Effectiveness and safety of cryotherapy after arthroscopic anterior cruciate ligament reconstruction. A systematic review of the literature

Cryotherapy is widely used in rehabilitation; however, its effectiveness after anterior cruciate ligament (ACL) reconstruction remains uncertain. To investigate the effectiveness and safety of cryotherapy following ACL reconstruction through a systematic review, randomized and quasi-randomized clinical trials were searched in the databases: MEDLINE, EMBASE, CENTRAL PEDro, SportDiscus, CINAHL, LILACS (June 2013). the primary outcomes measures were pain, edema and adverse events; the secondary outcomes were knee function, analgesic medication use, range of motion, blood loss, hospital stay, quality of life and patient satisfaction. the methodological quality of studies was evaluated using the Cochrane Collaboration risk-of-bias tool. Ten trials (a total of 573 patients) were included. Results of meta-analysis showed that the use of cold compression devices produced a significant reduction in pain scores 48 h after surgery (p < 0.00001), compared to no cryotherapy. the risk for adverse events did not differ between patients receiving cryotherapy versus no treatment (p = 1.00). the limited evidence currently available is insufficient to draw definitive conclusions on the effectiveness of cryotherapy for other outcomes. There is a need for well designed, good quality randomized trials to answer other questions related to this intervention and increase the precision of future systematic reviews. (C) 2014 Elsevier B.V. All rights reserved.

Safety-critical medical device development using the UPP2SF model translation tool

Software-based control of life-critical embedded systems has become increasingly complex, and to a large extent has come to determine the safety of the human being. For example, implantable cardiac pacemakers have over 80,000 lines of code which are responsible for maintaining the heart within safe operating limits. As firmware-related recalls accounted for over 41% of the 600,000 devices recalled in the last decade, there is a need for rigorous model-driven design tools to generate verified code from verified software models. To this effect, we have developed the UPP2SF model-translation tool, which facilitates automatic conversion of verified models (in UPPAAL) to models that may be simulated and tested (in Simulink/Stateflow). We describe the translation rules that ensure correct model conversion, applicable to a large class of models. We demonstrate how UPP2SF is used in themodel-driven design of a pacemaker whosemodel is (a) designed and verified in UPPAAL (using timed automata), (b) automatically translated to Stateflow for simulation-based testing, and then (c) automatically generated into modular code for hardware-level integration testing of timing-related errors. In addition, we show how UPP2SF may be used for worst-case execution time estimation early in the design stage. Using UPP2SF, we demonstrate the value of integrated end-to-end modeling, verification, code-generation and testing process for complex software-controlled embedded systems. © 2014 ACM.

New studies on the versatile roles of Polyaniline and its composites in polymer based optoelectronic and energy storage devices

From the early stages of the twentieth century, polyaniline (PANI), a well-known and extensively studied conducting polymer has captured the attention of scientific community owing to its interesting electrical and optical properties. Starting from its structural properties, to the currently pursued optical, electrical and electrochemical properties, extensive investigations on pure PANI and its composites are still much relevant to explore its potentialities to the maximum extent. The synthesis of highly crystalline PANI films with ordered structure and high electrical conductivity has not been pursued in depth yet. Recently, nanostructured PANI and the nanocomposites of PANI have attracted a great deal of research attention owing to the possibilities of applications in optical switching devices, optoelectronics and energy storage devices. The work presented in the thesis is centered around the realization of highly conducting and structurally ordered PANI and its composites for applications mainly in the areas of nonlinear optics and electrochemical energy storage. Out of the vast variety of application fields of PANI, these two areas are specifically selected for the present studies, because of the following observations. The non-linear optical properties and the energy storing properties of PANI depend quite sensitively on the extent of conjugation of the polymer structure, the type and concentration of the dopants added and the type and size of the nano particles selected for making the nanocomposites. The first phase of the work is devoted to the synthesis of highly ordered and conducting films of PANI doped with various dopants and the structural, morphological and electrical characterization followed by the synthesis of metal nanoparticles incorporated PANI samples and the detailed optical characterization in the linear and nonlinear regimes. The second phase of the work comprises the investigations on the prospects of PANI in realizing polymer based rechargeable lithium ion cells with the inherent structural flexibility of polymer systems and environmental safety and stability. Secondary battery systems have become an inevitable part of daily life. They can be found in most of the portable electronic gadgets and recently they have started powering automobiles, although the power generated is low. The efficient storage of electrical energy generated from solar cells is achieved by using suitable secondary battery systems. The development of rechargeable battery systems having excellent charge storage capacity, cyclability, environmental friendliness and flexibility has yet to be realized in practice. Rechargeable Li-ion cells employing cathode active materials like LiCoO2, LiMn2O4, LiFePO4 have got remarkable charge storage capacity with least charge leakage when not in use. However, material toxicity, chance of cell explosion and lack of effective cell recycling mechanism pose significant risk factors which are to be addressed seriously. These cells also lack flexibility in their design due to the structural characteristics of the electrode materials. Global research is directed towards identifying new class of electrode materials with less risk factors and better structural stability and flexibility. Polymer based electrode materials with inherent flexibility, stability and eco-friendliness can be a suitable choice. One of the prime drawbacks of polymer based cathode materials is the low electronic conductivity. Hence the real task with this class of materials is to get better electronic conductivity with good electrical storage capability. Electronic conductivity can be enhanced by using proper dopants. In the designing of rechargeable Li-ion cells with polymer based cathode active materials, the key issue is to identify the optimum lithiation of the polymer cathode which can ensure the highest electronic conductivity and specific charge capacity possible The development of conducting polymer based rechargeable Li-ion cells with high specific capacity and excellent cycling characteristics is a highly competitive area among research and development groups, worldwide. Polymer based rechargeable batteries are specifically attractive due to the environmentally benign nature and the possible constructional flexibility they offer. Among polymers having electrical transport properties suitable for rechargeable battery applications, polyaniline is the most favoured one due to its tunable electrical conducting properties and the availability of cost effective precursor materials for its synthesis. The performance of a battery depends significantly on the characteristics of its integral parts, the cathode, anode and the electrolyte, which in turn depend on the materials used. Many research groups are involved in developing new electrode and electrolyte materials to enhance the overall performance efficiency of the battery. Currently explored electrolytes for Li ion battery applications are in liquid or gel form, which makes well-defined sealing essential. The use of solid electrolytes eliminates the need for containment of liquid electrolytes, which will certainly simplify the cell design and improve the safety and durability. The other advantages of polymer electrolytes include dimensional stability, safety and the ability to prevent lithium dendrite formation. One of the ultimate aims of the present work is to realize all solid state, flexible and environment friendly Li-ion cells with high specific capacity and excellent cycling stability. Part of the present work is hence focused on identifying good polymer based solid electrolytes essential for realizing all solid state polymer based Li ion cells.The present work is an attempt to study the versatile roles of polyaniline in two different fields of technological applications like nonlinear optics and energy storage. Conducting form of doped PANI films with good extent of crystallinity have been realized using a level surface assisted casting method in addition to the generally employed technique of spin coating. Metal nanoparticles embedded PANI offers a rich source for nonlinear optical studies and hence gold and silver nanoparticles have been used for making the nanocomposites in bulk and thin film forms. These PANI nanocomposites are found to exhibit quite dominant third order optical non-linearity. The highlight of these studies is the observation of the interesting phenomenon of the switching between saturable absorption (SA) and reverse saturable absorption (RSA) in the films of Ag/PANI and Au/PANI nanocomposites, which offers prospects of applications in optical switching. The investigations on the energy storage prospects of PANI were carried out on Li enriched PANI which was used as the cathode active material for assembling rechargeable Li-ion cells. For Li enrichment or Li doping of PANI, n-Butyllithium (n-BuLi) in hexanes was used. The Li doping as well as the Li-ion cell assembling were carried out in an argon filled glove box. Coin cells were assembled with Li doped PANI with different doping concentrations, as the cathode, LiPF6 as the electrolyte and Li metal as the anode. These coin cells are found to show reasonably good specific capacity around 22mAh/g and excellent cycling stability and coulombic efficiency around 99%. To improve the specific capacity, composites of Li doped PANI with inorganic cathode active materials like LiFePO4 and LiMn2O4 were synthesized and coin cells were assembled as mentioned earlier to assess the electrochemical capability. The cells assembled using the composite cathodes are found to show significant enhancement in specific capacity to around 40mAh/g. One of the other interesting observations is the complete blocking of the adverse effects of Jahn-Teller distortion, when the composite cathode, PANI-LiMn2O4 is used for assembling the Li-ion cells. This distortion is generally observed, near room temperature, when LiMn2O4 is used as the cathode, which significantly reduces the cycling stability of the cells.

Development of thermo-analytical prediction and classification models for food in thermal devices using a multi sensor system and artificial neural networks

Die thermische Verarbeitung von Lebensmitteln beeinflusst deren Qualität und ernährungsphysiologischen Eigenschaften. Im Haushalt ist die Überwachung der Temperatur innerhalb des Lebensmittels sehr schwierig. Zudem ist das Wissen über optimale Temperatur- und Zeitparameter für die verschiedenen Speisen oft unzureichend. Die optimale Steuerung der thermischen Zubereitung ist maßgeblich abhängig von der Art des Lebensmittels und der äußeren und inneren Temperatureinwirkung während des Garvorgangs. Das Ziel der Arbeiten war die Entwicklung eines automatischen Backofens, der in der Lage ist, die Art des Lebensmittels zu erkennen und die Temperatur im Inneren des Lebensmittels während des Backens zu errechnen. Die für die Temperaturberechnung benötigten Daten wurden mit mehreren Sensoren erfasst. Hierzu kam ein Infrarotthermometer, ein Infrarotabstandssensor, eine Kamera, ein Temperatursensor und ein Lambdasonde innerhalb des Ofens zum Einsatz. Ferner wurden eine Wägezelle, ein Strom- sowie Spannungs-Sensor und ein Temperatursensor außerhalb des Ofens genutzt. Die während der Aufheizphase aufgenommen Datensätze ermöglichten das Training mehrerer künstlicher neuronaler Netze, die die verschiedenen Lebensmittel in die entsprechenden Kategorien einordnen konnten, um so das optimale Backprogram auszuwählen. Zur Abschätzung der thermische Diffusivität der Nahrung, die von der Zusammensetzung (Kohlenhydrate, Fett, Protein, Wasser) abhängt, wurden mehrere künstliche neuronale Netze trainiert. Mit Ausnahme des Fettanteils der Lebensmittel konnten alle Komponenten durch verschiedene KNNs mit einem Maximum von 8 versteckten Neuronen ausreichend genau abgeschätzt werden um auf deren Grundlage die Temperatur im inneren des Lebensmittels zu berechnen. Die durchgeführte Arbeit zeigt, dass mit Hilfe verschiedenster Sensoren zur direkten beziehungsweise indirekten Messung der äußeren Eigenschaften der Lebensmittel sowie KNNs für die Kategorisierung und Abschätzung der Lebensmittelzusammensetzung die automatische Erkennung und Berechnung der inneren Temperatur von verschiedensten Lebensmitteln möglich ist.

The creation of euro area financial safety nets. Bruegel Working Paper 2012/09, July 2012

The financial crisis has exposed the need to devise stronger and broader international and regional safety nets in order to deal with economic and financial shocks and allow for countries to adjust. The euro area has developed several such mechanisms over the last couple of years through a process of trial and error and gradual enhancement and expansion. Their overall architecture remains imperfect and leaves areas of vulnerabilities. This paper provides an overview of the recent financial stability mechanisms and their various shortcomings and tries to brush the outline of a more comprehensive safety net architecture that would coherently address the banking, sovereign and external imbalances crises against both transitory and more permanent shocks. It aims to provide a roadmap for further improvements of the current mechanism and the creation of new devices including a banking resolution mechanism and amore powerfulmechanismto provide financial assistance addressing both the sovereign and external dimensions of the shocks thereby reducing the need for the ECB to fill the current void.

Student perceptions of iPads as mobile learning devices for fieldwork

This paper reports findings from six field courses about student’s perceptions of iPads as mobile learning devices for fieldwork. Data were collected through surveys and focus groups. The key findings suggest that the multi-tool nature of the iPads and their portability were the main strengths. Students had some concerns over the safety of the iPads in adverse weather and rugged environments, though most of these concerns were eliminated after using the devices with protective cases. Reduced connectivity was found to be one of the main challenges for mobile learning. Finally, students and practitioners views of why they used the mobile devices for fieldwork did not align.

A comparison of Australian and Malaysian views on the use of biometric devices in everyday situations

Since the September 11, 2001 terrorist attacks in New York City, many countries including Australia and Malaysia have been able to justify the use biometric devices such as finger print scans, retina scans and facial recognition for identification and surveillance of its citizens and others in the name of national security. In addition, biometric devices are increasingly being used worldwide by organizations to keep track of their employees and their productivity, leading to concerns of privacy, the safety, reliability, abuse and misuse of the data collected and violations of civil liberties. Taking the critical theory perspective, this paper will analyse the data collected and report on the findings of a survey carried out in Australia and Malaysia, with respect to the responses provided and opinions expressed to the survey s open ended and other questions
by individuals as to their current use, experiences, preferences, concerns about the devices and the situations in which they think biometric devices should be used, including in their workplaces. This descriptive study uses both quantitative and qualitative data to examine what Australians and Malaysians think about the use of biometric devices in everyday situtions
and compare them as to their similarities and differences. The paper will then critically examine the ethical and civil liberties issues involved in the use of biometric devices in everyday life and argues that regulatory and legal measures should be taken to safeguard the rights of citizens while maintaining national security and productivity, in order to avoid the situation of Michel Foucaults Panopticon becoming an unpleasant everyday reality, which could negatively irifluence socialjustice and create social change due to its effects on individuals in two multicultural societies. The paper will argue about the need to educate the general public as to the issues of surveillance and privacy involved in the use of biometric devices in everyday situations.

A comparative analysis of opinions of Americans, Australians and Malaysians on the use of biometric devices in workplaces for security and monitoring of worker productivity

Since the September 11, 2001 terrorist attacks in New York, the use of biometric devices such as fingerprint scans, retina and iris scans and facial recognition in everyday situations for national security and border control, have become commonplace. This has resulted in the biometric industry moving from being a niche technology to one that is ubiquitous. As a result. more and more employers are using biometrics to secure staff access to their facilities as well as for tracking staff work hours, maintaining 'discipline' and carry out surveillance against thefts. detecting work hour abuses and fraud. However, the data thus collected and the technologies themselves are feared of having the potential for and actually being misused - both in terms of the violating staff privacy and discrimination and oppression of targeted workers. This paper examines the issue of using biometric devices in organisational settings their advantages, disadvantages and actual and potential abuses from the point of view of critical theory. From the perspectives of Panoptic surveillance and hegemonic organisational control, the paper examines the issues related to privacy and identification, biometrics and privacy, biometrics and the 'body', and surveillance and modernity. The paper also examines the findings ofa survey carried out in Australia. Malaysia and the USA on respondents' opinions on the use of biometric devices in everyday life including at workplaces. The paper concludes that along with their applications in border control and national security, the use of biometric devices should be covered by relevant laws and regulations. guidelines and codes of practice. in order to balance the rights to privacy and civil liberties of workers with employers' need for improved productivity, reduced costs, safeguards related to occupational health and safety, equal opportunity, and workplace harassment of staff and other matters, that employers are legally responsible for.

Design and analysis of an antenna for batteryless transcranial direct current stimulation devices

The purpose of this study is to design a low-cost planar Archimedean dipole antenna for batteryless transcranial direct current stimulation devices. The antenna parameters including resonance frequency, radiation efficiency, radiation pattern, and gain are simulated using finite difference time domain based electromagnetic simulation software XFdtd. The proposed antenna is simulated with low-cost FR4 PCB substrate of thickness of 1.6 mm. The antenna is designed with half wavelength of resonant frequency and fed with a matching line. The target frequency band is the industrial, scientific and medical (ISM) band of 915 MHz which is in the simulated band width of 31 MHz (903-934MHz). Moreover, since the bio-effect of specific absorption rate by radio frequency electromagnetic wave for power harvesting is an important concern, we try to find out the safety limit. Thus a quantitative analysis of distributions of electric field and power absorption in anatomical human head model by the far field radio frequency energy received by our designed antenna has been presented.

Comparison between common traffic lights and three types of traffic lights with visual cycle a safety and capacity analysis

The objective of this paper is compare the common traffic lights (CTL) to three different types of traffic lights with countdown displays (SCD) and assess their effects on road safety and capacity. This comparison is required because the results found in the literature are divergent among countries and cities, and one of the SCD analyzed in our study is different from the SCD used worldwide. An observational before-after study was conducted to evaluate the safety and capacity in a period of one year before and one year after the implementation of the SCD in three Brazilian cities. The results indicate that the SCD models 1 and 3 had around 35%±14% reduction in the total number of accidents; the model 2, does not have significant reduction. In order to perform the capacity analysis a framework for data collection and an adaptation for estimation of initial lost time in each phase were developed. Considering the capacity analysis there was a reduction around 11% in the lost time in SCD model 1, 7% in SCD model 2 and 3% in SCD model 3. However the implications of this on capacity are trifle due to a small increase in the average headways for all SCD models compare to CTL.

The use of Ground Penetrating Radar and alternative geophysical techniques for assessing embankments and dykes safety

The research is part of a survey for the detection of the hydraulic and geotechnical conditions of river embankments funded by the Reno River Basin Regional Technical Service of the Region Emilia-Romagna. The hydraulic safety of the Reno River, one of the main rivers in North-Eastern Italy, is indeed of primary importance to the Emilia-Romagna regional administration. The large longitudinal extent of the banks (several hundreds of kilometres) has placed great interest in non-destructive geophysical methods, which, compared to other methods such as drilling, allow for the faster and often less expensive acquisition of high-resolution data. The present work aims to experience the Ground Penetrating Radar (GPR) for the detection of local non-homogeneities (mainly stratigraphic contacts, cavities and conduits) inside the Reno River and its tributaries embankments, taking into account supplementary data collected with traditional destructive tests (boreholes, cone penetration tests etc.). A comparison with non-destructive methodologies likewise electric resistivity tomography (ERT), Multi-channels Analysis of Surface Waves (MASW), FDEM induction, was also carried out in order to verify the usability of GPR and to provide integration of various geophysical methods in the process of regular maintenance and check of the embankments condition. The first part of this thesis is dedicated to the explanation of the state of art concerning the geographic, geomorphologic and geotechnical characteristics of Reno River and its tributaries embankments, as well as the description of some geophysical applications provided on embankments belonging to European and North-American Rivers, which were used as bibliographic basis for this thesis realisation. The second part is an overview of the geophysical methods that were employed for this research, (with a particular attention to the GPR), reporting also their theoretical basis and a deepening of some techniques of the geophysical data analysis and representation, when applied to river embankments. The successive chapters, following the main scope of this research that is to highlight advantages and drawbacks in the use of Ground Penetrating Radar applied to Reno River and its tributaries embankments, show the results obtained analyzing different cases that could yield the formation of weakness zones, which successively lead to the embankment failure. As advantages, a considerable velocity of acquisition and a spatial resolution of the obtained data, incomparable with respect to other methodologies, were recorded. With regard to the drawbacks, some factors, related to the attenuation losses of wave propagation, due to different content in clay, silt, and sand, as well as surface effects have significantly limited the correlation between GPR profiles and geotechnical information and therefore compromised the embankment safety assessment. Recapitulating, the Ground Penetrating Radar could represent a suitable tool for checking up river dike conditions, but its use has significantly limited by geometric and geotechnical characteristics of the Reno River and its tributaries levees. As a matter of facts, only the shallower part of the embankment was investigate, achieving also information just related to changes in electrical properties, without any numerical measurement. Furthermore, GPR application is ineffective for a preliminary assessment of embankment safety conditions, while for detailed campaigns at shallow depth, which aims to achieve immediate results with optimal precision, its usage is totally recommended. The cases where multidisciplinary approach was tested, reveal an optimal interconnection of the various geophysical methodologies employed, producing qualitative results concerning the preliminary phase (FDEM), assuring quantitative and high confidential description of the subsoil (ERT) and finally, providing fast and highly detailed analysis (GPR). Trying to furnish some recommendations for future researches, the simultaneous exploitation of many geophysical devices to assess safety conditions of river embankments is absolutely suggested, especially to face reliable flood event, when the entire extension of the embankments themselves must be investigated.

Power Transient Analysis of Experimental Devices for Jules Horowitz Material Testing Reactor (JHR)

The objective of this thesis is the power transient analysis concerning experimental devices placed within the reflector of Jules Horowitz Reactor (JHR). Since JHR material testing facility is designed to achieve 100 MW core thermal power, a large reflector hosts fissile material samples that are irradiated up to total relevant power of 3 MW. MADISON devices are expected to attain 130 kW, conversely ADELINE nominal power is of some 60 kW. In addition, MOLFI test samples are envisaged to reach 360 kW for what concerns LEU configuration and up to 650 kW according to HEU frame. Safety issues concern shutdown transients and need particular verifications about thermal power decreasing of these fissile samples with respect to core kinetics, as far as single device reactivity determination is concerned. Calculation model is conceived and applied in order to properly account for different nuclear heating processes and relative time-dependent features of device transients. An innovative methodology is carried out since flux shape modification during control rod insertions is investigated regarding the impact on device power through core-reflector coupling coefficients. In fact, previous methods considering only nominal core-reflector parameters are then improved. Moreover, delayed emissions effect is evaluated about spatial impact on devices of a diffuse in-core delayed neutron source. Delayed gammas transport related to fission products concentration is taken into account through evolution calculations of different fuel compositions in equilibrium cycle. Provided accurate device reactivity control, power transients are then computed for every sample according to envisaged shutdown procedures. Results obtained in this study are aimed at design feedback and reactor management optimization by JHR project team. Moreover, Safety Report is intended to utilize present analysis for improved device characterization.

Safety of diagnostic balloon occlusion in normal coronary arteries

Diagnostic coronary balloon occlusion (CBO) is mandatory for collateral function assessment, during angioscopy and optical coherence imaging, and when using certain coronary protection devices against emboli. Thus far, the safety of diagnostic CBO regarding procedural and long-term complications in normal coronary arteries has not been studied. In 316 patients, diagnostic CBO was performed for collateral function measurement in 426 angiographically normal vessels. The angioplasty balloon was inflated for 60 to 120 seconds using inflation pressures of 1 to 3 atm, followed by control angiography during and after CBO. Patients were divided into groups with entirely normal (n = 133) and partially normal (n = 183) vessels. Primary end points were procedural and long-term complications. De novo stenosis development was assessed by quantitative coronary angiography in 35% of the patients. Secondary end points were cardiac events at 5 years of follow-up. Procedural complications occurred in 1 patient (0.2%). In 150 repeat angiographic procedures in 92 patients (follow-up duration 10 +/- 15 months), quantitative coronary angiography revealed no difference in percentage diameter narrowing between baseline and follow-up (4.1% vs 3.9%, p = 0.69). During follow-up periods of 14 and 72 months, respectively, a new stenotic lesion was detected in 1 patient in each group (1.3%). Major cardiac events and percutaneous coronary intervention for stable angina were less frequent in the group with entirely normal than with partially normal vessels (0.8% vs 5.5%, p = 0.02, and 0.8% vs 18%, p <0.0001). In conclusion, low-inflation pressure diagnostic CBO in angiographically normal coronary arteries bears a minimal risk for procedural and long-term complications and can therefore be regarded as a safe procedure.

Drug-eluting stents: limitations of early generation and progress with newer generation devices

The success of first generation drug-eluting stents, namely by reducing restenosis and the need of repeat revascularization procedures is hampered by some limitations affecting device safety. Intense research efforts helped to identify these shortcomings and direct research to develop newer generation drug-eluting stents with the potential to circumvent these drawbacks. This review will discuss limitations of early generation drug-eluting stents, focus on solutions provided by newer generation devices, and shed light on unresolved issues and potential future solutions.

Clinical outcome and predictors for adverse events after transcatheter aortic valve implantation with the use of different devices and access routes

Background Transcatheter aortic valve implantation (TAVI) is a treatment option for high-risk patients with severe aortic stenosis. Previous reports focused on a single device or access site, whereas little is known of the combined use of different devices and access sites as selected by the heart team. The purpose of this study is to investigate clinical outcomes of TAVI using different devices and access sites. Methods A consecutive cohort of 200 patients underwent TAVI with the Medtronic CoreValve Revalving system (Medtronic Core Valve LLC, Irvine, CA; n = 130) or the Edwards SAPIEN valve (Edwards Lifesciences LLC, Irvine, CA; n = 70) implanted by either the transfemoral or transapical access route. Results Device success and procedure success were 99% and 95%, respectively, without differences between devices and access site. All-cause mortality was 7.5% at 30 days, with no differences between valve types or access sites. Using multivariable analysis, low body mass index (<20 kg/m2) (odds ratio [OR] 6.6, 95% CI 1.5-29.5) and previous stroke (OR 4.4, 95% CI 1.2-16.8) were independent risk factors for short-term mortality. The VARC-defined combined safety end point occurred in 18% of patients and was driven by major access site complications (8.0%), life-threatening bleeding (8.5%) or severe renal failure (4.5%). Transapical access emerged as independent predictor of adverse outcome for the Valve Academic Research Consortium–combined safety end point (OR 3.3, 95% CI 1.5-7.1). Conclusion A heart team–based selection of devices and access site among patients undergoing TAVI resulted in high device and procedural success. Low body mass index and history of previous stroke were independent predictors of mortality. Transapical access emerged as a risk factor for the Valve Academic Research Consortium–combined safety end point.