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Objective: The objective of this study was to compare maternity leave satisfaction between physicians and nonphysicians. Currently, paid maternal leave is not guaranteed in the United States, resulting in palpable dissatisfaction among parents. Previous studies have shown associations between length of paid leave and career satisfaction and maternal happiness. Materials and Methods: A Qualtrics® electronic survey was distributed to female professionals through email and social media from April 2019 to March 2020. Inclusion criterion was ≥1 child by birth or adoption, or active pregnancy. Continuous and categorical data were analyzed using two-sample t-test and chi-square, respectively. Results: Of 808 respondents, 77% were physicians. Mean age at birth/adoption of first child was higher in physicians versus nonphysicians (32.1 years vs. 29.7 years; p < 0.001). Physicians took shorter maternity leave than nonphysicians (10.9 weeks vs. 12.0 weeks, p = 0.017) with half of that time paid by employers (5.4 weeks vs. 5.9 weeks, p = 0.2). Dissatisfaction was high among physicians (85.1%) and nonphysicians (92.4%) that correlates with maternity leave compensation dissatisfaction (49% vs. 71.3%, p < 0.001). Thirty-four percent of physicians versus 41% of nonphysicians stated that their health was negatively impacted by maternity leave length. Physicians and nonphysicians reported similar incidences of depression, and breastfeeding, delivery, and other postpartum complications. When queried, 38.8% of physicians and 57% of nonphysicians said they would desire >16 weeks of paid maternity leave (p < 0.001). Conclusions: In conclusion, dissatisfaction among professional women on maternity leave duration and compensation is high in the United States. Given health implications for both mother and child, this should invite further discussion and changes. [ABSTRACT FROM AUTHOR]

Contends that early childhood educators need to understand how exposure to computers and constructive computer programs affects the development of children. Specifically examines: (1) research on children's technology experiences; (2) determining best practices; and (3) addressing educators' concerns about computers replacing other developmentally appropriate activities, difficulty levels, social effects, student control, and stifled creativity; and (4) teacher role. (SD)

Histone deacetylase 3 (HDAC3) contributes to the regulation of gene expression, chromatin structure, and genomic stability. Because HDAC3 associates with oncoproteins that drive leukemia and lymphoma, we engineered a conditional [...]

Many doctors how work in a hospital do not discuss medical errors during morbidity and mortality conferences, according to doctors who observed 332 conferences. Surgery conferences were much more likely to discuss medical errors than internal medicine conferences. Morbidity and mortality conferences are often held every day, where groups of doctors discuss a particular case.

Introduction: Barriers to research participation by racial and ethnic minority group members are multi-factorial, stem from historical social injustices and occur at participant, research team, and research process levels. The informed consent procedure is a key component of the research process and represents an opportunity to address these barriers. This manuscript describes the development of the Strengthening Translational Research in Diverse Enrollment (STRIDE) intervention, which aims to improve research participation by individuals from underrepresented groups. Methods: We used a community-engaged approach to develop an integrated, culturally, and literacy-sensitive, multi-component intervention that addresses barriers to research participation during the informed consent process. This approach involved having Community Investigators participate in intervention development activities and using community engagement studios and other methods to get feedback from community members on intervention components. Results: The STRIDE intervention has three components: a simulation-based training program directed toward clinical study research assistants that emphasizes cultural competency and communication skills for assisting in the informed consent process, an electronic consent (eConsent) framework designed to improve health-related research material comprehension and relevance, and a "storytelling" intervention in which prior research participants from diverse backgrounds share their experiences delivered via video vignettes during the consent process. Conclusions: The community engaged development approach resulted in a multi-component intervention that addresses known barriers to research participation and can be integrated into the consent process of research studies. Results of an ongoing study will determine its effectiveness at increasing diversity among research participants. [ABSTRACT FROM AUTHOR]

Introduction: The updated common rule, for human subjects research, requires that consents "begin with a 'concise and focused' presentation of the key information that will most likely help someone make a decision about whether to participate in a study" (Menikoff, Kaneshiro, Pritchard. The New England Journal of Medicine. 2017; 376(7): 613–615.). We utilized a community-engaged technology development approach to inform feature options within the REDCap software platform centered around collection and storage of electronic consent (eConsent) to address issues of transparency, clinical trial efficiency, and regulatory compliance for informed consent (Harris, et al. Journal of Biomedical Informatics 2009; 42(2): 377–381.). eConsent may also improve recruitment and retention in clinical research studies by addressing: (1) barriers for accessing rural populations by facilitating remote consent and (2) cultural and literacy barriers by including optional explanatory material (e.g., defining terms by hovering over them with the cursor) or the choice of displaying different videos/images based on participant's race, ethnicity, or educational level (Phillippi, et al. Journal of Obstetric, Gynecologic, & Neonatal Nursing. 2018; 47(4): 529–534.). Methods: We developed and pilot tested our eConsent framework to provide a personalized consent experience whereby users are guided through a consent document that utilizes avatars, contextual glossary information supplements, and videos, to facilitate communication of information. Results: The eConsent framework includes a portfolio of eight features, reviewed by community stakeholders, and tested at two academic medical centers. Conclusions: Early adoption and utilization of this eConsent framework have demonstrated acceptability. Next steps will emphasize testing efficacy of features to improve participant engagement with the consent process. [ABSTRACT FROM AUTHOR]

Objective: To discuss the study design and data analysis for three‐phase interrupted time series (ITS) studies to evaluate the impact of health policy, systems, or environmental interventions. Simulation methods are used to conduct power and sample size calculation for these studies. Methods: We consider the design and analysis of three‐phase ITS studies using a study funded by National Institutes of Health as an exemplar. The design and analysis of both one‐arm and two‐arm three‐phase ITS studies are introduced. Results: A simulation‐based approach, with ready‐to‐use computer programs, was developed to determine the power for two types of three‐phase ITS studies. Simulations were conducted to estimate the power of segmented autoregressive (AR) error models when autocorrelation ranged from −0.9 to 0.9 with various effect sizes. The power increased as the sample size or the effect size increased. The power to detect the same effect sizes varied largely, depending on testing level change, trend changes, or both. Conclusion: This article provides a convenient tool for investigators to generate sample sizes to ensure sufficient statistical power when three‐phase ITS study design is implemented. [ABSTRACT FROM AUTHOR]

Outcomes: 1. Learn about the Massachusetts Medical Schools' Collaborative's toolbox of educational competencies and curriculum mapping in serious illness communication, with examples on using the tools to improve curricula at each school 2. Generate ideas and strategies for developing educational activities at your own institution that promote learners' acquisition of palliative care skills, regardless of their future discipline All clinicians require a sophisticated set of serious illness communication (SIC) skills to ensure high-quality, humanistic care for patients and families from diverse communities as they face life-changing medical decisions at vulnerable times in their lives. However, most clinicians are not trained in SIC and, as former students, learned these concepts "on the fly" or in electives. The Massachusetts Medical Schools' Collaborative was created to change this paradigm and ensure all students receive foundational SIC training. The collaborative includes faculty, administrators, and students from four schools (Boston University School of Medicine, Harvard Medical School, Tufts University School of Medicine, and UMass Chan Medical School) and is convened by the Massachusetts Coalition for Serious Illness Care, a group of over 125 member organizations focused on equity in serious illness care. Our collaborative seeks to develop longitudinal, developmentally based curricula in SIC. We first developed and published five educational SIC competencies. We then created a standardized curriculum mapping process to understand existing educational activities across schools and opportunities to fill gaps defined by the competencies. The collaborative also conducted focus groups with 50 fourth-year medical students; among key themes, students viewed SIC as essential, yet described their exposure as based mostly on "luck" if they were included in family meetings or coached on SIC. Armed with the competencies, curricular mapping, and focus group data, leaders at each school are expanding curricula in SIC and palliative care based on local needs and resources. Presenters will use most of the session to share concrete examples of curriculum design and implementation based on the collaborative's toolbox, which will be available for participants to bring to their own institutions. As a field, we can make this critical investment in the next generation of clinicians and create educational best practices to help build more trustworthy, equitable healthcare systems. [ABSTRACT FROM AUTHOR]

Marine alginates are well established in wound management. Compared with different modern wound dressings, marine alginates cannot prove superior effects on wound healing. Alginates from bacteria have never been studied for medical applications so far, although the microbial polymer raises expectations for improved binding of wound factors because of its unique O-acetylation. Due to its possible positive effects on wound healing, alginates from bacteria might be a superior future medical product for clinical use. To prove the binding capacity of microbial alginates to pathophysiological factors in chronic wounds, we processed microbial alginate fibres, produced from fermentation of the soil bacterium Azotobacter vinelandii ATCC 9046, into needle web dressings and compared them with commercial dressings made of marine alginate. Four dressings were assessed: Marine alginate dressings containing either ionic silver or zinc/manganese/calcium, and microbial alginate dressings with and without nanosilver. All dressings were tested in an in vitro approach for influence on chronic wound parameters such as elastase, matrix metalloproteases-2, tumour necrosis factor-α, interleukin-8, and free radical formation. Despite the alginate origin or addition of antimicrobials, all dressings were able to reduce the concentration of the proinflammatory cytokines TNF-α and IL-8. However, microbial alginate was found to bind considerable larger amounts of elastase and matrix metalloproteases-2 in contrast to the marine alginate dressings. The incorporation of zinc, silver or nanosilver into alginate fibres did not improve their binding capacity for proteases or cytokines. The addition of nanosilver slightly enhanced the antioxidant capacity of microbial alginate dressings, whereas the marine alginate dressing containing zinc/manganese/calcium was unable to inhibit the formation of free radicals. The enhanced binding affinity by microbial alginate of Azotobacter vinelandii to pathophysiological factors may be interesting to support optimal conditions for wound healing. [ABSTRACT FROM AUTHOR]

Summary Bromodomain and extra-terminal domain (BET) family inhibitors offer an approach to treating hematological malignancies. We used precision nuclear run-on transcription sequencing (PRO-seq) to create high-resolution maps of active RNA polymerases across the genome in t(8;21) acute myeloid leukemia (AML), as these polymerases are exceptionally sensitive to BET inhibitors. PRO-seq identified over 1,400 genes showing impaired release of promoter-proximal paused RNA polymerases, including the stem cell factor receptor tyrosine kinase KIT that is mutated in t(8;21) AML. PRO-seq also identified an enhancer 3′ to KIT. Chromosome conformation capture confirmed contacts between this enhancer and the KIT promoter, while CRISPRi-mediated repression of this enhancer impaired cell growth. PRO-seq also identified microRNAs, including MIR29C and MIR29B2 , that target the anti-apoptotic factor MCL1 and were repressed by BET inhibitors. MCL1 protein was upregulated, and inhibition of BET proteins sensitized t(8:21)-containing cells to MCL1 inhibition, suggesting a potential mechanism of resistance to BET-inhibitor-induced cell death. [ABSTRACT FROM AUTHOR]

The discovery of JAK2V617F a decade ago led to optimism for a rapidly developing treatment revolution in Ph- myeloproliferative neoplasms. Unlike BCR-ABL, however, JAK2 was found to have a more heterogeneous role in carcinogenesis. Therefore, for years, development of new therapies was slow, despite standard treatment options that did not address the overwhelming symptom burden in patients with primary myelofibrosis (MF), post-essential thrombocythemia MF, post-polycythemia vera MF, and myelodysplastic syndrome (MDS)/ myeloproliferative neoplasm (MPN) syndromes. JAK-STAT inhibitors have changed this, drastically ameliorating symptoms and ultimately beginning to show evidence of impact on survival. Now, the genetic foundations of myelofibrosis and MDS/MPN are rapidly being elucidated and contributing to targeted therapy development. This has been empowered through updated response criteria for MDS/MPN and refined prognostic scoring systems in these diseases. The aim of this article is to summarize concisely the current and rationally designed investigational therapeutics directed at JAK-STAT, hedgehog, PI3K-Akt, bone marrow fibrosis, telomerase, and rogue epigenetic signaling. The revolution in immunotherapy and novel treatments aimed at previously untargeted signaling pathways provides hope for considerable advancement in therapy options for those with chronic myeloid disease. [ABSTRACT FROM AUTHOR]

In 2003,Laricobius nigrinusFender was introduced into the eastern United States as a biological control agent of the hemlock woolly adelgid (Adelges tsugaeAnnand). Following its release, it was discovered thatL. nigrinuswas hybridising and producing viable progeny withLaricobius rubidusLeConte, a species native to eastern North America. Recently,Laricobius osakensisMontgomery and Shiyake was imported from Japan into the USA as a potential biological control agent of hemlock woolly adelgid. Hybridisation betweenL. nigrinusandL. rubidusled to interest in the outcome of interactions betweenL. osakensisand the other twoLaricobiusspp. The purpose of this study was to determine ifL. osakensiscould mate withL. nigrinus, if they could produce hybrid progeny, and whether mating interferes with reproductive output.Laricobiusspp. were observed mating directly following emergence and found to be capable of producing sterile eggs in the absence of a mating event. Laboratory and confined field studies found no evidence thatL. osakensisandL. nigrinuscould produce hybrid progeny and the interaction between the two species did not result in a lower reproduction associated with interspecific mating attempts. Interbreeding should therefore not have an impact on biological control using these species. Fecundity experiments showed thatL. osakensisproduced eggs earlier in the season and at a higher rate thanL. nigrinus, suggesting thatL. osakensismay have the potential to be an even more successful biological control agent thanL. nigrinus. [ABSTRACT FROM AUTHOR]

Two adelgid predators, Laricobius nigrinus Fender and Laricobius rubidus LeConte, were recently discovered to produce hybrid progeny in the eastern United States. L. rubidus is native to eastern North America where it feeds on pine bark adelgid ( Pineus strobi Hartig) and L. nigrinus is native to western North America and was introduced to the eastern United States in 2003 for biological control of hemlock woolly adelgid ( Adelges tsugae Annand). Currently, L. nigrinus and L. rubidus form a mosaic of hybrid zones throughout the eastern United States. It is not known whether these zones will be maintained over time and whether hybridization will impact the efficacy of biological control or result in displacement of L. rubidus . Sampling from 2007 to 2012 on eastern hemlock ( Tsuga canadensis Carrière) showed a clear increase in L. nigrinus , a decrease in L. rubidus , and a steady proportion of hybrids. Sampling from 2010 to 2012 on both eastern hemlock and white pine ( Pinus strobus L.) at ten sites showed that L. nigrinus was more dominant on hemlock and L. rubidus was more dominant on white pine, which may demonstrate habitat preference and promote segregation between the two species. Site factors were tested for a relationship with the proportion of hybrids. The number of years L. nigrinus had been present at the site was the only factor that showed a relationship. The results suggest that L. nigrinus may displace L. rubidus on hemlock, but not on white pine at sites where they are both present. [ABSTRACT FROM AUTHOR]

Objective: To determine whether the rates of nontraumatic dental condition (NTDC)-related emergency department (ED) visits are higher during the typical working hours of dental offices and lower during night hours, as well as the associated factors. Methods: We analyzed data from the National Hospital Ambulatory Medical Care Survey for 1997 through 2007 using multivariate binary and polytomous logistic regression adjusted for survey design to determine the effect of predictors on specified outcome variables. Results: Overall, 4,726 observations representing 16.4 million NTDC-related ED visits were identified. Significant differences in rates of NTDC-related ED visits were observed with 40%-50% higher rates during nonworking hours and 20% higher rates on weekends than the overall average rate of 170 visits per hour. Compared with 19-33 year olds, subjects ,18 years old had significantly higher relative rates of NTDC-related ED visits during nonworking hours [relative rate ratio (RRR) = 1.6 to 1.8], whereas those aged 73 and older had lower relative rates during nonworking hours (RRR = 0.4; overall P = 0.0005). Compared with those having private insurance, Medicaid and self-pay patients had significantly lower relative rates of NTDC visits during nonworking and night hours (RRR = 0.6 to 0.7, overall P , 0.0003). Patients with a dental reason for visit were overrepresented during the night hours (RRR = 1.3; overall P = 0.04). Conclusion: NTDC-related visits to ED occurred at a higher rate during nonworking hours and on weekends and were significantly associated with age, patient-stated reason for visit and payer type. [ABSTRACT FROM AUTHOR]