This study investigated environmental and family factors associated with daily television (TV) watching time among children with autism spectrum disorder (ASD) and typically developing (TD) children. The sample included 225 participants (65 ASD, 160 TD) aged 3 to 6 years. Data were obtained through caregiver-reported questionnaires assessing socioeconomic status (SES), indoor play spaces, family interaction during holidays, and daily electronic device usage time excluding television watching time. Regression analysis identified non-television electronic device usage time (p < .001) and indoor space availability (p = .012) as significant factors associated with TV watching time, while SES (p = .095) and family interaction during holidays (p = .072) demonstrated marginal associations. The final regression model demonstrated modest explanatory power (adjusted R² = .11). Children with ASD watched slightly less TV daily (M = 1.88, SD = 1.57 h) than TD children (M = 2.03, SD = 1.26 h). Greater family interaction during holidays was associated with lower TV watching time among children with ASD, suggesting a potential role of structured family engagement in supporting healthier TV watching habits. Lower SES and limited indoor play spaces were associated with longer TV watching time. These findings support existing WHO recommendations regarding limiting screen exposure in young children. This study highlights the potential importance of family involvement and environmental factors in shaping TV watching behaviours, particularly among children with ASD, and supports the need for targeted strategies to encourage healthier media habits.
Pediatric emergency departments are often fast-paced and high-intensity environments designed to deliver urgent medical care. To investigate the effects of playing digital games and watching cartoons on pain, fear, and anxiety levels in children during suture removal in a pediatric emergency unit. The study was conducted with 90 children aged between 5 and 10 years who presented to a hospital emergency department trauma unit for suture removal between July 2024 and April 2025; the children were allocated to the groups: Group 1, digital games (30 children); Group 2, cartoons (30 children); Group 3, control (30 children). Children in the intervention groups played digital games and watched cartoons immediately before the suture removal procedure. An Introductory Information Form, the Child Fear Scale, Wong Baker Pain Scale, and State-Trait Anxiety Inventory for Children were used to collect data. Analysis of pain change scores indicated significant differences between the groups based on evaluations provided by children, parents, and nurses. Change scores were calculated as post-procedure score minus pre-procedure score; negative values indicate a reduction in the outcome following the procedure. In terms of child pain score change, the change in pain scores of children in the control group (0.717 ± 1.381) was found to be significantly higher than that of children who played digital games (-0.833 ± 1.464) and watched cartoons (-0.483 ± 1.669) (F = 8.700, p < 0.001; the control group had significantly higher post-procedure pain than both intervention groups). In terms of child fear score change, the change scores in the control group (-1.733 ± 2.815) were found to be significantly different from that of children who played digital games (-4.300 ± 2.769) and watched cartoons (-2.000 ± 3.129) (F = 7.061, p = 0.001; the digital game group had significantly lower post-procedure fear than the cartoon and control groups). A similar trend was observed in anxiety change scores. The change in child anxiety in the control group (-1.633 ± 2.526) was significantly different from children playing digital games (-4.700 ± 3.019) and children watching cartoons (-1.833 ± 3.435) (F = 9.708, p < 0.001; the digital game group had significantly lower post-procedure anxiety than the cartoon and control groups). Playing digital games was the most effective method for alleviating pain, fear, and anxiety during suture removal. Digital games may be considered a useful non-pharmacological distraction technique for children aged 5-10 years undergoing suture removal in pediatric emergency settings.
To evaluate: (1) patient experiences and perceptions of Patient Watch; and (2) the effect on emergency department (ED) presentations, healthcare use, quality of life and chronic illness care. A prospective longitudinal cohort study using a convergent-parallel mixed methods study design combining: (1) qualitative semi-structured interviews analysed using reflexive thematic analysis and (2) quantitative assessment of Quality of Life-8D, Patient Assessment of Chronic Illness, routinely collected ED clinical data and Patient Watch programme data. A large public health service delivering care across the home, community, aged care and hospital, serving a regional centre and small, medium and large rural towns in Western Victoria, Australia. Forty-five participants were enrolled in the study. A subsample who completed all study requirements enabled baseline and 6-month follow-up analysis (n = 37). Patient Watch, a telehealth case management model of care adapted from a metropolitan to a rural context, to manage the care of frequent presenters to the emergency department. Before enrolment, patients reported health system, medical and situational complexity hindered effective care and contributed to high treatment burden, with acute exacerbations leading to increased healthcare use and negative care experiences. Patient Watch improved perceived care coordination, healthcare access and helped participants manage acute exacerbations. ED presentations (p < 0.001), hospital admissions (p < 0.001), general practitioner (p = 0.02) and specialist visits (p = 0.01) decreased at follow-up. Cohort heterogeneity challenged the effectiveness of a standardised care model, and the evolving nature of Patient Watch complicated impact evaluation. Frequent presenters showed diverse clinical and demographic profiles with high treatment burdens, highlighting the need for tailored care.
High-quality chest compressions are crucial for effective resuscitation, yet maintaining the guideline-recommended rate of 100-120 compressions per minute is challenging, particularly in stressful and noisy prehospital environments. Haptic feedback delivered through wearable technology may offer a reliable alternative to auditory cues by providing tactile rhythm guidance. To evaluate the efficacy of a smartwatch-based haptic feedback system delivering 110 vibrations per minute in improving adherence to the target chest compression rate during simulated adult cardiac arrest, compared with unassisted cardiopulmonary resuscitation (CPR). In this prospective, experimental, simulation-based crossover study, 80 volunteers (paramedic students, intern physicians, emergency medicine residents, and laypersons; n = 20 each) performed one minute of self-paced chest compressions on a Laerdal Little Anne QCPR manikin and, after a five-minute rest, repeated the task with a Samsung Galaxy Watch 5 delivering haptic impulses at 110 bpm. The primary endpoint was the percentage of compressions performed within the 100-120 bpm target range; secondary endpoints were the proportion of participants achieving the target rate and self-reported user experience. The study was designed and is reported in accordance with the Reporting Guidelines for Health Care Simulation Research. Haptic guidance substantially improved the percentage of compressions within the guideline-recommended 100-120 bpm range. The proportion of participants achieving the target compression rate increased from 45.0% at baseline to 93.75% with smartwatch-assisted feedback (McNemar test, p < 0.001). The mean percentage of compressions delivered within the target range rose from 43.55% during unassisted CPR to 90.71% with haptic guidance, and significant within-group improvements were observed across all four professional cohorts. Participant experience was highly positive: 93.75% endorsed the device for real-world clinical use, 95.00% found it useful for CPR training, and 95.00% expressed willingness to use it again. A smartwatch-based haptic metronome significantly improved adherence to the guideline-recommended chest compression rate across all experience levels. Given its high user acceptability and resilience to environmental noise, this wearable technology may provide a practical, low-cost adjunct to improve CPR quality in both training and prehospital settings.
Atrial fibrillation (AF) increases the risk of stroke and heart failure, yet accurate quantification of AF burden in daily life remains difficult. Although smartwatch photoplethysmography (PPG) supports continuous monitoring, complex rhythms and signal noise can impair burden estimation. We developed an AI-enhanced dual-modal framework that combines continuous watch-based PPG (W-PPG) with intermittent single-lead watch-based ECG (W-ECG). A hybrid convolutional neural network-long short-term memory model uses high-fidelity W-ECG segments as dynamic anchors to correct long-term W-PPG classifications. In this prospective validation study, 1,054 patients with AF undergoing catheter ablation (mean age, 62.1 years) were evaluated against patch-based ECG as the reference standard. After ECG-based correction, the system achieved 98.60% sensitivity and 99.27% specificity. The mean absolute percentage error of AF burden decreased by 23.4%, from 1.11% to 0.85%, while the Pearson correlation remained 0.9988. This dual-modal approach offers a scalable and clinically practical solution for long-term AF monitoring, improving burden estimation beyond PPG-only devices without requiring continuous multi-lead ECG. It may support personalized AF management and large-scale cardiovascular screening in real-world settings. (NCT06552468).
Whale watching is frequently presented as a benign form of wildlife interaction, yet its ethical and ecological acceptability depends on two conditions: vessel practices must minimize disturbance to free-ranging cetaceans, and tours must provide meaningful conservation-oriented education. This study assessed whale-watching operations in the New York City Metropolitan Area using three complementary frameworks: the Whale SENSE "On the Water" evaluation, the World Cetacean Alliance (WCA) Best Practice Guidance, and a Higher-Order Thinking Skills (HOTS) framework for interpretation. Eight trips representing the active full-time commercial sector in the study area were observed between May and November 2022. The results have revealed that certified operators generally performed better than uncertified operators, but the difference was not large enough to demonstrate that certification alone ensured welfare-protective practice. Educational content was often present but shallow, with limited discussion of cetacean threats, conservation measures, and legal protections, while higher-order engagement and multilingual accessibility were notably weak. Vessel behavior showed a similar pattern: certified operators achieved higher average scores, yet close approaches, inconsistent adherence to conservative speed and maneuvering guidance, and occasional unacceptable practices were still recorded. Overall, some operations still expose whales to avoidable disturbance and fail to meet the educational standards that give ecotourism its conservation value. Responsible whale watching should therefore be evaluated not only by whether vessels find whales and satisfy tourists, but also by whether operators demonstrably protect animal welfare and cultivate informed conservation attitudes. As such, this study offers a regionally novel benchmark for future comparative research, management evaluation, and the development of more responsible cetacean ecotourism.
Sleep bruxism (SB) is sleep-related movement disorder potentially affecting sleep architecture. This exploratory pilot study evaluated smartwatch-derived sleep estimates in young adults with a probable SB phenotype versus controls. In this cross-sectional study, 30 age- and sex-matched participants (18-50 years) were evaluated. The probable SB phenotype was defined by a triple-validations approach consisting of combined self report and clinical signs agreed upon by two clinicians. Controls were age- and sex-matched. Sleep estimates were recorded at home for 7 consecutive nights using a consumer-grade smartwatch (Apple Watch Series 8); nights with < 240 min of recorded sleep or substantial signal loss were excluded and repeated. Group comparisons used appropriate parametric/nonparametric tests and effect sizes (Cohen's d). Participants were analyzed (15 in probable SB group, 15 controls; 86.7% female in each). Total sleep time and light sleep estimates did not differ between groups. Compared with controls, the probable SB group had significantly reduced estimated durations of REM sleep (82.7 ± 18.9 vs. 111.5 ± 17.2 min; p < 0.001; d = 1.59) and deep sleep (49.1 ± 9.8 vs. 60.7 ± 6.9 min; p < 0.001; d = 1.37), with greater device-estimated sleep fragmentation (WASO median 27.0 vs. 3.0 min; p < 0.001; awakenings median 5 vs. 1; p < 0.001). Awakenings correlated positively with wake duration (r = 0.898) and negatively with REM duration (r = - 0.573) (both p < 0.001). Individuals with probable SB exhibited altered device-estimated sleep patterns, featuring reduced deep/REM sleep and increased fragmentation. Consumer wearables may offer exploratory, adjunctive data on sleep continuity in dental practice but cannot replace physiological sleep staging. Findings warrant confirmation with concurrent polysomnography. ClinicalTrials.gov; Registration No: NCT07453121. 25/02/2026.
Consumer smartwatches can provide longitudinal peripheral oxygen saturation (SpO2) estimates for wellness purposes, but there is limited evidence that they can be used to monitor respiratory disease. In this study, we described a 52-year-old man with fibrotic hypersensitivity pneumonitis who developed exertional hypoxemia, which progressed radiologically and led to functional decline. Systemic corticosteroids improved his symptoms, imaging, and lung function. The monthly mean Apple Watch SpO2 dropped from 95.7% to 94.4% within 3 months of the worsening and recovered to 96.5% 4 weeks after corticosteroid initiation. Daily-life SpO2 trends from smartwatches may be useful for monitoring respiratory diseases.
Naturalistic paradigms offer a powerful tool to investigate human brain function, but it remains difficult to link rich, continuous movie content to distributed brain activity in an interpretable way. In this study, I use a multimodal large language model (Gemini) as an automated "semantic annotator" to bridge naturalistic movie stimuli, brain responses, and cognitive performance. Using the Human Connectome Project movie-watching dataset, I segmented the film into 293 overlapping clips, prompting Gemini to rate each clip on 11 psychologically interpretable dimensions. Simultaneously, I extracted clip-wise BOLD activation patterns from the fMR images in 360 cortical ROIs. In this way, the AI and the brain effectively "watch" the same movies in parallel. For each brain ROI, I then fit linear regression models to predict clip-to-clip variation in movie-evoked responses from these features. Gemini-derived features robustly predicted movie-evoked responses in temporal, medial parietal, and lateral frontal association cortex, but explained little variance in unimodal somatosensory, dorsal parietal, insular, and piriform regions. Feature-weight maps reflected known functional specializations, and features with the largest global influence overlapped with the most explainable ROIs. Partial least squares analysis revealed that individual differences in resting-state connectivity strength and semantic explainability covaried along an asymmetric intrinsic axis: strongly integrated sensory-opercular systems at rest were associated with poorer AI predictability, whereas a smaller set of dorsal and medial association regions showed enhanced alignment. Finally, regional AI explainability in medial parietal and left perisylvian association areas was positively related to specific cognitive abilities. Together, these findings demonstrate that interpretable features from AI models provide a simple and scalable framework for quantifying AI-derived semantic predictability in naturalistic settings, offering a practical framework for utilizing artificial models as semantic references to probe human neural processing and individual differences.
Young children are taught primarily by stories, and many popular stories have gone digital. The aim of these stories is to teach children concepts that they can later apply to their own lives. Despite this, children often exhibit minimal learning after one-time exposure without additional help. Based on the propositions in Fisch's capacity model about children's information processing of educational narratives, this project investigates a simple instructional design intervention of adding structured previews ("advance organizers") at the beginning of two different commercially available digital narratives to manage children's essential processing. A total of 123 preschool-aged U.S. children (Mage = 52.33 months, 52% female, 74% White) were randomly assigned to one of three conditions: no advance organizer, an advance organizer about the overarching lesson, or an advance organizer about the plot. Children watched a prosocial digital narrative about sharing (Session 1) and watched a science, technology, engineering, and mathematics digital narrative about using a pan balance roughly 2 weeks later (Session 2). Linear mixed-effect models revealed that the efficacy of the advance organizers varied based on children's cognitive capacity or working memory. Children with lower cognitive capacity benefited more from a plot-focused advance organizer than a lesson-focused advance organizer, but children with more cognitive capacity benefited more from a lesson-focused advance organizer than a plot-focused advance organizer. The results have theoretical implications for the propositions put forth by information-processing approaches, as well as equity-minded implications about the design of children's digital narrative content. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
We provide a multimodal naturalistic neuroimaging dataset (NNDb-3T+), designed to support the study of brain function under both naturalistic and controlled experimental conditions. The dataset includes high-quality 3 T fMRI data from 40 participants acquired during full-length movie-watching and somatotopic, retinotopic, and tonotopic sensory mapping tasks. Each participant also completed synchronised eye-tracking during movie-watching and retinotopic mapping tasks, physiological recordings, and a battery of behavioural and cognitive assessments. Data were collected across two MRI sessions and a remote testing session, with all data organised in a BIDS-compliant format. Technical validation confirms high data quality, with minimal head motion, accurate eye-tracker calibration, and robust task-evoked activation patterns. The dataset provides a unique resource for investigating individual differences, functional topographies, multimodal integration, and naturalistic cognition. All raw and preprocessed data, quality metrics, and preprocessing scripts are publicly available to support reproducible research.
Conflicts of interest (CoI) can undermine trust in scientific publishing, yet empirical evidence on how often CoI lead to editorial action and how journals respond remains limited. This study aimed to characterise the frequency, patterns, and editorial handling of CoI‑related notices in the scholarly literature using an openly available, multidisciplinary dataset. We conducted a descriptive cross‑sectional analysis of publicly available records from the Retraction Watch (RW) database, accessed via Crossref, from inception to 23 April 2026. All editorial notices in which CoI was explicitly mentioned as the sole or one of several stated reasons were included, encompassing retractions, corrections, expressions of concern, and reinstatements. For each record, we extracted article and notice dates, article type, scientific field, country of the corresponding author, number of authors and institutions, publisher, and all stated reasons for the notice. Data were analysed using descriptive statistics and bootstrap‑based confidence intervals. We identified 886 CoI‑related records (748 retractions, 39 corrections, 97 expressions of concern, and 2 reinstatements). CoI was the sole stated reason in 95 cases (10.7%), including 32 retractions, 11 corrections, and 52 expressions of concern; in the remaining notices, CoI most commonly co‑occurred with concerns such as compromised peer review, authorship or affiliation problems, journal or institutional investigations, and broader ethical violations. The median time from publication to editorial action was longest for expressions of concern and shortest for corrections, with wide variability across records and notice types. CoI‑related notices were concentrated in basic life, biomedical, and health sciences, and were unevenly distributed across high‑output countries and a small number of large publishers, particularly open‑access outlets. Most affected articles were original research papers with multi‑author, multi‑institution teams. Among articles with determinable author gender, both first and last authors were more often male than female, although these patterns were exploratory and lacked a baseline comparator. Editorial actions explicitly linked to CoI remain relatively uncommon compared with the broader volume of retractions and corrections, and CoI are rarely cited in isolation. The frequent co‑occurrence of CoI with other forms of misconduct or procedural problems suggests that undisclosed or poorly managed CoI often signal deeper weaknesses in disclosure practices, editorial oversight, and research governance rather than isolated administrative lapses. Strengthening CoI policies, transparency, verification mechanisms, and linked metadata systems may help detect problems earlier and support more consistent, graduated editorial responses.
The maintenance of long-term contaminant monitoring programs, which are critical tools for establishing and providing the historical baselines necessary to guide future management and research efforts, faces inherent challenges related to evolving management priorities, budgetary constraints, variable end-user needs, and the dynamic nature of the systems in which they operate. This short communication explores these difficulties, proposes adaptive strategies, and highlights the National Oceanic and Atmospheric Administration's (NOAA) 40-year continuous national contaminant monitoring initiative, the National Mussel Watch Program (MWP), as a principal case study. We identify and discuss three adaptive strategies to ensure the continued applicability and longevity of such programs: (1) emphasizing stakeholder engagement; (2) refining data collection, evaluation, and analysis; and (3) ensuring data accessibility. Through the implementation of these adaptive measures, long-term contaminant monitoring programs, such as the MWP, can continue to fulfill programmatic mandates, serve as the provider of applicable baseline contaminant data, navigate shifts in contaminant monitoring priorities, and tailor data products to best meet the present and future needs of managers and stakeholders.
Locally advanced rectal cancer (LARC) is a common malignant tumor in the digestive system. Currently, despite growing recognition of personalized medicine, systematic risk stratification and full incorporation of patient preferences for anal preservation and treatment tolerance remain challenging in some clinical settings. This review summarizes the latest clinical research progress on the watch-and-wait (W&W) strategy for LARC, including the applicable population of W&W, the factors predicting tumor regression, and the methods to increase the W&W rate. By synthesizing the current evidence, this review aims to inform clinical decision-making and advance the practice of evidence-based precision medicine.
This study presents current data on POP levels in the soft tissues of Mytilus galloprovincialis from the Sochi River estuary on the Russian Black Sea coast. Our results revealed a predominance of degradation products (β-HCH, DDE, and DDD), indicating the long-term environmental persistence of these substances. However, the presence of parent pesticide compounds (lindane, o,p'-DDT, and p,p'-DDT) in some samples could suggest a possible recent local influx. Among PCBs, highly chlorinated congeners (PCBs 118, 153, and 138) were prevalent, implying a historical contribution of these xenobiotics. Significant intersex differences in ∑PCB accumulation were found, with males accumulating higher levels than females, which may be attributed to reproductive traits and the elimination of lipophilic compounds with gametes. An inverse relationship between mussel shell size and ∑PCB tissue concentrations was established, attributable to the growth dilution effect in actively growing young individuals. A comparative analysis showed that current POP levels in the study area are lower than the historical maxima recorded in the Black Sea in the late 20th century. However, the contaminant profile, characterized by a high proportion of HCH isomers, differs from those typical of other contemporary Black Sea studies (e.g., in Bulgaria and Turkey), where DDT metabolites dominate. This mixed profile shows a qualitative resemblance to findings from some developing nations in the Asia-Pacific region, although cross-study comparisons are complicated by methodological differences. These findings underscore the necessity for further monitoring of POPs in this area and highlight the need for wider spatial surveys along the Russian Black Sea coast.
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In 2026, a large number of clinical trials are underway for patients with systemic lupus erythematosus (SLE). In addition to multiple registration trials, several others, which we highlight here, target novel mechanisms that may yield insights into disease pathogenesis.
We compared the heart rate (HR) measurement accuracy of commercially available PPG-based wearable devices against an ECG-based reference device across different exercise intensities. Forty healthy young adults were recruited, and data from 37 participants were analyzed. HR was simultaneously measured using Polar H10 as the ECG-based reference and four PPG-based devices: Polar Verity Sense, Polar Pacer Pro, Apple Watch SE, and Galaxy Watch 6. Participants completed low-, moderate-, and high-intensity treadmill exercise. Accuracy was assessed using mean absolute error (MAE), mean absolute percentage error (MAPE), Lin's concordance correlation coefficient (CCC), and Bland-Altman analysis. MAE and MAPE generally decreased as intensity increased. Significant differences in MAE were observed among the devices across intensities (p = 0.002). The Polar Verity Sense and Apple Watch SE showed significantly lower MAE than the Polar Pacer Pro and Galaxy Watch 6. During low-intensity exercise, the Apple Watch SE showed lower MAE than the Polar Pacer Pro and Galaxy Watch 6, whereas during high-intensity exercise, the Polar Verity Sense showed lower MAE than the Galaxy Watch 6. CCC values increased with exercise intensity and were consistently higher for the Polar Verity Sense and Apple Watch SE. Bland-Altman analysis showed narrower limits of agreement for the Apple Watch SE and Polar Verity Sense. HR measurement accuracy differed substantially among the PPG-based wearable devices. The Apple Watch SE and Polar Verity Sense showed the highest agreement with the ECG-based reference, suggesting that wearable HR data should be interpreted based on device-specific validation.
Digital remote monitoring technologies, including smartphones and wearables, offer promising avenues for early detection of psychosis relapse. However, selecting devices that are acceptable to participants and produce high-quality data remains challenging. The aim of this nested pilot study was to assess the acceptability and data quality of 3 commercially available wearable devices in people with psychosis recruited to the CONNECT cohort study. Participants recruited to the CONNECT study before July 31, 2024, were included in the pilot study and selected 1 of 3 wearable devices: a Fitbit Charge 5, Samsung Galaxy Watch 5, or Apple Watch SE. Baseline demographics were compared between device groups. Acceptability of devices to participants was assessed through a Wearable Device Satisfaction Questionnaire after 3 months of use, with the proportion of positive responses to each question calculated and compared. Data completeness was also assessed by calculating the number (and percentage) of valid days of step count, heart rate, and sleep data, and comparing between groups. Data quality was assessed through summarizing the amount of troubleshooting required, additional metrics available from the wearables, and continuity of data completeness by calculating the proportion of participants with at least 3 days of heart rate data per week for the first 20 weeks of follow-up. Predefined criteria were used to determine the next steps for the wider CONNECT study: if one device was superior, this would be selected; if none were found to be superior and the Fitbit was found to be noninferior, then Fitbit would be retained. Of the first 107 participants recruited to CONNECT, 105 were included in the pilot study evaluation. The Samsung Galaxy Watch was selected most frequently by participants (46/105, 43.8%), followed by the Apple Watch (27/105, 25.7%), and Fitbit Charge (23/105, 21.9%). Differences in participant demographics were observed across device groups. Self-reported acceptability after use did not differ substantially between devices. However, in terms of data completeness, the median proportion of valid heart rate data days was significantly lower for Samsung Galaxy (median 31.2%, IQR 8.5%-46.0%) compared to Fitbit (median 80.1%, IQR 26.7%-95.0%; P=.003) and Apple Watch (median 49.3%, IQR 21.5%-86.0%; P=.02). There was no significant difference between Fitbit and Apple Watch. Similar patterns were observed for step count and sleep data. The Samsung Galaxy Watch required more frequent troubleshooting for data flow issues and lacked additional physiological metrics, available from the other devices. Due to comparatively lower data quality and technical performance, the Samsung Galaxy Watch was discontinued for use in the subsequent phase of the CONNECT study. The study highlights the importance of incorporating nested evaluations of devices in long-term research.
Investigation of factors associated with antimicrobial drug prescription (ADP) in cats receiving outpatient care is lacking, which limits antimicrobial stewardship efforts and benchmarking of veterinary antimicrobial use. This study aimed to identify factors associated with ADP in cats receiving outpatient care at a veterinary teaching hospital. A retrospective analysis of electronic medical record data from cats receiving outpatient care at a veterinary teaching hospital in 2022 was performed. Subjects included 2,245 cats with 3,973 outpatient visits. The primary study outcome was receipt of systemic ADP during or immediately following an outpatient visit; an exploratory outcome was receipt of a "Watch" or "Reserve" (WR) ADP using the World Health Organization (WHO) Access-Watch-Reserve (AWaRe) classification adapted to include veterinary agents. Independent variables including patient demographics, hospital service, and owner sociodemographic factors were identified for model fitting using univariable logistic regression; multivariable models were built using generalized estimating equations. 9.2% of outpatient visit records (367/3,973) were associated with ≥1 ADP. Factors significantly associated with receipt of ADP included patient sex, hospital service visited, veterinarian training status, visit duration, and urine culture performed. Among patients receiving any antimicrobial, factors associated with receipt of WHO-WR ADP included hospital service, visit date, receipt of >1 ADP, and history of a visit to any hospital service within the prior month. These findings expand our understanding of antimicrobial usage in cats. This knowledge identifying factors associated with antimicrobial use can be used to refine local prescribing practices and supports the development of veterinary and One Health antimicrobial stewardship initiatives and veterinary antimicrobial use benchmarking metrics.