The pediatric urgent care setting offers a unique opportunity to enroll pediatric patients and their families to facilitate the study of human immunology. However, it is an underutilized environment for recruiting participants into research studies, most likely driven by a fundamental “conflict of urgency” – the tension between the time-limited nature of acute ambulatory care and the time-intensive requirements of human subjects research. To address this challenge, we implemented a study of infant and maternal immune responses to respiratory tract infection (the MATMilk study) across four Seattle Children’s Hospital Urgent Care (SCHUC) clinics using a novel, two-phase study design, which uncoupled initial clinical contact from enrollment and specimen collection. This approach allowed complete remote participation and minimized disruption to clinical workflows. To date, we have enrolled n = 36 infants and n = 39 mothers and have complete biospecimen sets from n = 30 infants and n = 28 mothers. The cohort is from a broad geographical catchment in the Puget Sound region and is racially and ethnically diverse, reflecting the demographics of the SCHUC patient population. Our scalable, resource-efficient approach provides a model for integrating basic science research into hospital-affiliated pediatric urgent care networks.

Antimicrobial stewardship (AMS) is essential for mitigating antimicrobial resistance (AMR) in animal health, but implementing national initiatives is challenging due to diverse influencing factors and the need for context-specific approaches. An Animal AMS Practice Group, comprising individuals with lived experience overseeing AMS in various animal health contexts, was engaged and through an experience-based co-design approach created a comprehensive AMS Framework that captures progress and supports tangible improvements in AMS practices in each context. The Framework supported a cross-sectoral pilot assessment that helped users identify progress, areas for improvement and contextualise antimicrobial usage and AMR data, while also motivating further AMS efforts. Despite common barriers to the sharing of sensitive data, participants willingly shared AMS results for comparison and publication. The process demonstrated that co-design coupled with peer learning and expert support is essential to creating AMS tools that are relatable to users. Several participants incorporated the Framework into routine practice, with some using it to drive sector-level AMS action. The resulting Framework offers an adaptable, scalable entry point for AMS efforts and a platform for setting meaningful improvement goals. It supports broader opportunities for national-level AMS assessments and strategy development.

The ‘scholarship of engagement’, derived from work undertaken by the Boyer Commission in the US, emphasises the possibilities of enhanced undergraduate learning through research, yet in the UK this idea is less developed. Moreover, although the study of politics and international relations lends itself well to the use of placements to develop this model of learning, there are few examples of this in the UK. This article presents findings from a major research project, the Scholarship of Engagement for Politics, examining the ways in which placement learning can affect the student experience.

This pilot study is the first formal exploration of the concept of “Organizational Professionalism” (OP) among health system leaders in high-performing healthcare organizations. Semi-structured key informant interviews with 23 leaders from 8 healthcare organizations that were recipients of the Malcolm Baldrige National Quality Award (MBNQA) or Baldrige-based state quality award programs explored conceptualization, operationalization, and measurement of OP. Further exploration and understanding of OP in healthcare organizations has the potential to establish and sustain professional and ethical organizational cultures that bolster trust through the sound implementation of laws, policies, and procedures to support the delivery of high-quality patient care.

Objectives: Evidence is limited on the comparative impact of specific anesthetic agents used in electroconvulsive therapy (ECT) on outcomes in treatment-resistant depression (TRD). Our study aimed to compare the efficacy of methohexital vs propofol by examining the number of treatment sessions needed to transition from acute to maintenance ECT (NTS) (i.e., change from minimum of two to one or fewer treatments per week), missed treatment sessions, and seizure durations.

Methods: We conducted a retrospective cohort study via chart review of patients with TRD receiving ECT from October 2017 to October 2019. We included adult patients (3 18 years) diagnosed with TRD who received at least six ECT sessions. We analyzed our data using multilevel structural equation modeling(MSEM).

Results: We included 149 patients (36.9% or 55/149 were ³ 65 years): 54 were methohexital-treated (mean age 59 ± 17 years; 41% male) and 95 were propofol-treated (mean age 55 ± 17 years; 36% male). No significant differences between methohexital vs propofol groups were found in NTS (mean ± SD: 12.6 ± 6.6 vs 11.5 ± 6.1; p = 0.3) and missed treatment sessions (0.63 ± 1.2 vs 0.69 ± 1.2; p = 0.75). Patients receiving methohexital manifested longer motor (25.5 ± 10.6s vs 19.9 ± 8.4s; p < .001) and electroencephalographic (EEG) seizure durations (42 ± 17.5s vs .9± 13.1s; p < .001) vs propofol. MSEM revealed that (1) methohexital was associated with longer first-session seizure durations (motor seizure: b = 6.28, p < 0.05; EEG seizure: b = 8.03, p < 0.05) and more rapid decline in motor seizure duration across sessions (b = –.38, p < .05) over propofol, while accounting for relevant covariates; (2) regardless of anesthesia used, faster reductions in seizure durations across sessions predicted fewer NTS; and (3) methohexital was associated with fewer NTS adjusted for covariates which were driven by two indirect effects: (a) sharper decline in motor duration across sessions and (b) the association between a sharper decline in motor duration across sessions with fewer missed treatments. The outcomes were not influenced by age, indicating that the findings are relevant to older adults.

Conclusions: Our findings suggest that methoxexital had fewer NTS and longer seizure durations than propofol, indicating better ECT outcomes using methohexital for TRD. Further research is warranted to verify methohexital’s effects on cognitive and additional recovery outcomes within clinical practice.

Catalytic processes are critical steps in numerous industrial processes. The discovery of high reactivity of defects in metal-free two-dimensional materials has bolstered their emergence as catalysts. Here we consider the effect of defect-inducing methods in hexagonal boron nitride (h-BN) on their performance for olefin and CO2 hydrogenation. We compare the changes introduced by ball milling and heat treatment in h-BN and show how varying the treatment conditions can impact the properties. We provide some evidence of the reactivity of the powders. Our results highlight how characterization can be exploited to assess the potential catalytic activity of h-BN for heterogeneous catalysis.

Psithyrus spp. (Hymenoptera: Apidae) are obligate social parasites of bumble bees (Bombus spp.). Morphological and physiological features of P. ashtoni (Cresson) females, which may facilitate the successful usurpation of host nests, were examined. Parasite females were no larger than B. terricola Kirby queens, although they possessed a number of protective modifications to the exoskeleton, as well as increased offensive armament, including larger mandibles and a longer venom gland. Females of P. ashtoni and P. insularis (Smith) possessed a greater number of ovarioles than host queens, and produced smaller eggs. The Dufour’s glands of the two Psithyrus species were significantly larger than those of B. terricola. There appears to have been considerable convergence in the evolution of socially parasitic lifestyles in bumble bees and wasps (Vespula spp.), presumably as a consequence of similar selective pressures operating on parasites belonging to these distantly related but socially similar taxa.

ReB2 was recently reported to exhibit high hardness and low compressibility, which both are strong functions of its stoichiometry, namely Re to B ratio. Most of the techniques used for ReB2 synthesis reported 1:2.5 Re to B ratio because of the loss of the B during high temperature synthesis. However, as a result of B excess, the amorphous boron, located along the grain boundaries of polycrystalline ReB2, would degrade the ReB2 properties. Therefore, techniques which could allow synthesizing the stoichiometric ReB2 preferably at room temperature are in high demand. Here, we report synthesis of ReB2 powders using mechanochemical route by milling elemental crystalline Re and amorphous B powders in the SPEX 8000 high-energy ball mill for 80 h. The formation of boron and perrhenic acids are also reported after ReB2 powder was exposed to the moist air environment for a 12-month period of time.

Urinary excretion of neopterins and biopterins was measured in 23 patients with severe depression before and after receiving electroconvulsive therapy (ECT) and 26 healthy control subjects. Patients with psychotic depression and those responding to ECT had neopterin:biopterin (N:B) ratio significantly higher than controls before commencing ECT and positive therapeutic response was associated with reduction of N:B ratio towards control values. As a raised N:B ratio implies failure to convert neopterin to biopterin it is possible that reduced availability of tetrahydrobiopterin, the essential cofactor for the formation of noradrenaline, serotonin and dopamine, may exert rate limiting control over the synthesis of monoamines implicated in the pathogenesis of depressive disorders. The N:B ratio may be a marker for certain depressive subtypes and response to ECT.

Point defect scattering via the formation of solid solutions to reduce the lattice thermal conductivity has been an effective method for increasing ZT in state-of-the-art thermoelectric materials such as Si-Ge, Bi2Te3-Sb2Te3 and PbTe-SnTe. However, increases in ZT are limited by a concurrent decrease in charge carrier mobility values. The search for effective methods for decoupling electronic and thermal transport led to the study of low dimensional thin film and wire structures, in particular because scattering rates for phonons and electrons can be better independently controlled. While promising results have been achieved on several material systems, integration of low dimensional structures into practical power generation devices that need to operate across large temperature differential is extremely challenging. We present achieving similar effects on the bulk scale via high pressure sintering of doped and undoped Si and Si-Ge nanoparticles. The nanoparticles are prepared via techniques that include high energy ball milling of the pure elements. The nanostructure of the materials is confirmed by powder X-ray diffraction, transmission electron microscopy, scanning electron microscopy, and dynamic light scattering. Thermal conductivity measurements on the densified pellets show a drastic 90% reduction in the lattice contribution at room temperature when compared to doped single crystal Si. Additionally, Hall effect measurements show a much more limited degradation in the carrier mobility. The combination of low thermal conductivity and high power factor in heavily doped n-type nanostructured bulk Si leads to an unprecedented increase in ZT at 1275 K by a factor of 3.5 over that of single crystalline samples. Experimental results on both n-type and p-type Si are discussed in terms of the impact of the size distribution of the nanoparticles, doping impurities and nanoparticle synthesis processes.

Pulmonary arteriovenous malformations are a frequent cause of progressive cyanosis after construction of a cavopulmonary anastomosis. Their formation complicates the management of children with single ventricle physiology after a bidirectional Glenn shunt or the Kawashima procedure. The key role of the liver in this phenomenon is suggested by the observation that providing modifications of the Fontan procedure which permit hepatic venous effluent to reach the pulmonary arterial circulation limit further development of the malformations. In addition, it is known that patients with end-stage hepatic failure develop pulmonary arteriovenous malformations that diminish after liver transplantation. We have begun purification of a factor derived from hepatocyte-conditioned media that is inhibitory for the proliferation of cultured endothelial cells. This substance is heat sensitive, and binds avidly to a copper-containing chromatography column. These clinical observations, and this preliminary experimental work, support the concept that hepatic-derived angiogenic factors may play a role in the development of pulmonary arteriovenous malformations after construction of cavopulmonary anastomoses.

The concept of using “self-assembled” and “force-engineered” nanostructures to enhance the thermoelectric figure of merit relative to bulk homogeneous and composite materials is presented in general terms. Specific application is made to the Si-Ge system for use in power generation at high temperature. The scientific advantages of the nanocomposite approach for the simultaneous increase in the power factor and decrease of the thermal conductivity are emphasized along with the practical advantages of having bulk samples for property measurements and a straightforward path to scale-up materials synthesis and integration of nanostructured materials into thermoelectric cooling and power generation devices.

Against a backdrop of compelling societal needs, graduates in science and engineering now must master their disciplines and demonstrate a sophisticated level of cognitive, affective and social development. This has lead a number of national and international commissions on science and engineering to urge educators to re-think the way in which STEM disciplines are taught. We have chosen to “repackage” a traditional undergraduate materials engineering curriculum in a form designed to promote the development of higher-order cognitive skills like self-directed learning and design. Classic metallurgy experiments have been converted to project-based learning experiences where students are put in the role of “designers” of problem solutions and faculty play the role of coaches. These include: designing, prototyping and marketing of a cast metal object; systems designing, building and testing of a fiber optic spectrometer; product improvement of a prosthetic device; design and evaluation of a heat treatment process for roller bearings. Projects were designed to leverage known relationships within the educational psychology literature that enable deeper learning. Evaluation of 36 juniors in a project-based learning course (i.e., the test cohort) against a quasi-control group in traditional engineering courses showed that the test cohort scored significantly higher on two motivation scales shown to be critical components in self-directed learning (p<0.001). The test cohort also reported a significantly higher use of peers as learning resources than the quasi-control group. Their motivation scores also correlate highly with self-reported comfort with several aspects of design, implying that their motivation contributes significantly to students' ability to effectively engage in the design process. In this paper, we present examples of the materials engineering projects that were designed and implemented, and the design features that enable them to promote the development of sophisticated cognitive functioning.