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BackgroundTranscatheter aortic valve replacement (TAVR) is a widely established alternative to surgery in intermediate- and high-risk patients. TAVR program development within the Veterans Affairs (VA) system has been previously described. However, national TAVR registries do not capture VA outcomes data, and few data have been reported regarding TAVR outcomes at lower-volume federal institutions. The study aim was to demonstrate the evolution of a successful VA TAVR program.MethodsA retrospective analysis was performed of the first 100 TAVR patients at San Francisco VA Medical Center. Mortality and major complications were evaluated.ResultsBetween 25th November 2013 and 31st August 2016, a total of 100 TAVR procedures was performed at the authors' institution. The mean patient age was 79.7 ± 8.7 years. Patients underwent TAVR via percutaneous-transfemoral (n = 90), surgical cutdown-transfemoral (n = 8), or transapical (n = 2) approaches. The valve systems employed were Edwards SAPIEN (n = 16), SAPIEN XT (n = 31), SAPIEN 3 (n = 23), and Medtronic CoreValve (n = 16) and CoreValve Evolut R (n = 14). The overall device success was 96%. TAVR-in-TAVR was required in the remaining 4% of patients, and was successful. All-cause procedural mortality was 1%. Complications included tamponade (1%), stroke (2%), temporary hemodialysis (1%), vascular injuries requiring intervention (4%), and permanent pacemaker implantation (14%). There were no conversions to surgical aortic valve replacement. Twenty-two (22%) patients had mild, two (2%) had moderate, and none (0%) had severe paravalvular leakage. The post-procedure aortic valve gradient by echocardiography was 8.6 ± 4.5 mmHg. Follow up was 100% complete and survival was 99%, 93%, and 89% at one, six, and 12 months, respectively.ConclusionsSuccessful outcomes were demonstrated for a VA TAVR program that compared favorably with benchmarks established by the National Transcatheter Valve Therapies Registry. These results provide a necessary transparency of TAVR outcomes at a federal institution.

This paper provides technical method for poor eye sight persons or the blind and dumb person to communicate each other without any third person's help. The main parameters are hand gesture sensing, RF communication, sound output. The aim of the idea is to provide a gesture sensing gloves to the visually impaired one, a hand hold which shows a sound as output. This is done with help of flex sensors and sd-card module with speakers, whereas the flex sensing gloves detects the hand gestures and transmit the signals through a radiofrequency transmitter. This transmitted signal is received in the other and shows the signal as a sound output using speaker by the already recorded sounds in the sd-card module. They can communicate each other easily without anyone's help. [ABSTRACT FROM AUTHOR]

Nowadays the demand for power increases constantly. To meet the demands, production units were established all around the country. Until the electricity reaches our house it transforms both up and down many times, thus power fluctuation occurs in our house. To overcome this issue we have developed this device to identify the fault parameters and protect our household appliances using relay [ABSTRACT FROM AUTHOR]

Diabetes Mellitus in human beings is an inability to produce adequate insulin or process them which will cause a rise in blood sugar level. To maintain the blood glucose level check-up at a regular interval is required. The conventional method available currently involves pricking which irritates skin when done repeatedly. The objective of this paper is to overcome the painful process and to be noninvasive. Our proposed system is based on the NIR (near-infrared) spectroscopy method of a selected wavelength which is more sensitive to blood glucose. This helps to reduce the error factor and the system is implemented with machine learning to improve the efficiency of the output. [ABSTRACT FROM AUTHOR]