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During the COVID-19 pandemic, many emergency medical services (EMS) agencies modified treatment guidelines for clinical care and standard operating procedures. For the prehospital care of pediatric asthma exacerbations, modifications included changes to bronchodilator administration, systemic corticosteroid administration, and introduction of alternative medications. Since timely administration of bronchodilators and systemic corticosteroids has been shown to improve pediatric asthma clinical outcomes, we investigated the association of COVID-19 protocol modifications in the prehospital management of pediatric asthma on hospital admission rates and emergency department (ED) length-of-stay.This is a multicenter, retrospective, observational cohort study comparing prehospital pediatric asthma patients treated by EMS clinicians from four EMS systems before and after implementation of COVID-19 interim EMS protocol modifications. We included children ages 2-18 years who were treated and transported by ground EMS for respiratory-related prehospital primary complaints, and who also had asthma-related ED discharge diagnoses. Patient data and outcomes were compared from 12 months prior to and 12 months after the implementation of interim COVID-19 prehospital protocol modifications using univariate and multivariable statistics.A total of 430 patients met inclusion criteria with a median age of 8 years. There was a slight male predominance (57.9%) and the majority of patients were African American (78.4%). There were twice as many patients treated prior to the COVID-19 protocol modifications (Despite a decrease in prehospital bronchodilator administration after COVID-19 changes to prehospital pediatric asthma management protocols, hospital admission rates and ED length-of-stay did not significantly increase. However, this finding is tempered by the marked decrease in study patients treated after COVID-19 prehospital protocol modifications. Given the potential for future waves of COVID-19 variants, further studies with larger patient populations are warranted.

Thiophenol is a model compound used in the study of self-assembly of arylthiols on gold surfaces. In particular, changes in the surface-enhanced Raman scattering (SERS) spectra of these self-assembled monolayers (SAMs) with a change of conditions have been ascribed to, for example, differences in orientation with respect to the surface, protonation state, and electrode potential. Here, we show that potential-induced changes in the SERS spectra of SAMs of thiophenol on electrochemically roughened gold surfaces can be due to local pH changes at the electrode. The changes observed during the potential step and cyclic voltammetry experiments are identical to those induced by acid–base switching experiments in a protic solvent. The data indicate that the potential-dependent spectral changes, assigned earlier to changes in molecular orientation with respect to the surface, can be ascribed to changes in the pH locally at the electrode. The pH at the electrode can change as much as several pH units during electrochemical measurements that reach positive potentials where oxidation of adventitious water can occur. Furthermore, once perturbed by applying positive potentials, the pH at the electrode takes considerable time to recover to that of the bulk solution. It is noted that the changes in pH even during cyclic voltammetry in organic solvents can be equivalent to the addition of strong acids, such as CF3SO3H, and such effects should be considered in the study of the redox chemistry of pH-sensitive redox systems and potential-dependent SERS in particular.

Environmental justice (EJ) is a broad discipline that attempts to understand and redress unfair exposure to unhealthy environmental conditions. EJ is often made measurable with indicators, however the capabilities and the limitations of EJ indicators can be difficult for policy makers to understand. Using an exploratory review of EJ literature, this paper performs a research translation role by clarifying the key terms used to describe EJ indicators and by providing conceptual frameworks for developing locally valid EJ indicators for government and community. Issues such as the position of EJ in the context of the social determinants of health, indicator development, and definitions are explored. The exploratory literature review highlighted the potential and limitations of EJ indicators for measuring the extent and impact of EJ issues on human health and the environment. We found that EJ indicators are invariably (1) composed of two or more measures, and (2) developed iteratively, in consultation with those affected. To aid governments and communities, we present both a top-down and a bottom-up framework for developing EJ indicators, with the bottom-up framework guiding the combination of measures from four different core elements; environment, demography, epidemiology and procedures. A list of evidence-based example measures, from the literature, for developing EJ indicators is also provided. It is anticipated that the frameworks and list of EJ example measures will provide guidance for efficiently developing locally relevant EJ indicators.

Electron/proton transfers in water proceeding from ground/excited states are the elementary reactions of chemistry. These reactions of an iconic class of molecules─polypyridineRu(II)─are now controlled by capturing or releasing three of them with hosts that are shape-switchable. Reversible erection or collapse of the host walls allows such switchability. Some reaction rates are suppressed by factors of up to 120 by inclusive binding of the metal complexes. This puts nanometric coordination chemistry in a box that can be open or shut as necessary. Such second-sphere complexation can allow considerable control to be exerted on photocatalysis, electrocatalysis, and luminescent sensing involving polypyridineRu(II) compounds. The capturing states of hosts are symmetry-matched to guests for selective binding and display submicromolar affinities. A perching complex, which is an intermediate state between capturing and releasing states, is also demonstrated.

Mononuclear MnII oxidation catalysts with aminopyridine-based ligands achieve high turnover-number (TON) enantioselective epoxidation of alkenes with H2O2. Structure reactivity relations indicate a dependence of enantioselectivity and maximum TON on the electronic effect of peripheral ligand substituents. Competing H2O2 disproportionation is reduced by carrying out reactions at low temperatures and with slow addition of H2O2, which improve TONs for alkene oxidation but mask the effect of substituents on turnover frequency (TOF). Here, in situ Raman spectroscopy provides the high time resolution needed to establish that the minimum TOFs are greater than 10 s-1 in the epoxidation of alkenes with the complexes [Mn(OTf)2(RPDP)] [where R = H (HPDP-Mn) and R = OMe (MeOPDP-Mn) and RPDP = N,N′-bis(2″-(4″-R-pyridylmethyl)-2,2′-bipyrrolidine)]. Simultaneous headspace monitoring by Raman spectroscopy reveals that H2O2 disproportionation proceeds concomitant with oxidation of the substrate and that the ratio of reactivity toward substrate oxidation and H2O2 disproportionation is ligand-dependent. Notably, the rates of substrate oxidation and H2O2 disproportionation both decrease over time under continuous addition of H2O2 due to progressive catalyst deactivation, which indicates that the same catalyst is responsible for both reactions. Electrochemistry, UV/vis absorption, and resonance Raman spectroscopy and spectroelectrochemistry establish that the MnII complexes undergo an increase in oxidation state within seconds of addition of H2O2 to form a dynamic mixture of MnIII and MnIV species, with the composition depending on temperature and the presence of alkene. However, it is the formation of these complexes (resting states), rather than ligand degradation, that is responsible for catalyst deactivation, especially at low temperatures, and hence, the intrinsic reactivity of the catalyst is greater than observed TOFs. These data show that interpretation of effects of ligand substituents on reaction efficiency (and conversion) with respect to the oxidant and maximum TONs needs to consider reversible deactivation of the catalyst and especially the relative importance of various reaction pathways.

Molecular switching has established itself as a key functionality of building blocks developed for addressable materials and surfaces over the last two decades. Many challenges in their use and characterisation have been presented by the wide variation in interfaces studied, these ranging from truly single-molecule devices to two-dimensional self-assembled monolayers and thin films that bridge the gap between surface and macroscopically bulk materials (polymers, MOFs, COFs), and further still to other interfaces (solid–liquid, liquid–air, etc.). The low number density of molecules on monolayer-coated interfaces as well as in thin films, for example, presents substantial challenges in the characterisation of the composition of modified interfaces. The switching of molecular structure with external stimuli such as light and electrode potential adds a further layer of complexity in the characterisation of function. Such characterisation “in action” is necessary to correlate macroscopic phenomena with changes in molecular structure. In this review, key classes of molecular switches that have been applied frequently to interfaces will be discussed in the context of the techniques and approaches used for their operando characterisation. In particular, we will address issues surrounding the non-innocence of otherwise information-rich techniques and show how model – non-switching – compounds are often helpful in confirming and understanding the limitations and quirks of specific techniques.

This project sought to develop evidence-based guidelines for the administration of analgesics for moderate to severe pain by Emergency Medical Services (EMS) clinicians based on a separate, previously published, systematic review of the comparative effectiveness of analgesics in the prehospital setting prepared by the University of Connecticut Evidence-Based Practice Center for the Agency for Healthcare Research and Quality (AHRQ). A technical expert panel (TEP) was assembled consisting of subject matter experts in prehospital and emergency care, and the development of evidence-based guidelines and patient care guidelines. A series of nine "patient/population-intervention-comparison-outcome" (PICO) questions were developed based on the Key Questions identified in the AHRQ systematic review, and an additional PICO question was developed to specifically address analgesia in pediatric patients. The panel made a strong recommendation for the use of intranasal fentanyl over intravenous (IV) opioids for pediatric patients without intravenous access given the supporting evidence, its effectiveness, ease of administration, and acceptance by patients and providers. The panel made a conditional recommendation for the use of IV non-steroidal anti-inflammatory drugs (NSAIDs) over IV acetaminophen (APAP). The panel made conditional recommendations for the use of either IV ketamine or IV opioids; for either IV NSAIDs or IV opioids; for either IV fentanyl or IV morphine; and for either IV ketamine or IV NSAIDs. A conditional recommendation was made for IV APAP over IV opioids. The panel made a conditional recommendation against the use of weight-based IV ketamine in combination with weight-based IV opioids versus weight-based IV opioids alone. The panel considered the use of oral analgesics and a conditional recommendation was made for either oral APAP or oral NSAIDs when the oral route of administration was preferred. Given the lack of a supporting evidence base, the panel was unable to make recommendations for the use of nitrous oxide versus IV opioids, or for IV ketamine in combination with IV opioids versus IV ketamine alone. Taken together, the recommendations emphasize that EMS medical directors and EMS clinicians have a variety of effective options for the management of moderate to severe pain in addition to opioids when designing patient care guidelines and caring for patients suffering from acute pain.

Controlling the transmission of thin films with external stimuli is an important goal in functional optical materials and devices. Tuning is especially challenging where both broad band (neutral density filtering) and spectrally varied (colour) transmission are required. The external control provided by photochemically driven switching, between transmission levels and colours, is functionally simple from a device perspective. The limits due to the spectral ranges of individual photochromic compounds can be overcome by combining several photochromes within one material or device. Here we show that a combination of photochromic molecular switches immobilised in a PMMA polymer matrix enables tuning of colour and transparency. We show that only a single excitation wavelength is required through the use of the primary inner filter effect and the layered construction of the films in which the photochromes nitrospiropyran (NSP), and nitrothiospiropyran (TSP) or 1,2-bis-terthienyl-hexafluorocyclopentene (DTE) are separated spatially. The approach taken circumvents the need to match photochemical quantum yields and thermal reactivity of the component photochromes. The photochemical switching of the films was characterised by UV/vis absorption spectroscopy and shows that switching rates and photostationary states are limited by inner filter effects rather than the intrinsic properties of photochromes, such as photochemical quantum yields and thermal stability. The photochemical behaviour and stability of the photochromes in solution and in the PMMA films were compared and the concentration range over which self-inhibition of photochemical switching occurs was established. The rate of photochemical switching and the difference in transmission between the spiropyran and merocyanine forms in solution enable prediction of the performance in the films and enable rational design of colour tuning ranges and responsivity in thin film filters., A multilayer coating, with a different photochrome in each layer, enables predictable control over transmission and colour with a single wavelength of light, which is an important goal in functional optical materials and devices.

Molecular recognition-driven self-assembly employing single-stranded DNA (ssDNA) as a template is a promising approach to access complex architectures from simple building blocks. Oligonucleotide-based nanotechnology and soft-materials benefit from the high information storage density, self-correction, and memory function of DNA. Here we control these beneficial properties with light in a photoresponsive biohybrid hydrogel, adding an extra level of function to the system. An ssDNA template was combined with a complementary photo-responsive unit to reversibly switch between various functional states of the supramolecular assembly using a combination of light and heat. We studied the structural response of the hydrogel at both the microscopic and macroscopic scale using a combination of UV-vis absorption and CD spectroscopy, as well as fluorescence, transmission electron, and atomic force microscopy. The hydrogels grown from these supramolecular self-assembly systems show remarkable shape-memory properties and imprinting shape-behavior while the macroscopic shape of the materials obtained can be further manipulated by irradiation.

SMCHD1 mutations cause congenital arhinia (absent nose) and a muscular dystrophy called FSHD2. In FSHD2, loss of SMCHD1 repressive activity causes expression of double homeobox 4 (DUX4) in muscle tissue, where it is toxic. Studies of arhinia patients suggest a primary defect in nasal placode cells (human nose progenitors). Here, we show that upon SMCHD1 ablation, DUX4 becomes derepressed in H9 human embryonic stem cells (hESCs) as they differentiate toward a placode cell fate, triggering cell death. Arhinia and FSHD2 patient-derived induced pluripotent stem cells (iPSCs) express DUX4 when converted to placode cells and demonstrate variable degrees of cell death, suggesting an environmental disease modifier. HSV-1 may be one such modifier as herpesvirus infection amplifies DUX4 expression in SMCHD1 KO hESC and patient iPSC. These studies suggest that arhinia, like FSHD2, is due to compromised SMCHD1 repressive activity in a cell-specific context and provide evidence for an environmental modifier.

Purpose Universities’ unique position within society means they have an important role to contribute to sustainability and to help achieve the sustainable development goals (SDGs), which are one of the most widely recognised articulations of sustainability. This study aims to look at the integration of the SDGs in education, specifically, in the Bachelor of Design (B-DES) “pathways” at the University of Melbourne, Australia. Design/methodology/approach Interviews with pathway coordinators and a survey of all 45 core subjects were used to understand the current degree of integration and the benefits, constraints and opportunities of deeper integration. Findings Sustainability is deeply incorporated into B-DES curricula, but the SDGs are not. Most teachers, but particularly pathway coordinators, see value in deeper incorporation. Issues that constrain this include some students’ fatigue with the idea of “sustainability”, a crowded curriculum and some teachers’ scepticism, even disdain for the SDGs, which they see as contradictory, too broad or overly political. Originality/value This study sheds light on the extent of integration and reveals several possible pedagogical approaches: analysing what industries need to do to make a proportionate contribution to achieving the SDGs, critical review of industries’ use of and alignment with the SDGs, comparing and contrasting the SDGs with disciplines’ theoretical frameworks and critiquing the SDGs’ ambition with reference to the capabilities and technologies of a discipline. Provided they are done with due consideration of the SDGs’ limitations, these methods of integration have the potential to better prepare students as global citizens and for international employment.

Sexual harassment is widely recognized as a serious problem in the workplace, and a nuanced understanding of it is a necessary precondition to effective management. Much of the social science literature contends that sexual harassment is “not about sex but about power.” An evolutionary perspective, though acknowledging the link between sex and power, suggests that the causal implication of social scientists is often backward and that much behavior that is labeled sexual harassment reflects the different sexual strategies of males and females. It is less that men use sex to obtain power over women than it is that they use power to obtain sex, as they have throughout our evolutionary history. The fact that harassers tend to prefer young, attractive targets—that is, those who possess traits that are desirable in a consensual partner—reinforces the view that they are acting on sexual motivations. An understanding of the different sexual psychologies of males and females also sheds light on the question whether a reasonable-person standard or a reasonable-woman standard should be used to assess whether an environment is a hostile one. Men and women often perceive situations differently because of their evolved psychologies, so that an androgynous reasonable-person standard makes little sense. An evolutionary perspective, with its more realistic explanation of sexual harassment than its purely sociological competitors, is more likely to lead to effective mechanisms to combat it.

The mechanism and the reactive species involved in the oxidation of alkenes, and alcohols with H2O2, catalysed by an in situ prepared mixture of a MnII salt, pyridine-2-carboxylic acid and a ketone is elucidated using substrate competition experiments, kinetic isotope effect (KIE) measurements, and atom tracking with 18O labelling. The data indicate that a single reactive species engages in the oxidation of both alkenes and alcohols. The primary KIE in the oxidation of benzyl alcohols is ca. 3.5 and shows the reactive species to be selective despite a zero order dependence on substrate concentration, and the high turnover frequencies (up to 30 s−1) observed. Selective 18O labelling identifies the origin of the oxygen atoms transferred to the substrate during oxidation, and is consistent with a highly reactive, e. g., [MnV(O)(OH)] or [MnV(O)2], species rather than an alkylperoxy or hydroperoxy species.

Renewable polysaccharide feedstocks are of interest in bio-based food packaging, coatings and hydrogels. Their physical properties often need to be tuned by chemical modification, e.g. by oxidation using periodate, to introduce carboxylic acid, ketone or aldehyde functional groups. The reproducibility required for application on an industrial scale, however, is challenged by uncertainty about the composition of product mixtures obtained and of the precise structural changes that the reaction with periodate induces. Here, we show that despite the structural diversity of gum arabic, primarily rhamnose and arabinose subunits undergo oxidation, whereas (in-chain) galacturonic acids are unreactive towards periodate. Using model sugars, we show that periodate preferentially oxidises the anti 1,2-diols in the rhamnopyranoside monosaccharides present as terminal groups in the biopolymer. While formally oxidation of vicinal diols results in the formation of two aldehyde groups, only traces of aldehydes are observed in solution, with the main final products obtained being substituted dioxanes, both in solution and in the solid state. The substituted dioxanes form most likely by the intramolecular reaction of one aldehyde with a nearby hydroxyl group, followed by hydration of the remaining aldehyde to form a geminal diol. The absence of significant amounts of aldehyde functional groups in the modified polymer impacts crosslinking strategies currently attempted in the preparation of renewable polysaccharide-based materials.

New technologies allow perfect detection of environmental violations at near-zero marginal cost, but take-up is low. We conducted a field experiment to evaluate enforcement of water conservation rules with smart meters in Fresno, CA. Households were randomly assigned combinations of enforcement method (automated or in-person inspections) and fines. Automated enforcement increased households' punishment rates from 0.1 to 14%, decreased summer water use by 3%, and reduced violations by 17%, while higher fine levels had little effect. However, automated enforcement also increased customer complaints by 1,102%, ultimately causing its cancellation and highlighting that political considerations limit technological solutions to enforcement challenges.

A multistable molecular switching system based on an anthracene-extended bis-thiaxanthylidene with three individually addressable states that can be interconverted by electrochemical, thermal, and photochemical reactions is reported. Besides reversible switching between an open-shell diradical- and a closed-shell electronic configuration, our findings include a third dicationic state and control by multiple actuators. This dicationic state with an orthogonal conformation can be switched electrochemically with the neutral open-shell triplet state with orthogonal conformation, which was characterized by EPR. The remarkably stable diradical shows kinetic stability as a result of a significant activation barrier for isomerization to a more stable neutral closed-shell folded geometry. We ascribe this activation barrier of ΔG‡(293 K) = 25.7 kcal mol-1 to steric hindrance in the fjord region of the overcrowded alkene structure. The folded closed-shell state can be converted back to the diradical state by irradiation with 385 nm. The folded state can also be oxidized to the dicationic state. These types of molecules with multiple switchable states and in particular stable diradicals show great potential in the design of new functional materials such as memory devices, logic gates, and OFETs.

The epoxidation of ethylene-propylene-diene rubber (EPDM) with 5-ethylidene-2-norbornene (ENB) as the diene to epoxidized EPDM (eEPDM) creates additional routes to cross-linking and reactive blending, as well as increasing the polarity and thereby the adhesion to polar materials, e.g., mineral fillers such as silica. The low solubility of apolar, high molecular weight polymers in the polar solvents constrains the catalytic method for epoxidation that can be applied. Here we have applied an in situ prepared catalyst comprising a manganese(ii) salt, sodium picolinate and a ketone to the epoxidation of EPDM rubber with hydrogen peroxide (H2O2) as the oxidant in a solvent mixture, that balances the need for polymer and catalyst/oxidant miscibility and solubility. Specifically, a mixture of cyclohexane and cyclohexanone is used, where cyclohexanone functions as a co-solvent as well as the ketone reagent. Reaction progress was monitored off-line through a combination of Raman and ATR-FTIR spectroscopies, which revealed that the reaction profile and the dependence on the composition of the catalyst are similar to those observed with low molar mass alkene substrates, under similar reaction conditions. The combination of spectroscopies offers a reliable method for off-line reaction monitoring of both the extent of the conversion of unsaturation (Raman) and the extent of epoxidation (FTIR) as well as determining side reactions, such as epoxide ring opening and further, aerobic oxidation. The epoxidation of EPDM described, in contrast to currently available methods, uses a non-scarce manganese catalyst and H2O2, and avoids side reactions, such as those that can occur with peracids.