Transformation of WSDL files using ETL in the E-orientation domain

The E-orientations platforms become an essential space for students to base their choice on tangible elements, as they offer a macroscopic view of the different academic and professional fields. In this context the Center for Engineering Sciences and Applied Sciences “SISA” funded the MMS Orientation project to focus on student orientation in Morocco. With respect to the peculiarity and the different characteristics of the E-orientation platforms, a comparative study is essential. In this article we will proceed by a comparative study of a sample of platforms in order to highlight the major functionalities that we will model through descriptive files. The work is divided into two parts: The first part will be a comparison and description of existing platforms using descriptive language (WSDL), the second part will use ETL as a transformation technology in order to highlight generic files that will serve as a basis for work. the expected meta model

Tibiopedal arterial minimally invasive retrograde revascularization (TAMI) in patients with peripheral arterial disease and critical limb ischemia. On behalf of the Peripheral Registry of Endovascular Clinical Outcomes (PRIME)

Objectives and backgroundComplex peripheral arterial disease (PAD) and critical limb ischemia (CLI) are associated with high morbidity and mortality. Endovascular techniques have become prevalent in treatment of advanced PAD and CLI, and use of techniques such as tibiopedal minimally invasive revascularization (TAMI), have been proven safe in small, singleâ center series. However, its use has not been systematically compared to traditional approaches.Methods and resultsThis is a retrospective, multicenter analysis which enrolled 744 patients with advanced PAD and CLI who underwent 1,195 endovascular interventions between January 2013 and April 2018. Data was analyzed based on access used for revascularization: 840 performed via femoral access, 254 via dual access, and 101 via TAMI. The dual access group had the highest median Rutherford Class and lowest number of patent tibial vessels. Median fluoroscopy time, procedure time, hospital stay, and contrast volume were significantly lower in the TAMI access group when compared to both femoral/dual access groups. There was also a significant difference between all groups regarding location of target lesions: Femoropopliteal lesions were most commonly treated via femoral access; infrapopliteal lesions, via TAMI, and multilevel lesions via dual access.ConclusionsStandâ alone TAMI or tibial access as an integral part of a dual access treatment strategy, is safe and efficacious in the treatment of patients with advanced PAD and CLI who have infrapopliteal lesions. Larger prospective and randomized studies may be useful to further validate this approach.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154326/1/ccd28639.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154326/2/ccd28639_am.pd

A prospective, multi‐center study of the chocolate balloon in femoropopliteal peripheral artery disease: The Chocolate BAR registry

The Chocolate BAR study is a prospective multicenter post‐market registry designed to evaluate the safety and performance of the Chocolate percutaneous transluminal angioplasty balloon catheter in a broad population with symptomatic peripheral arterial disease. The primary endpoint is acute procedural success (defined as ≤30% residual stenosis without flow‐limiting dissection); secondary long‐term outcomes include freedom from target lesion revascularization (TLR), major unplanned amputation, survival, and patency. A total of 262 patients (290 femoropopliteal lesions) were enrolled at 30 US centers between 2012 and 2014. The primary endpoint of procedure success was achieved in 85.1% of cases, and freedom from stenting occurred in 93.1%. Bail out stenting by independent adjudication occurred in 1.6% of cases and there were no flow limiting dissections. There was mean improvement of 2.1 Rutherford classes (±1.5) at 12‐months, with 78.5% freedom from TLR, 97.2% freedom from major amputation, and 93.3% freedom from all‐cause mortality. Core Lab adjudicated patency was 64.1% at 12 months. Use of the Chocolate balloon in an “all‐comers” population achieved excellent procedural outcomes with low dissection rates and bailout stent use.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/143650/1/ccd27565_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143650/2/ccd27565.pd

Percutaneous stenting of anastomotic stenoses in tubular interposition grafts used to repair aortic coarctation in adults

Stenting is the usual treatment for recoarctation following resection with direct end-to-end anastomosis. We describe for the first time stenting to relieve anastomotic stenoses in tubular interposition grafts, which are used to repair approximately 10% of coarctations. Success in these two adults expands further the spectrum of large conduits that may be relieved of stenosis by stenting

Cost-effectiveness analysis of intravascular ultrasound-guidedperipheral vascular interventions in patients with femoropopliteal peripheralartery disease

<jats:p> Summary: Background: Intravascular ultrasound (IVUS)-guided percutaneous transluminal angioplasty (PTA) might offer clinical benefits compared to angiography-guided PTA in patients with peripheral artery disease (PAD). A cost-effectiveness model was developed to examine the benefits and costs of IVUS-guided PTA versus angiography-guided PTA in PAD patients with femoropopliteal (FP) occlusive disease. Methods: A two-step model (a one-year decision tree followed by a lifetime semi-Markov model) was developed from a German healthcare payer perspective to estimate the costs and outcomes over a one-year and lifetime horizon. Clinical events included target lesion revascularization (TLR), amputation, and death. Transition probabilities and utility values were derived from published literature. Healthcare costs were based on German Diagnosis Related Groups (DRG) codes. Costs and outcomes were discounted at a rate of 3% per year. The incremental cost-effectiveness ratio (ICER) was calculated, and sensitivity analyses were performed to assess the robustness of the results. Results: In the one-year horizon, IVUS-guided PTA resulted in incremental quality-adjusted life-years (QALY) and costs of 0.02 and €919 per patient respectively, with a corresponding ICER of €45,195/QALY gained versus angiography-guided PTA. In the lifetime horizon, IVUS-guided PTA outperforms angiography-guided PTA; it was associated with a cost saving of €46 per patient and incremental QALY of 0.22. Utility value for post-TLR, as well as probabilities of death and TLR had the greatest impact on the one-year ICER, while cost of TLR and probabilities of TLR and amputation influenced the lifetime ICER most. The probability of IVUS-guided PTA being cost-effective at a willingness-to-pay (WTP) threshold of €50,000/QALY was 50.4% in the one-year horizon and increased to 85.9% in the lifetime horizon. Conclusions: In this analysis IVUS-guided PTA among patients with symptomatic FP atherosclerosis was cost-saving in a lifetime horizon from the German healthcare payer perspective. </jats:p&gt

Acute procedural outcomes of orbital atherectomy for the treatment of iliac artery disease: Sub-analysis of the CONFIRM registries.

Endovascular intervention is an appealing revascularization strategy for iliac artery disease. Atherectomy of the iliac artery is uncommon due to the risk of life-threatening perforation but may be necessary if the iliac lesion is heavily calcified, preventing stent delivery or optimal expansion. We assessed the feasibility and safety of orbital atherectomy for the treatment of iliac artery disease. Demographic data, lesion characteristics, and procedure outcomes for the CONFIRM patients with at least one iliac artery lesion treated with orbital atherectomy (n=62 patients; n=68 lesions) were compared to patients with at least one superficial femoral artery (SFA) lesion treated with orbital atherectomy (n=1570 patients; n=1809 lesions). The procedural complication rate, defined as the composite of flow limiting dissection, perforation, slow flow, vessel closure, spasm, embolism, or thrombosis, was compared in iliac lesions versus SFA lesions. The iliac artery group had more patients with diabetes, shorter lesions, and more severely calcified lesions. The orbital atherectomy run time was significantly shorter in the iliac artery group. Additionally, in the iliac group there was one reported perforation and one reported vessel closure; the rates of slow flow, spasm, embolism, thrombus, and flow limiting dissection were 0%. The overall procedural complication rate was significantly lower in the iliac group (2.9% vs. 11.2%, p=0.03). Orbital atherectomy of the iliac artery is feasible with few reported angiographic complications and compared favorably with the SFA group. Orbital atherectomy may be considered to facilitate the delivery and expansion of a balloon or stent if the iliac artery is calcified

Incidence of adverse cardiovascular events in patients with insomnia: A systematic review and meta-analysis of real-world data

Insomnia is a prevalent sleeping disorder associated with increasing cardiovascular (CV) mortality and morbidity. However, data incorporating recent clinical studies evaluating these outcomes is scarce. Hence, we aimed to investigate the association of insomnia with CV mortality, myocardial infarction (MI), all-cause mortality, and incidence of CV disease by conducting the first-ever meta-analysis of real-world data evaluating these CV outcomes. MEDLINE and Scopus databases were queried till August 2022 to identify studies comparing prespecified outcomes in patients with and without insomnia. The primary outcomes were CV mortality and myocardial infarction, while secondary outcomes included all-cause mortality, and CV-disease incidence. All data were pooled using an inverse-variance weighted random-effects model, and results were reported as relative risks (RRs) and p-values. 21 studies were analyzed. Risks for CV mortality and MI were significantly higher in patients with insomnia (RR 1.53, p\u3c0.01, and RR 1.48, p = 0.03, respectively). The risk for all-cause mortality and CV disease incidence was also significantly higher in insomnia patients (RR 1.14, p = 0.03, and RR 1.31, p\u3c0.01, respectively). Individuals with insomnia experience a higher risk of long-term mortality, MI, and incidence of CV diseas