Weekend Briefing for October 4, 2025:

New Images in Clinical Medicine: Oral Verruciform Xanthomas nej.md/4mH8U2I

Four New Perspectives:

1️⃣ Occupational Health and Safety on the Chopping Block nej.md/3VMcttz

2️⃣ Emergency Medicaid at Risk nej.md/46MQec6

#MedSky

New research shows there’s a simple way to protect workers. Is OSHA listening? New research shows there's a simple way to protect workers. Is OSHA listening?

New research shows there’s a simple way to protect workers. Is OSHA listening?

The U.S. workplace regulator is considering a federal heat rule — if the shutdown doesn’t delay it further.

grist.org/business/sim...

#OSHA #Labor #Union #Workers #Heat #Weather

Images and descriptions of what's new on NEJM.org this week  

New in the October 9, 2025, issue of NEJM:

Baxdrostat Efficacy and Safety in Uncontrolled Hypertension (BaxHTN phase 3 trial) nej.md/4my7xUZ

Nexiguran Ziclumeran in ATTR with Polyneuropathy nej.md/46Qhur7

#MedSky

Occupational Health and Safety on the Chopping Block — What’s at Stake? | NEJM The U.S. government has taken steps to dismantle the National Institute for Occupational Safety and Health, the bedrock research agency charged with safeguarding worker health.

Our @nejm.org perspective examines how cuts to the National Institute for Occupational Safety & Health threaten decades of progress in protecting U.S. workers, and will leave us less prepared for the next pandemic or public health crisis

@aflcio.org
@npr.org

www.nejm.org/doi/full/10....

Episode 7 of the #surgicalergonomics podcast "Ergonomics for laparoscopic and robot-assisted surgery" with Dr. Ian Soriano is now available to listen to on all your favorite platforms or for free at www.buzzsprout.com/2449794

@andrewswrightmd.bsky.social @urogabe.bsky.social @ruthvmd.bsky.social

📢 Episode 6 of the Surgical Ergonomics podcast "Ergonomics for Ophthalmologists and how presbyopia affects us all" with Dr. Amy Zhang is now available to 🎧 to on all your favorite platforms or here at:
feeds.buzzsprout.com/2449794.rss
@facs.org @aatshq.bsky.social @ascrs.bsky.social

Are you a surgical leader?
Then Episode # 5 of the Surgical ergonomics podcast "Driving institutional change in surgical ergonomics" with Dr. Marc Rubin is for you.
🎧 Listen on your favorite platform or at:
lnkd.in/gPKSPZmb
@facs.org @ascrs.bsky.social @plasticsurgeryasps.bsky.social

Surgical Ergonomics podcast # 4 “Everything you wanted to know about disability insurance” is now available to 🎧 !
feeds.buzzsprout.com/2449794.rss

In this NOT to be missed episode Dr. Stephanie Pearson MD FACOG shares her personal journey and tips on why and how to get disability insurance

Surgical ergonomics: how and where to start? The field of ergonomics is dedicated to understanding the interactions between humans and elements of a system, with one of the core tenets of ergonomic approaches being the need to fit the…

⏪ Time to revisit: Surgical ergonomics: how and where to start?
➡️https://buff.ly/MjIrzRH
A clear and concise review presenting the key principles for optimal ergonomics in the OR.

@halletjulie.bsky.social #SurgSky #MedSky

Really enjoyed sharing the urology/trainee perspective on surgical ergonomics on the new @surgergonomics.bsky.social podcast!

Thanks for having me Geeta, exciting work ahead!

In pain/discomfort after OR: get yourself anti-fatigue mats!

RCT H&N surgery >3h - mat 🆚 not
⬇️ discomfort & pain in lower extremity, shoulders, neck & back
😀 Immediately postop and 24h after

Simple and it works!

📝 pubmed.ncbi.nlm.nih.gov/39882505/

📣 New pub from our group!

We identified significant gaps in workplace injury reporting among physicians to the Bureau of Labor Statistics when compared to other medical occupations and low-/high-hazard non-medical occupations

journals.lww.com/joem/abstrac...

Got back into reading this year, my 2024 reads 👇
#bookwrapped #booksky

🚨 #SurgErgoTip: Robotic console arm position💪

🔑Armrest height should be adjusted to keep hands near elbow height w/ 90-120° bicep angle

🔑Frequent use of clutch control to keep hands in center of working envelope w/ forearms on the rest (always be clutching!)

fig c/o rdcu.be/c95Dn #surgsky #medsky

Surgical ergonomics for urologists: a practical guide - Nature Reviews Urology Surgical ergonomics in urology has been understudied and underemphasized. This Review characterizes the burden of musculoskeletal injury in urologists and focuses on various ergonomic considerations r...

Fig ref - www.nature.com/articles/s41...

📣Bringing surgical ergonomics tips to #surgsky with #surgergotip

✴️Monitor position for laparoscopy/endoscopy

🔑Place monitor directly in front of the user, 3-6 ft away, slightly below eye level (~15°) for gaze-down viewing

✅Minimizes axial rotation & allows eye muscles to be in most relaxed state

In unexpected breaking news, I’m an elite athlete somehow

#MedSky

US surgeons are killing themselves at an alarming rate. One decided to speak out The grueling profession has long kept silent about mental distress. After losing a friend, Carrie Cunningham began telling her own story

More than a year later, this article is still incredibly powerful. “Surgery, especially, has always been cruel to its practitioners, who suffer high rates of #burnout, ergonomic injuries, miscarriages and infertility.”
System change is needed!
#SurgSky #Wellness

www.theguardian.com/us-news/2023...

Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections | NEJM Bloodstream infections are associated with substantial morbidity and mortality. Early, appropriate antibiotic therapy is important, but the duration of treatment is uncertain. In a multicenter, non...

Landmark trial in NEJM - BALANCE ⚖️

🏗️ 3608 hospitalized pts w/ bacteremia (MC bacteria E. Coli 44%; MC source urinary tract 42%) randomized to 7 vs. 14 days of abx

🎯 7d was non-inferior re: 90d mortality, resistant colonization, abx-related AEs

www.nejm.org/doi/full/10....

Totally agree. it’s a major problem that I along with a group of surgeons / human factors researchers in the Society of Surgical Ergonomics are studying to provide hard data to encourage companies to design instruments that accommodate varying surgeon anthropometrics

📣 Friendly reminder to all the surgeons on #surgsky #medsky — @amcollsurgeons.bsky.social released surgical ergonomics recommendations on how to optimize body posture and OR layout to mitigate risk of work-related MSK disorders — check them out!

#surgicalergonomics

Epic first 3 weeks chiefing the Hopkins pediatric urology service! 🫡

- cloacal exstrophy 2' closure
- classic exstrophy 1' closure
- b/l cutaneous ureterostomies
- SP robotic BNT
- augment / mitrofanoff
- 4 distal, 2 proximal hypos
- open b/l reimplant
- robotic VC fistula repair

How-to video on robotic-assisted augmented roof ureteroplasty with appendiceal onlay -- great technique for long mid-to-proximal ureteral strictures 🤖

Full video and commentary here: t.co/XzLPRbeQSY

#medsky #surgsky #pedssurgsky #surgery

@johnshopkins.bsky.social

For all #SurgSky #MedSky interested in ergonomics in the operating room - more human factors and ergonomics researchers and interested people are joining @bsky.app
Here’s a starter pack with a few voices in that space. Tag others 👇🏻and will add!

go.bsky.app/S3f1WcG

Action Intent Links | Bluesky Authors, websites, and apps can use action intent links to implement "Share on Bluesky" buttons, or similar in-app actions. Logged-in users will be directed to the corresponding action view in the Blu...

We strongly suggest that academic publishers and other platforms that host research rapidly implement a Share to Bluesky button for their articles. Here's how:

docs.bsky.app/docs/advance...

#AcademicSky #HigherEd #Altmetrics

🙋🏼🙋🏼

Struggling with surgical staplers design? 😖🤕

Check out this webinar from Society of Surgical Ergonomics
📆December 11
⏰7 PM ET
With Dr Amandeep Shergill, Geeta Lal, Susan Hallbeck and Ian Soriano, and industry partners (Teleflex & Medtronic)
Register🔗 tinyurl.com/4dj36rn3

SurgSky MedSky HPBSky

Putting X in the rearview, blue skies ahead 🪁

Follow me if you’re interested in pediatric reconstructive surgery, surgical ergonomics, AI, medical education, or just want to connect!