Assessment of cognitive factors and their relationship with burnout syndrome at different levels of medical education

Consecutive completion of specialist and residency training is an important stage in the development of a young physician. Therapeutic activity implies emotional intensity and a great number of factors, causing stress. The syndrome of emotional burnout is not only a result of neuropsychological stress, but also a consequence of uncontrolled stress. The aim of the research was to determine influence of thinking styles, types of thinking and creativity level on factors of cognitive appraisal as predictors of burnout syndrome development in higher education trainees (specialist and postgraduate training programmes). The search of predictors of a burnout syndrome was carried out for a sample of 330 medical students and 50 physicians of the control group. As a result of research it has been revealed that trainees as well as practitioners have a practical style of thinking; postgraduate trainees more often use the combined one, students, figurative; and physicians, sign type of thinking; higher parameters of creativity are marked in postgraduate trainees over physicians. In general, students on specialty and postgraduate training programmes have less difficulty with most of the cognitive assessment factors. The correlation analysis showed as follows: for students, there were direct links of medium strength between the sign type of thinking and “strong emotionsˮ, emotional detachment, and “future perspectiveˮ; for postgraduate trainees, there were direct and inverse links of very weak and weak strength, which could be neglected. However, further factor analysis is required in order to assess the influence of certain factor on the development of emotional burnout syndrome in medical trainees.

Relationship Between Pulmonary Hamartoma and Bronchus: Multislice Spiral Computed Tomography Findings

Objective The aim of the present study is to investigate the relationship between pulmonary hamartomas (PHs) and bronchi on multislice spiral computed tomography (MSCT) images. Methods The MSCT scans of 218 PHs from 216 pathologically confirmed patients were reviewed. The PHs were divided into two groups, namely, the central endobronchial and intraparenchymal groups, in accordance with location. Multiplanar reconstruction was used to demonstrate PH–bronchus relationship patterns. The PH–bronchus relationships in the intraparenchymal group were classified into five patterns: type I, the bronchus was cut off by the tumor; type II, the bronchus was contained within the tumor (air bronchogram sign); type III, the bronchus ran at the tumor periphery or was compressed by the tumor; and type IV, no tumor–bronchus relationship was observed. Results Nine (4.1%) PHs were assigned to the central endobronchial group and 209 (95.9%) PHs were assigned to the intraparenchymal group. In the endobronchial group, 1 (11.1%) PH was located in the trachea with the partial stenosis of the trachea, whereas the remaining 8 (88.9%) PHs were located in the lobar or segmental bronchus with the complete occlusion of the corresponding bronchus. In the intraparenchymal group, type IV (147, 70.3%) was most common pattern, followed by type III (54, 25.8%). Type I (8, 3.8%) was rare, and type II was not observed. Conclusion Central endobronchial PHs often obstructed bronchi, whereas only a few intraparenchymal PHs cut off bronchi. No air bronchogram sign was observed.

The main etiological reasons of fatal type 2 myocardial infarction

Funding Acknowledgements Type of funding sources: None. Purpose the assessment of the proportion of myocardial infarction (MI) type 2 in the structure of mortality in a multidisciplinary hospital Material and methods. A retrospective study was made of 1,574 autopsy protocols carried out in a multidisciplinary hospital in the period from 01.01.10 to 31.12.16, of which a group with postmortem type II MI was identified. The control group was composed of persons who died from proven atherothrombotic type 1 MI Results. In 360 cases (22.87%), the cause of death was MI. Of these, 137 cases were due to type 2 MI. The ratio of men and women was the same. Type 2 MI more often developed in elderly (48.2%) and senile (34.3%) ages; the average age of patients with type 2 MI was 71.7 ± years (68.2 ± 3 years among men and 75.3 ± 4 years among women p <0.05), which did not differ from the group with fatal type 1 MI. The main causes of death in type 2 MI were tachysystolic arrhythmias - 59.12% of cases, severe hypoxia of any etiology - 35.04%. The absence of significant stenoses of coronary artery (CA) is significantly more common in type 2 MI, and multivessel disease - in type 1 MI. In the group of patients with type 1 MI, 67.29% had multivessel lesions (Table 1). When comparing mortality in different departments of a multidisciplinary hospital, it turned out that only 29.2% of patients with type 2 MI were initially hospitalized in the cardiology department; 45.3% of patients - therapeutic, 25.5% of patients – surgical. Conclusion. Nearly one in four patients die as a result of MI, with more than 1/3 of fatal MIs occurring in type 2 MI. The main reasons for the development of type 2 MI: tachysystolic arrhythmias - 59.12%, hypoxia of various origins - 35.04%, sepsis - 2.2%. 25% of fatal type 2 MIs occurred in surgical patients. Table 1. CA in type 1 and 2 MI Sign Type 1 MY n = 223 Type 2 MY n = 137 p No significant stenosis 2,24% 32,85% 0,001 Single CA significant stenosis 8,07% 12,41% 0,193 2-CA significant stenosis 23,3% 23,36% 0,272 Multivessel stenosis 66,4% 31,38% 0,005 Occlusion of at least one CA 48,9% 4,38% 0,001

Pachychoroid Neovasculopathy; Findings, Diagnosis, and Treatment

Pachychoroid neovasculopathy (PNV) is a novel clinical entity with typical pachychoroid features accompanied by type 1 choroidal neovascularization (CNV). Typical optical coherence tomography finding of the disease is flat irregular pigment epithelial detachments (double layer sign). Type 1 CNV between retinal pigment epithelium and Bruch membrane is seen as a tangled network on optical coherence tomography angiography. Differential diagnosis of PNV from neovascular age-related macular degeneration is especially important because of the different epidemiological, genetic, and therapeutic features of these diseases. Current treatment approaches include intravitreal anti-vascular endothelial growth factor injections and photodynamic therapy.

Criteria for Embedded Eigenvalues for Discrete Schrödinger Operators

In this paper, we consider discrete Schrödinger operators of the form, $$\begin{equation*} (Hu)(n) = u({n+1})+u({n-1})+V(n)u(n). \end{equation*}$$We view $H$ as a perturbation of the free operator $H_0$, where $(H_0u)(n)= u({n+1})+u({n-1})$. For $H_0$ (no perturbation), $\sigma _{\textrm{ess}}(H_0)=\sigma _{\textrm{ac}}(H)=[-2,2]$ and $H_0$ does not have eigenvalues embedded into $(-2,2)$. It is an interesting and important problem to identify the perturbation such that the operator $H_0+V$ has one eigenvalue (finitely many eigenvalues or countable eigenvalues) embedded into $(-2,2)$. We introduce the almost sign type potentials and develop the Prüfer transformation to address this problem, which leads to the following five results. 1: We obtain the sharp spectral transition for the existence of irrational type eigenvalues or rational type eigenvalues with even denominators.2: Suppose $\limsup _{n\to \infty } n|V(n)|=a<\infty .$ We obtain a lower/upper bound of $a$ such that $H_0+V$ has one rational type eigenvalue with odd denominator.3: We obtain the asymptotical behavior of embedded eigenvalues around the boundaries of $(-2,2)$.4: Given any finite set of points $\{ E_j\}_{j=1}^N$ in $(-2,2)$ with $0\notin \{ E_j\}_{j=1}^N+\{ E_j\}_{j=1}^N$, we construct the explicit potential $V(n)=\frac{O(1)}{1+|n|}$ such that $H=H_0+V$ has eigenvalues $\{ E_j\}_{j=1}^N$.5: Given any countable set of points $\{ E_j\}$ in $(-2,2)$ with $0\notin \{ E_j\}+\{ E_j\}$, and any function $h(n)>0$ going to infinity arbitrarily slowly, we construct the explicit potential $|V(n)|\leq \frac{h(n)}{1+|n|}$ such that $H=H_0+V$ has eigenvalues $\{ E_j\}$.

An algorithm to determining the gear efficiency to a simple planetary train

The paper presents an original algorithm composed by authors in order to determine through exact calculations the efficiency value of a simple planetary mechanism, increasingly used in aerospace, robotics, mechatronics, machine building, and various automation. The calculation program is written in excel and for its simple automation four sign-type switches, are used plus or minus 1, and a logic function for checking the status and choosing the corresponding value. In this way, the program is generalized to be used for any type of simple planetary mechanism for the purpose of accurately determining its yield.

Polycentricity of Linguistic Landscape and Nation-Building in Post-Soviet Kazakhstan

This study illustrates a key existing challenge to realizing trilingualism as a major nation-building language ideology: the ideological polycentricity of multilingual signs—that is, the simultaneous orientation of multilingual signs to several authority centers. Combining diverse linguistic landscape (LL) methodologies such as code preferences (language choices and placement on a sign), indexical orders (patterns that index meta-messages), and polycentricity (a simultaneous orientation toward multiple centers), I examine how three state-approved languages (Kazakh, Russian, and English) are positioned on 346 state and private signs in a small town in northern Kazakhstan. The analysis reveals a range of indexical orders at the level of sign type: monolingual, bilingual, and trilingual sign types of horizontal, vertical, and centralized code combinations. At the level of signage group, bilingual Kazakh-Russian and trilingual Kazakh-Russian-English signs dominate in the top-down group, while monolingual Russian and bilingual Kazakh-Russian signs with centralized Russian dominate in the bottom-up group. The identified indexical orders indicate ideological polycentricity in town public signage, which presents a challenge for the nation-building process.

Detecting word endings in an unknown script

Date: Around 2200 BC.Location: Western, southern and eastern Iran.Type: Syllabic Script.Text Corpus: 22 (known a long time), plus 15 (known since 2015).Sign Corpus: 110 sign type, 1340 sign tokens.Status: Principally undeciphered, except the sound values for in, šu, uš, ši, na, and k, drawn from the divine name Inšušinak found in the only bilingual inscription. Several further sound values were proposed. In our paper, some of them are being corroborated, and a new one is presented.Language behind the signs: Based on graphotactical patterns found in the texts, this paper claims that it must be Elamite or a language closely related to it.

Handling Multiplicity in Neuroimaging through Bayesian Lenses with Multilevel Modeling

Here we address the current issues of inefficiency and over-penalization in the massively univariate approach followed by the correction for multiple testing, and propose a more efficient model that pools and shares information among brain regions. Using Bayesian multilevel (BML) modeling, we control two types of error that are more relevant than the conventional false positive rate (FPR): incorrect sign (type S) and incorrect magnitude (type M). BML also aims to achieve two goals: 1) improving modeling efficiency by having one integrative model and thereby dissolving the multiple testing issue, and 2) turning the focus of conventional null hypothesis significant testing (NHST) on FPR into quality control by calibrating type S errors while maintaining a reasonable level of inference efficiency The performance and validity of this approach are demonstrated through an application at the region of interest (ROI) level, with all the regions on an equal footing: unlike the current approaches under NHST, small regions are not disadvantaged simply because of their physical size. In addition, compared to the massively univariate approach, BML may simultaneously achieve increased spatial specificity and inference efficiency, and promote results reporting in totality and transparency. The benefits of BML are illustrated in performance and quality checking using an experimental dataset. The methodology also avoids the current practice of sharp and arbitrary thresholding in thep-value funnel to which the multidimensional data are reduced. The BML approach with its auxiliary tools is available as part of the AFNI suite for general use.