INTRODUCTION: Despite efforts to improve junior doctors' working conditions, burnout, distress and disillusionment persist, with implications for patient outcomes. This qualitative study analysed factors shaping the lived experiences of junior doctors in Singapore and their changes over time, thereby seeking to inform improvements to working conditions. METHOD: Thirty purposively sampled respondents who were junior doctors in Singapore between 1975 and 2022 were interviewed. Respondents were grouped into 3 cohorts: (1) junior, (2) middle and (3) senior. Employing the framework method of qualitative analysis, open coding was performed with reference to the individual, interpersonal, institutional, community and policy levels of the socioecological model (SEM). Four themes emerged: (1) inherent challenges of junior doctorship, (2) exacerbating factors, (3) alleviating factors and (4) responses of junior doctors to their experiences. Codes were reconstructed into a modified SEM, demonstrating trickle-down effects of interpersonal or structural forces on the individual doctor and pertinent factors evolving with time. RESULTS: Across cohorts, respondents echoed mental and physical challenges. While senior cohort doctors recounted higher patient-to-doctor ratios and longer working hours, junior cohort doctors cited new difficulties. These include a hostile medicolegal landscape, patients' increasingly complex needs and expectations, and higher administrative loads. Amid these difficulties, alleviating factors included good workplace relationships alongside institutional interventions. Doctors responded differently to their challenges. Some externalised difficulties through expression and advocacy; others internalised them, whether into fulfilment or distress. CONCLUSION While some facets of junior doctorship have improved with time, new challenges that warrant consideration are emerging. Junior doctors should be centred, listened to and empowered in shaping improvements to working conditions.
Singapore ; Humans ; Qualitative Research ; Medical Staff, Hospital/psychology* ; Male ; Female ; Adult ; Burnout, Professional/psychology* ; Workload/psychology* ; Attitude of Health Personnel ; Interviews as Topic ; Job Satisfaction

Curcuma zedoaria (Christm.) Rosc. is a popular traditional herb to treat digestive disorders in Asian tropical countries. Previous studies indicated the presence of sesquiterpenoids, diterpenoids, and curcuminoids with various bioactivities. To enrich the phytocomposition data of this plant, this investigation was conducted.The dried rhizomes of C. zedoaria were collected in Hai Phong City (Vietnam), extracted with methanol and fractionated with n-hexane, CH2Cl2 , and EtOAc. Compounds were isolated from n-hexane soluble fraction by open column chromatography combined with thin layer chromatography from fraction n-hexane. Their chemical structures were elucidated by 1D, and 2D NMR spectra and comparison with reported data. As a result, a phytochemical investigation was conducted to isolate six sesquiterpenes from C. zedoaria. Their chemical structures were elucidated to be curcumenol (1), procurcumenol (2), neoprocurcumenol (3), 13-hydroxygermacrone (4), zederone (5), and curcumalactone (6). Among isolated compounds, compounds 1, 2, 4, and 5 were reported from C. zedoaria. Meanwhile, neoprocurcumenol (3) and curcumalactone (6) are isolated from this species for the first time. Compound 5 exhibited a mild inhibitory effect on α-glucosidase with an IC50 of 99.45 ± 0.50 μg/mL.

Curcuma zedoaria (Christm.) Rosc. is a popular traditional herb to treat digestive disorders in Asian tropical countries. Previous studies indicated the presence of sesquiterpenoids, diterpenoids, and curcuminoids with various bioactivities. To enrich the phytocomposition data of this plant, this investigation was conducted.The dried rhizomes of C. zedoaria were collected in Hai Phong City (Vietnam), extracted with methanol and fractionated with n-hexane, CH2Cl2 , and EtOAc. Compounds were isolated from n-hexane soluble fraction by open column chromatography combined with thin layer chromatography from fraction n-hexane. Their chemical structures were elucidated by 1D, and 2D NMR spectra and comparison with reported data. As a result, a phytochemical investigation was conducted to isolate six sesquiterpenes from C. zedoaria. Their chemical structures were elucidated to be curcumenol (1), procurcumenol (2), neoprocurcumenol (3), 13-hydroxygermacrone (4), zederone (5), and curcumalactone (6). Among isolated compounds, compounds 1, 2, 4, and 5 were reported from C. zedoaria. Meanwhile, neoprocurcumenol (3) and curcumalactone (6) are isolated from this species for the first time. Compound 5 exhibited a mild inhibitory effect on α-glucosidase with an IC50 of 99.45 ± 0.50 μg/mL.

Curcuma zedoaria (Christm.) Rosc. is a popular traditional herb to treat digestive disorders in Asian tropical countries. Previous studies indicated the presence of sesquiterpenoids, diterpenoids, and curcuminoids with various bioactivities. To enrich the phytocomposition data of this plant, this investigation was conducted.The dried rhizomes of C. zedoaria were collected in Hai Phong City (Vietnam), extracted with methanol and fractionated with n-hexane, CH2Cl2 , and EtOAc. Compounds were isolated from n-hexane soluble fraction by open column chromatography combined with thin layer chromatography from fraction n-hexane. Their chemical structures were elucidated by 1D, and 2D NMR spectra and comparison with reported data. As a result, a phytochemical investigation was conducted to isolate six sesquiterpenes from C. zedoaria. Their chemical structures were elucidated to be curcumenol (1), procurcumenol (2), neoprocurcumenol (3), 13-hydroxygermacrone (4), zederone (5), and curcumalactone (6). Among isolated compounds, compounds 1, 2, 4, and 5 were reported from C. zedoaria. Meanwhile, neoprocurcumenol (3) and curcumalactone (6) are isolated from this species for the first time. Compound 5 exhibited a mild inhibitory effect on α-glucosidase with an IC50 of 99.45 ± 0.50 μg/mL.

Curcuma zedoaria (Christm.) Rosc. is a popular traditional herb to treat digestive disorders in Asian tropical countries. Previous studies indicated the presence of sesquiterpenoids, diterpenoids, and curcuminoids with various bioactivities. To enrich the phytocomposition data of this plant, this investigation was conducted.The dried rhizomes of C. zedoaria were collected in Hai Phong City (Vietnam), extracted with methanol and fractionated with n-hexane, CH2Cl2 , and EtOAc. Compounds were isolated from n-hexane soluble fraction by open column chromatography combined with thin layer chromatography from fraction n-hexane. Their chemical structures were elucidated by 1D, and 2D NMR spectra and comparison with reported data. As a result, a phytochemical investigation was conducted to isolate six sesquiterpenes from C. zedoaria. Their chemical structures were elucidated to be curcumenol (1), procurcumenol (2), neoprocurcumenol (3), 13-hydroxygermacrone (4), zederone (5), and curcumalactone (6). Among isolated compounds, compounds 1, 2, 4, and 5 were reported from C. zedoaria. Meanwhile, neoprocurcumenol (3) and curcumalactone (6) are isolated from this species for the first time. Compound 5 exhibited a mild inhibitory effect on α-glucosidase with an IC50 of 99.45 ± 0.50 μg/mL.

Curcuma zedoaria (Christm.) Rosc. is a popular traditional herb to treat digestive disorders in Asian tropical countries. Previous studies indicated the presence of sesquiterpenoids, diterpenoids, and curcuminoids with various bioactivities. To enrich the phytocomposition data of this plant, this investigation was conducted.The dried rhizomes of C. zedoaria were collected in Hai Phong City (Vietnam), extracted with methanol and fractionated with n-hexane, CH2Cl2 , and EtOAc. Compounds were isolated from n-hexane soluble fraction by open column chromatography combined with thin layer chromatography from fraction n-hexane. Their chemical structures were elucidated by 1D, and 2D NMR spectra and comparison with reported data. As a result, a phytochemical investigation was conducted to isolate six sesquiterpenes from C. zedoaria. Their chemical structures were elucidated to be curcumenol (1), procurcumenol (2), neoprocurcumenol (3), 13-hydroxygermacrone (4), zederone (5), and curcumalactone (6). Among isolated compounds, compounds 1, 2, 4, and 5 were reported from C. zedoaria. Meanwhile, neoprocurcumenol (3) and curcumalactone (6) are isolated from this species for the first time. Compound 5 exhibited a mild inhibitory effect on α-glucosidase with an IC50 of 99.45 ± 0.50 μg/mL.

Purpose: Carotid vessel wall volume (VWV) measurement on three-dimensional ultrasonography (3DUS) outperforms conventional two-dimensional ultrasonography for carotid atherosclerosis evaluation. Although time-saving semi-automated algorithms have been introduced, their clinical availability remains limited due to a lack of validation, particularly an extensive reliability analysis. This study compared inter-observer and intra-observer reliability between manual segmentation and semi-automated segmentation for carotid VWV measurements on 3DUS. Methods: Thirty-one 3DUS volume datasets were prospectively acquired from 20 healthy subjects, aged >18 years, without previous stroke, transient ischemic attack, or cardiovascular disease. Five observers segmented all volume datasets both manually and semi-automatically. The process was repeated five times. Reliability was expressed by the intraclass correlation coefficient, supplemented by the coefficient of variation. Results: Carotid VWV measurements using the common carotid artery (CCA) were more reliable than those using the internal carotid artery (ICA) or external carotid artery (ECA) for both manual and semiautomated segmentation (manual segmentation, CCA: inter-observer, 0.935; intra-observer, 0.934 to 0.966; ICA: inter-observer, 0.784; intra-observer, 0.756 to 0.878; ECA: inter-observer, 0.732; intraobserver, 0.919 to 0.962; semi-automated segmentation, CCA: inter-observer, 0.986; intra-observer, 0.954 to 0.993; ICA: inter-observer, 0.977; intra-observer, 0.958 to 0.978; ECA: inter-observer, 0.966; intra-observer, 0.884 to 0.937). Total carotid VWV measurements by manual (inter-observer, 0.922; intra-observer, 0.927 to 0.961) and semi-automated segmentation (inter-observer, 0.987; intra-observer, 0.968 to 0.989) were highly reliable. Semi-automated segmentation showed higher reliability than manual segmentation for both individual and total carotid VWV measurements. Conclusion 3DUS carotid VWV measurements of the CCA are more reliable than measurements of the ICA and ECA. Total carotid VWV measurements are highly reliable. Semi-automated segmentation has higher reliability than manual segmentation.

Background: Psychological factors such as anxiety and depression have been recognized as the etiology of temporomandibular disorders. Objectives: The study aimed to evaluate the prevalence of temporomandibular disorders in dental students and describe the state of depression and anxiety and related factors in the students with the disorders. Materials and methods: 323 students at the Faculty of Odonto-Stomatology, Hue University of Medicine and Pharmacy, were examined to detect temporomandibular disorders, using the DC/TMD axis I. Then GAD-7 and PHQ-9 questionnaires were used to screen for anxiety and depression in the group with the disorders. Results: The proportion of students with temporomandibular disorders was 38.1%, intra-articular disorders accounted for the highest rate (80.5%). The percentages of depression and anxiety among students with the disorder were 28.4% and 55.3%, respectively. 41.5% of TMD students had mild anxiety and the same proportion of students had risk of depression. Risk factors associated with depression and anxiety were economic status and excercise, respectively (p < 0.05). Conclusions: The percentage of students with temporomandibular disorders is relatively high. The majority of students with the disorders are at risk for depression and low level of anxiety. There is a link between the economic status and depression, between exercise and anxiety.

Background: The VEGFA gene encodes vascular endothelial growth factor A (VEGF-A), which plays a key role in vasculogenesis and angiogenesis. The VEGFA rs3025039 (+936C>T) polymorphism is associated with many diseases. This study aimed to: (1) Apply PCR-RFLP technique to identify the VEGFA rs3025039 (+936C>T) polymorphism; (2) Primarily evaluate the distribution of genotypes and allele frequencies of the rs3025039 polymorphism in volunteers. Materials and methods: DNA extraction was isolated from peripheral blood of 60 volunteers. Determining the VEGFA rs3025039 (+936C>T) polymorphism by PCR-RFLP technique. Confirming the results of the genotypes randomly by Sanger sequencing. Results: All PCR-RFLP results of validated samples were in concordance with sequencing results. The distribution of CC, CT and TT genotypes by rs3025039 polymorphism accounted for 80%, 16.7% and 3.3%, respectively. The frequencies of C and T alleles were 88.3% and 11.7%, respectively. Conclusion: Successfully applying PCR-RFLP technique to determine the VEGFA rs3025039 (+936C>T) polymorphism, which establishes the groundwork for further research into the association between this polymorphism and various disorders.

Background: The Lymphadenectomy in Ovarian Neoplasms (LION) study revealed that systemic lymphadenectomy did not bring survival benefit for advanced ovarian cancer patients with clinically normal lymph nodes and was associated with a higher incidence of operative complications. However, there is no consensus on whether lymphadenectomy has survival benefit or not in early epithelial ovarian cancer (EOC). Methods We designed the LOVE study, a multicenter, randomized controlled, phase III trial to compare the efficacy and safety of comprehensive staging surgery with or without lymphadenectomy in stages IA-IIB EOC and fallopian tube carcinomas (FTC). The hypothesis is that the oncological outcomes provided by comprehensive staging surgery without lymphadenectomy are non-inferior to those of conventional completion staging surgery in early-stage EOC and FTC patients who have indications for post-operative adjuvant chemotherapy. Patients assigned to experimental group will undergo comprehensive staging surgery, but lymphadenectomy. Patients assigned to comparative group will undergo completion staging surgery including systematic pelvic and para-aortic lymphadenectomy. All subjects will receive 3–6 cycles of standard adjuvant chemotherapy. Major inclusion criteria are pathologic confirmed stage IA-IIB EOC or FTC, and patients have indications for adjuvant chemotherapy either confirmed by intraoperative fast frozen section or previous pathology after an incomplete staging surgery. Major exclusion criteria are non-epithelial tumors and low-grade serous carcinoma. Patients with severe rectum involvement which lead to partial rectum resection will be excluded. The sample size is 656 subjects. Primary endpoint is disease-free survival.