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1. Documenting the Recovery of Vascular Services in European Centres Following the Initial COVID-19 Pandemic Peak: Results from a Multicentre Collaborative Study

Author

Ruth A. Benson, Maria Antonella Ruffino, Sharon Chan, Patrick Coughlin, Ayoola Awopetu, Philip Stather, Tristan Lane, Dimitrios Theodosiou, Mohamed Abozeid Ahmed, Thodur Vasudevan, Mohammed Ibrahim, Faraj Al Maadany, Mohamed Eljareh, Fatimah Saad Alkhafeefi, Raphael Coscas, Ertekin Utku Ünal, Raffaele Pulli, Sergio Zacà, Domenico Angiletta, Thomas Kotsis, Magdy Moawad, Matteo Tozzi, Nikolaos Patelis, Andreas M. Lazaris, Jason Chuen, Alexander Croo, Elpiniki Tsolaki, Gladiol Zenunaj, Dhafer Kamal, Mahmoud MH. Tolba, Martin Maresch, Vipul Khetarpaul, Joseph Mills, Gaurav Gangwani, Mohamed Elahwal, Rana Khalil, Mohammed A. Azab, Anver Mahomed, Richard Whiston, Ummul Contractor, Davide Esposito, Carlo Pratesi, Elena Giacomelli, Martín Veras Troncoso, Stephane Elkouri, Flavia Gentile Johansson, Ilias Dodos, Marie Benezit, José Vidoedo, João Rocha-Neves, António Henrique Pereira-Neves, Marina Felicidade Dias-Neto, Ana Filipa Campos Jácome, Luis Loureiro, Ivone Silva, Rodrigo Garza-Herrera, Victor Canata, Charlotte Bezard, Kathryn Bowser, Jorge Felipe Tobar, Carlos Gomez Vera, Carolina Salinas Parra, Eugenia Lopez, Yvis Gadelha Serra, Juan Varela, Vanessa Rubio, Gerardo Victoria, Adam Johnson, Leigh Ann O’Banion, Ragai Makar, Tamer Ghatwary Tantawy, Martin Storck, Vincent Jongkind, Orwa falah, Olivia McBride, Arda Isik, Athanasios Papaioannou, Paulo Eduardo Ocke Reis, Umberto Marcello Bracale, Ellie Atkins, Giovanni Tinelli, Emma Scott, Lucy Wales, Ashwin Sivaharan, Georgia Priona, Craig Nesbitt, Tabitha Grainger, Lauren Shelmerdine, Patrick Chong, Adnan Bajwa, Luke Arwynck, Nancy Hadjievangelou, Ahmed Elbasty, Oscar Rubio, Michael Ricardo, Jorge H. Ulloa, Marcos Tarazona, Manuel Pabon, Georgios Pitoulias, Kevin Corless, Orestis Ioannidis, Oliver Friedrich, Isabelle Van Herzeele, Badri Vijaynagar, Tina Cohnert, Rachel Bell, Hayley Moore, Prakash Saha, Edward Gifford, Matti Laine, Adel Barkat, Christos Karkos, Lenny Suryani Binti Safri, Gabriel Buitron, Javier Del Castillo, Paul Carrera, Nilson Salinas, Rodrigo Bruno Biagioni, Sergio Benites, César Andrés Mafla, Putera Mas Pian, Pereira Albino, Ernesto Serrano, Andres Marin, Marco González, Marsha Foreroga, Alejandro Russo, Andrés Reyes, Daniel Guglielmone, Lorena Grillo, Ronald Flumignan, Francisco Gomez Palones, Pierre Galvagni Silveira, Rosnelifaizur Bin Ramely, Sara Edeiken, Ian Chetter, Lucy Green, Abhilash Sudarsanam, Oliver Lyons, Gary Lemmon, Richard Neville, Mariano Castelli, Carlos A. Hinojosa, Rubén Rodríguez Carvajal, Aksim Rivera, Peng Wong, Laura Drudi, Jeremy Perkins, Kishore Sieunarine, Doaa Attia, Mahmoud Atef, Lostoridis Eftychios, Fred Weaver, Leong Chuo Ren, Mohannad Alomari, Reda Jamjoom, Qusai Aljarrah, Ayman Abbas, Faris Alomran, Ambrish Kumar, Abdulmajeed Altoijri, Kareem T. ElSanhoury, Ahmed Alhumaid, Tamer Fekry, Raghuram Sekhar, Panagiotis Theodoridis, Theodoridis Panagiotis, Konstantinos Roditis, Paraskevi Tsiantoula, Afroditi Antoniou, Raphael Soler, Natasha Hasemaki, Efstratia Baili, Eustratia Mpaili, Bella Huasen, Tom Wallace, Andrew Duncan, Matthew Metcalfe, Kristyn Mannoia, Carlos F. Bechara, Nikolaos Tsilimparis, Nathan Aranson, David Riding, Mariano Palena, Ciarán McDonnell, Nicolas J. Mouawad, Shonda Banegas, Peter Rossi, Taohid Oshodi, Rodney Diaz, Rana Afifi, Shiva Dindyal, Ankur Thapar, Ali Kordzadeh, Gonzalo Pullas, Stephanie Lin, Chris Davies, Katy Darvall, Akio Kodama, Thushan Gooneratne, Nalaka Gunawansa, Alberto Munoz, Ng Jun Jie, Nicholas Bradley, Wissam Al-Jundi, Felicity Meyer, Cheong Lee, Martin Malina, Sophie Renton, Dennis Lui, Andrew Batchelder, Grzegorz Oszkinis, Antonio Freyrie, Jacopo Giordano, Nikolaos Saratzis, Konstantinos Tigkiropoulos, Stavridis Kyriakos, Guriy Popov, Muhammad Usman Cheema, Pierfrancesco Lapolla, Yih Chun Ling Patricia, Raed Ennab, Brant W. Ullery, Ketino Pasenidou, Jacky Tam, Gabriel Sidel, Vivek Vardhan Jayaprakash, Lisa Bennett, Simon Hardy, Emma Davies, Sara Baker, Lasantha Wijesinghe, Adam Tam, Ken McCune, Manik Chana, Chris Lowe, Aaron Goh, Katarzyna Powezka, Ioanna Kyrou, Nishath Altaf, Denis Harkin, Hannah Travers, James Cragg, Atif sharif, Tasleem Akhtar, José Antonio Chávez, Claudia Ordonez, Martin Mazzurco, Edward Choke, Imran Asghar, Virginia Summerour, Paul Dunlop, Rachel Morley, Thomas Hardy, Paul Bevis, Robert Cuff, Konstantinos Stavroulakis, Efthymios Beropoulis, Angeliki Argyriou, Ian Loftus, Bilal Azhar, Sharvil Sheth, Marco Virgilio Usai, Asad Choudhry, Kira Nicole, Emily Boyle, Doireann Joyce, Mohammed Hassan Abdelaty Hassan, Alberto Saltiel, Gert Frahm-Jensen, George Antoniou, Muhammed Elhadi, Ali Kimyaghalam, Rafael Malgor, Leigh Ann O'Banion, Diego Telve, Andrej Isaak, Jürg Schmidli, Kevin McKevitt, Tam Siddiqui, Giuseppe Asciutto, Nikolaos Floros, George Papadopoulos, Alexandros Kafetzakis, Stylianos G. Koutsias, Petroula Nana, Athanasios Giannoukas, Stavros Kakkos, Konstantinos G. Moulakakis, Natasha Shafique, Arkadiusz Jawien, Matthew Popplewell, Chris Imray, Kumar Abayasekara, Timothy Rowlands, Ganesh Kuhan, Sriram Rajagopalan, Anthony Jaipersad, Uzma Sadia, Isaac Kobe, Devender Mittapalli, Ibrahim Enemosah, Christian-Alexander Behrendt, Adam Beck, Muayyad Almudhafer, Stefano Ancetti, Donald Jacobs, Priya Jayakumar, Fatemeh Malekpour, Sherene Shalhub, Boboyor Keldiyorov, Meryl Simon, Manar Khashram, Nicole Rich, Amanda Shepherd, Lewis Meecham, and Daniel Doherty

Subjects
AAA, COVID-19, PAD, Survey, Vascular surgery, Diseases of the circulatory (Cardiovascular) system, RC666-701, Surgery, RD1-811
Abstract

Objective: To document the recovery of vascular services in Europe following the first COVID-19 pandemic peak. Methods: An online structured vascular service survey with repeated data entry between 23 March and 9 August 2020 was carried out. Unit level data were collected using repeated questionnaires addressing modifications to vascular services during the first peak (March – May 2020, “period 1”), and then again between May and June (“period 2”) and June and July 2020 (“period 3”). The duration of each period was similar. From 2 June, as reductions in cases began to be reported, centres were first asked if they were in a region still affected by rising cases, or if they had passed the peak of the first wave. These centres were asked additional questions about adaptations made to their standard pathways to permit elective surgery to resume. Results: The impact of the pandemic continued to be felt well after countries’ first peak was thought to have passed in 2020. Aneurysm screening had not returned to normal in 21.7% of centres. Carotid surgery was still offered on a case by case basis in 33.8% of centres, and only 52.9% of centres had returned to their normal aneurysm threshold for surgery. Half of centres (49.4%) believed their management of lower limb ischaemia continued to be negatively affected by the pandemic. Reduced operating theatre capacity continued in 45.5% of centres. Twenty per cent of responding centres documented a backlog of at least 20 aortic repairs. At least one negative swab and 14 days of isolation were the most common strategies used for permitting safe elective surgery to recommence. Conclusion: Centres reported a broad return of services approaching pre-pandemic “normal” by July 2020. Many introduced protocols to manage peri-operative COVID-19 risk. Backlogs in cases were reported for all major vascular surgeries.

Published
2022
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3. Classification and treatment of endothermal heat-induced thrombosis: Recommendations from the American Venous Forum and the Society for Vascular Surgery This Practice Guidelines document has been co-published in Phlebology [DOI: 10.1177/0268355520953759] and Journal of Vascular Surgery: Venous and Lymphatic Disorders [DOI: 10.1016/j.jvsv.2020.06.008]. The publications are identical except for minor stylistic and spelling differences in keeping with each journal’s style. The contribution has been published under a Attribution-Non Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0), (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Author

Lowell S. Kabnick, Mikel Sadek, Haraldur Bjarnason, Dawn M. Coleman, Ellen D. Dillavou, Anil P. Hingorani, Brajesh K. Lal, Peter F. Lawrence, Rafael Malgor, and Alessandra Puggioni

Subjects
03 medical and health sciences, 0302 clinical medicine, 030212 general & internal medicine, General Medicine, 030204 cardiovascular system & hematology, Cardiology and Cardiovascular Medicine
Abstract

The American Venous Forum (AVF) and the Society for Vascular Surgery set forth these guidelines for the management of endothermal heat-induced thrombosis (EHIT). The guidelines serve to compile the body of literature on EHIT and to put forth evidence-based recommendations. The guidelines are divided into the following categories: classification of EHIT, risk factors and prevention, and treatment of EHIT. One major feature is to standardize the reporting under one classification system. The Kabnick and Lawrence classification systems are now combined into the AVF EHIT classification system. The novel classification system affords standardization in reporting but also allows continued combined evaluation with the current body of literature. Recommendations codify the use of duplex ultrasound for the diagnosis of EHIT. Risk factor assessments and methods of prevention including mechanical prophylaxis, chemical prophylaxis, and ablation distance are discussed. Treatment guidelines are tailored to the AVF EHIT class (ie, I, II, III, IV). Reference is made to the use of surveillance, antiplatelet therapy, and anticoagulants as deemed indicated, and the recommendations incorporate the use of the novel direct oral anticoagulants. Last, EHIT management as it relates to the great and small saphenous veins is discussed.

Published
2020
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4. Extended anticoagulation for venous thromboembolism: A survey of the American Venous Forum and the European Venous Forum

Author

Maxim E. Shaydakov, Windsor Ting, Mikel Sadek, Faisal Aziz, Jose A. Diaz, Anthony J. Comerota, Fedor Lurie, John Blebea, Bo G. Eklöf, Marzia Lugli, Marianne G.R. De Maeseneer, Stavros K. Kakkos, Andrew Nicolaides, Dominik Heim, Harold J. Welch, Maxim Shaydakov, Jose Diaz, Peter Henke, Nicos Labropoulos, Rafael Malgor, Andrea Obi, Sarah Onida, André van Rij, Ruben Vellettaz, and Dermatology

Subjects
Surveys and Questionnaires, Anticoagulants, Humans, Hemorrhage, Surgery, Venous Thromboembolism, Warfarin, Cardiology and Cardiovascular Medicine
Abstract

Objective: Extended anticoagulation therapy should always be considered after standard treatment of an unprovoked episode of venous thromboembolism (VTE). It can also be considered for selected patients with provoked VTE. However, the evidence-based protocols suggested by some clinical guidelines and risk assessment tools to guide this practice are limited and ambiguous. The goal of the present survey research was to analyze current practices in applying extended anticoagulation therapy for patients with VTE among members of the American Venous Forum (AVF) and European Venous Forum (EVF). Methods: An online survey was created by the AVF Research Committee. The survey consisted of 16 questions to identify the country of practice, specialty, experience of the participating physicians, and their clinical practice patterns in applying extended anticoagulation therapy for VTE patients. The survey was distributed via e-mail to the members of the AVF and EVF. Results: A total of 144 practitioners, 48 AVF members (33%) and 96 EVF members (66%), participated in the survey. Most of the respondents identified themselves as vascular specialists with primary certification in vascular surgery (70%), vascular medicine or angiology (9%), and venous disease or phlebology (3%). Of the 144 respondents, 72% believed that the risk of VTE recurrence will generally overweigh the risk of bleeding for patients with unprovoked VTE. Extended anticoagulation therapy might be used by 97% of providers. Different patterns in real world clinical practice were identified. More than one half of the practitioners estimated the VTE recurrence and bleeding risk subjectively. The antithrombotic drugs most commonly used for secondary prophylaxis were rivaroxaban, apixaban, warfarin, dabigatran, and aspirin, in decreasing order of frequency. Among the reasons selected for not regularly considering extended anticoagulation therapy were the lack of specific clinical practice guidelines (24%), lack of reported evidence (9%), and absence of valid VTE and/or bleeding risk prediction calculators (8%). Twelve participants (8%) stated that extended anticoagulation therapy would not be beneficial for most patients with VTE. Ten participants (7%) indicated that prescribing extended anticoagulation therapy was outside the scope of their specialty. Conclusions: Different practice patterns exist regarding extending anticoagulation therapy beyond the standard treatment for patients with VTE. Major gaps in knowledge remain a serious challenge at least partially explaining the inaccuracy and inconsistency in long-term VTE management. Appropriately designed studies are needed to evaluate risk stratification tools when contemporary best medical therapy is used, accurately predict VTE recurrence and its long-term outcomes, and tailor safe and effective secondary prophylaxis.

Published
2022
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5. Review of the current evidence for topical treatment for venous leg ulcers

Author

Maxim E. Shaydakov, Windsor Ting, Mikel Sadek, Faisal Aziz, José A. Diaz, Joseph D. Raffetto, William A. Marston, Brajesh K. Lal, Harold J. Welch, Maxim Shaydakov, Jose Diaz, Peter Henke, Nicos Labropoulos, Rafael Malgor, Andrea Obi, Sarah Onida, Andre Van Rij, and Ruben Vellettaz

Subjects
medicine.medical_specialty, Leg, business.industry, Administration, Topical, Topical treatment, Clinical manifestation, medicine.disease, Venous leg ulcer, law.invention, Varicose Ulcer, Clinical Practice, Wound care, Randomized controlled trial, law, Medicine, Humans, Surgery, Cardiology and Cardiovascular Medicine, business, Intensive care medicine, Venous disease, Systematic search
Abstract

Objective The development of a venous leg ulcer (VLU) represents the most severe clinical manifestation of a chronic venous disease. Despite major progress, our understanding of the VLU pathogenesis and wound healing biology has remained limited. Treatment of VLUs remains a serious challenge for physicians of different specialties. In the present review, we focused on describing the rationale and scientific basis for topical wound care in the management of VLUs. Methods A literature review was performed to summarize the methods with proven efficacy in VLU management. A systematic search was also performed to identify new evidence from the randomized controlled trials reported from 2014 to 2021. The scientific challenges, clinical practice concerns, economic obstacles, and possible directions for further research have been discussed. Results Hundreds of topical products have been advertised for the treatment of VLUs. However, the reported data on the topical treatment of venous ulcers are insufficient, scattered, and weak, with significant methodologic flaws. A total of 43 randomized controlled trials on the topical treatment of VLUs were reported from 2014 to 2021. Thus, the clinical practice guidelines require updating. We identified major gaps in knowledge and have provided suggestions for future research directions. Conclusions The American Venous Forum Research Committee would like to bring attention to the use of topical wound care for VLUs as a critical gap in knowledge and to encourage scientists, practitioners, and industry to collaborate to fill this gap.

Published
2021

6. Global impact of the first coronavirus disease 2019 (COVID-19) pandemic wave on vascular services

Author

Ruth A Benson, Sandip Nandhra, Joseph Shalhoub, Nikesh Dattani, Graeme K Ambler, David C Banquet, David C Bosanquet, Rachael Forsythe, Sarah Onida, George Dovell, Louise Hitchman, Ryan Preece, Athanasios Saratzis, Chris Imray, Adam Johnson, Andrew Choong, Jun Jie Ng, Sarah Aitken, Jana-Lee Moss, Abhilash Sudarsanam, Adam Tam, Adam W Beck, Adel Barkat, Adnan Bajwa, Ahmed Elbasty, A I Awopetu, Akio Kodama, Aksim G Rivera, Alberto Munoz, Alberto Saltiel, Alejandro Russo, Alex Rolls, Alexandros Kafetzakis, Ali Kimyaghalam, Ali Kordzadeh, Amanda Shepherd, Aminder Singh, Andrea Mingoli, Andreas M Lazaris, Andrej Isaak, Andres Marin, Andrés Reyes Valdivia, Andrew Batchelder, Andrew Duncan, Angeliki Argyriou, Anthony S Jaipersad, Antonio Freyrie, António Pereira-Neves, Anver Mahomed, Arda Isik, Arkadiusz Jawien, Asad J Choudhry, Ashwin Sivaharan, Athanasios Giannoukas, Athanasios Papaioannou, Ayman Abbas, Bakoyiannis Christos, Bekir Bogachan Akkaya, Bella Huasen, Bibombe Patrice, Mwipatayi, Bilal Azhar, Boboyor Keldiyorov, Brant W Ullery, Carlo Pratesi, Carlos A Hinojosa, Carlos F Bechara, Carolina Salinas Parra, Charalabopoulos Alexandros, Charlotte Bezard, Cheong Jun Lee, Chris Davies, Christian-Alexander Behrendt, Christopher Lowe, Christos D Karkos, Chun Ling Patricia Yih, Ciarán McDonnell, Claudia Ordonez, Craig Nesbitt, Croo Alexander, Daniel Guglielmone, Daniel T Doherty, David M Riding, Davide Esposito, Denis Harkin, Dennis H Lui, Dhafer M Kamal, Diego Telve, Dimitrios Theodosiou, Domenico Angiletta, Donald Jacobs, Edward Choke, Edward D Gifford, Efthymios Beropoulis, Eftychios Lostoridis, Eleanor Atkins, Elena Giacomelli, Elpiniki Tsolaki, Emma Davies, Emma Scott, Emmanouil Katsogridakis, Ernesto Serrano, Ertekin Utku Unal, Eugenia Lopez, Eustratia Mpaili, Fabrizio Minelli, Fatemeh Malekpour, Fatma Mousa, Felicity Meyer, Felipe Tobar, Filipa Jácome, Flavia Gentile Johansson, Fred Weaver, Gabriel Ab Proaño, Gabriel Sidel, Ganesh Kuhan, Gary Lemmon, George A Antoniou, George Papadopoulos, Georgios Pitoulias, Georgopoulos Sotirios, Gerardo Victoria, Gert Frahm-Jensen, Giovanni Tinelli, Giuseppe Asciutto, Gladiol Zenunaj, Gómez Vera Carlos Eduardo, Gonzalo Pullas, Grzegorz Oszkinis, Guriy Popov, Hakkı Zafer İscan, Hannah C Travers, Hashem Barakat, Hayrettin Levent Mavioglu, Ian Chetter, Ian Loftus, Ilias Dodos, Imran Asghar, Isabelle Van Herzeele, Jacopo Giordano, James Cragg, Jason Chuen, Javier Del Castillo Orrego, Jeremy Perkins, João Rocha-Neves, Jorge H Ulloa, José Antonio Chávez, José Vidoedo, Joseph Faraj, Joseph Mills, Juan Varela, Jürg Schmidli, Kakavia Kiriaki, Katarzyna Powezka, Kathryn Bowser, Katy Darvall, Kenneth McCune, Ketino Pasenidou, Kevin Corless, Kevin McKevitt, Kira Nicole Long, Konstantinos G Moulakakis, Konstantinos Roditis, Konstantinos Stavroulakis, Konstantinos Tigkiropoulos, Kristyn Mannoia, Kumar Abayasekara, Lalithapriya Jayakumar, Lasantha Wijesinghe, Laura Drudi, Lauren Shelmerdine, Leigh Ann O'Banion, Lewis Meecham, Lisa F Bennett, Lorena Grillo, Lucy Green, Lucy Wales, Luís Loureiro, Luis Mariano Palena, Mahmoud Mh Tolba, Manar Khashram, Manik Chana, Manuel Pabon, Marco González, Marco Virgilio Usai, Marcos Tarazona, Maria A Ruffino, Mariano Castelli, Marie Benezit, Marina Dias-Neto, Martin Malina, Martin Maresch, Martin Mazzurco, Martin Storck, Martín Veras Troncoso, Matt Popplewell, Matteo Tozzi, Matthew Metcalfe, Matti Laine, Mhammed Rawhi, Michael Ricardo, Mingzheng Aaron Goh, Mohamed Abozeid Ahmed, Mohammed Ibrahim, Mohannad Alomari, Muayyad Almudhafer, Muhammed Elhadi, Nalaka Gunawansa, Nancy Hadjievangelou, Natasha Hasemaki, Natasha Shafique, Nathan Aranson, Nicholas Bradley, Nicolas J Mouawad, Nicole C Rich, Nikolaos Floros, Nikolaos Patelis, Nikolaos Saratzis, Nikolaos Tsilimparis, Nilson Salinas, Nishath Altaf, Oliver Friedrich, Oliver Lyons, Olivia M B McBride, Orestis Ioannidis, Orwa Falah, Panagiotis Theodoridis, Paolo Sapienza, Paraskevi Tsiantoula, Patrick Chong, Patrick Coughlin, Paul Bevis, Paul Carrera, Paul Dunlop, Peng Foo Wong, Pereira Albino, Peter Rossi, Petroula Nana, Philip W Stather, Pierfrancesco Lapolla, Pierre Galvagni Silveira, Prakash Saha, Pranav Somaiya, Putera Mas Pian, Rachael L Morley, Rachel Bell, Raed M Ennab, Rafael Malgor, Raffaele Pulli, Ragai Makar, Raghuram Sekhar, Rana Afifi, Raphael Coscas, Raphael Soler, Robert F Cuff, Rodney Diaz, Rodrigo Biagioni, Rosnelifaizur Bin Ramely, Rubén Rodríguez Carvajal, Sandeep Jhajj, Sara Edeiken, Sergio Benites, Sergio Zacà, Sharath Paravastu, Sharon Chan, Sharvil Sheth, Sherene Shalhub, Shiva Dindyal, Shonda Banegas, Simon Hardy, Simona Sica, Siu Chung Tam, Sivaram Premnath, Sophie Renton, Sriram Rajagopalan, Stavridis Kyriakos, Stavros Kakkos, Stefano Ancetti, Stephane Elkouri, Stephanie Lin, Stephen Wing Keung Cheng, Stylianos G Koutsias, Tabitha Grainger, Tamer Fekry, Tamer Ghatwary Tantawy, Tamim Siddiqui, Taohid Oshodi, Tasleem Akhtar, Thomas James Hardy, Thomas Kotsis, Thushan Gooneratne, Timothy Rowlands, Tina U Cohnert, Tom Wallace, Tristan R A Lane, Umberto Marcello Bracale, Usman Cheema, Uzma Sadia, Vanessa Rubio, Victor Canata, Vincent Jongkind, Vipul Khetarpaul, Virginia Summerour, Walter Dorigo, Wissam Al-Jundi, Xun Luo, Yamume Tshomba, Yvis Gadelha Serra, A Benson, Ruth, Nandhra, Sandip, Shalhoub, Joseph, Dattani, Nikesh, K Ambler, Graeme, C Banquet, David, C Bosanquet, David, Forsythe, Rachael, Onida, Sarah, Dovell, George, Hitchman, Louise, Preece, Ryan, Saratzis, Athanasio, Imray, Chri, Johnson, Adam, Choong, Andrew, Jie Ng, Jun, Aitken, Sarah, Moss, Jana-Lee, Sudarsanam, Abhilash, Tam, Adam, W Beck, Adam, Barkat, Adel, Bajwa, Adnan, Elbasty, Ahmed, I Awopetu, A, Kodama, Akio, G Rivera, Aksim, Munoz, Alberto, Saltiel, Alberto, Russo, Alejandro, Rolls, Alex, Kafetzakis, Alexandro, Kimyaghalam, Ali, Kordzadeh, Ali, Shepherd, Amanda, Singh, Aminder, Mingoli, Andrea, M Lazaris, Andrea, Isaak, Andrej, Marin, Andre, Reyes Valdivia, André, Batchelder, Andrew, Duncan, Andrew, Argyriou, Angeliki, S Jaipersad, Anthony, Freyrie, Antonio, Pereira-Neves, António, Mahomed, Anver, Isik, Arda, Jawien, Arkadiusz, J Choudhry, Asad, Sivaharan, Ashwin, Giannoukas, Athanasio, Papaioannou, Athanasio, Abbas, Ayman, Christos, Bakoyianni, Bogachan Akkaya, Bekir, Huasen, Bella, Patrice, Bibombe, Mwipatayi, Azhar, Bilal, Keldiyorov, Boboyor, W Ullery, Brant, Pratesi, Carlo, A Hinojosa, Carlo, F Bechara, Carlo, Salinas Parra, Carolina, Alexandros, Charalabopoulo, Bezard, Charlotte, Jun Lee, Cheong, Davies, Chri, Behrendt, Christian-Alexander, Lowe, Christopher, D Karkos, Christo, Ling Patricia Yih, Chun, Mcdonnell, Ciarán, Ordonez, Claudia, Nesbitt, Craig, Alexander, Croo, Guglielmone, Daniel, T Doherty, Daniel, M Riding, David, Esposito, Davide, Harkin, Deni, H Lui, Denni, M Kamal, Dhafer, Telve, Diego, Theodosiou, Dimitrio, Angiletta, Domenico, Jacobs, Donald, Choke, Edward, D Gifford, Edward, Beropoulis, Efthymio, Lostoridis, Eftychio, Atkins, Eleanor, Giacomelli, Elena, Tsolaki, Elpiniki, Davies, Emma, Scott, Emma, Katsogridakis, Emmanouil, Serrano, Ernesto, Utku Unal, Ertekin, Lopez, Eugenia, Mpaili, Eustratia, Minelli, Fabrizio, Malekpour, Fatemeh, Mousa, Fatma, Meyer, Felicity, Tobar, Felipe, Jácome, Filipa, Gentile Johansson, Flavia, Weaver, Fred, Ab Proaño, Gabriel, Sidel, Gabriel, Kuhan, Ganesh, Lemmon, Gary, A Antoniou, George, Papadopoulos, George, Pitoulias, Georgio, Sotirios, Georgopoulo, Victoria, Gerardo, Frahm-Jensen, Gert, Tinelli, Giovanni, Asciutto, Giuseppe, Zenunaj, Gladiol, Vera Carlos Eduardo, Gómez, Pullas, Gonzalo, Oszkinis, Grzegorz, Popov, Guriy, Zafer İscan, Hakkı, C Travers, Hannah, Barakat, Hashem, Levent Mavioglu, Hayrettin, Chetter, Ian, Loftus, Ian, Dodos, Ilia, Asghar, Imran, Van Herzeele, Isabelle, Giordano, Jacopo, Cragg, Jame, Chuen, Jason, Del Castillo Orrego, Javier, Perkins, Jeremy, Rocha-Neves, João, H Ulloa, Jorge, Antonio Chávez, José, Vidoedo, José, Faraj, Joseph, Mills, Joseph, Varela, Juan, Schmidli, Jürg, Kiriaki, Kakavia, Powezka, Katarzyna, Bowser, Kathryn, Darvall, Katy, Mccune, Kenneth, Pasenidou, Ketino, Corless, Kevin, Mckevitt, Kevin, Nicole Long, Kira, G Moulakakis, Konstantino, Roditis, Konstantino, Stavroulakis, Konstantino, Tigkiropoulos, Konstantino, Mannoia, Kristyn, Abayasekara, Kumar, Jayakumar, Lalithapriya, Wijesinghe, Lasantha, Drudi, Laura, Shelmerdine, Lauren, Ann O'Banion, Leigh, Meecham, Lewi, F Bennett, Lisa, Grillo, Lorena, Green, Lucy, Wales, Lucy, Loureiro, Luí, Mariano Palena, Lui, Mh Tolba, Mahmoud, Khashram, Manar, Chana, Manik, Pabon, Manuel, González, Marco, Virgilio Usai, Marco, Tarazona, Marco, A Ruffino, Maria, Castelli, Mariano, Benezit, Marie, Dias-Neto, Marina, Malina, Martin, Maresch, Martin, Mazzurco, Martin, Storck, Martin, Veras Troncoso, Martín, Popplewell, Matt, Tozzi, Matteo, Metcalfe, Matthew, Laine, Matti, Rawhi, Mhammed, Ricardo, Michael, Aaron Goh, Mingzheng, Abozeid Ahmed, Mohamed, Ibrahim, Mohammed, Alomari, Mohannad, Almudhafer, Muayyad, Elhadi, Muhammed, Gunawansa, Nalaka, Hadjievangelou, Nancy, Hasemaki, Natasha, Shafique, Natasha, Aranson, Nathan, Bradley, Nichola, J Mouawad, Nicola, C Rich, Nicole, Floros, Nikolao, Patelis, Nikolao, Saratzis, Nikolao, Tsilimparis, Nikolao, Salinas, Nilson, Altaf, Nishath, Friedrich, Oliver, Lyons, Oliver, B McBride, Olivia M, Ioannidis, Oresti, Falah, Orwa, Theodoridis, Panagioti, Sapienza, Paolo, Tsiantoula, Paraskevi, Chong, Patrick, Coughlin, Patrick, Bevis, Paul, Carrera, Paul, Dunlop, Paul, Foo Wong, Peng, Albino, Pereira, Rossi, Peter, Nana, Petroula, W Stather, Philip, Lapolla, Pierfrancesco, Galvagni Silveira, Pierre, Saha, Prakash, Somaiya, Pranav, Mas Pian, Putera, L Morley, Rachael, Bell, Rachel, M Ennab, Raed, Malgor, Rafael, Pulli, Raffaele, Makar, Ragai, Sekhar, Raghuram, Afifi, Rana, Coscas, Raphael, Soler, Raphael, F Cuff, Robert, Diaz, Rodney, Biagioni, Rodrigo, Bin Ramely, Rosnelifaizur, Rodríguez Carvajal, Rubén, Jhajj, Sandeep, Edeiken, Sara, Benites, Sergio, Zacà, Sergio, Paravastu, Sharath, Chan, Sharon, Sheth, Sharvil, Shalhub, Sherene, Dindyal, Shiva, Banegas, Shonda, Hardy, Simon, Sica, Simona, Chung Tam, Siu, Premnath, Sivaram, Renton, Sophie, Rajagopalan, Sriram, Kyriakos, Stavridi, Kakkos, Stavro, Ancetti, Stefano, Elkouri, Stephane, Lin, Stephanie, Wing Keung Cheng, Stephen, G Koutsias, Styliano, Grainger, Tabitha, Fekry, Tamer, Ghatwary Tantawy, Tamer, Siddiqui, Tamim, Oshodi, Taohid, Akhtar, Tasleem, James Hardy, Thoma, Kotsis, Thoma, Gooneratne, Thushan, Rowlands, Timothy, U Cohnert, Tina, Wallace, Tom, A Lane, Tristan R, Bracale, UMBERTO MARCELLO, Cheema, Usman, Sadia, Uzma, Rubio, Vanessa, Canata, Victor, Jongkind, Vincent, Khetarpaul, Vipul, Summerour, Virginia, Dorigo, Walter, Al-Jundi, Wissam, Luo, Xun, Tshomba, Yamume, and Gadelha Serra, Yvis

Subjects
Global Health, Health Care Surveys, Health Services Accessibility, Humans, Pandemics, Practice Patterns, Physicians', Prospective Studies, Vascular Surgical Procedures, COVID-19, Physicians', Pandemic, Practice Patterns, Settore MED/22 - CHIRURGIA VASCOLARE, Prospective Studie, Global health, health care surveys, health services accessibility, humans, pandemics, practice patterns, physicians', prospective studies, vascular surgical procedures, Health Care Survey, Rapid Research Communication, Human, Vascular Surgical Procedure
Abstract

Graphical Abstract This online structured survey has demonstrated the global impact of the COVID-19 pandemic on vascular services. The majority of centres have documented marked reductions in operating and services provided to vascular patients. In the months during recovery from the resource restrictions imposed during the pandemic peaks, there will be a significant vascular disease burden awaiting surgeons. Graphical Abstract One of the most affected specialties

Published
2020

7. Intelligent Chatter Bot for Regulation Search

Author

Maria Daniela Lopez De Luise, Ben Raul Saad, Rafael Malgor, Patricio Carrilero, Claudia Alvarez, Joaquin Diaz, Andres Pascal, and Pablo Pescio

Subjects
89.20.ff, 0209 industrial biotechnology, Computer science, Physics, QC1-999, linguistic reasoning, General Physics and Astronomy, expert systems, text mining, data mining, 02 engineering and technology, computer.software_genre, Legal advice, Expert system, computational linguistic, World Wide Web, chatter bot, 020901 industrial engineering & automation, legal advice, 0202 electrical engineering, electronic engineering, information engineering, 020201 artificial intelligence & image processing, natural language processing, semantics, computer
Abstract

This communication presents a functional prototype, named PTAH, implementing a linguistic model focused on regulations in Spanish. Its global architecture, the reasoning model and short statistics are provided for the prototype. It is mainly a conversational robot linked to an Expert System by a module with many intelligent linguistic filters, implementing the reasoning model of an expert. It is focused on bylaws, regulations, jurisprudence and customized background representing entity mission, vision and profile. This Structure and model are generic enough to self-adapt to any regulatory environment, but as a first step, it was limited to an academic field. This way it is possible to limit the slang and data numbers. The foundations of the linguistic model are also outlined and the way the architecture implements the key features of the behavior.

Published
2016
Full Text
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8. Chatterbot inteligente para asesoramiento jurídico

Author

Patricio Carrilero, Claudia Alvarez, Andres Pascal, Ben Raul Saad, Rafael Malgor, Pablo Pescio, Joaquin Diaz, and Maria Daniela Lopez De Luise

Subjects
Flexibility (engineering), Structure (mathematical logic), business.industry, Programming language, Computer science, Semantics (computer science), Usability, Pragmatics, computer.software_genre, Expert system, Field (computer science), Architecture, business, Software engineering, computer
Abstract

This paper presents the first results of a functional prototype implementing a linguistic model focused on regulations in Spanish. Its global architecture, the reasoning model, a case-study and short statistics are provided for the prototype named PTAH. It mainly has a conversational robot linked to an Expert System by a module with many intelligent linguistic filters, implementing the reasoning model of an expert. It is focused in bylaws, regulations, jurisprudence and customized background representing entity mission, vision and profile. This structure and model are generic enough to self adapt to any regulatory environment, but as a first step, it was limited to academic field. This way it is possible to limit the slang and data number. The foundations of the linguistic model and the way the architecture implements the key features of the behavior, are also outlined. The cases presented are a few just to show the usability, flexibility and prospectives of this proposal.

Published
2016
Full Text
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9. Comparative effectiveness of the treatments for thoracic aortic transection [corrected]

Author

Mohammad Hassan, Murad, Adnan Z, Rizvi, Rafael, Malgor, Jantey, Carey, Aziz A, Alkatib, Patricia J, Erwin, W Anthony, Lee, and Ronald M, Fairman

Subjects
Male, Blood Vessel Prosthesis Implantation, Comparative Effectiveness Research, Postoperative Complications, Multiple Trauma, Spinal Cord Ischemia, Outcome Assessment, Health Care, Humans, Kidney Failure, Chronic, Aorta, Thoracic, Female, Wounds, Nonpenetrating, Vascular Surgical Procedures
Abstract

To synthesize the available evidence regarding the outcomes associated with nonoperative management, open repair, and endovascular repair of thoracic aortic transection.We searched electronic databases (MEDLINE, EMBASE Cochrane, Web of Science, and Scopus) for studies that enrolled patients with aortic transection and measured the outcomes of interest. Two reviewers determined study eligibility and extracted data. We estimated the event rate associated with the different approaches from case series and the relative risk from comparative studies. Estimates from each study were pooled using the random effects model.We found 139 studies that fulfilled the inclusion criteria, the majority of which were noncomparative surgical case series, retrospective, and none were randomized. Studies included 7768 patients, the majority of which were males. The mortality rate was significantly lower in patients who underwent endovascular repair, followed by open repair and nonoperative management (9%, 19%, and 46%, respectively, P.01). No significant difference in event rate across the three groups was noted for the outcomes of anterior stroke, posterior stroke, or any stroke. The risk of spinal cord ischemia and end-stage renal disease were higher in open repair compared with the other 2 groups (9% vs 3% and 3%, P = .01 for spinal cord ischemia and 8% vs 5% and 3%, P = .01 for end-stage renal disease). Compared with endovascular repair, open repair was associated with an increased risk of graft infection and systemic infections. Meta-analyses of comparative studies demonstrated that compared with open repair, endovascular repair is associated with reduced mortality and spinal cord ischemia (relative risk, 0.61; 95% confidence interval, 0.46-0.80; and relative risk, 0.34; 95% confidence interval, 0.16-0.74; respectively). Inferences are limited by methodological quality, survival, and publication biases.Very low-quality evidence suggests that, compared with open repair or nonoperative management, endovascular repair of thoracic aortic transection is associated with better survival and decreased risk of spinal cord ischemia, renal injury, and graft and systemic infections. Nonoperative management is associated with the least favorable outcomes.

Published
2010

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