Identifying and preventing burnout in young oncologists, an overwhelming challenge in the COVID-19 era: a study of the Spanish Society of Medical Oncology (SEOM).

BACKGROUND: Young oncologists are at particular risk of professional burnout, and this could have a significant impact on their health and care of their patients. The coronavirus disease 2019 (COVID-19) pandemic has forced rapid changes in professionals' jobs and training, with the consequent physical and psychological effects. We aimed to characterize burnout levels and determinants in young oncologists, and the effects of the pandemic on their training and health. METHODS: Two online surveys were conducted among oncology residents and young oncology specialists in Spain. The first addressed professional burnout and its determinants before the COVID-19 pandemic, while the second analyzed the impact of the pandemic on health care organization, training, and physical and psychological health in the same population. RESULTS: In total, 243 respondents completed the first survey, and 263 the second; 25.1% reported significant levels of professional burnout. Burnout was more common among medical oncology residents (28.2%), mainly in their second year of training. It was significantly associated with a poor work-life balance, inadequate vacation time, and the burnout score. Nearly three-quarters of respondents (72%) were reassigned to COVID-19 care and 84.3% of residents missed part of their training rotations. Overall, 17.2% of this population reported that they had contracted COVID-19, 37.3% had scores indicating anxiety, and 30.4% moderate to severe depression. Almost a quarter of young oncologists (23.3%) had doubts about their medical vocation. CONCLUSIONS: Burnout affects a considerable number of young oncologists. The COVID-19 pandemic has had a profound impact on causes of burnout, making it even more necessary to periodically monitor it to define appropriate detection and prevention strategies.

Chemical risks associated with ready-to-eat vegetables: quantitative analysis to estimate formation and/or accumulation of disinfection byproducts during washing.

Fresh produce can become contaminated with disease-causing microorganisms and chemical contaminants at every step of the production and processing chain and in a variety of ways, including through contact with contaminated process water. Water quality is critical to prevent microbial and chemical risks in any of the postharvest and processing operations related to fresh and fresh-cut fruits and vegetables. The wash process requires high volumes of water, which are usually reduced by water reuse. To maintain the microbiological quality of the process water, intervention strategies are needed. Chemical disinfection is the most common method to maintain the microbial quality of process water. However, the use of chemicals leads to the formation/accumulation of disinfection byproducts (DBPs), which can be absorbed by the washed vegetables. This is the case of trihalomethanes (THMs) and chlorates. The presence of high concentrations of DBPs in vegetables has led to an intensive debate on current disinfection practices and how DBPs may enter the food supply chain, becoming a potential health risk for consumers. To assess the risk associated with the formation/accumulation of DBPs in process water, a quantitative analysis was done. Available data have been used to develop mathematical models to predict the formation/accumulation of DBPs (chlorates and THMs) in process water due to the use of chlorine-derived compounds. Preliminary models have been developed, but adjustments are still needed to refine them. The present study contributes more information related to the development of a mathematical model for the accumulation of chlorates and THMs in process water.

Chemometric characterization of the trace element profile of raw meat from Rubia Gallega x Holstein Friesian calves from an intensive system.

This study was conducted to compare the essential and toxic element content of seven veal cuts: shoulder clod (SC), inside round (IR), eye of round (ER), bottom round (BR), heel of round (HR), knuckle (KK) and tenderloin (TL). Eighty-four meat samples were determined by ICP-MS. Overall, essential trace elements (Co, Cu, Fe, Mn and Zn), except Se, varied significantly between the different meat cuts. By contrast, there were no significant variations for the minor trace elements (Cr, Mo and Ni) or the toxic elements (As, Cd and Pb). Chemometric analysis of the data identified four clusters: (1) the main trace elements, except (2) Se, which was closely related to (3) the toxic elements, and finally (4) the minor trace elements. TL and ER cuts constituted two separated groups; most of the SC and KK samples were associated, and IR and BR samples overlapped. TL and SC contained the highest amounts of trace elements, whereas ER and KK the lowest.

Irrigating Lettuce with Wastewater Effluent: Does Disinfection with Chlorine Dioxide Inactivate Viruses?

Reclaimed water obtained from urban wastewater is currently being used as irrigation water in water-scarce regions in Spain. However, wastewater can contain enteric viruses that water reclamation treatment cannot remove or inactivate completely. In the present study, greenhouse-grown baby lettuce ( L.) was irrigated with secondary treatment effluent from a wastewater treatment plant untreated and treated using chlorine dioxide (ClO). The effect of ClO treatment on the physicochemical characteristics and the presence of enteric viruses in irrigation water and lettuce was assessed. The presence of human noroviruses genogroups I and II (NoV GI and NoV GII), and human astroviruses (HAstV), was analyzed by real-time polymerase chain reaction (RT-qPCR). Additionally, to check for the loss of infectivity induced by the disinfection treatment, positive samples were re-analyzed after pretreatment with the intercalating dye PMAxx before RNA extraction and RT-qPCR. There were no significant differences in the proportion of positive samples and the concentration of enteric viruses between treated and untreated reclaimed water without PMAxx pretreatment ( > 0.05). A significantly lower concentration of NoV GI was detected in ClO-treated water when samples were pretreated with PMAxx ( < 0.05), indicating that inactivation was due to the disinfection treatment. Laboratory-scale validation tests indicated the suitability of PMAxx-RT-qPCR for discrimination between potentially infectious and ClO-damaged viruses. Although the applied ClO treatment was not able to significantly reduce the enteric virus load of the secondary effluent from the wastewater treatment plant, none of the lettuce samples analyzed ( = 36) was positive for the presence of NoV or HAstV.

Effect of gender on breast and thigh turkey meat quality.

1. The influence of gender on chemical composition, physicochemical parameters, fatty acid profile, amino acid and mineral composition of turkey breast and thigh meat was studied in order to assess nutrient requirements. 2. Chemical composition showed that only intramuscular fat in breast meat was significantly affected by gender (p < 0.05). The results showed a higher percentage of intramuscular fat in male samples, almost double the amount found in females (0.73% vs. 0.38%). 3.For meat colour parameters, only a* showed different results between sexes, with male samples (breast: p < 0.01; thigh: p < 0.001) having the highest values. 4. Fatty acid profiles showed that medium chain unsaturated fatty acids were the most abundant. The significant differences (p < 0.05) found in both breast and thigh muscle could be linked to a difference in metabolism between males and females. 5.There were higher levels of C16:1n-7 in females (breast: p < 0.001; thigh: p < 0.01) compared with male muscle sample (5.05 vs. 2.67 g/100 g in breast and 4.95 vs. 3.27 g/100 g in thigh). Nutritional indices (n-6/n-3 and thrombogenic index) were more favourable in female samples demonstrating that female turkeys had better fatty acid profile than the others. 6. Turkey meat is an important source of dietary amino acids, and female samples had the highest contents both of essential and non-essential amino acids. Furthermore, gender had a numeric effect (p > 0.05) on amino acid composition. 7. Mineral composition showed that Na, Zn and Fe were the minerals most affected by turkey gender.

Measurement of fracture properties of concrete at high strain rates.

An analysis of the spalling technique of concrete bars using the modified Hopkinson bar was carried out. A new experimental configuration is proposed adding some variations to previous works. An increased length for concrete specimens was chosen and finite-element analysis was used for designing a conic projectile to obtain a suitable triangular impulse wave. The aim of this initial work is to establish an experimental framework which allows a simple and direct analysis of concrete subjected to high strain rates. The efforts and configuration of these primary tests, as well as the selected geometry and dimensions for the different elements, have been focused to achieve a simple way of identifying the fracture position and so the tensile strength of tested specimens. This dynamic tensile strength can be easily compared with previous values published in literature giving an idea of the accuracy of the method and technique proposed and the possibility to extend it in a near future to obtain other mechanical properties such as the fracture energy. The tests were instrumented with strain gauges, accelerometers and high-speed camera in order to validate the results by different ways. Results of the dynamic tensile strength of the tested concrete are presented.This article is part of the themed issue 'Experimental testing and modelling of brittle materials at high strain rates'.

Occurrence of enteric viruses in reclaimed and surface irrigation water: relationship with microbiological and physicochemical indicators.

AIMS: To assess the prevalence of enteric viruses in different irrigation water sources and in the irrigated produce, and the possible links with microbiological and physicochemical water characteristics. METHODS AND RESULTS: The prevalence and levels of Escherichia coli, Norovirus (NoV) genogroup I (GI) and II (GII), as well as Hepatitis A virus were assessed in three types of water: surface water (surface-W), reclaimed water subjected to secondary treatment (secondary-W) and reclaimed water subjected to tertiary treatment (tertiary-W), as well as in zucchini irrigated with these irrigation water sources. Chemical oxygen demand (COD), turbidity, total suspended solids, alkalinity and maximum filterable volume (MFV) were also measured in the water. Higher prevalence of NoV in secondary-W (GI 100%, GII 55·6%) and tertiary-W (GI 91·7%, GII 66·7%) compared with surface-W (GI 58·4%, GII 22·2%) was observed. Nov GI showed positive correlation with E. coli (Spearman's correlation coefficient = 0·68, P < 0·01), and with some physicochemical parameters such as COD (0·52, P < 0·01), turbidity (0·52, P < 0·01) and MFV (0·54, P < 0·01). Escherichia coli and enteric viruses were not detected in zucchini. CONCLUSION: There is a potential risk of contamination of crops with NoV when reclaimed water is used for irrigation. SIGNIFICANCE AND IMPACT OF THE STUDY: Increase the knowledge on the prevalence of enteric viruses in different irrigation water sources, and its consequences for fresh produce safety.

Suitability of different Escherichia coli enumeration techniques to assess the microbial quality of different irrigation water sources.

The use of fecal indicators such as Escherichia coli has been proposed as a potential tool to characterize microbial contamination of irrigation water. Recently, not only the type of microbial indicator but also the methodologies used for enumeration have been called into question. The goal of this study was to assess the microbial quality of different water sources for irrigation of zucchini plants by using E. coli as an indicator of fecal contamination and the occurrence of foodborne pathogens. Three water sources were evaluated including reclaimed secondary treated water (RW-2), reclaimed tertiary UV-C treated water (RW-3) and surface water (SW). The suitability of two E. coli quantification techniques (plate count and qPCR) was examined for irrigation water and fresh produce. E. coli levels using qPCR assay were significantly higher than that obtained by plate count in all samples of irrigation water and fresh produce. The microbial quality of water samples from RW-2 was well predicted by qPCR, as the presence of foodborne pathogens were positively correlated with high E. coli levels. However, differences in the water characteristics influenced the suitability of qPCR as a tool to predict potential contamination in irrigation water. No significant differences were obtained between the number of cells of E. coli from RW-2 and RW-3, probably due to the fact that qPCR assay cannot distinguish between viable and dead cells. These results indicated that the selection of the most suitable technique for enumeration of indicator microorganisms able to predict potential presence of fecal contamination might be influenced by the water characteristics.

Environmental stress in the Gulf of Mexico and its potential impact on public health.

The Deepwater Horizon (DWH) oil spill in the Gulf of Mexico was the largest maritime oil spill in history resulting in the accumulation of genotoxic substances in the air, soil, and water. This has potential far-reaching health impacts on cleanup field workers and on the populations living in the contaminated coastal areas. We have employed portable airborne particulate matter samplers (SKC Biosampler Impinger) and a genetically engineered bacterial reporter system (umu-ChromoTest from EBPI) to determine levels of genotoxicity of air samples collected from highly contaminated areas of coastal Louisiana including Grand Isle, Port Fourchon, and Elmer's Island in the spring, summer and fall of 2011, 2012, 2013 and 2014. Air samples collected from a non-contaminated area, Sea Rim State Park, Texas, served as a control for background airborne genotoxic particles. In comparison to controls, air samples from the contaminated areas demonstrated highly significant increases in genotoxicity with the highest values registered during the month of July in 2011, 2013, and 2014, in all three locations. This seasonal trend was disrupted in 2012, when the highest genotoxicity values were detected in October, which correlated with hurricane Isaac landfall in late August of 2012, about five weeks before a routine collection of fall air samples. Our data demonstrate: (i) high levels of air genotoxicity in the monitored areas over last four years post DWH oil spill; (ii) airborne particulate genotoxicity peaks in summers and correlates with high temperatures and high humidity; and (iii) this seasonal trend was disrupted by the hurricane Isaac landfall, which further supports the concept of a continuous negative impact of the oil spill in this region.

Methodology for modeling the disinfection efficiency of fresh-cut leafy vegetables wash water applied on peracetic acid combined with lactic acid.

A methodology to i) assess the feasibility of water disinfection in fresh-cut leafy greens wash water and ii) to compare the disinfectant efficiency of water disinfectants was defined and applied for a combination of peracetic acid (PAA) and lactic acid (LA) and comparison with free chlorine was made. Standardized process water, a watery suspension of iceberg lettuce, was used for the experiments. First, the combination of PAA+LA was evaluated for water recycling. In this case disinfectant was added to standardized process water inoculated with Escherichia coli (E. coli) O157 (6logCFU/mL). Regression models were constructed based on the batch inactivation data and validated in industrial process water obtained from fresh-cut leafy green processing plants. The UV254(F) was the best indicator for PAA decay and as such for the E. coli O157 inactivation with PAA+LA. The disinfection efficiency of PAA+LA increased with decreasing pH. Furthermore, PAA+LA efficacy was assessed as a process water disinfectant to be used within the washing tank, using a dynamic washing process with continuous influx of E. coli O157 and organic matter in the washing tank. The process water contamination in the dynamic process was adequately estimated by the developed model that assumed that knowledge of the disinfectant residual was sufficient to estimate the microbial contamination, regardless the physicochemical load. Based on the obtained results, PAA+LA seems to be better suited than chlorine for disinfecting process wash water with a high organic load but a higher disinfectant residual is necessary due to the slower E. coli O157 inactivation kinetics when compared to chlorine.

Reconstruction of mandibular vertical defects for dental implants with autogenous bone block grafts using a tunnel approach: clinical study of 50 cases.

The objective of this study was to evaluate the outcomes of mandibular vertical defect reconstruction with autologous bone and the use of a sub-periosteal tunnel approach in preparation for dental implant insertion. Forty-three consecutive patients with an atrophic posterior mandible were reconstructed using this method. Two thin laminae of cortical bone, obtained by splitting blocks harvested from the retromolar area, were fixed in a box-like framework containing cancellous and particulate bone. The goal was to achieve an alveolar ridge width of ≥5.5mm and an effective bone height (EBH) of ≥10.5mm for dental implant insertion (≥3.4mm diameter, ≥9.5mm length). Fifty reconstruction procedures were performed. The mean EBH was 7.1±1.3mm pre-treatment and 12.3±1.1mm post-treatment (mean increase 5.2±1.4mm). Complete graft loss was recorded in two cases; the remaining complications were minor. After a mean consolidation period of 3.5 months, 96 dental implants were placed. No failure of osseointegration was observed at follow-up (mean 32.9 months). The average bone height reduction was 0.9mm (graft vertical resorption 17.4%). Reconstruction of posterior mandibular vertical defects using two autogenous cortical bone blocks with particulate bone between them, combined with a tunnelling technique, provided good healing with no wound dehiscence and minimum resorption of the grafted bone, favouring a substantial vertical bone gain.

Hospital dental practice in special patients.

Dental patients with special needs are people with different systemic diseases, multiple disorders or severe physical and/or mental disabilities. A Medline search was made, yielding a total of 29 articles that served as the basis for this study, which offers a brief description of the dental intervention protocols in medically compromised patients. Dental treatment in patients with special needs, whether presenting medical problems or disabilities, is sometimes complex. For this reason the hospital should be regarded as the ideal setting for the care of these individuals. Before starting any dental intervention, a correct patient evaluation is needed, based on a correct anamnesis, medical records and interconsultation reports, and with due assessment of the medical risks involved. The hospital setting offers the advantage of access to electronic medical records and to data referred to any complementary tests that may have been made, and we moreover have the possibility of performing treatments under general anesthesia. In this context, ambulatory major surgery is the best approach when considering general anesthesia in patients of this kind.

Effect of photodiode angular response on surface plasmon resonance measurements in the Kretschmann-Raether configuration.

We study the effect of photodiode angular response on the measurement of surface plasmon resonance (SPR) in metallic thin films using the Kretschmann-Raether configuration. The photodiode signal depends not only on the light intensity but also on the incidence angle. This implies that the photodiode sensitivity changes along the SPR curve. Consequently, the measured SPR spectrum is distorted, thus affecting fits and numerical analyses of SPR curves. We analyze the magnitude of this change, determine when it is significant, and develop a calibration method of the experimental setup which corrects for this type of spectral shape distortions.

Jastrow correlated and quantum Monte Carlo calculations for the low-lying states of the carbon atom.

Different computational methods are employed to calculate excitation energies of the carbon atom. Explicitly correlated wave functions have been obtained in a Variational Monte Carlo calculation. Fixed node Diffusion Monte Carlo calculations for the lowest energy excited states of a given symmetry are reported. A systematic and quantitative analysis of the performance of the different schemes in the calculation of the excitation energy of up to 27 excited states of the carbon atom is carried out. The quality of the different methods have been studied in terms of the deviation with respect to the experimental excitation energies. A good agreement with the experimental values has been reached.

Overvalued ideas: psychopathologic issues.

The position attributed in recent years to overvalued ideas between delusion and obsession and that are derived from the reduction of the construct per se to one of its characteristics, that is, insight, has undergone a critical review. Using a case with dysmorphophobic ideas, the difficulties to define it and differentiate it from delusion are proposed and different psychopathological approaches are outlined that make it possible to reconstruct the case differently.

Quantum Monte Carlo ground state energies for the singly charged ions from Li through Ar.

Nonrelativistic frozen nucleus all-electron Quantum Monte Carlo ground state energies of positive and negative ions Li(+) to Ar(+) and Li(-) to Cl(-), respectively, are reported. Explicitly correlated wave functions with a single configuration model function times a Jastrow factor are employed for all of the systems studied. The accuracy obtained for the ions in the third period is similar to that reached for the ions in the second one. For those ions with a stronger multiconfiguration nature a restricted multiconfiguration expansion has been employed. The ground state energy here obtained for the charged species shows a similar quality to that reached for neutral atoms. Starting from those results, ionization potentials and electron affinities are calculated.

Near degeneracy effects on the low-lying spectrum of the iron atom.

The ground state and the LS terms coming from the ground-state configuration, [Ar]-3d(6)4s(2), of the iron atom are studied by carrying out an all electron Variational Monte Carlo calculation. Explicitly correlated trial functions including near degeneracy effects are used. The effect of electronic correlations and the importance of near degeneracy effects are systematically analyzed for the states here considered and compared with the experimental values. Correlations are important to reproduce, even qualitatively, the low-lying spectrum of this atom. A significant quantitative improvement when comparing with the experimental values is achieved when near degeneracy is considered along with dynamic correlations in the variational trial wave function. Finally, the effect of relativity on the results here reported is discussed.

Quantum Monte Carlo ground state energies for the atoms Li through Ar.

All-electron quantum Monte Carlo energies are reported for the ground state of the atoms Li to Ar. The present work is mainly focused on the atoms Na to Ar as well as in those that have a stronger multiconfiguration nature, i.e., Be, B, and C and Mg, Al, and Si. Explicitly correlated wave functions with a single configuration model function times a Jastrow factor are employed for all of the atoms studied. The accuracy obtained for the atoms Na to Ar is similar to that reached for the atoms Li to Ne. In addition, a restricted multiconfiguration expansion has been employed for the atoms Be, B, and C and Mg, Al, and Si obtaining accurate results. Near degeneracy and the effect of other configurations are systematically analyzed for these systems, at both variational and diffusion Monte Carlo levels.

[Eating habits in children under 2 years old according to ethnic origin in a Barcelona urban area]. / Hábitos alimentarios de niños menores de 2 años según el origen étnico de los progenitores en un área urbana de Barcelona.

INTRODUCTION: The importance of the influence of diet in the first few years of life on child growth and development and its relationship with the prevention of chronic diseases in childhood and adulthood has recently been stressed. The aim of the present study was to determine the presence or absence of inappropriate feeding practices, defined as non-compliance with dietary recommendations, in children aged less than 2 years old through a survey. SUBJECTS AND METHODS: The parents of 462 children were administered a 14-item questionnaire on compliance with dietary recommendations to define nutritional risk. Depending on the parents' country of birth, children were classified as autochthonous, gypsy, or non-autochthonous. RESULTS: In absolute results, high percentages of non-compliance with a substantial number of recommendations were found in all children and in each of the three groups, with the consequent danger of nutritional risk. CONCLUSIONS: In children in our environment, there are numerous inadequate feeding practices that constitute nutritional risk factors and require preventive and educational interventions to improve the future health of these children when they reach adulthood. In children from ethnic groups, no particularly severe inadequate feeding practices related to origin were found. The gypsy ethnic group requires additional nutritional health education interventions. Health workers should improve the information provided on nutritional recommendations and feeding practices to avoid misunderstanding, as in the case of gluten.