Dilemma of physician-mothers faced with an increased home burden and clinical duties in the hospital during the COVID-19 pandemic.

PURPOSE: Since December 2019, coronavirus disease 2019 (COVID-19) has spread rapidly across the world. During the pandemic, physicians in our hospital have had to respond both to the issue of treating the patients and the increasing domestic burden associated with social disruption. The purpose of this study was to assess how much the burden on our doctors, especially female doctors, was increasing. MATERIAL AND METHODS: The Physicians' Career Support Committee in Sapporo Medical University conducted a questionnaire survey. The questionnaire inquired about a wide range of subjects with regard to working style and family life during the first and second waves of the COVID-19 pandemic, and was sent to all medical/dental physicians working in Sapporo Medical University. RESULTS: A total of 266 (42.7%) physicians in our hospital responded to our questionnaire and the data for 264 data were analyzed. The total numbers of males, females, and others, including those who did not want to specify, were 178 (67.4%), 82 (31.0%), and 4 (1.5%), respectively. Among them, 62 (23.5%) and 23 (8.7%) answered that their domestic burden was slightly or markedly increased. The increase in the domestic burden showed a significant difference between genders (p = 0.04). Even after correction for background differences using multivariate analysis, being female (p<0.001), having child dependents (p<0.001), and treating COVID-19 patients (p = 0.03) were significantly related to an increased domestic burden. Regarding family style, 58.1% of the physician-fathers were from two-income families (i.e., families with both parents in employment), and they answered that their partner mainly cared for the children. In contrast, 97.3% of physician-mothers were from two-income families, and 94.6% of the physician-mothers had to take care of children by themselves. CONCLUSION: Physician-mothers are caught in a dilemma between an increased home burden and clinical duties in the hospital, with a significantly higher ratio than physician-fathers during the pandemic. As we showed, female doctors could have not continued their careers and take responsible positions in the same way as male doctors. This is a social risk in the timing of a crisis, such as a pandemic.

Reduction of ozone dosage by using ozone in ultrafine bubbles to reduce sludge volume.

Sludge ozonation, which promotes sludge disintegration and solubilization, is a promising technology for reducing waste sludge volume from biological wastewater treatment process. However, if this technology is to be widely adopted, reducing the energy consumption associated with ozone generation will be necessary. We used ultra-fine bubbles (UFBs) as ozone carriers to determine if their use could improve the efficiency of ozone treatment and reduce the ozone dose required. We used a spiral, liquid-type UFB generator, which can introduce UFBs directly into a sludge suspension. The death ratio of bacteria in sludge was used as an indicator of sludge reduction. The ozone requirement was reduced by UFBs. The ozone consumption required to achieve a death ratio of 80% was 15 mg-O3/g-MLSS in the sludge treated with ozone supplied by UFBs versus 25 and 45 mg-O3/g-MLSS in sludges treated with ozone supplied as a spiral, liquid-type microbubbles and by a diffuser, respectively. When mixing water ozonated with UFBs with sludge, the depth of the dead cell layer from the surface to the interior of the sludge floc was larger than that of ozonated water lacking UFBs at the same rate of ozone consumption. Ozone in UFBs kills bacteria inside the flocs. However, the fragmentation of sludge flocs by shear forces in the UFB generator made a larger contribution to the acceleration of bacterial death in sludge treated with ozone supplied by UFBs.

A quantitative analysis method to determine the amount of cellulose fibre in waste sludge.

A novel quantitative analysis method for cellulose fibre was developed to understand its behaviour in biological wastewater treatment and waste sludge processes. The method developed in this study was designed using Pseudomonas aeruginosa to remove it by dissolving all the organic components except cellulose from the sludge due to needing the solubilisation of bacteria occupied almost of sludge matrix and quantifying the amount of remaining cellulose. The results of this study indicated that a combined treatment process that employed 2,000 U/L protease, 2 M hydrogen peroxide, and 2 mM potassium hydroxide after pre-treatment for floc dispersion with an ultrasonic treatment at 26 W for 1 min resulted in a solubilisation of 96% of P. aeruginosa without losing the cellulose fibre. When it was applied to the cellulose fibre added in the sludge from a municipal wastewater treatment facility, 99.5% of the cellulose fibre was recovered by using the high-speed centrifuge.

The effectiveness of hybrid treatment for sever multiple trauma: a case of multiple trauma for damage control laparotomy and thoracic endovascular repair.

BACKGROUND: Time is a crucial factor for the successful early management of the multi-trauma patient. Hybrid operating theaters, which support the integration of surgical treatment and interventional radiology, provide opportunities to reduce the time-to-surgery for life threatening conditions. CASE PRESENTATION: We describe the early successful treatment of a 54-year-old male who sustained multiple injuries when he was hit by a 1000 kg bale of wheat that fell from a height. He was admitted with hemorrhagic shock due to intra-abdominal bleeding, an unstable fracture of the pelvis, and blunt aortic injury, which was considered to be at high risk of rupture. External fixation was applied to the pelvis in the resuscitation bay, and the patient was transferred to a hybrid operating theater for treatment of both the intra-abdominal hemorrhage and blunt aortic injury. Damage control laparotomy and thoracic endovascular aortic repair were performed uneventfully. CONCLUSIONS: Hybrid treatment, which combines emergency surgery and intraoperative interventional radiology, provides a prompt and appropriate management approach for the treatment of patients with severe multiple trauma and may improve patient outcomes.