This study aimed to assess Well-Being Index scores in paediatric cardiac ICU (PCICU) registered nurses and advanced practice providers. Secondary objectives included identifying factors correlating with at-risk Well-Being Index scores and exploring predictors of these scores, with attention to the impact of the coronavirus disease 2019 pandemic. A multicentre electronic survey was conducted between October 2021 and January 2022. Registered nurses and advanced practice providers working in PCICUs at US centres participating in the Collaborative Research from the Pediatric Cardiac Intensive Care Society were included.

The survey included the nine-item Well-Being Index and questions about demographics and factors influencing well-being, such as coronavirus disease 2019. The Well-Being Index is a validated tool to predict workforce distress and well-being. Out of 218 participants (180 registered nurses, 38 advanced practice providers), 137 registered nurses (76%) and 15 advanced practice providers (39%) had at-risk Well-Being Index scores. A total of 61% of nurses and 34% of advanced practice providers reported an intent to leave. Intent to leave was significantly linked to lower well-being for registered nurses (p = 0.002). Leadership support reduced registered nurses’ distress risk by 68% compared to no support (p = 0.04). Increased stress since coronavirus disease 2019 raised registered nurses’ poor well-being risk by four times (p = 0.001). PCICU registered nurses and advanced practice providers are at risk for poor well-being, exacerbated by the pandemic. Those with poor well-being may be more likely to leave. Leadership support is vital for nurses’ well-being. Further research is needed to establish baseline well-being.

In the setting of universal Clostridioides difficile screening, we implemented an alert that triggered when C. difficile treatment was ordered in patients who recently received laxatives. This resulted in C. difficile treatment avoidance in 37% of patients and was associated with drug cost savings of $143,905 over a 10-month period.

The Physician-Scientist Trainee Diversity Summit, hosted by the American Physician Scientists Association and the Burroughs Wellcome Fund, was conceived in 2019 with the mission of developing strategic plans to diversify the physician-scientist community using human-centered design thinking. In June 2024, the second iteration of this conference was held in Raleigh, North Carolina, and brought together a network of scientific and medical organizations to discuss issues of justice, equity, diversity, and inclusion facing physician-scientist trainees. This article summarizes the progress made from the first meeting, the proceedings of the 2024 Summit, and a thematic analysis of the recent meeting, offering tangible solutions to the physician-scientist community for supporting diversity and accessibility.

The elusive southern river otter (Lontra provocax; huillín in Spanish) is critically endangered in the Argentine portion of Tierra del Fuego, and low social awareness may be one of the major threats to its conservation. Our survey of local residents’ knowledge and valuation of the huillín showed that only 14% recognized photographs of the species, almost half did not know that it is endangered and most erroneously thought it was an introduced species. Greater knowledge about the huillín was related to higher respondent education levels. Younger and more knowledgeable residents valued the species more for ecological and relational reasons; its instrumental value was considered least important. More communication should be targeted at older people and groups not directly interacting with nature via informal education methods, including combining positive messages about the huillín and other native species with ongoing outreach efforts warning about biological invasions. Understanding perceptions and valuations of biodiversity can make conservation efforts more effective and inclusive.

The European Clozapine Task Force is a group of psychiatrists and pharmacologists practicing in 18 countries under European Medicines Agency (EMA) regulation, who are deeply concerned about the underuse of clozapine in European countries. Although clozapine is the most effective antipsychotic for people with treatment-resistant schizophrenia, a large proportion of them do not have access to this treatment. Concerns about clozapine-induced agranulocytosis and stringent blood monitoring rules are major barriers to clozapine prescribing and use. There is a growing body of evidence that the incidence of clozapine-induced agranulocytosis is very low after the first year of treatment. Maintaining lifelong monthly blood monitoring after this period contributes to unjustified discontinuation of clozapine. We leverage recent and replicated evidence on the long-term safety of clozapine to call for the revision and updating of the EMA’s blood monitoring rules, thus aiming to overcome this major barrier to clozapine prescribing and use. We believe the time has come for relaxing the rules without increasing the risks for people using clozapine in Europe.

Continental-scale patterns of morphological and biological change represent broad time- and spatially averaged interpretations. Conversely, regionally focused studies of morphological variability offer an opportunity to consider patterns of biological change at more refined spatial scales, where nuanced histories may be identified. That approach is particularly applicable for areas known to have dynamic biogeographic and glacial landscapes (e.g., western Canada). We studied proboscideans from Alberta, Canada, an area thought to represent a zone of sympatry between extinct forms of mammoth (i.e., Mammuthus columbi, Mammuthus primigenius) in order to test existing taxonomic hypotheses and chronologically contextualize the regional record of mammoths through the Late Pleistocene. Morphometric analysis of sixth molars of mammoths from Alberta (n = 17) support identification of three distinct morphologies that we assign to M. columbi, M. primigenius, and intermediates of those taxa. The presence of intermediate forms is perhaps unsurprising, given both the recognition of hybridization in M. columbi and M. primigenius and the previously documented occurrence of both taxa in Alberta. Some records of M. columbi may document a broader northern geographic incursion for that taxon than previously recognized, but could also represent a much deeper time component to the history of Mammuthus in Alberta (i.e., Mammuthus trogontherii).

Multi-layer networks arise when more than one type of relation is observed on a common set of actors. Modeling such networks within the exponential-family random graph (ERG) framework has been previously limited to special cases and, in particular, to dependence arising from just two layers. Extensions to ERGMs are introduced to address these limitations: Conway–Maxwell–Binomial distribution to model the marginal dependence among multiple layers; a “layer logic” language to translate familiar ERGM effects to substantively meaningful interactions of observed layers; and nondegenerate triadic and degree effects. The developments are demonstrated on two previously published datasets.

Under what conditions are people more likely to support judicial invalidation of legislative acts? We theorize that constitutional recency confers greater democratic legitimacy on constitutional provisions, reducing concerns that judges may use dated language to impose their own will on a living majority. Exploiting differences among US state constitutions, we show in a pre-registered vignette experiment and conjoint analysis that Americans are more supportive of judicial review and original intent interpretation when presented with a younger constitutional provision or constitution. These results imply that Americans might alter their approach to the US Constitution if it were changed as easily and as often as a typical state constitution.