Superconductivity from correlated hopping

We consider a chain described by a next-nearest-neighbor hopping combined with a nearest-neighbor spin flip. In two dimensions this three-body term arises from a mapping of the three-band Hubbard model for CuO$_2$ planes to a generalized $t-J$ model and for large O-O hopping favors resonance-valence-bond superconductivity of predominantly $d$-wave symmetry. Solving the ground state and low-energy excitations by analytical and numerical methods we find that the chain is a Luther-Emery liquid with correlation exponent $K_{\rho} = (2-n)^2/2$, where $n$ is the particle density.Comment: 10 pages, RevTeX 3.0 + 2 PostScript figs. Accepted for publication in Phys.Rev.

Pharmacists in general practice: a qualitative interview case study of stakeholders’ experiences in a West London GP Federation

Background Increased patient demand for healthcare services coupled with a shortage of general practitioners necessitates changes in professional roles and service delivery. In 2016, NHS England began a three year pilot study of pharmacists in general practice, however, this is not an entirely new initiative. There is limited, current, evidence-based, UK research to inform the pilot so studies of pre-existing services must suffice until findings from a formal national evaluation are available. Methods The aim of this exploratory, descriptive interview study was to explore the experiences of stakeholders in eight general practices in the Ealing GP Federation, West London, where pharmacy services have been provided for several years. Forty-seven participants, including pharmacy team members (pre-registration and clinical pharmacists, independent prescribers and pharmacy technicians), general practitioners, patients, practice managers, practice nurses and receptionists took part in semi-structured, audio-recorded qualitative interviews which were transcribed verbatim, coded and analysed thematically to extract the issues raised by participants and the practicalities of providing pharmacy services in general practice. Results Findings are reported under the themes of Complementarity (incorporating roles, skills, education and workloads); Integration (incorporating relationships, trust and communication) and Practicalities (incorporating location and space, access, and costs). Participants reported the need for time to develop and understand the various roles, develop communication processes and build inter-professional trust. Once these were established, however, experiences were positive and included decreased workloads, increased patient safety, improved job satisfaction, improved patient relationships, and enhanced cost savings. Areas for improvement included patients’ awareness of services; pharmacists’ training; and regular, onsite access for practice staff to the pharmacy team. Conclusions Recommendations are made for the development of clear role definitions, identification of training needs, dedication of time for team building, production of educational materials for practice staff members and patients, and provision of on-site, full-time pharmacy services. Future work should focus on evaluation of various models of employing pharmacy teams in general practice; integration of pharmacists and pharmacy technicians into multidisciplinary general practice teams; relationships between local community pharmacy and general practice personnel and patients’ service and information needs. A formal national evaluation of the pilot scheme is overdue

Neural correlates of rhythm in post-stroke aphasia (online Early)

ndividuals with post-stroke aphasia have long been observed to show relatively preserved musical and rhythm abilities in the presence of varied, and often profound, language impairments. Accordingly, speech-language pathologists frequently use rhythm-based strategies (e.g., tapping) to facilitate speech output in people with aphasia. However, there is little empirical work to support the clinical practice of using rhythm techniques.In this study, we investigated the neural bases of rhythm in aphasia by combining thorough behavioral rhythm assessments with structural brain imaging. Individuals with chronic, post-stroke aphasia (n=33) and a matched neurotypical control group (n=29) completed a rigorous battery of rhythm production and perception tasks.We found marked individual variability within the aphasia group, with about one third of individuals showing impaired rhythm processing, while the remaining two-thirds performed within the control range. Using lesion-symptom mapping, we found that individual variability in tapping performance was associated with damage to a left temporoparietal area, extending into white matter specifically in the arcuate fasciculus. That is, individuals who struggled with tapping tended to have damage to this region. Tapping was also associated with language production scores, but not motor speech, in the aphasia group.These findings, which systematically link rhythm, language, and the brain, have the potential of being translated into clinical practice for understanding which patients may benefit the most from rhythm-based treatments. Our study in a population with focal brain injury complements evolutionary work highlighting the importance of the left temporo-parietal region and underlying white matter for beat synchronization

Climate‐related variations in mixing dynamics in an Alaskan arctic lake

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109805/1/lno2009546part22401.pd

First-Line Mobocertinib Versus Platinum-Based Chemotherapy in Patients With EGFR Exon 20 Insertion-Positive Metastatic Non-Small Cell Lung Cancer in the Phase III EXCLAIM-2 Trial.

Mobocertinib is an oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor that targets EGFR exon 20 insertion (ex20ins) mutations in non-small cell lung cancer (NSCLC). This open-label, phase III trial (EXCLAIM-2, ClinicalTrials.gov identifier: NCT04129502) compared mobocertinib versus platinum-based chemotherapy as first-line treatment of EGFR ex20ins+ advanced/metastatic NSCLC. Patients with treatment-naive EGFR ex20ins+ locally advanced/metastatic NSCLC were randomly assigned 1:1 to mobocertinib 160 mg once daily or pemetrexed plus cisplatin or carboplatin every 3 weeks for four cycles followed by maintenance pemetrexed. The primary end point was progression-free survival (PFS) by blinded independent central review (BICR), with planned interim analysis (IA) after approximately 70% of 227 expected PFS events. A total of 354 patients were randomly assigned (mobocertinib: n = 179; chemotherapy: n = 175). Baseline characteristics were balanced between arms. At IA (cutoff: April 4, 2023), the median PFS per BICR was 9.6 months in each treatment arm (hazard ratio [HR], 1.04 [95% CI, 0.77 to 1.39]; P = .803). The primary end point crossed the prespecified futility boundary (HR > 1). The confirmed objective response rate (95% CI) per BICR was 32% (26 to 40) with mobocertinib versus 30% (24 to 38) with chemotherapy; the median duration of response was 12.0 versus 8.4 months. Quality-of-life assessments indicated clinically meaningful delays in time to deterioration of lung cancer symptoms, cognitive function, and constipation with mobocertinib versus chemotherapy. Grade ≥3 adverse events in >5% of patients (mobocertinib, chemotherapy) were diarrhea (20%, 1%), anemia (6%, 10%), increased lipase (6%, 0%), and decreased neutrophil count (1%, 7%). The EXCLAIM-2 trial did not meet its primary end point. The efficacy of mobocertinib was not superior to platinum-based chemotherapy for first-line treatment of patients with EGFR ex20ins+ advanced/metastatic NSCLC

Theorising variation in engagement in professional and curriculum development: performativity, capital, systems and purpose

Increasingly, policymakers seek to improve the quality of teaching through curriculum innovations and continuing professional development (CPD) programmes. However, engagement by schools and teachers varies due to mediating influences of neoliberal policies. In this article, we contribute to understanding how these tendencies affect participation. Problematising the notion of context, we examine ways in which systemic influences interacted with participation in a government-funded mathematics professional and curriculum development programme and also with participants’ purposes. A 3-level clustered Randomised Controlled Trial (RCT) and an implementation and process evaluation were augmented by in-depth case studies, cross-case analysis and the application of theoretical constructs to interpret findings. Theories of capital, figured worlds and systemic coupling are utilised to theorise context. Different levels of engagement are partly explainable by: the interaction of schools' relative systemic advantage and disadvantage; their orientation and coupling to performativity regimes; and the alignment or dissonance between continuing professional development or change programmes and the pedagogical and CPD cultures and purposes of the ‘actors’ (schools, departments and teachers). Performativity concerns restricted what were considered legitimate outcomes in some case study schools. This depended on teachers and schools' positioning in terms of relative degrees of systemic privilege or disadvantage - understood as economic, cultural, social and symbolic capital - and also in terms of figured worlds and system coupling. The case studies provide insights into how collaborative professional learning can be fostered more productively. Methodologically, we demonstrate the power of combining methodologies and applying explanatory social theory to augment quasi-experimental paradigms