Visualizing in deceased COVID-19 patients how SARS-CoV-2 attacks the respiratory and olfactory mucosae but spares the olfactory bulb.

Anosmia, the loss of smell, is a common and often the sole symptom of COVID-19. The onset of the sequence of pathobiological events leading to olfactory dysfunction remains obscure. Here, we have developed a postmortem bedside surgical procedure to harvest endoscopically samples of respiratory and olfactory mucosae and whole olfactory bulbs. Our cohort of 85 cases included COVID-19 patients who died a few days after infection with SARS-CoV-2, enabling us to catch the virus while it was still replicating. We found that sustentacular cells are the major target cell type in the olfactory mucosa. We failed to find evidence for infection of olfactory sensory neurons, and the parenchyma of the olfactory bulb is spared as well. Thus, SARS-CoV-2 does not appear to be a neurotropic virus. We postulate that transient insufficient support from sustentacular cells triggers transient olfactory dysfunction in COVID-19. Olfactory sensory neurons would become affected without getting infected.

Spectroscopy in Nanoscopic Cavities: Models and Recent Experiments.

The ability of nanophotonic cavities to confine and store light to nanoscale dimensions has important implications for enhancing molecular, excitonic, phononic, and plasmonic optical responses. Spectroscopic signatures of processes that are ordinarily exceedingly weak such as pure absorption and Raman scattering have been brought to the single-particle limit of detection, while new emergent polaritonic states of optical matter have been realized through coupling material and photonic cavity degrees of freedom across a wide range of experimentally accessible interaction strengths. In this review, we discuss both optical and electron beam spectroscopies of cavity-coupled material systems in weak, strong, and ultrastrong coupling regimes, providing a theoretical basis for understanding the physics inherent to each while highlighting recent experimental advances and exciting future directions.

Probing the Polarization of Low-Energy Excitations in 2D Materials from Atomic Crystals to Nanophotonic Arrays Using Momentum-Resolved Electron Energy Loss Spectroscopy.

Spectroscopies utilizing free electron beams as probes offer detailed information on the reciprocal-space excitations of 2D materials such as graphene and transition metal dichalcogenide monolayers. Yet, despite the attention paid to such quantum materials, less consideration has been given to the electron-beam characterization of 2D periodic nanostructures such as photonic crystals, metasurfaces, and plasmon arrays, which can exhibit the same lattice and excitation symmetries as their atomic analogues albeit at drastically different length, momentum, and energy scales. Because of their lack of covalent bonding and influence of retarded electromagnetic interactions, important physical distinctions arise that complicate interpretation of scattering signals. Here we present a fully-retarded theoretical framework for describing the inelastic scattering of wide-field electron beams from 2D materials and apply it to investigate the complementarity in sample excitation information gained in the measurement of a honeycomb plasmon array versus angle-resolved optical spectroscopy in comparison to single monolayer graphene.

Interim 2023/24 influenza A vaccine effectiveness: VEBIS European primary care and hospital multicentre studies, September 2023 to January 2024.

Influenza A viruses circulated in Europe from September 2023 to January 2024, with influenza A(H1N1)pdm09 predominance. We provide interim 2023/24 influenza vaccine effectiveness (IVE) estimates from two European studies, covering 10 countries across primary care (EU-PC) and hospital (EU-H) settings. Interim IVE was higher against A(H1N1)pdm09 than A(H3N2): EU-PC influenza A(H1N1)pdm09 IVE was 53% (95% CI: 41 to 63) and 30% (95% CI: -3 to 54) against influenza A(H3N2). For EU-H, these were 44% (95% CI: 30 to 55) and 14% (95% CI: -32 to 43), respectively.

Influenza versus other respiratory viruses - assessing severity among hospitalised children, Belgium, 2011 to 2020.

BackgroundKnowledge on the burden attributed to influenza viruses vs other respiratory viruses in children hospitalised with severe acute respiratory infections (SARI) in Belgium is limited.AimThis observational study aimed at describing the epidemiology and assessing risk factors for severe disease.MethodsWe retrospectively analysed data from routine national sentinel SARI surveillance in Belgium. Respiratory specimens collected during winter seasons 2011 to 2020 were tested by multiplex real-time quantitative PCR (RT-qPCR) for influenza and other respiratory viruses. Demographic data and risk factors were collected through questionnaires. Patients were followed-up for complications or death during hospital stay. Analysis focused on children younger than 15 years. Binomial logistic regression was used to identify risk factors for severe disease in relation to infection status.ResultsDuring the winter seasons 2011 to 2020, 2,944 specimens met the study case definition. Complications were more common in children with underlying risk factors, especially asthma (adjusted risk ratio (aRR): 1.87; 95% confidence interval (CI): 1.46-2.30) and chronic respiratory disease (aRR: 1.88; 95% CI: 1.44-2.32), regardless of infection status and age. Children infected with non-influenza respiratory viruses had a 32% higher risk of complications (aRR: 1.32; 95% CI: 1.06-1.66) compared with children with influenza only.ConclusionMulti-virus testing in children with SARI allows a more accurate assessment of the risk of complications and attribution of burden to respiratory viruses beyond influenza. Children with asthma and respiratory disease should be prioritised for clinical care, regardless of their virological test result and age, and targeted for prevention campaigns.

Polarization-Resolved Electron Energy Gain Nanospectroscopy With Phase-Structured Electron Beams.

Free-electron-based measurements in scanning transmission electron microscopes (STEMs) reveal valuable information on the broadband spectral responses of nanoscale systems with deeply subdiffraction limited spatial resolution. Leveraging recent advances in manipulating the spatial phase profile of the transverse electron wavefront, we theoretically describe interactions between the electron probe and optically stimulated nanophotonic targets in which the probe gains energy while simultaneously transitioning between transverse states with distinct phase profiles. Exploiting the selection rules governing such transitions, we propose phase-shaped electron energy gain nanospectroscopy for probing the 3D polarization-resolved response field of an optically excited target with nanoscale spatial resolution. Considering ongoing instrumental developments, polarized generalizations of STEM electron energy loss and gain measurements hold the potential to become powerful tools for fundamental studies of quantum materials and their interaction with nearby nanostructures supporting localized surface plasmon or phonon polaritons as well as for noninvasive imaging and nanoscale 3D field tomography.

Prognostic Impact of Bronchoalveolar Lavage Fluid Galactomannan and Aspergillus Culture Results on Survival in COVID-19 Intensive Care Unit Patients: a Post Hoc Analysis from the European Confederation of Medical Mycology (ECMM) COVID-19-Associated Pulmonary Aspergillosis Study.

Critically ill patients with coronavirus disease 2019 (COVID-19) may develop COVID-19-associated pulmonary aspergillosis (CAPA), which impacts their chances of survival. Whether positive bronchoalveolar lavage fluid (BALF) mycological tests can be used as a survival proxy remains unknown. We conducted a post hoc analysis of a previous multicenter, multinational observational study with the aim of assessing the differential prognostic impact of BALF mycological tests, namely, positive (optical density index of ≥1.0) BALF galactomannan (GM) and positive BALF Aspergillus culture alone or in combination for critically ill patients with COVID-19. Of the 592 critically ill patients with COVID-19 enrolled in the main study, 218 were included in this post hoc analysis, as they had both test results available. CAPA was diagnosed in 56/218 patients (26%). Most cases were probable CAPA (51/56 [91%]) and fewer were proven CAPA (5/56 [9%]). In the final multivariable model adjusted for between-center heterogeneity, an independent association with 90-day mortality was observed for the combination of positive BALF GM and positive BALF Aspergillus culture in comparison with both tests negative (hazard ratio, 2.53; 95% CI confidence interval [CI], 1.28 to 5.02; P = 0.008). The other independent predictors of 90-day mortality were increasing age and active malignant disease. In conclusion, the combination of positive BALF GM and positive BALF Aspergillus culture was associated with increased 90-day mortality in critically ill patients with COVID-19. Additional study is needed to explore the possible prognostic value of other BALF markers.

Nanometer-Scale Spatial and Spectral Mapping of Exciton Polaritons in Structured Plasmonic Cavities.

Exciton polaritons (EPs) are ubiquitous light-matter excitations under intense investigation as test beds of fundamental physics and as components for all-optical computing. Owing to their unique attributes and facile experimental tunability, EPs potentially enable strong nonlinearities, condensation, and superfluidity at room temperature. However, the diffraction limit of light and the momentum content of fast electron probes preclude the characterization of EPs in nanoscale structured cavities exhibiting energy-momentum dispersion. Here we present fully relativistic analytical theory and companion numerical simulations showing that these limitations can be overcome to measure EPs in periodic nanophotonic cavities on their natural energy, momentum, and length scales via lattice electron energy gain spectroscopy. With the combined high momentum resolution of light and nanoscale spatial resolution of focused electron beams, lattice electron energy gain spectroscopy can expose deeply subwavelength EP features using currently available monochromated, aberration-corrected scanning transmission electron microscopes.

Safety, efficacy, and pharmacokinetics of gremubamab (MEDI3902), an anti-Pseudomonas aeruginosa bispecific human monoclonal antibody, in P. aeruginosa-colonised, mechanically ventilated intensive care unit patients: a randomised controlled trial.

BACKGROUND: Ventilator-associated pneumonia caused by Pseudomonas aeruginosa (PA) in hospitalised patients is associated with high mortality. The effectiveness of the bivalent, bispecific mAb MEDI3902 (gremubamab) in preventing PA nosocomial pneumonia was assessed in PA-colonised mechanically ventilated subjects. METHODS: EVADE (NCT02696902) was a phase 2, randomised, parallel-group, double-blind, placebo-controlled study in Europe, Turkey, Israel, and the USA. Subjects ≥ 18 years old, mechanically ventilated, tracheally colonised with PA, and without new-onset pneumonia, were randomised (1:1:1) to MEDI3902 500, 1500 mg (single intravenous dose), or placebo. The primary efficacy endpoint was the incidence of nosocomial PA pneumonia through 21 days post-dose in MEDI3902 1500 mg versus placebo, determined by an independent adjudication committee. RESULTS: Even if the initial sample size was not reached because of low recruitment, 188 subjects were randomised (MEDI3902 500/1500 mg: n = 16/87; placebo: n = 85) between 13 April 2016 and 17 October 2019. Out of these, 184 were dosed (MEDI3902 500/1500 mg: n = 16/85; placebo: n = 83), comprising the modified intent-to-treat set. Enrolment in the 500 mg arm was discontinued due to pharmacokinetic data demonstrating low MEDI3902 serum concentrations. Subsequently, enrolled subjects were randomised (1:1) to MEDI3902 1500 mg or placebo. PA pneumonia was confirmed in 22.4% (n = 19/85) of MEDI3902 1500 mg recipients and in 18.1% (n = 15/83) of placebo recipients (relative risk reduction [RRR]: - 23.7%; 80% confidence interval [CI] - 83.8%, 16.8%; p = 0.49). At 21 days post-1500 mg dose, the mean (standard deviation) serum MEDI3902 concentration was 9.46 (7.91) µg/mL, with 80.6% (n = 58/72) subjects achieving concentrations > 1.7 µg/mL, a level associated with improved outcome in animal models. Treatment-emergent adverse event incidence was similar between groups. CONCLUSIONS: The bivalent, bispecific monoclonal antibody MEDI3902 (gremubamab) did not reduce PA nosocomial pneumonia incidence in PA-colonised mechanically ventilated subjects. Trial registration Registered on Clinicaltrials.gov ( NCT02696902 ) on 11th February 2016 and on EudraCT ( 2015-001706-34 ) on 7th March 2016.

Multinational Observational Cohort Study of COVID-19-Associated Pulmonary Aspergillosis1.

We performed an observational study to investigate intensive care unit incidence, risk factors, and outcomes of coronavirus disease-associated pulmonary aspergillosis (CAPA). We found 10%-15% CAPA incidence among 823 patients in 2 cohorts. Several factors were independently associated with CAPA in 1 cohort and mortality rates were 43%-52%.

Spotlight influenza: Extending influenza surveillance to detect non-influenza respiratory viruses of public health relevance: analysis of surveillance data, Belgium, 2015 to 2019.

BackgroundSeasonal influenza-like illness (ILI) affects millions of people yearly. Severe acute respiratory infections (SARI), mainly influenza, are a leading cause of hospitalisation and mortality. Increasing evidence indicates that non-influenza respiratory viruses (NIRV) also contribute to the burden of SARI. In Belgium, SARI surveillance by a network of sentinel hospitals has been ongoing since 2011.AimWe report the results of using in-house multiplex qPCR for the detection of a flexible panel of viruses in respiratory ILI and SARI samples and the estimated incidence rates of SARI associated with each virus.MethodsWe defined ILI as an illness with onset of fever and cough or dyspnoea. SARI was defined as an illness requiring hospitalisation with onset of fever and cough or dyspnoea within the previous 10 days. Samples were collected in four winter seasons and tested by multiplex qPCR for influenza virus and NIRV. Using catchment population estimates, we calculated incidence rates of SARI associated with each virus.ResultsOne third of the SARI cases were positive for NIRV, reaching 49.4% among children younger than 15 years. In children younger than 5 years, incidence rates of NIRV-associated SARI were twice that of influenza (103.5 vs 57.6/100,000 person-months); co-infections with several NIRV, respiratory syncytial viruses, human metapneumoviruses and picornaviruses contributed most (33.1, 13.6, 15.8 and 18.2/100,000 person-months, respectively).ConclusionEarly testing for NIRV could be beneficial to clinical management of SARI patients, especially in children younger than 5 years, for whom the burden of NIRV-associated disease exceeds that of influenza.

Engineering Directionality in Quantum Dot Shell Lasing Using Plasmonic Lattices.

We report how the direction of quantum dot (QD) lasing can be engineered by exploiting high-symmetry points in plasmonic nanoparticle (NP) lattices. The nanolaser architecture consists of CdSe-CdS core-shell QD layers conformally coated on two-dimensional square arrays of Ag NPs. Using waveguide-surface lattice resonances (W-SLRs) near the Δ point in the Brillouin zone as optical feedback, we achieved lasing from the gain in CdS shells at off-normal emission angles. Changing the periodicity of the plasmonic lattices enables other high-symmetry points (Γ or M) of the lattice to overlap with the QD shell emission, which facilitates tuning of the lasing direction. We also increased the thickness of the QD layer to introduce higher-order W-SLR modes with additional avoided crossings in the band structure, which expands the selection of cavity modes for any desired lasing emission angle.

Plasmonic Surface Lattice Resonances: Theory and Computation.

Plasmonic surface lattice resonances (SLRs) are mixed light-matter states emergent in a system of periodically arranged metallic nanoparticles (NPs) under the constraint that the array spacing is able to support a standing wave of optical-frequency light. The properties of SLRs derive from two separate physical effects; the electromagnetic (plasmonic) response of metal NPs and the electromagnetic states (photonic cavity modes) associated with the array of NPs. Metal NPs, especially free-electron metals such as silver, gold, aluminum, and alkali metals, support optical-frequency electron density oscillations known as localized surface plasmons (LSPs). The high density of conduction-band electrons in these metals gives rise to plasmon excitations that strongly couple to light even for particles that are several orders of magnitude smaller than the wavelength of the excitation source. In this sense, LSPs have the remarkable ability to squeeze far-field light into intensely localized electric near-fields that can enhance the intensity of light by factors of ∼103 or more. Moreover, as a result of advances in the synthesis and fabrication of NPs, the intrinsic dependence of LSPs on the NP geometry, composition, and size can readily be exploited to design NPs with a wide range of optical properties. One drawback in using LSPs to enhance optical, electronic, or chemical processes is the losses introduced into the system by dephasing and Ohmic damping-an effect that must either be tolerated or mitigated. Plasmonic SLRs enable the mitigation of loss effects through the coupling of LSPs to diffractive states that arise from arrays satisfying Bragg scattering conditions, also known as Rayleigh anomalies. Bragg modes are well-known for arrays of dielectric NPs, where they funnel and trap incoming light into the plane of the lattice, defining a photonic cavity. The low losses and narrow linewidths associated with dielectric NPs produce Bragg modes that oscillate for ∼103-104 cycles before decaying. These modes are of great interest to the metamaterials community but have relatively weak electric fields associated with dielectric NPs and therefore are not used for applications where local field enhancements are needed. Plasmonic lattices, i.e., photonic crystals composed of metallic NPs, combine the characteristics of both LSPs and diffractive states, enabling both enhanced local fields and narrow-linewidth excitations, in many respects providing the best advantages of both materials. Thus, by control of the periodicity and global symmetry of the lattice in addition to the material composition and shape of the constituent NPs, SLRs can be designed to simultaneously survive for up to 103 cycles while maintaining the electric field enhancements near the NP surface that have made the use of LSPs ubiquitous in nanoscience. Modern fabrication methods allow for square-centimeter-scale patches of two-dimensional arrays that are composed of approximately one trillion NPs, making them effectively infinite at the nanoscale. Because of these advances, it is now possible to experimentally realize SLRs with properties that approach those predicted by idealized theoretical models. In this Account, we introduce the fundamental theory of both SLRs and SLR-mediated lasing, where the latter is one of the most important applications of plasmonic SLRs that has emerged to date. The focus of this Account is on theoretical concepts for describing plasmonic SLRs and computational methods used for their study, but throughout we emphasize physical insights provided by the theory that aid in making applications.

Manipulating Light-Matter Interactions in Plasmonic Nanoparticle Lattices.

Rationally assembled nanostructures exhibit distinct physical and chemical properties beyond their individual units. Developments in nanofabrication techniques have enabled the patterning of a wide range of nanomaterial designs over macroscale (>in.2) areas. Periodic metal nanostructures show long-range diffractive interactions when the lattice spacing is close to the wavelength of the incident light. The collective coupling between metal nanoparticles in a lattice introduces sharp and intense plasmonic surface lattice resonances, in contrast to the broad localized resonances from single nanoparticles. Plasmonic nanoparticle lattices exhibit strongly enhanced optical fields within the subwavelength vicinity of the nanoparticle unit cells that are 2 orders of magnitude higher than that of individual units. These intense electromagnetic fields can manipulate nanoscale processes such as photocatalysis, optical spectroscopy, nonlinear optics, and light harvesting. This Account focuses on advances in exciton-plasmon coupling and light-matter interactions with plasmonic nanoparticle lattices. First, we introduce the fundamentals of ultrasharp surface lattice resonances; these resonances arise from the coupling of the localized surface plasmons of a nanoparticle to the diffraction mode from the lattice. Second, we discuss how integrating dye molecules with plasmonic nanoparticle lattices can result in an architecture for nanoscale lasing at room temperature. The lasing emission wavelength can be tuned in real time by adjusting the refractive index environment or varying the lattice spacing. Third, we describe how manipulating either the shape of the unit cell or the lattice geometry can control the lasing emission properties. Low-symmetry plasmonic nanoparticle lattices can show polarization-dependent lasing responses, and multiscale plasmonic superlattices-finite patches of nanoparticles grouped into microscale arrays-can support multiple plasmon resonances for controlled multimodal nanolasing. Fourth, we discuss how the assembly of photoactive emitters on the nanocavity arrays behaves as a hybrid materials system with enhanced exciton-plasmon coupling. Positioning metal-organic framework materials around nanoparticles produces mixed photon modes with strongly enhanced photoluminescence at wavelengths determined by the lattice. Deterministic coupling of quantum emitters in two-dimensional materials to plasmonic lattices leads to preserved single-photon emission and reduced decay lifetimes. Finally, we highlight emerging applications of nanoparticle lattices from compact, fully reconfigurable imaging devices to solid-state emitter structures. Plasmonic nanoparticle lattices are a versatile, scalable platform for tunable flat optics, nontrivial topological photonics, and modified chemical reactivities.

Capturing respiratory syncytial virus season in Belgium using the influenza severe acute respiratory infection surveillance network, season 2018/19.

BackgroundRespiratory syncytial virus (RSV) is a common cause of severe respiratory illness in young children (< 5 years old) and older adults (≥ 65 years old) leading the World Health Organization (WHO) to recommend the implementation of a dedicated surveillance in countries.AimWe tested the capacity of the severe acute respiratory infection (SARI) hospital network to contribute to RSV surveillance in Belgium.MethodsDuring the 2018/19 influenza season, we started the SARI surveillance for influenza in Belgium in week 40, earlier than in the past, to follow RSV activity, which usually precedes influenza virus circulation. While the WHO SARI case definition for influenza normally used by the SARI hospital network was employed, flexibility over the fever criterion was allowed, so patients without fever but meeting the other case definition criteria could be included in the surveillance.ResultsBetween weeks 40 2018 and 2 2019, we received 508 samples from SARI patients. We found an overall RSV detection rate of 62.4% (317/508), with rates varying depending on the age group: 77.6% in children aged < 5 years (253/326) and 34.4% in adults aged ≥ 65 years (44/128). Over 90% of the RSV-positive samples also positive for another tested respiratory virus (80/85) were from children aged < 5 years. Differences were also noted between age groups for symptoms, comorbidities and complications.ConclusionWith only marginal modifications in the case definition and the period of surveillance, the Belgian SARI network would be able to substantially contribute to RSV surveillance and burden evaluation in children and older adults, the two groups of particular interest for WHO.

Hierarchical Hybridization in Plasmonic Honeycomb Lattices.

This paper reports hierarchical hybridization as a mode-mixing scheme to account for the unique optical properties of non-Bravais lattices of plasmonic nanoparticles (NPs). The formation of surface lattice resonances (SLRs) mediated by localized surface plasmons (LSPs) of different multipolar orders (dipole and quadrupole) can result in asymmetric electric near-field distributions surrounding the NPs. This asymmetry is because of LSP hybridization at the individual NP level from LSPs of different multipole order and at the unit cell level (NP dimer) from LSPs of the same multipole order. Fabricated honeycomb lattices of silver NPs exhibit ultrasharp SLRs at the Γ point that can also facilitate nanolasing. Modeling of the stimulated emission process revealed that the multipolar component of the lattice plasmon mode was responsible for feedback for lasing. By leveraging multipolar LSP responses in Al NP lattices, we achieved two distinct Γ point band-edge modes from a single honeycomb lattice. This work highlights how multipolar LSP coupling in plasmonic lattices with a non-Bravais symmetry has important implications for the design of SLRs and their associated plasmonic near-field distributions. These relatively unexplored degrees of freedom can decrease both ohmic and radiative losses in nanoscale systems and enable SLRs to build unanticipated connections among photonics and nanochemistry.

Physicochemical Trapping of Neurotransmitters in Polymer-Mediated Gold Nanoparticle Aggregates for Surface-Enhanced Raman Spectroscopy.

Because of the sharp distance dependence of surface-enhanced Raman spectroscopy (SERS), analyte molecules that do not exhibit strong affinity for Au/Ag often elude detection. New methods of integrating such analytes with SERS substrates are required to circumvent this limitation and expand the sensitivity of SERS to new molecules and applications. We communicate here a solution-phase, capture agent-free method of aggregating Au nanospheres in the presence of five neurotransmitters (dopamine, epinephrine, norepinephrine, serotonin, and histamine) and preventing sedimentation by encapsulating the aggregated nanospheres with polyvinylpyrrolidone, thereby trapping the neurotransmitters in close proximity to the Au nanospheres and enabling SER detection. The primary advantages of this physicochemical trapping method, which is generalizable to analytes beyond the scope of this work, are the high signal-to-noise ratio and spectral consistency down to nM levels. Normal Raman spectra and density functional theory calculations corroborate the accuracy of the spectra. Spectra collected over a wide range of concentrations were used to construct adsorption isotherms for all five neurotransmitters, from which adsorption dissociation constants were calculated, spanning from 5.7 × 10-4 M to 1.7 × 10-10 M. We expect this method to produce high quality SER spectra of any molecule with an Au affinity known or expected (based on functional groups) to be within that range. Our results have implications for plasmonic detection of these neurotransmitters, particularly for mixtures of those that exhibited disparate Au affinity in our study. We also present evidence that this method produces spectra of sufficient resolution to explore hypotheses related to surface adsorption behavior.

How is equity approached in universal health coverage? An analysis of global and country policy documents in Benin and Senegal.

BACKGROUND: Equity seems inherent to the pursuance of universal health coverage (UHC), but it is not a natural consequence of it. We explore how the multidimensional concept of equity has been approached in key global UHC policy documents, as well as in country-level UHC policies. METHODS: We analysed a purposeful sample of UHC reports and policy documents both at global level and in two Western African countries (Benin and Senegal). We manually searched each document for its use and discussion of equity and related terms. The content was summarised and thematically analysed, in order to comprehend how these concepts were understood in the documents. We distinguished between the level at which inequity takes place and the origin or types of inequities. RESULTS: Most of the documents analysed do not define equity in the first place, and speak about "health inequities" in the broad sense, without mentioning the dimension or type of inequity considered. Some dimensions of equity are ambiguous - especially coverage and financing. Many documents assimilate equity to an overall objective or guiding principle closely associated to UHC. The concept of equity is also often linked to other concepts and values (social justice, inclusion, solidarity, human rights - but also to efficiency and sustainability). Regarding the levels of equity most often considered, access (availability, coverage, provision) is the most often quoted dimension, followed by financial protection. Regarding the types of equity considered, those most referred to are socio-economic, geographic, and gender-based disparities. In Benin and Senegal, geographic inequities are mostly pinpointed by UHC policy documents, but concrete interventions mostly target the poor. Overall, the UHC policy of both countries are quite similar in terms of their approach to equity. CONCLUSIONS: While equity is widely referred to in global and country-specific UHC policy documents, its multiple dimensions results in a rather rhetorical utilisation of the concept. Whereas equity covers various levels and types, many global UHC documents fail to define it properly and to comprehend the breadth of the concept. Consequently, perhaps, country-specific policy documents also use equity as a rhetoric principle, without sufficient consideration for concrete ways for implementation.

Programmable and reversible plasmon mode engineering.

Plasmonic nanostructures with enhanced localized optical fields as well as narrow linewidths have driven advances in numerous applications. However, the active engineering of ultranarrow resonances across the visible regime-and within a single system-has not yet been demonstrated. This paper describes how aluminum nanoparticle arrays embedded in an elastomeric slab may exhibit high-quality resonances with linewidths as narrow as 3 nm at wavelengths not accessible by conventional plasmonic materials. We exploited stretching to improve and tune simultaneously the optical response of as-fabricated nanoparticle arrays by shifting the diffraction mode relative to single-particle dipolar or quadrupolar resonances. This dynamic modulation of particle-particle spacing enabled either dipolar or quadrupolar lattice modes to be selectively accessed and individually optimized. Programmable plasmon modes offer a robust way to achieve real-time tunable materials for plasmon-enhanced molecular sensing and plasmonic nanolasers and opens new possibilities for integrating with flexible electronics.

Stretchable Nanolasing from Hybrid Quadrupole Plasmons.

This paper reports a robust and stretchable nanolaser platform that can preserve its high mode quality by exploiting hybrid quadrupole plasmons as an optical feedback mechanism. Increasing the size of metal nanoparticles in an array can introduce ultrasharp lattice plasmon resonances with out-of-plane charge oscillations that are tolerant to lateral strain. By patterning these nanoparticles onto an elastomeric slab surrounded by liquid gain, we realized reversible, tunable nanolasing with high strain sensitivity and no hysteresis. Our semiquantum modeling demonstrates that lasing build-up occurs at the hybrid quadrupole electromagnetic hot spots, which provides a route toward mechanical modulation of light-matter interactions on the nanoscale.