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

Analysis of the Potential of Meeting the EU’s Sustainable Aviation Fuel Targets in 2030 and 2050

Sustainable aviation fuel (SAF) is anticipated to have a significant impact on decarbonizing the aviation industry owing to its ability to be seamlessly incorporated into the current aviation infrastructure. This paper analyzes the potential of meeting the proposed SAF targets set by the ReFuelEU initiative. The approved SAF production pathways according to ASTM D7566 using renewable bio-based feedstocks were defined and analyzed. Moreover, a detailed matrix for comparison was used to provide an overview of the current state of those pathways. The analysis has shown that hydroprocessed esters of fatty acids (HEFA), alcohol to jet (ATJ), and Fischer–Tropsch (FT-SPK) are the most promising pathways in the foreseeable future due to their high technology readiness and fuel levels. HEFA is the most mature and affordable pathway; therefore, it is expected to form the backbone of the industry and stimulate the market in the short term despite its low sustainability credentials, limited feedstock, and geopolitical implications. On the other hand, FT-SPK can utilize various feedstocks and has the lowest greenhouse gas emissions with around 7.7 to 12.2 gCO2e/MJ compared to the conventional jet fuel baseline of 89 gCO2e/MJ. Overall, the EU has enough sustainable feedstocks to meet the short-term SAF targets using the current technologies. In the long term, the reliability and availability of biomass feedstocks are expected to diminish, leading to a projected deficit of 1.35 Mt in SAF production from bio-based feedstocks. Consequently, a further policy framework is needed to divert more biomass from other sectors toward SAF production. Moreover, a significant investment in R&D is necessary to improve process efficiencies and push new technologies such as power-to-liquid toward commercial operation

A Comprehensive Analysis of the Risks Associated with the Determination of Biofuels’ Calorific Value by Bomb Calorimetry

Two of the most commonly used solid biomass sources for fuel are wood chips and wood pellets. The calorific value and the moisture content of those biofuels determine the efficiency of the CHP and the biorefinery plants. Therefore, with the increased shift towards a biobased economy, the biomass cost and its physical properties must be precisely determined. Most of the current standards are lacking and provide neither enough details about the issues caused by the biomass heterogeneity nor with the variation in experimental practice. Phenomena such as data scattering, poor repeatability and wide uncertainty, are mostly observed during the measurements of the calorific value and the moisture content. To overcome such issues, an interlaboratory comparison between three national metrology institutes using bomb calorimetry has taken place. The comparison helped to identify the root causes behind the poor reproducibility of the wood samples. Factors such as the equilibrium moisture content of the biomass, the pellet mass, the applied pressure to form the pellet, the handling techniques and the determination errors are highlighted and analyzed. The final results paved the way to provide an enhanced detailed experimental practice where the repeatability and reproducibility have been strongly improved. Moreover, the detailed uncertainty sources and calculations are presented. It has been found that by fulfilling the recommended approach the measurement repeatability improved by up to 50–80%, while the final uncertainty improved by 10–30%. This enhancement leads to a maximum relative expanded uncertainty of around ±1% (coverage factor of k = 2 and a confidence level of 95%)

Improved Metrological Methodology to Address the Challenges Associated with the Determination of Biofuels Calorific Value by Bomb Calorimeter

The challenges associated with biofuel quality come from its heterogenous nature as biomass crops grow in different lands and under different conditions. Moreover, the inconsistency of the handling and sampling techniques in the laboratories or in the feedstock storage piles increase biomass variability. These issues affect the calorific value and as a result, the accuracy of the measurement for each feedstock pile of the measured data might be widely scattered. Furthermore, the current standards, e.g., ISO, DIN or ASTM are limited and do not consider the deviations caused by determination errors during the measurements. Therefore, this study quantifies the causes of these deviations by performing an inter-laboratory comparison on a metrological level between 3 national metrology institutes. Eventually this comparison helps to optimize the existing strategies and provides an enhanced technical practice for the determination of the calorific value by bomb calorimetry. It has been found that by assuring that the equilibrium moisture content of the samples is reached and that by avoiding the sources of error during the measurements, the repeatability of the samples can be improved by up to 50%. Consequently, this improvement will help to lower the final uncertainty by 10-25%