RESUMO
Tularemia is a rare zoonotic disease caused by Francisella tularensis. It can often present with varied clinical presentations, but meningitis is extremely rare. In this case study, we describe a patient who presented to our emergency department with a Tularemic infection coupled with acute atypical meningitis, after he was exposed to aerosolized rabbit hair from lawn mowing. Prompt diagnosis of tularemic meningitis may be difficult without a known history of animal exposure. Despite what is taught in medical school, numerous studies have shown Kernig's sign, Brudzinski's sign, and nuchal rigidity do not have much diagnostic value in adults with meningitis. Yet, almost all patients with meningitis present with at least 2 of the 4 symptoms of fever, headache, altered mental status, and neck stiffness. For this reason, it is essential to stop using Kernig's sign and Brudzinski's sign as the only basis for diagnosing meningitis in every case. With the rampant population increase of rabbits in states like Colorado, Missouri, and Illinois, and a growing number of tularemic patients from lawn mowing incidents popping up across the country, it is also vital to consider the diagnosis of tularemia in your differential diagnosis and send for a cerebrospinal fluid culture, based on a more detailed historytaking of your patient, specifically noting his/her outdoor activities during the initial assessment in the emergency department (ED). This would immensely speed up the process of diagnosing the patient and would ensure a timely start of antibiotics for a full recovery.
RESUMO
Recent advances in the development of attosecond soft X-ray sources ranging into the water window spectral range, between the 1s states of carbon and oxygen (284 eV-543 eV), are also driving the development of suited broadband multilayer optics for steering and shaping attosecond pulses. The relatively low intensity of current High Harmonic Generation (HHG) soft X-ray sources calls for an efficient use of photons, thus the development of low-loss multilayer optics is of uttermost importance. Here, we report about the realization of broadband Cr/Sc attosecond multilayer mirrors with nearly atomically smooth interfaces by an optimized ion beam deposition and assisted interface polishing process. This yields to our knowledge highest multilayer mirror reflectivity at 300 eV near normal incidence. The results are verified by transmission electron microscopy (TEM) and soft/hard X-ray reflectometry.
RESUMO
TbMnO(3) films have been grown under compressive strain on (001)-oriented SrTiO(3) crystals. They have an orthorhombic structure and display the (001) orientation. With increasing thickness, the structure evolves from a more symmetric (tetragonal) to a less symmetric (bulk-like orthorhombic) structure, while keeping constant the in-plane compression, thereby leaving the out-of-plane lattice spacing unchanged. The domain microstructure of the films is also revealed, showing an increasing number of orthorhombic domains as the thickness is decreased: we directly observe ferroelastic domains as narrow as 4 nm. The high density of domain walls may explain the induced ferromagnetism observed in the films, while both the decreased anisotropy and the small size of the domains could account for the absence of a ferroelectric spin spiral phase.
