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

Diagenesis and incipient metamorphism of the carboniferous rocks in South Wales coalfield

Imperial Users onl

Characterization of chert in the Dammam Formation (Eocene), Kuwait: Clues to groundwater silicification processes

International audienceConspicuous chert horizons occur as discontinuous bands and isolated nodules in dolostones in theEocene Dammam Formation, which is exposed in the southeast of Kuwait. The Formation has never been deeplyburied, and so chert formation is likely to have resulted from silicification processes at or near the land surface.Erosional reworking of the chert constrains its formation to a time period between the late Eocene and the Mio-Pliocene. As there is no significant source of silica in the dolostones, the chert was formed from silica imported fromother sources. This process, together with the specificity of chert to particular non-bedding horizons, suggests thatsilicification is related to discrete locations of the groundwater table during landscape incision and resultantgroundwater discharge in the region. Detailed petrographical studies demonstrate that‘‘chertification’’was initiatedby precipitation of nanoglobules of silica (opal-A) from supersaturated groundwater solutions flowing through voidsformed concomitantly by dissolution of dolomite. Subsequently, silica was precipitated as more crystalline forms ofchalcedony, microquartz, and megaquartz from successively less saturated groundwater. The most likely mechanismfor triggering the precipitation of silica is considered to be significant cooling of the groundwater as it neared thelandsurface and came into contact with a cold regolith terrain. Precipitation of disordered forms of silica (opal-A)occurred at the cold front: progressively more crystalline phases formed as the host rock was warmed by the inflowinggroundwater and its degree of supersaturation diminished. If our interpretation is correct, this‘‘chertification’’process could have been initiated during global cooling related to one of the glaciations recorded during Oligocene andMiocene times