614 research outputs found
Non-adiabatic spin torque investigated using thermally activated magnetic domain wall dynamics
Using transmission electron microscopy, we investigate the thermally
activated motion of domain walls (DWs) between two positions in permalloy
(Ni80Fe20) nanowires at room temperature. We show that this purely thermal
motion is well described by an Arrhenius law, allowing for a description of the
DW as a quasi-particle in a 1D potential landscape. By injecting small
currents, the potential is modified, allowing for the determination of the
non-adiabatic spin torque: the non-adiabatic coefficient is 0.010 +/- 0.004 for
a transverse DW and 0.073 +/- 0.026 for a vortex DW. The larger value is
attributed to the higher magnetization gradients present
A Prospective Longitudinal Study of the Clinical Outcomes from Cryptococcal Meningitis following Treatment Induction with 800 mg Oral Fluconazole in Blantyre, Malawi
Introduction: Cryptococcal meningitis is the most common neurological infection in HIV infected patients in Sub Saharan Africa, where gold standard treatment with intravenous amphotericin B and 5 flucytosine is often unavailable or difficult to administer. Fluconazole monotherapy is frequently recommended in national guidelines but is a fungistatic drug compromised by uncertainty over optimal dosing and a paucity of clinical end-point outcome data.
Methods: From July 2010 until March 2011, HIV infected adults with a first episode of cryptococcal meningitis were
recruited at Queen Elizabeth Central Hospital, Blantyre, Malawi. Patients were treated with oral fluconazole monotherapy 800 mg daily, as per national guidelines. ART was started at 4 weeks. Outcomes and factors associated with treatment failure were assessed 4, 10 and 52 weeks after fluconazole initiation.
Results: Sixty patients were recruited. 26/60 (43%) died by 4 weeks. 35/60 (58.0%) and 43/56 (77%) died or failed treatment by 10 or 52 weeks respectively. Reduced consciousness (Glasgow Coma Score ,14 of 15), moderate/severe neurological disability (modified Rankin Score .3 of 5) and confusion (Abbreviated Mental Test Score ,8 of 10) were all common at baseline and associated with death or treatment failure. ART prior to recruitment was not associated with better outcomes.
Conclusions: Mortality and treatment failure from cryptococcal meningitis following initiation of treatment with 800 mg oral fluconazole is unacceptably high. To improve outcomes, there is an urgent need for better therapeutic strategies and point-of-care diagnostics, allowing earlier diagnosis before development of neurological deficit
Mathematical Modeling to Assess the Drivers of the Recent Emergence of Typhoid Fever in Blantyre, Malawi
Background. Multiyear epidemics of Salmonella enterica serovar Typhi have been reported from countries across eastern and southern Africa in recent years. In Blantyre, Malawi, a dramatic increase in typhoid fever cases has recently occurred, and may be linked to the emergence of the H58 haplotype. Strains belonging to the H58 haplotype often exhibit multidrug resistance and may have a fitness advantage relative to other Salmonella Typhi strains. Methods. To explore hypotheses for the increased number of typhoid fever cases in Blantyre, we fit a mathematical model to culture-confirmed cases of Salmonella enterica infections at Queen Elizabeth Central Hospital, Blantyre. We explored 4 hypotheses: (1) an increase in the basic reproductive number (R(0)) in response to increasing population density; (2) a decrease in the incidence of cross-immunizing infection with Salmonella Enteritidis; (3) an increase in the duration of infectiousness due to failure to respond to first-line antibiotics; and (4) an increase in the transmission rate following the emergence of the H58 haplotype. Results. Increasing population density or decreasing cross-immunity could not fully explain the observed pattern of typhoid emergence in Blantyre, whereas models allowing for an increase in the duration of infectiousness and/or the transmission rate of typhoid following the emergence of the H58 haplotype provided a good fit to the data. Conclusions. Our results suggest that an increase in the transmissibility of typhoid due to the emergence of drug resistance associated with the H58 haplotype may help to explain recent outbreaks of typhoid in Malawi and similar settings in Africa
Tuneable magnetic patterning of paramagnetic Fe60Al40 (at. %) by consecutive ion irradiation through pre-lithographed shadow masks
This article may be downloaded for personal use only. Any other use requires prior permission of the author and the American Institute of Physics.Arrays of ferromagnetic circular dots (with diameters ranging from 225 to 420 nm) have been prepared at the surface of atomically ordered paramagnetic Fe60Al40 (at. %) sheets by means of ion irradiation through prelithographed poly(methyl methacrylate) (PMMA) masks. The cumulative effects of consecutive ion irradiation (using Ar+ ions at 1.2 × 1014 ions/cm2 with 10, 13, 16, 19 and 22 keV incident energies) on the properties of the patterned dots have been investigated. A progressive increase in the overall magneto-optical Kerr signal is observed for increasingly larger irradiation energies, an effect which is ascribed to accumulation of atomic disorder. Conversely, the coercivity, HC, shows a maximum after irradiating at 16-19 keV and it decreases for larger irradiation energies. Such a decrease in HC is ascribed to the formation of vortex states during magnetization reversal, in agreement with results obtained from micromagnetic simulations. At the same time, the PMMA layer, with an initial thickness of 90 nm, becomes progressively thinned during the successive irradiation processes. After irradiation at 22 keV, the remaining PMMA layer is too thin to stop the incoming ions and, consequently, ferromagnetism starts to be generated underneath the nominally masked areas. These experimental results are in agreement with calculations using the Monte-Carlo simulation Stopping Range of Ions in Matter software, which show that for exceedingly thin PMMA layers Ar+ ions can reach the Fe60Al40 layer despite the presence of the mask
Correlation between magnetic spin structure and the three-dimensional geometry in chemically synthesized nanoscale magnetite rings
The correlation between magnetic spin structure and geometry in nanoscale chemically synthesized Fe(3)O(4) rings has been investigated by transmission electron microscopy. We find primarily the flux closure vortex states but in rings with thickness variations, an effective stray field occurs. Using tomography, we determine the complete three-dimensional geometries of thicker rings. A direct correlation between the geometry and the magnetization which points out of plane in the thickest parts of the ring yielding an intermediate magnetic state between the vortex state and the tube state is found. The interaction between exchange coupled rings leads to antiparallel vortex states and extended onion states. (c) 2008 American Institute of Physics.Physics, AppliedSCI(E)EI2ARTICLE22null9
Extensive degeneracy, Coulomb phase and magnetic monopoles in an artificial realization of the square ice model
Artificial spin ice systems have been introduced as a possible mean to
investigate frustration effects in a well-controlled manner by fabricating
lithographically-patterned two-dimensional arrangements of interacting magnetic
nanostructures. This approach offers the opportunity to visualize
unconventional states of matter, directly in real space, and triggered a wealth
of studies at the frontier between nanomagnetism, statistical thermodynamics
and condensed matter physics. Despite the strong efforts made these last ten
years to provide an artificial realization of the celebrated square ice model,
no simple geometry based on arrays of nanomagnets succeeded to capture the
macroscopically degenerate ground state manifold of the corresponding model.
Instead, in all works reported so far, square lattices of nanomagnets are
characterized by a magnetically ordered ground state consisting of local
flux-closure configurations with alternating chirality. Here, we show
experimentally and theoretically, that all the characteristics of the square
ice model can be observed if the artificial square lattice is properly
designed. The spin configurations we image after demagnetizing our arrays
reveal unambiguous signatures of an algebraic spin liquid state characterized
by the presence of pinch points in the associated magnetic structure factor.
Local excitations, i.e. classical analogues of magnetic monopoles, are found to
be free to evolve in a massively degenerated, divergence-free vacuum. We thus
provide the first lab-on-chip platform allowing the investigation of collective
phenomena, including Coulomb phases and ice-like physics.Comment: 26 pages, 10 figure
Genomic identification of a novel co-trimoxazole resistance genotype and its prevalence amongst Streptococcus pneumoniae in Malawi
Objectives
This study aimed to define the molecular basis of co-trimoxazole resistance in Malawian pneumococci under the dual selective pressure of widespread co-trimoxazole and sulfadoxine/pyrimethamine use.
Methods
We measured the trimethoprim and sulfamethoxazole MICs and analysed folA and folP nucleotide and translated amino acid sequences for 143 pneumococci isolated from carriage and invasive disease in Malawi (2002–08).
Results
Pneumococci were highly resistant to both trimethoprim and sulfamethoxazole (96%, 137/143). Sulfamethoxazole-resistant isolates showed a 3 or 6 bp insertion in the sulphonamide-binding site of folP. The trimethoprim-resistant isolates fell into three genotypic groups based on dihydrofolate reductase (encoded by folA) mutations: Ile-100-Leu (10%), the Ile-100-Leu substitution together with a residue 92 substitution (56%) and those with a novel uncharacterized resistance genotype (34%). The nucleotide sequence divergence and dN/dS of folA and folP remained stable from 2004 onwards.
Conclusions
S. pneumoniae exhibit almost universal co-trimoxazole resistance in vitro and in silico that we believe is driven by extensive co-trimoxazole and sulfadoxine/pyrimethamine use. More than one-third of pneumococci employ a novel mechanism of co-trimoxazole resistance. Resistance has now reached a point of stabilizing evolution. The use of co-trimoxazole to prevent pneumococcal infection in HIV/AIDS patients in sub-Saharan Africa should be re-evaluated
Six-Month Mortality among HIV-Infected Adults Presenting for Antiretroviral Therapy with Unexplained Weight Loss, Chronic Fever or Chronic Diarrhea in Malawi.
In sub-Saharan Africa, early mortality is high following initiation of antiretroviral therapy (ART). We investigated 6-month outcomes and factors associated with mortality in HIV-infected adults being assessed for ART initiation and presenting with weight loss, chronic fever or diarrhea, and with negative TB sputum microscopy
Acute Bacterial Meningitis
Purpose of review
Community-acquired bacterial meningitis is a continually changing disease. This review summarises both dynamic epidemiology and emerging data on pathogenesis. Updated clinical guidelines are discussed, new agents undergoing clinical trials intended to reduce secondary brain damage are presented.
Recent findings
Conjugate vaccines are effective against serotype/serogroup-specific meningitis but vaccine escape variants are rising in prevalence. Meningitis occurs when bacteria evade mucosal and circulating immune responses and invade the brain: directly, or across the blood–brain barrier. Tissue damage is caused when host genetic susceptibility is exploited by bacterial virulence. The classical clinical triad of fever, neck stiffness and headache has poor diagnostic sensitivity, all guidelines reflect the necessity for a low index of suspicion and early Lumbar puncture. Unnecessary cranial imaging causes diagnostic delays. cerebrospinal fluid (CSF) culture and PCR are diagnostic, direct next-generation sequencing of CSF may revolutionise diagnostics. Administration of early antibiotics is essential to improve survival. Dexamethasone partially mitigates central nervous system inflammation in high-income settings. New agents in clinical trials include C5 inhibitors and daptomycin, data are expected in 2025.
Summary
Clinicians must remain vigilant for bacterial meningitis. Constantly changing epidemiology and emerging pathogenesis data are increasing the understanding of meningitis. Prospects for better treatments are forthcoming
Emergent dynamic chirality in a thermally driven artificial spin ratchet
Modern nanofabrication techniques have opened the possibility to create novel functional materials, whose properties transcend those of their constituent elements. In particular, tuning the magnetostatic interactions in geometrically frustrated arrangements of nanoelements called artificial spin ice1, 2 can lead to specific collective behaviour3, including emergent magnetic monopoles4, 5, charge screening6, 7 and transport8, 9, as well as magnonic response10, 11, 12. Here, we demonstrate a spin-ice-based active material in which energy is converted into unidirectional dynamics. Using X-ray photoemission electron microscopy we show that the collective rotation of the average magnetization proceeds in a unique sense during thermal relaxation. Our simulations demonstrate that this emergent chiral behaviour is driven by the topology of the magnetostatic field at the edges of the nanomagnet array, resulting in an asymmetric energy landscape. In addition, a bias field can be used to modify the sense of rotation of the average magnetization. This opens the possibility of implementing a magnetic Brownian ratchet13, 14, which may find applications in novel nanoscale devices, such as magnetic nanomotors, actuators, sensors or memory cells
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