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

Some Metabolic Parameters During Transition Period in Dairy Cows with and Without Retained Fetal Membranes

This study evaluated the levels of some serum metabolites for dairy cows (Holstein Friesian) in relation to expulsion of fetal membranes. Blood concentrations of glucose, triglycerides, total cholesterol and non-esterified fatty acid (NEFA) were determined (from 7 days before, day of parturition and 2 days after calving) in cows that expelled fetal membranes normally (n = 9 cows) and in cows that developed retention of fetal membranes (RFMs), n = 17). The cows that developed RFMs had lower concentrations of cholesterol at and after parturition, while the concentrations of NEFA and triglycerides were higher than those in cows that normally expelled the fetal membranes. Results revealed that the concentration of NEFA before calving was highly related to the RFMs. It may be inferred that monitoring the levels of NEFA during prepartum period would help in identifying the cows at the risk of developing RFMs