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

<span style="font-size:19.5pt;mso-bidi-font-size:14.5pt; line-height:115%;font-family:"Times New Roman","serif";mso-fareast-font-family: "Times New Roman";mso-ansi-language:EN-US;mso-fareast-language:EN-US; mso-bidi-language:AR-SA">Amelioration of NaCl stress in <i>Pisum sativum </i>Linn.</span>

469-475<span style="font-size: 13.5pt;mso-bidi-font-size:8.5pt;font-family:" times="" new="" roman","serif""="">Activity of endogenous auxins and growth inhibitors, gibberellins and cytokinins was observed in the extracts of seedlings of Pisum sativum under NaCI stress. After 6 days of germination, when Pisum sativum seedlings were subjected to low concentration of NaCl (50 <span style="font-size:13.0pt; mso-bidi-font-size:8.0pt;font-family:" arial","sans-serif""="">mM) <span style="font-size:13.5pt; mso-bidi-font-size:8.5pt;font-family:" times="" new="" roman","serif""="">or boron (10 ppm) increased the endogenous growth regulating substances. Higher concentration of NaCl ( 150 mM) decreased endogenous level of growth regulators, length of the root and shoot, and fresh and dry weights of seedlings, whereas boron increased the parameters except endogenous growth regulators. Mitotic index and some abnormalities were observed in the treated plants. SDS-PAGE banding pattern of Pisum sativum seedlings extracted in tris-glycine and tris-HCl showed that lower concentration of NaCl increased the number of protein  bands, while the higher concentration decreased these protein bands. Combination of boron and NaCl (150 <span style="font-size:13.0pt;mso-bidi-font-size: 8.0pt;font-family:" arial","sans-serif""="">mM) caused an increase in total number of protein bands compared with the total number of bands recorded by using NaCl ( 150 <span style="font-size:13.0pt; mso-bidi-font-size:8.0pt;font-family:" arial","sans-serif""="">mM) <span style="font-size:13.5pt; mso-bidi-font-size:8.5pt;font-family:" times="" new="" roman","serif""="">alone. </span