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

New cytotoxic spirostane saponin and biflavonoid glycoside from the leaves of <i>Acacia saligna</i> (Labill.) H.L. Wendl.

<div><p>New naturally occurring spirostane saponin (25<i>S</i>)-5β-spirostan-3β-yl-3-<i>O</i>-β-d-xylopyranosyl(1 → 3)-<i>O</i>-β-d-xylopyranosyl(1 → 4)-β-d-galactopyranoside (<b>6</b>) and biflavonoid glycoside myricetin-3-<i>O</i>-rhamnoside (C7-<i>O</i>-C7) myricetin-3-<i>O</i>-rhamnoside (<b>4</b>) along with a series of known compounds erythrodiol (<b>1</b>), 3β-<i>O</i>-<i>trans</i>-<i>p</i>-coumaroyl-erythrodiol (<b>2</b>), quercetin-3-<i>O</i>-α-l-rhamnoside (<b>3</b>) and myricetin-3-<i>O</i>-α-l-rhamnoside (<b>5</b>) were separated from the leaves of <i>Acacia saligna</i> (Labill.), H.L. Wendl. Compounds <b>1</b> and <b>2</b> were separated for the first time from genus <i>Acacia.</i> The structures of compounds <b>1</b>–<b>6</b> were established on the basis of extensive 1D and 2D NMR spectroscopic techniques in combination with EI-MS and HR-ESI-MS. These compounds were screened for their antioxidant and cytotoxic activities against HEPG2 (liver cancer) cell line and significant results were obtained.</p></div

New <i>ent</i>-kaurane diterpenoid dimer from <i>Pulicaria inuloides</i>

<p>A new naturally occurring <i>ent</i>-kaurane diterpenoid dimer, 15β, 15′β-oxybis (<i>ent</i>-kaur-16-en-19-oic acid) (<b>1</b>) along with six known compounds, 15β-hydroxy-<i>ent</i>-kaur-16-en-19-oic acid (<b>2</b>), 15β-hydroxy-<i>ent</i>-kaur-16-en-19-oate-β-d-glucopyranoside (<b>3</b>), 6-hydroxykaempferol-3, 7-dimethyl ether (<b>4</b>), quercetagetin 3, 7, 3′-trimethyl ether (<b>5</b>), β-sitosterol (<b>6</b>) and β-sitosterol glucoside (daucosterol) (<b>7</b>) were isolated from the aerial parts of <i>Pulicaria inuloides</i> DC. Compounds <b>2</b>–<b>5</b> were isolated for the first time from genus <i>Pulicaria.</i> The structures of compounds <b>1</b>–<b>7</b> were established on the basis of extensive 1D and 2D NMR spectroscopic techniques in combination with ESI-MS. The antimicrobial activity of the isolated compounds was evaluated against <i>Staphylococcus aureus</i>, <i>Escherichia coli</i> and <i>Candida albicans</i>. Sulphorhodamine B cytotoxic assay against HepG2 (liver cancer) cell line and ABTS antioxidant assay were carried out.</p