Topological qubits in graphenelike systems

The fermion-doubling problem can be an obstacle to getting half-a-qubit in two-dimensional fermionic tight-binding models in the form of Majorana zero modes bound to the core of superconducting vortices. We argue that the number of such Majorana zero modes is determined by a Z_2 x Z_2 topological charge for a family of two-dimensional fermionic tight-binding models ranging from noncentrosymmetric materials to graphene. This charge depends on the dimension of the representation (i.e., the number of species of Dirac fermions -- where the doubling problem enters) and the parity of the Chern number induced by breaking time-reversal symmetry. We show that in graphene there are as many as ten order parameters that can be used in groups of four to change the topological number from even to odd.Comment: 5 pages; 2 figures; 1 tabl

Homoeopathy

Homoeopathy is a system of treating patients using very low dose preparations according to the principle: "like should be cured with like". This paper summarises the research evidence presented in a recent issue of Effective Health Care on the effectiveness of homoeopathy. Increasing numbers of patients are seeking information on complementary medicines from NHS health professionals. Results of a 1998 survey of use and expenditure on complementary medicine in England suggested that 28% of respondents had either visited a complementary therapist or had purchased an over the counter herbal or homoeopathic remedy in the past year. From this survey it was estimated that there could be over 470 000 recent users of homoeopathic remedies in England

Masses and Majorana fermions in graphene

We review the classification of all the 36 possible gap-opening instabilities in graphene, i.e., the 36 relativistic masses of the two-dimensional Dirac Hamiltonian when the spin, valley, and superconducting channels are included. We then show that in graphene it is possible to realize an odd number of Majorana fermions attached to vortices in superconducting order parameters if a proper hierarchy of mass scales is in place.Comment: Contribution to the Proceedings of the Nobel symposium on graphene and quantum matte

Early Surgery for Traumatic Spinal Cord Injury: Where Are We Now?

Study Design: Narrative review. Objective: There is a strong biological rationale to perform early decompression after traumatic spinal cord injury (SCI). With an enlarging clinical evidence base, most spine surgeons internationally now favor early decompression for the majority of SCI patients; however, a number of pertinent questions remain surrounding this therapy. Methods: A narrative review evaluating the status of early surgery for SCI. In particular, we addressed the following questions: (1) Which patients stand to benefit most from early surgery? 2) What is the most appropriate time threshold defining early surgery? Results: Although heterogeneity exists, the evidence generally seems to support early surgery. While the best evidence exists for cervical SCI, there is insufficient data to support a differential effect for early surgery depending on neurological level or injury severity. When comparing thresholds to define early versus late surgery-including a later threshold (48-72 hours), an earlier threshold (24 hours), and an ultra-early threshold (8-12 hours)-the 2 earlier time points seem to be associated with the greatest potential for improved outcomes. However, existing prehospital and hospital logistics pose barriers to early surgery in a significant proportion of patients. An overview of recommendations from the recent AOSpine guidelines is provided. Conclusion: In spite of increasing acceptance of early surgery post SCI, further research is needed to (1) identify subgroups of patients who stand to derive particular benefit-in particular to develop more evidence-based approaches for central cord syndrome and (2) investigate the efficacy and feasibility of ultra-early surgery targeting more aggressive timelines

IMPACT: The Journal of the Center for Interdisciplinary Teaching and Learning. Volume 8, Issue 1, Winter 2019

IMPACT: The Journal of the Center for Interdisciplinary Teaching & Learning is a peer-reviewed, biannual online journal that publishes scholarly and creative non-fiction essays about the theory, practice and assessment of interdisciplinary education. Impact is produced by the Center for Interdisciplinary Teaching & Learning at the College of General Studies, Boston University (www.bu.edu/cgs/citl).In this issue of Impact you will find a humanities scholar deeply engaged with the arcing out of a new territory: the interdisciplinary study of the Grateful Dead. Impact’s own Christopher Coffman’s review essay should be required reading for scholars of popular music, performance studies and history. His review also serves as an important reference for those who aspire to teach a course on the Grateful Dead, as well as for those who wish to write review essays. In this issue we also hear from those who are engaged in teaching people who are incarcerated. Importantly, Stephanie Cage’s essay looks to incarcerated people themselves to find out what they think about prison education. Peter Wakefield encourages us to see The Great Gatsby anew, in particular in the context of American racism and White supremacy. Wakefield’s essay is important too because it had its genesis in Writing, the State, and the Rise of Neo-Nationalism: Historical Contexts and Contemporary Concerns, a conference sponsored by the Center for Interdisciplinary Teaching & Learning

Factors influencing students in choosing to study pharmacy in Great Britain

Aim - To produce empirical evidence on the commitment to study pharmacy in terms of what motivates and influences students in their choice of subject and university. Design - Self-completion survey. Quantitative analysis by SPSS. Subjects and setting - Year 1 and year 4 undergraduates in schools of pharmacy in Great Britain. Results - The response rate was 35.2%. Students registered a high desire to study pharmacy; 73% of year 1 and 71% of year 4 placed it first priority at the time of application. Of those for whom it was not first choice, medicine was the preferred option. The two most important factors in choice were reputation of the school of pharmacy and reputation of the university. Conclusion - This study confirms that most applicants to study pharmacy were strongly committed to the subject. In addition, this study has allowed us to put an empirical figure to the proportion of students who at the time of applying for pharmacy would rather study medicine

Crypto in Real Estate Finance

Blockchain and cryptocurrencies have ushered in a digital gold rush. But all that glitters is not gold. The latest fad is the use of non-fungible tokens (NFTs) to purchase and finance real estate. Typically, crypto real estate transactions begin with the transfer of title for a residential property into a dedicated business entity, such as a limited liability company. Thereafter, an NFT is ‘minted’ and used to represent the ownership interest in that entity. The real property is then marketed online specifying that, to acquire it, one simply purchases the relevant NFT via a blockchain transfer. Crucially, buyers are expected to use the NFT as collateral to fund their purchase, rather than obtaining a traditional mortgage. Proponents of this novel structure insist that it yields cheap, fast, and secure real estate transfers, disrupting a sector infamous for its high costs, delays, and labyrinthine bureaucracy.This Article offers the first exhaustive examination of crypto real estate transactions. We reveal that the NFT financing model is not a mere technological upgrade, but rather transports parties out of the domain of traditional mortgages and into secured transactions law, with significant legal and policy implications. Most worryingly, it exposes borrowers to swift and irreversible home liquidations in case of default, robbing them of the protections historically afforded to homeowners. As foreclosures already impact minorities disproportionately, crypto real estate transactions risk hurting society’s most vulnerable. Our proposed normative framework seeks to address these flaws. We contend that the law should look past technological mechanisms and focus on substance. These dealings are still real property purchases financed with a loan, so courts should offer those in default the same safeguards available under traditional mortgages. Robust public policies on ownership must be upheld, and fair protections for the family home cannot be sacrificed at the altar of innovation

Developing the public health function of locum pharmacists under the auspices of the new pharmacy contract

Focal Point - There are reduced opportunities for locum pharmacists to access training and education that meets their needs and enables them to play a full role under the new pharmacy contract - Eighty-six per cent of locums consider themselves to be more health professional than business person, compared to just 48% of pharmacy owners - Forty per cent of locums believe that a lack of access to training is a major barrier to the development of their public health function - While locum pharmacists are arguably more likely to embrace 'professionalising', patient-care-based roles, they are also the group least likely to be able to access the necessary training to fulfill such roles Introduction It has been suggested that locum pharmacists do not want the business-based responsibilities (e.g. staff management, meeting targets, etc) that come with pharmacy management.1 Research also suggests that locums derive great satisfaction from the health-professional aspects of the pharmacists’ role (e.g. patient contact, the provision of advice, etc).1 However, upon the introduction of the new pharmacy contract (April 2005), concerns were expressed that it was becoming increasingly difficult for locum pharmacists to access training and education that would meet their needs and enable them to play a full role under the new framework.2,3 Method After piloting, in August 2006 a self-completion postal questionnaire was sent to a random sample of practising community pharmacists, stratified for country and sex, within Great Britain (n = 1998), with a follow-up to non-responders 4 weeks later. Data were analysed using SPSS (v12.0). A final response rate of 51% (n = 1023/1998) was achieved. Respondents were asked ‘indicate how you view yourself as a pharmacist’ – in terms of their relative focus on the health-professional and business aspects of their role. Respondents were also asked ‘do you consider a lack of training opportunities to be a barrier to the development of the public health role of community pharmacists?’. Results Locums were significantly more likely than owners or employees to consider each factor a major barrier. Discussion Four in 10 locums consider a lack of training opportunities to constitute a major barrier to the development of their public health function. Pharmacy may not be able to provide the services required of it by the policy agenda if pharmacists are unable to be involved in extended role activities through a lack of training opportunities. Therefore, the paradox that needs to be addressed is that while locum pharmacists are arguably more likely to embrace ‘professionalising’, patient-care-based roles, they are also the group least likely to be able to access training to fulfil such roles. The training needs of this large subset of the pharmacist population need to be assessed and met if the whole community pharmacy workforce is going to maximise its contribution to public health under the new contractual framework. References 1 Shann P, Hassell K. An exploration of the diversity and complexity of the pharmacy locum workforce. London: Royal Pharmaceutical Society of Great Britain; 2004. 2 Almond M. Locums – key players in workforce – cast adrift as contract launched. Pharm J 2005;274:420. 3 Bishop DH. A lack of appreciation of what really happens. Pharm J 2005;274:451

Impact of the HOP-UP-PT program on older adults at risk to fall: a randomized controlled trial

BACKGROUND: Reduced falls and fall risks have been observed among older adults referred to the HOP-UP-PT (Home-based Older Persons Upstreaming Prevention-Physical Therapy) program. The purpose of this study was to describe outcomes of HOP-UP-PT program participants and then to compare these outcomes to non-participants. METHODS: Six Michigan senior centers referred adults ≥65 years who were at-risk for functional decline or falls. 144 participants (n = 72 per group) were randomized to either the experimental group (EG) or the control group (CG). Physical therapists (PTs) delivered physical, environmental, and health interventions to the EG over nine encounters (six in-person, three telerehabilitation) spanning seven months. The CG participants were told to continue their usual physical activity routines during the same time frame. Baseline and re-assessments were conducted at 0-, 3-, and 7-months in both groups. Descriptions and comparisons from each assessment encounter were analyzed. RESULTS: Participants ages were: EG = 76.6 (7.0) years and CG = 77.2 (8.2). Baseline measures were not significantly different apart from the Short Physical Performance Battery (SPPB) which favored the EG (P = 0.02). While no significant differences were identified in the survey outcomes or home environment assessments, significant differences in favor of the EG were identified in common fall risk indicators including the Timed Up and Go (P = 0.04), Four Test Balance Scale (P = 0.01), and the modified SPPB (P = 0.02) at the 3-month assessment visit. However, these differences were not sustained at the 7-month assessment as, notably, both groups demonstrated positive improvements in the Four Test Balance Score and SPPB. For individuals at a moderate/high fall risk at baseline, 47.8% of CG reported falling at seven months; whereas, only 6.3% of EG participants meeting the same criteria reported a fall after HOP-UP-PT participation. CONCLUSIONS: A prevention-focused multimodal program provided by PTs in older adults\u27 homes proved beneficial and those with the highest fall risk demonstrated a significant decrease in falls. A collaboration between PTs and community senior centers resulted in upstreaming care delivery that may reduce both the financial and personal burdens associated with falls in an older adult population. TRIAL REGISTRATION: This study was retrospective registered at Clinical Trials.gov , TRN: NCT04814459 on 24/03/2021

Community pharmacy in a commissioning-led NHS:can pharmacy compete effectively?

Introduction – The commissioning of services has been a core responsibility of English Primary Care Trusts (PCTs) since 2002. Primary care organisations (PCOs) in Scotland, Wales and Northern Ireland have also increased their commissioning activities but with, arguably, less fervour than their English counterparts. The commissioning function of English PCTs has been reinforced by the introduction of new contractual frameworks across primary care – for medical services, dentistry and pharmacy. The new pharmaceutical services contract for England and Wales introduced an “enhanced” category of services, the provision of which is dependent on the commissioning decisions of local PCTs. As the NHS, most pertinently in England, continues its transformation from a provider to a commissioner of healthcare, the ability of pharmacy to compete effectively for funding is likely to become increasingly important. Method - After piloting, in August 2006 a self-completion postal questionnaire was sent to a random sample of practising community pharmacists, stratified for country and sex, within Great Britain (n=1998), with a follow-up to non-responders 4 weeks later. Data were analysed using SPSS (v12.0). A final response rate of 51% (n=1023/1998) was achieved. Within the section of the questionnaire relating to service provision, respondents were asked “do you believe that pharmacy will be able to compete effectively with other healthcare providers for access to additional funding to develop services that address a public health need identified by your local Primary Care Organisation (PCO), e.g. PCT/LHB etc.?”. Answers were recorded on a three-point scale; pharmacy “will”, “may”, or “will not” be able to compete effectively for funding. Results - The attitudes of pharmacists showed variation depending on the type of pharmacy they worked in (supermarket, multiple (outlets (n)=200), large chain (200>n>20), small chain (20=n>5), or independent (n=5)) (?2 test with p=0.001). Over a third of survey pharmacists working in small chains and independents (37% (n=21/57) and 33% (n=113/341) respectively) believed that pharmacy would not be able to compete effectively for funding compared to 23% (n=15/65) for supermarket pharmacists, 22% (n=21/97) for pharmacists employed by large chains and just 18% (n=62/353) for pharmacists employed most regularly in multiples. Furthermore, attitudes also varied between the countries of residence of respondents (?2 test with p<0.05). 27% (n=242/893) of pharmacists resident in England and Wales believed that pharmacy would not be able to compete compared to 16% (n=18/116) of pharmacists resident in Scotland. Conclusions – It would appear that community pharmacists believe that the larger pharmacy chains and supermarkets will occupy an advantageous position in terms of attracting finance to develop services. This could have notable implications for service provision across the sector. If corporate pharmacy chains were to monopolise commissioning monies then the proportion of funding available to independents will be diminished; arguably further hastening their demise, as well as stifling the professional development of pharmacists employed within the independent sector. These findings, when combined with the variation observed between UK pharmacists operating under different contractual frameworks, may be a reflection of the divergent policy in the different administrations with developments in England, including the new pharmacy contract, reflecting a market-based approach with Scotland taking a near opposite stance with service integration and a commitment to new public health. However, it should be acknowledged that the questionnaire did not allow for detection of ambiguities in, or misunderstandings of, the survey question and this should be considered as a limitation of the research