Delphi definition of general practice/family medicine specialty for a post-COVID world: in-person and remote care delivery.

Introduction: The evolving landscape of general practice (GP)/family medicine (FM) in the post-COVID-19 era, focussing on integrating telemedicine and remote consultations requires a new definition for this specialty. Hence, a broader consensus-based definition of post-COVID-19 GP/FM is warranted.

Methods: This study involved a modified electronic Delphi technique involving 27 specialists working in primary care recruited via convenient and snowball sampling.

Chondroitin Sulfate Proteoglycan 4 (CSPG4) as an Emerging Target for Immunotherapy to Treat Melanoma.

Immunotherapies, including checkpoint inhibitor antibodies, have precipitated significant improvements in clinical outcomes for melanoma. However, approximately half of patients do not benefit from approved treatments. Additionally, apart from Tebentafusp, which is approved for the treatment of uveal melanoma, there is a lack of immunotherapies directly focused on melanoma cells.

Proactive frailty in primary care: A primary care system fit for frailty.

Older adults with frailty are at increased risk of premature death, and numerous negative sequalae including falls, disability, and dementia alongside increased healthcare costs. Most healthcare interactions for older people with frailty take place in primary care, and there is increasing interface working between primary and secondary care to manage this patient group including virtual wards, frailty management programmes and Hospital @ Home. This commentary aims to place proactive frailty into recent policy perspective, alongside highlighting some of the current challenges around the implementation of proactive frailty programmes.

Temperature-Dependent Structural and Optoelectronic Properties of the Layered Perovskite 2-Thiophenemethylammonium Lead Iodide.

Improved knowledge of the influence of temperature upon layered perovskites is essential to enable perovskite-based devices to operate over a broad temperature range and to elucidate the impact of structural changes upon the optoelectronic properties. We examined the Ruddlesden-Popper layered perovskite 2-thiophenemethylammonium lead iodide (ThMAPbI) and observed a structural phase transition between a high- and a low-temperature phase at 220 K using temperature-dependent X-ray diffraction, UV-visible absorption, and photoluminescence (PL) spectroscopy. The structural phase transition altered the tilt pattern of the inorganic octahedra layer, modifying the absorption and PL spectra.

Simultaneous measurement of orthogonal terahertz fields via an emission multiplexing scheme.

We propose a polarization sensitive terahertz time-domain spectrometer that can record orthogonally polarized terahertz fields simultaneously, using fibre-coupled photoconductive antennas and a scheme that modulated the emitter's polarization. The s and p channels of the multi-pixel terahertz emitter were modulated at different frequencies, thereby allowing orthogonal waveforms to be demultiplexed from the recorded signal in post-processing. The performance of the multi-pixel emitter used in this multiplexing scheme was comparable to that of a commercial single-polarization H-dipole antenna.

Terahertz Emission via Optical Rectification in a Metal-Free Perovskite Crystal.

We report on the emission of high-intensity pulsed terahertz radiation from the metal-free halide perovskite single crystal methyl-DABCO ammonium iodide (MDNI) under femtosecond illumination. The power and angular dependence of the THz output implicate optical rectification of the 800 nm pump as the mechanism of THz generation. Further characterization finds that, for certain crystal orientations, the angular dependence of THz emission is modulated by phonon resonances attributable to the motion of the methyl-DABCO moiety.

Clustering long-term health conditions among 67728 people with multimorbidity using electronic health records in Scotland.

There is still limited understanding of how chronic conditions co-occur in patients with multimorbidity and what are the consequences for patients and the health care system. Most reported clusters of conditions have not considered the demographic characteristics of these patients during the clustering process. The study used data for all registered patients that were resident in Fife or Tayside, Scotland and aged 25 years or more on 1st January 2000 and who were followed up until 31st December 2018.

Ultrafast THz spectroscopy of carbon nanotube-graphene composites.

Mixed nanomaterial composites can combine the excellent properties of well-known low-dimensional nanomaterials. Here we highlight the potential of one-dimensional single-walled carbon nanotubes interfaced with two-dimensional graphene by exploring the composite's ac conductivity and photoconductivity, and the influence of HAuCldoping. In the composite, the equilibrium terahertz conductivity from free carrier motion was boosted, while the localised plasmon peak shifted towards higher frequencies, which we attribute to shorter conductivity pathways in the composite.

Spectroscopic Insights into the Influence of Filling Carbon Nanotubes with Atomic Nanowires for Photophysical and Photochemical Applications.

Studying the optical performance of carbon nanotubes (CNTs) filled with guest materials can reveal the fundamental photochemical nature of ultrathin one-dimensional (1D) nanosystems, which are attractive for applications including photocatalysis. Here, we report comprehensive spectroscopic studies of how infiltrated HgTe nanowires (NWs) alter the optical properties of small-diameter ( < 1 nm) single-walled carbon nanotubes (SWCNTs) in different environments: isolated in solution, suspended in a gelatin matrix, and heavily bundled in network-like thin films. Temperature-dependent Raman and photoluminescence measurements revealed that the HgTe NW filling can alter the stiffness of SWCNTs and therefore modify their vibrational and optical modes.

Dephasing Dynamics across Different Local Vibrational Modes and Crystalline Environments.

The perturbed free induction decay (PFID) observed in ultrafast infrared spectroscopy was used to unveil the rates at which different vibrational modes of the same atomic-scale defect can interact with their environment. The N_{3}VH^{0} defect in diamond provided a model system, allowing a comparison of stretch and bend vibrational modes within different crystal lattice environments. The observed bend mode (first overtone) exhibited dephasing times T_{2}=2.

Multi-pixel photoconductive emitters for the controllable generation of azimuthal and radial terahertz beams.

A multi-pixel photoconductive emitter is reported that generates THz beams with either azimuthal, radial or linear polarization states. Switching between the different polarization states was purely electrical, via the bias voltage applied, circumventing the need for mechanical polarization optics or different THz emitters to change the polarization. Dipole array modelling was performed to validate emitter array designs, and to explore their optimal bias configuration, while spatially-resolved electro-optic detection of the generated beams confirmed that cylindrical-vector beams were produced.

Understanding the processes behind the decisions - GPs and complex multimorbidity decision making.

Complex multimorbidity, defined either as three or more chronic conditions affecting three or more different body systems or by the patients General Practitioner (GPs), is associated with various adverse outcomes. Understanding how GPs reach decisions for this complex group of patients is currently under-researched, with potential implications for health systems and service delivery. Schuttner and colleagues, through a qualitative approach, reported that internal factors of individuals (decisions tailored to patients; Primary Care Physician (PCP) consultation style; care planning towards an agreed goal of care), external factors within the environment or context of encounter (patient access to healthcare; organizational structures acting as barriers), and relationship-based factors (collaborative care planning; decisions within a dynamic patient clinician relationship) all influence care planning decisions.

Zigzag HgTe Nanowires Modify the Electron-Phonon Interaction in Chirality-Refined Single-Walled Carbon Nanotubes.

Atomically thin nanowires (NWs) can be synthesized inside single-walled carbon nanotubes (SWCNTs) and feature unique crystal structures. Here we show that HgTe nanowires formed inside small-diameter (<1 nm) SWCNTs can advantageously alter the optical and electronic properties of the SWCNTs. Metallic purification of the filled SWCNTs was achieved by a gel column chromatography method, leading to an efficient extraction of the semiconducting and metallic portions with known chiralities.

Mohs micrographic surgery for cutaneous malignancy of the hand & upper limb - Raising awareness of its applications and advantages.

Mohs Micrographic Surgery (MMS) is primarily recognised for use in facial tumours, however it should also be considered to aid excision of tumours of the hand, where preservation of tissue and maintenance of function are key factors. Mohs surgery can serve to facilitate decision making both by the patient and surgeon. This can be particularly helpful when proposing more extensive surgery, or prior to complex reconstruction where confirmation of tumour clearance is paramount.

Linear and Helical Cesium Iodide Atomic Chains in Ultranarrow Single-Walled Carbon Nanotubes: Impact on Optical Properties.

One-dimensional (1D) atomic chains of CsI were previously reported in double-walled carbon nanotubes with ∼0.8 nm inner diameter. Here, we demonstrate that, while 1D CsI chains form within narrow ∼0.

Changes in clinical manifestation of fibromyalgia syndromes after Alzheimer's disease diagnosis.

Fibromyalgia syndrome (FMS) is defined by chronic widespread pain persisting for more than 3 months without an apparent physical cause. The prevalence of FMS peaks between 50 and 70 years old, and it can be difficult to diagnose and treat due to other comorbid conditions. Recent work has suggested that neurodegenerative conditions can be complicated by chronic pain.

The Wire Study-a protocol for a multi-stage feasibility study evaluating K-wire fixation of hand fractures in the UK.

Background: Hand fractures are common and sometimes require surgery to restore function. Placement of Kirschner wires (K-wires) is the most common form of surgical fixation. After placement, a key decision is whether to bury the end of a K-wire or leave it protruding from the skin (exposed).

The 2021 ultrafast spectroscopic probes of condensed matter roadmap.

In the 60 years since the invention of the laser, the scientific community has developed numerous fields of research based on these bright, coherent light sources, including the areas of imaging, spectroscopy, materials processing and communications. Ultrafast spectroscopy and imaging techniques are at the forefront of research into the light-matter interaction at the shortest times accessible to experiments, ranging from a few attoseconds to nanoseconds. Light pulses provide a crucial probe of the dynamical motion of charges, spins, and atoms on picosecond, femtosecond, and down to attosecond timescales, none of which are accessible even with the fastest electronic devices.

Anti-granulocyte-macrophage colony-stimulating factor antibody otilimab in patients with hand osteoarthritis: a phase 2a randomised trial.

Background: Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a key mediator of signs and symptoms in preclinical models of osteoarthritis. We explored the efficacy, safety, and pharmacokinetics of an anti-GM-CSF antibody, otilimab, in patients with hand osteoarthritis.

Methods: This double-blind, randomised, placebo-controlled phase 2a study was done in 16 centres in the Netherlands, Germany, Poland, the UK, and the USA.

Emergent Antipolar Phase in BiFeO-LaSrMnO Superlattice.

Ferroelectric-paraelectric superlattices show emerging new states, such as polar vortices, through the interplay and different energy scales of various thermodynamic constraints. By introducing magnetic coupling at BiFeO-LaSrMnO interfaces epitaxially grown on SrTiO substrate, we find, for the first time in thin films, a sub-nanometer thick lamella-like BiFeO. The emergent phase is characterized by an arrangement of a two unit cell thick lamella-like structure featuring antiparallel polarization, resulting an antiferroelectric-like structure typically associated with a morphotropic phase transition.

Ultrafast Optoelectronic Processes in 1D Radial van der Waals Heterostructures: Carbon, Boron Nitride, and MoS Nanotubes with Coexisting Excitons and Highly Mobile Charges.

Heterostructures built from 2D, atomically thin crystals are bound by the van der Waals force and exhibit unique optoelectronic properties. Here, we report the structure, composition and optoelectronic properties of 1D van der Waals heterostructures comprising carbon nanotubes wrapped by atomically thin nanotubes of boron nitride and molybdenum disulfide (MoS). The high quality of the composite was directly made evident on the atomic scale by transmission electron microscopy, and on the macroscopic scale by a study of the heterostructure's equilibrium and ultrafast optoelectronics.