Impact of short term use of interdialytic 60% ethanol lock solution on tunneled silicone catheter dysfunction.

International audienceINTRODUCTION: Ethanol lock (EL) is used to reduce catheter infections, but its impact on dialysis catheter dysfunction has not been studied. METHODS: We analyzed the rate of dialysis silicone catheter dysfunction after an interdialytic 60% EL in an open prospective controlled non crossover cohort study, with each patient being his or her own control. The study was divided into three consecutive 2-week periods: the pre- and post-intervention periods, in which interdialytic standard locks (SL) were used, and the intervention period, in which one EL was instilled during the first week, and two consecutively in the second week. We analyzed the rate of catheter dysfunction (exchange, use of fibrinolytic, reversing the lines, difficulty in instilling or withdrawing fluid) after EL or SL. RESULTS: In 30 patients, 90 EL were instilled. The rate of catheter dysfunction increased during the EL period (2 - 13%, p < 0.001), and between the two consecutive dialysis sessions before and after EL (p < 0.05). It decreased between the two consecutive dialysis sessions after EL and the following dialysis session after an SL (p < 0.05). No catheter was removed. The urea reduction ratio did not differ in dialysis after an SL and after an EL (0.77 vs. 0.73, p = 0.17). CONCLUSION: Short term EL is associated with a transient increase in catheter dysfunction, without resulting in catheter removal or decreasing dialysis efficiency

A Framework for a Smart City Design : Digital Transformation in the Helsinki Smart City

Recently, there has been substantial interest in the concept of a smart city, as it has been a viable solution to the dilemmas created by the urbanization of cities. Digital technologies—such as Internet-of-Things, artificial intelligence, big data, and geospatial technologies—are closely associated with the concept of a smart city. By means of modern digital technologies, cities aim to optimize their performance and services. Further, cities actively endorse modern digital technologies to foster digitalization and the emergence of data-based innovations and a knowledge economy. In this paper, a framework for a smart city design is presented. The framework considers a smart city from the perspective of four dimensions—strategy, technology, governance, and stakeholders. The framework is complemented with sub-dimensions, and the purpose of this framework is to strengthen the governance and sustainability of smart city initiatives. Further, the proposed framework is applied to the Helsinki smart city, the capital of Finland. The objective is to analyse the Helsinki smart city through dimensions presented in the framework and learn how the city of Helsinki governs and implements its smart city initiativespeerReviewe