Safety and efficacy of the unilateral, suture-based, dry-closure technique in percutaneous trans-axillary aortic valve implantation.

Background: Transaxillary transcatheter aortic valve implantation (TAx-TAVI) is the most used alternative access when severe iliofemoral disease renders transfemoral access infeasible. Compared to surgical transaxillary access, a true percutaneous approach using vascular closure devices (VCD) has advantages but can be challenging. Herein, we describe the impact of the "unilateral, suture-mediated, dry-closure technique" on vascular safety and efficacy in patients undergoing true percutaneous TAx-TAVI.

Screening for cardiac sarcoidosis: diagnostic approach and long-term follow-up in a tertiary centre.

Background: Cardiac sarcoidosis (CS) is associated with poor prognosis, making early diagnosis and treatment important. This study evaluated the results of a diagnostic approach in patients with known sarcoidosis and suspected cardiac involvement in a tertiary centre and their long-term outcomes.

Methods: We included 180 patients with sarcoidosis and a clinical suspicion of CS.

Drivers of global tourism carbon emissions.

Tourism has a critical role to play in global carbon emissions pathway. This study estimates the global tourism carbon footprint and identifies the key drivers using environmentally extended input-output modelling. The results indicate that global tourism emissions grew 3.

Interbasin trade worsens the state of freshwater fish biodiversity in China.

Human economic activities severely threaten freshwater fish biodiversity in different river basins. Trade makes the impact more mysterious and complex and confounds local efforts to protect freshwater biodiversity. To investigate the relationship between trade and freshwater fishes, we developed a river-basin economic transaction model that is applied to mainland China, home to 9% of the world's freshwater fish species.

Long-term safety and efficacy of endovascular ultrasound renal denervation in resistant hypertension: 8-year results from the ACHIEVE study.

Background: Ultrasound renal sympathetic denervation (uRDN) reduces blood pressure (BP) in the absence and presence of antihypertensive treatment at 2 months. Beyond 3 years, there is a lack of follow-up data. This study investigated the long-term safety and efficacy of uRDN.

Localized nitrogen management strategies can halve fertilizer use in Chinese staple crop production.

Nitrogen (N) management is the key to achieving food security and environmental sustainability. Here we analyse N flows using a localized N management model for wheat, maize and rice in 1,690 Chinese counties, with a breakdown of multiple reactive N (Nr) loss pathways. Results show that the total N input for producing these three staple crops in China was 22.

Carbon and social impacts in the EU's consumption of fossil and mineral raw materials.

Fossil and mineral raw materials cause unintended and detrimental environmental and social impacts via extraction, production and combustion processes. In this study, we analyse how consumer demand in the European Union (EU) drives environmental and social impacts in mining sectors worldwide. We employ multi-regional input-output analysis to quantify positive (i.

Demographics and outcomes of patients younger than 75 years undergoing aortic valve interventions in Rotterdam.

Background: Transcatheter aortic valve implantation (TAVI) is considered a safe and effective alternative to surgical aortic valve replacement (SAVR) for elderly patients across the operative risk spectrum. In the Netherlands, TAVI is reimbursed only for patients with a high operative risk. Despite this, one fifth of TAVI patients are < 75 years of age.

Immediate versus staged complete revascularisation in patients presenting with STEMI and multivessel disease.

Background: Complete revascularisation is supported by recent trials in patients with ST-elevation myocardial infarction (STEMI) and multivessel disease (MVD) without cardiogenic shock. However, the optimal timing of non-culprit lesion revascularisation is currently debated.

Aims: This prespecified analysis of the BioVasc trial aims to determine the effect of immediate complete revascularisation (ICR) compared to staged complete revascularisation (SCR) on clinical outcomes in patients with STEMI.

Timing of Complete Multivessel Revascularization in Patients Presenting With Non-ST-Segment Elevation Acute Coronary Syndrome.

Background: Complete revascularization of the culprit and all significant nonculprit lesions in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and multivessel disease (MVD) reduces major adverse cardiac events, but optimal timing of revascularization remains unclear.

Objectives: This study aims to compare immediate complete revascularization (ICR) and staged complete revascularization (SCR) in patients presenting with NSTE-ACS and MVD.

Methods: This prespecified substudy of the BIOVASC (Percutaneous Complete Revascularization Strategies Using Sirolimus Eluting Biodegradable Polymer Coated Stents in Patients Presenting With Acute Coronary Syndrome and Multivessel Disease) trial included patients with NSTE-ACS and MVD.

Device infection in patients undergoing pacemaker or defibrillator surgery: risk stratification using the PADIT score.

Background: The use of an antibacterial envelope is cost-effective for patients at high risk of developing cardiac implantable electronic device (CIED) infection. The identification of these high-risk patients may be facilitated using a clinical risk score. The aim of the current study is to evaluate the PADIT score for identifying high-risk patients in patients undergoing a CIED procedure in a tertiary academic center.

Nutritional, environmental and economic impacts of ultra-processed food consumption in Australia.

Objective: To quantify the full life cycle impacts of ultra-processed foods (UPF) for key environmental, economic and nutritional indicators to identify trade-offs between UPF contribution to broad-scope sustainability.

Design: Using 24-h dietary recalls along with an input-output database for the Australian economy, dietary environmental and economic impacts were quantified in this national representative cross-sectional analysis. Food items were classified into non-UPF and UPF using the NOVA system, and dietary energy contribution from non-UPF and UPF fractions in diets was estimated.

Validation of Segmental Post-PCI Physiological Gradients With IVUS-Detected Focal Lesions and Stent Underexpansion.

Background: Segmental postpercutaneous coronary intervention (PCI) pressure gradients may detect residual disease and potential targets for optimization. However, universal definitions of relevant segmental gradients are lacking.

Objectives: This study sought to evaluate the diagnostic performance of post-PCI fractional flow reserve (FFR), distal coronary pressure-to-aortic pressure ratio (Pd/Pa), and diastolic pressure ratio (dPR) gradients to detect residual focal lesions and stent underexpansion as observed by intravascular ultrasound (IVUS).

Invasive Real Time Biventricular Pressure-Volume Loops to Monitor Dynamic Changes in Cardiac Mechanoenergetics During Structural Heart Interventions: Design and Rationale of a Prospective Single-Center Study.

Background: Transcatheter valvular interventions affect cardiac and hemodynamic physiology by changing ventricular (un-)loading and metabolic demand as reflected by cardiac mechanoenergetics. Real-time quantifications of these changes are scarce. Pressure-volume loop (PVL) monitoring appraises both load-dependent and load-independent compounds of cardiac physiology including myocardial work, ventricular unloading, and ventricular-vascular interactions.

Relationship between stent length and very long-term target lesion failure following percutaneous coronary intervention for ST-elevation myocardial infarction in the drug-eluting stents era: insights from the EXAMINATION-EXTEND study.

Background: Little data exist on the relationship between total stent length (TSL) and cardiovascular outcomes at very-long follow-up in patients with ST-elevation myocardial infarction (STEMI) in the 2nd generation drug-eluting stents (DES) era.

Aim: To analyze the relationship between TSL and 10-year target-lesion failure (TLF) in STEMI patients treated with percutaneous coronary intervention enrolled in the EXAMINATION-EXTEND.

Methods: The EXAMINATION-EXTEND was an extended-follow-up study of the EXAMINATION trial, which randomized 1:1 STEMI patients to receive DES or bare metal stent (BMS).

Effects of a Dedicated Cardiac Rehabilitation Program for Patients With Obesity on Body Weight, Physical Activity, Sedentary Behavior, and Physical Fitness: The OPTICARE XL Randomized Controlled Trial.

Objective: Previously published results of the OPTICARE XL open label randomized controlled trial showed no added value of OPTICARE XL CR, a dedicated cardiac rehabilitation (CR) program for patients with obesity, with respect to health-related quality of life (primary outcome). This clinical trial studied the effects of OPTICARE XL CR on several secondary outcomes, which included body weight, physical activity, sedentary behavior, and physical fitness.

Methods: Patients with coronary artery disease or atrial fibrillation and body mass index ≥ 30 were randomized to OPTICARE XL CR (n = 102) or standard CR (n = 99).

Impacts of climate change and extreme weather on food supply chains cascade across sectors and regions in Australia.

Disasters resulting from climate change and extreme weather events adversely impact crop and livestock production. While the direct impacts of these events on productivity are generally well known, the indirect supply-chain repercussions (spillovers) are still unclear. Here, applying an integrated modelling framework that considers economic and physical factors, we estimate spillovers in terms of social impacts (for example, loss of job and income) and health impacts (for example, nutrient availability and diet quality) resulting from disruptions in food supply chains, which cascade across regions and sectors.

Immediate versus staged complete revascularisation in patients presenting with acute coronary syndrome and multivessel coronary disease (BIOVASC): a prospective, open-label, non-inferiority, randomised trial.

Background: In patients with acute coronary syndrome and multivessel coronary disease, complete revascularisation by percutaneous coronary intervention (PCI) is associated with improved clinical outcomes. We aimed to investigate whether PCI for non-culprit lesions should be attempted during the index procedure or staged.

Methods: This prospective, open-label, non-inferiority, randomised trial was done at 29 hospitals across Belgium, Italy, the Netherlands, and Spain.

Cost-Effectiveness of a Cardiac Rehabilitation Program Specifically Designed for Patients With Obesity Within the OPTICARE XL Randomized Controlled Trial.

Objective: To assess the cost-effectiveness of a cardiac rehabilitation (CR) program specifically designed for cardiac patients with obesity vs standard CR.

Design: Cost-effectiveness analysis based on observations in a randomized controlled trial.

Setting: Three regional CR centers in the Netherlands.