A tailored COVID-19 vaccination pathway for children 5-11 years in Victoria, Australia.

BACKGROUND: Procedural anxiety was anticipated in children 5-11 years during the COVID-19 vaccine rollout in Victoria, Australia, as children in this age group receive few routine vaccines. Therefore, the Victorian state government designed a tailored, child-friendly vaccine program. This study aimed to assess parental satisfaction with elements of the bespoke vaccination pathway. METHODS: The Victorian government and state-run vaccination hubs in Victoria facilitated an online immunisation plan to help parents identify their child's support needs, and utilised experienced paediatric staff and additional supports for children with severe needle distress and/or disability. All parents/guardians of children 5-11 years who received a COVID-19 vaccine in a vaccination hub were sent a 16-item feedback survey via text message. RESULTS: Between 9 February and 31 May 2022 there were 9203 responses; 865 children (9.4%) had a first language other than English, 499 (5.4%) had a disability or special needs, and 142 (1.5%) were Aboriginal or Torres Strait Islander. Most parents (94.4%; 8687/9203) rated their satisfaction with the program as very good or excellent. The immunisation plan was used by 13.5% (1244/9203) of respondents, with usage more common for Aboriginal or Torres Strait Islander children (26.1%; 23/88) or families with a first language other than English (23.5%; 42/179). The child-friendly staff (88.5%, 255/288) and themed environment (66.3%, 191/288) were the most valued measures for vaccination. Additional support measures were required by 1.6% (150/9203) of children in the general population and 7.9%, (17/261) of children with a disability and/or special needs. CONCLUSION: A tailored COVID-19 vaccination program for children 5-11 years, with additional support for children with severe needle distress and/or disability, had high parental satisfaction. This model could be utilised for COVID-19 vaccination in pre-school children and for routine childhood vaccination programs to provide optimal support to children and their families.

Glassy Phonon Heralds a Strain Glass State in a Shape Memory Alloy.

Shape memory strain glasses are frustrated ferroelastic materials with glasslike slow relaxation and nanodomains. It is possible to change a NiCoMnIn Heusler alloy from a martensitically transforming alloy to a nontransforming strain glass by annealing, but minimal differences are evident in the short- or long-range order above the transition temperature-although there is a structural relaxation and a 0.18% lattice expansion in the annealed sample. Using neutron scattering we find glasslike phonon damping in the strain glass but not the transforming alloy at temperatures well above the transition. Damping occurs in the mode with displacements matching the martensitic transformation. With support from first-principles calculations, we argue that the strain glass originates not with transformation strain pinning but with a disruption of the underlying electronic instability when disorder resonance states cross the Fermi level.

Probing plasmons in three dimensions by combining complementary spectroscopies in a scanning transmission electron microscope.

The nanoscale optical response of surface plasmons in three-dimensional metallic nanostructures plays an important role in many nanotechnology applications, where precise spatial and spectral characteristics of plasmonic elements control device performance. Electron energy loss spectroscopy (EELS) and cathodoluminescence (CL) within a scanning transmission electron microscope have proven to be valuable tools for studying plasmonics at the nanoscale. Each technique has been used separately, producing three-dimensional reconstructions through tomography, often aided by simulations for complete characterization. Here we demonstrate that the complementary nature of the two techniques, namely that EELS probes beam-induced electronic excitations while CL probes radiative decay, allows us to directly obtain a spatially- and spectrally-resolved picture of the plasmonic characteristics of nanostructures in three dimensions. The approach enables nanoparticle-by-nanoparticle plasmonic analysis in three dimensions to aid in the design of diverse nanoplasmonic applications.

Local observation of the site occupancy of Mn in a MnFePSi compound.

MnFePSi compounds are promising materials for magnetic refrigeration as they exhibit a giant magnetocaloric effect. From first principles calculations and experiments on bulk materials, it has been proposed that this is due to the Mn and Fe atoms preferentially occupying two different sites within the atomic lattice. A recently developed technique was used to deconvolve the obscuring effects of both multiple elastic scattering and thermal diffuse scattering of the probe in an atomic resolution electron energy-loss spectroscopy investigation of a MnFePSi compound. This reveals, unambiguously, that the Mn atoms preferentially occupy the 3g site in a hexagonal crystal structure, confirming the theoretical predictions. After deconvolution, the data exhibit a difference in the Fe L_{2,3} ratio between the 3f and 3g sites consistent with differences in magnetic moments calculated from first principles, which are also not observed in the raw data.

Aberration-corrected scanning transmission electron microscopy: from atomic imaging and analysis to solving energy problems.

The new possibilities of aberration-corrected scanning transmission electron microscopy (STEM) extend far beyond the factor of 2 or more in lateral resolution that was the original motivation. The smaller probe also gives enhanced single atom sensitivity, both for imaging and for spectroscopy, enabling light elements to be detected in a Z-contrast image and giving much improved phase contrast imaging using the bright field detector with pixel-by-pixel correlation with the Z-contrast image. Furthermore, the increased probe-forming aperture brings significant depth sensitivity and the possibility of optical sectioning to extract information in three dimensions. This paper reviews these recent advances with reference to several applications of relevance to energy, the origin of the low-temperature catalytic activity of nanophase Au, the nucleation and growth of semiconducting nanowires, and the origin of the eight orders of magnitude increased ionic conductivity in oxide superlattices. Possible future directions of aberration-corrected STEM for solving energy problems are outlined.

The remarkable influence of M2delta to thienyl pi conjugation in oligothiophenes incorporating MM quadruple bonds.

Oligothiophenes incorporating MM quadruple bonds have been prepared from the reactions between Mo(2)(TiPB)(4) (TiPB = 2,4,6-triisopropyl benzoate) and 3',4'-dihexyl-2,2'-:5',2''-terthiophene-5,5''-dicarboxylic acid. The oligomers of empirical formula Mo(2)(TiPB)(2)(O(2)C(Th)-C(4)(n-hexyl)(2)S-(Th)CO(2)) are soluble in THF and form thin films with spin-coating (Th = thiophene). The reactions between Mo(2)(TiPB)(4) and 2-thienylcarboxylic acid (Th-H), 2,2'-bithiophene-5-carboxylic acid (BTh-H), and (2,2':5',2''-terthiophene)-5-carboxylic acid (TTh-H) yield compounds of formula trans-Mo(2)(TiPB)(2)L(2), where L = Th, BTh, and TTh (the corresponding thienylcarboxylate), and these compounds are considered as models for the aforementioned oligomers. In all cases, the thienyl groups are substituted or coupled at the 2,5 positions. Based on the x-ray analysis, the molecular structure of trans-Mo(2)(TiPB)(2)(BTh)(2) reveals an extended Lpi-M(2)delta-Lpi conjugation. Calculations of the electronic structures on model compounds, in which the TiPB are substituted by formate ligands, reveal that the HOMO is mainly attributed to the M(2)delta orbital, which is stabilized by back-bonding to one of the thienylcarboxylate pi* combinations, and the LUMO is an in-phase combination of the thienylcarboxylate pi* orbitals. The compounds and the oligomers are intensely colored due to M(2)delta-thienyl carboxylate pi* charge transfer transitions that fall in the visible region of the spectrum. For the molybdenum complexes and their oligomers, the photophysical properties have been studied by steady-state absorption spectroscopy and emission spectroscopy, together with time-resolved emission and transient absorption for the determination of relaxation dynamics. Remarkably, THF solutions the molybdenum complexes show room-temperature dual emission, fluorescence and phosphorescence, originating mainly from (1)MLCT and (3)MM(deltadelta*) states, respectively. With increasing number of thienyl rings from 1 to 3, the observed lifetimes of the (1)MLCT state increase from 4 to 12 ps, while the phosphorescence lifetimes are approximately 80 micros. The oligomers show similar photophysical properties as the corresponding monomers in THF but have notably longer-lived triplet states, approximately 200 micros in thin films. These results, when compared with metallated oligothiophenes of the later transition elements, reveal that M(2)delta-thienyl pi conjugation leads to a very small energy gap between the (1)MLCT and (3)MLCT states of <0.6 eV.

Nonstoichiometric dislocation cores in alpha-alumina.

Little is known about dislocation core structures in oxides, despite their central importance in controlling electrical, optical, and mechanical properties. It has often been assumed, on the basis of charge considerations, that a nonstoichiometric core structure could not exist. We report atomic-resolution images that directly resolve the cation and anion sublattices in alumina (alpha-Al2O3). A dissociated basal edge dislocation is seen to consist of two cores; an aluminum column terminates one partial, and an oxygen column terminates the second partial. Each partial core is locally nonstoichiometric due to the excess of aluminum or oxygen at the core. The implication for mechanical properties is that the mobile high-temperature dislocation core structure consists of two closely spaced partial dislocations. For basal slip to occur, synchronized motion of the partials on adjacent planes is required.

Medicare Part D coverage and its influence on transplant patients' out-of-pocket prescription expenses.

Since Medicare is available for qualifying individuals because of age (65 years or greater), disability, or end-stage renal disease, many transplant recipients have Medicare coverage. Everyone who is entitled to Medicare will qualify to enroll in a Part D plan-a voluntary prescription drug coverage option offered by private insurance companies who meet the standards established by Medicare. The addition of Medicare Part D may help reduce out-of-pocket medication expenses for transplant recipients who have Medicare; however, the reality of utilizing Part D to maximize recipients' benefits is not simple, but rather complicated. The intricacies of Part D involve not only understanding premium costs and benefit stages, but formularies, and, particularly for transplant patients, deciphering how Medicare Part B immunosuppressant coverage influences Part D coverage. This article details significant information concerning Part D that transplant health care professionals should know in order to maximize patients' benefits and minimize their out-of-pocket medication expenses.

Comments on the ring-opening polymerization of morpholine-2,5-dione derivatives by various metal catalysts and characterization of the products formed in the reactions involving R2SnX2, where X = OPr(i) and NMe2 and R = Bu(n), Ph and p-Me2NC6H4.

(3S,6S)-3-Isopropyl-6-methyl-morpholine-2,5-dione (1), and (3S,6S)-3,6-dimethyl-morpholine-2,5-dione (2), do not enter into ring-opening polymerization reactions with metal catalyst precursors commonly employed for lactides, and with Sn(II) octanoate, only low molecular weight oligomers are obtained. Reactions with R2SnX2 compounds, where R = Ph, Bu(n) and p-Me2NC6H4 and X = OPr(i) or NMe2, reveal that ring-opening of the morpholine-2,5-diones does occur, but that polymerization is terminated by the formation of kinetically-inert products such as {Ph2Sn[mu,eta(3)-OCH(Me)CONCH(Pr(i))COOPr(i)]}2 (3), and {[Bu(n))2Sn[mu,eta(3)-OCH(Me)CONCH(Me)CONMe2]}2 (4), with elimination of HX. Ph3SnOPr(i) is seen to react reversibly with morpholine-2,5-diones in toluene-d8 by 1H NMR spectroscopy while (Bu(n))3SnNMe2 reacts by ring opening to give (Bu(n))3SnOCH(Me)C(O)NHCHMeC(O)NMe2. The new organotin compounds have been characterized by 1H, 13C{1H} and 118Sn NMR spectroscopy and compounds 1, 2, 3 and 4 by single crystal X-ray crystallography.

Are postoperative complications more common with single-stage bilateral (SBTKR) than with unilateral knee arthroplasty: guidelines for patients scheduled for SBTKR.

A significant number of patients with degenerative arthritis of the knee require bilateral knee arthroplasty. Single-stage bilateral total knee arthroplasty (SBTKR) has been associated with increased patient morbidity and mortality. At our institution, the following steps have been taken to minimize the risks to patients undergoing this procedure: regional anesthesia and analgesia, invasive monitoring, postoperative observation in an intensive care unit setting, and aggressive management of hemodynamic aberrations. We reviewed the medical records of 462 sequential total knee arthroplasty patients, consisting of 169 SBTKR and 293 unilateral total knee arthroplasty (UTKR) cases. A total of 122 patients from each group were matched for age, weight, and a history of ischemic heart disease and hypertension. Patients for SBTKR exhibited a significantly higher incidence of fat embolism syndrome and cardiac arrhythmias than UTKR patients. There were no deaths in either group and the incidence of other serious postoperative complications was low and similar between the two groups. Elderly patients (approximately 75 years old) had more postoperative complications. With aggressive clinical management SBTKR can be safely performed in selected patients. Guidelines for the selection of these patients are presented.

Direct sub-angstrom imaging of a crystal lattice.

Despite the use of electrons with wavelengths of just a few picometers, spatial resolution in a transmission electron microscope (TEM) has been limited by spherical aberration to typically around 0.15 nanometer. Individual atomic columns in a crystalline lattice can therefore only be imaged for a few low-order orientations, limiting the range of defects that can be imaged at atomic resolution. The recent development of spherical aberration correctors for transmission electron microscopy allows this limit to be overcome. We present direct images from an aberration-corrected scanning TEM that resolve a lattice in which the atomic columns are separated by less than 0.1 nanometer.

Localization of smooth muscle actin in the iridocorneal angle of normal and spontaneous glaucomatous beagle dogs.

PURPOSE: To date, our knowledge of the canine trabecular meshwork (TM) with regard to contractility is incomplete. It is important to understand the potential contractile capability within the TM and possible changes associated with spontaneous hypertensive glaucoma. To that end we have examined the presence of actin, including smooth muscle (SM) actin, in the normal and glaucomatous canine iridocorneal angle (ICA) morphologically and immunohistochemically. METHODS: Sections from the ICAs of 12 Beagles with inherited glaucoma (3 months to 6 years old) and age-matched normal Beagles were treated with target retrieval, protein and power blocked and sequentially incubated with the primary antibody (rat anticanine SM actin) and the secondary antibody (rabbit antirat immunoglobulin), followed by peroxidase labeled streptavidin and incubation with substrate-chromogen solution (AEC). Smooth muscle fibers that lined an artery within canine heart tissue were used as positive controls. Separate specimens were prepared for ultrastructual observation. RESULTS: Ultrastructurally, cells within the inner, posterior region of the corneoscleral TM and outer, posterior region of the uveal TM contained many microfilaments, 6 nm in diameter (i.e. actin). Immunohistochemistry demonstrated that cells within these regions possessed SM actin, having been greatest posteriorly, but extended anteriorly to a lesser extent. In the preglaucomatous affected dog the localization pattern for SM actin was identical to that seen in the normal dogs. With the progression of the disease the pattern disappeared. CONCLUSIONS: The interior presence of myofibroblastic cells within the canine ICA suggests that these cells and the smooth muscle cells of the ciliary body along the same plane of orientation function to facilitate the removal of aqueous humor and are likely to be influenced by vascular mediators. The contractile apparatus for the ICA in the dog with inherited glaucoma appeared identical to that of the normal dog prior to expression of the disease, but weakened as the disease progressed.

Impact of clinical pharmacy services on renal transplant patients' compliance with immunosuppressive medications.

BACKGROUND: Non-compliance with immunosuppressive medications may result in allograft rejection and is regarded as an important impediment to post-transplant care. This randomized, controlled trial evaluates the impact of clinical pharmacy services on renal transplant patients' compliance with immunosuppressive agents. METHODS: Patients who received a renal transplant at the Medical College of Georgia from February 1997 through January 1999 were randomized in the intervention or control group provided they met study criteria. In addition to routine clinic services at each clinic visit, patients in the intervention group received clinical pharmacy services, which included medication histories and review of patients' medications with an emphasis on optimizing medication therapy to achieve desired outcomes and minimizing adverse medication events. The clinical pharmacist also provided recommendations to the nephrologists with the goal of achieving desired outcomes. To promote medication compliance by using compliance enhancement strategies, the clinical pharmacist counseled patients concerning their medication therapy and instructed them how to properly take their medications. Patients in the control group received the same routine clinic services as the intervention group except that they did not have any clinical pharmacist interaction. Compliance rate (CR) was calculated and patient's compliance status was determined from the CR. The CR, the fraction of patients remaining compliant for each month, and the mean time patients were compliant were compared between groups. Whether there was a difference in the frequency of patients achieving 'target' immunosuppressive levels in the control and study groups was evaluated. RESULTS: The mean CR for patients who had clinical pharmacist intervention (n=12) was statistically higher than the control group's (n=12) mean CR (p<0.001). During the 12-month post-transplant study period, patients in the intervention group had a longer duration of compliance than patients in the control group (p<0.05). Additionally, patients who had clinical pharmacy services had a greater achievement of 'target' levels than patients who did not receive these services (p<0.05). CONCLUSIONS: Patients who received clinical pharmacy services with traditional patient care services had better compliance with immunosuppressants than patients who only received traditional patient care services. Results of this study suggest a multidisciplinary team that includes a clinical pharmacist as part of the care for post-transplant patients is beneficial for enhancing medication compliance.

A comparison of the influences of alkoxide and thiolate ligands on the electronic structure and reactivity of molybdenum(3+) and tungsten(3+) complexes. preparation and structures of M(2)(O(T)Bu)(2)(S(t)Bu)(4), [Mo(S(t)Bu)(3)(NO)](2), and W(S(t)Bu)(3)(NO)(py).

M(2)(O(t)Bu)(6) compounds (M = Mo, W) react in hydrocarbon solvents with an excess of (t)BuSH to give M(2)(O(t)Bu)(2)(S(t)Bu)(4), red, air- and temperature-sensitive compounds. (1)H NMR studies reveal the equilibrium M(2)(O(t)Bu)(6) + 4(t)BuSH <==> M(2)(O(t)Bu)(2)(S(t)Bu)(4) + 4(t)BuOH proceeds to the right slowly at 22 degrees C. The intermediates M(2)(O(t)Bu)(4)(S(t)Bu)(2), M(2)(O(t)Bu)(3)(S(t)Bu)(3), and M(2)(O(t)Bu)(5)(S(t)Bu) have been detected. The equilibrium constants show the M-O(t)Bu bonds to be enthalpically favored over the M-S(t)Bu bonds. In contrast to the M(2)(O(t)Bu)(6) compounds, M(2)(O(t)Bu)(2)(S(t)Bu)(4) compounds are inert with respect to the addition of CO, CO(2), ethyne, (t)BuC triple bond CH, MeC triple bond N, and PhC triple bond N. Addition of an excess of (t)BuSH to a hydrocarbon solution of W(2)(O(t)Bu)(6)(mu-CO) leads to the rapid expulsion of CO and subsequent formation of W(2)(O(t)Bu)(2)(S(t)Bu)(4). Addition of an excess of (t)BuSH to hydrocarbon solutions of [Mo(O(t)Bu)(3)(NO)](2) and W(O(t)Bu)(3)(NO)(py) gives the structurally related compounds [Mo(S(t)Bu)(3)(NO)](2) and W(S(t)Bu)(3)(NO)(py), with linear M-N-O moieties and five-coordinate metal atoms. The values of nu(NO) are higher in the related thiolate compounds than in their alkoxide counterparts. The bonding in the model compounds M(2)(EH)(6), M(2)(OH)(2)(EH)(4), (HE)(3)M triple bond CMe, and W(EH)(3)(NO)(NH(3)) and the fragments M(EH)(3), where M = Mo or W and E = O or S, has been examined by DFT B3LYP calculations employing various basis sets including polarization functions for O and S and two different core potentials, LANL2 and relativistic CEP. BLYP calculations were done with ZORA relativistic terms using ADF 2000. The calculations, irrespective of the method used, indicate that the M-O bonds are more ionic than the M-S bonds and that E ppi to M dpi bonding is more important for E = O. The latter raises the M-M pi orbital energies by ca. 1 eV for M(2)(OH)(6) relative to M(2)(SH)(6). For M(EH)(3) fragments, the metal d(xz)(),d(yz)() orbitals are destabilized by OH ppi bonding, and in W(EH)(3)(NO)(NH(3)) the O ppi to M dpi donation enhances W dpi to NO pi* back-bonding. Estimates of the bond strengths for the M triple bond M in M(2)(EH)(6) compounds and M triple bond C in (EH)(3)M triple bond CMe have been obtained. The stronger pi donation of the alkoxide ligands is proposed to enhance back-bonding to the pi* orbitals of alkynes and nitriles and facilitate their reductive cleavage, a reaction that is not observed for their thiolate counterpart.

Physical structure and inversion charge at a semiconductor interface with a crystalline oxide.

We show that the physical and electrical structure and hence the inversion charge for crystalline oxides on semiconductors can be understood and systematically manipulated at the atomic level. Heterojunction band offset and alignment are adjusted by atomic-level structural and chemical changes, resulting in the demonstration of an electrical interface between a polar oxide and a semiconductor free of interface charge. In a broader sense, we take the metal oxide semiconductor device to a new and prominent position in the solid-state electronics timeline. It can now be extensively developed using an entirely new physical system: the crystalline oxides-on-semiconductors interface.