In this study, we assessed the association between single‐nucleotide polymorphisms (SNPs) in seven candidate genes involved in orchestrating the immune response against cytomegalovirus (CMV) and the ...12‐month incidence of CMV infection in 315 CMV‐seropositive kidney transplant (KT) recipients. Patients were managed either by antiviral prophylaxis or preemptive therapy. CMV infection occurred in 140 patients (44.4%), including 13 episodes of disease. After adjusting for various clinical covariates, patients harboring T‐allele genotypes of interleukin‐28B (IL28B) (rs12979860) SNP had lower incidence of CMV infection (adjusted hazard ratio aHR: 0.66; 95% confidence interval CI: 0.46–0.96; p‐value = 0.029). In the analysis restricted to patients not receiving prophylaxis, carriers of the TT genotype of toll‐like receptor 9 (TLR9) (rs5743836) SNP had lower incidence of infection (aHR: 0.61; 95% CI: 0.38–0.96; p‐value = 0.035), whereas the GG genotype of dendritic cell‐specific ICAM 3‐grabbing nonintegrin (DC‐SIGN) (rs735240) SNP exerted the opposite effect (aHR: 1.86; 95% CI: 1.18–2.94; p‐value = 0.008). An independent association was found between the number of unfavorable SNP genotypes carried by the patient and the incidence of CMV infection. In conclusion, specific SNPs in IL28B, TLR9 and DC‐SIGN genes may play a role in modulating the susceptibility to CMV infection in CMV‐seropositive KT recipients.
Using a large multicenter cohort of seropositive kidney transplant recipients, this study demonstrates the independent effect on the incidence of cytomegalovirus infection of single‐nucleotide polymorphisms in various genes involved in orchestrating innate and adaptive immune responses.
Launching and manipulation of polaritons in van der Waals materials offers novel opportunities for field-enhanced molecular spectroscopy and photodetection, among other applications. Particularly, ...the highly confined hyperbolic phonon polaritons (HPhPs) in h-BN slabs attract growing interest for their capability of guiding light at the nanoscale. An efficient coupling between free space photons and HPhPs is, however, hampered by their large momentum mismatch. Here, we show -by far-field infrared spectroscopy, infrared nanoimaging and numerical simulations- that resonant metallic antennas can efficiently launch HPhPs in thin h-BN slabs. Despite the strong hybridization of HPhPs in the h-BN slab and Fabry-Pérot plasmonic resonances in the metal antenna, the efficiency of launching propagating HPhPs in h-BN by resonant antennas exceeds significantly that of the non-resonant ones. Our results provide fundamental insights into the launching of HPhPs in thin polar slabs by resonant plasmonic antennas, which will be crucial for phonon-polariton based nanophotonic devices.
Risk factors for invasive pulmonary aspergillosis (IPA) after kidney transplantation have been poorly explored. We performed a multinational case–control study that included 51 kidney transplant (KT) ...recipients diagnosed with early (first 180 posttransplant days) IPA at 19 institutions between 2000 and 2013. Control recipients were matched (1:1 ratio) by center and date of transplantation. Overall mortality among cases was 60.8%, and 25.0% of living recipients experienced graft loss. Pretransplant diagnosis of chronic pulmonary obstructive disease (COPD; odds ratio OR: 9.96; 95% confidence interval CI: 1.09–90.58; p = 0.041) and delayed graft function (OR: 3.40; 95% CI: 1.08–10.73; p = 0.037) were identified as independent risk factors for IPA among those variables already available in the immediate peritransplant period. The development of bloodstream infection (OR: 18.76; 95% CI: 1.04–339.37; p = 0.047) and acute graft rejection (OR: 40.73, 95% CI: 3.63–456.98; p = 0.003) within the 3 mo prior to the diagnosis of IPA acted as risk factors during the subsequent period. In conclusion, pretransplant COPD, impaired graft function and the occurrence of serious posttransplant infections may be useful to identify KT recipients at the highest risk of early IPA. Future studies should explore the potential benefit of antimold prophylaxis in this group.
A multinational case‐control study in kidney transplant recipients finds that pretransplant diagnosis of chronic obstructive pulmonary disease, delayed graft function, bloodstream infection and acute graft rejection identify patients at the highest risk for early invasive pulmonary aspergillosis.
Photonic crystals (PCs) are periodically patterned dielectrics providing opportunities to shape and slow down the light for processing of optical signals, lasing and spontaneous emission control. ...Unit cells of conventional PCs are comparable to the wavelength of light and are not suitable for subwavelength scale applications. We engineer a nanoscale hole array in a van der Waals material (h-BN) supporting ultra-confined phonon polaritons (PhPs)-atomic lattice vibrations coupled to electromagnetic fields. Such a hole array represents a polaritonic crystal for mid-infrared frequencies having a unit cell volume of Formula: see text (with λ
being the free-space wavelength), where PhPs form ultra-confined Bloch modes with a remarkably flat dispersion band. The latter leads to both angle- and polarization-independent sharp Bragg resonances, as verified by far-field spectroscopy and near-field optical microscopy. Our findings could lead to novel miniaturized angle- and polarization-independent infrared narrow-band couplers, absorbers and thermal emitters based on van der Waals materials and other thin polar materials.
Phonon polaritons (PhPs) in van der Waals (vdW) crystal slabs enable nanoscale infrared light manipulation. Specifically, periodically structured vdW slabs behave as polaritonic crystals (vdW-PCs), ...where the polaritons form Bloch modes. Because the polariton wavelengths are smaller than that of light, conventional far-field spectroscopy does not allow for a complete characterization of vdW-PCs or for revealing their band structure. Here, we perform hyperspectral infrared nanoimaging and analysis of PhPs in a vdW-PC slab made of h-BN. We demonstrate that infrared spectra recorded at individual spatial positions within the unit cell of the vdW-PC can be associated with its band structure and local density of photonic states (LDOS). We thus introduce hyperspectral infrared nanoimaging as a tool for the comprehensive analysis of polaritonic crystals, which could find applications in the reconstruction of complex polaritonic dispersion surfaces in momentum-frequency space or for exploring exotic electromagnetic modes in topological photonic structures.
The prognostic factors and optimal therapy for invasive pulmonary aspergillosis (IPA) after kidney transplantation (KT) remain poorly studied. We included in this multinational retrospective study ...112 recipients diagnosed with probable (75.0% of cases) or proven (25.0%) IPA between 2000 and 2013. The median interval from transplantation to diagnosis was 230 days. Cough, fever, and expectoration were the most common symptoms at presentation. Bilateral pulmonary involvement was observed in 63.6% of cases. Positivity rates for the galactomannan assay in serum and bronchoalveolar lavage samples were 61.3% and 57.1%, respectively. Aspergillus fumigatus was the most commonly identified species. Six‐ and 12‐week survival rates were 68.8% and 60.7%, respectively, and 22.1% of survivors experienced graft loss. Occurrence of IPA within the first 6 months (hazard ratio HR: 2.29; p‐value = 0.027) and bilateral involvement at diagnosis (HR: 3.00; p‐value = 0.017) were independent predictors for 6‐week all‐cause mortality, whereas the initial use of a voriconazole‐based regimen showed a protective effect (HR: 0.34; p‐value = 0.007). The administration of antifungal combination therapy had no apparent impact on outcome. In conclusion, IPA entails a dismal prognosis among KT recipients. Maintaining a low clinical suspicion threshold is key to achieve a prompt diagnosis and to initiate voriconazole therapy.
Invasive pulmonary aspergillosis presents a high mortality rate in kidney transplant recipients, with diagnosis within the first 6 months posttransplantation and bilateral lung involvement as independent risk factors for mortality.
Cystinosis is a rare autosomal recessive disease leading to end‐stage renal disease within the second or third decade of life. Since the era of specific treatment with cysteamine, prognosis has ...substantially improved and pregnancy becomes an increasing concern. Pregnancy data in patients with cystinosis were collected through an anonymized survey. We collected data for 19 pregnancies in 12 women. Seventeen patients were transplanted, 1 was on hemodialysis and 1 had chronic kidney disease (CKD) stage 4. These 19 pregnancies resulted in 13 live births (68.4%): 3 spontaneous early miscarriages, 1 ectopic pregnancy, 1 early pre‐eclampsia (at 21 weeks), and 1 preterm birth with neonatal death at 24 weeks were reported. After exclusion of early miscarriage or termination, pregnancy success rate was 86.7%. In successful pregnancies, median gestational age at delivery was 34 weeks (24–37). Preeclampsia occurred in seven pregnancies (7/15, 46.7%). A cesarean section was performed in all pregnancies. Median baby weight at delivery was 2175 g (620–3374 g). After pregnancy, one patient reached end‐stage renal disease, but she already had advanced CKD before pregnancy (creatinine 239 μmol/L, eGFR 23 ml/min/1.73 m2). In three other patients, there was a decrease of eGFR of 8, 20, and 53 ml/min/1.73 m2, respectively. The majority of pregnancies were successful, but severe antenatal and post‐natal complications may occur, in particular preeclampsia that was noticed in nearly half of patients and fetal loss in one‐third of them. These results may help pre‐pregnancy counseling and pregnancy management.
Here we present the theoretical foundation of the strong coupling phenomenon between quantum emitters and propagating surface plasmons observed in two-dimensional metal surfaces. For that purpose, we ...develop a quantum framework that accounts for the coherent coupling between emitters and surface plasmons and incorporates the presence of dissipation and dephasing. Our formalism is able to reveal the key physical mechanisms that explain the reported phenomenology and also determine the physical parameters that optimize the strong coupling. A discussion regarding the classical or quantum nature of this phenomenon is also presented.
Abstract Objective: To examine any possible links between exposure to DDE (1,1-dichloro-2,2-bis (p -chlorophenyl)ethylene), the persistent metabolite of the pesticide dicophane (DDT), and breast ...cancer. Design: Multicentre study of exposure to DDE by measurement of adipose tissue aspirated from the buttocks. Laboratory measurements were conducted in a single laboratory. Additional data on risk factors for breast cancer were obtained by standard questionnaires. Setting: Centres in Germany, the Netherlands, Northern Ireland, Switzerland, and Spain. Subjects: 265 postmenopausal women with breast cancer and 341 controls matched for age and centre. Main outcome measure: Adipose DDE concentrations. Results: Women with breast cancer had adipose DDE concentrations 9.2% lower than control women. No increased risk of breast cancer was found at higher concentrations. The odds ratio of breast cancer, adjusted for age and centre, for the highest versus the lowest fourth of DDE distribution was 0.73 (95% confidence interval 0.44 to 1.21) and decreased to 0.48 (0.25 to 0.95; P for trend=0.02) after adjustment for body mass index, age at first birth, and current alcohol drinking. Adjustment for other risk factors did not materially affect these estimates. Conclusions: The lower DDE concentrations observed among the women with breast cancer may be secondary to disease inception. This study does not support the hypothesis that DDE increases risk of breast cancer in postmenopausal women in Europe. Key messages Organochlorines such as polychlorinated biphenyls and DDT may increase the risk of breast cancer in women DDE concentrations among the women with cancer were lower than among the controls, and there was an inverse risk gradient with higher DDE concentrations which remained significant after adjustment for risk factors for breast cancer These results are clearly incompatible with an increased risk of breast cancer at increased concentrations of DDE, although associations with other organochlorines cannot be excluded