The Association of Hobbies and Leisure Activities with Physician Burnout and Disengagement

Introduction: Burnout among physicians is a worldwide burden. While many causes of physician stress have been reported, we have found few quantitative studies of associations between burnout and participation in hobbies and interests outside of medicine. Our objective was to determine if health care professional burnout/disengagement could be mitigated by incorporating leisure interests and to characterize which specific interests, if any, are most significantly related. Methods: We conducted an online survey of 2,563 US-based physicians and 512 residents/fellows and queried their participation in a list of 117 individual hobbies, which we then further categorized into three perceived levels of social interactivity: 36 as “social,” 47 “isolated,” and 34 “indeterminate.” We utilized the Oldenburg Burnout Inventory to quantitate burnout and disengagement. In each of our 15 major categories of hobbies, burnout was significantly lower in those who were active in that category compared with those who were not (p ≤ 0.02) or who had given up certain hobbies (p ≤ 0.03). The highest levels of burnout were associated with discontinuance of hobbies, directly proportional to the number of hobbies given up. Across all demographic groups, lower burnout and disengagement levels were associated with a higher number of active hobbies and leisure activities. The least burnout and disengagement were associated with the subsets we defined as the most “social.” Specifically, despite being among the favorite hobbies by the majority of respondents, listening to music, home-based watching of TV and movies, and use of internet and video games were associated with the highest level of exhaustion. Results: Significant differences were seen across age groups, genders, and physician specialties in the level of burnout (p \u3c 0.01, p \u3c 0.01, p = 0.02, respectively) and job disengagement (p \u3c0.01, p = 0.02, p \u3c 0.01, respectively). Younger providers (age \u3c 60) and women had higher levels of burnout. Trainees had higher levels of burnout than full time, part time or retired physicians. North American graduates reported a slightly higher rate of burnout and disengagement than international graduates. 93.9% of physicians viewed outside interests as a substantial mitigation factor for burnout and disengagement. Conclusion: Our study identified associations rather than causality. Nevertheless, emphasizing hobbies and non-medical outside interests might well prove useful to temper epidemic burnout among healthcare professionals. We especially encourage those hobbies with stronger social underpinnings

ThermoPixels:Toolkit for Personalizing Arousal-based Interfaces through Hybrid Crafting

Much research has shown the potential of affective interfaces to support people reflect on, and understand their bodily responses. Yet, people find it difficult to engage with, and understand their biodata which they have limited prior experience with. Building on affective interfaces and material-centered design, we developed ThermoPixels, a toolkit including thermochromic and heating materials, as well as galvanic skin response sensors for creating representations of physiological arousal. Within 10 workshops, 20 participants created personalized representations of physiological arousal and its real-time changes using the toolkit. We report on participants’ material exploration, their experience of creating shapes and the use of colors for emotional awareness and regulation. Reflecting on our findings, we discuss embodied exploration and creative expression, the value of technology in emotion regulation and its social context, and the importance of understanding material limitations for effective sense-making

Rheb1 mediates DISC1-dependent regulation of new neuron development in the adult hippocampus

Acknowledgments: We thank D. Weinberger, D. St. Clair and D. Valle for discussion, Jaden Shin for gene expression analyses, members of Ming and Song Laboratories for help and critical comments, L. Liu, Y. Cai, Q. Hussaini, and M. Jardine-Alborz for technical support. Funding: This work was supported by NIH (NS048271, MH105128), NARSAD, and MSCRF to G-l.M., by NIH (NS047344 and NS093772) and MSCRF to H.S., by NARSAD and NIH (NS093772) to K.C., and by NARSAD to E.K.Peer reviewedPublisher PD

Follicular Oocytes Better Support Development in Rabbit Cloning Than Oviductal Oocytes

This study was conducted to determine the effect of rabbit oocytes collected from ovaries or oviducts on the developmental potential of nuclear transplant embryos. Donor nuclei were obtained from adult skin fibroblasts, cumulus cells, and embryonic blastomeres. Rabbit oocytes were flushed from the oviducts (oviductal oocytes) or aspirated from the ovaries (follicular oocytes) of superovulated does at 10, 11, or 12-h post-hCG injection. The majority of collected oocytes were still attached to the sites of ovulation on the ovaries. We found that follicular oocytes had a significantly higher rate of fusion with nuclear donor cells than oviductal oocytes. There was no difference in the cleavage rate between follicular and oviductal groups, but morula and blastocyst development was significantly higher in the follicular group than in the oviductal group. Two live clones were produced in follicular group using blastomere and cumulus nuclear donors, whereas one live clone was produced in the oviductal group using a cumulus nuclear donor. These results demonstrate that cloned rabbit embryos derived from follicular oocytes have better developmental competence than those derived from oviductal oocytes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90481/1/cell-2E2011-2E0030.pd

An African-Specific Variant of TP53 Reveals PADI4 as a Regulator of p53-Mediated Tumor Suppression

TP53 is the most frequently mutated gene in cancer, yet key target genes for p53-mediated tumor suppression remain unidentified. Here, we characterize a rare, African-specific germline variant of TP53 in the DNA-binding domain Tyr107His (Y107H). Nuclear magnetic resonance and crystal structures reveal that Y107H is structurally similar to wild-type p53. Consistent with this, we find that Y107H can suppress tumor colony formation and is impaired for the transactivation of only a small subset of p53 target genes; this includes the epigenetic modifier PADI4, which deiminates arginine to the nonnatural amino acid citrulline. Surprisingly, we show that Y107H mice develop spontaneous cancers and metastases and that Y107H shows impaired tumor suppression in two other models. We show that PADI4 is itself tumor suppressive and that it requires an intact immune system for tumor suppression. We identify a p53–PADI4 gene signature that is predictive of survival and the efficacy of immune-checkpoint inhibitors. Significance: We analyze the African-centric Y107H hypomorphic variant and show that it confers increased cancer risk; we use Y107H in order to identify PADI4 as a key tumor-suppressive p53 target gene that contributes to an immune modulation signature and that is predictive of cancer survival and the success of immunotherapy

Bowel function, sexual function, and symptoms of pelvic organ prolapse in women with and without urinary incontinence

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146399/1/nau23587_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146399/2/nau23587.pd

siRNA inhibition of telomerase enhances the anti-cancer effect of doxorubicin in breast cancer cells

<p>Abstract</p> <p>Background</p> <p>Doxorubicin is an effective breast cancer drug but is hampered by a severe, dose-dependent toxicity. Concomitant administration of doxorubicin and another cancer drug may be able to sensitize tumor cells to the cytotoxicity of doxorubicin and lowers the therapeutic dosage. In this study, we examined the combined effect of low-dose doxorubicin and siRNA inhibition of telomerase on breast cancer cells. We found that when used individually, both treatments were rapid and potent apoptosis inducers; and when the two treatments were combined, we observed an enhanced and sustained apoptosis induction in breast cancer cells.</p> <p>Methods</p> <p>siRNA targeting the mRNA of the protein component of telomerase, the telomerase reverse transcriptase (hTERT), was transfected into two breast cancer cell lines. The siRNA inhibition was confirmed by RT-PCR and western blot on hTERT mRNA and protein levels, respectively, and by measuring the activity level of telomerase using the TRAP assay. The effect of the hTERT siRNA on the tumorigenicity of the breast cancer cells was also studied <it>in vivo </it>by injection of the siRNA-transfected breast cancer cells into nude mice.</p> <p>The effects on cell viability, apoptosis and senescence of cells treated with hTERT siRNA, doxorubicin, and the combined treatment of doxorubicin and hTERT siRNA, were examined <it>in vitro </it>by MTT assay, FACS and SA-β-galactosidase staining.</p> <p>Results</p> <p>The hTERT siRNA effectively knocked down the mRNA and protein levels of hTERT, and reduced the telomerase activity to 30% of the untreated control. <it>In vivo</it>, the tumors induced by the hTERT siRNA-transfected cells were of reduced sizes, indicating that the hTERT siRNA also reduced the tumorigenic potential of the breast cancer cells. The siRNA treatment reduced cell viability by 50% in breast cancer cells within two days after transfection, while 0.5 μM doxorubicin treatment had a comparable effect but with a slower kinetics. The combination of hTERT siRNA and 0.5 μM doxorubicin killed twice as many cancer cells, showing a cumulative effect of the two treatments.</p> <p>Conclusion</p> <p>The study demonstrated the potential of telomerase inhibition as an effective treatment for breast cancer. When used in conjunction to doxorubicin, it could potentiate the cytotoxic effect of the drug to breast cancer cells.</p

Experimental Aspects of Synthesis

We discuss the problem of experimentally evaluating linear-time temporal logic (LTL) synthesis tools for reactive systems. We first survey previous such work for the currently publicly available synthesis tools, and then draw conclusions by deriving useful schemes for future such evaluations. In particular, we explain why previous tools have incompatible scopes and semantics and provide a framework that reduces the impact of this problem for future experimental comparisons of such tools. Furthermore, we discuss which difficulties the complex workflows that begin to appear in modern synthesis tools induce on experimental evaluations and give answers to the question how convincing such evaluations can still be performed in such a setting.Comment: In Proceedings iWIGP 2011, arXiv:1102.374

Development of Transgenic Cloned Pig Models of Skin Inflammation by DNA Transposon-Directed Ectopic Expression of Human β1 and α2 Integrin

Integrins constitute a superfamily of transmembrane signaling receptors that play pivotal roles in cutaneous homeostasis by modulating cell growth and differentiation as well as inflammatory responses in the skin. Subrabasal expression of integrins α2 and/or β1 entails hyperproliferation and aberrant differentiation of keratinocytes and leads to dermal and epidermal influx of activated T-cells. The anatomical and physiological similarities between porcine and human skin make the pig a suitable model for human skin diseases. In efforts to generate a porcine model of cutaneous inflammation, we employed the Sleeping Beauty DNA transposon system for production of transgenic cloned Göttingen minipigs expressing human β1 or α2 integrin under the control of a promoter specific for subrabasal keratinocytes. Using pools of transgenic donor fibroblasts, cloning by somatic cell nuclear transfer was utilized to produce reconstructed embryos that were subsequently transferred to surrogate sows. The resulting pigs were all transgenic and harbored from one to six transgene integrants. Molecular analyses on skin biopsies and cultured keratinocytes showed ectopic expression of the human integrins and localization within the keratinocyte plasma membrane. Markers of perturbed skin homeostasis, including activation of the MAPK pathway, increased expression of the pro-inflammatory cytokine IL-1α, and enhanced expression of the transcription factor c-Fos, were identified in keratinocytes from β1 and α2 integrin-transgenic minipigs, suggesting the induction of a chronic inflammatory phenotype in the skin. Notably, cellular dysregulation obtained by overexpression of either β1 or α2 integrin occurred through different cellular signaling pathways. Our findings mark the creation of the first cloned pig models with molecular markers of skin inflammation. Despite the absence of an overt psoriatic phenotype, these animals may possess increased susceptibility to severe skin damage-induced inflammation and should be of great potential in studies aiming at the development and refinement of topical therapies for cutaneous inflammation including psoriasis

Novel Genetic Variants for Cartilage Thickness and Hip Osteoarthritis

Osteoarthritis is one of the most frequent and disabling diseases of the elderly. Only few genetic variants have been identified for osteoarthritis, which is partly due to large phenotype heterogeneity. To reduce heterogeneity, we here examined cartilage thickness, one of the structural components of joint health. We conducted a genome-wide association study of minimal joint space width (mJSW), a proxy for cartilage thickness, in a discovery set of 13,013 participants from five different cohorts and replication in 8,227 individuals from seven independent cohorts. We identified five genome-wide significant (GWS, P≤5·0×10−8) SNPs annotated to four distinct loci. In addition, we found two additional loci that were significantly replicated, but results of combined meta-analysis fell just below the genome wide significance threshold. The four novel associated genetic loci were located in/near TGFA (rs2862851), PIK3R1 (rs10471753), SLBP/FGFR3 (rs2236995), and TREH/DDX6 (rs49654