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Sánchez-Santolino G, Rouco V, Puebla S, Aramberri H, Zamora V, Cabero M, Cuellar FA, Munuera C, Mompean F, Garcia-Hernandez M, Castellanos-Gomez A, Íñiguez J, Leon C, Santamaria J. A 2D ferroelectric vortex pattern in twisted BaTiO 3 freestanding layers. Nature 2024; 626:529-534. [PMID: 38356067 PMCID: PMC10866709 DOI: 10.1038/s41586-023-06978-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 12/14/2023] [Indexed: 02/16/2024]
Abstract
The wealth of complex polar topologies1-10 recently found in nanoscale ferroelectrics results from a delicate balance between the intrinsic tendency of the materials to develop a homogeneous polarization and the electric and mechanical boundary conditions imposed on them. Ferroelectric-dielectric interfaces are model systems in which polarization curling originates from open circuit-like electric boundary conditions, to avoid the build-up of polarization charges through the formation of flux-closure11-14 domains that evolve into vortex-like structures at the nanoscale15-17 level. Although ferroelectricity is known to couple strongly with strain (both homogeneous18 and inhomogeneous19,20), the effect of mechanical constraints21 on thin-film nanoscale ferroelectrics has been comparatively less explored because of the relative paucity of strain patterns that can be implemented experimentally. Here we show that the stacking of freestanding ferroelectric perovskite layers with controlled twist angles provides an opportunity to tailor these topological nanostructures in a way determined by the lateral strain modulation associated with the twisting. Furthermore, we find that a peculiar pattern of polarization vortices and antivortices emerges from the flexoelectric coupling of polarization to strain gradients. This finding provides opportunities to create two-dimensional high-density vortex crystals that would enable us to explore previously unknown physical effects and functionalities.
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Affiliation(s)
- G Sánchez-Santolino
- GFMC, Departamento Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain.
- Laboratorio de Heteroestructuras con aplicación en spintrónica, Unidad Asociada UCM/CSIC, Madrid, Spain.
| | - V Rouco
- GFMC, Departamento Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain.
| | - S Puebla
- Instituto de Ciencia de Materiales de Madrid ICMM-CSIC, Madrid, Spain
| | - H Aramberri
- Materials Research and Technology Department, Luxembourg Institute of Science and Technology (LIST), Esch-sur-Alzette, Luxembourg
| | - V Zamora
- GFMC, Departamento Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain
| | - M Cabero
- ICTS Centro Nacional de Microscopia Electrónica 'Luis Brú', Universidad Complutense, Madrid, Spain
| | - F A Cuellar
- GFMC, Departamento Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain
| | - C Munuera
- Laboratorio de Heteroestructuras con aplicación en spintrónica, Unidad Asociada UCM/CSIC, Madrid, Spain
- Instituto de Ciencia de Materiales de Madrid ICMM-CSIC, Madrid, Spain
| | - F Mompean
- Laboratorio de Heteroestructuras con aplicación en spintrónica, Unidad Asociada UCM/CSIC, Madrid, Spain
- Instituto de Ciencia de Materiales de Madrid ICMM-CSIC, Madrid, Spain
| | - M Garcia-Hernandez
- Laboratorio de Heteroestructuras con aplicación en spintrónica, Unidad Asociada UCM/CSIC, Madrid, Spain
- Instituto de Ciencia de Materiales de Madrid ICMM-CSIC, Madrid, Spain
| | - A Castellanos-Gomez
- Laboratorio de Heteroestructuras con aplicación en spintrónica, Unidad Asociada UCM/CSIC, Madrid, Spain
- Instituto de Ciencia de Materiales de Madrid ICMM-CSIC, Madrid, Spain
| | - J Íñiguez
- Materials Research and Technology Department, Luxembourg Institute of Science and Technology (LIST), Esch-sur-Alzette, Luxembourg
- Department of Physics and Materials Science, University of Luxembourg, Belvaux, Luxembourg
| | - C Leon
- GFMC, Departamento Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain
- Laboratorio de Heteroestructuras con aplicación en spintrónica, Unidad Asociada UCM/CSIC, Madrid, Spain
| | - J Santamaria
- GFMC, Departamento Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain.
- Laboratorio de Heteroestructuras con aplicación en spintrónica, Unidad Asociada UCM/CSIC, Madrid, Spain.
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Zhang Z, Dauvilliers Y, Plazzi G, Mayer G, Lammers G, Santamaria J, Gaig C, Partinen M, Overeem S, Rio-Villegas RD, Šonka K, Peraita-Adrados R, Heinzer R, Wierzbicka A, Högl B, Manconi M, Feketeova E, da Silva A, Bušková J, Bassetti C, Barateau L, Pizza F, Gool J, Fronczek R, Khatami R. Idling for decades: a European study on risk factors associated with long time to narcolepsy diagnosis. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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3
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Gool J, Zhang Z, Oei M, Mathias S, Dauvilliers Y, Mayer G, Plazzi G, del Rio-Villegas R, Santamaria J, Šonka K, Partinen M, Overeem S, Peraita-Adrados R, Heinzer R, Martins da Silva A, Högl B, Wierzbicka A, Heidbreder A, Feketeova E, Manconi M, Bušková J, Canellas F, Bassetti C, Barateau L, Pizza F, Schmidt M, Fronczek R, Khatami R, Lammers G. Unsupervised clustering of central hypersomnolence disorders enables data-driven phenotyping: toward more reliable diagnostic criteria. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Khan I, Brookes E, Santamaria J, Crisafi D, Wilson A, Darby J, Newcomb A. Evolving mortality rates in people who inject drugs: An Australian tertiary hospital observational study on infective endocarditis. PLoS One 2022; 17:e0270283. [PMID: 36018847 PMCID: PMC9417006 DOI: 10.1371/journal.pone.0270283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 06/07/2022] [Indexed: 11/18/2022] Open
Abstract
Background Injection drug use (IDU) associated infective endocarditis (IE) is clinically challenging due to social issues this population endures. Rates of IDU are rising globally, however, there is a lack of clear guidelines for IDU associated IE. The aim of this study is to assess the epidemiology of the IDU and non-IDU populations and compare their long-term outcomes to help guide future management. Methods An observational cohort study was conducted on all 350 patients treated for IE at St Vincent’s Hospital Melbourne between 1999 and 2015. Follow up was performed until death or January 2021. Primary outcome was all-cause mortality. Results IDU patients are younger (p<0.001), more likely to have concurrent infections (p<0.001), and other addiction disorders (p<0.001), while non-IDU patients are older with a higher level of comorbid illnesses (p<0.001). IDU and non-IDU patients received similar management during their admissions and experienced similar levels of in-hospital outcomes, except for non-IDU patient being more likely to develop pneumonia post-surgery (p = 0.03). IDU patients are more likely to become reinfected (p = 0.034) but have better long-term survival, with survival estimates at 15-years being 64.98% (95%CI: 50.94–75.92%) for IDU patients compared to 26.67% (95%CI: 19.76–34.05%) for non-IDU patients (p<0.001). Conclusion Despite having higher levels of reinfection, IDU patients have better long-term survival compared to non-IDU patients. Therefore, we suggest IDU patients should not have blanket restrictions on the management they are offered unless at the individual level there is a contraindication to therapy.
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Affiliation(s)
- Isa Khan
- Melbourne Medical School, University of Melbourne, Melbourne, Australia
- Department of Cardiothoracic Surgery, St Vincent’s Hospital Melbourne, Fitzroy, Australia
- * E-mail:
| | - Elizabeth Brookes
- Melbourne Medical School, University of Melbourne, Melbourne, Australia
| | - John Santamaria
- Department of Intensive Care, St Vincent’s Hospital Melbourne, Fitzroy, Australia
| | - Daniel Crisafi
- Melbourne Medical School, University of Melbourne, Melbourne, Australia
- Department of Cardiothoracic Surgery, St Vincent’s Hospital Melbourne, Fitzroy, Australia
| | - Andrew Wilson
- Department of Cardiology, St Vincent’s Hospital Melbourne, Fitzroy, Australia
| | - Jonathan Darby
- Department of Infectious Diseases, St Vincent’s Hospital Melbourne, Fitzroy, Australia
| | - Andrew Newcomb
- Department of Cardiothoracic Surgery, St Vincent’s Hospital Melbourne, Fitzroy, Australia
- Department of Surgery, University of Melbourne, Melbourne, Australia
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Sanchez-Manzano D, Mesoraca S, Cuellar FA, Cabero M, Rouco V, Orfila G, Palermo X, Balan A, Marcano L, Sander A, Rocci M, Garcia-Barriocanal J, Gallego F, Tornos J, Rivera A, Mompean F, Garcia-Hernandez M, Gonzalez-Calbet JM, Leon C, Valencia S, Feuillet-Palma C, Bergeal N, Buzdin AI, Lesueur J, Villegas JE, Santamaria J. Extremely long-range, high-temperature Josephson coupling across a half-metallic ferromagnet. Nat Mater 2022; 21:188-194. [PMID: 34857910 DOI: 10.1038/s41563-021-01162-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 10/21/2021] [Indexed: 06/13/2023]
Abstract
The Josephson effect results from the coupling of two superconductors across a spacer such as an insulator, a normal metal or a ferromagnet to yield a phase coherent quantum state. However, in junctions with ferromagnetic spacers, very long-range Josephson effects have remained elusive. Here we demonstrate extremely long-range (micrometric) high-temperature (tens of kelvins) Josephson coupling across the half-metallic manganite La0.7Sr0.3MnO3 combined with the superconducting cuprate YBa2Cu3O7. These planar junctions, in addition to large critical currents, display the hallmarks of Josephson physics, such as critical current oscillations driven by magnetic flux quantization and quantum phase locking effects under microwave excitation (Shapiro steps). The latter display an anomalous doubling of the Josephson frequency predicted by several theories. In addition to its fundamental interest, the marriage between high-temperature, dissipationless quantum coherent transport and full spin polarization brings opportunities for the practical realization of superconducting spintronics, and opens new perspectives for quantum computing.
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Affiliation(s)
- D Sanchez-Manzano
- GFMC, Departamento Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain
| | - S Mesoraca
- Unité Mixte de Physique, CNRS, Thales, Université Paris-Saclay, Palaiseau, France
| | - F A Cuellar
- GFMC, Departamento Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain
| | - M Cabero
- IMDEA Nanoscience Institute, Universidad Autonoma, Cantoblanco, Spain
- Centro Nacional de Microscopia Electronica, Universidad Complutense, Madrid, Spain
| | - V Rouco
- GFMC, Departamento Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain
| | - G Orfila
- GFMC, Departamento Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain
| | - X Palermo
- Unité Mixte de Physique, CNRS, Thales, Université Paris-Saclay, Palaiseau, France
| | - A Balan
- Unité Mixte de Physique, CNRS, Thales, Université Paris-Saclay, Palaiseau, France
| | - L Marcano
- Helmholtz-Zentrum Berlin für Materialien und Energie, Berlin, Germany
| | - A Sander
- Unité Mixte de Physique, CNRS, Thales, Université Paris-Saclay, Palaiseau, France
| | - M Rocci
- GFMC, Departamento Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain
- Instituto Nanoscienze, Consiglio Thales Alenia Space Italia, L'Aquila, Italy
| | | | - F Gallego
- GFMC, Departamento Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain
| | - J Tornos
- GFMC, Departamento Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain
| | - A Rivera
- GFMC, Departamento Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain
| | - F Mompean
- Instituto de Ciencia de Materiales de Madrid (ICMM, CSIC), Cantoblanco, Spain
- Laboratorio de Heteroestructuras con Aplicación en Spintrónica, Unidad Asociada (UCM-CSIC), Madrid, Spain
| | - M Garcia-Hernandez
- Instituto de Ciencia de Materiales de Madrid (ICMM, CSIC), Cantoblanco, Spain
- Laboratorio de Heteroestructuras con Aplicación en Spintrónica, Unidad Asociada (UCM-CSIC), Madrid, Spain
| | - J M Gonzalez-Calbet
- Centro Nacional de Microscopia Electronica, Universidad Complutense, Madrid, Spain
- Departamento Química Inorgánica, Facultad de Química, Universidad Complutense, Madrid, Spain
| | - C Leon
- GFMC, Departamento Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain
| | - S Valencia
- Helmholtz-Zentrum Berlin für Materialien und Energie, Berlin, Germany
| | - C Feuillet-Palma
- Laboratoire de Physique et d'Etude des Matériaux, ESPCI Paris, CNRS, PSL Research University, Sorbonne University, Paris, France
| | - N Bergeal
- Laboratoire de Physique et d'Etude des Matériaux, ESPCI Paris, CNRS, PSL Research University, Sorbonne University, Paris, France
| | - A I Buzdin
- LOMA, CNRS, Université Bordeaux, Talence, France
- Digital Biodesign and Personalized Healthcare, Sechenov First Moscow State Medical University, Moscow, Russia
| | - J Lesueur
- Laboratoire de Physique et d'Etude des Matériaux, ESPCI Paris, CNRS, PSL Research University, Sorbonne University, Paris, France
| | - Javier E Villegas
- Unité Mixte de Physique, CNRS, Thales, Université Paris-Saclay, Palaiseau, France.
| | - J Santamaria
- GFMC, Departamento Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain.
- Laboratorio de Heteroestructuras con Aplicación en Spintrónica, Unidad Asociada (UCM-CSIC), Madrid, Spain.
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Halliday AJ, Santamaria J, D'Souza WJ. Pre-hospital benzodiazepines associated with improved outcomes in out-of-hospital status epilepticus: A 10-year retrospective cohort study. Epilepsy Res 2022; 179:106846. [PMID: 34954464 DOI: 10.1016/j.eplepsyres.2021.106846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/05/2021] [Accepted: 12/16/2021] [Indexed: 11/03/2022]
Abstract
Outcomes of status epilepticus have not substantially changed over the last decade. Given onset is most often in the community, early termination strategies that are implementable outside of hospitals are of public health importance. This 10-year retrospective single-centre cohort study aimed to determine whether pre-hospital benzodiazepine administration is associated with improved health outcomes in patients with out-of-hospital onset status epilepticus. METHODS We reviewed the medical records of all patients admitted with status epilepticus between 2008 and 2018 at St Vincent's Hospital Melbourne. Data regarding onset setting, medical history, management and outcomes were extracted. RESULTS 72 patients meeting inclusion criteria were identified. Onset of status epilepticus was out-of-hospital for 74% (53/72) of patients, 66% (35/53) of whom were administered a benzodiazepine before reaching hospital, most often by ambulance officers (30/35, 86%). Pre-hospital benzodiazepine administration was associated with a 90% reduction in duration time to seizure cessation (0.65 vs 5.8 days, p = 0.012) and 50% reduction in length of hospital stay (7.6 vs 15.8 days, p = 0.045). In-hospital onset status epilepticus was associated with higher mortality than out-of-hospital onset (26% vs 4%, RR 6.5, p = 0.004). CONCLUSION Pre-hospital benzodiazepines shorten the time to seizure control and length of hospital stay in patients with out-of-hospital status epilepticus, although is under-utilised by both ambulance staff and home carers. Health policy measures to improve ambulance officer and home carer administration skills and confidence may address these issues.
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Affiliation(s)
- Amy J Halliday
- Department of Clinical Neurosciences, St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy, Melbourne, Victoria 3065, Australia.
| | - John Santamaria
- Department of Critical Care Medicine, St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy, Melbourne, Victoria 3065, Australia
| | - Wendyl J D'Souza
- Department of Clinical Neurosciences, St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy, Melbourne, Victoria 3065, Australia
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Julian I, Pedersen C, Jensen A, Baden A, Hueso J, Friderichsen A, Birkedal H, Mallada R, Santamaria J. From bench scale to pilot plant: A 150x scaled-up configuration of a microwave-driven structured reactor for methane dehydroaromatization. Catal Today 2022. [DOI: 10.1016/j.cattod.2021.04.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Arias-Egido E, Laguna-Marco MA, Piquer C, Jiménez-Cavero P, Lucas I, Morellón L, Gallego F, Rivera-Calzada A, Cabero-Piris M, Santamaria J, Fabbris G, Haskel D, Boada R, Díaz-Moreno S. Dimensionality-driven metal-insulator transition in spin-orbit-coupled IrO 2. Nanoscale 2021; 13:17125-17135. [PMID: 34635906 DOI: 10.1039/d1nr04207f] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
A metal-insulator transition is observed in spin-orbit-coupled IrO2 thin films upon reduction of the film thickness. In the epitaxially grown samples, the critical thickness (t ∼ 1.5-2.2 nm) is found to depend on growth orientation (001), (100) or (110). Interestingly from the applied point of view, the insulating behavior is found even in polycrystalline ultrathin films. By analyzing the experimental electrical response with various theoretical models, we find good fits to the Efros-Shklovskii-VRH and the Arrhenius-type behaviors, which suggests an important role of electron correlations in determining the electrical properties of IrO2. Our magnetic measurements also point to a significant role of magnetic order. Altogether, our results would point to a mixed Slater- and Mott-type of insulator.
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Affiliation(s)
- E Arias-Egido
- Instituto de Nanociencia y Materiales de Aragón (INMA), CSIC - Universidad de Zaragoza, Zaragoza 50009, Spain.
- Departamento de Física de la Materia Condensada, Universidad de Zaragoza, Zaragoza 50009, Spain
| | - M A Laguna-Marco
- Instituto de Nanociencia y Materiales de Aragón (INMA), CSIC - Universidad de Zaragoza, Zaragoza 50009, Spain.
- Departamento de Física de la Materia Condensada, Universidad de Zaragoza, Zaragoza 50009, Spain
- Instituto de Ciencia de Materiales de Madrid, CSIC, Cantoblanco, 28049 Madrid, Spain
| | - C Piquer
- Instituto de Nanociencia y Materiales de Aragón (INMA), CSIC - Universidad de Zaragoza, Zaragoza 50009, Spain.
- Departamento de Física de la Materia Condensada, Universidad de Zaragoza, Zaragoza 50009, Spain
| | - P Jiménez-Cavero
- Instituto de Nanociencia y Materiales de Aragón (INMA), CSIC - Universidad de Zaragoza, Zaragoza 50009, Spain.
- Departamento de Física de la Materia Condensada, Universidad de Zaragoza, Zaragoza 50009, Spain
| | - I Lucas
- Instituto de Nanociencia y Materiales de Aragón (INMA), CSIC - Universidad de Zaragoza, Zaragoza 50009, Spain.
- Departamento de Física de la Materia Condensada, Universidad de Zaragoza, Zaragoza 50009, Spain
| | - L Morellón
- Instituto de Nanociencia y Materiales de Aragón (INMA), CSIC - Universidad de Zaragoza, Zaragoza 50009, Spain.
- Departamento de Física de la Materia Condensada, Universidad de Zaragoza, Zaragoza 50009, Spain
| | - F Gallego
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | | | - M Cabero-Piris
- ICTS - Centro Nacional de Microscopía Electrónica, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - J Santamaria
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Laboratorio de Heteroestructuras con aplicación en spintrónica, Unidad Asociada UCM/CSIC, 28049 Madrid, Spain
- GFMC, Instituto de Magnetismo Aplicado, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - G Fabbris
- Advanced Photon Source, Argonne National Laboratory, Argonne, IL 60439, USA
| | - D Haskel
- Advanced Photon Source, Argonne National Laboratory, Argonne, IL 60439, USA
| | - R Boada
- Department of Chemistry Universitat Autonoma de Barcelona 08193 Bellaterra, Barcelona, Spain
- Diamond Light Source Ltd Harwell Science and Innovation Campus Didcot, Oxfordshire OX11 0DE, UK
| | - S Díaz-Moreno
- Diamond Light Source Ltd Harwell Science and Innovation Campus Didcot, Oxfordshire OX11 0DE, UK
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9
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Jahn B, Sroczynski G, Bicher M, Rippinger C, Mühlberger N, Santamaria J, Urach C, Ostermann H, Popper N, Siebert U. Evaluation of a targeted COVID-19 vaccination strategy for Austria–a decision-analytic modeling study. Eur J Public Health 2021. [PMCID: PMC8574282 DOI: 10.1093/eurpub/ckab165.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background The supply of COVID-19 vaccine was limited when introduced. We aimed to inform decision makers at an early stage about targeted COVID vaccination strategies, accounting for limited capacities and adherence to support vaccination prioritization in Austria. Methods We applied a dynamic agent-based population model to compare different vaccination prioritization strategies targeting the elderly (65 ≥ years), middle aged (45-64 years), younger (15-44 years), vulnerable (risk of severe disease due to comorbidities), and healthcare workers (HCW), to minimize COVID-19-related hospitalizations and deaths. First, outcomes were optimized for an initially available vaccine batch for 200,000 individuals. Second, stepwise optimization was performed, deriving a prioritization sequence for 2.5 million people. We considered sterilizing and non-sterilizing immunity, with different assumptions of effectiveness, over a 6-month period. The project team was advised by a Standing Policy and Expert Panel, consisting of Austrian decision makers, clinical and ethical experts as well as international modeling specialists. Results Maximum reduction of hospitalizations and deaths was achieved by starting vaccinations with the elderly and vulnerable, followed by middle-aged, HCW, and younger individuals. Optimizations for vaccinating 2.5 million individuals yielded the same prioritization and avoided about one third of deaths and hospitalizations. Starting vaccination with HCWs leads to slightly smaller reductions. The negative effects of COVID-19-related HCW absenteeism were not yet considered in our model. Conclusions Our decision-analytic study shows that the elderly and vulnerable should be prioritized for vaccination until further vaccines are available to minimize COVID-19-related hospitalizations and deaths. An important ethical aspect complementing our modeling results is the protection of HCW, maximizing their occupational safety and ensuring risk-compensatory justice. Key messages To minimize COVID‐19‐related hospitalizations and death the elderly and vulnerable should be prioritized for vaccination until further vaccines are available. Prioritizing health care workers for COVID-19 vaccination is slightly less effective in the simulation but they may be considered for occupational safety and to ensure risk-compensatory justice.
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Affiliation(s)
- B Jahn
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - G Sroczynski
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - M Bicher
- dwh GmbH, dwh Simulation Services, Vienna, Austria
- Institute of Information Systems Engineering, TU Wien, Vienna, Austria
| | - C Rippinger
- dwh GmbH, dwh Simulation Services, Vienna, Austria
| | - N Mühlberger
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - J Santamaria
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - C Urach
- dwh GmbH, dwh Simulation Services, Vienna, Austria
| | - H Ostermann
- Austrian National Public Health Institute, Gesundheit Österreich GmbH, Vienna, Austria
| | - N Popper
- dwh GmbH, dwh Simulation Services, Vienna, Austria
- Institute of Information Systems Engineering, TU Wien, Vienna, Austria
- Association for Decision Support for Health Policy and Planning, DEXHELPP, Vienna, Austria
| | - U Siebert
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
- Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Center for Health Decision Science, Depts. of Epidemiology and Health Policy & Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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10
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Khan I, Brookes E, Santamaria J, Wilson A, Darby J, Newcomb A. Long-term outcomes of intravenous drug use associated infective endocarditis: a contemporary 20-year study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Intravenous drug use (IVDU) associated infective endocarditis (IE) is a clinically challenging case. Not only can the natural history of IE in the IVDU population be significantly different, making detection a diagnostic dilemma, additional social factors associated with this population can drastically change management, including suitability for surgery or long-term intravenous access for antibiotics Furthermore, the rates of IVDU are increasing globally, leading to increasing incidence of IVDU associated IE.
Purpose
With a lack of clear mangement guidelines for IVDU associated IE, our study assesses the differences in presentation, management and long-term prognosis of IE between the IVDU population and the non-IVDU population to help guide future care.
Methods
This is an observational cohort study on a prospectively collected database of 350 patients treated for IE at our centre between 1999 and 2015. Patients were followed-up until death or January 2021. The primary outcome was all-cause mortality. Continuous variables were compared using unpaired t-test. Categorical variables were compared using Chi-square test when sample size was >5 or Fisher's exact test when sample size was ≤5. Long-term survival data was analysed using Kaplan-Meier survival curves.
Results
The IVDU population was younger, more likely to have concurrent infections and other substance use, while the non-IVDU population was older with a higher level of overall comorbidity. IVDU patients were more likely to become reinfected (p-value=0.034) but had better long-term survival compared to the non-IVDU population (p<0.001). Survival estimates at 15-years were 64.98% (95% CI: 50.94–75.92%) for the IVDU population compared to 26.67% (95% CI: 19.76–34.05%) for the non-IVDU population (p-value<0.0001).
Conclusion
Despite having higher levels of reinfection, IVDU patients have better long-term outcomes of IE compared to non-IVDU patients. Therefore, IVDU patients should not have blanket restrictions on the management they are offered unless the individual has clear contraindications to a particular therapy.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- I Khan
- University of Melbourne, Melbourne, Australia
| | - E Brookes
- University of Melbourne, Melbourne, Australia
| | | | - A Wilson
- St Vincent's Hospital, Melbourne, Australia
| | - J Darby
- St Vincent's Hospital, Melbourne, Australia
| | - A Newcomb
- St Vincent's Hospital, Melbourne, Australia
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11
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Yoo MW, Tornos J, Sander A, Lin LF, Mohanta N, Peralta A, Sanchez-Manzano D, Gallego F, Haskel D, Freeland JW, Keavney DJ, Choi Y, Strempfer J, Wang X, Cabero M, Vasili HB, Valvidares M, Sanchez-Santolino G, Gonzalez-Calbet JM, Rivera A, Leon C, Rosenkranz S, Bibes M, Barthelemy A, Anane A, Dagotto E, Okamoto S, te Velthuis SGE, Santamaria J, Villegas JE. Large intrinsic anomalous Hall effect in SrIrO 3 induced by magnetic proximity effect. Nat Commun 2021; 12:3283. [PMID: 34078889 PMCID: PMC8172877 DOI: 10.1038/s41467-021-23489-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 04/25/2021] [Indexed: 02/04/2023] Open
Abstract
The anomalous Hall effect (AHE) is an intriguing transport phenomenon occurring typically in ferromagnets as a consequence of broken time reversal symmetry and spin-orbit interaction. It can be caused by two microscopically distinct mechanisms, namely, by skew or side-jump scattering due to chiral features of the disorder scattering, or by an intrinsic contribution directly linked to the topological properties of the Bloch states. Here we show that the AHE can be artificially engineered in materials in which it is originally absent by combining the effects of symmetry breaking, spin orbit interaction and proximity-induced magnetism. In particular, we find a strikingly large AHE that emerges at the interface between a ferromagnetic manganite (La0.7Sr0.3MnO3) and a semimetallic iridate (SrIrO3). It is intrinsic and originates in the proximity-induced magnetism present in the narrow bands of strong spin-orbit coupling material SrIrO3, which yields values of anomalous Hall conductivity and Hall angle as high as those observed in bulk transition-metal ferromagnets. These results demonstrate the interplay between correlated electron physics and topological phenomena at interfaces between 3d ferromagnets and strong spin-orbit coupling 5d oxides and trace an exciting path towards future topological spintronics at oxide interfaces.
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Affiliation(s)
- Myoung-Woo Yoo
- grid.460789.40000 0004 4910 6535Unité Mixte de Physique, CNRS, Thales, Université Paris-Saclay, Palaiseau, France
| | - J. Tornos
- grid.4795.f0000 0001 2157 7667GFMC, Dept. Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain
| | - A. Sander
- grid.460789.40000 0004 4910 6535Unité Mixte de Physique, CNRS, Thales, Université Paris-Saclay, Palaiseau, France
| | - Ling-Fang Lin
- grid.411461.70000 0001 2315 1184Department of Physics and Astronomy, University of Tennessee, Knoxville, TN USA ,grid.263826.b0000 0004 1761 0489School of Physics, Southeast University, Nanjing, China
| | - Narayan Mohanta
- grid.135519.a0000 0004 0446 2659Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN USA
| | - A. Peralta
- grid.4795.f0000 0001 2157 7667GFMC, Dept. Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain
| | - D. Sanchez-Manzano
- grid.4795.f0000 0001 2157 7667GFMC, Dept. Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain
| | - F. Gallego
- grid.4795.f0000 0001 2157 7667GFMC, Dept. Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain
| | - D. Haskel
- grid.187073.a0000 0001 1939 4845Advanced Photon Source Argonne National Laboratory, Lemont, IL USA
| | - J. W. Freeland
- grid.187073.a0000 0001 1939 4845Advanced Photon Source Argonne National Laboratory, Lemont, IL USA
| | - D. J. Keavney
- grid.187073.a0000 0001 1939 4845Advanced Photon Source Argonne National Laboratory, Lemont, IL USA
| | - Y. Choi
- grid.187073.a0000 0001 1939 4845Advanced Photon Source Argonne National Laboratory, Lemont, IL USA
| | - J. Strempfer
- grid.187073.a0000 0001 1939 4845Advanced Photon Source Argonne National Laboratory, Lemont, IL USA
| | - X. Wang
- grid.253355.70000 0001 2192 5641Department of Physics, Bryn Mawr College, Bryn Mawr, PA USA
| | - M. Cabero
- grid.5515.40000000119578126IMDEA Nanoscience Campus Universidad Autonoma, Cantoblanco, Spain ,grid.4795.f0000 0001 2157 7667Centro Nacional de Microscopia Electronica, Universidad Complutense, Madrid, Spain
| | - Hari Babu Vasili
- grid.423639.9CELLS-ALBA Synchrotron Radiation Facility, Cerdanyola del Valles, Spain
| | - Manuel Valvidares
- grid.423639.9CELLS-ALBA Synchrotron Radiation Facility, Cerdanyola del Valles, Spain
| | - G. Sanchez-Santolino
- grid.4795.f0000 0001 2157 7667GFMC, Dept. Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain
| | - J. M. Gonzalez-Calbet
- grid.4795.f0000 0001 2157 7667Centro Nacional de Microscopia Electronica, Universidad Complutense, Madrid, Spain ,grid.4795.f0000 0001 2157 7667Department Quimica Inorganica, Facultad de Quimica, Universidad Complutense, Madrid, Spain
| | - A. Rivera
- grid.4795.f0000 0001 2157 7667GFMC, Dept. Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain
| | - C. Leon
- grid.4795.f0000 0001 2157 7667GFMC, Dept. Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain
| | - S. Rosenkranz
- grid.187073.a0000 0001 1939 4845Materials Science Division, Argonne National Laboratory, Lemont, IL USA
| | - M. Bibes
- grid.460789.40000 0004 4910 6535Unité Mixte de Physique, CNRS, Thales, Université Paris-Saclay, Palaiseau, France
| | - A. Barthelemy
- grid.460789.40000 0004 4910 6535Unité Mixte de Physique, CNRS, Thales, Université Paris-Saclay, Palaiseau, France
| | - A. Anane
- grid.460789.40000 0004 4910 6535Unité Mixte de Physique, CNRS, Thales, Université Paris-Saclay, Palaiseau, France
| | - Elbio Dagotto
- grid.411461.70000 0001 2315 1184Department of Physics and Astronomy, University of Tennessee, Knoxville, TN USA ,grid.135519.a0000 0004 0446 2659Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN USA
| | - S. Okamoto
- grid.135519.a0000 0004 0446 2659Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN USA
| | - S. G. E. te Velthuis
- grid.187073.a0000 0001 1939 4845Materials Science Division, Argonne National Laboratory, Lemont, IL USA
| | - J. Santamaria
- grid.4795.f0000 0001 2157 7667GFMC, Dept. Fisica de Materiales, Facultad de Fisica, Universidad Complutense, Madrid, Spain
| | - Javier E. Villegas
- grid.460789.40000 0004 4910 6535Unité Mixte de Physique, CNRS, Thales, Université Paris-Saclay, Palaiseau, France
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12
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Nguyen J, Baradi A, Reid D, Jin D, Navani R, Huang K, Ellis Z, Santamaria J, Newcomb A, Darby J, Wilson A. Characteristics, Outcomes and Prognostic Factors of Infective Endocarditis in the Intensive Care Unit. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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13
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Hernandez-Martin D, Gallego F, Tornos J, Rouco V, Beltran JI, Munuera C, Sanchez-Manzano D, Cabero M, Cuellar F, Arias D, Sanchez-Santolino G, Mompean FJ, Garcia-Hernandez M, Rivera-Calzada A, Pennycook SJ, Varela M, Muñoz MC, Sefrioui Z, Leon C, Santamaria J. Controlled Sign Reversal of Electroresistance in Oxide Tunnel Junctions by Electrochemical-Ferroelectric Coupling. Phys Rev Lett 2020; 125:266802. [PMID: 33449729 DOI: 10.1103/physrevlett.125.266802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 11/24/2020] [Indexed: 06/12/2023]
Abstract
The persistence of ferroelectricity in ultrathin layers relies critically on screening or compensation of polarization charges which otherwise destabilize the ferroelectric state. At surfaces, charged defects play a crucial role in the screening mechanism triggering novel mixed electrochemical-ferroelectric states. At interfaces, however, the coupling between ferroelectric and electrochemical states has remained unexplored. Here, we make use of the dynamic formation of the oxygen vacancy profile in the nanometer-thick barrier of a ferroelectric tunnel junction to demonstrate the interplay between electrochemical and ferroelectric degrees of freedom at an oxide interface. We fabricate ferroelectric tunnel junctions with a La_{0.7}Sr_{0.3}MnO_{3} bottom electrode and BaTiO_{3} ferroelectric barrier. We use poling strategies to promote the generation and transport of oxygen vacancies at the metallic top electrode. Generated oxygen vacancies control the stability of the ferroelectric polarization and modify its coercive fields. The ferroelectric polarization, in turn, controls the ionization of oxygen vacancies well above the limits of thermodynamic equilibrium, triggering the build up of a Schottky barrier at the interface which can be turned on and off with ferroelectric switching. This interplay between electronic and electrochemical degrees of freedom yields very large values of the electroresistance (more than 10^{6}% at low temperatures) and enables a controlled switching between clockwise and counterclockwise switching modes in the same junction (and consequently, a change of the sign of the electroresistance). The strong coupling found between electrochemical and electronic degrees of freedom sheds light on the growing debate between resistive and ferroelectric switching in ferroelectric tunnel junctions, and moreover, can be the source of novel concepts in memory devices and neuromorphic computing.
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Affiliation(s)
| | - F Gallego
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
- 2D-Foundry Group, Instituto de Ciencia de Materiales de Madrid ICMM-CSIC, 28049 Madrid, Spain
| | - J Tornos
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
- 2D-Foundry Group, Instituto de Ciencia de Materiales de Madrid ICMM-CSIC, 28049 Madrid, Spain
| | - V Rouco
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - J I Beltran
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Instituto Pluridisciplinar, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - C Munuera
- 2D-Foundry Group, Instituto de Ciencia de Materiales de Madrid ICMM-CSIC, 28049 Madrid, Spain
- Unidad Asociada UCM/CSIC, Laboratorio de Heteroestructuras con Aplicación en Spintrónica, 28049 Madrid, Spain
| | | | - M Cabero
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - F Cuellar
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - D Arias
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - G Sanchez-Santolino
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
- 2D-Foundry Group, Instituto de Ciencia de Materiales de Madrid ICMM-CSIC, 28049 Madrid, Spain
- Instituto Pluridisciplinar, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - F J Mompean
- 2D-Foundry Group, Instituto de Ciencia de Materiales de Madrid ICMM-CSIC, 28049 Madrid, Spain
- Unidad Asociada UCM/CSIC, Laboratorio de Heteroestructuras con Aplicación en Spintrónica, 28049 Madrid, Spain
| | - M Garcia-Hernandez
- 2D-Foundry Group, Instituto de Ciencia de Materiales de Madrid ICMM-CSIC, 28049 Madrid, Spain
- Unidad Asociada UCM/CSIC, Laboratorio de Heteroestructuras con Aplicación en Spintrónica, 28049 Madrid, Spain
| | - A Rivera-Calzada
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Unidad Asociada UCM/CSIC, Laboratorio de Heteroestructuras con Aplicación en Spintrónica, 28049 Madrid, Spain
| | - S J Pennycook
- Department of Materials Science & Engineering, National University of Singapore, Singapore 117575
| | - M Varela
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Instituto Pluridisciplinar, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - M C Muñoz
- Unidad Asociada UCM/CSIC, Laboratorio de Heteroestructuras con Aplicación en Spintrónica, 28049 Madrid, Spain
- Instituto de Ciencia de Materiales de Madrid ICMM-CSIC, 28049 Madrid, Spain
| | - Z Sefrioui
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Unidad Asociada UCM/CSIC, Laboratorio de Heteroestructuras con Aplicación en Spintrónica, 28049 Madrid, Spain
- GFMC, Instituto de Magnetismo Aplicado, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - C Leon
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Unidad Asociada UCM/CSIC, Laboratorio de Heteroestructuras con Aplicación en Spintrónica, 28049 Madrid, Spain
- GFMC, Instituto de Magnetismo Aplicado, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - J Santamaria
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Unidad Asociada UCM/CSIC, Laboratorio de Heteroestructuras con Aplicación en Spintrónica, 28049 Madrid, Spain
- GFMC, Instituto de Magnetismo Aplicado, Universidad Complutense de Madrid, 28040 Madrid, Spain
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14
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Angus DC, Derde L, Al-Beidh F, Annane D, Arabi Y, Beane A, van Bentum-Puijk W, Berry L, Bhimani Z, Bonten M, Bradbury C, Brunkhorst F, Buxton M, Buzgau A, Cheng AC, de Jong M, Detry M, Estcourt L, Fitzgerald M, Goossens H, Green C, Haniffa R, Higgins AM, Horvat C, Hullegie SJ, Kruger P, Lamontagne F, Lawler PR, Linstrum K, Litton E, Lorenzi E, Marshall J, McAuley D, McGlothin A, McGuinness S, McVerry B, Montgomery S, Mouncey P, Murthy S, Nichol A, Parke R, Parker J, Rowan K, Sanil A, Santos M, Saunders C, Seymour C, Turner A, van de Veerdonk F, Venkatesh B, Zarychanski R, Berry S, Lewis RJ, McArthur C, Webb SA, Gordon AC, Al-Beidh F, Angus D, Annane D, Arabi Y, van Bentum-Puijk W, Berry S, Beane A, Bhimani Z, Bonten M, Bradbury C, Brunkhorst F, Buxton M, Cheng A, De Jong M, Derde L, Estcourt L, Goossens H, Gordon A, Green C, Haniffa R, Lamontagne F, Lawler P, Litton E, Marshall J, McArthur C, McAuley D, McGuinness S, McVerry B, Montgomery S, Mouncey P, Murthy S, Nichol A, Parke R, Rowan K, Seymour C, Turner A, van de Veerdonk F, Webb S, Zarychanski R, Campbell L, Forbes A, Gattas D, Heritier S, Higgins L, Kruger P, Peake S, Presneill J, Seppelt I, Trapani T, Young P, Bagshaw S, Daneman N, Ferguson N, Misak C, Santos M, Hullegie S, Pletz M, Rohde G, Rowan K, Alexander B, Basile K, Girard T, Horvat C, Huang D, Linstrum K, Vates J, Beasley R, Fowler R, McGloughlin S, Morpeth S, Paterson D, Venkatesh B, Uyeki T, Baillie K, Duffy E, Fowler R, Hills T, Orr K, Patanwala A, Tong S, Netea M, Bihari S, Carrier M, Fergusson D, Goligher E, Haidar G, Hunt B, Kumar A, Laffan M, Lawless P, Lother S, McCallum P, Middeldopr S, McQuilten Z, Neal M, Pasi J, Schutgens R, Stanworth S, Turgeon A, Weissman A, Adhikari N, Anstey M, Brant E, de Man A, Lamonagne F, Masse MH, Udy A, Arnold D, Begin P, Charlewood R, Chasse M, Coyne M, Cooper J, Daly J, Gosbell I, Harvala-Simmonds H, Hills T, MacLennan S, Menon D, McDyer J, Pridee N, Roberts D, Shankar-Hari M, Thomas H, Tinmouth A, Triulzi D, Walsh T, Wood E, Calfee C, O’Kane C, Shyamsundar M, Sinha P, Thompson T, Young I, Bihari S, Hodgson C, Laffey J, McAuley D, Orford N, Neto A, Detry M, Fitzgerald M, Lewis R, McGlothlin A, Sanil A, Saunders C, Berry L, Lorenzi E, Miller E, Singh V, Zammit C, van Bentum Puijk W, Bouwman W, Mangindaan Y, Parker L, Peters S, Rietveld I, Raymakers K, Ganpat R, Brillinger N, Markgraf R, Ainscough K, Brickell K, Anjum A, Lane JB, Richards-Belle A, Saull M, Wiley D, Bion J, Connor J, Gates S, Manax V, van der Poll T, Reynolds J, van Beurden M, Effelaar E, Schotsman J, Boyd C, Harland C, Shearer A, Wren J, Clermont G, Garrard W, Kalchthaler K, King A, Ricketts D, Malakoutis S, Marroquin O, Music E, Quinn K, Cate H, Pearson K, Collins J, Hanson J, Williams P, Jackson S, Asghar A, Dyas S, Sutu M, Murphy S, Williamson D, Mguni N, Potter A, Porter D, Goodwin J, Rook C, Harrison S, Williams H, Campbell H, Lomme K, Williamson J, Sheffield J, van’t Hoff W, McCracken P, Young M, Board J, Mart E, Knott C, Smith J, Boschert C, Affleck J, Ramanan M, D’Souza R, Pateman K, Shakih A, Cheung W, Kol M, Wong H, Shah A, Wagh A, Simpson J, Duke G, Chan P, Cartner B, Hunter S, Laver R, Shrestha T, Regli A, Pellicano A, McCullough J, Tallott M, Kumar N, Panwar R, Brinkerhoff G, Koppen C, Cazzola F, Brain M, Mineall S, Fischer R, Biradar V, Soar N, White H, Estensen K, Morrison L, Smith J, Cooper M, Health M, Shehabi Y, Al-Bassam W, Hulley A, Whitehead C, Lowrey J, Gresha R, Walsham J, Meyer J, Harward M, Venz E, Williams P, Kurenda C, Smith K, Smith M, Garcia R, Barge D, Byrne D, Byrne K, Driscoll A, Fortune L, Janin P, Yarad E, Hammond N, Bass F, Ashelford A, Waterson S, Wedd S, McNamara R, Buhr H, Coles J, Schweikert S, Wibrow B, Rauniyar R, Myers E, Fysh E, Dawda A, Mevavala B, Litton E, Ferrier J, Nair P, Buscher H, Reynolds C, Santamaria J, Barbazza L, Homes J, Smith R, Murray L, Brailsford J, Forbes L, Maguire T, Mariappa V, Smith J, Simpson S, Maiden M, Bone A, Horton M, Salerno T, Sterba M, Geng W, Depuydt P, De Waele J, De Bus L, Fierens J, Bracke S, Reeve B, Dechert W, Chassé M, Carrier FM, Boumahni D, Benettaib F, Ghamraoui A, Bellemare D, Cloutier È, Francoeur C, Lamontagne F, D’Aragon F, Carbonneau E, Leblond J, Vazquez-Grande G, Marten N, Wilson M, Albert M, Serri K, Cavayas A, Duplaix M, Williams V, Rochwerg B, Karachi T, Oczkowski S, Centofanti J, Millen T, Duan E, Tsang J, Patterson L, English S, Watpool I, Porteous R, Miezitis S, McIntyre L, Brochard L, Burns K, Sandhu G, Khalid I, Binnie A, Powell E, McMillan A, Luk T, Aref N, Andric Z, Cviljevic S, Đimoti R, Zapalac M, Mirković G, Baršić B, Kutleša M, Kotarski V, Vujaklija Brajković A, Babel J, Sever H, Dragija L, Kušan I, Vaara S, Pettilä L, Heinonen J, Kuitunen A, Karlsson S, Vahtera A, Kiiski H, Ristimäki S, Azaiz A, Charron C, Godement M, Geri G, Vieillard-Baron A, Pourcine F, Monchi M, Luis D, Mercier R, Sagnier A, Verrier N, Caplin C, Siami S, Aparicio C, Vautier S, Jeblaoui A, Fartoukh M, Courtin L, Labbe V, Leparco C, Muller G, Nay MA, Kamel T, Benzekri D, Jacquier S, Mercier E, Chartier D, Salmon C, Dequin P, Schneider F, Morel G, L’Hotellier S, Badie J, Berdaguer FD, Malfroy S, Mezher C, Bourgoin C, Megarbane B, Voicu S, Deye N, Malissin I, Sutterlin L, Guitton C, Darreau C, Landais M, Chudeau N, Robert A, Moine P, Heming N, Maxime V, Bossard I, Nicholier TB, Colin G, Zinzoni V, Maquigneau N, Finn A, Kreß G, Hoff U, Friedrich Hinrichs C, Nee J, Pletz M, Hagel S, Ankert J, Kolanos S, Bloos F, Petros S, Pasieka B, Kunz K, Appelt P, Schütze B, Kluge S, Nierhaus A, Jarczak D, Roedl K, Weismann D, Frey A, Klinikum Neukölln V, Reill L, Distler M, Maselli A, Bélteczki J, Magyar I, Fazekas Á, Kovács S, Szőke V, Szigligeti G, Leszkoven J, Collins D, Breen P, Frohlich S, Whelan R, McNicholas B, Scully M, Casey S, Kernan M, Doran P, O’Dywer M, Smyth M, Hayes L, Hoiting O, Peters M, Rengers E, Evers M, Prinssen A, Bosch Ziekenhuis J, Simons K, Rozendaal W, Polderman F, de Jager P, Moviat M, Paling A, Salet A, Rademaker E, Peters AL, de Jonge E, Wigbers J, Guilder E, Butler M, Cowdrey KA, Newby L, Chen Y, Simmonds C, McConnochie R, Ritzema Carter J, Henderson S, Van Der Heyden K, Mehrtens J, Williams T, Kazemi A, Song R, Lai V, Girijadevi D, Everitt R, Russell R, Hacking D, Buehner U, Williams E, Browne T, Grimwade K, Goodson J, Keet O, Callender O, Martynoga R, Trask K, Butler A, Schischka L, Young C, Lesona E, Olatunji S, Robertson Y, José N, Amaro dos Santos Catorze T, de Lima Pereira TNA, Neves Pessoa LM, Castro Ferreira RM, Pereira Sousa Bastos JM, Aysel Florescu S, Stanciu D, Zaharia MF, Kosa AG, Codreanu D, Marabi Y, Al Qasim E, Moneer Hagazy M, Al Swaidan L, Arishi H, Muñoz-Bermúdez R, Marin-Corral J, Salazar Degracia A, Parrilla Gómez F, Mateo López MI, Rodriguez Fernandez J, Cárcel Fernández S, Carmona Flores R, León López R, de la Fuente Martos C, Allan A, Polgarova P, Farahi N, McWilliam S, Hawcutt D, Rad L, O’Malley L, Whitbread J, Kelsall O, Wild L, Thrush J, Wood H, Austin K, Donnelly A, Kelly M, O’Kane S, McClintock D, Warnock M, Johnston P, Gallagher LJ, Mc Goldrick C, Mc Master M, Strzelecka A, Jha R, Kalogirou M, Ellis C, Krishnamurthy V, Deelchand V, Silversides J, McGuigan P, Ward K, O’Neill A, Finn S, Phillips B, Mullan D, Oritz-Ruiz de Gordoa L, Thomas M, Sweet K, Grimmer L, Johnson R, Pinnell J, Robinson M, Gledhill L, Wood T, Morgan M, Cole J, Hill H, Davies M, Antcliffe D, Templeton M, Rojo R, Coghlan P, Smee J, Mackay E, Cort J, Whileman A, Spencer T, Spittle N, Kasipandian V, Patel A, Allibone S, Genetu RM, Ramali M, Ghosh A, Bamford P, London E, Cawley K, Faulkner M, Jeffrey H, Smith T, Brewer C, Gregory J, Limb J, Cowton A, O’Brien J, Nikitas N, Wells C, Lankester L, Pulletz M, Williams P, Birch J, Wiseman S, Horton S, Alegria A, Turki S, Elsefi T, Crisp N, Allen L, McCullagh I, Robinson P, Hays C, Babio-Galan M, Stevenson H, Khare D, Pinder M, Selvamoni S, Gopinath A, Pugh R, Menzies D, Mackay C, Allan E, Davies G, Puxty K, McCue C, Cathcart S, Hickey N, Ireland J, Yusuff H, Isgro G, Brightling C, Bourne M, Craner M, Watters M, Prout R, Davies L, Pegler S, Kyeremeh L, Arbane G, Wilson K, Gomm L, Francia F, Brett S, Sousa Arias S, Elin Hall R, Budd J, Small C, Birch J, Collins E, Henning J, Bonner S, Hugill K, Cirstea E, Wilkinson D, Karlikowski M, Sutherland H, Wilhelmsen E, Woods J, North J, Sundaran D, Hollos L, Coburn S, Walsh J, Turns M, Hopkins P, Smith J, Noble H, Depante MT, Clarey E, Laha S, Verlander M, Williams A, Huckle A, Hall A, Cooke J, Gardiner-Hill C, Maloney C, Qureshi H, Flint N, Nicholson S, Southin S, Nicholson A, Borgatta B, Turner-Bone I, Reddy A, Wilding L, Chamara Warnapura L, Agno Sathianathan R, Golden D, Hart C, Jones J, Bannard-Smith J, Henry J, Birchall K, Pomeroy F, Quayle R, Makowski A, Misztal B, Ahmed I, KyereDiabour T, Naiker K, Stewart R, Mwaura E, Mew L, Wren L, Willams F, Innes R, Doble P, Hutter J, Shovelton C, Plumb B, Szakmany T, Hamlyn V, Hawkins N, Lewis S, Dell A, Gopal S, Ganguly S, Smallwood A, Harris N, Metherell S, Lazaro JM, Newman T, Fletcher S, Nortje J, Fottrell-Gould D, Randell G, Zaman M, Elmahi E, Jones A, Hall K, Mills G, Ryalls K, Bowler H, Sall J, Bourne R, Borrill Z, Duncan T, Lamb T, Shaw J, Fox C, Moreno Cuesta J, Xavier K, Purohit D, Elhassan M, Bakthavatsalam D, Rowland M, Hutton P, Bashyal A, Davidson N, Hird C, Chhablani M, Phalod G, Kirkby A, Archer S, Netherton K, Reschreiter H, Camsooksai J, Patch S, Jenkins S, Pogson D, Rose S, Daly Z, Brimfield L, Claridge H, Parekh D, Bergin C, Bates M, Dasgin J, McGhee C, Sim M, Hay SK, Henderson S, Phull MK, Zaidi A, Pogreban T, Rosaroso LP, Harvey D, Lowe B, Meredith M, Ryan L, Hormis A, Walker R, Collier D, Kimpton S, Oakley S, Rooney K, Rodden N, Hughes E, Thomson N, McGlynn D, Walden A, Jacques N, Coles H, Tilney E, Vowell E, Schuster-Bruce M, Pitts S, Miln R, Purandare L, Vamplew L, Spivey M, Bean S, Burt K, Moore L, Day C, Gibson C, Gordon E, Zitter L, Keenan S, Baker E, Cherian S, Cutler S, Roynon-Reed A, Harrington K, Raithatha A, Bauchmuller K, Ahmad N, Grecu I, Trodd D, Martin J, Wrey Brown C, Arias AM, Craven T, Hope D, Singleton J, Clark S, Rae N, Welters I, Hamilton DO, Williams K, Waugh V, Shaw D, Puthucheary Z, Martin T, Santos F, Uddin R, Somerville A, Tatham KC, Jhanji S, Black E, Dela Rosa A, Howle R, Tully R, Drummond A, Dearden J, Philbin J, Munt S, Vuylsteke A, Chan C, Victor S, Matsa R, Gellamucho M, Creagh-Brown B, Tooley J, Montague L, De Beaux F, Bullman L, Kersiake I, Demetriou C, Mitchard S, Ramos L, White K, Donnison P, Johns M, Casey R, Mattocks L, Salisbury S, Dark P, Claxton A, McLachlan D, Slevin K, Lee S, Hulme J, Joseph S, Kinney F, Senya HJ, Oborska A, Kayani A, Hadebe B, Orath Prabakaran R, Nichols L, Thomas M, Worner R, Faulkner B, Gendall E, Hayes K, Hamilton-Davies C, Chan C, Mfuko C, Abbass H, Mandadapu V, Leaver S, Forton D, Patel K, Paramasivam E, Powell M, Gould R, Wilby E, Howcroft C, Banach D, Fernández de Pinedo Artaraz Z, Cabreros L, White I, Croft M, Holland N, Pereira R, Zaki A, Johnson D, Jackson M, Garrard H, Juhaz V, Roy A, Rostron A, Woods L, Cornell S, Pillai S, Harford R, Rees T, Ivatt H, Sundara Raman A, Davey M, Lee K, Barber R, Chablani M, Brohi F, Jagannathan V, Clark M, Purvis S, Wetherill B, Dushianthan A, Cusack R, de Courcy-Golder K, Smith S, Jackson S, Attwood B, Parsons P, Page V, Zhao XB, Oza D, Rhodes J, Anderson T, Morris S, Xia Le Tai C, Thomas A, Keen A, Digby S, Cowley N, Wild L, Southern D, Reddy H, Campbell A, Watkins C, Smuts S, Touma O, Barnes N, Alexander P, Felton T, Ferguson S, Sellers K, Bradley-Potts J, Yates D, Birkinshaw I, Kell K, Marshall N, Carr-Knott L, Summers C. Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial. JAMA 2020. [PMID: 32876697 DOI: 10.1001/jama.2020.1702221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. OBJECTIVE To determine whether hydrocortisone improves outcome for patients with severe COVID-19. DESIGN, SETTING, AND PARTICIPANTS An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. INTERVENTIONS The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). MAIN OUTCOMES AND MEASURES The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). RESULTS After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. CONCLUSIONS AND RELEVANCE Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02735707.
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Affiliation(s)
- Derek C Angus
- The Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- The UPMC Health System Office of Healthcare Innovation, Pittsburgh, Pennsylvania
| | - Lennie Derde
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
- Intensive Care Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Farah Al-Beidh
- Division of Anaesthetics, Pain Medicine and Intensive Care Medicine, Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Djillali Annane
- Intensive Care Unit, Raymond Poincaré Hospital (AP-HP), Paris, France
- Simone Veil School of Medicine, University of Versailles, Versailles, France
- University Paris Saclay, Garches, France
| | - Yaseen Arabi
- Intensive Care Department, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Abigail Beane
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Wilma van Bentum-Puijk
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Zahra Bhimani
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Marc Bonten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Charlotte Bradbury
- Bristol Royal Informatory, Bristol, United Kingdom
- University of Bristol, Bristol, United Kingdom
| | - Frank Brunkhorst
- Center for Clinical Studies and Center for Sepsis Control and Care (CSCC), Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany
| | - Meredith Buxton
- Global Coalition for Adaptive Research, San Francisco, California
| | - Adrian Buzgau
- Helix, Monash University, Melbourne, Victoria, Australia
| | - Allen C Cheng
- Infection Prevention and Healthcare Epidemiology Unit, Alfred Health, Melbourne, Victoria, Australia
- Australian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Menno de Jong
- Department of Medical Microbiology, Amsterdam University Medical Center, University of Amsterdam, the Netherlands
| | | | - Lise Estcourt
- NHS Blood and Transplant, Bristol, United Kingdom
- Transfusion Medicine, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
| | | | - Herman Goossens
- Department of Microbiology, Antwerp University Hospital, Antwerp, Belgium
| | - Cameron Green
- Australian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rashan Haniffa
- Network for Improving Critical Care Systems and Training, Colombo, Sri Lanka
- Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - Alisa M Higgins
- Australian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Christopher Horvat
- The Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- The UPMC Health System Office of Healthcare Innovation, Pittsburgh, Pennsylvania
| | - Sebastiaan J Hullegie
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Peter Kruger
- Intensive Care Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | | | - Patrick R Lawler
- Cardiac Intensive Care Unit, Peter Munk Cardiac Centre, University Health Network, Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kelsey Linstrum
- The Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Edward Litton
- School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia
| | | | - John Marshall
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
- Interdepartmental Division of Critical Care, University of Toronto, Toronto, Ontario, Canada
| | - Daniel McAuley
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | | | - Shay McGuinness
- Australian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital, Auckland, New Zealand
- The Health Research Council of New Zealand, Wellington, New Zealand
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Bryan McVerry
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Stephanie Montgomery
- The Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- The UPMC Health System Office of Healthcare Innovation, Pittsburgh, Pennsylvania
| | - Paul Mouncey
- Clinical Trials Unit, Intensive Care National Audit & Research Centre (ICNARC), London, United Kingdom
| | - Srinivas Murthy
- University of British Columbia School of Medicine, Vancouver, Canada
| | - Alistair Nichol
- Australian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Anesthesia and Intensive Care, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
- Department of Intensive Care, Alfred Health, Melbourne, Victoria, Australia
| | - Rachael Parke
- Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital, Auckland, New Zealand
- The Health Research Council of New Zealand, Wellington, New Zealand
- Medical Research Institute of New Zealand, Wellington, New Zealand
- School of Nursing, University of Auckland, Auckland, New Zealand
| | - Jane Parker
- Australian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Kathryn Rowan
- Clinical Trials Unit, Intensive Care National Audit & Research Centre (ICNARC), London, United Kingdom
| | | | - Marlene Santos
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | | | - Christopher Seymour
- The Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- The UPMC Health System Office of Healthcare Innovation, Pittsburgh, Pennsylvania
| | - Anne Turner
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Frank van de Veerdonk
- Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Balasubramanian Venkatesh
- Southside Clinical Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- The George Institute for Global Health, Sydney, Australia
| | - Ryan Zarychanski
- Department of Medicine, Critical Care and Hematology/Medical Oncology, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Roger J Lewis
- Berry Consultants LLC, Austin, Texas
- Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, California
- Department of Emergency Medicine, David Geffen School of Medicine at University of California, Los Angeles
| | - Colin McArthur
- Medical Research Institute of New Zealand, Wellington, New Zealand
- Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand
| | - Steven A Webb
- Australian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia
- St John of God Hospital, Subiaco, Western Australia, Australia
| | - Anthony C Gordon
- Division of Anaesthetics, Pain Medicine and Intensive Care Medicine, Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare NHS Trust, London, United Kingdom
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Angus DC, Derde L, Al-Beidh F, Annane D, Arabi Y, Beane A, van Bentum-Puijk W, Berry L, Bhimani Z, Bonten M, Bradbury C, Brunkhorst F, Buxton M, Buzgau A, Cheng AC, de Jong M, Detry M, Estcourt L, Fitzgerald M, Goossens H, Green C, Haniffa R, Higgins AM, Horvat C, Hullegie SJ, Kruger P, Lamontagne F, Lawler PR, Linstrum K, Litton E, Lorenzi E, Marshall J, McAuley D, McGlothin A, McGuinness S, McVerry B, Montgomery S, Mouncey P, Murthy S, Nichol A, Parke R, Parker J, Rowan K, Sanil A, Santos M, Saunders C, Seymour C, Turner A, van de Veerdonk F, Venkatesh B, Zarychanski R, Berry S, Lewis RJ, McArthur C, Webb SA, Gordon AC, Al-Beidh F, Angus D, Annane D, Arabi Y, van Bentum-Puijk W, Berry S, Beane A, Bhimani Z, Bonten M, Bradbury C, Brunkhorst F, Buxton M, Cheng A, De Jong M, Derde L, Estcourt L, Goossens H, Gordon A, Green C, Haniffa R, Lamontagne F, Lawler P, Litton E, Marshall J, McArthur C, McAuley D, McGuinness S, McVerry B, Montgomery S, Mouncey P, Murthy S, Nichol A, Parke R, Rowan K, Seymour C, Turner A, van de Veerdonk F, Webb S, Zarychanski R, Campbell L, Forbes A, Gattas D, Heritier S, Higgins L, Kruger P, Peake S, Presneill J, Seppelt I, Trapani T, Young P, Bagshaw S, Daneman N, Ferguson N, Misak C, Santos M, Hullegie S, Pletz M, Rohde G, Rowan K, Alexander B, Basile K, Girard T, Horvat C, Huang D, Linstrum K, Vates J, Beasley R, Fowler R, McGloughlin S, Morpeth S, Paterson D, Venkatesh B, Uyeki T, Baillie K, Duffy E, Fowler R, Hills T, Orr K, Patanwala A, Tong S, Netea M, Bihari S, Carrier M, Fergusson D, Goligher E, Haidar G, Hunt B, Kumar A, Laffan M, Lawless P, Lother S, McCallum P, Middeldopr S, McQuilten Z, Neal M, Pasi J, Schutgens R, Stanworth S, Turgeon A, Weissman A, Adhikari N, Anstey M, Brant E, de Man A, Lamonagne F, Masse MH, Udy A, Arnold D, Begin P, Charlewood R, Chasse M, Coyne M, Cooper J, Daly J, Gosbell I, Harvala-Simmonds H, Hills T, MacLennan S, Menon D, McDyer J, Pridee N, Roberts D, Shankar-Hari M, Thomas H, Tinmouth A, Triulzi D, Walsh T, Wood E, Calfee C, O’Kane C, Shyamsundar M, Sinha P, Thompson T, Young I, Bihari S, Hodgson C, Laffey J, McAuley D, Orford N, Neto A, Detry M, Fitzgerald M, Lewis R, McGlothlin A, Sanil A, Saunders C, Berry L, Lorenzi E, Miller E, Singh V, Zammit C, van Bentum Puijk W, Bouwman W, Mangindaan Y, Parker L, Peters S, Rietveld I, Raymakers K, Ganpat R, Brillinger N, Markgraf R, Ainscough K, Brickell K, Anjum A, Lane JB, Richards-Belle A, Saull M, Wiley D, Bion J, Connor J, Gates S, Manax V, van der Poll T, Reynolds J, van Beurden M, Effelaar E, Schotsman J, Boyd C, Harland C, Shearer A, Wren J, Clermont G, Garrard W, Kalchthaler K, King A, Ricketts D, Malakoutis S, Marroquin O, Music E, Quinn K, Cate H, Pearson K, Collins J, Hanson J, Williams P, Jackson S, Asghar A, Dyas S, Sutu M, Murphy S, Williamson D, Mguni N, Potter A, Porter D, Goodwin J, Rook C, Harrison S, Williams H, Campbell H, Lomme K, Williamson J, Sheffield J, van’t Hoff W, McCracken P, Young M, Board J, Mart E, Knott C, Smith J, Boschert C, Affleck J, Ramanan M, D’Souza R, Pateman K, Shakih A, Cheung W, Kol M, Wong H, Shah A, Wagh A, Simpson J, Duke G, Chan P, Cartner B, Hunter S, Laver R, Shrestha T, Regli A, Pellicano A, McCullough J, Tallott M, Kumar N, Panwar R, Brinkerhoff G, Koppen C, Cazzola F, Brain M, Mineall S, Fischer R, Biradar V, Soar N, White H, Estensen K, Morrison L, Smith J, Cooper M, Health M, Shehabi Y, Al-Bassam W, Hulley A, Whitehead C, Lowrey J, Gresha R, Walsham J, Meyer J, Harward M, Venz E, Williams P, Kurenda C, Smith K, Smith M, Garcia R, Barge D, Byrne D, Byrne K, Driscoll A, Fortune L, Janin P, Yarad E, Hammond N, Bass F, Ashelford A, Waterson S, Wedd S, McNamara R, Buhr H, Coles J, Schweikert S, Wibrow B, Rauniyar R, Myers E, Fysh E, Dawda A, Mevavala B, Litton E, Ferrier J, Nair P, Buscher H, Reynolds C, Santamaria J, Barbazza L, Homes J, Smith R, Murray L, Brailsford J, Forbes L, Maguire T, Mariappa V, Smith J, Simpson S, Maiden M, Bone A, Horton M, Salerno T, Sterba M, Geng W, Depuydt P, De Waele J, De Bus L, Fierens J, Bracke S, Reeve B, Dechert W, Chassé M, Carrier FM, Boumahni D, Benettaib F, Ghamraoui A, Bellemare D, Cloutier È, Francoeur C, Lamontagne F, D’Aragon F, Carbonneau E, Leblond J, Vazquez-Grande G, Marten N, Wilson M, Albert M, Serri K, Cavayas A, Duplaix M, Williams V, Rochwerg B, Karachi T, Oczkowski S, Centofanti J, Millen T, Duan E, Tsang J, Patterson L, English S, Watpool I, Porteous R, Miezitis S, McIntyre L, Brochard L, Burns K, Sandhu G, Khalid I, Binnie A, Powell E, McMillan A, Luk T, Aref N, Andric Z, Cviljevic S, Đimoti R, Zapalac M, Mirković G, Baršić B, Kutleša M, Kotarski V, Vujaklija Brajković A, Babel J, Sever H, Dragija L, Kušan I, Vaara S, Pettilä L, Heinonen J, Kuitunen A, Karlsson S, Vahtera A, Kiiski H, Ristimäki S, Azaiz A, Charron C, Godement M, Geri G, Vieillard-Baron A, Pourcine F, Monchi M, Luis D, Mercier R, Sagnier A, Verrier N, Caplin C, Siami S, Aparicio C, Vautier S, Jeblaoui A, Fartoukh M, Courtin L, Labbe V, Leparco C, Muller G, Nay MA, Kamel T, Benzekri D, Jacquier S, Mercier E, Chartier D, Salmon C, Dequin P, Schneider F, Morel G, L’Hotellier S, Badie J, Berdaguer FD, Malfroy S, Mezher C, Bourgoin C, Megarbane B, Voicu S, Deye N, Malissin I, Sutterlin L, Guitton C, Darreau C, Landais M, Chudeau N, Robert A, Moine P, Heming N, Maxime V, Bossard I, Nicholier TB, Colin G, Zinzoni V, Maquigneau N, Finn A, Kreß G, Hoff U, Friedrich Hinrichs C, Nee J, Pletz M, Hagel S, Ankert J, Kolanos S, Bloos F, Petros S, Pasieka B, Kunz K, Appelt P, Schütze B, Kluge S, Nierhaus A, Jarczak D, Roedl K, Weismann D, Frey A, Klinikum Neukölln V, Reill L, Distler M, Maselli A, Bélteczki J, Magyar I, Fazekas Á, Kovács S, Szőke V, Szigligeti G, Leszkoven J, Collins D, Breen P, Frohlich S, Whelan R, McNicholas B, Scully M, Casey S, Kernan M, Doran P, O’Dywer M, Smyth M, Hayes L, Hoiting O, Peters M, Rengers E, Evers M, Prinssen A, Bosch Ziekenhuis J, Simons K, Rozendaal W, Polderman F, de Jager P, Moviat M, Paling A, Salet A, Rademaker E, Peters AL, de Jonge E, Wigbers J, Guilder E, Butler M, Cowdrey KA, Newby L, Chen Y, Simmonds C, McConnochie R, Ritzema Carter J, Henderson S, Van Der Heyden K, Mehrtens J, Williams T, Kazemi A, Song R, Lai V, Girijadevi D, Everitt R, Russell R, Hacking D, Buehner U, Williams E, Browne T, Grimwade K, Goodson J, Keet O, Callender O, Martynoga R, Trask K, Butler A, Schischka L, Young C, Lesona E, Olatunji S, Robertson Y, José N, Amaro dos Santos Catorze T, de Lima Pereira TNA, Neves Pessoa LM, Castro Ferreira RM, Pereira Sousa Bastos JM, Aysel Florescu S, Stanciu D, Zaharia MF, Kosa AG, Codreanu D, Marabi Y, Al Qasim E, Moneer Hagazy M, Al Swaidan L, Arishi H, Muñoz-Bermúdez R, Marin-Corral J, Salazar Degracia A, Parrilla Gómez F, Mateo López MI, Rodriguez Fernandez J, Cárcel Fernández S, Carmona Flores R, León López R, de la Fuente Martos C, Allan A, Polgarova P, Farahi N, McWilliam S, Hawcutt D, Rad L, O’Malley L, Whitbread J, Kelsall O, Wild L, Thrush J, Wood H, Austin K, Donnelly A, Kelly M, O’Kane S, McClintock D, Warnock M, Johnston P, Gallagher LJ, Mc Goldrick C, Mc Master M, Strzelecka A, Jha R, Kalogirou M, Ellis C, Krishnamurthy V, Deelchand V, Silversides J, McGuigan P, Ward K, O’Neill A, Finn S, Phillips B, Mullan D, Oritz-Ruiz de Gordoa L, Thomas M, Sweet K, Grimmer L, Johnson R, Pinnell J, Robinson M, Gledhill L, Wood T, Morgan M, Cole J, Hill H, Davies M, Antcliffe D, Templeton M, Rojo R, Coghlan P, Smee J, Mackay E, Cort J, Whileman A, Spencer T, Spittle N, Kasipandian V, Patel A, Allibone S, Genetu RM, Ramali M, Ghosh A, Bamford P, London E, Cawley K, Faulkner M, Jeffrey H, Smith T, Brewer C, Gregory J, Limb J, Cowton A, O’Brien J, Nikitas N, Wells C, Lankester L, Pulletz M, Williams P, Birch J, Wiseman S, Horton S, Alegria A, Turki S, Elsefi T, Crisp N, Allen L, McCullagh I, Robinson P, Hays C, Babio-Galan M, Stevenson H, Khare D, Pinder M, Selvamoni S, Gopinath A, Pugh R, Menzies D, Mackay C, Allan E, Davies G, Puxty K, McCue C, Cathcart S, Hickey N, Ireland J, Yusuff H, Isgro G, Brightling C, Bourne M, Craner M, Watters M, Prout R, Davies L, Pegler S, Kyeremeh L, Arbane G, Wilson K, Gomm L, Francia F, Brett S, Sousa Arias S, Elin Hall R, Budd J, Small C, Birch J, Collins E, Henning J, Bonner S, Hugill K, Cirstea E, Wilkinson D, Karlikowski M, Sutherland H, Wilhelmsen E, Woods J, North J, Sundaran D, Hollos L, Coburn S, Walsh J, Turns M, Hopkins P, Smith J, Noble H, Depante MT, Clarey E, Laha S, Verlander M, Williams A, Huckle A, Hall A, Cooke J, Gardiner-Hill C, Maloney C, Qureshi H, Flint N, Nicholson S, Southin S, Nicholson A, Borgatta B, Turner-Bone I, Reddy A, Wilding L, Chamara Warnapura L, Agno Sathianathan R, Golden D, Hart C, Jones J, Bannard-Smith J, Henry J, Birchall K, Pomeroy F, Quayle R, Makowski A, Misztal B, Ahmed I, KyereDiabour T, Naiker K, Stewart R, Mwaura E, Mew L, Wren L, Willams F, Innes R, Doble P, Hutter J, Shovelton C, Plumb B, Szakmany T, Hamlyn V, Hawkins N, Lewis S, Dell A, Gopal S, Ganguly S, Smallwood A, Harris N, Metherell S, Lazaro JM, Newman T, Fletcher S, Nortje J, Fottrell-Gould D, Randell G, Zaman M, Elmahi E, Jones A, Hall K, Mills G, Ryalls K, Bowler H, Sall J, Bourne R, Borrill Z, Duncan T, Lamb T, Shaw J, Fox C, Moreno Cuesta J, Xavier K, Purohit D, Elhassan M, Bakthavatsalam D, Rowland M, Hutton P, Bashyal A, Davidson N, Hird C, Chhablani M, Phalod G, Kirkby A, Archer S, Netherton K, Reschreiter H, Camsooksai J, Patch S, Jenkins S, Pogson D, Rose S, Daly Z, Brimfield L, Claridge H, Parekh D, Bergin C, Bates M, Dasgin J, McGhee C, Sim M, Hay SK, Henderson S, Phull MK, Zaidi A, Pogreban T, Rosaroso LP, Harvey D, Lowe B, Meredith M, Ryan L, Hormis A, Walker R, Collier D, Kimpton S, Oakley S, Rooney K, Rodden N, Hughes E, Thomson N, McGlynn D, Walden A, Jacques N, Coles H, Tilney E, Vowell E, Schuster-Bruce M, Pitts S, Miln R, Purandare L, Vamplew L, Spivey M, Bean S, Burt K, Moore L, Day C, Gibson C, Gordon E, Zitter L, Keenan S, Baker E, Cherian S, Cutler S, Roynon-Reed A, Harrington K, Raithatha A, Bauchmuller K, Ahmad N, Grecu I, Trodd D, Martin J, Wrey Brown C, Arias AM, Craven T, Hope D, Singleton J, Clark S, Rae N, Welters I, Hamilton DO, Williams K, Waugh V, Shaw D, Puthucheary Z, Martin T, Santos F, Uddin R, Somerville A, Tatham KC, Jhanji S, Black E, Dela Rosa A, Howle R, Tully R, Drummond A, Dearden J, Philbin J, Munt S, Vuylsteke A, Chan C, Victor S, Matsa R, Gellamucho M, Creagh-Brown B, Tooley J, Montague L, De Beaux F, Bullman L, Kersiake I, Demetriou C, Mitchard S, Ramos L, White K, Donnison P, Johns M, Casey R, Mattocks L, Salisbury S, Dark P, Claxton A, McLachlan D, Slevin K, Lee S, Hulme J, Joseph S, Kinney F, Senya HJ, Oborska A, Kayani A, Hadebe B, Orath Prabakaran R, Nichols L, Thomas M, Worner R, Faulkner B, Gendall E, Hayes K, Hamilton-Davies C, Chan C, Mfuko C, Abbass H, Mandadapu V, Leaver S, Forton D, Patel K, Paramasivam E, Powell M, Gould R, Wilby E, Howcroft C, Banach D, Fernández de Pinedo Artaraz Z, Cabreros L, White I, Croft M, Holland N, Pereira R, Zaki A, Johnson D, Jackson M, Garrard H, Juhaz V, Roy A, Rostron A, Woods L, Cornell S, Pillai S, Harford R, Rees T, Ivatt H, Sundara Raman A, Davey M, Lee K, Barber R, Chablani M, Brohi F, Jagannathan V, Clark M, Purvis S, Wetherill B, Dushianthan A, Cusack R, de Courcy-Golder K, Smith S, Jackson S, Attwood B, Parsons P, Page V, Zhao XB, Oza D, Rhodes J, Anderson T, Morris S, Xia Le Tai C, Thomas A, Keen A, Digby S, Cowley N, Wild L, Southern D, Reddy H, Campbell A, Watkins C, Smuts S, Touma O, Barnes N, Alexander P, Felton T, Ferguson S, Sellers K, Bradley-Potts J, Yates D, Birkinshaw I, Kell K, Marshall N, Carr-Knott L, Summers C. Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial. JAMA 2020; 324:1317-1329. [PMID: 32876697 PMCID: PMC7489418 DOI: 10.1001/jama.2020.17022] [Citation(s) in RCA: 542] [Impact Index Per Article: 135.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
IMPORTANCE Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. OBJECTIVE To determine whether hydrocortisone improves outcome for patients with severe COVID-19. DESIGN, SETTING, AND PARTICIPANTS An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. INTERVENTIONS The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). MAIN OUTCOMES AND MEASURES The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). RESULTS After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. CONCLUSIONS AND RELEVANCE Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02735707.
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Affiliation(s)
- Derek C Angus
- The Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- The UPMC Health System Office of Healthcare Innovation, Pittsburgh, Pennsylvania
| | - Lennie Derde
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
- Intensive Care Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Farah Al-Beidh
- Division of Anaesthetics, Pain Medicine and Intensive Care Medicine, Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Djillali Annane
- Intensive Care Unit, Raymond Poincaré Hospital (AP-HP), Paris, France
- Simone Veil School of Medicine, University of Versailles, Versailles, France
- University Paris Saclay, Garches, France
| | - Yaseen Arabi
- Intensive Care Department, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Abigail Beane
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Wilma van Bentum-Puijk
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Zahra Bhimani
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Marc Bonten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Charlotte Bradbury
- Bristol Royal Informatory, Bristol, United Kingdom
- University of Bristol, Bristol, United Kingdom
| | - Frank Brunkhorst
- Center for Clinical Studies and Center for Sepsis Control and Care (CSCC), Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany
| | - Meredith Buxton
- Global Coalition for Adaptive Research, San Francisco, California
| | - Adrian Buzgau
- Helix, Monash University, Melbourne, Victoria, Australia
| | - Allen C Cheng
- Infection Prevention and Healthcare Epidemiology Unit, Alfred Health, Melbourne, Victoria, Australia
- Australian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Menno de Jong
- Department of Medical Microbiology, Amsterdam University Medical Center, University of Amsterdam, the Netherlands
| | | | - Lise Estcourt
- NHS Blood and Transplant, Bristol, United Kingdom
- Transfusion Medicine, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
| | | | - Herman Goossens
- Department of Microbiology, Antwerp University Hospital, Antwerp, Belgium
| | - Cameron Green
- Australian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rashan Haniffa
- Network for Improving Critical Care Systems and Training, Colombo, Sri Lanka
- Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - Alisa M Higgins
- Australian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Christopher Horvat
- The Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- The UPMC Health System Office of Healthcare Innovation, Pittsburgh, Pennsylvania
| | - Sebastiaan J Hullegie
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Peter Kruger
- Intensive Care Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | | | - Patrick R Lawler
- Cardiac Intensive Care Unit, Peter Munk Cardiac Centre, University Health Network, Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kelsey Linstrum
- The Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Edward Litton
- School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia
| | | | - John Marshall
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
- Interdepartmental Division of Critical Care, University of Toronto, Toronto, Ontario, Canada
| | - Daniel McAuley
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | | | - Shay McGuinness
- Australian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital, Auckland, New Zealand
- The Health Research Council of New Zealand, Wellington, New Zealand
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Bryan McVerry
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Stephanie Montgomery
- The Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- The UPMC Health System Office of Healthcare Innovation, Pittsburgh, Pennsylvania
| | - Paul Mouncey
- Clinical Trials Unit, Intensive Care National Audit & Research Centre (ICNARC), London, United Kingdom
| | - Srinivas Murthy
- University of British Columbia School of Medicine, Vancouver, Canada
| | - Alistair Nichol
- Australian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Anesthesia and Intensive Care, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
- Department of Intensive Care, Alfred Health, Melbourne, Victoria, Australia
| | - Rachael Parke
- Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital, Auckland, New Zealand
- The Health Research Council of New Zealand, Wellington, New Zealand
- Medical Research Institute of New Zealand, Wellington, New Zealand
- School of Nursing, University of Auckland, Auckland, New Zealand
| | - Jane Parker
- Australian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Kathryn Rowan
- Clinical Trials Unit, Intensive Care National Audit & Research Centre (ICNARC), London, United Kingdom
| | | | - Marlene Santos
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | | | - Christopher Seymour
- The Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- The UPMC Health System Office of Healthcare Innovation, Pittsburgh, Pennsylvania
| | - Anne Turner
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Frank van de Veerdonk
- Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Balasubramanian Venkatesh
- Southside Clinical Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- The George Institute for Global Health, Sydney, Australia
| | - Ryan Zarychanski
- Department of Medicine, Critical Care and Hematology/Medical Oncology, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Roger J Lewis
- Berry Consultants LLC, Austin, Texas
- Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, California
- Department of Emergency Medicine, David Geffen School of Medicine at University of California, Los Angeles
| | - Colin McArthur
- Medical Research Institute of New Zealand, Wellington, New Zealand
- Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand
| | - Steven A Webb
- Australian and New Zealand Intensive Care Research Centre, School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia
- St John of God Hospital, Subiaco, Western Australia, Australia
| | - Anthony C Gordon
- Division of Anaesthetics, Pain Medicine and Intensive Care Medicine, Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare NHS Trust, London, United Kingdom
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16
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Nobili L, de Weerd A, Rubboli G, Beniczky S, Derry C, Eriksson S, Halasz P, Högl B, Santamaria J, Khatami R, Ryvlin P, Rémi J, Tinuper P, Bassetti C, Manni R, Koutroumanidis M, Vignatelli L. Standard procedures for the diagnostic pathway of sleep-related epilepsies and comorbid sleep disorders: an EAN, ESRS and ILAE-Europe consensus review. Eur J Neurol 2020; 28:15-32. [PMID: 32959446 DOI: 10.1111/ene.14468] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 08/01/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND PURPOSE Some epilepsy syndromes (sleep-related epilepsies, SREs) have a strong link with sleep. Comorbid sleep disorders are common in patients with SRE and can exert a negative impact on seizure control and quality of life. Our purpose was to define the standard procedures for the diagnostic pathway of patients with possible SRE (scenario 1) and the general management of patients with SRE and comorbidity with sleep disorders (scenario 2). METHODS The project was conducted under the auspices of the European Academy of Neurology, the European Sleep Research Society and the International League Against Epilepsy Europe. The framework entailed the following phases: conception of the clinical scenarios; literature review; statements regarding the standard procedures. For the literature search a stepwise approach starting from systematic reviews to primary studies was applied. Published studies were identified from the National Library of Medicine's MEDLINE database and Cochrane Library. RESULTS Scenario 1: Despite a low quality of evidence, recommendations on anamnestic evaluation and tools for capturing the event at home or in the laboratory are provided for specific SREs. Scenario 2: Early diagnosis and treatment of sleep disorders (especially respiratory disorders) in patients with SRE are likely to be beneficial for seizure control. CONCLUSIONS Definitive procedures for evaluating patients with SRE are lacking. Advice is provided that could be of help for standardizing and improving the diagnostic approach of specific SREs. The importance of identifying and treating specific sleep disorders for the management and outcome of patients with SRE is underlined.
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Affiliation(s)
- L Nobili
- Child Neuropsychiatry, IRCCS G. Gaslini Institute, Genoa, Italy.,Department of Neuroscience - Rehabilitation - Ophthalmology - Genetics - Child and Maternal Health (DINOGMI), University of Genoa, Italy
| | - A de Weerd
- Stichting Epilepsie Instellingen Nederland, Zwolle, The Netherlands
| | - G Rubboli
- Danish Epilepsy Centre, Dianalund, Denmark.,University of Copenhagen, Copenhagen, Denmark
| | - S Beniczky
- Department of Clinical Neurophysiology, Danish Epilepsy Centre, Dianalund, Denmark.,Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - C Derry
- Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK.,Department of Clinical Neurosciences and Sleep Medicine, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - S Eriksson
- Department of Clinical and Experimental Epilepsy, National Hospital for Neurology and Neurosurgery and Institute of Neurology, University College London, London, UK
| | - P Halasz
- National Institute of Clinical Neuroscience, Budapest, Hungary
| | - B Högl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - J Santamaria
- Multidisciplinary Sleep Unit, Neurology Service, Hospital Clínic, Barcelona, Spain
| | - R Khatami
- Department of Neurology, Inselspital, University of Bern, Bern, Switzerland.,Barmelweid Academy, Center of Sleep Medicine, Sleep Research and Epilepsy, Klinik Barmelweid AG, Barmelweid, Switzerland
| | - P Ryvlin
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - J Rémi
- Epilepsy Center, Department of Neurology, University of Munich Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - P Tinuper
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Ospedale Bellaria, Bologna, Italy
| | - C Bassetti
- Department of Neurology, Inselspital, University of Bern, Bern, Switzerland.,Neurology Department, Sechenov First Moscow State Medical University, Moscow, Russia
| | - R Manni
- Unit of Sleep Medicine and Epilepsy, IRCCS Mondino Foundation, Pavia, Italy
| | - M Koutroumanidis
- Department of Neurology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - L Vignatelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Ospedale Bellaria, Bologna, Italy
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17
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Campabadal A, Inguanzo A, Segura B, Serradell M, Abos A, Uribe C, Gaig C, Santamaria J, Compta Y, Bargallo N, Junque C, Iranzo A. Cortical gray matter progression in idiopathic REM sleep behavior disorder and its relation to cognitive decline. Neuroimage Clin 2020; 28:102421. [PMID: 32957013 PMCID: PMC7509231 DOI: 10.1016/j.nicl.2020.102421] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 09/04/2020] [Accepted: 09/06/2020] [Indexed: 12/24/2022]
Abstract
Cortical degeneration over time in IRBD patients is larger than in normal aging. IRBD patients have progressive parieto-occipital and orbitofrontal thinning. Visuospatial decline in IRBD is associated with degeneration in parietal regions. Increasing motor signs in IRBD are related to frontal and parietal degeneration. Cortical thinning in posterior regions is associated with late-onset IRBD.
Background Idiopathic Rapid eye movement sleep behavior disorder (IRBD) is recognized as the prodromal stage of the alpha-Synucleinopathies. Although some studies have addressed the characterization of brain structure in IRBD, little is known about its progression. Objective The present work aims at further characterizing gray matter progression throughout IRBD relative to normal aging and investigating how these changes are associated with cognitive decline. Methods Fourteen patients with polysomnography-confirmed IRBD and 18 age-matched healthy controls (HC) underwent neuropsychological, olfactory, motor, and T1-weighted MRI evaluation at baseline and follow-up. We compared the evolution of cortical thickness (CTh), subcortical volumes, smell, motor and cognitive performance in IRBD and HC after a mean of 1.6 years. FreeSurfer was used for CTh and volumetry preprocessing and analyses. The symmetrized percent of change (SPC) of the CTh was correlated with the SPC of motor and neuropsychological performance. Results IRBD and HC differed significantly in the cortical thinning progression in regions encompassing bilateral superior parietal and precuneus, the right cuneus, the left occipital pole and lateral orbitofrontal gyri (FWE corrected, p < 0.05). The Visual form discrimination test showed worse progression in the IRBD relative to HC, that was associated with gray matter loss in the right superior parietal and the left precuneus. Increasing motor signs in IRBD were related to cortical thinning mainly involving frontal regions, and late-onset IRBD was associated with cortical thinning involving posterior areas (FWE corrected, p < 0.05). Despite finding olfactory identification deficits in IRBD, results did not show decline over the disease course. Conclusion Progression in IRBD patients is characterized by parieto-occipital and orbitofrontal thinning and visuospatial loss. The cognitive decline in IRBD is associated with degeneration in parietal regions.
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Affiliation(s)
- A Campabadal
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - A Inguanzo
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - B Segura
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII), Barcelona, Spain
| | - M Serradell
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII), Barcelona, Spain; Sleep Disorders Center, Neurology Service, Hospital Clínic, Barcelona, Catalonia, Spain
| | - A Abos
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain
| | - C Uribe
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain
| | - C Gaig
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII), Barcelona, Spain; Sleep Disorders Center, Neurology Service, Hospital Clínic, Barcelona, Catalonia, Spain
| | - J Santamaria
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII), Barcelona, Spain; Sleep Disorders Center, Neurology Service, Hospital Clínic, Barcelona, Catalonia, Spain
| | - Y Compta
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII), Barcelona, Spain; Parkinson's Disease & Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain
| | - N Bargallo
- Centre de Diagnòstic per la Imatge, Hospital Clínic, Barcelona, Catalonia, Spain
| | - C Junque
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII), Barcelona, Spain.
| | - A Iranzo
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII), Barcelona, Spain; Sleep Disorders Center, Neurology Service, Hospital Clínic, Barcelona, Catalonia, Spain
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18
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Campabadal A, Abos A, Segura B, Serradell M, Uribe C, Baggio HC, Gaig C, Santamaria J, Compta Y, Bargallo N, Junque C, Iranzo A. Disruption of posterior brain functional connectivity and its relation to cognitive impairment in idiopathic REM sleep behavior disorder. Neuroimage Clin 2019; 25:102138. [PMID: 31911344 PMCID: PMC6948254 DOI: 10.1016/j.nicl.2019.102138] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 12/16/2019] [Accepted: 12/21/2019] [Indexed: 12/12/2022]
Abstract
There is a reduced brain posterior functional connectivity in IRBD patients. Reduced temporo-parietal connectivity correlates with mental processing slowness. Left superior parietal lobule has reduced centrality in IRBD patients.
Background Resting-state functional MRI has been proposed as a new biomarker of prodromal neurodegenerative disorders, but it has been poorly investigated in the idiopathic form of rapid-eye-movement sleep behavior disorder (IRBD), a clinical harbinger of subsequent synucleinopathy. Particularly, a complex-network approach has not been tested to study brain functional connectivity in IRBD patients. Objectives The aim of the current work is to characterize resting-state functional connectivity in IRBD patients using a complex-network approach and to determine its possible relation to cognitive impairment. Method Twenty patients with IRBD and 27 matched healthy controls (HC) underwent resting-state functional MRI with a 3T scanner and a comprehensive neuropsychological battery. The functional connectome was studied using threshold-free network-based statistics. Global and local network parameters were calculated based on graph theory and compared between groups. Head motion, age and sex were introduced as covariates in all analyses. Results IRBD patients showed reduced cortico-cortical functional connectivity strength in comparison with HC in edges located in posterior regions (p <0.05, FWE corrected). This regional pattern was also shown in an independent analysis comprising posterior areas where a decreased connectivity in 51 edges was found, whereas no significant results were detected when an anterior network was considered (p <0.05, FWE corrected). In the posterior network, the left superior parietal lobule had reduced centrality in IRBD. Functional connectivity strength between left inferior temporal lobe and right superior parietal lobule positively correlated with mental processing speed in IRBD (r = .633; p = .003). No significant correlations were found in the HC group. Conclusion : Our findings support the presence of disrupted posterior functional brain connectivity of IRBD patients similar to that found in synucleinopathies. Moreover, connectivity reductions in IRBD were associated with lower performance in mental processing speed domain.
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Affiliation(s)
- A Campabadal
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona. Barcelona, Catalonia, Spain
| | - A Abos
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona. Barcelona, Catalonia, Spain
| | - B Segura
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona. Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII) Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain
| | - M Serradell
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII) Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain.; Multidisciplinary Sleep Unit, Neurology Service, Hospital Clínic, Barcelona, Catalonia, Spain
| | - C Uribe
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona. Barcelona, Catalonia, Spain
| | - H C Baggio
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona. Barcelona, Catalonia, Spain
| | - C Gaig
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII) Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain.; Multidisciplinary Sleep Unit, Neurology Service, Hospital Clínic, Barcelona, Catalonia, Spain
| | - J Santamaria
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII) Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain.; Multidisciplinary Sleep Unit, Neurology Service, Hospital Clínic, Barcelona, Catalonia, Spain
| | - Y Compta
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII) Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain.; Parkinson's disease & Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona. Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain
| | - N Bargallo
- Centre de Diagnòstic per la Imatge, Hospital Clínic, Barcelona, Catalonia, Spain
| | - C Junque
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona. Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII) Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain..
| | - A Iranzo
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED:CB06/05/0018-ISCIII) Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain.; Multidisciplinary Sleep Unit, Neurology Service, Hospital Clínic, Barcelona, Catalonia, Spain
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19
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Gersel Stokholm M, Iranzo A, Østergaard K, Serradell M, Otto M, Bacher Svendsen K, Garrido A, Vilas D, Fedorova T, Santamaria J, Møller A, Gaig C, Hiraoka K, Brooks D, Okamura N, Borghammer P, Tolosa E, Pavese N. Cholinergic denervation in patients with idiopathic rapid eye movement sleep behaviour disorder. Eur J Neurol 2019; 27:644-652. [DOI: 10.1111/ene.14127] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 11/11/2019] [Indexed: 11/29/2022]
Affiliation(s)
- M. Gersel Stokholm
- Department of Nuclear Medicine & PET Centre Aarhus University Hospital Aarhus Denmark
| | - A. Iranzo
- Department of Neurology Hospital Clínic de Barcelona Barcelona
- Centro de Investigación Biomédica en Red sobre Enfermedades eurodegenerativas (CIBERNED) Hospital Clínic IDIBAPS Universitat de Barcelona Catalonia
- Multidisciplinary Sleep Unit Hospital Clinic Barcelona Spain
| | - K. Østergaard
- Department of Neurology Aarhus University Hospital Aarhus
| | - M. Serradell
- Department of Neurology Hospital Clínic de Barcelona Barcelona
- Multidisciplinary Sleep Unit Hospital Clinic Barcelona Spain
| | - M. Otto
- Department of Clinical Neurophysiology Aarhus University Hospital Aarhus Denmark
| | | | - A. Garrido
- Centro de Investigación Biomédica en Red sobre Enfermedades eurodegenerativas (CIBERNED) Hospital Clínic IDIBAPS Universitat de Barcelona Catalonia
- Movement Disorders Unit Neurology Service Hospital Clínic de Barcelona Catalonia Spain
| | - D. Vilas
- Centro de Investigación Biomédica en Red sobre Enfermedades eurodegenerativas (CIBERNED) Hospital Clínic IDIBAPS Universitat de Barcelona Catalonia
- Movement Disorders Unit Neurology Service Hospital Clínic de Barcelona Catalonia Spain
| | - T.D. Fedorova
- Department of Nuclear Medicine & PET Centre Aarhus University Hospital Aarhus Denmark
| | - J. Santamaria
- Department of Neurology Hospital Clínic de Barcelona Barcelona
- Centro de Investigación Biomédica en Red sobre Enfermedades eurodegenerativas (CIBERNED) Hospital Clínic IDIBAPS Universitat de Barcelona Catalonia
- Multidisciplinary Sleep Unit Hospital Clinic Barcelona Spain
| | - A. Møller
- Department of Nuclear Medicine & PET Centre Aarhus University Hospital Aarhus Denmark
| | - C. Gaig
- Department of Neurology Hospital Clínic de Barcelona Barcelona
- Centro de Investigación Biomédica en Red sobre Enfermedades eurodegenerativas (CIBERNED) Hospital Clínic IDIBAPS Universitat de Barcelona Catalonia
- Multidisciplinary Sleep Unit Hospital Clinic Barcelona Spain
| | - K. Hiraoka
- Division of Cyclotron Nuclear Medicine, Cyclotron and Radioisotope Center Tohoku University Sendai Japan
| | - D.J. Brooks
- Department of Nuclear Medicine & PET Centre Aarhus University Hospital Aarhus Denmark
- Division of Neuroscience Newcastle University Newcastle upon Tyne UK
| | - N. Okamura
- Division of Pharmacology Faculty of Medicine Tohoku Medical and Pharmaceutical University Sendai Japan
| | - P. Borghammer
- Department of Nuclear Medicine & PET Centre Aarhus University Hospital Aarhus Denmark
| | - E. Tolosa
- Centro de Investigación Biomédica en Red sobre Enfermedades eurodegenerativas (CIBERNED) Hospital Clínic IDIBAPS Universitat de Barcelona Catalonia
- Movement Disorders Unit Neurology Service Hospital Clínic de Barcelona Catalonia Spain
| | - N. Pavese
- Department of Nuclear Medicine & PET Centre Aarhus University Hospital Aarhus Denmark
- Division of Neuroscience Newcastle University Newcastle upon Tyne UK
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20
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Campabadal A, Segura B, Junque C, Serradell M, Abos A, Uribe C, Baggio HC, Gaig C, Santamaria J, Bargallo N, Iranzo A. Comparing the accuracy and neuroanatomical correlates of the UPSIT-40 and the Sniffin' Sticks test in REM sleep behavior disorder. Parkinsonism Relat Disord 2019; 65:197-202. [PMID: 31253493 DOI: 10.1016/j.parkreldis.2019.06.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 05/30/2019] [Accepted: 06/19/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Olfactory impairment increases the risk of developing neurodegenerative diseases in patients with idiopathic REM sleep behavior disorder (IRBD). Knowing the test properties of distinct olfactory measures could contribute to their selection for clinical or research purposes. OBJECTIVE To compare the accuracy in distinguishing IRBD patients from controls with the University of Pennsylvania Smell Identification Test (UPSIT-40) and Sniffin' Sticks Extended test, and to assess the gray-matter volume correlates of these tests. METHOD Twenty-one patients with IRBD and 27 healthy controls were assessed using both olfactory tests. Independent logistic regressions were computed with diagnosis as a dependent variable and olfactory measures as predictive variables. Receiver operating characteristic curves were computed for each olfactory subtest. Diagnostic accuracy for IRBD was calculated according to the resulting optimal cut-off score. Structural MRI data, acquired with a 3T scanner, were analyzed with voxel-based morphometry. RESULTS Patients differed from controls in all olfactory measures. The Sniffin-Identification correctly classified 89.1% of cases; the UPSIT-40, 85.4%; the Sniffin-Discrimination, 82.6%; the Sniffin-Total, 81.8%; and the Sniffin-Threshold, 77.3%. Respective AUROC, optimal cut-off, sensitivity, and specificity for each test were: 0.902, ≤26, 85.7%, and 85.2% for the UPSIT-40; 0.884, ≤29, 89.5%, and 76.0% for the Sniffin-Total; 0.922, ≤11, 90.5%, and 88.0% for the Sniffin-Identification; 0.739, ≤4, 73.7%, and 76.0% for the Sniffin-Threshold; and 0.838, ≤11, 85.7%, and 76.0% for the Sniffin-Discrimination. UPSIT-40 scores correlated with gray-matter volumes in orbitofrontal regions in anosmic patients. CONCLUSIONS UPSIT-40 and Sniffin' Identification showed similar discrimination accuracy, but only the UPSIT-40 showed structural correlates (p ≤ .05 FDR-corrected).
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Affiliation(s)
- A Campabadal
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - B Segura
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain.
| | - C Junque
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.
| | - M Serradell
- Neurology Service, Multidisciplinary Sleep Unit, Hospital Clínic, Barcelona, Spain.
| | - A Abos
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - C Uribe
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - H C Baggio
- Medical Psychology Unit, Department of Medicine. Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - C Gaig
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain; Neurology Service, Multidisciplinary Sleep Unit, Hospital Clínic, Barcelona, Spain.
| | - J Santamaria
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain; Neurology Service, Multidisciplinary Sleep Unit, Hospital Clínic, Barcelona, Spain.
| | - N Bargallo
- Centre de Diagnòstic per la Imatge, Hospital Clínic, Barcelona, Catalonia, Spain.
| | - A Iranzo
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain; Neurology Service, Multidisciplinary Sleep Unit, Hospital Clínic, Barcelona, Spain.
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21
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Ramirez A, Hueso JL, Abian M, Alzueta MU, Mallada R, Santamaria J. Escaping undesired gas-phase chemistry: Microwave-driven selectivity enhancement in heterogeneous catalytic reactors. Sci Adv 2019; 5:eaau9000. [PMID: 30899784 PMCID: PMC6420312 DOI: 10.1126/sciadv.aau9000] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 01/30/2019] [Indexed: 06/09/2023]
Abstract
Research in solid-gas heterogeneous catalytic processes is typically aimed toward optimization of catalyst composition to achieve a higher conversion and, especially, a higher selectivity. However, even with the most selective catalysts, an upper limit is found: Above a certain temperature, gas-phase reactions become important and their effects cannot be neglected. Here, we apply a microwave field to a catalyst-support ensemble capable of direct microwave heating (MWH). We have taken extra precautions to ensure that (i) the solid phase is free from significant hot spots and (ii) an accurate estimation of both solid and gas temperatures is obtained. MWH allows operating with a catalyst that is significantly hotter than the surrounding gas, achieving a high conversion on the catalyst while reducing undesired homogeneous reactions. We demonstrate the concept with the CO2-mediated oxidative dehydrogenation of isobutane, but it can be applied to any system with significant undesired homogeneous contributions.
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Affiliation(s)
- A. Ramirez
- Department of Chemical and Environmental Engineering, University of Zaragoza, 50018 Zaragoza, Spain
- Institute of Nanoscience of Aragon (INA), University of Zaragoza, 50018 Zaragoza, Spain
| | - J. L. Hueso
- Department of Chemical and Environmental Engineering, University of Zaragoza, 50018 Zaragoza, Spain
- Institute of Nanoscience of Aragon (INA), University of Zaragoza, 50018 Zaragoza, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, (Spain)
- Instituto de Ciencia de Materiales de Aragon (ICMA), Consejo Superior de Investigaciones Científicas (CSIC-Universidad de Zaragoza), 50009, Zaragoza, Spain
| | - M. Abian
- Department of Chemical and Environmental Engineering, University of Zaragoza, 50018 Zaragoza, Spain
- Aragon Institute of Engineering Research (I3A), University of Zaragoza, 50018 Zaragoza, Spain
| | - M. U. Alzueta
- Department of Chemical and Environmental Engineering, University of Zaragoza, 50018 Zaragoza, Spain
- Aragon Institute of Engineering Research (I3A), University of Zaragoza, 50018 Zaragoza, Spain
| | - R. Mallada
- Department of Chemical and Environmental Engineering, University of Zaragoza, 50018 Zaragoza, Spain
- Institute of Nanoscience of Aragon (INA), University of Zaragoza, 50018 Zaragoza, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, (Spain)
- Instituto de Ciencia de Materiales de Aragon (ICMA), Consejo Superior de Investigaciones Científicas (CSIC-Universidad de Zaragoza), 50009, Zaragoza, Spain
| | - J. Santamaria
- Department of Chemical and Environmental Engineering, University of Zaragoza, 50018 Zaragoza, Spain
- Institute of Nanoscience of Aragon (INA), University of Zaragoza, 50018 Zaragoza, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, (Spain)
- Instituto de Ciencia de Materiales de Aragon (ICMA), Consejo Superior de Investigaciones Científicas (CSIC-Universidad de Zaragoza), 50009, Zaragoza, Spain
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Tornos J, Gallego F, Valencia S, Liu YH, Rouco V, Lauter V, Abrudan R, Luo C, Ryll H, Wang Q, Hernandez-Martin D, Orfila G, Cabero M, Cuellar F, Arias D, Mompean FJ, Garcia-Hernandez M, Radu F, Charlton TR, Rivera-Calzada A, Sefrioui Z, Te Velthuis SGE, Leon C, Santamaria J. Ferroelectric Control of Interface Spin Filtering in Multiferroic Tunnel Junctions. Phys Rev Lett 2019; 122:037601. [PMID: 30735408 DOI: 10.1103/physrevlett.122.037601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 07/27/2018] [Indexed: 06/09/2023]
Abstract
The electronic reconstruction occurring at oxide interfaces may be the source of interesting device concepts for future oxide electronics. Among oxide devices, multiferroic tunnel junctions are being actively investigated as they offer the possibility to modulate the junction current by independently controlling the switching of the magnetization of the electrodes and of the ferroelectric polarization of the barrier. In this Letter, we show that the spin reconstruction at the interfaces of a La_{0.7}Sr_{0.3}MnO_{3}/BaTiO_{3}/La_{0.7}Sr_{0.3}MnO_{3} multiferroic tunnel junction is the origin of a spin filtering functionality that can be turned on and off by reversing the ferroelectric polarization. The ferroelectrically controlled interface spin filter enables a giant electrical modulation of the tunneling magnetoresistance between values of 10% and 1000%, which could inspire device concepts in oxides-based low dissipation spintronics.
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Affiliation(s)
- J Tornos
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - F Gallego
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - S Valencia
- Hemholtz-Zentrum Berlin für Materialen und Energie, Albert-Einstein-Strasse 15, 12489 Berlin, Germany
| | - Y H Liu
- Oak Ridge National Laboratory, Neutron Scattering Division, Oak Ridge, Tennessee 37831, USA
- Argonne National Laboratory, Materials Science Division, Argonne, Illinois 60439, USA
| | - V Rouco
- Unité Mixte de Physique, CNRS, Thales, Université Paris-Saclay, 91767 Palaiseau, France
| | - V Lauter
- Oak Ridge National Laboratory, Neutron Scattering Division, Oak Ridge, Tennessee 37831, USA
| | - R Abrudan
- Hemholtz-Zentrum Berlin für Materialen und Energie, Albert-Einstein-Strasse 15, 12489 Berlin, Germany
- Institut für Experimentalphysik (Festkörperphysik), Ruhr-Universität Bochum, 44780 Bochum, Germany
| | - C Luo
- Hemholtz-Zentrum Berlin für Materialen und Energie, Albert-Einstein-Strasse 15, 12489 Berlin, Germany
- University of Regensburg, Universitätsstrasse 31, 93053 Regensburg, Germany
| | - H Ryll
- Hemholtz-Zentrum Berlin für Materialen und Energie, Albert-Einstein-Strasse 15, 12489 Berlin, Germany
| | - Q Wang
- Argonne National Laboratory, Materials Science Division, Argonne, Illinois 60439, USA
| | | | - G Orfila
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - M Cabero
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - F Cuellar
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - D Arias
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - F J Mompean
- 2D-Foundry Group, Instituto de Ciencia de Materiales de Madrid ICMM-CSIC, 28049 Madrid, Spain
- Laboratorio de Heteroestructuras con aplicación en spintrónica, Unidad Asociada UCM/CSIC, 28049 Madrid, Spain
| | - M Garcia-Hernandez
- 2D-Foundry Group, Instituto de Ciencia de Materiales de Madrid ICMM-CSIC, 28049 Madrid, Spain
- Laboratorio de Heteroestructuras con aplicación en spintrónica, Unidad Asociada UCM/CSIC, 28049 Madrid, Spain
| | - F Radu
- Hemholtz-Zentrum Berlin für Materialen und Energie, Albert-Einstein-Strasse 15, 12489 Berlin, Germany
| | - T R Charlton
- ISIS, Rutherford Appleton Laboratory, Chilton, Oxon OX11 0QX, United Kingdom
| | - A Rivera-Calzada
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Laboratorio de Heteroestructuras con aplicación en spintrónica, Unidad Asociada UCM/CSIC, 28049 Madrid, Spain
| | - Z Sefrioui
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Laboratorio de Heteroestructuras con aplicación en spintrónica, Unidad Asociada UCM/CSIC, 28049 Madrid, Spain
- GFMC, Instituto de Magnetismo Aplicado, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - S G E Te Velthuis
- Argonne National Laboratory, Materials Science Division, Argonne, Illinois 60439, USA
| | - C Leon
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Laboratorio de Heteroestructuras con aplicación en spintrónica, Unidad Asociada UCM/CSIC, 28049 Madrid, Spain
- GFMC, Instituto de Magnetismo Aplicado, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - J Santamaria
- GFMC, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Laboratorio de Heteroestructuras con aplicación en spintrónica, Unidad Asociada UCM/CSIC, 28049 Madrid, Spain
- GFMC, Instituto de Magnetismo Aplicado, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Piercy M, Lau S, Loh E, Reid D, Santamaria J, Mackay P. Unplanned Admission to the Intensive Care Unit in Postoperative Patients—An Indicator of Quality of Anaesthetic Care? Anaesth Intensive Care 2019; 34:592-8. [PMID: 17061633 DOI: 10.1177/0310057x0603400504] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
As a clinical indicator, unplanned admission to the Intensive Care Unit from the operating room has been thought to reflect the quality of anaesthesia care intraoperatively. To explore this concept, we examined all such admissions at three hospitals over a three-month period. Cases were classified according to the Victorian Consultative Council on Anaesthetic Mortality and Morbidity (VCCAMM) classification system and an assessment was made as to whether the admission was inevitable or not. Demographic data were collected as well as co-morbidities, severity of illness, length of stay, discharge functional status and destination. There were 165 admissions identified: 55.8% were male, the median age was 63.5 years (range 15–90). There were 24 in-hospital deaths: 151 patients suffered serious morbidity or mortality. In 32 patients (19.4%), the morbidity or mortality was considered at least partially anaesthetic-related, and in 20 (12.1 %), under the control of the anaesthetist. There were 28 admissions (17.0%) with a further 9 anaesthetic-related admissions (5.5%) which were considered potentially avoidable. Avoidable anaesthetic-related admissions were due to drug overdosage (5 cases), drug error (1 case), problems relating to preoperative assessment (1 case), aspiration (1 case) and pulmonary oedema (1 case). These findings suggest that unplanned admission to the Intensive Care Unit from the operating room is not a satisfactory indicator of quality of care by the anaesthesia team. This indicator appears to represent mainly the surgical and medical conditions of the patients, and their complications. Only one in twenty unplanned admissions in this series were potentially avoidable due to complications of the anaesthetic or the postoperative analgesia.
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Affiliation(s)
- M Piercy
- Department of Intensive Care, St Vincent's Hospital, Melbourne, Australia
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Abstract
The clinical indicator is a tool used to monitor the quality of health care. Its use in the Intensive Care Unit (ICU) is desirable for many reasons: the maintenance of minimum standards, the development of best practice and the delivery of cost-effective health care. The utility of clinical indicators in ICU is limited by the lack of universal, robust, transparent, evidence-based and risk-adjusted measures of quality, and the difficulties in defining “quality care” and “good outcome”. Monitoring of adverse events, system descriptors, and resource indicators is valuable but they have a limited relationship to the quality of care. ICU mortality prediction models provide a global measure of quality and, despite their inherent deficiencies, remain one of the most robust and useful clinical indicators.
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Affiliation(s)
- G Duke
- Critical Care Department, The Northern Hospital, Epping, Victoria
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25
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Smith R, Santamaria J, Reid D. Hospital Admission Characteristics are Associated with Hospital Discharge Outcomes After in-Hospital Arrest. Aust Crit Care 2019. [DOI: 10.1016/j.aucc.2018.11.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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26
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Barbier L, Ramos E, Mendiola J, Rodriguez O, Santamaria G, Santamaria J, Arteagoitia I. Autologous dental pulp mesenchymal stem cells for inferior third molar post-extraction socket healing: A split-mouth randomised clinical trial. Med Oral Patol Oral Cir Bucal 2018; 23:e469-e477. [PMID: 29924768 PMCID: PMC6051678 DOI: 10.4317/medoral.22466] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 06/15/2018] [Indexed: 01/04/2023] Open
Abstract
Background Since the discovery of adult mesenchymal stem cells extensive research has been conducted to determine their mechanisms of differentiation and effectiveness in cell therapy and regenerative medicine. Material and Methods To assess the efficacy of autologous dental pulp mesenchymal stem cells delivered in a collagen matrix for post-extraction socket healing, a single-centre, double-blind, randomised, split-mouth, controlled clinical trial was performed. Both impacted mandibular third molars were extracted from 32 patients. Dental pulp was collected and dissociated; the resulting cell suspension, obtained by centrifugation, was incorporated into a resorbable collagen matrix and implanted in 32 experimental post-extraction sockets. Collagen matrices alone were implanted in 32 contralateral, control post-extraction sockets. Two neuroradiologists independently assessed the extent of bone repair at 6 months after the extractions. Computed tomography (CT, Philips Brilliance) and an advanced display platform (IntelliSpace Portal) was used to record extraction socket density, expressed as Hounsfield units (HU) and height (mm) of the distal interdental bone septum of the second molar. Measurements at 6 months post-extraction were compared with measurements obtained immediately after extraction. Data were analysed with the statistical program STATA 14. Results Two patients dropped out of the study. The final sample consisted of 22 women and 8 men (mean age, 23 years; range: 18–30 years). Clinical, radiological, and surgical characteristics of impacted third molars of the control and experimental groups were homogeneous. Measurements obtained by the two neuroradiologists showed agreement. No significant differences were found in the extent of bone repair during analyses of density (p=0.4203 neuroradiologist 1; p=0.2525 neuroradiologist 2) or interdental septum height (p=0.2280 neuroradiologist 1; p=0.4784 neuroradiologist 2). Conclusions In our clinical trial, we were unable to demonstrate that autologous dental pulp mesenchymal stem cells reduce socket bone resorption after inferior third molar extraction. Key words:Clinical trial, autologous, pulpal stem cells, extraction socket healing.
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Affiliation(s)
- L Barbier
- University of Basque Country, Departamento de Estomatologia, c/ Barrio Sarriena s/n, 48940 Leioa, Bizkaia,
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27
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Gunasekaran B, Weil J, Whelan T, Santamaria J, Boughey M. Assessment of potential opioid toxicity and response to naloxone by rapid response teams at an urban Melbourne hospital. Intern Med J 2018; 48:198-200. [DOI: 10.1111/imj.13692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 05/07/2017] [Accepted: 05/14/2017] [Indexed: 11/30/2022]
Affiliation(s)
| | - Jennifer Weil
- Centre for Palliative Care; St Vincent’s Hospital; Melbourne Victoria Australia
| | - Tom Whelan
- Centre for Palliative Care; St Vincent’s Hospital; Melbourne Victoria Australia
| | - John Santamaria
- Intensive Care Unit; St Vincent’s Hospital; Melbourne Victoria Australia
| | - Mark Boughey
- Centre for Palliative Care; St Vincent’s Hospital; Melbourne Victoria Australia
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Abstract
Objectives There has been renewed interest in lactate as a risk biomarker in sepsis and septic shock. However, the ability of the odds ratio (OR) and change in the area under the receiver operator characteristic curve (AUC-ROC) to assess biomarker added-value has been questioned. Design, setting and participants A sepsis cohort was identified from the ICU database of an Australian tertiary referral hospital using APACHE III diagnostic codes. Demographic information, APACHE III scores, 24-hour post-admission patient lactate levels, and hospital mortality were accessed. Measurements and main results Hospital mortality was modelled using a base predictive logistic regression model and sequential addition of admission lactate, lactate clearance ([lactateadmission—lactatefinal]/lactateadmission), and area under the lactate-time curve (LTC). Added-value was assessed using lactate index OR; AUC-ROC difference (base-model versus lactate index addition); net (mortality) reclassification index (NRI; range -2 to +2); and net benefit (NB), the number of true positives per patient adjusted for the number of false positives. The data set comprised 717 patients with mean(SD) age and APACHE III score 61.1(16.5) years and 68.3(28.2) respectively; 59.2% were male. Admission lactate was 2.3(2.5) mmol/l; with lactate of ≥ 4 mmol/L (37% hospital mortality) in 17% and patients with lactate < 4 mmol/L having 18% hospital mortality. The admission base-model had an AUC-ROC = 0.81 with admission lactate OR = 1.127 (95%CI: 1.038, 1.224), AUC-ROC difference of 0.0032 (-0.0037, 0.01615; P = 0.61), and NRI 0.240(0.030, 0.464). The over-time model had an AUC-ROC = 0.86 with (i) clearance OR = 0.771, 95%CI: 0.578, 1.030; P = 0.08; AUC-ROC difference 0.001 (-0.003, 0.014; P = 0.78), and NRI 0.109(-0.193, 0.425) and (ii) LTC OR = 0.997, 95%CI: 0.989, 1.005, P = 0.49; AUC-ROC difference 0.004 (-0.002, 0.004; P = 0.34), and NRI 0.111(-0.222, 0.403). NB was not incremented by any lactate index. Conclusions Lactate added-value assessment is dependent upon the performance of the underlying predictive model and should incorporate risk reclassification and net benefit measures.
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Affiliation(s)
- John L. Moran
- Department of Intensive Care Medicine, The Queen Elizabeth Hospital, Woodville, South Australia, Australia
- * E-mail:
| | - John Santamaria
- Department of Critical Care Medicine, St Vincent’s Hospital Melbourne, Fitzroy, Victoria, Australia
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Iranzo A, Stefani A, Serradell M, Martí MJ, Lomeña F, Mahlknecht P, Stockner H, Gaig C, Fernández-Arcos A, Poewe W, Tolosa E, Högl B, Santamaria J. 0728 CHARACTERIZATION OF PATIENTS WITH LONG-TERM IDIOPATHIC REM SLEEP BEHAVIOR DISORDER. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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30
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Ortega-Liebana MC, Hueso JL, Arenal R, Santamaria J. Titania-coated gold nanorods with expanded photocatalytic response. Enzyme-like glucose oxidation under near-infrared illumination. Nanoscale 2017; 9:1787-1792. [PMID: 27714228 DOI: 10.1039/c6nr06300d] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Gold nanorods coated with a uniform titanium dioxide nanoshell have been prepared and used as glucose-oxidase surrogates. Remarkably, this core-shell photocatalytic nanostructure has been able to induce complete oxidation of glucose at near room temperature (32-34 °C) in a wide range of pH values with the aid of a near-infrared (NIR) irradiation source. In contrast, the uncoated gold nanorods exhibit negligible photo-oxidation response under identical experimental conditions thereby proving the photoactivity of the titania shell towards glucose oxidation. The process takes place via in situ photo-generation of singlet oxygen or hydroxyl radicals as reactive oxidative species (ROS). This underlines the role played by the core nanorods as plasmonic light harvesters in the NIR range and constitutes the first example of a NIR-activated enzyme-like catalyst.
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Affiliation(s)
- M C Ortega-Liebana
- Institute of Nanoscience of Aragon (INA) and Department of Chemical Engineering and Environmental Technology, University of Zaragoza, 50018 Zaragoza, Spain. and CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Centro de Investigación Biomédica en Red, C/Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain
| | - J L Hueso
- Institute of Nanoscience of Aragon (INA) and Department of Chemical Engineering and Environmental Technology, University of Zaragoza, 50018 Zaragoza, Spain. and CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Centro de Investigación Biomédica en Red, C/Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain
| | - R Arenal
- Laboratorio de Microscopías Avanzadas, Instituto de Nanociencia de Aragón, Universidad de Zaragoza, 50018 Zaragoza, Spain and ARAID Foundation, 50018 Zaragoza, Spain
| | - J Santamaria
- Institute of Nanoscience of Aragon (INA) and Department of Chemical Engineering and Environmental Technology, University of Zaragoza, 50018 Zaragoza, Spain. and CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Centro de Investigación Biomédica en Red, C/Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain
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31
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Stefani A, Iranzo A, Santamaria J, Högl B. Description of sleep paralysis in The Brothers Karamazov by Dostoevsky. Sleep Med 2017; 32:198-200. [PMID: 28366334 DOI: 10.1016/j.sleep.2016.12.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 12/07/2016] [Accepted: 12/08/2016] [Indexed: 11/26/2022]
Affiliation(s)
- A Stefani
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - A Iranzo
- Neurology Service, Multidisciplinary Sleep Unit, Hospital Clinic de Barcelona, IDIBAPS, CIBERNED, Barcelona, Spain.
| | - J Santamaria
- Neurology Service, Multidisciplinary Sleep Unit, Hospital Clinic de Barcelona, IDIBAPS, CIBERNED, Barcelona, Spain
| | - B Högl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
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Grisolia M, Varignon J, Sanchez-Santolino G, Arora A, Valencia S, Varela M, Abrudan R, Weschke E, Schierle E, Rault J, Rueff JP, Barthélémy A, Santamaria J, Bibes M. Hybridization-controlled charge transfer and induced magnetism at correlated oxide interfaces. Nat Phys 2016; 12:484-492. [PMID: 27158255 PMCID: PMC4856211 DOI: 10.1038/nphys3627] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 12/04/2015] [Indexed: 05/22/2023]
Abstract
At interfaces between conventional materials, band bending and alignment are classically controlled by differences in electrochemical potential. Applying this concept to oxides in which interfaces can be polar and cations may adopt a mixed valence has led to the discovery of novel two-dimensional states between simple band insulators such as LaAlO3 and SrTiO3. However, many oxides have a more complex electronic structure, with charge, orbital and/or spin orders arising from strong Coulomb interactions between transition metal and oxygen ions. Such electronic correlations offer a rich playground to engineer functional interfaces but their compatibility with the classical band alignment picture remains an open question. Here we show that beyond differences in electron affinities and polar effects, a key parameter determining charge transfer at correlated oxide interfaces is the energy required to alter the covalence of the metal-oxygen bond. Using the perovskite nickelate (RNiO3) family as a template, we probe charge reconstruction at interfaces with gadolinium titanate GdTiO3. X-ray absorption spectroscopy shows that the charge transfer is thwarted by hybridization effects tuned by the rare-earth (R) size. Charge transfer results in an induced ferromagnetic-like state in the nickelate, exemplifying the potential of correlated interfaces to design novel phases. Further, our work clarifies strategies to engineer two-dimensional systems through the control of both doping and covalence.
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Affiliation(s)
- M.N. Grisolia
- Unité Mixte de Physique CNRS/Thales, 1 avenue A. Fresnel, 91767 Palaiseau, France, and Université Paris-Sud, 91405 Orsay, France
| | - J. Varignon
- Unité Mixte de Physique CNRS/Thales, 1 avenue A. Fresnel, 91767 Palaiseau, France, and Université Paris-Sud, 91405 Orsay, France
| | - G. Sanchez-Santolino
- GFMC, Departamento Física Aplicada III, Universidad Complutense Madrid, 28040 Madrid, Spain, and Laboratorio de Heteroestructuras con aplicación en Spintronica, Unidad Asociada CSIC/Universidad Complutense de Madrid, Sor Juana Inés de la Cruz, 3, 28049 Madrid, Spain
| | - A. Arora
- Helmholtz-Zentrum Berlin für Materialen & Energie, Albert-Einstein-Strasse 15, 12489 Berlin, Germany
| | - S. Valencia
- Helmholtz-Zentrum Berlin für Materialen & Energie, Albert-Einstein-Strasse 15, 12489 Berlin, Germany
| | - M. Varela
- GFMC, Departamento Física Aplicada III, Universidad Complutense Madrid, 28040 Madrid, Spain, and Laboratorio de Heteroestructuras con aplicación en Spintronica, Unidad Asociada CSIC/Universidad Complutense de Madrid, Sor Juana Inés de la Cruz, 3, 28049 Madrid, Spain
- Materials Science & Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
| | - R. Abrudan
- Helmholtz-Zentrum Berlin für Materialen & Energie, Albert-Einstein-Strasse 15, 12489 Berlin, Germany
- Institut für Experimentalphysik/Festkörperphysik, Ruhr-Universität Bochum, 44780 Bochum, Germany
| | - E. Weschke
- Helmholtz-Zentrum Berlin für Materialen & Energie, Albert-Einstein-Strasse 15, 12489 Berlin, Germany
| | - E. Schierle
- Helmholtz-Zentrum Berlin für Materialen & Energie, Albert-Einstein-Strasse 15, 12489 Berlin, Germany
| | - J.E. Rault
- Synchrotron SOLEIL, L'Orme des Merisiers Saint-Aubin, BP 48, 91192 Gif-sur-Yvette, France
| | - J.-P. Rueff
- Synchrotron SOLEIL, L'Orme des Merisiers Saint-Aubin, BP 48, 91192 Gif-sur-Yvette, France
| | - A. Barthélémy
- Unité Mixte de Physique CNRS/Thales, 1 avenue A. Fresnel, 91767 Palaiseau, France, and Université Paris-Sud, 91405 Orsay, France
| | - J. Santamaria
- GFMC, Departamento Física Aplicada III, Universidad Complutense Madrid, 28040 Madrid, Spain, and Laboratorio de Heteroestructuras con aplicación en Spintronica, Unidad Asociada CSIC/Universidad Complutense de Madrid, Sor Juana Inés de la Cruz, 3, 28049 Madrid, Spain
| | - M. Bibes
- Unité Mixte de Physique CNRS/Thales, 1 avenue A. Fresnel, 91767 Palaiseau, France, and Université Paris-Sud, 91405 Orsay, France
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Gabriel LEK, Bailey MJ, Bellomo R, Stow P, Orford N, McGain F, Santamaria J, Scheinkestel C, Pilcher DV. Insurance status and mortality in critically ill patients. CRIT CARE RESUSC 2016; 18:43-49. [PMID: 26947415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The association between insurance status and outcome in critically ill patients is uncertain. We aimed to determine if there was an independent relationship between the presence or absence of compensable insurance status and mortality, after admission to the intensive care unit. METHODS We performed a retrospective cohort study in five public hospitals in Victoria, comprising adult patients admitted to the ICU between 2007 and 2012. We obtained data on demographics, severity of illness, chronic health status, insurance category, length of stay (LOS) and mortality. We matched socio-economic indices (collected from the Australian Bureau of Statistics) to postcodes. The primary outcome measured was in-hospital mortality. Secondary outcomes were ICU mortality, and ICU and hospital LOS, measured in days. RESULTS We studied 33 306 patients. Compensable patients comprised 21.2% of the study population (7046). Personal private insurance accounted for 13.4% (4451) and Transport Accident Commission insurance for 5.1% (1701) of compensable patients. Unadjusted in-hospital mortality was higher in publicly insured patients (13.4% v 10.6%, P < 0.0001). After adjusting for age, severity of illness, diagnosis and socio-economic status, being a compensable patient in a public hospital ICU was independently associated with a reduction in mortality (odds ratio, 0.73; 95% CI, 0.65-0.80; P < 0.001). CONCLUSIONS Among ICU patients treated in public hospitals in Victoria, being a compensable patient appears to be independently associated with a reduction in mortality. Further studies are needed to confirm and validate these findings elsewhere in Australia.
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Affiliation(s)
| | - Michael J Bailey
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Rinaldo Bellomo
- Department of Intensive Care, Austin Hospital, Melbourne, VIC, Australia
| | - Peter Stow
- Department of Intensive Care, Barwon Health, Geelong, VIC, Australia
| | - Neil Orford
- Department of Intensive Care, Barwon Health, Geelong, VIC, Australia
| | - Forbes McGain
- Department of Intensive Care, Western Health, Melbourne, VIC, Australia
| | - John Santamaria
- Department of Critical Care Medicine, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Carlos Scheinkestel
- Department of Intensive Care, The Alfred Hospital, Melbourne, VIC, Australia
| | - David V Pilcher
- Department of Intensive Care, The Alfred Hospital, Melbourne, VIC, Australia
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Moreno I, Navascues N, Irusta S, Santamaria J. Modulation of bactericidal action in polymer nanocomposites: light-tuned Ag+ release from electrospun PMMA fibers. RSC Adv 2016. [DOI: 10.1039/c6ra16876k] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Silver rate release from electrospun PMMA fibers tuned by combination of silver ions and silver nanoparticles produced by UV irradiation.
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Affiliation(s)
- I. Moreno
- Dept. Chemical Engineering
- Nanoscience Institute of Aragon (INA)
- University of Zaragoza
- 50018 Zaragoza
- Spain
| | - N. Navascues
- Dept. Chemical Engineering
- Nanoscience Institute of Aragon (INA)
- University of Zaragoza
- 50018 Zaragoza
- Spain
| | - S. Irusta
- Dept. Chemical Engineering
- Nanoscience Institute of Aragon (INA)
- University of Zaragoza
- 50018 Zaragoza
- Spain
| | - J. Santamaria
- Dept. Chemical Engineering
- Nanoscience Institute of Aragon (INA)
- University of Zaragoza
- 50018 Zaragoza
- Spain
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Alberca A, Munuera C, Azpeitia J, Kirby B, Nemes NM, Perez-Muñoz AM, Tornos J, Mompean FJ, Leon C, Santamaria J, Garcia-Hernandez M. Phase separation enhanced magneto-electric coupling in La0.7Ca0.3MnO3/BaTiO3 ultra-thin films. Sci Rep 2015; 5:17926. [PMID: 26648002 PMCID: PMC4673425 DOI: 10.1038/srep17926] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 11/09/2015] [Indexed: 12/03/2022] Open
Abstract
We study the origin of the magnetoelectric coupling in manganite films on ferroelectric substrates. We find large magnetoelectric coupling in La0.7Ca0.3MnO3/BaTiO3 ultra-thin films in experiments based on the converse magnetoelectric effect. The magnetization changes by around 30-40% upon applying electric fields on the order of 1 kV/cm to the BaTiO3 substrate, corresponding to magnetoelectric coupling constants on the order of α = (2-5) · 10(-7) s/m. Magnetic anisotropy is also affected by the electric field induced strain, resulting in a considerable reduction of coercive fields. We compare the magnetoelectric effect in pre-poled and unpoled BaTiO3 substrates. Polarized neutron reflectometry reveals a two-layer behavior with a depressed magnetic layer of around 30 Å at the interface. Magnetic force microscopy (MFM) shows a granular magnetic structure of the La0.7Ca0.3MnO3. The magnetic granularity of the La0.7Ca0.3MnO3 film and the robust magnetoelastic coupling at the La0.7Ca0.3MnO3/BaTiO3 interface are at the origin of the large magnetoelectric coupling, which is enhanced by phase separation in the manganite.
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Affiliation(s)
- A. Alberca
- Instituto de Ciencia de Materiales de Madrid, Consejo Superior de Investigaciones Científicas, Sor Juana Inés de la Cruz, 3, ES-28049 Madrid, Spain
| | - C. Munuera
- Instituto de Ciencia de Materiales de Madrid, Consejo Superior de Investigaciones Científicas, Sor Juana Inés de la Cruz, 3, ES-28049 Madrid, Spain
- Laboratorio de Heteroestructuras con aplicación en Spintronica, Unidad Asociada Consejo Superior de Investigaciones Científicas/Universidad Complutense Madrid, Sor Juana Inés de la Cruz, 3, ES-28049 Madrid, Spain
| | - J. Azpeitia
- Instituto de Ciencia de Materiales de Madrid, Consejo Superior de Investigaciones Científicas, Sor Juana Inés de la Cruz, 3, ES-28049 Madrid, Spain
- Laboratorio de Heteroestructuras con aplicación en Spintronica, Unidad Asociada Consejo Superior de Investigaciones Científicas/Universidad Complutense Madrid, Sor Juana Inés de la Cruz, 3, ES-28049 Madrid, Spain
| | - B. Kirby
- Center for Neutron Research, National Institute of Standards and Technology, Gaithersburg, Maryland 20899, USA
| | - N. M. Nemes
- GFMC, Departamento de Física Aplicada III, Universidad Complutense, CEI Campus Moncloa, ES-28040 Madrid, Spain
- Laboratorio de Heteroestructuras con aplicación en Spintronica, Unidad Asociada Consejo Superior de Investigaciones Científicas/Universidad Complutense Madrid, Sor Juana Inés de la Cruz, 3, ES-28049 Madrid, Spain
| | - A. M. Perez-Muñoz
- GFMC, Departamento de Física Aplicada III, Universidad Complutense, CEI Campus Moncloa, ES-28040 Madrid, Spain
- Laboratorio de Heteroestructuras con aplicación en Spintronica, Unidad Asociada Consejo Superior de Investigaciones Científicas/Universidad Complutense Madrid, Sor Juana Inés de la Cruz, 3, ES-28049 Madrid, Spain
| | - J. Tornos
- GFMC, Departamento de Física Aplicada III, Universidad Complutense, CEI Campus Moncloa, ES-28040 Madrid, Spain
| | - F. J. Mompean
- Instituto de Ciencia de Materiales de Madrid, Consejo Superior de Investigaciones Científicas, Sor Juana Inés de la Cruz, 3, ES-28049 Madrid, Spain
- Laboratorio de Heteroestructuras con aplicación en Spintronica, Unidad Asociada Consejo Superior de Investigaciones Científicas/Universidad Complutense Madrid, Sor Juana Inés de la Cruz, 3, ES-28049 Madrid, Spain
| | - C. Leon
- GFMC, Departamento de Física Aplicada III, Universidad Complutense, CEI Campus Moncloa, ES-28040 Madrid, Spain
- Laboratorio de Heteroestructuras con aplicación en Spintronica, Unidad Asociada Consejo Superior de Investigaciones Científicas/Universidad Complutense Madrid, Sor Juana Inés de la Cruz, 3, ES-28049 Madrid, Spain
| | - J. Santamaria
- GFMC, Departamento de Física Aplicada III, Universidad Complutense, CEI Campus Moncloa, ES-28040 Madrid, Spain
- Laboratorio de Heteroestructuras con aplicación en Spintronica, Unidad Asociada Consejo Superior de Investigaciones Científicas/Universidad Complutense Madrid, Sor Juana Inés de la Cruz, 3, ES-28049 Madrid, Spain
| | - M. Garcia-Hernandez
- Instituto de Ciencia de Materiales de Madrid, Consejo Superior de Investigaciones Científicas, Sor Juana Inés de la Cruz, 3, ES-28049 Madrid, Spain
- Laboratorio de Heteroestructuras con aplicación en Spintronica, Unidad Asociada Consejo Superior de Investigaciones Científicas/Universidad Complutense Madrid, Sor Juana Inés de la Cruz, 3, ES-28049 Madrid, Spain
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Rocci M, Azpeitia J, Trastoy J, Perez-Muñoz A, Cabero M, Luccas RF, Munuera C, Mompean FJ, Garcia-Hernandez M, Bouzehouane K, Sefrioui Z, Leon C, Rivera-Calzada A, Villegas JE, Santamaria J. Proximity Driven Commensurate Pinning in YBa2Cu3O7 through All-Oxide Magnetic Nanostructures. Nano Lett 2015; 15:7526-7531. [PMID: 26441137 DOI: 10.1021/acs.nanolett.5b03261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The design of artificial vortex pinning landscapes is a major goal toward large scale applications of cuprate superconductors. Although disordered nanometric inclusions have shown to modify their vortex phase diagram and to produce enhancements of the critical current ( MacManus-Driscoll , J. L. ; Foltyn , S. R. ; Jia , Q. X. ; Wang , H. ; Serquis , A. ; Civale , L. ; Maiorov , B. ; Hawley , M. E. ; Maley , M. P. ; Peterson , D. E. Nat. Mater. 2004 , 3 , 439 - 443 and Yamada , Y. ; Takahashi , K. ; Kobayashi , H. ; Konishi , M. ; Watanabe , T. ; Ibi , A. ; Muroga , T. ; Miyata , S. ; Kato , T. ; Hirayama , T. ; Shiohara , Y. Appl. Phys. Lett. 2005 , 87 , 1 - 3 ), the effect of ordered oxide nanostructures remains essentially unexplored. This is due to the very small nanostructure size imposed by the short coherence length, and to the technological difficulties in the nanofabrication process. Yet, the novel phenomena occurring at oxide interfaces open a wide spectrum of technological opportunities to interplay with the superconductivity in cuprates. Here, we show that the unusual long-range suppression of the superconductivity occurring at the interface between manganites and cuprates affects vortex nucleation and provides a novel vortex pinning mechanism. In particular, we show evidence of commensurate pinning in YBCO films with ordered arrays of LCMO ferromagnetic nanodots. Vortex pinning results from the proximity induced reduction of the condensation energy at the vicinity of the magnetic nanodots, and yields an enhanced friction between the nanodot array and the moving vortex lattice in the liquid phase. This result shows that all-oxide ordered nanostructures constitute a powerful, new route for the artificial manipulation of vortex matter in cuprates.
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Affiliation(s)
- M Rocci
- GFMC, Dpto. Fisica Aplicada III, Univ. Complutense Madrid , 28040 Madrid, Spain
- Unidad Asociada Laboratorio de Heteroestructuras con Aplicación en Espintrónica" UCM-CSIC , 28049 Madrid, Spain
| | - J Azpeitia
- Instituto de Ciencia de Materiales de Madrid , 28049 Madrid, Spain
- Unidad Asociada Laboratorio de Heteroestructuras con Aplicación en Espintrónica" UCM-CSIC , 28049 Madrid, Spain
| | - J Trastoy
- Unité Mixte de Physique, CNRS, Thales, Univ. Paris-Sud, Université , Paris-Saclay, 91767, Palaiseau, France
- Université Paris Sud , 91407 Orsay, France
| | - A Perez-Muñoz
- GFMC, Dpto. Fisica Aplicada III, Univ. Complutense Madrid , 28040 Madrid, Spain
- Unidad Asociada Laboratorio de Heteroestructuras con Aplicación en Espintrónica" UCM-CSIC , 28049 Madrid, Spain
| | - M Cabero
- GFMC, Dpto. Fisica Aplicada III, Univ. Complutense Madrid , 28040 Madrid, Spain
- Unidad Asociada Laboratorio de Heteroestructuras con Aplicación en Espintrónica" UCM-CSIC , 28049 Madrid, Spain
| | - R F Luccas
- Instituto de Ciencia de Materiales de Madrid , 28049 Madrid, Spain
- Unidad Asociada Laboratorio de Heteroestructuras con Aplicación en Espintrónica" UCM-CSIC , 28049 Madrid, Spain
| | - C Munuera
- Instituto de Ciencia de Materiales de Madrid , 28049 Madrid, Spain
- Unidad Asociada Laboratorio de Heteroestructuras con Aplicación en Espintrónica" UCM-CSIC , 28049 Madrid, Spain
| | - F J Mompean
- Instituto de Ciencia de Materiales de Madrid , 28049 Madrid, Spain
- Unidad Asociada Laboratorio de Heteroestructuras con Aplicación en Espintrónica" UCM-CSIC , 28049 Madrid, Spain
| | - M Garcia-Hernandez
- Instituto de Ciencia de Materiales de Madrid , 28049 Madrid, Spain
- Unidad Asociada Laboratorio de Heteroestructuras con Aplicación en Espintrónica" UCM-CSIC , 28049 Madrid, Spain
| | - K Bouzehouane
- Unité Mixte de Physique, CNRS, Thales, Univ. Paris-Sud, Université , Paris-Saclay, 91767, Palaiseau, France
- Université Paris Sud , 91407 Orsay, France
| | - Z Sefrioui
- GFMC, Dpto. Fisica Aplicada III, Univ. Complutense Madrid , 28040 Madrid, Spain
- Unidad Asociada Laboratorio de Heteroestructuras con Aplicación en Espintrónica" UCM-CSIC , 28049 Madrid, Spain
| | - C Leon
- GFMC, Dpto. Fisica Aplicada III, Univ. Complutense Madrid , 28040 Madrid, Spain
- Unidad Asociada Laboratorio de Heteroestructuras con Aplicación en Espintrónica" UCM-CSIC , 28049 Madrid, Spain
| | - A Rivera-Calzada
- GFMC, Dpto. Fisica Aplicada III, Univ. Complutense Madrid , 28040 Madrid, Spain
- Unidad Asociada Laboratorio de Heteroestructuras con Aplicación en Espintrónica" UCM-CSIC , 28049 Madrid, Spain
| | - J E Villegas
- Unité Mixte de Physique, CNRS, Thales, Univ. Paris-Sud, Université , Paris-Saclay, 91767, Palaiseau, France
- Université Paris Sud , 91407 Orsay, France
| | - J Santamaria
- GFMC, Dpto. Fisica Aplicada III, Univ. Complutense Madrid , 28040 Madrid, Spain
- Unidad Asociada Laboratorio de Heteroestructuras con Aplicación en Espintrónica" UCM-CSIC , 28049 Madrid, Spain
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Moore E, Tobin A, Reid D, Santamaria J, Paul E, Bellomo R. The Impact of Fluid Balance on the Detection, Classification and Outcome of Acute Kidney Injury After Cardiac Surgery. J Cardiothorac Vasc Anesth 2015; 29:1229-35. [DOI: 10.1053/j.jvca.2015.02.004] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Indexed: 12/20/2022]
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Niewiadomski O, Studd C, Hair C, Wilson J, Ding NS, Heerasing N, Ting A, McNeill J, Knight R, Santamaria J, Prewett E, Dabkowski P, Dowling D, Alexander S, Allen B, Popp B, Connell W, Desmond P, Bell S. Prospective population-based cohort of inflammatory bowel disease in the biologics era: Disease course and predictors of severity. J Gastroenterol Hepatol 2015; 30:1346-53. [PMID: 25867770 DOI: 10.1111/jgh.12967] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/20/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIM We have previously found high incidence of inflammatory bowel disease (IBD) in Australia. A population-based registry was established to assess disease severity, frequency of complications, and prognostic factors. METHODS Incident cases were prospectively identified over 4 years. Early disease severity was assessed according to need for hospitalization and resective surgery and medication use. RESULTS We report on the early outcomes (median 18 months, range 12-60 months) for 252 patients comprising 146 with Crohn's disease (CD), 96 with ulcerative colitis (UC), and 10 IBD undifferentiated. Eighty-seven percent of CD patients had inflammatory disease at diagnosis, and this reduced to 73% at 5 years (n = 38). Immunomodulators were prescribed in 57% of CD patients and 19% with UC. A third of all CD patients were hospitalized, the majority (77%) in the first 12 months. Risk factors for hospitalization included penetrating, perianal, and ileocolonic disease (P < 0.05). Twenty-four percent of UC patients were hospitalized, most within the first 12 months. Intestinal resection rates were 13% at 1 year in CD and 26% at 5 years. Risk factors include penetrating and stricturing disease (P < 0.001) and ileal involvement (P < 0.05). Colectomy rates in UC were 2% and 13% at 1 and 5 years. High C-reactive protein (CRP) at diagnosis was associated with colectomy. CONCLUSIONS A high rate of inflammatory disease, frequent immunomodulator use in CD, and a low rate of surgery in both CD and UC were identified. In CD, ileal involvement and complex disease behavior are associated with a more severe disease course, while in UC a high CRP predicted this outcome.
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Affiliation(s)
- Olga Niewiadomski
- Gastroenterology, St Vincent's Hospital, Fitzroy, Victoria, Australia
| | - Corrie Studd
- Gastroenterology, Royal Hobart Hospital, Hobart, Tasmania, Australia
| | - Chris Hair
- Gastroenterology, Barwon Health, Geelong, Victoria, Australia
| | - Jarrad Wilson
- Gastroenterology, North West Regional Hospital, Burnie, Tasmania, Australia
| | - Nik S Ding
- Gastroenterology, Barwon Health, Geelong, Victoria, Australia
| | - Neel Heerasing
- Gastroenterology, Barwon Health, Geelong, Victoria, Australia
| | - Alvin Ting
- Gastroenterology, Barwon Health, Geelong, Victoria, Australia
| | - John McNeill
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ross Knight
- Gastroenterology, Barwon Health, Geelong, Victoria, Australia
| | - John Santamaria
- Gastroenterology, St Vincent's Hospital, Fitzroy, Victoria, Australia
| | - Emily Prewett
- Gastroenterology, Barwon Health, Geelong, Victoria, Australia
| | - Paul Dabkowski
- Gastroenterology, Barwon Health, Geelong, Victoria, Australia
| | - Damian Dowling
- Gastroenterology, Barwon Health, Geelong, Victoria, Australia
| | - Sina Alexander
- Gastroenterology, Barwon Health, Geelong, Victoria, Australia
| | - Ben Allen
- Gastroenterology, Barwon Health, Geelong, Victoria, Australia
| | - Benjamin Popp
- Pathology, St John of God, Geelong, Victoria, Australia
| | - William Connell
- Gastroenterology, St Vincent's Hospital, Fitzroy, Victoria, Australia
| | - Paul Desmond
- Gastroenterology, St Vincent's Hospital, Fitzroy, Victoria, Australia.,Gastroenterology Department, University of Melbourne, Fitzroy, Victoria, Australia
| | - Sally Bell
- Gastroenterology, St Vincent's Hospital, Fitzroy, Victoria, Australia
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Bassetti CL, Ferini-Strambi L, Brown S, Adamantidis A, Benedetti F, Bruni O, Cajochen C, Dolenc-Groselj L, Ferri R, Gais S, Huber R, Khatami R, Lammers GJ, Luppi PH, Manconi M, Nissen C, Nobili L, Peigneux P, Pollmächer T, Randerath W, Riemann D, Santamaria J, Schindler K, Tafti M, Van Someren E, Wetter TC. Neurology and psychiatry: waking up to opportunities of sleep. : State of the art and clinical/research priorities for the next decade. Eur J Neurol 2015; 22:1337-54. [DOI: 10.1111/ene.12781] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 06/05/2015] [Indexed: 12/22/2022]
Affiliation(s)
- C. L. Bassetti
- Department of Neurology; Inselspital, Bern University Hospital; University of Bern; Bern Switzerland
| | - L. Ferini-Strambi
- Division of Neuroscience; Sleep Disorders Centre; Università Vita-Salute San Raffaele; Milan Italy
| | - S. Brown
- Institute of Pharmacology and Toxicology; University of Zürich; Zürich Switzerland
| | - A. Adamantidis
- Department of Neurology; Inselspital, Bern University Hospital; University of Bern; Bern Switzerland
| | - F. Benedetti
- Department of Clinical Neurosciences; Scientific Institute and University Vita-Salute San Raffaele; Milan Italy
| | - O. Bruni
- Department of Developmental and Social Psychology; Sapienza University; Rome Italy
| | - C. Cajochen
- Psychiatric University Clinic; Basel Switzerland
| | - L. Dolenc-Groselj
- Division of Neurology; Institute of Clinical Neurophysiology; University Medical Centre Ljubljana; Ljubljana Slovenia
| | - R. Ferri
- Department of Neurology; Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS); Troina Italy
| | - S. Gais
- Medical Psychology and Behavioural Neurobiology; Eberhard Karls Universität Tübingen; Tübingen Germany
| | - R. Huber
- Department of Paediatrics; Children's University Hospital; Zurich Switzerland
| | - R. Khatami
- Sleep Centre; Klinik Barmelweid AG; Barmelweid Switzerland
| | - G. J. Lammers
- Department of Neurology and Clinical Neurophysiology; Leiden University Medical Centre; Leiden The Netherlands
- Sleep Wake Centre SEIN; Stichting Epilepsie Instellingen Nederland; Heemstede The Netherlands
| | - P. H. Luppi
- UMR 5292 CNRS/U1028 INSERM; Centre de Recherche en Neurosciences de Lyon (CRNL); Team “Physiopathologie des réseaux neuronaux responsables du cycle veille-sommeil”; Université Claude Bernard Lyon I; Lyon France
| | - M. Manconi
- Sleep and Epilepsy Centre; Neurocentre of Southern Switzerland; Civic Hospital (EOC) of Lugano; Lugano Switzerland
| | - C. Nissen
- Department of Clinical Psychology and Psychophysiology/Sleep Medicine; Centre for Mental Disorders; Freiburg University Medical Centre; Freiburg Germany
| | - L. Nobili
- Centre of Epilepsy Surgery ‘C. Munari’; Niguarda Hospital; Milan Italy
| | - P. Peigneux
- UR2NF - Neuropsychology and Functional Neuroimaging Research Unit; CRCN - Centre de Recherches Cognition et Neurosciences and UNI - ULB Neurosciences Institute; Université Libre de Bruxelles (ULB); Brussels Belgium
| | - T. Pollmächer
- Center of Mental Health; Klinikum Ingolstadt; Ingolstadt Germany
| | - W. Randerath
- Institut für Pneumologie; Krankenhaus Bethanien gGmbH; Universität Witten/Herdecke; Solingen Germany
| | - D. Riemann
- Department of Clinical Psychology and Psychophysiology/Sleep Medicine; Centre for Mental Disorders; Freiburg University Medical Centre; Freiburg Germany
| | - J. Santamaria
- Neurology Service; Hospital Clínic of Barcelona; Institut d'Investigació Biomèdiques August Pi i Sunyer (IDIBAPS); Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED); Barcelona Spain
| | - K. Schindler
- Department of Neurology; Inselspital, Bern University Hospital; University of Bern; Bern Switzerland
| | - M. Tafti
- Centre for Integrative Genomics; University of Lausanne; Lausanne Switzerland
- Centre for Investigation and Research in Sleep; Vaud University Hospital; Lausanne Switzerland
| | - E. Van Someren
- Department of Sleep and Cognition; Netherlands Institute for Neuroscience; Amsterdam The Netherlands
- Departments of Integrative Neurophysiology and Medical Psychology; Center for Neurogenomics and Cognitive Research (CNCR); VU University and Medical Center; Amsterdam The Netherlands
| | - T. C. Wetter
- Department of Psychiatry and Psychotherapy; University of Regensburg; Regensburg Germany
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40
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Bruno FY, Grisolia MN, Visani C, Valencia S, Varela M, Abrudan R, Tornos J, Rivera-Calzada A, Ünal AA, Pennycook SJ, Sefrioui Z, Leon C, Villegas JE, Santamaria J, Barthélémy A, Bibes M. Insight into spin transport in oxide heterostructures from interface-resolved magnetic mapping. Nat Commun 2015; 6:6306. [PMID: 25686532 DOI: 10.1038/ncomms7306] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 01/15/2015] [Indexed: 11/09/2022] Open
Abstract
At interfaces between complex oxides, electronic, orbital and magnetic reconstructions may produce states of matter absent from the materials involved, offering novel possibilities for electronic and spintronic devices. Here we show that magnetic reconstruction has a strong influence on the interfacial spin selectivity, a key parameter controlling spin transport in magnetic tunnel junctions. In epitaxial heterostructures combining layers of antiferromagnetic LaFeO(3) (LFO) and ferromagnetic La(0.7)Sr(0.3)MnO(3) (LSMO), we find that a net magnetic moment is induced in the first few unit planes of LFO near the interface with LSMO. Using X-ray photoemission electron microscopy, we show that the ferromagnetic domain structure of the manganite electrodes is imprinted into the antiferromagnetic tunnel barrier, endowing it with spin selectivity. Finally, we find that the spin arrangement resulting from coexisting ferromagnetic and antiferromagnetic interactions strongly influences the tunnel magnetoresistance of LSMO/LFO/LSMO junctions through competing spin-polarization and spin-filtering effects.
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Affiliation(s)
- F Y Bruno
- Unité Mixte de Physique CNRS/Thales, 1 Avenue A. Fresnel, 91767 Palaiseau, France and Université Paris-Sud, 91405 Orsay, France
| | - M N Grisolia
- Unité Mixte de Physique CNRS/Thales, 1 Avenue A. Fresnel, 91767 Palaiseau, France and Université Paris-Sud, 91405 Orsay, France
| | - C Visani
- Unité Mixte de Physique CNRS/Thales, 1 Avenue A. Fresnel, 91767 Palaiseau, France and Université Paris-Sud, 91405 Orsay, France
| | - S Valencia
- Helmholtz-Zentrum-Berlin für Materialen und Energie, Albert-Einstein-Strasse 15, 12489 Berlin, Germany
| | - M Varela
- 1] GFMC, Departamento Física Aplicada III, Universidad Complutense Madrid, 28040 Madrid, Spain [2] Laboratorio de Heteroestructuras con aplicación en Spintronica, Unidad Asociada CSIC/Universidad Complutense de Madrid, Sor Juana Inés de la Cruz, 3, 28049 Madrid, Spain [3] Materials Science &Technology Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - R Abrudan
- 1] Helmholtz-Zentrum-Berlin für Materialen und Energie, Albert-Einstein-Strasse 15, 12489 Berlin, Germany [2] Institut für Experimentalphysik/Festkörperphysik, Ruhr-Universität Bochum, 44780 Bochum, Germany
| | - J Tornos
- 1] GFMC, Departamento Física Aplicada III, Universidad Complutense Madrid, 28040 Madrid, Spain [2] Laboratorio de Heteroestructuras con aplicación en Spintronica, Unidad Asociada CSIC/Universidad Complutense de Madrid, Sor Juana Inés de la Cruz, 3, 28049 Madrid, Spain
| | - A Rivera-Calzada
- 1] GFMC, Departamento Física Aplicada III, Universidad Complutense Madrid, 28040 Madrid, Spain [2] Laboratorio de Heteroestructuras con aplicación en Spintronica, Unidad Asociada CSIC/Universidad Complutense de Madrid, Sor Juana Inés de la Cruz, 3, 28049 Madrid, Spain
| | - A A Ünal
- Helmholtz-Zentrum-Berlin für Materialen und Energie, Albert-Einstein-Strasse 15, 12489 Berlin, Germany
| | - S J Pennycook
- Department of Materials Science and Engineering, The University of Tennessee, Knoxville, Tennessee 37996, USA
| | - Z Sefrioui
- 1] GFMC, Departamento Física Aplicada III, Universidad Complutense Madrid, 28040 Madrid, Spain [2] Laboratorio de Heteroestructuras con aplicación en Spintronica, Unidad Asociada CSIC/Universidad Complutense de Madrid, Sor Juana Inés de la Cruz, 3, 28049 Madrid, Spain
| | - C Leon
- 1] GFMC, Departamento Física Aplicada III, Universidad Complutense Madrid, 28040 Madrid, Spain [2] Laboratorio de Heteroestructuras con aplicación en Spintronica, Unidad Asociada CSIC/Universidad Complutense de Madrid, Sor Juana Inés de la Cruz, 3, 28049 Madrid, Spain
| | - J E Villegas
- Unité Mixte de Physique CNRS/Thales, 1 Avenue A. Fresnel, 91767 Palaiseau, France and Université Paris-Sud, 91405 Orsay, France
| | - J Santamaria
- 1] GFMC, Departamento Física Aplicada III, Universidad Complutense Madrid, 28040 Madrid, Spain [2] Laboratorio de Heteroestructuras con aplicación en Spintronica, Unidad Asociada CSIC/Universidad Complutense de Madrid, Sor Juana Inés de la Cruz, 3, 28049 Madrid, Spain
| | - A Barthélémy
- Unité Mixte de Physique CNRS/Thales, 1 Avenue A. Fresnel, 91767 Palaiseau, France and Université Paris-Sud, 91405 Orsay, France
| | - M Bibes
- Unité Mixte de Physique CNRS/Thales, 1 Avenue A. Fresnel, 91767 Palaiseau, France and Université Paris-Sud, 91405 Orsay, France
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Ortega-Liebana MC, Hueso JL, Larrea A, Sebastian V, Santamaria J. Feroxyhyte nanoflakes coupled to up-converting carbon nanodots: a highly active, magnetically recoverable, Fenton-like photocatalyst in the visible-NIR range. Chem Commun (Camb) 2015; 51:16625-8. [DOI: 10.1039/c5cc05387k] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Magnetic traffic-lights for photocatalysis: a novel nanohybrid combining feroxyhyte nanoflakes and upconverting carbon nanolights extends the activity range towards the near-infrared using inexpensive LED illumination.
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Affiliation(s)
- M. C. Ortega-Liebana
- Institute of Nanoscience of Aragon (INA) and Department of Chemical Engineering and Environmental Technology
- University of Zaragoza
- 50018 Zaragoza
- Spain
- Networking Research Center on Bioengineering
| | - J. L. Hueso
- Institute of Nanoscience of Aragon (INA) and Department of Chemical Engineering and Environmental Technology
- University of Zaragoza
- 50018 Zaragoza
- Spain
- Networking Research Center on Bioengineering
| | - A. Larrea
- Institute of Nanoscience of Aragon (INA) and Department of Chemical Engineering and Environmental Technology
- University of Zaragoza
- 50018 Zaragoza
- Spain
| | - V. Sebastian
- Institute of Nanoscience of Aragon (INA) and Department of Chemical Engineering and Environmental Technology
- University of Zaragoza
- 50018 Zaragoza
- Spain
- Networking Research Center on Bioengineering
| | - J. Santamaria
- Institute of Nanoscience of Aragon (INA) and Department of Chemical Engineering and Environmental Technology
- University of Zaragoza
- 50018 Zaragoza
- Spain
- Networking Research Center on Bioengineering
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42
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Moore E, Tobin A, Reid D, Santamaria J, Paul E, Bellomo R. The impact of fluid balance on the detection, classification and outcome of acute kidney injury after cardiac surgery. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2014.12.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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43
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Cuellar FA, Liu YH, Salafranca J, Nemes N, Iborra E, Sanchez-Santolino G, Varela M, Garcia Hernandez M, Freeland JW, Zhernenkov M, Fitzsimmons MR, Okamoto S, Pennycook SJ, Bibes M, Barthélémy A, te Velthuis SGE, Sefrioui Z, Leon C, Santamaria J. Reversible electric-field control of magnetization at oxide interfaces. Nat Commun 2014; 5:4215. [PMID: 24953219 DOI: 10.1038/ncomms5215] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 05/27/2014] [Indexed: 11/09/2022] Open
Abstract
Electric-field control of magnetism has remained a major challenge which would greatly impact data storage technology. Although progress in this direction has been recently achieved, reversible magnetization switching by an electric field requires the assistance of a bias magnetic field. Here we take advantage of the novel electronic phenomena emerging at interfaces between correlated oxides and demonstrate reversible, voltage-driven magnetization switching without magnetic field. Sandwiching a non-superconducting cuprate between two manganese oxide layers, we find a novel form of magnetoelectric coupling arising from the orbital reconstruction at the interface between interfacial Mn spins and localized states in the CuO2 planes. This results in a ferromagnetic coupling between the manganite layers that can be controlled by a voltage. Consequently, magnetic tunnel junctions can be electrically toggled between two magnetization states, and the corresponding spin-dependent resistance states, in the absence of a magnetic field.
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Affiliation(s)
- F A Cuellar
- 1] GFMC, Departamento Fisica Aplicada III, Universidad Complutense Madrid, 28040 Madrid, Spain [2]
| | - Y H Liu
- Materials Science Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - J Salafranca
- 1] GFMC, Departamento Fisica Aplicada III, Universidad Complutense Madrid, 28040 Madrid, Spain [2] Materials Science & Technology Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - N Nemes
- GFMC, Departamento Fisica Aplicada III, Universidad Complutense Madrid, 28040 Madrid, Spain
| | - E Iborra
- GMME Departamento de Tecnologia Electronica, ETSIT, Universidad Politecnica de Madrid, 28040 Madrid, Spain
| | - G Sanchez-Santolino
- 1] GFMC, Departamento Fisica Aplicada III, Universidad Complutense Madrid, 28040 Madrid, Spain [2] Laboratorio de Heteroestructuras con aplicación en Spintronica, Unidad Asociada CSIC/Universidad Complutense Madrid, Sor Juana Inés de la Cruz, 3, ES-28049 Madrid, Spain
| | - M Varela
- 1] GFMC, Departamento Fisica Aplicada III, Universidad Complutense Madrid, 28040 Madrid, Spain [2] Materials Science & Technology Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - M Garcia Hernandez
- 1] Laboratorio de Heteroestructuras con aplicación en Spintronica, Unidad Asociada CSIC/Universidad Complutense Madrid, Sor Juana Inés de la Cruz, 3, ES-28049 Madrid, Spain [2] Instituto de Ciencia de Materiales de Madrid, 28049 Madrid, Spain
| | - J W Freeland
- Advanced Photon Source, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - M Zhernenkov
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - M R Fitzsimmons
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S Okamoto
- Materials Science & Technology Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - S J Pennycook
- Department of Materials Science and Engineering, The University of Tennessee, Knoxville, Tennessee 37996, USA
| | - M Bibes
- 1] Unité Mixte de Physique CNRS/Thales, 1 avenue Augustin Fresnel, Campus de l'Ecole Polytechnique, 91767 Palaiseau, France [2] Université Paris-Sud, 91905 Orsay, France
| | - A Barthélémy
- 1] Unité Mixte de Physique CNRS/Thales, 1 avenue Augustin Fresnel, Campus de l'Ecole Polytechnique, 91767 Palaiseau, France [2] Université Paris-Sud, 91905 Orsay, France
| | - S G E te Velthuis
- Materials Science Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - Z Sefrioui
- 1] GFMC, Departamento Fisica Aplicada III, Universidad Complutense Madrid, 28040 Madrid, Spain [2] Laboratorio de Heteroestructuras con aplicación en Spintronica, Unidad Asociada CSIC/Universidad Complutense Madrid, Sor Juana Inés de la Cruz, 3, ES-28049 Madrid, Spain
| | - C Leon
- 1] GFMC, Departamento Fisica Aplicada III, Universidad Complutense Madrid, 28040 Madrid, Spain [2] Laboratorio de Heteroestructuras con aplicación en Spintronica, Unidad Asociada CSIC/Universidad Complutense Madrid, Sor Juana Inés de la Cruz, 3, ES-28049 Madrid, Spain
| | - J Santamaria
- 1] GFMC, Departamento Fisica Aplicada III, Universidad Complutense Madrid, 28040 Madrid, Spain [2] Laboratorio de Heteroestructuras con aplicación en Spintronica, Unidad Asociada CSIC/Universidad Complutense Madrid, Sor Juana Inés de la Cruz, 3, ES-28049 Madrid, Spain
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44
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Ariño H, Iranzo A, Gaig C, Santamaria J. Sexsomnia: Parasomnia associated with sexual behaviour during sleep. Neurología (English Edition) 2014. [DOI: 10.1016/j.nrleng.2013.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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45
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Matthews IG, D'Souza D, Prior D, Santamaria J, Smith B. PW037 Management of heart failure patients admitted under cardiologists or general physicians. Glob Heart 2014. [DOI: 10.1016/j.gheart.2014.03.2192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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46
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Smith R, Reid D, Faraone E, Santamaria J. The mortality associated with hospital medical emergency calls (Respond Medical Emergency Team or Respond Blue). Aust Crit Care 2014. [DOI: 10.1016/j.aucc.2013.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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47
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Moore EM, Tobin A, Reid D, Santamaria J, Bellomo R. Acute kidney injury and cardiac surgery: impact of fluid balance on AKI classification and prognosis. Crit Care 2014. [PMCID: PMC4069370 DOI: 10.1186/cc13557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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48
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Moore EM, Tobin A, Reid D, Santamaria J, Bellomo R. Fluid accumulation post cardiac surgery and risk for renal replacement therapy. Crit Care 2014. [PMCID: PMC4069369 DOI: 10.1186/cc13578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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49
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Schenck C, Montplaisir J, Frauscher B, Hogl B, Gagnon JF, Postuma R, Sonka K, Jennum P, Partinen M, Arnulf I, de Cock VC, Dauvilliers Y, Luppi PH, Heidbreder A, Mayer G, Sixel-Döring F, Trenkwalder C, Unger M, Young P, Wing Y, Ferini-Strambi L, Ferri R, Plazzi G, Zucconi M, Inoue Y, Iranzo A, Santamaria J, Bassetti C, Möller J, Boeve B, Lai Y, Pavlova M, Saper C, Schmidt P, Siegel J, Singer C, St Louis E, Videnovic A, Oertel W. Corrigendum to “Rapid eye movement sleep behavior disorder: devising controlled active treatment studies for symptomatic and neuroprotective therapy—a consensus statement from the International Rapid Eye Movement Sleep Behavior Disorder Study Group” [Sleep Med 14(8) (2013) 795–806]. Sleep Med 2014. [DOI: 10.1016/j.sleep.2013.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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50
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Liu Y, Cuellar FA, Sefrioui Z, Freeland JW, Fitzsimmons MR, Leon C, Santamaria J, te Velthuis SGE. Emergent spin filter at the interface between ferromagnetic and insulating layered oxides. Phys Rev Lett 2013; 111:247203. [PMID: 24483696 DOI: 10.1103/physrevlett.111.247203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Indexed: 06/03/2023]
Abstract
We report a strong effect of interface-induced magnetization on the transport properties of magnetic tunnel junctions consisting of ferromagnetic manganite La0.7Ca0.3MnO3 and insulating cuprate PrBa2Cu3O7. Contrary to the typically observed steady increase of the tunnel magnetoresistance with decreasing temperature, this system exhibits a sudden anomalous decrease at low temperatures. Interestingly, this anomalous behavior can be attributed to the competition between the positive spin polarization of the manganite contacts and the negative spin-filter effect from the interface-induced Cu magnetization.
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Affiliation(s)
- Yaohua Liu
- Materials Science Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - F A Cuellar
- GFMC, Departamento de Fisica Aplicada III, Universidad Complutense de Madrid, Campus Moncloa, ES-28040 Madrid, Spain
| | - Z Sefrioui
- GFMC, Departamento de Fisica Aplicada III, Universidad Complutense de Madrid, Campus Moncloa, ES-28040 Madrid, Spain
| | - J W Freeland
- Advanced Photon Source, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - M R Fitzsimmons
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - C Leon
- GFMC, Departamento de Fisica Aplicada III, Universidad Complutense de Madrid, Campus Moncloa, ES-28040 Madrid, Spain
| | - J Santamaria
- GFMC, Departamento de Fisica Aplicada III, Universidad Complutense de Madrid, Campus Moncloa, ES-28040 Madrid, Spain
| | - S G E te Velthuis
- Materials Science Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
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