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Background The BNT162b2 mRNA vaccine has been shown to be effective at preventing serious COVID-19 events in clinical trials. There is less evidence on effectiveness in real-world settings, especially for older people. Here, we aimed to estimate vaccine effectiveness in the context of the rapid NHS mass-vaccination programme in England, exploiting age-based vaccination eligibility thresholds to minimise and correct for selection bias. Methods We studied 170,226 individuals between the ages of 80 and 83 years from community settings outside care homes who received one dose of BNT162b2 mRNA between the 15 and 20 December 2020 and were scheduled a second dose 21 days later. We matched these vaccine recipients to slightly younger (aged 76–79 years) persons not yet eligible to receive the vaccine on gender, area of residence, area deprivation, health status, living arrangements, acute illness, and history of seasonal flu vaccination. We compared their rates of COVID-19 positivity and hospitalisation in the subsequent 45 days. We adjusted for the increasing concentration of COVID-19 positivity in the control population caused by the requirement to have no COVID-19 symptoms prior to vaccination. Results Emergency hospital admissions were 51.0% (95% confidence interval 19.9 to 69.5%) lower and positive COVID-19 tests were 55.2% (40.8 to 66.8%) lower for vaccinated individuals compared to matched controls 21 to 27 days after first vaccination. Emergency admissions were 75.6% (52.8 to 87.6%) lower, and positive COVID-19 tests were 70.1% (55.1 to 80.1%) lower 35 to 41 days after first vaccination when 79% of participants had received a second dose within 26 days of their first dose. Conclusions Receipt of the BNT162b2 mRNA vaccine is effective at reducing COVID-19 hospitalisations and infections. The nationwide vaccination of older adults in England with the BNT162b2 mRNA vaccine reduced the burden of COVID-19.

Melanin, a bio-polymer responsible for visible pigmentation in the human body, works as a protective layer in our skin by absorbing UV radiation and efficiently dissipating it into heat, preventing DNA damage. The primary structure of eumelanin, one of the two main forms of melanin, is presumed to be a co-polymer of 5,6-dihydroxyindole (DHI) and 5,6-dihydroxyindole- 2-carboxylic acid (DHICA) monomers, with DHI being the major component. The solution phase investigation into the origin of broadband monotonic absorption spectrum of melanin has been unfolded through the polymerization of dopamine and L-DOPA, the molecular precursors of DHI and DHICA, respectively, in an ionic liquid (IL). This study reveals that the evolution of the electronic absorption spectrum of polymerized L-DOPA did not mimic the electronic spectrum of eumelanin, which was attributed to their inability to form stable redox states, as elucidated via structural characterization. Contrary to that, polymerized DA (pDA) mimics the eumelanin absorption spectrum, and the structural characterization of the polymerization process performed with 1H and 13C NMR and DOSY spectroscopy allowed us to identify chromophores responsible for the absorption profile of pDA. Furthermore, identified chromophores were subjected to quantum chemical calculations and their absorption spectra not only supported their presence in the experimental UV-Vis spectra but also allowed us to identify their gradual evolution during polymerisation. The knowledge of chromophores responsible for the optical properties of melanin will undoubtedly result in their increased application in functional materials.

Minimal understanding of the formation mechanism and structure of polydopamine (pDA) and its natural analogues, eumelanin impedes the practical application of these versatile polymers and limits our knowledge of the origin of melanoma.1–8 The lack of conclusive structural evidence stems from the insolubility of these materials, which has spawned significantly diverse suggestions of pDA’s structure in the literature.9,10 We discovered that pDA is soluble in certain ionic liquids. Using these ionic liquids (ILs) as solvents, we present an experimental methodology to solvate pDA, enabling us to identify pDA’s chemical structure. The resolved pDA structure consists of self-assembled supramolecular aggregates that contribute to the increasing complexity of the polymer. The underlying molecular energetics of pDA solvation and a macroscopic picture of the disruption of the aggregates using IL solvents have been investigated, along with studies of the aggregation mechanism in water.

BackgroundThere is increasing demand for more rapid evaluation of innovation in health and social care, to support timely decision-making about service redesign. These pressures have increased during the COVID-19 pandemic. Making evaluations more rapid raises challenges in terms of ensuring rigour and the effective use of resources, but assessment of rapid evaluation methodologies has been lacking. MethodsWe conducted a scoping review to map the developing field of methods of rapid evaluation of innovation in health and social care, to describe the existing literature, categorise different approaches to rapid evaluation, and identify knowledge gaps. We searched multiple databases and websites of key organisations. We prioritised studies with relevance to the context of the NHS in England. We extracted information to enable us to classify and map existing studies on key characteristics. We undertook a narrative synthesis to identify the evidence and the gaps; focussing on the different approaches to conducting rapid evaluation in primary research. ResultsWe identified 14069 records from our searches of which 352 explored rapid evaluations of innovations, methods for rapid evaluation or rapid evaluation of implementation. Our scoping review identified four main approaches used for rapid evaluation: (1) Use of a methodology designed specifically for rapid evaluation;(2) Increasing rapidity by doing less or using a less time-intensive methodology;(3) Use of alternative technologies and/or data to increase the speed of an existing evaluation method; (4) Adaptation of part of a non-rapid evaluation DiscussionThis scoping review identified a lack of clarity about ‘rapid evaluation’ but identified some useful preliminary categories. There is very little comparative research on the impact of using rapid rather than standard evaluation. There is a need for clarity and consistency in terms of what constitutes rapid evaluation, the development of specific methodologies for making evaluation more rapid, and assessment of the advantages and disadvantages of rapid methodology in terms of rigour, cost and impact.

Aim/Purpose: When Data Science students use a Cloud environment such as AWS or Azure, they are not able to have direct hands-on experience with the under-lying hardware components. When students create virtual machines in the Cloud, they specify memory size, CPUs, disk space, etc. However, they cannot reach out and touch the underlying hardware directly since it resides in the Cloud. Background: The ability to purchase commodity servers (e.g., $3,000 per Dell server) to create a cluster of multiple machines is cost prohibitive for most faculty and students because it can cost upwards of $30,000 for 10 machines. This cost does not include the other hardware components that are required for the cluster, such as cooling equipment, cables, rack, etc. Methodology: The research methodology leveraged for this research was to build a prototype to evaluate the costs of using inexpensive hardware and software ($1628.82) in comparison to a more expensive cluster of commodity servers ($30,000). Contribution: There is very little research literature about using this approach of using Raspberry Pi servers as an inexpensive replacement for commodity servers. Findings: This paper demonstrates that Raspberry Pi 4b servers (with 8 gig of RAM) can be leveraged to build a cluster of low cost servers to run both Linux Ubuntu 20 and MongoDB Sharding (distributed processing). Recommendations for Practitioners: Practitioners will appreciate this paper because it is a tutorial that describes assembling the cluster components and then installing MongoDB Shar-ding (distributed processing) on a cluster of 9 Rpi 4b servers. Recommendations for Researchers: Researchers will appreciate this paper because it provides a new inexpensive alternative to using a Cloud environment or an expensive cluster of commodity servers to research distributed processing. Impact on Society: Students and faculty now have an inexpensive option of creating a personalized cluster of servers to experiment with distributed processing. Future Research: Future Research can include testing this cluster with other distributed processing tools, such as the Hadoop ecosystem or NoSQL Databases (e.g. such as Cassandra)

Two robust hexacationic cages incorporating either urea or isophthalamide motifs were synthesized via a short and high-yielding synthetic pathway using hydrazone condensation reactions in water for the cage forming step. Stability testing revealed that the cages are stable to a range of stimuli in water and in organic solvents. The urea containing cage can bind anions in pure water, and displays strong and selective binding of SO42– over HPO42–. The isophthalamide containing cage binds SO42– only weakly in 1:1 D2O:d6-DMSO but displays strong and cooperative binding of two HPO42– anions. Combined quantum mechanical/annealed molecular dynamics simulations suggest that the remarkable differences in anion selectivity are largely a result of the differing flexibilities of the two cages.

ObjectiveThe COVID-19 pandemic increased the demand for rapid evaluation of innovation in health and social care. Assessment of rapid methodologies is lacking although challenges in ensuring rigour and effective use of resources are known. We mapped reports of rapid evaluations of health and social care innovations, categorised different approaches to rapid evaluation, explored comparative benefits of rapid evaluation, and identified knowledge gaps.DesignScoping review.Data sourcesMEDLINE, EMBASE and Health Management Information Consortium (HMIC) databases were searched through 13 September 2022.Eligibility criteria for selecting studiesWe included publications reporting primary research or methods for rapid evaluation of interventions or services in health and social care in high-income countries.Data extraction and synthesisTwo reviewers developed and piloted a data extraction form. One reviewer extracted data, a second reviewer checked 10% of the studies; disagreements and uncertainty were resolved through consensus. We used narrative synthesis to map different approaches to conducting rapid evaluation.ResultsWe identified 16 759 records and included 162 which met inclusion criteria.We identified four main approaches for rapid evaluation: (1) Using methodology designed specifically for rapid evaluation; (2) Increasing rapidity by doing less or using less time-intensive methodology; (3) Using alternative technologies and/or data to increase speed of existing evaluation method; (4) Adapting part of non-rapid evaluation.The COVID-19 pandemic resulted in an increase in publications and some limited changes in identified methods. We found little research comparing rapid and non-rapid evaluation.ConclusionsWe found a lack of clarity about what ‘rapid evaluation’ means but identified some useful preliminary categories. There is a need for clarity and consistency about what constitutes rapid evaluation; consistent terminology in reporting evaluations as rapid; development of specific methodologies for making evaluation more rapid; and assessment of advantages and disadvantages of rapid methodology in terms of rigour, cost and impact.

There is limited evidence on the relationship between informal and formal care using panel data in a UK setting and focused specifically on people living together (co-residents). Using all 18 waves of the British Household Panel Survey (BHPS) (1991-2009), we analyse the effect of informal care given by co-residents on use of formal home care and health care services more generally. To account for endogeneity, we estimate models using random effects instrumental variable (REIV) regression using the number of daughters as a source of exogenous variation. We find that a 10% increase in the monthly provision of informal care hours decreases the probability of using home help (formal home care) by 1.02 percentage points (p

PODEMOS, Spanish for “We Can”, is an interdisciplinary healthcare organization based in Columbus, Ohio, that is designed to meet the healthcare needs of communities around the city of El Progreso, Honduras. Honduras is a developing country in Central America that scores low in most indicators of healthcare quality and access. Most notably, there is a tremendous need for expanded access in rural communities. Established in 2008 by students from the Ohio State University College of Medicine, PODEMOS conducts biannual medical brigades that run primary care clinics in three rural communities around El Progreso through the volunteer service of United States (US)-based medical, pharmacy, and dental professionals. Additionally, the organization works with local leaders to provide healthcare services for patients with chronic conditions, fill gaps in US-based provider coverage, and recruit patients. PODEMOS bases its care on two models, the acute care model for common adult complaints and all children under the age of 18, and the chronic care model for a subset of adult patients who need more complex care for chronic conditions such as diabetes mellitus and hypertension. Providers then have access to select laboratory and pharmacy services for their patient’s needs. PODEMOS has had a large impact on local communities since its inception, as evidenced by the numerous acute patient visits in its 11 years of existence and the 136 patients currently enrolled in chronic care program. Nevertheless, the organization continues to face challenges in areas such as interprofessional collaboration, security, and maintaining patient turnout. This piece is a descriptive report on PODEMOS, a student-run international medical organization based out of the Ohio State University Wexner Medical Center, that seeks to inform other student-run organizations about the organization’s structure and operation.

Analyses of an individual's sexual orientation over time are desirable for policy evaluations and in estimating causal effects. We explore whether accounting for those who change sexual orientation over two time points, to create a measure of fluidity, produces substantially different results compared to sexual orientation measured at one time point and extrapolated to subsequent survey waves. We use seven waves of the UK Household Longitudinal Study which asked sexual orientation identity questions at two time points: waves three (2011-2013) and nine (2017-2019). Using the relationship with sexual orientation and various health outcomes as an empirical example, via a correlated random effects estimation approach, we find that the infrequent reporting of sexual orientation could over-estimate the negative impact for lesbian, gay and "other" individuals and under-estimate the negative impact for bisexuals. We further test the feasibility of the fluidity measure by examining attrition by sexual orientation identity and find small but statistically significant probabilities of attrition. Correction for attrition bias through inverse probability weighting makes little difference to the results. These results highlight the importance of accounting for changes in sexual orientation in empirical analysis and that doing so is feasible.