Geometrically enhanced closed-loop multi-turn sensor devices that enable reliable magnetic domain wall motion

We experimentally realize a sophisticated structure geometry for reliable magnetic domain wall-based multi-turn-counting sensor devices, which we term closed-loop devices that can sense millions of turns. The concept relies on the reliable propagation of domain walls through a cross-shaped intersection of magnetic conduits, to allow the intertwining of loops of the sensor device. As a key step to reach the necessary reliability of the operation, we develop a combination of tilted wires called the syphon structure at the entrances of the cross. We measure the control and reliability of the domain wall propagation individually for cross-shaped intersections, the syphon geometries and finally combinations of the two for various field configurations (strengths and angles). The various measured syphon geometries yield a dependence of the domain wall propagation on the shape that we explain by the effectively acting transverse and longitudinal external applied magnetic fields. The combination of both elements yields a behaviour that cannot be explained by a simple superposition of the individual different maximum field operation values. We identify as an additional process the nucleation of domain walls in the cross, which then allows us to fully gauge the operational parameters. Finally, we demonstrate that by tuning the central dimensions of the cross and choosing the optimum angle for the syphon structure reliable sensor operation is achieved, which paves the way for disruptive multi-turn sensor devices

Reliable Propagation of Magnetic Domain Walls in Cross Structures for Advanced Multiturn Sensors

[EN] We develop and analyze an advanced concept for a domain-wall-based sensing of rotations. Moving domain walls in n closed loops with n - 1 intersecting convolutions by rotating fields, we are able to sense n rotations. By combining loops with coprime numbers of rotations, we create a sensor system allowing for the total counting of millions of turns of a rotating applied magnetic field. We analyze the operation of the sensor and identify the intersecting cross structures as the critical component for reliable operation. Specifically, depending on the orientation of the applied field angle with the magnetization in the branches of the cross, a domain wall is found to propagate in an unwanted direction, yielding failures and counting errors in the device. To overcome this limiting factor, we introduce a specially designed syphon structure to the controlled pinning of the domain wall before the cross and depinning and propagation only for a selected range of applied field angles. By adjusting the syphon and the cross geometry, we find that the optimized combination of both structures prevents failures in the full sensor structure yielding robust operation. Our modeling results show that the optimized element geometry allows for the realization of the sensor with cross-shaped intersections and an operation that is tolerant to inaccuracies of the fabrication.Comisión Europea (P7-PEOPLE-2013-ITN 608031) Gobierno de España (MAT2014-52477-C5-4-P) Junta de Castilla y Leon (SA090U16) European Research Council (MultiRev ERC-2014-PoC 665672) German Research Foundation (SFB TRR173 Spin+X

Gene expression profile predicts outcome after anthracycline-based adjuvant chemotherapy in early breast cancer

International audiencePrognosis of early beast cancer is heterogeneous. Today, no histoclinical or biological factor predictive for clinical outcome after adjuvant anthracycline-based chemotherapy (CT) has been validated and introduced in routine use. Using DNA microarrays, we searched for a gene expression signature associated with metastatic relapse after adjuvant anthracycline-based CT without taxane. We profiled a multicentric series of 595 breast cancers including 498 treated with such adjuvant CT. The identification of the prognostic signature was done using a metagene-based supervised approach in a learning set of 323 patients. The signature was then tested on an independent validation set comprising 175 similarly treated patients, 128 of them from the PACS01 prospective clinical trial. We identified a 3-metagene predictor of metastatic relapse in the learning set, and confirmed its independent prognostic impact in the validation set. In multivariate analysis, the predictor outperformed the individual current prognostic factors, as well as the Nottingham Prognostic Index-based classifier, both in the learning and the validation sets, and added independent prognostic information. Among the patients treated with adjuvant anthracycline-based CT, with a median follow-up of 68 months, the 5-year metastasis-free survival was 82% in the "good-prognosis" group and 56% in the "poor-prognosis" group. Our predictor refines the prediction of metastasis-free survival after adjuvant anthracycline-based CT and might help tailoring adjuvant CT regimens

An agenda for ethics and justice in adaptation to climate change

As experts predict that at least some irreversible climate change will occur with potentially disastrous effects on the lives and well-being of vulnerable communities around the world, it is paramount to ensure that these communities are resilient and have adaptive capacity to withstand the consequences. Adaptation and resilience planning present several ethical issues that need to be resolved if we are to achieve successful adaptation and resilience to climate change, taking into consideration vulnerabilities and inequalities in terms of power, income, gender, age, sexuality, race, culture, religion, and spatiality. Sustainable adaptation and resilience planning that addresses these ethical issues requires interdisciplinary dialogues between the natural sciences, social sciences, and philosophy, in order to integrate empirical insights on socioeconomic inequality and climate vulnerability with ethical analysis of the underlying causes and consequences of injustice in adaptation and resilience. In this paper, we set out an interdisciplinary research agenda for the inclusion of ethics and justice theories in adaptation and resilience planning, particularly into the Sixth Assessment Report of the International Panel on Climate Change (IPCC AR6). We present six core discussions that we believe should be an integral part of these interdisciplinary dialogues on adaptation and resilience as part of IPCC AR6, especially Chapters 2 (“Terrestial and freshwater ecosystems and their services”), 6 (“Cities, settlements and key infrastructure”), 7 (“Health, wellbeing and the changing structure of communities”), 8 (“Poverty, livelihoods and sustainable development”), 16 “Key risks across sectors and regions”), 17 (“Decision-making options for managing risk”), and 18 (“Climate resilient development pathways”).: (i) Where does ‘justice’ feature in resilience and adaptation planning and what does it require in that regard?; (ii) How can it be ensured that adaptation and resilience strategies protect and take into consideration and represent the interest of the most vulnerable women and men, and communities?; (iii) How can different forms of knowledge be integrated within adaptation and resilience planning?; (iv) What trade-offs need to be made when focusing on resilience and adaptation and how can they be resolved?; (v) What roles and responsibilities do different actors have to build resilience and achieve adaptation?; (vi) Finally, what does the focus on ethics imply for the practice of adaptation and resilience planning

An agenda for ethics and justice in adaptation to climate change

As experts predict that at least some irreversible climate change will occur with potentially disastrous effects on the lives and well-being of vulnerable communities around the world, it is paramount to ensure that these communities are resilient and have adaptive capacity to withstand the consequences. Adaptation and resilience planning present several ethical issues that need to be resolved if we are to achieve successful adaptation and resilience to climate change, taking into consideration vulnerabilities and inequalities in terms of power, income, gender, age, sexuality, race, culture, religion, and spatiality. Sustainable adaptation and resilience planning that addresses these ethical issues requires interdisciplinary dialogues between the natural sciences, social sciences, and philosophy, in order to integrate empirical insights on socioeconomic inequality and climate vulnerability with ethical analysis of the underlying causes and consequences of injustice in adaptation and resilience. In this paper, we set out an interdisciplinary research agenda for the inclusion of ethics and justice theories in adaptation and resilience planning, particularly into the Sixth Assessment Report of the International Panel on Climate Change (IPCC AR6). We present six core discussions that we believe should be an integral part of these interdisciplinary dialogues on adaptation and resilience as part of IPCC AR6, especially Chapters 2 (“Terrestial and freshwater ecosystems and their services”), 6 (“Cities, settlements and key infrastructure”), 7 (“Health, wellbeing and the changing structure of communities”), 8 (“Poverty, livelihoods and sustainable development”), 16 “Key risks across sectors and regions”), 17 (“Decision-making options for managing risk”), and 18 (“Climate resilient development pathways”).: (i) Where does ‘justice’ feature in resilience and adaptation planning and what does it require in that regard?; (ii) How can it be ensured that adaptation and resilience strategies protect and take into consideration and represent the interest of the most vulnerable women and men, and communities?; (iii) How can different forms of knowledge be integrated within adaptation and resilience planning?; (iv) What trade-offs need to be made when focusing on resilience and adaptation and how can they be resolved?; (v) What roles and responsibilities do different actors have to build resilience and achieve adaptation?; (vi) Finally, what does the focus on ethics imply for the practice of adaptation and resilience planning

Diagnostic accuracy of a clinical diagnosis of idiopathic pulmonary fibrosis: An international case-cohort study

We conducted an international study of idiopathic pulmonary fibrosis (IPF) diagnosis among a large group of physicians and compared their diagnostic performance to a panel of IPF experts. A total of 1141 respiratory physicians and 34 IPF experts participated. Participants evaluated 60 cases of interstitial lung disease (ILD) without interdisciplinary consultation. Diagnostic agreement was measured using the weighted kappa coefficient (\u3baw). Prognostic discrimination between IPF and other ILDs was used to validate diagnostic accuracy for first-choice diagnoses of IPF and were compared using the Cindex. A total of 404 physicians completed the study. Agreement for IPF diagnosis was higher among expert physicians (\u3baw=0.65, IQR 0.53-0.72, p20 years of experience (C-index=0.72, IQR 0.0-0.73, p=0.229) and non-university hospital physicians with more than 20 years of experience, attending weekly MDT meetings (C-index=0.72, IQR 0.70-0.72, p=0.052), did not differ significantly (p=0.229 and p=0.052 respectively) from the expert panel (C-index=0.74 IQR 0.72-0.75). Experienced respiratory physicians at university-based institutions diagnose IPF with similar prognostic accuracy to IPF experts. Regular MDT meeting attendance improves the prognostic accuracy of experienced non-university practitioners to levels achieved by IPF experts

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

A Novel, Minimally Invasive Method to Retrieve Failed Dental Implants in Elderly Patients

This practice-based study presents the clinical outcomes of a minimally invasive method for retrieving failed dental implants from elderly patients. Traditional removal methods for failed dental implants include trephination and other invasive procedures. That can be a special concern for the elderly, since aging exacerbates oral surgery-related morbidity and anxiety. This retrospective cohort study gathers data from 150 patients seen in a private clinic. Their implants (n = 199) failed due to biological, mechanical, or iatrogenic causes, and were removed as part of their treatment plan. Collected data included: (1) implant location (maxilla/mandible, anterior/posterior region), (2) reasons for implant retrieval, (3) connection type, (4) removal torque, and (5) operatory procedure—flapless and using a counter-torque removal kit, whenever possible. Flapless/minimally invasive retrieval was successful for 193 implants (97%). The remaining six implants demanded trephination (open-flap). The most common reasons for implant retrieval (81%) involved biological aspects, whereas iatrogenic (12%) and biomechanical (7%) reasons were less common. The surgical technique used was not associated to connection types or removal torque. Authors conclude that a counter-torque ratchet system is a minimally invasive technique with a high success rate in retrieving implants from elderly patients. Present findings support its use as a first-line approach for implant retrieval in that population