Unconventional Josephson effect in hybrid superconductor-topological insulator devices

We report on transport properties of Josephson junctions in hybrid superconducting-topological insulator devices, which show two striking departures from the common Josephson junction behavior: a characteristic energy that scales inversely with the width of the junction, and a low characteristic magnetic field for suppressing supercurrent. To explain these effects, we propose a phenomenological model which expands on the existing theory for topological insulator Josephson junctions.

Feeling connected: technology and the support of clinical teachers in distant locations

CONTEXT

This paper discusses a key finding arising from a qualitative research project which explored the provision of educational support to clinical teachers who were at least 100 kilometres distant from a university medical school.

OBJECTIVES

We examined the preferences of clinical teachers in relation to the preferred use of technology as a medium for educational support.

METHODS

A qualitative approach was used for which 19 participants were interviewed using structured interviews consisting of prepared open-ended questions.

FINDINGS

All participants reported that they had a very positive association with the university. However, they overwhelmingly expressed a need to feel more strongly connected to the university and with each other.

DISCUSSION

Although a trial of the videoconferencing technology had problems, there was still great potential to connect clinical teachers in a Community of Practice.

Neutron Reflection Studies of Swelling of Chemically End-Grafted Polymer Chains

Neutron reflection is used to compare the swelling of two chemically end-grafted polystyrene brushes having different grafting densities exposed to a theta solvent cyclohexane and to a good solvent toluene. The relative swelling of tie brushes with a variation of solvent quality becomes smaller and the temperature dependence becomes weaker with an increase of grafting density. This type of swelling is very similar to polymer networks where an increase of cross-linking density leads to a decreased range of swelling and diminished dependence of the swelling. Our model density profile fits to the body of both brushes is parabolic in a good solvent so that some fluctuation effects, as found generally in lower density brushes, are obtained as the brush expands.

Outcome of patients in laparoscopic training courses compared to standard patients

BACKGROUND & AIM

Current Laparoscopic simulators have limited usefulness and patients have been used for training since the dawn of surgery. NUGITS (Northumbrian Upper Gastro Intestinal Team of Surgeons) Laparoscopic Skills courses utilise hands-on experience with simulators moving to live operating on volunteer patients. It is vital to know that the volunteer patient is not disadvantaged by greater surgical risk.

METHODS

This was a case-controlled prospective comparison of patients undergoing both Laparoscopic Cholecystectomy (LC) [n=51] and Laparoscopic Inguinal Hernia (LIH) [n=62] during NUGITS training courses. They are compared with a matched (age, sex and ASA grade) control group LC (n=51) and LIH (n=62) operated on by consultants. The outcome measures were surgical peri-and post-operative complications, post-operative hospital stay, readmission and early recurrence of inguinal hernia (<6 months).

RESULTS

In the LC cohort, there was no significant difference in the length of hospital stay (p=0.07) or readmission (p=0.16) in both the groups. The mean operating time was higher in the trainee compared to the control group (p=0.001). There was no difference in the post-operative morbidity or mortality in either group. In LIH cohort, the mean operating time was higher in the trainee compared with the control group. There was no significant difference in post-operative complications (p>0.05) and early post-operative recurrence of hernia (p>0.05).

CONCLUSION

The post-operative outcomes of patients undergoing laparoscopic surgery during laparoscopic training courses are similar to consultant-operated patients. Thus, it is acceptable and safe to encourage patients to volunteer for laparoscopic training courses.

The neurocognitive performance of drug-free and medicated euthymic bipolar patients do not differ

OBJECTIVE

Although it is established that euthymic bipolar patients have neurocognitive deficits, the influence of medication on their cognitive performance is uncertain and requires investigation.

METHOD

Neuropsychological tests of executive function, memory and attention were performed on 44 prospectively verified, euthymic bipolar I patients, 22 of whom were drug-free. Residual mood symptom effects were controlled statistically using ancova.

RESULTS

Drug-free and medicated patients differed only in delayed verbal recall (Rey AVLT list A7, drug-free > medicated), and perseverations during the five-point test (drug-free > medicated). When residual mood symptoms were controlled statistically, differences between drug-free and medicated subjects became insignificant. Medication effect sizes were modest. Significant correlations were found between residual depression scores and measures of verbal learning.

CONCLUSION

Medications did not have any significant influence on neurocognitive performance, suggesting that neurocognitive deficits are an integral part of bipolar disorder.

Psychosocial adjustment to diabetes-related lower limb amputation

AIM

To examine psychosocial adjustment in persons with lower limb amputations related to diabetes.

METHODS

Thirty-eight participants with diabetes-related lower limb amputations, recruited from two limb-fitting centres, completed three psychological self-report assessments: the Trinity Amputation and Prosthesis Experience Scales (TAPES); the Hospital Anxiety and Depression Scale (HADS); and the Amputation Body Image Scale-Revised (ABIS-R).

RESULTS

Over 18% of participants scored above the normal range (> 8) for depression on the HADS and 18.5% scored above the normal range for anxiety. Both depression (rho = 0.75, P < 0.01) and anxiety (rho = 0.62, P < 0.01) scores were significantly associated with body image disturbance, as measured using the ABIS-R. Significant relationships were also observed between body image disturbance and three TAPES subscales measuring psychosocial adjustment [general adjustment (rho = -0.48, P < 0.01), social adjustment (rho = -0.51, P < 0.01), adjustment to limitations (rho = -0.45, P < 0.05)].

CONCLUSIONS

Individuals with diabetes-related amputations may be at elevated risk for psychological distress as a result of their co-morbid medical condition. Regular screening for anxiety and depression and the provision of appropriate follow-up care may therefore be advisable in this population.

Appropriate prescribing in the elderly: an investigation of two screening tools, Beers criteria considering diagnosis and independent of diagnosis and improved prescribing in the elderly tool to identify inappropriate use of medicines in the elderly in primary care in Ireland

BACKGROUND

Elderly patients are particularly vulnerable to inappropriate prescribing, with increased risk of adverse drug reactions and consequently higher rates of morbidity and mortality. A large proportion of inappropriate prescribing is preventable by adherence to prescribing guidelines, suitable monitoring and regular medication review. As a result, screening tools have been developed to help clinicians improve their prescribing.

OBJECTIVES

To compare identification rates of inappropriate prescribing in elderly patients in primary care using two validated screening tools: Beers' criteria and improved prescribing in the elderly tool (IPET); to calculate the net ingredient cost (NIC) per month (euro) of the potentially inappropriate medicines in this population of patients.

METHOD

A consecutive cohort of 500 patients 65 years of age and over were recruited prospectively from primary care over a 6 month period in a provincial town in Ireland. Patients' medical records (electronic and paper) were screened and all relevant information concerning current illnesses and medications was recorded on a standardized data collection form to which Beers' criteria [considering diagnosis (CD) and independent of diagnosis (ID)] and IPET tools were applied. The NIC was calculated from an edition of the Irish monthly index of medical specialities published concurrently with the data collection.

RESULTS

Beers' criteria identified a total of 69 medicines that were prescribed inappropriately (eight CD and 61 ID) in 65 patients (13%), costing euro824.88 per month while IPET identified 63 potentially inappropriate medicines in 52 (10.4%) patients costing euro381.28 per month.

CONCLUSIONS

Potentially inappropriate medications are prescribed in a significant proportion of elderly people in primary care, with significant economic implications.

External breast prostheses in post-mastectomy care: women's qualitative accounts

A good-quality external breast prosthesis and prosthesis-fitting service is an integral part of the recovery process post-mastectomy. However, this is an area of care that has minimal information or research available. The aim of this research was to investigate women's experience of the provision, fitting, supply and use of breast prostheses in Ireland. To ascertain women's own personal and subjective experiences, five focus groups with 47 women recruited through national cancer advocacy/support organizations and four Follow-up Breast Clinics throughout Ireland were conducted. As a result, five main themes emerged: (1) The fitting experience--Fitting? (2) Post-mastectomy products--Having? (3) Cost--Affording? (4) Information--Knowing? and (5) Adaptation--Accepting? The emerging themes pinpointed the impact of the fitting experience, fitting environment and the qualities of a prosthesis fitter on a woman's experience in obtaining a first or replacement breast prosthesis; the importance of the physical characteristics of the prosthesis and mastectomy bras; cost, affordability and entitlements; a lack of and perceived difficulty in getting information; and the myriad of personal and social impacts of a breast prosthesis for the woman. These findings are integral for the development of standards of practice in the fitting and supply of external breast prostheses in post-mastectomy care.

Experiences in the provision, fitting and supply of external breast prostheses: findings from a national survey

A good-quality external breast prosthesis and prosthesis-fitting service is integral to recovery post-mastectomy. However, this area of care has minimal information or research available. The aim of this study was to investigate women's experience of the provision, fitting, supply and use of breast prostheses in Ireland. Three national surveys were undertaken with women (n = 527), breast care nurses (BCNs) (n = 32) and retail prosthesis fitters (n = 12). The findings identified the importance of the prosthesis for shape, appearance to self, appearance to others, sense of well-being, self-confidence and femininity. Dissatisfaction with weight, comfort and movement of the prosthesis was identified. Cost and travel distance were found to influence the replacement of the prosthesis. Dissatisfaction emerged with the display and choice of products, and brochure availability at the prosthesis fitting. Women preferred to be fitted for the first silicone prosthesis by a BCN in a hospital setting whereas for the replacement prosthesis they preferred a trained fitter at a specialized prosthesis supplier. BCNs and retail fitters identified the need for service guidelines and increased availability of professional development opportunities in prosthesis-fitting. These findings contributed to the development of standards of care for breast prosthesis-fitting services to benefit women and to provide guidelines for those providing the service.

A comparison of neurocognitive impairment in younger and older adults with major depression

BACKGROUND

Neurocognitive impairment is a well-recognized feature of depression that has been reported in younger and older adults. Similar deficits occur with ageing and it is unclear whether the greater deficits in late-life depression are an ageing-related phenomenon or due to a difference in the nature of late-life depression itself. We hypothesized that ageing alone would not fully explain the increased neurocognitive impairment in late-life depression but that differences in the illness explain the greater decrements in memory and executive function.

METHOD

Comparison of the neuropsychological performance of younger (<60 years) and older (60 years) adults with major depressive disorder (MDD) and healthy comparison subjects. Scores for each depression group were normalized against their respective age-matched control group and the primary comparisons were on four neurocognitive domains: (i) attention and executive function; (ii) verbal learning and memory; (iii) visuospatial learning and memory; and (iv) motor speed.

RESULTS

We recruited 75 subjects with MDD [<60 years (n=44), 60 years (n=31)] and 82 psychiatrically healthy comparison subjects [<60 years (n=42), 60 years (n=40)]. The late-life depression group had greater impairment in verbal learning and memory and motor speed but not in executive function. The two depressed groups did not differ in depression severity, global cognitive function, intelligence or education.

CONCLUSIONS

Late-life depression is associated with more severe impairment in verbal learning and memory and motor speed than depression in earlier adult life and this is not due to ageing alone.

Angiotensin-(1-7) inhibition of human breast tumors with distinct hormone receptor expression results in a differential regulation of Akt

Abstract #3127

Angiotensin-(1-7) [Ang-(1-7)] is an endogenous, seven amino acid peptide hormone with anti-proliferative and anti-angiogenic properties that mediates biological effects through activation of a specific AT(1-7) receptor, mas. We previously showed that the heptapeptide significantly reduced the growth of human lung cancer cells in vitro and human A549 lung tumor xenografts. The purpose of this study was to determine whether Ang-(1-7) can be used as an effective chemotherapeutic agent for breast cancer. Ang-(1-7) significantly inhibited the growth of ZR-75-1 cells, a human ER positive breast cancer cell line, BT-474 cells, a human HER2-amplified breast cancer cell line, and MDA-MB-231 cells, a triple negative breast cancer cell line. More importantly, Ang-(1-7) decreased ZR-75-1, BT-474, and MDA-MB-231 tumor growth in vivo. Cells were injected into the mammary fat pad of athymic female mice that were ovariectomized and implanted with estrogen pellets for continuous hormone deliver. Once the tumors reached a size of 100-200 mm3, osmotic minipumps were implanted to provide subcutaneous delivery of either saline or Ang-(1-7) in saline at a rate of 24 µg/kg/h, and tumor size was measured using a caliper. A marked reduction in tumor volume of Ang-(1-7) treated mice was observed when compared to saline treated animals (ZR-75-1 tumors from 322 ± 29.7 mm3 to 74 ± 13.6 mm3 , BT-474 tumors from 5209 ± 419 mm3 to 1656 ± 124 mm3, and MDA-MB-231 tumors from 492 ± 89.0 mm3 to 191 ± 8.8 mm3 , n = 5, p &lt; 0.05). Tumor weight at the end of treatment was also decreased significantly by Ang-(1-7) administration (ZR-75-1 tumors from 0.26 ± 0.04 g to 0.13 ± 0.02 g, BT-474 tumors from 3.6 ± 0.2 g to 2.2 ± 0.1 g, MDA-MB-231 tumors from 1.00 ± 0.21 g to 0.49 ± 0.04 g, n = 5, p &lt; 0.05). Although Ang-(1-7) inhibited the growth of all three breast tumors types, the heptapeptide was more effective in tumors that did not over-express HER2. Analysis of the orthotopic tumors by Western blot hybridization demonstrated that Ang-(1-7) significantly decreased phosphorylated Akt in ZR-75-1 and MDA-MB-231 tumors (from 0.90 ± 0.09 densitometric units to 0.03 ± 0.01 and 0.96 ± 0.05 to 0.47 ± 0.13, respectively, p &lt; 0.05) while there was a significant increase (from 0.40 ± 0.12 to 1.55 ± 0.22, p &lt; 0.05) in phosphorylated Akt in Ang-(1-7)-treated BT-474 tumors. Similarly, Ang-(1-7) treatment of the parent ZR-75-1 and MDA-MB-231 cells resulted in a time-dependent reduction (4-fold and 3-fold, respectively) in phosphorylated Akt, while incubation with the heptapeptide increased phosphorylated Akt 1.8-fold in BT-474 cells. These data indicate that Ang-(1-7) effectively reduces the growth of three different human breast tumors each expressing distinctive hormone receptor profiles and thus may serve as a first in class treatment for breast cancer. Further, Ang-(1-7) was more efficacious in preventing the proliferation of tumors that do not over-express the HER2 receptor, indicating that a combinatorial therapeutic modality may be more successful in treating HER2 amplified breast cancer.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3127.