The Maritime Aerosol Network (MAN) has been collecting data over the oceans since November 2006. Over 80 cruises were completed through early 2010 with deployments continuing. Measurement areas ...included various parts of the Atlantic Ocean, the Northern and Southern Pacific Ocean, the South Indian Ocean, the Southern Ocean, the Arctic Ocean and inland seas. MAN deploys Microtops hand-held sunphotometers and utilizes a calibration procedure and data processing traceable to AERONET. Data collection included areas that previously had no aerosol optical depth (AOD) coverage at all, particularly vast areas of the Southern Ocean. The MAN data archive provides a valuable resource for aerosol studies in maritime environments. In the current paper we present results of AOD measurements over the oceans, and make a comparison with satellite AOD retrievals and model simulations.
In this study the shortwave cloud radiative effect (SWCRE) over ocean calculated by the ECHAM 5 climate model is evaluated for the cloud property input derived from ship based measurements and ...satellite based estimates and compared to ship based radiation measurements. The ship observations yield cloud fraction, liquid water path from a microwave radiometer, cloud bottom height as well as temperature and humidity profiles from radiosonde ascents. Level-2 products of the Satellite Application Facility on Climate Monitoring (CM~SAF) from the Spinning Enhanced Visible and InfraRed Imager (SEVIRI) have been used to characterize clouds. Within a closure study six different experiments have been defined to find the optimal set of measurements to calculate downward shortwave radiation (DSR) and the SWCRE from the model, and their results have been evaluated under seven different synoptic situations. Four of these experiments are defined to investigate the advantage of including the satellite-based cloud droplet effective radius as additional cloud property. The modeled SWCRE based on satellite retrieved cloud properties has a comparable accuracy to the modeled SWCRE based on ship data. For several cases, an improvement through introducing the satellite-based estimate of effective radius as additional information to the ship based data was found. Due to their different measuring characteristics, however, each dataset shows best results for different atmospheric conditions.
Surgical skills are traditionally taught and practiced in the operating room. However, changes in health care policy and outcome-based evaluation have decreased trainee operative autonomy. We ...examined cardiothoracic residents' perceptions of operative experience and the role of simulation.
The In-Training Examination (ITE) is taken each year by all residents. Completion of a 30-question preexamination survey is mandatory, ensuring a 100% response rate. Survey data related to operative experience, career preparedness, and surgical simulation were analyzed. Opinion questions were asked on a 5-point Likert scale. Respondents were grouped into three cohorts by training paradigm (2-year versus 3-year traditional programs and 6-year integrated programs).
In all, 314 respondents (122 2-year, 96 3-year, and 96 6-year integrated) completed the survey. Of the three groups, residents in 3-year programs had the highest levels of satisfaction. Advanced training was most common among residents in 6-year integrated programs (66%, versus 49% for 2-year and 26% for 3-year programs; p = 0.63). Desire to specialize drove further training (97%), with 2% stating further training was needed owing to inadequacy and 1% owing to a poor job market. In all assessed categories, the majority of residents believed that simulation did not completely replicate the educational value of an operative case.
Cardiothoracic residents largely feel well prepared for the transition to practice under the current educational paradigm. Although many residents seek advanced training, it seems driven by the desire for specialization. Residents view simulation as an adjunct to traditional intraoperative education, but not as a viable replacement. Further study is necessary to better understand how best to integrate simulation with operative experience.
Resident perceptions of 2-year (2Y) vs 3-year (3Y) programs have never been characterized. The objective was to use the mandatory Thoracic Surgery Residents Association and Thoracic Surgery Directors ...Association In-Training Examination survey to compare perceptions of residents graduating from 2Y vs 3Y cardiothoracic programs.
Each year Accreditation Council for Graduate Medical Education cardiothoracic residents are required to take a 30-question survey designed by the Thoracic Surgery Residents Association and the Thoracic Surgery Directors Association accompanying the In-Training Examination with a 100% response rate. The 2013 and 2014 survey responses of residents graduating from 2Y vs 3Y training programs were compared. The Wilcoxon signed rank test was used to analyze ordinal and interval data.
Graduating residents completed 167 surveys, including 96 from 2Y (56%) and 71 from 3Y (43%) programs. There was no difference in the perception of being prepared for the American Board of Thoracic Surgery examinations or amount of debt between 2Y and 3Y respondents. There was no difference in intended academic vs private practice. Graduating 3Y residents felt more prepared to meet case requirements and better trained, were more likely to pass their written American Board of Thoracic Surgery examinations, and were less likely to pursue additional training beyond their cardiothoracic residency.
There was no difference in field of interest, practice type, and amount of debt between graduating 2Y vs 3Y residents. Respondents from 2Y programs expressed more difficulty in meeting case requirements, whereas residents from 3Y programs felt more prepared for independent practice and had higher American Board of Thoracic Surgery written pass rates.
Improvements in surgical technique and perioperative care have resulted in increased long-term survival for patients with congenital heart disease. As these patients begin to reach their later years, ...clinicians are challenged with determining optimal management of noncardiac diseases in this complex patient population, including surgically treatable malignancies. We present a case of esophageal cancer in a patient with previously repaired tetralogy of Fallot and right-sided aortic arch, treated with neoadjuvant therapy followed by laparoscopic and left thoracoscopic esophagectomy.
Development of a tracheopharyngeal fistula after pharyngeal perforation is an uncommon occurrence. As a result, published guidance for management of this rare type of aerodigestive tract fistula is ...limited. We describe the workup and management of a traumatic tracheopharyngeal fistula caused by foreign body impaction. A conservative, endoscopic treatment strategy with broad-spectrum antibiotics, transnasal drainage, and covered tracheal stent placement was used. The stent was removed after 4 weeks, and complete closure of the fistula tract was confirmed by endoscopy and contrast esophagram. Although tracheopharyngeal fistulae are rare and operative treatment can be complex, this case demonstrates that conservative management with antibiotics, drainage, and endoscopic stenting can be successful in select patients.
Airborne measurements of upward solar spectral irradiances were performed during the second Saharan Mineral dUst experiMent (SAMUM-2) campaign based on the Cape Verde Islands. Additionally, airborne ...high resolution lidar measurements of vertical profiles of particle extinction coefficients were collected in parallel to the radiation data. Aerosol layers of Saharan dust, partly mixed with biomass-burning smoke, were probed. With corresponding radiative transfer simulations the single scattering albedo and the asymmetry parameter of the aerosol particles were derived although with high uncertainty. The broad-band aerosol solar radiative forcing at the top of atmosphere was calculated and examined as a function of the aerosol types. However, due to uncertainties in both the measurements and the calculations the chemical composition cannot be identified. In addition, a mostly measurement-based method to derive the broad-band aerosol solar radiative forcing was used. This approach revealed clear differences of broad-band net irradiances as a function of the aerosol optical depth. The data were used to identify different aerosol types from different origins. Higher portions of biomass-burning smoke lead to larger broad-band net irradiances.
So, you are looking for a job: Pearls for a successful first cardiothoracic job search Macke, Ryan A.; Ghanta, Ravi; Starnes, Sandra ...
Journal of thoracic and cardiovascular surgery/The Journal of thoracic and cardiovascular surgery/The journal of thoracic and cardiovascular surgery,
October 2018, 2018-Oct, 2018-10-00, 20181001, Letnik:
156, Številka:
4
Journal Article
Recenzirano
Odprti dostop
The final year of cardiothoracic surgery residency is an exciting time for most trainees because it marks the culmination of many years of hard work and dedication. However, it is not uncommon for ...trainees to also experience some degree of anxiety or uncertainty, particularly when it comes to understanding the necessary steps and finer details involved in seeking out and securing that much anticipated and well-deserved first job. This article explores the philosophy, strategy, and etiquette essential to navigating the various stages of one's initial job search, providing valuable information and perspective to those hoping to find a position that is best suited to one's skill set, needs, and long-term career goals.
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