Acute Kidney Injury: Controversies Revisited

This paper addresses the epidemiology of AKI specifically in relation to recent changes in AKI classification and revisits the controversies regarding the timing of initiation of dialysis and the use of peritoneal dialysis as a renal replacement therapy for AKI. In summary, the new RIFLE/AKIN classifications of AKI have facilitated more uniform diagnosis of AKI and clinically significant risk stratification. Regardless, the issue of timing of dialysis initiation still remains unanswered and warrants further examination. Furthermore, peritoneal dialysis as a treatment modality for AKI remains underutilised in spite of potential beneficial effects. Future research should be directed at identifying early reliable biomarkers of AKI, which in conjunction with RIFLE/AKIN classifications of AKI could facilitate well-designed large randomised controlled trials of early versus late initiation of dialysis in AKI. In addition, further studies of peritoneal dialysis in AKI addressing dialysis dose and associated complications are required for this therapy to be accepted more widely by clinicians

Preventing AVF thrombosis: the rationale and design of the Omega-3 fatty acids (Fish Oils) and Aspirin in Vascular access OUtcomes in REnal Disease (FAVOURED) study

Background: Haemodialysis (HD) is critically dependent on the availability of adequate access to the systemic circulation, ideally via a native arteriovenous fistula (AVF). The Primary failure rate of an AVF ranges between 20-54%, due to thrombosis or failure of maturation. There remains limited evidence for the use of anti-platelet agents and uncertainty as to choice of agent(s) for the prevention of AVF thrombosis. We present the study protocol for a randomised, double-blind, placebo-controlled, clinical trial examining whether the use of the anti-platelet agents, aspirin and omega-3 fatty acids, either alone or in combination, will effectively reduce the risk of early thrombosis in de novo AVF

State of the art review on the sustainable dry machining of advanced materials for multifaceted engineering applications: progressive advancements and directions for future prospects

In this article, the comprehensive review on the application, and indeed, a comparative analysis on dry machining of different types of materials (Inconel, steel, aluminum, cast iron, magnesium and advanced materials) used in machining (turning, drilling and milling operations) were carried out in the light of utmost works published in the literature. The work describes the scientific findings of the past twenty years, including sustainable methods (surface texture, solid lubricants, vibration-assisted machining, laser-assisted machining), tool coatings, and geometry of tools. Vibration-assisted machining is another direction that researchers have investigated without the use of cutting coolants, where the complete disposal of coolants is not possible. Various researchers have carried out rigorous experimental work on milling, drilling, and turning operations under dry conditions to machine numerous materials. A significant proportion of experimental data about tool wear, tool wear machining, surface quality, surface integrity, etc, has been analyzed under dry conditions. However, the critical analysis of dry machining for different conventional machining operations for a variety of industrial materials is still lacking for establishing dry machining as a sustainable process for industrial applications. Thus, the critical analysis of various machining parameters and their consequences on tool wear and the surface quality of machined work was carried out in this work. Finally, scientific recommendations based on critical findings were proposed for industrial implementation of dry machining