Emergence of Poultry-Associated Human Salmonella enterica Serovar Abortusovis Infections, New South Wales, Australia.

Salmonella enterica serovar Abortusovis is a ovine-adapted pathogen that causes spontaneous abortion. Salmonella Abortusovis was reported in poultry in 2009 and has since been reported in human infections in New South Wales, Australia. Phylogenomic analysis revealed a clade of 51 closely related isolates from Australia originating in 2004. That clade was genetically distinct from ovine-associated isolates. The clade was widespread in New South Wales poultry production facilities but was only responsible for sporadic human infections. Some known virulence factors associated with human infections were only found in the poultry-associated clade, some of which were acquired through prophages and plasmids. Furthermore, the ovine-associated clade showed signs of genome decay, but the poultry-associated clade did not. Those genomic changes most likely led to differences in host range and disease type. Surveillance using the newly identified genetic markers will be vital for tracking Salmonella Abortusovis transmission in animals and to humans and preventing future outbreaks.

Climatic effects on the synchrony and stability of temperate headwater invertebrates over four decades.

Important clues about the ecological effects of climate change can arise from understanding the influence of other Earth-system processes on ecosystem dynamics but few studies span the inter-decadal timescales required. We, therefore, examined how variation in annual weather patterns associated with the North Atlantic Oscillation (NAO) over four decades was linked to synchrony and stability in a metacommunity of stream invertebrates across multiple, contrasting headwaters in central Wales (UK). Prolonged warmer and wetter conditions during positive NAO winters appeared to synchronize variations in population and community composition among and within streams thereby reducing stability across levels of ecological organization. This climatically mediated synchronization occurred in all streams irrespective of acid-base status and land use, but was weaker where invertebrate communities were more functionally diverse. Wavelet linear models indicated that variation in the NAO explained up to 50% of overall synchrony in species abundances at a timescale of 4-6 years. The NAO appeared to affect ecological dynamics through local variations in temperature, precipitation and discharge, but increasing hydrochemical variability within sites during wetter winters might have contributed. Our findings illustrate how large-scale climatic fluctuations generated over the North Atlantic can affect population persistence and dynamics in inland freshwater ecosystems in ways that transcend local catchment character. Protecting and restoring functional diversity in stream communities might increase their stability against warmer, wetter conditions that are analogues of ongoing climate change. Catchment management could also dampen impacts and provide options for climate change adaptation.

To Eat or Not to Eat: Novel Stable Isotope Models Reveal a Shift in Carnivory with Nutrient Availability for Aquatic Utricularia spp.

BACKGROUND AND AIMS: Freshwater nitrogen inputs are increasing globally, altering the structure and function of wetland ecosystems adapted to low nutrient conditions. Carnivorous wetland plants, Utricularia spp., are hypothesised to reduce their reliance on carnivory and increase their assimilation of environmental nutrients when the supply of ambient nutrients increases. Despite success in using stable isotope approaches to quantify carnivory of terrestrial carnivorous plants, quantifying carnivory of aquatic Utricularia requires improvement. METHODS: We developed stable isotope mixing models to quantify aquatic plant carnivory and used these models to measure dietary changes of three Utricularia species: Utricularia australis, U. gibba, and U. uliginosa in 11 wetlands across a 794 km gradient in eastern Australia. Diet was assessed using multiple models that compared variations in the natural abundance nitrogen isotope composition (δ15N) of Utricularia spp. with that of non-carnivorous plants, and environmental and carnivorous nitrogen sources. KEY RESULTS: Carnivory supplied 40 - 100 % of plant nitrogen. The lowest carnivory rates coincided with the highest availability of ammonium and dissolved organic carbon. CONCLUSIONS: Our findings suggest that Utricularia populations may adapt to high nutrient environments by shifting away from energetically costly carnivory. This has implications for species conservation as anthropogenic impacts continue to affect global wetland ecosystems.

A data-driven approach to multiple-stressor impact assessment for a marine protected area.

The coastal environment is not managed in a way that considers the impact of cumulative threats, despite being subject to threats from all realms (marine, land, and atmosphere). Relationships between threats and species are often nonlinear; thus, current (linear) approaches to estimating the impact of threats may be misleading. We developed a data-driven approach to assessing cumulative impacts on ecosystems and applied it to explore nonlinear relationships between threats and a temperate reef fish community. We used data on water quality, commercial fishing, climate change, and indicators of recreational fishing and urbanization to build a cumulative threat map of the northern region in New South Wales, Australia. We used statistical models of fish abundance to quantify associations among threats and biophysical covariates and predicted where cumulative impacts are likely to have the greatest impact on fish. We also assessed the performance of no-take zones (NTZs), to protect fish from cumulative threats across 2 marine protected area networks (marine parks). Fishing had a greater impact on fish than water quality threats (i.e., percent increase above the mean for invertivores was 337% when fishing was removed and was 11% above the mean when water quality was removed inside NTZs), and fishing outside NTZs affected fish abundances inside NTZs. Quantifying the spatial influence of multiple threats enables managers to understand the multitude of management actions required to address threats.

Una estrategia basada en datos para la evaluación de impacto de múltiples estresores en un área marina protegida Resumen Los ambientes costeros no se manejan de manera que se considere el impacto de las amenazas acumulativas, a pesar de que se enfrentan a amenazas de todos los entornos (marinas, terrestres y atmosféricas). Las relaciones entre las amenazas y las especies casi siempre son no lineales; por lo tanto, las estrategias actuales (lineales) para estimar el impacto de las amenazas pueden ser engañosas. Desarrollamos una estrategia basada en datos para evaluar el impacto acumulativo sobre los ecosistemas y la aplicamos para explorar las relaciones no lineales entre las amenazas y la comunidad de peces de arrecifes templados. Usamos datos de la calidad del agua, pesca comercial, cambio climático e indicadores de pesca recreativa y urbanización para construir un mapa acumulativo de amenazas de la región norte de Nueva Gales del Sur, Australia. Usamos modelos estadísticos de la abundancia de peces para cuantificar las asociaciones entre las amenazas y las covarianzas biofísicas y pronosticamos en dónde es probable que los impactos acumulativos sean mayores sobre los peces. También evaluamos el desempeño de las zonas de veda para así proteger a los peces de las amenazas acumulativas en dos redes de áreas marinas protegidas (parques marinos). La pesca tuvo un mayor impacto que la calidad del agua sobre los peces (es decir, el incremento del porcentaje por encima de la media de depredadores de invertebrados fue de 337% cuando se eliminó la pesca y fue de 11% por encima de la media cuando se eliminó la calidad del agua dentro de las zonas de veda) y la pesca fuera de las zonas de veda afectó la abundancia de los peces dentro de ellas. La cuantificación de la influencia espacial de las múltiples amenazas permite que los gestores entiendan la multitud de acciones de manejo que se requieren para abordar las amenazas.

Stone-Wales defects preserve hyperuniformity in amorphous two-dimensional networks.

Disordered hyperuniformity (DHU) is a recently discovered novel state of many-body systems that possesses vanishing normalized infinite-wavelength density fluctuations similar to a perfect crystal and an amorphous structure like a liquid or glass. Here, we discover a hyperuniformity-preserving topological transformation in two-dimensional (2D) network structures that involves continuous introduction of Stone-Wales (SW) defects. Specifically, the static structure factor [Formula: see text] of the resulting defected networks possesses the scaling [Formula: see text] for small wave number k, where [Formula: see text] monotonically decreases as the SW defect concentration p increases, reaches [Formula: see text] at [Formula: see text], and remains almost flat beyond this p. Our findings have important implications for amorphous 2D materials since the SW defects are well known to capture the salient feature of disorder in these materials. Verified by recently synthesized single-layer amorphous graphene, our network models reveal unique electronic transport mechanisms and mechanical behaviors associated with distinct classes of disorder in 2D materials.

Assisted dying: principles, possibilities, and practicalities. An English physician's perspective.

It seems probable that some form of medically-assisted dying will become legal in England and Wales in the foreseeable future. Assisted dying Bills are at various stages of preparation in surrounding jurisdictions (Scotland, Republic of Ireland, Isle of Man, Jersey), and activists campaign unceasingly for a change in the law in England and Wales. There is generally uncritical supportive media coverage, and individual autonomy is seen as the unassailable trump card: 'my life, my death'.However, devising a law which is 'fit for purpose' is not an easy matter. The challenge is to achieve an appropriate balance between compassion and patient autonomy on the one hand, and respect for human life generally and medical autonomy on the other. More people should benefit from a change in the law than be harmed. In relation to medically-assisted dying, this may not be possible. Protecting the vulnerable is a key issue. Likewise, not impacting negatively on societal attitudes towards the disabled and frail elderly, particularly those with dementia.This paper compares three existing models of physician-assisted suicide: Switzerland, Oregon (USA), and Victoria (Australia). Vulnerability and autonomy are discussed, and concern expressed about the biased nature of much of the advocacy for assisted dying, tantamount to disinformation. A 'hidden' danger of assisted dying is noted, namely, increased suffering as more patients decline referral to palliative-hospice care because they fear they will be 'drugged to death'.Finally, suggestions are made for a possible 'least worse' way forward. One solution would seem to be for physician-assisted suicide to be the responsibility of a stand-alone Department for Assisted Dying overseen by lawyers or judges and operated by technicians. Doctors would be required only to confirm a patient's medical eligibility. Palliative-hospice care should definitely not be involved, and healthcare professionals must have an inviolable right to opt out of involvement. There is also an urgent need to improve the provision of care for all terminally ill patients.

Crumpling Defective Graphene Sheets.

Upon crumpling, graphene sheets yield intriguing hierarchical structures with high resistance to compression and aggregation, garnering a great deal of attention in recent years for their remarkable potential in a variety of applications. Here, we aim to understand the effect of Stone-Wales (SW) defects, i.e., a typical topological defect of graphene, on the crumpling behavior of graphene sheets at a fundamental level. By employing atomistically informed coarse-grained molecular dynamics (CG-MD) simulations, we find that SW defects strongly influence the sheet conformation as manifested by the change in size scaling laws and weaken the self-adhesion of the sheet during the crumpling process. Remarkably, the analyses of the internal structures (i.e., local curvatures, stresses, and cross-section patterns) of crumpled graphene emphasize the enhanced mechanical heterogeneity and "glass-like" amorphous state elicited by SW defects. Our findings pave the way for understanding and exploring the tailored design of crumpled structure via defect engineering.

Survey of National Health Service (NHS) orthodontic practitioners in Wales, UK. Part 2: job satisfaction perceptions of the workforce 2021-2022.

OBJECTIVE: To ascertain the perceptions of the Welsh NHS orthodontic workforce regarding their job satisfaction and work life balance. DESIGN: Descriptive cross-sectional survey. PARTICIPANTS AND SETTING: Clinicians providing NHS orthodontic treatment in Wales. METHODS: An anonymised, email-distributed, electronic, two-part survey (onlinesurveys.ac.uk) of the Welsh NHS orthodontic workforce working within Wales was undertaken. The survey consisted of three sections: (1) demographic information (part 1); (2) respondents' working pattern (part 1); and (3) perceptions of professional job satisfaction and work/life balance (part 2). The responses received were exported into an Excel spreadsheet for descriptive analysis. The free-text comments were collated for each question and subsequently underwent a content analysis to identify any common themes. RESULTS: Part 2 of the survey yielded an overall response rate of 69.6% (n = 78). Over 96% (n = 75) of respondents felt that they had 'made the right career choice, including 100% of orthodontic trainees, orthodontic specialists and orthodontic consultants. Of the respondents, 88.5% (n = 69) said they 'enjoyed going to work', with the remaining being mostly neutral in their opinion. Of the respondents, 79.5% (n = 62) felt they were able to 'provide their patients the optimum care' and 64.1% (n = 50) felt that more demands were being placed upon them by patients and parents. Overall, 52.6% (n = 41) of survey respondents believed it was becoming increasingly difficult to achieve an effective work/life balance, and this was more prevalent among male respondents (61.5%, n = 16) than female respondents (48.1%, n = 25), although this difference was not statistically significant (P >0.05). CONCLUSIONS: Over 96% of respondents felt they have chosen the right career and that flexibility and a good working environment are important to job satisfaction. Respondents felt that there are increasing demands being placed upon them by patients/parents, employers, the Regulators, the Government and Health Boards. This is leading to increased difficulty in achieving a satisfactory work/life balance, especially among male respondents.

Survey of National Health Service (NHS) orthodontic practitioners in Wales, UK. Part 1: working patterns 2021-2022.

OBJECTIVE: To ascertain the working patterns of the NHS orthodontic workforce in Wales and any possible future changes. DESIGN: Descriptive cross-sectional survey. PARTICIPANTS: NHS orthodontic practitioners in Wales. METHODS: An anonymised email distributed an electronic two-part survey of the Welsh NHS orthodontic workforce. The survey consisted of three sections: (1) demographic information; (2) respondents' working pattern (part 1); and (3) perceptions of professional satisfaction (part 2). RESULTS: Part 1 of the survey yielded a 70.5% response rate (n = 79); 65.8% of the respondents were women. Of the respondents, 45.6% (n = 36) worked full time (F/T), 39.2% (n = 31) worked less than F/T and 15.2% (n = 12) worked more than F/T. Of the male respondents, 81.5% (n = 22) worked 10 sessions or more compared to 50% (n = 26) of women. The respondents undertook 508.5 orthodontic clinical sessions per week within Wales; of these sessions, 87.6% (n = 445.5) delivered NHS orthodontic care. Of the respondents, 8.4% (n = 7) were planning to increase their orthodontic clinical time within the next 2 years, 24.1% (n = 19) were planning to decrease it and 20.3% (n = 16) were unsure. One-quarter of respondents indicated that they were planning to stop clinical orthodontic activity within the next 5 years, including 53.3% (n = 8) of DwSIs, 37% (n = 10) of primary care specialists and 13.3% (n = 2) of consultants. The pandemic was an influencing factor for 80% of these clinicians. CONCLUSIONS: Part 1 of the survey suggested that the majority of the orthodontic workforce was female, were working full time or more, and spent most sessions delivering NHS care. One-quarter of respondents were planning to cease undertaking orthodontic activity within the next 5 years.

Defining digital nursing.

BACKGROUND: The use of technology in health care, including nursing, is growing, owing in part to the COVID-19 pandemic and in response to national policy. AIMS: To investigate nurses' perceptions of digital nursing (DN). METHODS: Community and primary care nurses from across Wales were recruited (n=249) through a survey comprising open and closed questions. This was supplemented with semistructured interviews (n=25). Thematic analysis was used to analyse qualitative data. FINDINGS: Nurses had a broad range of perspectives on what DN meant, with four main themes being identified: access; impact on care; technology; and digital future. The positive impacts of DN on ways of working and patient outcomes were supported by answers to closed survey questions. CONCLUSION: Many nurses understand the value of digital tools within nursing and are clear about their benefits for patients, nurses and multiprofessional teams. However, there is a need for a clear definition and increased awareness of DN.

On-Surface Synthesis of Non-Benzenoid Nanographenes Embedding Azulene and Stone-Wales Topologies.

The incorporation of non-benzenoid motifs in graphene nanostructures significantly impacts their properties, making them attractive for applications in carbon-based electronics. However, understanding how specific non-benzenoid structures influence their properties remains limited, and further investigations are needed to fully comprehend their implications. Here, we report an on-surface synthetic strategy toward fabricating non-benzenoid nanographenes containing different combinations of pentagonal and heptagonal rings. Their structure and electronic properties were investigated via scanning tunneling microscopy and spectroscopy, complemented by computational investigations. After thermal activation of the precursor P on the Au(111) surface, we detected two major nanographene products. Nanographene Aa-a embeds two azulene units formed through oxidative ring-closure of methyl substituents, while Aa-s contains one azulene unit and one Stone-Wales defect, formed by the combination of oxidative ring-closure and skeletal ring-rearrangement reactions. Aa-a exhibits an antiferromagnetic ground state with the highest magnetic exchange coupling reported up to date for a non-benzenoid containing nanographene, coexisting with side-products with closed shell configurations resulted from the combination of ring-closure and ring-rearragement reactions (Ba-a , Ba-s , Bs-a and Bs-s ). Our results provide insights into the single gold atom assisted synthesis of novel NGs containing non-benzenoid motifs and their tailored electronic/magnetic properties.

Stone-Wales Defect in Graphene.

2D graphene the most investigated structures from nanocarbon family studied in the last three decades. It is projected as an excellent material useful for quantum computing, artificial intelligence, and next generation advanced technologies. Graphene exists in several forms and its extraordinary thermal, mechanical, and electronic properties, principally depend on the kind of perfection of the hexagonal atomic lattice. Defects are always considered as undesired components but certain defects in graphene could be an asset for electrochemistry and quantum electronics due to the engineered electronclouds and quantum tunnelling. The authors carefully discuss the Stone-Wales imperfections in graphene and its derivatives comprehensively. A specific emphasis is focused on the experimental and theoretical aspects of the Stone-Wales defects in graphene with respect to structure-property relationships. The corroboration of extrinsic defects like external atomic doping, functionalization, edge distortion in the graphene consisting of Stone-Wales imperfections, which are very significant in designing graphene-based electronic devices, are summarized.

Diabetes mellitus-related hospital admissions and prescriptions of antidiabetic agents in England and Wales: an ecological study.

BACKGROUND: Around 6.5% of the population in the United Kingdom has been diagnosed with diabetes. It is associated with several long-term consequences and higher hospitalization rates. AIM: To examine the profile of hospital admissions related to diabetes mellitus and the prescription rates of antidiabetic medications in England and Wales. METHOD: This is an ecological study that was conducted for the period between April 1999 and April 2020 using publicly available hospitalisation data in England and Wales. Hospital admission data for patients of all ages was extracted from Hospital Episode Statistics in England and the Patient Episode Database for Wales. The difference between admission rates in 1999 and 2020, as well as the difference between diabetes mellitus medication prescription rates in 2004 and 2020, were assessed using the Pearson Chi-squared test. A Poisson regression model with robust variance estimation was used to examine the trend in hospital admissions. RESULTS: A total of 1,757,892 diabetes mellitus hospital admissions were recorded in England and Wales during the duration of the study. The hospital admission rate for diabetes mellitus increased by 15.2%. This increase was concomitant with an increase in the antidiabetic medication prescribing rate of 105.9% between 2004 and 2020. Males and those in the age group of 15-59 years had a higher rate of hospital admission. The most common causes of admissions were type 1 diabetes mellitus related complications, which accounted for 47.1% of all admissions. CONCLUSION: This research gives an in-depth overview of the hospitalization profile in England and Wales during the previous two decades. In England and Wales, people with all types of diabetes and related problems have been hospitalized at a high rate over the past 20 years. Male gender and middle age were significant determinants in influencing admission rates. Diabetes mellitus type 1 complications were the leading cause of hospitalizations. We advocate establishing preventative and educational campaigns to promote the best standards of care for individuals with diabetes in order to lower the risk of diabetes-related complications.

Excess deaths by cause and place of death in England and Wales during the first year of COVID-19.

Using officially registered weekly mortality data, we estimate a counterfactual death count in the absence of the pandemic and we calculate the number of excess deaths in England and Wales during 2020 after the pandemic onset. We also break down those figures by region, age, gender, place of death, and cause of death. Our results suggest that there were 82,428 (95% Confidence interval [CI]: 78,402 to 86,415) excess deaths, and 88.9% (95% CI: 84.8%-93.5%) of them was due to COVID-19, suggesting that non-COVID-19 excess mortality may have been slightly higher that what has been previously estimated. Regarding deaths not due to COVID-19, persons older than 45 years old who died at their homes, mainly from heart diseases and cancer, were the most affected group. Across all causes of death, there was increased excess mortality from dementia and Alzheimer's disease, diabetes, Parkinson's disease and heart-related disease, while at the same period there was a reduction in deaths from pneumonia and influenza, stroke as well as infectious diseases and accidents. Supported by regional panel event estimates, our results highlight how measures to mitigate the pandemic spread and ease the pressure on healthcare service systems may adversely affect out-of-hospital mortality from other causes.

A consensus approach: Understanding the support needs of women in Newport West, Wales, to participate in breast screening.

INTRODUCTION: Breast screening is an effective way to improve the early detection of breast cancer and reduce mortality. Unfortunately, low uptake of screening is often reported. This study aimed to explore the support needs of women residing in Newport West, Wales, to participate in breast screening. METHODS: Group Concept Mapping, a structured participatory consensus approach, was used as the method. Participants completed three activities either online or offline: brainstorming to generate statements, sorting statements into themed categories; rating statements for perceived importance and accessibility (easy to get). RESULTS: Thirty-seven participants from seven ethnic groups took part. Sixty-three statements (items of support) were generated and sorted into seven conceptually similar clusters (themes) (Trusting that I will be respected; Reassurance about my experience; Accessibility and convenience; Practical support; Addressing cultural diversity; Information tailored to individual needs; Raising awareness and understanding of breast screening). The 'Trusting that I will be respected' cluster was rated most important, while the 'Practical support' cluster was rated least accessible. Some disparity between responses was found based on ethnicity, language, disability and previous attendance of breast screening. CONCLUSIONS: Women require a range of support to participate in breast screening. The results highlight the importance of ensuring women feel and are respected, instilling trust in the staff performing the screening, offering reassurance about positive experiences of breast screening and providing practical support, especially individualized/targeted support for people who do not speak and/or read English and those with a disability. PATIENT OR PUBLIC CONTRIBUTION: The public contributed to the development of the information sheet, consent form, recruitment and data collection method.

Trends in hospital admissions and prescribing due to chronic obstructive pulmonary disease and asthma in England and Wales between 1999 and 2020: an ecological study.

OBJECTIVE: To investigate the trends in hospital admissions and medication prescriptions related to asthma and chronic obstructive pulmonary disease (COPD) in England and Wales. METHODS: An ecological study was conducted between April 1999 and April 2020 using data extracted from the hospital episode statistics database in England and the patient episode database for Wales. The Office of National Statistics mid-year population estimates for 1999 through 2020 were collected, and medication prescription data for 2004-2020 were extracted from the prescription cost analysis database. RESULTS: The total annual number of COPD and asthma hospital admissions for various causes increased by 82.2%, from 210,525 in 1999 to 383,652 in 2020, representing a 59.1% increase in hospital admission rate (from 403.77 in 1999 to 642.42 per 100,000 persons in 2020, p < 0.05). Chronic obstructive pulmonary disease with acute lower respiratory infection accounted for 38.7% of hospital admissions. Around 34.7% of all hospital admissions involved patients aged 75 and older. Around 53.8% of all COPD and asthma hospital admissions were attributable to females. The annual number of prescriptions dispensed for COPD and asthma medications increased by 42.2%. CONCLUSIONS: Throughout the study period, hospital admissions due to chronic obstructive pulmonary disease and asthma, as well as medication prescriptions, increased dramatically among all age groups. Hospitalization rates were higher for women. Further observational and epidemiological research is required to identify the factors contributing to increased hospitalization rates.

Trends in female sterilisations in New South Wales, 2010-2019.

BACKGROUND: Female sterilisation remains a common contraceptive method in many countries. AIMS: The aim is to analyse the recent changes in the incidence of female sterilisation in New South Wales (NSW). METHODS: Data were obtained from the NSW Admitted Patients Data Collection for all female patients who had undergone one of the five sterilisation procedures in a public or private hospitals in NSW during 2010 and 2019. Denominators for calculating sterilisation rates were estimated using census and other population data. RESULTS: The number of sterilisation cases dropped from 3407 in 2010 to 2561 in 2019, and the sterilisation rate declined from 22.6 per 10 000 females aged 20-49 in 2010 to 15.4 in 2019. Incidence was at its peak in the 35-39 age group in both years. Indigenous females had higher sterilisation rates than non-Indigenous females born in Australia or overseas. While some foreign-born females had higher sterilisation rates than for those who were in Australia or overseas on average their rates were lower than those who were born in Australia or overseas. There was a clear socio-economic gradient such that females living in the most disadvantaged areas had much higher sterilisation rates than those living in the least disadvantaged areas. The Indigenous, ethnic and socio-economic differences in sterilisation rates persisted in both years of this study. CONCLUSION: Although fertility rates in NSW changed little over the 10-year interval a steady decline in sterilisation occurred, consistent with other forms of contraception (particularly long-acting reversible types) increasing concurrently in popularity.

Carboxyl Functionalization of N-MWCNTs with Stone-Wales Defects and Possibility of HIF-1α Wave-Diffusive Delivery.

Nitrogen-doped multi-walled carbon nanotubes (N-MWCNTs) are widely used for drug delivery. One of the main challenges is to clarify their interaction with hypoxia-inducible factor 1 alpha (HIF-1α), the lack of which leads to oncological and cardiovascular diseases. In the presented study, N-MWCNTs were synthesized by catalytic chemical vapor deposition and irradiated with argon ions. Their chemical state, local structure, interfaces, Stone-Wales defects, and doping with nitrogen were analyzed by high resolution transmission electron microscopy (HRTEM), Raman spectroscopy, X-ray photoelectron spectroscopy (XPS), and near-edge X-ray absorption fine structure (NEXAFS) spectroscopy. Using experimental data, supercells of functionalized N-MWCNTs with an oxygen content of 2.7, 4 and 6 at. % in carboxyl groups were built by quantum chemical methods. Our analysis by the self-consistent charge density functional tight-binding (SCC DFTB) method shows that a key role in the functionalization of CNTs with carboxyl groups belongs to Stone-Wales defects. The results of research in the decoration of CNTs with HIF-1α demonstrate the possibility of wave-diffusion drug delivery. The nature of hybridization and relaxation determines the mechanism of oxygen regulation with HIF-1α molecules, namely, by OH-(OH-C) and OH-(O=C) chemical bonds. The concentration dependence of drug release in the diffusion mode suggests that the best pattern for drug delivery is provided by the tube with a carboxylic oxygen content of 6 at. %.

The New South Wales Sudden Cardiac Arrest Registry: A Data Linkage Cohort Study.

BACKGROUND: Sudden cardiac arrest (SCA) in young people aged 1 to 50 years often occurs with no presenting symptoms or risk factors prompting screening for cardiovascular disease prior to their cardiac arrest. Approximately 3,000 young Australians suffer from sudden cardiac death (SCD) each year, making this a major public health issue. However, there is significant variation in the way incidence is estimated resulting in discrepancy across reporting which impacts our ability to understand and prevent these devastating events. We describe the New South Wales (NSW) Sudden Cardiac Arrest Registry: a retrospective, data linkage study which will identify all SCAs in the young in NSW from 2009 through to June 2022. OBJECTIVE: To determine the incidence, demographic characteristics and causes of SCA in young people. We will develop an NSW-based registry that will contribute to a greater understanding of SCA including risk factors and outcomes. METHODS: The cohort will include all people who experience a SCA in the NSW community aged between 1 to 50 years. Cases will be identified using the following three datasets: the Out of Hospital Cardiac Arrest Register housed at NSW Ambulance, the NSW Emergency Department Data Collection, and the National Coronial Information System. Data from eight datasets will be collected, anonymised and linked for the entire cohort. Analysis will be undertaken and reported using descriptive statistics. CONCLUSIONS: The NSW SCA registry will be an important resource for the improved understanding of SCA and inform the widespread impacts it has on individuals, their families and society.

The Epidemiology of Infective Endocarditis in New South Wales, Australia: A Retrospective Cross-Sectional Study From 2001 to 2020.

OBJECTIVES: This study aimed to investigate the demographic differences amongst patients diagnosed with infective endocarditis (IE), predictors of adverse events, and the association between clinical decision-making and adverse health outcomes amongst patients with IE. DESIGN: A retrospective cross-sectional study was conducted using the New South Wales (NSW) Admitted Patient Data Collection (APDC) from the Centre for Health Record Linkage (CHeReL). PARTICIPANTS: All patients (N=18,044) from 2001 to 2020 in New South Wales who received a diagnosis of IE using ICD-10-AM diagnostic code 133.0 were included. METHODS: Categorical variables were compared using the chi-square test or Fisher's exact test, while the t-test was used for continuous variables. The association between clinical decision-making and adverse health outcomes amongst patients with IE were examined via generalised linear mixed models. RESULTS: Sex, age, birthplace and referral impacted clinical decision-making, in-hospital death and severity of the disease. Women experienced a higher risk of death and fewer escalations of care. Admission and mortality increased with age, with those aged 60 years and above responsible for 60.8% of hospitalisations. Despite octogenarians making up one-fifth of admissions and having the worst mortality rate (15.1%), they experienced only one in 10 intensive care (ICU) admissions. Overseas-born patients had fewer escalations of care and experienced less severe disease if referred by a medical practitioner. One out of 10 admissions that resulted in a hospital death were given non-emergency status, and one in two ICU patients died in hospital. CONCLUSIONS: Sex, age, place of birth, and clinical decision-making were important predictors of severe disease and death in hospital, lending weight that health care clinical decisions may adversely impact health outcomes for populations of interest.