1,721,028 research outputs found

    Percutaneous Heart Valve Replacement: An Update

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    Valvular heart disease continues to be an important health care problem. Although surgical valve replacement remains the standard treatment, minimally invasive approaches for valve repair and replacement are becoming attractive alternatives among physicians and patients. In fact, percutaneous procedures can extend treatment to the increasing population of elderly patients with severe comorbidities who cannot withstand the stress of open heart surgery and to the younger patients at the early stage of valve disease, who are not treated until older ages to avoid multiple invasive surgeries. Feasibility of this technique has been shown in the first clinical experiences, and the early results are promising. However, it is clear that percutaneous valve replacement therapy is still at the early stage of development and requires enhanced implantation procedures and substantial design improvements as well as long-term follow-up to show the safety and effectiveness of this new treatment modality

    Going Beyond Counting First Authors in Author Co-citation Analysis

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    The 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

    Manufacturing and hydrodynamic assessment of a novel aortic valve made of a new nanocomposite polymer

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    Synthetic leaflet heart valves have been widely studied as possible alternatives to the current mechanical and bioprosthetic valves. Assessing the in vitro hydrodynamic function of these prostheses is of great importance to predict their hemodynamic behaviour prior to implantation. This study introduces an innovative concept of a low-profile semi-stented surgical aortic valve (SSAV) made of a novel nanocomposite polyurethane with a polycarbonate soft segment (PCU) and polyhedral oligomeric silsesquioxane (POSS) nanoparticles covalently bonded as a pendant cage to the hard segment. The POSS-PCU is already used in surgical implants, including lacrimal duct, bypass graft, and recently, a tracheal replacement. Nine valves of three leaflet thicknesses (100, 150 and 200. μm) and 21. mm internal diameter were prepared using an automated dip-coating procedure, and assessed in vitro for their hydrodynamic performance on a pulse duplicator system. A commercially available porcine bioprosthetic valve (EpicTM, St. Jude Medical) of equivalent size was selected as a control model. Compared to the bioprosthetic valve, the SSAVs showed a considerably lower transvalvular pressure drop and larger effective orifice area (EOA). They were also characterised by a lower systolic energy loss, especially at high cardiac outputs. The leaflet thickness was found to significantly affect the hydrodynamics of these valves (. P<0.01). The SSAVs with 100. μm leaflets demonstrated improved flow characteristics compared to the bioprosthetic valve. The enhanced hydrodynamic function of the SSAV suggests that the proposed design together with the advanced POSS-PCU material can represent a significant step towards the introduction of polyurethane valves into the clinical application. © 2012

    Variations on the Author

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    “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

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    We 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

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    We 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

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    Novel heart valve prosthesis with self-endothelialization potential made of modified polyhedral oligomeric silsesquioxane-nanocomposite material

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    In the cardiovascular system, the endothelial layer provides a natural antithrombogenic surface on the inner portion of the heart and associated vessels. For a synthetic material therefore, the ability to attract and retain endothelial or endothelial progenitor cells (EPCs), ultimately creating a single endothelial layer on its surface, is of prime importance. The authors have developed a nanocomposite polymer, based on a combination of polyhedral oligomeric silsesquioxane nanoparticles and polycarbonate urea urethane (POSS-PCU), which is biocompatible and has been used in human for the world's first synthetic trachea, tear duct, and bypass graft. In this study, the authors modified the surface of this casted nanocomposite by grafting fibronectin derived bioactive peptides [glycine-arginine-glycine-aspartic acid-glycine (GRGDG) and lauric acid conjugated GRGDG (GRGDG-LA)] to enhance the endothelialization for using heart valves leaflets from circulating EPCs. Human peripheral blood mononuclear cells were separated using Ficoll-Paque centrifugation, with harvested EPCs purified using CD34 microbead labeling and magnetic-activated cell sorting. Cells were seeded onto 96 well plates coated with POSS-PCU, GRGDG/GRGDG-LA modified POSS-PCU and PCU polymers, for a period of 21 days. Cells were studied under light, confocal, and scanning electron microscope (SEM). Fluorescence-activated cell sorting was used to analyze cell surface markers. Cell attachment and proliferation was observed in all POSS-PCU samples, significantly higher than the activity seen within the control PCU polymers (p < 0.05). Microscopic examination revealed clonal expansion and morphological changes in cells seeded on POSS-PCU. The cells expressed increasing levels of mature endothelial cell markers over time with a concurrent reduction in hematopoietic stem cell marker expression. SEM showed a mixed population of morphologically differentiated endothelial cells and EPCs. These results support the use of heart valve made with the POSS-PCU polymer and demonstrate that suitable chemical modification of this nanocomposite could increase self-endothelialization potential and reduce associated thrombotic events

    A novel nanocomposite polymer for development of synthetic heart valve leaflets

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    A novel nanocomposite polymer with a polycarbonate soft segment (PCU) and polyhedral oligomeric silsesquioxanes (POSS) nanoparticle (POSS-PCU) has been selected for a synthetic heart valve due to its superior biocompatibility and in vivo biostability. However, the development of synthetic heart valves from polymeric materials requires an understanding of the basic mechanical and surface properties of the polymer. In this study, the mechanical properties of POSS-PCU, including tensile strength, tear strength and hardness, were tested and compared to control (PCU). The surface property was analyzed using contact angle measurement and the resistance to platelet adhesion was also investigated. POSS-PCU (hardness 84 ± 0.8 Shore A) demonstrated significantly higher tensile strength 53.6 ± 3.4 and 55.9 ± 3.9 N mm-2 at 25 and 37 °C, respectively) than PCU (33.8 ± 2.1 and 28.8 ± 3.4 N mm-2 at 25 and 37 °C, respectively). Tensile strength and elongation at break of POSS-PCU was significantly higher than PCU at both 25 and 37 °C (P < 0.001). POSS-PCU showed a relatively low Young's modulus (25.9 ± 1.9 and 26.2 ± 2.0 N mm-2) which was significantly greater in comparison with control PCU (9.1 ± 0.9 and 8.4 ± 0.5 N mm-2) at 25 and 37 °C, respectively, with 100 μm thickness. There was no significant difference (P > 0.05) in tear strength between POSS-PCU and PCU at 25 °C. However, tear strength increased significantly (P < 0.001) (at 37 °C) as the thickness increased from 100 μm (51.0 ± 3.3 N mm-1) to 200 μm (63 ± 1.5 N mm-1). The surface of POSS-PCU was significantly less hydrophilic than that of PCU. © 2009 Acta Materialia Inc
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