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

Preliminary survey of potential vectors of 'Candidatus Phytoplasma phoenicium' in Lebanon and probability of occurrence of apricot chlorotic leaf roll (ACLR) phytoplasma

Malaise traps and sticky yellow traps were placed in two almond orchards infected with almond witches' broom (AlmWB) phytoplasma in 2004 and in 2010. Collected insects were tested by nested PCR using universal primers for detection of phytoplasma. In 2004 Asymmetrasca decedens, Euscelidius sp. and Fieberiella sp. gave positive results with the universal primers and also with the pigeon pea group specific primers. The mere presence of phytoplasma in an insect is not a proof that it is a vector, but it may help narrowing the choice of insects for conducting actual transmission tests. In 2010, early in the season, in over 20 species surveyed we were not able to detect phytoplasma except in Psammotettix provincialis. The PCR amplicon was sequenced (1180 bp) and found to be most closely related to the Aster yellows (AY) group 16Srl, subgroup F which includes apricot chlorotic leaf roll (ACLR) phytoplasma. Late in the season, most PCR tests were negative, the major reason was correlated with DNA degradation which resulted from the hot summer temperatures combined with the method of insect collection. The implications of these findings are discussed