Evaluation of Microtensile Bond Strength of Universal Self-etch Adhesive System to Wet and Dry Dentin

BACKGROUND: The durability of dentin-resin interfaces with the universal adhesive system is a crucial characteristic with chemical interactions between the exposed collagen and the adhesive monomers, but it is still compromised with wet and dry mode. AIM: The present study evaluated the effect of dentin wetness and solvents containing of one-step self-etch adhesives on the microtensile bond strength (μTBS) of dentin at different storage times. METHODS: Occlusal dentin of 54 extracted human molars was exposed. Each adhesive agent was applied according to manufacturer instructions to wet and dry dentin surfaces. Composite resin was incrementally built up. Bond strengths to dentin were determined using the μTBS test after water storage for 24 h, 1 month, and 6 months. One-way ANOVA was used to compare between more than two non-related samples. The significance level was set at p ≤ 0.05. RESULTS: Dryness of dentin increases the μTBS with solvent-containing adhesives while decrease the μTBS with solvent-free adhesive. There was an increase in microtensile bond strength values in the case of ethanol water-based self-etch adhesive over time. No statistically significant difference was found among different storage times regarding μTBS for solvent-free adhesive, while a statistically significant difference was found among different storage times in μTBS for solvent-containing adhesives. CONCLUSION: Universal adhesive systems improve the durability and stability of dentin bond strength

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

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries