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Science Advances
Research ArticleCHEMICAL PHYSICS
Electrical control of single-photon emission in highly charged individual colloidal quantum dots
View ORCID ProfileSergii Morozov1,*,
View ORCID ProfileEvangelina L. Pensa1,†,
View ORCID ProfileAli Hossain Khan2,
Anatolii Polovitsyn2,
View ORCID ProfileEmiliano Cortés3,
View ORCID ProfileStefan A. Maier1,3,
Stefano Vezzoli1,
View ORCID ProfileIwan Moreels2 and
View ORCID ProfileRiccardo Sapienza1,‡
1The Blackett Laboratory, Department of Physics, Imperial College London, London SW7 2BW, UK.
2Department of Chemistry, Ghent University, Krijgslaan 281-S3, Gent 9000, Belgium.
3Chair in Hybrid Nanosystems, Nano-Institute Munich, Faculty of Physics, Ludwig-Maxilimians-Universität München, München 80539, Germany.
↵‡Corresponding author. Email: r.sapienza{at}imperial.ac.uk
↵* Present address: Centre for Nano Optics, University of Southern Denmark, Campusvej 55, Odense M DK-5230, Denmark.
↵† Present address: Physics of Synthetic Biological Systems, Physics-Department and ZNN, Technische Universität München, Garching 85748, Germany.
Science Advances 18 Sep 2020:
Vol. 6, no. 38, eabb1821
DOI: 10.1126/sciadv.abb1821
Sergii Morozov
ORCID record for Sergii Morozov
Evangelina L. Pensa
ORCID record for Evangelina L. Pensa
Ali Hossain Khan
ORCID record for Ali Hossain Khan
Anatolii Polovitsyn
Emiliano Cortés
ORCID record for Emiliano Cortés
Stefan A. Maier
ORCID record for Stefan A. Maier
Stefano Vezzoli
Iwan Moreels
ORCID record for Iwan Moreels
Riccardo Sapienza
ORCID record for Riccardo Sapienza
For correspondence: r.sapienza@imperial.ac.uk
Electron transfer to an individual quantum dot promotes the formation of charged excitons with enhanced recombination pathways and reduced lifetimes. Excitons with only one or two extra charges have been observed and exploited for very efficient lasing or single–quantum dot light-emitting diodes. Here, by room-temperature time-resolved experiments on individual giant-shell CdSe/CdS quantum dots, we show the electrochemical formation of highly charged excitons containing more than 12 electrons and 1 hole. We report the control over intensity blinking, along with a deterministic manipulation of quantum dot photodynamics, with an observed 210-fold increase in the decay rate, accompanied by 12-fold decrease in the emission intensity, while preserving single-photon emission characteristics. These results pave the way for deterministic control over the charge state, and room-temperature decay rate engineering for colloidal quantum dot–based classical and quantum communication technologies.
The observation of reduced Auger recombination, leading to an increased quantum yield of colloidal quantum dots, has sparked a fast-paced progress in the development of highly fluorescent and stable quantum dots for displays (1), light-emitting diodes (LEDs) (2), and coherent (3) and quantum light sources (4, 5). Still, in the colloidal quantum dot community, there is an ongoing struggle to reconcile suppressed Auger recombination with fast radiative recombination (6). Existing systems that reduce Auger recombination also tend to have a lower electron-hole overlap (6) and therefore, increased fluorescence lifetime [surpassing 100 ns (7, 8)], which hampers quantum and classical photonic technologies that rely on high brightness and fast communication rates.
A nanophotonic approach can boost light-matter interactions and modify an emitter's decay rate by several orders of magnitude (9–11). Nevertheless, experimental studies have been limited so far to decay rate enhancements of ∼6 for a quantum dot surrounded by a plasmonic shell (7) or ∼80 inside plasmonic nanogaps (12) and patch antennas (13). This enhancement comes at the cost of a reduced single-photon emission purity due to strong biexciton emission, limited tunability, and the fabrication challenge of nanometric precision in positioning the quantum dots (9, 14).
A different route is to exploit exciton charging to enhance the emission rate of quantum dots themselves, which can be realized by electrochemical (15–18) or photochemical (19, 20) charge injection. Excitons with only one or two extra charges have allowed for the development of very efficient quantum dot lasing (3) and the understanding of blinking dynamics (15), while charge transfer management has yielded single–quantum dot LEDs (4), LEDs with reduced efficiency roll-off (2), and enabled studies of carrier and spin dynamics (21). The additional charge brings new recombination pathways—thus faster decay rates—and modifies the electronic state of the quantum dot due to Coulomb interactions, which are enhanced by strong spatial confinement and reduced dielectric screening (22).
Electrochemical injection of up to eight electrons in 1Se and 1Pe states has been reported for thin ZnO (23), CdTe (24), PbSe (25, 26), and CdSe (26–29) quantum dot films. In these cases, charge injection in the lowest quantum state has been verified by a bleaching of the ground-state exciton absorption. Extension of these electrochemical charging experiments to individual quantum dots, beyond ensemble averaging, has been hampered by sample degradation at high voltages and poor photostability of the quantum dots. This has been remedied by exploiting the giant-shell quantum dot architecture, whereby different emissive quantum states have been resolved in doubly charged CdSe/CdS and CdSeS/ZnS quantum dots, showing a reduced blinking and a modulated photoluminescence intensity and lifetime (15, 17, 18, 30).
Here, we go beyond the weak charge injection regime, and we report the observation of controllable, stable, and highly charged excitonic states in an individual giant-shell CdSe/CdS quantum dot. To induce the highly charged states, we used a lithography-free electrochemical cell. We show reversible control of individual quantum dot single-photon dynamics, allowing for an on-demand increase in spontaneous emission decay rate up to 210-fold, with only a minor 12-fold decrease in emission intensity.
Quantum dots and experimental setup
Two batches of giant-shell CdSe/CdS quantum dots were synthesized following a recently published protocol (8), with a minor modification (see Materials and Methods). Both batches have the same 4-nm CdSe core but with a different shell thickness, resulting in a total diameter of 10.6 ± 1.1 and 13.1 ± 2.1 nm, and we labeled them batches 1 and 2, respectively. Having two batches with different shell sizes aided us with the statistics, extension, and reliability of our findings. A representative transmission electron microscope (TEM) image for batch 2 is shown in Fig. 1A, together with the absorption and emission spectrum in Fig. 1B, showing the CdS band edge lying around 500 nm and an emission peak around 655 nm. These quantum dots exhibit nonblinking behavior at a low pump fluency (see Materials and Methods).
Fig. 1 Colloidal giant-shell CdSe/CdS quantum dots and experimental setup.
(A) TEM image of batch 2. (B) Absorption and photoluminescence spectra of batch 2. a.u., arbitrary units. (C) Sketch of a confocal microscope focused on an individual quantum dot subjected to a voltage bias between reference (RE) and working (WE) electrodes of a three-electrode electrochemical cell, while a Pt-coiled wire served as a counter electrode (CE). NA, numerical aperture. (D) Energy diagram of a quantum dot with valence (VB) and conduction (CB) bands accommodating an exciton. A 442-nm laser induces above bandgap excitation of the carriers in the CdS shell, which can relax to the CdSe core recombining radiatively at γr = γ0 rate. The position of the Fermi level (orange dashed line) can be manipulated via the application of a voltage bias and adjusted for the electron injection into the conduction band, leading to exciton charging.
We excited individual quantum dots with a blue laser at 442 nm (2.8 eV) in a custom-built confocal microscope capable of recording the fluorescence with time-correlated single-photon counting, with an overall time response of 400 ps. The quantum dots were subjected to a voltage bias in an electrochemical cell, composed of a transparent indium tin oxide (ITO) working electrode and Pt quasi-reference and counter electrodes (Fig. 1C), as detailed in Materials and Methods. The position of the Fermi level (orange dashed line in Fig. 1D) was controlled by the applied voltage bias.
Statistical scaling model for charged excitons
The optical properties of an individual quantum dot depend markedly on its charge state. The most common model describing the change in optical response under charging is the statistical scaling model (15, 31). The model links the total decay rate (γN − 1) and the quantum yield (QYN − 1) of excitonic states with N charges. In our case, because of the fast hole Auger rate in giant quantum dots, which is due to the stronger confinement (32), we consider only the case of an excess of electrons. In this case, the radiative recombination rate of a charged exciton formed by the coupling of N electrons in the conduction band and a single hole in the valence band increases with the electron number as Nγ0, where γ0 is the radiative rate of a neutral exciton. It can be understood as an N-fold increase in the recombination pathways as each electron contributes. This is illustrated in Fig. 2, where X0 (orange) is the neutral exciton, and X− (green) is the negative trion. Auger recombination is a nonradiative decay pathway, with a rate that increases with the electron number as γN−1A=N(N−1)γA, where γA is a constant characterizing the rate of a single electron pathway (33). The total recombination rate of band-edge excitons is the sum of radiative and nonradiative (Auger) rates, i.e., γN−1=Nγ0+γN−1A. Its statistical scaling can be rewritten as (see the Supplementary Materials for a full derivation)γN−1/γ0=N[1+γAγ0(N−1)](1)andQYN−1=[1+γAγ0(N−1)]−1(2)
Fig. 2 FLID at 0 V and statistical scaling model.
(A) Photoluminescence (PL) intensity time trace of an individual quantum dot qd1 from batch 1 measured at 0-V bias and 30-nW excitation power. Neutral exciton X0 and negative trion X− are highlighted by orange and green areas, respectively. The time bin is 10 ms. (B) Decay histograms of X0 and X− were acquired using the photon arrival times from the orange and green time windows in (A). The decay histograms are fitted with a biexponential function (black lines) to filter out the contribution of positive trion and multiexciton states characterized by short lifetimes (see fig. S5). (C) Fluorescence lifetime intensity distribution (FLID) visualizes X0 and X− states, with lifetime and intensity extracted from the selected green and orange time windows in (A). The blue open circles represent statistics acquired during 60 s at 0-V bias. The red squares represent the discrete statistical scaling model (with a red connecting line as a guide to the eye), according to Eqs. 1 and 2 calculated per additional electron, and its solutions are presented for the Auger-free case (γA/γ0 = 0) and a quantum dot with Auger processes (γA/γ0 = 0.5).
The Auger processes can be reduced in quantum dots with a giant shell (30). According to Eqs. 1 and 2, in the limit γA ≪ γ0, the emission rate of charged excitons roughly scales as Nγ0, and the emission intensity is similar to that of the neutral exciton X0.
A typical experimental intensity time trace collected on a quantum dot of batch 1, for 0-V applied bias, is shown in Fig. 2A (blue trace). The decay histograms (Fig. 2B) were extracted from Fig. 2A by accumulating delay times in the two time windows indicated by the orange and green shaded areas. They reveal the neutral exciton X0 and the negative charged exciton (trion) X− as the dominant states, with single exponential decays and lifetimes of 125 ± 6 and 42 ± 3 ns, respectively. These states can be identified in a fluorescence lifetime intensity distribution (FLID), which correlates the fluorescence intensity and lifetime, as shown in Fig. 2C. The blue points in the FLID were obtained by splitting the intensity time trace in 20-ms-long time bins and computing the corresponding lifetime-intensity pair. The spread of the data points between X0 and X− is due to the fast blinking (flickering), and thus averaging, between the two states. States observed with the same lifetime and different fluorescence intensities are an example of B-type blinking due to the hot-exciton trapping (30). The X0 and X− states are located along the red line, which connects the states predicted from Eqs. 1 and 2, for γA/γ0 = 0.5 ± 0.1. The latter value is extracted from the X0/X− lifetime-intensity ratios in Fig. 2B after integrating for the orange and green time window periods. The relatively slow Auger recombination (γA/γ0 = 0.5 ± 0.1) is due to the thick 3.3-nm CdS shell in batch 1, and it is even slower (γA/γ0 = 0.08 ± 0.02), thus less efficient, for quantum dots in batch 2 with 35% thicker shell (4.5 nm, cfr. below).
Control of intensity blinking
The intensity time trace at 0 V in Fig. 3A presents a typical blinking behavior between high (35 kHz) and low (5 kHz) emissivity states, which correspond to the neutral exciton and positive trion (see fig. S5). When the applied bias is lowered to −1.4 V (Fig. 3C), the blinking between exciton and positive trion is completely suppressed, while the blinking between negatively charged excitons still takes place, which can be seen from the wide intensity distribution in the corresponding occurrences histogram. Further lowering of the applied bias to −1.7 V induces formation of highly charged and stable excitonic states (Fig. 3E), since the applied static bias does not allow them to decay to lower charged excitonic states. Besides the reduction in blinking, the applied voltage has an effect on the quantum dot fluorescence intensity, as the average state emissivity decreases from 35 to 20 kHz for −1.4 V. This dimming progresses further when the applied bias is lowered to −1.7 V, reaching 10 kHz (Fig. 3E). By Hanbury Brown and Twiss interferometry, we verified that the second-order correlation at zero delay times g(2)(0) does not rise above 0.5 for the bias above −1.8 V, which means that the investigated quantum dot remains a single-photon emitter (Fig. 3, B, D, and F). Instead, at −1.8 V, g(2)(0) raises to 0.57 ± 0.05 (see fig. S4). The increase in the zero delay peak is assigned to an increased biexciton emission efficiency at high negative bias, as the Auger rate for holes becomes comparable to the radiative rate of charged excitons (34). For completeness, we report that some quantum dots displayed a photoluminescence brightening when subjected to a negative bias (see fig. S9). We attribute this to a retrieval of the exciton brightness at a negative potential similar to what has been reported in (35), probably due to an initial high density of defect states that were passivated.
Fig. 3 Control of blinking and intensity via application of voltage bias.
(A, C, and E) Photoluminescence intensity time traces of the quantum dot qd1 from batch 1 obtained at 0-, −1.4-, and −1.7-V static bias. The time bin is 10 ms. (B, D, and F) Intensity autocorrelation g(2) (t) histograms for the corresponding values of static voltage bias measured during 120 s. The measured values of g(2) (0) confirm that the quantum dot remains a good single-photon source at negative bias. (A) At the constant bias of 0 V, we observe photoluminescence blinking between high and low emissive states, which we attribute to neutral exciton and positive trion. (C) The decrease in applied potential to −1.4 V suppresses the blinking to positive trion. (E) Further lowering of bias to −1.7 V induces formation of highly charged excitons characterized by lower emission intensity.
Control of decay rate
The decrease in emission intensity shown in Fig. 3 is correlated with a change in decay rate. This is demonstrated in Fig. 4A for a wide range of negative voltage bias. Decay histograms integrated for 60 s for the same quantum dot as in Fig. 3 indicate a marked reduction in the fluorescence decay time, from 125 ns at 0 V down to 0.9 ns at −2 V (140-fold). The correlation between fluorescence lifetime and intensity at various negative bias can again be combined into a FLID plot, as shown in Fig. 4B. The applied bias is encoded in different color maps that represent the distribution of occurrences. The measured states monotonically decrease their lifetime and intensity upon applying of the negative bias. For each applied voltage, the quantum dot is in a well-defined lifetime-intensity state, with fluctuations mostly due to experimental noise.
Fig. 4 Active control of decay rate with voltage bias.
(A) The quantum dot qd1 from batch 1 was measured at different voltage biases in the electrochemical cell (the applied voltage biases are coded with colors, as shown in the inset). The overall decay histograms acquired during 60 s demonstrate a shortening of the lifetime with increasing negative bias. (B) Each of the fluorescence intensity time traces, measured at static bias, was processed as described in Fig. 2, resulting in a FLID. The intensity-lifetime pairs are represented here as a normalized distribution where the number of occurrences is measured by the level of transparency (a representative scale bar is shown for 0 V). (C) Decay rate enhancement could be controlled by applying a voltage bias. The decay rate increased rapidly for voltages below −1.4 V. The shortest decay lifetime 0.9 ± 0.2 ns was measured at −2 V for this particular quantum dot, which corresponded to an enhancement of 140 ± 30.
Charge-state tomography of an individual quantum dot
Figure 5 (A and B) plots the FLID data for both batches, when the bias was continuously varied in a voltage scan from 0 to −2 V, as shown in Fig. 5C. Cyclic voltammetry scan allowed us to span the charge-state configuration space in a short time (20 s), minimizing optical misalignment issues. Obtained results were similar to what is observed at static bias in Fig. 4.
Fig. 5 Optical response of a quantum dot during a cyclic voltammetry scan demonstrating reproducibility.
(A) FLID of the quantum dot (qd1; blue circles) from batch 1, which has been shown in Figs. 2 to 4, extracted from intensity time traces measured during cyclic voltammetry scans, as shown in (D). (B) FLID of another quantum dot, from batch 2 (qd2; purple circles). In (A) and (B), the red lines represent the statistical scaling model for different Auger rates according to Eqs. 1 and 2. In the cyclic voltammetry scans, the bias was varied linearly in time, as indicated in (C). At t = 10 s, the scan polarity was reversed to return to the initial bias of 0 V. Positive bias caused quenching of the neutral exciton (see an example in fig. S6). (D) Intensity time trace measured during the potential scan of qd1 from batch 1 used to build FLID in (A). After the suppression of blinking around −1.4 V, the photoluminescence intensity was gradually quenched under the linear decrease in the applied potential. The initial photoluminescence intensity was restored when the scan polarity was reversed (an intensity trace of this quantum dot during six voltammetric cycles is shown in fig. S8) and began to blink again around −1.4 V. The time bin is 10 ms.
The red line in Fig. 5 (A and B) represents the statistical scaling model according to Eqs. 1 and 2, where the relative Auger rates γA/γ0 were obtained, for batch 1, from the lifetime-intensity ratios of exciton and trion, as described in the "Statistical scaling model for charged excitons" section. Instead, for batch 2, we extracted γA/γ0 from the fit of the lifetime-intensity distribution of the neutral and low charged excitons, i.e., beyond the trion, as the quantum yields of exciton and trion are too similar and the Auger rate estimation has a very large error (see fig. S12). The evolution of intensity and lifetime for low bias, up to X4− for batch 1 and X12− for batch 2, can be fitted with the statistical scaling model, which is, in essence, a single-particle model that assumes a fixed electron-hole overlap and thus neglects many-body Coulomb interactions (22). For lower negative bias, the quantum dots in batches 1 and 2 are charged beyond X4− and X12− states, respectively, and a pronounced deviation is visible in Fig. 5 (A and B) (see Materials and Methods). In this case, the FLID cannot be fitted with Eqs. 1 and 2. Considering that previous results on charged excitons and biexcitons already confirmed that an ad hoc β factor should be used to improve the agreement between lifetime and fluorescence intensity in the scaling model (22, 31), we postulate that the higher carrier densities created here will only lead to a further modification of the electron wave function, affecting both electron-hole overlap (and thus γ0) and the Auger recombination rate γA, which is highly sensitive to the behavior of the electron wave function at the CdSe/CdS interface (36). The lowest applied potential of −2 V causes a large decrease in the lifetime, with largest recorded values of 140 ± 30–fold, while the intensity drops by a factor of 25 ± 4 for batch 1 and 210 ± 40 and 12 ± 3 for batch 2, respectively. These values of decay enhancement and intensity drop were limited by the lowest voltage bias −2 V, which did not cause the degradation of ITO substrate.
Coulomb repulsion upon charging, especially in air or vacuum, can limit the charge state attainable. However, in our experiments in liquid, adsorption of tetrabutylammonium (TBA) cations compensates the electrochemical buildup surface potential due to the injected charges (37). These screened charges reduce the overpotential requirements for further charge injection (28). In a simplified estimation for our giant-shell quantum dots, each quantum dot (diameter, ∼12 nm) can allocate up to ∼100 TBA cations (radius, ∼0.5 nm) on its surface. Therefore, we conclude that Coulomb repulsion is not the dominant effect due to the larger surface area in our quantum dots.
Once the bias is increased to reach the band edge, electron injection depends on the available states. From a density of states reasoning, we have calculated the expected level spacing (details in the Supplementary Materials), and we confirm theoretically that for a voltage of 80 to 150 meV above the conduction band edge, ∼20 states can be populated. Switching of the photodynamics from a charging state to another can be performed by simply applying the voltage, with a rise time of about 2 μs, limited by our electronics (see fig. S8).
Last, we discuss the repeatability and reproducibility of the results. We repeated this experiment with 37 individual quantum dots from two batches, and we observed charging beyond doubly negative charged exciton in 13 cases, which is around 30%, while in the other cases, the quantum dots did not demonstrate the lifetime-intensity dip as in Fig. 5D (see fig. S7 and table S1). Moreover, it has been recently pointed out that charging-induced damage can occur because of reduction in the quantum dot surface (38). Here, the application of up to −2 V of negative potential is reversible and does not damage the quantum dot (Fig. 5D). We believe that this is because the quantum dot thick shell can accommodate many defect states. In our experiments, the voltage bias was gradually varied, and Fig. 5D shows a clear drop in the emitted intensity for voltages below −1.4 V, which recovers when the bias is returned to 0 V. This recovery can be repeated many times with no sign of degradation in the optical properties (fig. S8): We tested it up to 540 cycles during 3 hours, a time span limited by the degradation of the ITO working electrode. Besides, here, the heating of quantum dots is not a concern, as we are not inducing photon absorption as in photoexcitation experiments.
Controlling the charge state of an individual quantum dot can be very important for quantum technologies, where the undesired switching to a different charge state precludes interfacing the electronic spin to photons (39). Boosting the decay rate now brings the colloidal nanocrystals on par with the fluorescence lifetime of nitrogen vacancy (NV) centers in diamond (40), as well as epitaxial quantum dots (41), and could open a path toward coherent emission at room temperature once the decay rate becomes faster than the decoherence rate (42). An intensity-switchable nanoscale light source can find important applications for optical signal processing with very stable giant quantum dots, where the switching speed is usually limited by the decay rate of the quantum dot, which can here instead reach gigahertz speeds when the exciton is maximally charged.
In conclusion, we report the observation of highly charged excitons, which induces a greater than 210-fold increase in the decay rate, with only a 12-fold reduction in the quantum yield. The charging process is reversible and deterministic, allowing for direct manipulation of the quantum dot emission rate through the applied bias, while preserving the single-photon emission characteristics. The fluorescence intensity-lifetime relation observed at high charge density goes beyond the conventional statistical scaling model, and not all quantum dots show the lifetime reduction, indicating the need for a more general model, including many-body corrections. Charging colloidal quantum dots is a powerful route for enhancing and controlling their photodynamics, which has important implications for tunable quantum sources, brighter displays, and optical signal processing and can lead to previously unknown approaches to charge/voltage sensing.
Quantum dots
CdSe/CdS core/shell quantum dots were synthesized using established methods (8), with a small modification: Before CdS shell growth, CdSe core quantum dots were suspended in ODE (octadecene), together with 0.25 ml of a 0.5 M solution of cadmium oleate in ODE. This mixture was degassed for 30 min at 110°C and subsequently heated to 300°C. Next, an equimolar mixture a 0.5 M cadmium oleate solution in ODE, and a 0.5 M TOPS (trioctylphosphine sulfide) solution was then slowly injected (at a rate of about 1 ml/hour) by a syringe pump to grow the CdS shell, with the total amount of Cd and S precursors determined by the desired shell thickness. Individual quantum dots from both batches exhibited nonblinking photodynamics at a low pump fluency and blinking at a high pump fluency, as in the presented here experiments (see fig. S2).
We remark here that we used a very short time bin (10 ms) to plot the intensity time traces, much shorter than in most reported nonblinking quantum dots experiments (30 to 200 ms) (22, 30, 43, 44), which is also why we can capture very fast-blinking events.
The experimental setup consisted of a custom-built three-electrode electrochemical cell mounted on a time-resolved confocal fluorescence microscope. Diluted quantum dots in toluene were spin-coated at ITO substrates (70 to 100 ohms per square; Diamond Coatings), which was the working electrode of the electrochemical cell. Coiled and straight Pt wires served as counter and quasi-reference electrodes, respectively. The distance between working and counter electrodes was 0.5 cm. The electrolyte was 0.1 M TBA hexafluorophosphate (≥99.0%; Sigma-Aldrich) in acetonitrile (99.8%; Sigma-Aldrich) or propylene carbonate (99%; Sigma-Aldrich). The voltage bias between the reference and working electrodes was controlled with a CHI 760C potentiostat (CH Instruments). As an almost negligible ohmic drop was determined for our setup (up to 9 mV, cf. notes in the Supplementary Materials), all voltage biases are reported, as recorded, i.e., without iR drop correction and versus the Pt quasi-reference electrode. The Pt quasi-reference electrode potential against Ag/AgCl(sat) was measured to be 57 ± 2 mV under our experimental conditions [cf. notes in the Supplementary Materials for conversion of the potential values into normal hydrogen electrode scale].
Lifetime measurements
We used a blue laser (LDH-D-C-440, PicoQuant) at 442 nm with a pulse width of 64 ps and a repetition frequency of 2.5 MHz to excite quantum dots. Samples were scanned using a three-dimensional piezo stage (E-545.3CD PI Nano). A high–numerical aperture (NA) oil-immersion objective (Plan Apochromat 100×; NA, 1.45) focused the laser beam on an individual quantum dot and collected the photoluminescence signal using an avalanche photo diode (SPCM-AQRH, PerkinElmer) connected to a time-correlated single-photon counting module (TimeHarp 260, PicoQuant). Photoluminescence decay histograms were obtained by recording the time between a laser excitation pulse and arrival time of a photon at a detector.
Photon antibunching
The collected photoluminescence signal from a quantum dot was tested in a Hanbury Brown and Twiss interferometer to verify the single-photon emission nature. The setup consisted of a 50/50 beam splitter and two avalanche photo diodes, which detected the arrival times of photons to build a coincidence histogram. The second-order correlation function g(2)(0) was measured by comparing the peak area at zero arrival time with the area averaged over the first three lagging peaks without any background subtraction.
Charge state of exciton
We extract the excitonic charge state by fitting the intensity-lifetime evolution with the statistical scaling model, which is valid for low charge states, assuming a fixed electron-hole overlap and neglecting many-body effects. The fit is robust; we have tested it by varying the initial conditions and the fitting range, and we got a variability in the range of 4 to 6 electrons for batch 1 and 12 to 16 electrons for batch 2 (see fig. S12). We report a conservative estimation of the exciton charging (4 and 12 for batches 1 and 2, respectively), which was extracted from the point where the statistical scaling model starts to deviate strongly from the experimental results, which is X4− for batch 1 and X12− for batch 2 (see Fig. 5, A and B).
Supplementary material for this article is available at http://advances.sciencemag.org/cgi/content/full/6/38/eabb1821/DC1
This is an open-access article distributed under the terms of the Creative Commons Attribution license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Acknowledgments: Funding: S.M. and R.S. acknowledge funding by EPSRC (EP/P033369 and EP/M013812/1). E.C. and S.A.M. acknowledge funding and support from the Deutsche Forschungsgemeinschaft (DFG; German Research Foundation) under Germany's Excellence Strategy EXC 2089/1 390776260, the Bavarian program Solar Energies Go Hybrid (SolTech), and the Center for NanoScience (CeNS). E.C. acknowledges funding from the 2020 European Research Council (802989 CATALIGHT). S.A.M acknowledges the Royal Society, AFOSR/EOARD, and the Lee-Lucas Chair in Physics. This project has received funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation program (802989 CATALIGHT and 714876 PHOCONA). A.H.K. and I.M. acknowledge the TEM facility of the Nematology Research Unit, member of the UGent TEM-Expertise center (life sciences). Author contributions: R.S. conceived the idea. I.M., A.H.K., and A.P. synthesized the quantum dots. S.M., E.L.P., and E.C. designed the electrochemical cell. S.M. conducted the experiments. S.M., S.V., and R.S. analyzed the data. The project was supervised by R.S., I.M., and S.A.M. All authors provided critical feedback and helped shape the research, analysis, and manuscript. Competing interests: The authors declare that they have no competing interests. Data and materials availability: All data needed to evaluate the conclusions in the paper are present in the paper and/or the Supplementary Materials. The data that support the findings of this study are openly available in Figshare at http://doi.org/10.6084/m9.figshare.12145593. Additional data related to this paper may be requested from the authors.
Copyright © 2020 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works. Distributed under a Creative Commons Attribution License 4.0 (CC BY).
Vol 6, No. 38
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Sothebys world record pink diamond – CWEB.com
Today a rare diamond known as the Pink Star has been sold in Hong Kong for more than $71m (£57m), setting a new world record for any gemstone at auction.
The oval-shaped 59.6 carat stone was bought after just five minutes' bidding at Sotheby's, reports said.
It is the largest polished diamond in its class to go under the hammer.
It sold for $83m in Geneva in 2013 but the buyer later defaulted. The record until now was held by the Oppenheimer Blue, which sold for $50m last May.
Bidding for the gem, which was found by De Beers at a mine in Africa in 1999 and cut over a period of two years, began at $56m.
Sotheby's said the buyer was Hong Kong jewellery retailer Chow Tai Fook Jewellery.
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With 60 call stations we can undertake fast and effective telephone surveys. Our interviewers are skilled at passing gatekeepers and leading respondents to other research methods such as Internet (CAWI) interviews.
Our large capacity assures you unique flexibility and freedom of action. We undertake thorough telephone coverage of any defined sector of the Israeli public, no matter how specific.
The Ultra-Orthodox (Haredi) community and the Arab population are two specific groups where the telephone is sometimes more effective than the computer. Moreover, interviewers need a special mind-set to approach such groups.
If your targets are businesses or professionals, then CATI is the way to reach them. Our team is experienced in B2B areas and has the skills to persuade gatekeepers of the value in reaching and engaging the final respondents.
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Thanksgiving is my favorite holiday of all, partly because it has not been tampered with as much as the other holidays (notwithstanding Black Friday). There is a lot to be thankful for and thankfulness is a calm balm that is truly encouraging.
My grandparents were dairy farmers in a small town in Connecticut. Part of the house they lived in dates back more than 300 years ago. The town and surrounding area still radiates the history of early America. Every time I have traveled to New England, I feel the history of those people who bravely set out to find freedom in order to live the kind of life God intended for them. Our literature today reflecting back on that time period, along with most of the history books in school, are skewed by the political leanings and ideologies of their authors. The diaries and logs of the men and women who lived back then are the best places to go to truly understand the history of that era in American history.
Loving God has so little to do with the 'ought to' mentality. The people of early Plymouth didn't do the things they did out any duty they felt they needed to perform. Their actions speak of a firm acknowledgement of knowing a loving God in much the same way as men like Moses, Joshua, Daniel, Isaiah, Deborah, Jeremiah, Ezekiel, David and many others of the Bible. The fruit of their labors and beliefs are easily recognized today, even with the confusion and chaos that is constantly stirring things up.
It is a relief!!! to pray and not an obligation! We can all excel in prayer and be so much the more blessed. The pilgrims knew the value and love of humble prayer. Their government was simple. They knew the God who loved them.
Recently, I was having a conversation with a friend and we got to talking about respect and the current culture. He made a statement to me that it was important to respect people's beliefs. I had to think about that for a moment. In my own mind, I think it is important to respect others as people but not necessarily to respect their beliefs. We respect people's right to choose what they believe as long as it doesn't violate the welfare and freedom of another person.
The word 'respect' is composed of two sub-words 're' and 'spect' or 'to look back on'. 'Giving consideration' can be another shade of meaning. In relationships and in our conversations, we are never alone or ever without effect on one another. Wonderful loving conversations are thoughtful and respectful and hopefully not selfish. We are all too human at times, but that doesn't mean that that we never stand up for what we believe in and speak truthfully and openly. Often that can be the most loving (love is the key) thing to do for another person. Words have power and we should use them wisely.
The Corinthian culture at the time of the New Testament had a lot of similarities to our culture today especially in philosophy of life and social issues. Paul, in writing to them about the beautiful concept of grace, was clear in enlightening his readers on the love of God and true freedom.
We can become slaves to the culture and the philosophies of the day. We can even be enslaved by our own appetites, emotions and thinking. The point Paul is making is that God's heart is that we are free from things unprofitable and that do not benefit us if we so choose. He cannot control those things that are set in our path to enslave us. He does however gives us a lot of resources to help us and then he leaves the choice up to us.


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Home > Where we go > Projects > Narrabri to North Star > Status
Narrabri
Works and planning
Works notifications
Planning approval documents
The Phase 1 section is in the construction phase
The Phase 2 section is in the reference design phase
Phase 1: Narrabri North to North Star
In 2016 the Narrabri to North Star project was declared State Significant Infrastructure under the NSW Environmental Planning and Assessment Act 1979 (EP&A Act) and a controlled action under the Commonwealth Environment Protection and Biodiversity Conservation Act 1999 (EPBC Act).
In late 2017, the Environmental Impact Statement (EIS) was placed on public exhibition, with 18 submissions received.
All NSW and Commonwealth governments planning and environmental approvals for Phase 1 are now finalised. The Submissions and Preferred Infrastructure Report (SPIR) released in December 2019 was a key step in the approval process for Phase 1.
The SPIR was prepared to address the issues raised in EIS submissions and to complete environmental assessments of the finalised design. The Department of Planning, Industry and Environment accepted public submissions on the SPIR in January 2020 and concluded their assessment of the Phase 1 under the EP&A Act in mid-2020. The Commonwealth Minister for Environment set further conditions under the EPBC Act which are now met.
View all Phase 1 project applications and documents on the Major Projects website.
Phase 2: Moree to Camurra
The NSW Secretary's Environmental Assessment Requirements for Moree to Camurra was issued in October 2020. It is a significant planning milestone for this phase.
The EIS for this second phase is expected to be on public exhibition in mid-2021.
Learn more about what's involved in the reference design and detailed design stages.
View project stages
Construction on Narrabri to North Star Phase 1 is well underway, and we have been tracking the project team's construction progress against completion targets.
We're providing a quarterly update on how the team is delivering key construction activities, such as how many new sleepers, track and culverts are installed and how many kilometres of old material have been removed.
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A reality of the works required to construct the Narrabri to North Star Phase 1 project is removing existing flora and fauna in the local area.
Trans4m Rail commissions local Indigenous artist
Local Gamilaroi Artist, Ann Johnson was recently commissioned by Trans4m Rail to create an artwork that depicts the communities situated throughout the Narrabri to North Star Phase 1 project. These communities and the project are all on traditional lands of the Gamilaroi people.


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text:
My Top 20 Favorite Survivors PART I
In the lieu of the End of another Survivor Season. I would so Love to blog about my review and my feelings over the Finale but as what I hate to feel myself, I don't want to spoil any other die hards like me. So instead, in celebration of the 20th Season of Survivor, I will be counting down 20 of my Favorite Survivors. For the First Part. Survivors 20 - 16 will be counted down. Here are the ones that made the first quarter of my Favorite Twenty
PS: To get you more suspended, I reversed the order of my posts to make it in order from 20 -1! Hoe you like my list :D
20. Jerri Manthey, Australia
She has been known to be Survivor's Original Black Widow. I was not able to watch her first attempt in joining Survivor during the second season on Australia(since I started watching on the Third) but I did had a glimpse of what THE Jerri is during the All-Star Season. I can never forget the booing of the fans during the Reunion Show. But tables turned during the Last Anniversary Season where she has redeemed herself and though she will always be known as a Villain, she has shown the her heart can be a Heroic Heart as well.
19. Terry Deitz, Exile Island Panama
You might be wondering why Terry made it to my list where he is quite hated by most. Well, He was the very last La Mina Member left when he won all 5 consecutive Immunities and cruised effortlessly to the Final 3. His Perseverance and Performance despite his name always on top of the chopping block every single Tribal Council makes him get my respect
18. Eliza Orlins, Vanuatu
She was my bet to win among the most powerful All Girl Alliance after Survivor Micronesia's Pack. Well, I don't have to elaborate why I like Eliza. I just like her attitude, her personality, I just like her period.
17. Candice Woodcock, Cook Islands
The fact she had the most number of Exile on Survivor History, I really like her heroic acts. Though she failed during the last season where she was also part of the Heroes Tribe, when she believed in Russel instead of her Allies and switched with the Villains. She should have gone better on my Favorites ranking but because of that very move she did. But I still like her, I still do.
16. Shii Ann Huang, Thailand
What can I say, called herself the 'Shi-Devil'. She was the most and for me, honestly, the only remarkable Castaway during the Fifth Season on Thailand. She stood out of them all even though she did not place farther with the game. Also, she was a very important figure that resulted to Amber Brkish's win during the Survivor All-stars where Amber awarded her the Prize Car.
Well that is just the First Five of the Top Twenty Castaways I will be running down. I just Love Survivor with all my Heart. I love the game, the people, the social rambles, I JUST LOVE SURVIVOR THAT'S IT!
So Stay tuned for the next parts of this Series as I ran down the remaining Top 15 Castaways that made my list.
Category: Reviews, TV
Beautiful Blackhawk


text:
Q: Как сделать редирект без смены url? Есть ссылка
http://datum-s.ru/catalog/servers-and-components/rack/?SECTION_ID=servers-and-components&ELEMENT_ID=rack%2F&set_filter=y&arrFilter_163_3623318330=Y&arrFilter_298_1210362188=Y&arrFilter_266_MAX=2048&arrFilter_266_MIN=32&arrFilter_269_MAX=25&arrFilter_269_MIN=2&arrFilter_P10_MAX=3554855&arrFilter_P10_MIN=23943
Реально ли сделать для нее чпу представление, например, такое:
http://datum-s.ru/catalog/servers-and-components/rack/hp/dl160
чтобы при нажатии на вторую сслыку отрывался материал из первого, но в адресной строке была вторая?
То есть, по сути, нужен редирект, но с сохранением адреса.
Я подумал, по факту, мне нужно просто создать синоним для ссылки.
A: Обновление:

# arrFilter_163_3623318330=Y - фильтр указывает на servers-and-components/rack/hp
# arrFilter_298_1210362188=Y - фильтр указывает на servers-and-components/rack/hp/dl160

RewriteRule catalog/([^/]+)/([^/]+)/hp$ catalog/$1/$2/?SECTION_ID=$1&ELEMENT_ID=$2/&set_filter=y&arrFilter_163_3623318330=Y

RewriteRule catalog/([^/]+)/([^/]+)/hp/dl160$ catalog/$1/$2/?SECTION_ID=$1&ELEMENT_ID=$2/&set_filter=y&arrFilter_163_3623318330=Y&arrFilter_298_1210362188=Y

A: Редирект тебе как раз не нужен, при редиректе меняется адресная строка. Тебе надо просто преобразование адреса.
RewriteRule Адрес_из_адресной_строки Целевой_адрес [L] # L означает, что после этого правила никакие преобразования применяться не будут.

redpajama_set_name: RedPajamaStackExchange


text:
Review ArticlePractice
Approach to lymphogranuloma venereum
Patrick O'Byrne, Paul MacPherson, Stephane DeLaplante, Gila Metz and Andree Bourgault
Patrick O'Byrne
Associate Professor of Nursing at the University of Ottawa in Ontario.
For correspondence: pjobyrne@uottawa.ca
Paul MacPherson
Associate Professor of Medicine at the University of Ottawa.
Stephane DeLaplante
Family physician and Lecturer of Medicine at the University of Ottawa.
Gila Metz
Medical Director of the Ottawa Public Health Sexual Health Centre.
Andree Bourgault
Nurse practitioner at the Ottawa Public Health Sexual Health Centre.
Objective To review the literature about lymphogranuloma venereum (LGV) and to provide an overview and discussion of practice guidelines.
Sources of information The terms Chlamydia trachomatis and lymphogranuloma venereum were searched separately in PubMed. Empirical studies, practice reviews, and clinical guidelines were included. All reference lists were reviewed for additional articles.
Main message Since 2003, there has been a resurgence of LGV among men who have sex with men in many Western countries, including Canada. Although LGV is a serovar of Chlamydia trachomatis (serovar L), it can invade regional lymph nodes, and consequently presents with different symptoms than the other subtypes of chlamydia (serovars A through K). Specifically, LGV transitions through 3 phases: a painless papule or ulcer at the site of inoculation; invasion of the regional lymph nodes, which can present with an inguinal or rectal syndrome; and irreversible destruction of lymph tissue. In contrast, chlamydia serovars A to K exclusively produce superficial mucosal infections. Lymphogranuloma venereum also requires a different treatment regimen than other chlamydia serovars.
Conclusion In light of the current resurgence of LGV, its unique symptoms and clinical course, and its requirement for a different treatment than other chlamydia serovars, it is important for primary care providers to recognize when LGV should be included as an appropriate differential diagnosis.
A 34-year-old man presented to an outpatient sexually transmitted infection (STI) testing clinic. He reported a 2-week history of a painful, red, swollen bump in the right inguinal region near the base of his penis. He denied fever, chills, night sweats, rashes, genital lesions, dysuria, urethral discharge, testicular pain, proctitis, rectal discharge, tenesmus, and diarrhea. He stated he had visited a walk-in clinic and received oral cloxacillin to be taken in 500-mg doses 4 times a day for 1 week but that this had provided no benefit. He reported previous unprotected receptive and penetrative oral and anal sexual contacts with male partners.
Examination revealed a 5-cm, tender, erythematous, inguinal bubo that was free of discharge and ulceration. There was no visible groove sign (ie, inflammation of the "inguinal nodes above and femoral nodes below the inguinal ligament"1). The genitourinary examination was otherwise unremarkable, as was the examination of his cervical lymph nodes and oropharynx. Specimens were collected to test for gonorrhea and chlamydia, including first-void urine for a nucleic acid amplification test (NAAT) and pharyngeal and rectal swabs for culture. Lymphogranuloma venereum (LGV) genotyping was requested for all specimens that had positive test results for chlamydia. Samples for serology tests for syphilis, HIV, and chlamydia serovar L were also sent. Based on a presumptive clinical diagnosis of LGV, we prescribed 100 mg of oral doxycycline twice daily for 3 weeks, and instructed him to return to the clinic in 2 weeks for a follow-up assessment.
Follow-up showed near-complete resolution of symptoms. Serology for chlamydia serovar L had positive results, with a titre of 1:512 by microimmunofluorescence. The HIV test results were also positive. All other results were negative and, as chlamydia was not detected in the urine, pharyngeal, and rectal specimens, the laboratory did not perform LGV genotyping. We took the clinical presentation, including the response to doxycycline, and the elevated LGV serology titre to form a diagnosis of probable LGV.1 As this diagnosis did not fulfil the public health case definition for chlamydia infection,1 no public health reporting or follow-up occurred. Nevertheless, we did encourage the patient to refrain from sexual activity until 7 days after he had completed his treatment, and to inform all sexual partners from the previous 60 days to present for testing and empiric treatment.
Chlamydia trachomatis is an obligate intracellular pathogen.2 Its 15 serovars can be classified into 3 groups based on type of infection: trachoma (serovars A, B, Ba, and C), anogenital infection (serovars D to K), and LGV (serovar L: L1, L2, and L3).2,3 Although chlamydia infections are often asymptomatic, worldwide, trachomas are a leading cause of blindness, and anogenital chlamydia infections are the most common STI and a frequent cause of infertility and pelvic inflammatory disease.4–7 In contrast to serovars A to K, which cause mucosal infections by infecting columnar epithelial cells, serovars L1, L2, and L3 cause systemic disease by infecting monocytes and macrophages and then invading submucosal sites and regional lymph nodes.8,9
In Western countries, the incidence of LGV has been increasing since 2003, primarily among HIV-positive men who have sex with men (MSM).10–17 Part of the challenge with diagnosis is that the clinical presentation of LGV is often variable and nonspecific.18–22 Compounding this is the fact that few laboratories can differentiate serovars D to K from L. Identifying serovar L is essential, as LGV requires a longer course of treatment compared with other chlamydia serovars to mitigate related sequelae.23–25 Herein, our objective is to review the literature about LGV, and to provide an overview and discussion of practice guidelines.
The information for this clinical review article arises from a literature search on LGV. The terms Chlamydia trachomatis and lymphogranuloma venereum were searched separately in PubMed. Empirical studies, practice reviews, and clinical guidelines were included. We reviewed all reference lists for additional articles.
Epidemiology.
Lymphogranuloma venereum has not historically been identified in Western countries. However, since 2003—when clinicians identified a cluster of such infections in the Netherlands—LGV has become endemic in Canada, the United States (US), the United Kingdom (UK), and Australia.10–17 Indeed, the Public Health Agency of Canada11 indicates that, between 2004 and 2012 inclusively, there were 170 reported cases of LGV. As LGV is not reportable in all jurisdictions in Canada (eg, in Ontario), these numbers likely underrepresent the true burden of infection.
Because researchers identified that substance use, sex parties, anonymous sex, rectal douching, use of sex toys, fisting, and receptive anal intercourse correlated with LGV detection, initial speculation suggested rectum-to-rectum transmission.8,14,16,21 However, subsequent analyses of stored urine samples identified a number of undiagnosed urethral LGV infections. It is possible that this reservoir of urethral infections went undetected because many previous guidelines only recommended LGV screening for rectal samples.12 It is also possible that practitioners did not test for LGV because—unlike the textbook description of LGV25,26—most of the identified LGV infections were asymptomatic.12 Moreover, subsequent reports have identified a small number of cases of pharyngeal LGV.27–29
Infections with chlamydia serovars D to K are typically asymptomatic. When present, symptoms tend to be consistent with localized mucosal inflammation (eg, urethritis, dysuria, proctitis, cervicitis, atypical vaginal discharge). Less commonly, these infections can ascend the genital tract and result in more severe syndromes (eg, pelvic inflammatory disease or epididymitis). In contrast, LGV symptoms are classically divided into 3 stages: local infection (primary stage), regional dissemination (secondary stage), and progressive tissue damage (tertiary stage).5,7,8,25,26
Primary: Although often unnoticed by patients, about 3 to 30 days after inoculation localized inflammation manifests at the site of exposure (often genital or rectal, but can be oropharyngeal).8,9,12 Classically, this lesion is a transient papule, but can be a pustule or ulcer.5,8 Direct rectal inoculation, as in the recent outbreak of LGV among MSM, can result in proctitis with symptoms of rectal pain, anorectal bleeding, mucoid or hemopurulent rectal discharge, tenesmus, and constipation.8,9,13 The differential diagnoses for the primary lesions depend on their presentation (as papules versus ulcers), and include herpes, syphilis, genital warts, pearly penile papules, molluscum, other bacterial and fungal infections, contact dermatitis, fixed drug eruption, trauma, and Behçet syndrome. For proctitis, the list includes inflammatory bowel disease, lymphoma, anorectal carcinoma, and other STIs (eg, gonorrhea, chlamydia serovars A to K, herpes, syphilis).
Secondary: About 2 to 6 weeks after the primary lesion appears, regional tissue invasion occurs and can be accompanied by constitutional symptoms (eg, fever, chills, malaise, myalgia, arthralgia).25,26 While symptoms depend on the site of inoculation, some individuals might be asymptomatic during this stage.5,18 With penile, urethral, or vulvar inoculation, the main presentation is an inguinal syndrome.8 In such cases, LGV induces often unilateral, painful, firm, inguinal or femoral lymphadenopathy known as buboes. These lymph nodes can suppurate, ulcerate, and possibly lead to purulent discharge through cutaneous fistulas.5–8 Concurrent inguinal and femoral lymphadenopathy can create the groove sign, which is present in 10% to 20% of cases.12 Rectal inoculation results in proctitis and lower abdominal or low-back pain due to involvement of the pelvic and retroperitoneal lymph nodes.12,13 In these cases lymphadenopathy is not evident on physical examination but can often be identified through imaging (eg, computed tomography or magnetic resonance imaging).8,12,13 The differential diagnosis for localized inguinal or pelvic lymphadenopathy includes herpes, syphilis, gonorrhea, lower-limb infections, lymphoma, and pelvic malignancy.
Tertiary: If untreated, LGV can lead to irreversible tissue destruction and scarring.25,26 In particular, the chronic lymphangitis and subsequent lymphatic obstruction caused by LGV can cause regional lymphedema and genital elephantiasis.6,7 In cases of rectal involvement, perirectal abscesses, anal fistulas, and strictures are possible.
Practice guidelines.
Guidelines regarding LGV diagnosis and treatment from Canada,1,7 the US,6 the UK,5 and Europe4 are similar. They recommend clinicians consider LGV in the differential diagnosis when sexually active patients present with inguinal or femoral lymphadenopathy or buboes or proctitis, particularly when patients are sexually active, HIV-positive MSM.1,4–7 When assessing patients with such symptoms, clinicians should collect samples for chlamydia NAATs or culture from the oropharynx, rectum, cervix, or urethra (via urine sample) based on patients' anatomy and sexual history, and request that the laboratory perform LGV genotyping on chlamydia-positive samples.1,4–7 This process is also recommended for patients who are sexual partners of persons diagnosed with LGV.1,4–7 Because the current LGV resurgence has been among MSM, the guidelines also indicate that, when screening asymptomatic MSM (especially those who are HIV-positive), clinicians should consider requesting that chlamydia-positive specimens undergo LGV genotyping.1,4–7 The possible outcomes of this testing are negative results, positive results for chlamydia with non-LGV serovars, and positive results for chlamydia with LGV serovars.
The guidelines differ regarding the use of serology in diagnosis. The Canadian guidelines1,7 state that "serology is not recommended, given cross-reactions with other Chlamydia species, and difficulties interpreting variations in titres (for example, low titres do not rule out LGV)."7 As well, how to interpret changes in titres after treatment is unknown.1,7,30 In contrast, the US,6 UK,5 and European4 guidelines indicate that LGV serology can be used to support the diagnosis of LGV in some contexts, eg, when a laboratory cannot perform LGV genotyping. These guidelines4–6 adopt a different approach—they indicate that while the stated shortcomings of LGV serology are valid, a microimmunofluorescence titre greater than 1:256 is suggestive of LGV. This is because LGV is invasive and can induce higher antibody titres than mucosal serovars A to K usually can.6
When contemplating the value of LGV serology, it is important to evaluate the limitations of available chlamydia testing. Currently, in Canada and the US, NAATs for chlamydia are only approved for genital sites (ie, tests are done on first-void urine and cervical and urethral swabs).1,6,7 Nucleic acid amplification tests are not currently approved by the US Food and Drug Administration for extragenital sites (eg, pharyngeal, rectal), limiting diagnosis at these locations to culture.1,6,7 This is concerning because the sensitivity of chlamydia culture from extragenital sites is poor—as low as 50%.31 As a sizable number of chlamydia infections among MSM are exclusively rectal, many of these infections could be missed.32,33 Moreover, research has shown that chlamydia serovars can differ by anatomic site in some individuals.34 Indeed, "significant differences in serovar prevalence are found between rectal and urogenital specimens in men."34 An LGV diagnosis could thus be missed even when urine NAAT results are positive for chlamydia and negative for LGV, and the extragenital test result is falsely negative. As "NAATs typically detect 20%–50% more chlamydial infections than could be detected by culture,"31 some of these limitations could be overcome if NAATs were approved for extragenital sites.
Given the current limitations in detecting chlamydia at extragenital sites, we see a role for LGV serology in specific clinical situations. Because a negative result from a rectal chlamydia culture can be incorrect up to 50% of the time, and because only chlamydia-positive specimens undergo molecular testing for LGV, the diagnosis in MSM patients experiencing extragenital symptoms could be missed. Performing LGV serology in such a context as an adjunct to genital chlamydia NAAT and extragenital chlamydia cultures could be beneficial. However, given the limitations of LGV serology, it should be reserved for instances of high pretest probability, ie, patients from high-risk groups such as MSM who either have symptoms suggestive of LGV or are known to have had sexual contact with persons diagnosed with LGV. Owing to the issues with interpreting LGV serology (ie, cross reactivity, variability in titre, and how to interpret titres after treatment), serology likely has no role in routine testing when the likelihood of detecting LGV is low based on LGV prevalence and clinical presentation.
For treatment, the Canadian,1,7 US,6 UK,5 and European4 guidelines recommend 100 mg of oral doxycycline twice daily for 21 days, which is longer than the treatment of non-LGV chlamydia infections (ie, 1 dose of 1 g of oral azithromycin or 100 mg of oral doxycycline twice daily for 7 days). This is based on evidence that LGV RNA can be isolated for up to 16 days during treatment.23 An alternative regimen for LGV is 500 mg of oral erythromycin 4 times a day for 21 days, or 1 g of oral azithromycin once a week for 3 weeks.
All guidelines also recommend ongoing follow-up until signs and symptoms resolve.1,4–7 When LGV diagnosis was through molecular testing or culture of a genital or extragenital sample with positive test results for chlamydia, the Canadian guidelines recommend repeating the chlamydia test until the results are negative, thus confirming cure of LGV. This test of cure is not possible in cases where LGV was diagnosed through serology, as the expected duration of elevated titres has not been clearly defined.6 In these cases, follow-up should continue until signs and symptoms resolve.
For partner follow-up, the guidelines all recommend that sexual contacts from the preceding 60 days should be tested for chlamydia at all appropriate sites (ie, urethra, cervix, rectum, and pharynx); tested for other sexually transmitted infections, including HIV, syphilis, gonorrhea, and hepatitis B and C; and given empiric treatment of chlamydia infection. This treatment is 1 oral 1-g dose of azithromycin, or 100 mg of oral doxycycline twice daily for 1 week. However, because routine treatment of chlamydia does not eliminate LGV infection, in the absence of NAATs for extragenital chlamydia infections, we treat contacts of both confirmed and probable cases of LGV with full LGV treatment (100 mg of oral doxycycline twice daily for 21 days). This practice differs from the guidelines, but ensures appropriate treatment is not withheld owing to the poor sensitivity of extragenital chlamydia culture.
Given the resurgence of LGV in Western countries,10–17 it is important that clinicians are aware of both the clinical course and the presentation of this infection, and the limitations of diagnosis as outlined in current guidelines. Understanding practice guidelines,1,4–7 including differences in these documents, can help inform clinical decision making and patient treatment. Regarding our 34-year-old male patient, the serology findings support a clinical diagnosis of probable LGV. In light of the limited sensitivity of extragenital testing for chlamydia, the absence of a culture with positive results for chlamydia does not rule out LGV. Based on such a scenario, until NAATs are approved for extragenital chlamydia testing, in contrast to recent Canadian recommendations, we believe LGV serology continues to have a role in clinical practice. Where LGV symptoms are present, clinicians should consider molecular testing of genital and extragenital samples that have positive results for chlamydia; in patients with extragenital symptoms, use of LGV serology in conjunction with chlamydia testing could help improve detection of LGV.
Given the resurgence of lymphogranuloma venereum (LGV) in Western countries, it is important that clinicians be aware of not only the clinical course and presentation of this infection, but also the limitations of diagnosis as outlined in current guidelines.
Where LGV symptoms are present, clinicians should consider molecular testing of genital and extragenital samples that have positive results for chlamydia; in patients with extragenital symptoms, the use of LGV serology in conjunction with chlamydia culture could improve detection of LGV.
Until nucleic acid amplification tests are approved for extragenital chlamydia testing, in contrast to recent Canadian recommendations, LGV serology continues to have a role in clinical practice.
Dr O'Byrne completed the literature review, and all authors contributed to the interpretation of the literature and to preparing the manuscript for publication.
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Patrick O'Byrne, Paul MacPherson, Stephane DeLaplante, Gila Metz, Andree Bourgault
Substantial underdiagnosis of lymphogranuloma venereum in men who have sex with men in Europe: preliminary findings from a multicentre surveillance pilot
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Passing through the Kuromon Gate of and climbing up the approach to Nakayama Hokekyo-ji Temple, you could find a small tiled-roofed gate, it is the gate of Seikaen, a small silent space in the residential area in Nakayama. You could look into the garden through the gate and pass through it, you could find a peaceful place to rest and enjoy your time. Near the gate, there is a Japanese style garden, and the behind the garden, its style is changed, it is like an European style.
The land of Seikaen garden was donated by Hana Ishii in April 9th of 1992. The Ishii's family had lived in Nakayama from Kyoho era (1716~36) in the middle of Edo period, and the family opened a shop named Seikado to sell stationaries and second hand books, so they contributed to the development of Nakayama. In 2001, Seikaen was opened as a cultural center. And also it is a branch office of the City Hall of Ichikawa City.
Seikaen has a great accessibility from both Narita and Haneda International Airport.


"Who am I? Who are you?
What is the actual power of a human being to really benefit the world when they're able to put the priorities of the whole system in front of themselves, even if that means they have to die in the process?
How many of us can do that right now?
Maybe the one thing that keeps us from solving all of the other problems of the world is this persistant, flawed thought that we are separate from the world.
We all should listen to Jeff Lieberman and other wise advises . To make it easier first we have to learn to like thinking. We have to search within our selves, and when we learn to see with the soul's eye than we will feel the closeness to each other and to infinity of the universe.