The current state of training in pain medicine fellowships: An Association of Pain Program Directors (APPD) survey of program directors.

Introduction: The Accreditation Council for Graduate Medical Education (ACGME) approved the first pain medicine fellowship programs over three decades ago, designed around a pharmacological philosophy. Following that, there has been a rise in the transition of pain medicine education toward a multidisciplinary interventional model based on a tremendous surge of contemporaneous literature in these areas. This trend has created variability in clinical experience and education amongst accredited pain medicine programs with minimal literature evaluating the differences and commonalities in education and experience of different pain medicine fellowships through Program Director (PD) experiences.

Pain Medicine Fellowship Video Interviews: A COVID-19 Trend or Here to Stay?

Background: The COVID-19 pandemic ushered in a shift to a video format for pain medicine fellowship interviews for the 2021-2022 academic year, which represented a major change in the fellowship interview paradigm.

Objectives: Our aim was to assess the experience of a video-only format in place of in-person interviews for Pain Medicine fellowship program directors and applicants after the 2020 fellowship interview season to determine the feasibility for continuation beyond COVID-19 travel restrictions.

Study Design: Survey via Qualtrics.

A dose-escalation clinical trial of intranasal ketamine for uncontrolled cancer-related pain.

Study Objective: The objective of our study was to determine safety and pharmacology (pharmacokinetics and preliminary efficacy) of intranasal (IN) ketamine for uncontrolled cancer-related pain.

Design: Dose escalation clinical trial.

Setting: Outpatient.

Telemedicine and current clinical practice trends in the COVID-19 pandemic.

Telemedicine is the medical practice of caring for and treating patients remotely. With the spread of the coronavirus disease-2019 (COVID-19) pandemic, telemedicine has become increasingly prevalent. Although telemedicine was already in practice before the 2020 pandemic, the internet, smartphones, computers, and video-conferencing tools have made telemedicine easily accessible and available to almost everyone.

Opioid-Free Anesthesia for Craniotomy.

Background: Perioperative opioids are problematic following craniotomy as they can impede neurological examination because of excessive sedation and mask surgical complications. Multimodal anesthetic techniques including nerve blocks have been used successfully to deliver opioid-free anesthesia in other surgical populations; however, no clinical data evaluating opioid-free anesthesia for craniotomy exists within the current body of literature.

Materials And Methods: Six prospectively identified patients underwent supratentorial craniotomy at Emory University Hospital using a multimodal opioid-free anesthetic (OFA) technique consisting of preoperative scalp block, dexmedetomidine and intravenous acetaminophen.

Stellate ganglion blockade for treating refractory electrical storm: a historical cohort study.

Background: Stellate ganglion blockade (SGB) has been used to treat electrical storm (ES) refractory to antiarrhythmic therapy or to stabilize patients before more definitive intervention. Nevertheless, its efficacy is not well understood, with only a few case reports and retrospective case series in the literature.

Methods: We conducted a historical cohort study on patients with drug-refractory ES who underwent ultrasound-guided unilateral SGB from 1 January 2010 until 19 July 2019 at two hospital sites.

Lumbar Spondylolisthesis Progression: What is the Effect of Lumbar Medial Branch Nerve Radiofrequency Ablation on Lumbar Spondylolisthesis Progression? A Single-Center, Observational Study.

Background: Radiofrequency ablation (RFA) is a denervation therapy commonly performed for pain of facet etiology. Degenerative spondylolisthesis, a malalignment of the spinal vertebrae, may be a co-existing condition contributing to pain; yet the effect of RFA on advancing listhesis is unknown. To the extent that denervating RFA may weaken paraspinal muscles that provide stability to the spine, the therapy can potentially contribute to progressive spinal instability.

Maintaining High-Quality Multidisciplinary Pain Medicine Fellowship Programs: Part I: Innovations in Pain Fellows' Education, Research, Applicant Selection Process, Wellness, and ACGME Implementation During the COVID-19 Pandemic.

Background: Pain fellowship programs are facing unique challenges during the COVID-19 pandemic. Restrictions from state governments and the Centers for Disease Control and Prevention have resulted in a rapidly changing and evolving learning environment for todays' fellows. Innovative solutions must be sought to guarantee that proper education is maintained and to ensure the well-being of our trainees.

Maintaining High-Quality Multidisciplinary Pain Medicine Fellowship Programs: Part II: Innovations in Clinical Care Workflow, Clinical Supervision, Job Satisfaction, and Postgraduation Mentorship for Pain Fellows During the COVID-19 Pandemic.

Background: Pain fellowship programs are facing unique challenges during the COVID-19 pandemic. Restrictions by state governments and the Centers for Disease Control and Prevention have resulted in a rapidly changing and evolving learning environment for today's fellows. Innovative solutions must be sought to maintain proper education and ensure the well-being of our trainees.

Abdominal Surgery With Bilateral Rectus Sheath Block: A Case Report.

A 44-year-old man, American Society of Anesthesiologists physical status class IV, presented for fulguration of anal condyloma and diverting colostomy. The patient's medical history includes World Health Organization (WHO) class I pulmonary hypertension (PH), right heart failure, and bilateral lower extremity paralysis due to Pott's disease. The patient was not a candidate for neuraxial anesthesia due to sacral decubitus ulcers, and alternative options to general anesthesia (GA) were considered to avoid the high risk of right ventricular (RV) failure and ensuing complications.

Safety of Intranasal Ketamine for Reducing Uncontrolled Cancer-Related Pain: Protocol of a Phase I/II Clinical Trial.

Background: Approximately 12 million Americans are affected with cancer. Of these, 53% experience pain at all stages of cancer. Pain may remain uncontrolled despite high-dose opioid therapy, and opioids have many well-documented harmful side effects.

Low Back Pain, a Comprehensive Review: Pathophysiology, Diagnosis, and Treatment.

Purpose Of Review: Low back pain encompasses three distinct sources: axial lumbosacral, radicular, and referred pain. Annually, the prevalence of low back pain in the general US adult population is 10-30%, and the lifetime prevalence of US adults is as high as 65-80%.

Recent Findings: Patient history, physical exam, and diagnostic testing are important components to accurate diagnosis and identification of patient pathophysiology.

Measurement of resonant and nonresonant induced refractive index changes in Yb-doped fiber grating amplifier.

We have measured the refractive index change (RIC) induced in a fiber Bragg grating (FBG) written in a Yb-doped fiber amplifier (YB-FBG) because of the amplifier pumping. The measurement was performed by exploiting the high sensitivity of the YD-FBG transmission to the RIC. We have separated between electronic and thermal contributions to the RIC based on the difference between the time-scales of the two effects.

Selection of dark modes in resonators with conical reflectors.

Selection of modes containing different dark regions was studied in resonators with conical reflectors. The possibility of selecting whole subgroups of such modes was shown in circularly symmetric resonators. To handle single-mode selection employing extra intracavity spatial filters, modified integral equations and a numerical method of their analysis are proposed.

Absorption enhancement by matching the cross-section of plasmonic nanowires to the field structure of tightly focused beams.

Nanostructured materials, designed for enhanced light absorption, are receiving increased scientific and technological interest. In this paper we propose a physical criterion for designing the cross-sectional shape of plasmonic nanowires for improved absorption of a given tightly focused illumination. The idea is to design a shape which increases the matching between the nanowire plasmon resonance field and the incident field.

Material classification of nanoparticles by focused beam scattering.

Advanced science and technology frequently encounters the need to detect particles in the micrometer and nanometer range of a given composition. While the scattering process of light by small particles is well documented, most conventional analytic methods employ wide illumination of large ensembles of particles. With such an approach, no information can be obtained about single particles due to their weak interaction.

Scattering of singular beams by subwavelength objects.

In recent years, there has been a mounting interest in better methods of measuring nanoscale objects, especially in fields such as nanotechnology, biomedicine, cleantech, and microelectronics. Conventional methods have proved insufficient, due to the classical diffraction limit or slow and complicated measuring procedures. The purpose of this paper is to explore the special characteristics of singular beams with respect to the investigation of subwavelength objects.

Plasmonic resonance scattering from silver nanowire illuminated by tightly focused singular beam.

We investigate scattering features of tightly focused singular beams by placing a cylindrical nanowire in the vicinity of a line phase singularity. Applying an illumination wavelength corresponding to silver cylinder plasmonic resonance, we compare the scattering response with that of a perfect conductor. The rigorous modeling employs a 2D version of the Richards-Wolf focusing method and the source model technique.

Pattern generation with an extended focal depth.

The depth of focus of light patterns can be extended, within given tolerances, beyond the classical limits. For a quantitative evaluation we introduce a degree of depth-of-focus extension and a three-dimensional energy-distribution efficiency. The basic limitations involved in depth-of-focus extension are discussed.

Singular beam microscopy.

Optical singularities are localized regions in a light field where one or more of the field parameters, such as phase or polarization, become singular with associated zero intensity. Singular beam microscopy exploits the fact that the strong variations of the optical field around the singularities are highly sensitive to changes in their neighborhood. As a consequence, analysis of the light field scattered from the object during a scanning process can yield useful information about the object features.

Laser-mode selection by a combination of biprism-like reflectors with narrow amplitude masks.

In recent work the laser mode selectivity induced separately by a biprism-like reflector and by an absorbing strip was investigated by numerical analysis. It was shown that each of these elements in an otherwise conventional resonator was suitable to cause the laser to oscillate preferentially on the first odd mode that contains a line singularity, which is a useful dark beam (i.e.

Two regions of mode selection in resonators with biprismlike elements.

A resonator structure in which one reflector is replaced by a biprismlike reflecting surface is investigated theoretically. It is shown that such a modification leads to two regions of parameters, each with different regimes of mode selection. The first region has an improved laser power output because of the nearly flat-top mode shape.