To assess the frequency of coronavirus disease-2019 (COVID-19) and the effect of obstructive sleep apnea (OSA) management on COVID-19 among patients with confirmed OSA. Cross-sectional telephone interview survey. Academic sleep labs. Iranian adults ≥ 18 years old with confirmed OSA. Among 275 participants with OSA, 20% (n = 55) were suspected to have history of COVID-19 but had no positive test, and 18% (n = 51) were in the definite COVID-19 group according to their reported symptoms or confirmed positive test. Having severe OSA (apnea hypopnea index ≥ 30) was associated with an increased risk of definite COVID-19, with an odds ratio (OR) with 95% confidence interval (95% CI) of 2.31 (0.87-5.55) compared to having mild OSA in definite COVID-19 group. Those not undergoing treatment for OSA had an OR (95% CI) of 2.43 (1.26-4.67) for definite COVID-19 compared to those accepting treatment in definite COVID-19 group. Total sleep times (TSTs) were 354, 340, and 320 minutes in healthy, suspected, and COVID-19 groups, respectively; TST was associated with COVID-19 (P-value = .04). Similarly, sleep efficiency (SE) scores were 75.7, 74.2, and 67.9% for the healthy, suspected, and COVID-19 groups, respectively (P-value = .005); Beck Depression scores were 13.8, 13.0, and 17.7, respectively (P-value = .056). OSA as a proinflammatory condition with multiple comorbidities may be a contributing factor to developing COVID-19. Greater OSA severity, no treatment for OSA, and lower TST and SE were associated with increased COVID-19 prevalence among patients with OSA.

Background: Sleep apnea is a prevalent sleep disorder, especially in males and older ages. The common diagnostic methods, including polysomnography (PSG), are expensive, difficult to perform, and time-consuming. Numerous studies are focusing on developing easy-to-perform methods based on artificial intelligence (AI) for the early diagnosis of sleep apnea. This systematic review aimed to gather current methods based on the convolutional neural network (CNN) for the diagnosis of sleep apnea. Methods: Three international electronic databases (PubMed, Web of Science [WoS], and Scopus) were searched from 2010 to October 2023. All studies that have developed CNN-based methods for the diagnosis of sleep apnea and have accomplished the performance tests were included. Finally, the characteristics of the studies were extracted and summarized. Results: A total of 36 studies were included in this systematic review. Various physiological signals have been proposed to detect sleep apnea, including electrocardiogram (ECG), blood oxygen saturation (SpO2), sound signals, respiratory signals, electroencephalogram (EEG), and nasal airflow. Electrocardiogram was the most frequently used signal in the studies, followed by SpO2. The highest reported accuracy was achieved by SpO2 or ECG-based methods and with a one-dimensional CNN (1D-CNN) classifier. Using multiple signals did not necessarily increase the performance of test results. Conclusions: Diagnostic methods based on CNN can be used only as screening tools or home diagnosis of sleep apnea. These methods are easy to perform and can only reduce the diagnostic costs and waiting time for a sleep study in special scenarios. Nevertheless, PSG is still the gold standard for the diagnosis of sleep disorders.

Burnout can be defined as a serious work-related syndrome characterized by depersonalization, emotional exhaustion, and reduced personal accomplishment, particularly among healthcare practitioners such as medical students. It can adversely affect academic performance and compromise vital professional values, including altruism, honesty, and empathy. While some studies have suggested that there is no connection between burnout and professional behavior, other studies have highlighted this relationship. This systematic review seeks to clarify the link between burnout and professionalism. A comprehensive search was performed across PubMed, Web of Science, Scopus, and Embase to identify studies examining the association between burnout and professionalism among medical students and residents. The inclusion criteria required studies to use validated measures, including the Maslach Burnout Inventory. Two authors screened and extracted data from eligible studies, resolving disagreements through a third reviewer. The quality of the studies was examined through the risk of bias tool named the Cochrane Collaboration. A total of twenty-nine studies were analyzed, comprising approximately 14,974 participants, which included 4,242 medical students and 10,732 residents. The majority of the studies reported a negative correlation. Additionally, most studies reported negative correlations between burnout and professionalism, patient care practices, and medical knowledge, whereas some reported negative correlations with lifelong learning and communication skills. The association between burnout and professionalism among medical trainees is complex and has considerable implications for patient care, trainee well-being, and medical education. Increased levels of burnout can lead to a decline in empathy and professionalism, resulting in a cycle of emotional exhaustion and disengagement. To address this challenge effectively, a holistic approach is essential, encompassing mental health resources, professional training, and systemic modifications aimed at fostering supportive environments.

Context: Among patients undergoing surgery, preoperative anxiety (PA) is one of the most common psychological problems that can negatively impact the patient's physical health and the operation's outcome. Preoperative patient education (PPE) is a way to reduce PA, which has many advantages over pharmaceutical methods. Therefore, this study aimed to evaluate the effectiveness of PPE on PA in patients who are candidates for surgery by reviewing similar previous studies. Evidence Acquisition: The data in this narrative review were collected by searching past studies in reliable international databases, including Web of Science, Science Direct, Scopus, PubMed, and Google Scholar, in the last two decades. In the first stage of the search, 248 articles and scientific reports were received, and then 30 articles were selected as final studies by considering the inclusion and exclusion criteria. Results: In most previous similar studies, PPE significantly reduced PA in patients who are candidates for surgery. However, the findings of a small number of studies also showed that PPE had little positive effect, no effect, or negative effect on PA control. There were different methods to provide information to patients before surgery, and the efficiency and application of each were different based on the demographic characteristics of the patients. Conclusions: Based on the findings, appropriate training methods can reduce the level of PA in patients who are candidates for surgery. However, in some past studies, providing information about the surgical procedure may increase patients' PA. Therefore, nurses or medical staff with more contact with patients are suggested to have sufficient experience and knowledge in providing information and choosing the training method for patients before surgery.

Objective: During the COVID-19 pandemic, burnout of healthcare workers, including anesthetists, has become a critical issue. This study aimed to provide a practical framework for decreasing and preventing burnout among anesthesiology residents through preserving their good mental health. Materials and methods: Since the onset of the COVID-19 outbreak, anesthesiology residents have been members of medical teams with the attending staff, senior residents, and partner residents. Besides, the following measures were taken to reduce burnout: providing financial support for the attending staff to procure personal protective equipment (PPE), rearrangement of work schedules to reduce the workload, holding training sessions in virtual meetings, and improving the social network system for reducing burnout. Results: The interventional program could help anesthesiology residents to adapt to or cope with the healthcare system status and also prevent burnout. Moreover, development of empathy, integrity, and cohesion in the healthcare system motivated the staff to comply with the principles of medical professionalism. Conclusion: During the current health crisis due to COVID-19, it is essential to implement specific interventional and training programs for decreasing or preventing burnout among healthcare workers.

Background: Obstructive sleep apnea (OSA) is characterized by disruptive breathing, resulting in a decline in cognitive performance. This study investigates the role of oxygen extraction fraction (OEF) and quantitative susceptibility mapping (QSM) in OSA‐related cognitive impairment.Methods: The study recruited 15 patients with confirmed OSA and 16 healthy controls, who underwent overnight polysomnography and brain MRI using a 3 Tesla machine and 64‐channel head coil. A two‐step MRI analysis was employed to measure OEF. QSM was first created by processing separate phase and magnitude images. OEF maps were then generated by identifying veins based on their susceptibility. Volumetric analysis was performed using the FreeSurfer. Neuropsychological tests were administered to evaluate cognition.Results: The analysis of OEF revealed significantly lower values in various cerebral cortical regions of OSA patients than in controls. Notably, OEF in the cerebral cortex and frontal, temporal, and occipital regions showed negative correlations with the duration of stage N2 sleep (highest correlation between N2 and right temporal OEF: p = 0.005, r = −0.681). Furthermore, poorer performance on neuropsychological tests, such as the backward digit span test, was significantly correlated with reduced OEF in the left hemisphere (p = 0.016), left cerebral cortex (p = 0.019), right frontal (p = 0.034), left frontal (p = 0.014), left parietal (p = 0.008), left temporal (p = 0.048), and left occipital lobes (p = 0.015). No significant differences in QSM or brain volume were observed.Conclusions: Decreased OEF emerges as a potential biomarker for cognitive deficits in OSA, suggesting disturbances in cerebral oxygen metabolism may underlie cognitive impairments. These findings underscore the importance of investigating physiological markers in understanding OSA‐related cognitive dysfunction.