Temperature-dependent gap edge in strong-coupling superconductors determined using the Eliashberg-Nambu formalism

Using the theory of Eliashberg and Nambu for strong-coupling superconductors, we have calculated the gap function for a model superconductor and a selection of real superconductors includong the elements Al, Sn, Tl, Nb, In, Pb and Hg and one alloy, Bi2Tl. We have determined thetemperature-dependent gap edge in each and found that in materials with weak electron-phonon ($\lambda 1.20$), not only is the gap edge double valued but it also departs significantly from the BCS form and develops a shoulderlike structure which may, in some cases, denote a gap edge exceeding the $T = 0$ value. These computational results support the insights obtained by Leavens in an analytic consideration of the general problem. Both the shoulder and double value arise from a common origin seated in the form of the gap function in strong coupled materials at finite temperatures. From the calculated gap function, we can determine the densities of states in the materials and the form of the tunneling current-voltage characteristics for junctions with these materials as electroddes. By way of illustration, results are shown for the contrasting cases of Sn ($\lambda=0.74$) and Hg ($\lambad=1.63$). The reported results are distinct in several ways from BCS predictions and provide an incentive determinative experimental studies with techniques such as tunneling and far infrared absorption.

Polypharmacy and inappropriate medication use in patients with dementia: an underresearched problem

Multimorbidity and polypharmacy are increasingly prevalent across healthcare systems and settings as global demographic trends shift towards increased proportions of older people in populations. Numerous studies have demonstrated an association between polypharmacy and potentially inappropriate prescribing (PIP), and have reported high prevalence of PIP across settings of care in Europe and North America and, as a consequence, increased risk of adverse drug reactions, healthcare utilisation, morbidity and mortality. These studies have not focused specifically on people with dementia, despite the high risk of adverse drug reactions and PIP in this patient cohort. This narrative review considers the evidence currently available in the area, including studies examining prevalence of PIP in older people with dementia, how appropriateness of prescribing is assessed, the medications most commonly implicated, the clinical consequences, and research priorities to optimise prescribing for this vulnerable patient group. Although there has been considerable research effort to develop criteria to assess medication appropriateness in older people in recent years, the majority of tools do not focus on people with dementia. Of the limited number of tools available, most focus on the advanced stages of dementia in which life-expectancy is limited. The development of tools to assess medication appropriateness in people with mild-to-moderate dementia or across the full spectrum of disease severity represents an important gap in the research literature and is beginning to attract research interest, with recent studies considering the medication regimen as a whole, or misprescribing, overprescribing or underprescribing of certain medications/medication classes including anticholinergics, psychotropics, antibiotics and analgesics. Further work is required in development and validation of criteria to assess prescribing appropriateness in this vulnerable patient population, to determine prevalence of PIP in large cohorts of people with the full spectrum of dementia variants and severities and to examine the impact of PIP on health outcomes.