Doctors’ job satisfaction, organizational citizenship behavior and burnout: an empirical study in China’s public hospital

JEL: M54Job satisfaction, organizational citizenship behavior (OCB) and burnout have been heavily researched, but the study of the relationships among these three constructs has been rare. In this thesis quantitative and qualitative research methods are employed to address this gap by studying the relationships among doctors’ job satisfaction, OCB and burnout in a selected sample of China’s public hospitals. A questionnaire survey was distributed to 571 doctors in four municipal public hospitals in Shenzhen, China and 485 valid copies were collected. Statistical analysis techniques and methods such as descriptive statistics, factor analysis, correlation analysis, one-way analysis of variance, regression analysis have been used to study doctors’ job satisfaction, OCB and burnout as a whole and explore the relationship among the three dimensions. The results suggest that the doctors have low job satisfaction and low organizational citizenship behavior. Results suggest that doctors in this study have low job satisfaction and low OCB. Moreover, they suffer from strong burnout due to a high level of emotional exhaustion. Among doctors in those China’s public hospitals studied, job satisfaction is negatively correlated to burnout and has a negative impact on it; job satisfaction is not correlated to OCB, but only positively correlated to interpersonal harmony, a dimension of OCB. OCB is negatively correlated to burnout, and the emotional exhaustion dimension of burnout is significantly negatively correlated to OCB and its altruism, conscientiousness and interpersonal harmony dimensions. Results suggest that OCB might have a buffer effect against the burnout that doctors experience at work. This buffer effect forms the basis of interactive models so that, for example, an increasing OCB may help reduce burnout. In summary, job satisfaction was a valid predictor of burnout, whereas OCB was found to moderate the relationship between job satisfaction and burnout: the higher the OCB, the less the magnitude of the job satisfaction influence in protecting doctors from burnout. Twenty six interviews were conducted to explain the quantitative findings. Practical implications were discussed.Dimensões como a satisfação no trabalho, o comportamento de cidadania organizacional (CCO) e o esgotamento têm sido bastante estudadas, mas a investigação sobre como estas dimensões se relacionam entre si é ainda escassa. Esta tese utiliza métodos de investigação quantitativos e qualitativos na expectativa de contribuir para um melhor conhecimento da forma como estes construtos interagem, através de um estudo empírico de uma amostra de médicos a trabalhar nos quatro maiores hospitais públicos na cidade chinesa de Shenzhen. Um questionário foi distribuído a 571 médicos tendo sido recolhidos 485 exemplares válidos. Foram utilizadas diversas técnicas estatísticas para processamento dos dados incluindo estatística descritiva, análise fatorial, análise de variância unidirecional, correlação e regressão múltipla no sentido de estudar as dimensões em análise como um todo e explorar as relações entre elas. Os resultados revelam que os médicos inquiridos têm um baixo nível de satisfação no trabalho e de CCO. Além disso sofrem de um elevado nível de esgotamento derivado sobretudo de exaustão emocional. Nos médicos estudados, a satisfação no trabalho está negativamente correlacionada com o nível de esgotamento e exerce uma influência negativa sobre ele. Contudo, a satisfação no trabalho não está relacionada com o CCO, mas apenas regista uma correlação positiva com uma das suas dimensões, a harmonia interpessoal. Por seu turno, o CCO tem uma correlação negativa com o esgotamento enquanto que a exaustão emocional, uma dimensão de esgotamento, regista uma correlação negativa significativa com o CCO e com as suas dimensões de altruísmo, consciencialização e harmonia interpessoal. Os resultados sugerem ainda que o CCO pode ter um efeito amortecedor no nível de esgotamento que os médicos sofrem no trabalho. Este efeito pode constituir uma base para modelos interativos de forma a que, por exemplo, um aumento de CCO possa contribuir para diminuir o nível de esgotamento. Em resumo verificou-se que a satisfação no trabalho é um preditor válido de esgotamento e que o CCO tem um efeito amortecedor na relação entre a satisfação no trabalho e o esgotamento: quanto mais elevado for o CCO mais reduzida é a influência que a satisfação no trabalho pode ter no sentido de proteger os médicos de esgotamento. Foram ainda conduzidas entrevistas que ajudaram a explicar e a interpretar os resultados do inquérito.Satisfação no trabalho, Comportamento de Cidadania Organizacional, esgotamento, hospitais públicos na Chin

Vibration Parameter Optimization of a Linear Vibrating Banana Screen Using DEM 3D Simulation

In this paper, the effects of vibration parameters of a banana screen, i.e. frequency, amplitude and vibration direction angle, on the screening efficiency per unit time were studied using the discrete element method (DEM). The simulations were validated according to data collected from an experimental prototype screen. Functional relationships between vibration parameters and screening efficiency per unit time are presented. The results showed that the screening efficiency per unit time first displays an increase and later a decrease when the frequency, amplitude or vibration direction angle increased respectively. Vibration parameter optimization was also investigated, using an orthogonal experiment. Based on the banana screen model, it can be concluded that when the frequency is 22 Hz, the amplitude is 2.2 mm and the vibration direction angle is 39°, the screening efficiency of a banana screen is optimal

Vibration Parameter Optimization of a Linear Vibrating Banana Screen Using DEM 3D Simulation

In this paper, the effects of vibration parameters of a banana screen, i.e. frequency, amplitude and vibration direction angle, on the screening efficiency per unit time were studied using the discrete element method (DEM). The simulations were validated according to data collected from an experimental prototype screen. Functional relationships between vibration parameters and screening efficiency per unit time are presented. The results showed that the screening efficiency per unit time first displays an increase and later a decrease when the frequency, amplitude or vibration direction angle increased respectively. Vibration parameter optimization was also investigated, using an orthogonal experiment. Based on the banana screen model, it can be concluded that when the frequency is 22 Hz, the amplitude is 2.2 mm and the vibration direction angle is 39°, the screening efficiency of a banana screen is optimal

Severe Maternal Hyperglycemia Exacerbates the Development of Insulin Resistance and Fatty Liver in the Offspring on High Fat Diet

Background. Adverse maternal environments may predispose the offspring to metabolic syndrome in adulthoods, but the underlying mechanism has not been fully understood. Methods. Maternal hyperglycemia was induced by streptozotocin (STZ) injection while control (CON) rats received citrate buffer. Litters were adjusted to eight pups per dam and then weaned to standard diet. Since 13 weeks old, a subset of offspring from STZ and CON dams were switched to high fat diet (HFD) for another 13 weeks. Glucose and insulin tolerance tests (GTT and ITT) and insulin secretion assay were performed; serum levels of lipids and leptin were measured. Hepatic fat accumulation and islet area were evaluated through haematoxylin and eosin staining. Results. STZ offspring exhibited lower survival rate, lower birth weights, and growth inhibition which persisted throughout the study. STZ offspring on HFD showed more severe impairment in GTT and ITT, and more profound hepatic steatosis and more severe hyperlipidemia compared with CON-HFD rats. Conclusions. Offspring from diabetic dams would be prone to exhibit low birth weight and postnatal growth inhibition, but could maintain normal glucose tolerance and insulin sensitivity. HFD accelerates development of insulin resistance in the offspring of diabetic dams mainly via a compensatory response of islets

Peptidylarginine deiminase 1-catalyzed histone citrullination is essential for early embryo development

Peptidylarginine deiminase (PADI) enzymes are increasingly being associated with the regulation of chromatin structure and gene activity via histone citrullination. As one of the PADI family members, PADI1 has been mainly reported to be expressed in the epidermis and uterus, where the protein in keratinocytes is thought to promote differentiation by citrullinating filament proteins. However, the roles of PADI1 in preimplantation development have not been addressed. Using a PADI1-specific inhibitor and Padi1-morpholino knockdown, we found that citrullination of histone tails at H4R3 and H3R2/8/17 were markedly reduced in the 2- and 4-cell embryos. Consistent with this observation, early embryo development was also arrested at the 4-cell stage upon depletion of PADI1 or inhibition of PADI1 enzyme activity. Additionally, by employing 5-ethynyl uridine (EU) incorporation analysis, ablation of PADI1 function led to a dramatic decrease in overall transcriptional activity, correlating well with the reduced levels of phosphorylation of RNA Pol II at Ser2 observed at 2- or 4-cell stage of embryos under Padi1 knockdown or inhibiting PADI1. Thus, our data reveal a novel function of PADI1 during early embryo development transitions by catalyzing histone tail citrullination, which facilitates early embryo genome transactivation

Hyalinizing clear cell carcinoma of salivary gland: a clinicopathological study of 8 cases

Background and purpose: Hyalinizing clear cell carcinoma (HCCC) of salivary gland is a rare tumor with low-grade malignancy, which usually occurs in minor salivary glands. Due to its rarity, the tumor type is not well known to pathologists and misdiagnosis frequently occurred. The aim of this study was to investigate the histologic, immunophenotypic and molecular features of HCCC. Methods: Eight cases of salivary gland HCCC diagnosed at the Department of Pathology, Fudan University Shanghai Cancer Center from January 2015 to October 2019 were collected. Clinicopathologic characteristics were analyzed, and fluorescence in situ hybridization (FISH) assay was used to detect EWSR1 translocation in tumor tissue. Diagnostic criteria and differential diagnosis were summarized, with a review of the literature. Results: All patients were female, aged 26 to 68 years, and the tumor locations included the oral cavity, nasopharynx, parotid gland and other sites of head and neck. Microscopically, the tumors consisted mainly of clear cells and eosinophilic cells with variable proportions, arranged in nests, sheets and trabeculae. In 1 case, the tumor was composed almost entirely of eosinophilic cells; in 6 cases, obvious nuclear pseudo-inclusion bodies were seen; in 1 case, neoplastic cells were connected to the surface squamous epithelium; in 1 case, the glandular structure was seen in some areas of the tumor; in 3 cases, a sheath of lymphocyte was formed around the tumor nests; in 7 cases, there was a sclerosing or hyalinizing stromal reaction, showing desmoplastic changes; and 1 case featured stoma with myxoid changes. There was no definite keratinization or necrosis in all tumors, and mitotic figures were generally rare. Immunohistochemical staining showed that tumor cells of 8 cases were diffusely positive for AE1/AE3 protein, 7 cases expressed P63, and 7 cases focally expressed low molecular weight keratin CK7 or CAM5.2, however, S-100, calponin, PAX-8 and CD10 were all negative. All tumors showed low proliferative activity, with the Ki-67 proliferation index less than 5%. FISH test revealed EWSR1 translocation in all 8 cases. All patients demonstrated no recurrence or metastasis during the follow up ranging 4-50 months. Conclusions: HCCC of salivary gland is a low-grade malignancy occurring mainly in minor salivary glands, with characteristic histological and molecular features. This cancer type needs to be distinguished with many morphologic mimics of salivary gland. Most cases with salivary HCCC feature a good prognosis

The nucleus accumbens functional connectivity in patients with insomnia using resting-state fMRI

BackgroundThe aim of this study was to investigate the functional abnormalities between the nucleus accumbens (NAc) and the whole brain in individuals with Insomnia Disorder (ID) using resting-state functional magnetic resonance imaging (fMRI). Additionally, the study aimed to explore the underlying neural mechanisms of ID.MethodsWe enrolled 18 participants with ID and 16 normal controls (NC). Resting-state functional connectivity (FC) between the NAc and the whole brain voxels was calculated and compared between the two groups to identify differential brain region. Receiver operating characteristic (ROC) curve analysis was employed to assess the ability of differential features to distinguish between groups. Furthermore, Pearson correlation analysis was performed to examine the relationship between neurocognitive scores and differential features.ResultsThe ID group exhibited significantly reduced FC values in several brain regions, including the right supplementary motor area, the bilateral middle frontal gyrus, the bilateral median cingulate and paracingulate gyri and the left precuneus. The area under the curve (AUC) of the classification model based on FC in these brain regions was 83.3%. Additionally, the abnormal functional changes observed in ID patients were positively correlated with the Fatigue Severity Scale (R = 0.650, p = 0.004).ConclusionThese findings suggest that the NAc may play a crucial role in the diagnosis of ID and could serve as a potential imaging biomarker, providing insights into the underlying neural mechanisms of the disorder

Effects of Wenxin Keli on the Action Potential and L-Type Calcium Current in Rats with Transverse Aortic Constriction-Induced Heart Failure

Objective. We investigated the effects of WXKL on the action potential (AP) and the L-type calcium current (ICa-L) in normal and hypertrophied myocytes. Methods. Forty male rats were randomly divided into two groups: the control group and the transverse aortic constriction- (TAC-) induced heart failure group. Cardiac hypertrophy was induced by TAC surgery, whereas the control group underwent a sham operation. Eight weeks after surgery, single cardiac ventricular myocytes were isolated from the hearts of the rats. The APs and ICa-L were recorded using the whole-cell patch clamp technique. Results. The action potential duration (APD) of the TAC group was prolonged compared with the control group and was markedly shortened by WXKL treatment in a dose-dependent manner. The current densities of the ICa-L in the TAC group treated with 5 g/L WXKL were significantly decreased compared with the TAC group. We also determined the effect of WXKL on the gating mechanism of the ICa-L in the TAC group. We found that WXKL decreased the ICa-L by accelerating the inactivation of the channels and delaying the recovery time from inactivation. Conclusions. The results suggest that WXKL affects the AP and blocked the ICa-L, which ultimately resulted in the treatment of arrhythmias

Crystal Structure of the Caenorhabditis elegans Apoptosome Reveals an Octameric Assembly of CED-4

SummaryThe CED-4 homo-oligomer or apoptosome is required for initiation of programmed cell death in Caenorhabditis elegans by facilitating autocatalytic activation of the CED-3 caspase zymogen. How the CED-4 apoptosome assembles and activates CED-3 remains enigmatic. Here we report the crystal structure of the complete CED-4 apoptosome and show that it consists of eight CED-4 molecules, organized as a tetramer of an asymmetric dimer via a previously unreported interface among AAA+ ATPases. These eight CED-4 molecules form a funnel-shaped structure. The mature CED-3 protease is monomeric in solution and forms an active holoenzyme with the CED-4 apoptosome, within which the protease activity of CED-3 is markedly stimulated. Unexpectedly, the octameric CED-4 apoptosome appears to bind only two, not eight, molecules of mature CED-3. The structure of the CED-4 apoptosome reveals shared principles for the NB-ARC family of AAA+ ATPases and suggests a mechanism for the activation of CED-3

Berberine Ameliorates Hepatic Steatosis and Suppresses Liver and Adipose Tissue Inflammation in Mice with Diet-induced Obesity

Increasing evidence demonstrates that berberine (BBR) is beneficial for obesity-associated nonalcoholic fatty liver disease (NAFLD). However, it remains to be elucidated how BBR improves aspects of NAFLD. Here we revealed an AMP-activated protein kinase (AMPK)-independent mechanism for BBR to suppress obesity-associated inflammation and improve hepatic steatosis. In C57BL/6J mice fed a high-fat diet (HFD), treatment with BBR decreased inflammation in both the liver and adipose tissue as indicated by reduction of the phosphorylation state of JNK1 and the mRNA levels of proinflammatory cytokines. BBR treatment also decreased hepatic steatosis, as well as the expression of acetyl-CoA carboxylase and fatty acid synthase. Interestingly, treatment with BBR did not significantly alter the phosphorylation state of AMPK in both the liver and adipose tissue of HFD-fed mice. Consistently, BBR treatment significantly decreased the phosphorylation state of JNK1 in both hepatoma H4IIE cells and mouse primary hepatocytes in both dose-dependent and time-dependent manners, which was independent of AMPK phosphorylation. BBR treatment also caused a decrease in palmitate-induced fat deposition in primary mouse hepatocytes. Taken together, these results suggest that BBR actions on improving aspects of NAFLD are largely attributable to BBR suppression of inflammation, which is independent of AMPK.National Institutes of Health [HL108922, HL095556, R01DK095828, R01DK095862]; National Natural Science Foundation of China [81100562/H0711]; Hatch Program of the National Institutes of Food and Agriculture (NIFA)SCI(E)[email protected]; [email protected]