The COVID-19 pandemic's impact on sleep medicine fellowship telemedicine training: a follow-up survey of program directors.

STUDY OBJECTIVES: Our 2019 survey of sleep medicine fellowship program directors (PDs) indicated that fellows' contact with telemedicine was limited. Within months, the coronavirus disease 2019 (COVID-19) pandemic significantly impacted the field. This survey describes fellows' telemedicine exposure, their PDs' attitudes toward it, and their formalized telemedicine training during the pandemic's third year. METHODS: A 33-item SurveyMonkey questionnaire was developed. Many quantitative (Likert scale) items were identical to items on the 2019 survey for direct comparison. An open-ended question was added for qualitative analyses. All 91 sleep medicine fellowship PDs were invited to participate. The SurveyMonkey platform provided quantitative item descriptive statistics. Qualitative data underwent thematic analyses using codebook methodology. RESULTS: Forty (97.5%) PDs indicated their program offers a telemedicine experience. Thirty-two (80%) PDs observed at least a 10% increase in sleep fellows' telemedicine encounters compared with prepandemic times. Although 27 (67.5%) PDs agreed that a national telemedicine curriculum could be useful, 8 (20%) of them offer a sleep telemedicine curriculum. Qualitative feedback revealed diverging attitudes toward telemedicine's place in sleep medicine practice, fellowship training, and the utility of a national curriculum. CONCLUSIONS: Sleep telemedicine utilization during fellowship training was markedly higher on this 2022 survey (97.5%) compared with a similar 2019 survey (33.3%), and most PDs agreed a standardized curriculum could be useful. However, relatively few programs offer formalized telemedicine training. These findings imply that, while most sleep medicine fellows participate in telemedicine, they lack the formalized training that may optimize their utilization of the medium in their postfellowship careers. CITATION: Fields BG, Kaur K, Dholakia S, Ioachimescu O. The COVID-19 pandemic's impact on sleep medicine fellowship telemedicine training: a follow-up survey of program directors. J Clin Sleep Med. 2024;20(2):201-210.

Fibroblastic osteosarcoma: A perplexing entity.

Osteosarcoma (OS), also referred to as osteogenic sarcoma, is the most common primary malignant tumour affecting long bones, characterised by the proliferation of osteoblastic precursor cells and the production of osteoid or immature bone. OSs of the head and neck region have unique biology, exhibiting a clinical behaviour and a natural history that are distinct from OSs of the trunk and extremities. Similarly, their radiological appearance and histological growth pattern can be quite diverse proving to be a challenge to histopathologists to arrive at a diagnosis. Hence, OSs of the jaw remain enigmatic, and a number of difficulties related to their diagnosis and treatment are yet to be resolved. This article reports on a case of advanced OS of the mandible in a 45-year-old woman who came for the evaluation of swelling. This case illustrates the various modalities of diagnosis, such as radiology, histopathology and immunohistochemistry for the confirmation of the variants of OS, leading to an enormously improved quality of life by offering an improved opportunity for cure and treatment.

Comparison of Immediate Versus Staged Complete Revascularisation in Patients Presenting With Acute Coronary Syndrome and Multivessel Disease: A Meta-Analysis of Randomized and Non-randomized Studies.

Acute myocardial infarction is a critical medical condition that poses a significant health burden, leading to substantial morbidity. Despite advancements in medical care, managing this condition is challenging for patients and society. The preferred approach appears to be comprehensive multivessel revascularization, yet the optimal timing remains uncertain. This study aims to compare immediate complete revascularisation and stage complete vascularization in patients presenting with acute coronary syndrome (ACS) and multivessel coronary artery disease (MVD). The Preferred Reporting of Systematic Reviews and Meta-analysis (PRISMA) guidelines conducted the present meta-analysis. A comprehensive literature search was conducted using online databases, including PubMed, and EMBASE from 2010 onwards, to identify articles that compared cardiovascular outcomes between patients undergoing immediate and staged complete revascularization. We also searched Google Scholar for additional studies relevant to the present meta-analysis. The primary outcome assessed in this study was major adverse cardiovascular events (MACE). Secondary outcomes included all-cause mortality, cardiovascular mortality, myocardial infarction (MI), and revascularization. A total of 15 studies fulfilled pre-defined eligibility criteria and were included in the final analysis. Our analysis shows that staged revascularization is associated with improved outcomes in patients with ACS and multivessel CAD, including all-cause mortality and cardiovascular mortality, without increasing the risk of major adverse cardiovascular events, myocardial infarction, and the need for unplanned revascularization.

CARD 2023: expanded curation, support for machine learning, and resistome prediction at the Comprehensive Antibiotic Resistance Database.

The Comprehensive Antibiotic Resistance Database (CARD; card.mcmaster.ca) combines the Antibiotic Resistance Ontology (ARO) with curated AMR gene (ARG) sequences and resistance-conferring mutations to provide an informatics framework for annotation and interpretation of resistomes. As of version 3.2.4, CARD encompasses 6627 ontology terms, 5010 reference sequences, 1933 mutations, 3004 publications, and 5057 AMR detection models that can be used by the accompanying Resistance Gene Identifier (RGI) software to annotate genomic or metagenomic sequences. Focused curation enhancements since 2020 include expanded ß-lactamase curation, incorporation of likelihood-based AMR mutations for Mycobacterium tuberculosis, addition of disinfectants and antiseptics plus their associated ARGs, and systematic curation of resistance-modifying agents. This expanded curation includes 180 new AMR gene families, 15 new drug classes, 1 new resistance mechanism, and two new ontological relationships: evolutionary_variant_of and is_small_molecule_inhibitor. In silico prediction of resistomes and prevalence statistics of ARGs has been expanded to 377 pathogens, 21,079 chromosomes, 2,662 genomic islands, 41,828 plasmids and 155,606 whole-genome shotgun assemblies, resulting in collation of 322,710 unique ARG allele sequences. New features include the CARD:Live collection of community submitted isolate resistome data and the introduction of standardized 15 character CARD Short Names for ARGs to support machine learning efforts.

Assessing the Levels of Anger and Coping Behaviour among BSc Nursing and GNM Students in MOH College of Nursing, Ludhiana, Punjab.

The study was undertaken to assess the anger and coping behaviours adopted by nursing students. A comparative study was conducted among 90 BSc Nursing students and 90 GNM students. Simple random sampling technique by lottery method was used for selecting the sample. Level of anger was assessed by Clinical Anger Scale (CAS) and Structured Coping Behaviour Checklist was used to assess the coping behaviours adopted by nursing students. The finding revealed that majority of BSc Nursing and GNM students had minimal level of anger and adopt the adaptive behaviours to tide over the angry feelings. There was moderately negative correlation between anger and coping behaviours. Gender had statistically significant effect on anger and coping behaviours in both the groups at the level of p<0.05.