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Burnout and work-related stressors in gastroenterology: a protocol for a multinational observational study in the ASEAN region.
BACKGROUND: Clinician burnout is an important occupational hazard that may be exacerbated by the novel COVID-19 pandemic. Within Southeast Asia, burnout in gastroenterology is understudied. The primary objective of this study is to estimate the prevalence of burnout symptoms within gastroenterology, in member states of the Associations of Southeast Asian Nations (ASEAN), during and after the COVID-19 pandemic. The secondary objective is to identify work-related stressors that contribute to burnout in ASEAN gastroenterologists. METHODS AND ANALYSIS: This is an observational study that will use anonymised online surveys to estimate the prevalence of burnout symptoms at two time points: during the COVID-19 pandemic in 2020 and in 2022 (assumed to be after the pandemic). Gastroenterologists from Singapore, Malaysia, Thailand, Indonesia, Philippines and Brunei will be invited to participate in the online survey through their national gastroenterology and endoscopy societies. Burnout will be assessed using the Maslach Burnout Inventory-Human Services Survey tool. Supplementary questions will collect demographic and qualitative data. Associations between demographic characteristics and burnout will be tested by multiple regression. RESULTS: The prevalence of burnout symptoms in gastroenterology during the COVID-19 pandemic, and the baseline prevalence after COVID-19, will be established in the above-mentioned countries. Work-related stressors commonly associated with burnout will be identified, allowing the introduction of preventative measures to reduce burnout in the future. ETHICS AND DISSEMINATION: Ethical approval was granted by the Singhealth Centralised Institutional Review Board (2020/2709). Results will be submitted for publication
Dimensional crossover in topological matter: Evolution of the multiple Dirac point in the layered system to the flat band on the surface
We consider the dimensional crossover in the topological matter, which
involves the transformation of different types of topologically protected
zeroes in the fermionic spectrum. In the considered case, the multiple Dirac
(Fermi) point in quasi 2-dimensional system evolves into the flat band on the
surface of the 3-dimensional system when the number of atomic layers increases.
This is accompanied by formation of the spiral nodal lines in the bulk. We also
discuss the topological quantum phase transition at which the surface flat band
shrinks and changes its chirality, while the nodal spiral changes its helicity.Comment: 13 pages, 7 figure
A randomized controlled trial on the effect of VCO in reducing glucose and body weight in post-acute coronary syndrome patients : a pilot study
The aims of this paper were to determine the effect of virgin coconut oil (VCO) on bodyweight and serum glucose level among acute coronary syndrome (ACS) patients. Various clinical trials on animal studies have found that the VCO has many beneficial effects on health. However, there have been limited published human studies on the pharmacological properties of VCO. Investigation on human subjects is extremely required in order to provide more empirical evidence to show the effect of VCO for ACS patients. Randomised single blind study conducted between March 2018 and April 2018. RCT was conducted among 70 ACS patients for 30 days. Participants in group A received their bottles containing 100 pieces of virgin coconut oil soft gels and were required to ingest 10 capsules per day (5 mL/5 gm) and continue routine treatment (diabetic diet and diabetic medication). Group B participants continued receiving routine treatment. Changes in serum fating blood sugar and body weight were identified using a paired t-test and independent t-test. A total of 70 patients participated with ages of 51 years old and older and were mostly male. The serum FBS and body weight of the intervention group that received VCO were reduced about 13.6% on day 30, from the baseline on day 1. They also had body weight reduction of about 2% with p value of less than 0.05. In contrast, the control group that only received routine treatment showed an increment of 12.1% in their serum FBS and had no changes in body weight. These reductions were noted within 30 days of consuming a daily dose of VCO (5 g every day). The properties of lauric acid and antioxidants present in the VCO composition were key players in the reduction of serum glucose levels and body weight. VCO can reduce serum glucose levels and body weight with 5 mL (5 g) of VCO per day for 30 days. Also, VCO may have a positive effect towards the glucose level and other cardiovascular risk factors
Effect of remote ischemic preConditioning on liver injury in patients undergoing liver resection: the ERIC-LIVER trial
OBJECTIVE: Novel hepatoprotective strategies are needed to improve clinical outcomes during liver surgery. There is mixed data on the role of remote ischemic preconditioning (RIPC). We investigated RIPC in partial hepatectomy for primary hepatocellular carcinoma (HCC). METHODS: This was a Phase II, single-center, sham-controlled, randomized controlled trial (RCT). The primary hypothesis was that RIPC would reduce acute liver injury following surgery indicated by serum alanine transferase (ALT) 24 h following hepatectomy in patients with primary HCC, compared to sham. Patients were randomized to receive either four cycles of 5 min/5 min arm cuff inflation/deflation immediately prior to surgery, or sham. Secondary endpoints included clinical, biochemical and pathological outcomes. Liver function measured by Indocyanine Green pulse densitometry was performed in a subset of patients. RESULTS: 24 and 26 patients were randomized to RIPC and control groups respectively. The groups were balanced for baseline characteristics, except the duration of operation was longer in the RIPC group. Median ALT at 24 h was similar between groups (196 IU/L IQR 113.5-419.5 versus 172.5 IU/L IQR 115-298 respectively, p = 0.61). Groups were similar in secondary endpoints. CONCLUSION: This RCT did not demonstrate beneficial effects with RIPC on serum ALT levels 24 h after partial hepatectomy
Evaluation of Mode I Fracture Toughness Assisted by the Numerical Determination of K-Resistance
The fracture toughness of a rock often varies depending on the specimen shape and the loading type used to measure it. To investigate the mode I fracture toughness using semi-circular bend (SCB) specimens, we experimentally studied the fracture toughness using SCB and chevron bend (CB) specimens, the latter being one of the specimens used extensively as an International Society for Rock Mechanics (ISRM) suggested method, for comparison. The mode I fracture toughness measured using SCB specimens is lower than both the level I and level II fracture toughness values measured using CB specimens. A numerical study based on discontinuum mechanics was conducted using a two-dimensional distinct element method (DEM) for evaluating crack propagation in the SCB specimen during loading. The numerical results indicate subcritical crack growth as well as sudden crack propagation when the load reaches the maximum. A K-resistance curve is drawn using the crack extension and the load at the point of evaluation. The fracture toughness evaluated by the K-resistance curve is in agreement with the level II fracture toughness measured using CB specimens. Therefore, the SCB specimen yields an improved value for fracture toughness when the increase of K-resistance with stable crack propagation is considered
Scattering Theory and -Symmetry
We outline a global approach to scattering theory in one dimension that
allows for the description of a large class of scattering systems and their
-, -, and -symmetries. In
particular, we review various relevant concepts such as Jost solutions,
transfer and scattering matrices, reciprocity principle, unidirectional
reflection and invisibility, and spectral singularities. We discuss in some
detail the mathematical conditions that imply or forbid reciprocal
transmission, reciprocal reflection, and the presence of spectral singularities
and their time-reversal. We also derive generalized unitarity relations for
time-reversal-invariant and -symmetric scattering
systems, and explore the consequences of breaking them. The results reported
here apply to the scattering systems defined by a real or complex local
potential as well as those determined by energy-dependent potentials, nonlocal
potentials, and general point interactions.Comment: Slightly expanded revised version, 38 page
Author correction : a global database for metacommunity ecology, integrating species, traits, environment and space
Correction to: Scientific Data https://doi.org/10.1038/s41597-019-0344-7, published online 08 January 202
Effect of Mouth Rinsing and Ingestion of Carbohydrate Solutions on Mood and Perceptual Responses During Exercise
Background: The aim of this study was to investigate whether mouth rinsing or ingesting carbohydrate (CHO) solutions impact on perceptual responses during exercise. Methods: Nine moderately trained male cyclists underwent a 90-min glycogen-reducing exercise, and consumed a low CHO meal, prior to completing an overnight fast. A 1-h cycle time trial was performed the following morning. Four trials, each separated by 7days, were conducted in a randomized, counterbalanced study design: 15% CHO mouth rinse (CHOR), 7.5% CHO ingestion (CHOI), placebo mouth rinse (PLAR) and placebo ingestion (PLAI). Solution volumes (1.5ml·g-1 ingestion trials and 0.33ml·kg-1 rinsing trials) were provided after every 12.5% of completed exercise. Perceptual scales were used to assess affective valence (feeling scale, FS), arousal (felt arousal scale, FAS), exertion (ratings of perceived exertion, RPE) and mood (profile of mood states, POMS) before, during and immediately after exercise. Results: There was no difference in RPE (CHOI, 14.0±9; CHOR, 14.2±.7; PLAI, 14.6±1.8; PLAR, 14.6±2.0; P=0.35), FS (CHOI, 0.0±1.7; CHOR, -0.2±1.5; PLAI, -0.8±1.4; PLAR, -0.8±1.6; P0.15), or FAS (CHOI, 3.6±1.1; CHOR, 3.5±1.0; PLAI, 3.4±1.4; PLAR, 3.3±1.3; P=725) scores between trials. While overall POMS score did not appear to differ between trials, the 'vigour' subscale indicated that CHOI may facilitate the maintenance of 'vigour' scores over time, in comparison to the steady decline witnessed in other trials (P=0.04). There was no difference in time trial performance between trials (CHOI, 65.3±4.8min; CHOR, 68.4±3.9min; PLAI, 68.7±5.3min; PLAR, 68.3±5.2min; P=0.21) but power output was higher in CHOI (231.0±33.2 W) relative to other trials (221-223.6 W; Plt0.01). Conclusions: In a CHO-reduced state, mouth rinsing with a CHO solution did not impact on perceptual responses during high-intensity exercise in trained cyclists and triathletes. On the other hand CHO ingestion improved perceived ratings of vigour and increased power output during exercise
Positive psychology of Malaysian students: impacts of engagement, motivation, self-compassion and wellbeing on mental health
Malaysia plays a key role in education of the Asia Pacific, expanding its scholarly output rapidly. However, mental health of Malaysian students is challenging, and their help-seeking is low because of stigma. This study explored the relationships between mental health and positive psychological constructs (academic engagement, motivation, self-compassion, and wellbeing), and evaluated the relative contribution of each positive psychological construct to mental health in Malaysian students. An opportunity sample of 153 students completed the measures regarding these constructs. Correlation, regression, and mediation analyses were conducted. Engagement, amotivation, self-compassion, and wellbeing were associated with, and predicted large variance in mental health. Self-compassion was the strongest independent predictor of mental health among all the positive psychological constructs. Findings can imply the strong links between mental health and positive psychology, especially selfcompassion. Moreover, intervention studies to examine the effects of self-compassion training on mental health of Malaysian students appear to be warranted.N/
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