The Doctor of Clinical Laboratory Science (DCLS) is a novel advanced-practice doctoral degree that was established in 2014 to equip medical laboratory scientists for integrative practice roles within clinical healthcare teams (e.g., diagnosticians, consultants, directors). The goal of this study was to comprehensively review the professional trajectories of DCLS graduates from 3 programs in the United States. Further, the study sought to understand the professional society resources needed by DCLS practitioners to support career development. This study employed a cross-sectional survey design to characterize the educational background, professional roles, practice settings, and career trajectory of DCLS graduates. The survey was developed by the Association for Diagnostics & Laboratory Medicine (ADLM) DCLS Task Force. A total of 41 DCLS alumni completed the survey. Most respondents held roles in education (39%), as laboratory administrative directors (29.2%), or as medical laboratory directors (24.4%). Respondents were largely specialized in hematology and coagulation (46.3%; n = 19) and clinical chemistry and toxicology (43.9%; n = 18). Most respondents expressed interest in board certification, and nine were board-certified by the National Registry of Certified Chemists (NRCC). Respondents expressed interest in advocacy for broader recognition and understanding of DCLS skill sets. DCLS graduates hold a variety of roles within the clinical laboratory across various clinical pathology subspecialties. Most DCLS graduates function in clinical oversight, administrative leadership capacities, and education. Graduates expressed interest in increased recognition of DCLS roles and a broader awareness of DCLS skill sets across the laboratory medicine community.
Arginine methylation, catalyzed by protein arginine methyltransferases (PRMTs), is a critical post-translational modification that modulates gene expression and signal transduction. Although the involvement of PRMTs in malignancy is increasingly recognized, a comprehensive pan-cancer synthesis of this family remains elusive. We sought to elucidate the multi-omic landscape of PRMTs and define their biological contributions to colorectal cancer (CRC) progression. Using multi-omic data from TCGA and GTEx, we performed an integrative pan-cancer analysis of PRMT expression, genetic alterations, epigenetic modifications, and their associations with prognosis, genomic heterogeneity, stemness, the tumor microenvironment, and oncogenic pathways. After validating PRMT expression patterns across multiple independent CRC cohorts from the GEO database, PRMT1 was prioritized for further investigation. Its expression was assessed in a real-world CRC cohort using immunohistochemistry, while its oncogenic potential was scrutinized through in vitro proliferation assays. PRMT family genes exhibit heterogeneous molecular profiles across cancers, which correlate significantly with genomic instability, stemness, immune infiltration, and oncogenic pathway activation. Clinical validation demonstrated that PRMT1 is markedly upregulated in CRC, where its overexpression correlates with larger tumor size, advanced T stage, and lymph node metastasis. Loss-of-function experiments demonstrated that PRMT1 is essential for maintaining CRC cell proliferation. Our study highlights the multifaceted roles of PRMTs across the pan-cancer spectrum. By identifying PRMT1 as a key driver of CRC progression, this work provides a rationale for the development of PRMT-targeted therapies and personalized diagnostic biomarkers.
Optimal postprocedural antithrombotic management after left atrial appendage closure (LAAC) remains undefined, particularly in patients with high bleeding risk. Early complete cessation (<6 months) of antithrombotic therapy (AT) following LAAC is increasingly adopted, yet supportive evidence is limited. This study sought to evaluate the safety of early (<6 months) complete discontinuation of AT after LAAC. A systematic review and meta-analysis of observational studies was conducted. PubMed and Scopus were searched through September 2025. The primary endpoint was stroke events; secondary endpoints included all-cause mortality, major bleeding, and device-related thrombus (DRT). Random-effects models were used to calculate pooled risk ratios (RRs). Subgroup and sensitivity analyses were performed. Seven studies including 1841 patients (529 with early AT cessation) were analyzed. Patients undergoing early AT discontinuation exhibited high baseline thromboembolic and bleeding risk, and most of them (67%) had prior bleeding events. Over a weighted mean follow-up of 19.2 months, early discontinuation of AT was not associated with increased risk of stroke (RR, 1.04; 95% CI, 0.40-2.66), all-cause death (RR, 1.03; 95% CI, 0.49-2.17), major bleeding (RR, 1.22; 95% CI, 0.75-2.01), or DRT (RR, 0.49; 95% CI, 0.14-1.73). No significant differences were observed between very early (<1 month) and early (<6 months) cessation strategies. Among high-bleeding-risk patients undergoing LAAC, early complete discontinuation of AT was not associated with an increased risk of thromboembolic events or death during mid-term follow-up. These results support the potential ischemic safety of early antithrombotic cessation in carefully selected patients and highlight the need for definite evidence from randomized trials.
To optimize osteoporosis therapy with the parathyroid hormone fragment teriparatide (PTH1-34), we sought to determine whether strontium (Sr) could potentiate the bone anabolic action of intermittent PTH1-34 in ovariectomized rats. Female rats were either Sham-operated or ovariectomized (Ovx) at 6 months of age. Eight weeks after surgery, Ovx rats received either vehicle solutions, 625 mg/kg/day Sr (5 days per week), 8 µg/kg/day PTH1-34 (5 days per week), or the combined treatments for 8 weeks. PTH1-34 reversed Ovx-induced deterioration of trabecular microarchitecture, apparent volumetric bone mineral density (vBMD), and strength, whereas Sr alone increased tissue-level vBMD without significantly affecting trabecular bone mass. Co-treatment with Sr and PTH1-34 further increased trabecular thickness (+ 8.9% vs. PTH1-34 alone), apparent and tissue-level vBMD (+ 9.6% and 6.7% vs. PTH1-34 alone), bone material properties (maximum force, + 18.2% vs. PTH1-34 alone; working energy, + 17% vs. PTH1-34 alone), and trabecular bone strength compared with PTH1-34 alone. In cortical bone, PTH1-34 increased bone volume, cortical thickness, and apparent vBMD, while co-treatment further enhanced cortical thickness (+ 7.2% vs. PTH1-34 alone) and apparent vBMD (+ 7% vs. PTH1-34 alone), maintained the Sr-induced increase in tissue-level vBMD, and significantly improved bone strength. In primary osteoblast cultures, Sr and PTH1-34, administered either alone or in combination, increased Rankl and decreased Opg expression, consistent with the elevated urinary levels of the bone resorption marker deoxypyridinoline in vivo. Sr or PTH1-34 alone stimulated Igf1 and Alpl expression, whereas co-stimulation further enhanced these osteogenic markers. In conclusion, combining Sr with PTH1-34 integrates the osteoanabolic effects of PTH1-34 on bone mass with the mineral-level effects of Sr on bone material properties, leading to synergistic stimulation of bone formation and superior improvements in bone quality and strength.
This project sought to increase the vaccination completion rate to 95% in an adolescent medicine practice. We aimed to increase the percentage of individuals who were up to date on their meningococcal, human papillomavirus, and tetanus, diphtheria, and pertussis vaccinations to 80% and to verify that these efforts led to more equitable care. We used the Model for Improvement. After a current-state analysis, the team implemented a bundled intervention that included obtaining missing records, notifying providers about patients who needed vaccinations, and providing electronic medical record alerts when vaccinations were due. Patients received vaccine education, and nurses offered a numbing spray to mitigate needle-related vaccine hesitancy. Statistical process control charts showed a shift in the percentage of complete vaccination records from 88% to 95%. There was a mean shift for the combined meningococcal, human papillomavirus, and tetanus, diphtheria, and pertussis completion percentage from 70% to 76%. All race and payer subgroups improved with the interventions. Racial disparity analysis for the completion percentage pre- and postintervention showed that there were 2 disparities observed between the reference group, Hispanic patients, and other racial groups. No disparities were observed between publicly and privately insured patients before or after the interventions. The bundled intervention was associated with higher rates of vaccine documentation and administration. The highly engaged nursing staff and innovative technology drove success.
to analyze the factors associated with HIV among young people in a large Brazilian city. a case-control study was conducted with individuals aged 15 to 24 years old who sought services at the city's Testing and Counseling Centers. Cases consisted of young people with a positive HIV test result, while controls were those with a negative result. Data were analyzed using descriptive statistics, chi-square test, and logistic regression. men were 5.38 times more likely to have reactive HIV tests, sex workers were 31.5 times more likely to be infected with HIV, and those who sometimes or never used condoms were 2.43 times more likely to acquire the infection. Vaginal sex was a protective factor against HIV infection. factors associated with HIV should guide strategies that prioritize men, sex workers, and people with unprotected and non-vaginal sexual practices.
Obstructive Sleep Apnea Syndrome (OSAS) is increasingly recognized as a serious, worldwide public health concern characterized by significant systemic consequences, primarily metabolic dysfunction driven by intermittent hypoxia (IH). The specific metabolic phenotype of pediatric OSAS remains largely unexplored, as the pediatric form differs substantially from the adult phenotype. To address this gap, this pilot investigation sought to characterize plasma acylcarnitine signatures in a children cohort using tandem mass spectrometry. We analyzed 27 plasma acylcarnitines in 11 children (4-10 years) with polysomnography-confirmed moderate-to-severe OSAS using FIA-MS/MS. The resulting data were compared to age-stratified reference limits for the pediatric population. Our data reveal a severe and statistically significant depletion exclusively in two species, Acetylcarnitine (C2) and Octenoylcarnitine (C8:1), compared to age-matched reference values, which remained significant even after stringent False Discovery Rate (FDR) correction. Our study has provided important insights into the pediatric OSAS metabolic landscape, albeit based on a small sample size. We observed a selective reduction of circulating C2 and C8:1 in children with OSAS, proposing them as intriguing biomarkers and/or possible targets of nutritional intervention, warranting further investigation.
The exposome has been proposed to have a key role in the development of atopic dermatitis (AD). However, whether early-life infections are associated with AD risk remains unclear. To investigate whether early infection burden and infection subtypes are associated with the risk of childhood AD. A cohort study using data from children aged 0 to 10 years from the 2010 Danish Copenhagen Prospective Studies on Asthma in Childhood (COPSAC2010) birth cohort who were monitored for infection diagnoses, AD diagnosis, Scoring Atopic Dermatitis (SCORAD) index score, systemic antibiotics, and filaggrin gene (FLG) status. Replication was sought in a second birth cohort from the US Vitamin D Antenatal Asthma Reduction Trial (VDAART) cohort. Data were analyzed between January and February 2026. Daily diary-registered infection episodes of cold, acute otitis media, tonsillitis, pneumonia, gastroenteritis, and fever episodes and days until age 3 years in COPSAC2010. Cold, fever, respiratory infection, and fever episodes until age 3 years in VDAART. Risk of AD during age 0 to 10 years using diagnostic criteria with longitudinal risk assessment from a generalized estimating equation (GEE) model in COPSAC2010. Analyses adjusted for FLG variant and systemic antibiotic treatments. Parental report of physician AD diagnosis until age 6 years was used in VDAART. Among 663 children in COPSAC2010, children in the upper (n = 221; 112 males [51%], 109 females [49%]) vs lower (n = 221; 109 males [49%], 112 females [51%]) tertiles of infection episodes and days were associated with higher risk of yearly AD prevalence during ages 0 to 10 years (GEE model): adjusted odds ratio (AOR), 1.61; 95% CI, 1.05-2.47; P = .03; and AOR, 1.69; 95% CI, 1.11-2.58; P = .01, respectively. Each infection episode was associated with a higher AD risk as well, independently of systemic antibiotic treatments and FLG variants. Associations were mainly driven by respiratory infections. In VDAART (n = 707), children in the upper (n = 235; 125 males [53%], 110 females [47%]) vs lower (n = 236; 119 males [50%], 117 females [50%]) tertiles of infection episodes were associated with a higher risk of AD at ages 0 to 6 years (OR, 1.76; 95% CI, 1.16-2.70; P = .01), increasing by each infection episode (OR, 1.03; 95% CI, 1.01-1.05; P = .002). This study found that early respiratory infection burden is associated with AD diagnosis in a dose-dependent manner in 2 independent birth cohorts. These findings suggest a long-term relationship between early respiratory infections and AD that has previously been unclear due to inconsistent findings in previous studies.
While efforts to enhance employment outcomes for individuals with intellectual and developmental disabilities (IDD) have increased, research has primarily focused on job attainment rather than long-term employment sustainability (e.g., 12 months or more). Few studies have explored whether staff using evidence-based employment models (e.g., Project SEARCH) express an interest in virtual reality support tools to enhance employment sustainability. This study sought to examine whether Project SEARCH staff expressed interest in using virtual reality as a potential method to support employment sustainability for transition-age youth with IDD. Project SEARCH staff (N = 234) completed a brief descriptive survey about their experiences with students with IDD and the role that practicing workplace conversations via virtual reality has in their students' ability to sustain employment. The majority of Project SEARCH staff report that over 75% of the youth they served were able to obtain employment with low rates of job loss. Additionally, 91.9% of Project SEARCH staff perceived virtual reality as a helpful means to support workplace conversations among transition-age students with IDD. Project SEARCH staff expressed an interest in virtual reality tools to help students practice workplace conversations. Future efforts should consider technologies that incorporate soft skills in the workplace to enhance employment sustainability.
More than 100,000 patients are on the U.S. transplant waitlist, with proportionally fewer organ donations coming from rural areas. Optimization of donation services in rural and frontier communities could address this discrepancy. We sought to better understand attitudes, knowledge, and concerns regarding organ donation and transplantation among frontier populations by surveying patients in the United States Great Plains region. A 15-item survey was distributed for voluntary completion to patients ≥18 years at three rural clinics in the Great Plains from July 2025 to January 2026. The survey included questions on demographics, exposure to and knowledge of organ donation, and attitudes regarding organ donation and transplantation. A total knowledge score was created by scoring participants' accuracy in selecting which organs/tissues can be donated. Statistical analyses included Fisher exact and Mann Whitney U testing, as well as a multiple logistic regression. A p-value of ≤0.05 was considered significant. Among 101 respondents (74.3% female, 77.2% registered donors), 90.1% were White and 7.9% were Native American/Alaska Native (NA/AN). Registered donors had significantly higher knowledge scores than non-donors (p=0.0012). Men were more likely to limit transplant acceptance to donations from friends/relatives (p=0.024), while NA/AN respondents showed higher willingness for unconditional living donation (p=0.039). Multivariable regression identified knowledge score as the sole independent predictor of donor status amongst variables surveyed (OR 1.48; 95% CI 1.13-1.99). The primary concern with donation reported was fear of health complications (37.5%) and the most requested intervention was more information on the donation process (18.1%). Medical literacy appears to be positively associated with organ donor status in this population. Sex-, race-, and education-specific differences in donation attitudes exist and may inform targeted interventions. Addressing knowledge gaps and specific concerns through education and outreach could provide a strategy to increase donation rates in rural populations.
The perioperative period is a critical phase for kidney transplantation. Emerging evidence indicates the potential utility of several perioperative strategies to support immediate graft function and patient outcomes. In other countries surveying only anesthesiologists, there is broad variation in the reported routine care for kidney transplant recipients. We sought to describe routine perioperative care for kidney transplant from a multidisciplinary perspective including perioperative clinicians (nephrologists, surgeons and anesthesiologists) caring for kidney transplant recipients in Canada. We created an evidence-informed qualitative and quantitative survey of routine perioperative practices using an iterative and collaborative process. The survey was reviewed by our multidisciplinary group and tested by 3 nephrologists, 3 surgeons and 3 anesthesiologists prior to circulation. After research ethics board approval, an online survey was distributed via e-mail to all Canadian adult kidney transplant centers. Transplant directors were asked by e-mail to distribute the survey to transplant nephrologists, surgeons and anesthesiologists involved in the perioperative care of kidney transplant recipients at their center. Survey responses were collected electronically from January 13, 2025 to April 13, 2025. We recorded all answers to our survey questions including multiple choice and free-text responses. We defined agreement as >70% of respondents selecting the same response for a routine perioperative care question. Descriptive statistics were used to describe the variation across disciplines and across transplant centers in Canada. Respondents included 18 nephrologists, 14 surgeons and 39 anesthesiologists representing all kidney transplant centers in Canada (n=18). We found several areas of agreement including preoperative hemoglobin optimization and transfusion targets, hemodynamic monitoring, immunosuppression and use of preoperative dialysis. Routine care was variable with respect to the use of diuretics, blood pressure targets and intravascular fluid. We were unable to link reported routine care practices with patient or graft outcomes. We also are unable to provide consensus recommendations for perioperative care based on this survey study. We describe perioperative care for kidney transplantation by transplant nephrologists, surgeons and anesthesiologists in Canada. Some elements of care exhibit variation in practice while others show consistency between transplant clinicians and transplant hospitals. These findings identify priority areas of practice variation that may inform the design of future comparative studies and the development of evidence-informed perioperative strategies.
Background: This research sought to determine the math proficiency of pharmacy technicians and the potential causes for the technicians' feelings of deficiency when attending continuing pharmacy education activity (CPE) and performing pharmaceutical calculations. Methods: To investigate these questions, the following questionnaire and test methods were utilized. Pharmacy technicians attending a 2-hour CPE activity completed a pre-activity survey assessing demographics, attitudes toward solving math problems, and sample calculation problems. Subsequently, the post-activity evaluation included additional calculation problems for comparison. Results: Our research found that most participants were nationally certified (82% of participants), but that most had not completed or were unsure if they had completed a formalized training program (58% of participants). Pre-survey data revealed participants perceiving low confidence in their pharmaceutical mathematical capability, as well as their over-reliance on rote memorization as their biggest barriers to solving pharmacy calculations. Baseline performance on calculation problems averaged 32% correct, with technicians finding the greatest difficulty in percentage strength, pediatric dosing, and alligation problems. Post-activity scores improved to an average of 66% correct across these areas. Conclusion: This in-person CPE activity improved pharmacy technicians' calculation skills. Although many pharmacy technicians struggle with pharmaceutical math problems, the reasons for these issues can be attributed to low confidence and lack of training rather than inability. Future CPE activities can continue to be focused on improving knowledge of underlying math concepts.
Arctic and boreal regions are experiencing rapid environmental changes that include thawing permafrost and increasing disturbances. The NASA Arctic-Boreal Vulnerability Experiment (ABoVE) sought to better understand these changes through field, airborne, and remote sensing measurements. One key airborne instrument was the Land, Vegetation, and Ice Sensor (LVIS), a wide-swath imaging laser altimeter system. LVIS conducted 32 flights during June-August periods of 2017 and 2019, capturing data across more than 91,000 km² of diverse Arctic and boreal ecosystems. The surface topography and vegetation structure data collected throughout Alaska and Northwestern Canada spans boreal forests to Arctic tundra, crossing 12 distinct ecoregions. This airborne collection enables direct comparison with coincident NASA Ice, Cloud, and Land Elevation Satellite-2 (ICESat-2) data, extends research beyond the ~52° N limit of NASA's Global Ecosystem Dynamics Investigation (GEDI) sensor, and provides precursor data for future satellite missions, such as NASA's recently selected Earth Dynamics Geodetic Explorer (EDGE). We summarize detailed information on LVIS data records from ABoVE deployments, including access and visualization using custom open source tools.
The present research sought to explore the predictive role of environmental interpretation (EI) on guests of rural eco-certified guesthouses in Romania, focusing specifically on their loyalty intentions towards these units, their self-reported in-situ environmental behaviors during their stays, and their environmental intentions upon returning home. An integrated theoretical framework was developed by merging the Reasoned Action Approach (RAA) and Norm Activation Theory (NAT). A quantitative approach was employed, collecting data from a cross-sectional sample of guests at rural Romanian eco-certified guesthouses. The structural model assessment revealed that while perceived EI is a significant direct predictor of loyalty intentions and environmental intentions in everyday life, its direct association with reported in-guesthouse behavior is non-significant. Instead, the multi-stage sequential mediation analysis demonstrated that the effects of EI on outcomes operate predominantly through complex, sequential cognitive-moral pathways involving personal attitude, problem awareness, ascribed responsibility, and personal norms. The integrated framework demonstrated high predictive power for both loyalty and future environmental intentions, whereas subjective norms remained non-significant within these settings. These findings offer distinct theoretical contributions to environmental psychology and sustainable tourism research, alongside managerial implications for developing more effective interpretation programs that promote sustainable tourist behaviors both during and after the stay.
The Apple app store and the Google Play Store are major platforms for downloading mobile applications (apps). E-cigarette entertainment apps, such as games and simulators, commonly feature youth-appealing characteristics, such as animated or youthful characters and instances of magic or fantasy. Both platforms' policies limit tobacco-related apps; however, enforcement is inconsistent. This study sought to determine if e-cigarette entertainment apps appear in searches for e-cigarette-related terms and whether they contain youth-appealing content. Using Python, the Apple App Store and the Google Play Store were searched for 41 e-cigarette-related terms. Two coders reviewed all returned apps to identify e-cigarette entertainment apps. These apps' store listings (the web page for the app on the store) and app content were coded for youth-appealing features using a codebook. Both platforms had e-cigarette-related apps (Apple App Store: 42; Google Play Store: 73). While almost all (n=40) App Store apps were cessation-focused, e-cigarette entertainment apps (n=33) were found on the Google Play store. Many e-cigarette entertainment apps contained themes such as violence (n=13) and visible smoke/aerosol (n=26). Characters coded in the apps were mostly animated (n=12). Four characters were coded as appearing under 18 years old. Youth-appealing features of tobacco ads are regulated in broadcast and print media, but regulations do not pertain to mobile apps. While Apple has removed much of the concerning content from its App Store, the Google Play Store has numerous e-cigarette entertainment apps containing youth-appealing features.
Since rotation data were last cataloged in 2013 by Khandelwal et al., there have been significant events that impacted emergency medicine (EM). Investigators sought to determine characteristics of EM experiences offered at US medical schools. We anticipated that, compared to data collected in 2013, there would be more required clinical rotations, but variability in timing and length. We conducted an internet search of publicly available EM curricula for 224 accredited, degree-granting (158 MD, 66 DO) US medical schools. We examined if an EM clinical experience was required, when it occurred, rotation length, and the number and length of shifts. We identified that 61.2% (137/224) of schools had a required EM clerkship, most frequently occurring after core clinical rotations. Advanced electives (sub-internships/acting internships) were offered at 110/224 schools (49.1%). These experiences were typically 4 weeks in length. Additional information regarding the number of shifts, shift length, and preceptorship, was limited and variable. Most US medical schools require EM rotations, an increase over the prior decade. The Structure and timing of rotations vary, and many curricular details are not publicly available. A direct survey of clerkship directors and continued maintenance of existing repositories are needed to completely assess national trends.
Per- and polyfluoroalkyl substances (PFAS) are persistent contaminants detected in aquatic systems globally, yet environmental data for PFAS in saltwater environments remain scarce relative to freshwater systems. Similarly, toxicity data describing the developmental impacts of environmentally relevant exposure concentrations of PFAS remains limited for marine biota, with the majority of toxicity studies utilizing freshwater models and/or exposure concentrations that are several orders of magnitude higher than those measured in saltwater systems. Therefore, the present study sought to characterize the occurrence and extent of PFAS contamination in Matagorda Bay - an urbanized estuary along the Gulf Coast of Texas (USA) - and to evaluate the developmental effects of PFAS on an estuarine fish model, Cyprinodon variegatus. Most field-collected sediment samples contained measurable quantities of PFAS, with PFOS consistently detected as the dominant compound. Field-collected data were used to select five structurally distinct PFAS (PFOS, PFOA, PFNA, PFDA, PFOSA) for a series of graded dose-response studies conducted with environmentally informed aqueous concentrations of individual PFAS (0-44 μg/L) through 6 days post-fertilization. Hatch success, survival, and morphology of newly hatched larvae were evaluated as endpoints. PFAS exposure did not result in mortality; however, compound-specific sublethal effects on development were observed. PFNA and PFOS produced the most pronounced and consistent responses, including increased total length and alterations in energy allocation. In contrast, PFOA, PFOSA, and PFDA elicited weaker or more variable responses, with limited evidence of consistent significant dose-dependent effects. These findings indicate that PFAS can differentially alter developmental processes in estuarine fishes at environmentally informed concentrations, even in the absence of acute toxicity. Moreover, compound-specific effects observed in the present study highlight the importance of considering PFAS as a diverse class of contaminants in ecological risk assessments.
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutritious foods, nutrition education, breastfeeding support, and referrals to low-income women and their children up to age 5. WIC participants' weight is measured and discussed at appointments, creating an opportunity for weight stigma to be transmitted. Weight stigma has recently received attention within the WIC setting because experiencing weight stigma in health care is associated with delays in care and health care avoidance. This study aimed to fill a gap in our understanding of WIC staff's training needs and advice to reduce weight stigma experienced by WIC clients. We conducted semi-structured in-depth qualitative interviews with WIC clinic staff in partnership with the Minnesota Department of Health WIC. The study included 25 staff members across 16 local agencies. We employed a rapid qualitative template analysis to analyze the interviews. Staff sought guidance on how much emphasis to place on weight and wanted to focus on health behavior goals, rather than weight. Staff wanted comprehensive training on weight stigma and practical skills to confidently discuss weight with clients, including across diverse cultural contexts. Finally, staff desired virtual trainings that are WIC-specific and include interactive components. Appropriate training on weight stigma and guidance for how weight should be discussed during appointments can improve the client experience in WIC and, in turn, may improve program retention. Findings from this study will be used to develop a systems-level intervention, including comprehensive workforce training, to address weight stigma at WIC.
Workplace-related ocular injuries (WROI) are a major public health concern, particularly in developing countries where occupational safety measures are often insufficient. This study investigates the epidemiological and clinical characteristics of WROI among Southern Railways employees in India, aiming to improve preventive strategies and workplace safety. This retrospective study was conducted at a tertiary care hospital in South India over a one-year period (January to December 2024). Medical records of 159 railway employees who sustained WROI were reviewed. Data included demographic details, type and cause of injury, visual acuity, use of protective eyewear, time of presentation, and treatment modalities. The study population was predominantly male (95%), with the highest incidence in the age group of 21-40 years (99%). Mechanical injuries (primarily corneal foreign bodies) were more common than nonmechanical injuries (notably radiation-related photokeratitis from welding. Adnexal injuries were observed in 15.2% of cases. Occupations involving welding and grinding accounted for 59.75% of injuries, followed by construction work. Most injuries were unilateral (84.2%), and 81% of patients sought treatment within 24 h. Despite availability, only 16.9% of patients reported using protective eyewear at the time of injury; discomfort and poor visibility were cited as key reasons for noncompliance. At presentation, 89.9% had visual acuity of 6/60 or better. Medical management sufficed in over 95% of cases. Mechanical injuries are the most prevalent, often associated with inadequate use of protective equipment. Improved safety training, better-designed protective gear, and stricter enforcement of safety protocols could significantly reduce the incidence of WROI.
We sought to determine if modified ultrafiltration (MUF) in the current era was associated with improved outcomes after neonatal cardiopulmonary bypass (CPB). Retrospective analysis of the PC4/NEPHRON dataset from 22 centers (2015-18). Neonates were stratified by MUF use and outcomes were compared. Multivariable regression models were adjusted for center use of MUF and high-risk covariates. There were 1,654 neonatal CPB operations, 993 (60%) utilized MUF. MUF was not evenly distributed among centers. Patient characteristics were similar between cohorts with notable exceptions: the MUF cohort had fewer Hispanic neonates, more STAT 5 operations, shorter CPB times, more frequent use of deep hypothermic circulatory arrest and fewer STS preoperative risk factors. The MUF cohort had less fluid accumulation, including in the operating room and at peak postoperative fluid balance. Mortality, duration of invasive ventilation, length of stay and clinically important bleeding were not different between MUF and non-MUF neonates. In multivariable analysis, neonates receiving MUF had a higher likelihood of achieving a first daily negative fluid balance prior to postoperative day 3 (OR 1.98, 95% CI = 1.38-2.84). MUF use was associated with lower early postoperative fluid accumulation. MUF did not result in a significantly shorter duration of invasive ventilation, a shorter length of stay, or lower mortality.