Sequential antimicrobial therapy: treatment of severe lower respiratory tract infections in children

Although there have been a number of studies in adults, to date there has been little research into sequential antimicrobial therapy (SAT) in paediatric populations. The present study evaluates the impact of a SAT protocol for the treatment of severe lower respiratory tract infection in paediatric patients. The study involved 89 paediatric patients (44 control and 45 SAT). The SAT patients had a shorter length of hospital stay (4.0 versus 8.3 days), shorter duration of inpatient antimicrobial therapy (4.0 versus 7.9 days) with the period of iv therapy being reduced from a mean of 5.6 to 1.7 days. The total healthcare costs were reduced by 52%. The resolution of severe lower respiratory tract infection with a short course of iv antimicrobials, followed by conversion to oral therapy yielded clinical outcomes comparable to those achieved using longer term iv therapy. SAT proved to be an important cost-minimizing tool for realizing substantial healthcare costs savings.

The Respiratory Syncytial Virus G Protein Conserved Domain Induces a Persistent and Protective Antibody Response in Rodents

Respiratory syncytial virus (RSV) is an important cause of severe upper and lower respiratory disease in infants and in the elderly. There are 2 main RSV subtypes A and B. A recombinant vaccine was designed based on the central domain of the RSV-A attachment G protein which we had previously named G2Na (aa130–230). Here we evaluated immunogenicity, persistence of antibody (Ab) response and protective efficacy induced in rodents by: (i) G2Na fused to DT (Diphtheria toxin) fragments in cotton rats. DT fusion did not potentiate neutralizing Ab responses against RSV-A or cross-reactivity to RSV-B. (ii) G2Nb (aa130–230 of the RSV-B G protein) either fused to, or admixed with G2Na. G2Nb did not induce RSV-B-reactive Ab responses. (iii) G2Na at low doses. Two injections of 3 µg G2Na in Alum were sufficient to induce protective immune responses in mouse lungs, preventing RSV-A and greatly reducing RSV-B infections. In cotton rats, G2Na-induced RSV-reactive Ab and protective immunity against RSV-A challenge that persisted for at least 24 weeks. (iv) injecting RSV primed mice with a single dose of G2Na/Alum or G2Na/PLGA [poly(D,L-lactide-co-glycolide]. Despite the presence of pre-existing RSV-specific Abs, these formulations effectively boosted anti-RSV Ab titres and increased Ab titres persisted for at least 21 weeks. Affinity maturation of these Abs increased from day 28 to day 148. These data indicate that G2Na has potential as a component of an RSV vaccine formulation.

Moxifloxacin sensitivity of respiratory pathogens in the United Kingdom

The in vitro activity of moxifloxacin and comparator agents against respiratory isolates from a range of geographically distinct centres around the United Kingdom was investigated in the following study. Clinical isolates of Streptococcus pneumoniae (n = 257), Haemophilus influenzae (n = 399) and Moraxella catarrhalis (n = 253) were obtained between March 1998 and April 1999 from nine centres in the United Kingdom. Sensitivity was determined by testing each isolate for its minimum inhibitory concentration (MIC) by agar dilution. Against Streptococcus pneumoniae moxifloxacin and grepafloxacin were the most active (MIC90 = 0.25 mg/l). Trovafloxacin and sparfloxacin were the next most active (MIC90 = 0.5 mg/l) followed by levofloxacin and ciprofloxacin. MIC90 values of the six fluoroquinolones versus H. influenzae ranged from ciprofloxacin > levofloxacin. Against M. catarrhalis the lowest MIC90 was that of grepafloxacin at 0.0625 mg/l followed by moxifloxacin, sparfloxacin, levofloxacin and ciprofloxacin. Trovafloxacin demonstrated the highest MIC90 at 0.5 mg/l. These results demonstrate that moxifloxacin has superior in vitro activity against respiratory tract pathogens than any other comparator quinolones available for clinical use.

Optomechanical cooling with generalized interferometers

The fields in multiple-pass interferometers, such as the Fabry-Pérot cavity, exhibit great sensitivity not only to the presence but also to the motion of any scattering object within the optical path. We consider the general case of an interferometer comprising an arbitrary configuration of generic beam splitters and calculate the velocity-dependent radiation field and the light force exerted on a moving scatterer. We find that a simple configuration, in which the scatterer interacts with an optical resonator from which it is spatially separated, can enhance the optomechanical friction by several orders of magnitude.

Exciton-mediated photothermal cooling in GaAs membranes

Cooling of the mechanical motion of a GaAs nano-membrane using the photothermal effect mediated by excitons was recently demonstrated by some of the authors (Usami et al 2012 Nature Phys. 8 168) and provides a clear example of the use of thermal forces to cool down mechanical motion. Here, we report on a single-free-parameter theoretical model to explain the results of this experiment which matches the experimental data remarkably well.

Scattering theory of cooling and heating in optomechanical systems

We present a one-dimensional scattering theory which enables us to describe a wealth of effects arising from the coupling of the motional degree of freedom of scatterers to the electromagnetic field. Multiple scattering to all orders is taken into account. The theory is applied to describe the scheme of a Fabry-Perot resonator with one of its mirrors moving. The friction force, as well as the diffusion, acting on the moving mirror is derived. In the limit of a small reflection coefficient, the same model provides for the description of the mechanical effect of light on an atom moving in front of a mirror.

Cavity cooling of atoms: Within and without a cavity

We compare the efficiencies of two optical cooling schemes, where a single particle is either inside or outside an optical cavity, under experimentally-realisable conditions. We evaluate the cooling forces using the general solution of a transfer matrix method for a moving scatterer inside a general one-dimensional system composed of immobile optical elements. Assuming the same atomic saturation parameter, we find that the two cooling schemes provide cooling forces and equilibrium temperatures of comparable magnitude.

Atom cooling using the dipole force of a single retroreflected laser beam

We present a mechanism for cooling atoms by a laser beam reflected from a single mirror. The cooling relies on the dipole force and thus in principle applies to arbitrary refractive particles including atoms, molecules, or dielectric spheres. Friction and equilibrium temperatures are derived by an analytic perturbative approach. Finally, semiclassical Monte-Carlo simulations are performed to validate the analytic results.

Optical Cooling of Atoms in Microtraps by Time-Delayed Reflection

We present a theoretical analysis of a novel scheme for optical cooling of particles that does not in principle require a closed optical transition. A tightly confined laser beam interacting with a trapped particle experiences a phase shift, which upon reflection from a mirror or resonant microstructure produces a time-delayed optical potential for the particle. This leads to a nonconservative force and friction. A quantum model of the system is presented and analyzed in the semiclassical limit.

Optical Cooling Using the Dipole Force

The term `laser cooling' is applied to the use of optical means to cool the motional energies of either atoms and molecules, or micromirrors. In the literature, these two strands are kept largely separate; both, however suffer from severe limitations. Laser cooling of atoms and molecules largely relies on the internal level structure of the species being cooled. As a result, only a small number of elements and a tiny number of molecules can be cooled this way. In the case of micromirrors, the problem lies in the engineering of micromirrors that need to satisfy a large number of constraints---these include a high mechanical Q-factor, high reflectivity and very good optical quality, weak coupling to the substrate, etc.---in order to enable efficient cooling. During the course of this thesis, I will draw these two sides of laser cooling closer together by means of a single, generically applicable scattering theory that can be used to explain the interaction between light and matter at a very general level. I use this `transfer matrix' formalism to explore the use of the retarded dipole--dipole interaction as a means of both enhancing the efficiency of micromirror cooling systems and rendering the laser cooling of atoms and molecules less species selective. In particular, I identify the `external cavity cooling' mechanism, whereby the use of an optical memory in the form of a resonant element (such as a cavity), outside which the object to be cooled sits, can potentially lead to the construction of fully integrated optomechanical systems and even two-dimensional arrays of translationally cold atoms, molecules or even micromirrors.