537 research outputs found
Edge-dependent reflection and inherited fine structure of higher-order plasmons in graphene nanoribbons
We investigate higher-order plasmons in graphene nanoribbons, and present how
electronic edge states and wavefunction fine structure influence the graphene
plasmons. Based on nearest-neighbor tight-binding calculations, we find that a
standing-wave model based on nonlocal bulk plasmon dispersion is surprisingly
accurate for armchair ribbons of widths even down to a few nanometers, and we
determine the corresponding phase shift upon edge reflection and an effective
ribbon width. Wider zigzag ribbons exhibit a similar phase shift, whereas the
standing-wave model describes few-nanometer zigzag ribbons less satisfactorily,
to a large extent because of their edge states. We directly confirm that also
the larger broadening of plasmons for zigzag ribbons is due to their edge
states. Furthermore, we report a prominent fine structure in the induced
charges of the ribbon plasmons, which for armchair ribbons follows the
electronic wavefunction oscillations induced by inter-valley coupling.
Interestingly, the wavefunction fine structure is also found in our analogous
density-functional theory calculations, and both these and tight-binding
numerical calculations are explained quite well with analytical Dirac theory
for graphene ribbons
Emergent scale invariance of non-classical plasmons in graphene nanoribbons
Using a nearest-neighbor tight-binding model we investigate quantum effects
of plasmons on few-nanometer wide graphene nanoribbons, both for zigzag and
armchair edge terminations. With insight from the Dirac description we find an
emerging scale-invariant behavior that deviates from the classical model both
for zigzag and armchair structures. The onset of the deviation can be related
to the position of the lowest parabolic band in the band structure. Dirac
theory is only valid in the parameter subspace where the scale invariance holds
that relates narrow ribbons with high doping to wide ribbons with low doping.
We also find that the edge states present in zigzag ribbons give rise to a
blueshift of the plasmon, in contrast to earlier findings for graphene
nanodisks and nanotriangles
Editorial
Non-pharmacological therapy for recurrent tachycardiaAlpha-adrenergic agonists in anaesthesia and analgesia The high price of becoming a docto
Tuberculose pulmonaire et cutanée chez un sujet VIH négatif antérieurement traité pour Histoplasmose cutanée : une observation clinique inhabituelle: Pulmonary and cutaneous tuberculosis in an HIV negative patient with a previous treatment for cutaneous histoplasmosis: an unusual report
The authors report through this clinical observation, a case of pulmonary and cutaneous tuberculosis in a 41 year old man with a previous history of treated and cured histoplasmosis. The presentation emphasizes the relevance of addressing immunosuppressive conditions other than HIV/AIDS in case of opportunistic infections affecting HIV-negative patients.
Par cette observation de tuberculose multifocale sur terrain antĂ©rieurement traitĂ© pour histoplasmose cutanĂ©e, les auteurs attirent lâattention des prestataires sur lâoccurrence possible dâaffections rares, suggestives du VIH/SIDA, pouvant faire rechercher dâautres causes dâimmunodĂ©pression chez les sujets VIH nĂ©gatifs
The plasma level of soluble urokinase receptor is elevated in patients with Streptococcus pneumoniae bacteraemia and predicts mortality
ABSTRACTThis multicentre prospective study was conducted to investigate whether the level of the soluble form of urokinase-type plasminogen activator receptor (suPAR) is elevated during pneumococcal bacteraemia and is of predictive value in the early stage of the disease. Plasma levels of suPAR were increased significantly (median 5.5; range 2.4â21.0 ng/mL) in 141 patients with pneumococcal bacteraemia, compared to 31 healthy controls (median 2.6, range 1.5â4.0 ng/mL, p 0.001). Furthermore, suPAR levels were elevated significantly in patients who died from the infection (n = 24) compared to survivors (n = 117; p < 0.001). No correlation was found between suPAR levels and C-reactive protein. In univariate logistic regression analysis, hypotension, renal failure, cerebral symptoms and high serum concentrations of protein YKL-40 and suPAR were associated significantly with mortality (p < 0.05). In multivariate analysis, only suPAR remained a significant predictor of death (mortality rate of 13 for suPAR levels of > 10 ng/mL; 95% CI: 1.1â158). The increase in suPAR levels may reflect increased expression by vascular or inflammatory cells in the setting of pneumococcal sepsis. This plasma protein may be used to identify patients who are severely ill with pneumococcal bacteraemia
Incidence, risk factors and mortality of tuberculosis in Danish HIV patients 1995-2007
<p>Abstract</p> <p>Background</p> <p>Human Immunodeficiency Virus (HIV) infection predisposes to tuberculosis (TB). We described incidence, risk factors and prognosis of TB in HIV-1 infected patients during pre (1995-1996), early (1997-1999), and late Highly Active Antiretroviral Therapy (HAART) (2000-2007) periods.</p> <p>Methods</p> <p>We included patients from a population-based, multicenter, nationwide cohort. We calculated incidence rates (IRs) and mortality rates (MRs). Cox's regression analysis was used to estimate risk factors for TB infection with HAART initiation included as time updated variable. Kaplan-Meier was used to estimate mortality after TB.</p> <p>Results</p> <p>Among 2,668 patients identified, 120 patients developed TB during the follow-up period. The overall IR was 8.2 cases of TB/1,000 person-years of follow-up (PYR). IRs decreased during the pre-, early and late-HAART periods (37.1/1000 PYR, 12.9/1000 PYR and 6.5/1000 PYR respectively). African and Asian origin, low CD4 cell count and heterosexual and injection drug user route of HIV transmission were risk factors for TB and start of HAART reduced the risk substantially. The overall MR in TB patients was 34.4 deaths per 1,000 PYR (95% Confidence Interval: 22.0-54.0) and was highest in the first two years after the diagnosis of TB.</p> <p>Conclusions</p> <p>Incidence of TB still associated with conventional risk factors as country of birth, low CD4 count and route of HIV infection while HAART reduces the risk substantially. The mortality in this patient population is high in the first two years after TB diagnosis.</p
Impact of Non-HIV and HIV Risk Factors on Survival in HIV-Infected Patients on HAART: A Population-Based Nationwide Cohort Study
BACKGROUND: We determined the impact of three factors on mortality in HIV-infected patients who had been on highly active antiretroviral therapy (HAART) for at least one year: (1) insufficient response to (HAART) and presence of AIDS-defining diseases, (2) comorbidity, and (3) drug and alcohol abuse and compared the mortality to that of the general population. METHODOLOGY/PRINCIPAL FINDINGS: In a Danish nationwide, population-based cohort study, we used population based registries to identify (1) all Danish HIV-infected patients who started HAART in the period 1 January 1998-1 July 2009, and (2) a comparison cohort of individuals matched on date of birth and gender (Nâ=â2,267 and 9,068, respectively). Study inclusion began 1 year after start of HAART. Patients were categorised hierarchically in four groups according to the three risk factors, which were identified before study inclusion. The main outcome measure was probability of survival from age 25 to 65 years. The probability of survival from age 25 to age 65 was substantially lower in HIV patients [0.48 (95% confidence interval (CI) 0.42-0.55)] compared to the comparison cohort [0.88 (0.86 to 0.90)]. However, in HIV patients with no risk factors (Nâ=â871) the probability of survival was equivalent to that of the general population [0.86 (95% CI 0.77-0.92)]. In contrast, the probability of survival was 0.58 in patients with HIV risk factors (Nâ=â704), 0.30 in patients with comorbidities (Nâ=â479), and 0.03 in patients with drug or alcohol abuse (Nâ=â313). CONCLUSIONS: The increased risk of death in HIV-infected individuals is mainly attributable to risk factors that can be identified prior to or in the initial period of antiretroviral treatment. Mortality in patients without risk factors on a successful HAART is almost identical to that of the non-HIV-infected population
Smoking and life expectancy among HIV-infected individuals on antiretroviral therapy in Europe and North America.
BACKGROUND: Cardiovascular disease and non-AIDS malignancies have become major causes of death among HIV-infected individuals. The relative impact of lifestyle and HIV-related factors are debated.
METHODS: We estimated associations of smoking with mortality more than 1 year after antiretroviral therapy (ART) initiation among HIV-infected individuals enrolled in European and North American cohorts. IDUs were excluded. Causes of death were assigned using standardized procedures. We used abridged life tables to estimate life expectancies. Life-years lost to HIV were estimated by comparison with the French background population.
RESULTS: Among 17â995 HIV-infected individuals followed for 79â760 person-years, the proportion of smokers was 60%. The mortality rate ratio (MRR) comparing smokers with nonsmokers was 1.94 [95% confidence interval (95% CI) 1.56-2.41]. The MRRs comparing current and previous smokers with never smokers were 1.70 (95% CI 1.23-2.34) and 0.92 (95% CI 0.64-1.34), respectively. Smokers had substantially higher mortality from cardiovascular disease, non-AIDS malignancies than nonsmokers [MRR 6.28 (95% CI 2.19-18.0) and 2.67 (95% CI 1.60-4.46), respectively]. Among 35-year-old HIV-infected men, the loss of life-years associated with smoking and HIV was 7.9 (95% CI 7.1-8.7) and 5.9 (95% CI 4.9-6.9), respectively. The life expectancy of virally suppressed, never-smokers was 43.5 years (95% CI 41.7-45.3), compared with 44.4 years among 35-year-old men in the background population. Excess MRRs/1000 person-years associated with smoking increased from 0.6 (95% CI -1.3 to 2.6) at age 35 to 43.6 (95% CI 37.9-49.3) at age at least 65 years.
CONCLUSION: Well treated HIV-infected individuals may lose more life years through smoking than through HIV. Excess mortality associated with smoking increases markedly with age. Therefore, increases in smoking-related mortality can be expected as the treated HIV-infected population ages. Interventions for smoking cessation should be prioritized
Long-term mortality in HIV patients virally suppressed for more than three years with incomplete CD4 recovery: A cohort study
<p>Abstract</p> <p>Background</p> <p>The mortality in patients with persistent low CD4 count despite several years of HAART with sustained viral suppression is poorly documented. We aimed to identify predictors for inadequate CD4 cell recovery and estimate mortality in patients with low CD4 count but otherwise successful HAART.</p> <p>Method</p> <p>In a nationwide cohort of HIV patients we identified all individuals who started HAART before 1 January 2005 with CD4 cell count †200 cells/ΌL and experienced three years with sustained viral suppression. Patients were categorized according to CD4 cell count after the three years suppressed period (†200 cells/ΌL; immunological non-responders (INRs), >200 cells/ΌL; immunological responders (IRs)). We used logistic regression and Kaplan-Meier analysis to estimated risk factors and mortality for INRs compared to IRs.</p> <p>Results</p> <p>We identified 55 INRs and 236 IRs. In adjusted analysis age > 40 years and > one year from first CD4 cell count †200 cells/ΌL to start of the virologically suppressed period were associated with increased risk of INR. INRs had substantially higher mortality compared to IRs. The excess mortality was mainly seen in the INR group with > one year of immunological suppression prior to viral suppression and injection drug users (IDUs).</p> <p>Conclusion</p> <p>Age and prolonged periods of immune deficiency prior to successful HAART are risk factors for incomplete CD4 cell recovery. INRs have substantially increased long-term mortality mainly associated with prolonged immunological suppression prior to viral suppression and IDU.</p
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