Exploration of exposure to artificial intelligence in undergraduate medical education: a Canadian cross-sectional mixed-methods study.

BACKGROUND: Emerging artificial intelligence (AI) technologies have diverse applications in medicine. As AI tools advance towards clinical implementation, skills in how to use and interpret AI in a healthcare setting could become integral for physicians. This study examines undergraduate medical students' perceptions of AI, educational opportunities about of AI in medicine, and the desired medium for AI curriculum delivery. METHODS: A 32 question survey for undergraduate medical students was distributed from May-October 2021 to students to all 17 Canadian medical schools. The survey assessed the currently available learning opportunities about AI, the perceived need for learning opportunities about AI, and barriers to educating about AI in medicine. Interviews were conducted with participants to provide narrative context to survey responses. Likert scale survey questions were scored from 1 (disagree) to 5 (agree). Interview transcripts were analyzed using qualitative thematic analysis. RESULTS: We received 486 responses from 17 of 17 medical schools (roughly 5% of Canadian undergraduate medical students). The mean age of respondents was 25.34, with 45% being in their first year of medical school, 27% in their 2nd year, 15% in their 3rd year, and 10% in their 4th year. Respondents agreed that AI applications in medicine would become common in the future (94% agree) and would improve medicine (84% agree Further, respondents agreed that they would need to use and understand AI during their medical careers (73% agree; 68% agree), and that AI should be formally taught in medical education (67% agree). In contrast, a significant number of participants indicated that they did not have any formal educational opportunities about AI (85% disagree) and that AI-related learning opportunities were inadequate (74% disagree). Interviews with 18 students were conducted. Emerging themes from the interviews were a lack of formal education opportunities and non-AI content taking priority in the curriculum. CONCLUSION: A lack of educational opportunities about AI in medicine were identified across Canada in the participating students. As AI tools are currently progressing towards clinical implementation and there is currently a lack of educational opportunities about AI in medicine, AI should be considered for inclusion in formal medical curriculum.

About time! A scoping review of public-facing emergency department wait time displays in Canada.

PURPOSE: Waiting is a common experience for patients during an emergency department (ED) visit. While high acuity patients are seen with little delay, low acuity patients may experience dissatisfaction from prolonged wait times. One strategy to improve patient experience involves changing the perception of the wait by providing realistic expectations of wait times using public-facing wait time displays. The primary objective of this study is to quantify the number of Canadian EDs with online wait time displays and describe the features and type of information provided. METHODS: A systematic online search of all Canadian EDs was completed to identify EDs with public-facing wait time displays. A scoping review was then performed to assess their message characteristics, translations offered, availability of multi-site information, and accessibility features. Data were summarized using descriptive statistics. RESULTS: Sixty (9.3%) of the 647 Canadian EDs identified provide public-facing real-time wait time displays. Thirteen of these (21.7%) were associated with a single proprietary system. Distribution of wait time displays differs across Canada, with a range of zero to 100% of EDs within each province utilizing this communication tool. Common characteristics include "average" wait time (95%), graphical trend data (32%), number of patients waiting (33%), longest wait time (12%), and expected length of stay (10%). Sixty-two percent of wait time displays provide a combination of these methods to inform wait times. Important accessibility features include language translation, compliance with Canadian National Institute for the Blind (CNIB) accessibility guidelines and availability on a mobile application. CONCLUSION: Currently, there is emerging use of wait time displays in Canada with considerable variability in the information communicated through these tools. Effectiveness of these displays and their content needs to be determined.

RéSUMé: OBJECTIF: L'attente est une expérience courante pour les patients lors d'une visite au service des urgences (SU). Alors que les patients avec un niveau d'acuité élevé sont vus dans les plus brefs délais, les patients à faible degré d'acuité peuvent éprouver de l'insatisfaction à cause des temps d'attente prolongés. Une stratégie visant à améliorer l'expérience des patients consiste à modifier la perception de l'attente en fournissant des attentes réalistes en matière de temps d'attente au moyen d'affichages de temps d'attente destinés au public. L'objectif principal de la présente étude est de quantifier le nombre de services d'urgence canadiens qui affichent les temps d'attente en ligne et de décrire les caractéristiques et le type d'information fournie. MéTHODES: Une recherche systématique en ligne de tous les services d'urgence canadiens a été effectuée afin d'identifier les services d'urgence qui affichent les temps d'attente à l'intention du public. Un examen de la portée a ensuite été effectué pour évaluer les caractéristiques de leurs messages, les traductions offertes, la disponibilité d'informations multisites et les caractéristiques d'accessibilité. Les données ont été résumées à l'aide de statistiques descriptives. RéSULTATS: Soixante (9,3 %) des 647 urgences canadiennes recensées offrent au public un affichage en temps réel des temps d'attente. Treize d'entre eux (21,7 %) étaient associés à un seul système propriétaire. La répartition des affichages sur les temps d'attente varie d'un bout à l'autre du Canada, avec une fourchette de zéro à 100 % des services d'urgence dans chaque province utilisant cet outil de communication. Les caractéristiques communes comprennent le temps d'attente « moyen ¼ (95 %), les données de tendance graphique (32 %), le nombre de patients en attente (33 %), le temps d'attente le plus long (12 %) et la durée prévue du séjour (10 %). Soixante-deux pour cent des affichages des temps d'attente fournissent une combinaison de ces méthodes pour informer les temps d'attente. Les fonctionnalités d'accessibilité importantes incluent la traduction linguistique, la conformité aux directives d'accessibilité de l'Institut national canadien pour les aveugles (INCA) et la disponibilité sur une application mobile. CONCLUSION: À l'heure actuelle, l'utilisation des présentoirs sur les temps d'attente au Canada est de plus en plus répandue, et l'information communiquée au moyen de ces outils varie considérablement. L'efficacité de ces affichages et de leur contenu doit être déterminée.

The intra-mitochondrial O-GlcNAcylation system rapidly modulates OXPHOS function and ROS release in the heart.

Protein O-GlcNAcylation is increasingly recognized as an important cellular regulatory mechanism, in multiple organs including the heart. However, the mechanisms leading to O-GlcNAcylation in mitochondria and the consequences on their function remain poorly understood. In this study, we use an in vitro reconstitution assay to characterize the intra-mitochondrial O-GlcNAc system without potential cytoplasmic confounding effects. We compare the O-GlcNAcylome of isolated cardiac mitochondria with that of mitochondria acutely exposed to NButGT, a specific inhibitor of glycoside hydrolase. Amongst the 409 O-GlcNAcylated mitochondrial proteins identified, 191 display increased O-GlcNAcylation in response to NButGT. This is associated with enhanced Complex I (CI) activity, increased maximal respiration in presence of pyruvate-malate, and a striking reduction of mitochondrial ROS release, which could be related to O-GlcNAcylation of specific subunits of ETC complexes (CI, CIII) and TCA cycle enzymes. In conclusion, our work underlines the existence of a dynamic mitochondrial O-GlcNAcylation system capable of rapidly modifying mitochondrial function.

Protein O-GlcNAcylation in Cardiac Pathologies: Past, Present, Future.

O-GlcNAcylation is a ubiquitous and reversible post-translational protein modification that has recently gained renewed interest due to the rapid development of analytical tools and new molecules designed to specifically increase the level of protein O-GlcNAcylation. The level of O-GlcNAc modification appears to have either deleterious or beneficial effects, depending on the context (exposure time, pathophysiological context). While high O-GlcNAcylation levels are mostly reported in chronic diseases, the increase in O-GlcNAc level in acute stresses such as during ischemia reperfusion or hemorrhagic shock is reported to be beneficial in vitro, ex vivo, or in vivo. In this context, an increase in O-GlcNAc levels could be a potential new cardioprotective therapy, but the ambivalent effects of protein O-GlcNAcylation augmentation remains as a key problem to be solved prior to their transfer to the clinic. The emergence of new analytical tools has opened new avenues to decipher the mechanisms underlying the beneficial effects associated with an O-GlcNAc level increase. A better understanding of the exact roles of O-GlcNAc on protein function, targeting or stability will help to develop more targeted approaches. The aim of this review is to discuss the mechanisms and potential beneficial impact of O-GlcNAc modulation, and its potential as a new clinical target in cardiology.