Survival of patients treated with extended-hours haemodialysis in Europe : an analysis of the ERA-EDTA Registry

Background. Previous US studies have indicated that haemodialysis with >= 6-h sessions [extended-hours haemodialysis (EHD)] may improve patient survival. However, patient characteristics and treatment practices vary between the USA and Europe. We therefore investigated the effect of EHD three times weekly on survival compared with conventional haemodialysis (CHD) among European patients. Methods. We included patients who were treated with haemodialysis between 2010 and 2017 from eight countries providing data to the European Renal Association-European Dialysis and Transplant Association Registry. Haemodialysis session duration and frequency were recorded once every year or at every change of haemodialysis prescription and were categorized into three groups: CHD (three times weekly, 3.5-4h/treatment), EHD (three times weekly, >= 6h/treatment) or other. In the primary analyses we attributed death to the treatment at the time of death and in secondary analyses to EHD if ever initiated. We compared mortality risk for EHD to CHD with causal inference from marginal structural models, using Cox proportional hazards models weighted for the inverse probability of treatment and censoring and adjusted for potential confounders. Results. From a total of 142 460 patients, 1338 patients were ever treated with EHD (three times, 7.10.8h/week) and 89 819 patients were treated exclusively with CHD (three times, 3.9 +/- 0.2h/week). Crude mortality rates were 6.0 and 13.5/100 person-years. In the primary analyses, patients treated with EHD had an adjusted hazard ratio (HR) of 0.73 [95% confidence interval (CI) 0.62-0.85] compared with patients treated with CHD. When we attributed all deaths to EHD after initiation, the HR for EHD was comparable to the primary analyses [HR 0.80 (95% CI 0.71-0.90)]. Conclusions. EHD is associated with better survival in European patients treated with haemodialysis three times weekly.Peer reviewe

eIF4A2 drives repression of translation at initiation by Ccr4-Not through purine-rich motifs in the 5'UTR

Background: Regulation of the mRNA life cycle is central to gene expression control and determination of cell fate. miRNAs represent a critical mRNA regulatory mechanism, but despite decades of research, their mode of action is still not fully understood. Results: Here, we show that eIF4A2 is a major effector of the repressive miRNA pathway functioning via the Ccr4-Not complex. We demonstrate that while DDX6 interacts with Ccr4-Not, its effects in the mechanism are not as pronounced. Through its interaction with the Ccr4-Not complex, eIF4A2 represses mRNAs at translation initiation. We show evidence that native eIF4A2 has similar RNA selectivity to chemically inhibited eIF4A1. eIF4A2 exerts its repressive effect by binding purine-rich motifs which are enriched in the 5′UTR of target mRNAs directly upstream of the AUG start codon. Conclusions: Our data support a model whereby purine motifs towards the 3′ end of the 5′UTR are associated with increased ribosome occupancy and possible uORF activation upon eIF4A2 binding

Trends in SAVR with biological vs. mechanical valves in middle-aged patients: results from a French large multi-centric survey

Background/introductionCurrently, despite continued issues with durability ( 1), biological prosthetic valves are increasingly chosen over mechanical valves for surgical aortic valve replacement (SAVR) in adult patients of all ages, at least in Western countries. For younger patients, this choice means assuming the risks associated with a redo SAVR or valve-in-valve procedure.PurposeTo assess the use of mechanical vs. biological valve prostheses for SAVR relative to patient's age and implant time in a large population extracted from the French National Database EPICARD.MethodsPatients in EPICARD undergoing SAVR from 2007 to 2022 were included from 22 participating public or private centers chosen to represent a balanced representation of centre sizes and geographical discrepancies. Patients with associated pathology of the aorta (aneurysm or dissection) and requiring a vascular aortic prosthesis were excluded. Comparisons were made amongst centers, valve choice, implant date range, and patient age.ResultsWe considered 101,070 valvular heart disease patients and included 72,375 SAVR (mean age 71.4 ± 12.2 years). We observed a mechanical vs. biological prosthesis ratio (MBPR) of 0.14 for the overall population. Before 50 years old (y-o), MBPR was >1.3 (p < 0.001) while patients above 60 years-old received principally biological SAVR (p < 0.0001). Concerning patients between 50 and 60 years-old patients, MPVR was 1.04 (p = 0.03). Patients 50–60 years-old from the first and second study duration quartile (before August 2015) received preferentially mechanical SAVR (p < 0.001). We observed a shift towards more biological SAVR (p < 0.001) for patients from the third and fourth quartile to reach a MBPR at 0.43 during the last years of the series. Incidentally, simultaneous mitral valve replacement were more common in case of mechanical SAVR (p < 0.0001), while associated CABGs were more frequent in case of biological SAVR (p < 0.0001).ConclusionIn a large contemporary French patient population, real world practice showed a recent shift towards a lower age-threshold for biological SAVR as compared to what would suggest contemporary guidelines

Boron deactivation in preamorphized silicon on insulator: Efficiency of the buried oxide as an interstitial sink

Preamorphization of ultrashallow implanted boron in silicon on insulator is optimized to produce an abrupt boxlike doping profile with negligible electrical deactivation and significantly reduced transient enhanced diffusion. The effect is achieved by positioning the as-implanted amorphous/crystalline interface close to the buried oxide interface to minimize interstitials while leaving a single-crystal seed to support solid-phase epitaxy. Results support the idea that the interface between the Si overlayer and the buried oxide is an efficient interstitial sink

Epidémie du Covid 19 en Belgique francophone : regard sur les patients dialysés en techniques ambulatoires

In the French-speaking part of Belgium, between march and end of may 2020, 284 patients have suffered a Covid-19 infection, 7,9% of the prevalent dialysis population. Some of them have been  diagnosed through rt-PCT as they were symptomatic, others, asymptomatic,  being diagnosed by swab viral culture. Fifty two patients died (18% of the positive patients). The vast majority of them were patients on hemodialysis, only ten cases have been observed in patients on home dialysis techniques. Primary renal disease were diabetes or renal hypertensive disease in more than 50% of the patients and the most important comorbidities were cardiac ischemic or congestive disease, autonomy problems, cancer and smoking habits.En Belgique francophone, pendant la période mars à fin  mai 2020, 284 patients en dialyse ont contracté le Covid-19, soit 7,9% de la population prévalente, qu’ils aient été diagnostiques par rt-PCT parce que symptomatiques ou dépistés par culture virale systématique alors qu’asymptomatiques. Cinquante-deux décès ont été observés soit 18% de la population atteinte. La toute grand majorité de ces patients (274) étaient traités par hémodialyse en centre, seuls 10 patients étaient en traitement à domicile. Leurs maladies rénales primitives étaient à plus de 50% des diabète et pathologies vasculaires hypertensives et leurs comorbidités essentielles, les pathologies cardiovasculaires ischémiques et congestives, les problèmes d’autonomie, les néoplasies et le tabagisme

Vacancy-engineering implants for high boron activation in silicon on insulator

The formation of boron interstitial clusters is a key limiting factor for the fabrication of highly-conductive ultrashallow doped regions in future silicon-based device technology. Optimized vacancy engineering strongly reduces boron clustering, enabling low-temperature electrical activation to levels rivalling what can be achieved with conventional pre-amorphization and solid-phase epitaxial regrowth. An optimized 160-keV silicon implant in a 55/145nm silicon-on-insulator structure enables stable activation of a 500eV boron implant to a concentration ~ 5x1020cm-3

In situ plasma remediation of buried nuclear, chemical and biological wastes

Issued as final reportThis item was temporarily removed from SMARTech at the request of the Georgia Tech Research Institute on May 8, 2009

Perceptive barriers to peritoneal dialysis implementation: An opinion poll among the French-speaking Belgian nephrologists

Although peritoneal dialysis (PD) is recognized as an effective renal replacement therapy (RRT) alternative to haemodialysis (HD), its prevalence is around 15% in most of the industrialized countries. In the French-speaking part of Belgium, PD is clearly underused with a prevalence of 8.7% in 2009. The main objectives of this work were to evaluate the nephrologists' perceived obstacles to PD implementation and reflect on possible actions towards PD development. A computer-based 33-item questionnaire was sent by e-mail to all nephrologists affiliated to the French-speaking association. Among 120 adult nephrologists targeted by this inquiry, 97 completed the online questionnaire (response rate 80.8%). Among them, 29% had little experience with PD (treating less than five patients) and 39% reported no specific training with this modality of RRT. However, 88% of responders claimed PD prevalence should be around 20-25%. Half of the responders would choose PD as a first RRT option if they required RRT for themselves. The three main reasons given to the low prevalence of PD were an easy access to HD, patient refusal and lack of nephrologist motivation. Almost all the nephrologists insisted on the need for a dedicated nursing team delivering an effective educational programme and PD management and care. They believe that PD could and should be implemented in Belgium. Enhanced nephrologist motivation and training in PD were identified as predominant factors to be upgraded, as well as patient education programmes. © The Author 2013. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Opportunities for Local Food Systems Research and Extension in the South- A Land Grant University System Initiative

Acknowledging regional differences in the development of Local Food Systems across the United States, Southern Experiment Station Directors and Extension Directors decided to commission the development of an effective collaboration plan between southern Land Grant University (LGU) faculty in the area of Local Food Systems (LFS). The United States southern region’s unique characteristics, such as the historically large concentration of underserved and small farms (Goodwin 2013), could impose unique challenges and opportunities for the development of LFS, and therefore a regional approach to addressing this region’s unique needs may be appropriate. With the support of the Southern Risk Management Education Center (SRMEC), the SRMEC Local Food Systems Work Group was created in 2013. During the first two years, this group identified research and extension priorities for LFS in the south. The ultimate goal of this group is to establish LFS programing that can help the southern LGU system more effectively address key factors supporting the successful development of LFS in this region. This group identified ten research and extension priorities for LFS in the south, also represented graphically in Figure 1, from the perspective of agricultural economics and risk management: 1) market and supply chain logistics; 2) financial and risk management for LFS; 3) economic, social, and environmental outcomes; 4) consumer demand; 5) food safety; 6) financial and risk management for enterprises; 7) food security; 8) food access; 9) food system policies; and 10) general knowledge associated with LFS. A complete discussion of identified priorities one to five was published in an invited issue of Choices entitled “Developing Local Food Systems in the South” (Goodwin 2013). In this issue, the SRMEC LFS Work Group specifically discussed the role of the LGU system in supporting each of the priorities identified. For example, this group highlights the important role the southern LGU system plays in the development of LFS-focused education and capacity building programs to support LFS development (Woods et al. 2013). Additionally, this group acknowledges the importance of creating a network of researchers and extension professionals providing objective feedback on research areas that could guide the allocation of resources for the development of LFS such as the evaluation of social, economic, and environmental outcomes associated with LFS (Lamie et al. 2013). Future plans of the SRMEC LFS Work Group include expanding the discussion of priorities six to ten, as well as the identification and implementation of research and extension outreach collaboration opportunities