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

Review of COVID-19 in Children Admitted to King Fahad Hospital, Albaha, Saudi Arabia in 2020

Background: The coronavirus disease (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first identified at the end of 2019 in Wuhan City, China and then spread worldwide. Objectives: The study aimed to evaluate COVID-19 symptoms, signs, management, and outcomes in admitted children. Methods: This retrospective cohort study was conducted at King Fahad Hospital, Albaha, Saudi Arabia, which is designated as the center for COVID-19 patients. Data were collected retrospectively between Apr 2020 and Mar 2021. The protocols of health authorities in Saudi Arabia were used for the diagnosis and management of all patients. Results: Positive test results were confirmed in 95 patients. Of these, 44 (46%) were males and 51 (54%) were females. Fever, cough, nasal congestion, sore throat, myalgia, and upper respiratory tract infections were the most common symptoms. The common comorbidities in this cohort were respiratory diseases (19%), type1 diabetes mellitus (16%), followed by obesity (11%), chronic kidney disease (4%), congenital heart diseases (2%), while in (48%) pts no comorbidity factors were reported. Fever was the most frequent symptom, reported in 95% of patients. Multisystem inflammatory syndrome (MIS-C) has been reported in one patient. Guillain-Barre syndrome was reported in one female patient and Kawasaki symptoms in one male patient. No mortality was reported. Conclusion: Most children with COVID-19 presented with mild clinical manifestations and good outcomes. No mortality was reported in this study. Obesity is a serious comorbidity and risk factor for severe diseases

Anaerobic Digestion, Codigestion of Food Waste, and Chicken Dung: Correlation of Kinetic Parameters with Digester Performance and On-Farm Electrical Energy Generation Potential

Valorization of agro-food waste through anaerobic digestion (AD) is gaining prominence as alternative method of waste minimization and renewable energy production. The aim of this study was to identify the key parameters for digester performance subjected to kinetic study and semicontinuous operation. Biochemical methane potential (BMP) tests were conducted in two different operating conditions: without mixing (WM) and continuous mixing (CM). Three different substrates, including food waste (FW), chicken dung (CD), and codigestion of FW and CD (FWCD) were used. Further kinetic evaluation was performed to identify mixing’s effect on kinetic parameters and correlation of the kinetic parameters with digester performance (volatile solid removal (VS%) and specific methane production (SMP)). The four models applied were: modified Gompertz, logistic, first-order, and Monod. It was found that the CM mode revealed higher values of Rm and k as compared to the WM mode, and the trend was consistently observed in the modified Gompertz model. Nonetheless, the logistic model demonstrated good correlation of kinetic parameters with VS% and SMP. In the continuous systems, the optimum OLR was recorded at 4, 5, and 7 g VS/L/d for FW, CD, and FWCD respectively. Therefore, it was deduced that codigestion significantly improved digester performance. Electrical energy generation at the laboratory scale was 0.002, 0.003, and 0.006 kWh for the FW, CD, and FWCD substrates, respectively. Thus, projected electrical energy generation at the on-farm scale was 372 kWh, 382 kWh, and 518 kWh per day, respectively. Hence, the output could be used as a precursor for large-scale digester-system optimization

Anaerobic Digestion, Codigestion of Food Waste, and Chicken Dung: Correlation of Kinetic Parameters with Digester Performance and On-Farm Electrical Energy Generation Potential

Valorization of agro-food waste through anaerobic digestion (AD) is gaining prominence as alternative method of waste minimization and renewable energy production. The aim of this study was to identify the key parameters for digester performance subjected to kinetic study and semicontinuous operation. Biochemical methane potential (BMP) tests were conducted in two different operating conditions: without mixing (WM) and continuous mixing (CM). Three different substrates, including food waste (FW), chicken dung (CD), and codigestion of FW and CD (FWCD) were used. Further kinetic evaluation was performed to identify mixing’s effect on kinetic parameters and correlation of the kinetic parameters with digester performance (volatile solid removal (VS%) and specific methane production (SMP)). The four models applied were: modified Gompertz, logistic, first-order, and Monod. It was found that the CM mode revealed higher values of Rm and k as compared to the WM mode, and the trend was consistently observed in the modified Gompertz model. Nonetheless, the logistic model demonstrated good correlation of kinetic parameters with VS% and SMP. In the continuous systems, the optimum OLR was recorded at 4, 5, and 7 g VS/L/d for FW, CD, and FWCD respectively. Therefore, it was deduced that codigestion significantly improved digester performance. Electrical energy generation at the laboratory scale was 0.002, 0.003, and 0.006 kWh for the FW, CD, and FWCD substrates, respectively. Thus, projected electrical energy generation at the on-farm scale was 372 kWh, 382 kWh, and 518 kWh per day, respectively. Hence, the output could be used as a precursor for large-scale digester-system optimization

Anaerobic digestion, codigestion of food waste, and chicken dung: correlation of kinetic parameters with digester performance and on-farm electrical energy generation potential

Valorization of agro-food waste through anaerobic digestion (AD) is gaining prominence as alternative method of waste minimization and renewable energy production. The aim of this study was to identify the key parameters for digester performance subjected to kinetic study and semicontinuous operation. Biochemical methane potential (BMP) tests were conducted in two different operating conditions: without mixing (WM) and continuous mixing (CM). Three different substrates, including food waste (FW), chicken dung (CD), and codigestion of FW and CD (FWCD) were used. Further kinetic evaluation was performed to identify mixing’s effect on kinetic parameters and correlation of the kinetic parameters with digester performance (volatile solid removal (VS%) and specific methane production (SMP)). The four models applied were: modified Gompertz, logistic, first-order, and Monod. It was found that the CM mode revealed higher values of Rm and k as compared to the WM mode, and the trend was consistently observed in the modified Gompertz model. Nonetheless, the logistic model demonstrated good correlation of kinetic parameters with VS% and SMP. In the continuous systems, the optimum OLR was recorded at 4, 5, and 7 g VS/L/d for FW, CD, and FWCD respectively. Therefore, it was deduced that codigestion significantly improved digester performance. Electrical energy generation at the laboratory scale was 0.002, 0.003, and 0.006 kWh for the FW, CD, and FWCD substrates, respectively. Thus, projected electrical energy generation at the on-farm scale was 372 kWh, 382 kWh, and 518 kWh per day, respectively. Hence, the output could be used as a precursor for large-scale digester-system optimization

A Survey on Knowledge, Attitude, and Practices of Large-Animal Farmers towards Antimicrobial Use, Resistance, and Residues in Mymensingh Division of Bangladesh

The widespread and indiscriminate use of antimicrobials in food animals is a key contributor to antimicrobial resistance and antimicrobial residue, which have become a growing public and animal health concern in developing countries such as Bangladesh. This study was aimed to assess the knowledge, attitude, and practices (KAP) of large-animal farmers towards antimicrobial use (AMU), antimicrobial resistance (AMR), and antimicrobial residue (AR) with their correlation. A cross-sectional survey was conducted with a structured and pretested questionnaire in the Mymensingh division of Bangladesh. A total of 212 large-animal farmers (dairy, beef fattening, buffalo, sheep, and goat farmers) were surveyed. Results showed that most of the farmers are male (85.8%) and belong to the 18–30 age group (37.3%). About 20.3% had no formal education, and nearly half of the participants (48.1%) received training regarding antibiotic use and resistance. Penicillin is the most common class of antibiotic used (61.8%) in the study area, followed by other antimicrobials. Only 37.7% of the farmers used antimicrobials on the recommendation of their veterinarian. Overall, 41.5%, 42.5%, and 21.7% of farmers possess adequate knowledge and a satisfactory attitude and perform desirable practices, respectively. Farmers in the 31–40 age group have adequate knowledge, attitude, and ability to implement desired practices compared to farmers in the 18–30 age group. Farmers having a graduate or post-graduate degree scored better in relation to knowledge, attitude, and practice than other farmers. Analysis revealed that farmers who received training on AMU and AMR had 10.014 times (OR = 10.014, 95% CIs: 5.252–19.094), 9.409 times (OR = 9.409, 95% CIs: 4.972–17.806), and 25.994 times (OR = 25.994, 95% CIs: 7.73–87.414) better knowledge, attitude, and performance, respectively, compared to their counterparts. A significant proportion of farmers (97.2%) dispose of leftover antibiotics inappropriately. The findings of the present study will be used to intervene in the education and training of the farmers, which will help to limit the indiscriminate and irrational use of antimicrobials, leading to reducing the chances of developing AMR