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Climate Disclosure Mandates, Climate Reporting Specialists, and Labor Market Constraints
No full textThis paper examines the labor-related costs of climate disclosure mandates and whether labor market constraints increase these costs and decrease the climate reporting activities driven by these mandates. I first classify a sample of climate reporting specialists (CRS) to measure firms’ hiring practices for job positions related to climate reporting. Using the European Union (EU)’s Non-Financial Reporting Directive (NFRD) as a setting, I find a significant increase in the acquisition of CRS in EU firms after the passage of the NFRD, compared to matched US firms. More importantly, EU firms pay a persistent wage premium to CRS that cannot be explained by position, firm, and individual characteristics and fill CRS positions with less qualified individuals, indicating that the increased demand for CRS leads to constraints in the labor market for CRS. These effects are more pronounced in positions that are non-entry level and in countries with fewer climate-related education programs. Lastly, I show that labor market constraints decrease firms’ climate reporting activities, undermining the effectiveness of the NFRD. Overall, this study quantifies the labor-related costs of climate disclosure mandates and highlights the labor-related challenges of implementing these mandates.</p
Impact of Maternal Factors on Infant Immunity to BCG and TB
No full textInfants from high Tuberculosis (TB) burden settings have a higher risk of exposure to Human Immunodeficiency Virus (HIV) and latent TB infection (LTBI) in utero. Whether or not exposure to HIV and TB in utero influences the development of infant immunity is unclear. Therefore, we investigated the effects of LTBI exposure in HIV-exposed uninfected infants on Mycobacterium tuberculosis (Mtb)-specific antibody levels and function, phenotypic profiles of immune subsets, and the proliferation and functional capacity of T cell responses to Bacille Calmette-Guérin (BCG) vaccine and Mtb-specific antigens. Frozen plasma and peripheral blood mononuclear cells (PBMC) from 199 pregnant women living with HIV and their infants were studied from the IMPAACT P1078 clinical trial. Mothers and infants were assessed for LTBI via the interferon gamma release assay (IGRA). 6 mothers progressed to possible, probable, or confirmed active TB (ATB). We revealed that antibody functional responses were impaired in the context of HIV/TB coinfection. Progression to ATB in mothers was marked by reduced lipoarabinomannan (LAM)-specific antibodies and enhanced Mtb-specific phagocytosis. This data also revealed that exposure to LTBI in utero influenced functional antibody and T cell responses with exposed infants demonstrating a Th1-dominated response to BCG. Further analysis of infants who became IGRA+ at 44 weeks showed that IGRA+ infants had enhanced Mtb-specific phagocytosis, similar to TB progressors, while T cell responses to BCG were dominated by a suboptimal Th17 response when compared to IGRA- infants. In utero exposure to LTBI results in immune alterations that mimic a classic TB response potentially indicating the presence of in utero sensitization. However, it is unclear if immune priming is beneficial to infants in the first year of life. While this research provides evidence of the short-term impact on in utero exposure to LTBI, further studies are warranted to understand the impact of these changes in the long term and whether these infants are more or less likely to develop TB as they age.</p
Engineering Fluidic Platforms for Optimizing Retinal Organoids and Eye Transplants
No full textIn-vitro culture systems generally apply homogeneous stimuli and rely on intercellular signaling to guide growth of tissues. However, to derive complex tissue structures such as the human retina, a gradation of certain stimuli is required. The inner retina resides in a hypoxic environment (2% O2) adjacent to the vitreous cavity. From there, oxygenation levels rapidly increase towards the outer retina (18% O2) at the choroid. We developed a retinal organoid chip allowing the maturation of inner and outer retinal cell phenotypes. The chip is assembled from a micro-milled acrylic slide, a gas-permeable film, a cover glass, and double-sided adhesives. The 55 culture wells, connected by a singular channel, each hold one retinal organoid. A sodium sulfite solution provides the chip with an oxygen leaching channel and a push/pull syringe pump creates a 50 µL/hour continuous flow of culture medium though the bioreactor. Retinal organoids are placed in the wells exposed to the oxygen gradient for the duration of 20 weeks. The gas diffusion throughout the culture medium resulted in an oxygen concentration gradient along the z-axis. Retinal organoids are successfully differentiated and present both inner and outer retinal cell phenotypes. This open-well retinal organoid chip is easily accessible for downstream analysis, establishes a steep oxygen gradient and allows high-throughput retinal organoid culture. It will help retinal organoids mature into the complex structure to use them for disease modeling and drug testing. Furthermore, the culture system contains a holder setup to facilitate the use of microfluidics during culture and allows transport to a microscope for live imaging. Continuous culture medium flow provides a stable environment without changes in pH due to waste secretion of organoids. In addition to retinal organoid culture, this bioreactor can also be used for other applications that benefit from an oxygen concentration gradient.</p
A Qualitative Study Exploring the Role of Culture on Endometrial Cancer in the Haitian Community
No full textIntroduction:Significant racial disparities persist in cancer outcomes, particularly among Black women, who have lower 5-year survival rates for diseases such as endometrial cancer (EC). Delays in detection contribute to more advanced-stage diagnoses and poorer prognoses, yet little is known about the specific cultural and structural factors influencing these delays among Haitian women. Existing studies often overlook how cultural beliefs, family dynamics, healthcare mistrust, and limited awareness of EC symptoms, such as abnormal vaginal bleeding, shape healthcare-seeking behaviors. This study explores how cultural factors influence healthcare-seeking among Creole-speaking Haitian women.Methods:We conducted four focus groups with 19 Haitian women under 50 years old. Data were analyzed using a Thematic Analysis (TA) codebook approach, structured around the Andersen Model of Total Patient Delay. Two independent raters coded the transcripts using NVivo qualitative software.Results:Six major themes emerged: Awareness and Understanding of Menopause, Information Seeking and Appraisal, Social Influence on Decisions, Stigma and Taboos, Access and Organization, and Traditional Practices and Beliefs. Participants exhibited limited awareness of EC, often attributing abnormal bleeding to non-cancerous causes like hormonal imbalances or contraceptive use. Cultural beliefs, family influence, reliance on traditional remedies, and spiritual practices contributed to healthcare delays. Barriers included financial constraints, long appointment wait times, and mistrust in healthcare providers. Participants preferred culturally tailored education and community-based resources for health information.Conclusions:Culturally sensitive interventions are essential to improve EC awareness, build healthcare trust, and reduce systemic barriers. Addressing traditional practices, family dynamics, and spiritual beliefs is key to promoting early detection and improving cancer outcomes among Haitian women
Short-Term Intervention Effects on Distress, Inflammation, and Cognitive Functioning in Middle-Aged and Older Women with Breast Cancer
No full textAn estimated 75% of women diagnosed with breast cancer who receive treatment experience cancer-related cognitive impairment (CRCI), with up to 35% continuing to report symptoms months or years after treatment. Psychological distress and inflammation have been associated with CRCI; however, underlying mechanisms remain unclear. Given that most women diagnosed with breast cancer are over age 50 and transition into survivorship, further research is needed to understand how breast cancer exacerbates cognitive decline, particularly in the context of normal aging. Previous research has examined interventions such as cognitive behavioral therapy (CBT) and relaxation training for improving cognitive functioning, but none have tested the efficacy of an intervention that encompasses both elements, such as a remotely-delivered cognitive-behavioral stress management (R-CBSM) intervention. This study examined the effects of a 10-week R-CBSM intervention (compared to a wait-list control [WLC]) on subjective cognitive functioning in women (>50 years) with breast cancer and whether changes in breast cancer-specific distress and inflammation mediate intervention effects from baseline to 6-month follow-up. Women (N=101) with non-metastatic breast cancer were randomized to R-CBSM (N=51) or WLC (N=50). Participants completed psychosocial batteries and blood draws at baseline and 6-month follow-up. Results revealed no significant differences in cognitive functioning, distress, or inflammation between study conditions. Across the sample, cognitive functioning worsened, distress improved, and inflammation remained unchanged over time. Exploratory moderation analysis revealed that R-CBSM participants with moderate-to-high post-intervention distress had a significant cognitive decline; those with low distress had no change. Among WLC participants, distress was not associated with cognitive change. Findings underscore the importance of tailoring psychosocial interventions to address age-related stressors and cognitive health in breast cancer survivors.</p
Examining the Impact of Adverse Life Events and Mental Health on Cardiovascular Disease Risk among Black Women Living with HIV: Does Resilience Mitigate CVD Risk?
No full textBlack women living with HIV (BWLWH) are particularly vulnerable for experiencing worsened cardiovascular health. Trauma exposure and intersectional stigma are common sources of stress among BWLWH and have been directly linked to adverse mental health outcomes which often heightens CVD risk. To manage stress related to sexism, racism, and HIV stigma, Black women often rely on resilient coping mechanisms which may include intrapersonal resilience, social support, and posttraumatic growth. However, little is known about how this myriad of psychosocial factors together may influence CVD risk among BWLWH. The present study evaluated whether intersectional adversities including HIV discrimination and microaggressions, racial discrimination, gender discrimination, gendered racial microaggressions, and trauma exposure predict CVD risk via depression and trauma symptoms among 117 BWLWH through utilizing structural equation modeling and path analysis. Resilience resources was also explored as a moderator. Latent microaggressions and latent trauma exposure had significant direct and positive relationships with traumatic stress symptoms and depression symptoms. There were also significant direct pathways from intersectional adversities to traumatic stress symptoms and depression symptoms. Latent resilience resources moderated the relationship between intersectional adversities and traumatic stress symptoms. Indirect and direct pathways to CVD risk were not significant in each model. Trauma exposure and discrimination at the intersection of race, gender, and HIV status have a negative impact on the mental health of BWLWH. Resilience resources may help mitigate some of the negative consequences such stressors and adversities can have on their mental health. Given the prevalence of CVD risk factors among BWLWH more research is needed to elucidate the psychosocial mechanisms that contribute to racial and gender disparities in cardiovascular health among this population over time.</p
Investigating the Combined Detrimental Effects of Noise Exposure and Electrode Insertion Trauma for Hearing Preservation
No full textIn our increasingly noisy world, the general population experiences damaging environmental noise exposures routinely that may contribute to noise-induced hearing (NIHL). It is known that acoustic trauma leads to auditory dysfunction known as NIHL and eventually manifests into permanent sensorineural hearing loss (SNHL). The negative effects of NIHL are not limited to extreme cases, such as concert attendance, or in chronically noise-exposed groups, like firefighters. Unfortunately, the average person experiences damaging ambient noise during everyday life. The gold standard treatment option for those with severe-to-profound SNHL is cochlear implantation (CI). CIs are one of the most successful neuroprostheses to date and have benefited a vast number of patients. Due to their success, CI have expanded to include those with normal low frequency hearing function allowing for acoustic and electric stimulation. However, hearing preservation CI outcomes can vary significantly, often leading to loss of residual hearing. Prior limited research has shown that CI candidates with NIHL may be an at increased risk to lose residual hearing. However, while some studies have investigated this relationship between prior NIHL damage and loss of residual hearing after implantation, most results are contradictory or inconclusive. Independent examinations of NIHL and electrode insertion trauma (EIT) damage have been established, but there is a lack of agreement within the field regarding their negative synergistic effects on hearing preservation outcomes.Therefore, this proposal will ascertain how combined noise and EIT contributes to poor residual hearing outcomes in a controlled preclinical environment. Here, we propose to first characterize noise sensitivity profiles in rats to mimic CI candidacy and in turn, establish a novel double-insult rodent model with added EIT. Through timepoint-based experiments, we will distinguish the underlying electrophysiological mechanisms at play following noise-induced SNHL with CI-driven postoperative residual hearing loss.</p
Predictors of Engagement in Learning Collaboratives for Youth with Trauma: A Replication and Extension
No full textSeveral determinants of provider engagement in evidence-based practice (EBP) training programs have been previously identified; however, replication of these findings is sparse. The current study aimed to extend and replicate findings of a previous study examining predictors of provider engagement within two community-based learning collaboratives (CBLC) for youth trauma-focused cognitive-behavioral therapy (TF-CBT).
The sample consisted of 135 providers recruited across 22 agencies. The mean (SD) age of participants was 37.0 (11.1), and most participants were female (
= 104, 77%). Fifty-eight (43%) participants identified as Caucasian and 63 (46.7%) identified as Hispanic. Generalized Estimating Equations (GEEs) were run to account for nesting of clinicians within agencies.
Overall, engagement rates were higher in the replication. Rates of completion were similar across each of the CBLC components; however, brokers were much less likely to complete the CBLC than other providers. This study reconfirmed that providers who already viewed their individual practices as trauma-informed were more likely to engage with the CBLC. The current study failed to replicate a relationship between implementation climate and overall provider training engagement, as well as between previous use of TF-CBT components and clinician training engagement. Both studies failed to find a significant relationship between positive attitudes, better organizational support, and prior TF-CBT knowledge and training engagement.
Replicated findings underscore the importance of existing provider practices when designing and planning CBLC implementation. Future implementation efforts should identify methods to increase CBLC fit for providers at-risk of lower engagement
Melanoma Subtypes: Pathology and Clinical Behavior
No full textMelanoma comprises a heterogeneous group of malignancies arising from melanocytes in cutaneous, acral, mucosal, and ocular sites, each exhibiting distinct clinical behavior, histopathologic features, molecular profiles, and prognostic implications. Contemporary classification systems, including the World Health Organization framework, increasingly emphasize tumor evolutionary pathways and cumulative solar damage (CSD) status to better reflect biologic diversity and guide management. This review provides a comprehensive overview of the major melanoma types and subtypes, including ocular, mucosal, acral, and cutaneous melanoma, as well as clinically important variants such as amelanotic melanoma. For each entity, we summarize epidemiology, risk factors, clinical presentation, dermoscopic findings, histopathologic characteristics, and patterns of disease progression. Particular attention is given to diagnostically challenging subtypes—such as acral lentiginous, desmoplastic, nevoid, and spitzoid melanomas—and to the role of dermoscopy and molecular testing in improving diagnostic accuracy. An enhanced understanding of melanoma subtypes and their biologic behavior is essential for timely diagnosis, appropriate staging, individualized treatment planning, and improved patient outcomes
Utility of intraoperative frozen section analysis in risk stratification and surgical decision-making for salivary gland neoplasms of uncertain malignant potential
No full textSalivary gland aspirates classified as salivary gland neoplasm of uncertain malignant potential (SUMP) under the Milan System for Reporting Salivary Gland Cytopathology pose a diagnostic challenge due to their indeterminate cytologic features. We evaluate the utility of intraoperative frozen section in risk stratification and in guiding surgical management in SUMP cases.
We retrospectively reviewed 75 SUMP cases from 2019 to 2024 with paired frozen section and final pathology. Frozen section diagnoses, final pathology, and intraoperative decision-making processes were analyzed.
Frozen section reclassified 89% (67/75) of cases as benign or malignant, while 11% (8/75) remained indeterminate. Excluding indeterminate cases, frozen section demonstrated a diagnostic accuracy of 96% (64/67), with a sensitivity of 81% (13/16) and a specificity of 100% (51/51). Frozen section refined risk stratification by decreasing the baseline risk of malignancy from 23% before frozen section to 6% in benign frozen section cases. Malignant and indeterminate frozen section cases had risks of malignancy of 100% and 13%, respectively (χ2 = 53.84, P < .001). The combination of intraoperative findings and frozen section results influenced surgical management: More extensive resections were performed in 15% (11/75) of patients, whereas the remainder underwent conservative surgery.
Intraoperative frozen section substantially improves risk stratification and informs surgical management in SUMP, though persistent indeterminate cases underscore the need for enhanced preoperative diagnostic strategies