The Problem Of The Authenticity Of The Cinquiesme Livre De Pantagruel: A Quantitative Study.

Ph.D.LiteratureUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/190965/2/7500777.pd

Threats of Longline Fishing to Global Albatross Diversity

Albatrosses are among the most threatened seabird species. Often entangled in gillnets or hooked while longline fishing gear is being set, albatrosses are affected by fishing. This is assumed to be especially true in cases where illegal longline fishing vessels are involved, as they are less likely to implement the bycatch mitigation measures implemented to reduce the risk of albatrosses being caught on their hooks. This is the assumption that was tested in the current study, which uses environmental criminology as its guiding theoretical framework. Using the spatial units of one-half-degree by one-half-degree longitude/latitude cells, this research examined the patterns of concentration of potentially illegal longlining efforts and their relationships to commercially sought-out and illegally caught (i.e., CRAAVED—concealable, removable, abundant, accessible, valuable, enjoyable, disposable) fish species concentrations, as well as their effects on the average risk of albatrosses. The results indicated that (a) potentially illegal longlining activity is spatially concentrated; (b) this concentration is exhibited in areas with the highest concentrations of the presence of CRAAVED fish; and (c) the average risk score of albatrosses, as measured by their International Union for Conservation of Nature (IUCN) Red List status, is significantly higher in the areas where illegal longlining vessels are found controlling for the activities of legal longlining vessels. These findings provide strong grounding that illegal longline fishing poses a particularly serious threat to the survival of albatrosses. These activities, however, are not randomly spread across the vast oceans, but rather are highly spatially concentrated. Therefore, the bird conservation lobby should work closely with regional fisheries management organizations to devise and implement targeted interventions aimed at reducing potential illegal longline fishing, which, in turn, will likely have positive effects on albatrosses

Mid-Term Outcomes of Transcatheter Aortic Valve Replacement in Extremely Large Annuli With Edwards SAPIEN 3 Valve.

OBJECTIVES: The aim of this study was to report the 1-year results of transcatheter aortic valve replacement (TAVR) with the Edwards SAPIEN 3 (S3) valve in extremely large annuli. BACKGROUND: Favorable 30-day outcomes of S3 TAVR in annuli \u3e683 mm METHODS: From December 2013 to December 2018, 105 patients across 15 centers with mean area 721.3 ± 36.1 mm RESULTS: The mean age was 76.9 ± 10.4 years, and Society of Thoracic Surgeons predicted risk score averaged 5.2 ± 3.4%. One-year overall mortality and stroke rates were 18.2% and 2.4%, respectively. Quality-of-life index improved from baseline to 30 days and at 1 year (p \u3c 0.001 for both). Mild paravalvular aortic regurgitation occurred in 21.7% of patients, while moderate or greater paravalvular aortic regurgitation occurred in 4.3%. Mild and moderate or severe transvalvular aortic regurgitation occurred in 11.6% and 0%, respectively. Valve gradients remained stable at 1 year. CONCLUSIONS: S3 TAVR in annular areas \u3e683 m

Surgical Explantation After TAVR Failure: Mid-Term Outcomes From the EXPLANT-TAVR International Registry

Objectives: The aim of this study was to evaluate clinical characteristics, mechanisms of failure, and outcomes of transcatheter aortic valve replacement (TAVR) explantation. Background: Surgical explantation following TAVR may be required for structural valve degeneration, paravalvular leak, infection, or other reasons. However, in-depth data on indications and outcomes are lacking. Methods: Data from a multicenter, international registry (EXPLANT-TAVR) of patients who underwent TAVR explantation were reviewed retrospectively. Explantations performed during the same admission as initial TAVR were excluded. Clinical and echocardiographic outcomes were evaluated. Median follow-up duration was 6.7 months (interquartile range [IQR]: 1.0-18.8 months) after TAVR explantation and was 97.7% complete at 30 days and 86.1% complete at 1 year. Results: From November 2009 to September 2020, 269 patients across 42 centers with a mean age of 72.7 ± 10.4 years underwent TAVR explantation. About one quarter (25.9%) were deemed low surgical risk at index TAVR, and median Society of Thoracic Surgeons risk at TAVR explantation was 5.6% (IQR: 3.2%-9.6%). The median time to explantation was 11.5 months (IQR: 4.0-32.4 months). Balloon-expandable and self-expanding or mechanically expandable valves accounted for 50.9% and 49.1%, respectively. Indications for explantation included endocarditis (43.1%), structural valve degeneration (20.1%), paravalvular leak (18.2%), and prosthesis-patient mismatch (10.8%). Redo TAVR was not feasible because of unfavorable anatomy in 26.8% of patients. Urgent or emergency cases were performed in 53.1% of patients, aortic root replacement in 13.4%, and 54.6% had concomitant cardiac procedures. Overall survival at last follow-up was 76.1%. In-hospital, 30-day, and 1-year mortality rates were 11.9%, 13.1%, and 28.5%, respectively, and stroke rates were 5.9%, 8.6%, and 18.7%, respectively. Conclusions: The EXPLANT-TAVR registry reveals that surgical risks associated with TAVR explantation are not negligible and should be taken into consideration in the lifetime management of aortic stenosis