Intro: Standards in otolaryngology residency education mandate empathy and tolerance for ambiguity as required competencies, yet many otolaryngology training programs lack a formal curriculum designed to develop these skills. The purpose of this study is to assess the impact of a novel medical humanities curriculum on resident empathy, social connectedness, and overall well-being in an otolaryngology residency program. Methods: Over a six-month period, five one-hour sessions of a medical humanities curriculum were implemented within the residency program. These sessions included group discussion and a written narrative component. Survey scores were summarized using means, standard deviation, and median, minimum, and maximum. The mean scores were compared using an ANOVA F-test under a linear mixed effects model, with a random subject intercept and the fixed effect of time. Between-session comparisons were conducted where p-values were adjusted for multiple testing using Tukey’s method. All the hypothesis tests were two-sided. The statistical analyses were performed in R version 4.2.2. Significance was assessed at a 5% level ( p < 0.05). Results: There was no statistically significant improvement in empathy, social connectedness, or well-being with the implementation of the humanities curriculum. However, all residents expressed satisfaction with the curriculum. Qualitative feedback indicated that the sessions facilitated career reflection and encouraged open discussion and appreciation of diverse perspectives. Conclusion: This pilot study did not demonstrate statistically significant improvements in empathy, social connectedness, or well-being among a small group of residents. Nevertheless, resident satisfaction and qualitative feedback suggest that the medical humanities may promote career reflection and provide a forum for the exchange of opinions and viewpoints.

Objective: We investigated the relationship between trimester-specific SARS-CoV-2 infection and newborn growth metrics. We hypothesize that COVID-19 may result in disproportion between neonatal head measurements and weight without increasing the risk of SGA, and that this relationship may be associated with timing of COVID-19 exposure in pregnancy. Design: Retrospective cohort Setting: Northeast USA academic tertiary hospital Population of sample: COVID-19-infected (n=140) and COVID-19-uninfected (n=136) patients Methods: Inclusion criteria: a) singleton birth between April 28, 2020, and December 31, 2022; and b) maternal COVID-19 infection diagnosed via PCR. Exclusion criteria: < 12 years of age, major fetal anomalies, and fetal loss < 15 weeks. Main Outcomes Measures: Outcomes were a comparison of newborn growth measurements (length, weight, and head circumference (HC) at birth), Ponderal Index (PI), and development of SGA between SARS-CoV-2-infected and uninfected patients. Maternal and neonatal characteristics were descriptively summarized, and multivariate analyses and linear regression models were performed. Results: Baseline maternal demographics did not significantly differ among the uninfected and infected cohorts. Compared to the uninfected cohort, COVID-19 diagnosed in the third trimester was associated with a lower neonatal HC compared to newborns of uninfected patients (β=-0.38 [0.38 SD lower], 95% CI -0.65 to -0.10, p=0.024). There was no significant difference among the cohorts for birth length, weight, or diagnosis of small for gestational age. Conclusion: We found that COVID-19 infection in the third trimester was associated with a lower neonatal head circumference without associated SGA. The cause underlying this association is unknown. Further research to determine the risk of neurotropic fetal infection by SARS-CoV-2, like ZIKA’s effect on the fetal immune system leading to microcephaly, is urgently needed.

Objective: Preeclampsia (PE) is a leading cause of morbidity and mortality in pregnancy. This observational study aims to determine associations between oral and placental microbiome in women with and without preeclampsia and periodontal disease (PD) and evaluate systemic immune responses in patients with and without PE and PD. Population: Fifty-four pregnant patients with and without PE and PD were recruited. The microbiome profiles of both oral subgingival region and placenta were characterized by V4 region of 16S rRNA gene sequencing. Systemic inflammation markers tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), lipopolysaccharide binding protein (LBP), interleukins 6 & 8 (IL-6, IL-8) in blood were measured by ELISA. Results: PD significantly increased the risk of PE after adjustments for age, preterm delivery and smoking status (OR=2.26, 95% CI=1.14-4.48, p=0.024). A group of oral associated bacteria Veilonella, Fusobacterium, Haemophilus, Granulicatella, Streptococcus, Gemella and Neisseria in placenta had significantly higher prevalence in women with PE compared to women without PE (53.8% vs 19.0%, p=0.018), the highest prevalence in patients with both PE and PD (58.8%). Relative abundances of Haemophilus, Veillonella and Fusobacterium in oral samples were significantly higher in patient with PE than those without PE. Proinflammation cytokine analysis showed that PE patients with PD had higher blood IL-8 levels than PE patients without PD (p=0.028). Conclusion: Oral-like microbiome was identified in placenta more frequently in patients with PE than those without PE. Placental microbiome is associated with systemic inflammation. High abundances of Haemophilus in oral cavity is associated with increased risk of PE.