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

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Synthese de nouveaux monomeres a chaines laterales pyrazole et bipyrazole et leurs polymerisations

SIGLEAvailable from INIST (FR), Document Supply Service, under shelf-number : T 83833 / INIST-CNRS - Institut de l'Information Scientifique et TechniqueFRFranc

A theoretical investigation of a low-correction windtunnel wall configuration for airfoil testing

This thesis deals with anew approach to reduce wall corrections in high-lift airfoil testing, by employing symmetrically transversely slotted walls. The solid elements of the slotted wall are symmetrical airfoils at zero incidence, the spaces between the slats are nonuniform, increasing linearly towards the rear. This wall configuration provides flow conditions close to the free air test environment which leads to negligible or. small wall corrections. The theory uses the potential flow surface vortex-element method, with "Full Load" Kutta Conditions satisfied on the test airfoil and wall slats. This method is very well supported by physical evidence and it is simple to use. The surface velocities can be calculated directly and the aerodynamic lift and pitching moment are determined by numerical integration of the calculated pressure distributions around the airfoil contour. This method can be developed in order to include the flow in the plenum chambers in the analysis.Applied Science, Faculty ofMechanical Engineering, Department ofGraduat

An investigation of the theoretical and experimental aerodynamic characteristics of a low-correction wind tunnel wall configuration for airfoil testing

This thesis deals with a new approach to reduce wall corrections in high-lift airfoil testing, by employing two similar non-uniform transversely slotted walls. The solid elements of the slotted wall are symmetrical airfoils at zero incidence, and the spaces between the slats are non-uniform, increasing linearly towards the rear. This wall configuration provides the flow conditions close to the free air test environment which lead to negligible or small wall corrections. The theory uses the potential flow surface vortex-element method, with "Full Load" Kutta Conditions satisfied on the test airfoil and wall slats. This method is very well supported by physical evidence and it is simple to use. The surface velocities can be calculated directly and the aerodynamic lift and pitching moment are determined by numerical integration of the calculated pressure distributions around the airfoil contour. This method can be developed to include a simulation of the flow in the plenum chambers in the analysis. Also, the performance of this new wall configuration was examined experimentally. Two different sizes of NACA-0015 airfoil were tested in the existing low speed wind tunnel after modifying both the configuration of the side walls and the test section to accommodate the new test. Pressure distributions about the test airfoils were measured using pressure taps around their contours. Also the lifts and the pitching moments were obtained by integrating the measured surface pressures. The experimental, results show that the use of the new wall configuration with AOAR = 59% would produce wind tunnel test data very close to the free air values.Applied Science, Faculty ofMechanical Engineering, Department ofGraduat

Fluorinated polymers based on pyrazole groups for fuel cellmembranes

International audienceThe synthesis and characterization of two fluorinated copolymers bearing pyrazole group as precursor of proton-conducting membranes in polymer electrolyte fuel cells are described. 1-Benzyl-5-methyl-3-hydroxymethyl-pyrazole was first synthesized in a two step-reaction. It was then grafted onto poly(chlorotrifluoroethylene -alt-2-iodoethyl vinyl ether) copolymer (poly(CTFE-alt-IEVE)). The degree of grafting was controlled by the reaction time, and reached 30 and 55% after 24 and 48 hours, respectively. Deprotection of the benzyl group produced poly(CTFE-alt-IEVE)-dep-pyrazoley% copolymers. NMR spectroscopy enabled to monitor all reaction steps and ensured the purity of these functional fluorinated copolymers. The poly(CTFE-alt-IEVE)-dep-pyrazoley% copolymers were thermally stable (up to 200 °C under air) and showed a maximum proton conductivity of 4×10-5 mS.cm-1 at 180 °C under anhydrous conditions. From cyclic voltammetry (CV), these copolymers displayed an electrochemical stability domain extended over 2.0 V

Synthesis and characterization of new fluorinated copolymers based on azole groups for fuel cell membranes

International audienceTwo new fluorinated copolymers synthesized by grafting ω-hydroxyl pyrazolic (Trip) and triazolic (Trit) tripods onto poly(chlorotrifluoroethylene-alt-2-iodoethyl vinyl ether) copolymer (poly(CTFE-alt-IEVE) are reported.These copolymers were prepared in two steps: the ω-hydroxy nitrogenous heterocycles reacted with iodine atomsof poly(CTFE-alt-IEVE) copolymer followed by the deprotection of the benzyl group. The chemical structuresof tripod monomers and resulting copolymers were characterized by nuclear magnetic resonance and infraredspectroscopies, elemental analysis, and mass spectrometry. The first analysis allowed one to determine the degreeof grafting that reached 80 and 19% for copolymers bearing pyrazole and triazole, respectively. Membraneswere processed in pellet form by compressing these copolymers. Thermal properties of the membranes,examined by thermogravimetric analysis and differential scanning calorimetry, showed that such copolymerswere thermally stable up to 200°C under air, and exhibited glass transition temperatures ranging between 31and 47°C. The temperature dependence of conductivity led to a simple Arrhenius behavior for both copolymers.Poly(CTFE-alt-IEVE)-dep-Trit⁠19% and poly(CTFE-alt-IEVE)-dep-Trip⁠80% copolymers had a maximum protonconductivity of 1.3 10⁠−3 and 5.91 10⁠−5mS/cm respectively at 180°C under quasi-anhydrous conditions. CyclicVoltammetry (CV) study illustrated that the electrochemical stability

Synthesis and thermal properties of new copolyesters based on polycaprolactone

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