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

Numerical optimization of process parameters and quality stability of active edible coated jaggery cubes during storage

The present investigation was focused on the optimization of process parameters for edible coating and the evaluation of quality characteristics of coated jaggery cubes stored for a period of 150 days. Quality parameters were evaluated at intervals of 0, 45, 90, 120, 135, and 150 days under ambient storage conditions. A total of 17 experiments as per BBD were carried out with three independent variables, including the HDPE bag thickness (100, 150, and 200 μm), the moisture absorber (1.5, 2.5, and 3.5 g/L), and the concentration ratio of CMC and HPMC (0.8, 1.2, and 1.6 g/100 mL). The responses, i.e., moisture content, pH, hardness, overall acceptability, and yeast/mould count for coated jaggery cubes, were evaluated. The optimization was performed using design expert software (ver. 13), and optimised values for process parameters were observed as 100 μm (HDPE bag thickness), 1.5 g/L (moisture absorber), and 0.8 g/100 mL (concentration of CMC and HPMC). From the storage study results, it was observed that after 150 days of storage, the yeast/mould count (98 cfu/g) in the control sample was highest compared to the control sample (15 cfu/g). The highest overall acceptability score was observed in the case of packed coated jaggery cubes (8.5), while the least (5.5) was observed for control after 150 days of storage. It was concluded that edible coatings consisting of moisture absorbers (dimethyl fumarate and silica gel) and concentration ratios of CMC and HPMC, along with HDPE bags, could maintain the quality characteristics of jaggery cubes and enhance the shelf life up to 150 days