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Objective: Individual placement and support (IPS) has shown consistently better outcomes on competitive employment for patients with severe mental illness than traditional vocational rehabilitation. The evidence for efficacy originates from few countries, and generalization to different countries has been questioned. This has delayed implementation of IPS and led to requests for country‐specific RCTs. This meta‐analysis examines if evidence for IPS efficacy can be generalized between rather different countries. Methods: A systematic search was conducted according to PRISMA guidelines to identify RCTs. Overall efficacy was established by meta‐analysis. The generalizability of IPS efficacy between countries was analysed by random‐effects meta‐regression, employing country‐ and date‐specific contextual data obtained from the OECD and the World Bank. Results: The systematic review identified 27 RCTs. Employment rates are more than doubled in IPS compared with standard vocational rehabilitation (RR 2.07 95% CI 1.82–2.35). The efficacy of IPS was marginally moderated by strong legal protection against dismissals. It was not moderated by regulation of temporary employment, generosity of disability benefits, type of integration policies, GDP, unemployment rate or employment rate for those with low education. Conclusions: The evidence for efficacy of IPS is very strong. The efficacy of IPS can be generalized between countries. [ABSTRACT FROM AUTHOR]

Riparian vegetation actively interacts with fluvial systems affecting river hydrodynamics, morphodynamics and groundwater. These interactions can be coupled because both vegetation and hydromorphology (i.e. the combined scientific study of hydrology and fluvial geomorphology) involve dynamic processes with similar temporal and spatial scales. To predict and assess the consequences of restoration measures, maintenance operations or human pressures in rivers, managers and planners may wish to model these interactions considering the different and interdisciplinary implications in the fields of ecology, geomorphology and hydrology. In this paper, we review models that are currently available and that incorporate the processes that relate riparian vegetation to hydromorphology. The models that are considered include those emphasizing hydraulic-geomorphological processes (such as flow resistance, sediment transport and bank dynamics) as well as those emphasizing ecological processes (seed dispersal, plant survival, growth, succession and mortality). Models interpreting the coupled evolution between riparian vegetation and river morphology and groundwater are also presented. The aim is to provide an overview of current modelling capabilities and limitations and to identify future modelling challenges. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The development and implementation of both economically and environmentally sustainable precision crop management systems can be greatly enhanced through the use of hyperspectral sensing. In this study, the potential of narrow-waveband hyperspectral observations for the discrimination of water-stressed tomato plants ( Solanum lycopersicum L.) was investigated in a field experiment conducted in southern Italy. The tomato crop was grown in a 1.8-ha test field that was split into two plots with different irrigation treatments: optimal and deficit water supplies, with the deficit supply using half of the water of the optimal supply in the second half of the crop growing cycle. Hyperspectral measurements were taken with a field spectroradiometer. To reduce the number of variables, principal component analysis was applied to each of six wavelength band sub-intervals across the whole wavelength interval from 400 to 1000 nm. The retained principal components were then submitted to canonical discriminant analysis. Finally, the principal components and the canonical component were interpolated using multivariate and univariate geostatistical techniques, respectively, and then mapped. The two irrigation treatments produced different plant biomass and leaf area indices, which were higher under optimal than deficit water conditions, as was the plant water potential. These data show that the correlation between the individual bands varied during the crop cycle, so it was not feasible to choose a specific band to discriminate between the water treatments. However, we show that only a combination of all of the bands that use the full spectral information with differential weighting leads to clear discrimination of the two differently irrigated areas, with a mean accuracy of 75% to 77%. The processing of hyperspectral reflectance data using canonical discriminant analysis can thus provide valuable information for the agricultural producer for the identification of within-field areas of plant stress, so as to implement site-specific irrigation strategies. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The purpose of this study was to provide more information on the kinetics of the immunological changes occurring in the abomasal mucosa after single and trickle infections with the bovine parasite Ostertagia ostertagi. The time course analysis of gene expression revealed that the major changes coincided with the emergence of adult worms from the gastric glands. These changes consisted of a simultaneous upregulation of Th1- and Th2-type cytokines. In addition, a single O. ostertagi infection elicited an upregulation of the epithelial-derived cytokine IL33, while TSLP expression levels were not impacted. Apart from the massive increase in inflammatory cytokines IL6, IL17 and IL21, O. ostertagi infection also elicited an upregulation of the immunosuppressors TGFB, IL10 and ARG1, as well as NK and γδ- T cell markers. Furthermore, the cytotoxic factors granulysin, perforin and granzyme B were upregulated following an O. ostertagi infection. Analysis of cytokine transcript levels in animals receiving trickle infections for 60 days showed a similar trend as observed following a single infection except for IL33, IL6, GATA-3, TBX21 and NCR1, which were no longer upregulated after trickle infections. Finally, the long trickle infections were associated with mucosal eosinophilia and mastocytosis. [ABSTRACT FROM AUTHOR]

BACKGROUND AND PURPOSE Inflammation plays a key role in the development of benign prostatic hyperplasia (BPH). Eicosanoids derived from the COX and 5-lipoxygenase (5-LOX) pathways are elevated in the enlarging prostate. Flavocoxid is a novel flavonoid-based 'dual inhibitor' of the COX and 5-LOX enzymes. This study evaluated the effects of flavocoxid in experimental BPH. EXPERIMENTAL APPROACH Rats were treated daily with testosterone propionate (3 mg·kg−1 s.c.) or its vehicle for 14 days to induce BPH. Animals receiving testosterone were randomized to receive vehicle (1 mL·kg−1, i.p.) or flavocoxid (20 mg·kg−1, i.p.) for 14 days. Histological changes, eicosanoid content and mRNA and protein levels for apoptosis-related proteins and growth factors were assayed in prostate tissue. The effects of flavocoxid were also tested on human prostate carcinoma PC3 cells. KEY RESULTS Flavocoxid reduced prostate weight and hyperplasia, blunted inducible expression of COX-2 and 5-LOX as well as the increased production of PGE2 and leukotriene B4 (LTB4), enhanced pro-apoptotic Bax and caspase-9 and decreased the anti-apoptotic Bcl-2 mRNA. Flavocoxid also reduced EGF and VEGF expression. In PC3 cells, flavocoxid stimulated apoptosis and inhibited growth factor expression. Flavocoxid-mediated induction of apoptosis was inhibited by the pan-caspase inhibitor, Z-VAD-FMK, in PC3 cells, suggesting an essential role of caspases in flavocoxid-mediated apoptosis during prostatic growth. CONCLUSION AND IMPLICATIONS Our results show that a 'dual inhibitor' of the COX and 5-LOX enzymes, such as flavocoxid, might represent a rational approach to reduce BPH through modulation of eicosanoid production and a caspase-induced apoptotic mechanism. [ABSTRACT FROM AUTHOR]

Summary Ostertagia ostertagi is one of the most important gastrointestinal parasites infecting millions of cattle in temperate climate areas. Because infection leads to significant losses in productivity, farmers are pushed, because of the on-going intensification of the livestock production systems, to frequently administer anthelmintics to minimize the exposure of their animals to this parasite. However, whether such approach is sustainable in the long term, especially in an era of emerging drug resistance and global climatic changes, is still a matter of debate. Immunological control of worm infections through vaccination is often put forward as the most rational and cost-effective alternative for anthelmintics to control helminth infections. However, the development of an immunologically based control strategy requires a thorough knowledge of the host-parasite interactions, the immune responses involved and the biology of the parasite itself. The aim of this review is to consolidate information available in these areas, specifically for O. ostertagi, and identify some critical gaps in our current knowledge. [ABSTRACT FROM AUTHOR]

Scalar-tensor theories of gravitation attract again a great interest since the discovery of the Chameleon mechanism and of the Galileon models. The former allows reconciling the presence of a scalar field with the constraints from Solar System experiments. The latter leads to inflationary models that do not need ad hoc potentials. Further generalizations lead to a tensor-scalar theory, dubbed the "Fab Four," with only first and second order derivatives of the fields in the equations of motion that self-tune to a vanishing cosmological constant. This model needs to be confronted with experimental data in order to constrain its large parameter space. We present some results regarding a subset of this theory named "John," which corresponds to a nonminimal derivative coupling between the scalar field and the Einstein tensor in the action. We show that this coupling gives rise to an inflationary model with very unnatural initial conditions. Thus, we include the term named "George," namely, a nonminimal, but nonderivative, coupling between the scalar field and Ricci scalar. We find a more natural inflationary model, and, by performing a post-Newtonian analysis, we derive the set of equations that constrain the parameter space with data from experiments in the Solar System. [ABSTRACT FROM AUTHOR]

Summary Galectin-11 ( LGALS11) has been suggested to play an important role in protective immunity against gastrointestinal nematodes in ruminants. However, in cattle, this molecule has not been characterized in detail. In the current study, it was shown that transcription of LGALS11 was highly inducible in the bovine abomasal mucosa after an Ostertagia ostertagi infection. LGALS11 protein expression was also increased in the abomasal mucosa following O. ostertagi infection and localized to the nucleus and cytoplasm of epithelial cells and the mucus. Using in vitro abomasal epithelial cell cultures, it was shown that LGALS11 induction was associated with the proliferative and dedifferentiated status of cells. However, LGALS11 was not induced following stimulation with O. ostertagi excretory-secretory products. These results suggest that LGALS11 induction in vivo may be an indirect rather than a direct effect of the parasite on the epithelium. In addition, LGALS11 transcript was also detected in the abomasal lymph nodes where it was shown to be transcribed in MHCII + cells; however, transcription levels in the lymph nodes were not altered after O. ostertagi infection. In addition, LGALS11 was also induced in the small intestine by different types of parasites, including the nematode Cooperia oncophora and the protozoan parasite Giardia duodenalis. [ABSTRACT FROM AUTHOR]

Sacral nerve stimulation (SNS) is an effective but expensive treatment for faecal incontinence. About 50% of the patients are unresponsive for unknown reasons, hence knowledge of any factors predictive of success would be highly desirable. The aim of this study was to analyse the potential factors associated with a successful outcome of the temporary test of electrostimulation. Eighty-five patients with faecal incontinence were tested for SNS. The cause was idiopathic in 45, iatrogenic or obstetric in 28, spinal lesion or neurological diseases in nine and anal malformation in three patients; 43 were tested with a unipolar electrode and 42 with a quadripolar electrode. The severity of faecal incontinence was evaluated using the American Medical System (AMS) score and Wexner's score. A positive response was obtained in 45 patients (53%); 40 (47%) were implanted with a permanent pulse generator. Responders and nonresponders were comparable in age, duration of incontinence, anal manometry, pudendal nerve terminal motor latency and diabetes. Unipolar electrode test (PNE test) was able to elicit positive responses in 18 of 43 (42%) and the quadripolar in 27 of 42 patients ( P < 0.001). Type of incontinence and gender did not affect the success rate. Patients with idiopathic incontinence had a significantly higher response rate ( P = 0.022). Multivariate regression analysis indicated use of a quadripolar electrode as the only independent variable predicting the success of SNS (OR = 5.58, P = 0.009). Use of the quadripolar electrode is the only factor significantly related to the success of SNS. [ABSTRACT FROM AUTHOR]

Fibrin glue treatment of anal fistulae has been proposed to minimize the risk of faecal incontinence but its acceptance by coloproctologists is still poor because the published data is controversial. Therefore, we carried out a prospective randomized crossover trial comparing treatment with a commercial fibrin glue to classical seton treatment, with healing rate, hospital stay, healing time, faecal incontinence and postoperative pain as study outcomes. Sixty-four homogeneous patients with trans-sphincteric anal fistulae referred to seven colorectal units were randomized to undergo fibrin glue (39 patients) or seton (25 patients) treatment. Patients failing to heal after treatment with fibrin glue were re-randomized to undergo a second injection with glue or seton treatment. Sixty-two of the 64 patients completed the minimum 1-year follow-up period. Twenty-one of 24 patients healed in the seton group compared with 15/38 in the fibrin glue group ( P = 0.0007). The 23 failures after glue treatment were re-randomized to have a second glue injection (eight patients) or a seton treatment (15 patients). Four of the eight (50%) patients treated with a second injection of glue, and nine out of the 15 (60%) patients in the seton group, healed. Patients treated with fibrin glue reported less postoperative pain and had a shorter hospital stay than patients treated with a seton; furthermore, faecal continence and anal manometry significantly worsened after seton treatment. Seton treatment has a significantly higher probability of success compared with fibrin glue treatment but poses a higher risk of faecal incontinence. Fibrin glue could be considered as a first line of treatment for patients at risk of faecal incontinence or other comorbidities. [ABSTRACT FROM AUTHOR]

In the context of UK policy to promote employment for people with disability as a means to greater social inclusion, this study investigated how people with severe mental health problems fare in existing supported employment agencies. The aim of the study was to identify factors associated with successful placement in work and to test the impact of working on psychological well-being in this group. One hundred and fifty-five users of six English agencies were followed up for 1 year (2005-2006). Information was collected about their employment status, job-seeking behaviour, perceived obstacles to work, self-esteem and hope, and the employment support received. Eighty-two per cent of those working at baseline were still in work a year later. The support agencies helped 25% of unemployed clients into work, a statistically significant increase in the proportion of clients in employment. Gaining employment was associated with improvements in financial satisfaction and self-esteem. There was a trend towards working half time. People who had been out of work longer were less likely to secure employment. No significant associations were found between getting a job and personal characteristics, the quantity of employment support given, nor the recipient's rating of the support offered. The odds of moving into work were nearly four times higher for those people who visited a job centre prior to the start of the study. Clients of specialist agencies rated their provision more highly than clients of pan-disability agencies. These results demonstrate the benefits of working for this group and support the development of employment services with an individualised, rapid placement approach, linked to job centre advice and expert mental health service input. This is consistent with the Individual Placement and Support model, and highlights in addition the importance of job centres for its implementation in England. [ABSTRACT FROM AUTHOR]

Background. Ochroconis gallopava is a neurotropic dematiaceous mold that causes respiratory and central nervous system (CNS) infection in domestic poultry and in immunocompromised patients. We recently treated 3 solid organ transplant (SOT) recipients for pulmonary Ochroconis infections with successful outcome, prompting us to review the literature on this unique pathogen. Methods. We reviewed all published cases of O. gallopava infections in SOT recipients and analyzed the impact of CNS infection on the outcome. Results. In addition to the 3 new cases reported here, 9 published cases of Ochroconis infection were analyzed. The disease involved the lungs only in 5/12 (42%) of patients, brain in 6/12 (50%) patients, and lung and skin in 1 patient. Survival was significantly reduced with brain infection (33% vs. 100%; P<0.03; Fisher's exact test). Conclusions. O. gallopava may infect SOT recipients with a particular tropism for the CNS. Early recognition of O. gallopava pulmonary infection is important, as the prognosis is excellent before dissemination to the brain. [ABSTRACT FROM AUTHOR]

Objective There is no objective means to assess the obstructed defaecation syndrome (ODS), to allow evaluation of outcome or to compare the efficacy of treatment including surgery. The study aimed to validate a disease-specific index to quantify severity to allow assessment of the results of treatment in clinical trials, to permit comparison between them. Method Seventy-six patients with ODS and 30 healthy controls entered the study after proctologic and ano-rectal physiological investigation. Hirschsprung's disease and slow transit constipation were excluded. An eight-item questionnaire with four or five possible answers was administered by two independent researchers at two different times. The ODS score was the sum of all points with a maximum possible of 31 points. Agreement between the two operators was evaluated by the Kappa coefficient for each single item. The coefficient of repeatability (CR) was assessed by the Bland and Altman plot. The internal consistency was evaluated by the Crohnbach-alpha test. A cluster analysis was carried out on each clinical finding. The Mann–Whitney U-test was used to compare median ODS score between patients and controls. Results The ODS score of the two operators was normally distributed and strongly correlated ( r = 0.89). The correlation coefficient between the score assigned to each item by two operators ranged from 0.79 to 0.98. The degree of agreement between the operators was good and the two methods were reproducible (CR = 3.13). There was a significant difference between the mean ODS score for patients and controls ( t = 20.70, P < 0.001). The Crohnbach alpha value for internal reliability was +0.513. Cluster analysis showed a different profile between cluster 1 (a nonhomogenous group including rectocoele, intussusception or perineal descent), and cluster 2 (pelvic dysynergia). Conclusion The ODS score offers a validated severity of disease index in grading the severity of disease and monitoring the efficacy of therapy. [ABSTRACT FROM AUTHOR]

The human apoE gene ( APOE, GenBank accession AF261279) shows a common polymorphism, with the three ℇ2, ℇ3 and ℇ4 alleles resulting from the haplotypes of two C→T SNPs. However, whereas the three common T-T, T-C and C-C haplotypes corresponding to the ℇ2, ℇ3 and ℇ4 alleles are well known, the last C-T haplotype (GenBank accession AY077451), encoding a fourth apoE allele, has rarely been reported. We detected this fourth allele in a Caucasian patient with motor neuron disease (MND). According to the literature we refer to this allele as ℇ3r. Although several explanations may be proposed for its formation, the existence of this fourth allele is consistent with the evolutionary hypothesis generally accepted for the apoE alleles. The rarity and physiological role of ℇ3r remains to be explained, and requires further investigation. [ABSTRACT FROM AUTHOR]

Soil moisture and temperature, sowing depth and penetration resistance affect the time and percentage of seedling emergence, which are crucial for the simulation of drought-limited crop production. The aim of this research was to measure the effect of soil water potential on germination and emergence, shoot and root elongation rates ( SER and RER) of two different seed/crop types. Sugar beet and durum wheat seeds were sown into two soils (clay and loam), submitted to five matric potentials (−0.01, −0.1, −0.2, −0.4 and −0.8 MPa) and incubated at constant temperature (25°C) and humidity. Cumulative count analysis was used to estimate parameters of the distribution of germination or emergence times for each box of beet or wheat seeds and to derive estimates for base potentials ( ψb), hydrothermal times ( H) and numbers of viable units. In a second experiment, NaCl solution was used to mimic the soil matric potentials to estimate potential RER and SER. Germination of sugar beet was slightly more sensitive to matric potential than durum wheat ( ψb of −1.13 and −1.23 MPa, respectively). H(g) was longer for sugar beet than for durum wheat (67 vs 47 MPa °Cd). For emergence ψb was similar for both seed types and soils but hydrothermal times ( H(e)) were 40 MPa °Cd higher for sugar beet than for wheat. Emergence was about 20 MPa °Cd earlier in loam than in clay. SER measured in soils were similar for both crops and for durum wheat it agreed with those determined in NaCl solution. RER and SER fell with decreasing osmotic potential to approximately 20% of their maximum values (1.03 mm h−1 and 0.57 mm h−1, respectively). Seedling viability decreased with decreasing matric potential and more in clay than in loam soil and more for sugar beet than durum wheat. Seed and soil aggregate size are discussed with respect to the effects of water diffusion and soil–seed contact on germination and emergence modelling. [ABSTRACT FROM AUTHOR]

We investigated the in vitro susceptibilities of 213 cerebrospinal fluid isolates of Cryptococcus neoformans isolated from 192 patients through a 10-year period, 1990-99, against fluconazole, voriconazole and posaconazole (SCH56592) by using the NCCLS (National Committee for Clinical Laboratory Standards) macrodilution method, M27-A. The overall MICs[sub 50] and MICs[sub 90] of fluconazole, voriconazole and posaconazole were found to be 2 and 8 μml[sup -1] ≤ 0.125 μ ml[sup -1] (both), and ≤ 0.015 and 0.06 μg ml[sup -1], respectively. The MIC ranges, MICs[sub 50], and MICs[sub 90] of three triazoles were also determined according to the defined year category (1990-94, 1995, 1996, 1997 and 1998-99). The MICs[sub 50] and MICs[sub 90] of each triazole remained almost unchanged and did not exhibit any sign of an upward shift during a decade (1990-99). However, a tendency for development of possible cross-resistance between the three triazoles was observed only in 1996. Meanwhile, the individual relapsing isolates (n:21) from 20 patients exhibited same, higher or, suprisingly, lower MICs, particularly against fluconazole and posaconazole. [ABSTRACT FROM AUTHOR]

Background Tachykinins (TKs) have been shown to be involved in the excitatory enteric motor pathway. This study aimed to examine the direct and nerve-mediated effect of specific NK[sub 1], NK[sub 2] and NK[sub 3] receptor agonists and antagonists in colonic preparations from control subjects and patients with idiopathic chronic constipation (ICC). Materials and methods Cumulative concentrations of Sar[sup 9]Met(O[sub 2])[sup 11] substance P (selective NK[sub 1] receptor agonist), [Ala[sup 5],b-Ala[sup 8]]-neurokinin A (4-10) (selective NK[sub 2] receptor agonist) and [MePhe[sup 7]]-neurokinin B (selective NK[sub 3] receptor agonist) were tested on colonic circular muscle strips to evaluate the direct drug effects. In addition, in the presence of atropine, the role of TKs in the off-contraction that follows the typical inhibitory response evoked by low frequencies of electrical field stimulation (0·5-10 Hz, 20 V, 1 ms pulse trains lasting 1 min) was investigated. Results In control preparations, the rank order of potency was: NK[sub 2] receptor-selective agonist > NK[sub 3] receptor-selective agonist > NK[sub 1] receptor-selective agonist. The off-contraction was found to be reduced by about 30-40% in colonic circular muscle from ICC patients with respect to controls. Incubation with the NK[sub 1] receptor agonist did not modify the off-contraction measurements in either control or ICC preparations. Conversely, both NK[sub 2] and NK[sub 3] receptor agonists significantly (P < 0·01) increased the off-contraction in ICC preparations only. This increased response was fully antagonized by MEN-10627, a NK[sub 2] and NK[sub 3] receptor antagonist depending on the dose. Conclusions We may conclude that ICC is hyporesponsive to TKs and that the contractile reflex to distension is greatly reduced in ICC disease, but can be restored by incubation with NK[sub 2] and NK[sub 3] receptor agonists. [ABSTRACT FROM AUTHOR]

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The article discusses a study related to simultaneous evaluation of maternal glucose homeostasis and fetal cerebrovascular Doppler ultrasound in normal pregnancy. Topics include screening for gestational diabetes mellitus (GDM) through the oral glucose tolerance test (OGTT) as per Italian and American guidelines, vasoconstriction in the fetal middle cerebral artery (MCA) from maternal hyperglycemia induced by OGTT and more information from simultaneous evaluation than separate assessment.

The article discusses various reports published within the issue, including one by Gareth Pender, Andrey B. Shvidchenko and Amir Chegini on the relationship between critical shields stress, grain size and bed slope and another by Joanna C. Curran on step-pool formation models.

We present the case of an intraperitoneal IUD incidentally noted on lumbar spine X-rays and confirmed by CT. This was secondary to asymptomatic uterine perforation occurred at the time of insertion 17 years before. [ABSTRACT FROM AUTHOR]

Stream meander restoration designs currently used by many state and local government agencies are often based on empirical equations, such as those developed by Leopold and Wolman (1957; 1960). In order to assess the suitability of these equations and propose alternative strategies, 18 sites in Central Maryland were selected and data on channel planform, cross-sections, sediments, and spacing and sizing of thepools and riffles were collected and analyzed to characterize the channel type in the study area. A large bias was found comparing the meander parameters measured to those computed using the Leopold and Wolman equations for the streams in central Maryland. Based on these results, appropriate empirical equations for the study area that can assist in stream restoration designs were investigated. An additional approach that can assist in stream restoration consists of the application of a detailed stream reconnaissance to verify that the restoration project is consistent with the natural form and processes of the river. [ABSTRACT FROM AUTHOR]

Introduction: Left ventricular assist device (LVAD) therapy may lead to an aortic regurgitation, limiting left ventricular unloading and causing adverse events. Whether concomitant aortic valve replacement may improve outcomes in patients with preoperative mild-to-moderate aortic regurgitation remains unclear., Methods: A retrospective propensity score-matched analysis of adult patients with preoperative mild-to-moderate aortic regurgitation undergoing durable LVAD implantation between 01/01/2011 and 30/11/2021 was performed. Patients undergoing concomitant valve surgery other than biological aortic valve replacement were excluded, resulting in 77 with concomitant biological aortic valve replacement and 385 without., Results: Following 1:1 propensity score matching, two groups of 55 patients with and without biological aortic valve replacement were obtained, (mean age 59 ± 11 years, 92% male, 59.1% HeartWare). Aortic regurgitation was mild in 72.7% and 76.4% and moderate in 27.3% and 23.6% in non-replacement and replacement cohorts respectively. The 30-day survival was 89.1% vs. 85.5% (p = 0.59), 1-year survival 69.1% vs. 56.4% (p = 0.19), and 2-year survival 61.8% vs. 47.3% (p = 0.10) in the non-replacement and replacement groups, respectively. After a mean follow-up of 1.2 years, non-replacement patients had a higher incidence of pump thrombosis (11 [20%] vs. 3 [5.5%], p = 0.022) and fewer major bleedings (2 [3.6%] vs. 11 [20%], p = 0.008)., Conclusion: Compared with those treated conservatively, patients with mild-to-moderate aortic regurgitation undergoing concomitant aortic valve replacement during LVAD implantation have a similar survival up to 2 years on support. Patients with concomitant valve replacement had a higher risk of bleeding complications but fewer pump thromboses., (© 2024 The Author(s). Artificial Organs published by International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.)