Severe symptomatic aortic stenosis: medical therapy and transcatheter aortic valve implantation (TAVI)—a real-world retrospective cohort analysis of outcomes and cost-effectiveness using national data

Objectives: Determine the real-world difference between 2 groups of patients with severe aortic stenosis and similar baseline comorbidities: surgical turn down (STD) patients, who were managed medically prior to the availability of transcatheter aortic valve implantation (TAVI) following formal surgical outpatient assessment, and patients managed with a TAVI implant. Design: Retrospective cohort study from real-world data. Setting: Electronic patient letters were searched for patients with a diagnosis of severe aortic stenosis and a formal outpatient STD prior to the availability of TAVI (1999–2009). The second group comprised the first 90 cases of TAVI in South Wales (2009 onwards). 2 years prior to and 5 years following TAVI/STD were assessed. Patient data were pseudoanonymised, using the Secure Anonymized Information Linkage (SAIL) databank, and extracted from Office National Statistics (ONS), PatientEpisode Database for Wales (PEDW) and general practitioner databases. Population: 90 patients who had undergone TAVI in South Wales, and 65 STD patients who were medically managed. Main outcome measures: Survival, hospital admission frequency and length of stay, primary care visits, and cost-effectiveness. Results: TAVI patients were significantly older (81.8 vs 79.2), more likely to be male (59.1% vs 49.3%), baseline comorbidities were balanced. Mortality in TAVI versus STD was 28% vs 70% at 1000 days follow-up. There were significantly more hospital admissions per year in the TAVI group prior to TAVI/STD (1.5 (IQR 1.0– 2.4) vs 1.0 IQR (0.5–1.5)). Post TAVI/STD, the TAVI group had significantly lower hospital admissions (0.3 (IQR 0.0–1.0) vs 1.2 (IQR 0.7–3.0)) and lengths of stay (0.4 (IQR 0.0–13.8) vs 11.0 (IQR 2.5–28.5), p<0.05). The incremental cost-effectiveness ratio (ICER) for TAVI was £10 533 per quality-adjusted life year (QALY). Conclusions: TAVI patients were more likely to survive and avoid hospital admissions compared with the medically managed STD group. The ICER for TAVI was £10 533 per QALY, making it a cost-effective procedure

Galaxy Merger Statistics and Inferred Bulge-to-Disk Ratios in Cosmological SPH Simulations

We construct merger trees for galaxies identified in a cosmological hydrodynamical simulation and use them to characterize predicted merger rates as a function of redshift, galaxy mass, and merger mass ratio. At z=0.3, we find a mean rate of 0.054 mergers per galaxy per Gyr above a 1:2 mass ratio threshold for massive galaxies (baryonic mass above 6.4E10 \Msun), but only 0.018 / Gyr for lower mass galaxies. The mass ratio distribution is proportional to R_merg^-1.2 for the massive galaxy sample, so high mass mergers dominate the total merger growth rate. The predicted rates increase rapidly with increasing redshift, and they agree reasonably well with observational estimates. A substantial fraction of galaxies do not experience any resolved mergers during the course of the simulation, and even for the high mass sample only 50% of galaxies experience a greater than 1:4 merger since z=1. Typical galaxies thus have fairly quiescent merger histories. We assign bulge-to-disk ratios to simulated galaxies by assuming that mergers above a mass ratio threshold R_major convert stellar disks into spheroids. With R_major of 1:4, we obtain a fairly good match to the observed dependence of early-type fraction on galaxy mass. However, the predicted fraction of truly bulge-dominated systems (f_bulge} > 0.8) is small, and producing a substantial population of bulge-dominated galaxies may require a mechanism that shuts off gas accretion at late times and/or additional processes (besides major mergers) for producing bulges.Comment: submitted to MNRAS, 11 pages, 11 figures, a version of the paper with a high resolution version of Figure 2 at http://www.astro.umass.edu/~ari/pub.htm

The Lantern Vol. 60, No. 1, December 1992

• Bacon and Incense • The Rubix Cube • Recovery • Untitled • Star Six Nine • Breakfast Talk • Life as a Worker Bee • Cabal • One Cold Sunday Morning With Eggs • By the End of February • Eight Years and Five Minutes Away • Distance • Stuart\u27s Gift • Solitary Remembrance • The Gene Thing • Addictionhttps://digitalcommons.ursinus.edu/lantern/1139/thumbnail.jp

A formally verified compiler back-end

This article describes the development and formal verification (proof of semantic preservation) of a compiler back-end from Cminor (a simple imperative intermediate language) to PowerPC assembly code, using the Coq proof assistant both for programming the compiler and for proving its correctness. Such a verified compiler is useful in the context of formal methods applied to the certification of critical software: the verification of the compiler guarantees that the safety properties proved on the source code hold for the executable compiled code as well

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

Edible films and coatings as carriers of living microorganisms: a new strategy towards biopreservation and healthier foods

Edible films and coatings have been extensively studied in recent years due to their unique properties and advantages over more traditional conservation techniques. Edible films and coatings improve shelf life and food quality, by providing a protective barrier against physical and mechanical damage, and by creating a controlled atmosphere and acting as a semipermeable barrier for gases, vapor, and water. Edible films and coatings are produced using naturally derived materials, such as polysaccharides, proteins, and lipids, or a mixture of these materials. These films and coatings also offer the possibility of incorporating different functional ingredients such as nutraceuticals, antioxidants, antimicrobials, flavoring, and coloring agents. Films and coatings are also able to incorporate living microorganisms. In the last decade, several works reported the incorporation of bacteria to confer probiotic or antimicrobial properties to these films and coatings. The incorporation of probiotic bacteria in films and coatings allows them to reach the consumers gut in adequate amounts to confer health benefits to the host, thus creating an added value to the food product. Also, other microorganisms, either bacteria or yeast, can be incorporated into edible films in a biocontrol approach to extend the shelf life of food products. The incorporation of yeasts in films and coatings has been suggested primarily for the control of the postharvest disease. This work provides a comprehensive review of the use of edible films and coatings for the incorporation of living microorganisms, aiming at the biopreservation and probiotic ability of food products.Ana Guimaraes received support through grant SFRH/BD/ 103245/2014 from the Portuguese Foundation for Science and Technology (FCT). Luís Abrunhosa was supported by grant UMINHO/BPD/51/2015 from project UID/BIO/04469/2013 financed by FCT/MEC (OE). This study was supported by FCT under the scope of the strategic funding of UID/BIO/04469/2013 unit and COMPETE 2020 (POCI-01-0145-FEDER-006684), and of BioTecNorte operation (NORTE-01-0145-FEDER000004) funded by European Regional Development Fund under the scope of Norte2020 - Programa Operacional Regional do Norte. Vectors used in Figure were designed by Freepik.info:eu-repo/semantics/publishedVersio