Context-aware analysis enhances autoscoring accuracy of home sleep apnea testing.

Study Objectives: Home sleep apnea testing based on peripheral arterial tonometry (P-HSAT) is increasingly being deployed because of its ability to test for multiple nights. However, P-HSATs do not have access to modalities such as airflow and cortical arousals and instead rely on alternative sources of information to detect respiratory events. This results in an a-priori performance disadvantage.

The evaluation of a novel single-lead biopotential device for home sleep testing.

Study Objectives: This paper reports on the clinical evaluation of the sleep staging performance of a novel single-lead biopotential device.

Methods: 133 patients suspected of obstructive sleep apnea were included in a multi-site cohort. All patients underwent polysomnography and received the study device, a single-lead biopotential measurement device attached to the forehead.

Dissecting cell death pathways in fed-batch bioreactors.

Chinese hamster ovary (CHO) cells are widely used for production of biologics including therapeutic monoclonal antibodies. Cell death in CHO cells is a significant factor in biopharmaceutical production, impacting both product yield and quality. Apoptosis has previously been described as the major form of cell death occurring in CHO cells in bioreactors.

Central Sleep Apnea Detection by Means of Finger Photoplethysmography.

Unlabelled: Obstructive Sleep Apnea (OSA) and Central Sleep Apnea (CSA) are two types of Sleep Apnea (SA) with different etiologies and treatment options. Home sleep apnea testing based on photoplethysmography-derived peripheral arterial tonometry (PAT HSAT) has become the most widely deployed outpatient SA diagnostic method. Being able to differentiate between CSA and OSA based solely on photoplethysmography-data would further increase PAT HSAT's clinical utility.

A multicentric validation study of a novel home sleep apnea test based on peripheral arterial tonometry.

Study Objectives: This paper reports on the multicentric validation of a novel FDA-cleared home sleep apnea test based on peripheral arterial tonometry (PAT HSAT).

Methods: One hundred sixty-seven participants suspected of having obstructive sleep apnea (OSA) were included in a multicentric cohort. All patients underwent simultaneous polysomnography (PSG) and PAT HSAT, and all PSG data were independently double scored using both the recommended 1A rule for hypopnea, requiring a 3% desaturation or arousal (3% Rule), and the acceptable 1B rule for hypopnea, requiring a 4% desaturation (4% Rule).

Correlations between home sleep apnea tests and polysomnography outcomes do not fully reflect the diagnostic accuracy of these tests.

Study Objectives: The clinical performance of home sleep apnea tests (HSATs) can be described by their (diagnostic) accuracy, defined as the percentage agreement with the obstructive sleep apnea severity category (normal, mild, moderate, and severe) based on polysomnography. Rather than reporting on accuracy, there has been a strong reliance in the literature to report correlation coefficients between the apnea-hypopnea index of HSATs and polysomnography to support claims of diagnostic performance. This is surprising, as it has been well described that correlation coefficients are inadequate to evaluate equivalence between 2 parameters.

Phenotyping REM OSA by means of peripheral arterial tone-based home sleep apnea testing and polysomnography: A critical assessment of the sensitivity and specificity of both methods.

The clinical relevance of rapid eye movement sleep-related obstructive sleep apnea (REM OSA) is supported by its associated adverse health outcomes and impact on optimal treatment strategies. To date, no assessment of REM OSA phenotyping performance has been conducted for any type of sleep testing technology. The objective of this study was to assess this for polysomnography and peripheral arterial tone-based home sleep apnea testing (PAT HSAT).

An Evaluation of the NightOwl Home Sleep Apnea Testing System.

Study Objectives: The objective of this study was to evaluate the performance of a miniaturized home sleep apnea test, called NightOwl. The system consists of a sensor placed on the fingertip and a cloud-based analytics software. The sensor acquires accelerometer and photoplethysmographic data.

Engagement in an Online Cultural Competency Training.

Objectives: Engagement with online cultural competency training has not been well studied. We examined knowledge, attitudes, and skills differences among medical students, physicians, and other professionals in an online cultural competency education program.

Methods: A total of 1745 participants completed up to four online modules aimed at exploring stereotype, bias, diet, and religion among African American patients with hypertension.

Step Up-Not On-The Step 2 Clinical Skills Exam: Directors of Clinical Skills Courses (DOCS) Oppose Ending Step 2 CS.

Recently, a student-initiated movement to end the United States Medical Licensing Examination Step 2 Clinical Skills and the Comprehensive Osteopathic Medical Licensing Examination Level 2-Performance Evaluation has gained momentum. These are the only national licensing examinations designed to assess clinical skills competence in the stepwise process through which physicians gain licensure and certification. Therefore, the movement to end these examinations and the ensuing debate merit careful consideration.

The Impact of Stigma and Personal Experiences on the Help-Seeking Behaviors of Medical Students With Burnout.

Purpose: Because of the high prevalence of burnout among medical students and its association with professional and personal consequences, the authors evaluated the help-seeking behaviors of medical students with burnout and compared their stigma perceptions with those of the general U.S. population and age-matched individuals.

A web-based cultural competency training for medical students: a randomized trial.

Background: The objectives of this research were to compare a Web-based curriculum with a traditional lecture format on medical students' cultural competency attitudes using a standardized instrument and to examine the internal consistency of the standardized instrument.

Methods: In 2010, we randomized all 180 1st-year medical students into a Web-based (intervention group) or a lecture-based (control group) cultural competency training. The main outcome was the overall score on the Health Belief Attitudes Survey (1 = lowest, 6 = highest).

Distress among matriculating medical students relative to the general population.

Purpose: Many medical students experience distress during medical school. If matriculating medical students (MMSs) begin training with similar or better mental health than age-similar controls, this would support existing concerns about the negative impact of training on student well-being. The authors compared mental health indicators of MMSs versus those of a probability-based sample of the general U.

Evaluation of an advanced physical diagnosis course using consumer preferences methods: the nominal group technique.

Background: Current evaluation tools of medical school courses are limited by the scope of questions asked and may not fully engage the student to think on areas to improve. The authors sought to explore whether a technique to study consumer preferences would elicit specific and prioritized information for course evaluation from medical students.

Methods: Using the nominal group technique (4 sessions), 12 senior medical students prioritized and weighed expectations and topics learned in a 100-hour advanced physical diagnosis course (4-week course; February 2012).

A multi-institutional study exploring the impact of positive mental health on medical students' professionalism in an era of high burnout.

Purpose: Although burnout is associated with erosion of professionalism and serious personal consequences, whether positive mental health can enhance professionalism and how it shapes personal experience remain poorly understood. The study simultaneously explores the relationship between positive mental health and burnout with professionalism and personal experience.

Method: The authors surveyed 4,400 medical students at seven U.

Distress and empathy do not drive changes in specialty preference among US medical students.

Background: Although medical student specialty choices shape the future of the healthcare workforce, factors influencing changes in specialty preference during training remain poorly understood.

Aim: To explore if medical student distress and empathy predicts changes in students' specialty preference.

Methods: A total of 858/1321 medical students attending five medical schools responded to surveys in 2006 and 2007.

Relationship of pass/fail grading and curriculum structure with well-being among preclinical medical students: a multi-institutional study.

Purpose: Psychological distress is common among medical students. Curriculum structure and grading scales are modifiable learning environment factors that may influence student well-being. The authors sought to examine relationships among curriculum structures, grading scales, and student well-being.

The problems program directors inherit: medical student distress at the time of graduation.

Background: Distress is prevalent among residents and often attributed to rigors of training.

Aims: To explore the prevalence of burnout and depression and measured mental quality of life (QOL) among graduating medical students shortly before they began residency.

Method: Pooled analysis of data from 1428 fourth year medical students who responded to 1 of 3 multi-institutional studies.

Relationship between burnout and professional conduct and attitudes among US medical students.

Context: The relationship between professionalism and distress among medical students is unknown.

Objective: To determine the relationship between measures of professionalism and burnout among US medical students.

Design, Setting, And Participants: Cross-sectional survey of all medical students attending 7 US medical schools (overall response rate, 2682/4400 [61%]) in the spring of 2009.

Burnout and serious thoughts of dropping out of medical school: a multi-institutional study.

Purpose: Little is known about students who seriously consider dropping out of medical school. The authors assessed the severity of thoughts of dropping out and explored the relationship of such thoughts with burnout and other indicators of distress.

Method: The authors surveyed medical students attending five medical schools in 2006 and 2007 (prospective cohort) and included two additional medical schools in 2007 (cross-sectional cohort).

The importance of measuring competency-based outcomes: standard evaluation measures are not surrogates for clinical performance of internal medicine residents.

Background: Despite recent emphasis on educational outcomes, program directors still rely on standard evaluation techniques such as tests of knowledge and subjective ratings.

Purposes: To assess the correlation of standard internal medicine (IM) residency evaluation scores (attending global evaluations, In-Training examination, and Mini-Clinical Examination Exercise) with documented performance of preventive measures for continuity clinic patients.

Methods: Cross-sectional study of 132 IM residents attending an IM teaching clinic, July 2000 to June 2003, comparing standard evaluations with chart audit.

The learning environment and medical student burnout: a multicentre study.

Objectives: Little is known about specific personal and professional factors influencing student distress. The authors conducted a comprehensive assessment of how learning environment, clinical rotation factors, workload, demographics and personal life events relate to student burnout.

Methods: All medical students (n = 3080) at five medical schools were surveyed in the spring of 2006 using a validated instrument to assess burnout.