Healthcare Students’ Abilities To Translate Interprofessional Education To Collaborative Practice

Interprofessional education is considered the first step to providing students with the knowledge and skill required to participate in interprofessional collaboration. The lingering question in research is if students can take these skills from the classroom to clinical practice. The answer to this question will help guide educators when developing effective IPE training. This quantitative, correlational study aimed to explore if healthcare students that participated in a two-part, case-based interprofessional educational session were able to transfer that skill to their clinical experience. Data was collected from healthcare students in the professions of physical therapy, occupational therapy, and nursing. The participants completed an electronic survey that consisted of the validated Interprofessional Collaborative Competency Attainment Survey (ICCAS) and basic demographic questions. The electronic survey assessed the participants’ behaviors associated with the six interprofessional collaboration core competencies developed by the Canadian Interprofessional Health Collaborative. Participants completed it after their clinical experience coursework. The data from this survey were compared to the results of data collected with the ICCAS during a previous research study the same cohort of students had participated in. The data were analyzed using the repeated measures ANOVA testing. There were statistical significances found between the ex post facto and pre-clinical experience as well as the pre-clinical and post-clinical experience. However, the mean scores were higher with the ex post facto data than the other two points in time. This outcome suggests the participants felt more confident with their interprofessional collaborative skills after their classroom training than they did prior to and after their clinical experience

Development of EM-CCD-based X-ray detector for synchrotron applications

A high speed, low noise camera system for crystallography and X-ray imaging applications is developed and successfully demonstrated. By coupling an electron-multiplying (EM)-CCD to a 3:1 fibre-optic taper and a CsI(Tl) scintillator, it was possible to detect hard X-rays. This novel approach to hard X-ray imaging takes advantage of sub-electron equivalent readout noise performance at high pixel readout frequencies of EM-CCD detectors with the increase in the imaging area that is offered through the use of a fibre-optic taper. Compared with the industry state of the art, based on CCD camera systems, a high frame rate for a full-frame readout (50 ms) and a lower readout noise (<1 electron root mean square) across a range of X-ray energies (6–18 keV) were achieved

Controversial issues in the neoadjuvant treatment of triple-negative breast cancer.

Triple-negative breast cancer (TNBC), as a collective group of heterogenous tumours, displays the highest rate of distant recurrence and lowest survival from metastatic disease across breast cancer subtypes. However, a subset of TNBC display impressive primary tumour response to neoadjuvant chemotherapy, translating to reduction in future relapse and increased overall survival. Maximizing early treatment response is crucial to improving the outlook in this subtype. Numerous systemic therapy strategies are being assessed in the neoadjuvant setting and the current paradigm of generic chemotherapy components in regimens for high-risk breast cancers, regardless of biological subtype, is changing. Therapeutic approaches with evidence of benefit include platinum drugs, polyadenosine diphosphate ribose polymerase (PARP) inhibitors, immunotherapy and second adjuvant therapy for those not achieving pathological complete response. Importantly, molecular testing can identify subgroups within TNBC, such as deoxyribonucleic acid (DNA) homologous recombination repair deficiency, lymphocyte-predominant tumours, and TNBC type 4 molecular subtypes. Clinical trials that address the interaction between these biomarkers and treatment approaches are a priority, to identify subgroups benefiting from additional therapy

Improving the resolution in soft X-ray emission spectrometers through photon-counting using an Electron Multiplying CCD

In 2007, a study of back-illuminated Charge-Coupled Devices (CCDs) for soft X-ray photon detection demonstrated the improvements that could be brought over more traditional micro-channel plate detectors for X-ray spectrometers based on diffraction gratings and position sensitive detectors. Whilst the spatial resolution was reported to be improved dramatically, an intrinsic limit of approximately 25 micrometers was found due to the spreading of the charge cloud generated in the CCD across several pixels. To overcome this resolution limit, it is necessary to move away from the current integrated imaging methods and consider a photon-counting approach, recording the photon interaction locations to the sub-pixel level. To make use of photon-counting techniques it is important that the individual events are separable. To maintain the throughput of the spectrometer for high intensity lines, higher frame rates and therefore higher readout speeds are required. With CCD based systems, the increased noise at high readout speeds can limit the photon-counting performance. The Electron-Multiplying CCD shares a similar architecture with the standard CCD but incorporates a "gain register". This novel addition allows controllable gain to be applied to the signal before the read noise is introduced, therefore allowing individual events to be resolved above the noise even at much higher readout rates. In the past, the EM-CCD has only been available with imaging areas too small to be practical in soft X-ray emission spectrometers. The current drive for large area Electron-Multiplying CCDs is opening this technology to new photon-counting applications, requiring in-depth analysis of the processes and techniques involved. Early results indicate that through the introduction of photon-counting techniques the resolution in such systems can be dramatically improved

Differences in breast cancer hormone receptor status in ethnic groups: a London population.

BACKGROUND: Triple negative breast cancer (TNBC) is associated with different ethnic groups in the United States (US), however this has not previously been examined in a population-based study within the United Kingdom (UK). METHODS: Electronic pathology reports from the North East London Cancer Network (NELCN) on women diagnosed with breast cancer between 2005 and 2007 were collated. The statuses of oestrogen receptor, progesterone receptor and HER-2 were extracted. Women were classified as having TNBC if all three receptor statuses were negative, and as not having TNBC if at least one receptor was positive or borderline. Logistic regression was used to quantify the association between TNBC and ethnicity, adjusting for age, year of diagnosis and socioeconomic deprivation. Overall survival in different ethnic groups was examined using Cox regression, adjusting as appropriate for age, stage of disease, triple negative status, year of diagnosis, socioeconomic deprivation and recorded treatment. RESULTS: There were 2417 women resident in NELCN diagnosed with breast cancer between 2005 and 2007, and TNBC status was determined for 1228 (51%) women. Overall, of women who had their TNBC status determined, 128 (10%) were diagnosed with TNBC. Compared with White women, Black (odds ratio [OR]=2.81, p<0.001) and South Asian (OR=1.80, p=0.044) women with breast cancer were more likely to have TNBC. Black women had a worse age-adjusted survival than White women (hazard ratio [HR]=2.05, p<0.001). This was attenuated by further adjustment for stage of disease (1.52, p=0.032) and triple negative status (1.31, p=0.175). CONCLUSION: Better methods of early detection may need to be developed in addition to more effective systemic treatment in order to improve outcomes for women with TNBC

Molecular alterations in triple-negative breast cancer-the road to new treatment strategies.

Triple-negative breast cancer is a heterogeneous disease and specific therapies have not been available for a long time. Therefore, conventional chemotherapy is still considered the clinical state of the art. Different subgroups of triple-negative breast cancer have been identified on the basis of protein expression, mRNA signatures, and genomic alterations. Important elements of triple-negative breast cancer biology include high proliferative activity, an increased immunological infiltrate, a basal-like and a mesenchymal phenotype, and deficiency in homologous recombination, which is in part associated with loss of BRCA1 or BRCA2 function. A minority of triple-negative tumours express luminal markers, such as androgen receptors, and have a lower proliferative activity. These biological subgroups are overlapping and currently cannot be combined into a unified model of triple-negative breast cancer biology. Nevertheless, the molecular analysis of this disease has identified potential options for targeted therapeutic intervention. This has led to promising clinical strategies, including modified chemotherapy approaches targeting the DNA damage response, angiogenesis inhibitors, immune checkpoint inhibitors, or even anti-androgens, all of which are being evaluated in phase 1-3 clinical studies. This Series paper focuses on the most relevant clinical questions, summarises the results of recent clinical trials, and gives an overview of ongoing studies and trial concepts that will lead to a more refined therapy for this tumour type