Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Circular Carbon Economy (CCE): A Way to Invest CO2 and Protect the Environment, a Review

Increased levels of carbon dioxide have revolutionised the Earth; higher temperatures, melting icecaps, and flooding are now more prevalent. Fortunately, renewable energy mitigates this problem by making up 20% of human energy needs. However, from a “green environment” perspective, can carbon dioxide emissions in the atmosphere be reduced and eliminated? The carbon economic circle is an ideal solution to this problem, as it enables us to store, use, and remove carbon dioxide. This research introduces the circular carbon economy (CCE) and addresses its economic importance. Additionally, the paper discusses carbon capture and storage (CCS), and the utilisation of CO2. Furthermore, it explains current technologies and their future applications on environmental impact, CO2 capture, utilisation, and storage (CCUS). Various opinions on the best way to achieve zero carbon emissions and on CO2 applications and their economic impact are also discussed. The circular carbon economy can be achieved through a highly transparent global administration that is supportive of advanced technologies that contribute to the efficient utilisation of energy sources. This global administration must also provide facilities to modernise and develop factories and power stations, based on emission-reducing technologies. Monitoring emissions in countries through a global monitoring network system, based on actual field measurements, linked to a worldwide database allows all stakeholders to track the change in greenhouse gas emissions. The process of sequestering carbon dioxide in the ocean is affected by the support for technologies and industries that adopt the principle of carbon recycling in order to maintain the balance. This includes supporting initiatives that contribute to increasing vegetation cover and preserving oceans from pollutants, especially chemicals and radioactive pollutants, which will undoubtedly affect the process of sequestering carbon dioxide in the oceans, and this will contribute significantly to maintaining carbon dioxide at acceptable levels

The Effects of Different Pediatric Drugs and Brushing on the Color Stability of Esthetic Restorative Materials Used in Pediatric Dentistry: An In Vitro Study

The aim of the current study is to observe how different pediatric drugs and tooth brushing affect the color stability of different esthetic restorative materials. Three restorative materials (composite, compomer, and glass ionomer cement (GIC)) were each used to produce 72 specimens (10 mm × 2 mm). The specimens were divided into six groups and immersed in distilled water and five different pediatric drugs (amoxicillin, ibuprofen, ventolin, paracetamol, and multivitamins). Each group was divided into two subgroups (brushed and non-brushed). Over the course of two weeks, the specimens were agitated for one minute every eight hours. Color changes in all the specimens were evaluated using a spectrophotometer at 1 and 2 weeks. GIC showed a change in color that was significantly greater than that in all the other materials in each solution, except for those in amoxicillin. After a period of 1 to 2 weeks, the most noticeable change in color was detected in the amoxicillin composite and amoxicillin GIC unbrushed groups, and after 2 weeks, a significant difference was found in the ventolin GIC unbrushed group. The color stability of the restorative materials used in pediatric dentistry can be influenced by using popular liquid pediatric medications. GIC was the least color-stable material when subjected to liquid medications

Parents’ Knowledge of and Attitude toward Acute Otitis Media and Its Treatment in Children: A Survey at Primary Healthcare Centers in the Aseer Region

Background: Acute otitis media (AOM) in children aged 5 years old and younger poses a critical health concern, affecting both the general health of children and the emotional well-being of parents. The objective of this study was to evaluate parental understanding, attitudes, and experiences related to AOM and its management, including the use of antibiotics without physician prescription. Method: A cross-sectional study was carried out during the months of May and June of 2023. To collect data for this study, a validated questionnaire was converted into a Google form and given to parents of children aged 5 years and younger who sought healthcare for their children in primary healthcare centers in Abha city, Aseer region, Saudi Arabia. Results: A total of 406 parents participated in this study, 64.8% of them were women and 45.3% of them were in the age range of 25 to 34 years. The majority (90.1%) resided in urban areas and a significant proportion (72.2%) had a university education. Among the respondents, 22.7% agreed that bacteria are the cause of AOM, while 21.7% agreed that it is caused by viruses. A total of 51.0% acknowledged the need for antibiotics in the management of AOM. In terms of treatment, 84.5% and 83.5% believed that analgesics and antibiotics, respectively, were the most effective for otalgia. A substantial portion, 43.1%, 34.7%, and 37.7%, respectively, believed that antibiotics could reduce pain, relieve fever, and prevent recurrence. Almost three-quarters sought medical advice primarily from paediatricians and 37.7% obtained information about AOM from the Internet. Furthermore, almost a third (28.8%) chose not to wait for the physician’s appointment and immediately administered antibiotics without the physician’s prescription due to concerns about disease progression. Approximately two fifths (38.4%) requested physicians to prescribe antibiotics, a pattern that was in agreement with the actual rate of antibiotic prescriptions (38.4%). Conclusions: A notable deficiency in knowledge and unsafe practices about AOM and its management is evident among parents in the Aseer region. This underscores the pressing need for an educational program aimed at improving parental health literacy regarding otitis media causes and treatments, as well as its preventive measures

Marginal Adaptation and Internal Fit of 3D-Printed Provisional Crowns and Fixed Dental Prosthesis Resins Compared to CAD/CAM-Milled and Conventional Provisional Resins: A Systematic Review and Meta-Analysis

The aim of this systematic review was to evaluate the marginal fit and internal adaptation of provisional crowns and fixed dental prostheses (FDPs) fabricated using 3D-printing resins and compared them with those fabricated by CAD/CAM (computer-aided designing/computer-aided manufacturing) milling and conventional resins. The null hypotheses tested were that there would be no differences in the marginal fit and internal adaptation of 3D-printed provisional crowns and FDP resins when compared to CAD/CAM-milled and conventional provisional resins. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to construct this systematic review. The focused PICO/PECO (Population, Intervention/Exposure, Comparison, Outcome) question was “Do provisional crowns and FDPs (P) fabricated by 3D-printing (I) have similar marginal adaptation and internal fit (O) when compared to those fabricated by CAD/CAM milling and conventional techniques (C)?”. The protocol used for this systematic review was pre-registered in the International Prospective Register of Systematic Reviews (PROSPERO). Electronic databases (e.g., MEDLINE/PubMed and Web of Science (Core Collection)) were systematically searched for indexed English literature published up to June 2022. In the initial electronic search of the selected databases, 519 articles were identified. Duplicates were removed, and screening was performed to select the articles that met the preset inclusion criteria. Sixteen studies were selected for qualitative analysis, but only ten of them provided comparative data and were selected for quantitative analysis. The modified CONSORT scale was used for qualitative analysis, and most of the included studies were rated to be of moderate quality. Based on the findings, it could be concluded that provisional crowns and FDPs fabricated from 3D-printing resins have a superior marginal fit and internal adaptation when compared to CAD/CAM-milled and conventional provisional resins; thus, they can be used as a dependable alternative to other resins