International Labour Conference (93rd : 2005 : Geneva, Switzerland)

Krzaklewska, Ewa , author

Vågnes, Øyvind, 1972-

Khan, Shahnaz

Rotenstreich, Nathan, 1914-1993

This prespecified secondary analysis of the MOMENTUM 3 randomized clinical trial aims to determine whether clinical outcomes of patients with 2 different left ventricular assist devices differed based on preoperative categories of bridge to transplant/bridge to candidacy vs destination therapy.

Secondary mitral regurgitation (MR) has long been recognized as prognostically important. Even mild MR is associated with adverse outcomes. Yet, surgical trials have not shown improved survival with invasive therapy whereas medical therapy and cardiac resynchronization therapy are associated with improved outcomes. The 2018 publication of the Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation (COAPT) and Multicentre Study of Percutaneous Mitral Valve Repair MitraClip Device in Patients With Severe Secondary Mitral Regurgitation (MITRA-FR) trials and their apparently discordant results have focused attention on the differences in trial design as well as patient populations.

To the Editor We read with interest the study by Sepehrvand et al, which described secular trends in the conduct of pragmatic or explanatory cardiovascular randomized clinical trials over 2 decades. We believe extension of this thoughtful analysis can provide additional insights into pragmatic vs explanatory trials.

In Reply We thank Fernandes et al for their interest in our study and agree that this field requires further exploration. Explanatory trials are primed to maximize the likelihood of finding efficacy of an intervention by testing it in an ideal setting, whereas pragmatic trials aim to test effectiveness of an intervention in a more generalizable setting. Hence, they are expected to generate more generalizable results, with the risk understood that there may be more variation in less tightly controlled environments, which may result in differing results.

This Special Communication proposes a classification of patients with left-ventricular disease according to the severity of mitral regurgitation that is proportionate vs disproportionate to left-ventricular end-diastolic volume.

The disappearance of inflammatory communal slogans from political speeches suggests development is the agenda for 2014.

Perk, Marcel van der, author

Australia. Parliament. Senate. Select Committee on Murray-Darling Basin Plan, author, issuing body

Australia. Parliament. Senate. Environment and Communications References Committee, author, issuing body

Gershwin, Lisa-Ann, author

Coen, Natasha Jeanne, author

Dinar, Shlomi, author

Martin, Sarah, author

Dipper, Frances, 1951- author

Morrissey, Karyn, author

Nielsen, Larry A., 1948- author

Carruthers, Jane, author

Choden, Thinley, author

Australia. Parliament. Senate. Rural and Regional Affairs and Transport References Committee, author, issuing body

Australia. Parliament. Senate. Environment and Communications References Committee

Alegre, Helena, author

Australia. Parliament. Senate. Rural and Regional Affairs and Transport References Committee, author, issuing body

Australia. Productivity Commission, author, issuing body

Australia. Department of the Environment and Energy, author

This JAMA Clinical Guidelines Synopsis summarizes the Advisory Committee on Immunization Practices’ 2019 updated recommendations for human papillomavirus vaccination for adults.