METHODS: The curriculum development process involved a gap analysis, comprehensive literature review, and expert consensus through a modified RAND/UCLA appropriateness method/Delphi survey.
RESULTS: The curriculum offers 2 flexible tracks: a 1-year program (Track A) and a 2-year program (Track B), accommodating varied educational pathways and health care system structures across Asia. Key features of the curriculum include detailed learning outcomes, competency-based educational content, and recommendations for teaching and learning activities. The assessment strategy incorporates summative and formative methods, with standard setting and program evaluation guidelines. The curriculum also provides recommendations for program accreditation, fellow-faculty ratios, and funding considerations.
CONCLUSIONS: The Asian adult sleep medicine fellowship training curriculum provides a standardized yet adaptable framework for sleep medicine education across diverse Asian health care landscapes. By emphasizing flexibility and customization while maintaining high training standards, the curriculum aims to bridge the gap in sleep medicine training across Asia, ultimately improving the quality of sleep health care and patient outcomes throughout the region.
CITATION: BaHammam AS, Al-Abri MA, Al Oweidat K, et al. Asian adult sleep medicine fellowship training curriculum: one curriculum, many contexts. J Clin Sleep Med. 2025;21(4):627-638.
METHODS: PRS performance was evaluated using multivariable logistic regression and the area under the ROC curve.
RESULTS: Both EUR and Asian PRSs performed worse in H/L samples compared with original reports. The best EUR PRS performed better than the best Asian PRS in pooled H/L samples. EUR PRSs had decreased performance with increasing Indigenous American (IA) ancestry, while Asian PRSs had increased performance with increasing IA ancestry. The addition of two H/L SNPs increased performance for all PRSs, most notably in the samples with high IA ancestry, and did not impact the performance of PRSs in individuals with lower IA ancestry.
CONCLUSIONS: A single PRS that incorporates risk variants relevant to the multiple ancestral components of individuals from Latin America, instead of a set of ancestry-specific panels, could be used in clinical practice.
IMPACT: The results highlight the importance of population-specific discovery and suggest a straightforward approach to integrate ancestry-specific variants into PRSs for clinical application.
METHODS: L-arginine (2 % w/v.) was added to five commercial fancy waters: Oasis-Lemon, Oasis-Lemon Mint, Perrier-Lemon, Perrier-Grapefruit, Pellegrino-Lemon; and deionized water served as a negative control. The pH, buffer capacity of added Arg, and F- concentrations were measured. Tooth specimens were prepared and baseline volumetric assessment (T0) was conducted using micro-CT. Subsequently, the specimens were immersed in fancy waters for 72 h, kept in an incubator (37 ℃) and solutions were changed every 24 h. After the experimental cycle (T1), 3D volumetric analysis was performed, and 3D structural images were reconstructed for qualitative assessment.
RESULTS: The pH and F- concentrations of fancy waters with Arg were significantly higher than the control (p < 0.001). The buffer capacity of added Arg with Perrier-Grapefruit was significantly higher than Oasis-Lemon, Oasis-Lemon Mint & Pellegrino-Lemon (p < 0.05), except for Perrier-Lemon (p > 0.05). At T1, the specimen volume in Oasis-Lemon Mint (+/- Arg) and Pellegrino-Lemon (control) was significantly lower than T0 (p < 0.05). At T1, the specimen volume of Oasis-Lemon Mint and Pellegrino-Lemon (control) was significantly lower than Arg-containing fancy waters (p < 0.05). Surface contrast indicating wear was evident from T0 to T1 in specimens from the Oasis-Lemon Mint (+/- Arg) and Pellegrino-Lemon (- Arg).
CONCLUSION: Incorporating Arg in fancy waters reduces the potential of erosive tooth wear associated with these beverages.
CLINICAL SIGNIFICANCE: Consuming fancy water beverages (flavoured sparkling/carbonated) can lead to erosive tooth wear in young people. Incorporating Arg in fancy water beverages can prevent the erosive wear potential of these beverages while alleviating the burden of oral care on individuals at risk to erosive wear.
OBJECTIVES: We aimed to compare the outcomes of budesonide/formoterol (160/4.5 mcg/inhalation) turbuhaler versus pressurized metered-dose inhaler (pMDI) salbutamol (100 mcg/puff) in acute asthma in the outpatient ED.
METHODS: This single-centre, prospective, randomized, and open-label study involved adult asthma patients with mild to moderate asthma exacerbation who attended the outpatient ED of a tertiary hospital in Malaysia. The intervention arm received budesonide/formoterol (Symbicort® 160/4.5 mcg) turbuhaler, while the control arm received pMDI salbutamol with a valved holding chamber. Stratified randomization with variable baseline ICS use was employed. Direct discharge rate from outpatient ED was the primary outcome. Vital signs pre- and post-treatment between the two arms were also compared.
RESULTS: Seventy-four (n = 37 for each arm) asthma patients were recruited. Baseline clinical characteristics were comparable between the two arms. Direct discharge rates from ED were comparable between the intervention (94.6%) and the control (91.9%) arms (p = 1.000). Post-treatment outcomes (respiratory rate, oxygen saturation, peak expiratory flow rate) were similar between the two arms, except for the higher increment of heart rate (p
CASE PRESENTATION: A 67-year-old female with a history of rheumatoid arthritis presented with escalating right knee pain, unresponsive to increasing doses of opioids. She also reported mild abdominal discomfort. A knee X-ray was unremarkable, but an abdominopelvic CT scan revealed an incarcerated obturator hernia. Emergent laparoscopic transabdominal pre-peritoneal (TAPP) repair was performed, leading to significant postoperative improvement in her knee pain.
DISCUSSION: This case highlights the unusual presentation of obturator hernia with referred knee pain, which could often be misdiagnosed as a musculoskeletal issue. The likely mechanism is obturator nerve impingement caused by the hernia, and surgical intervention successfully resolved the symptoms.
CONCLUSION: Clinicians should consider obturator hernia in the differential diagnosis of unexplained knee pain, particularly in patients with risk factors like advanced age, low body weight and the female gender, to avoid delayed diagnosis and prevent serious complications.