Measured FEV1 in the first postoperative day, and not ppoFEV1, is the best predictor of cardio-respiratory morbidity after lung resection☆

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Women in thoracic surgery: European perspectives

During the last decades, women have been discouraged from entering the medical career and in particular in the surgical specialties. This situation is changing across continents and national and international initiatives are supporting aspiring female surgeons in pursuing the surgical career through mentorship and fellowship programmes. Due to the differences in training programmes, Health Care systems and cultural backgrounds, it's not easy to describe unanimously the pathways and obstacles that junior female thoracic surgeons are experiencing in Europe. The development of female surgical associations, mentorship programmes and national initiatives will further champion the gender equality in this specialty across Europe. During the recent years, the European Society of Thoracic Surgeons (ESTS) has established initiatives like the first ESTS Women in Thoracic Surgery Scientific Session or the annual Women in Thoracic ESTS Reception during the Annual Conference, which are done in an effort to encourage all female colleagues to join this specialty and increase the opportunity to share their experience and meet potential mentors. In this article we will depict the situation in some of the European countries whose female thoracic surgeons have led their way. We aim to give the next generation the examples that can influence women's choice of surgical career, and the possible strategies and initiatives to reduce the gender discrimination within healthcare

How will lung cancer screening and lung nodule management change the diagnostic and surgical lung cancer landscape?

INTRODUCTION: Implementation of lung cancer screening, with its subsequent findings, is anticipated to change the current diagnostic and surgical lung cancer landscape. This review aimed to identify and present the most updated expert opinion and discuss relevant evidence regarding the impact of lung cancer screening and lung nodule management on the diagnostic and surgical landscape of lung cancer, as well as summarise points for clinical practice. METHODS: This article is based on relevant lectures and talks delivered during the European Society of Thoracic Surgeons-European Respiratory Society Collaborative Course on Thoracic Oncology (February 2023). Original lectures and talks and their relevant references were included. An additional literature search was conducted and peer-reviewed studies in English (December 2022 to June 2023) from the PubMed/Medline databases were evaluated with regards to immediate affinity of the published papers to the original talks presented at the course. An updated literature search was conducted (June 2023 to December 2023) to ensure that updated literature is included within this article. RESULTS: Lung cancer screening suspicious findings are expected to increase the number of diagnostic investigations required therefore impacting on current capacity and resources. Healthcare systems already face a shortage of imaging and diagnostic slots and they are also challenged by the shortage of interventional radiologists. Thoracic surgery will be impacted by the wider lung cancer screening implementation with increased volume and earlier stages of lung cancer. Nonsuspicious findings reported at lung cancer screening will need attention and subsequent referrals where required to ensure participants are appropriately diagnosed and managed and that they are not lost within healthcare systems. CONCLUSIONS: Implementation of lung cancer screening requires appropriate mapping of existing resources and infrastructure to ensure a tailored restructuring strategy to ensure that healthcare systems can meet the new needs.</p

Varroa destructor economic injury levels and pathogens associated with colony losses in Western Canada

IntroductionThe honey bee parasitic mite, Varroa destructor, is considered the main factor associated with winter colony losses. To control this mite, beekeepers must implement Integrated Pest Management (IPM) strategies. An effective IPM strategy is based on timely monitoring of mite levels to treat the colonies when the mites reach an economic threshold and before they grow to damaging levels (economic injury level). Additionally, concerns have been raised about the possible interaction between V. destructor and other stressors; stressors acting additively or synergistically may lead to high colony mortality.MethodologyVarroa destructor levels were recorded in colonies from five regions of British Columbia, Canada: Lower Mainland, Kootenay, Okanagan, Cariboo, and Peace. Mite levels were analyzed for associations with colony strength and mortality, as well as with other pathogens that were identified using total RNA sequencing.ResultsThe Kootenay and Lower Mainland regions had the highest V. destructor levels in the fall (3.38±0.65 and 2.51±0.57, respectively) followed by the Okanagan (1.54±0.36), Cariboo (1.31±0.39), and Peace (0.66±0.25) regions. The Peace region had a significantly lower proportion of dead colonies than the other regions. Varroa destructor levels in the fall significantly predicted odds of colony mortality in the spring. Colonies with ≥ 1% mite infestation in the fall (August) had a significantly higher mortality rate (p=0.005) compared to colonies with &lt;1% mite levels. Therefore, treatment is recommended above that threshold. Also, deformed wing virus-B levels were 8.4 times higher than those of deformed wing virus-A variant in all the regions and were highest in the Kootenay region, which also had the highest rate of colony losses. Lastly, Malpighamoeba mellificae and Nosema (Vairimorpha) apis transcripts were identified along with other pathogens that deserve further investigation, including Apis mellifera filamentous virus, Apis rhabdovirus, Lake Sinai virus, Varroa tymo-like, and Apis mellifera solinvivirus 1.DiscussionThe dynamic nature of host-pathogen interactions requires frequent pathogen surveillance to determine the prevalence and levels of parasitic mites and associated infectious diseases, and their impact on honey bee health, not only in the regions of this study, but globally. Nevertheless, more studies are needed to determine the nature of the type of interaction between the identified pathogens and V. destructor. Also, more research is needed to evaluate their potential impact on colony survival, to provide accurate mite and disease control recommendations to beekeepers

Wind speed description and power density in northern Spain

Wind resources are increasingly being investigated as a clean alternative for generating energy. This paper analyses the daily wind speed recorded at 46 automatic weather stations located in Navarre, northern Spain, in 2005e2015. Key points are the surface density of stations and the range of time that ensure a faithful depiction of wind speed together with surface calculations from image analysis and correlation with height. Different statistics were used. Median wind speed at 10 m was low, about 3.3 m s 1 and its interquartile range was narrow, about 2.3 m s 1. Nearly half the surface shows a median wind speed above 3.0 m s 1. The method of moments was employed to calculate the parameters of the Weibull distribution. Around half of the surface presented a shape parameter above 2.25 and the scale parameter was above 4 m s 1 for nearly 41% of the region. Although wind resources are not suitable for wind turbine applications in most of the region, since the wind speed is low in low-lying areas, about 12% of the region is suitable for stand-alone applications and, moreover, a substantial part of the region, around 23%, presents satisfactory wind resources for the installation of wind turbines.Ministry of Economy and Competitiveness and ERDF funds (project numbers CGL2009-11979 and CGL2014-53948-P

A geometrical robust design using the Taguchi method: application to a fatigue analysis of a right angle bracket

The majority of components used in aeronautic, automotive or transport industries are subjected to fatigue loads. Those elements should be designed considering the fatigue life. In this paper the geometrical design of a right angle bracket has been simulated by FEM, considering the type of material, the applied load and the geometry of the pieces. The geometry of the right angle bracket has been optimized using the Taguchi’s robust optimization method. As far as the authors know, there are no publications dealing with the use of the Taguchi’s robust optimization method applied to the geometric design of industrial pieces having as output variable the Findley fatigue coefficient. This paper presents a method for determining the critical design parameters to extend the product life of components subject to fatigue loading. This pioneer idea is applicable to any other design or physical or mechanical application so it can be widely used as new methodology to fatigue robust design of mechanical parts and components.La gran parte de los componentes usados en la industria aeronáutica, automovilista o del transporte están sometidos a cargas de fatiga. Esos componentes deberían ser diseñados considerando la vida a fatiga. En este artículo el diseño de una escuadra ha sido simulad por MEF teniendo en cuenta el tipo de material, cargas aplicadas y la geometría. La geometría de la escuadra se ha optimizado usando el método de optimización robusta de Taguchi. Hasta donde los autores han comprobado no hay ninguna publicación que emplee el método de optimización robusta de Taguchi aplicándolo al diseño geométrico de elementos industriales tomando como variable de salida el coeficiente de fatiga de Findley. Este artículo presenta un método para determinar los parámetros críticos en el diseño que afectan a la vida a fatiga del componente. Esta idea es pionera y aplicable a otros diseños o aplicaciones mecánicas que pueden emplear esta metodología para el diseño robusto a la fatiga de partes y componentes mecánicos

The impact of gender bias in cardiothoracic surgery in Europe: a European Society of Thoracic Surgeons and European Association for Cardio-Thoracic Surgery survey

OBJECTIVES The European Society of Thoracic Surgeons and the European Association for Cardio-Thoracic Surgery designed a questionnaire to assess the impact of gender bias on a cardiothoracic surgery career. METHODS A 46-item survey investigating gender bias was designed using online survey software from December 2020 to January 2021. All European Society of Thoracic Surgeons and European Association for Cardio-Thoracic Surgery members and non-members included in the mailing lists were invited to complete an electronic survey. Descriptive statistics and a comparison between gender groups were performed. RESULTS Our overall response rate was 11.5% (1118/9764), of which 36.14% were women and 63.69% were men. Women were more likely to be younger than men (P < 0.0001). A total of 66% of the women reported having no children compared to only 19% of the men (P < 0.0001). Only 6% of women vs 22% of men were professors. More women (72%) also reported never having been a formal mentor themselves compared to men (38%, P < 0.0001). A total of 35% of female respondents considered leaving surgery because of episodes of discrimination compared to 13% of men; 67% of women said that they experienced being unfairly treated due to gender discrimination. Of the male surgeons, 31% reported that they were very satisfied with their career compared to only 17% of women (P < 0.0001). CONCLUSIONS Women in cardiothoracic surgery reported significantly high rates of experiences with bias that may prevent qualified women from advancing to positions of leadership. Efforts to mitigate bias and support the professional development of women are at the centre of newly formed European committees

Cardiotrophin-1 opposes renal fibrosis in mice: Potential prevention of chronic kidney disease

[EN]Chronic kidney disease is characterized by tubulointerstitial fibrosis involving inflammation, tubular apoptosis, fibroblast proliferation and extracellular matrix accumulation. Cardiotrophin-1, a member of the interleukin-6 family of cytokines, protects several organs from damage by promoting survival and anti-inflammatory effects. However, whether cardiotrophin-1 participates in the response to chronic kidney injury leading to renal fibrosis is unknown. We hypothesized and assessed the potential role of cardiotrophin-1 in a mice model of tubulointerstitial fibrosis induced by unilateral ureteral obstruction (UUO). Three days after UUO, obstructed kidneys from cardiotrophin-1-/- mice show higher expression of inflammatory markers IL-1β, Cd68, ICAM-1, COX-2 and iNOs, higher activation of NF-κB, higher amount of myofibroblasts and higher severity of tubular damage and apoptosis, compared with obstructed kidneys from wild-type littermates. In a later stage, obstructed kidneys from cardiotrophin-1-/- mice show higher fibrosis than obstructed kidneys from wild-type mice. Interestingly, administration of exogenous cardiotrophin-1 prevents the increased fibrosis resulting from the genetic knockout of cardiotrophin-1 upon UUO, and supplementation of wild-type mice with exogenous cardiotrophin-1 further reduces the renal fibrosis induced by UUO. In vitro, renal myofibroblasts from cardiotrophin-1-/- mice have higher collagen I and fibronectin expression and higher NF-κB activation than wild-type cells. Cardiotrophin-1 participates in the endogenous response that opposes renal damage by counteracting the inflammatory, apoptotic and fibrotic processes. And exogenous cardiotrophin-1 is proposed as a candidate for the treatment and prevention of chronic renal fibrosis