Is online learning during the COVID-19 pandemic associated with increased burnout in medical learners?: A medical school's experience.

INTRODUCTION: The COVID-19 pandemic necessitated a shift to virtual curriculum delivery at Canadian medical schools. At the NOSM University, some learners transitioned to entirely online learning, while others continued in-person, in-clinic learning. This study aimed to show that medical learners who transitioned to exclusively online learning exhibited higher levels of burnout compared to their peers who continued in-person, clinical learning. Analysis of factors that protect against burnout including resilience, mindfulness, and self-compassion exhibited by online and in-person learners at NOSM University during this curriculum shift were also explored. METHODS: As part of a pilot wellness initiative, a cross-sectional online survey-based study of learner wellness was conducted at NOSM University during the 2020-2021 academic year. Seventy-four learners responded. The survey utilized the Maslach Burnout Inventory, the Brief Resilience Scale, Cognitive and Affective Mindfulness Scale-Revised, and the Self-Compassion Scale-Short Form. T-tests were utilized to compare these parameters in those who studied exclusively online and those who continued learning in-person in a clinical setting. RESULTS: Medical learners who engaged in online learning exhibited significantly higher levels of burnout when compared with learners who continued in-person learning in a clinical setting, despite scoring equally on protective factors such as resilience, mindfulness, and self-compassion. CONCLUSION: The results discussed in this paper suggest that the increased time spent in a virtual learning environment during the COVID-19 pandemic might be associated with burnout among exclusively online learners, as compared to learners who were educated in clinical, in-person settings. Further inquiry should investigate causality and any protective factors that could mitigate negative effects of the virtual learning environment.

Cytotoxic and Antibiotic Potential of Secondary Metabolites from the Lichen Umbilicaria muhlenbergii.

OBJECTIVE: Lichens are emerging as a promising natural source of bioactivities of pharmaceutical interest. The present study aims to contribute to the knowledge of the lichen Umbilicaria muhlenbergii as a potential source of pharmaceutically relevant anticancer and antibiotic lichen chemicals. METHODS: The crude acetone extract of U. muhlenbergii exhibited 13.3 µg mL-1 cytotoxic activity (EC50) against breast cancer cells (MCF-7), as compared to a cisplatin positive control with EC50 of 5.8 µg mL-1. The antibiotic activity of the crude extract against a gram-positive Staphylococcus aureus was 22.5 µg mL-1 as MIC. Using silica gel 60 (SG60) column chromatography, the crude extract was then separated into eight fractions, which were further evaluated for their anticancer activities against MCF-7 cells. By means of propidium iodide flow cytometry, two of the eight SG60 fractions were found to cause cell cycle arrest in MCF-7 cells (73.14% of cells) at the G2 phase, which is indicative of apoptosis and inhibition of cellular proliferation. RESULTS: Identification of chemical constituents present in these two SG60 fractions was carried out with Thin-Layer Chromatography (TLC) and a lichen metabolite database (Wintabolites). The two fractions (SG60-5 and SG60-6) were found to contain compounds belonging to the chemical families depsides, depsidones, anthraquinones, and xanthones. DISCUSSION: The SG60-5 and SG60-6 fractions were further fractionated with Sephadex LH-20. Over 15% of the 46 LH-20 fractions obtained from the SG60-5 fraction caused 100% cell death, whereas 32% of the LH-20 fractions derived from SG60 6 fraction reduced cell survival to below 20%. CONCLUSION: This work extends the evaluation of the cytotoxic and antibiotic activities of lichen secondary metabolites to the species U. muhlenbergii. It presents encouraging results of pharmaceutical interest that set up lichens as an effective source of new bioactive natural products. Further investigations are underway to reveal the full biopharmaceutical potential of U. muhlenbergii.

Biological activities of undescribed North American lichen species.

BACKGROUND: Lichens provide a large array of compounds with the potential for pharmaceutical development. In the present study, extracts from three previously undescribed North American lichen species were examined for antioxidant, antibacterial and anticancer activities. RESULTS: The results from this study demonstrated the following: (i) Acarospora socialis ethanol extract exhibited significant DPPH antioxidant scavenging activities, which were concentration dependent; (ii) acetone and ethyl acetate extracts of Xanthoparmelia mexicana inhibited Gram-positive bacteria but had no effect on Gram-negative bacteria; X. mexicana acetone extract yielded a minimum inhibitory concentration (MIC) of 20.9 µg mL-1 against Staphylococcus aureus, and 41.9 µg mL-1 against Enterococcus faecalis; (iii) acetone extract of Lobothallia alphoplaca inhibited growth of cultured breast cancer MCF-7 cells with an effective concentration (EC50 ) of 87 µg mL-1 ; the MCF-7 cell cycle appears arrested in the G2 phase, whereas the DNA synthesis cell cycle (S) may be inhibited. CONCLUSION: New lichen species that possess strong biological activities have been identified. These lichens comprise secondary metabolites that possess antioxidant, antibacterial and anticancer properties. © 2017 Society of Chemical Industry.