Improving Clinician's Knowledge and Comfort with Prenatal and Postpartum Employment Laws: A Pilot Intervention.

Background: It is common for pregnant people in the United States to continue to work throughout their pregnancy. Pregnant people may need leave time or other accommodations to continue working safely. It is imperative that obstetric providers are knowledgeable regarding laws that govern the prenatal and postpartum period to provide appropriate counseling and medical documentation in support of requests for leave time and workplace accommodations. Methods: We created a virtual training for obstetric clinicians regarding employment considerations in the prenatal and postpartum period. The training details the federal laws that govern this period, when and how to request reasonable accommodations from an employer, and provides resources for clinicians to use when they believe pregnancy-related discrimination has occurred. We conducted pretest and post-test surveys to assess change in knowledge about employment laws and comfort with counseling patients. Results: There were 61 clinicians who completed the training (50.4% response rate). The majority (88%, n = 54) of respondents reported no prior formal training about employment laws in pregnancy. On the pretraining self-assessment, >93% (n = 57) of participants felt they had minimal or very minimal knowledge regarding lactation and pregnancy-related accommodations, compared with >91% (n = 55) feeling very or somewhat knowledgeable after the training. The mean percent correct on the knowledge assessment increased from 55% to 67% on the pre- and post-test knowledge questions, respectively. Discussion: Our findings suggest an on-demand virtual training can improve knowledge and comfort for obstetric clinicians about federal employment laws in pregnancy and postpartum.

Comparison of the Mineral Profile of Two Types of Horse Diet, Silage and Commercial Concentrate, and Their Impacts on Hoof Tensile Strength.

The type of diet that a horse consumes is one of the most important factors determining the mineral profile and tensile strength of its hooves, so the quality and nutritional value of the supplied feed are fundamental to achieving satisfactory hoof quality. The objective of this study was to compare the differences in the mineral concentrations of sodium (Na), potassium (K), magnesium (Mg), zinc (Zn), and Iron (Fe) between two diets, namely silage and a commercial concentrate, using atomic absorption spectrometry and to determine which led to higher increases in the hoof tensile strength of horses consuming these diets. Thirty-two Spanish horses were randomly divided into two groups, where the diet of the horses in group 1 was silage oat hay, and that of the horses in group 2 was a commercial concentrate and oat hay. Both diets were provided for 12 months. The hoof tensile strength was then measured using an Instron universal testing machine. Mg and Fe levels were higher (p < 0.05) in the silage than in the commercial concentrate, and hoof Mg, Zn, K, and tensile strength were also influenced by the hormonal stage (p < 0.05). The type of diet directly affected the hoof Mg, Zn, K, Na, and tensile strength (p < 0.05), which Mg, K and Na were higher in horses fed with concentrate. It was found that for each unit of Zn (µg/g and Na (µg/g)), in the hoof, the tensile strength is affected by −0.10 N/mm2 and −0.003 N/mm2, respectively for each mineral.

Standardizing, harmonizing, and protecting data collection to broaden the impact of COVID-19 research: the rapid acceleration of diagnostics-underserved populations (RADx-UP) initiative.

OBJECTIVE: The Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) program is a consortium of community-engaged research projects with the goal of increasing access to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) tests in underserved populations. To accelerate clinical research, common data elements (CDEs) were selected and refined to standardize data collection and enhance cross-consortium analysis. MATERIALS AND METHODS: The RADx-UP consortium began with more than 700 CDEs from the National Institutes of Health (NIH) CDE Repository, Disaster Research Response (DR2) guidelines, and the PHENotypes and eXposures (PhenX) Toolkit. Following a review of initial CDEs, we made selections and further refinements through an iterative process that included live forums, consultations, and surveys completed by the first 69 RADx-UP projects. RESULTS: Following a multistep CDE development process, we decreased the number of CDEs, modified the question types, and changed the CDE wording. Most research projects were willing to collect and share demographic NIH Tier 1 CDEs, with the top exception reason being a lack of CDE applicability to the project. The NIH RADx-UP Tier 1 CDE with the lowest frequency of collection and sharing was sexual orientation. DISCUSSION: We engaged a wide range of projects and solicited bidirectional input to create CDEs. These RADx-UP CDEs could serve as the foundation for a patient-centered informatics architecture allowing the integration of disease-specific databases to support hypothesis-driven clinical research in underserved populations. CONCLUSION: A community-engaged approach using bidirectional feedback can lead to the better development and implementation of CDEs in underserved populations during public health emergencies.

Preoperative level of neutrophil-lymphocyte ratio: Comparison between cyanotic and acyanotic congenital heart disease.

INTRODUCTION: Elevated neutrophil-lymphocyte ratio (NLR) has been associated with poorer outcomes in children undergoing congenital heart surgery under cardiopulmonary bypass (CPB). OBJECTIVE: To compare preoperative NLR levels between cyanotic and acyanotic children undergoing surgical repair with CPB. METHODS: We performed a retrospective cohort study in 60-paired children (30 with tetralogy of Fallot [TOF] and 30 with ventricular septal defect [VSD]) between January 2018 and December 2019 matched by age, weight, and gender. Preoperative NLR was measured from the last complete blood count test before the surgery. All of them had negative viral screening. RESULTS: The median age in VSD children was 9.5 months (interquartile range [IQR]: 5-12), weight 7 kg (IQR: 5.5-8.7), 19 (63%) was female, and NLR was 0.45 (IQR: 0.3-0.65). The median age in TOF children was 8.5 months (IQR: 5-12), weight 7.6 kg (IQR: 5.8-8.7), 16 (53%) were female, and NLR was 0.67 (IQR: 0.41-1.1). Demographic parameters did not show any statistically significant difference between groups (p > .05). Children with TOF had higher preoperative NLR compared with VSD patients (p = .004). As lower O2 saturation as higher the NLR (p = .005). CONCLUSION: The preoperative level of NLR was higher in cyanotic congenital heart disease patients.

Preliminary Study on the Connection Between the Mineral Profile of Horse Hooves and Tensile Strength Based on Body Weight, Sex, Age, Sampling Location, and Riding Disciplines.

Hoof mineral profile is important as it could affect locomotion. Factors such as body weight, sex, age, and riding disciplines affect hoof mineral profile. In Mexico and globally, studies are needed on the characterization of mineral profile of hooves and tensile strength, as this could help to prevent overgrowth or microfractures. Therefore, in the present survey, 165 samples of equine hoof cuttings from different sex, ages, breeds, and riding disciplines from different regions of Mexico were analyzed for their mineral composition, and a universal testing machine was used to measure tensile strength. More than half of the samples were from males (63%) and aged 3 to 5 years (52%). Most samples were obtained from horses used for reproduction (36%) and working (29%) purposes. The most preponderant minerals were K (3,416 µg/g), Na (2,242 µg/g), and Ca (631 µg/g). Tensile strength ranged from 1.2 to 45 N. Females had higher (P < 0.05) amounts of Zn than males. Animals younger than 3 years old have lower (P < 0.05) levels of Na than those between 3 and 5 years old. Horses used for reproduction had lower (P < 0.05) Mg concentrations than animals used for running and working. Tensile strength was similar between demographic characteristics. Horses from Santa Gertrudis military ranch had higher (P < 0.05) levels of Ca, Se, and Na compared with horses from other sampling location. Copper was higher (P < 0.05) in horses from racecourse. Potassium was higher (P < 0.05) in horses from the Presidential General Staff. Overall, there was no evident connection between sex, ages, breeds, and riding disciplines from different regions of Mexico and the mineral composition of the hoof or its tensile strength. Further research should focus on the relation on specific feeding regimes, horse individual characteristic, hoof mineral contents, and tensile strength.