Age-related loss of intestinal barrier integrity plays an integral role in thymic involution and T cell ageing.

The intestinal epithelium serves as a physical and functional barrier against harmful substances, preventing their entry into the circulation and subsequent induction of a systemic immune response. Gut barrier dysfunction has recently emerged as a feature of ageing linked to declining health, and increased intestinal membrane permeability has been shown to promote heightened systemic inflammation in aged hosts. Concurrent with age-related changes in the gut microbiome, the thymic microenvironment undergoes a series of morphological, phenotypical and architectural alterations with age, including disorganisation of the corticomedullary junction, increased fibrosis, increased thymic adiposity and the accumulation of senescent cells.

High Charge Carrier Mobility in Porphyrin Nanoribbons.

Polydisperse edge-fused nickel(II) porphyrin nanoribbons have been synthesized by Yamamoto coupling followed by gold(III)-mediated fusion, with average degrees of polymerization of up to 37 repeat units (length 31 nm). Time-resolved optical-pump terahertz spectroscopy measurements indicate that photo-generated charge carriers have dc mobilities of up to 205 cm V s in these nanoribbons, exceeding the values previously reported for most other types of nanoribbon or π-conjugated polymer.

A Randomized Trial of Drug Route in Out-of-Hospital Cardiac Arrest.

Background: In patients with out-of-hospital cardiac arrest, the effectiveness of drugs such as epinephrine is highly time-dependent. An intraosseous route of drug administration may enable more rapid drug administration than an intravenous route; however, its effect on clinical outcomes is uncertain.

Methods: We conducted a multicenter, open-label, randomized trial across 11 emergency medical systems in the United Kingdom that involved adults in cardiac arrest for whom vascular access for drug administration was needed.

Potassium- and Lithium-Ammonia Intercalation into Excitonic Insulator Candidate TaNiSe.

Two new reduced phases derived from the topical excitonic insulator candidate TaNiSe have been synthesized via the intercalation of lithium and potassium from solutions of the metals in liquid ammonia. Li(NH)TaNiSe and KTaNiSe both crystallize in orthorhombic space group with the following lattice parameters: = 3.5175(1) Å, = 18.

Transient Ischaemic attack Emergency Referral (TIER): randomised feasibility trial results.

Background: Early assessment of patients with suspected transient ischaemic attack (TIA) is crucial to provision of effective care, including initiation of preventive therapies and identification of stroke mimics. Many patients with TIA present to emergency medical services (EMS) but may not require hospitalisation. Paramedics could identify and refer patients with low-risk TIA, without conveyance to the ED.

Isolation and characterization of a two-coordinate phosphinidene oxide.

Nitroso compounds, R-N=O, are common intermediates in organic synthesis, and are typically amenable to storage and manipulation at ambient temperature under aerobic conditions. By contrast, phosphorus-containing analogues, such as R-P=O (R = OH, CH, OCH, Ph), are extremely reactive and need to be studied in inert gas matrices at ultralow temperatures (3-15 K). These species are believed to be key intermediates in the degradation/combustion of organic phosphorus compounds, a class of chemicals that includes chemical warfare agents and flame retardants.

Facilitators and barriers to the delivery of the PARAMEDIC2 trial.

Background: PARAMEDIC2 was a medicines trial comparing adrenaline with placebo in out-of-hospital cardiac arrest (OHCA). At the time, United Kingdom (UK) Emergency Medical Systems (EMS) were inexperienced in delivering such research.

Aim: To identify barriers and facilitators to delivery of the PARAMEDIC2 (Adrenaline) trial by five UK NHS EMS.

Optimising the acid-base ratio of Mg-Al layered double oxides to enhance CO capture performance: the critical role of calcination conditions.

The effect of calcination conditions (ramp rate, calcination temperature and time) on the formation of MgAl layered double oxides (MgAl LDOs) as well as their CO capture performance, has been systematically investigated. This study explores novel insights into the intricate relationship between these calcination conditions and the resulting surface characteristics, which play a vital role in CO capture efficiency. Notably, it is revealed that a rapid ramp rate (100 °C min) significantly increases surface area and hydroxyl concentration, leading to a 69% increase in CO capture efficiency compared to slower ramp rate.

The COVID-19 ambulance response assessment (CARA) study: a national survey of ambulance service healthcare professionals' preparedness and response to the COVID-19 pandemic.

Background: The COVID-19 pandemic placed significant demand on the NHS, including ambulance services, but it is unclear how this affected ambulance service staff and paramedics in other clinical settings (e.g. urgent and primary care, armed services, prisons).

Route of drug administration in out-of-hospital cardiac arrest: A protocol for a randomised controlled trial (PARAMEDIC-3).

Aims: The PARAMEDIC-3 trial evaluates the clinical and cost-effectiveness of an intraosseous first strategy, compared with an intravenous first strategy, for drug administration in adults who have sustained an out-of-hospital cardiac arrest.

Methods: PARAMEDIC-3 is a pragmatic, allocation concealed, open-label, multi-centre, superiority randomised controlled trial. It will recruit 15,000 patients across English and Welsh ambulance services.

Real-world experience of implementing the MOLES score in a virtual choroidal naevi clinic at a tertiary referral centre.

Introduction: The MOLES score has been validated to clinically differentiate choroidal naevi from melanomas by ocular oncologists and community optometrists. However, its utility in a virtual choroidal naevi clinic at a tertiary eye hospital without specialist ocular oncology services has not yet been evaluated.

Methods: A retrospective case review of 385 choroidal lesions in the virtual choroidal naevus clinic at Bristol Eye Hospital during January-March 2020 and April-August 2021 was performed.

Experiences and views of people who frequently call emergency ambulance services: A qualitative study of UK service users.

Introduction: People who call emergency ambulances frequently are often vulnerable because of health and social circumstances, have unresolved problems or cannot access appropriate care. They have higher mortality rates. Case management by interdisciplinary teams can help reduce demand for emergency services and is available in some UK regions.

Lithium Intercalation into the Excitonic Insulator Candidate TaNiSe.

A new reduced phase derived from the excitonic insulator candidate TaNiSe has been synthesized via the intercalation of lithium. LiTaNiSe crystallizes in the orthorhombic space group (no. 62) with lattice parameters = 3.

National survey of corneal cross-linking (CXL) practice patterns in the United Kingdom during 2019.

Objective: To provide an insight into trends in corneal cross-linking (CXL) practice in the UK, including criteria for progression of corneal ectasia, identification of patients for CXL, the CXL procedure itself and post-operative management.

Methods: All ophthalmologist members of the UK Cross-linking (UK-CXL) Consortium were invited to complete an online survey about CXL practice for the year 2019. The data collected was anonymised by site and analysed with descriptive statistics.

Assuring safe artificial intelligence in critical ambulance service response: study protocol.

Introduction: Early recognition of out-of-hospital cardiac arrest (OHCA) by ambulance service call centre operators is important so that cardiopulmonary resuscitation can be delivered immediately, but around 25% of OHCAs are not picked up by call centre operators. An artificial intelligence (AI) system has been developed to support call centre operators in the detection of OHCA. The study aims to (1) explore ambulance service stakeholder perceptions on the safety of OHCA AI decision support in call centres, and (2) develop a clinical safety case for the OHCA AI decision-support system.

Heroism and paramedic practice: A constructivist metasynthesis of qualitative research.

Objectives: We aimed to identify, appraise, and synthesise the qualitative literature to develop theory on heroism and paramedic practice.

Hypothesis/research Question: What does published literature tell us about heroism and paramedic practice?

Setting: Paramedics and other healthcare workers (HCWs) faced an outpouring of public support for them early in the COVID-19 pandemic which brought into focus the relationship between them and society, where they are portrayed as heroes.

Participants: We conducted a metasynthesis using Evolved Grounded Theory and procedural guidelines of Noblit and Hare to guide analysis.

Impact Electrochemistry of MoS: Electrocatalysis and Hydrogen Generation at Low Overpotentials.

MoS materials have been extensively studied as hydrogen evolution reaction (HER) catalysts. In this study nanoparticulate MoS is explored as a HER catalyst through impact voltammetry. The onset potential was found to be -0.

Drug routes in out-of-hospital cardiac arrest: A summary of current evidence.

Recent evidence showing the clinical effectiveness of drug therapy in cardiac arrest has led to renewed interest in the optimal route for drug administration in adult out-of-hospital cardiac arrest. Current resuscitation guidelines support use of the intravenous route for intra-arrest drug delivery, with the intraosseous route reserved for patients in whom intravenous access cannot be established. We sought to evaluate current evidence on drug route for administration of cardiac arrest drugs, with a specific focus on the intravenous and intraosseous route.

Electrochemical Metal Recycling: Recovery of Palladium from Solution and In Situ Fabrication of Palladium-Carbon Catalysts via Impact Electrochemistry.

Recycling of critical materials, regeneration of waste, and responsible catalyst manufacture have been repeatedly documented as essential for a sustainable future with respect to the environment and energy production. Electrochemical methods have become increasingly recognized as capable of achieving these goals, and "impact" electrochemistry, with the advantages associated with dynamic nanoelectrodes, has recently emerged as a prime candidate for the recovery of metals from solution. In this report, the nanoimpact technique is used to generate carbon-supported palladium catalysts from low-concentration palladium(II) chloride solutions (i.

Clinical and cost-effectiveness of paramedic administered fascia iliaca compartment block for emergency hip fracture (RAPID 2)-protocol for an individually randomised parallel-group trial.

Background: Approximately 75,000 people fracture a hip each year in the UK. This painful injury can be devastating-with a high associated mortality rate-and survivors likely to be more dependent and less mobile. Pain relief at the scene of injury is known to be inadequate.

STRategies to manage Emergency ambulance Telephone Callers with sustained High needs: an Evaluation using linked Data (STRETCHED) - a study protocol.

Introduction: UK ambulance services have identified a concern with high users of the 999 service and have set up 'frequent callers' services, ranging from within-service management to cross-sectoral multidisciplinary case management approaches. There is little evidence about how to address the needs of this patient group.

Aim: To evaluate effectiveness, safety and efficiency of case management approaches to the care of people who frequently call the emergency ambulance service, and gain an understanding of barriers and facilitators to implementation.

Sterically rigid bismuth pincer complexes; observation of the growing polymer chain in polar monomer polymerisation.

A family of pyridine dipyrrolide bismuth complexes (L)MX (1-6) (M = Bi, X = O-2,6-Me-CH = OXyl (1); M = Sb, X = OXyl (2); M = Bi, X = O-2,6-Pr-CH = ODipp (3), O-2,6-Bu-CH = OAr (4), OBu (5) and OCMeEt = OAm (6), N(SiMe) = N'' (7) and CHPh (8)) have been prepared and investigated as initiators for the ring-opening polymerisation of lactide monomers. Bismuth lactate complexes (L)Bi{OC(H)(Me)C(O)OR} were prepared as models for the propagating species (R = Bu (9), Me (10), Pr (11)). The first insertion of the lactide monomer is rate limiting and the second and subsequent insertions are more rapid ( ≪ < ), leading to a significant induction period.