Determinants of stress on resident physicians: systematic review and meta-synthesis

Stress/burnout on resident physicians is common. Various determinants can be related to resident stress. This systematic review was conducted to determine how situational, personal, or professional determinants influence resident stress. We identified an English and Indonesia articles using online database including PubMed, Wiley Online Library, Google Scholar, Garba Rujukan Digital (GARUDA), and manually searching bibliographies of the included studies from January 01, 2001 until April 30, 2021. Three main search terms included are resident physician, determinant, and stress/burnout. Study selection included was peer-reviewed literatures of observational studies that discuss about stress determinants on residents from various year of training and medical specialties. Methodological quality of studies was assessed using Newcastle-Ottawa Scale adopted for cross-sectional studies. Data extraction conducted by 3 authors. All pooled synthesis were summarized based on narrative methods. Fifty-three cross-sectional, 1 prospective, and 1 combination of cross-sectional and longitudinal studies meet our inclusion criteria (n=29.031). Fifty-one percent are male, and the average age of the participants was 29 years old. The most stress/burnout validated tool used are Maslach Burnout Inventory. The average quality of study was moderate for cross-sectional studies. The main identified determinant was situational, the second was personal, and the latter was professional. The most stressor identified was ‘excessive working time per week, includes night shift, on-call, work on day off, and rotation more than 24 hours.’ Stress/burnout on residents closely related mainly to situational, followed by personal, and less by professional determinants. There was needed for an intervention to the educational program from institution in the future for better accomplishment.

Gene Expression Analysis Reveals the Concurrent Activation of Proapoptotic and Antioxidant-Defensive Mechanisms in Flavokawain B–Treated Cervical Cancer HeLa Cells

Flavokawain B (FKB) is known to possess promising anticancer abilities. This is demonstrated in various cancer cell lines including HeLa cells. Cervical cancer is among the most widely diagnosed cancer among women today. Though FKB has been shown to be effective in treating cancer cells, the exact molecular mechanism is still unknown. This study is aimed at understanding the effects of FKB on HeLa cells using a microarray-based mRNA expression profiling and proteome profiling of stress-related proteins. The results of this study suggest that FKB induced cell death through p21-mediated cell cycle arrest and activation of p38. However, concurrent activation of antioxidant-related pathways and iron sequestration pathway followed by activation of ER-resident stress proteins clearly indicate that FKB failed to induce apoptosis in HeLa cells via oxidative stress. This effect implies that the protection of HeLa cells by FKB from H2O2–induced cell death is via neutralization of reactive oxygen species.

Stress in Medical Residency

Resident physicians endure substantial amounts of stress to acquire the necessary skills and knowledge to become competent, certified physicians. Multiple factors that contribute to high levels of stress in different areas of the healthcare domain have been identified, but stress continues to be a major problem despite this knowledge and efforts to reduce it. This study employed the framework of Cognitive Work Analysis to systematically review and organize relevant research literature to gain a holistic understanding of resident stress. The result of our work is a representation of resident physicians’ work domain with relevant literature investigating resident stress associated to each area of the representation. The representation provides an organizational structure to examine sources of stress that have been heavily investigated in the resident physicians work domain and identifies areas that lack systematic research.

Influence of Annealing Time on the Properties of GZO Thin Films Fabricated by Direct Current Magnetron Sputtered

The films were deposited on glass slide substrates by DC magnetron sputtering method by using a ZnO target doped with Ga2O3 of 3wt%, then annealing processing were implemented respectively under the temperature of 250 °C with the time of 0,30,60,90 and 120 minutes.Effects of sputtering on the structural and optical and electrical properties of GZO films had been investigated. The results showed that GZO films with high quality could be fabricated after vacuum-annealed. crystal face of GZO films had a good tendency of c axis. the (002) diffraction peak reached a maximum at the annealing time of 1.5 hours; at the same time ,crystal grain became larger and crystal boundaries narrow, film’s resident stress reduced to 0.5 Mpa.With the annealing time increasing, the resistivity of GZO films decreased and reached the minimum which was 9.1×10-4 Ω·cm at 1.5 hours. While the average transmittance decreased sharply after the time of 1.5 hours in visible region. Consequently, the best annealing time is 1.5 hours.

Effect of Resident Stress on the Aberration Correction Ability of MEMS Spatial Light Modulator

In this paper, the effect of resident stress on surface flatness and aberration correction ability of spatial light modulator (SLM) is studied. An optical simulation model based on ZEMAX software is presented to calculate the Strehl ratio of SLM. The result shows that the decrease of curvature radius can result in the decrease of Strehl ratio and aberration correction ability. Moreover, resident tensile stress and resident compressive stress have the same effect on the change of Strehl ratio.