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

Enhanced photocatalytic removal of phenol from aqueous solutions using ZnO modified with Ag

Different photocatalysts based on commercial ZnO modified by silver photodeposition were prepared in this work. The samples were characterized by X-ray fluorescence spectrometry (XRF), specific surface area (SSA), transmission electron microscopy (TEM), X-ray photoelectron spectroscopy (XPS), X-ray diffraction (XRD) and UV–vis diffuse reflectance (UV–vis DRS). XRD and XPS showed that Ag/ZnO samples are composed of metallic Ag (Ag0) and ZnO structure was identified. Furthermore, TEM analysis evidenced that the number of silver particles increased with the Ag content. At last, UV–vis DRS results revealed a reflectance band for Ag/ZnO samples, ascribed to the surface plasmon resonance (SPR) absorption of metal silver particles. Commercial ZnO and Ag/ZnO samples were evaluated in the phenol removal under UV light irradiation. It was observed an enhancement of photocatalytic phenol removal from aqueous solutions by silver addition in comparison to commercial ZnO. In particular, the phenol removal increased with the silver content from 0.14 to 0.88 wt%, after this content (i.e 1.28 wt%) the phenol degradation significantly decreased indicating that the optimal Ag content was equal to 0.88 wt%. The influence of the best photocatalyst dosage and the change of the initial phenol concentration in solution were also investigated in this work and the best photocatalytic performance was obtained by using 50 mg L−1 of phenol initial concentration and 0.15 g L−1 of photocatalyst dosage. Finally, the optimized Ag/ZnO photocatalyst was employed for the treatment of a real drinking wastewater containing phenol in which the almost total phenol removal was achieved after 180 min of UV irradiation time.This work was financed by Fondo Nacional de Financiamiento para la Ciencia, la Tecnología y la Innovación “Fransisco José de Caldas – Colciencias”, Project 279-2016, Universidad Pedagógica y Tecnológica de Colombia and by research fund from Project Ref. CTQ2015-64664-C2-2-P (MINECO/FEDER, UE)

UV and visible-light driven photocatalytic removal of caffeine using ZnO modified with different noble metals (Pt, Ag and Au)

In this work, ZnO photocatalyst was modified with different noble metals (Pt, Ag and Au) through photodeposition method and then characterized by different techniques (XRD, XRF, BET, UV–vis DRS, FESEM, and XPS). The addition of noble metals produces important changes in the light absorption properties with a significant absorbance in the visible region due to the existence of surface plasmon resonance (SPR) observed at about 450 nm and 550 nm for ZnO modified with Ag and Au, respectively. The morphology of the samples was studied by TEM and the size ranges of the different metals were estimated. Noble metal nanoparticles were in every case heterogeneously deposited on the larger ZnO particles. All the prepared photocatalysts were tested in the photocatalytic removal of caffeine (toxic and persistent emerging compound) under UV and visible light irradiation. It was observed an enhancement of photocatalytic caffeine removal from aqueous solutions under UV light irradiation with the increase of metal content (from 0.5 to 1 wt %) for ZnO modified with Ag and Au (Ag/ZnO and Au/ZnO). In particular, Ag/ZnO and Au/ZnO with higher Ag and Au content (1 wt %) allowed to achieve the almost complete caffeine degradation after only 30 min and a TOC removal higher than 90% after 4 h of UV light irradiation. These two photocatalysts were investigated also under visible light irradiation and it was found that their photocatalytic performances were strongly enhanced in presence of visible light compared to unmodified ZnO. In particular, Ag/ZnO photocatalyst was able to reach the complete caffeine degradation and a TOC removal of about 70% after 4 h of visible light irradiation

UV and visible-light driven photocatalytic removal of caffeine using ZnO modified with different noble metals (Pt, Ag and Au)

In this work, ZnO photocatalyst was modified with different noble metals (Pt, Ag and Au) through photodeposition method and then characterized by different techniques (XRD, XRF, BET, UV–vis DRS, FESEM, and XPS). The addition of noble metals produces important changes in the light absorption properties with a significant absorbance in the visible region due to the existence of surface plasmon resonance (SPR) observed at about 450 nm and 550 nm for ZnO modified with Ag and Au, respectively. The morphology of the samples was studied by TEM and the size ranges of the different metals were estimated. Noble metal nanoparticles were in every case heterogeneously deposited on the larger ZnO particles. All the prepared photocatalysts were tested in the photocatalytic removal of caffeine (toxic and persistent emerging compound) under UV and visible light irradiation. It was observed an enhancement of photocatalytic caffeine removal from aqueous solutions under UV light irradiation with the increase of metal content (from 0.5 to 1 wt %) for ZnO modified with Ag and Au (Ag/ZnO and Au/ZnO). In particular, Ag/ZnO and Au/ZnO with higher Ag and Au content (1 wt %) allowed to achieve the almost complete caffeine degradation after only 30 min and a TOC removal higher than 90% after 4 h of UV light irradiation. These two photocatalysts were investigated also under visible light irradiation and it was found that their photocatalytic performances were strongly enhanced in presence of visible light compared to unmodified ZnO. In particular, Ag/ZnO photocatalyst was able to reach the complete caffeine degradation and a TOC removal of about 70% after 4 h of visible light irradiation

Augmented reality (AR) in minimally invasive surgery (MIS) training: where are we now in Italy? The Italian Society of Endoscopic Surgery (SICE) ARMIS survey

Minimally invasive surgery (MIS) is a widespread approach in general surgery. Computer guiding software, such as the augmented reality (AR), the virtual reality (VR) and mixed reality (MR), has been proposed to help surgeons during MIS. This study aims to report these technologies' current knowledge and diffusion during surgical training in Italy. A web-based survey was developed under the aegis of the Italian Society of Endoscopic Surgery (SICE). Two hundred and seventeen medical doctors' answers were analyzed. Participants were surgeons (138, 63.6%) and residents in surgery (79, 36.4%). The mean knowledge of the role of the VR, AR and MR in surgery was 4.9 ± 2.4 (range 1-10). Most of the participants (122, 56.2%) did not have experience with any proposed technologies. However, although the lack of experience in this field, the answers about the functioning of the technologies were correct in most cases. Most of the participants answered that VR, AR and MR should be used more frequently for the teaching and training and during the clinical activity (170, 80.3%) and that such technologies would make a significant contribution, especially in training (183, 84.3%) and didactic (156, 71.9%). Finally, the main limitations to the diffusion of these technologies were the insufficient knowledge (182, 83.9%) and costs (175, 80.6%). Based on the present study, in Italy, the knowledge and dissemination of these technologies are still limited. Further studies are required to establish the usefulness of AR, VR and MR in surgical training