Search

Racial/ethnic discrimination is one form of mistreatment and a known risk factor for physician burnout. In the present study, we aimed to characterize the forms and identify the sources of racial/ethnic discrimination among vascular surgery trainees. We performed a cross-sectional study of U.S. vascular surgery trainees who had voluntarily participated in an anonymous survey administered after the 2021 Vascular Surgery In-Training Examination. The primary outcome measures were self-reported mistreatment and sources of mistreatment between race and ethnicity groups. We used χ2 tests and logistic regression for bivariate and multivariable analyses, respectively. Representing all 123 vascular surgery training programs, 510 trainees (66.9% men) participated in the survey (83.6% response rate). Most of the trainees had self-identified as White (53.1%), followed by Asian (24.4%), Hispanic/Latinx (7.6%), Black (4.2%), and other/prefer not to say (10.8%). No significant differences were found in the self-reported duty hour violations among the groups. Black (56.3%) and Asian (36.3%) trainees reported higher rates of racial/ethnic discrimination compared with the White, Hispanic/Latinx, and other/prefer not to say groups (P <.001). Patients and their families were reported as the most common source (74.7%). Other reported sources of discrimination included nurses or staff (60%), attendings (37.4%), co-residents (31.3%), and administration (16.9%). Regarding specific forms of racial discrimination, Black and Asian trainees reported the highest rates of different standards of evaluation (20% and 5.9%, respectively), being mistaken for a nonphysician (50.0% and 5.9%, respectively), slurs and/or hurtful comments (13.3% and 5.9%, respectively), social isolation (13.0% and 1.0%, respectively), and being mistaken for another trainee of the same race/ethnicity (60.0% and 33.7%, respectively). Only 62.5% of Black trainees reported their program/institution would take their mistreatment report seriously compared with the White (88.9%), Hispanic/Latinx (88.2%), Asian (83.2%), and other/prefer not to say (71.4%) trainees (P =.01). On multivariable analysis, female gender (odds ratio [OR], 2.5; 95% confidence interval [CI], 1.44-4.33), Asian race (OR, 6.9; 95% CI, 3.53-13.3), Black race (OR, 13.6; 95% CI, 4.25-43.4), and training in the Southeastern United States (OR, 3.8; 95% CI, 1.17-12.80) were risk factors for racial/ethnic discrimination. The results from the survey revealed that racial/ethnic discrimination persists in surgical training programs, with Asian and Black trainees reporting higher rates than other racial and ethnic groups. Overall, patients and family members were the most common source of racial/ethnic discrimination. However, faculty, staff, and co-trainees also contributed to racial/ethnic discrimination. Further interventions that optimize diversity, equity, and inclusion strategies and policies to address all forms of racial/ethnic discrimination with faculty, staff, and patients within the hospital are critically needed. [ABSTRACT FROM AUTHOR]

Burnout and suicidality are known risks for vascular surgeons above other surgical subspecialties, with surgical trainees at risk for exposure to factors that increase burnout. This study aimed to inform initiatives to improve wellness by assessing the prevalence of hazards in vascular training (mistreatment, duty-hour violations) and the rates of wellness outcomes (burnout, thoughts of attrition/specialty change/suicide). We hypothesized that mistreatment and duty-hour violations would predispose trainees to increased burnout. We performed a cross-sectional study of residents and fellows enrolled in accredited United States vascular surgery training programs using a voluntary, confidential survey administered during the 2020 Vascular Surgery In-Training Examination. The primary outcome assessed was burnout symptoms reported on a weekly basis or more frequently. The rates of wellness outcomes were measured. The association of mistreatment and duty hours with the primary outcome was modeled with multivariable logistic regression. A total of 475 residents and fellows who were enrolled in one of 120 vascular surgery training programs completed the survey (84.2% response rate). Of 408 trainees completing burnout survey items, 182 (44.6%) reported symptoms of burnout. Fewer trainees reported thoughts of attrition (n = 42 [10.0%], specialty change (n = 35 [8.4%]), or suicide (n = 22 [4.9%]). Mistreatment was reported by 191 vascular trainees (47.3%) and was more common in female trainees (n = 63 [48.5%] reporting monthly or more frequently) compared with male trainees (n = 51 [18.6%]; P <.001). Duty-hour violations were also more commonly reported by female trainees (n = 31 [21.4%] reporting 3+ months in violation) compared with male trainees (n = 50 [16.2%]; P =.002). After controlling for race/ethnicity, postgraduate year, program type, and geography, female trainees were less likely to report burnout (odds ratio [OR], 0.49; 95% confidence interval [CI], 0.28-0.86). Trainees experiencing mistreatment monthly or more were three times more likely to report burnout (OR, 3.09; 95% CI, 1.78-5.39). Frequency of duty-hour violations also increased the odds of reporting burnout (1-2 months in violation: OR, 2.09; 95% CI, 1.17-3.73; 3+ months in violation: OR, 3.95; 95% CI, 2.24-6.97). Nearly one-half of vascular surgery trainees reported symptoms of burnout, which was associated with frequency of mistreatment and duty-hour violations. Interventions to improve well-being in vascular surgery must be tailored to the local training environment to address trainee experiences that contribute to burnout. [ABSTRACT FROM AUTHOR]

Microplastics are ubiquitous in the marine environment but characterizing them in marine organisms is challenging. Herein we describe a method to detect, identify, and quantify microplastics in marine mussels (Mytilus edulis) using thermal gravimetric analysis – Fourier Transform infrared spectroscopy – gas chromatography mass spectrometry (TGA-FTIR-GC/MS) after extracting and isolating the microplastics using chemical digestion, density separation, and filtration. Combining the three instrumental techniques adds discriminatory power as temperature profiles, chromatograms, and vibrational and mass spectra differ among common plastics. First, we tested several digestion schemes after spiking the mussels with plastics commonly found in the marine environment, including polyethylene (PE), polystyrene (PS), polypropylene (PP) and polyvinyl chloride (PVC). KOH (10%, w/v) was the most suitable reagent, providing good recoveries (>97%) without degrading the microplastics. We show that the technique TGA-FTIR-GC/MS can be optimized to readily determine both the type (polymer) and amount (mass) of microplastics in the sample. Applied to 100 mussels from each of six locations along the coast of China, we found an average of 0.58 mg of plastic per kg of tissue (range 0.16–1.71 mg/kg), with PE being the most abundant type of plastic measured. Among the coastal cities, mussels from Dalian had the highest microplastic content. Overall, we demonstrate that the method is a powerful technique to quantify masses of microplastics in marine mussels, a species commonly used as a bioindicator of pollution, and may be applied to other biota as well. Image 1 • Effective method to identify and quantify microplastics in mussels. • KOH (10%, w/v) frees microplastics from the tissues without damaging them. • Recoveries for mussels spiked with microplastics were >97%. • Method applied to mussels from 6 cities along the coast of China. • Each sample had microplastics with PE the most abundant type. [ABSTRACT FROM AUTHOR]

Microplastic pollution is a major global environmental problem in both aquatic and terrestrial environments. Pesticides are frequently applied to agricultural soil to reduce the effects of pests on crops, but may also affect the degradation of plastics. In this study, we generated microplastics from polyethylene (PE) film and biodegradable poly(butylene adipate-co-terephthalate) (PBAT) film and determined (1) the effect of prothioconazole on degradation of the microplastics, and (2) the adsorption and release characteristics of heavy metals (Cr, Cu, As, Pb, Ba, and Sn) by the microplastics during degradation process. Changes of surface functional groups and morphologies were measured by FTIR and SEM, while metal concentrations were determined by ICPMS. Prothioconazole was found to promote plastic degradation. PBAT degraded faster and adsorbed more heavy metals from the soil than PE. Whether the microplastics adsorb or release heavy metals depended on the metal and their concentrations. Prothioconazole inhibited the adsorption of Cr, As, Pb and Ba by microplastics, promoted the adsorption of Cu, and had no significant effect for Sn. These results can help to assess the ecological risk of microplastic pollution from plastic mulch when combined with heavy metals. Image 1 • The effects of prothioconazole on the degradation of PE and PBAT were examined. • Prothioconazole promoted the degradation of the microplastics. • Biodegradable PBAT had more obvious degradation changes than polyethylene. • Prothioconazole affects the adsorption of heavy metals to microplastics in soils. • Biodegradable PBAT absorbed more heavy metals in the degradation process. Prothioconazole promoted the degradation of microplastics and affected the adsorption/release characteristics of heavy metals to microplastics in soil. [ABSTRACT FROM AUTHOR]