30 research outputs found
Electronic states for excess electrons in polyethylene compared to long-chain alkanes
Versión Post-Print del autorWe use a pseudopotential model to calculate the electronic states available to an excess electron in crystalline and amorphous regions of model polyethlyene as well as the molecular crystal of the linear alkane C27H56. It is shown that alkane crystals of whatever chain length are not representative of crystalline polyethylene (PE) although they are often considered to be so. We discuss the implications for electron transport in PE.This work was supported by EPSRC through Grants GR/R18222 and GR/M9442
Computer simulations of localized small polarons in amorphous polyethylene
We use a simple mean field scheme to compute the polarization energy of an excess electron in amorphous polyethylene that allows us to study dynamical properties. Nonadiabatic simulations of an excess electron in amorphous polyethylene at room temperature show the spontaneous formation of localized small polaron states in which the electron is confined in a spherically shaped region with a typical dimension of 5 Å. We compute the self-trapping energy to be −0.06±0.03 eV, with a lifetime on the time scale of a few tens of picoseconds
Dielectric breakdown strength and electrical conductivity of low density polyethylene octylnanosilica composite
One challenge in studying nanodielectric composites is to produce reliable, reproducible samples. A common strategy to suppress aggregation and make the particles more compatible with the polymer matrix is to modify the nanoparticle surface chemistry but, often, evaluation of the effectiveness of the chosen surface functionalization process can prove difficult. In this paper the emphasis is on feasible ways to monitor the production of silane coupled nanosilica low density polyethylene (LDPE) composites, using Fourier transform infrared spectroscopy (FTIR) and thermal gravimetric analysis (TGA). The AC-breakdown properties of the resulting composites is studied and the field dependency of the DC-conductivity is measured and also calculated using a space charge limited conduction (SCLC) model together with densities of states obtained from ab initio calculations. For composites containing 13 wt% of nanosilica, breakdown strengths some 18 % higher than that of the unfilled LDPE were obtained. However, the results are not stable over time. This appears to be related to how extensively the composite is dried at elevated temperatures under vacuum
Single electron states in polyethylene
We report computer simulations of an excess electron in various structural motifs of polyethylene at room temperature, including lamellar and interfacial regions between amorphous and lamellae, as well as nanometre-sized voids. Electronic properties such as density of states, mobility edges, and mobilities are computed on the different phases using a block Lanczos algorithm. Our results suggest that the electronic density of states for a heterogeneous material can be approximated by summing the single phase density of states weighted by their corresponding volume fractions. Additionally, a quantitative connection between the localized states of the excess electron and the local atomic structure is presented.The US National Science Foundation under grant CHE-0911635 and from his Stokes Professorship in Nano Biophysics from Science Foundation Ireland thanks the Irish Centre for High End Computing (ICHEC) for computer resources and Science Foundation Ireland for support from grant 08-IN.1-I1869
Access to interpreting services in England: secondary analysis of national data
Background:
Overcoming language barriers to health care is a global challenge. There is great linguistic diversity in the major cities in the UK with more than 300 languages, excluding dialects, spoken by children in London alone. However, there is dearth of data on the number of non-English speakers for planning effective interpreting services. The aim was to estimate the number of people requiring language support amongst the minority ethnic communities in England.
Methods:
Secondary analysis of national representative sample of subjects recruited to the Health Surveys for England 1999 and 2004.
Results:
298,432 individuals from the four main minority ethnic communities (Indian, Pakistani, Bangladeshi and Chinese) who may be unable to communicate effectively with a health professional. This represents 2,520,885 general practice consultations per year where interpreting services might be required.
Conclusion:
Effective interpreting services are required to improve access and health outcomes of non-English speakers and thereby facilitate a reduction in health inequalities
Preoperative chemoradiation with capecitabine, irinotecan and cetuximab in rectal cancer: significance of pre-treatment and post-resection RAS mutations
Background: The influence of EGFR pathway mutations on cetuximab-containing rectal cancer preoperative chemoradiation (CRT) is uncertain. Methods: In a prospective phase II trial (EXCITE), patients with magnetic resonance imaging (MRI)-defined non-metastatic rectal adenocarinoma threatening/involving the surgical resection plane received pelvic radiotherapy with concurrent capecitabine, irinotecan and cetuximab. Resection was recommended 8 weeks later. The primary endpoint was histopathologically clear (R0) resection margin. Pre-planned retrospective DNA pyrosequencing (PS) and next generation sequencing (NGS) of KRAS, NRAS, PIK3CA and BRAF was performed on the pre-treatment biopsy and resected specimen. Results: Eighty-two patients were recruited and 76 underwent surgery, with R0 resection in 67 (82%, 90%CI: 73–88%) (four patients with clinical complete response declined surgery). Twenty–four patients (30%) had an excellent clinical or pathological response (ECPR). Using NGS 24 (46%) of 52 matched biopsies/resections were discrepant: ten patients (19%) gained 13 new resection mutations compared to biopsy (12 KRAS, one PIK3CA) and 18 (35%) lost 22 mutations (15 KRAS, 7 PIK3CA). Tumours only ever testing RAS wild-type had significantly greater ECPR than tumours with either biopsy or resection RAS mutations (14/29 [48%] vs 10/51 [20%], P=0.008), with a trend towards increased overall survival (HR 0.23, 95% CI 0.05–1.03, P=0.055). Conclusions: This regimen was feasible and the primary study endpoint was met. For the first time using pre-operative rectal CRT, emergence of clinically important new resection mutations is described, likely reflecting intratumoural heterogeneity manifesting either as treatment-driven selective clonal expansion or a geographical biopsy sampling miss
Nonadherence to systemic immune-modifying therapy in people with psoriasis during the COVID-19 pandemic: findings from a global cross-sectional survey
BACKGROUND: Nonadherence to immune-modifying therapy is a complex behaviour which, before the COVID-19 pandemic, was shown to be associated with mental health disorders in people with immune-mediated diseases. The COVID-19 pandemic has led to a rise in the global prevalence of anxiety and depression, and limited data exist on the association between mental health and nonadherence to immune-modifying therapy during the pandemic. OBJECTIVES: To assess the extent of and reasons underlying nonadherence to systemic immune-modifying therapy during the COVID-19 pandemic in individuals with psoriasis, and the association between mental health and nonadherence. METHODS: Online self-report surveys (PsoProtectMe), including validated screens for anxiety and depression, were completed globally during the first year of the pandemic. We assessed the association between anxiety or depression and nonadherence to systemic immune-modifying therapy using binomial logistic regression, adjusting for potential cofounders (age, sex, ethnicity, comorbidity) and country of residence. RESULTS: Of 3980 participants from 77 countries, 1611 (40.5%) were prescribed a systemic immune-modifying therapy. Of these, 408 (25.3%) reported nonadherence during the pandemic, most commonly due to concerns about their immunity. In the unadjusted model, a positive anxiety screen was associated with nonadherence to systemic immune-modifying therapy [odds ratio (OR) 1.37, 95% confidence interval (CI) 1.07-1.76]. Specifically, anxiety was associated with nonadherence to targeted therapy (OR 1.41, 95% CI 1.01-1.96) but not standard systemic therapy (OR 1.16, 95% CI 0.81-1.67). In the adjusted model, although the directions of the effects remained, anxiety was not significantly associated with nonadherence to overall systemic (OR 1.20, 95% CI 0.92-1.56) or targeted (OR 1.33, 95% CI 0.94-1.89) immune-modifying therapy. A positive depression screen was not strongly associated with nonadherence to systemic immune-modifying therapy in the unadjusted (OR 1.22, 95% CI 0.94-1.57) or adjusted models (OR 1.14, 95% CI 0.87-1.49). CONCLUSIONS: These data indicate substantial nonadherence to immune-modifying therapy in people with psoriasis during the pandemic, with attenuation of the association with mental health after adjusting for confounders. Future research in larger populations should further explore pandemic-specific drivers of treatment nonadherence. Clear communication of the reassuring findings from population-based research regarding immune-modifying therapy-associated adverse COVID-19 risks to people with psoriasis is essential, to optimize adherence and disease outcomes
Radical surgery versus organ preservation via short-course radiotherapy followed by transanal endoscopic microsurgery for early-stage rectal cancer (TREC): a randomised, open-label feasibility study
Background:
Radical surgery via total mesorectal excision might not be the optimal first-line treatment for early-stage rectal cancer. An organ-preserving strategy with selective total mesorectal excision could reduce the adverse effects of treatment without substantially compromising oncological outcomes. We investigated the feasibility of recruiting patients to a randomised trial comparing an organ-preserving strategy with total mesorectal excision.
Methods:
TREC was a randomised, open-label feasibility study done at 21 tertiary referral centres in the UK. Eligible participants were aged 18 years or older with rectal adenocarcinoma, staged T2 or lower, with a maximum diameter of 30 mm or less; patients with lymph node involvement or metastases were excluded. Patients were randomly allocated (1:1) by use of a computer-based randomisation service to undergo organ preservation with short-course radiotherapy followed by transanal endoscopic microsurgery after 8–10 weeks, or total mesorectal excision. Where the transanal endoscopic microsurgery specimen showed histopathological features associated with an increased risk of local recurrence, patients were considered for planned early conversion to total mesorectal excision. A non-randomised prospective registry captured patients for whom randomisation was considered inappropriate, because of a strong clinical indication for one treatment group. The primary endpoint was cumulative randomisation at 12, 18, and 24 months. Secondary outcomes evaluated safety, efficacy, and health-related quality of life assessed with the European Organisation for Research and Treatment of Cancer (EORTC) QLQ C30 and CR29 in the intention-to-treat population. This trial is registered with the ISRCTN Registry, ISRCTN14422743.
Findings:
Between Feb 22, 2012, and Dec 19, 2014, 55 patients were randomly assigned at 15 sites; 27 to organ preservation and 28 to radical surgery. Cumulatively, 18 patients had been randomly assigned at 12 months, 31 at 18 months, and 39 at 24 months. No patients died within 30 days of initial treatment, but one patient randomly assigned to organ preservation died within 6 months following conversion to total mesorectal excision with anastomotic leakage. Eight (30%) of 27 patients randomly assigned to organ preservation were converted to total mesorectal excision. Serious adverse events were reported in four (15%) of 27 patients randomly assigned to organ preservation versus 11 (39%) of 28 randomly assigned to total mesorectal excision (p=0·04, χ2 test). Serious adverse events associated with organ preservation were most commonly due to rectal bleeding or pain following transanal endoscopic microsurgery (reported in three cases). Radical total mesorectal excision was associated with medical and surgical complications including anastomotic leakage (two patients), kidney injury (two patients), cardiac arrest (one patient), and pneumonia (two patients). Histopathological features that would be considered to be associated with increased risk of tumour recurrence if observed after transanal endoscopic microsurgery alone were present in 16 (59%) of 27 patients randomly assigned to organ preservation, versus 24 (86%) of 28 randomly assigned to total mesorectal excision (p=0·03, χ2 test). Eight (30%) of 27 patients assigned to organ preservation achieved a complete response to radiotherapy. Patients who were randomly assigned to organ preservation showed improvements in patient-reported bowel toxicities and quality of life and function scores in multiple items compared to those who were randomly assigned to total mesorectal excision, which were sustained over 36 months’ follow-up. The non-randomised registry comprised 61 patients who underwent organ preservation and seven who underwent radical surgery. Non-randomised patients who underwent organ preservation were older than randomised patients and more likely to have life-limiting comorbidities. Serious adverse events occurred in ten (16%) of 61 non-randomised patients who underwent organ preservation versus one (14%) of seven who underwent total mesorectal excision. 24 (39%) of 61 non-randomised patients who underwent organ preservation had high-risk histopathological features, while 25 (41%) of 61 achieved a complete response. Overall, organ preservation was achieved in 19 (70%) of 27 randomised patients and 56 (92%) of 61 non-randomised patients.
Interpretation:
Short-course radiotherapy followed by transanal endoscopic microsurgery achieves high levels of organ preservation, with relatively low morbidity and indications of improved quality of life. These data support the use of organ preservation for patients considered unsuitable for primary total mesorectal excision due to the short-term risks associated with this surgery, and support further evaluation of short-course radiotherapy to achieve organ preservation in patients considered fit for total mesorectal excision. Larger randomised studies, such as the ongoing STAR-TREC study, are needed to more precisely determine oncological outcomes following different organ preservation treatment schedules.
Funding:
Cancer Research UK
A systematic correlation of nanoparticle size with diffusivity through biological fluids
Nanomedicine, the application of nanotechnology for medical purposes, has been widely identified as a potential solution for today‟s healthcare problems. Nanomedicine uses the "bottom-up‟ principles of nanoscale engineering to improve areas of medicine which have previously been considered undevelopable. One of the enduring challenges for medicine is the design of innovative devices able to overcome biological barriers, allowing drugs and therapeutics to effectively reach their correct location of action. Biological barriers are a defence mechanism of the body which are extremely well-evolved to protect the body from foreign and harmful particles. Therapeutic drugs and devices, which are not harmful, are often identified by the body as dangerous because their composition differs from native and accepted entities. The traversal of these biological barriers, such as mucus, remains a bottleneck in the progress of drug delivery and gene therapy. The mucus barrier physically limits the motion of particles due to its complicated mesh structure which obstructs the particles' traversal path. Mucus fibres can also adhere to the particles, entrapping them and restricting their motion. Particle traversal of mucus is carried out by passive diffusion. As diffusion has traditionally been defined by the Stokes-Einstein equation as inversely proportional to particle radius, it follows that reducing particle sizes into the nanoscale would result in increased diffusive ability. These predictions, however, do not consider the obstructive effects of the complicated mesh structure for the case of mucus. The exact effect of reducing particle size into the nanoscale for diffusion through mucus is therefore unknown. Multiple Particle Tracking was used to obtain real-time movies of the diffusion of nanoparticles, ranging from 12nm – 220nm in diameter, through mucus samples. The experimental data generated was used to systematically correlate the relationship between particle size and diffusivity through mucus. This study reveals that nanoparticles, smaller than the average pore size in the mucus mesh structure, can diffuse through lower viscosity pores which pose less resistance to diffusive motion, allowing nanoparticles to travel at up to four times the speed expected from the bulk viscosity of the mucus. This type of information can help researchers understand the importance of size for therapeutic nanoparticles, allowing researchers to decide whether attempts to decrease nanoparticle size at the expense of other functionality are worthwhile.EThOS - Electronic Theses Online ServiceGBUnited Kingdo