Síndrome de Burnout um risco aos profissionais de educação física: uma revisão integrativa / Burnout syndrome a risk to physical education profes-sionals: an integrative review / El síndrome de Burnout un riesgo para los profesionales de la educación física: una revisión integrativa

Objetivou-se identificar e analisar as características da síndro-me de burnout em profissionais da educação física no Brasil. Foi realiza-da uma revisão integrativa, entre os meses de janeiro e julho de 2022, com buscas nos BVS/ Portal Bireme, Scielo, Lilacs, e Google Acadêmico. Foram identificados 10 estudos nos últimos 20 anos. A prevalência da síndrome de Burnout foi em média de 11,55%. Os estudos associam o esgotamento profissional a sobrecarga de trabalho, pluriemprego e remuneração inadequada. Desta forma, evidenciou-se os riscos aos quais essa classe profissional é exposta, ressaltando a importância de manter condições e ambientes de trabalhos adequados. Todavia, mais estudos sobre a síndrome de Burnout em profissionais da educação física devém ser conduzidos no Brasil.

This research aimed to identify and analyze the Burnout syn-drome characteristics in physical education professionals in Brazil. An in-tegrative review was carried out, from January to July 2022. The research were performed in the BVS/Portal Bireme, Scielo, Lilacs and Google Scholar. The literature reported 10 studies in Brazil in the last 20 years. In general, the mean prevalence of Burnout syndrome was 11,55%. Moreover, the studies associate professional exhaustion with overwork, multiple jobs and inadequate remuneration. The study highlighted the syndrome incidence and risks to this professional class and emphasized the importance of maintaining adequate working conditions and envi-ronments. However, more studies on Burnout syndrome in physical ed-ucation professionals should be conducted in Brazil.

El objetivo fue identificar y analizar las características del síndrome de burnout en profesionales de educación física en Brasil. Se realizó una revisión integradora entre enero y julio de 2022, con búsque-das en el Portal BVS/Bireme, Scielo, Lilacs y Google Scholar. Se identifica-ron 10 estudios en los últimos 20 años. El predominio del síndrome de Burnout fue en promedio de 11,55%. Los estudios asocian el desgaste profesional con el exceso de trabajo, el pluriempleo y la remuneración inadecuada. De esta manera, se resaltaron los riesgos a los que está ex-puesta esta clase profesional, resaltando la importancia de mantener condiciones y ambientes de trabajo adecuados. Sin embargo, se debenrealizar más estudios sobre el síndrome de Burnout en profesionales de la educación física en Brasil.

Síndrome de Burnout um risco aos profissionais de educação física: uma revisão integrativa / Burnout syndrome a risk to physical education profes-sionals: an integrative review / El síndrome de Burnout un riesgo para los profesionales de la educación física: una revisión integrativa

Objetivou-se identificar e analisar as características da síndro-me de burnout em profissionais da educação física no Brasil. Foi realiza-da uma revisão integrativa, entre os meses de janeiro e julho de 2022, com buscas nos BVS/ Portal Bireme, Scielo, Lilacs, e Google Acadêmico. Foram identificados 10 estudos nos últimos 20 anos. A prevalência da síndrome de Burnout foi em média de 11,55%. Os estudos associam o esgotamento profissional a sobrecarga de trabalho, pluriemprego e remuneração inadequada. Desta forma, evidenciou-se os riscos aos quais essa classe profissional é exposta, ressaltando a importância de manter condições e ambientes de trabalhos adequados. Todavia, mais estudos sobre a síndrome de Burnout em profissionais da educação física devém ser conduzidos no Brasil (AU).

This research aimed to identify and analyze the Burnout syn-drome characteristics in physical education professionals in Brazil. An in-tegrative review was carried out, from January to July 2022. The research were performed in the BVS/Portal Bireme, Scielo, Lilacs and Google Scholar. The literature reported 10 studies in Brazil in the last 20 years. In general, the mean prevalence of Burnout syndrome was 11,55%. Moreover, the studies associate professional exhaustion with overwork, multiple jobs and inadequate remuneration. The study highlighted the syndrome incidence and risks to this professional class and emphasized the importance of maintaining adequate working conditions and envi-ronments. However, more studies on Burnout syndrome in physical ed-ucation professionals should be conducted in Brazil (AU).

El objetivo fue identificar y analizar las características del síndrome de burnout en profesionales de educación física en Brasil. Se realizó una revisión integradora entre enero y julio de 2022, con búsque-das en el Portal BVS/Bireme, Scielo, Lilacs y Google Scholar. Se identifica-ron 10 estudios en los últimos 20 años. El predominio del síndrome de Burnout fue en promedio de 11,55%. Los estudios asocian el desgaste profesional con el exceso de trabajo, el pluriempleo y la remuneración inadecuada. De esta manera, se resaltaron los riesgos a los que está ex-puesta esta clase profesional, resaltando la importancia de mantener condiciones y ambientes de trabajo adecuados. Sin embargo, se deben realizar más estudios sobre el síndrome de Burnout en profesionales de la educación física en Brasil (AU).

Identificación de dimensiones del síndrome de burnout en estudiantes de Contaduría y Finanzas / Identification of dimensions of burnout syndrome in Accounting and Finance students / Identificação das dimensões da síndrome de burnout em estudantes de Contabilidade e Finanças

El síndrome de burnout, también conocido como síndrome del desgaste o agotamiento físico y mental, constituye un problema de gran repercusión social en nuestros días. Objetivo. Identificar las dimensiones del síndrome de Burnout en estudiantes universitarios de la Carrera de Contaduría y Finanzas. Materiales y Método. Se desarrolló bajo un diseño observacional de corte transversal. En este sentido, un total de 161 estudiantes participaron en la investigación. Se utilizó el Maslach Burnout Inventory for Educators. Resultados. Los participantes al ser clasificados en las diferentes dimensiones del síndrome burnout mostraron como regularidad diferencias significativas (p<1.056e-06), (p<1.199e-10), (p<1.309e-13) con 74 (46%) y 57 (35%), 85 (53%) y 47 (29%) y 91 (56%) y 39 (24%) para los niveles bajo y alto de las dimensiones agotamiento emocional, cinismo e ineficacia profesional, respectivamente. No se encontraron asociaciones estadísticas entre las dimensiones del síndrome y las variables edad, género y estado civil de los participantes. Conclusión. Existen diferencias significativas entre los valores de las dimensiones del síndrome de burnout en estudiantes de la Carrera de Contaduría y Finanzas; la mayor cantidad de participantes clasifican en los niveles bajo y alto de las tres dimensiones. Por otro lado, no se observaron asociaciones estadísticas al clasificar a los participantes según edad, género y estado civil. Estos hallazgos brindan información relevante sobre la prevalencia de las dimensiones del síndrome de burnout en estudiantes, lo que puede ser útil para el desarrollo de estrategias de prevención y apoyo.

Burnout syndrome, also known as burnout syndrome or physical and mental exhaustion, is a problem of great social repercussion nowadays. Objective. To identify the dimensions of burnout syndrome in university students of Accounting and Finance. Materials and Method. The study was developed under a cross-sectional observational design. In this sense, a total of 161 students participated in the research. The Maslach Burnout Inventory for Educators was used. Results. The participants when classified in the different dimensions of burnout syndrome showed as regularity significant differences (p<1.056e-06), (p<1.199e-10), (p<1.309e-13) with 74 (46%) and 57 (35%), 85 (53%) and 47 (29%) and 91 (56%) and 39 (24%) for the low and high levels of the dimensions emotional exhaustion, cynicism and professional inefficacy, respectively. No statistical associations were found between the dimensions of the syndrome and the variables age, gender and marital status of the participants. Conclusion. There are significant differences between the values of the dimensions of burnout syndrome in Accounting and Finance students; most participants are classified in the low and high levels of the three dimensions. On the other hand, no statistical associations were observed when classifying participants according to age, gender and marital status. These findings provide relevant information on the prevalence of the dimensions of burnout syndrome in students, which may be useful for the development of prevention and support strategies.

A síndrome de burnout, também conhecida como síndrome de esgotamento ou exaustão física e mental, é um problema com grandes repercussões sociais nos dias de hoje. Objetivos. Identificar as dimensões da Síndrome de Burnout em estudantes universitários de Contabilidade e Finanças. Material e Método. O estudo foi realizado através de um desenho observacional transversal. Participaram da pesquisa 161 estudantes. Foi utilizado o Maslach Burnout Inventory for Educators. Resultados. Os participantes quando classificados nas diferentes dimensões da síndrome de burnout apresentaram regularmente diferenças significativas (p<1,056e-06), (p<1,199e-10), (p<1,309e-13) com 74 (46%) e 57 (35%), 85 (53%) e 47 (29%) e 91 (56%) e 39 (24%) para os níveis baixo e alto das dimensões exaustão emocional, cinismo e ineficácia profissional, respetivamente. Não foram encontradas associações estatísticas entre as dimensões da síndrome e as variáveis idade, género e estado civil dos participantes. Conclusões. Existem diferenças significativas entre os valores das dimensões da síndrome de burnout em estudantes de Contabilidade e Finanças; a maioria dos participantes está classificada nos níveis baixo e alto das três dimensões. Por outro lado, não foram observadas associações estatísticas ao classificar os participantes de acordo com a idade, o género e o estado civil. Estes resultados fornecem informações relevantes sobre a prevalência das dimensões da síndrome de burnout em estudantes, o que pode ser útil para o desenvolvimento de estratégias de prevenção e apoio.

Effects of immune exhaustion and senescence of innate immunity in autoimmune disorders

Innate immune system activation is crucial in the inflammatory response, but uncontrolled activation can lead to autoimmune diseases. Cellular exhaustion and senescence are two processes that contribute to innate immune tolerance breakdown. Exhausted immune cells are unable to respond adequately to specific antigens or stimuli, while senescent cells have impaired DNA replication and metabolic changes. These processes can impair immune system function and disrupt homeostasis, leading to the emergence of autoimmunity. However, the influence of innate immune exhaustion and senescence on autoimmune disorders is not well understood. This review aims to describe the current findings on the role of innate immune exhaustion and senescence in autoimmunity, focusing on the cellular and molecular changes involved in each process. Specifically, the article explores the markers and pathways associated with immune exhaustion, such as PD-1 and TIM-3, and senescence, including Β-galactosidase (β-GAL), lamin B1, and p16ink4a, and their impact on autoimmune diseases, namely type 1 diabetes, rheumatoid arthritis, systemic lupus erythematosus, and immune-mediated myopathies. Understanding the mechanisms underlying innate immune exhaustion and senescence in autoimmunity may provide insights for the development of novel therapeutic strategies.

Mechanism of Tumor T Cell Exhaustion from Perspective of ''Sanjiao-Yingwei'' Qi Transformation Malfunction / 中国实验方剂学杂志

In order to promote the innovative application of Sanjiao theory and Yingwei theory， this paper tries to apply the ''Sanjiao-Yingwei'' Qi transformation theory to the treatment of tumor diseases， integrating it with T cell exhaustion mechanism to elaborate on its scientific connotation and using network pharmacology and bioinformatics to elucidate the correlation between the anti-tumor mechanism of ''Sanjiao-Yingwei'' Qi transformation and T cell exhaustion. The ''Sanjiao-Yingwei'' Qi transformation function is closely related to the immunometabolic ability of the human body， and the ''Sanjiao-Yingwei'' Qi transformation system constitutes the immunometabolic exchange system within and outside the cellular environment. Cancer toxicity is generated by the fuzzy Sanjiao Qi， and the long-term fuzzy Sanjiao Qi is the primary factor leading to T cell exhaustion， which is related to the long-term activation of T cell receptors by the high tumor antigen load in the tumor microenvironment. Qi transformation malfunction of the Sanjiao produces phlegm and collects stasis， which contributes to T cell exhaustion and is correlated with nutrient deprivation， lipid accumulation， and high lactate levels in the immunosuppressed tumor microenvironment， as well as with the release of transforming growth factor-β and upregulated expression of programmed death receptor-1 by tumor-associated fibroblasts and platelets in the tumor microenvironment. Ying and Wei damage due to Sanjiao Qi transformation malfunction is similar to the abnormal manifestations such as progressive loss of exhausted T cell effector function and disturbance of cellular energy metabolism. Guizhi decoction， Shengming decoction， and Wendan decoction can correct T cell exhaustion and exert anti-tumor effects through multi-target and multi-pathways by regulating ''Sanjiao-Yingwei'' Qi transformation， and hypoxia inducible factor-1α （HIF-1α） may be one of the main pathways to correct T cell exhaustion. It was found that HIF-1α may be one of the important prognostic indicators in common tumors by bioinformatics. The use of the ''Sanjiao-Yingwei'' Qi transformation method may play an important part in improving the prognosis of tumor patients in clinical practice.

Strategy of Targeted T Cell Immunotherapy for Acute Myeloid Leukemia / 肿瘤防治研究

T cell dysfunction is a common feature in patients with acute myeloid leukemia (AML). The up-regulation of immune checkpoint (IC) proteins resulting in T cell exhaustion is a key reason for T cell dysfunction. Immunotherapy with IC inhibitors exerts a remarkable effect on AML. However, due to the heterogeneity of T cell exhaustion and other factors that impair T cell function in patients with AML, the optimization of targeted T cell immunotherapy strategy for AML might be based on the multidimensional investigation of immune deficiency with different T cell subtypes.

Cancer immunotherapy with enveloped self-amplifying mRNA CARG-2020 that modulates IL-12, IL-17 and PD-L1 pathways to prevent tumor recurrence

Targeting multiple immune mechanisms may overcome therapy resistance and further improve cancer immunotherapy for humans. Here, we describe the application of virus-like vesicles (VLV) for delivery of three immunomodulators alone and in combination, as a promising approach for cancer immunotherapy. VLV vectors were designed to deliver single chain interleukin (IL)-12, short-hairpin RNA (shRNA) targeting programmed death ligand 1 (PD-L1), and a dominant-negative form of IL-17 receptor A (dn-IL17RA) as a single payload or as a combination payload. Intralesional delivery of the VLV vector expressing IL-12 alone, as well as the trivalent vector (designated CARG-2020) eradicated large established tumors. However, only CARG-2020 prevented tumor recurrence and provided long-term survival benefit to the tumor-bearing mice, indicating a benefit of the combined immunomodulation. The abscopal effects of CARG-2020 on the non-injected contralateral tumors, as well as protection from the tumor cell re-challenge, suggest immune-mediated mechanism of protection and establishment of immunological memory. Mechanistically, CARG-2020 potently activates Th1 immune mechanisms and inhibits expression of genes related to T cell exhaustion and cancer-promoting inflammation. The ability of CARG-2020 to prevent tumor recurrence and to provide survival benefit makes it a promising candidate for its development for human cancer immunotherapy.

Differences of gene expression profiles of different subpopulations of exhausted T cells in patients with active pulmonary tuberculosis / 中华传染病杂志

Objective:To explore the differences of gene expression profiles of precursors of exhausted T cells (Tpex) and terminal exhausted T cells (Tex) in the peripheral blood of patients with active pulmonary tuberculosis (ATB).Methods:Twenty-five cases of ATB, 13 cases of latent tuberculosis infection (LTBI) and 10 health controls were enrolled from January 2021 to October 2022 in the Fifth People′s Hospital of Wuxi. The proportions of Tpex and Tex in the peripheral blood mononuclear cells (PBMCs) of the three groups were detected by flowcytometry. PBMCs of ATB were separated into Tpex and Tex by fluorescence-activated cell sorting. RNA-sequencing was performed and up-regulated and down-regulated genes were screended. Differently expressed genes were analyzed by gene set enrichment analysis of gene ontology (GO) to find regulatory pathways affecting cell metabolism and function. Wilcoxon matched-pairs signed rank test, Kruskal-Wallis test and Dunn multiple comparsion test were used for statistical analysis.Results:The proportion of Tpex in ATB group was 2.86%(1.74%), which was lower than 7.93%(6.16%) of Tex, and the difference was statistically significant ( Z=-3.91, P<0.001). The proportions of Tpex and Tex in LTBI group were 9.47%(6.26%) and 7.43%(5.48%), respectively, and the difference was not statistically significant ( Z=-0.93, P=0.345). The proportions of Tpex and Tex in healthy control group were 8.42%(2.69%) and 6.49%(5.14%), respectively, with no statistical significance ( Z=-1.36, P=0.170). There was statistical difference of the proportion of Tpex among the three groups ( H=21.93, P<0.001), and the proportion of Tpex in ATB group was lower than those in LTBI and heathy control groups, and the differences were both statistically significant ( Z=4.16, P<0.001 and Z=3.34, P=0.003, respectively), while the proportions of Tex in these three groups were not statistically different ( H=2.17, P=0.338). Compared with Tex, the gene expressions of memory markers, such as B-cell lymphoma 2 of Tpex were up-regulated, and the gene expressions of exhausted markers, such as lymphocyte activation gene 3 were down-regulated. In terms of cellular metabolism, the gene expressions of mitochondrial protein complex, mitochondrial matrix and oxidative phosphorylation of Tpex were up-regulated, and the gene expressions of glycolysis were down-regulated. The gene expressions of pyruvate metabolism in Tex were up-regulated, and the gene expressions of CD4 + T lymphocyte activation and differentiation and glycolytic process in Tpex were down-regulated. Conclusions:Tpex in ATB express more characteristics of memory cells and less features of exhausted markers compared with Tex, and the function of mitochondria of Tpex preserves well.

Factors associated with Burnout Syndrome in police officers: a scoping review / Factores asociados al Síndrome de Burnout en policías: revisión de alcance / Fatores associados à Síndrome de Burnout em policiais: revisão de escopo

ABSTRACT Objectives: to synthesize research on factors associated with Burnout Syndrome (BS) in police officers. Methods: a scoping review was conducted without temporal or language restrictions. Data were exported to EndNote to remove duplicates and then imported into the Rayyan app for organization, article selection, and data extraction. Results: a total of 4559 publications were identified, with 50 studies included in the review. Research conducted in Brazil and the United States predominated. Certain occupational factors were found to be more closely linked to police officers compared to other professions, including law enforcement, frequency of interaction with suspects and criminals, rank, dissatisfaction with the organization, and civilian confrontations. Conclusions: certain aspects of the police profession contribute to BS, even in countries with better working conditions in public security. It is recommended to prioritize health promotion initiatives for these professionals.

RESUMEN Objetivos: sintetizar los estudios que abordan los factores asociados al síndrome de burnout (SB) en policías. Métodos: revisión de alcance, sin restricción temporal y de idiomas con exportación a EndNote, eliminación de duplicados y exportación a la aplicación Rayyan para organización, selección de artículos y extracción de datos. Resultados: se identificaron 4559 publicaciones con inclusión de 50 estudios. Hubo predominio de investigaciones realizadas en Brasil y Estados Unidos. Algunos factores laborales estuvieron más relacionados con los policías en comparación con otras profesiones, como la aplicación de la ley, la frecuencia de interacción con sospechosos y criminales, ser cabo, insatisfacción con la corporación y enfrentamientos con civiles. Conclusiones: ciertos aspectos laborales contribuyen al SB, incluso en países con mejores condiciones laborales en Seguridad Pública. Se recomienda priorizar acciones de promoción de la salud para estos profesionales.

RESUMO Objetivos: sintetizar os estudos que abordam os fatores associados à síndrome de burnout (SB) em policiais. Métodos: revisão de escopo, sem restrição temporal e de idiomas, com exportação para o EndNote, suprimindo os duplicados, e exportados para o aplicativo Rayyan, para organização, seleção dos artigos e extração dos dados. Resultados: foram identificadas 4559 publicações, com inclusão de 50 estudos. Houve predominância de pesquisas realizadas no Brasil e nos Estados Unidos. Alguns fatores laborais foram mais relacionados aos policiais quando comparados com outras profissões, como a aplicação da lei, frequência de interação com suspeitos e criminosos, ser cabo, insatisfação com a corporação e confrontos com civis. Conclusões: certos aspectos laborais contribuem para a SB, mesmo em países com melhores condições de trabalho na Segurança Pública. Recomenda-se priorizar ações de promoção da saúde para esses profissionais.

Preocupación por el contagio de la COVID-19 y carga laboral como predictores del malestar psicológico durante la emergencia sanitaria en personal de salud de Perú

Introducción: Durante la emergencia sanitaria, preocupan las repercusiones en la salud mental que pudieran estar experimentando los trabajadores sanitarios peruanos, quienes representan la primera línea de atención contra la COVID-19. Objetivo: Determinar si la preocupación por la COVID-19 y la carga laboral predicen el malestar psicológico en personal de salud. Métodos: Estudio predictivo en 367 trabajadores (enfermeros, médicos, técnicos en enfermería, obstetras, odontólogos, psicólogos, nutricionistas, entre otros) de ambos sexos en 12 redes de salud de la región de Puno, seleccionados a través de un muestreo no probabilístico intencional. Los datos se recogieron a través de la Escala de malestar psicológico de Kessler, la Escala de preocupación por el contagio de la COVID-19 y la Escala de carga de trabajo (ECT). Resultados: Se encontró que no hay diferencias significativas entre varones y mujeres en el malestar psicológico, la preocupación por el contagio de la COVID-19 y la carga laboral; además, se hallaron correlaciones muy significativas entre las variables de estudio (p < 0,01). El análisis de regresión múltiple demostró un ajuste adecuado para el modelo (F = 94,834; p < 0,001), en el que la preocupación por la COVID-19 (ß =-0,436; p < 0,01) y la carga laboral (ß = 0,239; p < 0,01) son variables que predicen significativamente el malestar psicológico (R2 ajustado = 0,33). Conclusiones: La preocupación por la COVID-19 y la sobrecarga de trabajo predicen el malestar psicológico en el personal sanitario de la región de Puno.

Introduction: During the health emergency, there is concern about the mental health repercussions that Peruvian health workers, who represent the front line of care for COVID-19, may be experiencing. Objective: To determine whether concern about COVID-19 and workloads predict psychological distress in healthcare workers. Methods: Predictive study in which 367 workers (nurses, doctors, nursing assistants, obstetricians, dentists, psychologists, nutritionists, among others) from 12 health networks in the Puno region participated, selected through intentional non-probabilistic sampling. The data were collected via the Kessler Psychological Distress Scale, the COVID-19 Scale of Concern and the Workload Scale. Results: It was found that there are no significant differences between men and women in psychological discomfort and concern about COVID-19 infection and workload. Furthermore, highly significant correlations were found between the study variables (p <0.01). Multiple regression analysis showed an adequate adjustment for the model (F = 94.834; p <0.001), where concern about COVID-19 (ß = -0.436; p <0.01) and workload (ß = 0.239; p <0.01) are variables that significantly predict psychological discomfort (adjusted R2 = 0.33). Conclusions: Concern about COVID-19 and work overload predict psychological distress in health personnel in the Puno region.

Encuesta burnout (¿estás quemado?) en Especialistas de Cardiología SAC / Burnout Survey among SAC Cardiologists

RESUMEN Introducción. Los profesionales de la salud se encuentran expuestos a un fenómeno ocupacional que resulta del estrés crónico en el ámbito laboral llamado síndrome de burnout (SBO). Este se ha convertido en uno de los riesgos laborales psicosociales más importantes en la sociedad actual y genera costos significativos en el ámbito de la salud. Objetivos. Evaluar la prevalencia de SBO por percepción subjetiva y mediante la aplicación del inventario del síndrome del Desgaste Ocupacional "Burnout" de Maslach (MBI) en los especialistas de cardiología del padrón de la Sociedad Argentina de Cardiología (SAC), y las diferencias acordes al sexo. Material y métodos. Estudio observacional, de corte transversal, mediante una encuesta anónima realizada en abril de 2023 a los especialistas del padrón SAC. Se recabaron datos sobre impresión subjetiva de SBO (sentirse "quemado"), sexo, edad, tiempo de ejercicio profesional. Fue opcional completar el inventario MBI (subescalas) para establecer el diagnóstico de burnout. Resultados. Participaron 756 profesionales, 51,4 % fueron mujeres. El 62 % tenían más de 40 años y el 61 % tenía más de 10 años de ejercicio profesional. Del total de médicos encuestados, el 94,4 % eligió realizar el test de Maslach (MBI), siendo esto más frecuente en las mujeres (96,6 % vs 91,3 %, p < 0,001). La prevalencia de SBO por un MBI de alto puntaje (≥67puntos) fue del 75 % y la prevalencia de percepción de SBO fue del 69 % (p < 0,001). De los que se autopercibieron "quemados" (69 %), el 96,8 % contestó el inventario MBI y se confirmó el diagnóstico de SBO por MBI de alto puntaje en el 78 %. De los que se autopercibieron "no quemados" (31 %), el 89,3 % completó el inventario MBI con diagnóstico de SBO en la subescala cansancio emocional (24 %), despersonalización (18 %) y realización personal (10 %) más allá de no tener la impresión subjetiva de estar "quemado". Los menores de 40 años tuvieron más SBO por MBI de alto puntaje (50 % vs 28 %, p= 0,001) al igual que los profesionales con menos de 10 años en el ejercicio de su profesión (45 % vs 20 % en aquellos con tiempo mayor, p < 0,001). El SBO fue más prevalente en las mujeres que en los hombres, tanto por autopercepción (77 % vs 56 %, p < 0,001) como por el inventario de Maslach (80 % vs 74 %, p=0,001), específicamente en la subescala agotamiento emocional (37 % vs 29 %; p < 0,001) y realización personal (37 % vs 41 %, p < 0,001), sin diferencias por sexo en la esfera de despersonalización. Conclusión. El SBO tiene alta prevalencia entre los cardiólogos encuestados, principalmente en mujeres, tanto por autopercepción como por aplicación del inventario MBI. Por otro lado 1 de cada 4 profesionales encuestados que no se autopercibían "quemados" tuvieron un test positivo para SBO. Teniendo en cuenta la alta prevalencia de SBO entre los especialistas en cardiología es imperioso realizar acciones de prevención e intervención concertadas y sostenidas para transformar esta realidad que impacta desfavorablemente tanto en la salud de los pacientes como en la de los propios médicos.

ABSTRACT Background. Healthcare professionals are exposed to an occupational phenomenon as a result of chronic stress in the workplace called burnout syndrome (BOS). Burnout has become one of the most important psychosocial occupational hazards today and generates significant health care costs. Objectives. The aim of our study was to evaluate the subjective perception of the prevalence of BOS among cardiologists of the Argentine Society of Cardiology (SAC) using Maslach Burnout Inventory (MBI), and the differences between sexes. Methods. We conducted an observational, cross-sectional study using an anonymous survey distributed among specialists of the SAC register in April 2023. The information collected included the subjective impression of BOS (feeling "burned out"), sex, age and years of practice. The participants could optionally complete the MBI (subscales) to establish the diagnosis of BOS. Results. A total of 756 professionals participated in the survey; 51.4% were women. Sixty-two percent of the participants were >40 years old, and 61 % had been practicing medicine for more than 10 years. Of all the physicians surveyed, 94.4% completed the MBI, with women more likely to do so than men (96.6% vs. 91.3%, p < 0.001). The prevalence of BOS, assessed by a high MBI score (≥ 67), was 75%, while 69% reported feeling burned out (p < 0.001). Of those who felt burned out (69 %), 96.8 % completed the MBI, and 78% of them received a diagnosis of BOS based on high MBI scores. Of the 31 % who did not feel burned out, 89.3 % completed the MBI. Burnout syndrome was diagnosed in the emotional exhaustion subscale in 24 %, in the depersonalization subscale in 18%, and in the personal accomplishment subscale in 10%. The diagnosis of BOS made by high MBI score was more common in survey participants under 40 years than in older participants (50 % vs. 28 %, p < 0.001) and in professionals who have been practicing medicine for less than 10 years (45 % vs. 20 % in those with more years of practice, p < 0.001). Women were more likely to experience BOS according to their own perception (77 % vs. 56 %, p < 0.001) and MBI score (80 % vs. 74 %, p < 0.001), specifically in the emotional exhaustion (37 % vs. 29 %, p < 0.001) and personal accomplishment (37 % vs. 41 %, p < 0.001) subscales, with No differences by sex in the depersonalization sphere. Conclusion. Burnout syndrome was found to be prevalent among the surveyed cardiologists, particularly in female participants, as indicated by both their own perception and the MBI assessment. In addition, 1 out of 4 professionals surveyed who did not feel "burned out" tested positive for BOS. Given the high prevalence of BOS among cardiologists, coordinated and sustained prevention and intervention actions should be undertaken to change this reality that negatively impacts both patient and physician health.

Covid-19: a sobrecarga de trabalhona luta pela vida. Representações sociaisde profissionais de enfermagem / Covid-19: work overload in the fight for life. Social representations of nursing professionals

Conhecer as representações sociais de profissionais de enfermagem que atuaram no atendimento aos pacientes acometidos pela COVID-19 diante da sobrecarga de trabalho. Método: Estudo de natureza descritiva com abordagem qualitativa utilizando como referencial a Teoria das Representações Sociais. O cenário foi um hospital que atendeu pacientes acometidos pela COVID-19. Os participantes foram profissionais de enfermagem. Os dados se deram através de entrevistas semiestruturadas. A análise ocorreu conforme a perspectiva de Bardin. Resultados: As representações retrataram condições de trabalho identificando desgaste mental diante em um cenário de inúmeras incertezas, de modo a suprir as necessidades exigida pela crise sanitária, impactando diretamente na sua saúde mental. Conclusão: Possibilidade da construção de um modelo de assistência que reestruture no processo de trabalho da enfermagem, minimizando possíveis sobrecarga de trabalho associados à sua saúde mental, otimizando assim a melhoria das suas condições de trabalho, fortalecendo respostas rápidas e precisas quando necessárias.(AU)

Objective: To learn about the social representations of nursing professionals who worked in the care of patients affected by COVID-19 in the face of work overload. Method: A descriptive study with a qualitative approach, using the Theory of Social Representations as a reference. The setting was a hospital that treated patients affected by COVID-19. The participants were nursing professionals. The data was collected through semi-structured interviews. The analysis took place according to Bardin's perspective. Results: The representations portrayed working conditions identifying mental exhaustion faced in a scenario of countless uncertainties, in order to meet the needs demanded by the health crisis, directly impacting on their mental health. Conclusion: The possibility of building a care model that restructures the nursing work process, minimizing possible work overload associated with their mental health, thus optimizing the improvement of their working conditions, strengthening quick and precise responses when necessary.(AU)

Objetivo: Conocer las representaciones sociales de los profesionales de enfermería que han trabajado en el cuidado de pacientes afectados por COVID-19 ante la sobrecarga de trabajo. Método: Estudio descriptivo con enfoque cualitativo, tomando como referencia la Teoría de las Representaciones Sociales. El escenario fue un hospital que atendía a pacientes afectados por COVID-19. Los participantes fueron profesionales de enfermería. Los datos se recogieron mediante entrevistas semiestructuradas. El análisis se realizó según la perspectiva de Bardin. Resultados: Las representaciones retrataron condiciones de trabajo que identifican agotamiento mental enfrentado en un escenario de innumerables incertidumbres, para atender a las necesidades demandadas por la crisis de salud, impactando directamente en su salud mental. Conclusión: Es posible construir un modelo de atención que reestructure el proceso de trabajo de enfermería, minimizando la posible sobrecarga de trabajo asociada a su salud mental, optimizando así la mejora de sus condiciones de trabajo, fortaleciendo respuestas rápidas y precisas cuando sea necesario.(AU)

Cansancio emocional y bienestar psicológico en estudiantes peruanos de enfermería durante la pospandemia por la COVID-19 / Emotional exhaustion and psychological well-being in Peruvian Nursing students during COVID-19 post-pandemic

Introducción: La pandemia por la COVID-19 ocasionó una serie de repercusiones y cambios drásticos en la salud mental de los estudiantes de pregrado, como el cansancio emocional, lo cual pudo afectar su bienestar psicológico. Objetivo: Determinar si existe relación entre el cansancio emocional y el bienestar psicológico de los estudiantes de la carrera profesional de enfermería. Método: El enfoque fue cuantitativo, el diseño no experimental y el tipo, descriptivo-correlacional de corte transversal. La muestra estuvo conformada por 184 estudiantes a quienes se les aplicó la Escala de Cansancio Emocional y la Escala de Bienestar Psicológico para Adultos, instrumentos adaptados para estudiantes y con adecuados niveles de validez basada en el contenido y confiabilidad. Para identificar la relación entre las variables de estudio se aplicó el coeficiente de correlación de Pearson. Resultados: El 63 por ciento de los estudiantes evidenciaron niveles moderados de cansancio emocional y el 75 por ciento tuvieron altos niveles de bienestar psicológico. Por otro lado, se observó una correlación inversa entre las variables cansancio emocional y bienestar psicológico (r= -0,267; p< 0,05). Asimismo, se encontró que las mujeres presentaron mayores niveles de cansancio emocional que los varones. Conclusiones: Existe relación inversa y significativa entre el cansancio emocional y el bienestar psicológico de los estudiantes de Enfermería durante la pospandemia(AU)

Introduction: The COVID-19 pandemic caused a series of repercussions and drastic changes in the mental health of undergraduate students, such as emotional exhaustion, which would have affected their psychological well-being. Objective: To determine if there is a relationship between emotional exhaustion and the psychological well-being of Nursing students. Method: The approach was quantitative, the design was non-experimental and the type was descriptive - correlational, cross-sectional. The sample consisted of 184 students to whom the Emotional Fatigue Scale and the Psychological Well-Being Scale for Adults were applied, instruments adapted for students and with adequate levels of validity based on content and reliability. To identify the relationship between the study variables, the Pearson correlation coefficient was applied. Results: 63 percent of the students showed moderate levels of emotional exhaustion and 75 percent had high levels of psychological well-being. On the other hand, an inverse correlation was observed between the variables emotional exhaustion, and psychological well-being (r= -0.267; p< 0.05). Likewise, it was found that women presented higher levels of emotional exhaustion than men. Conclusions: There is an inverse and significant relationship between emotional exhaustion and the psychological well-being of Nursing students during the post-pandemic(AU)

Síndrome de Burnout en médicos residentes de medicina interna

Introducción: el síndrome de Burnout se define como una respuesta al estrés laboral crónico, integrado por actitudes y sentimientos negativos hacia las personas con las que se trabaja y hacia el propio rol profesional. Se considera como la fase avanzada del estrés profesional. Objetivos: evaluar la prevalencia del síndrome de Burnout en médicos residentes del área de medicina interna en un hospital de tercer nivel. Materiales y métodos: se realizó un estudio observacional, descriptivo y transversal mediante una encuesta en línea a través de Google Forms™, a médicos residentes del área de medicina interna aplicando el test Maslach Burnout Inventory (MBI). Resultados: de los 60 residentes, que incluyen a los de primer, segundo y tercer año, se obtuvo una participación de 71,6%. El 58,1% corresponde al sexo femenino y 41,9% al sexo masculino. El grupo etario con mayor participación (79,1%) tiene 26 a 30 años. Si se tiene en cuenta la presencia de 2 de 3 variables (cansancio emocional, despersonalización, falta de realización personal), la prevalencia de síndrome de Burnout fue 46,5% (20 de 43 encuestados). Conclusión: la prevalencia de síndrome de Burnout en base a 2 de sus 3 criterios fue 46,5%.

Introduction: Burnout syndrome is defined as a response to chronic work stress, made up of negative attitudes and feelings towards the people with whom one works and towards one's own professional role. It is considered as the advanced phase of professional stress. Objectives: To evaluate the prevalence of Burnout syndrome in internal medicine residents in a tertiary level hospital. Materials and methods: An observational, descriptive and cross-sectional study was carried out by means of an online survey through Google Forms™ applied to resident physicians in the area of ​​internal medicine applying the Maslach Burnout Inventory (MBI) test. Results: Of the 60 residents, which include first, second and third-year students, 71.6% participated, 58.1% correspond to women and 41.9% to men. The age group with the highest participation (79.1%) is between 26 and 30 years old. If the presence of 2 of 3 variables is taken into account (emotional exhaustion, depersonalization, lack of personal fulfillment), the prevalence of Burnout syndrome was 46.5% (20 of 43 respondents). Conclusion: The prevalence of Burnout syndrome based on 2 of its 3 criteria was 46.5%.

Influência da nutrição e exercícios físicos na saúde mental / Influence of nutrition and physical exercises on mental health

Os transtornos mentais são ocasionados pela falha de comunicação entre os neurotransmissores e o sistema nervoso central, onde ocorre algumas ações psicomotoras, apetite, sono e humor, sendo os principais serotonina e dopamina. Alguns dados epidemiológicos mostram que pessoas moderadamente ativas têm menor risco de ser acometidas por desordens mentais, evidenciando assim que a prática de exercícios físicos exerce benefícios físicos e psicológicos, a prática é importante contra o declínio cognitivo e demência, os praticantes de exercícios físicos podem possuir um processamento cognitivo mais rápido, acarretando em alterações positivas no comportamento das pessoas idosas com déficit cognitivo e demência. A prática de dietas para emagrecimento é um fator precipitante mais frequente para o desenvolvimento de Transtornos Alimentares (TA). Estudos demonstram que a dieta aumenta de modo considerável o risco para os TA. Sendo os mais comuns desses transtornos a bulimia e a anorexia nervosa que são perturbações do comportamento alimentar, com várias consequências físicas, psicológicas e sociais.Conclui-se que a prática de exercícios físicos é benéfica em qualquer idade e sexo do indivíduo, trazendo benefícios na saúde física, saúde mental, qualidade do sono e uma melhor qualidade de vida.Trata-se de um estudo de revisão bibliográfica de natureza qualitativa descritiva, baseada em artigos científicos, nas bases Google Acadêmico, Scielo e BVS (Biblioteca Virtual em Saúde).

Evaluation of peripheral blood T-lymphocyte subpopulations features in patients with hepatitis B virus-related acute-on-chronic liver failure based on single-cell sequencing technology / 中华肝脏病杂志

Objective: T lymphocyte exhaustion is an important component of immune dysfunction. Therefore, exploring peripheral blood-exhausted T lymphocyte features in patients with hepatitis B virus-related acute-on-chronic liver failure may provide potential therapeutic target molecules for ACLF immune dysfunction. Methods: Six cases with HBV-ACLF and three healthy controls were selected for T-cell heterogeneity detection using the single-cell RNA sequencing method. In addition, exhausted T lymphocyte subpopulations were screened to analyze their gene expression features, and their developmental trajectories quasi-timing. An independent sample t-test was used to compare the samples between the two groups. Results: Peripheral blood T lymphocytes in HBV-ACLF patients had different differentiation trajectories with different features distinct into eight subpopulations. Among them, the CD4(+)TIGIT(+) subsets (P = 0.007) and CD8(+)LAG3(+) (P = 0.010) subsets with highly exhausted genes were significantly higher than those in healthy controls. Quasi-time analysis showed that CD4(+)TIGIT(+) and CD8(+)LAG3(+) subsets appeared in the late stage of T lymphocyte differentiation, suggesting the transition of T lymphocyte from naïve-effector-exhausted during ACLF pathogenesis. Conclusion: There is heterogeneity in peripheral blood T lymphocyte differentiation in patients with HBV-ACLF, and the number of exhausted T cells featured by CD4(+)TIGIT(+)T cell and CD8(+)LAG3(+) T cell subsets increases significantly, suggesting that T lymphocyte immune exhaustion is involved in the immune dysfunction of HBV-ACLF, thereby identifying potential effective target molecules for improving ACLF patients' immune function.

WGCNA-based identification of novel T-cell exhaustion-related gene signatures to predict the prognosis and response to immunotherapy of osteosarcoma patients / 肿瘤

Objective:To screen T-cell exhaustion-related signature genes as the prognostic marker for osteosarcoma and establish a prognostic model for osteosarcoma patients based on weighted gene co-expression network analysis(WGCNA)and Least absolute shrinkage and selection operator(LASSO)-COX regression analysis. Methods:GSE21257 dataset was downloaded from Gene Expression Omnibus(GEO)database for the establishment of the prognostic model for osteosarcoma.4 T-cell exhaustion-related gene sets were downloaded from The Molecular Signatures Database(MisgDB)and their enrichment scores in GSE21257 samples were calculated by single sample gene set enrichment analysis(ssGSEA).WGCNA was carried out to screen the gene module that is highly associated with T-cell exhaustion based on ssGSEA results followed by GO(Gene Ontology)and KEGG(Kyoto Encyclopedia of Genes and Genomes)analysis of the biological processes and signaling transduction pathways that those genes are involved in.The signature genes that are highly associated with the prognosis of osteosarcoma patients were obtained through LASSO-COX regression and a prognostic model was established based on these signature genes.Osteosarcoma-related expression profile data from the GSE21257 and TAEGET datasets on XENA were downloaded from the Gene Expression Omnibus.Clinical information for the training and validation sets was obtained.T-cell exhaustion-related genes were screened using a weighted correlation network analysis.Realtime fluorescence quantitative PCR,COX regression analysis,external dataset and nomogram were used to evaluate the reliability and accuracy of the prognostic model.A immunotherapy-related dataset was used to assess the efficacy of this prognostic model for the prediction of patients'responses to immunotherapy. Results:Analysis results based on the ssGSEA scores showed that T-cell exhaustion-related genes were related to the metastasis and age of osteosarcoma patients.Many T-cell exhaustion-related genes were found to be differentially expressed in metastatic and non-metastatic osteosarcoma patients.1 256 T-cell exhaustion-related genes were identified through WGCNA and these candidate markers were mainly distributed in structures like secretory granule membranes and endocytic vesicles and were involved in T-cell activation.COX regression analysis screened 68 significant prognostic markers out of the 1 256 genes,and 12 signature genes were further confirmed with LASSO-COX regression analysis.A prognostic model was established based on the 12 signature genes.Results of real-time fluorescence quantitative PCR showed a similar trend in the expression of most of the signature genes in different osteosarcoma cell lines.COX regression analysis of the internal and external datasets verified that the risk score calculated with the prognostic model was an independent prognostic factor for osteosarcoma patients,and high-risk score was associated with poor prognosis of the patients.Receiver operating characteristic(ROC)curves demonstrated excellent prognostic efficacy of the model.Nomogram analysis verified the prognostic model is highly accurate and reliable in predicting the prognosis of osteosarcoma patients.Analysis using the immunotherapy-related dataset indicated that this prognostic model could also be used to predict patients'responses to immunotherapy. Conclusion:The 12 signature gene(CD300LB,TRO,SNX3,VENTX,PPM1M,DOT1L,CDC37,NAT9,TRMT1,PPP1R3C,CHTF18 and NSUN5)-based prognostic model can effectively predict the prognosis and responses to immune check-point inhibitors for osteosarcoma patients,which may provide evidence for the prediction of prognosis as well as the selection of immunotherapy plans in clinical practice.

Relationship between emotional exhaustion and work stress, thought suppression, difficulties in emotion regulation in clinical nurses / 中国职业医学

Objective To explore the current status of emotional exhaustion among clinical nurses and its relationship with work stress, thought suppression, difficulties in emotion regulation. Methods A totally of 1 159 clinical nurses from 10 cities in Henan Province and Fujian Province were enrolled as the research subjects using grabbing random balls method. And their status of work stress, thought suppression, difficulties in emotion regulation and emotional exhaustion were investigated by Depression-Anxiety-Stress Scale, White Bear Suppression Inventory, Brief Version of the Difficulties in Emotion Regulation Scale and Emotional Exhaustion Scale. Results The scores for work stress, thought suppression, difficulties in emotion regulation, emotional exhaustion were (23.5±3.8), (47.4±6.5), (54.1±7.2), (11.7±4.2), respectively. Among them, 40.0% of nurses experienced emotional exhaustion. Bootstrap analysis results showed that work stress positively affected emotional exhaustion among clinical nurses [standardized partial regression coefficient (β)=0.42, 95% confidence intervals (CI)： 0.36-0.44］. Work stress affected emotional exhaustion through thought suppression (β=0.16, 95%CI： 0.14-0.20), difficulties in emotion regulation (β=0.16, 95%CI： 0.14-0.19), and the chain mediating role of thought suppression and difficulties in emotion regulation (β=0.07, 95%CI： 0.04-0.09). Conclusion Emotional exhaustion symptoms are prevalent among clinical nurses. Work stress directly and indirectly influences thought suppression, difficulties in emotion regulation and emotional exhaustion of nurses.

A biomimetic liver cancer on-a-chip reveals a critical role of LIPOCALIN-2 in promoting hepatocellular carcinoma progression

Hepatic stellate cells (HSCs) represent a significant component of hepatocellular carcinoma (HCC) microenvironments which play a critical role in tumor progression and drug resistance. Tumor-on-a-chip technology has provided a powerful in vitro platform to investigate the crosstalk between activated HSCs and HCC cells by mimicking physiological architecture with precise spatiotemporal control. Here we developed a tri-cell culture microfluidic chip to evaluate the impact of HSCs on HCC progression. On-chip analysis revealed activated HSCs contributed to endothelial invasion, HCC drug resistance and natural killer (NK) cell exhaustion. Cytokine array and RNA sequencing analysis were combined to indicate the iron-binding protein LIPOCALIN-2 (LCN-2) as a key factor in remodeling tumor microenvironments in the HCC-on-a-chip. LCN-2 targeted therapy demonstrated robust anti-tumor effects both in vitro 3D biomimetic chip and in vivo mouse model, including angiogenesis inhibition, sorafenib sensitivity promotion and NK-cell cytotoxicity enhancement. Taken together, the microfluidic platform exhibited obvious advantages in mimicking functional characteristics of tumor microenvironments and developing targeted therapies.

Research progress on the occurrence and characteristics of CD8+T cell exhaustion and its relationship with tumor immunotherapy resistance / 中国肿瘤临床

Immune checkpoint inhibitors(ICIs)have emerged as important targets of treatment for various types of cancers,yet drug resist-ance poses considerable problems.Tumor immunotherapy resistance is closely related to the tumor microenvironment(TME).Exhaustion of CD8+T cells in the TME continuously express high levels of inhibitory receptors(IRs)and play a central role in ICIs resistance.Targeting IRs provides new prospects for overcoming immunotherapy resistance.This review focuses on the occurrence and characteristics of CD8+T cell exhaustion and explores its association with tumor immunotherapy resistance.