1,721,096 research outputs found
One-Year Outcomes After Amulet or Watchman Device for Percutaneous Left Atrial Appendage Closure: a Pre-Specified Analysis of the SWISS-APERO Randomized Clinical Trial.
Full text linkP ercutaneous left atrial appendage (LAA) closure (LAAC) prevents thromboembolisms in patients with atrial fibrillation. However, residual LAA patency after LAAC has been associated with higher thromboembolic risk, especially when detected remotely after the procedure. 1 Residual leaks are typically assessed by transesophageal echocardiography or cardiac computed tomography angiography (CCTA), and the latter imaging modality provides a comprehensive operator-independent assessment and higher sensitivity compared with transesophageal echocardiography. 2 The SWISS-APERO trial (Comparison of Amulet Versus Watchman/FLX Device in Patients Undergoing Left Atrial Appendage Closure; URL: https://clinicaltrials.gov; Unique identifier: NCT03399851) is the first random-ized comparison between Watchman FLX (Boston Scientific) and Amplatzer Amulet (Abbott), which are the 2 most frequently used devices for LAAC worldwide. 3,4 Patients with nonvalvular atrial fibrillation and clinically indicated LAAC were eligible if they provided written informed consent and had a CHA 2 DS 2-VASc score of ≥2 and either HAS-BLED score of ≥3 or presence of high-bleeding-risk features. 3 The key exclusion criteria included the presence of LAA thrombus or LAA morphology not suitable for both study devices at trans-esophageal echocardiography. All patients randomized to Watchman before October 2019 received Watchman 2.5; Watchman FLX was used exclusively thereafter. Postimplantation treatment was left to discretion of the treating physician. At 13 months (395±30 days), patients underwent an onsite clinical visit and CCTA. The CCTA images and clinical events were centrally and blindly assessed. LAA was defined as patent appendage (PA) if LAA density was ≥100 Hounsfield unit or ≥25% of that of the left atrium. 3,4 In patients with PA, the presence of visible leaks was adjudicated as intradevice leak, peridevice leak, or mixed leak if contrast medium was visible along the entire length or part of the length of the device or as PAs with no visible leak if none of the above was detected. Device-related thrombus was defined as homogeneous hypoattenu-ated thickening on the atrial surface of the device and centrally adjudicated as definitive or possible device-related thrombus. 3 The trial was an investigator-initiated trial, partially supported by a research grant from Abbott (St. Jude Medical/Abbott, North Plymouth, MN). The trial protocol was approved by the institutional review boards, and all patients provided informed consent before enrollment. The imaging end points were analyzed with the χ 2 test, and risk ratios (RRs) with 95% CIs are reported. The clinical end points were analyzed with Cox proportional hazards model, and hazard ratios with 95% CIs are reported. Data were analyzed according to the intention-to-treatAmplatzer Amulet, Amplatzer, and Amulet are trademarks of Abbott or its related companies. Reproduced with permission of Abbott, © 2023. All rights reserved. Images of Watchman FLX have been provided courtesy of Boston Scientific
Feasibility and safety of transcaval transcatheter aortic valve implantation: a multicentre European registry
No full textAIMS
A transfemoral transarterial approach is considered the preferable access route for transcatheter aortic valve implantation (TAVI), followed by a transaxillary/subclavian TAVI approach. However, these approaches may not be an option in all patients. This study aimed to report the initial European experience with transfemoral transcaval TAVI.
METHODS AND RESULTS
Data on 50 patients treated by transcaval TAVI in five European centres were collected and analysed according to the Valve Academic Research Consortium (VARC)-2 definitions. The study population had a mean age of 78.7±8.0 years and a high surgical risk profile (median STS risk score 6.1%, interquartile range 3.0-11.2%). Transcaval access was successful in 49 out of 50 patients and device success was obtained in 94% of cases. Closure of the caval-aortic puncture site with a nitinol cardiac occluder was successful in all cases without need for emergent surgery. One patient received additional sealing of the aortic puncture site with a covered stent one day post TAVI due to a gradual haemoglobin drop of 3 g/dL. VARC-2-defined life-threatening bleeding and major vascular complications possibly related to transcaval access were 4% and 10%, respectively. There were no bleeding or vascular complications after discharge. At 30 days, the clinical efficacy endpoint was reached in 88% of patients.
CONCLUSIONS
Transfemoral transcaval access proved to be a feasible and safe TAVI approach for high-risk patients with severe aortic stenosis not suitable for transfemoral or transaxillary/subclavian transarterial access
Amulet or Watchman Device for Percutaneous Left Atrial Appendage Closure: Primary Results of the SWISS-APERO Randomized Clinical Trial.
Full text linkBackground: No study has so far compared Amulet with the new Watchman FLX in terms of residual left atrial appendage (LAA) patency or clinical outcomes in patients undergoing percutaneous LAA closure (LAAC). Methods: In the investigator-initiated SWISS APERO trial, patients undergoing LAAC were randomized (1:1) open-label to receive Amulet or Watchman 2.5 or FLX (Watchman) across 8 European centres. The primary endpoint was the composite of justified crossover to a non-randomized device during LAAC procedure or residual LAA patency detected by cardiac computed tomography angiography (CCTA) at 45 days. The secondary endpoints included procedural complications, device related thrombus (DRT), peridevice leak (PDL) at transesophageal echocardiography (TEE) and clinical outcomes at 45 days. Results: Between June 2018, and May 2021, 221 patients were randomly assigned to Amulet (111 [50.2%]) or Watchman (110 [49.8%]), of whom 25 (22.7%) patients included before October 2019 received Watchman 2.5, and 85 (77.3%) patients received Watchman FLX. The primary endpoint was assessable in 205 (92.8%) patients and occurred in 71 (67.6%) Amulet and 70 (70.0%) Watchman patients respectively (risk ratio [RR] 0.97 [95% CI 0.80- 1.16]; P=0.713). A single justified cross-over occurred in an Amulet patient who fulfilled LAA patency criteria at 45-day CCTA. Major procedure related complications occurred more frequently in the Amulet group (9.0% vs. 2.7%; P=0.047), owing to more frequent bleeding (7.2% vs.1.8%). At 45 days, the PDL rate at TEE was higher with Watchman than Amulet (27.5% vs. 13.7%, p=0.020), albeit none was major (i.e. > 5 mm), whereas DRT was detected in 1 (0.9%) patient with Amulet and 3 (3.0%) patients with Watchman at CCTA and in 2 (2.1%) and 5 (5.5%) patients at TEE, respectively. Clinical outcomes at 45 days did not differ between the groups. Conclusions: Amulet was not associated with lower rate of the composite of crossover or residual LAA patency compared with Watchman at 45-day CCTA. Amulet, was however associated with lower PDL rates at TEE, higher procedural complications and similar clinical outcomes at 45 days compared with Watchman. The clinical relevance of CCTA-detected LAA patency requires further investigation. Clinical Trial Registration: URL https://clinicaltrials.gov Unique Identifier NCT03399851
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
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