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"Lee, J. P."
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Topologically Protected States in One-Dimensional Systems
We study a class of periodic Schrödinger operators, which in distinguished cases can be proved to have linear band-crossings or
“Dirac points”. We then show that the introduction of an “edge”, via adiabatic modulation of these periodic potentials by a domain wall,
results in the bifurcation of spatially localized “edge states”. These bound states are associated with the topologically protected
zero-energy mode of an asymptotic one-dimensional Dirac operator. Our model captures many aspects of the phenomenon of topologically
protected edge states for two-dimensional bulk structures such as the honeycomb structure of graphene. The states we construct can be
realized as highly robust TM-electromagnetic modes for a class of photonic waveguides with a phase-defect.
eBook
A sustained high-temperature fusion plasma regime facilitated by fast ions
Nuclear fusion is one of the most attractive alternatives to carbon-dependent energy sources
1
. Harnessing energy from nuclear fusion in a large reactor scale, however, still presents many scientific challenges despite the many years of research and steady advances in magnetic confinement approaches. State-of-the-art magnetic fusion devices cannot yet achieve a sustainable fusion performance, which requires a high temperature above 100 million kelvin and sufficient control of instabilities to ensure steady-state operation on the order of tens of seconds
2
,
3
. Here we report experiments at the Korea Superconducting Tokamak Advanced Research
4
device producing a plasma fusion regime that satisfies most of the above requirements: thanks to abundant fast ions stabilizing the core plasma turbulence, we generate plasmas at a temperature of 100 million kelvin lasting up to 20 seconds without plasma edge instabilities or impurity accumulation. A low plasma density combined with a moderate input power for operation is key to establishing this regime by preserving a high fraction of fast ions. This regime is rarely subject to disruption and can be sustained reliably even without a sophisticated control, and thus represents a promising path towards commercial fusion reactors.
A magnetic confinement regime established at the Korea Superconducting Tokamak Advanced Research device enables the generation of plasmas over 10
8
kelvin for 20 seconds with the aid of fast ions without plasma edge instabilities or impurity accumulation.
Journal Article
Noise and sound in the intensive care unit: a cohort study
Intensive care units (ICUs) are acknowledged for their propensity for noise, often exhibiting higher sound levels on average than other departments. This is mainly ascribed to a high concentration of medical devices and staff, creating an acoustic environment characterised by a high level of staff activity and a concoction of alarms from therapeutic and monitoring devices. Excessive noise in ICUs has been associated with adverse health effects and human factor impacts acknowledged to negatively affect both patients and healthcare providers. This study aimed to evaluate the sound levels of the Royal Liverpool University Hospital (RLUH) ICU and compare it against recommended guidelines. Prospective sound level measurements were taken from a six-bedded bay within the RLUH ICU between 15th June and 1st July 2022. This audit focussed on sound data that equal or exceeded 87 dBA, in accordance with levels in the UK Noise Regulations. The data involved 11 patients admitted to the bay within the defined timeframe. A retrospective review of the patients’ records was conducted to identify potential noisy events during the recording period. Results revealed all L
Aeq
and
L
Amax
measurements exceeded the recommended guidelines. Although HSE exposure limit values were not exceeded, the lowest
L
Amin
value recorded was 44.2 dBA and only one hour from 16 days of recording (less than 1% of the time) fell below international daytime guidelines of 45 dBA. The top documented potential causes of noise were patient repositioning/personal care, medication administration and suctioning. Sound levels in the RLUH ICU considerably exceed national and international guidelines. These findings highlight the need to address the issue of noise pollution in the ICU setting. Hospital staff should consider implementing strategies and interventions for noise reduction in ICUs.
Journal Article
Rexodus
\"With the aid of Kelvin, a dinosaur from the past, Amber must save her father--and the rest of us--from the very same danger that caused the dinosaurs to flee--and from the dinosaurs themselves as they return to Earth\"-- Back cover.
Book
Safety of zoledronic acid and incidence of osteonecrosis of the jaw (ONJ) during adjuvant therapy in a randomised phase III trial (AZURE: BIG 01–04) for women with stage II/III breast cancer
The AZURE trial is an ongoing phase III, academic, multi-centre, randomised trial designed to evaluate the role of zoledronic acid (ZOL) in the adjuvant therapy of women with stage II/III breast cancer. Here, we report the safety and tolerability profile of ZOL in this setting. Eligible patients received (neo)adjuvant chemotherapy and/or endocrine therapy and were randomised to receive neither additional treatment nor intravenous ZOL 4 mg. ZOL was administered after each chemotherapy cycle to exploit potential sequence-dependent synergy. ZOL was continued for 60 months post-randomisation (six doses in the first 6 months, eight doses in the following 24 months and five doses in the final 30 months). Serious (SAE) and non-serious adverse event (AE) data generated during the first 36 months on study were analysed for the safety population. 3,360 patients were recruited to the AZURE trial. The safety population comprised 3,340 patients (ZOL 1,665; control 1,675). The addition of ZOL to standard treatment did not significantly impact on chemotherapy delivery. SAE were similar in both treatment arms. No significant safety differences were seen apart from the occurrence of osteonecrosis of the jaw (ONJ) in the ZOL group (11 confirmed cases; 0.7%; 95% confidence interval 0.3–1.1%). ZOL in the adjuvant setting is well tolerated, and can be safely administered in addition to adjuvant therapy including chemotherapy. The adverse events were consistent with the known safety profile of ZOL, with a low incidence of ONJ.
Journal Article
Controllable Photonic Time-Bin Qubits from a Quantum Dot
Photonic time-bin qubits are well suited to transmission via optical fibers and waveguide circuits. The states take the form1(2)(α|0⟩+eiϕβ|1⟩), with|0⟩and|1⟩referring to the early and late time bin, respectively. By controlling the phase of a laser driving a spin-flip Raman transition in a single-hole-charged InAs quantum dot, we demonstrate complete control over the phase,ϕ. We show that this photon generation process can be performed deterministically, with only a moderate loss in coherence. Finally, we encode different qubits in different energies of the Raman scattered light, paving the way for wavelength-division multiplexing at the single-photon level.
Journal Article
Management of cardiac health in trastuzumab-treated patients with breast cancer: updated United Kingdom National Cancer Research Institute recommendations for monitoring
More women are living with and surviving breast cancer, because of improvements in breast cancer care. Trastuzumab (Herceptin
®
▾) has significantly improved outcomes for women with HER2-positive tumours. Concerns about the cardiac effects of trastuzumab (which fundamentally differ from the permanent myocyte loss associated with anthracyclines) led to the development of cardiac guidelines for adjuvant trials, which are used to monitor patient safety in clinical practice. Clinical experience has shown that the trial protocols are not truly applicable to the breast cancer population as a whole, and exclude some women from receiving trastuzumab, even though they might benefit from treatment without long-term adverse cardiac sequelae. Consequently, five oncologists who recruited patients to trastuzumab trials, some cardiologists with whom they work, and a cardiovascular lead general practitioner reviewed the current cardiac guidelines in the light of recent safety data and their experience with adjuvant trastuzumab. The group devised recommendations that promote proactive pharmacological management of cardiac function in trastuzumab-treated patients, and that apply to all patients who are likely to receive standard cytotoxic chemotherapy. Key recommendations include: a monitoring schedule that assesses baseline and on-treatment cardiac function and potentially reduces the overall number of assessments required; intervention strategies with cardiovascular medication to improve cardiac status before, during, and after treatment; simplified rules for starting, interrupting and discontinuing trastuzumab; and a multidisciplinary approach to breast cancer care.
Journal Article