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

Fast and novel multiwalled carbon nanotubes decorated with metal oxide nanoparticles for potentiometric detection of a prohibited medication in sports acebutolol hydrochloride

A straightforward approach for creating fast and novel potentiometric sensors that are modified with multi-walled nanotubes (MWCNTs) was described. The impact of the selective sensor's material was studied. The suggested sensors were successfully fabricated for instant and fast detection of the prohibited β-adrenoreceptor blocking agent acebutolol hydrochloride (AC) in commercial products. Acebutolol-phosphomolybdate (AC-PM) carbon paste sensor was formed by mixing AC and phosphomolybdic acid and graphite powder in the presence of o-nitrophenyl octyl ether (o-NPOE) as a plasticizing agent. The functionalized AC-PM-MWCNTs and AC-PM-MWCNTs-Al2O3 nanocomposite sensors were prepared and all parameters affecting the sensors' potential responses have been investigated as well as the green synthesis of Al2O3NPs has been characterized using various microscopic and spectroscopic techniques. AC-PM-MWCNTs and AC-PM-MWCNTs-Al2O3 nanocomposite sensors demonstrated linearity of 1.0 × 10−7-1.0 × 10−2 and 1.0 × 10−8-1.0 × 10−2 mol L−1, respectively with regression equations −53.571x + 423.24 (r = 0.999) and −57.107x + 518.54 (r = 0.999). It also revealed excellent selectivity and sensitivity for the determination and quantification of AC. The developed potentiometric system was suitable for the determination of AC in bulk powder and commercial products

New Construction of Functionalized CuO/Al₂O₃ Nanocomposite-Based Polymeric Sensor for Potentiometric Estimation of Naltrexone Hydrochloride in Commercial Formulations

Electrically conductive polymeric nanocomposites with nanoparticles are adaptable types of nanomaterials that are prospective for various applications. The extraordinary features of copper oxide (CuO) and aluminium oxide (Al2O3) nanostructures, encourages extensive studies to prospect these metal oxide nanocomposites as potential electroactive materials in sensing and biosensing applications. This study suggested a new CuO/Al2O3 nanocomposite-based polymeric coated wire membrane sensor for estimating naltrexone hydrochloride (NTX) in commercial formulations. Naltrexone hydrochloride and sodium tetraphenylborate (Na-TPB) were incorporated in the presence of polymeric polyvinyl chloride (PVC) and solvent mediator o-nitrophenyloctyl ether (o-NPOE) to form naltrexone tetraphenylborate (NTX-TPB) as an electroactive material. The modified sensor using NTX-TPB-CuO/Al2O3 nanocomposite displayed high selectivity and sensitivity for the discrimination and quantification of NTX with a linearity range 1.0 × 10−9–1.0 × 10−2 mol L−1 and a regression equation EmV = (58.25 ± 0.3) log [NTX] + 754.25. Contrarily, the unmodified coated wire sensor of NTX-TPB exhibited a Nernstian response at 1.0 × 10−5–1.0 × 10−2 mol L−1 and a regression equation EmV = (52.1 ± 0.2) log [NTX] + 406.6. The suggested modified potentiometric system was validated with respect to various criteria using the methodology recommended guidelines

Assessment of essential elements and heavy metals in Saudi Arabian rice samples underwent various processing methods

Environmental, soil, and groundwater pollution from toxic heavy metals, as well as food safety are all global concerns nowadays. The effect of various processes viz. washing, soaking, and cooking of rice samples (ten rice varieties, 50 samples) on the concentration of essential elements and toxic heavy metals was determined using the inductively coupled plasma-mass spectrometry technique. The concentrations of As, Cd, Cu, and Ni were found to be below the maximum permissible levels. The range of mean concentrations of metals (mg/kg) was recorded as Al (15.495–8.151), Fe (10.358–7.499), Ni (0.399–0.176), Cu (4.518–2.615), Zn (28.635–12.880), As (0.152–0.042), Cd (0.233–0.038), Pb (0.713–0.417), Ti (2.157 > 0.521), Sn (1.406–0.016), and W (1.114–0.017) mg/kg. Pt and Ag metals were not found in all samples. Soaking rice for 2 h was one of the most successful techniques for lowering heavy metal concentrations, followed by overnight soaking, which aided in the elimination of Al, Cd, Pb, and Pb. Heavy metal exposure has a significant impact on human health. This study creates a promising view to use a simple and accurate detection method for minimizing the effect of different processing methods on the essential elements and heavy metal contents

Ultrasensitive functionalized CeO2/ZnO nanocomposite sensor for determination of a prohibited narcotic in sports pethidine hydrochloride

The extraordinary features of cerium oxide (CeO2) and zinc oxide (ZnO) nanostructures have encouraged substantial attention to those nanocomposites as probable electroactive complexes for sensing and biosensing purposes. In this study, an advanced novel factionalized CeO2/ZnO nanocomposite-aluminum wire membrane sensor was designed to assess pethidine hydrochloride (PTD) in commercial injection samples. Pethidine-reineckate (PTD-RK) was formed by mixing pethidine hydrochloride and ammonium reineckate (ARK) in the presence of polymeric matrix (polyvinyl chloride) and o-nitrophenyl octyl ether as a fluidizing agent. The functionalized nanocomposite sensor displayed a fast dynamic response and wide linearity for the detection of PTD. It also revealed excellent selectivity and sensitivity, high accuracy, and precision for the determination and quantification of PTD when compared with the unmodified sensor PTD-RK. The guidelines of analytical methodology requirements were obeyed to improve the suitability and validity of the suggested potentiometric system according to several criteria. The developed potentiometric system was suitable for the determination of PTD in bulk powder and commercial products

Identification of Chemical Composition and Metal Determination of Retama raetam (Forssk) Stem Constituents Using ICP-MS, GC-MS-MS, and DART-MS

This study aims to investigate the chemical constituents of the stem of Retama raetam growing in Saudi Arabia. The organic and inorganic composition of ethanol extract of R. raetam stem has been explored using direct analysis in real time-mass spectrometry (DART-MS), gas chromatography-mass spectrometry (GC-MS), and inductively coupled plasma-mass spectrometry (ICP-MS). Analysis conducted by DART-MS and GC-MS reveals the presence of several interesting organic constituents identified as 2,4-di-tert-butylphenol, sparteine, benzenepropanoic acid, 3,5-bis(1,1-dimethylethyl)-4-hydroxy-, methyl ester, phthalic acid, 1-octadecanol, squalene, argentamin, 2,4-di-tert-butylphenol, sparteine, benzene propanoic acid, 3,5-bis(1,1-dimethylethyl)-4-hydroxy-, methyl ester, phthalic acid, 1-octadecanol, squalene, argentamin, and hentriacontane in the ethanol extract of the R. raetam stem. The ICP-MS analysis of stem extract showed the presence of a significant amount of important inorganic elements including aluminum, chlorine, calcium, bromine magnesium, phosphorus, scandium, and chromium. The current study complements other R. raetam extract investigations carried out in the past and provides the additional data for the future research studies

Short-term evaluation of motor and sensory nerve conduction parameters in COVID-19-associated peripheral neuropathy patients

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS‐COV‐2) is mostly associated with upper and lower respiratory tract manifestations. However, coronavirus disease 19 (COVID-19) can result in a wide range of other systemic symptomatology, including neuropsychiatric, psychological, and psychosocial impairments. Literature regarding neurological compromise, including neuropathy and sensory and motor affection associated with COVID-19, is still limited. This study aims to evaluate the sensory, motor neuropathy, and secondary neurological impairment among patients with mild to moderate coronavirus disease associated with peripheral neuropathy within 1 month. Methods Forty participants, including 20 mild to moderate COVID-19 patients with peripheral neuropathy and 20 age and gender-matched healthy volunteers, were recruited in this case/control study. Laboratory evaluation focused on C-reactive protein (CRP) and D-dimer levels. Oxygen saturation for all participants was recorded. The neurophysiological study included motor nerve study, sensory nerve study, and F wave study for upper and lower limbs were done. Results The two groups were similar regarding baseline data. Neurological symptoms’ onset in the COVID-19 group ranged from 4 to 24 days. Levels of CRP and D-dimer levels were significantly higher in patients versus the control group. Motor nerve conduction (MNC) amplitude and latency for the median nerve were significantly compromised among the COVID-19 group. The MNC latency and F wave latency for the posterior tibial nerve were significantly higher in the COVID-19 group. The CRP and D-dimer levels were associated with a significant positive correlation with a latency of median nerve MNC, sensory nerve conduction (SNC), and f-wave; latency of MNC and F wave of the posterior tibial nerve; and SNC latency for sural nerve. Conclusion neurological involvement can occur in mild to moderate cases of SARS-COV-2 infection and add to the burden of the disease. Neurological symptoms in the course of COVID-19 disease should be interpreted cautiously, and appropriate diagnosis, including nerve conduction studies and management, should be considered. Trial registration ClinicalTrials.gov. NCT05721040

Exploiting of Green Synthesized Metal Oxide Nanoparticles for Spectrophotometric Determination of Levofloxacin, Cephalexin, and Cefotaxime Sodium in Commercial Products

In this study, two metal oxide nanoparticles NiO and MnO2 were synthesized from green sources Mentha spicata (M. spicata) extract and Malus domestica (M. domestica) peel extract, respectively. The optical and physical properties of the synthesized nanoparticles were characterized using spectroscopic and microscopic techniques. Simple, precise, and new spectrophotometric probes were suggested for the determination of three cephalosporin antibiotics, including levofloxacin (LVX), cephalexin (CPX), and cefotaxime sodium (CTX) in their pure form and commercial products. The spectrophotometric detection of the selected drugs is based on the catalytic enhancement of NiO and MnO2 nanoparticles (NPs) due to their unique optical properties. Linear relationships with main correlation coefficients 0.999 were obtained at 0.1–20, 1.0–80, and 0.001–100 µg mL−1 for the three drugs in the presence of NiONPs, whereas 0.01–60, 0.1–160, and 0.01–80 µg mL−1 were obtained in the presence of MnO2NPs at absorption wavelengths 290, 262, and 235 nm for LVX, CPX and CTX, respectively. The analytical methods were validated and successfully used for determination of the instigated drugs in their bulk and commercial dosage forms

Combined radiofrequency and chemoembolization vs. chemoembolization in management of hepatocellular carcinoma

Aim: Hepatocellular carcinoma (HCC) is one of the most common cancers in the world. If left untreated, liver cancer has a poor prognosis with more than 90% of patients dying of the disease within 5 years of diagnosis. The aim of this study is to assess the value of combined radiofrequency ablation (RFA), followed by trans-arterial chemoembolization (TACE) in the management of HCC.Methods: Fifty HCC patients with chronic liver disease were categorized into two groups according to the modality of locoregional treatment: 25 HCC patients treated with RFA followed by TACE within 5 days and 25 HCC patients treated with TACE only.Results: Complete response was achieved in 100% and 84% of the HCC patients after 1 month from combined RFA-TACE therapy and TACE only respectively. The rate of objective response after 7 months was 84% and 44% in the RFA-TACE and TACE groups respectively. One year disease free survival rate was 56% and 24% in RFA-TACE and TACE groups respectively, and overall survival rate was 88% in the RFA-TACE group and 80% in the TACE only group.Conclusion: Combined RFA-TACE appears to be an effective modality and superior to TACE only for the treatment of HCC