Comparative one-month safety and effectiveness of five leading new-generation devices for transcatheter aortic valve implantation

Transcatheter aortic valve implantation (TAVI) for aortic stenosis is becoming an appealing alternative to surgical aortic valve replacement in high-risk patients and to medical therapy for inoperable ones. Several new-generation TAVI devices have been recently introduced, but comparative analyses are lacking. We aimed to compare 1-month outcomes associated with such five leading new-generation TAVI devices exploiting data collected in the prospective observational RISPEVA (Registro Italiano GISE sull’impianto di Valvola Aortica Percutanea) Study. We queried the dataset of the ongoing RISPEVA study to retrieve baseline, procedural and 1-month outcome details of patients undergoing TAVI with Acurate, Evolut, Portico, Lotus, and Sapien3. Analysis was based on unadjusted and propensity score-adjusted methods. We included 1976 patients, 234 (11.8%) treated with Acurate, 703 (35.6%) with Evolut, 151 (7.6%) with Lotus, 347 (17.6%) with Portico, and 541 (27.4%) with Sapien3. Unadjusted analysis for baseline features highlighted several significant differences, and other discrepancies were found for procedural features. Despite these differences, device and procedural success were similarly high (ranging from 98.0% to 99.4%, p > 0.05). However, procedural valve migration appeared more common with Acurate (p = 0.007), and major bleeding with Sapien3 (p = 0.002). Unadjusted analysis for 1-month outcomes also highlighted significant differences in the composite of death, stroke, myocardial infarction, major vascular complication, major bleeding, or renal failure (favoring Portico, p < 0.001), major vascular complications (favoring Lotus, p < 0.001), renal failure (favoring Portico, p = 0.035), and permanent pacemaker implantation (favoring Acurate, p < 0.001). Propensity score-adjusted analyses showed lower rates of major adverse events with Evolut and Portico (p < 0.05), major vascular complications with Lotus and Portico (p < 0.05), renal failure with Sapien3 (p < 0.05) and permanent pacemaker implantation with Acurate (p < 0.05). In conclusion, new-generation TAVI devices have different profiles of early comparative safety and efficacy. These findings should be taken into account for individualized decision making and patient management

Qualitative Behavioural Assessment of emotionality in pigs

AbstractScientific assessment of affective states in animals is challenging but vital for animal welfare studies. One possible approach is Qualitative Behavioural Assessment (QBA), a ‘whole animal’ methodology which integrates information from multiple behavioural signals and styles of behavioural expression (body language) directly in terms of an animal's emotional expression. If QBA provides a valid measure of animals’ emotional state it should distinguish between groups where emotional states have been manipulated. To test this hypothesis, QBA was applied to video-recordings of pigs, following treatment with either saline or the neuroleptic drug Azaperone, in either an open field or elevated plus-maze test. QBA analysis of these recordings was provided by 12 observers, blind to treatment, using a Free Choice Profiling (FCP) methodology. Generalised Procrustes Analysis was used to calculate a consensus profile, consisting of the main dimensions of expression. Dimension one was positively associated with terms such as ‘Confident’ and ‘Curious’ and negatively with ‘Unsure’ and ‘Nervous’. Dimension two ranged from ‘Agitated’/‘Angry’ to ‘Calm’/‘Relaxed’. In both tests, Azaperone pre-treatment was associated with a more positive emotionality (higher scores on dimension one reflecting a more confident/curious behavioural demeanour) than control pigs. No effect of drug treatment on dimension two was found. Relationships between qualitative descriptions of behaviour and quantitative behavioural measures, taken from the same recordings, were found. Overall, this work supports the use of QBA for the assessment of emotionality in animals

DIGE Proteome Analysis Reveals Suitability of Ischemic Cardiac In Vitro Model for Studying Cellular Response to Acute Ischemia and Regeneration

Proteomic analysis of myocardial tissue from patient population is suited to yield insights into cellular and molecular mechanisms taking place in cardiovascular diseases. However, it has been limited by small sized biopsies and complicated by high variances between patients. Therefore, there is a high demand for suitable model systems with the capability to simulate ischemic and cardiotoxic effects in vitro, under defined conditions. In this context, we established an in vitro ischemia/reperfusion cardiac disease model based on the contractile HL-1 cell line. To identify pathways involved in the cellular alterations induced by ischemia and thereby defining disease-specific biomarkers and potential target structures for new drug candidates we used fluorescence 2D-difference gel electrophoresis. By comparing spot density changes in ischemic and reperfusion samples we detected several protein spots that were differentially abundant. Using MALDI-TOF/TOF-MS and ESI-MS the proteins were identified and subsequently grouped by functionality. Most prominent were changes in apoptosis signalling, cell structure and energy-metabolism. Alterations were confirmed by analysis of human biopsies from patients with ischemic cardiomyopathy

Should a robot guide like a human? A qualitative four-phase study of a shopping mall robot

International audienceProviding guidance to customers in a shopping mall is a suitable task for a social service robot. To be useful for customers, the guidance needs to be intuitive and effective. We conducted a four-phase qualitative study to explore what kind of guidance customers need in a shopping mall, which characteristics make human guidance intuitive and effective there, and what aspects of the guidance should be applied to a social robot. We first interviewed staff working at the information booth of a shopping mall and videotaped demonstrated guidance situations. In a human-human guidance study, ten students conducted seven way-finding tasks each to ask guidance from a human guide. We repli-cated the study setup to study guidance situations with a social service robot with eight students and four tasks. The robot was controlled using Wizard of Oz technique. The characteristics that make human guidance intuitive and effective, such as estimation of the distance to the destination , appropriate use of landmarks and pointing gestures, appear to have the same impact when a humanoid robot gives the guidance. Based on the results, we identified nine design implications for a social guidance robot in a shopping mall