Clinical and parasitological response to oral chloroquine and primaquine in uncomplicated human Plasmodium knowlesi infections

Background: Plasmodium knowlesi is a cause of symptomatic and potentially fatal infections in humans. There are no studies assessing the detailed parasitological response to treatment of knowlesi malaria infections in man and whether antimalarial resistance occurs. Methods: A prospective observational study of oral chloroquine and primaquine therapy was conducted in consecutive patients admitted to Kapit Hospital, Sarawak, Malaysian Borneo with PCR-confirmed single P. knowlesi infections. These patients were given oral chloroquine for three days, and at 24 hours oral primaquine was administered for two consecutive days, primarily as a gametocidal agent. Clinical and parasitological responses were recorded at 6-hourly intervals during the first 24 hours, daily until discharge and then weekly to day 28. Vivax malaria patients were studied as a comparator group. Results: Of 96 knowlesi malaria patients who met the study criteria, 73 were recruited to an assessment of the acute response to treatment and 60 completed follow-up over 28 days. On admission, the mean parasite stage distributions were 49.5%, 41.5%, 4.0% and 5.6% for early trophozoites, late trophozoites, schizonts and gametocytes respectively. The median fever clearance time was 26.5 [inter-quartile range 16-34] hours. The mean times to 50% (PCT50) and 90% (PCT90) parasite clearance were 3.1 (95% confidence intervals [CI] 2.8-3.4) hours and 10.3 (9.4-11.4) hours. These were more rapid than in a group of 23 patients with vivax malaria 6.3 (5.3-7.8) hours and 20.9 (17.6-25.9) hours; P = 0.02). It was difficult to assess the effect of primaquine on P. knowlesi parasites, due to the rapid anti-malarial properties of chloroquine and since primaquine was administered 24 hours after chloroquine. No P. knowlesi recrudescences or re-infections were detected by PCR. Conclusions: Chloroquine plus primaqine is an inexpensive and highly effective treatment for uncomplicated knowlesi malaria infections in humans and there is no evidence of drug resistance. Further studies using alternative anti-malarial drugs, including artemisinin derivatives, would be desirable to define optimal management strategies for P. knowlesi.Publisher PDFPeer reviewe

Sleep hygiene in medical students in Tehran; do they learn to attend to their own health?

Background: Poor sleep quality in medical students may negatively affect their professional training and deteriorate neurocognitive and academic performance. Objectives: In this study, we aim to determine the prevalence and determinants of poor sleep quality and its scales in a group of medical students in Tehran, Iran in 2017. Methods: In this cross-sectional study, Pittsburgh Sleep Quality Index (PSQI) was completed by 154 medical students in Tehran, Iran. Demographic characteristics were also gathered. Global PSQI and scales scores were calculated. Results: Median Global PSQI score was 5. Poor sleep quality was observed in 65 (42) students. Participants scored worst in sleep duration and daytime dysfunction scales, and 84.4 of the total participants reported some degree of daytime dysfunction. More than 90 of the participants reported no use of sleep medication. Neither of the variables sex, age, place of residence, being a freshman or having a history of sleep problems showed any significant association with sleep quality. When evaluating the scales, sleep duration problem was mostly observed in freshmen (P = 0.02), while medication use and daytime dysfunction were more common in second-year students (P = 0.04 and P = 0.01, respectively). Conclusions: The prevalence of poor sleep quality was high in this group of medical students in Tehran. The problem was largely observed in sleep duration and daytime dysfunction subscales of sleep quality. © 2020, Author(s)

Spin instabilities and quantum phase transitions in integral and fractional quantum Hall states

The inter-Landau-level spin excitations of quantum Hall states at filling factors nu=2 and 4/3 are investigated by exact numerical diagonalization for the situation in which the cyclotron (hbar*omega_c) and Zeeman (E_Z) splittings are comparable. The relevant quasiparticles and their interactions are studied, including stable spin wave and skyrmion bound states. For nu=2, a spin instability at a finite value of epsilon=hbar*omega_c-E_Z leads to an abrupt paramagnetic to ferromagnetic transition, in agreement with the mean-field approximation. However, for nu=4/3 a new and unexpected quantum phase transition is found which involves a gradual change from paramagnetic to ferromagnetic occupancy of the partially filled Landau level as epsilon is decreased.Comment: 4 pages, 5 figures, submitted to Phys.Rev.Let

Quantum Hall ferromagnets, cooperative transport anisotropy, and the random field Ising model

We discuss the behaviour of a quantum Hall system when two Landau levels with opposite spin and combined filling factor near unity are brought into energetic coincidence using an in-plane component of magnetic field. We focus on the interpretation of recent experiments under these conditions [Zeitler et al, Phys. Rev. Lett. 86, 866 (2001); Pan et al, Phys. Rev. B 64, 121305 (2001)], in which a large resistance anisotropy develops at low temperatures. Modelling the systems involved as Ising quantum Hall ferromagnets, we suggest that this transport anisotropy reflects domain formation induced by a random field arising from isotropic sample surface roughness.Comment: 4 pages, submitted to Physical Review

Sustainable Environment: Nexus project

Arequipa region is locaed in Southwestern Peru. The Arequipa Nexus Institute for food, energy, water and the environment aims to address the key challenges to a sustainable furture for the people in the region. This roundtable discusses about the sustainable water management, geosaptial analysis and environment sharing, long range sensor network solution for soil health monitoring and data management and sharing in this Nexus project

Spins, charges and currents at Domain Walls in a Quantum Hall Ising Ferromagnet

We study spin textures in a quantum Hall Ising ferromagnet. Domain walls between ferro and unpolarized states at $\nu=2$ are analyzed with a functional theory supported by a microscopic calculation. In a neutral wall, Hartree repulsion prevents the appearance of a fan phase provoked by a negative stiffness. For a charged system, electrons become trapped as solitons at the domain wall. The size and energy of the solitons are determined by both Hartree and spin-orbit interactions. Finally, we discuss how electrical transport takes place through the domain wall.Comment: 4 pages, 3 figures include