The unnamed Division 14 officer is the first on-screen appearance of an Edosian character since Enterprise navigator Lt. Arex in Star Trek: The Animated Series (1973). The three-legged, three-armed aliens are much easier to show in animation than in live-action shows, especially those made before the advent of CGI effects.
The freak 'Anthony' resembles the salamander-like creatures Paris and Janeway turn into in Threshold (1996). Paris figures out how to break the warp 10 barrier in a specially modified shuttle, which has the side effect of causing anyone onboard to "evolve" into a salamander-like creature. Paris mutates first, goes crazy and kidnaps Janeway, takes her on the shuttle to warp 10 changing her and then they wind up on a planet and mate resulting in Janeway having several "children". This is widely considered the worst episode of Voyager and one of the worst Star Trek episodes of all time.
Several characters are seen in the same type of wheelchair as Captain Christopher Pike in The Menagerie: Part I (1966) and Through the Valley of Shadows (2019).
When discussing the temporary captain for the Cerritos, Mariner comments on how much she hates substitute captains, saying "I don't want some babysitter Jellico-type hovering over us" referencing the Enterprise-D substitute captain Edward Jellico when Picard was captured by the Cardassians in Chain of Command, Part I (1992).
The Division 14 ship, USS Osler (NX-75300), is named after Sir William Osler, a Canadian physician and one of the founders of Johns Hopkins Hospital.