TCT-804 Outcomes of Trans-Carotid TAVR in a high-Volume Center

Background Although the preferred route for transcatheter aortic valve replacement is through the femoral artery, alternatives remain necessary for patients with obstructive iliofemoral disease. Our valve team has developed a large experience using the carotid artery as a primary alternative vascular access approach for transcatheter aortic valve replacement (TAVR). We aim to compare short-term outcomes by access route in a single-center, high-volume, transcarotid (TC) TAVR program. Methods All patients undergoing TAVR between September 2012 and September 2018 were included in the study. Baseline demographics and outcomes were obtained from data our institution submitted in compliance with TVT (Transcatheter Valve Therapy) reporting and are supplemented by individual chart review. Results Overall, 1,153 commercial TAVR procedures were completed during the study period. Of these, 976 (85%) were transfemoral (TF), 105 (9%) were TC, and 72 (6%) were other (53 transapical, 14 transaxillary, 5 transaortic). TF patients had lower Society of Thoracic Surgeons (STS) scores (6.0% vs. 7.1% vs. 8.3%), peripheral vascular disease (24% vs. 88% vs. 72%), and cerebral vascular disease (11% vs. 17% vs. 32%) compared with TC and other patients, respectively (p \u3c 0.001). Combined in-hospital and 30-day mortality was 2.6% for the TF cohort versus 3.8% for TC (p = 0.36) and 13.9% for other (p \u3c 0.001). The stroke rate at 30 days was 3.7% for TF versus 3.8% for TC and 4.2% for other access routes (p = 0.98) (Table). Conclusion TAVR can be safely performed from the TC access route at a high-volume center with similar in-hospital and 30-day mortality and stroke rates compared with TF patients. Mortality was significantly increased, however, in patients treated with other alternative access routes

Exploring The Relationship Between Biodiversity And Pollution In Natural History Studies

Natural history museums & libraries provide exceptional resources for both traditional & non-traditional education settings. Because they are snapshots in time & space, collections provide information that can never be duplicated. Learning about & interacting deeply with the living world is facilitated by exposure to collections. Specimens in collections allow for direct tracking of global biological diversity & also changes in that diversity, whether those changes are ancient or recent. This paper investigates the significance of biodiversity & pollution in the field of natural history studies, as well as the connection between the two concepts. It is emphasised here how the current rise in specimen-based digitization programmes has provided access to an unprecedented biodiversity data wealth, vastly expanding the scope of natural history collections. The methodology was used as a secondary source of data, which was gathered using online sources. By providing access tospecimens & data housed in natural history collections, online databases have allowed scientists along with the general public to address worldwide, regional, & also local concerns concerning biodiversity in a manner that was not conceivable a decade ago

AI Unveiled Personalities: Profiling Optimistic and Pessimistic Attitudes in Hindi Dataset using Transformer-based Models

Both optimism and pessimism are intricately intertwined with an individual's inherent personality traits and people of all personality types can exhibit a wide range of attitudes and behaviours, including levels of optimism and pessimism. This paper undertakes a comprehensive analysis of optimistic and pessimistic tendencies present within Hindi textual data, employing transformer-based models. The research represents a pioneering effort to define and establish an interaction between the personality and attitude chakras within the realm of human psychology. Introducing an innovative "Chakra" system to illustrate complex interrelationships within human psychology, this work aligns the Myers-Briggs Type Indicator (MBTI) personality traits with optimistic and pessimistic attitudes, enriching our understanding of emotional projection in text. The study employs meticulously fine-tuned transformer models—specifically mBERT, XLM-RoBERTa, IndicBERT, mDeBERTa and a novel stacked mDeBERTa —trained on the novel Hindi dataset ‘मनोभाव’ (pronounced as Manobhav). Remarkably, the proposed Stacked mDeBERTa model outperforms others, recording an accuracy of 0.7785 along with elevated precision, recall, and F1 score values. Notably, its ROC AUC score of 0.7226 underlines its robustness in distinguishing between positive and negative emotional attitudes. The comparative analysis highlights the superiority of the Stacked mDeBERTa model in effectively capturing emotional attitudes in Hindi text

Leveling transparency via situated intermediary learning objectives (SILOs)

When designers set out to create a mathematics learning activity, they have a fair sense of its objectives: students will understand a concept and master relevant procedural skills. In reform-oriented activities, students first engage in concrete situations, wherein they achieve situated, intermediary learning objectives (SILOs), and only then they rearticulate their solutions formally. We define SILOs as heuristics learners devise to accommodate contingencies in an evolving problem space, e.g., monitoring and repairing manipulable structures so that they model with fidelity a source situation. Students achieve SILOs through problem-solving with media, instructors orient toward SILOs via discursive solicitation, and designers articulate SILOs via analyzing implementation data. We describe the emergence of three SILOs in developing the activity Giant Steps for Algebra. Whereas the notion of SILOs emerged spontaneously as a framework to organize a system of practice, i.e. our collaborative design, it aligns with phenomenological theory of knowledge as instrumented action