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In an era marked by a growing demand for sustainable and high-performance materials, the convergence of additive manufacturing (AM), also known as 3D printing, and the thermal treatment, or pyrolysis, of polymers to form high surface area hierarchically structured carbon materials stands poised to catalyze transformative advancements across a spectrum of electrification and energy storage applications. Designing 3D printed polymers using low-cost resins specifically for conversion to high performance carbon structures via post-printing thermal treatments overcomes the challenges of 3D printing pure carbon directly due to the inability of pure carbon to be polymerized, melted, or sintered under ambient conditions. In this perspective, we outline the current state of AM methods that have been used in combination with pyrolysis to generate 3D carbon structures and highlight promising systems to explore further. As part of this endeavor, we discuss the effects of 3D printed polymer chemistry composition, additives, and pyrolysis conditions on resulting 3D pyrolytic carbon properties. Furthermore, we demonstrate the viability of combining continuous liquid interface production (CLIP) vat photopolymerization with pyrolysis as a promising avenue for producing 3D pyrolytic carbon lattice structures with 15 μm feature resolution, paving way for 3D carbon-based sustainable energy applications.

Persistent social inequities in the United States demand attention to culturally responsive (CR) teaching, which requires a specific disposition toward students and teaching. Using survey data of secondary teachers (N = 417) in seven urban districts across the country engaging in equity-oriented professional learning (PL) initiatives, we examine the relationship between teachers' beliefs about, self-efficacy for, and engagement in PL around CR teaching and their self-reported CR teaching practices. We find correlational evidence that teacher-reported self-efficacy with CR teaching and engagement in PL focused on CR teaching are associated with higher self-reported frequency of CR teaching. We also find that teachers who have beliefs aligned with CR teaching have a stronger relationship between their CR teaching self-efficacy and self-reported CR teaching practices. Finally, we find evidence that changes in CR teaching self-efficacy are associated with changes in self-reported CR teaching--suggesting that CR teaching self-efficacy may drive changes in CR teaching.

Many education leaders may wonder how to implement sustainable policy changes that will benefit youth, families, and the community. Arielle Lentz, Laura Desimone, Amy Stornaiuolo, Katie Pak, Nelson Flores, Philip Nichols, Morgan Polikoff, and Andy Porter share findings from school change efforts in more than 170 districts in five states. They present six key strategies based on this work, and they share examples of how districts employed the success factors of specificity, consistency, power, and stability to help build authority, which in turn led to successful implementation of new policies, curriculums, and professional learnings.

Abstract Background Intraoperative hemorrhage in cardiac surgery increases risk of morbidity and mortality. Low pre-operative and perioperative levels of fibrinogen, a key clotting factor, are associated with severity of hemorrhage and increased transfusion of blood components. The ability to supplement fibrinogen during hemorrhagic resuscitation is delayed 45–60 min because cryoprecipitated antihemophilic factor (cryo AHF) is stored frozen, due to a short post-thaw shelf life. Pathogen Reduced Cryoprecipitated Fibrinogen Complex (INTERCEPT Fibrinogen Complex, IFC) can be kept thawed, at room temperature, for up to 5 days, making it possible to be immediately available for hemorrhaging patients. This trial will investigate if earlier correction of acquired hypofibrinogenemia with IFC in hemorrhaging cardiac surgery patients reduces the total number of perioperatively transfused allogeneic blood products (red blood cells, plasma, and platelets) as compared to cryo AHF. Methods This is a single center, prospective, cluster randomized trial with an adaptive design. Acquired hypofibrinogenemia will be assessed by rotational thromboelastometry (ROTEM) and the threshold for cryo AHF/IFC transfusion defined as FIBTEM A10 ≤ 10 mm in bleeding patients. IFC/cryo AHF will be randomized by 1-month blocks. Cardiac surgery patients will be enrolled in the study if they have an eligible procedure and at least one dose of a cryo AHF/IFC product (approximately 2 g fibrinogen) is transfused. Data from the electronic health record, including the blood bank and lab information systems, will be prospectively collected from the health system’s data warehouse. Discussion This trial aims to provide evidence of the clinical efficacy of utilizing readily available thawed IFC during acute bleeding in the cardiac surgery setting compared to traditional cryo AHF. Trial registration ClinicalTrials.gov NCT05711524. Feb 3, 2023.

BACKGROUND: Anemia in very low birth weight (VLBW) infants is common and frequently managed with red blood cell (RBC) transfusions. We utilized a linked vein-to-vein database to assess the role of blood donors and component factors on measures of RBC transfusion effectiveness in VLBW infants. STUDY DESIGN AND METHODS: We linked blood donor and component manufacturing data with VLBW infants transfused RBCs between January 1, 2013 and December 31, 2016 in the Recipient Epidemiology Donor Evaluation Study-III (REDS III) database. Using multivariable regression, hemoglobin increments and subsequent transfusion events following single-unit RBC transfusion episodes were examined with consideration of donor, component, and recipient factors. RESULTS: Data on VLBW infants (n = 254) who received one or more single-unit RBC transfusions (n = 567 units) were linked to donor demographic and component manufacturing characteristics for analysis. Reduced post-transfusion hemoglobin increments were associated with RBC units donated by female donors (-0.24 g/dL [95% confidence interval (CI) -0.57, -0.02]; p = .04) and donors

Background and aimsColchicine is an anti-inflammatory drug that may prevent post-operative atrial fibrillation (POAF). The effect of this drug has been inconsistently shown in previous clinical trials. We aimed to compare the efficacy and safety of colchicine vs. placebo to prevent POAF in patients undergoing cardiac surgery.Methods and resultsA systematic search of EMBASE, MEDLINE, SCOPUS, ClinicalTrials.gov, and the Cochrane Library for randomized controlled trials (RCTs) was conducted from inception till April 2023. The primary outcome was the incidence of POAF after any cardiac surgery. The secondary outcome was the rate of drug discontinuation due to adverse events and adverse gastrointestinal events. Risk ratios (RR) were reported using the Mantel Haenszel method. A total of eight RCTs comprising 1885 patients were included. There was a statistically significant lower risk of developing POAF with colchicine vs. placebo (RR: 0.70; 95% CI: 0.59-0.82; P < 0.01, I2 = 0%), and this effect persisted across different subgroups. There was a significantly higher risk of adverse gastrointestinal events (RR: 2.20; 95% CI: 1.38-3.51; P < 0.01, I2 = 55%) with no difference in the risk of drug discontinuation in patients receiving colchicine vs. placebo (RR: 1.33; 95% CI: 0.93-1.89; P = 0.11, I2 = 0%).ConclusionThis meta-analysis of eight RCTs shows that colchicine is effective at preventing POAF, with a significantly higher risk of adverse gastrointestinal events but no difference in the rate of drug discontinuation. Future studies are required to define the optimal duration and dose of colchicine for the prevention of POAF.

Abstract Bleed‐off and shut‐in of injection have been implemented in different Enhanced Geothermal Systems (EGS) in an attempt to mitigate the induced seismicity at and after the injection stop. This article tackles the controversial discussion on the mitigation of the post‐injection induced seismicity through ending fluid injection by either a bleed‐off or a shut‐in. Both scenarios failed to mitigate the occurrence of large magnitude earthquake after stopping injection in numerous EGS. The two protocols are compared by using a seismological forecasting methodology coupled with a hydro‐mechanical model reproducing flow, poroelastic stress and fault failure in a domain including a discrete fault network based on Basel EGS (Switzerland, 2006). Unlike bleed‐off, shut‐in mitigates early post‐injection seismicity by smoothly reducing pressure, and consequently poroelastic stress changes in the modelled Basel EGS. Although post‐injection pore pressure diffusion eventually reaches distant faults and destabilizes them, seismicity is not initiated according to our simulation forecasting.

Summary: Low doses of general anesthetics like ketamine and dexmedetomidine have anxiolytic properties independent of their sedative effects, but the underlying mechanisms remain unclear. We discovered a population of GABAergic neurons in the oval division of the bed nucleus of the stria terminalis that are activated by multiple anesthetics and the anxiolytic drug diazepam (ovBNSTGA). The majority of ovBNSTGA neurons express neurotensin receptor 1 (Ntsr1) and form circuits with brain regions known to regulate anxiety and stress responses. Optogenetic activation of ovBNSTGA or ovBNSTNtsr1 neurons significantly attenuated anxiety-like behaviors in both naive animals and mice with inflammatory pain, while inhibition of these cells elevated anxiety. Activation of these neurons decreased heart rate and increased heart rate variability, suggesting that they reduce anxiety by modulating autonomic responses. Our study identifies ovBNSTGA/ovBNSTNtsr1 neurons as a common neural substrate mediating the anxiolytic effect of low-dose anesthetics and a potential therapeutic target for treating anxiety-related disorders.

AimsHaematopoietic stem cell transplantation (HSCT) is a potentially curative therapy for several malignant and non-malignant haematologic conditions. Patients undergoing HSCT are at an increased risk of developing atrial fibrillation (AF). We hypothesized that a diagnosis of AF would be associated with poor outcomes in patients undergoing HSCT.Methods and resultsThe National Inpatient Sample (2016-19) was queried with ICD-10 codes to identify patients aged >50 years undergoing HSCT. Clinical outcomes were compared between patients with and without AF. A multivariable regression model adjusting for demographics and comorbidities was used to calculate the adjusted odds ratio (aOR) and regression coefficients with corresponding 95% confidence intervals and P-values. A total of 50 570 weighted hospitalizations for HSCT were identified, out of which 5820 (11.5%) had AF. Atrial fibrillation was found to be independently associated with higher inpatient mortality (aOR 2.75; 1.9-3.98; P < 0.001), cardiac arrest (aOR 2.86; 1.55-5.26; P = 0.001), acute kidney injury (aOR 1.89; 1.6-2.23; P < 0.001), acute heart failure exacerbation (aOR 5.01; 3.54-7.1; P < 0.001), cardiogenic shock (aOR 7.73; 3.17-18.8; P < 0.001), and acute respiratory failure (aOR 3.24; 2.56-4.1; P < 0.001) as well as higher mean length of stay (LOS) (+2.67; 1.79-3.55; P < 0.001) and cost of care (+67 529; 36 630-98 427; P < 0.001).ConclusionAmong patients undergoing HSCT, AF was independently associated with poor in-hospital outcomes, higher LOS, and cost of care.

This study proposes an empirically grounded theory of how school reform implementation relates to effectiveness, useful for developing and studying many approaches to school reform both in the U.S. and abroad, and also for assessing how policymakers and implementers might leverage various aspects of implementation to create effective school improvement models at scale. Guided by a new framework that links Bryk and colleagues' (2010) five essential supports and as reported by Desimone's (2002) adaptation of Porter and colleagues' (1986) policy attributes theory, we use a mixed-methods approach to study the implementation and effectiveness of school turnaround efforts in the School District of Philadelphia. We explore the relationships among key turnaround model components, approaches to model implementation, and academic achievement using a matched comparison design and estimating a series of regressions. Qualitative methods are used to contextualize findings and offer explanatory hypotheses.

Spinal arachnoid web is a rare condition characterized by extramedullary bands of arachnoid tissue at the level of the dorsal thoracic spinal cord that may lead to progressive, permanent neurological deficits. To date, this condition has been radiographically characterized by a scalpel sign, which has been pathognomonic in all reported cases of spinal arachnoid webs. In this case, we report the first known patient with confirmed spinal arachnoid web without radiographic evidence of the scalpel sign. In reporting our finding, we encourage a higher clinical suspicion for spinal arachnoid web in patients presenting with progressive thoracic myelopathy following trauma, and radiographic evidence of ventrally displaced spinal cord and turbulent cerebrospinal fluid flow, even in the absence of a scalpel sign.

The differentiation of wide complex tachycardias (WCTs) into ventricular tachycardia (VT) and supraventricular wide tachycardia (SWCT) via 12-lead ECG (electrocardiogram) interpretation is a crucial yet demanding clinical task. Decades of research have been dedicated to simplifying and improving this differentiation via manual algorithms. Despite such research, the effectiveness of such algorithms still remains limited, primarily due to reliance on user expertise. To combat this limitation, automated algorithms have been created that show promise as alternatives to manual ECG interpretation. However, direct comparison of the methods’ diagnostic performances has not been undertaken. A recent publication (LoCoco et al., 2024) compared the diagnostic performance between traditional manual ECG interpretation approaches (i.e. Brugada, Vereckei aVR, and VT Score) to novel automated wide QRS complex tachycardia differentiation algorithms (i.e. WCT Formula I, WCT Formula II, VT Prediction Model, Solo Model, and Paired Model). Two electrophysiologists independently applied the 3 manual WCT differentiation approaches to 213 ECGs. Simultaneously, computerized data from the same paired WCT with baseline ECGs were processed by the 5 automated WCT differentiation algorithms. Following these analyses, the diagnostic performance of automated algorithms was compared with manual ECG interpretation approaches. In this article, a summary of data components relating to diagnostic performance of the methods tested is presented.