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

Experimental Investigations of the Behavior of Stiffened Perforated Cold-Formed Steel Sections Subjected to Axial Compression

Cold-formed steel sections are becoming popular for different steel structures, because they have a high resistance against different straining actions, with a minimal weight compared with hard steel sections. Recently, perforated cold-formed steel (PCFS) sections have been used in many applications, such as perforated upright storage racks. Experimental research into the behavior of steel storage rack uprights subjected to axial compression is presented in this paper. First, tensile tests determined the material qualities of the cold-formed steel uprights. Then, seventeen perforated specimens were examined under axial compression, with five different cross-sections, three different web heights and thicknesses, and varying lengths. The study’s goals were to find out how perforations affect the performance and failure mode of steel storage rack uprights, to discuss the interaction of distortional and global buckling, and to verify the accuracy of using the direct strength method (DSM) for predicting the ultimate strength before failure in buckling interactions for perforated uprights. It was found that the failure modes of perforated specimens with stiffeners generally cannot be well predicted using the direct strength method. However, when the modifications proposed by Xianzhong Zhao et al. are used, the accuracy is acceptable

Evaluation of Axial Compression Slenderness Limits of High and Ultra-High-Strength Steel Circular Hollow Sections

Despite significant advances in metallurgy and the potential to create high and ultra-high-strength steel, all international specifications for steel design provide little information about the limits of slenderness for high-strength steel sections (HSSs) and don’t provide anything about the design of ultra-high-strength steel sections (UHSSs). The current international steel codes such as AISC 360-16 and EC3 can be applied only to steel grades up to S690 and S460, respectively, according to their limitations. These approaches for normal-strength steel are used for HSSs and UHSSs without extensive studies to determine their accuracy in these cases. Therefore, it is one of the main objectives of this study. The behavior of high and ultra-high-strength steel circular hollow sections under axial compression load is studied in this research. Sixteen nonlinear finite element (FE) models were generated to replicate stub column tests that were experimentally tested by others in previous research. Hence, a parametric study was conducted using forty FE models developed to investigate the local buckling behavior under various slenderness ratios comprehensively. The developed models covered slenderness ratios ranging from 20 to 1226 and steel grades S460 and S1100 with yield stress equal to 460 MPa and 1152 MPa, respectively. The FE results were combined with 105 previously collected experimental results to assess the applicability of existing codified design methodologies in the Euro code and the North American codes of cold-formed circular hollow sections (CHSs). Based on the results of this study, new cross-section slenderness limits and new design equations for more efficient simple designs were presented for circular hollow sections of HSSs and UHSSs and compared with the results of experimental tests and FE models

Evaluation of Axial Compression Slenderness Limits of High and Ultra-High-Strength Steel Circular Hollow Sections

Despite significant advances in metallurgy and the potential to create high and ultra-high-strength steel, all international specifications for steel design provide little information about the limits of slenderness for high-strength steel sections (HSSs) and don’t provide anything about the design of ultra-high-strength steel sections (UHSSs). The current international steel codes such as AISC 360-16 and EC3 can be applied only to steel grades up to S690 and S460, respectively, according to their limitations. These approaches for normal-strength steel are used for HSSs and UHSSs without extensive studies to determine their accuracy in these cases. Therefore, it is one of the main objectives of this study. The behavior of high and ultra-high-strength steel circular hollow sections under axial compression load is studied in this research. Sixteen nonlinear finite element (FE) models were generated to replicate stub column tests that were experimentally tested by others in previous research. Hence, a parametric study was conducted using forty FE models developed to investigate the local buckling behavior under various slenderness ratios comprehensively. The developed models covered slenderness ratios ranging from 20 to 1226 and steel grades S460 and S1100 with yield stress equal to 460 MPa and 1152 MPa, respectively. The FE results were combined with 105 previously collected experimental results to assess the applicability of existing codified design methodologies in the Euro code and the North American codes of cold-formed circular hollow sections (CHSs). Based on the results of this study, new cross-section slenderness limits and new design equations for more efficient simple designs were presented for circular hollow sections of HSSs and UHSSs and compared with the results of experimental tests and FE models

Parametric Study on the Behavior of Steel Tube Columns with Infilled Concrete—An Analytical Study

Concrete-filled steel tube (CFST) columns are used in tall buildings and bridges, and they provide more rigidity and higher bearing capacity, but buckling affects their behavior. There is an exceptional need to study the behavior of these columns under various conditions. The numerical method is beneficial in supplementing the experimental works and is used to explore the effects of various parameters because of the limitations in cost, apparatus, and time of the experimental program. The various parameters, such as the different slenderness ratios, i.e., column-height-to-cross-section-dimension (H/D), different steel-tube-thickness-to-column-dimension (D/t), and different compressive strength of concrete to yield strength of steel tube ratio (fc/fy) under concentric axial loading are considered in this current study. Firstly, a finite element model used the “ANSYS” software program and was constructed to validate the results of the experimental works. The extensive numerical models were carried out to extensively widen the study in this field. The numerical work was conducted on sixty-four specimens. Moreover, the analytical calculations from the different international codes/standards were compared with the numerical results to test their reliability in predicting the ultimate carrying loads. The study provided results that show the improvement effect of CFST columns with the high compressive strength of infilled concrete, while no remarkable enhancement effect with the high yield strength of steel tube was observed. Increasing the columns’ diameter is more effective in enhancing the load capacity (about three times more) than increasing the tube thickness (about 1.3 times). Ring stiffeners for long CFST columns (H/D > 12) do not lead to any enhancement of the column behavior due to yielding occurring firstly at the location of the rings. ECP205-2007 is the most conservative design code in predicting the load capacity of CFST columns, while the AIJ design code is good at predicting the ultimate load failure compared to the other codes/standards. Eurocode 4 provides underestimation values of the load-carrying capacity of CFST columns