Faculty Bibliography

INTRODUCTION AND AIMS/OBJECTIVE:The bidirectional relationship between periodontitis and chronic kidney disease (CKD) underscores the importance of oral health in CKD management. However, interdisciplinary collaboration between dental and nephrology professionals remains limited. This study assessed dental professionals' knowledge, clinical experiences, referral patterns, perceived barriers, and attitudes towards integrated oral-renal care. METHODS:A cross-sectional web-based survey was conducted internationally in Asia, North America, Africa, Europe, South America, and Australia from November 2025 to February 2026. The instrument explored demographics, clinical exposure to CKD/end-stage kidney disease patients, self-assessed knowledge and confidence, referral/communication patterns, barriers to coordination, and interest in interdisciplinary protocols. Data from 89 valid responses were analysed using descriptive and inferential statistical methods. RESULTS:Respondents were predominantly experienced practitioners (74.2% with >10 years of practice; 67.4% had treated CKD patients; 53.9% dialysis patients). The self-assessed composite knowledge-and-confidence score for oral-renal interactions was moderate (mean 7.67/12). Referrals from nephrologists and direct interdisciplinary communication were infrequent. Primary barriers included a lack of a clear point of contact (51.7%) and a lack of shared patient records (50.6%). Oral health was rated as very or moderately important in CKD management by 94.4% of respondents, and 100% expressed definite or possible interest in formal interdisciplinary care protocols. CONCLUSIONS:Despite moderate self-assessed knowledge and substantial clinical exposure, structural and systems-level barriers appear to impede the integration of oral-renal care. Dental professionals nevertheless demonstrate near-universal motivation for interdisciplinary collaboration and strong interest in formal care protocols. CLINICAL RELEVANCE/CONCLUSIONS:Findings highlight the need for educational initiatives, standardized referral pathways, interoperable records, and policy support to advance multidisciplinary care for CKD patients.

BACKGROUND:Medical training is a high-stress period, and residents in surgical specialties face elevated risk for depression due to demanding schedules, intensity of training, persistent mistreatment, and long work hours. Obstetrics and gynecology is the only surgical specialty predominantly composed of women, who face higher rates of depression than men and greater increases in depressive symptoms during internship. These challenges, compounded by work-family conflict and policy pressures, contribute to workforce strain in a specialty already facing a projected shortage. Understanding the mental health burden is critical to supporting both trainee well-being and long-term workforce sustainability, yet depressive symptoms, risk factors, and treatment-seeking have not been systematically studied in obstetrics and gynecology trainees. OBJECTIVE:To assess the prevalence of depressive symptoms and mental health treatment-seeking among obstetrics and gynecology first-year residents and identify associated demographic, psychological, and workplace factors. STUDY DESIGN/METHODS:tests, stepwise linear regression, and generalized estimating equation models were used to identify baseline and internship-related predictors of depressive symptoms. Sample weights were applied to address nonrepresentative sampling and attrition biases. RESULTS:Of 1603 enrolled obstetrics and gynecology interns (86.5% women; median age 27 years), 1271 (79.3%) completed at least one internship assessment and were included in the analysis. During internship, 35.6% screened positive for depression on the 9-item Patient Health Questionnaire at one or more assessments, yet less than one-third of those affected sought mental health treatment. Baseline predictors of increased depressive symptoms included history of depression, higher baseline depressive symptoms, neuroticism, a difficult early family environment, and not being in a committed relationship. Internship-related factors associated with worsening symptoms included fewer sleep hours, longer work hours, and reported medical errors. CONCLUSION/CONCLUSIONS:More than one-third of obstetrics and gynecology residents screened positive for depression on the 9-item Patient Health Questionnaire during their first year, yet treatment-seeking remained critically low. Both preexisting vulnerabilities and modifiable workplace stressors contributed to depressive symptoms. These findings are particularly notable given the female-predominant composition of the obstetrics and gynecology field and the growing representation of women in surgical specialties. The low treatment-seeking rate highlights the urgent need for improved mental health access, including opt-out service models. Structural interventions targeting workload and sleep are essential to support trainee well-being and long-term workforce sustainability in obstetrics and gynecology.

BACKGROUND:Medical training is a high-stress period, and residents in surgical specialties face elevated risk for depression due to demanding schedules, intensity of training, persistent mistreatment, and long work hours. Obstetrics and gynecology is the only surgical specialty predominantly composed of women, who face higher rates of depression than men and greater increases in depressive symptoms during internship. These challenges, compounded by work-family conflict and policy pressures, contribute to workforce strain in a specialty already facing a projected shortage. Understanding the mental health burden is critical to supporting both trainee well-being and long-term workforce sustainability, yet depressive symptoms, risk factors, and treatment-seeking have not been systematically studied in obstetrics and gynecology trainees. OBJECTIVE:To assess the prevalence of depressive symptoms and mental health treatment-seeking among obstetrics and gynecology first-year residents and identify associated demographic, psychological, and workplace factors. STUDY DESIGN/METHODS:tests, stepwise linear regression, and generalized estimating equation models were used to identify baseline and internship-related predictors of depressive symptoms. Sample weights were applied to address nonrepresentative sampling and attrition biases. RESULTS:Of 1603 enrolled obstetrics and gynecology interns (86.5% women; median age 27 years), 1271 (79.3%) completed at least one internship assessment and were included in the analysis. During internship, 35.6% screened positive for depression on the 9-item Patient Health Questionnaire at one or more assessments, yet less than one-third of those affected sought mental health treatment. Baseline predictors of increased depressive symptoms included history of depression, higher baseline depressive symptoms, neuroticism, a difficult early family environment, and not being in a committed relationship. Internship-related factors associated with worsening symptoms included fewer sleep hours, longer work hours, and reported medical errors. CONCLUSION/CONCLUSIONS:More than one-third of obstetrics and gynecology residents screened positive for depression on the 9-item Patient Health Questionnaire during their first year, yet treatment-seeking remained critically low. Both preexisting vulnerabilities and modifiable workplace stressors contributed to depressive symptoms. These findings are particularly notable given the female-predominant composition of the obstetrics and gynecology field and the growing representation of women in surgical specialties. The low treatment-seeking rate highlights the urgent need for improved mental health access, including opt-out service models. Structural interventions targeting workload and sleep are essential to support trainee well-being and long-term workforce sustainability in obstetrics and gynecology.

BACKGROUND:Transoesophageal echocardiography (TEE) enables continuous cardiac imaging during cardiopulmonary resuscitation (CPR) without interrupting chest compressions, but its impact on patients' outcomes remains uncertain. We performed a scoping review to comprehensively map the evidence on intra-arrest TEE in cardiac arrest. METHODS:We searched PubMed, Embase, CENTRAL, ClinicalTrials.gov, and grey literature from inception to March 2026. Studies evaluating TEE during CPR in adults with in- or out-of-hospital cardiac arrest were included. Outcomes comprised survival, neurological status, return of spontaneous circulation, CPR quality metrics, diagnostic findings, impact on management, feasibility, and safety. RESULTS:Twenty-two studies including 1,254 patients (84% out-of-hospital cardiac arrest) were identified; most were single-centre observational studies without comparators. Two randomized trials reported no difference between TEE-guided and conventional CPR in return of spontaneous circulation, survival, or favourable neurological outcome. Observational data suggested associations between TEE-defined compression location and outcomes, with compressions over the left ventricular outflow tract or aortic valve associated with less frequent return of spontaneous circulation and short-term survival. TEE-guided modification of chest compression position occurred in 19-76% of cases. TEE influenced management in 31-48% of patients and identified potential arrest aetiology in 20-86%. TEE was associated with shorter pauses compared with transthoracic echocardiography. Feasibility was high (successful insertion 80-100%), with few reported complications. Knowledge gaps include lack of long-term outcomes, standardized protocols, and evidence on safety and effectiveness across different clinical settings. CONCLUSIONS:Intra-arrest TEE appears feasible and frequently alters resuscitation management, but current evidence does not demonstrate improved patient-centred outcomes. Further studies are required to inform appropriate integration into resuscitation practice.

INTRODUCTION/BACKGROUND:There are multiple human papillomavirus (HPV)-related disparities experienced by sexual and gender minority (SGM) populations in the United States (U.S.), including higher rates of some HPV-associated cancers, lower rates of HPV vaccination among certain subgroups, and higher rates of healthcare discrimination. METHODS:We conducted a national cross-sectional survey of U.S. primary care clinicians (physicians and advanced practice providers [APPs]) in 2024 to examine HPV vaccination recommendation practices for SGM patients. Participants responded to a series of six clinical vignettes which varied by patients' sexual orientation, sex assigned at birth, and gender identity. RESULTS:The sample (n = 483) was primarily non-Hispanic (93%), White (74%), physicians (56%), and did not practice in a rural/frontier community (70%). Across the vignettes, regardless of patient characteristics, 59-69% reported they would always recommend the HPV vaccine; whereas 9-19% reported they would recommend the HPV vaccine often (50-79% of the time). The vast majority were highly consistent in recommendation likelihood across vignettes. Greater likelihood of recommending the HPV vaccine was observed for APPs versus physicians (p = 0.016), female clinicians versus males (p < 0.001), and non-Hispanic White clinicians versus other racial/ethnic groups (p = 0.006). CONCLUSIONS:In summary, participants generally reported high likelihood of recommending the HPV vaccine, with recommendations differing very little by patient sex, sexual orientation, or gender identity.

Carrier screening for genetic conditions performed preconception or during pregnancy allows identification of fetal risk for inherited autosomal recessive and X-linked conditions. The goal is to identify at-risk patients/couples and offer them reproductive options such as preimplantation genetic diagnosis, prenatal testing, or targeted newborn testing. Although individuals are expected to be carriers for autosomal recessive conditions, most couples are not carriers of the same condition. The traditional understanding is that carriers do not exhibit symptoms of disease. However, recent studies have shown that there may be clinical implications for medical management of some conditions in the carrier state, especially in the obstetrical setting. One study showed that 9% of patients who underwent large carrier screening panels were carriers for a condition with clinical implications in the heterozygous state. It is estimated that 2.5% of females are heterozygous for a condition that impacts their medical management during pregnancy. Obstetric clinicians who often interpret carrier screen results must be aware of the potential clinical implications and incorporate this information into their counseling and management plans. In this review, we examined three large panethnic, commercially available carrier screening panels that collectively cover 818 genes. We found that 112 (13.7%) of the conditions have definite or strong implications in the carrier state, and another 100 (12.2%) have moderate or limited evidence of implications in the carrier state. Of the identified genes, 19 may have an impact during pregnancy. This information, if used to guide clinicians on conditions that require further counseling and evaluation, may improve outcomes when incorporated into obstetric practice.

OBJECTIVE:To examine how abortion policy environments and geographic context are associated with reproductive health outcomes, and to characterize implications for obstetrics and gynecology (OBGYN) care. METHODS:comparisons and Spearman correlations assessed the relationship of these environmental factors with 32 outcomes. RESULTS:= 0.001). CONCLUSIONS:Health disparities associated with restrictive abortion policies and geographic inequities signal regional variation in OBGYN workforce strain, reinforcing the need for systems-level, context-aware strategies to support retention and sustainability.

OBJECTIVE:Cesarean delivery (CD) remains a key obstetric quality metric, particularly among nulliparous, term, singleton, vertex (NTSV) pregnancies. In 2024, NTSV CD rate at NYU-LI was 32.9%, exceeding The Joint Commission (TJC) benchmark of ≤30% and demonstrating racial and ethnic disparities. This study aimed to reduce the institutional NTSV CD rate to ≤30% through a multidisciplinary QI initiative while prospectively monitoring safety outcomes and racial disparities. STUDY DESIGN/METHODS:A single-site QI initiative was implemented from 2024-2025 incorporating provider education, patient-centered interventions (TeamBirth and structured labor huddles), standardized labor management, and performance monitoring through monthly case review, clinician feedback, and quarterly equity-focused data review. Outcome measures included monthly overall and quarterly race- and ethnicity-stratified NTSV CD rates. Process measures assessed adherence to evidence-based labor dystocia criteria. Balancing measures included postpartum hemorrhage (PPH) and TJC PC-06 rates. Temporal trends were evaluated using multivariable Poisson regression with adjustment for maternal age, gestational age at delivery, and body mass index. RESULTS:The overall NTSV CD rate decreased from 32.9% in 2024 to 27.8% in 2025, remaining below TJC benchmark in 10 of 12 months. Across the 8-quarter study period, there was a significant decline in the outcome over time (aRR per quarter 0.97, 95% CI 0.95-0.99, p=0.003). Reductions were observed across racial and ethnic groups, including among Black non-Hispanic patients (44.0% to 40.0%) and Asian non-Hispanic patients (37.0% to 29.6%). Adherence to evidence-based labor dystocia criteria remained high, while PPH and PC-06 rates remained stable. CONCLUSIONS:A standardized, multidisciplinary QI initiative was associated with NTSV cesarean delivery rate below the Joint Commission benchmark without increases in maternal or neonatal adverse outcomes. The initiative was also associated with partial reduction in racial disparities in cesarean delivery rates, although persistent inequities remained. Future PDSA cycles will focus on sustaining standardized care and advancing equitable obstetric outcomes.

BACKGROUND/UNASSIGNED:Numerous formal and informal resources exist to support the transition to residency. Little is known about how postgraduate year (PGY) 1 residents perceive and utilize these tools. OBJECTIVE/UNASSIGNED:To explore PGY-1 obstetrics and gynecology (OB/GYN) residents' perspectives on the utility and impact of structured and informal resources supporting the transition to residency. METHODS/UNASSIGNED:We used a qualitative thematic analysis of in-depth interviews with PGY-1 OB/GYN residents using self-determination theory as a framework. In 2024, participants were recruited via email and social media from across the United States. Two residents performed virtual interviews. Three independent coders used inductive coding to analyze the data, then interpreted the patterns that emerged using self-determination theory as an interpretive framework. RESULTS/UNASSIGNED:A total of 11 interviews were performed. Three themes were identified in residents' experience that aligned with the core domains of self-determination theory: the heterogeneity of learning needs as new residents strive towards independence (autonomy), responsibilities for patient care serving as a powerful motivator for learning (competence), and the need for a supportive learning environment (belonging). Residents expressed diverse learning needs, and the abundance of tools often contributed to feelings of being overwhelmed. CONCLUSIONS/UNASSIGNED:Tailoring support strategies to align with learning goals may enhance the effectiveness of transition resources and promote early resident growth and well-being. Educators may help learners identify resources but also allow for learner autonomy in setting learning goals, focus on practical skills to develop competence in clinical duties, and create structures to support a culture of belonging.

BackgroundCervical cancer is a preventable disease, and reaching populations who are under-screened and/or at highest risk is essential to the goal of disease elimination. Hispanic women in the US have a disproportionately higher incidence rate than non-Hispanic women.ObjectivePost hoc analysis of the SELF-CERV study of the unique experience and preferences among Hispanic compared to non-Hispanic participants with the goal of facilitating and improving screening and follow-up in more vulnerable populations.MethodsWomen 25 to 65 years who were enrolled performed self-collection (SC) of vaginal samples for high-risk human papillomavirus (hrHPV) testing using a unique device in a simulated at-home environment. For method comparison, a clinician-collected (CC) sample was obtained. Participants also completed usability and screening preference surveys.ResultsA total of 609 participants were consented and 603 used the SC device. Of the 603 SC users, 115 (19.1%) identified themselves as Hispanic/Latinx. Compared to non-Hispanic women, Hispanic women, had significantly lower annual income (p < .001), a lower percentage of private insurance with more uninsured (p < .001) and lower levels of education (p < .001). There was no significant difference between Hispanic and non-Hispanic women in understanding the purpose of cervical cancer screening. No difference was noted in delaying screening, although English Not Primary speaking Hispanic women were somewhat more likely to delay (p = 0.22). Financial barriers were observed to be more of an impediment to Hispanic women compared to non-Hispanic women (p = 0.016). Negative experiences with in-clinic speculum exams were similar; however, Hispanic women (78%) expressed a significantly higher endorsement of SC than non-Hispanic women (62%), (p = 0.001). Both populations reported that they would be more likely to stay up to date with cervical cancer screening with the at-home SC device, but non-Hispanic women to a significantly lesser degree (p = 0.002). In terms of assessing utility of telemedicine in screening, both populations reported similar engagement in healthcare activities, willingness to try new technology and current use of smartphones. Hispanic and non-Hispanic women were both nearly equally divided as to their preference for in-clinic visits vs telehealth.ConclusionsFacilitating screening uptake is especially critical for Hispanic women, who bear a disproportionate burden of cervical cancer diagnoses and mortality while facing more obstacles to screening than non-Hispanic women. A clinically validated and accessible at-home SC alternative holds potential for meaningful impact and improved health outcomes within this community.