Improvement in detecting cytomegalovirus drug resistance mutations in solid organ transplant recipients with suspected resistance using next generation sequencing

Objetives The aim of this study was to identify CMV drug resistance mutations (DRM) in solid organ transplant (SOT) recipients with suspected resistance comparing next-generation sequencing (NGS) with Sanger sequencing and assessing risk factors and the clinical impact of resistance. Methods Using Sanger sequencing as the reference method, we prospectively assessed the ability of NGS to detect CMV DRM in the UL97 and UL54 genes in a nationwide observational study from September 2013 to August 2016. Results Among 44 patients recruited, 14 DRM were detected by Sanger in 12 patients (27%) and 20 DRM were detected by NGS, in 16 (36%). NGS confirmed all the DRM detected by Sanger. The additional six mutations detected by NGS were present in <20% of the sequenced population, being located in the UL97 gene and conferring high-level resistance to ganciclovir. The presence of DRM by NGS was associated with lung transplantation (p = 0.050), the administration of prophylaxis (p = 0.039), a higher mean time between transplantation and suspicion of resistance (p = 0.038) and longer antiviral treatment duration before suspicion (p = 0.024). However, the latter was the only factor independently associated with the presence of DRM by NGS in the multivariate analysis (OR 2.24, 95% CI 1.03 to 4.87). Conclusions NGS showed a higher yield than Sanger sequencing for detecting CMV resistance mutations in SOT recipients. The presence of DRM detected by NGS was independently associated with longer antiviral treatment.Funding: M.A.M. was supported in part by: Agency for Health Technology Assessment and Research Supported by Ministerio de Economía y Competitividad, Instituto de Salud Carlos III (PS12/02131 and PI17/02150); Agència de Gestió d´Ajuts Universitaris I de Recerca, Generalitat de Catalunya, 2017 SGR 794; and Fundació Marató TV3 project code 201824

Large-scale magnetic fields from inflation due to a CPTCPT-even Chern-Simons-like term with Kalb-Ramond and scalar fields

We investigate the generation of large-scale magnetic fields due to the breaking of the conformal invariance in the electromagnetic field through the $CPT$-even dimension-six Chern-Simons-like effective interaction with a fermion current by taking account of the dynamical Kalb-Ramond and scalar fields in inflationary cosmology. It is explicitly demonstrated that the magnetic fields on 1Mpc scale with the field strength of $\sim 10^{-9}$G at the present time can be induced.Comment: 18 pages, 6 figures, version accepted for publication in Eur. Phys. J.

Reconstructing the Cosmic Expansion History up to Redshift z=6.29 with the Calibrated Gamma-Ray Bursts

Recently, Gamma-Ray Bursts (GRBs) were proposed to be a complementary cosmological probe to type Ia supernovae (SNIa). GRBs have been advocated to be standard candles since several empirical GRB luminosity relations were proposed as distance indicators. However, there is a so-called circularity problem in the direct use of GRBs. Recently, a new idea to calibrate GRBs in a completely cosmology independent manner has been proposed, and the circularity problem can be solved. In the present work, following the method proposed by Liang {\it et al.}, we calibrate 70 GRBs with the Amati relation using 307 SNIa. Then, following the method proposed by Shafieloo {\it et al.}, we smoothly reconstruct the cosmic expansion history up to redshift $z=6.29$ with the calibrated GRBs. We find some new features in the reconstructed results.Comment: 12 pages, 4 figures, 1 table, revtex4; v2: title changed, accepted by Eur. Phys. J. C; v3: published versio

Space Telescope and Optical Reverberation Mapping Project. VII. Understanding the Ultraviolet Anomaly in NGC 5548 with X-Ray Spectroscopy

During the Space Telescope and Optical Reverberation Mapping Project observations of NGC 5548, the continuum and emission-line variability became decorrelated during the second half of the six-month-long observing campaign. Here we present Swift and Chandra X-ray spectra of NGC 5548 obtained as part of the campaign. The Swift spectra show that excess flux (relative to a power-law continuum) in the soft X-ray band appears before the start of the anomalous emission-line behavior, peaks during the period of the anomaly, and then declines. This is a model-independent result suggesting that the soft excess is related to the anomaly. We divide the Swift data into on- and off-anomaly spectra to characterize the soft excess via spectral fitting. The cause of the spectral differences is likely due to a change in the intrinsic spectrum rather than to variable obscuration or partial covering. The Chandra spectra have lower signal-to-noise ratios, but are consistent with the Swift data. Our preferred model of the soft excess is emission from an optically thick, warm Comptonizing corona, the effective optical depth of which increases during the anomaly. This model simultaneously explains all three observations: the UV emission-line flux decrease, the soft-excess increase, and the emission-line anomaly

Customer emotions in service failure and recovery encounters

Emotions play a significant role in the workplace, and considerable attention has been given to the study of employee emotions. Customers also play a central function in organizations, but much less is known about customer emotions. This chapter reviews the growing literature on customer emotions in employee–customer interfaces with a focus on service failure and recovery encounters, where emotions are heightened. It highlights emerging themes and key findings, addresses the measurement, modeling, and management of customer emotions, and identifies future research streams. Attention is given to emotional contagion, relationships between affective and cognitive processes, customer anger, customer rage, and individual differences

Excimer laser-assisted corneal epithelial pattern ablation for corneal cross-linking

Purpose To determine corneal cross-linking (CXL) efficacy and chromophore penetration after excimer laser-assisted patterned de-epithelialization. Methods Two-hundred-twenty porcine eyes were de-epithelialized ex vivo, either fully (mechanical; n = 88) or patterned (excimer laser; n = 132). Consecutively, corneas were impregnated with hypo- or hyperosmolar riboflavin (RF; n = 20, RF-D; n = 40, respectively) or water-soluble taurine (WST11; n = 40, and WST-D; n = 40, respectively), or kept unimpregnated (n = 80). Sixty corneas were subsequently irradiated, inducing CXL, with paired contralateral eyes serving as controls. Outcome measurements included strip extensiometry to assess CXL efficacy, and spectrophotometry and fluorescence microscopy to determine stromal chromophore penetration. Results All tested chromophores induced significant CXL (p < 0.001), ranging from 7.6% to 14.6%, with similar stiffening for all formulations (p = 0.60) and both de-epithelialization methods (p = 0.56). Light transmittance was significantly lower (p < 0.001) after full compared with patterned de-epithelialization. Stromal chromophore penetration was comparable between fully and patterned de-epithelialized samples, with full penetration in RD and RF-D samples and penetration depths measuring 591.7 +/- 42.8 mu m and 592.9 +/- 63.5 mu m for WST11 (p = 0.963) and 504.2 +/- 43.2 mu m and 488.8 +/- 93.1 mu m for WST-D (p = 0.669), respectively. Conclusions Excimer laser-assisted patterned de-epithelialization allows for effective CXL. Stromal chromophore concentration is, however, reduced, which may have safety implications given the need for sufficient UVA attenuation in RF/UVA CXL. The different safety profile of near-infrared (NIR) may allow safe WST11/NIR CXL even with reduced stromal chromophore concentration values. In vivo studies are needed to evaluate the benefits and further assess safety of excimer laser-assisted patterned de-epithelialization for corneal CXL

Síndrome de Intestino Irritable; papel de la microbiota y probiótico-terapia

Trabajo presentado en el VI Workshop Probióticos, Prebióticos y Salud: Evidencia Científica, celebrado en Oviedo (España) el 5 y 6 de febrero de 2015.El Síndrome de intestino irritable (SII) se define por síntomas de dolor abdominal, y alteración del hábito intestinal. Cuenta con diversos tratamientos disponibles, sin que hasta el momento haya destacado ninguna estrategia terapéutica en especial. La fisiopatología del SII permanece inexplicada, aunque diversas líneas de evidencia sugieren un papel de la microbiota intestinal. A pesar de que existe controversia, es probable que la microbiota contribuya a la generación de síntomas, al menos en algunos pacientes, a través de un proceso de fermentación alterado, de la modificación de la función de barrera intestinal, de la modulación inadecuada de la función sesorio-motora entérica y del eje cerebro-enteral. La probiótico-terapia produce un modesto alivio sintomático en SII, aunque la evidencia actual no es suficiente para la recomendación general de uso. Los mejores resultados se obtienen, en niños, con Lactobacillus rhamnosus GG, que mejora discretamente el dolor abdominal, mientras que en adultos el beneficio parece mayor empleando especies de Bifidobacterium.Peer reviewe