte count, CMV viremia, bacterial HAP, and pneumomediastinum were associated with non-survival. Subsequent multivariate Cox regression analysis revealed that non-solid malignancies (HR = 2.77, χ2 = 4.83, p = 0.03, 95% CI: 1.12–6.89), CMV viremia (HR = 3.33, χ2 = 8.93, p < 0.01, 95% CI: 1.51–7.33), bacterial HAP (HR = 2.21, χ2 = 4.10, p = 0.04, 95% CI: 1.03–4.77) and pneumomediastinum (HR = 2.50, χ2 = 3.96, p < 0.05, 95% CI: 1.01–6.14) were independent risk factors associated with poor survival in patients with malignancy-PJP.

    Table 3 Univariable and multivariable Cox regression analysis of survival associated risk factors for patients with malignancy-PJP

    Kaplan‒Meier analysis (Fig. 2) was performed to explore the impact of the different types of underlying malignancies on the cumulative survival of malignancy-PJP patients. The results revealed that there was no significant difference in survival between patients with non-hematological malignancies and those with hematological malignancies. Compared with that of patients with solid malignancies, the survival rate of patients with non-solid malignancies (p < 0.05) was significantly lower.

    Fig. 2
    figure 2

    Kaplan-Meier analysis of malignancy-PJP patients on 60-day. A with hematological malignancies and with non-hematological malignancies; B with solid malignancies and with non-solid malignancies

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  • Correlation of inflammatory burden index with 30-day readmission rates in patients post-elective percutaneous coronary intervention | Journal of Cardiothoracic Surgery

    Correlation of inflammatory burden index with 30-day readmission rates in patients post-elective percutaneous coronary intervention | Journal of Cardiothoracic Surgery

    Our study provides novel insights into the relationship between the IBI and the risk of 30-day readmission following elective PCI. By leveraging a comprehensive retrospective cohort, we have demonstrated that higher IBI values are significantly correlated with an increased risk of readmission, independent of traditional risk factors. This correlation was particularly pronounced in older, male patients and those with diabetes, highlighting the potential utility of IBI in risk stratification for these vulnerable populations. Our multivariate analysis revealed that a one-unit increase in IBI is associated with a 41% increase in the risk of 30-day readmission (OR 1.41, 95% CI 1.19–1.67, p < 0.001). This means that for every unit increase in IBI, the likelihood of a patient being readmitted within 30 days increases significantly. For example, a patient with an IBI of 2 compared to a patient with an IBI of 1 would have a 41% higher risk of readmission. This increased risk is likely due to the role of inflammation in promoting plaque instability, thrombus formation, and other adverse cardiovascular events that can lead to hospital readmission.

    When compared to other studies, our findings are consistent with those of Li et al. [9], who demonstrated the association between inflammatory markers and the risk of hospitalization for heart failure post-myocardial infarction. However, our study extends these insights by showing that an integrated inflammatory index, rather than a single biomarker, is associated with readmission, emphasizing the complexity of inflammatory processes in cardiovascular disease [10]. The association between inflammation and cardiovascular outcomes, including post-PCI readmission, is well-established in the literature [11, 12]. Our findings are consistent with those of recent studies that have implicated inflammation in the pathogenesis of adverse cardiovascular events [13]. For instance, a study by Xie et al. [14] confirmed the predictive value of C-reactive protein, a key component of IBI, for cardiovascular events. Our study extends these insights by showing that an integrated inflammatory index, rather than a single biomarker, is associated with readmission, emphasizing the complexity of inflammatory processes in cardiovascular disease.

    The potential mechanisms underlying the association between IBI and readmission are multifaceted. Inflammation is known to play a role in plaque rupture and thrombus formation, which can lead to acute coronary syndromes and potentially readmission [15]. Also, local or systemic inflammation has been proven to be a possible mechanism underlying the development of coronary slow flow phenomenon [16, 17]. Many patients experience recurrent episodes of angina due to the coronary slow flow phenomenon, leading to frequent hospitalizations [18]. Furthermore, inflammation may also contribute to the development of heart failure, a common cause of readmission following PCI [19]. By integrating multiple inflammatory biomarkers, IBI may provide a more comprehensive assessment of the inflammatory state and its impact on post-PCI outcomes.

    The stronger correlation observed in older patients and those with diabetes may reflect the heightened inflammatory state often observed in these patient groups [20, 21]. Diabetes is known to induce a chronic low-grade inflammatory state, which could potentiate the association between IBI and readmission [22]. Similarly, aging is associated with an increased inflammatory burden, which may contribute to the observed association [23]. These findings underscore the importance of considering IBI in the context of patient-specific risk factors when assessing the risk of readmission. The stronger correlation observed in males may reflect sex-specific differences in inflammatory responses to PCI [24]. Emerging evidence suggests that sex hormones modulate inflammation, with males exhibiting higher levels of certain inflammatory markers compared to females [25]. This could potentially explain the enhanced association between IBI and readmission in male patients. Additionally, the higher IBI in males may also be indicative of a more aggressive inflammatory process post-PCI, which could lead to a higher likelihood of complications and subsequent readmission [26].

    IL−6 is a well-established inflammatory marker that has been extensively studied in the context of cardiovascular disease. Recent studies have shown that elevated IL−6 levels are associated with increased risk of adverse outcomes following PCI. For instance, high levels of IL−6 have been linked to larger infarct sizes and higher mortality rates in patients with ST-segment elevation myocardial infarction [27]. Additionally, IL−6 has been identified as an independent predictor of non-target lesion progression in patients after coronary stenting [28]. In our study, we collected data on IL−6 levels to provide additional supporting evidence for the effectiveness of IBI. The significant difference in IL−6 levels between the readmitted and non-readmitted groups aligns with the observed trends in IBI, further validating its role as a comprehensive measure of inflammation. The inclusion of IL−6 in our data collection was intended to demonstrate that it shares a similar trend with IBI, thereby reinforcing the validity of IBI as a predictor of readmission risk.

    The implications of our findings for clinical practice are significant. By identifying patients with higher IBI values as being at increased risk of readmission, clinicians may be able to target these individuals for more intensive post-discharge monitoring and intervention. This could potentially lead to a reduction in readmission rates and associated healthcare costs, as well as improved patient outcomes.

    It is important to note that our study is not without limitations. As a retrospective cohort study, it is subject to the inherent biases and limitations of such designs. First, Our study is limited by the lack of standardized adjudication of readmission urgency or etiology, which precluded stratification into urgent vs. non-urgent or cardiac vs. non-cardiac categories. Future prospective studies with dedicated adjudication committees are needed to validate these findings in such contexts. Secondly, Second, geographical factors and variations in healthcare practices, as well as disparities in the availability and utilization of primary care, can significantly influence readmission rates. Our study population is drawn from a specific region, which may not be representative of other areas with different healthcare systems, patient demographics, or clinical practices. For instance, regions with limited access to primary care or specialized cardiovascular services may experience higher readmission rates due to inadequate post-discharge follow-up and management. Notably, we excluded patients who experienced major procedural complications, which were defined as complications necessitating additional interventions or treatments beyond standard PCI, such as vascular perforation, acute stent thrombosis, or significant bleeding requiring transfusion. While this exclusion was intended to focus on the elective PCI population and minimize confounding from procedures that became emergent, it may introduce selection bias. Future prospective studies are needed to validate our findings and to explore the potential of IBI as a predictive tool in a broader range of patient populations and clinical settings.

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