Transplantation rénale au Maroc: l’hémodialysé et son entourage sont-ils suffisamment informés ?

Introduction: la transplantation rénale constitue le traitement idéal de l'insuffisance rénale chronique. Cependant il existe une insuffisance de donneurs contrairement aux receveurs dont le nombre ne cesse de s'accroitre. La méconnaissance de la transplantation par les hémodialysés et leur entourage pourrait être l'une des causes. Notre but était d'évaluer les connaissances et opinions de l'hémodialysé et de son entourage sur la transplantation rénale. Méthodes: l'enquête menée en Aout 2013 avait inclus 83 hémodialysés de notre centre et 70 membres de leur entourage. Ils ont été soumis à un questionnaire qui portait sur les thèmes suivants: statut socio-économique, volonté d'être transplanté ou d'être donneur, avantages de la transplantation rénale, point de vue de la religion sur la transplantation. Aucun des individus interrogés n'avait jamais fait l'objet d'une transplantation ou d'un don d'organe. Résultats: parmi 83 hémodialysés on notait 49,4 % de femmes avec une moyenne d'âge de 41,4±12 ans. Le niveau socio-économique bas représentait 66,7 %. Le manque d'information chez était estimé à 62,7 %. Seuls 41% se disaient être candidat à la transplantation rénale mais 12 % seulement était inscrit sur la liste d'attente de greffe. La transplantation était estimée plus couteuse que l'hémodialyse par 50,6 % des patients et seuls 71,1 % estimaient qu'elle offrait une meilleure vie. Pour 20,5 %, l'Islam s'opposerait au don cadavérique et pour 10,9 % au don vivant. Parmi les 70 membres de l'entourage interrogé il y avait 56,8% de femmes ; la moyenne d'âge était de 44,4±10,5 ans. Le niveau économique bas représentait 52,3 %. Le manque d'information était estimé à 61,4 %. Pour 56,8 % la vie serait impossible avec un seul rein. Seuls 13,6 % étaient inscrit sur le registre de don. Pour 45,5 % l'Islam s'opposerait au don cadavérique. Conclusion: il importe d'intensifier la sensibilisation des hémodialysées et leur famille sur la transplantation rénale

Design and implementation of the European-Mediterranean Postgraduate Programme on Organ Donation and Transplantation (EMPODaT) for Middle East/North Africa countries

This prospective study reports the design and results obtained after the EMPODaT project implementation. This project was funded by the Tempus programme of the European Commission with the objective to implement a common postgraduate programme on organ donation and transplantation (ODT) in six selected universities from Middle East/North Africa (MENA) countries (Egypt, Lebanon and Morocco). The consortium, coordinated by the University of Barcelona, included universities from Spain, Germany, Sweden and France. The first phase of the project was to perform an analysis of the current situation in the beneficiary countries, including existing training programmes on ODT, Internet connection, digital facilities and competences, training needs, and ODT activity and accreditation requirements. A total of 90 healthcare postgraduate students participated in the 1-year training programme (30 ECTS academic credits). The methodology was based on e-learning modules and face-to-face courses in English and French. Training activities were evaluated through pre- and post-tests, self-assessment activities and evaluation charts. Quality was assessed through questionnaires and semi-structured interviews. The project results on a reproducible and innovative international postgraduate programme, improvement of knowledge, satisfaction of the participants and confirms the need on professionalizing the activity as the cornerstone to ensure organ transplantation self-sufficiency in MENA countries

Global nephrology workforce: gaps and opportunities toward a sustainable kidney care system

The health workforce is the cornerstone of any health care system. An adequately trained and sufficiently staffed workforce is essential to reach universal health coverage. In particular, a nephrology workforce is critical to meet the growing worldwide burden of kidney disease. Despite some attempts, the global nephrology workforce and training capacity remains widely unknown. This multinational cross-sectional survey was part of the Global Kidney Health Atlas project, a new initiative administered by the International Society of Nephrology (ISN). The objective of this study was to address the existing global nephrology workforce and training capacity. The questionnaire was administered online, and all data were analyzed and presented by ISN regions and World Bank country classification. Overall, 125 United Nations member states responded to the entire survey, with 121 countries responding to survey questions pertaining to the nephrology workforce. The global nephrologist density was 8.83 per million population (PMP); high-income countries reported a nephrologist density of 28.52 PMP compared with 0.31 PMP in low-income countries. Similarly, the global nephrologist trainee density was 1.87 PMP; high-income countries reported a 30 times greater nephrology trainee density than low-income countries (6.03 PMP vs. 0.18 PMP). Countries reported a shortage in all care providers in nephrology. A nephrology training program existed in 79% of countries, ranging from 97% in high-income countries to 41% in low-income countries. In countries with a training program, the majority (86%) of programs were 2 to 4 years, and the most common training structure (56%) was following general internal medicine. We found significant variation in the global density of nephrologists and nephrology trainees and shortages in all care providers in nephrology; the gap was more prominent in low-income countries, particularly in African and South Asian ISN regions. These findings point to significant gaps in the current nephrology workforce and opportunities for countries and regions to develop and maintain a sustainable workforce

Empirical models for estimating monthly global solar radiation: a most comprehensive review and comparative case study in China

Global solar radiation is a core component of scientific research and engineering application across a broad spectrum. However, its measurement is limited by a small number of stations due to the technical and financial restricts. Estimating solar radiation with the meteorological variables using empirical models is of benefit to obtain solar radiation data at global scale. Yet, there are various options of available empirical models to select the most suitable one. This study conducted a most comprehensive collection and review of empirical models employing the commonly measured meteorological variables and geographic factors. A total of 294 different types of empirical models were collected and classified into 37 groups according to input attributes. Such collection built an empirical model library providing an overall overview of the developed empirical models in literatures. Furthermore, the collected models were calibrated and evaluated at three meteorological stations in the Three Gorges Reservoir Area in China. This study suggests that these model-comparing processes can assist the governments, scientists and engineers in tailoring the most fitted model for specific applications and in particular areas

Status of care for end stage kidney disease in countries and regions worldwide:international cross sectional survey

ObjectiveTo determine the global capacity (availability, accessibility, quality, and affordability) to deliver kidney replacement therapy (dialysis and transplantation) and conservative kidney management.DesignInternational cross sectional survey.SettingInternational Society of Nephrology (ISN) survey of 182 countries from July to September 2018.ParticipantsKey stakeholders identified by ISN's national and regional leaders.Main outcome measuresMarkers of national capacity to deliver core components of kidney replacement therapy and conservative kidney management.ResultsResponses were received from 160 (87.9%) of 182 countries, comprising 97.8% (7338.5 million of 7501.3 million) of the world's population. A wide variation was found in capacity and structures for kidney replacement therapy and conservative kidney management-namely, funding mechanisms, health workforce, service delivery, and available technologies. Information on the prevalence of treated end stage kidney disease was available in 91 (42%) of 218 countries worldwide. Estimates varied more than 800-fold from 4 to 3392 per million population. Rwanda was the only low income country to report data on the prevalence of treated disease; 5 (<10%) of 53 African countries reported these data. Of 159 countries, 102 (64%) provided public funding for kidney replacement therapy. Sixty eight (43%) of 159 countries charged no fees at the point of care delivery and 34 (21%) made some charge. Haemodialysis was reported as available in 156 (100%) of 156 countries, peritoneal dialysis in 119 (76%) of 156 countries, and kidney transplantation in 114 (74%) of 155 countries. Dialysis and kidney transplantation were available to more than 50% of patients in only 108 (70%) and 45 (29%) of 154 countries that offered these services, respectively. Conservative kidney management was available in 124 (81%) of 154 countries. Worldwide, the median number of nephrologists was 9.96 per million population, which varied with income level.ConclusionsThese comprehensive data show the capacity of countries (including low income countries) to provide optimal care for patients with end stage kidney disease. They demonstrate substantial variability in the burden of such disease and capacity for kidney replacement therapy and conservative kidney management, which have implications for policy

Optimization of the Active Layer P3HT:PCBM for Organic Solar Cell

ITO/PEDOT:PSS/P3HT:PC60BM/Mg-Al organic solar cells (OSCs) were fabricated depending on optimization of Poly(3-hexylthiophene-2,5-diyl) (P3HT) and phenyl-C61-Butyric-Acid-Methyl Ester (PC60BM). The optimization of the active layer, P3HT:PC60BM, was carried out under different spin frequencies coating from 900 to 3000 rpm. The post-production annealing temperature of all prepared OSC was studied from 130 to 190 °C. The holes transport layer, poly(3,4-ethylene dioxythiophene) polystyrene sulfonate (PEDOT:PSS), was prepared under constant conditions of 3000 rpm for 35 s, and annealing temperature 178 °C for 15 min. From our study, the optimum conditions for P3HT:PC60BM were spin coating of 3000 rpm, and annealing temperature of 160 °C for 5 min. The optimum J-V parameters values for the prepared OSC were JSC = 12.01 mA/cm2, VOC = 660 mV, FF = 59%, PCE = 4.65%, and EQE = 61%. A complete OSC with acceptable efficiency was designed using simple and low-cost techniques that may be utilized in the industry. Furthermore, the cost of the synthesized solar cell is projected to be around 1 $/cm2, with the goal of lowering the cost and increasing efficiency in the future by incorporating more commercial nanostructured electron/hole transport components

An adaptive wavelet-network model for forecasting daily total solar-radiation

The combination of wavelet theory and neural networks has lead to the development of wavelet networks. Wavelet-networks are feed-forward networks using wavelets as activation functions. Wavelet-networks have been used successfully in various engineering applications such as classification, identification and control problems. In this paper, the use of adaptive wavelet-network architecture in finding a suitable forecasting model for predicting the daily total solar-radiation is investigated. Total solar-radiation is considered as the most important parameter in the performance prediction of renewable energy systems, particularly in sizing photovoltaic (PV) power systems. For this purpose, daily total solar-radiation data have been recorded during the period extending from 1981 to 2001, by a meteorological station in Algeria. The wavelet-network model has been trained by using either the 19 years of data or one year of the data. In both cases the total solar radiation data corresponding to year 2001 was used for testing the model. The network was trained to accept and handle a number of unusual cases. Results indicate that the model predicts daily total solar-radiation values with a good accuracy of approximately 97% and the mean absolute percentage error is not more than 6%. In addition, the performance of the model was compared with different neural network structures and classical models. Training algorithms for wavelet-networks require smaller numbers of iterations when compared with other neural networks. The model can be used to fill missing data in weather databases. Additionally, the proposed model can be generalized and used in different locations and for other weather data, such as sunshine duration and ambient temperature. Finally, an application using the model for sizing a PV-power system is presented in order to confirm the validity of this model

Monitoring of Solar Still Desalination System Using the Internet of Things Technique

In this work, a smart solar still prototype for water desalination is designed. It consists of a basic solar still, a solar preheater and a remote monitoring system based on the Internet of Things (IoT) technique. The monitoring system is developed and integrated into the hybrid solar still in order to control its evolution online, as well the quality of the freshwater provided by checking measured parameters such as pH. Thanks to the IoT technique, parameters collected by the monitoring system (e.g., air temperatures, relative humidity, etc.) are uploaded to the cloud for online remote monitoring. The users are notified by an SMS about the status of the system (e.g., water level in the basin, water in the tank, etc.), using an GSM module. The whole system, including the preheater, water pump, valve, sensors and an electronic board, is powered by a photovoltaic module of 75 Wp. The results showed that by adding a solar preheater system, the evaporation process is accelerated and, consequently, the daily yield is improved and reaches the value of 12.165 L/m2/day. The saline concentration of the tested ground water is 3.9 g/Kg (0.39%), and, after desalination, the salinity is 0.1 g/Kg (0.01%)

IoT-Based Low-Cost Photovoltaic Monitoring for a Greenhouse Farm in an Arid Region

In this paper, a low-cost monitoring system for an off-grid photovoltaic (PV) system, installed at an isolated location (Sahara region, south of Algeria), is designed. The PV system is used to supply a small-scale greenhouse farm. A simple and accurate fault diagnosis algorithm was developed and integrated into a low-cost microcontroller for real time validation. The monitoring system, including the fault diagnosis procedure, was evaluated under specific climate conditions. The Internet of Things (IoT) technique is used to remotely monitor the data, such as PV currents, PV voltages, solar irradiance, and cell temperature. A friendly web page was also developed to visualize the data and check the state of the PV system remotely. The users could be notified about the state of the PV system via phone SMS. Results showed that the system performs better under this climate conditions and that it can supply the considered greenhouse farm. It was also shown that the integrated algorithm is able to detect and identify some examined defects with a good accuracy. The total cost of the designed IoT-based monitoring system is around 73 euros and its average energy consumed per day is around 13.5 Wh