An Update on Anti-thrombotic Therapy Following Transcatheter Aortic Valve Implantation: Expert Cardiologist Opinion from a UK and Ireland Delphi Group

Transcatheter aortic valve implantation (TAVI) is an effective and established treatment for symptomatic aortic stenosis. However, there is a lack of consensus concerning the need for peri- and post-procedural anti-thrombotic medication. Contemporary guidelines recommend that anti-thrombotic therapy is balanced against a patient’s bleeding risk following TAVI, but do not fully consider the evolving evidence base. The purpose of the Delphi panel recommendations presented here is to provide a consensus elicited from a panel of experts who regularly prescribe anti-thrombotic therapy post-TAVI. The goal was to address evidence gaps across four key topics: anti-thrombotic therapy (anti-platelet and/or anti-coagulant) in TAVI patients in sinus rhythm; anti-thrombotic therapy in TAVI patients with AF; direct oral anti-coagulants versus vitamin K antagonists; and the need for UK/Ireland specific guidance. This consensus statement aims to inform clinical decision-making by providing a concise, evidence-based summary of best practice for prescribing anti-thrombotic therapies following TAVI and highlights areas where further research is needed

Introduction to Guitar Ethnographies: Performance, Technology and Material Culture.

Entangled in global cultural flows, but also held in place locally, empowered and agential, musical instruments resonate with social significance. The guitar is, perhaps, the example par excellence, yet it has received little attention within ethnomusicology. This Introduction sets out the theoretical and methodological framework informing the four case studies of the guitar that follow, and provides a relevant literature review. Based largely on deep immersive ethnography and prolonged study in the field, we have been especially influenced by publications in the areas of the ethnography of musical performance, material culture studies, organology, the anthropology of globalisation, and studies of the role of audio technologies in the production of music cultures. Each one of the articles represents a first for the study of the guitar. In two cases, local professional guitarists have a hand in writing the articles. Therefore, this Introduction and the articles that follow include semi-autobiographical detail as we take our guitars with us into ‘the field’ and further into the ever-broadening terrain covered by ethnomusicological studies. The case studies demonstrate the value of the authors' performance skills and knowledge of the instrument and its manufacture in providing an entrée into often-challenging and close-knit guitar worlds (e.g., workshops, retail outlets, backstage meet and greets, and recording studios). Yet local questions about the guitar often demand a larger context of study; for instance, in relation to processes of globalisation, nationalism and ethnicity, the location of the instrument within a wider web of sound technologies, the international trade in musical instruments and natural resources, and hybrid designs and performance techniques