Commentary on: Diagnosing conflict in clerkship: insights from medical students’ experiences
Erin S. Barry1,2,3*, Bobbie Ann Adair White4,5
1Department of Health Professions Education, Uniformed Services University, Bethesda, MD, USA
2Department of Anesthesiology, Uniformed Services University, Bethesda, MD, USA
3Department of Military & Emergency Medicine, Uniformed Services University, Bethesda, MD, USA
4Health Professions Education Program, MGH Institute of Health Professions, Boston, MA, USA
5Department of Surgery, Baylor Scott and White Health System, Temple, TX, USA
Our recent study examined medical students’ perspectives on conflict during clinical clerkships, identifying common settings, types, and triggers of conflict, and the strategies students used to respond. These findings are particularly relevant to anesthesiology, where high-paced, team-based work creates both opportunities for productive disagreement and risks for mismanaged conflict. In this commentary, we highlight the implications of our findings for anesthesiology training and practice, outlining practical strategies to strengthen team communication, psychological safety, and conflict competence in perioperative care.
DOI: 10.29245/2768-5365/2025/3.1170 View / Download PdfBeyond Stroke—Investigating Heart-Brain Connections in Migraine and Pain: A Mini Review
Roshni Riaz Memon1*, Muqadas Bhatti2, Umar Aziz3, Javeria Nawaz4, Vicky Kumar5, Haris Muhammad6, Ali Ather7, Aparna Iyer8
1Ziauddin University, Karachi, Pakistan
2Department of Public Health, Bahria University, Karachi, Pakistan
3Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan
4Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
5George Washington University, Washington, D.C, USA
6Newark Beth Israel Medical Centre, New Jersey, USA
7Shalamar Medical and Dental College, Lahore, Pakistan
8Maimonides Medical Centre, New York, USA
The patent foramen ovale (PFO), a congenital interatrial communication caused by incomplete septal closure, has long been recognised as a factor contributing to cryptogenic stroke, especially among younger adults. However, recent evidence has expanded its clinical relevance, revealing a strong association between PFO and migraine with aura. This emerging link has sparked interest in evaluating PFO closure not only for secondary stroke prevention but also as a possible treatment for neurovascular pain syndromes. Randomised controlled trials such as PRIMA and PREMIUM have assessed the impact of transcatheter PFO closure on migraine frequency. While these studies showed modest reductions, the varied outcomes highlight the complexity of the PFO–migraine relationship. Despite this variability, transcatheter closure with nitinol-based occluders remains a safe and effective procedure, achieving long-term closure rates of over 98% with few complications.
Recent advances, including biodegradable occluders studied in the BioMetal trial, reflect increasing momentum towards personalised and biocompatible treatment approaches. Overall, these developments suggest that PFO closure could provide meaningful relief for carefully selected migraine sufferers—particularly those with frequent aura and refractory symptoms. Going forward, collaboration between cardiologists, neurologists, and pain specialists will be crucial to understanding the underlying mechanisms and refining patient selection. As knowledge advances, PFO closure holds promise as a transformative intervention that links cerebrovascular health and chronic pain management.
DOI: 10.29245/2768-5365/2025/3.1166 View / Download Pdf