University of Maryland Eastern Shore

The life-threatening coronavirus disease 2019 (COVID-19) affects about 1 in 1,000 healthy people under 50 without underlying conditions. Among patients with critical COVID-19 pneumonia, rare germline variants at genes controlling type I IFN immunity have been reported in up to 5% of patients. Causal etiologies in 80-85% of cases are still unknown. We analyzed two families with hypoxemic COVID-19 pneumonia for known single-gene inborn errors of immunity. In Family 1, two siblings with critical COVID-19 were homozygous for a DOCK2 variant, c.3624+5G>A. DOCK2 deficiency is a known T-cell disorder underlying severe viral diseases. The variant resulted in skipping exon 35, which was predicted to produce a frameshift truncated protein (p.L1157Ifs*12). The proband showed markedly decreased blood CD4 T-helper cell counts, impaired T lymphocyte transformation test, and increased serum IgG, IgA, and IgE levels, as documented in other DOCK2-deficient patients. In Family 2, the proband had lethal COVID-19 and HPV-2-associated multiple recalcitrant warts. She was heterozygous for a deletion in GATA2:c.1075_1102del28, p.W360Sfs*18. GATA2 haploinsufficiency is a known cause of severe viral diseases due to a lack of plasmacytoid dendritic cell (pDC) development. The proband had monocytopenia and a lack of circulating pDCs, as reported in other patients with GATA2 haploinsufficiency. Overall, both DOCK2 deficiency and GATA2 haploinsufficiency are associated with critical and often fatal COVID-19 pneumonia.

Type 2 diabetes (T2D) is an escalating concern in South Asia, with prevalence surging over the past two decades. Family members often significantly influence T2D outcomes and management, yet involvement remains informal, unstructured, and unrecognized within healthcare systems. This viewpoint calls for a more structured, equitable approach to family engagement in T2D care, outlining three models (family-supported, family-wide, and family-led) that can optimize the role of family in T2D care. Given the diversity of household structures, interventions must be adaptable to varying family dynamics. While family involvement can enhance care, challenges such as cultural barriers, gender and age disparities, and inconsistent healthcare guidance must be addressed. Providers need training and clear protocols to engage families, while policies must ensure that caregivers are equipped with adequate support. Digital tools, including social media and telemedicine, offer promising ways to enhance family support in T2D management. Ultimately, South Asia must move beyond reliance on informal care to system-integrated family engagement that recognizes and empowers those often at the frontlines of care.

To examine how specific demographic factors affect pharmacy faculty perceptions of workload equity.

A post hoc analysis of previously published survey results was conducted. Faculty were asked about the comparison of actual vs assigned workload, fairness of assigned workload, domains used by primary decision maker(s) when assigning workload, and the importance of factors to improve perceived fairness. Responses were grouped by gender identity (female vs nonfemale), race and ethnicity (White vs non-White), and clinical practice status (clinical vs nonclinical).

A total of 662 complete responses were received (15.9% response rate). The distribution of effort for research/scholarship differed significantly between females and nonfemales (14.8% vs 22.2%, respectively). Female respondents reported significantly lower alignment between actual and assigned workload and indicated performing more actual service than assigned, compared to nonfemale respondents. This misalignment was also observed among non-White faculty. White faculty were more likely to believe that those assigning workload considered individual context and contributions. Differences were also found in workload allocation across gender identity, race and ethnicity, and clinical practice status, with the most substantial variations in time dedicated to research/scholarship vs clinical practice.

Faculty self-reported workload allocation/assignment and perceptions of actual vs assigned workload varied based on gender identity, race and ethnicity, and clinical practice status. These findings highlight the importance of clear, transparent workload policies and equitable assignment of responsibilities. Considering individual faculty roles and contributions to the overall program is crucial for improving perceived fairness and job satisfaction.