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

Commercial Seaweed Liquid Extract as Strawberry Biostimulants and Bioethanol Production

Seaweeds are increasingly intriguing as a sustainable source of bioactive compounds. They have applications in agriculture, fuels, feed, and food products. To become a cost-competitive product with zero waste, a biorefinery approach is applied, where several products are valorized at the same time. True-Algae-Max (TAM®) has been investigated for its ability to improve the yield and nutritional facts of a strawberry plant. Three concentrations of TAM (0, 50, and 100%) were examined by foliar spray in 2017 with 50% NPK chemical fertilizer. Results indicated that growth, yield, chlorophyll, and potassium content were significantly improved by TAM treatments. TAM50 % resulted in maximum root length, leaf area, plant fresh weight, fruit weight, and yield with an increase ranging from 10 to 110% compared to control. Compared to the NPK control, strawberries grown with TAM50% improved total soluble solids (TSS) from 7.58 to 10.12% and anthocyanin from 23.08 to 29.42 mg CGE 100 g−1. Noteworthily, this reduced total sugar, and total phenolics were boosted by TAM applications, while non-reducing sugar was reduced compared to control. On the other hand, whole seaweed biomass and TAM residuals were used for bioethanol production by acid scarification. The maximum bioethanol yield was observed in residual biomass (0.34 g g−1 dw), while the whole seaweed biomass showed only 0.20 g g−1 dw. These results proved the biorefinery concept of using seaweed extract as a biostimulator and bioethanol production

Outcomes in Newly Diagnosed Atrial Fibrillation and History of Acute Coronary Syndromes: Insights from GARFIELD-AF

BACKGROUND: Many patients with atrial fibrillation have concomitant coronary artery disease with or without acute coronary syndromes and are in need of additional antithrombotic therapy. There are few data on the long-term clinical outcome of atrial fibrillation patients with a history of acute coronary syndrome. This is a 2-year study of atrial fibrillation patients with or without a history of acute coronary syndromes