DataSheet1.XLSX

<p>Studies have shown that traumatic experiences may affect hormonal systems mediated by the hypothalamic-pituitary-adrenal (HPA) axis and the oxytocinergic system. This effect is the result of long-term impairments in hypothalamic structures and negative feedback mechanisms within the HPA axis, structures that mediate the response to stress. This deregulation reduces the production and release of cortisol and oxytocin (OXT), which may alter stress responses and lead to increased vulnerability to impairments from stressful experiences. The presence of gene polymorphisms might also have an impact on the vulnerability to psychopathology. We made a systematic review of articles dealing with the relationship between OXT and traumatic emotional experiences in humans. Thirty-five studies were reviewed and significant associations between experiences of emotional trauma (ET) and OXT were found. The main results showed that the presence of ET and post-traumatic stress disorder (PTSD) is strongly associated with reductions in endogenous OXT, and also that the acute effects of OXT administrations in individuals with ET tend to be anxiolytic only in less severe forms. In victims of recent traumatic experiences (RTE), OXT increased the re-experience of traumas and restored the function of different neural networks associated with fear control/extinction in PTSD patients. The results available also suggest that gene receptor polymorphisms may have a protective function in different outcomes after the experience of traumatic events. We conclude that the relationship between ET and OXT is multifaceted, complex, and mediated by contextual and individual factors. Directions for future studies are suggested considering the gaps in the available literature.</p

Data_Sheet_1_Burnout in residents during the first wave of the COVID-19 pandemic: a systematic review and meta-analysis.docx

IntroductionThe high prevalence of burnout in resident physicians is expected to have increased as a result of the expansion of the pandemic. We conducted a systematic review with a meta-analysis of studies conducted during the first wave of the COVID-19 pandemic on burnout in residents and potential associated risk factors.MethodsThe search was done in the Web of Science, MEDLINE, Scopus, and Lillac databases (April 2020–October 2021) using a priori protocol based on the PRISMA guidelines. The Newcastle Ottawa Scale was used to assess the risk of bias in the included studies. We estimated the pooled prevalence (95% CI) of burnout and the prevalence ratio (95% CI) of each risk factor associated.ResultsWe included 23 studies from 451 potential initial articles and those written in the English language; all of the collected studies were cross-sectional with anonymous online surveys, involving 4,998 responders (34%), of which 53.2% were female responders, 51% were R1-2, and 71% were in direct contact with COVID-19 patients. Eighty-seven percent presented a low-to-moderate risk of bias. Publication bias was not shown. The estimated pooled prevalence of burnout was 40% (95% CI = 0.26 – 0.57). Burnout was associated with psychiatry history (PR = 4.60, 95% CI = 1.06 – 20.06). There were no differences by gender, civil status, children in-charge, year of residency, or time exposure to COVID-19.DiscussionThe overall prevalence of burnout in residents during the first wave of the pandemic was in line with the results described in this collective before the pandemic. The presence of a psychiatry history was a potential burnout risk factor, suggesting a high vulnerability during the peak of the stress period and the need to implement mental health surveillance for this subgroup.</p

Table_1_Burnout in residents during the first wave of the COVID-19 pandemic: a systematic review and meta-analysis.docx

IntroductionThe high prevalence of burnout in resident physicians is expected to have increased as a result of the expansion of the pandemic. We conducted a systematic review with a meta-analysis of studies conducted during the first wave of the COVID-19 pandemic on burnout in residents and potential associated risk factors.MethodsThe search was done in the Web of Science, MEDLINE, Scopus, and Lillac databases (April 2020–October 2021) using a priori protocol based on the PRISMA guidelines. The Newcastle Ottawa Scale was used to assess the risk of bias in the included studies. We estimated the pooled prevalence (95% CI) of burnout and the prevalence ratio (95% CI) of each risk factor associated.ResultsWe included 23 studies from 451 potential initial articles and those written in the English language; all of the collected studies were cross-sectional with anonymous online surveys, involving 4,998 responders (34%), of which 53.2% were female responders, 51% were R1-2, and 71% were in direct contact with COVID-19 patients. Eighty-seven percent presented a low-to-moderate risk of bias. Publication bias was not shown. The estimated pooled prevalence of burnout was 40% (95% CI = 0.26 – 0.57). Burnout was associated with psychiatry history (PR = 4.60, 95% CI = 1.06 – 20.06). There were no differences by gender, civil status, children in-charge, year of residency, or time exposure to COVID-19.DiscussionThe overall prevalence of burnout in residents during the first wave of the pandemic was in line with the results described in this collective before the pandemic. The presence of a psychiatry history was a potential burnout risk factor, suggesting a high vulnerability during the peak of the stress period and the need to implement mental health surveillance for this subgroup.</p

Table_3_Burnout in residents during the first wave of the COVID-19 pandemic: a systematic review and meta-analysis.docx

IntroductionThe high prevalence of burnout in resident physicians is expected to have increased as a result of the expansion of the pandemic. We conducted a systematic review with a meta-analysis of studies conducted during the first wave of the COVID-19 pandemic on burnout in residents and potential associated risk factors.MethodsThe search was done in the Web of Science, MEDLINE, Scopus, and Lillac databases (April 2020–October 2021) using a priori protocol based on the PRISMA guidelines. The Newcastle Ottawa Scale was used to assess the risk of bias in the included studies. We estimated the pooled prevalence (95% CI) of burnout and the prevalence ratio (95% CI) of each risk factor associated.ResultsWe included 23 studies from 451 potential initial articles and those written in the English language; all of the collected studies were cross-sectional with anonymous online surveys, involving 4,998 responders (34%), of which 53.2% were female responders, 51% were R1-2, and 71% were in direct contact with COVID-19 patients. Eighty-seven percent presented a low-to-moderate risk of bias. Publication bias was not shown. The estimated pooled prevalence of burnout was 40% (95% CI = 0.26 – 0.57). Burnout was associated with psychiatry history (PR = 4.60, 95% CI = 1.06 – 20.06). There were no differences by gender, civil status, children in-charge, year of residency, or time exposure to COVID-19.DiscussionThe overall prevalence of burnout in residents during the first wave of the pandemic was in line with the results described in this collective before the pandemic. The presence of a psychiatry history was a potential burnout risk factor, suggesting a high vulnerability during the peak of the stress period and the need to implement mental health surveillance for this subgroup.</p

Data_Sheet_2_Burnout in residents during the first wave of the COVID-19 pandemic: a systematic review and meta-analysis.docx

IntroductionThe high prevalence of burnout in resident physicians is expected to have increased as a result of the expansion of the pandemic. We conducted a systematic review with a meta-analysis of studies conducted during the first wave of the COVID-19 pandemic on burnout in residents and potential associated risk factors.MethodsThe search was done in the Web of Science, MEDLINE, Scopus, and Lillac databases (April 2020–October 2021) using a priori protocol based on the PRISMA guidelines. The Newcastle Ottawa Scale was used to assess the risk of bias in the included studies. We estimated the pooled prevalence (95% CI) of burnout and the prevalence ratio (95% CI) of each risk factor associated.ResultsWe included 23 studies from 451 potential initial articles and those written in the English language; all of the collected studies were cross-sectional with anonymous online surveys, involving 4,998 responders (34%), of which 53.2% were female responders, 51% were R1-2, and 71% were in direct contact with COVID-19 patients. Eighty-seven percent presented a low-to-moderate risk of bias. Publication bias was not shown. The estimated pooled prevalence of burnout was 40% (95% CI = 0.26 – 0.57). Burnout was associated with psychiatry history (PR = 4.60, 95% CI = 1.06 – 20.06). There were no differences by gender, civil status, children in-charge, year of residency, or time exposure to COVID-19.DiscussionThe overall prevalence of burnout in residents during the first wave of the pandemic was in line with the results described in this collective before the pandemic. The presence of a psychiatry history was a potential burnout risk factor, suggesting a high vulnerability during the peak of the stress period and the need to implement mental health surveillance for this subgroup.</p

Image_2_Burnout in residents during the first wave of the COVID-19 pandemic: a systematic review and meta-analysis.pdf

IntroductionThe high prevalence of burnout in resident physicians is expected to have increased as a result of the expansion of the pandemic. We conducted a systematic review with a meta-analysis of studies conducted during the first wave of the COVID-19 pandemic on burnout in residents and potential associated risk factors.MethodsThe search was done in the Web of Science, MEDLINE, Scopus, and Lillac databases (April 2020–October 2021) using a priori protocol based on the PRISMA guidelines. The Newcastle Ottawa Scale was used to assess the risk of bias in the included studies. We estimated the pooled prevalence (95% CI) of burnout and the prevalence ratio (95% CI) of each risk factor associated.ResultsWe included 23 studies from 451 potential initial articles and those written in the English language; all of the collected studies were cross-sectional with anonymous online surveys, involving 4,998 responders (34%), of which 53.2% were female responders, 51% were R1-2, and 71% were in direct contact with COVID-19 patients. Eighty-seven percent presented a low-to-moderate risk of bias. Publication bias was not shown. The estimated pooled prevalence of burnout was 40% (95% CI = 0.26 – 0.57). Burnout was associated with psychiatry history (PR = 4.60, 95% CI = 1.06 – 20.06). There were no differences by gender, civil status, children in-charge, year of residency, or time exposure to COVID-19.DiscussionThe overall prevalence of burnout in residents during the first wave of the pandemic was in line with the results described in this collective before the pandemic. The presence of a psychiatry history was a potential burnout risk factor, suggesting a high vulnerability during the peak of the stress period and the need to implement mental health surveillance for this subgroup.</p

Image_1_Burnout in residents during the first wave of the COVID-19 pandemic: a systematic review and meta-analysis.TIFF

IntroductionThe high prevalence of burnout in resident physicians is expected to have increased as a result of the expansion of the pandemic. We conducted a systematic review with a meta-analysis of studies conducted during the first wave of the COVID-19 pandemic on burnout in residents and potential associated risk factors.MethodsThe search was done in the Web of Science, MEDLINE, Scopus, and Lillac databases (April 2020–October 2021) using a priori protocol based on the PRISMA guidelines. The Newcastle Ottawa Scale was used to assess the risk of bias in the included studies. We estimated the pooled prevalence (95% CI) of burnout and the prevalence ratio (95% CI) of each risk factor associated.ResultsWe included 23 studies from 451 potential initial articles and those written in the English language; all of the collected studies were cross-sectional with anonymous online surveys, involving 4,998 responders (34%), of which 53.2% were female responders, 51% were R1-2, and 71% were in direct contact with COVID-19 patients. Eighty-seven percent presented a low-to-moderate risk of bias. Publication bias was not shown. The estimated pooled prevalence of burnout was 40% (95% CI = 0.26 – 0.57). Burnout was associated with psychiatry history (PR = 4.60, 95% CI = 1.06 – 20.06). There were no differences by gender, civil status, children in-charge, year of residency, or time exposure to COVID-19.DiscussionThe overall prevalence of burnout in residents during the first wave of the pandemic was in line with the results described in this collective before the pandemic. The presence of a psychiatry history was a potential burnout risk factor, suggesting a high vulnerability during the peak of the stress period and the need to implement mental health surveillance for this subgroup.</p

Table_2_Burnout in residents during the first wave of the COVID-19 pandemic: a systematic review and meta-analysis.docx

IntroductionThe high prevalence of burnout in resident physicians is expected to have increased as a result of the expansion of the pandemic. We conducted a systematic review with a meta-analysis of studies conducted during the first wave of the COVID-19 pandemic on burnout in residents and potential associated risk factors.MethodsThe search was done in the Web of Science, MEDLINE, Scopus, and Lillac databases (April 2020–October 2021) using a priori protocol based on the PRISMA guidelines. The Newcastle Ottawa Scale was used to assess the risk of bias in the included studies. We estimated the pooled prevalence (95% CI) of burnout and the prevalence ratio (95% CI) of each risk factor associated.ResultsWe included 23 studies from 451 potential initial articles and those written in the English language; all of the collected studies were cross-sectional with anonymous online surveys, involving 4,998 responders (34%), of which 53.2% were female responders, 51% were R1-2, and 71% were in direct contact with COVID-19 patients. Eighty-seven percent presented a low-to-moderate risk of bias. Publication bias was not shown. The estimated pooled prevalence of burnout was 40% (95% CI = 0.26 – 0.57). Burnout was associated with psychiatry history (PR = 4.60, 95% CI = 1.06 – 20.06). There were no differences by gender, civil status, children in-charge, year of residency, or time exposure to COVID-19.DiscussionThe overall prevalence of burnout in residents during the first wave of the pandemic was in line with the results described in this collective before the pandemic. The presence of a psychiatry history was a potential burnout risk factor, suggesting a high vulnerability during the peak of the stress period and the need to implement mental health surveillance for this subgroup.</p

Flow diagram of included neuroimaging studies in chronic cannabis users.

<p>Flow diagram of included neuroimaging studies in chronic cannabis users.</p

Functional neuroimaging studies in chronic cannabis users.

<p>Note: Yr.  =  years; CU  =  Cannabis users; HC  =  Healthy controls; M  =  Male; F  =  Female; SD  =  Standard deviation; FL  =  Frontal lobe; PL  =  Parietal lobe; TL  =  Temporal lobe; OL  =  Occipital lobe; I  =  Insula; BG  =  Basal ganglia; Cb  =  Cerebellum; fMRI  =  Functional magnetic resonance imaging; SPECT  =  Single photon emission tomography; PET  =  Positron emission tomopgraphy; DSC  =  Dynamic susceptibility contrast; V_T  =  Distribution volume; BP_ND  =  Non-displaceable binding potential; FDG  =  Fludeoxyglucose; L  =  Left hemisphere; R  =  Right hemisphere; ROI  =  Region of interest; MSIT  =  Multi-Source Interference Task; CBF  =  Global cerebral blood flow; rCBF  =  Regional cerebral blood flow; BOLD  =  blood oxygenation-level dependent; NE  =  Not specified; PFC  =  Prefrontal cortex; DLPFC  =  Dorsolateral prefrontal cortex; VMPFC  =  Ventromedial prefrontal cortex; OFC  =  Orbitofrontal cortex; ACC  =  Anterior cingulated cortex; NAcc  =  Nucleus accumbens; VS  =  Ventral striatum; STG  =  Superior temporal gyrus; SWM  =  Spatial working task; IGT  =  Iowa Gambling Task.</p>*<p>If not otherwise specified, results are presented in terms of chronic cannabis users.</p><p>○  =  Significant differences; ○  =  Non-significant differences;  =  Not examined.</p>**<p>Two subjects in the marijuana group met criteria for alcohol abuse.</p>***<p>Four teens in the chronic cannabis group met criteria for alcohol use disorder, two cases of abuse and two cases of dependence.</p>†<p>One control, three recent users and two abstinent users met criteria for alcohol use disorders.</p>†<p>Multiple comparison correction.</p