Evaluation of radiology resident well-being at a single institution with a dedicated wellness curriculum.

INTRODUCTION: Increasing rates of physician burnout over recent years have resulted in the need for formal tools and programming dedicated to physician well-being. The Accreditation Council for Graduate Medical Education (ACGME) has taken measures to prioritize trainee well-being by revising its common program requirements. Widespread departmental initiatives have been developed in line with these changes. At the authors' institution, a committee was developed to design and implement a holistic wellness curriculum for radiology trainees. OBJECTIVE: The objective of this study was to assess overall well-being in a cohort of radiology residents at a training program with a dedicated wellness curriculum. METHODS: A wellness curriculum for radiology residents was developed and implemented. Over a 3-year period, data was collected using the Maslach Burnout Inventory (MBI), Brief Resilience Scale (BRS). RESULTS: Rates amongst respondents were low, compared to average, for emotional exhaustion (below 17, average 25.2), depersonalization (6, average 10), and of personal accomplishment were moderate to high (37.5, average 32.9). PGY-4 level residents had the highest rates of burnout (p = 0.042 for depersonalization, p = 0.006 for emotional exhaustion). PGY-4 residents also had the lowest rates of resilience based on the BRS, and PGY-3 the highest (p = 0.037). There were no statistically significant differences between gender or differing relationship status for MBI or BRS. The most commonly cited barriers to wellness practices included fatigue, competing responsibilities, and not knowing where to start. CONCLUSION: Radiology residents at a single institution with a dedicated wellness curriculum demonstrated overall lower rates of burnout compared to their peers.

Long COVID incidence in adults and children between 2020 and 2023: a real-world data study from the RECOVER Initiative.

Estimates of post-acute sequelae of SARS-CoV-2 infection (PASC) incidence, also known as Long COVID, have varied across studies and changed over time. We estimated PASC incidence among adult and pediatric populations in three nationwide research networks of electronic health records (EHR) participating in the RECOVER Initiative using different classification algorithms (computable phenotypes). Overall, 7% of children and 8.5%-26.4% of adults developed PASC, depending on computable phenotype used. Excess incidence among SARS-CoV-2 patients was 4% in children and ranged from 4-7% among adults, representing a lower-bound incidence estimation based on two control groups - contemporary COVID-19 negative and historical patients (2019). Temporal patterns were consistent across networks, with peaks associated with introduction of new viral variants. Our findings indicate that preventing and mitigating Long COVID remains a public health priority. Examining temporal patterns and risk factors of PASC incidence informs our understanding of etiology and can improve prevention and management.

Acute Appendicitis in the Epicenter of the COVID-19 Pandemic: A New York City Single-Center Experience.

BACKGROUND: Appendectomy is the gold standard for simple appendicitis. During the coronavirus-19 pandemic, it was estimated that appendectomies in the United States decreased by 24%. We aimed to describe trends in acute appendicitis management at a center located in one of the largest epicenters of the pandemic. METHODS: This is a retrospective cohort study in a single institution located in Queens, New York, of patients who presented with acute appendicitis. A pre-COVID time period, March-June 2019, was compared to peak-COVID, March-June 2020, and late-COVID, March-June 2021. RESULTS: Of the 382 patients admitted with appendicitis during the time periods, 164 were admitted pre-COVID. Appendicitis presentations decreased by 44% during peak-COVID and 23% in late-COVID. Patients were younger during peak-COVID compared to pre-COVID (39 vs 34 years old, P = .036). Incidence of complicated appendicitis in pre-, peak-, and late-COVID was equivalent (41% vs 46% vs 45%) and operative management was similar (85% vs 76% vs 79%). Non-operative patients had shorter lengths of stay (pre- vs peak-COVID: 4.6 vs 2.9 days, P = .006). Readmission rates were similar between the cohorts across time periods. CONCLUSIONS: During peak-COVID, there was a significant decrease in presentation of acute appendicitis but clinical presentation and outcomes remained similar between the cohorts. Patients who were managed non-operatively may be discharged earlier without increased rates of readmissions.

Annexin A2 promotes phagophore assembly by enhancing Atg16L⁺ vesicle biogenesis and homotypic fusion.

Plasma membrane budding of Atg-16L-positive vesicles represents a very early event in the generation of the phagophore and in the process of macroautophagy. Here we show that the membrane curvature-inducing protein annexin A2 contributes to the formation of these vesicles and their fusion to form phagophores. Ultrastructural, proteomic and FACS analyses of Atg16L-positive vesicles reveal that 30% of Atg16L-positive vesicles are also annexin A2-positive. Lipidomic analysis of annexin A2-deficient mouse cells indicates that this protein plays a role in recruiting phosphatidylserine and phosphatidylinositides to Atg16L-positive vesicles. Absence of annexin A2 reduces both vesicle formation and homotypic Atg16L vesicle fusion. Ultimately, a reduction in LC3 flux and dampening of macroautophagy are observed in dendritic cells from Anxa2(-/-) mice. Together, our analyses highlight the importance of annexin A2 in vesiculation of a population of Atg16L-positive structures from the plasma membrane, and in their homotypic fusion to form phagophore structures.