The Rate and Time Course of Complications in Catheter-Dependent Hemodialysis Patients

Many patients with end-stage renal disease come to rely on catheters as their only means of hemodialysis when other options are no longer viable. These patients have a very poor quality of life due to their chronic illness as well as many long-term complications related to the use of tunneled catheters. Many prior attempts have been made to understand these catheter-related problems. Yet, they continue to be a major cause of morbidity and mortality in chronic catheter-reliant patients. We hope to examine the rate as well as long term time course of these complications such that in future, we may decrease their occurrence. We predict that over time, chronic catheter use decreases the mean indwell time for each catheterization and increases the incidence of complications. To study this, we conducted a retrospective study looking at all patients who had three or more tunneled catheter exchanges between July 2003 and July 2008. We collected information from Yale IDX database on the patients age and gender, the type of catheter used, the indwell time of the catheter, the vessel used as access, the indication for catheter removal, whether the procedure was performed by a medical doctor (M.D.) or physicians assistant (P.A.) and whether it was a de novo insertion or over-the-wire exchange. We collected a total of 764 data points on 191 patients (89 males and 102 females). They ranged from 8 to 87 years old with a median age of 56 years. Infection was the number one indication for catheter removal at 37%. The rate of infection was 3.34 per 1,000 catheter days. There was no difference in the rate of complications by the side of vessel accessed nor by type of catheter. However, right-sided catheters had a longer indwell time of 117 + 159 days compared to left-sided catheters, 87 + 124 days (p =0.008). There was no significant difference in the indwell duration of first catheter in comparison to all subsequent placements. There was also no difference in complications whether the catheter was exchanged over the wire or placed de novo. Nor were complication rates different among M.D. versus P.A. conducted procedures. We conclude that our rates of infection are similar to other institutions and the vessels located on the right-side of the neck are preferable to left-sided vessels to increase catheter longevity. Future research is needed to better assess how rates and incidences of complications change with long standing catheter-reliance

Design in the anthropocene, broadening human centred design

Service design innovations have the potential to contribute to systemic change towards some of the most pressing problems of modern society such as climate mitigation and equitable integration of the disadvantaged sections of the society. Although there are many theories and frameworks guiding the transition towards environmental and social sustainability, implementing them into practice could be challenging. To understand these challenges, I am reflecting on three service design projects done as part of the academic curriculum in 2020. By reflecting on my learning experiences, I intend to translate my learnings to other creative practitioners to broaden the current human-centred paradigm of problem-solving towards a wider lens of systems thinking towards the collective good. After mapping out three milestones of the projects — project briefing, reframing, intervention point, I indulged my teammates and experts to share their perspectives on the role of designers to reframe and intervene the wicked challenges towards systemic innovation. Through this process, four takeaways were generated. First, it was observed that there were benefits in terms of clarifying the semantics of concepts and terms, exploring hidden assumptions, and building a unified meaning of the context. Second, the need for systems mapping before stakeholder mapping is identified. Third, emphasis is laid on the underpinning role of service designers as visionaries of the project who propose the scope of sustainability in the form of manageable and strategic goals. Lastly, accentuating the culture of monitoring the impact of the outcome generated. As a result of this study, a list of recommended questions is generated that could be pondered upon at different stages of the design process starting from project briefing to reframing to intervention to outcome delivery. The recommended questions are conceptualised to help service designers, especially entry-level designers who might get weighed down by practical tasks such as making visuals and conducting workshops to reorient their role in the team as strategic thinkers and visionaries towards solving complex problems. The set of recommendations could also be used to probe their teammates to keep the bigger picture in mind

Sustainable Consumption : Political Economy of Sustainable Food

This book was written with the assistance of Maija Harju, Ruta Jumite, Juuso Kortelainen, Marianna Laine, Shreya Sood and Sonja SorriThe theoretical structure for this textbook and course were developed over the 2 years of the ATARCA project. We worked to develop a means to mitigate the environmental tragedy of the commons associated with climate change. We diagnosed that two problems to be solved are (1) the negligible impact each individual makes on the global atmospheric commons, and (2) the worry that others will not do their part in making sustainable choices. As well, individuals may not have perfect information about the impact of their consumptive choices. The introductory video is here: https://www.youtube.com/watch?v=PgBEQq0laKE&t=2

Midgut Non Rotation in a Middle-aged Male with Suspected Pancreatitis

Midgut development is a dynamic process that begins from the fifth week of development. During this process, the midgut undergoes physiological herniation in the umbilical cord. Subsequently, it returns to the abdominal cavity through a complex 270° counterclockwise rotation [1]. This normal rotation results in the formation of a duodenojejunal loop on the left-side of the midline, a peripheral large bowel, a centrally located small bowel with the caecum in the right iliac fossa, and the duodenojejunal flexure on the left-side near the pylorus [2]. Disruption of this sequential return can lead to anomalies in midgut rotation, such as non rotation, malrotation, or reverse rotation [1]

Screening of Plant-Growth-Promoting Bacterial Isolates from Rhizosphere Soil of Prosopis cineraria from U.A.E.

Desert regions occupy 33% of the Earth’s land surface. Despite the harsh climatic conditions, different types of plants and microorganisms have adapted to survive and proliferate in these arid extreme conditions and developed associations. Prosopis cineraria is able to flourish in spite of the harsh climatic conditions of high salinity in the desert soils of the United Arab Emirates (U.A.E.), the present study therefore aimed at isolating, screening and understanding the diversity of microflora associated with the rhizosphere region of Prosopis cineraria grown at 15 ds/m salinity. Eleven morphologically distinct purified isolates from rhizosphere soil were screened for IAA production, phosphate solubilization, antibacterial activity and nitrogen-fixing activity. Four of the isolates exhibited nitrogen-fixing activity, two antibacterial activity and five phosphate-solubilizing activity. The plant-growth-promoting bacterial (PGPB) isolates can be used as appropriate bioinoculants which can then in turn be used for cultivation of other plants in the region

Radiologist’s approach in diagnosing fronto-ethmoidal meningoencephalocele in an adult: a case report

Abstract Background Fronto-ethmoidal meningoencephalocele is an uncommon pathology. Most of the cases present a history of trauma or paranasal surgical intervention. Spontaneous development of such pathology is extremely rare. The aim of this case report was to demonstrate a rare appearance of spontaneous fronto-ethmoidal meningoencephalocele in an adult male with high-quality images in multiple modalities used in radiology. Case presentation This case report demonstrates an extremely rare pathology of spontaneous development of fronto-ethmoidal meningoencephalocele in a 50-year-old male. The patient complained of swelling involving the nasal bridge, the left side of the nose, and the left cheek for more than 20 years, which was spontaneous without any trauma or surgical intervention. The patient underwent radiological investigations of ultrasonography, computed tomography of the paranasal sinus, and contrast-enhanced magnetic resonance imaging of the brain. The diagnosis of spontaneous development of left fronto-ethmoidal meningoencephalocele abutting the left orbit was made. No other complications of the brain tissue were noted. Conclusions Knowledge about etiopathogenesis and various types of meningoencephalocele helps manage this pathology

Proceedings of International Conference on Women Researchers in Electronics and Computing

This proceeding contains articles on the various research ideas of the academic community and practitioners presented at the international conference, “Women Researchers in Electronics and Computing” (WREC’2021). WREC'21 was organized in online mode by Dr. B R Ambedkar National Institute of Technology, Jalandhar (Punjab), INDIA during 22 – 24 April 2021. This conference was conceptualized with an objective to encourage and motivate women engineers and scientists to excel in science and technology and to be the role models for young girls to follow in their footsteps. With a view to inspire women engineers, pioneer and successful women achievers in the domains of VLSI design, wireless sensor networks, communication, image/ signal processing, machine learning, and emerging technologies were identified from across the globe and invited to present their work and address the participants in this women oriented conference. Conference Title: International Conference on Women Researchers in Electronics and ComputingConference Acronym: WREC'21Conference Date: 22–24 April 2021Conference Location: Online (Virtual Mode)Conference Organizers: Department of Electronics and Communication Engineering, Dr. B. R. Ambedkar National Institute of Technology, Jalandhar, Punjab, INDI