The International Trifecta^TM and Epic^TM Valve-in-Valve Registry: insights into clinical & hemodynamic outcomes

Background: little is known about the clinical and hemodynamic outcome of valve-in-valve transcatheter aortic valve replacement (ViV-TAVR) for failed Trifecta surgical aortic bioprotheses.Aims: we aimed to compare outcomes of valve-in-valve transcatheter aortic valve replacement (ViV-TAVR into failed TrifectaTM vs. ViV-TAVR into a standard aortic bioprosthetic valve with internally mounted leaflets (EpicTM, Abbott, Minneapolis, MN).Methods: data of consecutive patients who underwent ViV-TAVR into either failed TrifectaTM or EpicTM bioprostheses between October 2015 and June 2020 were retrospectively collected within the International Trifecta and Epic Valve-in-Valve Registry, and analyzed for a primary composite outcome of 30-day mortality and/or coronary obstruction (CO), defined as: (1) CO resulting in myocardial infarction and/or cardiogenic shock, or (2) CO requiring emergent coronary intervention.Results: a total of 76 patients (49 Trifecta, 27 Epic) with a median age of 80 years (interquartile range [IQR] 75.0; 82.0]) and a median Society of Thoracic Surgeons-score of 5.4 (IQR 4.0; 9.8) were identified. Coronary protection techniques were more frequently performed in Trifecta than Epic patients (29.6% vs. 0%, p = 0.01). The primary composite outcome was observed in three Trifecta versus five Epic cases (6.1% vs. 20%, p = 0.1), which included one case of CO following ViV-TAVR into Epic requiring stenting. Increased rates of patient-prosthesis mismatch (PPM) following valve-in-Epic were found (41.7% vs. 75%, p = 0.08). Survival at a median of 365 days was 86.2% and did not differ between groups (log-rank p = 0.37).Conclusions: compared to a stented prosthesis without increased risk of CO, ViV-TAVR into Trifecta prostheses can be performed with low risk of CO and acceptable short-term clinical outcomes. As the rate of post-ViV PPM is substantial for both prostheses, careful patient selection is warranted. (NCT05389631).<br/

International Encyclopaedia of Laws-Contracts-China

The book bridges academic insight and practical application, making it an essential resource for lawyers, judges, arbitrators, scholars, and policymakers engaged with Chinese or comparative contract law. Written with both domestic and international audiences in mind, it situates Chinese contract law within the broader global context of commercial practice and comparative legal studies

Productive robots and industrial employment: the role of national innovation systems

In a model with robots, automatable and nonautomatable production, we study robot-labor substitutions and show how they are influenced by a country's “innovation system.” Substitution depends on demand and production elasticities, the country's innovation capabilities, and openness. Making use of World Economic Forum data, we estimate the relationship for 13 countries and find that countries with poor innovation capabilities substitute robots for workers much more than countries with richer innovation capabilities, which might complement them. Innovation capabilities play a bigger role in the high-tech electronics sector than in other manufacturing and play a limited role in nonmanufacturing.</p

A typology of explanations for explainability-by-design

As automated decision-making permeates almost all aspects of everyday life, capabilities to generate meaningful explanations for various stakeholders (i.e., decision-makers, addressees of decisions including individuals, auditors, and regulators) should be carefully deployed. This paper presents a typology of explanations intended to support the first pillar of an explainability-by-design strategy. Its production has been achieved by pursuing a responsible innovation approach and introducing a new persona within the research and innovation process, i.e., a legal engineer, whose role is to work at the interface of two teams, the compliance and the engineering teams and to oversee the process of requirement elicitation, which is often opinionated and narrowing. Once explanation requirements have been derived from applicable regulatory requirements, compliance rules or business policies, they have been mapped to the dimensions of the typology to produce fine-grained explanation requirements, forming computable building blocks that can then be translated into system requirements during the technical design phase. The typology has been co-created with industry partners operating in two sectors: finance and education. Two pilot studies have thus been conducted to test both the feasibility of the generation and computation of explanations on the basis of the typology and the usefulness of the outputs in the light of the state of the art. The typology comprises nine hierarchical dimensions. It can be leveraged to operate a stand-alone classifier of explanations that acts as detective controls within a broader partially-automated compliance strategy. A machine-readable format of the typology is provided in the form of a light ontology.. A machine-readable format of the typology is provided in the form of a light ontology

State responsiveness, collective efficacy and threat perception: Catalyst and complacency effects in opposition to crime across eight countries.

Collective action can be a crucial tool for enabling individuals to combat crime in their communities. In this research, we investigated individuals' intentions to mobilize against organized crime, a particularly impactful form of crime characterized by its exercises of power over territories and communities. We focused on individuals' views and perceptions of state authorities, examining how these views may be linked to intentions for collective mobilization. Using a large dataset with participants from eight countries (NTotal = 2088), we tested two distinct and opposing indirect paths through which perceived state responsiveness may be associated with collective mobilization intentions against organized crime, namely increased collective community efficacy (a CatalystIndirect Effect) and diminished perceived threat from criminal groups (a Complacency Indirect Effects). Results showed that state responsiveness was associated with stronger collective action intentions through increased collective community efficacy. There was also some evidence of reduced collective action intentions through diminished perceived threat. These findings highlight the complex role of state responsiveness in predicting people's intentions to mobilize against collective problems in their communities. Implications of the findings, limitations and future directions are discussed

Lost in turbulence? Healthcare workers’ conceptualisations and experiences with navigating time in personalised care

Purpose: The study aims to explore how healthcare workers (HCWs) navigate and experience time when caring for older cancer patients living with other illnesses. Design/methodology/approach: This paper presents findings from a qualitative study of how HCWs conceptualise and navigate the temporal aspects of delivering personalised care to older people living with multimorbidity. Building on research from organisation studies and the sociology of time, we interviewed 19 UK HCWs about their experiences of delivering care to this patient group. Findings: Our findings illustrate how the delivery of personalised care contradicts contemporary models for healthcare delivery defined by efficiency and standardisation. We found that HCWs engage with time as both a valuable commodity to be rationed and prioritised within a constrained context and as a malleable resource for managing workload and overcoming “turbulence” in the system. However, participants in this study also shared how the simultaneous multiplicity and lack of time had a profoundly personal impact on them through the emotional toll associated with “time debt” and “lost” time. Originality/value: This research presents a unique analysis of how time is conceptualised and navigated in contemporary healthcare, offering valuable insights for policy improvement. We conclude that personalised models of healthcare are incompatible with many current temporal structures of treatment trajectories and work-practices, by nature of being centred around the person and not the system of delivery.</p

Exploring the potential benefits and challenges of artificial intelligence for research funding organisations: a scoping review

Background: Artificial Intelligence (AI) is at the forefront of today’s technological revolution, enhancing efficiency in many organisations and sectors. However, in some research environments, its adoption is tempered by the risks AI poses to data protection, ethics, and research integrity. For research funding organisations (RFOs), although there is interest in the application of AI to boost productivity, there is also uncertainty around AI’s utility and its safe integration into organisational systems and processes. The scoping review explored: ‘What does the evidence say about the current and emerging use of AI?’; ‘What are the potential benefits of AI for RFOs?’ and ‘What are the considerations and risks of AI for RFOs?’Methods: a scoping review was undertaken with no study, language, or field limits. Due to the rapidly evolving AI field, searches were limited to the last three years (2022-2024). Four databases were searched for academic and grey literature in February 2024 (including 13 funding and professional research organisation websites). A classification framework captured the utility and potential, and considerations and risks of AI for RFOs.Results: 122 eligible articles revealed that current and emerging AI solutions could potentially benefit RFOs by enhancing data processes, administration, research insights, operational management, and strategic decision-making. These solutions ranged from AI algorithms to data management platforms, frameworks, guidelines, and business models. However, several considerations and risks need to be addressed before RFOs can successfully integrate AI (e.g., improving data quality, regulating ethical use, data science training).Conclusion: while RFOs could potentially benefit from a breadth of AI-driven solutions to improve operations, decision-making and data management, there is a need to assess organisational ‘AI readiness’. Although technological advances could be the solution there is a need to address AI accountability, governance and ethics, address societal impact, and the risks to the research funding landscape.<br/

Feeling Safe and Nostalgia in Healthy Aging

The population of older adults worldwide is growing, with an urgent need for approaches that develop and maintain intrinsic capacity consistent with healthy aging. Theory and empirical research converge on feeling safe as central to healthy aging. However, there has been limited attention to resources that cultivate feeling safe to support healthy aging. Nostalgia, “a sentimental longing for one’s past”, is established as a source of comfort in response to social threat, existential threat, and self-threat. Drawing from extant theory and research, we build on these findings to position nostalgia as a regulatory resource that cultivates feeling safe and contributes to intrinsic capacity to support healthy aging. Using a narrative review method, we: (a) characterize feeling safe as a distinct affective dimension, (b) summarize the character of nostalgia in alignment with feeling safe, (b) propose a theoretical account of the mechanisms through which nostalgia cultivates feeling safe, (c) highlight the contribution of nostalgia to feeling safe and emotional, physiological, and behavioral regulatory capabilities in healthy aging, and (d) offer conclusions and direction for research

Single-cell impedance spectroscopy of bacteria

Bacteria are the causative agents of many diseases, and understanding biophysical changes in bacteria following physical or chemical treatment is of considerable interest. In this thesis, different bacteria were measured using single-cell impedance cytometry in order to understand changes in electrical properties following exposure to different perturbations. Traditionally, alternating current (AC) electrokinetic methods are used to measure the electrical properties of cells. However, the throughput of these techniques is low. To overcome this limitation single-cell impedance cytometry measures the impedance of individual cells at hundreds per second.In this study, the electrical properties of single cells were measured across a broad range of frequencies at the rate of tens of thousands of cells in a few minutes. The complex impedance spectrum was modelled using Maxwell’s mixture equation together with the multi-shell model to extract dielectric parameters for each bacterium.Two model organisms were used for experiments: Escherichia coli and Staphylococcus aureus. Impedance cytometry was used to characterise the effect of heat treatment (including pasteurisation and autoclaving) on bacteria and results showed that the dielectric properties of the cells were in agreement with AC electrokinetic methods. Bacteria were also exposed to three classes of antibiotics, namely β-lactam, polymyxin and aminoglycoside. Dielectric characterisation demonstrated that bacteria respond differently following exposure to different antibiotics. Their phenotypic response changes their dielectric parameters in a way that is consistent with the mode of action of antibiotics.Single-cell impedance cytometry was also used to follow bacterial-phage interaction. Experiments showed that the phenotypic response of bacteria can be followed during the phage infection cycle, and that the technique can rapidly identify bacterial susceptibility to phages. The data also helps explain the complex bacterial defence mechanisms against phages from a dielectric perspective.In summary, this thesis describes an electrical method for probing bacteria, linking measured biophysical changes to biological responses, furthering our understanding of the action of antibiotics and phage therapies