A survey among physicians in surgery and anesthesiology departments after the first surge of SARS-CoV-2 infections in Germany : Preparing for further challenges ahead.

BACKGROUND: The SARS-CoV­2 pandemic has extensively challenged healthcare systems all over the world. Many elective operations were postponed or cancelled, changing priorities and workflows in surgery departments. AIMS: The primary aim of this cross-sectional study was to assess the workload and psychosocial burden of surgeons and anesthesiologists, working in German hospitals during the first wave of SARS-CoV­2 infections in 2020. METHODS: Quantitative online survey on the workplace situation including psychosocial and work-related stress factors among resident and board-certified surgeons and anesthesiologists. Physicians in German hospitals across all levels of healthcare were contacted via departments, professional associations and social media posts. RESULTS: Among 154 total study participants, 54% of respondents stated a lack of personal protective equipment in their own wards and 56% reported increased staff shortages since the onset of the pandemic. While routine practice was reported as fully resumed in 71% of surgery departments at the time of the survey, work-related dissatisfaction among responding surgeons and anesthesiologists increased from 24% before the pandemic to 36% after the first wave of infections. As a countermeasure, 94% of participants deemed the establishment of action plans to increase pandemic preparedness and strengthening German public health systems a useful measure to respond to current challenges. CONCLUSION: The aftermath of the first wave of SARS-CoV­2 infections in Germany has left the surgical staff strained, despite temporarily decreased workloads. Overall, a critical review of the altered conditions is indispensable to identify and promote effective solutions and prudent action plans required to address imminent challenges.

Reasons for Reduced Moisture Resistance of Sulfur-Extended Asphalt Concrete.

The paper presents the results of a study of the mechanism for reducing the moisture resistance of sulfur-extended asphalt concrete. It is shown that a decrease in moisture resistance occurs due to the occurrence of chemical and physical processes. At the same time, it was found that during the manufacture of sulfur-bitumen composites, toxic gases H2S and SO2 are formed, which are capable of interacting with a mineral filler, as well as the interaction of sulfur with a mineral powder with the formation of sulfur-containing water-soluble salts, the extraction of which leads to a decrease in the moisture resistance of sulfur-bitumen materials. The change in the rate of leaching of these substances from the composite is due to the physical process caused by the crystallization of sulfur and the formation of a capillary structure, which significantly increases the rate of leaching of calcium and magnesium salts, which are products of dissolution or hydrolytic decomposition of water-soluble products of the interaction of sulfur, H2S and SO2 gases with calcium and magnesium carbonates. The intensity of chemical and physical processes intensifies with an increase in the amount of sulfur in sulfur-bitumen materials.

[SARS-CoV-2 Infections and Clinical Consequences in a Cohort of Solid Organ Transplant Recipients during the first Wave in Germany - a Single Centre Survey and a Case Report]. / SARS-CoV-2-Infektionen und klinische Konsequenzen bei organtransplantierten Patienten im Rahmen der ersten Ansteckungswelle in Deutschland - eine monozentrische Umfrage und ein Fallbericht.

BACKGROUND: The SARS-CoV-2 pandemic has caused an unprecedented global health crisis, with exceptionally high mortality rates in high-risk groups of affected patients. It is alarming that a steadily increasing number of clinical reports on outcomes of COVID-19 in solid organ transplant (SOT) recipients suggests a detrimental impact linked to high overall mortality. However, systematic data on SARS-CoV-2 infections in SOT recipients in Germany are still scarce. MATERIAL AND METHODS: We conducted a survey on SARS-CoV-2 infection status among 387 SOT recipients treated at our centre during the past 5 years - located in a severely affected region in Germany. The survey was sent out two months after the first SARS CoV-2 outbreak in our region had resulted in government-imposed lockdown measures. RESULTS: An incidence rate of 0.4% SARS-CoV-2-positive SOT recipients was determined in our cohort, in line with reported local infection rates in the general population at this time. However, the only SARS CoV-2 infection known to us within this group of patients led to severe morbidity - resulting in prolonged mechanical ventilation, hospitalisation > 60 days and finally in irreversible loss of graft function. CONCLUSION: Our data demonstrate that SOT recipients are at equal risk for SARS-CoV-2 infections when compared to the general population, while SARS-CoV-2 infections in SOT recipients seem to be associated with deleterious clinical consequences.

SARS-CoV-2 in Solid Organ Transplant Recipients: A Structured Review of 2020.

BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is challenging health systems all over the world. Particularly high-risk groups show considerable mortality rates after infection. In 2020, a huge number of case reports, case series, and consecutively various systematic reviews have been published reporting on morbidity and mortality risk connected with SARS-CoV-2 in solid organ transplant (SOT) recipients. However, this vast array of publications resulted in an increasing complexity of the field, overwhelming even for the expert reader. METHODS: We performed a structured literature review comprising electronic databases, transplant journals, and literature from previous systematic reviews covering the entire year 2020. From 164 included articles, we identified 3451 cases of SARS-CoV-2-infected SOT recipients. RESULTS: Infections resulted in a hospitalization rate of 84% and 24% intensive care unit admissions in the included patients. Whereas 53.6% of patients were reported to have recovered, cross-sectional overall mortality reported after coronavirus disease 2019 (COVID-19) was at 21.1%. Synoptic data concerning immunosuppressive medication attested to the reduction or withdrawal of antimetabolites (81.9%) and calcineurin inhibitors (48.9%) as a frequent adjustment. In contrast, steroids were reported to be increased in 46.8% of SOT recipients. CONCLUSIONS: COVID-19 in SOT recipients is associated with high morbidity and mortality worldwide. Conforming with current guidelines, modifications of immunosuppressive therapies mostly comprised a reduction or withdrawal of antimetabolites and calcineurin inhibitors, while frequently maintaining or even increasing steroids. Here, we provide an accessible overview to the topic and synoptic estimates of expectable outcomes regarding in-hospital mortality of SOT recipients with COVID-19.

Hydration of Cement in the Presence of Biocidal Modifiers Based on Metal Hydrosilicates.

This article presents the results of a study of the characteristics of hydration and properties of a composite biocidal cement binder containing hydrosilicates of barium, copper or zinc. It was found that copper hydrosilicates block hydration processes, and when zinc hydrosilicates are used, the rate of hydration is determined by the content of silicic acid. The limiting concentrations of biocidal modifiers have been established: zinc hydrosilicates-no more than 4% and copper hydrosilicates-no more than 0.5%, which are advisable to use for the manufacture of a biocidal composite binder. It is shown that modifying additives slow down the setting time, the amount of tricalcium silicate in cement stones increases, and their strength for some compositions decreases. Active binding of portlandite with the formation of calcium hydrosilicates occurs when the content of zinc hydrosilicates is 2%, which leads to an increase in the strength of the materials.

[Multimodular Cognitive Training for Nursing Staff Aged 50+: Initial Results of a Pilot Study on Feasibility and Efficacy]. / Multimodulares kognitives Training für Mitarbeiter in der Pflege 50+: Erste Ergebnisse einer Pilotstudie zur Durchführbarkeit und Wirksamkeit.

THE AIM OF THE STUDY: was the assessment of the feasibility of a cognitive training program for employees of care 50+. METHOD: A cognitive training program (13 h, 5 sessions) was conducted with 15 nurses of the University Hospital Munich (KUM). Acceptance of and effects on cognitive and psychological performance were determined. RESULTS: The measure was well accepted and received positive ratings. In addition, there were significant improvements in cognitive performance and self-efficacy. CONCLUSION: The training program can be implemented on a regular basis; initial results providing evidence in support of positive training effects must be confirmed in future randomized controlled trials.

Antigenotoxic effect of kefir and ayran supernatants on fecal water-induced DNA damage in human colon cells.

Fermented dairy products and their component bacteria have been shown to possess health-promoting functions in consumers and recently have been suggested to reduce the risk of colorectal cancer. Kefir and ayran are two popular fermented milk drinks that have their origins in the Caucasus region of Russia. The present study aimed to evaluate their potential anticancer properties in colon cells in vitro. The comet assay and transepithelial resistance assay were used to assess the effect of kefir and ayran supernatants on genotoxicity of fecal water samples and on intestinal tight junction integrity. Their antioxidant capacity was measured by trolox equivalent antioxidant capacity assay and compared with that of unfermented milk. The results showed that DNA damage induced by 2 of 4 fecal water samples was significantly decreased by kefir and ayran supernatants and with ayran the effect was dose-dependent. However no effect on intestinal tight junctions was observed. The supernatants of kefir and ayran contained high amounts of acetic and lactic acid but only a very small quantity of caproic and butyric acid, and they showed significantly greater antioxidant capacity than milk. These findings suggest kefir and ayran can reduce DNA damage, which might be due to their antioxidant capacities.