Thoracic surgery - An underestimated dream job?

Background: Thoracic surgery is an expanding surgical specialty, but a shortage of qualified and motivated thoracic surgery residents is expected. It is estimated that around 23 % of all surgical specialist jobs will be vacant by 2030. We therefore need to assess the current clinical situation and urgently improve the recruitment and training of our next generation of surgeons.

[Deficit of trainees in thoracic surgery : Do we need to adapt or become extinct?].

Background: Although thoracic surgery is a challenging and versatile surgical specialty, a shortage of qualified and motivated thoracic surgery residents is expected in the coming years. In the inpatient setting, a shortage of approximately 7300 surgeons is expected. Therefore, there is an urgent need to attract more interested young medical students and improve the medical training of our next generation of surgeons.

Sex Differences in Short- and Long-Term Survival after Acute Type A Aortic Dissection.

: Acute type A aortic dissection (AAD) is a life-threatening disease. No differences between men and women have been made in the treatment of AAD so far and knowledge about sex differences regarding long-term outcomes is limited. : Between 01/2004 and 12/2021, 874 patients were operated on for AAD, including 313 (35.

Surgery for Infective Endocarditis after Primary Transcatheter Aortic-Valve Replacement-A Retrospective Single-Center Analysis.

Unlabelled: Transcatheter aortic-valve replacement (TAVR) is increasingly being used for the treatment of aortic-valve stenosis. Therefore, the total number of patients with an aortic-valve prosthesis is increasing, causing the incidence of prosthetic-valve endocarditis to increase.

Methods: Between March 2016 and July 2019, ten patients underwent surgery due to prosthetic-valve endocarditis after TAVR.

Interacting jammed granular systems.

More than 30 years ago Edwards and co-authors proposed a model to describe the statistics of granular packings by an ensemble of equiprobable jammed states. Experimental tests of this model remained scarce so far. We introduce a simple system to analyze statistical properties of jammed granular ensembles to test Edwards theory.

Direct true lumen cannulation in type A acute aortic dissection: A review of an 11 years' experience.

Objectives: Direct true lumen cannulation (DTLC) of the aorta is an alternative cardiopulmonary bypass cannulation technique in the context of type A acute aortic dissection (A-AAD). DTLC has been reported to be effective in restoring adequate perfusion to jeopardized organs. This study reports and compares operative outcomes with DTLC or alternative cannulation techniques in a large cohort of patients with A-AAD.

Short- and long-term outcomes for the surgical treatment of acute pulmonary embolism.

Objectives: Acute pulmonary embolism can be a life-threatening condition with a high mortality. The treatment choice is a matter of debate. The early and late outcomes of patients treated with surgical pulmonary embolectomy for acute pulmonary embolism in a single center were analyzed.

(Neuro)Psychological Interventions for Non-Motor Symptoms in the Treatment of Patients with Parkinson's Disease: a Systematic Umbrella Review.

Conducted in a multidisciplinary and multimodal setting, the main objectives of neuropsychological treatment are to improve cognition, alleviate affective disorders, and to promote activities and participation. This article reviews the evidence on therapeutic or educative interventions based on psychological principles for patients with Parkinson's disease. The electronic bibliographic databases MEDLINE, PsycINFO, PSYNDEX, and CINAHL were systematically searched for meta-analyses on psychological interventions for patients with Parkinson's disease, published from January 2000 to June 2018.

Lactococcus garvieae Endocarditis in a Prosthetic Aortic Valve: A Case Report and Literature Review.

Background: Lactococcus garvieae (LG) is a gram-positive coccus known to be a major pathogen in aqua farming, which is responsible for severe outbreaks. Its incidence in humans is extremely rare. Prior to 1985, all bacteria in the genus Lactococcus were included in the Streptococcus genus.

Survival and reinterventions after isolated proximal aortic repair in acute type A aortic dissection.

Objectives: Conventional treatment for acute type A dissection is the replacement of the ascending aorta. This study demonstrates the results of a conventional approach with isolated proximal repair combined with concomitant endovascular procedures.

Methods: Replacement of the ascending aorta with or without an open distal anastomosis was defined as isolated proximal repair and was performed in 562/588 patients between January 2004 and June 2017.

The anticoagulant effect of heparin during radiofrequency ablation (RFA) in patients taking apixaban or rivaroxaban.

Purpose: Measuring the anticoagulant effect of heparin during radiofrequency ablation (RFA) in patients taking apixaban and rivaroxaban is challenging, since the activated coagulation time (ACT) does not seem to reflect the true anticoagulant activity of these drugs. We therefore evaluated coagulation properties of apixaban and rivaroxaban during RFA by different coagulation assays to better monitor periprocedural hemostasis.

Methods: The study included 90 patients (61 ± 12 years) with atrial fibrillation who underwent RFA procedures.

Effect of the FXa inhibitors Rivaroxaban and Apixaban on platelet activation in patients with atrial fibrillation.

Rivaroxaban and Apixaban, increasingly used for stroke prevention in non-valvular atrial fibrillation (AF), might impact platelet reactivity directly or indirectly. By inhibition of Factor Xa (FXa) they preclude not only generation of relevant thrombin amounts but also block signalling of FXa via protease activated receptors. However, weather FXa-inhibition affects platelet haemostasis remains incompletely known.

Following the steps of a reaction by direct imaging of many individual molecules.

The dehydrogenation and dechlorination of FeOEP-Cl on Cu(111) has been studied in detail by scanning tunneling microscopy. Although, it is not possible to follow the reaction of an individual molecule, the complete pathway of the reaction with 22 inequivalent intermediate states and the rates of the involved processes are revealed. This is achieved by combining the analysis of a large data set showing thousands of molecules in the different stages of the reaction with numerical simulations.

Trapping of interacting propelled colloidal particles in inhomogeneous media.

A trapping mechanism for propelled colloidal particles based on an inhomogeneous drive is presented and studied by means of computer simulations. In experiments this method can be realized using photophoretic Janus particles driven by a light source, which is partially blocked by a shading mask. This leads to an accumulation of particles in the passive part.

Anisotropy of electromigration-induced void and island drift.

By means of our novel self-learning kinetic Monte Carlo model (Latz et al 2012 J. Phys.: Condens.

A three-dimensional self-learning kinetic Monte Carlo model: application to Ag(111).

The reliability of kinetic Monte Carlo (KMC) simulations depends on accurate transition rates. The self-learning KMC method (Trushin et al 2005 Phys. Rev.

Shear flow of dense granular materials near smooth walls. II. Block formation and suppression of slip by rolling friction.

The role of rotational degrees of freedom and of microscopic contact properties at smooth walls in two dimensional planar shear has been investigated by contact dynamics simulations of round hard frictional particles. Our default system setup consists of smooth frictional walls, giving rise to slip. We show that there exists a critical microscopic friction coefficient at the walls, above which they are able to shear the granular medium.

Strength and failure of cemented granular matter.

Cemented granular materials (CGMs) consist of densely packed solid particles and a pore-filling solid matrix sticking to the particles. We use a sub-particle lattice discretization method to investigate the particle-scale origins of strength and failure properties of CGMs. We show that jamming of the particles leads to highly inhomogeneous stress fields.

Antagonistic and agonistic GnRH analogue treatment of precocious puberty: tracking gonadotropin concentrations in urine.

Background: The pharmacodynamics of gonadotropin-releasing hormone (GnRH) agonists includes an initial 'flare-up' of the pituitary-gonadal axis, followed by reduced luteinizing hormone (LH) secretion. The question is if combining a short-acting antagonist with a long-acting agonist can diminish gonadotropin flare-up.

Methods: To achieve quick downregulation in patients with recently diagnosed central precocious puberty (CPP, 7 patients) or short stature with short predicted final height (3 patients), we combined the GnRH antagonist cetrorelix (3 subcutaneous injections every 72 h) at the beginning of GnRH agonist treatment (leuprorelin or triptorelin) in 6 patients and compared the effect to 4 patients treated solely with GnRH agonist.

Swelling behavior and structural characteristics of wheat gluten polypeptide films.

Wheat gluten films were subjected to controlled thermomechanical treatments to increase the percentage of aggregated sodium dodecyl sulfate (SDS)-insoluble gluten protein, the aggregation reaction being disulfide bonding. The rheological properties of the films were measured under immersion in water, where wheat gluten films are stable and show only slight swelling. The equilibrium swelling of the gluten films in water decreased with the increase of the percentage of SDS-insoluble protein aggregates, and the frequency the independent shear modulus increased sharply with increasing percentage of SDS-insoluble aggregates.

SHORT syndrome.

We describe a mother and her son with short stature, progeroid facies, Rieger anomaly, teething delay, and mild developmental retardation, particularly speech delay, which are characteristic features of the SHORT syndrome. An additional sign of all described patients is the slight build with lack of subcutaneous fat. Resistance to insulin was suggested by an oral glucose tolerance test in the mother, whereas the test was normal in the index patient at the age of 2 years 2 months.

Elastic behavior in contact dynamics of rigid particles.

The systematic errors due to the practical implementation of the contact dynamics method for simulation of dense granular media are examined. It is shown that, using the usual iterative solver to simulate a chain of rigid particles, effective elasticity and sound propagation with a finite velocity occur. The characteristics of these phenomena are investigated analytically and numerically in order to assess the limits of applicability of this simulation method and to compare it with soft particle molecular dynamics.